Insurer in the context of prices, because it is about the price at the end of the day. What we attempt to do as best we can on behalf of the customers who choose to pay us a premium to become our customer pursuant to that contractual relationship is to go into the marketplace and to negotiate the best price that we can yield combined with the best quality to make that available to the customer that is paying that premium. And thats what weve traditionally done. I mean, that may be an overly simplistic way of looking at any kind of insurance, but certainly health insurance. But thats, thats what we try to do. And were going to continue to try to do that and leverage all of the wonderful technologies and innovation and collaborations and things that we can do to help bring, take pressure off of those, off of those prices. So its very important that we, that we continue to do that. And as we go forward, we all need to be vigilant about those that, as dr. Reinhardt has alluded to, that have a vested interest in keeping those prices high. Because as these innovative tools are rolled out whether its a contractual arrangement or whether its a particular device thats demonstrated to bring a price down, there are those that will advocate that we pass laws to prohibit them. And we are seeing those conversations spawn across america as these new mechanisms are being developed. Therefore, as a consumer, all of us as a consumer, we need to Pay Attention to that very Important Health policy side. And that piece in particular and help all of us make the judgments of where we want those tradeoffs to be and either advocate for those prohibitions which will have a cop intention, or add consequence, or advocate against them so that we can have more and greater flexibility to deliver that Consumer Value which everyone is demanding. So, again, thank you for the opportunity to be with you. [inaudible] ill piggyback on that comment, because i think that was a wonderful summary. And what id like to adjust maybe a couple of thoughts, and that is i can assure you that every entity whether its a provider or a payer, the business community, in the legislative arena theres a pursuit of a new Value Proposition in the health care arena. I can speak for our organization, wellpoint, that we are very, very engaged with all kinds of constituents trying to vector toward a Value Proposition that best serves our public. What is fascinating, and i think it was mentioned here a few times, is the reality of a public that has to become very educated with respect to how to access this new, this new, brave new world weve come upon. And when a consumer cant describe what a deductible is, weve got a problem. For all of the intentions that were advancing around new devices, technologies and pharma, payments, methodologies that reward value, at the end of the day we need consumers that completely understand the system, how to access it to better their circumstances in terms of the health care that they are demanding to improve their circumstances. We, i know, are very engaged in educating the public, but it is a kind of a partnering responsibility, and id just close by saying thats a why i kept emphasizing the necessity for collaboration in a spirit that we have not witnessed in this industry, well, at least in the four decades ive been part of it. So im hopeful that, im very, very hopeful that were going to make Great Strides going to the future to improve circumstances for the consumers that were serving in this new world. Thank you, joe. Ark avik . Last week i was asked the speak at the americans for prosperity American Dreams summit, the big Koch Brothers outfit that has grassroots activists from all over country. They came in by the busload, 3,000 of them. Ted cruz had spoken the second day of the conference and said we will repeal every word of obamacare, and there was a oneminutelong standing ovation for ted cruz. The day before i spoke to a subsection of that group, and i gave the talk pretty much similar to the one that i gave you today. And i opened by asking the group raise your hand if youre on medicare. And more than half the room raised their hand. I said, guess what . Youre on singlepayer health care. And they were kind of stunned by that. And, of course, this is a group thats very passionate about wanting to repeal obamacare. [laughter] the trojan horse for singlepayer medicine in america, you might have heard. So i think what i would urge my conservative brethren to do is we have to do a much better job of explaining to the public that we didnt have a Market Health care system in 2009, 2008, that there were Serious Problems of access and cost in the Health Care System before 2010. And if our voters believe that repealing obamacare will fundamentally solve the Health Care Problems in this country, it wont. And i dont think that weve done a good job of that, ask we have and we have to do a better job of that, and thats on us. Uwe . One of the more encouraging remarks i heard this morning from brad and joe is this issue of transparency. Because thats been missing. I always sort of tell the way americans bought health care is a little bit like blind folding people, shoving them into macys and say go and buy a shirt efficiently. And you come out with shorts that dont fit [laughter] and then half a year later youll get some bill that you understand absolutely nothing other than pay this amount. And thats how its been. And that is clearly not how you can run anything that wants to engage Market Forces even at the fringes. Now, the europeans dont need Price Transparency because they negotiate fees that apply to every provider in their state or canton in switzerland and to every insurer. So you dont need the price, theyre all the same. You would need only quality. But here we need both price and quality and not hospital charges. We need, a, what we actually have to pay out of pocket in going to this hospital or that doctor, etc. Ideally, i would like to know the total price, frankly, to pick up some drug, 26. 95 copay, not a big deal. But i sort of ask, well, whats the total price, what fraction am i paying, and im not allowed to know. And i actually think i should know what the whole thing is. The other thing is there is now, we have selfinsured at princeton, but we have insurance policy carriers who do the claims processing. What is it, tpa, we call that . And they have a cost estimator. Now, where you can put the doctor and a hospital in, and it gives you but theyre not binding prices. They just estimate what they are. I looked normal delivery, i couldnt find it. I found that the insurance, can you help me find normal delivery, they couldnt either. The theory must have been that professors dont procreate [laughter] and we do. [laughter] we do. So some of these are not as good as they should be and, again, i would encourage my colleagues in the insurance policy side make sure these things really are reliable and that, in fact, if a patient has to pay more than your cost estimators say, that there is a way for the patient to tell you that so that you can see the varian minneapoliss and maybe talk variances and maybe talk to the provider and say what are you doing . Something to really make transparency work. Then we can have a little more market at the fringes. Great. Well, thank you and, again, id like to just thank all of you for joining us today. Id like to give a special thank you to Katherine Santora and carolyn meyerss, Katie Mcdonald and their team who helped put this on today. Id also like to let everyone know that therell be a recording available on our web site next week, nihcm. Org, and then please join me now in a final round of applause for our wonderful panel. [applause] [inaudible conversations] you can also watch the panel if you missed any of it, if you want to go back and watch certain portions of it right online at cspans video library, thats at cspan. Org. [inaudible conversations] yesterday was the first in a sevenpart series on the roosevelts by film maker ken burns that premiered on pbs. Well have live coverage of his remarks today at the National Press club scheduled for 12 30 eastern time. And live coverage of the house and senate today at 2 00 eastern. The house plans to take up a number of small bills, some dealing with financial services, and the senate has work scheduled on a pay equity bill. Live coverage of the house on cspan and the senate right here on cspan2. The hill reports the house and senate are under pressure to pass funding this week to avoid a Government Shutdown and to reauthorize arming Syrian Rebels make that authorize Syrian Rebels. Many lawmakers will be leaving washington, d. C. Soon, though, to head off on the campaign trail ahead of the midterm elections. The president sent a request for authorization to arm moderate Syrian Rebels to fight isis. Many members, though, of both parties want to hold separate votes on those issues. This week officials from the Obama Administration will testify on capitol hill to four house and Senate Committees to make the case for arming the Syrian Rebels. Defense secretary chuck hagel and joint chiefs of staff chair, general martin dempsey, theyll appear before the Senate Armed Services committee tomorrow at 9 30 a. M. Eastern on our companion network, cspan3. And secretary of state john kerry will testify before two congressional committees on the strategy to fight isis starting wednesday with the house foreign Registrations CommitteeRelations Committee live at 2 30 eastern. And last month the directer of the National Counterterrorism center, matthew olsen, spoke at the american Political Science association. He defended the nsa surveillance programs and argued the amount to collect intelligence the ability to collect intelligence on americans who take up arms with isis abroad is crucial. Next, that panel. Okay, lets go. Welcome to the Plenary Session on, quote, nsa surveillance and its consequences. The theme fits nicely into the larger theme of the convention entitled after the digital revolution. The controversy surrounding the nsa deeply implication the uses and potential abuses of Digital Technology by government and nongovernmental actors. Violent i jihadists use Digital Technology to build their movements, and states use it to trace these threats. As legal and National Security scholar phillip bob bit has said, terrorist movements often reflect or mirror the resources, tools and aspects of the societies that they attack. They use Digital Technology to attack us, to build their movements, and we use it to track them. In a sense, we see the very forces that were fighting. So Digital Technology has provided great benefits. It also enhanced threats. Many say this paradox also applies to the nsa. Finish it, too, uses technology, Digital Technology to protect us from terrorism, but there is also potential for abuse. Im reminded of James Madisons famous statement in federalist 51 where he said that we need government to protect us, but at the same time, we need what he called precautionary or auxiliary precautions to protect us from the government. If, indeed, there are angels, they dont dwell on this particular earth. Were fortunate today to have a very distinguished panel to discuss the nsa and to set the stage for what i hope will be a very interesting q a. I am donald downs, university of wisconsin, and im the moderator of this discussion. Also especially given the situation in the world today, whats going on in iraq and in syria and elsewhere, the discussion is all the more relevant. Now, thats said to get a grasp on the nsa and what it does, its difficult. For one thing, the government has moderated the programs due to political pressure, and adding to the fog is the classified nature of the nsas work and the complexity of its interactions with the nsa, with the fisa courts, congress and the executive branch. In addressing the nsa question, we have to know enough trees, know whats going on, but also see the forest. And i hope the panel today will get the right balance. And if the nsas watching this Plenary Session, welcome. [laughter] if germanys watching, welcome to you too. Now, well give you a sampling of the questions well be dealing with. How legal are nsas programs . How effective are they . Indeed, what are they . How serious are the dangers and threats that nsa programs address . And how do we define these dangers for legal and policy purposes . Is there a way to obtain sufficient data without sweeping communications and information into metadata and other forms of Data Collection . Or is such sweeping necessary . If so, what are the safeguards . How much should the rules and norms governing foreign intelligence gathering differ from the rules and norms governing domestic Law Enforcement . Just how different is foreign intelligence gathering from domestic Law Enforcement . How much overview is provided by the system of checks and balances in our constitutional system . Such as judicial review, congressional checking, Public Opinion, the press, inspector generals, the executive Branch Oversight . And has such checks been sufficient . The nsa is often has often done its job with secrecy, especially in the past. So what is the proper balance between secrecy and openness in a constitutional democracy, and who should decide where that line is drawn . What is the role and legitimacy of whistleblowers and leakers in our system . What is the legal and normative status of Edward Snowden, whose leaks provided so much information especially about the metadata programs . What about other leakers and whistleblowers . If snowden returns to america, should he be punished, or is spending a few years with putin punishment enough . How has the Simple Growth of new technology been responsible for the nature of nsa programs . How does the press deal with the publication of stories involving National Security . How do Public Opinion and the press shape policy in the government response . And finally, what is the classic tradeoff between liberty and security . Or as benjamin wittens has said, there really is no necessary conflict unless we become unbalanced on one side or the other, that security and liberty actually should reinforce one another if properly done. Now, before i introduce the panel, i want to Say Something very briefly about the programs to sort of set the stage, and the panelists will say a lot more about this about them. The nsa was officially established in 952, though it was based on previous intelligence operations. The core mission, as i said, is to gather foreign intelligence through surveillance. And this mission is distinct from the normal operations of domestic Law Enforcement. Indeed, when the Foreign Intelligence Surveillance Act was passed in 1978, itself based on a reaction to the previous abuses of surveillance by the government, its Main Objective was to give the government the power to do whats necessary when it comes to surveillance. At the same time, preventing that power from leaking over into the domestic sphere. American citizens are distinct from foreign intelligence dangers. Of course, what happens when theres a third category, when american citizens are involved with foreign intelligence in and thats sort of that third area where a lot of controversy arises. Much of the controversy over the nsa programs in recent times pivots around this congenital concern as nonforeign intelligence has often been swept into the intelligence gathered regarding foreign intelligence. Now, since 9 11 for the most part this is sort of my father sarduci production of the programs to a simple formula there are four basic programs that have been used. Two of them are contentbased surveillance of telephone and internet communications. Section 702 of the fisa act amendments of 2008 addresses when the nsa may look into this content. If its purely foreign intelligence, it lies beyond the purview of the Fourth Amendment. But if its intelligence that pertains to american citizens, then there are legal standards, and such investigation needs to be covered by the law. The second set of programs involve metaData Collection, both internet and telephone. Now, its my understanding maybe the panel will correct me that the Internet Program has been dropped or seriously modified, but the Telephone Program remains. This is largely covered by section 215 of the patriot act. The Business Records provision. Metadata has been stored by government and private communic