we are very lucky to have with us live here in the studio this morning dr walter thomas situs dr weil to term side us has over forty two years of industrial experience in the commercial and nuclear chemical industry he worked for twenty years for dupont subsequently twenty three years for u r s and its predecessors on july second of two thousand and ten dr thomas side is the deputy chief process engineer and research and technology manager for the waste treatment plant at the hanford nuclear reservation in eastern washington was terminated by bechtel after raising safety concerns on issues that would impact the overall safety and operation of the plant walt thank you very much for coming and spending time with us this morning mike thank you it's an honor to be on mike in the morning thanks so start out to tell us what is the way streetman plant and what was your role there ok before i start i have to say one thing i've always wanted to do this waste treatment plant project it's also known as devitt plant it is the biggest cleanup program in our country environmental cleanup program it is the biggest single project in our country and that translates to taxpayer dollars which we'll talk more about and it's also the biggest nuclear chemical plant ever built in the world and by nuclear chemical plant the emphasis is on chemical plant not nuclear it's not a nuclear reactor it's not a nuclear generating station it takes to fifty six million gallons of nuclear waste hazardous nuclear waste that was generated in the in from world war two the bomb effort in the cold war afterwards and it converts it into glass and then the glass would be is a very stable waste form so they all say the bad actors in the waste can't reach the environment  and the glass will be put in some repast atory and i'm sure all your listeners have heard a yucca mountain and other ways to handle the waste but that's a big issue right now as to where the waste will go but the objective of the plan is to put that bad waste the bad acting waste into into a glass form now there's one hundred seventy seven waste tanks at hanford mike hundred seventy seven let's call it one hundred eighty for round numbers i'm an engineer and about a third of those of lakes so that means about sixty of them have a lake to our known leakers which puts the waste in about one hundred twenty tanks those hundred twenty tags hold a fifty six million gallons a waste and those tanks are way past third design life so there's a number of hazards that exist even if the plant is not built and the biggest the biggest potential disaster is for those old age tanks to leak or for something abnormal to happen in them and for that material to be released into the environment because the columbia river flows right by the plant and you know over the past decades it's been known that nuclides have have reached the columbia river so there's a number of aspects of safety that really need to be addressed all right and a lot of those tanks we literally don't know what's in them i mean it's a mix a soup right yes or it's a mix a soup that the waste is in a form where they call salt or sludge salt is where you take the waste and you evaporate the water off to concentrate it in little crystals form sludge is where you have essentially solids and it's mixed in with the water and it's like the water rema terrio on it's like a mud so much  a waste is very thick very thick and when it was pumped into the tanks it was not well mixed or due to the difference in the weights at a material as they went into the tank they layer they segregated and in the in the past over t decades when they were putting waste in there no they were not sampling at the early they do not have any extensive analysis to give you a couple numbers i mentioned that there's fifty six million gallons a waste sitting in about one hundred twenty tanks out of fifty six million gallons a waste if they have sampled one hundred gallons of that fifty six million and let's even called a thousand gallons of the fifty six million gallons a waste that's all they sample to really tell what's out there so you have if you divide one thousand gallons by fifty six million and multiply it by one hundred you have the percentage in you of waste that's been sampled and you'll see that is point zero zero zero zero percent whatever waste that's been sampled so what specifically was the scope of your job and how did you get  fired basically ok my job back in the mix and there but a number of technical issues existed with the plant my job and really the job of my group i had an outstanding group with many outstanding people and and they're all outstanding let me say that where they're all standing and there's a lot of outstanding people in the project but wanted a issues which was really plaguing the project was the mixing issue in late september of zero nine the deal we manage man asked that i and i and my team be specifically put in charge of the mixing program to drive it the closure when i went into that program i told the b management i said i will take the project on but one of the criteria is that back to all engineering well implement what we recommend i said in the past i used these exact words in a meeting with greg actually and ted fagot obama bill guy i said i have been stabbed in the back in the past by backed on generic where the our group would recommend something and then engineering would say no can do no do can't do and the reason for it was obvious if they implemented what we recommended it would cost a bunch of money i'm back to old they don't want to spend the money on their neck all now it's all taxpayer money and this gets a little complicated samana try to go through it quickly and and simply hopefully for everybody it's all taxpayer money the plant right now start was originally back bill quoted four point six billion of taxpayer dollars to build it four point six billion recently they announced that it appears it's going to go to thirteen billion near thirteen billion four point six the thirteen build a billion they've been on it ten years so it's increased almost ten billion dollars over a decade ten billion  big not an m and now when they look ahead there's internal studies right now saying the cost is going to top twenty billion and that does not include the additional support facilities that are needed such as a low level that the fixing the pretreatment plant there even considering a pretreatment for pretreatment there's problems in the pretreatment plan but i know i'm getting complicated here but that's the fun end of the that plant where i could come back to it might but it's the front end of it plant and they're even consider in a pretreatment for pretreatment apparently they think if one doesn't work well to what work better so there's and my group was responsible for solving solving those problems back till an october at that meeting agreed that they would implement what by group decided was needed and they said that i was even told throw to kitchen sink at wall throw the kitchen sink we want you to solve this problem deal we want you to manage it solve the problems in january a new back door manager came in frank russo and it became obvious from the beginning that the first thing back the first question asked was well how do we live with the tanks we have and then nash ortley thereafter he made two organizational moves he put a backdoor manager over the mixing programme over may which dio we had dio he had asked for me the run the program but they put the manager he put a manager over me which in a way was ok because i could focus on the on the technical aspects by it gave him the direct route to the program through the back to management he also at the same time which is more telling moved in generic away from you r s the company i work for so that it reported directly to him so he now that essentially asking how do we make the existing tanks work and oh by the way organizationally he not only controls the mixing program but he controls the engineering group directly controls the engineering group so from there we got into march all fast forward to march and a deal we chief scientist very smart individual by the name of dr don alexander raised questions with some of the tanks about the mixing and the questions he raised dealt with this sludge material that you were asking about mike the waste it's a very thick material and he was asking if we have solids and like particles of sand mixed into the mud and you start to disturb the mud in the mud becomes a little bit thinner you add some water what happens to these heavy particles that are in it that are like gravel and they represented some of the bad actors in the nuclear in the nuclear waste so it appeared what would happen is as you stir the mud if you well the slurry the the gravel would fall to the bottom and the gravel represented the plutonium and if the plutonium kept falling to the bottom as you get in the mud kept moving to the top you're concentrating your plutonium you have the potential to concentrate your plutonium at the bottom of the tank which could lead to a critic ality now a criticality is an uncontrolled nuclear reaction where you get a burst of energy very similar to what goes off in a bomb it's very quick and it hits over suddenly but it makes for a bad day now the other thing that can happen in the tanks in this laurie is i talk about the poor mixing one the major major issues mike is that the thick way he sed is it's really like a catch up and when you turn a ketchup bottle upside down to catch up doesn't flow out so we've all know you have to beat on the bottom bottom of it and then they want the plastic bottle so you could squeeze it to get it out and what happens is the waste hydrogen gas is generated in the waste from the radiation and the radiation for a quick chemistry lesson here splits the water molecule the hydrogen and oxygen molecule and you always have gas being generated with all these little bubbles get trapped in the waste because they're not buoyant enough to come up through it it's just like taking a dairy queen blizzard a straw and if you give a little puff puff into it the bubble will actually stay down in the in the catch up or in the dairy queen blizzard but as the bubbles accumulate they start to go together you get a big bubble and then you get what is a burp just like in a water cooler the bubble now is big enough that it can bloop up by itself to top it tank and create a very explosive atmosphere and atop a tank and in the safety world you have to allow that you always have a spark you cannot assume you don't have a spark so your safety protection is to protect against fuel or oxygen you assume you have a spark and by having to blow up in gas which they've had in tanks s why i want to wanted hanford was a classic purple you can't you have to allow that you would have an explosion so the poor mixing leads to trap hydrogen gas which can burp for an explosion and a critic ality so now back with that little bit of background story for digression the it's now mar alexander raised questions about the call of the pebble settling out to the bottom i looked at it and i offered to actually provide a counter to don alexander thought i could look at the data look at the testing and and thought maybe done had i had missed something quite frankly well when i looked at it i concluded don was exactly right and i recommended testing be done now the problem was if we added that testing into the program in march there's no way it would have completed by june and there was a five million dollar bounty on the line for backbone so back to you r s would get five million dollars if they could claim the program was finished if you well by the end of june so now here it is the beginning of april and all walt on alexander saying hey you need to do this testing well now back to the management the management concluded  decided that they would attempt to pencil weapon and they're going to torque if you will people at national labs to say that no testing is needed well things are really beginning to smell bad as you get to the may period now beginning to sense and be an isolated people are not inviting me to meetings i'm not getting the reports that are coming out and it's now heading into june in june the engineering manager went back engineering manager and asked for a claim to drawers exercise so a clean the doors exercise man everybody bring forth your issues and let's put them on a list and see what we have well most people the brighter lights the tray i'm not the brightest light on the tray but some of the people who brought forth issues had one or two my list had almost fifty issues and you can guess it many of them dealt with mixing meanwhile the backbone management us management deal we management are pushing to get this issue closed and i could tell that was wrong that did not sit right so i had basically three approaches i could do nothing i could take a funnel attack or i could solicit attempt to solicit input from others and see if others were concerned the frontal attack wouldn't have worked this been chopped down a few well standing up they had already isolated me and cut me out of beatings and so on the doing nothing did not work either it was wrong the plant would not work it was major safety hazards if somebody didn't speak up back to what a continued to push forward with the design and it would have been doomed to failure from from that day on so i sent out an e mail with three consultants saying hey here's what's going on in a century what do you think well now the management two things happened on july first of ten of zero ten they get the email and now they're aware of the fifty issue list which they were aware of a week earlier had been sent barbara saying go the engineering manager bill get a top u r s manager and they were aware of what the issues list was so i go in for a meeting on july first then to make a long story short i go in my group was being reassigned to another area on the plant i went in with one of my mom one of my staff and the manager comes out that i'm going to meet with the operations manager and says to my deputy you could leave you don't need to be here geez when i say what's going on the meeting is change get in the office give me your badge your blackberry your phone and you're fired from the project and i said whoa what happened wait what's going on you know you must have the wrong person here i am not a morning person but gracious you know this sounds bad what's happening no i told you i don't have anything more to say give me your bad your blackberry or phone and get off the site immediately you'll be escorted off and get off the hanford site wait wait who made that decision frank russo to back the manager made the decision can i go back to why do you make it i don't know why i don't know i turned to the h r manager how come i don't know just get off the site i'm doing what i'm told give me your equipment to get off the site i said well you know now i'm clearly not getting any answer can i go back to my office get my personal things no no i said you can't do anything you've got to get to go leave the site i said ok look it's fourth of july weekend i have somebody babysitting my dog i'd like to pay him in advance their daughter's baby no you can't even talk to anybody we're going to escort you out through a kind of a route where there's not a lot of people if you will to the front door and you'll go so i got a scored out down to the front door it was an off day i was actually in there on an off day for this meeting and the doors are like tronic lee controlled and the h r person opened the door said good bye i asked one more time why what's going on don't know walt i don't know what's going on now you got to leave and pulled the door shut behind me and that click which i heard mike i mean still echoes in my ears and now i'm standing in the parking lot and that just had the most i don't know shocked stunned  useless feeling i'm not sure how you would describe it that i ever had like a man with no country after forty three years of work forty two years of work at that time and it's like a man with no country where do you turn so i went home and i'll  try to fast forward here if i have time i went home and i pulled in the garage and the wife said what are you doing home what you forget because you know often i forget my phone or something i'm not a morning person and i said you won't believe this i just got fired from the project and she said no yeah yeah right yeah i clearly you must have another raise and now i got fired and i musta had an ashen look to my face pale and she could tell right away i was serious so i went and i made some phone calls was told to go to a can sound carolina to me with one of the vice presidents to follow in wake as i thought about things over the next two weeks i said you know this is wrong what they did was wrong i don't even have a reason after two weeks why they did it what they propose what they're going to do with me nothing this is wrong this is not right it just smell bad and i had always told my young people when you're going to do something ask yourself what do you think is the right thing to do and then ask yourself what are you going to do now if there's a difference in those two are you willing to stand up and tell the people why you're not doing what you think is the best thing to do so as i thought about it mike i said you know this just isn't right and i would really want it to  it addressed i was concerned if i had three desires which i have right now the three desires three reasons i got into it one is so young engineers know that that is not the way you manage what they did was wrong the reason they did it was wrong how they did it was wrong why they did it was wrong it is not the way to manage and i don't want any person that's going to be following as an engineering manager our country thinking that that is the right way to manage period second i want to see to be a tepee bill well we needed w t p especially in the north west this fifty six million gallons a waste is sitting on the shores of the columbia river and it's got to be put in a more stable waste form if i had not written a letter to the defense nuclear facility safety board they would just moved ahead and it would have been a monument on the hanford horizon and years from now thirdly i wanted to see the culture addressed by call true i mean the management processes how things are managed the contract clauses i want to see things change so that contractors cannot operate the same way in the future so i wrote a letter with those three things in mind it is there's a number of changes that need to be made including more oversight over d o way the department of energy so that sin we're now in the engaged in the legal battle to hopefully to get those things done implemented there was a major hearing in cannes awake yesterday not yes basically thursday with the defense nuclear facility safety board and they i think this session was outstanding  when i say outstanding i mean i believe the people that community there were people from portland there that got an earful of what the problems are i would find it very hard to believe mike that anybody coming away from that meeting could come to any conclusion other than holy mackerel this place is laced with technical problems they have no safety basis established no controls in mind as to how to control it and the culture is really down the rabbit hole i mean there were people number of craftsmen who showed up to talk to people from the tank farm people i don't even know showed up and were often public  comments so now at the balls and according to defense board and they've done an outstanding job over the past over the past well about eighteen months from the from june of july of zero ten to two now to eighteen i have twenty one whatever it is in months they've done an outstanding outstanding job in following up on deal wait the issue is that the defense board has no  t i want to call it authoritative power for correcting it they can issue recommendations in my mind escaping me on the word they don't have i don't want to call it punitive but they don't have gosh my mind's going blank they don't have the right to enforce it i'll call it enforcement they've got the authority to issue recommendations but they don't have enforcement authority so they have teeth but the teeth are a little b so some of the things we would like i'd like to see changes i'd like to see a technical group established the put over the w t pay to really make the decisions on what's required technically for this place to work i mean we're going to spend that plant will cost i assure you over twenty billion dollars for the complete system by the time it's done and to build a plant where you're going to risk a hydrogen explosion where you're going to accept explosions of hydrogen gas in the pipeline and they say well that's ok because the pipe won't break to risk criticality is to risk the major plug ages and at twenty billion again with the baby plant i don't think that's the way you design a chemical plant even today more shocking the most shocking thing really is today after a decade they cannot define what the feat is and what the plane can handle so we started out mike with an outstanding question from you in the beginning of gosh well what's in the tanks since they really don't know they don't really know what's coming through the pipeline and even if they knew what was coming through the pipeline they're not sure how to control it and then they if they knew and could control it they don't know if the plant can handle it so the very basics of care of a chemical plant on defining your feet and knowing what it can handle what you're building it for is undefined it's ludicrous but the gov gov website read the information and write letters to doc hastings patty murray maria cantwell and and demand action because the money is just you know right now is not being used effectively and we're talking big bucks in a time when our country cannot afford it in addition it's more the culture as we look forward in the world becomes more and more competitive and smaller if you well i know those sound like trite phrases we need to establish higher at the x more detail you can't let engineering managers run wild the way they are and focus on the profits and approaches the focus on the profits not on the product my experience says whenever you focus on the product the profits come their focus is like focus on the product on the profits and not the product and that leads to a very bad product only two minutes left ok in does washington state offer any protection to people like yourself who are whistleblowers wow outstanding question let me give give a very direct answer no washington state is one of  the say one of the week it's different the week it's state in the country and whistleblower protection laws in fact they have none recent cases i say recent over recent years have indicated that if a contractor and hanford a concern a valid concern one which everybody would agree is only way of recourse is to go through the department of labor and i did that in the ground to a halt we're now into federal court system  for the whistleblower there is no protection where in state court in the appeal process with what's called a just say a tort suit at this time states all right well with that we are unfortunately out of time while there's a lot we could say yeah we'll have to have you back you no problem over the several replies i regularly come over occasionally and i would love to be on mike in the morning again all right because there's obviously way more to cover on this and this specific issue and none of this is going away probably in our lifetime no it's and it needs to be addressed the longer it goes the they're building without having to design finished and even knowing what the design is and that's just going to we're very lucky to have with us live in the studios this morning dr quentin young dr quentin young is an internist who recently retired from a decades long practice in the hyde park community of chicago's south side he is clinical professor of preventative medicine and community health at the university of illinois medical center he was the founder and served as national chairman of the medical committee for human rights which was formed in june one thousand nine hundred sixty four to provide medical care for civil rights workers community activists and summer volunteers working in mississippi during freedom summer he and c h r also volunteered and helped set up black panthers and young lord's health clinics and provided emergency medical care to protesters at the one hundred sixty eight democratic national convention in chicago during the one nine hundred seventy s and early eight as chairman of the department of internal medicine at cook county where he established the department of occupational medicine and he is currently the national coordinator of physicians for a national health program lets start out tell us how did you get involved in the well it started quite young i actually thinking of careers and i was in high school and and when i attended the university of chicago as an undergraduate and i think medicine and i were talking nineteen forty's because it was a thing to me a profession where you didn't have to be that bad and by bad i mean exploiting people taking advantage of them in a number as ways that professionals cannot be obviously can and many did exploit their position role but the in have to and you could make a decent living and have a public role as a citizen and still be helping people in that that looked to me and i'm so i think it's been that good in the subsequent sixty years and can you talk about how you came to founding the medical community for the committee for human rights well it was the medical arm of the civil rights movement and i'm sure many of your listeners know what a dynamic that was in the fifty's and sixty's of the last century we had a civil war to end slavery but we certainly didn't and discrimination and legally in the south and we'll just by custom in the north blacks were excluded from everyday life places to eat were forbidden them in the south and certain extent in the north they had inferior jobs and while slavery was no longer legal  meant that the plight of people of color was really good and many attempts to rectify it over the years following the civil war but only in the late fifty's and early sixty's th movement and i use that word movement very judiciously is a very important word certainly blacks and people who sympathize with them hated slavery and wish it would come to an end but until it became a movement and human rights was founded and developed into the medical arm of the civil rights movement well i mean it meant that we had doctors and nurses volunteers who went down to the south where they had demonstrations we were the sponsor of the movement as dr martin luther king subsequently led and we shared a certain extent the kind of oppression that the blacks who chose to demonstrate for their rights experienced we were there to give medical were needed and not infrequently was needed people were injured in the confrontation they were nonviolent that was one of the principles of the civil rights movement th about the second the second class citizenship for people of color and we had a victory for the civil rights movement the place was dear i remind you of you need reminding that after king gave his life he was assassinated murdered in the in the city of memphis where he was working and many similar tragedies before victory was won but that that was what the discrimination that we experience here in the south but there's many segregated and other kinds of punishments for people of color why don't you work in your own community think a minute that's a much more serious thing it's creative and we commend the people took two four six weeks went south and help help the movement by medical support but that doesn't begin to to rival working in your own city then that because it was illegal but the people who ran the hospital said all we don't have a discrimination why we never require us to raise a patient well we were able to the device of giving birth and death certificates which are indicate the race of the patient and the hospital we were interested in the hospital admissions and we asked the then commissioner of health in chicago dr brander said there was a  national earned reputation nationally as a public health man and we thought and got an appointment with him and we wanted him to give us the births and certificates of people who died in and maybe another ten percent the one so called black hospital and a handful of people be born in another spittles cynics said these were mothers who delivered in the emergency room before they could b resolution resolutions laws that made it illegal to require the race of a patient if you were going to lead him to the hospital or indeed the race of a patient who's going to be born in that hospital so it takes a little ingenuity but it's a very good cause and people who participated felt very good about it you were also involved with helping to set up community clinics for the black important way of confronting the fact that people didn't have the money to begin to pay for the hospital bill people who didn't enjoy health insurance and their job or independently had to pay f dollar and last dollar out of their pocket and then as now medical bills were a major cause of bankruptcy and you can be certain that the the void was worse in the communities where hispanics  and and immigrants and and people of color black people live and so it was a very honorable period for american medicine there were literally scores of clinics across the country now  probably know that was costly and belly to do a full range of diagnostic tests wasn't there but these clinics who were there to give primary care and where the patient was seriously ill send them to the emergency room so they made some difference in the health care to health care opportunities of the underprivileged and a lot of american doctors had a rich experience that they wouldn't get in any other way working in these free clinics it seems like with the state of our health care here in the u s now until organizations like yours help us to bring single payer health care to us that maybe community clinics might be a good stepping stone to returning to well certainly it's good to have communities involved in meeting their health needs and you've mentioned seeing a payer that's what we're for and i want to make sure your listeners understand that the simplest way to describe it is improved medicare for improved wealthy beneficiaries but of your poor elderly person that that ten dollars co pay or that hundred dollars deductible for the before your insurance kicks in can be a very and happening factor so when we talk about single pa r we should define it as improved medicare for all and all means all everybody in the country is covered and there's no in korea steers social economic status when you can when you present for care and the idea is to treat people the earliest possible time and take advantage of the enormous free health care resources we have in this country and we have them we have highly technical machines we have well trained doctors and nurses but we also have fifty million people without insurance that is mean they don't get care but it means they come into the emergency room quite ill and the outcome is always poor if you delay care and and so  that's to to create a situation that ironically the rest of the world that resembles us enjoyed by resembles i mean countries that have an industrial economic system as we do and have a political system that's democratic twenty nations fit that definition nineteen of them have adopted some form of single payer and the nineteen includes western europe france scandinavia britain has actually a socialized system and friendship with that nation there's so many misunderstandings about the canadian health system and then interestingly enough emerging countries in asia like taiwan korea have elegant systems and  elegant i'm talking about outcomes life expectancy in all these other nineteen countries longer than ours freedom for or for access to treatment for preventable disease better than ours on a scale that takes all the public health measures listeners with a little statistics we spend twice as much per capita for the people in this country as the other one thousand countries spend them dollars it's about ten thousand dollars per year per person even though fifty million people have no insurance but factoring them in we come out with an average of about ten grand for every person's country as compared to five thousand an average for the other nineteen with better res and my optimism about this reform being enacted and forseeable future is based on the fact that it really isn't the health is you who wish it were it's rather the economic case you were in a serious recession now maybe we're coming out of it but the vacs are that the prosperity that characterized american livelihood for the last hundred years each generation doing better than their parents that's over and one of the biggest causes for this complication is high costs of health care now in my professional lifetime which is some sixty years and the last twenty years has been a startling and dangerous transformation the control of health care slipped out of the hands of doctors and the american medical association which was once much more powerful not necessarily in the good way but that that's that's over the power in medicine is in the hands of said improved medicare and that's because the medicare system can be improved and better than it is but that never and we must never lose sight that for seniors in our country people sixty five and older who get medicare with we still have co pays and deductibles that are very very burdensome for many old people and certainly the other sector that is covered by the by the insurance law is people who are totally disabled totally disabled gave the most difficult sectors of the population and happily these two groups are protected but what about the other two hundred fifty million of us if you can get where you're employed but even that is diminishing employees are trying to get out from under the ever rising costs of health care and as the characteristic of our health care system every year we have double digit increases in the  and more people not getting what they need i can report to you and your listeners that this is not as bleak as it was just two or three years ago when congress enacted health reform senator ba the committee that have control senator baucus said and i even at this moment i don't i find it hard to believe that he would say this he said everything is on the table except single payer in a democratic society would you legislature say might even be to be concealed but so arrogant are these people who are in the control of the health system and let's talk about it a little bit  is no sideshow and you know that doesn't really affect the economy affects it morally and i would argue that the main reason we're going to move in that direction several states have taken the initial steps in the vanguard of what we hope will be a national movement and let me spend a moment and what i mean by movement ideas come to fruition come to decision in this country it was slavery in the eighteen hundreds and we had a cruel civil war before it was finally settled but you know people have been against slavery was once it was introduced in the sixteenth hundreds being a popular idea to being a movement a movement is something that changes things and suing decades we had women's suffrage we had workman's compensation worker health and we had antiwar movements that move from popular acceptance to movement states there's a difference in strength and i think cleaver just such an environment today and health it's our i propose a national health insurance is supported in every poll that you take of the american people and very interesting and i'm very pleased with this doctors who are very conservative bunch now fifty nine percent of doctors last year said changed conservative to a much more open idea and it's because of the experience they've had with the corporations the corporations have have brutalized doctors and taken away the thirty th your talk about that so you'd see the end goal of having a national plan here the different states and acting their own plans single pair that's very american people don't really know that things like work work working conditions minimum wage sites in this country in one or two of the states and it's a success of the federal government the next and so with the single payer movement we think and to report to you and your audience where we are in that where there was nothing really tangible three or four years ago we now have three states that are getting very close to an acting in a hostile environment they can bet that the insurance companies is literally spending millions of dollars in advertisements and park shows and the right ways they have to control public opinion and public opinion is discouraging because it just  elections like that both the governor and both houses came down on the side of the single payer commitment and they didn't act certain legislation that facilitates single payer that establishes but takes  unnecessary steps nother state that isn't going in the same direction as california your neighbor to the south california when schwarzenegger was the governor and we should have veto it the legislature three times has single payer legislation and yes well schwarzenegger vetoed it now he's out of office of course and they have a liberal democrat mr brown the former governor brown got reelected this period and they have as you well know of a serious financial problems like many states these days and what i'm saying now is my interpretation  i have a pupil i think governor brown doesn't want to deal with a massive i don't like single payer for the whole state of california and not in a public way but he has passed the word that he'd like it not to be passed now until we get to the point about two he's got the legislature didn't oppose it but the necessary majority were left the floor so they only had one thousand votes where they needed twenty one and so for this the people in california are going to have to work hard to convince the governor and the people who work for us dancers of the bill who walked off the floor so they wouldn't give the necessary majority so i'm i'm very optimistic about california i a governor who was in the congress where he was a sponsor of the single payer bill so i would like you to keep your eye on those three states there are others perhaps as many as twenty like my own state of illinois where  lead people have health care without going bankrupt is going to be decisive it's obviously a political question you're going to have to elect people who say i'm going to support them and defeat those who refused to do so so do you see that there's the money available to make this switch well i pasted the question though if you think about it the money is there who are spending it now and we're spending tries per capita than any other nation in the world thirty seven i would say to number one certainly in the first ten at least with just putting it together there's some dominants plans that's worth mentioning and for example the normal ratio of primary care doctors to specialists is about seventy primary care to thirty specialists that's based on the man the need and we enjoyed that ratio up until a few years ago but the economics of health care is such that medical students come out of their training with a two hundred thousand dollar debt a mansion and they are two large extent forced into the more lucrative specialties surgical specialties dermatology these are all much better rewarded and as we are talking now there is a serious void in people in training to be primary care doctors well you know it doesn't sound bad as i say here but that could create a crisis when there is literally no point of entry the specialists are very important but if you have more specialists than primary care doctor you're going to have one procedures and most i you won't get primary care so that's accelerating the problem and that's going on as we speak if you spec the annual one moment of primary doctors in training they're all going into the specialist aware of these other ills they'll be more political will to have a system that's balanced we should pay our primary care doctors more and possibly pay somewhat less to our specialists i mean they should still have they should do they probably will always earn more than primary care doctors but the three to one ratio that we experience today is is hazardous only about a minute left so you are still optimistic i mean despite the changes for instance in corporations appearing to have a stranglehold on so march you still believe this can become a movement i do and more you listen been criticized for being too optimistic but i really route and in every one of these countries whether you're talking about france or canada or what have you the people like it and they they have a huge fear of a disease with the agent so she's with with the exposure to disease and people like to be free they like to have health care when they need not be worried that they're going to go broke so i believe the politics of it is in our direction what will happen depends on whether we popular idea and become a movement and the civil rights movement and the war movement i believe it's going to happen and the choice for american people will become increasingly clear all right well i want to thank you