Live Coverage of the Washington Ideas Forum, Day 1

Notes, quotes, and big thoughts from newsmakers 
Walter Isaacson and Susan Rice at the 2013 Washington Ideas Forum (The Atlantic)

Welcome to live coverage of the Washington Ideas Forum, presented by The Atlantic, the Aspen Institute, and the Newseum. We'll have live updates on all the speakers at the Newseum in Washington throughout the day right here, so stay with us or check back frequently. This page will automatically refresh with updates. You can also watch the events here.

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6:01 p.m. That's a wrap, folks! We'll be back tomorrow morning around 8:40 for the second day of the Washington Ideas Forum. See you then.

6 p.m. Stein: I frequently hear from young scientists who say they're giving up on the field. Are you worried about brain drain out of the field? Collins: This is maybe the most important question facing my field. He says many native-born American scientists in surveys have said they're considering leaving the U.S. for other countries with better research prospects. Even if you don't notice when you go to your doctor today, he says, you will in 10 years.

5:58 p.m. Stein: What is the future of medical-marijuana-research funding? Collins: NIH has studied drugs for some time, and it has tried to provide real evidence about benefits and risks of marijuana in both medical and non-medical situations. We're in that space, but we're not trying to make a political or moral judgment. Stein: Are you concerned about states legalizing in small doses? Collins refuses to take a stand.

5:56 p.m Stein: You're famously religious. Has your opinion on human cloning evolved? Collins: I think we simply should not do human reproductive cloning. There's not good reason, and there's no way to tell it's safe.

5:54 p.m. Stein: Obama rescinded research bans on stem cells. What sort of progress has that created? Collins: There's been a lot. But the realization that you can derive stem cells from any cells, not just fetuses, was an even bigger deal.

5:51 p.m. Collins: All three Nobel Prize winners this year were NIH-funded; all three said they weren't sure they could have gotten funding for their prize-winning projects in the current climate.

5:48 p.m. Stein: The U.S. still spends an incredible amount on health research. Why is this so bad? Collins says the U.S. is losing ground not only on per capita spending but even in absolute dollars—China will soon pass the U.S. by that measure too. He says other countries see American successes of the past as a model and are baffled by why we would be cutting.

5:47 p.m. Collins says fiscal year 2013 is the worst in NIH history: 640 research grants had to be killed because of the sequester—projects in cancer, infectious diseases, chronic diseases, rare diseases, etc.

5:45 p.m. Now up: Dr. Francis Collins, head of the National Institutes of Health, with the Huffington Post's Sam Stein.

5:43 p.m. Robinson: Paint me a picture of the ideal, transformed health-care system. Emanuel: First, more people will be in the exchanges, with fewer and fewer people getting employer-based insurance. Second, more and more health care will come from clinics and not from hospitals and physicians offices—it will be far more convenient. Third, there will be more "VIP care" focused on patients with chronic illnesses. They're the folks who use the system most and cost the most. The greater attention on them will help save money by preventing them from getting sick.

5:40 p.m. Robinson is asking Emanuel some pretty technical questions, but it's not clear he's in any position to answer them. But he says it doesn't matter yet whether insurance companies are getting data from the exchange website—that only takes weeks.

5:37 p.m. Robinson asks about the push by some Democrats to keep existing plans. Emanuel: No one forced any insurance company to cancel a plan. The insurance companies are canceling plans—and before Obamacare they changed plans, killed plans, excluded coverage, too. It's easy for them to blame Obamacare. "I believe we kept the president's promise because we grandfathered every plan." The blame goes to the insurance companies, not the law or the administration. Many people disagree, but "if the website were working, this would be a tempest in a teapot." And Emanuel is very skeptical of plans to keep all the old plans. He mocks Republicans for pretending to protect patients by going back to the old system.

5:36 p.m. Emanuel: This law is going to be a good thing in the long run.

5:35 p.m. Robinson: How far does this set Obamacare back from its final goal? Emanuel: Assuming the website gets fixed, people are going to shop at the last minute. He says it's very difficult to extrapolate from the early numbers, and it's absolutely possible to get to the 7 million new insured goal.

5:31 p.m. Emanuel: The ACA is the law, so the big thing is getting the exchanges running adequately in the next few weeks, then ironing things out over time. Jeff Zients is great, but he's temporary—there needs to be a permanent chief.

5:29 p.m. Robinson: "What the hell happened?" Emanuel pleads ignorance. He says what the law needed was a great CEO who understood health insurance and enough of the IT to make it work. That was key, but no one got appointed to do it. Giving care of the law to CMS was a mistake.

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David A. Graham is a senior associate editor at The Atlantic, where he oversees the Politics Channel. He previously reported for Newsweek, The Wall Street Journal, and The National.

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