Skip to main content

tv   Washington Journal  CSPAN  September 22, 2014 7:45am-10:01am EDT

7:45 am
climate change i do believe is real. i believe it is done by god and not by man on earth. money look at all of the most of the scientists who believe in global warming is done by man, they are all getting money from governments. as long as you give the government the information they want, you're going to keep getting money. you've got a bunch of scientists that say it is not done by man. these people that are pushing this are a bunch of hypocrites. they are preaching about how doesn't stop that them from flying all over the country.
7:46 am
if you're going to preach the stuff, you need to live it. host: our last caller in this segment. up next, susan crabtree joins us. she is the white house correspondent for the "washington examiner." isisll talk about recruiting western fighters. we will be right back. >> here are just a few of the comments we have received from our viewers. >> the historical educational informative and highly educational.
7:47 am
they are invaluable to a young society today. i highly encourage you guys to show more. i am watching nancy pelosi. i accuse c-span of being a liberal. this is a classic example of what i am talking about. we don't need her giving a weekly briefing. dietn sees that we get a of nancy pelosi. most of the time she never tells the truth. give us a break. >> i enjoy your programming.
7:48 am
the examination of little bighorn and all of it is very good programming. whatntinue to let us know you think about the programs you are watching a. join the c-span conversation. like us on facebook, follow us on twitter. campaign 2014 debate coverage continues tonight at 7:30 p.m. eastern with the pennsylvania governor's race. 9:00, theight at nebraska senate race. next sunday, the iowa senate debate between bruce braley and
7:49 am
jodi ernst. more than 100 debates for the control of congress. "washington journal" continues. the: susan crabtree is "washington examiner" white house correspondent. pastdid we learn from the week about the issue of homegrown isis threats in the united states? was a lot of attention to this on capitol hill. they came out of those with wide eyes. they have never seen such a threat since 9/11. we have learned a lot. there are two different types of homegrown threats they are concerned about. one of those are people who are called out to syria, they are
7:50 am
recruited by isis and other organizations operating in syria. one is isis. it they go over there and they train to be suicide bombers and train to fight with them. then they come back to the ad states. that is the main concern. types that are radicalized locally. they are reaching out to the internet and social media. they are seeing well-funded propaganda from isis. they have a very sophisticated media operation. there is fear they will use their passports and visas. host: what is the scenario that lawmakers are more worried about? a widely coordinated attack? -- wolf, one person attack? guest: i think they're scared of
7:51 am
both this point. there is a group called cores on in syria. it is entirely different. it is a cell from out data -- al qaeda. focusing on western attacks. this is a new threat. it peter king talked about it last wednesday. jeh johnson just shut down talk aboutand cannot it in a classified setting. they were asking about it at the white house briefing. from --completely different from isis. they are coming from all over the place. they are mainly coming from yemen and saudi arabia. we have not fully reported on it because it is so new.
7:52 am
people on capitol hill are worried about it is they would not speak about it in an open hearing. host: you talked a little bit about recruiting efforts. can you talk about how those efforts work and what the scenarios are to get upwards of 100 americans it been recruited at this point by isis? rochester wasn operating a convenience store. jury indicted him. it was unsealed last week. eric holder announced this tuesday night. he was recruiting different people. he was spending $600 of his own money to send these guys over to syria. he was recruiting local new yorkers to go to syria.
7:53 am
he was planning attacks. attack u.s. military coming back from iraq. he is now under indictment and we will see how that jerry plays out there in they discovered him through twitter. they were looking at his twitter account and it was interesting. radical jihadist statements. it doesn't seem like he knew the fbi could catch on to that. host: they are concerned about .alf again that campaigns this is jeh johnson talking about isis and their propaganda campaign. we will play that and come back. thatthink it is important in our efforts we not enable the than we recruit faster
7:54 am
can capture or kill the enemy. ,hen it comes to the homeland along with the efforts of our military and along with the overseasf our partners to take the fight directly to isis, there has to be an effort to counter their propaganda and their social media. there has to be an effort at engaging potential violent extremist threats here at home. out, these pointed groups in the current age are very good at propaganda and recruitment. doc --n't have to and indoctrinate them in a terrorist training camp. on counteracting the literature and the
7:55 am
that isis, the notion is an islamic state. that is false eeriest it is not a state and it is not islamic. it is a group of murderers and kidnappers. it they are a group of depraved individual that have captured the world's attention. i think i am addressing the premise of your question. it has to be a comprehensive agent -- effort. host: how does that work? what are the strategies to do that? guest: they're trying to get different imams to stand up and say this is not part of our religion. this is a radical extreme version and we denounce it. they have been releasing weeksents over the last showing different leaders of the
7:56 am
muslim faith that are standing up against isis and saying it is not legitimate. host: is this something new with isis? is this not true of al qaeda? i think it is more aggressive. this is even more barbaric. people are taken aback on capitol hill. this is aein says completely different version than what we have seen before. felt like there might be something happening but we did not know what the threat was. we know what the threat is. they are declaring us a strategic enemy and are plotting attacks. host: we are talking to susan crabtree. if you have question or comments for her, phone lines are open.
7:57 am
susan crabtree, the u.n. is meeting this week. there is going to be a meeting held specifically on isis threats. what do we know about that meeting question mark guest: we have a wednesday address from president obama. there are 15,000 from even to syria tontries fight with isis. they want to know how we can stop this. do we need to revoke passports? do we need to make it illegal for people to go to syria? britain has aren't taken steps
7:58 am
to stop their citizens to go to syria. there is a movement that is building steam on capitol hill to make it illegal for americans to travel to syria. that is very difficult because you can go to turkey and jordan and they are our nato allies. i expect the president to speak about this on wednesday and hold a big assignment with other world leaders. host: we want to get to your calls. dakota is in oregon on the republican line. caller: good morning. i have several questions for you. i study foreign policy at the university of portland. andstened to your comments the videos that were given by c-span as examples. i follow with great enthusiasm statements given by the prime minister of britain and the president of the united states.
7:59 am
of we have no strategy for isis was sort of fire, he flaming the was trying to be honest and genuine with the press. to get your opinion on how certain statements could the ind as a defensive weapon terms of mocking us. guest: i wouldn't say we have a strategy to defeat them. we have -- the fbi has been tracking different people. a florida man went to syria, , he came backsis
8:00 am
to the united states and went to see his parents. this was an american-born a person who was raised in the united states. this is according to videos he released on youtube before he went back to damascus somewhere in syria and blew up a restaurant with syrian regime soldiers in it. he felt the fbi was on his trail. you also have the justice department, as i just mentioned, and feeling an indictment against rochester, new york. being developed to late last year. it is not like our government is doing anything and i do not want to send that message in any way, shape, or form.
8:01 am
you had jeh johnson in the homeland security committee last week saying we have a reasonable degree of confidence that we know when people are traveling but we do not know who is traveling there and that is of deep concern. we also have president obama with a strategy of arming syrian rebels. we are taking steps. aemphasize that there is not direct -- we do not have aced that we knowt about right now, that the homeland security department and other intelligence agencies are working very actively to track as many people as we can fighting over there but there is knows as of the threat and that does not mean anything. as i was told last week, we did not know before 9/11 either. >> we're talking about
8:02 am
recruiting efforts and shared the video of jeh johnson talking about recruiting efforts. examine the pitch for recruits and you will find religious governments -- we're talking about the threat isis poses here in the homeland. david is in maryland on our line for independents. >> good morning. i have a question. we heard jeh johnson and probably other world leaders say very clearly that the islamic state -- it is not a state and also not islamic there is some us who do not know any better have a really hard time understanding how it is not islamic. againstany muslims are -- who are against what the islamic state is doing. how is an entity not islamic
8:03 am
doing such a better job at ,ecruitment than al qaeda was less radical than the islamic state? is the islamic state radicalizing muslims who are otherwise from moderate backgrounds? how are they doing that? finally, this insistence among our leaders that these guys are not islamic, is this a way to prepare us for going to war with them? >> we might also get to this question from twitter asking to explain the exact meeting -- meaning of the term radicalized. you had john kerry last week in his foreign relations committee hearing saying they are exactly what you just said. they are not islamic and he even said, they are the spawn of help. i was taken aback. you do not hear that kind of language because john kerry knows what it means to say that.
8:04 am
said, i wouldg say how are americans and other westerners supposed to take this? we always see coming out of syria and iraq, these beheadings, and that just captures the public. we will associate that with the muslim religion and islam in general. it is something i think muslims really need to consider and they need to take greater stance to announce this. these groups if you look at them, they are more interested in holding power and me, then, it seems to really talking about their religion. all religions are supposed to be aspiring to help people. this is not something that -- i just think if you look at what people on capitol hill are saying, that these are thugs and holdingn power
8:05 am
territory. how you go from a kid, a florida kid whose 22, a college dropout, how do you go from playing basketball for your high school team and talking about how you like a goes on fourook to going to fight in syria. it is a process, people say how could it happen better than al qaeda. it is because social media right now is much different than we had 10 or 13 years ago. before 9/11. intelligence agencies are concerned about how quickly people are becoming radicalized. radicalization means you are reaching out to people in syria and reaching out to these terrorist groups and they are giving you information about how to build bombs. there is a magazine called how to teaching people
8:06 am
build bombs. it is readily available on the internet and you have youtube audio spirit it seems people in this country are looking for a movement, looking for a cause. they have strongly held opinions for their background and they're looking for a way to join forces. 22-year-old,ida the accounts i have seen and read, talked about how he was promised a wife over there when he got there, that he would be martyred, that he would be in heaven. it is something we obviously need to learn more about. >> what are the estimates in the number of westerners who have gone over, specifically to join isis? >> there are at least 100 americans. believe there is 1500 or more, around 2000 is the most i've heard, 1500, from the west.
8:07 am
otheroes not include countries out there. i have seen a map, a chart, that shows recruits from every country in europe, russia. they're coming from everywhere, and it is up to 15,000. >> let's go to virginia on our line for independents. kevin is waiting. go ahead. >> hello. the other factor in this nation is probably our prison systems. there are so many muslims in our state prisons and they're angry, bitter people to begin with. you could always guys in jail such, theyments and are recruiting people all the time. to know anything about the 100 or so americans that have gone over the estimates, or have
8:08 am
you been able to check who the people are and what their background is? >> we have certain cases coming forward. three comingast from minnesota. minnesota has a huge somalian population. all. not new for them at i chuck -- i spoke to john kline. somalisr, you have the from a smalley population in st. paul and minneapolis, going over .o somalia this has been a growing concern, but like jeh johnson said and the homeland security committee last week, we do not know exactly. we do not have a high degree of confidence that we know everyone going over there. >> eleanor is up next, springfield, massachusetts, on our line for republicans. >> good morning. let's start with the battlefield at home.
8:09 am
we have languages, and it should be more than one language, because the people on the other side of the paper call in and .ote --have instantaneous instantaneous citizens. so this article one, section eight, and by press the president and put on the border eight, --ction >> eleanor brings up the border and i want to stay on that for a second. how much concern on capitol hill is there for the border and how much isis is trying to
8:10 am
specifically target the southern border? what jeh johnson said, again, was that he did not have any knowledge of people coming across the border for isis related or other terrorist groups. he would not be definitive. this, he said, let me make sure and get back to our people at the homeland security department and get back to you on that ear from my knowledge, i can say, there were no examples he could cite. >> one other official on capitol hill being asked the question, director of the counterterrorism center. i hear a bit of his testimony on homeland terrorism and threats to the united states. >> we have seen nothing to indicate there is any sort of operational effort or plot to
8:11 am
infiltrate or move operatives into the united states to the southern border. >> are there further hearings that will be scheduled? any committees coming back to talk about the issues and a time between now and november 12? >> not that i know of era as you know, you probably reported on, there will be a big and huge debate when we get back to november about the authorization process and whether president obama needs to renew the 2001 authorization that allows president bush to go after al qaeda and is september 11 attacks to post a threat then. now, president obama said we do not really need that but we welcome the debate. we expect that to take place in november. i am certain the homegrown threat will continue to be a problem and there will be a
8:12 am
continuous issue that people focus on and there will be an effort and focus on hearings when congress gets back. >> we have about 15 minutes or .o courage, our line for democrats, good morning. i am calling to thank c-span for having richard gage and the architects and engineers for 9/11 truth. i would like to see you have more people on like that. pilots for 9/11 truth and physicists. >> the topic we're talking about now, do you have a question? >> are talking about terrorist attacks and if we get the truth out, we understand all the fear mongering will not get us anywhere. i want to touch on something else you covered, the discussion
8:13 am
on capitol hill to possibly suspend the visa waiver program, about isis, radicalized isis fighters coming back and using the waiver program as a way to get in the country. can you talk a little bit about that? >> there are 38 countries that allow people to come to the united states from those countries and they do not have to have a visa at all or they can just come here for business and pleasure and stay for 90 days without question. there is concern that because we cannot track these homegrown fighters to go to isis, to go to syria to fight with isis, they would go to norway and some of these participating countries, and be able to come here very easily. there is some talk about suspending the program but the bigger issues in the bills that are getting more traction in capitol hill are those to make it illegal to travel to syria
8:14 am
completely. representative frank wolf has a bill to do so. that would be good for our law enforcement agencies. right now, you have the fbi director on capitol hill last week saying he is really concerned about due process and we need to protect our due process rights. he needs to figure out if we can take those -- it has to be a crime. you have to have evidence against these people in order to stop them or revoke their passports. the state department is the only institution right now that can revoke passports. you cannot revoke passports without any kind of criminal activity or evidence of criminal behavior. we can go to syria and prove that, immediately, we can hold them and say there is a crime and they returned to the united states and we can say they committed a crime.
8:15 am
read there was some concern about law enforcement officials that if we shut down travel to some of these countries, losing people we may be able to track when they come back in the country that may tell us who else they are associating with their >> exactly right, like the fbi director said last week, that is another concern of his. sometimes you want people to come back in the united states so you can track and monitor them closely. others say, we do not have a high degree of confidence that we could -- that we could track his people. how can we be sure we are monitoring them? >> diane is up next, connecticut, our line for independents. caller: good morning. in 1993, i was in new york city coming out andd i guess in your 20's, they wanted to kill me and they kept following me and i saw them go russ the street, and they took
8:16 am
off ahead and a white woman said, they put it in the plastic egg, and i saw there had in the bag. time, i knew that was what they wanted to do to me. i stretched out my hands and said, go ahead and kill me. they kept walking by me and had a large, long circle. all right, concerns about specific scenarios. members are worried about what will happen here in the united states. we have heard concerns expressed for allies and other countries. what seems most likely at this moment? you have that terrorist group focused on airliner bombs. experience with that, of course. not only on 9/11. as you recall, christmas day .009
8:17 am
we had a christmas day bomber and it was unsuccessful thanks to another guy on the plane and the fact that the bomb was not that sophisticated. that is what i think members of congress are most concerned about. there are obviously a wide variety of terrorist threats they are dealing with here in when they got out of the classified briefing of the intelligence community last week , all i could hear was how grim they think the situation is. i always say, we do not want to be fear mongering and we want to nosure we say there is specific threat and the country has not raised a threat level and i think that for a reason. britain did raise the threat level over there and they have a lot more fighters in isis than we do, to be quite honest. we have a greater threat but there is a reason we have not raised our threat. we do not want to live in mass hysteria. we want to be methodical and take it step-by-step.
8:18 am
that briefing on capitol hill last week, you had members of congress rattled. >> on our twitter page, extremism peers to be growing around the world. byron is in cleveland, tennessee, on our line for democrats. good morning. turn down your tv and go ahead with your question or comment. we will come back. let's go to ali waiting in massachusetts on our line for independents. i wanted to quickly ask if she could elaborate on reports coming out as far as about a year ago. that, it was actually the syrian extremistswing these -- to fight the national syrian
8:19 am
free army. and it was actually the regime there and perhaps even with the help of iranians that created a byious cycle of violence letting passage to these folks. i do not know if you've heard any of these reports. >> i am not familiar with them. differentso many countries and individuals that report and are applying and funding terrorist groups in syria. this is part of the effort by the state department and john kerry to reach out and say, it is time to really address this situation. you have saudi arabia very concerned. helping provide the space to train the syrian fighters. the u.s., there will be u.s.
8:20 am
military in saudi arabia training syrian rebels. syria has already woken up saying we need to do something about this. democrats, their on with steven. -- i want to say, i think america has a problem with the truth. start looking at foundations of things, instead of trying to build a house from the roof down. you cannot do that. that weest problem is turn our backs to what is actually true that we would rather believe the lie. during the incident with michael brown, you have these guys over in iraq getting beheaded. that is a foreigner doing that. in a war zone.
8:21 am
what do you expect? >> let's go to thomas waiting in illinois on our line for independents. good morning. >> yes. thank you for c-span. i want to bring up the point that when libya was attacked, it thatout in mainstream news al qaeda was financed and used i attack libya and then when want to attack syria, they were going to use al qaeda, again, the same al qaeda that attacked our troops, killed our troops. is just a name change. isis is nothing more than a name change their it if you look at who created hamas, al qaeda, who created all these terrorist groups, it is this government.
8:22 am
that is who attacked us on 9/11. any comments on his thoughts? think we have to be concerned about not only how we get into conflicts but how we leave the conflicts. osama bin laden's troops have been trade -- troops have been traced back. we had charlie wilson where we were convert -- covertly supplying the regime against the russians. them high and dry even though representative wilson at the time, right the character, tried to advocate for us to really finishnd the job there and not just leave afghans high and try. i think you have to worry about that and what happened in iraq when we left, and a lot of talk on capitol hill that after we and we believe in iraq just pulled up shop there and
8:23 am
did not leave a trip, that we do not have the intelligence we need on the ground here at midweek could've foreseen the isis threat. i think that is a hypothetical and i do not think it could be proven one way or the other. these are all ends up for discussion, not only how we we leaves, but how them. >> as you said, some discussion going on in the u.n. this week on homegrown terrorist threats. are we expecting a resolution on these discussions? >> that is a good question. you can have a lot of talk at the summit, and we were worried is on the first day a few weeks ago. you had john kerry meeting with the coalition of the willing. i do not say that as a pejorative. there are about 10 people who came out of the nato summit and you had a resolution saying it's a major concern, but you did not have a plan of action going
8:24 am
forward. these serve as a great dialogue. resolutions come later when you have agreements worked out country to country. --. obamaerry and president have said, each country, especially those in the region, will be able to announce what they're comfortable with supplying. you had france last week saying they're willing to do airstrikes just in iraq and not in syria appeared we're waiting for anybody else who would provide military force for serious self. we know only france will provide airstrikes. other countries are providing different things, humanitarian aid, intelligence assessments. we have about 40 countries who say they will purchase a paid in some way against isis. >> roger is up next. good morning.
8:25 am
i am not a big obama fan but he is actually done something i'm kind of happy with. he has not jumped into the thing with both feet and sensuous and everything. everything is just awful over there, but it is not worth sending troops, in my personal opinion. the millions of law enforcement in this country and we cannot keep people out who are going to hurt us? it does not make sense. >> it is hard to track everybody. our intelligence community was criticized this past year for overly aggressive surveillance and now on capitol hill, their appreciative of surveillance and people are saying that is our tax dollars at work. >> there were announcements last
8:26 am
week, the justice department starting a pilot program to counter extremism. it was a program to sort of identify people may be in certain mosques and sun communities. it is a way to be in touch better. it is interesting. i talked to one fbi agent said, that is strange because we have always been doing that. how is this a pilot program? we have done it since 9/11. a new program, why did we stop doing that? i need to look into it more. that is something eric holder needs to expand on a little bit. is up good morning. >> before i forget, something
8:27 am
just can't my mind. withnk we have a problem the media as far as how safe we are crossing the borders. k2 many people crossing the borders for our borders to be as poor as they say they are. that is an immediate thing and political. that is a problem. i think the thing with isis, the gun lobbyists are the ones pushing this thing because they make money from it. muchnot think we are in as -- how can i say it, i don't aink isis is that big of problem for the u.s. at this time. maybe other people, i do not know. think the gun lobbyists and fox news, they're very bad about this. fear mongering. that is what i think.
8:28 am
>> on that caller's comment, senator dianne feinstein is very concerned about isis and she is also the biggest proponent of gun control on capitol hill. in 1994.ut there i would say our intelligence thoughty is concerned i that threat might be overblown. .ou only have 35,000 fighters if you talk to major players on capitol hill in the intelligence communities and foreign affairs committees, they have deep concerns about this and are getting classified briefings that we do not have access to. appreciate your time. up next, we will talk with the
8:29 am
former chairman of the joint chiefs of staff who joins us to talk about u.s. military effort and strategy about isis. later, we will discuss the billions of dollars spent on hospice care each year. first, a news update from c-span radio. [captions copyright national cable satellite corp. 2014] [captioning performed by national captioning institute] collects the man accused of scaling a security fence and getting into the white house with a knife appears in federal court today. facing charges of unlawfully entering a restricted voting were grounds while carrying a deadly or dangerous weapon. the new york times reports this morning the secret service is considering screening tourists at other visitors checkpoints before they enter public areas in front of the white house. up itfinding -- following and is hearing less just exactions like a proposal to keep people off the sidewalks around the white house fence and create several yards of additional barriers around the compound perimeter. cbs news chief white house
8:30 am
correspondent please this our that additional secret service agents are visible inside and out of the white house this morning. watching the fence line and the north lawn. the president and mrs. obama traveled -- travel to manhattan tomorrow for the clinton global initiative, a climate summit, and then ebola meeting. of thewill have coverage president passes event. you can listen to it here on c-span radio. those are some of the latest headlines. i, wade baker, chief technology up to sir and security director on the recent data breaches at home depot, target, and jpmorgan chase. >> it is truly all of the above. we have worked with law enforcement agencies who have busted down doors and dread people literally out of their basement.
8:31 am
we have also participated in fairly large-scale arrests of multiple individuals highly connected and organized, with individual specialties and roles. someone writes malicious software and the others know how to watch the money and all these things, just like physical, organized crime. then there are others deftly working on behalf of the government. they have an office here at gahr pictures, recon photos, all of those things, going out to work. and they go to that building and that is their job, to hack companies and still information on behalf of the government. i have seen photos of eastern european towns that were just an insane number of people drive lamborghinis and things like this. spam, thehat is the fake pharmaceuticals, financial fraud, tax fraud, medicare
8:32 am
fraud, all of these things. aregering amounts of money at some point along the train traced back to the data stolen or stored at a corporation government. >> tonight at 8:00 eastern on the communicators on c-span2. >> "wash to journal" continues. formerhe general is a chairman of the joint chiefs of staff. he joins us now as we continue u.s.ssion -- discussing strategy in isis. looking at the threat posed by isis and the plan the obama administration has come up with here to combat isis, do you think isis can be defeated without having boots on the ground question mark -- ground? to see we haved a strategy and it is being articulated. the thing worrisome is that we cannot use solely air pilots to
8:33 am
defeat isis. that begs the question, if you cannot do that, do we need to put boots on the ground? generalyou heard dempsey said last week that ultimately, we need to be prepared to have to put boots on the ground. i would submit that marty is right on track with that. first and foremost, we need to think about the thousands of that we trained in iraq that should be capable now of being the boots on the ground . is there nation and we trained them. it is time to fight against isis. serve as theey boots on the ground. can't, we have got a bigger problem. >> he mentioned a lot of reaction on capitol hill, leading to articles with headlines like "strategic risk widens between obama and the
8:34 am
pentagon. ?o you see a risk >> i think marty is doing what any good chairman and military advisor is doing, he is giving the president is best recommendation based on what the military seizes the right answer. we all know this problem is not just a military problem. it is more of a political and this morning.blem president obama has got to be involved in the informational problem, fighting against the that isis uses in washington dc and all the other capitals in the world. president obama has got to put it all together, to bring the political face together and the military. what is worrisome is we say we
8:35 am
could win this without boots on the ground. limp -- limiting ourselves in that matter sends the wrong signal to the enemy. if we will not put those on the ground, are we serious about winning the war? first and foremost, let's use the troops we trained. the chilean dollars. train iraqis to defend themselves together -- to give them a chance at an inclusive government. let's push the new president and anme minister into doing -- inclusive government first and foremost, and then start to use to ground troops we trained carry troops to isis as well as othernt groups fighting -- fighting support. he has got to form his own strategy within iraq, hopefully with our help, but go after them
8:36 am
himself. you talk about sending messages. are you concerned the administration is to open about what it is and is not willing to do when it comes to isis? >> as a military man, i would tell you i never agree with showing our cards to the enemy. let's let them wonder what our next step will be. what are we willing to do? you can have a strategy. the american people understand there are certain things in the government that ought not be given to the enemy. for example, an exit strategy should not include the precise date attached to it. it plays right in the hands of the enemy. he can wait you out and lay back and wait until you leave. let's don't show everything to the enemy. we are not going to have to use ground troops or american troops, that is telling him
8:37 am
you're not going to face america, so go ahead and pursue this and it going. sends the wrong signal, clearly. >> he talk about the dynamic when you're trying to figure out which cards to show in which cars not to, the dynamic and the the chairman of the joint chiefs of staff, the secretary of defense on capitol hill testifying. how does that work and who gets to decide what they're talking about? >> it goes to the national security council and the meetings you have with the entire group in one room, the president, the vice president, and all the key secretaries discussing our national policy on national security strategy, talking about what we should and should not lay out for the world to see. it is more than just the american people. the dynamic goes from the secretary and the chairman, when
8:38 am
they go to the white house. hopefully, they are of one mind. the secretary dealing with policy issues, which includes our communications plans. coming in withan military options we have and a recommendation as to what would military -- m a if that is the case, they lay out their concerns in the national security council. the president is the deciding member of the council. he makes the decision as to which way he wants to go and what ties invest with the political and information plan envisions for his strategy. that is the plan we go forward with. two-person that personally think the political states. kenneth isis are getting in the way of the military strategy being laid out and discuss? >> not in any way, shape, or form.
8:39 am
it has got to be one plan, one strategy. the fact that there may be a little bit of disagreement within the administration as to what is best, there is nothing new. when we went into cozumel, the president understood very well that air power might be able to win the war. we have done everything we should to make sure we have not an american troops on the ground and ultimately, with a strategy, we have got serbia to surrender and pulled their troops back out of kos about. however, you cannot use the same model when you look at isis and iraq. iraq, they can pull their tanks and artillery, anything they have got, the headquarters into hospitals, schools, things of that nature so the air power going after them pass to kill a
8:40 am
tremendous number of innocent civilians and destroy this things like mosques and schools and hospitals in order to kill them. we do not have a homeland to go after like we did. you're now left with, you have got to go in and rule them out. i would say again first and foremost, it ought to be iraqi ground troops. i would not take american groups off the ground and off the table here if that is what it will take to defeat isis. general hugh shelton. mewill start on our line for -- for independence, missouri. thank you for your service. women talk about terrorism, isis --
8:41 am
my question to the general is, if the general was going to advise president obama [indiscernible] goes for the regime change in of appeasementte policy for three decades? thank you very much. host: go ahead. for yourank you question and kind comments. iran is the major source of problems throughout the middle east. let's not forget iran is the greatest asked order of terrorism in the world. let's not forget iran is pursuing -- pursuing a unique capability. refused toteadfastly give up their enrichment program and lowering or reducing the stock pile.
8:42 am
they are a problem and not part of the solution. they are part of the problem. i would tell you up front, i putd first and foremost iran to the side and not let them get involved in iraq in any way, shape, or form. they would use that to strengthen their position in iraq, a physician they have lost now with malik it. malki was an iranian public -- puppet. return to the iranian dissidents, that are stationed right now. let's start treating them as human beings, as citizens, and giving them freedom of movement. let's let them take the sewage out of the camp. let's treat them as criminals. they are the enemy of iran.
8:43 am
look at the 10 points, it reads like america's declaration of independence. in favor of freedom of religion, freedom of rest, all of the things we hold near and dear in america. why should they not be a friend of america and why should we support them? that of them. after all, america guaranteed their safety and security. we should not say we no longer have a role in that just because we are no longer in iraq. we need to let the prime minister as if theyat them are american citizens and any attack on them is an attack against america. ambassador was asked about what the u.s. is and is not willing to do when it comes to iran yesterday on faith and nation. here's a bit of what she had to say. >> secretary kerry said last
8:44 am
week in new york that every part in this, including iran. what is ackley is iran's part? >> let me stress we are not coordinating sharing intelligence with iran. the secretary met iran made it used isil as an enemy and a threat. in that respect, although our operations around rejecting and degrading isil, we are waiting to hear if iran has a constructive role to play. i know iran's behavior and actions in syria have been destructive from our perspective, supporting hezbollah and the rest -- assad regime. exhibiting any energy or intensity going after isaiah, spending much more time going after civilian neighborhoods than going after a profound monstrous terrorist threat.
8:45 am
they have received support in iran in this conflict. those actions have to change if we will deal with isil in a conference of way. assad is not somebody who can be relied upon. shelton.eral guest: i think she hit it out of the ballpark. she said basically what i would say. we have got to treat iran as part of the problem and not part if iran has an. constructive role we should play on this, we should hear him, but let's not fall play. let's watch very carefully what they're talking about when they talk about helping in syria. forget iran wants to be the key player in the middle
8:46 am
east and they want to be the one that everyone in the middle east has to kindle two -- cater to. we talk about iraq and influence they exert it over malki. at the common iranian puppet. i believe iran would continue to pursue that to the last to do great. they will not give up on long-term goals. caller: i want to ask a question about the united states. the former guest of minnesota having great population of and a lot of the fighters have went back to somalia and different places, and then recruited. also, the boston bombing. what i don't understand is why we are not focusing more on united states safety than other
8:47 am
countries. the republicans were talking about, there is no money. there is no money for unemployment, for different people. here in the united states. run.sota is cap companies, doctors, the banks, everybody is run by other people that come from other countries. first and foremost, you make a very valid point. we have to be concerned about homeland. secretary johnson in homeland security and a director with the fbi, that is part of the major focus, protecting america. that justt suggest because we have a large number of people that come from different countries in the world soon to be congregated in one spot, you look at watching and easy and you find almost the very same thing you mentioned
8:48 am
about minnesota. we need to be vigilant and watch that. i would also say any time we have an individual who visits anther country, whether attempt to go to syria, whether it is trying to get into iraq or whatever, we need to make sure we understand why they are going and monitor them very closely. our previous speaker in the program this morning suggest it may ought to be a crime to go to these countries. i believe we need legislation. in countries like syria right now. if we have american that will go join freedom fighters in somalia isis,s. or iraq, joining we also have a law that says, that is an act of treason punishable by death. we ought to become very hard on that. in mys a serious offense
8:49 am
opinion. when america turns its back on its country, he ought to give up all his rights as an american and convicted of treason. >> talking about threats against the united states, against the united states. we are joined now by the former chairman of the joint chiefs of staff who currently works as the shelton of the hugh leadership center. basically starting with young high school students, going all the way up until best to the corporate level, stretching value leadership, integrity, ethics, compassion, things that make great leaders. trying to stress leaders that lead by the golden rule, that people respect. we will leave a legacy of being a great leader.
8:50 am
>> general shelton served as the chairman of the joint chiefs of staff. here to answer your questions and take your comments. leno, maryland, on our line for republicans, your next. caller: first, i would like to thank the general for your service. i myself am a vet. i can kind of speak to what he is saying. just as when i was a veteran, was part of one of the last groups that was supposed to go to iraq and was pulled from that because the president wanted to pull our troops. our mission as intelligence soldiers was to create the iraqis. that created a vacuum. people need to realize that. , whichnot follow through the general and other guys probably said was coming. it created a vacuum to what we see now. that is one. the american military, this is
8:51 am
what we do. everybody does not like the military to be in certain places, but it is what we trained to do. first of all, thank you for your service. it is very commendable. thank you. i would agree with you 100%. you have to have an orderly withdrawal plan whenever you going to the country. you have to have an exit strategy. part of the exit strategy is to make sure you leave in place a government that can stand up and , a government that can survive. it is important as we're doing this is to make sure as we pull our troops out that the in factnt is one that will not be, as in the case of byki, very controlled another foreign entity, in this case iran. if it is, no matter how long we stay there, the government is headed in the wrong direction. unless we have an exit strategy that includes a long-term
8:52 am
presence to give the country time to get on its feet and operate the way we feel like they should be able to operate and defend itself, if you will, and provide for its own security, and we in fact will and in this case in iraq, we saw the iranians moving quickly influencing malki and starting to turn things around. a very nonsectarian government, one noninclusive and did not include iraqi tribes, did not include sunnis, and therefore, it started falling apart quickly. caught in the middle of all of that were the 3000 iranian dissidents with -- that should be supporting and making sure they're taking care for getting out of the mess we left them in. host: melvin is up next. you're on with general shelton. i want to thank the general for his service and the undertaking with
8:53 am
students. one thing i want to remind him of is, when you do this, make sure the information you lay is always accurate. what hedempsey, actually said with respect to the president's plan, he agreed to the plan as is. after being questioned several times, he indicated if there came a time when troops may be necessary, i would make the recommendation for the troops to be used only as advisory. he did not say he wanted troops on the ground now. this is like individual undergoing operation. i think we can treat this without any surgery. if it comes to that, we will do that. he did not indicate anything about putting troops in initially. he said i agree with the plan assets. you are exactly right.
8:54 am
that is exactly what he said. what he did they was ultimately, if the plan could not exceed without troops on the ground, then that might be required. he agreed with the plan. that is important. he was also quick to say that plan might not be sufficient to ensure a victory against isis and if it was not him about my call for putting troops on the ground. that in fact is what we will have to wait and see. if iraq is come through the way they should, the troops on the ground will be the iraqis. there will have to be troops on the ground to defeat isis. we are already seeing them modify tactics and techniques to include moving up against populated areas and into populated areas so you have to kill a lot of civilians there it is the iraqi troops go in and root them out of there and put them in places where air power can get to them, and we can win it was just the iraqi troops
8:55 am
there in america, i think we all hope that is how it turns out here in >> in the wake of the testimony and capitol hill last this one in the washington post, military skepticism of obama's plan. press,ay, on meet the admiral mike mullen was asked about his disagreement and here is a bit of his reaction. dempsey,k when general our current chairman, anticipated a question at a hearing that he would be asked about ground troops, took it off the table in his opening standpointrom the of, if the circumstances back.ted it, that he go that is a natural part of the discussion in this debate about how to execute a mission. there should not be any question in the end of who decides this and that is the president.
8:56 am
i think what general dempsey was trying to do is certainly understand, explain to some degree how the process works. i think it has been blown way out of proportion in terms of the disagreement between the military and the president. do you agree? has it been blown out of proportion? guest: i would say yes, to a degree. this is a natural debate that takes place when you go in with any kind of strategy. most of the time, i would say when you come out of the national security council meeting, the president has made a decision. you have got pretty much an agreement across the board. in this case, as i indicated earlier, marty looking down from a military perspective, can see exactly what isis might do if in fact we used our air power. if the iraqis were not capable of routing them out for those populated areas and getting them thatith air power to them,
8:57 am
would change dynamics of the demands so to speak. i think marty was laying the groundwork. that is part of the overall solution to the issue. and the way the system works. steve is a mess calling from new york on our line for independents. caller: good morning. general, and honor to talk to you. i am wondering about the service to air missiles in syria. i am wondering where they went in the world with north korea, if we will put all this emphasis -- am power, i understand i right? i am not sure i know
8:58 am
exactly where they stand in rank in the world, but they do have the capability. i would also they in the meantime, we use our air power in a hostile environment there that is one of the first things we have to consider. what types of systems do they have. that dictates what types of defense systems we use in order to nullify the effects of their air to air missiles. as you probably remember, we flew over iraq for years enforcing the no-fly zone and the no drive zone and they never hit one of our planes in the process. that was not just by accident. systemsecause defensive we use, our electronic warfare systems, etc., were all in place and doing their job. did the same thing in both cases making sure we protect the winpower that we employ to the war against isil. >> there were concerns about syria passes air defense capabilities last year when the u.s. was considering airstrikes
8:59 am
after the chemical weapons attack, correct? guest: without a doubt to the first things you do when fighting against an enemy that has that type of capability is you go in and take out the systems. you make sure you know if i them for the sake of the airmen who will be flying the close air support missions or the bombing missions over serial or iraq. new jersey, next, our line for independents. caller: good morning. as is chris. general, i want to thank you for your service. typesoncerned about the of ammunition being used in iraq. i hear a lot about uranium and when i hear about troops coming home sick and the high cancer rates discovered both in iraq and former yugoslavia, i am there still being used
9:00 am
and now, contaminated the war zones are, used the troops provided without session, we heard the second troop -- bush and ministration, the troops were not being provided with adequate protection when they were going to war because there were budget cuts and i was hoping for some answers. guest: we were worried first and foremost about the safety of our troops when we were committing to a hostile environment. that would include protection against everything that we knew that was in that particular zone. and budget cuts, never entered into it, to be very candid. we prioritize those things that were necessary to protect our troops, their safety in their security. that was at the top of the list. and so that got funded. and so i feel confident, even
9:01 am
though i'm not in the administration now, that those types of concerns are being taken into consideration, and that the troops are being provided with all the protection that we can, realizing the fact that if you have a war where you put troops on the ground like we did in iraq and now in afghanistan, that there are going to be certain hazards. not only from depleted uranium, but also from unexploded ordinance that is on the ground. it can be th very devastating. that is always our consideration, and that is what our force commanders on the ground are taking into consideration when they are making other battle plans. host: we are talking with retired general hugh shelton. he was promoted to general and became canto commander-in-chieff the special operations command.
9:02 am
we have them for the next 20 minutes or so. tom in pennsylvania on our line for republicans. caller: good morning. know, when weo were doing this thing with assad fighters andining jordan. it was publicized and on the news. do not understand why we need to train muslim fighters to go fight isis. it is clear to me we created isis. we funded these guys to fight assad. but there only to his to islam, they are not going to fight with u.s. .e traded afghanistan these people.t why would we train muslims when
9:03 am
they are our enemy? would berst of all i very cautious about putting in sayingn a category that because they are muslim they are our enemy. there are different types of muslim, almost as many as we have baptists or democrats in this country. and what we're talking about are the extremists. some great muslims, and i know a lot of them. we have muslims who ,olunteered to help us fight right the next morning on 912 after 9/11. they said they would do whatever was necessary to help us. i think we have to get involved in training. you have to, identify who the good guys are on the bad guys are. obviously, those extremists, the
9:04 am
ones who want to bring harm to the united states and all "we are the ones to be aware of. but the ones who want to stand up and fight for an inclusive government, we need to train them, arm them, and equipped them because they will do the fighting on the ground that is necessary to preserve an inclusive government that may be one of our great friends in that region of the world. that is of course a region that is in the vital national interest of the united states. we have inproblem syria right now in my opinion is that we have to be careful that the ones that we fund and help aren on the ground today the good guys, so to speak. the ones that we want to win great isis is clearly a group that we want to eliminate. we want to defeat, we want to kill, capture and destroy.
9:05 am
not all people that live in that region are our enemy. and so we have to make sure that we target our efforts against those we want to succeed. so that if they -- if and when they succeed they will be out of our effort -- we can be proud of our effort. military does the u.s. cut down on these sort of attacks that we have seen especially in afghanistan in the situation that the caller brought up? had them right here in the united states, fort aod being a good example of guy who went off the deep end. commanders throughout our armed forces have to be cognizant of their surroundings, of their own troops. you have to look at this major in fort hood is an example and say why did we not pick up on that before now? that goes back to our background checks, to our intelligence
9:06 am
networks that we have. looking at all of our forces and we could areas that suffer harm or great damage and certainly when we are overseas we have to be very careful. vietnam was no exception. the viet cong tried to infiltrate our rakes, they are doing the same thing that we are finding now in afghanistan. you just have to be very beilant and you just have to careful to weed them out. as yout try as hard might, but every once in a while you will miss one. it cannot be 100%, unfortunately. that we are as good as anyone in the world. host: a call on our line for republicans. of my questions is how do we stabilize syria after defeat isis on the ground? it
9:07 am
does not seem like we have a plan for dealing with assad. how do we deal with an unstable syria after isil? question, and i wish i had an answer. assad is obviously not the answer, he has to go. isil we have to defeat, and a wrong claims they would like to iran claims they would like to help eliminate them, but they are part of the problem. they take advantage when you do not have an inclusive government. they go into that crack and they get both groups to start fighting against the incumbent, with the hopes that whichever one wins will be in favor with the wrong -- with iran. we need to look at those who want an inclusive government, we areide who earlier on
9:08 am
good support in this battle. the one that will be able to stabilize the country with our help and with the help of our allies and our friends, the 40 or 50 nations that would help to come in and stabilize the country. and that is the only answer. there is no >> solution, but -- quick solution, but we have to use all of our resources to make sure that it comes out like we would like in the long run. effortore news on this to get our allies together. john kerry says the united states expects that turkey will haveup know that they secure the release of 49 hostages that were held by the militants. who are going to be the key region nations way to work with?
9:09 am
guest: we need to have all of our nato allies involved with this in the region. and then we need to look at the eu and all of the eu members need to be involved. and then we need to look at our friends and allies in the middle east. , bahrain, theuae list goes on. the king of jordan is a great friend in this region. those of the key states we really need to focus on. there at get egypt, for a long time there were one of our greatest allies. and now we do not have that as a right decision disintegrating. we need to look at all of these asians to help us in this fight.
9:10 am
host: a few minutes left with general hugh shelton. we have a: our line for democrats. caller: good morning. i wanted you to take a look back -- we have to understand that we have a lot of tools in the united states to protect the united states. and we have done a great job of cautious of rushing into a situation. this is a very complicated situation we are involved in right now. to the president, gnu, and to others that has done a good job,
9:11 am
i think we should have caution before we actually -- your i want to get thoughts on that topic, how long it took them to come up with this strategy. some criticism has been leveled rumpled from capitol hill. hill.m folks on capitol guest: i think we waited way too long to recognize the influence , and we stuck with up until they threw him out of office. we should not have done that. we allowed iraq to disintegrate and now we are having to fight ice will sil. the same thing happened in a syria.
9:12 am
too long i think america did have a lack of leadership. i agree totally, and thanks for tor service, that you have be very cautious about rushing into these situations because you want to make sure in long-term that you're not some warning a group that is going to go into control and become another terrorist exporting organization that you wish you supported in the first place, like maliki turned out to be. anytime america walks into the room, and i know this from having been the chairman with a all turnaround and look at the american in the room to see what he is going to say and what he is going to do. they look to america for leadership. it is the same way with our president. if we wait too long, others will step into the void. putin,e seen that with
9:13 am
first in georgia, and now when you carry -- and now in the ukraine. of americanvoid leadership. a cautious, but stay in the lead is what i would advise. the boston globe from september 11. our linealling from for independents. caller: i would like to respectfully disagree that the syria-- iran and main terrorist exporters of the middle east.
9:14 am
we have allied with the sunnis in this conflict, and doing that ellie and its us in the middle east. initiates are seeing us as siding with the sunnis. this is a problem, seeing how iran is diametrically opposed to isis being a sunni fundamentalist group. logically -- it would be logical to ally ourselves with those who have completely disavow these groups such as the kurds, the arabians, and the syrian government. host: general? first and foremost we need to understand that what we have supported throughout the united states is an inclusive government that includes everyone. we have not cited with a particular article and we see , excluding 8rge
9:15 am
million sunnis from the government, and the kurds and the iraqi tribes. that is not right. -- saba start to disintegrate good we did not do anything about it. we did not put pressure on maliki to form an inclusive government like we should be doing now. it is important that the united states remains neutral up to a point. it needs to include all of its people like our government does. it is undisputed fact that they are the largest exporter of terrorism in the world. everyone knows that. our cia, and ei, everyone will tell you that. i have no doubt that they are of of the problems we
9:16 am
have in the middle east at this point. thene who is an enemy of united states as a friend of a ron, that is just how it works. cautious of any deal we could make with iran in low long-term -- in the long term. good morning. thank you very much for sharing your time. extremists being iran, who are [indiscernible] as the enemy of everyone, what
9:17 am
role cap may play -- can they play? guest: that is a great comment. she represents what the united states hold near and dear to their heart, she wants an inclusive government. dress,ts a freedom of freedom of religion, things that we feel are right in a democratic system. she represents that. she also represents -- she is the leader of the iranian dissident group that is outside of her ron that wants to see iran get rid of the mullahs that are executing individuals right and left. is a very serious thing. the iraqi people deserve better than matt. that is what she would like to
9:18 am
carry back to iran. and see thelike her doremist and the damage they make them valuable allies. host: a call from an independent. israel tonominate clean up the mess seeing as how according to edward snowden, peeps supported has -- they supported head of isis. they shippedamas, an in the 1980's to use against a rock.
9:19 am
iraq. host: do you want to talk about the role of israel? blame israel for having trained different people. we have trained people as well. they do not always turn out the way we would like for them to turn out. but you identify who you think the good guys are, who represents what you feel are important for the people of that particular region or that country, and you give it your best shot. i think israel can play a role in this, and i think they can play a role through a number of means. they can play a role in supporting an individual taking charge in iraq. they can eliminate the shia militia that are closely allied to make sure that they do not create an inclusive government and become another
9:20 am
puppet of iran. they can play a role in advising, the same way the united states plays. they are much closure to the region -- closer to the region. there are some issues that we do not have, but they could play a valuable role. good morning. veteran.etnam andnted to make a comment ask a good question -- asking question. war, when they engagement,rules of it has gone a lot of jihad is killed over the last 40 years. f1used what we called
9:21 am
00s, a tactical nuclear weapon. them, the army used them in the canon. i would like to see them used in , to say did you get the message? and if they don't, to say did you get it this time? host: tactical nuclear weapons? employi am trained to tactical nuclear weapons, i went through that course when i was a young officer in the military. i declare long way away from where we would want to use nuclear weapons because of all of the issues that they do create. the damage that they do. it is hard to separate the good guys from the bad guys, so you
9:22 am
feel a tremendous number of .ivilians in the process i do not think we need to use nuclear weapons in this. there was a time and a place in our history when they were appropriate. and they may be again in the future. i would not rule them out, but i would not say to eliminate any type of ability, but now is not the time or place in my opinion. our democratfrom line. caller: good morning. i am a retired sergeant major from the first infantry division . i went through the marine corps for the korean war. it is a pleasure to talk to a man with your caliber.
9:23 am
in big mistake when we were a rocket gave the country back to them to we did not leave a general to set up a government like we did in japan and we did in germany. that was our big mistake. that is what we should have done. we should have dictated what had to go on, not let them to us what had to go on. with this administration in power queen do not know what they're going to do, but this man was never in command of anything. he was nothing but an organizer. he does not know the first thing about military or foreign affairs or anything. no president should be an president unless he has had some type of military service. as far as what we should use, i would use napalm over there to teach them a lesson. service.anks for your
9:24 am
semper fi. i think you're 100% right that we should have had a neck since strategy for iraq that left -- and exite strategy for iraq that left someone there. to make sure that the transition went as wernment envisioned it going. an inclusive government of all of the iraqi people, and left behind a stable government that could protected of borders and secure its own country with its police force. we trained both of those forces to do that. the problem was we pulled the and on them in 2009, without that residual force in deteriorated rather rapidly. with the help of the iranians who wanted to see it deteriorate , and it developed into what we have today. a loud i sold to move into that sectarian cap and immediately start bubbling up to the surface
9:25 am
and become a sizable force before we reacted to it. recognize that it was deteriorating, and we could have done a lot better. that is not what i would call america's finest hour. host: we do appreciate your time this morning. guest: a pleasure to be with you. host: a programming note, coming up later today at 5:30 p.m. on c-span, cbs news chief washington correspondent bob panel on will host a combating isis and terrorist groups. weekly your money segment, we will discuss the federal medicare funding that goes towards hostile this care. each year the united date's -- in the united ways, but an update in c-span radio. the united states is
9:26 am
expecting that turkey will step country hasthe secure the release of 49 hostages. were returned to turkey on saturday after more than three months in the islamic state group. , a nato member, has attended conferences, and secretary kerry says they are committed to helping with the effort against isis, but he said they needed to deal with their hostage situation first. now secretary kerry, speaking earlier today on msnbc says that the proof will be in the pudding. meanwhile the prime minister says the country is ready to the worsthat he calls scenario involving syrian refugees. that official says that just in the past four days turkey has seen 100 30,000 syrian refugees crossed the border to escape isis. they warn that the number would likely rise. 's top officials officials in isis
9:27 am
are threatening to kill citizens of any country that join the coalition. they are prepared to respond to the threat. political's playbook shows that former senator joseph lieberman, mark wallace, and a former security adviser will launch the counter extremism project. a group of former world leaders and diplomats. the aim is to combat extremism by pressuring financial support networks, countering the narrative of extremists and their on non-recruitment, and advocating for stronger laws, policies, and regulations. that announcement is a corrected this morning. those are some of our latest headlines. camhe 2015 student competition is underway.
9:28 am
200 cash prizes for students and teachers totaling $100,000. washington journal continues. host: each week in this segment journalashington f we look at how your money is at work in different federal programs. this week we are looking at medicare. we're talking to peter whoriskey . thatf the medical services fall into the definition of hospice care and what we're going to be talking about? guest: it pertains to people who
9:29 am
die, where two doctors have said you're going to die within six months. of're going to get palate care, something to make a comfortable as you are leaving this world, and enable people to talk to their family. come out,ker's that there are visits, doctors, it involves medical care and family care. there is bereavement, a package of services that will help people in their last days. host: how big is the hospice industry in the united states today? guest: $20 billion in revenue. the medicare chunk of it that is -- was about $17 billion in 2012.
9:30 am
people who areor over 65, and most of the people who are dying are over 65. that is where your business is. host: this is a growth in terms of federal money that has gone toward the hospice industry, that has happened specifically since 1983 i understand. what happened then that sort of changed the way the hospice industry saved its money? guest: it started as a nonprofit , do-gooder movement that happened and community organizations, churches. they needed a way to pay for it. in 1983 they got medicare to start paying for it. it was still a tiny fraction of people that were getting hospice care. since then, it has grown steadily. for-profitd companies entering the picture. and now about half of americans, half of those on medicare die after getting some form of hospice.
9:31 am
it has gone from zero to half of sinceing population just 1983. host: how does one qualify for hot as care through federal funded medicare? guest: if you're over 65 you're going to get medicare or medicare advantage. be enrolled in hospice care and have medicare two doctors have to say you are likely to die within six months. they have to say what you're actually dying. this has become somewhat of a controversy, because it is difficult to predict. cancer, ites such as is easy to say you have this much time left. but other diseases that people die of, alzheimer's and others, are much harder to predict. so people are complaining that we should have hospice care for this patient, but we cannot say
9:32 am
they are going to die in six months. this is one of the biggest issues. host: what does medicare payout for a daily basis of someone in a hospice? guest: several different ways they can do it. most people, 97%, they want to be out of the hospital and want to be at home or in a nursing home. for those patients, medicare pays $150 or $160 a day. it varies by geography. for the other patients, who want to be in an actual building that is like a hospital, accepted as a hospice focus, that is going to be $700 for it hundred dollars a day. set up a payments have bit of an incentive that has created a problem within the industry. guest: the way you get paid, it is a little different.
9:33 am
replacement, it n amount of money that you get immediately. a large problem is that a patient who is at the beginning or end of their stay costs a lot of more money. andhe end they are dying need more money, and at the beginning they are getting equipment. so what they have found is some unscrupulous hospice operators will find people who are not actually dying or near death at all, so they will have a very long hospice day. this large glut of days in the middle where they do not have to do that much and they are still collecting $150 a day. congress passed a bill that said
9:34 am
there is going to be ways for medicare to stop that. here is his story in the washington post. if you want to read more on that. the next half for hour on the hospice industry in the united states. if you have questions for him and his series, our phone lines are split up-- regionally. we will start with john calling in from san antonio, texas. you're on the air.
9:35 am
toler: i am just trying comment. i think the hospice is really good. i am a care provider, my wife passed away, she was in hospice for eight days. my mother was also in hospice, i had two people in hospice at the same time. however, my wife was not intensive care -- host: we lost john, i am sorry. what do the survey show about care and the family's ago through this process along with a loved one? good storiesre that come with hospice. people swear by it and talk about the people who work at
9:36 am
hospices as angels. that is a very civic minority veteran providing for less -- a very specific minority who are providing far less. on the other hand we also get some letters from people saying that hospice was going to be great, they thought, and then it turned out to be a terrible way to die. host: what are some examples that have stuck with you have you has written this series. ? guest: a woman in florida was dying of multiple issues. tell when someone is about to die. the nurse who was at the house said i have to go.
9:37 am
just the abandoned at the time when you most need someone with comfort,nowledge, and there are a lot of stories of people being left in pain. that was the one that stuck with me, that the nurse might just bow out when it is the end of her shift even though you're about to lose your loved one. she died about 45 minutes later. host: terminal neglect, some to --es treat dying pays how some hospices treat dying patients. donna calling from georgia. caller: good morning. i just wanted to say, there were some things in the affordable and then theilies
9:38 am
-- older person persons speaking with their doctor long before they were dying, to help with these sorts of things. the republicans called them death panels, so the democrats backed down. veryught that was important to do. i have done that. i'm 62, i have done that and gotten everything all set up. so that you do not spend a fortune at the end of your life. aest: not only do not spend fortune, but that was intended to help people decide what kind of care they wanted. sometimes there is invasive care that doctors feel compelled to do if you have not given advanced directive. that was taken out of the affordable care act. there is some hope that they will start moving back toward paying for those discussions.
9:39 am
of thosethere a fear discussions coming up on capitol hill because of some of those debates and how he did they begin -- how heated they became? yes.: there was a study by the medicine,of m and saying just because we do -- for for tourists doctors to have these end-of-life discussions does not mean you're not going to die. hospitals ise in different than we did 50 years ago. these discussions are not only good for patients, but families. it also saves money. host: a special line for hospice providers as we talk with peter whoriskey of the washington post. good morning.
9:40 am
my mother passed recently in june. i would like to say that the hospice admission was an extremely tedious process. a doctor had to recommend it, and then we went to a major two our interview where the representative came to my apartment and we were all president. the inter-router -- they interviewed her, and she was at home for four days and then we had to take her to the residence herself or she stayed for seven days before she passed. they receive from people is outstanding. goes, medicareng may pay for much of this day, however we paid $200 a day out of pocket.
9:41 am
so funding comes from the individual, and as far as the facility, the care that in the individual receives in any nursing facility depends upon the family's support. the more you visit that person who is there in carrot for, the more they take care of that person. they see that you are attentive as well. i am not familiar with a family having two pic -- to hospice ill of the if they are on medicare. the reason that they do often intake extensive processes because they want to make sure you are appropriate. not only do they want to make sure that you are probably near death, they want to make sure that you are ready to make a decision not to opt for curative
9:42 am
care. that you are just looking to be comfortable. it is a different set of medical issues that would arise. hospice care -- is worth every penny to give your loved ones the respect and pain relief. caller: good morning. i saw a documentary on home hospice. that were sole well taken care of that they fell off of hospice because they were in good health. they did not die. some evidences
9:43 am
that some people, and it is a fairly small group, probably live longer if they get on hospice. it is interesting because they spiceot supposed to -- ho is being comfortable as you die, rather than curing you of the illness. is very know -- it difficult to know about these individual stories. you're not supposed to became dos. if you live longer than six months, it is not supposed to be kicked off. average, the hospice is not supposed to have patients that longer than six months. that is when they start to get in trouble. some patients will last a year patients willome only last seven days. but on average, that is where the six month in in terms of who gets kicked out or not. host: can you explain the term
9:44 am
hospice survivor you use? this is the unscrupulous operators sure going to get patients who are not dying. veu will see some hospices ha very strange looking statistics. one in four patients are released alive. the purpose of hospice care is to take care of you until you die. if one or more are released alive, that suggest that they are not enrolling the right people for hospice care. that is not only a financial problem for the government, and it is a financial problem, it also, when a patient gets into
9:45 am
hospice it often exposes them to a different regime of drugs. antipsychotics, that will actually endanger a patient who otherwise might live for a longer time. recoupoing anything to costs from unscrupulous providers? guest: congress just last week gave medicare the ability to say that if you have a large percentage of people discharged alive. if a lot of your patients are living, and they get so good that they do not need hospice anymore, we're going to look at your bills because we may be holding back payments. we think maybe you are doing something wrong. tucson, arizona, helen is in --c allin calling
9:46 am
caller: my mother was on hospice. i had her put on hospice twice. i would like to say that hospice was tremendous. they helped me so much. come in twice a week and bathe her. i had a nurse come in and check up once a week. doctor come in and check her every once in a while. without hospice, i would not have gotten through with it. adviceve me so much about how to take care of my mother to make sure that her where theon earth best understood the circumstances -- under the circumstances. matter of fact, just a
9:47 am
couple of weeks ago, one of the caregivers called me to see how i was doing. i do not think i could have given my mother a better care without them. host: thank you for the story. chris from pennsylvania. [video clip] caller: good morning. for severalan rn years for hospice and i love my job. the affordable care act looking into hospice is a good idea. i worked for a good company, i was able to spend the night with people who were not able to breathe right. i helped them get their treatments they needed. it made me feel so good as a nurse, and it helped the family so much. my company i worked for did not watch the dollars and c
9:48 am
ents quite so much. i applied for another company that said that if they wanted it, it did not mean that they always needed it. said to stopt their heart medicine because they had been using it for a few months, and they did not need it anymore. they were in heart failure. and the company did not want to pay for the heart medication anymore. my mom is now in hospice, and i just went through the new regulation of having medicare oversee every medication she was given. to make hospice pay for the ones that are not hospice. that got strained out, they fixed that rolule. guest: thanks for that call.
9:49 am
she brings up a lot of issues hearwe see, and that i frequently from nurses who used to work cross best. -- to work at hospice. this is the economic incentive problem coming up, that they're being paid $150 a day if they can -- a day. your heart stop medicine, if they do not have to call on u.s. frequently, they will increase their profits. unfortunately, there are hospices that will do that. the problem for consumers will be to know which ones are the good ones and which ones are the bad ones. for is a real issue consumers. the second thing she was talking
9:50 am
about, i think she was reviewing -- referring to medicare of having to review which drug she would get. this is because of a new problem with everything that comes up in medicare. there are some bad hospices doing bad things. that puts medicare the position of having to correct or punish or tried to detect people who are doing bad things. when they do that that means that they are going to look at everybody and it slows the whole process down for everyone and puts a burden on everyone good are bad -- good or bad. taking a close look at what drugs hospices were giving out to patients, and forcing them to ask for approval. i am told that that was going to be ironed out, i do not know if it has been. this is one of the real problems in this area because if there is a good hospice you do not want to hang them up with more rules
9:51 am
and regulation. there are a lot of false hospices that we should be looking at harder. are special line for hospice workers as well as regional lines. good morning from california. caller: thank you for taking my call. covers theatement disease ofe u.s. financial grade. it has encompassed everything from life to death. everybody is out to make a dollar, regardless of how scrupulous or unscrupulous the means are. have an out right
9:52 am
lifestyle that has been inducted since i have been in this country. i went intovice, civilian work for 42 years. had no contact with the government rather than your standard getting a reliable's license renewed -- drivers license renewed. level ofcked at the incompetence i encountered from the clerks to the decision-makers. but overall the underlying , iblem in almost everything can look at everything that the is going wrong and underlying it is
9:53 am
absolute greed. -- towithout even a control that. host: alice from copeland, texas. caller: thank you. ie subject today just has -- had a memorial service for my husband yesterday. he died september the fourth/ we were on hospice care for about a month. providerustin was the and they were great. it does not seem like they are the greedy kind of hot as company -- hospice company. i did research before signing him up, and there were some that are advertised on tv. and that has to take away from the care of evil if they are spending their dollars advertising on tv.
9:54 am
care of people if they are spending their dollars advertising on tv. is there a way to find out the good ones from the bad ones? write that if you're advertising on tv that you're not spending your money the right way? guest: i do not know. i've never seen a hospice that on tv. but if they are spending on advertising, they are not spending on other things. as far as what consumers can do, lot, but there are some things. one of the things is to look if it is accredited. there are several groups which do accreditations of this is -- of hospices. that is a good sign. hospices werek
9:55 am
being inspected once every six years. nobody that is a -- things that is enough. that is going to change to every three years. one of the things you can do is look at the accreditation because they do in sections everywhere -- in specs and's every three years. ask what sort of services do they provide. do they provide bereavement? how long have they been in business under the same honor? -- owner? many of the horror stories i have heard have come from businesses that recently recently changed hands. they do not know what they're doing or do not have the systems in place very well. can also ask whether they are for-profit or nonprofit.
9:56 am
that is not going to tell you everything because there are profitod for and very good nonprofit. ohio, you're on with peter whoriskey. caller: i have a comment. i do not know a lot of people that have been on hospice. but my brother was in a cost to facility, a hospice in bad shape, he was only 57 but he had cancer in the lower parts. he needed a lot of pain medication. my sister-in-law, she did the best she could. him, and over time i notice that if i was there at
9:57 am
lunchtime, they would go by but they would not bring anything in. aren't you day, going to bring him in a lunch? they don't do that, they just keep him comfortable. they don't feed him? that is not their job. he looked worse than a survivor of the holocaust. he was in there about three probably weighed 100 pounds and he was six foot three inches. his eyes were sunken into his head so bad. i'm not saying that i'm against hospice, but for me, it was such a bad experience. my husband is not in good health, i will take care of him as lung as i can. i would never put him in a facility.
9:58 am
that wasn't a terrible experience, to starve anybody to death. i know he was going to die, but they could've at least fed him. that is a terrible story. to what the doctors were thinking, or if a doctor saw him and said he should not be eating. that is something they should have discussed with the family, and from my understanding of hospice that would have been something that the patient and the family would have discussed and come to peace with. host: you can check out on his the business of dying at the washington post and we appreciate your time this morning. that is our show for today. one programming note for you, this week c-span continuing its
9:59 am
tour on the washington journal. we will be on campus at purdue university in indiana. -- at wednesday we will be at northwestern university and then on thursday michigan state university. back heree you right tomorrow morning at 7:00 a.m. eastern. have a great day. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] >> we have several live events coming up at 4:00 today treasury set terry
10:00 am
jack lew -- it's treasury secretary jack lew talks about climate change. shortly after that cbs news chief washington correspondent bob schieffer moderates a discussion on combating isis and other terrorist groups. now what are in those 38 pages. host: let's try the philadelphia her latest book on private military and security companies. our campaign 2014 coverage continues at 7:40 eastern with live coverage of tig


info Stream Only

Uploaded by TV Archive on