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tv   Key Capitol Hill Hearings  CSPAN  November 5, 2015 2:00am-4:01am EST

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first step, and i don't say let every jailbird loose on society. i'm not suggesting that at all, but i do think certain sentencing measures could be adopted that would result in freeing up space. >> what's your -- >> behind bars. >> what's your advice to john boehner? >> well, i'm not sure that he needs my advice. i think boehner has been criticized from within and without. but my rating of john boehner is he's been favorable. i think he's a pretty good speaker. comes from a hard working family. job duties were cleaning up the bathroom at the end of a busy day. he's been there, done that. >> looking around your office here on capitol hill, two things
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i wanted to note. number one, there's some photos of you with cigars, with cigar smoke. long time cigar smoker? >> there's the cigar picture right there. i like what i call ponies, peter. small cigars. at one time i was smoking probably five or six cigars -- well, strike that. three or four cigars a day. now that changed to three or four cigars a week. then finally i just said to heck with it. part of the reason was the staff didn't like it. some of my colleagues didn't like it. the chief of staff, i think, led the fight on that. what the heck? if it is annoying to them, i don't have to have a cigar in my mouth every day. i've been free of cigar smoke probably in excess of five years. >> congressman coble, you've
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worked on a couple of issues that may not strike your colleagues as positive, such as limiting congressional retirement, term limits, cola increases, being careful about cola increases. have you gotten so pushback from your colleagues up here on capitol hill? >> when i came up here, i said i was going to try to get rid of the congressional pension. that got the attention of a lot of senior members who explained things to me. but i vowed that i would -- just to make a point -- that i would not take the congressional pension, which i've not done. that's going to cost me a lot of money, but i felt like that's one of the issues back home. today's issues jobs, the economy, unemployment, all put
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into one hat -- now i've drawn a blank. >> we were talking about money issues. you're not taking the congressional pension. >> i have a bill that would change the eligibility date. now the congressional pension kicks in or vests at five years. my bill would increase that to 12 years. not one cosponsor. now term limits subject to interpretation. some favor it. some abhor it. i think a good argument can be made that we have term limits now. if you want to vote for the appeal, you have the right to do that. if you don't, that's you exercising term limits. >> but aren't there a lot of built-in advantages for incumbents? >> i think that's why the folks
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back home don't like it because it's obvious that -- ultimately, highly favored on the one hand, crumbs from the table on the other. to this day folks come to me and complain about congressional pension. i may be the only one who has refused the pension and the thrift plan. we really have two pension routes called the thrift plan and the pension. not my most brilliant financial decision, i might add. >> you're a bachelor. lifelong bachelor. why is that? >> yeah. i told a girl i was dating one time -- she asked me. i said i've never had time. that would normally be a bachelor cop out, but knowing you, that's probably the truth. i've dated girls who i've liked more than they liked me,
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conversely girls that have liked me more than i liked them, but it just never did play out. >> why retire today? why are you retiring? >> well, i've got a bad back. i've got skin cancer. neither of which is imminently failing my health, but out of a total of ten counties in all with a bum back -- a lot of these folks don't know me as opposed to the old district. i just felt like it might be a good time to walk away. >> where are you going? what are you going to do? >> well, someone asked me that the other day and i said i haven't thought about it. he said, haven't thought about it? you've had 30 years of no spare time. you're going to be in a position where you're going to have nothing but spare time. you better be thinking about it.
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i won't fail retirement. i'll try to stay active, but the colleagues that have been up here, democrats and republicans alike, were very endearing to me. and i apologize, peter, to you and your staff. i'm coming down with my late summer/early autumn cold. >> what are you going to miss most about capitol hill? >> tomorrow, i'm scheduled to go to meet with a judicial conference at the supreme court. we meet with them periodically. i'll miss meeting with them. i will not miss my weekly trek to the airport. i recall, peter, several years some months ago -- actually, it's been some years now. i was being driven to the airport by one of our staffers for rural randolph county. 95 degree day. you can see the sun is my enemy. 95 degree day.
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bumper to bumper traffic. i said to her, i wouldn't live in this town. she said, you do live in this town, but you don't think of this town being home. but that aside, it's still recognized as the cradle of democracy. the cradle of freedom, the cradle of liberty. and i'm proud -- when i look out that window and see the capital, if i'm griping and complaining, it pretty well falls in line this is the best place to be. >> are you hiding back to the district after january? >> oh, yeah. i'm sure i will be. >> where are you going to keep your papers and your office records? >> university of north carolina at greensboro. >> why there? >> well, my alma mater gilford college didn't have an adequate library that could handle it. uncg does have an adequate
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library. >> who are you going to miss here? >> i've been richly blessed with a good staff, peter, so i'll miss my staffers. i'll miss my colleagues. both sides of the aisle. but i really have been indebted to a good stuff. i tried to treat them right. they in turn try to treat me right. >> you've had long-term staff, haven't you? >> attrition has not been a problem for us. people come and they stay, which of course affords reliability, affords -- promotes confidence without walking back and forth, in and out the door. one day here, one day gone. >> any regrets? >> maybe should have taken the
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congressional pension. i say that halfway in jest. >> congressman howard coble after 30 years retiring from congress. thanks for your time. >> thank you, peter. ohio governor john kasich has announced that a special election to fill the congressional seat vacated by house speaker john boehner will be held on june 7th. the winner of that election will serve the remainder of the current term. a primary election for that race will be held on march 15th. mr. boehner represented ohio's eight district. it spans six counties and includes the cities of troy and westchester. nebraska senator ben sasse will be among those testifying tomorrow morning on the closure of several health care insurance co-ops. the house energy and commerce subcommittee hearing is live at 10:00 a.m. eastern here on c-span 3. republican congressman jeff
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miller and democrat tim walz from the house veterans affairs committee talk about the va health care system and what can be done to make it more effective. >> good morning, everyone. thank you for coming to brookings to discuss the important subject of veterans affairs as we continue to recognize just how much our men and women in uniform have done for us throughout our history and for us in the wars of the last 15 years as well and many of them, of course, leaving the military service with challenges. and also even those more generally who don't have challenges, we still owe them a debt of gratitude. the veterans affairs system is set to address a lot of these enduring needs. let me introduce them. i'm michael o'hanlon with the defense center at brookings in the foreign policy program.
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just to my left is congressman jeff miller from pensacola, florida, who has been in congress now for a good chunk of time, a good deal of experience. i first met him probably a dozen years ago. he had just been preparing for a trip to north korea. so many interests in his national security and foreign affairs portfolio. he is, as i say, chairman of the veterans affairs committee and also a member of the armed services committee and was really in many ways the impetus for today's event because he has a lot of ideas he would like to present and discuss about addressing the enduring needs of the department of veterans affair. he is like his colleague tim walz from minnesota, also on both of those committees, a five-term congressman who is the democrat joining congressman
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miller today. we know we want to take better care of our men and women who have worn the uniform and of course the department of veterans affairs covers issues ranging from the g.i. bill to acute health care problems to enduring chronic health care problems to mental health challenges. it is an enormous and very expensive part of the federal pushing $200 billion a year now in its annual budget. that's not part of the defense budget. that's separate from the defense budget. it would be roughly tied with china for the second largest military budget in the world, so it is a very expensive system. we have pumped a lot of resources into it, especially since 9/11, and yet we know many problems endure. what we want to do today is focus most of the time with discussion first up here with ourselves and then with you about the problems that are still within the veterans affairs system that we know we
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need to do better in order to help our men and women in uniform. congressman miller and congressman walz are going to help us do a primmer on where we stand in the department of veterans affairs. the question i would like to pose to both of you gentlemen, if i could, is what are we doing well and what are we not doing well? we have put a lot of resources and time and effort and a lot of reform into it. we presumably have made some progress in the last decade or 15 years. and i wondered if you could begin just by answering that broad question, what are we doing well and where are the most severe problems today? >> it's great to be here with my friend tim. the department of veterans affairs -- and you set the scene very well. i think part of the story needs to be that it's also about 330,000 individuals that work at the department of veterans affairs, and they've gone a long
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way from their original mission, which of course abraham lincoln said was to care for those who had borne the battle, their widows, and orphans. now they do everything pretty much from a to z, whether it is managing cemeteries, to home mortgages, to the g.i. bill, to homelessness, disability benefits. those are things you hear a lot about. what you're hearing a lot about in the media these days -- and the secretary is quick to remind me we're not bad at everything we do. they do a lot of things good. obviously, the national cemetery administration does things extremely well. they do great with the va mortgage side of the world. i come from a home building background. we use the va loans in the northwest florida area significantly, but i will tell you that the biggest problems that exist out there still remain within the disability
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side, the veterans benefit administration, and then the vha, the veterans health administration. not everything is a bad story, but some of the things that have occurred obviously according to the ieg are systemic. we still have wait lists, some unrealistic wait times. the va is trying to work on that. i was with the secretary this morning for breakfast. they've got some great ideas they're trying to roll out, moving in a direction that's more than in the 21st century. i would say they're making some strides there, but as bad as he wants me to move away from what's happened in the past, we still have to try to root out some of the culture that's more in the va that's more about taking care of the bureaucrat instead of the veteran. until that is done, i think the va will be operating on all eight cylinders. >> thank you.
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great introduction. congressman walz. >> pleasure to be here with my friend. we often say that in congress. this time we really mean it. i can tell you our commitment, there's not an inch of daylight between us. i would say this is true of the american public. there's probably no issue that unifies them more than should we care for our veterans. only 7% of the american public are veterans. so while the public is there, they want to get it right. very few have a deep understanding of how this system works. i've often said i'm the va's staunchest supporter. i'll be their harshest critic. this is a zero sum game. if one veteran waits too long, that's a failure. if it is unrealistic to shoot for 100%, i think in any organization that has to be the goal. i'm a product of that system in
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terms of the g.i. bill, whiis hi got a college education. a va home loan that allows you to buy a home without -- those things are managed well and are doing well. it is a large organization. i represent the male clinic in rochester, minnesota. folks saying one of the best health care systems in the country, if not the world. it's the tenth largest, by the way, the male is, with the va being the first. the va being somewhere around 42 billion. jeff is right. we have to simultaneously look at the things that go wrong. you cannot have abuses in the system. you cannot have mismanagement in the system. you cannot have cronyism in the system. if that is a distraction from this big picture fix we need to
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do, the va does many things right. if you want to get some of the best health care in the world, it's the minneapolis polytrauma center. it's an integral part of our health care system in general. and you can't talk about the va and va health care reform in a vacuum outside of the larger issue. and i think chairman miller has done a really good job of this, asking va to focus on their core competency. this becomes a proxy fight for privatization versus non-privatization. they're intertwined very closely. when the va, when they do focus on their core competencies, they can get better if they're willing to look at that term of 21st century. i don't think it's as much reform as it is disruptive
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innovation. health care innovation is changing rapidly. i see it at mayo clinic. when they try to build hospitals, they are not good at it. they're not good at the construction of hospitals, and that is not a proxy fight for government versus nongovernment. it is just a reality. we, as citizens, want the best care for veterans. we want it delivered in a timely manner because they've earned it, and we want it to be cost effective. whatever model that is is the one we should go for, so i think now is a golden opportunity to do some of that. there are many things going well. there are many people going to work at va facilities that are giving of themselves, veterans themselves delivering highest quality of care. all you have to do is turn on the tv and see that's not the case elsewhere. i think we're holding onto a system that is no longer keeping up with modern challenges. that's our opportunity. >> thank you. before i get to the question of priva privatization, let me ask to
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break down a little bit the distinction between core competencies of physical health care in the sense of injury, to limbs to the body in general, versus mental health care, pts, traumatic brain injury, is the va system better at one of those than the other, or is that really not the right framework to break it down? >> i don't know if that's the right framework. you have to look at the va and the way they can treat tbi, the signature injury of the last two wars. post-traumatic stress is an issue that is effecting all generations. you're seeing it really manifest itself within the vietnam veterans now where a lot of them as they get older, certain triggers are being hit. obviously mental health care is something that's important to all of us and to make sure that we do everything we can to stop
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the scourge of 22 veterans a day committing suicide. the vast majority of those are older veterans, and they're vietnam era veterans. i learned this morning at a breakfast with the secretary that the vast majority of those that do commit suicide aren't even in the va system. i think they said like 7 out of 10. it's a huge number. so the va has no way of even knowing that these folks actually are in need of help and of course the veterans themselves aren't willing to step forward. there's a stigma there that needs to be overridden. >> when you say they're not in the system, you mean they're not actively part of a hospital treatment program at this time? >> right. there's a category 1 through 8. you have to apply to be put in a category. and most of these individuals aren't even getting any type of a health care benefit from the department. >> so they may be getting some
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kind of a va benefit or their families through a g.i. bill, but they're not in the health care system of the va, which is about half the overall budget, i believe? >> that's correct. >> most of the people. >> the numbers are about 57% on that. i would fall into that category where i do not use the va hospital for health care services. in many cases you do have some of the highest quality care being delivered. you can have the best physician in the world, but if there's an inept administrator, they're not going to get the help they need. i want to keep coming back to this. as a country in general, mental health parody is something still we're struggling with. the va is moving forward on this. i'm proud just recently, the chairman and i together did the clay hunt suicide act, which started to take some of the new
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best practices. that was a clear cut case. one of the best practices piece shows if you can get peer counseling and peer work as we recall as possible with some of these folks, you reduce the significance of a suicide or an attempted suicide. that's just smart. that's just smart to get them back in their community because if they have to travel to minneapolis and they live in southern minnesota, they're disrupted from their community. it's disjointed from that. they would be better off to get that from home. they're starting to lead on many of these things as the va always has done, but again they're not going to do it alone and there are those barriers that make it very difficult for some of the practitioners to deliver that. i think again trying to compare them -- we know it is an overus overused cliche, that if you've been to one va hospital, you've been to all va hospitals, but
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there are some that are better than others. i think overall compared to patient care in the private sector they stack up pretty well. i think the chairman would say this, as he always has, if you can get in and if you can get by the barriers. >> the surveys are fairly good for those who are in and getting physical treatment. the level of happiness or satisfaction is roughly comparable to what we see elsewhere. i just have two more questions and then we'll go to all of you. and i'm trying to anticipate the question of what are the policy initiatives or reforms that we still need that we haven't yet accomplished and that's going to be my last question. before that, could you each say a word at what we've gotten better at in the last 15 years? frame this in terms of both the bush and the obama administrations. we're probably going to spend most of the rest of our time talking about what we haven't yet fixed. but just for the sake of understanding the context, are
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there any reforms of the bush and obama period that have been particularly effective, where we can say we're better now than we were, let's say, in the 1990s? >> i would start out we adjusted for the use of our ground forces that were predominantly active army forces coming out of the national guard. we're doing a better job of integrating those folks into the system on the benefit side as well as getting them into the va. something we do much better now and the statistics showed this, but it's a double edged sword, more of our newer veterans are joining and enrolling in the va. i remember it when i first got to congress, at that time the va was saying they didn't feel like they could advertise to get people in even. we had to have this debate. they started putting up placards on the side of buses. if you can advertise for a few good men and women, we'll take those few good men and women into the system.
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again, the downside of this was there was very little preparation to prepare for that. i would say to keep this in mind. the bulk of those suicides and the bulk of the care contrary to what might be popular belief are the veterans of these recent conflicts. it's like the rabbit through the boa constrictor. the bubble comes 50 years after the conflict starts. we're seeing the vietnam veterans now. the real push to the va from the current conflict will come in 2050. that's why i say there's no excuse for not being prepared for 2050 if we let that slip. that's why i think now is the time. we're getting better. we're getting them to know their benefits are there and treating them and many of those things can be preventive medicine. then the problems that start to arise on wait times i don't believe have gotten significantly better. >> i would also say one of the
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things that the committee mandated several years ago was mandatory transition assistance, the tap program. it used to be most branchs of the military did not require their folks to go through tap, and even what was required i think was the marine corps and the marines only required five years. you can't teach everything somebody needs to know about reintegrating into the civilian life in a five-hour period, so it's a longer process, more involved. granted, most folks when they're exiting the service are not focused on the things they may need 20 years down the road. they're focused on getting back to their brand-new pickup truck and their boyfriend or girlfriend, whatever it may be. something very different. but still making sure they know the benefits are available and where they need to go. one of the things va is doing very quickly from an i.t. standpoint, they had websites
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that are all over the map that provided information for veterans, but you had to figure out where to go. and now they're bringing -- i think i heard the number 70 websites this morning. they're bringing that down into one where a veteran can actually go into one singlular website and navigate their way through that process, making it easier for them to know what's available. >> by the way, just a framing or a factual point, congressman walz, you mentioned it is only 7% of the population today that's veterans, and that's of course a very important statistic, but it is worth reversing it and looking it at the other way. that's still almost 25 million veterans. when you think of families, we're talking perhaps a 1/3 to half the country that is very closely linked to a veterans issue. the g.i. bill, even though it is not the health care domain, it's part of the broader veterans
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affairs effort, and that is better because that is now more accessible to family members. but let me now turn to, as you said both earlier, has to be our main concern, which is where are with still falling short. you both alluded to wait times, to the culture of bureaucracy. and so in addition to maybe delving into any of those issues in greater detail, i wondered if you could also offer for all of us the one or two most important policy initiatives that you would advocate or propose. what's the fix for the worst of the problems that we still face today? >> i'll tell you i think we really started changing the way va does business last august, a year ago august, when we passed the choice act. va has always had fee for services, but it wasn't used in a way i think the veterans would expect it to be used. so what we're trying to do -- not to tear va down brick by
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brick, but to supplement there's only 6.5 million in the health care system. it's a significantly smaller number, and they're struggling to fill that number. they're trying to be all things to all people, and what i heard the doctor say this morning, who is the new veterans health administration undersecretary, is that we need to start focusing what we do well and nobody else can do, which is the polytrauma centers, the traumatic brain trauma centers. the amputees, the things that are most critical that va does that are so important. and the things that allow the veteran to go outside the va. it makes no sense that a veteran would be required to go to a clinic to get a flu shot. the same thing with eyeglasses, unless there's an eye injury or something. and from a standpoint of
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optometry, i understand that. but there are many, many things from the basic health care that can be done outside. and we don't have to go and spend hundreds of millions of dollars in infrastructure that the va owns and has to take care of, but we can leverage what we already have and expand outside into the community. and that's why i think, you know, for the veterans service organizations, we're very thankful that they were involved in the negotiations when we were doing the choice act, that this is trying to help the va do what they do best. and, and that is, obviously, take care of the most seriously injured of our veterans. >> so just before i go to congressman welch on the same question but to understand that more fully, you're advocating a much, much broader privatization option than we've done so far with the choice act. because the choice act basically says you have to wait a month or
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be in a rural area where you're a long way away otherwise you have no choice but to use the va system. what you're saying is we should give the veteran the choice no matter where they live or how long they've waited. >> it's probably not going to be reality anytime soon. when we did the choice act, we appropriated $10 billion. and what that $10 billion was supposed to cover was folks that were outside that 40 mile parameter, and of course those that were on a wait list, longer, if you remember, va was measuring it at 14 days, and now it's 30 days. of course i'd like to see the veteran have the choice of where they go, continuity cares, something you hear the va talk about a lot. and they're very concerned with that. but this is actually va's plan, talking about going outside and taking care of things that they
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do well and letting others do the things that they do. >> thank you. congressman? >> and i do think you'll see a bit of a blended system. and jeff was right. we've always had fee for service. one of the issues, again, and i want to keep bringing back this frame to it is talking about this outside of health care in general. can you give, and a bulk, a large percentage, a disproportionate percentage of our veterans do come from rural areas, even though we make up about 20% to 25% of the population, nearly all the veterans come from that area. so if you give it to mountain lake, minnesota, you're trying to make it work. but i do think that there is a reality. we should be using that. we should not be duplicating services. we should not ever forget, though, that dwee have a special responsibility. those who would say just give them a card and let them go on their own, what do congress men
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do then when the local hospital doesn't get them in on time? do we go to hearings on why mayo didn't get them in quick enough for a knee replacement? a proxy fight for something that it's not. 's a realization that health care and the country's population and changing demographics and things are changing to the point where we're going to have to be open to this idea that you're not going to be able to drive down the street maybe to a big va hospital in that. that's not the way it works. we can't build them again. if there's open beds at louisville we should be making that work. >> or a dod at that facility. >> or indian health care facility. it has to be the best care for the veteran, it should be the smartest care for veterans and the most cost-effective. but one of the things that we can figure out, because again, this issue of a medical continuity of care, will be
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greater enhanced, and i think dod should be the place it starts, it's absolutely unacceptable that we do not have electronic medical records. and i've learned from mayo clinic, it is not just a database. it's a diagnostic tool. if it's done correctly, the al goe riches can make that work. so i am tconvinced you will seea blended system. those core things that need to be there will remain. but we need to be smart about how we deliver it. and that's what we need to think about health care in general. these veterans come back home, yes, they're veterans, we have a responsibility. but they're also citizens seeking health care in the local community. a shortage of primary care
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physicians in the local community will impact the veteran just like it will the non-veteran. >> i do have one final question. last week there was some high-level, presidential-level political debate about this. you were involved a little bit. and i'm trying to understand exactly, if there's a fair amount of consensus, not just between you two, but even with the veterans affairs system about what the goal, what the plan, the options that veterans should have. where's the current disaingredient that we need to folk in on to resolve. disagreement gets a bad name. it focuses the issues and the choices that we have to confront. so what's system -- and by system i mean all this in washington -- what's the system doing that it could be doing better to get us to the next step, even if we're not going to get to the final goal anytime soon to at least get us to the next step? >> if i were to pick one thing,
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accountability is the thing that's going to change the system the quickest. and we pass an accountability bill through the house. we're trying to get, in fact, i spoke to richard blumenthal. he objected when senator rubio tried to get unanimous consent to bring it to the floor. the number one person in the benefits administration, the other night, said it is too difficult to fire people at the department of veterans affairs, and you have to be able to hold people accountable. that's not to say everybody out there needs to be fired. it's probably not a huge number as relates to 330,000 people, but it still has to be done. and accountability and transparency are the two biggest things. so i would say the most important thing is to make it easier to discipline individuals who can't or won't do their jobs. most people at the va, as tim has already said, are doing their job and doing it very,
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very well. but there are people out there that know that they are protected, and i can't do anything to them. and they're causing the grief at the va right now. >> well, i agree on one piece of this, the accountability piece. and jeff and i disagree on this. i'm a public schoolteacher, and i've always heard that you can't fire public schoolteachers, one of the thing is they don't get out of their offices to see if they're performing or not performing. i don't think it makes much sense to strip the ability of workers to have collective bargaining wri bargaining rights. if many cases, we don't disagree. i think he has been a champion on accountability. i couldn't agree more. and we passed one on these ses folks. these are highly qualified people. they can either take a position as the hospital director at the mayo clinic or the va hospital. we want them in the va hospital, so there has to be some
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incentive, but not the abuse that was there and the idea that they would simply outlast administrations and be there beyond that. so i do agree, the quickest thing you can do is have that accountability piece in it. i think it's done by having high expectations of what we're going to say and do. and there are ways and they would have it if they would just move on their job and get rid of them, breaking that piece of the culture, but i would say right now, i think a big mistake is going to be made that is going to have long-lasting implications and hurt our opportunity do their is, dod, regardless, and they said they're going to do it, they're on the path to purchasing a new electronic record and they don't care what the va says. so you, the taxpayer, earveryon we're going to buy a system for them that won't be able to communicate with the va and the private sector. i think there's agreement on this. hold those that are doing wrong quickest as possible. but give us the tools to have their big systemic change, and
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the big systemic change is being able to manage data, being able to manage data towards an outcome. >> real quick to piggyback off what tim said, we spent $1 billion that was supposed to be an integrated system. dod finally they said, we're not going to do it. now they're using this word inoperable. in the 21st century it doesn't make any sense at all, even though they both are doing different things with that system, the system can be made to work like this, not like this. which is exactly, i'm afraid, what they're doing. >> because they make the argument, dod makes the argument our system has to work in a submarine in limited band with. well, if uber can come up with an app, you should be able to do
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their. this is more complex than a uber app. but the sentiment is decent that i do believe we have overcome this. i would make the argument that va and dod when it comes to health care and focussiixing th would be better, it would have a radical impact. >> on the issue of accountability, do you have legislation? >> i think they have the ability to do it and they simply aren't enforcing it. jeff does it. i don't question him. it's to get the best care possible. i think it won't have the same effe effect. and i've seen that where you couldn't get rid of a bad teacher. of c
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you k bcan, but you have to doe work. they want to get rid of this, and we differ there. i think jeff thinks they need more protection. >> and what i've told the secretary is that they may need to -- there's a lot of risk analysis that's done in what they do, is it less expensive to just reach a settlement with this individual than it would be to take them all the way through, let them appeal to the protection board and then they end up back at the va and we're paying for their attorney fees? i get that. but i think we're going to have to take one of the most egregious cases. even if it gets reversed. the american people would be able to see how difficult it appears to be able to do this. you know, if you go back to the phoenix wait list issue with sharon hellman, you know, she ended up being fired, not for the manipulation of the wait
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times. in fact, va almost lost that, what they ended up doing was finding out she'd been taking gifts on the side, and that's what she ended up getting fired for. so realistically you can say right now only three people have been fired as it relates to wait times. none of them, the senior folks, and now there are a couple other folks that are in the process, and i think there was one last week, maybe the chief medical officer out at thoma, i think they have now taken action there for overprescribing opioids. again, whether there's a problem, it takes way too long. we still have people that are on paid administrative leaves. a year and a half after, they're still on administrative the leave getting paid from phoenix.
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>> wait for a microphone and pose, if you would, one question so we can get to you. in the back, yes. >> hi, arthur allen from politico. you're talking about electronic health records. the defense, the department of defense has already signed an agreement to get started on their commercial ehr. and there was recently a report by the miter corps suggesting that the va look into getting a commercial system as well, but va says they're, have their own kind of program per developing there called evolve. this has been going on for so long. this whole process. what do you think needs to be done to just make decision, since it seems key that dod and va be on the same track, working together and coordinated, i mean, is that actually happening now? or do you feel like somebody
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needs to step in, the white house or someone to clarify what's going on. >> that's my answer. you're right on. i do believe that. i've been down this road. i understand technology is expensive. like everyone else, i'm frustrated when i bought a computer and three years later i feel like, $1500, you have to upgrade it. that is not what's at heart here. this is a culture that started with the vista system. and the mayo clinic told me they were pioneers. they said at one point, the vista system was one of the best record. but it is inexcusable that we're not working to the. it's inexcusable that we're not using the clout of these two huge medical systems to force this change into the private sector, because most people understood, and most people who are involved with health care rye form understood this electronic medical record was at the heart of reform. it was as much to do with anything to improve america's
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health care system. i would welcome white house intervention to drop the hammer on this one and force them to do this. >> and it really needs to be done, you know, the secretary will talk about a lot of the code that's being written cobal, the language being older language. congress appropriated the money for dod to do it, and dod just said forget it. and it seems that va wants to write their own, which is not necessarily the best way to go, because there may be something off the shelf that somebody can go and purchase, and i think that, again, the only leader that has jurisdiction over both of them is the president and the white house. and their involvement, i think, would be very important. because theis is a critical piee that will take it decades down the road for the young person
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that's enlisting today to be able to have that truly electronic health record that follows them from induction to death. basically, i mean, the only, it's amazing to me as somebody who did not wear the uniform, when i first got elected in 2001, i thought that a veteran was a veteran. then i find out, no. there's a veteran, and then there's retirees. and there's two different classes there. and you find out that when dod is done with you, you get your dd 214, and you are not involved with dod anymore. you are now va's problem. look, these are americans. and the federal government is supposed to be taking care of them from the beginning to the end. and va does a good job on the inside, but that middle is still very mushy. >> thank you. we'll keep working our way up. so the woman in the purple shirt right there. >> hi, i'm emory with elizabeth
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dole foundation, and i will a question i guess for both the congress men. i was wondering, how can congress work together to support the va and expand various programs within the va such as the caregiver program and opening that up to all areas and all veterans, because with the care givers will help bring the veterans to va, help reduce the homelessness, and they do a lot of the behind the scenes work in order to get the veteran to take full advantage of the programs offered. >> i think we will both readily agree that the caregiver program is one of the best things that's going out there. i mean, obviously, especially if it's a family member that's taking care of, you know, that veteran, being able to make sure that they do the things that they need to do, go where they need to go, and unfortunately, when the caregiver program was rolled out, they tried to go, i
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guess, as far out as they could but not, not very deep. and you talk about going back to vietnam and korea and world war ii. it's a focus of the committee. but are it's just one of the things, i guess, that's in the mix right now. >> i would agree to that. i know that former senator dole, elizabeth dole's working heavily on this, coming and working on this. the one thing i would say is the healthy part of this debate is, especially considering all the problems with the va, the va committee could have turned into a partisan sniping back and forth instead of driving on to fix some of these things, and there has been good legislation passed even in the midst of this. and the caregiver one is one. i don't think any of us are happy with where this has gone. >> i think the public cares deeply, but you have spouses and parents who have given up
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careers, and we're not paying anything for this, as the rest of the citizens of this country for that wounded warrior. it's being burdened, or that entire burden is by that family. and i think many of us have tried to push forward on that. this is a case, again, where i do not believe the va will solve this alone. it's not a choice of government versus non-government. it's going to be collectively to figure that out. i think there's more to do with these, and i think having natter dole involved is starting to elevate that discussion. >> and i agree. i couldn't have said it better. she has brought to the discussion credibility and certainly she has been able to do some things outside of the system. >> yes. >> that are working. and bringing it to us and really being a resource to try to resolve some of the issues that remain out there for the caregivers. >> so let's keep moving up here, i guess in the sixth row on your left, right there, yeah.
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>> hi, tom porter with iava. first of all, thank you, chairman miller for your va accountability bill. we were a strong supporter of that. we do need you to work with the other side to get something passed into law, though. so we appreciate you working to the. a big question, as you know, the clay hunt act that you passed earlier this year, that's a top priority. suicide, mental health for our members. that was beginning of the year, we strongly would like to see how va is coming along and implementing that. and would really like to see an oversight hearing on implementation, would want to know what your plans are for that. >> based on that request, we'll schedule one. that's easy enough. obviously, don't think we'll be able to do it before the end of the year, as much as i think we would all like to, especially on the senate side, there are some issues out there that they're trying to put an omnibus va bill
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together, which is the way they operate different than what we do. we pass individual bills, but yeah, i think, you know, a one-year check is critical, and, you know, you have my pledge that we'll have a hearing early next year. >> thank you. >> i would just say on this issue of suicides and the issue of working on bills, i'm gr a'm you brought this up. it's not that people don't care, it's that they move on to the next issue. on the day we passed that, in my local newspaper on the top page of the paper, it cass clay hunt bill passes congress. the bottom half was about an of veteran who walked into a university library and shot himself. the idea that we passed a bill and the situation's going to get better, we better be careful. so your request is appreciated. we look forward to that hear egg. >> yes, sir. here, on the other side.
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>> yes, thank you. my name's dave kitras. if the provisions of hr 1994 becomes law as they're implemented to va, do you look at that as perhaps sort of almost a pilot in which the same type of provisions could be spread to other agencies as a way to improve performance and address some of these problems that obviously exist in the va in a special situation, but also perhaps are are are are are are are are exist in other government agencies? >> i do. >> sit down. don't jump. because this is not just at the department of veterans affairs. throughout the federal government, there are issues out there, and you always need to keep things moving around. and don't become static. part of what has happened at the va, and this is not an obama issue. it's not a bush issue. i mean, it goes years and years.
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it's just the way they've always done it. and so, when you're trained, you're trained in the wrong way to do something. and from an accountability standpoint, things have gotten tougher and tougher and tougher as it relates to, in my opinion, holding people accountable. and that's why i contend that it still is difficult to do it. and, again, you know, when, when danny pummel came before us the other night for a hearing on monday night, he said it's virtually impossible. that's not me saying it. that's somebody at the va. and not just somebody down here, but somebody up at the very top. so yes, i would like to see if you, if va is the test case, va is the test case. i would like to see it expanded. and, again, what i talk to -- and i'll make the same offer to
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my friend tim. with dick blumenthal this morning, it's let's find a way to find that middle ground on this bill to get it passed. because that's what's important. you know, i don't think that there's a change in evidentiary requirements. i don't think there's a, you know, we're not taking away somebody's ability to appeal. you know, again, where i come from, when you're fired, you're fired. you, you walk out the door that day. you know, so what you hear from va is, well, we've given notice that somebody's going to be fired. thoma in particular. the individual's still on the payroll until november 9th. to me, that's not firing somebody. so we've got different ways and different ways that we look at it. but i think we will find a solution that we can all agree to and pass. i'm, i'm pretty stubborn, but i'm not stubborn enough to hold
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up a good accountability piece, even if it's not 100% of what i wanted. >> and i agree with the chairman. everybody, when you hear this, these are healthy debates going on. it starts with the premise that i do not question in one inch the purpose of what the chairman's trying to do is to hold people accountable to provide better quality health care for our veterans. what the second and third degree effects of doing this would happen. and i think it's fair to try and find this middle ground. i certainly don't think this is an attempt at right to work of the government, and it will be characterized that way. it's not an 800-pound gorilla in the room. it's understanding that there are problems of accountability, people that need to be fired. i would make the case that mr. pummel could have done his job better and not give bonuses to an underperforming employee and move them somewhere else under the guise that he couldn't do
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anything about it. i think he could have, and that's maybe where we differ, and i agree that we have to find a place where that happens, and i think that's why the va committee's the best place for this to happen. you have chairman miller leading this on the exact tone, but no daylight between what the outcome or the goal is. >> here in the row. >> joel coopersmith. i now am directing a group for veterans studies. t va has always depended on the public sector. choice has been very good. it has enabled empowerment of veterans over their own health care. and if it gets to a point where the best resources of the communities and the va are used, i think that will be a great
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thing. however, there are about 7 million or 8 million veterans who are eligible for veterans care in the va who do not now use it. and of those who use it, i think it's 34%, they use it for 34% of their health care. and to increase it by 1%, i understand, is going to cost $1.4 million for each percent. so, as you expand choice, it could get to be very expensive. i wonder how you would respond to that. >> yes, it will be expensive, but the thing is, va, i can tell you how much it costs to see a doctor in a particular community. va, up until just recently, cannot tell you how much it, now they will say what the doc's salary is and the nurse and all of those things, but you've got to factor in the hard costs, too, as you understand. there was a study that came out,
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and i have yet to have an opportunity to read it, but the number was like $$250 an hour o pervisity, versus in the private sector, $40 or $50 or whatever medicare rates are. there should be a correlation, as you expand the choice that, you know, there is a savings within the va system, but you are absolutely right. the va has used the private sector for many years. if it wasn't for omar bradley who actually made the integration between the medical schools and the va, va wouldn't be near what it is today. and they still have a huge collaborative effort in that process, but, you know, what we have promised the veteran is that we will provide them quality health care. and whether that's in the v
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apartment or o a or outside the va, it should the veteran's choice as to whether they go and get that health care. that's why there should be these third party administrators right now at least through the choice program so you don't have somebody going out to the doctor who advertises in every magazine and charges three times. you have to get them in at a certain rate, obviously, that va can budget for. >> that's a great point. i would just quickly on this, that you hit on this again. you can't talk about this outside of health care in general, how we're going to deliver it and how we're going to care. i hear this, the veterans have a card bill, but how you frame this thing is becoming more important. that's why i'm glad that it's in the presidential debate. it's kind of like single payer health care. we can't call it that. the fact of the matter is what jeff's explaining what most veterans expect is that.
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but you can't do that and avoid where the cost is. you can get health care in some places that the outcomes are far better, the costs are far lower, and maybe it's probingial on my part. the may yoi clo clinic is able deliver that but sometimes they're dealing with specialty care. your veterans are going to have some of the most expensive injuries. you're going to take in all of the agent orange claim, all the gulf war claims. that's going to factor in costs. we, as a nation, have to figure out how to do exactly what he said, deliver that health characteristic the bethe best quality, the most timely, efficient manner and at a rate and cost that is do-able. and that's our challenge. >> the other interesting thing when the choice act passed, you heard great accolades from most people. then all of a sudden you heard people in the rural communities or rural states like kansas and
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alaska, oh, my goodness, they were using the arch, which was the pilot program, maine had it to. the reimbursements were higher under arch than they are under the choice act. and so they're like, we want to be let out of choice and remain in arch. so we'll find it. i mean, it's there. again, we've been at this now for less than a year. but i think that va atruly is changing the way they think about the delivery of health care for the veterans today, and i think the veterans will be better served. >> i think that's true. this is at a point i don't think we've been at. and i think we will all, veterans, americans, those on the committee. if we miss this opportunity, my fear is that we put out some of the short-term fires. you can be certain it will come
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back. now is the time to deal with it. >> we've got a couple minutes. i'm going to take two questions together. and in a perfect world, one would be for each congressman. we would let them sort out how they're going to respond. >> hi. from government executive. we talked about government accountability and the difficulties in firing federal workers, but what about hiring and training? are there areas where they are falling short, do you have ideas how they can improve that? >> it is way too hard in the system to hire somebody, especially physicians in this process. i met yesterday with some folks that do staffing of hospitals and things, and i asked them. i said do you do things with the va? and they said oh, yeah, but we get a doctor that's ready to go, and it takes so long to go through the credentialing process and everything they have
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to do the doctor's going to go somewhere else. so yes, getting people into the system is very, very difficult. they've got the dollars there. we gave them $5 billion in the choice act that plus upped the dollars that they needed to hire. but oh, absolutely. i mean, both ends of the sprek trum need to be revamped. >> he's exactly right. we have the capacity to plul tie task while holding people accountability and firing people. we need to simultaneously figure out how to hire and retain the best possible. >> i'll ask you two gentlemen to conclude. >> thank you for being here. in my former life i was a rifleman in the marine corps. congressman you mentioned three or four firings out of 300,000 or 400,000 employees? i'm not a mathematician, but i think that's 1 thousandth of a percent.
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>> as a junior the rifleman i could be denied reenlistment. the reason these people are fired probably has to do an a little bit with the administration, but fundamentally the reason we have to pass legislation to get sesers out is because of the civil reform act, justify biy i allow it. are you looking at enabling the firing of people that are incompetent, that kill veterans, that overprescribe opioids? >> i want to be very clear that i absolutely agree with that. but and the v apartment's a's g you different numbers. nothing bothers me more than
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see an incompetent person. the congressman has made that overture today that we have the tools necessary to remove folks that aren't performing, and it needs to happen. so i'm open to looking. and i think maybe in that you hear the spirit of this, i think considering the way washington has been acting, considering some of the issues that come up, i feel very fortunate and it's a testament to what the american people want and the people we get in the committee that we still work together to find this, with a respect to get there, using and i see many of them in this room, the veterans service organizations, private providers, all of the folks that are here trying to find answer. i think it would be disingenuous. i want to turn it away from the union versus not union. there's a difference in there. whatever it takes to deliver the
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highest quality health care on our promises is the one we should choose. i am not, i don't have an ideological dog that i'm tied to in this fight. what i care about is that outcome. and i think this committee is still going there. i would tell the american public that if we don't do this now, it would be very difficult. this is a moment in history with the public focussing things that are there. we should fine that answer, and i'm certainly willing to compromise where it needs to be to make it happen. >> let me make it clear. the number the secretary would say, i think he's fired 2200 since he became the secretary. about half of those were probationary folks. so they just didn't work out. so i don't really count those as firing, although technically, they may qualify as that. absolutely. times, they are achanging. and the american public wants accountability. they want accountability from us, as members of congress. and you hear it out on the political stump right now. people are angry, because they
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don't think their federal government is serving them well. they think the government is taking advantage of them, and that's the problem. they want people who want to do the right thing. they want to work. they want to take care of veterans. but people who won't or can't do their job, go do something somewhere else, because there are a lot of people ready to come inside the va. they want to come in and go to work. so yes. >> great discussion. thank you for all your excellent questions. thanks for being here and please join me in thanking these two gentlemen. [ applause ] our c-span road to the white house 2016 bus stopped in jackson, mississippi this week. jackson mayor tony yarber speaks on the bus. here's cheer leading squad posing for a photo. to track the bus, follow us on
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twitter and instagram using #at the bus. the of sub committee hearing is live here on c-span 3. a a defense spokesman briefed reporters from baghdad on u.s. military operations against isis. colonel steve warren told reporters that the recent announcement bit u.s. to send special forces to syria would not change the coalition's efforts. this is about 45 minutes. good morning, and thank you for coming out at the earlier time. sorry for the technical delay. as you know, we fall back and the folks in baghdad do not. we've moved the time back on our
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end to accommodate steve. steve, can you hear us okay? >> i canla larhear you loud and clear, thanks. >> i will turn it over to you. >> thanks, jeff. and pentagon press corps, it's good to be with you. i can't sigh you today, which normally, i can. if i look down more than usual, that's why. so i've got a few prepared comments i'll start with. we'll go to questioning. today i'd like to start with an overview of the battlefield. i'm going to start west in syria and move to the east. so i'll jump right into it. on october 31st, along the so-called marra line, north of alip boy, forces of the syrian opposition resumed the offense, this is north of aleppo. vetted syrian opposition groups
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along with syrian forces that we trained in turkey participated in this effort to pressure the isil along the turkish/syrian border. of note, turkey provided synchronized air support for this mission, using f-16s, the turks conducted several strikes which destroyed enemy fighting positions and killed over a score of enemy fighters. further east in syria, in the vicinity of al hal, the syrian democratic forces conducted an attack from the northeast to the southwest. of driving isil back and reclaiming approximately 255 square kilometers of ground. of note, because we supplied the vetted syrian arab coalition, what we're calling the sac with ammunition on october 12th, that force was able to conduct this
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afault as part of the sdf. this is important because al hal is predominantly an arab area, and the zasac is the arab component. they had 17 airstrikes, destroyed isil vehicles, fighting positions, weapons systems and killed 79 enemy fighters. while this was not a loorge tactical operation, we believe that it demonstrates the viability of our program to provide support to these forces and further demonstrates our operational effort to pressure isil from multiple directions at the same time. both of these actions also tie into the accelerant that we announced on friday. if you recall, friday's announcement mentioned deploying a-10s and f-15s. those a-10s were among the platforms that provided the air power for this action.
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continuing east into iraq, kurdish forces are massing near mt. sinjar. the city of sinjar sits astride highway 47, which is one of isil's primary routes for funneling equipment and fighters between mosul and raqqah. i'm not going to get into the specifics of our operational plan, but i can tell you that since october 1st, the coalition has conducted 104 airstrikes as part of the shaping fires. 48 of those strikes just since october 21st. continuing east to ramadi, after several days of bad weather, iraq ei forces have restarted there. of forces have advanced several kilometers. and, as we speak, they are fighting inside camp warar. all forces continue to encounter small arms fires and ied
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clusters. coalition forces have conducted 18 strikes in ramadi since we last spoke on the 28th. in beiji, isf and federal police continue to enforce their positions. the beiji oil refinery and sanaa. the of of iraqi air force continues to fly in beiji and continues to fly throughout iraq, striking isil targets as they're able to develop the intelligence picture. so to finish you up, i know there's been a lot of discussion about the accelerant announced on friday. from our perspective here in baghdad, the coalition strategy has not changed. this tour of the battlefield i just gave you is in our view ill str illustra
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illustra illustrative. the coalition provides devastating air power all along the way. this week isil lost ground. we're going to continue to operate this way as long as it works well. if needed, we'll adjust. we've demonstrated we are able to recognize when our approach needs improvement or where we need to am aplify an approach wn it's working well. this is awkward for me, because unlike normal, i can't see you, but i guess bob or whoever's there, let's start with you. >> hi, steve. it's leta. thanks for doing this. does this success you're talking about in terms of the air coalition suggest that there will be another drop of weapons of ammunition soon and/or is there more consideration to providing them actual weaponry? and then, could you just give us
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a quick update on russian airstrike activity, please, in syria. >> sure. on the weapons resupply, yes, the answer is yes. in fact, this al hal operation really was the validate irfor that program, right. >> i think i told you when we first did this airdrop that we were going to keep an eye on this initial 50 tons of ammunition that was dropped. we were going to validate that it was distributed and used properly. we have seen that. we believe that this success, this 200-plus kilometers of ground that the syrian arab coalition has managed to take, to some extent validates this program. it's not a complete validation. i want to be clear about that. but we're encouraged by what we
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see, and, as i said earlier, we intend to reenforce success. on russia, there has been an increase in russian air activity this week. they are supporting forces that have initiated offensive operations. i think probably most notably in aleppo, and that has met with mixed success. the regime forces in some areas have managed to gain a little bit of ground. in other areas they gained ground, they were counterattacked and lost the ground that they gained. so it's a tough fight in aleppo and in other areas where the russians are operating. and, you know, it really bee lays the point that we believe that the russian decision to double down on their support of the assad regime is, you know, strategically short-sighted. we've seen reckless use of
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munitions, primarily dumb bombs, dropped without precision. and, you know, this is concerning to us. we've long asked, we've long called on the russians to do what they originally said that they would do, which is to fight isil. we have not seen that. >> just to follow up, will we see another ammunition drop in the near future, and has there been a decision to definitely provide small arms to the arab coalition? >> right. sorry about that. so i think you will see continued resupply of these forces. i don't want to telegraph times, obviously or even approximate them. but i am comfortable saying that you'll see us continue to reenforce the system you've already seen. i don't have a good edge on weapons.
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my understanding is that weapons are in the decision matrix, but frankly, i don't know if we've made that final decision yet. >> steve, i would ask you about the ypg. we told by a senior official that the ypg would not be getting any ammunition or weapons, and if that were to happen, you'd work something out with turkey. where are you on that? presumably, the kurds would like, the ypg would like weapons and ammunition, so where does that stand? >> yeah, as of now, we're not providing weapons or ammunition to the ypg, the weapons that weave provideds through far or the ammunition that we've provided in our one airdrop that we've executed was for the syrian air coalition. as of now. future resupplies will also go to vetted syrian opposition
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members. so, you know, as of now, that's where our policy stands. >> what about talking with tur sdm key? that's what the official suggested. is that going to happen or not happen? >> the turks are both a nato ally and a close partner here in this fight. so we're going to continue discussions with the turks. i'm not going to get into the details of our diplomatic discussions, but yeah, we're in very close contact with them. i'm not going to telegraph what decisions that we've made. obviously, the turks, you know, obviously, the turks have concerns. they're our partners and allies. we're going to work with them to achieve our common goal, which is to defeat isil, right? and, again, the turks showed tremendous work from the turks up along the mara line up in northern syria. very pleased that they were able
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to provide close air support to vetted syrian forces. these are the very forces that we trained in turkey, infiltrated back into the class one and class two that we talked about over the summer. so, you know, and i'm highlighting that, because, you know, we keep, you know, we've heard so much discussion of how this was a failed program, and et cetera. yeah. it's a program that we've discontinued. butt resu but the results of that program are out there on the battlefield right now. >> hi, steve, quick follow up on al hal. can you give us a sense of how big this town is or village is that was cleared by theis group and how the operation went? and the other question i would ask on special operations forces, has there been any additional activity in iraq by u.s. special operations forces
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accompanying iraqis? can you give us any sense of how far beyond the kind of training activities they've been doing, what kind of activities they've been doing outside the wire in general and especially since, if there's been any activity since the new decision on friday? >> phil, i'll start with the second part of that question, and then you'll have to ask the first part again because you broke up a little bit. so the second part of your question just to review. you asked about soft accompaniment, the soft advising the mission here in iraq and what they're doing. so from the beginning these sop accompaniment missions they've been adjustable based on conditions on the battlefield. what we've seen up north in the kurdish area is that we have a
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static or a well-held line of troops. there's a clear line between friendly forces and enemy forces. so that allows our sop partners to or our sop forces to be able to partner more closely with the kurds that they're supporting. so they are linked up with units. they are providing advice, assist. and they are willing to move around outside of the wire when the conditions are right. and the conditions really have to be that we don't believe there's imminent threat of enemy contact. and in all cases, the sop portions need to stay back from the front lines. so i don't want to get any more detail than that for i think obvious protection reasons, but our advise and assisting personnel are actively advising and assisting. and we've seen that takely nopay
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notable in the north where there's more freedom of movement. so we're able to move more in accordance with our own preestablished standards, which is the threat of enemy contact as well. so reask your first question. you broke up on me. >> the first part of the question was on the initial operation. you said that the sac had helped clear this village. i think it was al hal. can you give us a little more detail on that operation, how big is this place that they took? how long did the operation take? can you give us any kind of die ta -- detail so we request bette understand it. can you put up the slide. >> since i can't see it, you'll have to tell me when the slide's
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up. >> we got you up. you're good to go. >> okay. great. so, of course i can't see it, so i'm going off of memory lehere. you see al hal there. it's in the vicinity of al hal. what we have here is the syrian arab coalition, armed with the ammunition that we provided on october 12th. on the upper right hand corner of the map. they pushed toward the lower left hand corner of the map. sow siee al hal outlined in blu. and you move from the upper right hand corner down toward the lower left hand corner of the map. it was a fairly straightforward conventional operation. we estimated the enemy situation
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to be several hundred enemy located in that vicinity, there was a substantial friendly force, well over 1,000 participated in the offensive part of this operation. and they were able to very deliberately executing the plan that they had made themselves and supported by, by coalition air power, they were able to take over 200 kilometers worth of territory. i think it's notable. and i said this in the opener, but i want to reemphasize it. as we talk about the accelerants, we talk about the importance of repositioning or being able to position more assets. and what that does and, again, it shortens our legs, right? so the aircraft, because they're only flying from interlick into the battlefield, they're able to do more turns quicker, they're able to loiter longer, and we
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saw that make a difference here where we're able to bring a-10s and specter gunship. and what can only be described as a devastating manner, we killed nearly 80 enemy fighters and the syrian arab coalition fought with valor. they showed us something here. and we're pleased by that. >> steve, hey, it's andrew tillman. i want to ask you a little bit more detail about ramadi. specifically, is isil still able to get supplies in and out of the city? or have the iraqi forces been able to fully isolate and essentially put the city under siege? and also, a few weeks ago you told us that you felt that the iraqis were ready to make a final, full-scale assault on the city. are you, are you sighing that? you indicated that it stopped for a few days because of weather. but are the iraqis mounting the
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kind of full-scale attack on the city that hundred hoped to see a few weeks ago? >> hey, go ahead and throw the ramadi slide up. we believe the conditions were set for the iraqis. we have been encouraging them to do so. that said, it remains a tough fight. so they have not completed the encirclement of the city. the enemy is able -- is the slide up? >> you said they have now completed or they have not? >> not. >> go ahead. we've got ramadi up. >> okay. ramadi's up, good, so yeah, what we've, what we're seeing is, again, a tough fight. the enemy has established
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complex and in many cases sophisticated defensive barriers along the various avenues of approach into ramadi. so isil's primary line of communication right now is the euphrates river. so we have not been able to cut the euphrates river yet. so we have forces along the north. they're moving sort of south and west. on the western access they're moving east. so the western access is to the left hand of this slide. and they're moving towards the right hand of it. in the south, off the southern edge of this map, you have the southern access, which is fairly well-established in the vicinity of anbar university. and to the east, we have federal police, primarily, which is established the blocking
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position to prevent any enemy from moving east into fallujah. of so that's kind of what the battlefield looks like. and, again, the key part here is at the upper portion of the map where you see, one, it crosses the euphrates river. that's the palestine bridge. they've been able to cut the u flat ease river, which will substantially, significantly constrict significantly constrict isil's ability to resupply itself. isil knows that. that's their primary line of communication. so they're defending it fiercely. this fight is going to continue and it's going to continue for as long as it takes to get it done. >> hi, steve. it's carla. last week you had said that ramadi was surrounded on four sides and that they were squeezing in.
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so what's the difference now? is it just that they're squeezing but they haven't squeezed in enough to shut off the euphrates? is that how i should interpret this? >> yeah, that's exactly right. this encirclement that the iraqi security forces are attempting to complete, they've got the south and west essentially locked up, the east is blocked, to the north there's movement, you know, south and west. but you've still got a space towards the top of your map there that remains open. so when they're able to complete this encirclement, they will have been able to reduce the enemy's ability to resupply it. that doesn't mean there's in way to create an impeer meebl barrier around a city. the enemy will have the ability to resupply itself to come
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extent. but once that euphrates river line of communication is cut. we'll see, i think, a significant reduction in isis's ability to reply itself with weapons and fighters. and then, you know, it's on to the hard part, which is urban fight. our enemy here has had months to prepare complex depences inside the urban area of the city. and that is going to be a difficult, hot, dangerous, scary fight. and it will take a while. >> hi, it's andrew again. when you say that the river is their primary line of communication, are they bringing supplies in by boat? is that what you're saying, that the river is navigatable and that's how they're bringing supplies in? >> yes.
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that's exactly what i'm saying. we do our best to keep an eye on. ef once in a while you'll see that we struck a boat. but that river is full of traffic. it's a hoo, highway, a water born highway. we have to have the proper intelligence. we use very stringent civilian casualty reduction measures. we're not in this to accidentally strike civilians. so we go to great length to ensure that we don't do that. but yeah, that's the primary line of communication right now. >> colonel warren can we go back to syria for a moment. do you see any indications that russian forces are moving further to the east with their helicopter or other forces closer to palmyra, closer to isis strongholds that they might plan to increase their actual
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isis strikes? >> jeff, can you repeat this question? i didn't get a word of it. >> russian movements toward the east toward palmyra. >> the russians are all the way to the east, or to the west. they're moving east, right. i don't know that they're moving toward palmyra. i've seen reporting that there bes been some strikes in the vicinity. u the regime forces aren't conducting an operation, at least not a significant one. palmyra is a fairly major and fairly significant feature. you know, the regime wants it back badly. i certainly wouldn't be surprised to see that. but i have not seen anything to indicate significant activity there. their focus right now is in
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aleppo. >> and gary, i got you. >> hi steve. back on the force and the syrian coalition, i know it has been discuss a lot but yesterday there was an article in "the new york times" saying that while -- after ten days of interview with the commanders and fighters on the ground, it found out that actually the syrian force is just existing by name and a defense official told the same newspaper that syrian coalition actually is an american invention to cover up the supply to the kurdish forces. could you comment on this or identify the differences between the groups, the relations between the two groups? that's it. thank you.
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>> i barely heard a word of that. we're definitely suffering from some technical problems. i think what you asked is who are the difference between the syrian democratic force and the coalition? >> he was asking you about the "the new york times" article yesterday, syrian arab coalition, u.s. invention to cover up u.s. supply to kurds. >> yeah. we're not trying to cover anything up. we're providing weapons, or in this case ammunition to the syrian arab coalition. that's what we said we're doing and that's what we're doing. it's a larger force made up of syrian arabs, christians, and kurds as well. it's a larger kind of force that's, again, sort of a team of teams or a group of groups. these are various groups from
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various sects and religions were various groups that have come together to defeat isil. we're supported them. the air power that we brought to bear along the turkish border since the beginning of the operation has been significant and it's allowed the primary kurdish forces to regain territory all the way from the syrian iraq border in the east all the way to the border. we've not tried to hide that. we've been very open about that. that said, we understand that there are -- there's a limit to how far kurdish forces can push south because of the mixes there. so that's why we see the syrian arab coalition come into play and that's why we're providing them with the support that need so they can can't pushing south. >> do you deny the "the new york
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times" article? >> well, it was a long article. you got to be a little more specific. >> i'm going to take gary. >> steve, hi. two things i wanted to ask you about. first of all, you'll know that britain is now much less likely in the future to supply any air power to assist in syria and also we know, of course, the canadians with their new leader are planning to withdraw that facilities for air strikes too. is that going to have an impact on what you do over syria? and secondly, were there any prisoners taken? were there any senior ranks taken? what happens to the prisoners that are taken in those
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circumstances? who intergatro gates them, whero they go? >> again, we right now don't have any personnel in syria whatsoever. so i don't have an answer for you frankly. we expect -- when we removed the leadership of the syrian arab coalition off the battlefield to spend some time with them, giving them briefings and training, part of that training focused on law of the line warfare. part of that is to appropriate treatment of prisoners. we have trained these personnel or the leadership of these personnel in the appropriate use of prisoner procedures. and of course with the convention and the established
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international norms. so, you know, and of course we expect them to follow that training and to, you know, force follow the geneva convention law of ware fair. we do not have eyes on the ground. prisoners are taken by the coalition forces on the ground are a mat are for the air coalition forces on the ground to speak to and to handle. going back to your -- i couldn't quite get it. you were asking something about air strikes in syria and the british participation. i didn't quite get it. >> following up on what you just said first of all, you did say when you had the raid that you captured significant intelligence as part of that. you were interested in intelligence that was available in that operation. why wouldn't you be interested in getting the intelligence from
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the capture of prisoners in syria. and you know now that britain is less likely to conduct british air strikes. and you know of course the canadians are planning to withdraw their support for air strikes inside syria. is that going to have an effect on your operational capacity at all? >> well, i'm not going to get involved in national politics of the coalition partners. we appreciate the contribution of every single one 0 our international partners and we understand that every one of our international partners have to contribute in accordance with their own national security objectives and national policies. every time we lose impact, there's some impact. but we have other coalition partners, so we make it work. on intelligence and prisoners, of course we would like intelligence. we want intelligence from
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anywhere we can get it. that sad, we don't have personnel on the ground if syria right now and therefore we're not interacting with any of the prisoners that are taken. >> lucas, let us know, steve if you're having a hard time hearing lucas. >> hey, colonel warren. it's lucas. is there any information that they're going beyond aleppo and striking isis targets? >> didn't get it, jeff. what did he say? >> any indication that the russians are going beyond aleppo and striking isis targets. >> yeah. the russians have only struck -- they've been hundreds of air strikes at this point. i'm not putting out the count anymore. but you know, they're continuing to conduct air strikes but only a fraction of them have been against isil targets. when i'm saying a fraction, i'm
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talking under 10%. a number of their strikes have been using dumb bombs, gravity bombs unguided and very unsophisticated. they've hit a smattering of isil targets, some in aleppo to answer your question, but their focus has been in support of the assad regime and whatever the assad regime's objectives are. so if the assad regime's objectives are in a location of isil, isil will achieve the attention. but the majority of the regions that assad has been interested in are syrian regime that are not isil. >> we're going to do the phil don hugh method. >> is the announced deployment, does that have anything to do with the type of aircraft that the russians have deployed to
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syria? >> well, you know, i wouldn't get specifically into those details. we've said we're going to have a mix of c and d models. anything researched with the specific models. but we position platforms at various locations based on where we expect the mission requirement to be. >> have anything to do with keeping russian air superiority fighters in check? >> you know, again, i'm not going to get into specific details. i want to assure that we've always got the appropriate mix of air to air capability and air to ground capability and direct ground strike capability. we're always adjusting and we're going to assure that whatever aircraft we have operating in the skies in syria is appropriately supported. >> back to the boats on the
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euphrates river. does isis have a navy or a gun boat navy and are they capable marine mariners? and that's all. >> to my knowledge, isil does not have a navy. what they do have is the ability to get in barges, float down the euphrates river. that's what we're seeing. again, when our intelligence picks up, you know, homemade explosives or foreign fighters or some type of war making material, sometimes we can see it getting loaded on to a barge. sometimes we catch it at that time and we're going to sink the ship or the barge or the boat. but there is a lot of civilian traffic along that river. so we are going to be careful. just like ever highway. we're not going to hit every single vehicle. we have to be confident that we know what we're striking is the enemy. so, you know, that's our
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standard. it's a golden standard unmatched throughout the world and in the history of aviation. but when we do see an isil barge floating down the euphrates river, we'll sink it rapidly. >> steve, this is mic. could you describe for us, please, the level, the content and frequency of communications between the russian and u.s. militari militaries? so, you know, we established this memorandum of understanding with the russians. it was signed several weeks ago. it established some protocols for how we interact with the russians over this skies of syria. one of the provisions of that mou is that we wouldn't make it public. so we haven't. what i'll tell you is that, you know, we are in contact with the
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russians regularly to ensure that we all understand kind of the rules of the sky. as you know, we executed or we conducted, you know, a radio check last night. this was, you know, u.s. fighter aircraft and a russian fighter aircraft. it was preplanned that these two aircraft would come together in the skies over south western syria and establish radio communications along a preestablished radio frequency. so we executed that test, only took about three minutes to get it all done. afterwards there was a phone call between the russians, to kind of go over what happened. we're going to continue that because, you know, as we've always said, safety of our forces is one of our primary concerns. and in this case establishing these safety protocols is key
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and critical to ensuring the safety of our personnel. but i want to be very clear with you, mic, that's all it is. we are not conducting any type of coordination on strikes. we are certainly not running our strikes past them. we're not asking their permission to do anything. all we're doing is establishing an open line of communication to ensure that if there is a midair emergency or a midair encounter of some sort that we've got established line of communication to enable us to quickly mitt gate that. >> steve, it's phil again. just to clarify. you said one of the provisions of the mou is that the u.s. and russia won't make the publications public. can you clarify what that is and did russian violate that by putting out a statement about those communications yesterday?
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>> no. i don't believe they violated it. although i'm not in the legal community, i'm certainly no international lawyer. but the sense is no. they didn't tell us they were going to issue out the release. but so no, we don't believe they violated it. the first part of your question, what was it again? >> you said the mou, one of the provisions of the mou is that such communications wouldn't be made public. can you collar fie what you meant by that? >> jeff, can you repeat that question? you just broke up completely. >> steve, you said one of the provisions of the mou is that the u.s. and russia would not make such communications public. i thought that's what you said. could you clarify what you meant by that? that's it. >> now, okay. i got it. no what we said is we would not like the mou public. we would not make the mou
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public. i'm sorry, would not make the provisions of the mou. that might have been where you didn't hear me. we agloed not to make the specific provisions of the mou public. from where i sit, i don't believe the russians violated anything. if you want i can find a lawyer and figure out if they did. this is a small thing, right? it was a communications test. the communications test was conducted successfully. and we're all moving on with our d day. >> hello, colonel. i would like to come back to the question of did "the new york times" article about the syrian arab coalition, it was -- someone is quoted in the article saying that it is an invention, this syrian arab coalition is an american invention.
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what element consist you give to explain that the syrian arab coalition does exist and it is active. what can you give us to understand that? >> sure. that's easy. the syrian arab coalition seized over 200 square kilometer of terrain over the last couple of days. so i don't care who invented it. it's a fighting force on the ground in syria. it's been supplied 50 tons of ammunition by, you know, an american air drop executed on 12 october. and now they're battling isil and seizing and holding ground. i'm not sure who cares who invented them. what they are is a fighting force in syria that's aligned with us that's in the process of
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killing peterrorists. >> why was the operation chosen for the area around al has wall. what's the significance of that ar area? >> that's where they wanted to fight. that's where their forces already kind of were located. there's an enemy force position there. i don't want to get into the specific details of what other operations that may not have happened yet that it's tied into. but what i'll tell you is it was a good -- it was a well-planned, well-executed operation that in fact in some ways is still on a much smaller level, they're conducting their consolidation of reorganization. they'll reset and be prepared for further offensive operations. >> all right. we got nancy. does she have her voice back? tom is going to ask a question on behalf of nancy. imagine nancy's voice. >> just imagine this is nancy
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and not me, all right? nancy would like to know in the area around there, how populous is that area? are we talking desert? and i actually had my own question. we keep hearing the term thicken the air strikes. we heard that from a senior defense official on friday. i think ash carter mentioned that as well. the air strikes will now thicken. why are you doing it snow? why didn't you do it many months ago when everyone was complaining that these air strikes were too little and too late? and lastly from nancy, how many fighters there? >> nancy, great question. tom's question, not so much. but nancy, your question your question was good. i don't have the statistics.
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the enemy strength in that area was several hundred fighters. i don't have a good answer for you unfortunately. you know, you can see where -- i don't know if you pulled the map up. i'm looking at the map right now. you can see where it is in relation to sinjar and hasaka. so you know, it's not a densely populated area but certainly it's a town in syria occupied by isil fighters. and again several hundred isil fighters in this case. on the thickening piece, that -- the reason we're able -- that i guess -- i don't know that thicken is necessary a term. it's descriptive. what we're looking at doing is not necessarily -- it's related or linked to the opening of the air base. now that we've got the ability to fly out of turkey, like i
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said earlier, our flight legs are shorter. our loiter time is longer, our response time is shorter. so what that does, you know, the impact of that down the road, so we haven't made a substantial shift. we haven't committed a higher number of resources. what we've done is because of the turks allowing us this access, what we've done is be able to have more air presence in the battle space when we need it. does that make sense? so it's kind of a cause and effect. it's open to more of the combat aircraft and other locations throughout turkey have become available. what that does is allow us to reposition so that an aircraft doesn't have to fly 1,000 miles before it has the opportunity to release its bomb. but that crushes the young crew. has all sorts of these second and third order effects when you have two midair refuelings on the way out, two on the way
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back. there's all sorts of different factors that cause the opening or -- or the availability of ramp space in turkey to allow us to thicken our presence in the skies over syria and iraq. does that make sense? does that answer your question? >> hi, it's jacqueline. you had said that part of the reason the u.s. couldn't collect any intel from the operation in al hal was there were no u.s. forces in syria. do you expect the 50 special operators will be able to increase the u.s. ability to collect intelligence from things like that? >> well, everyone, you know, in uniform is a collector. we always collecting intelligence no matter where with reand what we're doing. that goes without saying, i think. but the purpose of these forces is to advice and assist our
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friendly forces there. >> all right. anyone else? last call, going once, going twice. steve, thank you very much for your time. we look forward to seeing you next week, if not sooner. rchlts thank very much. sorry to bring you guys in an hour earlier. but if we had done this at 1900, we would have missed dinner here. thanks for letting me get dinner. we'll see everybody next week. every weekend the c-span networks feature programs on politics, nonfiction books and american history. as the nation commemorates veteran's day, saturday starting at ra history will be live from the national world war ii museum in new orleans as we look back 70 years to the war's end and legacy. we'll take your calls and tweets. and starting this week and every
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sunday morning at 10:00, our new program takes a look at the past presidential campaigns. this sunday will feature ronald reagan's 1979 presidential campaign announcement. and on c-span saturday night at 8:30, the debates of the effects of legalized marijuana in colorado and other states around the country. and our road to white house coverage continues with maryland governor and democrat presidential candidate martin o'malley who will speak at a town hall meeting in durham. and saturday afternoon on c-span 2 book's tv, it's the boston book festival, including jessica stern on the terrorist group isis, joe cline and his book about two iraq and afghanistan war veterans who use their military discipline and value to help others. and james wood and his book on
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the connections between fictional writing and life. and sunday night at 11:00, a book discussion with ann romney on her book "in this together" about her journey with multiple sclerosis. get your complete schedule at c-span.org. british prime minister david cameron answered questions from members of the house of commons on the military and veterans. the uk observes remembrance day on november 11th. he also answered questions on tax credits and longer waiting sometimes in the national health service. this is about 35 minutes. >> order. questions to the prime minister, mr. craig tracy. question number one, mr. speaker. >> thank you, mr. speaker. at the last prime minister's questions i know the whole house will join me in paying tribute to all of those who have fallen
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serving our country. they gave their lives so we could live ours in freedom and it's right to pause and reflect every year on ar mists day. mr. speaker, this morning i had meetings with ministerial clegg colleague and others and i should have further meetings later on today. >> craig tracy. >> thank you, mr. speaker. i would like to associate myself with the prime minister's comments. i look forward to joining the parade in any constituency which has been in existence since 1921. speaking to constituents, the government commitment of 2% gdp spending spending was welcome. given the volatile states of the world, it's more important than ever that we maintain the commitment and give our brave troops the support and

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