tv Prime News HLN October 10, 2009 4:10am-5:00am EDT
again they pursue their separatist. it became a part of the american security when doug taliban kimber into domination of afghanistan and the taliban was a regime about its offensive to our head conviction of fundamental human rights has existed anywhere in the world. that in itself would not have produced american intervention. it then became the base from which a series of attacks on american national security objectives is conducted in
africa, yemen and finally in the united states. therefore, to intervene in afghanistan became an issue of national security. as fundamentalist jihadi evolves, afghanistan also became a place with a conflict between fundamentalist jihad and the other institutions in the muslim world and security of the whole world came to be tested. so, now afghanistan as a center
of terrorist or jihadi activities is in a position where it threatens fundamentally the cohesion of pakistan where it threatens an directly the security of india where this and fundamentalist islam will go. the muslim regions of russia, some portions of china and even iran. is it is now a problem in which the future security of the world, it's fundamentally involved. now we are there exclusively and that is a condition but we
cannot remedy it in a month. the president stated as a candidate and stated several times a person it's one that he considers afghanistan a war of mississippi. and i agree with it. he has added an troops deployed with it and that i agree with. he now has before him the recommendation of the commander that was appointed by this administration and even supplanted by this administration, and the
commander of the central command. it is no political basis on which to -- there's no strategic bases and the political lesson that one would have to draw from their is that america does not want to put through the strategy that it has announced as its goal. so i would argue one wants more diplomatic flexibility or whether one believes that there has to be a certain military outcome in either case, we should follow the basic recommendations that are now before us. when we have -- we then need to
to move toward some international status for afghanistan that applies in afghanistan something that has not existed. in europe and when there were vacuums' between various countries and a 19th century they came up with the concept of naturalizing belgium for example. which meant to intervene to protect their interest. i would say we need anti-terrorist agreement that
agrees on the fundamental security out objective and that separates this from a purely american problem. before that, we need time. and therefore, i believe for us now to redefine our objective only because we cannot face the domestic consequences of following the strategic recommendations would be a big mistake. >> that is a fascinating example of applying historical insight to contemporary problems. i can't think of anybody else in the world who would have drawn a parallel between afghanistan the neutralization of belgium after the napoleonic period but it raises a question about iran which is one of the stakeholders by virtue of geography in the fate of afghanistan.
you're earlier work you wrote a great deal about revolutionary power and the threat they pose to international order and it seems to me that iran since 1979 has perfectly fit the bill of a revolutionary part challenging international order. now, i would like you to tell a little bit about how you think we should proceed with this revolutionary power 30 years after its revolution and what you think we can achieve with diplomatic means to try to contain its obvious determination to become a nuclear armed power. what do we do next? >> when i mentioned iran with relation to afghanistan, it was not because i thought iran was a benign country that had an interest in abstract ability in afghanistan. i meant that the taliban being a
sunni aberration and most fundamentalist version of sunni religion inherently class's with shia and iran, not because of the abstract desirability that because it is in the nature of things and so at some point, iran might participate in such a process but not undertaking conditions. now, iran. in the mythologies that now exists about iran the argument is that american administrations in love with other regimes for 30 years and supported thought shah of iran in order to have some form of government and that
made it easier to deal with but that wasn't the case. the case was iran was considered an essential building block of a strategy that kept the soviet union out of the middle east and that a strong and developing iran what's considered by a series of administrations of both parties from eisenhower through kennedy through johnson and nixon, of both parties a building block of a strategy that contributed to the conduct of the cold war and to the prevention of communist domination of the area and one has to remember that too few people remember the influx of soviet arms into the region and
concern with communists, radical party some at the time. i mention this because there's no reason why america to fuel and iran that governs itself and that believes in pursuing its historic national purposes what creates a strategic problem for us and the world is iran that seeks the nomination on the basis of its shiite revolutionary fundamentalist that supports terrorist organizations and lebanon on the west bank and over the region and therefore it is an element
in the instability of the region precisely because of the fear that iran inspires nuclear efforts. it is usually presented primarily as a threat to israel. that's one aspect of it but a major aspect is the impetus it will give to other countries in the region to protect themselves similarly by requiring weapons of to iran or by building up the infrastructure to get it, and there, if you look at the diplomacy with respect to iran the major countries of the world for nearly a decade have announced that a nuclear program weapons program in iran is
unacceptable. the word unacceptable isn't hard to comprehend. succumb if they accept that any way, that will create a certain expectation of the meaning of the so-called world community. so, for all of these reasons it is important to be clear that this is a total dividing line. now have favored in the previous administration and at this administration negotiations with iran because i believe that we owe it to the american public and the world public to show that if there is a peaceful way out we have attempted to take it but i don't believe negotiations out of the psychological or
psychiatric. it is not a question of getting people into a conference room. it is a question of what outcome occurs in what period of time. and therefore we have in our planning to convey this is serious business and there are consequences to the failure of the negotiations and that there is some sort of a time limit within which this house to take place. the key issue is can iran transform itself from a cause to a nation if the latter, many things are possible. if not, the situation will become very problematic. and if they acquire nuclear weapons, we better start
thinking of what it will be like to live in a world of multiple nuclear powers that had the technical capacity to safeguard their weapons away the major powers and cold war were able to and may not understand the consequence of using nuclear weapons against population. >> if it seems that within a space of time iran will become a nuclear armed power iranian nuclear facilities as a legitimate action for an american administration, and if not, would it be a legitimate unilateral action by an israeli government in your view? >> i can understand that in an israeli government would feel
that a state that has announced that it seeks the eradication of the state and also acquires nuclear weapons is a security problem. so, from the point of view of an israeli national leader, i can understand that decision and that there is legitimacy to that. from the american point of view, what we have to ask ourselves is what do we do the day after such an attack? and israel has to ask itself what happens the day after such an attack or the week after such an attack. and we will be faced with having to take positions of both
international parties and bilateral relationships with our reaction to this. if we certify and say it was legitimate we almost might participate in it. but then that one type of situation. if we oppose it, then we will be in a situation in which it's analogous in some respects to 1956 where many can argue we broke the back the of the global foreign policy that europeans were still conducting at that point. so what ever we have to say about israel in an attack we
should not defer until after it has taken place. and we should recognize that this is not a way out of our difficulties that we should magnified, magnify the difficulties. >> it is appropriate here to -- of the iri, to ask of an alternative strategy, namely to aim at regime change in iran by no military means. did you feel in june we might have done more and in particular the administration might have done more to encourage what seemed to be a revolutionary challenge to a stolen election or do you think president obama did the right thing? i can't help asking that
question because as some of you may know i like to pose what if questions, and so what if question that haunts me at the moment and has haunted me since june is what if another man in the white house in june of this year, how would he have reacted to what seemed like a moment of regime change in iraq? >> i believe the event in june either beginning of a gradual disintegration of this particular regime for the following reasons: the current regime has three pillars. the ayatollah, i iranian nationalism, and the space structure that produced the
we are facing. and we do not slide in the position [inaudible] government increase its conduct or semi thinking and acting [inaudible] of the people who have been making the opposition to the united states will, the governing principles would say should be the principal objective of our policy. the policy should be to make clear what kind of iran and also to make clear the dangers of which iran has nuclear weapons and not get confused in endless
negotiations on technical points. >> when i was invited to participate in this evening i was given an almost military program of evin discount to the smallest second and keeping painfully aware we are running out of time, however, i think it would be an agreed just waste of an opportunity if i didn't ask the secretary kissinger at least one more question. stop me if you disagree. [laughter] you have presented us with eight world fraught with danger, war in afghanistan on the knife edge, a decision that could be taken on the basis as you put it domestic politics over strategic judgment, iran on the verge of becoming a nuclear power and yet a week regime. and i always think an important lesson of history is it is the
weaker regimes that take lesser strategic decisions, not strong ones. let me introduce a third element into the complex three-dimensional chess of american grand strategy, china. now, as was mentioned by the lawrence eagleburger, perhaps for single greatest contribution to the history of the united states was a fundamental transformation and the relationship between the united states and the people's republic of china with the benefit historical hindsight that looks like a turning point of the second half of the 20th century. i have written recently about that relationship becoming a some biotic one. i coined the phrase chimerica to what seemed like a fusion between the two economies but i wonder whether that fusion is beginning to disintegrate and whether we are entering a new phase in relations between china
and america in which a degree of strategic rivalry begins to take over from common economic interest, partly and simply because we are no longer such an attractive customer but partly because they are becoming more and more an economic equal to the united states. if anything poses a real historic challenge to the united states today it is the fact that within a relatively short space of time, some say as soon as the 2020's china will be as large economically as the united states, something that never happened in the cold war foe of the soviets durham of it. tellus your vision of the future relationship between the united states and china as they become more and more equal at least in the realm of economics and a lot of the lessons of history do you do as the dominant power when you see a real challenger coming apart on your heels?
>> you should have practiced here -- [inaudible] [laughter] >> the last time i interviewed henry it lasted about eight hours. >> let me -- it is the key may be the key question. i want to make one point about the previous question. one often finds oneself in these debates being accused of pessimism. to describe the situation in afghanistan it's complicated and that the jihad is a major challenger does not mean that we cannot overcome it. the cold war and we overcame
that. and if you had to play the hand of the jihadists out and outside no major country in the world supporting them, if i would say that our greatest danger is in impatience and if we did a lot of patience for the long range strategy, we can overcome many of the problems i described in answer to the questions. now about china, it is without any question an awful experience for us to be read the analogy, the right of germany after the unification of germany which led to world war i. but it led to world war i for
two reasons. one because germany and grew in power but also because germany conducted an extremely provocative foreign policy and took about 25 years of one believably short-sighted policy to generate a willingness in britain to go into a world war. so when you have a right and power and the challenge militarily than a conflict is very likely. now, what mitigates the prospect of this is a war with modern weapons between major countries is unprecedentedly and destructive. none of the leaders that started the war one which was the seminal event in the decline of europe, none of those leaders would have started the war had
they known what the world would look like three or four years later so that is one restraining element in basic policy entirely or largely. second there is a series of issues that are unprecedented, climate, environment, energy, issues that can only be dealt with on a general basis. and third, i would say this: if it develops into a challenge, then we will have a kind of confrontational policy around the world which would be extremely trolleying, but if it happened, we would have to do it. but i also believe it is in the interest of both countries to
avoid it. if each side follows its dna, there is a good possibility that it will develop the way that you described. the chinese have a middle kingdom experience. we have a combination of concentration on the western hemisphere plus a certain missionary trend. if we can develop the statesmanship on both sides to overcome than it, what did you call it? >> i called it chimerica. it is a pawn on the word chimaera because i don't know that this relationship can last. >> it may not have to take historical experience you would say probably not. but we face a situation that is beyond historical experience and that is unique and therefore it
must be explored. it is the big challenge before the world. i can't predict how it will end. we will certainly attempt to look after our security but i wouldn't -- but it would be different from the previous security challenges. and therefore we have even when we look toward security we have to look at a structure that transcends what used to be the traditional pattern and i say that as somebody who very often draws conclusions from historical experience. this is a case where we have to transcend historical experience. >> secretary kissinger, that seems a very appropriate note on which to complete the
next is one of our prime sponsors of the legislation, gentlewoman from florida, ms. castor. >> thank you very much for convening this timely hearing during national breast cancer awareness month. breast cancer is still a brutal killer in america. but we are going to continue to fight, and we are going to make progress. and we're going to make progress due in large part to the leaders who are here today. to my colleagues here on the health subcommittee, but to these brave members of congress that represent hundreds of
thousands of people and many, many women who have struggled with breast cancer. congre congresswoman and my good friend from florida, congresswoman debbie wassermann-schultz. she's been a fine example of perseverance and a great role model for anyone that has been diagnosed with breast cancer. and i'm proud to be a co-sponsor of her bill. i'm also eager to hear from the top experts in the field today on our latest legislation. and mr. chairman, our colleague, congresswoman dr. donna kristensen is the author of the act that will will consider today. i would like to thank her for all of her attention to disparate diagnoses and treatment that still plagues health care in america. it is no secret that quality health care in the united states
is not equally accessible to all of our communities. as a committee, we have worked diligently for the better part of this year to improve health care in america and to make quality care affordable and accessible for all. and we are closer to that than ever before. but we still have these underlying issues of disparate diagnosis and treatment that must be addressed directly. and one of the most disturbing involves breast cancer and women of color. overall, breast cancer survival rates in the last two decades have improved with one exception. minority women. women of color suffer from significantly higher death rates after diagnoses than white women. the american cancer society reports that delays in receiving care after breast cancer diagnosis are greater for african-american women than for white women.
african-american women with breast cancer are less likely to receive standard therapy than white women. african-american and hispanic patients are significantly more likely than white patients to be diagnosed at a more advanced stage of breast cancer. and regardless of insurance status, african-american women are almost two times more likely to be diagnosed with an advanced stage of breast cancer than white women, and hispanic women are about 1.5 times more likely to be diagnosed with an advanced stage of breast cancer than white women. african-american women are 10% more likely not to receive tests to determine if breast cancer has spread to axillary underarm lymph nodes. this screening is essential. health insurance status, race, income and educational background are directly linked to irregularity in administering
this vital screening. substantial disparities remain regarding cancer diagnosis and treatment. so in order to eliminate these -- this unacceptable variance in treatment and quality care, it is necessary that we create real incentives and requirements for medical professionals to provide the best care. all patients should receive the most modern and high standard treatment for their conditions. so our bill seeks to put an end to the inequities and treatment for breast cancer and will help ensure that every patient has access to the most appropriate care. the legislation will implement breast cancer treatment performance measures requiring the secretary of hhs to work with the national quality forum to develop standard best practices for breast cancer treatment. these measures will address patient outcomes, the process for delivering medical care related to breast cancer treatment, patient counseling and engagement in decision-making, overall patient
experience, physician care coordination, and then the secretary will develop a six-year breast cancer treatment quality performance initiative. in years one through three physicians will be encouraged to follow the new recommendations and report their practices on a voluntary basis. in years three flew six, the reporting will be required -- reporting will be required and the secretary will evaluate the care that is furnished to patients. low-quality treatment from providers will result in reduced medicare payments for those physicians. improvements in treatment will be recognized, and payments will be scaled based on the care provided. the secretary will be required to report to congress so we can keep track of the progress. mr. chairman, this legislation will help eliminate disparities in the treatment of breast cancer. we must continue to use all of our expertise and modern tools to fight this brutal killer, improve diagnoses and improve treatment. it will save lives. it will save money. and it will save in heartache. thank you very much. i look forward to hearing from
the panels. >> thank you. the gentleman from illinois, mr. shimkus. >> i want to welcome my colleagues here. they are all sincere and respected public policy experts. and i appreciate their attendance. and i yield back my time. >> thank you. the gentlewoman from illinois. >> thank you, mr. chairman. i'll put my full statement in the record, but i do want to thank all of my colleagues, debbie wassermann schultz and rosa deloro and jerry nadler and kathy castor of one of the bills i'm proud to be co-sponsor of. chicago has one of the largest disparities in death rate as a result of breast cancer. a report released in 2007 showed that breast cancer kills minority women at a rate of 68%
higher than white women. mostly because of inequities and access to affordable quality care. i want to give a shout-out to an organization. we're going to have a briefing with them next week. pinna's sister is a chicago organization started by access community health network community health center. every mother's day the organization coordinates an event in black and latino churches. the women are invited to place a pin on a sister to empower her to learn more about breast cancer and to show she's not alone in her experience with breast cancer. but they need help. these bills that you have sponsored and that i feel certain that will pass are really going to help them and all women, those faces breast cancer and potentially those who may face it in the future. thank you very much. i yield back. >> thank you. gentlewoman from tennessee. ms. blackburn. >> thank you, mr. chairman. and i thank our colleagues for
the good work that they have done and the attention that they have brought to this issue. and we're delighted that you are here. i will place my full statement in the record. i do want to highlight some of our volunteers in tennessee that have done exceptional work on the issue of breast cancer. our tennessee breast cancer coalition really has taken the lead in tennessee. we do know that the work we did last year on the breast cancer environmental research center act was very important. this is something the environmental pressures that come to bear on tennessee women is something that has gained a lot of attention in our state and has caused a lot of concern. and we have several facilities that are doing a great deal of wonderful research. the ut cancer institute, the vanderbilt ingram cancer center
and the minnie pearl sara cannon cancer center. and so i highlight the good work that is being done there. in tennessee, we have 3,970 new cases of breast cancer that will be diagnosed this year. and 910 women will probably end up losing their life to this disease. we know the legislation before us will help assist the good, ongoing research equally in the manner that the legislation we passed last year did, and we look forward to eradicating the disease and certainly making a difference in the lives of men and women that are affected by this. and i thank you for the hearing and yield my time. >> thank you. gentleman from utah, mr. matheson. >> thanks, mr. chairman. i'll submit my full written statement for the record. just very briefly, i would point out that it's appropriate we have four different bills today. this is a complicated issue, and there are a lot of aspects in terms of addressing trying to
fight this disease that we should consider as a committee. and i want to thank the lead sponsors, representative castor, representative nadler and wassermann schultz for championing this issue. congresswoman deloro has been a great advocate. we passed it last time and hopefully we get it across the finish line this time. a lot of people point out different populations affected differently. i would just highlight one interesting demographic in my home state. where in utah the incidence of breast cancer is actually much lower than the national average. and yet the mortality rate is about the same. and that's because we have a problem where it's usually diagnosed at later stages. that's why congressman wassermann schultz's bill is something of particular interest to me that will help in my state. it points out you hear people from around the country, there are so many ways we need to try to attack this issue. i commend the committee for holding this hearing and bringing all of these folks together.
i look forward to advocating for all these bills. mr. chairman, once again, i thank my colleagues for being here, and i'll yield back my time. >> thank you. the gentlewoman from the virgin e islands, ms. christiansen. >> thank you. thank you for holding this hearing on such an important issue and making, we hope, this breast cancer awareness month a decisive one in the fight against breast cancer. i'd like to welcome my colleagues as well. with these bills, we would not only expand access to mammography and other often life-saving breast cancer screening technologies but would protect and ensure the health care coverage for breast cancer patients, educate women earlier about breast cancer and eliminate the breast cancer disparities that have a disastrous impact on far too many women of color. i'd like to thank representatives deloro, castor with whom i worked on 2279 and especially congresswoman debbie wassermann schultz, herself a breast cancer survivor,
especially for your bill's emphasis on educating younger women earlier about breast cancer. it's unacceptable that today one in every eight women will have invasive breast cancer at some point in her life and that breast cancer remains a second leading cause of cancer death for women in this country. but as women these statistics are even worse when you consider racial and ethnic disparities and breast cancer incidence, mortality and prevention. for example, while african-americans have lower breast cancer incidence rates than their white counterparts, they're more likely to die from the disease. latina, asian and indian women are also more less likely to not have a mammogram in the recent who years, but finally while breast cancer death rates have been on the decline since 1990 overall, we find that the five-year breast cancer survival rate for american-indian women is lower than any other population group of women. so these statistics suggest that while we've made great progress
in the fight against breast cancer, much to the credit of the witnesses we'll hear from today and continuing with the legislation before us, we have a long way to go. and i look forward to today's testimonies and discussions and anticipate that this hearing will serve as the impetus needed to take our collective fight against breast cancer and every cancer really to the very next level. and i thank you. i yield back. >> thank you. gentleman from maryland. mr. sarbanes. >> thank you, mr. chairman. i'll be very brief. these are all incredibly important measures. and i just want to salute our colleague and my colleague, kathy castor, for their work on this. i'm embarrassed, debbie, that i am not wearing any pink today. but i am turning pink with embarrassment at that. so that will have to do. anyway, congratulations on your work. we look forward to your testimony. >> thank you. the gentleman from georgia, mr. barrow.
i'll mention to members that we have three votes, a 15 -- four, i'm sorry, four votes. there's 15 and then three fives. we'll let mr. barrow, if you'd like to make an opening, go ahead. >> thank you, mr. chairman, i would. it's estimated that one in eight women will develop breast cancer over their lifetime. and it's the leading cause of death among women age 45 and older. this disease is far too preventable and too treatable for these numbers to be so high. i know because my mother who turns 89 years of age today is a 35-year survivor of breast cancer. curing breast cancer is a huge challenge, and it can only happen with good science, adequate funding, effective treatments, and greater awareness and education. these bill s we're addressing today represent small but important steps along the way. october is national breast cancer awareness this month.
this gives us an excuse to work on this legislation. but i look forward to the day when this time will not be a time to raise awareness but how to h our efforts led to the eradication of breast cancer. i want to thank the chairman and ranking member for addressing this important issue and our subcommittee as well as representatives nadler, deloro and congresswoman wassermann schultz and castor for introducing critical bills to promote prevention, research, quality care. thank you and i yield back. >> thank you. i think that concludes our opening. we could get a couple of you in. i don't think we can get all three. do you want to proceed? okay. all right. i'll dispense with my remarks other than to say the three of you are wonderful. two of you are cancer survivors. all three of you have been, you know, championed this and other issues so effectively. if anybody can get anything done, it's the three of you. and i start with