Skip to main content

tv   Washington Journal  CSPAN  August 9, 2014 7:00am-10:01am EDT

7:00 am
7:01 am
skies. >> do you support the president's a
7:02 am
7:03 am
7:04 am
7:05 am
7:06 am
7:07 am
7:08 am
7:09 am
7:10 am
7:11 am
7:12 am
7:13 am
7:14 am
7:15 am
7:16 am
7:17 am
7:18 am
>> i think right now we take care of it. we should have gone in a little bit sooner, but i think we have enough people in there to deal with the situation. but if we use--if we have rockets we can take out a whole grid. >> one other statement i want to show you from senator dianne feinstein, democratic from california, a chair of the senate intelligence committee
7:19 am
she said it takes an army to defeat an army. i believe we confront isil now or confront a larger enemy in the future. i support action by the administration coordinate efforts with iraq and other allies. use our military strength and targeting expertise to the extent possible. bringing members from members of congress. we want to hear from you, our viewers. let's go to michael waiting on our line for independence. michael, good morning. >> good morning, the cpsan show is a great show. i'm a professor in graduate school, and i've been following isis. it's start and it's funding. isis is a sunni group as they were funded by kuwait, who are
7:20 am
also sunni. if you want to put pressure on isis, you got to cut off the funding. really, you know, president obama should go to the saudis and try to redirect this group because i've followed them over the past two years. thank you so much. >> that's michael in new york. we want to show a text in the letter from the white house, the speaker of the house and the president approach him in the senate. the president noting i have directed the actions in iraq which are in the national security in foreign policy interest in the united states pursue santa to my constitutional authority. i'm providing this report as part of my effort to keep the congress fully informed, consistent with the war powers resolution. i appreciate support of the congress in this action. that's president in his letter yesterday. one of the questions that has
7:21 am
popped up in the wake of these airstrikes in iraq is how long this is going to last, what the end goal is. yesterday the questions were asked of white house spokesman josh earnest. >> the president has not laid out a specific end date. we're going to take this approach in which those kinds of decisions are vaulted regularly and driven by the security situation on the ground. both as it relates to safety and security of american personnel, but also as it relates to supporting the ongoing efforts of those kurdish security force and iraqis. >> that's josh earnesest yesterday. let's go to the line, rick, good morning. >> yes, good morning. i just wanted to say that you
7:22 am
know everybody has had an opinion about this thing, but you know what, one thing i do know is that the president probably knows something that we don't know. and when people say that he doesn't say anything because sometimes it's wise not to say anything. and for anybody to think that the enemy has any disrespect for this president, they're just a big of fool. hit's best to be quiet than to e a fool and open the mouth. this president knows what it means to send f-18 hornets in to get the job done. that's third in line of the best fighter power planes we have. don't take this president short if they think he doesn't know what is going on. they're making a terrible mistake. thank you. >> here is a picture of one of those f-18 fighter planes that was used in the operation that's from the front page of today's
7:23 am
"washington post." and their lead story of what is happening in iraq. let's go to andre waiting in colorado on that line we have set up for iraq war veterans. andre, thanks for calling this morning. >> good morning. >> go ahead, andre. >> yes, i would like to begin with the last caller speaking on the president as it regards of actions and pool speaking on him. it's our duty to require this information of the chain if they can make a difference on the battlefield. it's part of counter and insurgency angle. my second point is the efforts of the kurdish how can i say forces. i believe that the callers are correct. we need more efforts for the kurdish force misbut we need more effort in teaching the religious beliefs the hadif as they're called in islam
7:24 am
correctly. and i believe many people are uninformed on the religion as far as islam. i had time to learn of islam from shiite militants who were fighting along with us. it's all about the belief systems. the six belief systems is one, they believe in one god. i think we all use god more than we all can say any other type of god. you have to have belief in angels. if you believe in the devil, he was an angel. you believe in divine books, the curran, thqur'an, the bible, ant is, you believe in the book for the knowledge it gives you. >> where did you serve and what years did you serve in iraq. >> oh, i serve in 2006-2007 with 425 out of alaska or airborne all the way. >> and andre, are you still in
7:25 am
the military? in the reserves now? >> i'm a disabled combat veteran attending school to learn how to more of africaen and middle eastern studies on my g.i. bill. >> that's the line for iraq war veterans. also on that line scott is waiting in arizona. scott, good morning. >> good morning, cspan. good morning, american. >> hi, scott. >> yes, you know, wars never rest, only the warriors. those of us who put on the uniform for our nation, it even means that our commander of chief has made that decision. what is significant about that is our nation has drawn down it's military forces at the same time we're committed to honor obligations around the globe. a lot of those are either
7:26 am
reservist or active forces. i've been active and i've been reserves. you call them reserve the reser, and they have-- >> are you still with us? i think we lost the caller on that line. we'll go to greg in south carolina on our line for democrats. greg, good morning. >> yes, thank you for taking my call. i just thought i would give a call and express a layman's term. i'm not that educated in politics. i just know what i observe. especially when it comes to war and how we run our wars that we get ourselves into. if we're going to obtain abe kind of end game when it comes to fighting, especially the islamic extremist states we have to lead by example. and it's just been observation that we'r we are setting a poor
7:27 am
example to the rest of the world coming to any end game when it comes to dealing with the islamic extremists. so any way. it's my opinion that if we're going to get it done we should really put our military in full strength to give them all the support possible, and show the extremists that we're not going to mess around and have them run the world, which is exactly what their agenda is. it's obvious what they're doing to the christians, and this is a sad day. i just thought that this--i have this opinion that it seems to be very much the opinion that i have experienced from the majority of the people that i've talked to, and it's quite aa a. it may be politically incorrect, but the muslims are out to beat us up pretty bad. >> among others opinions this morning is the financial times
7:28 am
editorial board. their lead editorial obama is right to take a risk in iraq. there is a real danger of humanitarian catastrophe combined with a strategic disaster. a new jihadist stand in the corridor to the mediterranean. isis is on the march and has to be stopped. only the u.s. has the wherewithal to halt its advance. that's the editorial board of the fiscal times. sylvester is up next in new york on our line for independence. sylvester, good morning. >> good morning. my comment is this. america is a very good nation. one thing that makes america is great nation is that america is one. and for years america has been the world power. i see america as the world police. now, what for the past ten years or the past maybe eight years is
7:29 am
this: america is slowly becoming or deteriorate because of politics. we have the president, and we voted him into power. he has the support. in all these things that is going on whatever he's doing we have to give him our support because together we can take this isis people out of whatever they are doing. one i would like to tell americans is this. one stick is easily broken but together it is not easily brok broken. >> that's sylvester in california. we'll be take area calls on this in just a second. i want to show you other headlines going around the country on the front page of today's "washington post."
7:30 am
brady's death is ruled a homicide. james brady has been ruled a homicide from a gunshot wound he suffered three decades ago. it's no word if the shooter who is being treated at the psychiatric hospital will be facing new charges. one other foreign policy story to show you this morning. rockets from gaza mark the end of the cease-fire there. gaza based militants fired a barrage of rockets into vole prompts israel to resume its bombing campaign in the-month-old war. one more story the majority leader at the hill up in house majority leader kevin mccarthy
7:31 am
has told his members to expect bills when they return from the august recess. the house plans to repackage the so-called jobs bills that has passed in this session of congress and consolidate them in larger passages including limiting various regulations and regnawing tax breaks such as research and kennedy tax credit. those are some of the story going on around the country. back to the story of new u.s. airstrikes we'll continue to take your questions this morning. we're joined by pentagon reporter for the wall street journal. we appreciate you coming on. we want to get your impression of the strikes that we've seen in the last few days. how would you characterize these hits? are they seen more as a warning shot or prelude to something much larger. >> i think warning shots is a good way to look at them initially. we've seen three strikes so far. the first one was on artillery
7:32 am
unit, a piece that was moving away. that was by jet fighter. and then the predator drone to hit a mortar position, and then they hit a seven-car convoy, that was the third hit that we know of so far. and what the administration has said is essentially they're drawing a line in the sand saying that the islamic state cannot advance any further on to the capitol, the kurdish capitol. and so i think right now what they're trying to do is see if they can hold the line and if they'll push back and if they can prevent them from getting closer to the capitol and assess what the islamic state is going to do. today out of the region is that the islamic state is not advancing on, but trying to consolidate the gains they've made in the kurdish region which is what they did in mosul.
7:33 am
that was a su
7:34 am
7:35 am
>> president does not believe that it would be in the national security interest of the united states of america. the president does in the believe that would be the best interest of the united states military. there's a fundamental disagreement about that but i would admit that the vast majority of the public would be on the side of the president in reaching the conclusion that the situation in iraq, the situation that is best resolved by the iraqi people, about an inclusive iraqi government, and by a capable iraq security force, that has the ability to represent and protect the interest in iraq. the president does not believe it would be in the interest of the united states of america for tens of thousands of he american combat troops to be on the ground fighting isil right now.
7:36 am
that's an honest disagreement that exists between the president and his critics on capitol hill, many who are in the republican party. >> josh ernest talking about the disagreements that have come up since the strikes began. >> there are two components. there is the military component that we would better off if we had more on the ground advising. the argument on the other side is a political fight. the problem is we've got a prime minister in iraq nouri al-maliki who does not represent the sunni minority in the country. the reason why the military won't fight is because they don't have a fate in the government in baghdad. that's the essential argument. unless you have a government in baghdad that the military is willing to fight for, then the islamic state will expand and take over. that's the heart of it. the president is saying we're not going to do any more here
7:37 am
until you get a change in leadership in baghdad. that's another reason why you see this push in kurdistan because there is a difference between kurdistan and baghdad. so with this fight you're able to help the kurds, who are seen more favorable to the americans without necessarily taking the pressure off the prime minister in baghdad. >> why is the u.s. doing this alone right now? are there efforts to get other allies involved militarily. >> there are of the toss get allies to help with the humanitarian effort. one of the things we have not spoken about yet is the second component which is to try and help the yazidi who is trapped in the mountains. the second component, this is two humanitarian drops to get good and water to women and
7:38 am
children who are dying of thirst in those mountains. part of this is they've been trying to get help and get other air drops in. they have been talking to neighbors of iraq to see if they'll help here bu. >> one of the reporters on today's lead story in the wall street journal u.s. launches airstrikes in iraq. we read that story at the top of the show. he's joining us now to answer your questions on the operation and what's happening over the past two days. let's go to james in north carolina on our line for independent. good morning. >> good morning. i want to say that i voted for the president twice but i totally disagree with this move that he's making now. for two reasons. one is that there is no such thing as a humanitarian bombing campaign. number two, there is no difference between what isis is
7:39 am
doing to the kurds and what israel is doing in the gaza strip. to the palestinians. can you imagine what we would be doing if the palestinians had done in the past few weeks. everybody would be coming down on the palestinians. >> stick to iraq. and how much of an effort does the president have to do to sell this to the american public? there is a story in the watt post talking about polls on u.s. action in iraq. a june washington poll found 45%, fewer than half americans supported airstrikes. and 30% supported ground troops. the majority say that the stews doeunitedstates does not have te
7:40 am
responsibility to stop violence in that country. >> the president has to sell it himself. he's relunthey were reluctant tt people on the ground. we have several hundred people there who have been assessing the situation. this group at the pentagon has not even made former recommendations of how to handle this, and the thought was they were going to wait until there was change of leadership in baghdad, which has not happened. you have the president himself who has been very reluctant to carry out this air campaign and wants to keep it limited. he does not want to get back in a ground war in iraq. he said there are not going to be troops on the ground. that's where it starts. he's not even that interested in doing this, trying to keep it limited. when you start there, i think you have a ways to go to sell it to the american public. >> on twitter we have a question about what comes next.
7:41 am
even if you stop isil. won't there be another group to develop. you can't fight religious ideology with bombs. >> certainly the president said this is not going to be solved by a military solution alone. there has to be a political solution. this is incredibly complicated because isis is a group that stretches across iraq into syr syria, and they have essentially a capitol in syria where they're carrying out very hard line governance. so you've got a lot of problems. it stretches across border and syria is an even more complicated problem for the world that has--that doesn't have a military solution for the u.s. to get involved in. very messy. >> from wyoming, waiting on the line for republicans. good morning. >> good morning. thanks for cspan. thanks, georgi gentlemen, for yr service. i'm wondering if some weapons
7:42 am
should be dropped to those poor folks in that mountaintop in northwestern iraq. >> some 72 bundles of supplies and three different drops from c-17 and two c-130s have made drops on that mountain, and we're talking about the sinjar mountains where that humanitarian crisis was taking place. >> so what you've got there are civilians. dropping weapons to them is not really going to help. they probably wouldn't know how to use them. they're refugees who just have the clothes on their backs essentially. but what they would like to do because they're surrounded in these mountains by these islamic state forces is create a humanitarian corridor to get them out. the idea is to break the siege
7:43 am
and this is maybe what we might see as the next part of this air campaign where u.s. military would do airstrikes to basically break the siege of the islamic state on that mountain, and allow the refugees to get out. that's the part of the campaign we may see unfold over the next few days. >> and where do they go? do they go to the kurdish region of iraq? >> the united nations is there and they would try to get them out. probably go to a refugee camp in the area, but it's unclear where the safe areas are right now. >> over and over the destruction has been left in the wake of our metamettling, this is not condue for democracy. jesse, good morning. >> good morning. >> how are you doing, jesse, go ahead. >> i got in one time. what i'm about the iraq war going on. we shouldn't have never went there in the first place.
7:44 am
now the president is in there. he has to do something. are they going to do a job and fight the war? i was in vietnam. i know what it's like. you don't need no boots on the ground. they do the right thing and act quickly with those jets. they can do a lot of damage to that group, and they can kill a lot of people without beam goinn the ground. we've done that before. i feel like all the people coming over there, the expertise of what's going on, and none of them ain't gonna do anything after the republicans on vacation, like john boehner, he could have done something before this happened. he seen this happened. but he didn't do anything immediate. >> the caller bringing up whether this can be accomplished
7:45 am
with boots on the ground or airstrikes alone. what are officials at the pentagon saying about this? >> well, the president has said no boots on the ground. he doesn't want to get back into war that he launched his presidency on ending. the question is, are the iraqi forces, are the kurdish forces on the ground capable of turning this around? the kurdish forces are seen as the stronger fighting force in the country, and i think people were surprised that they had such a difficult time fighting the islamic state. people were surprised that they turned their sights on the kurds. so that's one component. the iraqi military itself really folded in mosul, and that was another surprise, and the pentagon has been over there trying to figure out how to shore them up. i think another component that he might see is expedited
7:46 am
military aid to get the iraqi military more weapons. we've been sending them thousands of hell fire missiles, but they really don't have a lot of aircraft to use. they do need more weaponry, but they need more training, and they need more leadership. that's not something that you can really turn around in 30 to 60 days. so there are a lot of questions about whether they're capable of turning around. but the strategy is to focus on that and certainly not put american forces back in ther thn a combat role on the ground. >> good morning. >> good morning, how are you? i would like to say and make a couple of statements, and i need a couple of answers. okay, if our government has been over there ten years, and you cannot train them people with all the weapons we left over there, you are talking about two
7:47 am
obeing over there ten years, thy should know how to run these weapons, and they should know how to defend themselves. you were over there for devilment. you committed devilment. iraq is not iraq. that's babylon, and said it was going tgod said itwas going to s and cats, and nothing... >> the u.s. training efforts on the equipment that was left over there. how can the u.s. be confident the next time if the situation stabilizes that it will remain that way? >> that's an open question. you know, i think that's the debate that is going on in washington. if we had left trainers in iraq after 2011 when we pulled everyone out would we be in a better situation than we are now? it's an open question. if you've got several thousand
7:48 am
advisers, you're only able to do so much. it really does come back to the iraqi government's ability to build up a zone military witho m outside and provide a government that they have faith in. these are two of the big pieces, and i think there is a limited amount that the united states can do in both of those capacities. it comes down to the iraqi government itself to take this on. we have seen a reluctance to provide the iraqi military and iraqi government with weapons because of the lack of faith in nouri al-maliki. he came to washington recently, and he was appealing for more support. he went up to washington and you have lawmakers were both sides saying look, we're not willing to give you more support until you create a more inclusive government. we have not seen that happen. there is a reluctance in
7:49 am
government to give the support to iraq until there is a new government. >> what about the support in iraq with the humanitarian crisis that we've seen. and also the humanitarian crisis taking place next door in syria. what is the white house saying about why this iraqi humanitarian crisis required military intervention and not syria. >> the president used the word genocide. you have a very small religious sect here that the islamic state has threatened to eradicate, forcing people to convert to islam, executing those who don't. they run the yazidis minority out into these mountains. there was a real concern that this was the beginning of an act of president. for the president that was the red line. that's the distinction of what
7:50 am
he makes now in northern iraq and syria. >> we're taking your calls and comments for the next ten minutes and then we'll revisit the subject at the end of the program on the washington journal. if you don't get in the next ten minutes we have another half hour at the end of the show. kurt. thanks for watching the washington journal. >> i was over there in th the 2005-2006 national guard. we did convoy escort, which is the most dangerous job in iraq because that's where the roads have bombs, and that's why our men have lost limbs, legs and arms. we took a direct hit on thanksgiving in 2005. we had the ammo tested.
7:51 am
and we saw american armament. it was the rounds that you shut out of artillery. the problem was we were going up against syrian fighters. that's what we found out. i just don't understand why we just don't go in and level damascus. nobody talks damascus, and i think that's where the heart of the jiha jihadist movement reals at right now. i could tell a lot more but i want to tell my comrades that i love them. >> out of georgia this morning, concerns about the cause of this coming from other places and not just the territory and efforts that isis or isil is taking in iraq. >> well, this is a very complicated situation that even experts have a hard time understanding because there are so many players involved. in terms of the caller's
7:52 am
question, damascus is where president assad is, and actually these fighters are trying to uproot president assad. president assad is in his own battles with these extremists fighters. the islamic state is believed to get support from citizens of saudi arabia and qatar. they have significant training. and they are opposed by fighters backed by iran. it's a very complicated situation. there are players involved including american-backed players. we're backing different people in different places. it's not as easy as going in and attacking president assad. this situation, what's happening on the other side of iraq, that probably wouldn't address the issue. it would help them, in fact,. >> in california, stan i samueln the line for independence. >> good morning. >> good morning. >> i just called in. i don't think the u.s. should be
7:53 am
getting involved with all them airstrikes in israel. we have enough to worry on our own. >> that's samuel in california. janet, good morning. >> good morning. >> hi, janet. >> hi. i just want to say i have never in my life seen such a mess since obama has been in there. god help us, i tell you those people are savages. they're not fighters, isis, killing all those people. and children, and they don't say anything about that. and obama doesn't. i think he's really wanting them to win. and understand this. that's all i got to say.
7:54 am
>> your top adviser is saying we need to step in and prevent
7:55 am
genocide and protect americans. >> who was in the white house when this decision was made? >> you have secretary of state. his chief of staff. you have susan rice and all the key national players have been involved in this decision making. and they're trying to figure out the strategy. the interesting thing here is this is not the beginning of a strategy administration officials have been saying this is not the beginning of a broad based attack on the islamic state. this is narrowly defined effort to protect americans in erbil and try and deal with the yazidis refugees. this is not a war on the islamic state. that's the concern that you see people raise in washington and around the country, that this is the beginning of us being dragged back into the war in iraq. >> fred on twitter has a question about some of the terms we've been using.
7:56 am
what's the difference between isis and isil. >> it's basically a different translation of the same group. isis, the islamic state in iraq and syria, and isil is the islamic state in iraq and lavant, a different way of describing the same area. they've renamed themselves the islamic state and declared and established a new caliphate in this country and they call themselves the islamic state. every time you see isis, isil, islamic state, it's all the same group. >> monty about the u.s. looking for allies. why should they do anything. they push us to the front lines and watch us pay the price. we go to our line for independence. ron, good morning. >> good morning. i would like to ask your guest about gulf state involvement and turkey in this isis situation. as i understand it initial funding for isis was coming from the gulf state. is that in reaction to the
7:57 am
threat of iran as far as sunnies in the gulf versus shiite in iran. secondly, as far as turkey goes in 2012 turkey pushed forward in a very aggressive move 150,000-man force on the border with syria with a thought of moving in on the isis terrorist camp. two weeks later ambassador stevens was killed in libya after talking with the turkish ambassador there at the gates with the bengahzi embassy. what is turkey available to do now concerning the terrorist camps in syria that their isis, and are they willing? >> questions about players in the region? >> certainly a larger geopolitical problem here. iran is a key player here.
7:58 am
certainly saudi arabia is concerned about iranian influence in the area. i have to say that i'm not. i don't know where turkey stands at this point, whether they're willing to engage syria. my census is to fight a defensive war, but they certainly don't want to go over the border and get involved in the mess in syria. they're trying to protect their country. they've got a significant refugee problem there. they don't want to stir things up. they have their own kurdish minority where they have contention and problems as well. it would be difficult to imagine them getting involved and sending in troops. >> mary anne calling from north carolina on our line for independence. good morning. >> good morning. i haven't heard anyone talking about the fact that the iraqis have elected a new government
7:59 am
there in the process right now, also i agree that the president is doing what he needed to do, and what concerns me is i don't know why it wasn't done when they knew that this was a terrorist was first coming in to the country. they could have eliminated the process that we've got here. thirdly, now all of a sudden the president is jumping in. however, i have not heard anything about the hundreds and thousands of christians that have been beheaded and so forth. i'm afraid, i almost agree with the welcome from west virginia, what a mess. i've never seen such a mess in my whole lifetime. >> we'll take those questions including questions about the new government in baghdad.
8:00 am
8:01 am
8:02 am
8:03 am
follow us on twitter. watch american history tv in prime time. tv offers atory variety of topics. think about the programs you are watching. us.can e-mail
8:04 am
host: they were investigating the iris division that deals with nonprofit groups. what is dark money and how is the irs involved in its regulation? that animated a bunch of political entities including corporations and unions in super pac's. they can raise and spend unlimited amount of money. they have not had a primary purpose.
8:05 am
they were able to raise and spend unlimited amounts of money -- dark money is a term. isis the general term that used for money that is flowing into the political process and used in elections and campaigns television. you know the organization is sponsoring the ad. if you ask a question who is behind that money? it is very difficult to answer that question in any empirical across-the-board way. been able tohave avoid having to disclose that
8:06 am
kind of money that they are using in the political process in a way that the candidates have to do by law. we have heard a lot about the irs. remind us about their role in regulating. guest: people think of the federal election commission. they are the ones who are supposed to be the cops on the beat. and regulate campaign laws and rules and regulations. if somebody does something that crosses a line that is potentially illegal, they are tasked to investigate. when we get into the realm of nonprofits it becomes part of the irs domain. there is an entity called the exempt organizations division. that is the nonprofit division. when you think of a iris you think about the guys who are andecting the taxes
8:07 am
bringing money into the government. the exempt organizations division is different. they ensure that nonprofit retainingons are nonprofit or getting nonprofit status in the first place. when you have these nonprofit , these are social welfare organizations were business trade groups that became very political in some cases following that citizens united decision. when these groups are spending millions of dollars to advocate for candidates, it called in the question about getting too political. are they violating the terms of being a nonprofit organization?
8:08 am
? why should people care about this if you have a nonprofit that is getting very political and should not have a purpose of engaging in politics, the packs -- taxpayer is given a subsidy. whether you are a republican or an becomes if this group is politically active and should be registering as a political committee without the benefit of being a nonprofit organization. >> these organizations are spending $300 million in the 2012 election. you can include in your --estigation that the
8:09 am
we investigated a number of different realms. some of that came from statistics that we got through the freedom of information act and some from documents that we attain from the sources at the irs and elsewhere. we did two dozen interviews with people in high-ranking officials. they have been reluctant to engage in enforcement actions. host: does that predate some of these target investigations it we are seen hearings on? guest: it has accelerated in the last couple of years. scandal thathe blew up with the targeting of move totive groups, the
8:10 am
go after organizations that had tea party in their name or other identifiable words that would indicate there is a good chance that they were conservative and they were political in some way. the research issue goes back a couple of decades. there has been a systematic bleeding of staffing and financial resources to this one element of the irs. it tracks the slide down from a was a much more robust division at one point to what we have today, which is an organization or an element of the irs that has fewer staffers than it has had a long time. it has less money. suggested, the
8:11 am
amount of spending that is going on in the political realm by these nonprofit organizations and these new abilities and freedoms to engage in the political process over the last four years, that money has been going up and up and up. it is not stopping. cycle, it4 election is going up at an accelerated rate in a way you can only imagine. muchan only imagine how they will spend in the 2016 cycle. money,esources and more they don't have the capacity to comprehensively look into these groups and make sure that they are following the law. for: as applications nonprofit status have gone up, the number of inquiries are going down.
8:12 am
thear in the 2014 cycle, amount of dark money in this cycle will eclipse the we saw in the last midterm and maybe eclipse the last presidential election. the center for public integrity. let's go to: in oklahoma. good subject. the conflict is created by the , this is a government agency
8:13 am
being an arm of the democratic arctic. -- democratic party. unionsiticians and the are ganging up on the taxpayers. detroit shows the that eventually goes down the drain. happeninge same thing throughout government. irs is the lead attacker in the situation. when you talk about dark money, there needs to be all of this brought up. know there was a union cobol in the irs. the caller is right in
8:14 am
the sense that the situation shined a lot of light into what setting conservative sensibilities on fire. irse were elements in the otherois lerner and information that has come out that there was at some level to some degree targeting conservative organizations. you can debate the merits of whether or not that was fair. there is a major part as an element that came about as result of this. it raises the broader question of whether these organizations
8:15 am
or the irs is being evenhanded with in-service groups versus liberal groups. for themajor question parties themselves if they feel like they are being treated fairly. talked to the commissioner i have the -- of the irs. ruleseed to rewrite the as it applies to nonprofit organizations to make them more equitable. to make some warfare. -- to make them more fair. these about be proposed until after the 2014 midterms. do not hold your breath, and will not happen until after the 2014 election cycle. happen early in 2015. it could have some effect on the
8:16 am
2016 election cycle. we will obviously have a pretty -- presidential race. involvese of this defining what political activity is under irs rules for nonprofits. guest: absolute. this is something liberals and conservatives are concerned about. if you are in a football game and you are told that maybe you need 10 yards for a first down but it might be eight or 12, the teams are going to throw their hands up in the air. they need a certain measure. many liberalk to and conservative groups, the agreement is they want the rules to be consistent and for the rules to be well-known. purpose,n of primary
8:17 am
it is very fuzzy. half of the money the nonprofit there are some other factors that go into that. money.ot half the it is very confusing for the groups that want to abide i the law and comply with the law and involve themselves in politics to some degree but don't want to cross a red line and go into a realm that could get them in trouble. about there talking irs and dark money. john is calling from michigan on the line for democrats. caller: good morning. i had a couple of comments and the question.
8:18 am
this citizens united and campaign funds are now free taxch, you shouldn't get a deduction for using your constitutional right. my question is, is there anyone looking to eliminate texted actions for campaign contributions because they are now free speech? guest: one important point to if you make a campaign contribution you do not get a tax deduction if it is directly to a candidate.
8:19 am
even if you make a donation to 501 c4 groups, that is not tax-deductible from the donation standpoint. if you're a nonprofit group and i given you $100, i can't do that that off my taxes. is operating as a nonprofit and is tax-free in a certain regard. that is important. do the broader point if these organizations should be able to operate tax-free or in a political way, that is going straight to the height -- heart of what the irs is going to propose in its new rules. this is going to be a very
8:20 am
public ross s. people a political persuasions are going to have the opportunity to weigh in and an open run up to what is going to be made by the irs. morning, alan. caller: i always enjoy the show. a couple of things. i have a couple of questions. the irs and the election commission are all supposed to be nonpolitical. lois lerner called the in an e-mail that was released. dark money comes in from both sides. majority ofke the the targeting was the tea party groups. the words progressive and union were not targeted.
8:21 am
unions -- we have to get the unions out of the government. they are led to contribute to campaigns. they are one-sided with their political views. by the union.dled how deep thatw was ingrained. they are not going to go after union groups because they are going after their own supporters . you the irs situation as it is right now, most of the situation is looked at with conservative groups. there have been a number of left leaning or democratic nonprofit organizations that have been doing the same thing as many
8:22 am
conservative organizations. they are pouring in lots of this so-called dark money into the political system. in terms of a balance right now, there are more conservative dollars flowing into the system. democrats and liberals are andainly aware of the rules the laws as they exist today. toy have made the decision engage in the process the way the rules are written right now. you do have a number of these groups. democrats often talk about the -- dark money being a terrible thing and all money should be transparent. there is money flowing in right now coming from liberal organizations. the irs is aware of this. going back to our interview, it
8:23 am
was clear that it was going to be a goal of the irs to move beyond strategic targeting of certain organizations by their name and do it in a way that is more equitable. least, they are aware of the issue. that should be very evident to anybody who is watching any of the hearings on capitol hill. according to the center $43responsive politics, million spent by nonprofit groups in the 2014 cycle. let's go to carl waiting in west virginia on the line for republicans. 40 years ago richard
8:24 am
nixon was forced to resign his office. what do you know about this organization in texas? sheway i understand it, formed an organization to train poll watchers. she applied for this tax exempt. the irs audited her business and her personal account and then the fbi investigated the business because they have tobacco and firearms for a license to manufacture firearms. upa came down and wrote them
8:25 am
. a congressman said his staff down there to investigate this woman. guts than halfe the people in texas. i will call them what they are. i would like to know what you think about this organization? in, headore dave jumps over to american history tv later today and we will have several hours worth of programming on nixon's resignation. i just went from san antonio last night. topic amongas a hot people i was talking to. i don't know the particulars of the situation. this is in general a major issue
8:26 am
for anyone who is going to be under the watchful eye of the irs to any degree. this could be onerous to a point that i won't be able to do my job. i won't be able to do my work. my organization is going to have a burden on it that will prevent me from doing what i want to do. often times it is a mixed bag. sometimes you might want to get a group that is getting a strong degree of scrutiny from the irs. that is going to anger a lot of groups. that is going to be a major concern. we hear this a lot. it goes back to that lack of equity that groups feel they are getting more scrutiny than other groups. host: marcus in pennsylvania.
8:27 am
i am a tax professional. what i am hearing is mostly from republicans is the usual right-wing hysteria. i deal with the irs on a daily basis. i feel them to be professional and courteous. they are overworked and underfunded. these are people who are barely able to do their jobs. darrell issa oversight hearing is nothing more than to whip up the republican base to come out this november. the irs is just doing their job. they are taxed with determining whether or not these applications are valid or not. if mostly conservative groups are applying then guess who is going to be under the scrutiny?
8:28 am
trying to type e-mails into the white house, they can look at e-mails and there is nothing there. host: to your point on resources for the irs, one of the numbers centere piece from the for public integrity noted that division has 14% fewer staff than it did two decades ago. the sentiments were echoed by many of the irs employees that we talk to for our story. this, theyctively are being bled of resources but most of them are just trying to do their jobs and follow the law that has been written by congress. aty point the finger congress as being the villain in all this. it is not the irs. this is the sentiment of the
8:29 am
employees and not talking about anybody else. they feel like they have been set up to be the bogeyman when in fact they were just trying to do their due diligence and make sure that the rules and regulations of the country that were set up by a bipartisan congress were followed to achieve. -- if they went off track than that is fair to question. they felt in the interviews that we did that if they don't have the person power to investigate they don't have the resources and the money to do so in a way that is going to be fair and across the board to all organizations than they are going to have to pick and choose the battles they fight and what groups they look into. it becomes a situation for them that is untenable.
8:30 am
this is not something that is turning around in their favor. caller: it is good that we can voice our opinion. we don't need more money in the irs.
8:31 am
they are taking money away from the american people. i am 70 years old. . can remember i was a young mother when nixon was going on. the american people had no idea what was going on.
8:32 am
8:33 am
8:34 am
8:35 am
8:36 am
8:37 am
8:38 am
8:39 am
8:40 am
8:41 am
8:42 am
8:43 am
8:44 am
8:45 am
8:46 am
guest: some folks, particularly those who might lean to the left would like. host: dave levinthal is the senior political writer for the center for public integrity. thank you so much for joining us. guest: it's been my pleasure. thank you. host: up next, dr. atul groer joins us discussing concerns
8:47 am
about the growing doctor shortage in the u.s. we'll be back.
8:48 am
8:49 am
host: dr. atul groer joins us to discuss the growing concern of a doctor shortage in the united states. what's causing the startage and how are patients feeling that shortage. guest: it's been really -- talking about doubling the number of people over the age of 65. they're the people that use the most healthcare services from primary care to medical sub specialtities like oncology and surgical services. so we have known that population has been
8:50 am
coming down the pike for years but have failed to act on it. we said let's limit the amount of training that we'll support. host: another group that uses the medical facilities quite a bit are veterans. $5 billion given to hire more medical personnel for the va. are there enough doctors to file that $5 billion worth of holes? guest: that's the difficult question. right now, there's no shortage in opportunity for physicians. for the first time in decades, our physician population is dropping. it's very difficult to see where you're going to get the additional physicians from until we actually start training some more. last time i checked, the
8:51 am
va had openings for about 800 physicians. two-thirds of those were in sub specialty fields. it's very similar, i think, to what we're going to see with the population moving forward. so the most vulnerable cases, veterans, are the first ones to feel the effects. host: and where do they feel it? is there a geographic element to this? guest: there's always trouble getting physicians and healthcare professionals into rural areas and inner cities. there's certainly been a growth in population in the west and southwest. host: last time you were on this program in january, we talked about the impacts of the affordable care act on this doctor shortage that we're talking about and the seven months since then, what's the
8:52 am
impact you've seen. guest: it's not as if everybody showed up january, 2014 and said i'm going to go to the emergency room, the hospital, see a doctor. so we've seen a steady increase that's gone with the patient increase in medicaid and the exchanges. we're not at the point where we've seen a dramatic increase in wait times. however, the latest surveys show that wait times are creeping up. i don't know if you've had this experience as well but even in a city like washington d.c. where you could say we have a sufficient number of physicians compared to other parts of the country, it's still pretty difficult to get in to see a doctor as a new patient. host: we're talking with dr. atul groer about doctor shortages in the united states. phone lines are open. we'd love
8:53 am
to hear from you, our viewers. we'll also look for your tweets and comments on our facebook page as well. dr. groer, can you talk about the breakdown along the lines of primary care and specialty care practices? guest: right now, we see an even split in the shortages we're going to expect in primary care, especially adult primary care, family medicine, internal medicine. we expect it to address a third of the shortage, to train about 2 thousand professionals. surgeons, interestingly, a lot of our
8:54 am
surgical sub specialties, the numbers are dropping, not even keeping up with population growth. host: a recent report from the institute of medicine questioning if there's a shortage of all or how bad it is. projectionsing don't consider geographic differences and ignore the role of new technologies and alternate providers like nurse practitioners allowing doctors to get back and do the jobs that they were meant to do. is this shortage overblown? guest: i don't think it is and i think the irm presented a very thoughtful discussion of this and what they found was they can't find clear evidence right now that there's a shortage but also can't find clear evidence that there's not going to be a shortage. and i think the challenge is when we've gotten
8:55 am
the projections wrong in the past, that's usually because we've made assumptions about how drastically the healthcare system will change. we don't think that we should put patients at risk by saying let's not train enough doctors just in case everything lines up perfectly. we want to train more than we need. and let's also work on the technology, improve efficiencies. reduce redundancies. i think we certainly have a lot of ways to get over some of the scope of practice battles and reimbursement issues that we have at the federal and state level that really inhibits the use of other health
8:56 am
professionals as well. host: do you have other projections taking into new technologies helping here, nurse practitioners allowing doctors to be able to spend time with patients and things like this story, can wal-mart help solve the u.s. healthcare access crisis, some of these facilities at wal-mart and other places like cvs that are seeing patients? guest: again, it requires healthcare providers to actually care for patients. and even if you can replace some of the activities of these, the challenge is me as a patient, i want a fully trained neurosurgeon in the operating room no matter who is assisting me. as we put these numbers out, a lot of things could change the equation. this could certainly reduce that shortage somewhat but it's not going to
8:57 am
eliminate it. host: we're talking with dr. atul groer about doctor shortages around the united states. we'll start with colleen in newton, massachusetts. good morning. caller: good morning. thank you both for being here. my husband runs a clinic at one of the big teaching hospitals here in boston and there's been a big turnover in his practice, all the older doctors are leaving and one reason that many of the older doctors are leaving is that there's a -- quite a change in how doctors practice medicine and the need for this high technology that doctors require is really driving a lot of the older doctors out of practice. now, in my husband's practice, as he tries to replace these
8:58 am
doctors, he has to hire people from oversees and there are so many difficulties from these doctors who are well qualified, they're having great difficulty just getting visas and once they're here, renewing their visas, and it's also very costly and administratively for the hospitals, it's difficult to provide all the administrative paperwork just to get these people to stay here. so in order to allow -- in order to address this shortage of doctors, somehow the united states has got to make it a lot easier for these very well-qualified doctors to move in from overseas. guest: those are some important points. i think the first being that it's not only our patients getting older, it's our physicians. roughly a quarter of our physicians are likely to
8:59 am
retire in the next ten years or so and we don't have a pipeline to replace them and that's not coming from the medical schools. i think colleen certainly understands that physicians, once they graduate, have to do a residency. that's what we're talking about in terms of the bottle neck. so we don't have enough residency positions because medicare froze their support for its share of the cost of that funding in 1997 limiting not only the number of u.s. graduates that can go in and get trained, also the number of foreign graduates. the visa issue is a bit more complicated. there's the conrad j. one waiver program where every state has a limited number of these visa waivers. different states make
9:00 am
it more difficult than others. what's interesting is that all the states have pretty much used up all of those waiver positions that allows foreign positions to stay here if they're serving in an underserved hear. half of those spots with used for sub specialties and it's at the max that it can be used from and we're just not keeping up with the demand. host: and you also expressed concern about recertification efforts. guest: medicine is changing and that's -- i think that's probably the one certainty that we have in medicine, that things are changing. i think for younger physicians who are entering the field and acknowledging that these changes are happening, it's easier to keep practicing and say i'll go with the flow but if you're used to doing something for 30 or 40
9:01 am
years and suddenly the rules start to change, i think people are less likely to want to hang out and keep practicing if all the rest of medicine is really not a positive experience for them. host: and for the groups pushing for more recertification? guest: those efforts are happening more often. certainly when i trained 20 years ago was the first time that we started to require people to recertify. we used to think if i came out of residency, demonstrated my clinical skills and passed a board certification test in my specialty, that, that made me qualified to practice. but it changes so rapidly that it's our responsibility to continually and keep up our skills. we train residents, we're advancing
9:02 am
research and discovery, we're constantly asking questions and advancing our knowledge base but if you're out in the community, this becomes more of a challenge because you're not always given that opportunity to do scholarly work, catch up on readings and more. it's there for the right reason but there are going to be bumps in the road. host: lee is calling from tennessee. good morning, lee. caller: yes. my question was, or comment, i am on medicare. i'm disabled 100 percent. and i have tried to get additional help with the 20 percent that i'm stuck with. i can't seem to
9:03 am
get any help with getting that. and being on a limited income, i have no means. i can't work another job because of the way the situation is set up with medicare and, you know, are there programs out there that people are looking at for -- i paid taxes for 32 years. had a business with 30 employees and all the money i paid in, it's like when i became disabled, instead of going back to the year when i became disabled, they went back three years from
9:04 am
the time i got my disability which any income had went from around 180 to around 35. host: any thoughts? guest: i think that lee brings up another issue of the complexity of our payment reimbursement system and what that does to patients. a lot of the hearings on the hill have been around in the last couple of years, unless you're a patient in the hospital, spanning to midnight, 11:30, 11:30, you're not qualified as an inpatient meaning suddenly that patient is stuck with a part b or outpatient deductible of 20 percent and we created medicare in a world when most stuff was done in the inpatient setting, fees weren't as high as
9:05 am
they were and i think we have just not modernize that program. for patients who can afford it, they can buy med gap but if you're someone in lee's situation it's much more difficult. particularly if you're in a state that's not as generous with its medicaid coverage and expanding it to people who are duly eligible but it's an exam of how these regulations don't do well for patients. host: we're going to hear from laura from troy, michigan. caller: i'm an office manager of an internal medicine
9:06 am
practice. where do old doctors go? they go to congress. i see a plethora of different people in congress and of course they only work three days a week, so they can still have a practice although they're not supposed to. i want to address the affordable care act which our practice has increased as a result of people being able to come in and often times they find out that they have diabetes or blood pressure problems and things of that nature that they probably never would have checked on had they not been able to have that free exam. also, the payment that the internal medicine doctors get is very small compared to what a surgeon or someone in the more
9:07 am
specific practice gets and, yet, these people are sort of the gate keepers. i know our physicians often times have to refer people to something for specialized and, yet, they're not compensated for their knowledge. host: dr. groer. guest: i think it's a very important point and one that i'm sensitive to. historically, our system has not paid for cognitive work as well as procedural work. so coordinating care as you do in an internist's office. so we need to rethink how we deal
9:08 am
with -- the only other point i would make is i think what you're seeing in this practice in michigan is similar to what happened in massachusetts when care was expanded there. you saw up to a 20 percent increase in the rate of elective surgeries in poor minority populations and we're not talking about cosmetic work, this is people who can't afford to get a knee replacement or heart valve replacement when they really need one. hopefully now that will improve but in the interim, you're going to see a spike in both the use of primary care and sub specialty services laura was referring to. host: florida is next. sarah, thank you for calling the washington journal. caller: thank you. i'm a physician assistant in south florida and i want to address a
9:09 am
comment about seeing social workers for medical needs. i was just curious if he would see a pharmacist. the training for pharmacy as i know, i have many colleagues that are pharmacists that i've known for a while, it's pretty much just dispensing medication. yes, they know what it's for but as a professional, i'm on the phone with them and they really have no idea what is going on and as a physician assistant or as we really are physician extenders, i was just wondering why physicians are so -- not afraid but not hiring as much because we are trained and we don't have residency. we're able to just go in and do on-the-job training so to speak. we are extenders of their knowledge and we do it all. host: dr. groer.
9:10 am
guest: i think there are some great questions there. on the issue of pharmacists, i'm talking about people who have doctorates in pharmacy and additional training. we've used them for over a decade now for particular things. pharmacists often run anti-coagulation clinics and they do an excellent job with that. on the issue of use of pas, i mean, we are seeing rapid uptake of all the additional p.a.s and nurse
9:11 am
practitioners. the challenge again is sometimes the financial models and payment mechanisms make it difficult to figure out at least without up front funding how you're going to make that model work when you already have someone coding and billing and clerical staff and nursing staff to take on another professional on that team unless you know how the economics are going to work. i think you'll increasingly see more use of p.a.s and we know at least academically, 80 percent of our medical schools require training along with other professionals. we think they are really going to drive the change in the system moving forward so medicine is more of a team sport. host: edgar is waiting on the
9:12 am
line. good morning. caller: good morning. dr. groer, good morning to you, sir. guest: good morning. caller: i want to ask you how nurse practitioner malpractice insurance is $1,200. number two, nurse practitioners have training of two years and practice as an internist versus an internist who has gone through all intensive training, anatomy, physiology, pharmacology, how they can practice independently versus -- and if you can equate them to a physician. host: before the doctor jumps
9:13 am
in, what's your involvement in the medical field? caller: i'm a doctor. host: all right. guest: i think too often we get wrapped up in this discussion of how is that patient qualified to do something or practice independently when, in fact, we need to be figuring out what the best defects and patients are for each of us as professionals to take care of. there's clearly a subset of patients. i take my children who are young and healthy when they have an ear infection, a question of a strep throat, down to a chain drugstore where there's a nurse practitioner and i feel entirely comfortable that they can manage that isolated incident on their own. i do think though that there are patients that -- i'm a general internist, you need the training of a physician if you've got patients who are diabetic, have heart failure,
9:14 am
kidney disease, pulmonary disease, then you're likely to need someone with advanced medical training. but i think we have to get past the issue of turf wars and talk about how we function as a team and what's best for patients. host: cam ron, good morning, you're on the line. caller: i'd like to ask you regarding physicians assistants. my son has seen a few physician assistants and we get the charged the same as seeing a doctor and i'd like to have you address that. why the insurance companies and the doctors charge the same and you're not even seeing a doctor. guest: that various by payer in my cases -- so i can't speak to what your particular practice or insurance company does. i think often times if you look at
9:15 am
healthcare as a commodity, as a service, people will argue, well, if i'm providing the same service, why don't i just pay the same amount for it. again, this is a very complicated system of finance and reimbursement and regulation in healthcare. many states are different and i think these are discussions that will continue moving forward. plus, as a physician's assistant, your physician in that office is super vising that p.a. host: we have about 15 minutes left with dr. groer. bill is waiting in lexington, kentucky. good morning, bill. caller: good morning. i am a large surgical practice and there's something that we can do to increase the number of patients the physicians see. there are a number of regulations that have come in,
9:16 am
meaningful use parts one and two and the emr and our practice, the emr adds about two hours a day to the work of every physician in our practice. and there's also something called icd ten that i know you are familiar with which will come in october 2015 changing the entire diagnosis system. instead of using a three or four digit number, it will be alpha numeric. it's going to cost anywhere from 30 to $60,000 per physician in every practice including academic practices. so there are things that the government has put on us that we can't do anything about and there's no evidence, for example, that the meaningful use asking somebody when they come in if their father is still deceased which you asked them the last time they were there so those things also consume time. host: as you break down some of
9:17 am
those programs? guest: so the issue of emrs, electronic medical records, is something that passed congress early in 2009 as part of what was originally called the high-tech act to actually spur the use of electronic health records by providers. they provided financial incentives if you achieved meaningful use, computerize entry, the ability to track population health on to more sophisticated schemes where you're going to have that emr interoperable to talk to other systems. that requires a huge investment in technology by practices, particularly for smaller practices, that's a large investment that perhaps was difficult to meet and as the law moves forward, it's not just incentives and rewards, it
9:18 am
becomes -- so you have financial penalties if you don't adhere. i think the other challenge of this and the sort of added time that the caller referred to is that physicians are now spending a lot of time at the computer and anybody who's been in the physician office or a hospital recently would know that, it's all sort of how do i look at the patient and talk to them rather than spending time entering information on the computer. we need to figure that out. what i would bring this back to though is at the beginning of our discussion, we talked about this report saying technology is going to increase efficiency. and here you have a perfect example of where technology is not adding to it, it's detracting from it. it may end up to be better care in the end.
9:19 am
host: bob, good morning. caller: good morning. a couple of quick things. one is malpractice insurance obviously affects the medical profession. when you look at, for example, some doctors that i know today that are working here in the central florida area, they want to come in early and practice medicine from outside the country and couldn't because i guess the med medical malpractice -- new doctors to try to come in and intern and go through that procedure. but how does the malpractice insurance affecting obamacare. and why wasn't it really addressed? guest: yeah, there was very little discussion about it. it allowed for grants for states to look at. problem and address
9:20 am
it. individual states have tried to address this, texas being one example but clearly we have not found an adequate solution to the problem. i think even with, you know, even with concerns that you want to be able to take care of patients that have been the victims of a medical misadventure or harm, you also don't want to have a lot of frivolous lawsuits. and i think that trying to find a solution for that at the local level is probably the best thing to look forwards. i don't think the feds are going to be able to do much about this in the long run. i will say that physicians, it's not how much they're going to get sued for it. they don't want to get sued. they want to do the right thing for their patients. host: we've been talking about this looming doctor shortage in the united states, a recent bill
9:21 am
by senator patty murray would address the current u.s. doctor shortage. can you take us through what this legislation does and whether your group sports it? guest: yes. senator murray has been a -- title seven and public health service. what her bill would do would really fail to invest in resources and training but rather just move the pieces around so it would cut money from some training programs to establish other training programs which doesn't get to the root cause of the issue which is we're not training enough physicians. so it may help with some local issues, it's not something that could be a national solution. we have endorsed other language in the house and the senate.
9:22 am
host: donna is waiting from new york. good morning, donna. caller: good morning. i'm a physician in new york. i'm in my early 60s. i have fallen victim to the new acos because all the hospitals are buying up private practices in the highly populated part of new york that i live in, there are very few private practices left and most of them are plastic surgery. primary care physicians tonight have private practices here anymore. it's now owned by the
9:23 am
hospital or now insurance companies are buying up practices. our particular practice was 166 physicians. we were bought by an insurance company. they bought several other companies there were groups of medical doctors and we now have corporate medicine. corporate medicine has led to a really toxic environment for doctors and although i plan on practicing probably another ten years in our new contracts, there is a clause that says you can be dismissed for any reason or no reason at all. and i was an executive position, ran a group of offices in obgyn and radiology and when they joined together five different groups, they had five different people who had my same title and i was one of the physicians that they just decided to let go. and
9:24 am
i've had a very difficult time mentally deciding that i really want to go back into that toxic environment or not and practice medicine which i love practicing medicine, but it's a new world out there that's very unpleasant for doctors to work in. i mean, to have to learn the emr and that's not really a problem because in my field i'm pretty familiar with computers. guest: i think again it's just a perfect example of some of the frustration that some of the people are feeling and causing physicians to leave the work force earlier than that would have. the other thing that this brings up is there's a lot of -- the caller mentioned acos, accountable care organizations, the thought is if we can get providers to collaborate across settings to get some benefit if
9:25 am
they lower utilization by patients, lower cost of care, that we will suddenly become more efficient. there's no evidence to suggest that, that's happening yet so all you see is a lot of shifting in the marketplace. i think sometimes for good reasons, that we want to better align episodes of care but also because people are trying to figure out what this new healthcare system is going to look like as even the insurance companies sounds like are doing in new york. one interesting thing, new physicians finishing residency trainings, they really want to be employed. it's a very different outlook than it was 30 or 40 years ago and very few of them want to go out and either work in the small practice or set up their own businesses. they have gone in with the expectation that they were going to work for some larger organization. host: should we be preparing people earlier for medical
9:26 am
profession, start them in high school, cut out several years in school? guest: one of the things that the aamc is engaged in now is we're work, the board of pediatrics and other groups trying to figure out if we can cut out some time in training. and maybe use competencies. and there are programs across the country that allow for a six years combined pa, mds. the challenge is people have not usually opted for those routes to cut out that time in high school or college. they generally value that experience as part of becoming a professional. host: james is in new york, new york. good morning.
9:27 am
caller: good morning. here's another spin on this toxic environment that physicians face. can you comment on the situation where doctors lose their license because of political -- dirty politics where someone in the community or at the hospital doesn't like this particular doctor, they make a phone call to the health department, and because the health department has quotas, they take the chart and spin it out of control and where it could be just bad note taking, it comes to the point where it says, oh, you murdered this patient. host: in the last minute or so? guest: i'm not familiar with that being a common problem. i know it's always a difficult line to balance out. the same convey when we think about doing things like training. what's best for the patient. the bottom line is you have people that are leaving medicine and not enough people coming in to fill their shoes and we need to
9:28 am
address the residency shortage issue. host: dr. groer is with the association of american medical colleges. we always appreciate you coming by. host: coming up, we'll continue to take your calls on the new u.s. military action in iraq. we'll be right back.
9:29 am
9:30 am
9:31 am
host: and we're back and will be taking your phone calls for the next hour. we want to hear your thoughts on the latest u.s. military efforts in iraq. you can call us on our phone lines. if you can't reach us on the phones, you can always get us on associate media. we're on facebook. twitter. or you can email us at your honor at can
9:32 am >> there are more than a couple of differences between the situation in syria and the situation in iraq. let me highlight a couple of the more important ones that might illustrate the decision making in these instances. first and importantly, the united states' military involvement in iraq was at the invitation of the iraqi government. that is obviously an important distinction between the relationship to the extent that there is one between the united states and the assad regime. secondly, the u.s. has in iraq significant resources in iraq. that ensures that american decision makers, the american military, and american intelligence officers have pretty good visibility into the situation on the ground in iraq. those kinds of assets and that
9:33 am
kind of intelligence to that extent does not exist as it relates to the situation in syria. a consequence of those intelligence efforts that have been underway in iraq for some time is that we have enhanced military capabilities in iraq, that using that intelligence and using the partnership that exists between the united states and the kurds and the iraqis, there is more capabilities to take the steps that would be beneficial to the situation in that country. host: meanwhile, house speaker john boehner released a statement saying the president needs a long term strategy. the president is willing to put
9:34 am
forth such a strategy, i'm willing to listen to him and work with him. for now, i wish god speed to all those participating. our first caller is mike from new york. good morning. caller: good morning. i'm a little disenchanted with everything. we never give any credit to obama for everything that he's doing. this is a war created by the first george bush in washington in 1991 in desert storm. we cut it off at the head and we came back. and as the thing progressed, we got ourselves more and more involved. every president tried to -- difficulty the president is up against in making these
9:35 am
decisions. host: do you support the u.s. air strikes in iraq? caller: yes, i do. yes, i do. and i'd like to see boots go back on the ground. okay. for the sake of the people in the mountains. host: all right, mike, we'll turn now to norman from tuskegee, alabama. you're on the air. caller: i'm just calling in to say i support the president and what he's doing. i consider myself a nonviolent person, you know, i follow the strategy of martin luther king but i'm also a realist and realize that sometimes you got to take a stand. i mean, this is just totally awful in today's age when somebody's going to point a gun at your head and tell you that you have to change your religion or we're going to kill you. this just does not happen in the modern day world.
9:36 am
christians are being just chased out of their homeland -- have read a lot of people, the peacock angel making them a very unique people with a unique form of worship and there's not too many of them left as it is so before they're driven out of existence -- host: do you think the u.s. is doing enough in iraq right now? caller: obviously not. but, you know, these people are fanatics. these are not real muslims. and if you don't stop them now, no telling where they're going. they're the worst level of religion. had
9:37 am
somebody stopped hit letter, millions of lives would have been saved. host: our next call is from illinois. maria, good morning. caller: good morning. i am pumuslim and i want to say we a all people from god. god create us same. we don't need to use religion. some people just want to kill people. we need to stop war everywhere, doesn't matter. everybody is innocent. they should not shoot anybody with bombs, know what i mean, hurting us, hurting everybody. host: maria, we heard your call. our next caller is bill from florida. caller: yes, good morning. i just hope a lot of people saw
9:38 am
the picture of mccane with the isis fighters. i saw that on, what is it, the channel with -- the free speech people. and the fox people are nothing more than cheer leaders for this war and the other war that's going on. thank you. host: we're on to fargo, north dakota with kevin. go ahead. caller: hi. i just wanted to make a comment. you know, i've been watching for the last three months, you know, or better, and it's really sad. this isis or whatever they're called, these
9:39 am
guys are bad. i mean, they're bad. i mean, this is going to take everybody, no politics, we got to stick together. i mean, they're cutting heads off of kids. you don't see it on the main media but you go to the internet and you can find it in two minutes. we have to stick together and put politics aside. host: what doing the u.s. should do? caller: that's why we got to get together and figure it out. put politics and elections aside, come on. it's bad. i mean, come on. it's just time to say, okay, let's go. we got to figure this out. i don't know. i don't have the answer. that's why we have to stick together and this election, that election, it's -- you don't see it on the press, but, i mean, you take one second and i could
9:40 am
show you 40 minutes of it. host: all right, kevin. our next caller is from eden, north carolina. caller: my comment today is i believe that we are missing the western society in the principles -- christopher hitchens. i voted for obama twice and i originally voted for him because of my lack of support for the iraq war and i had a quarrel -- and i see now that the situation has changed so rapidly and gotten so poor that he may have been correct all along, we are fighting a
9:41 am
hideous group of people that we can't allow ourselves to run from again. host: all right. we're going to switch gears now and turn to the state of hawaii which is experiencing two primary elections today, some of which are going to be notably tough. there are some nail biters happening. we will actually be able to take one more phone call before we get to hawaii, and that is from douglas in michigan. caller: good morning. host: you have a comment today about the u.s. involvement in iraq? caller: okay. i wondered why they don't go to the united nations and get more help to do some of our work over there instead of sending our kids and men to be killed or help. we
9:42 am
don't hear too much about the united nations and i wondered if you could comment on that. thank you. host: we have another caller now. we have jean from fair oaks, california. jean, you're on the line. good morning. caller: good morning. i'm wondering if we -- the people who lied to us -- but if we -- people that got us into a war with the muslims, if -- wouldn't hate us so much if we had a legal system that really punished our leaders who lied to us and got us into this war in the first place. it might not be turning everyone against us.
9:43 am
and also we shouldn't let base our economy on supplying military weapons to other countries to fight their wars because it just turns back on us. host: sounds like you believe that we shouldn't have involved in air strikes against iraq? caller: well, no, i think we have to. i don't know how else we can -- i don't know if we can turn it around other than maybe punishing the people who got us into this originally. i don't know if that would even make any difference. it's almost too late for that. host: and we'll now turn to hawaii which is facing several primary elections today in the wake of some major storms moving through the area. here to talk
9:44 am
about it with us is chad blair. he's a reporter in honolulu covering the elections today. good morning, chad. guest: a very early good morning to you in hawaii. host: can you tell us the situation on the ground right now. can people get out and vote after the storms? guest: the first storm has passed by. we're in the all clear. there was some damage. no casualties, but on the big island, two voting precincts today will be closed. there's a contingency plan and they will provide for absentee balloting for those people. so the other polls will be open three hours from now. another hurricane is headed our way but the most recent forecast suggests it will
9:45 am
pass north of us. we'll keep our fingers crossed if that's the case. host: so two incumbents, governor abercrombie runs the risk of being unseated here. guest: it's remarkable. i've never seen anything like it in hawaii politics. very blue state. neil abercrombie is down by double digits including our own poll that had him down last week to david ige. why is that? it's a difficult question to answer but a lot of people seem to not like the guy very much. he's doing a good job. the economy is doing well. there's been no major scandals. but he's not been able to persuade
9:46 am
folks to keep him another four years. another fellow was appointed by abercrombie and some people are angered that abercrombie did not pick someone else for that seat. our poll shows shots up by eight points but another poll has another leading by eight points. host: is there any correlation to demographics in these elections and how is that playing out in these elections? guest: one of the things that everybody talks about when it comes to hawaii politics is whether ethnicity makes a difference. there's a large asian population here, japanese
9:47 am
american population especially. convention wisdom suggests that they tend to vote for one of their own kind. however, there are other folks that look at other factors, gender, age, those factors are at play in this election as well. and believe it or not, some people are actually looking at the character and the positions that these candidates have which is a good thing considering policy is the most important qualitity to have for office. host: and you mentioned -- performing pretty well in relation to senator shots there but a washington post poll also said that often these numbers in hawaii particularly are unreliable. how much stock are you putting in the polling numbers and how much of a surprise might we see today.
9:48 am
guest: i can tell you that one of the stories coming out of the election regardless of the results is which poll got it right and which poll got it wrong. i'm a little defensive when people say we have all over the map polling here, having said that, there are two polls in the state of hawaii. we've called a few races correctly, and some races wrong. >> come sunday morning, people are going to say hey, you said so and so was going to win but in fact, well, that will certainly be one of the stories of the election. host: does the president's endorsement help or hurt the
9:49 am
governor? guest: it doesn't seem to be helping at all. neil abercrombie actually new the president's parents. went to school at the university of hawaii, was there when the president was born in 1961. and still the president remains very popular here in hawaii with ratings somewhere in the 60th percentile. that's not what the national numbers are saying about the president as you know but it doesn't appear to be translating directly to neil abercrombie. it's almost as if it doesn't matter that the president has endorsed him. host: thank you chad for sharing your thoughts and
9:50 am
insights. thanks for joining us. host: we'll turn now back to your phone calls on the latest u.s. military involvement in iraq and the air strikes. our next caller is from hollywood, florida. caller: thank you very much. i would like to say that if our news media can point a finger to our allies, saudi srabia and jordon to infiltrate isis and be a whistle blower throughout the world through our muslim brothers in every country to find out who the incity gaiters are and then saudi arabia and
9:51 am
jordon put the boots on the ground and say to themselves america is our al lie, they are our friends, they have supported us, we're right here, why don't we deal with this with the u.n. and go and find out throughout the world and make peace. host: sounds like you're saying our allies should step up and do more. maybe the u.s. doesn't need to be involved. caller: that's right. they know exactly more than we do and they can -- and throughout the world in every country and they can tell our muslim brothers who are the culprits in every city
9:52 am
and even if it's within the family, these culprits, they want to create murder and havoc and let the families who know this more than anyone else within the communities be the whistle blowers and point the finger and say you need to have psychological help. host: all right. today in the new york times, thomas feedman, an opp ed columnist for the newspaper asked president obama to explain the president's decision to use military force to protect refugees from isis. and the president said you have a strong international concern that these people need to be protected, we have an obligation
9:53 am
to do so. we also have to ask not just how do we push back on isis but also how do we preserve the space for the best inside of iraq and that has been on my mind throughout. he also addressed the issue of how far the u.s. would be willing to go in its involvement in the latest air strikes and the president said he's telling every faction in iraq we'll be your partners but we're not going to do it for you. we're not going to send a bunch of u.s. troops back on the ground. you have to show us that you are willing to maintain an iraqi government that is based on compromise. our next call is ralph from providence, rhode island. caller: better than -- they're
9:54 am
in hiding and maybe the cia is going to try to figure things out but it's a good time to strike that i can see. also, it's better to strike now when they're not on u.s. soil, you know, because the damage would be just as much as they get there here. but anyway, i do support the president. i think he's done a really good job and, like i said, it's better to strike now. thank you. bye. host: all right. our next caller is james from bristol, tennessee. go ahead. caller: yeah. i'm a cold war veteran and i believe they need to increase, in other words, this pinpoint dropping bombs, they need to increase the
9:55 am
bombing completely eradicate those terrorists over there. that's the only way they're going to stop them, in other words, just completely wipe them out because this pinpoint dropping ain't going to have no side effect. all it's going to do is make them that much more madder. host: okay. our next caller is cathy from pennsylvania. caller: hello? host: cathy, you're on the air. caller: yes. i've been watching this, this morning and i'm not too familiar with what's going on in iraq but the united states is getting blamed for everything. what happened to the commandments do not kill? as far as the air strike in iraq, i'm not sure whether that was the right to thing to do or
9:56 am
not because i don't know what the problems are there and i just want to know what they thought about thou shall not kill. host: all right. our next caller is from alexandria, virginia. caller: good morning. my issue with president obama's foreign policy is it is absolutely inconsistent. i don't think he has any clear view of what he wants to accomplish. you know, he's getting involved in so many places and that is really draining the economy, not just for now but for a long time from here and i am in my early 50s and i basically have given up in my social security expecting anything from it because
9:57 am
inflation and the burden, the debt in the economy. and not only that, iraq is -- i mean, we created that problem. and iraq was -- there is nothing we could do to put them together. we should, in fact -- create some kind of safe haven for themselves rather than the united states spending more money sending troops and all kinds of stuff because it is an endless situation right now. i mean, you go to, you know, with russia, the middle east, africa, everywhere. obama is really, i'm sorry to say, i'm embarrassed by what he is by the -- just about everything and i voted for him twice. host: all right. thank you for calling in. our final caller
9:58 am
today is sandra calling in from sacramento, california. good morning. caller: first, thank you brian lamb for creating this venue. i think we need to remember what president eisenhower said when he was leaving office. they're using our government to accomplish their own greedy ends. they get us in these wars, manipulate the situation, everybody, all of it works for them, cia, nsa, all that and we're being lied to. lincoln said you can fool all the people some of the time some of too people all the time but you can't fool all the people all the time and we need to stop
9:59 am
being fools. we need to quit faking that our government won't do what they are doing. really this is impeelism. they can dress it up and say whatever it is but it's not. when you get down to it, it's all about money and the majority of the people all over the world people are suffering because a few people are so ridiculously mentally ill that they have to have more and more money. host: all right. that concludes our show for today. join us tomorrow at 7:00 a.m. washington journal will continue then.
10:00 am
leaders gathered monday to discuss strategies for innovation and economic growth and development in africa. speakers included representatives of companies with african initiatives including microsoft, general and, safaricom. hostedoking institution this event. it is about one hour and 20 minutes. minutes. >> goo


info Stream Only

Uploaded by TV Archive on