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tv   Key Capitol Hill Hearings  CSPAN  October 16, 2015 3:00pm-5:01pm EDT

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question with a minimum comment. >> i'm wondering, lieutenant governor, you talked about the importance of home visits, as a social worker who's moving into policy, i agree with you they're very important. but what do you think about but what do you think about increasing training and just education for the people that are going into the homes talking about this? it's often a really hard conversation. there a lot of religious and moral objections to birth control for teens, so just wondering what you would do for the people that are actually providing that? mr. northam: it's a wonderful question and i thank you for bringing it up, because when we talk about going into homes, do we have the manpower, if you will, the number of social workers, and nurses, and whoever we choose to take into the homes. the answer to that is no. we're very underfunded for that. just to give you an example in hampton roads, where we have a program, a statewide program
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where we go into homes. for every one home that we visit, there are ten others that need our help. so we're chipping away really by what we're doing right now. but you're exactly right. and not just in that area, but mental health issues that we're working on in virginia. we're very much underfunded and understaffed with psychologists, social workers. so it's all about priorities and all about where we want to make our investments. but your point is well taken and we do need to make sure that we have more individuals that are trained to do that, and able to get into these homes and help. try to bend that curve of poverty, that's what our intentions are. mr. haskins: right here on the aisle. wait until you get the mic. >> thank you, i am a virginia voter, so thank you for being here and your service. mr. haskins: that sounds like a
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warning to me. >> i would suggest that the smoking analogy is slightly off, since most religions didn't think that smoking was a sin. and there are still a number or religions who think sex outside of marriage is wrong. so there's that difference there. but the political, the question i would actually like to pose to you is that you say the people will ultimately choose. but the people that are actually the people who vote who choose to come to local elections and state elections, and not just national elections. in the state of virginia women between the ages i would say of 21 and 35, do not necessarily come out to vote. i'm not a politician, or a pollster, but it's pretty obvious. mr. northam: you're on the right track, you're doing very well.
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>> i would ask you to comment on the need or the role for outreach to the voters who don't vote in local and state elections in states like virginia regarding issues like this. mr. northam: your point is so well taken. and i think a lot of us if we remember back to when we were 25 years old, politics and policymaking was not real high on our radar screen. one of the things that we're doing and we're very active, at least in virginia, i can't speak for other areas, but is going to our colleges and universities, community college systems and talking to those individuals and talking about these very issues just like with larcs. and whether legislators, most of whom are men by the way, should be telling women what they should and shouldn't be doing with their bodies, whether legislators should be telling people who they should love, who they should live with. that is all part of the process as we move forward to make our
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young folks -- and the reason i'm so interested in this is i have a 27 and a 24-year-old. i see their friends. i see what's important to them. i am working as hard as i can and a lot of other folks are, as well, to make sure that we do reach out to that population. just as a follow up and a conclusion of that, when we do do polling, when i ran in 2013 for lieutenant governor we knew that the people that would be voting were elderly and women. those were the two big areas. that's who the folks that were heavily targeted. does that mean that we should ignore the rest of the folks? no. that's our job now is to get out and make sure that in the next election, that it's not just the elderly and the women, but it is young folks who are educated and in colleges and universities, so that's all part of the overall plan. but you make a great point.
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i don't know what your career's in, but politics and polling may be good for you. mr. haskins: another question. over here in the middle up here. and then the next, and last one, will be on the back aisle there. >> lieutenant governor, i'm also a virginia resident and voter, and i want to congratulate you on whatever role you had in turning around the bogus regulations of clinics. there have to be some challenges for the next several steps to make sure that it sticks. so what do you see as the challenges? where are they coming from? what is your approach going to be? mr. northam: that's a great question. those changed the structural regulations for women's reproductive clinics. i certainly don't want to get off on a tangent, but that was done in the guise of making it safer for women.
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and the data is not there to support that. my concern, as a pediatric neurologist, and as physician, i have people like me that are doing procedures. in our office, for example, i do lumbar punctures. you have gastroenterologists, plastic surgeons, dermatologists, that are doing procedures that are much more dangerous than an abortion, if you look at the data. my question to them when they introduced and then unfortunately passed this legislation, am i next? if you're worried about the safety of our patients, what's going to happen if you think this out? so right now we have been able to kind of stop the progress of closing down our women's clinics. that's all through what we call an executive order. that's done through the governor and the board of health. what needs to happen, if we're going to make those changes permanent, is we need to change some of the seats in the legislature.
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right now the republicans have the majority in both the house and the senate. so it's difficult to go back on laws that have been passed. but that's down the road, what we would need to do and what we would hope to do, to i think to keep virginia moving in a positive direction. i would just tell you that a big part of my job, as lieutenant governor, is in economic development. we want to bring businesses, manufacturers, jobs to virginia, because that's what pays for all of the things that we like to talk about. if we're going to do that, we need to have the lights on, as they say. we need to welcome people. we don't want to deter women from coming to the commonwealth and folks like lgbt community, we want to accept anybody that would like to come and live in virginia. so that's the direction we need to go in, i believe, to move virginia forward. mr. haskins: so governor, before we end this panel, i have a suggestion for you about how you
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you can, this is a suggestion about how to advance the debate on larcs. and that is that we mentioned the colorado situation where they had a big fight and republicans were opposed to paying for larcs, or extended birth control. and they won. despite the fact that one of their most conservative members, led the fight against his own party. so i suggest you invite him to virginia to come down to talk to republicans in your legislature. mr. northam: i think that's a great suggestion and we'll take you up on that. mr. haskins: good. invite me to come, because i want to hear what happens when you do that. join me in thanking the lieutenant governor. [applause] bear with us for a minute, we're going to bring up more opinions. thank you very much.
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now we have a disguised panel of people with lots of views on these issues. i hope, you probably all memorized my last slide about
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all the advantages we could get if we were more successful in ending or at least reducing the number of unplanned pregnancies, and for almost every issue on there, someone on this panel has studied it, written about it, thought about it, so i'm hoping that we'll really dig into some of these issues. so let me just introduce the whole panel and then we'll proceed. so this is andrea kane. she's the head of policy at the national campaign to prevent teen and unplanned pregnancy. i worked with andrea for many, many years, and my typical response to her is, yes, ma'am. that's what i'm going to do. it's amazing how much she knows about what's going on in the hill. i really like people like that that keep up on the hill. i've been able to have contacts through lots of staffers on issues.
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i call andrea and she tells me who to call, so that's very good. to the extent possible it would be great if you could reflect things that you have heard about on the hill in your remarks. then rachel gold is from guttmacher institute. she just wrote a wonderful paper. on coercion, and that's an issue that we're very concerned about that some women may feel -- the lieutenant governor brought up the issue of males telling women what they should do, and they we throw racial issues and ethnic issues into the match. this is an area that we ought to anticipate and be sophisticated about or we could really cause some problems or even worse we could do things that are wrong. then mark edwards. mark is a wonderful story. mark was on the board of directors at the national campaign to prevent teen and unplanned pregnancy, and talk about turning someone into a true believer. he quit his job and moved to another city so he could start an organization called upstream, and he now flies all over the country and he tells people how
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they can bill the federal government to pay for birth control measures. is that right? rachel's reaction was, oh god. anyway, mark really knows a lot about this because he teaches states how to set up these clinics and train their personnel and all the issues having to do with what it takes to do a good job, especially with regard to having a good program that makes larcs available. they each have a chance for an opening statement, and then i'm going to try to stump them, and then you get a chance to try to stump them. so we're going to begin with mark. mr. edwards: i've been introduce lots of ways. never that way. i want to thank you for today and for your incredible work. part of that story's actually true which is that the two of
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you really have inspired me to change what i'm doing to work on this important issue. i remember when i read the creating opportunities society, which was an extraordinarily powerful book. i think this volume here is fabulous. i will admit my bias. i think that helping women achieve their own goals and become pregnant when they want to is one of the most powerful things we can do increase opportunity and economic mobility. upstream usa delivers training and technical assistance to health centers so they can offer their patients the full range of contraceptive methods, particularly the most effective ones. we've done work in about half a dozen states around the country. one thing we didn't talk about as much in the beginning here is that the government, all the governing bodies in the medical field now are really behind these methods, so the cdc sort of talks about how important it is to have access to these methods. the american college of ob-gyns, and most recently the american academy of pediatrics has come out with a definitive committee
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opinion saying that iuds and implants should be the methods of choice for all women, including all adolescents. so this is really sort of middle of the road sort of modern contraceptive methods. part of what we do is acknowledge that there's a big gap between what the policy may say and then what actually happens in health centers. what happens more often than not is that women are given a false choice when they go to a health center. they're told you can get the pill today or it'll take you two or three visits to get one of these other methods of contraception. as an aside, only in women's health would this kind of a false choice be available. if there was a really good stent that was 20 times more effective than a regular one there would be law suits if you couldn't get those methods the same day, but we can't. and so when women are faced with that choice they will either use the pill, and we know that the failure rate in the pill is really quite high, or they'll say they'll come back for one of these other methods. they don't come back and they often will come back pregnant. so we've had a couple examples that illustrate, i think, what can happen.
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the very first health center we did some work in was in amarillo, texas. a place that has incredibly high rates of unplanned pregnant, teen pregnancy, premature birth, and this is a health center that just wanted to do best in class medicine for their patients. they are now, after the training, making sure that the entire health center is aligned to make these methods available same day. that means not only training clinicians and providers on how to place iuds and implants, but also ensuring that they can bill for them, code for them. they can schedule properly and they can be counseled properly. too often patients aren't counseled. they don't know the difference in the efficacy rates between these various methods. what the data shows that when you tell patients about this, and you make them aware of the various efficacy rates they will often, on their own, chose iuds and implants for themselves. my colleague rachel's going to talk about coercion, which is a
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really important piece of this here. we should not be forcing women to do anything. they should be given a true choice, and unfortunately, the choice they have right now is not a true choice. but at this health center now they're doing six times as many iuds and implants as they were before the training. what's most interesting though is that also their revenue is up about 400%, and it's largely because of word of mouth. when women know that they can get these methods they are then tell their friends. patient volume is way up. satisfaction is way higher. we asked patients who chose the method? did you choose it? did you choose it with your provider or did your provider choose it for you? i think it's a really important question because we want to make sure women are not being forced into this. what we're finding is that upwards of 95% of the women are saying they chose the method. when you give women full information they make great choices. another area where we're seeing a real issue, most of this unplanned pregnancy, of course, occurs to women who are using a contraceptive method, but it's using a method that's not working well for them. these really are accidental pregnancies. these are pregnancies that are
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often occurring to women who know this is not a good time to get pregnant. they know this is not when they want to get pregnant, but the pill, as a method, is simply not that effective unless you're really good about taking it. so this is really an opportunity to help women achieve their own goals. what we're also seeing is that in many health centers women are not even being screened for pregnancy intention as a regular part of their well care. women are actually in these health centers for a whole range of other health issues, but no one is asking them about pregnancy intention. and so one of the things that we do with our training is to ensure that that becomes a standard part of their intake, and so women are asked the question, do you want to become pregnant in the next year? it's sort of a standard part of their intake. we should have a conversation about contraceptive counseling. if the answer is yes, then let's get you into preconception care right away. unfortunately, that is a
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question which is not a standard part of care. we're doing a project at a large health center in massachusetts. only 18% of the women of reproductive age are considered contraceptive clients. the other 82% are there in the health center for a whole variety of other reasons, but no one is asking about pregnancy intention, and as a result some of the same women are coming back just a few months later accidentally pregnant with this whole set of negative outcomes that the lieutenant governor was just speaking about because no one thought about this. this is not a central piece of women's care, as i really believe it should be. finally, just speaking to the notion of costs. we're doing a state-wide project in delaware. delaware's really interested. it actually has one of the highest rates of unintended pregnancy in the country. we crossed medicaid data with prams data, the pregnancy risk assessment monitoring system data, and discovered that 74.6% of the medicaid births were unplanned, three out of four medicaid births were unplanned.
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this isn't what women want themselves. it is extraordinarily expensive for the state, just in health outcomes alone. so it really is, i think, unusual opportunity to both help women achieve their own goals, and also to save money at the same time. i just want to close with three quick points. one is that this really has to be all about patient choice. i know rachel's going to be talking about this, but that is such a central part of this. we cannot force women to use any methods at all, but true choice means that they really ought to be offered the full range of methods same day. that's what the data shows, how critical that is. not that they can get some methods some days and takes you two or three visits for another, but rather all methods same day. that's really important. second, is that iuds and implants, they're not a panacea. we know that that's not the solution to the cycle of poverty, as the lieutenant governor spoke about. but we also know that last year there were 1.4 million unplanned births in this country. my own view is that if we want
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to increase opportunity, if we want to make sure that children can achieve their full potential we really need to include this as part of what we think about as an opportunity continuum. we can't just simply start the conversation once children are born. we have to ensure that the children are born to parents that want them, who plan for them, and who think this is a good time to have them. finally, i just want to say that this basic idea that women should be able to plan their pregnancies and have children when they want them -- in my view, this is not about those women. this is what i would want for my own children. i have three college-aged girls, myself. my new occupation has certainly changed the conversation around the dining room table in my household, as you can imagine. but i want them to become pregnant only when they want to, and not a minute before. so this is really why wouldn't i want them to have access to the most effective methods of contraception? if those methods don't work then we can move on to something else, but my oldest is now 23
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was never offered these methods. she just didn't even know about them, and yet we know the failure rates are so different. i think it's important as we have this conversation to recognize that this is not -- we focus a lot on poor women and low income women where the rates of unplanned pregnancy are actually going up. this is important and best class medicine for all women. [applause] mr. haskins: thank you, mark. ms. gold: i could not agree with mark more about the importance of enabling women to make free judgments and free decisions about their child bearing. i think that is an absolutely critical goal. i could not agree with mark more about the potential of larc methods. they have amazing potential. i think that means several things. i think that means that we have
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an obligation to remove any and all barriers to use of these methods. we have to make sure that women can afford them. we have to make sure that they are available and accessible in the places that women go for care. i think we need to make sure that women who have just had a baby, who have just delivered have access to larc methods that day. i think we need to pay a whole heck of a lot more attention to the availability of larc methods for women who have just had an abortion. i think that's something we don't talk about a whole lot. we don't think about a whole lot. i think that's a really important missing piece of this whole debate. having said all of that, i think we have to, as we go down this road, be mindful every single minute of going too far. in the guise of making sure that we are removing barriers and leveling the playing field we absolutely cannot go too far and end up titling that playing field in the other direction,
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and end up being directive. i think that is something we have to constantly keep in our minds as we go forward. in that regard, i think it's important to look at history and learn the lessons of history. i guess one lesson for me is once a history major, always a history major, so let's think about the history and some of the history having to do with contraception in this country unfortunately is not great. some of the history specifically having to do with larc methods in this country is not great. i think that means we have an obligation to learn those lessons. within days of when the initial larc method, or one of the initial larc methods, the contraceptive implant was approved by the fda in 1990, within days there started to be proposals to offer financial incentives to women if they agree to get a contraceptive implant. that instantly embroiled this method in an incredible controversy. a controversy from which i don't think it ever recovered.
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just within a couple of years, in 13 states legislators had introduced provisions that were not adopted. they were not enacted, but they were introduced, offering women financial incentives if they agree to get a contraceptive implant. in seven states legislators introduced measures mandating use of contraceptive implants for women on welfare, women who had recently given birth to a drug exposed infant, and at least in one case mandating use of contraceptive implants to women who had had a publicly funded abortion. again, none of these were passed, none of these were adopted, but they were proposed. we also in five states had judges handing down decisions or offering deals to people who had been convicted of child abuse, offering reduced sentences if they agreed to get a contraceptive implant. what this did was it took this method, that had such potential, and completely engulfed it in controversy, and especially
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engulfed it in controversy in those very communities that we, as family planning programs, were seeking to serve, and moved this method from having enormous potential to being a source of controversy. it was an incredibly unfortunate event. even more unfortunate is that we're starting to see some ripples of this come back. just this year there was a bill proposed in the legislature in arkansas, again proposed, not adopted but proposed, that would have offered women $2,500 to a woman on medicaid who already had a child, a $2,500 payment if she agreed to a larc method. again, didn't go anywhere, but it was considered by a committee. the district attorney in nashville, tennessee, you know, which is like not a foreign place. that's where my son lives, nashville, tennessee. the district attorney went so far as to formally ban the prosecutors that worked for him from offering reduced sentences
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to people who had been convicted of child abuse if they agreed to sterilization. apparently, according to media reports, the da took this action after four reports in the last five years of these deals being offered to people. not widespread, but i think something we just have to keep in our minds constantly. so i think while these methods have enormous, enormous potential while we have an obligation to remove any and all barriers that could possibly stand in the way of women getting access to these methods. i think these are some minefields we have to be mindful of. that was not a great sentence. we need to be careful to remember these minefields. we need to remember that the principle of giving women the voluntary and informed choice of the full range of contraceptive methods has been at the heart of family planning programs in this country for decades. that principle has served us incredibly well and we need to remember that principle.
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we need to remember that for some women the choice of a contraceptive method is not solely about efficacy. it's about what choice this woman wants to make and what she feels is going to be best for her life. because at the end of the day the method that the woman chooses voluntarily, the one that she thinks is going to best fit into her life is going to be the method that she can use most effectively to avoid a pregnancy that she doesn't want to have. thank you. [applause] ms. kane: i feel like when we talk about this issue we're sort of talking almost on two levels. there's so much progress. there's so much momentum. the conversations that we're having around the country. the research that's coming out of places like colorado and iowa and st. louis are so exciting.
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then there's also a lot of landmines, as rachel said. what i want to do is just try to put some of this in policy and political context based on the experience that national campaign has had in talking to a lot of people from diverse viewpoints around the country, on the hill, and state governments, local communities. i think one of the most encouraging things is there is potential for broad bipartisan support on this. i think as the lieutenant governor said, if you look at the list of arguments that ron put up or the list of potential outcomes that ron put up if we reduce unintended pregnancy. there's something there for everyone, and it happens to be true which helps too. reducing unintended pregnancy, in particular, through the use of effective contraception does reduce abortion. it does save money. it improves child outcomes. it empowers women to achieve their goals, and there's
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something there really for everybody. what we can learn from are some of the places where people have come together to find ways to talk about this. it doesn't mean that it's all perfect. colorado's worth just spending a little bit of time on because it is an exciting, but also cautionary tale. the legislature there who ron mentioned is a very conservative, pro-life, self-proclaimed redneck republican who saw the value of making iuds and implants available to women in the state. they weren't the only methods available, as rachel said, but it reduced the barriers to those methods being available by extra education and counseling so that women could choose those as well as other things. when good counseling was available, when the barriers were removed lots of young women did choose those methods.
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that initiative was privately funded, as ron said, and when it came time for the state of colorado to step up and continued the initiative and a very modest sum of $5 million, this republican was one of the champions. you should look him up, you should google him come because his quotes are really prices, but i want to mention a couple of them because for a state like virginia they could be very helpful. he said, "if you are like i am and you do not support abortion to break thed cycle of poverty and save taxpayers dollars, why would you not support this legislation?" he thought cost savings to medicaid would be a way to get his colleagues along good i think the fact that he was only able to get three republicans to is extremely telling and cautionary.
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the reason he gave for that is extremely important. he said it was fear. behind the scenes, and this is similar to what we here on the hill -- ron asked me to talk about that -- behind the scenes his colleagues said, "i get it, i would love to support this bill. the researchers there -- research is there, it is fantastic policy. but there is a political liability for doing that." there is every expectation that other people in colorado will come back at this next year. maybe they will have more success. they have learned some things about how to tweak the approach from how to talk about it, that could be instructive. one of the other landmines is when we talk about iud'and implants in teens. i find it a little bit unfortunate that so many of the headlines coming out of colorado iud's todo is giving
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teenagers. no, it was making it available to women, including teenagers, the headline -- but the headline for teenagers" grabs attention and i don't think it has been helpful. we differently find that on the hill when we talk to republicans that when we talk about making contraception available to women of all ages, you get a very different response than when you focus on teenagers. that doesn't mean teenagers have excluded. i just think it is really important. i think the cost argument is very, very powerful. but it excluded. i just think it is really important. also can be -- there are some landmines there. i think the arkansas example is a good one. that legislator was very motivated by the idea of saving government money, and we can give people incentives to save money, but perhaps that had
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unintended consequences that we have to be really, really about.l we definitely have to get the policies aligned. the affordable care act, the contraceptive coverage requirement, making all methods of contraception available with no cost sharing to women who have private plans is a huge step. but we can't forget that there are still a number of states where people don't have access to medicaid. the medicaid expansion. including virginia. there are still a lot of low-income women who don't have that choice, as rachel said. that is a big policy very appeared we can't -- big policy barrier. we can't just look at the national picture on this. we have to look at the specific states and the work that mark is doing to help improve access is really important. even if we can get the financing in the policies all aligned and the supply side is all perfect, i think we have a lot of work to do politically and on the ground
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in terms of the demand side and patient education. if we want voters to be the ones that help make the decision, we have a lot of work to do to educate voters about this. consumers, the patients we are talking about. the national campaign recently finished qualitative research with the target audience, young women 18 to 30 who would benefit 's and implants, and we learned a lot about how to talk about it and how not to talk about it. insight is don't use the word larkin that is something we have to learn from. we have to listen to the patients, also has voters, and look at what they want. researchof important findings from public opinion data -- knowledge about the iud and implant is very limited. what people do know is often
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incorrect, inaccurate, out of .ate, confused for example, we found 77% of adults say they know little or nothing about the implant. 68% say they know little or nothing about iud's. how can they communicate their desires to elected officials if they don't have good knowledge themselves about the issues? we have work to do there. we often talk about sex education for teenagers. that is often where the debate goes and it often becomes a debate. but we can't stop at teenagers. it was a fantastic policy initiative announced in new york city this week that i would encourage you to check out. i guess it was last week. they are not educating college students -- they are now educating college students about the potential for iud's and they will move on to other methods in time as well because this is a college completion strategy. that is a way of framing this issue that is very inviting and appealing and powerful and happens to be true.
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reducingnot just about the births, it is about helping people get through college. maybe in surprising is, we have seen great success in mississippi and arkansas around the idea of educating college students, particularly community college students, about unplanned pregnancies, or sex education for college students, which helps students learn about the full range of contraceptives and how that can help them achieve their educational goals. that has probably happened in those conservative states because we are talking about adults and not teenagers. i want to again caution us to think about how we talk about who people have in mind when we are talking about these policy ideas. sign?t my time up ok. yes, so, ok, we will have more discussions now.
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[indiscernible] give us an idea of the overall state of the financing for birth control in general in the states where you have been. his financing a big problem, or can they figure it out and mostly get the federal government to pay their share? mr. edwards: i would toss this also to andrea, who has a better sense of the national sense. think they centers are losing money when they offer these methods, what when they
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actually do the data and look at it, they actually are not. they are actually making money, in part that this is part of the procedure to make money there. cost is less of a barrier -- mr. haskins: you and talking about benefit costs. you're talking about it brings in more money to operate their center. the notion that somehow these methods are so expensive -- mr. haskins: do you tell that to the next clinic you work with? do they believe it? mr. edwards: again, we have not been in every clinic in the country and there are many where that is not the case, but in many cases, cost is not been -- just some important areas we need to do work on. for example, postpartum access to iud's, postabortion. in the middle of that bell curve, cost is actually not the barrier here. mr. haskins: add to this, and jump in anytime.
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ms. gold: one thing we hear from family planning centers anytime is that it is having the upfront money, so that you have it in the closet that waiting for the woman to come in and want it. it is available on the same day. it is being able to have that upfront money and make that investment. i think, as andrea said, we made a lot of progress on the insurance side. medicaid, expanding medicaid in many states -- unfortunately, not virginia. although virginia is one of the several states that has medicaid expansion specifically for family planning. have made a lot of progress, again, as andrea said, on the affordable care act, making sure that women have a choice of contraceptive methods in their private coverage. what we still have is the gap between medicaid and private coverage. we have low income women who don't qualify for medicaid. we have low income women -- we have immigrants, recent
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immigrants who don't qualify for medicaid. we have people going on and off coverage. we can't just look at the insurance side. we have to make sure that there is a pot of funding available to provide coverage for people who are between or without insurance coverage. that is what federal programs like the federal titles and an national family planning program can do and to provide a flexible funding to meet the needs of women who don't have insurance coverage on the day they come in. just to jump in on that, i think that is where we have a perfect storm between the politics and the policy, because the title 10 program is often what provides a flexible funding, and there is good research that shows that went clinic gets the title 10 funding, it provides better quality care and access to a range of methods. that is proposed for elimination by the house appropriations the senate, 10% in
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really for political reasons, which just makes no sense when it is very clear it helps reduce abortion and save money. again, that is the political reality that we face. rachel talked about an important issue, the question of if health centers can offer them the same day, any health centers don't realize you can get 90-120-date terms with these methods. one of the improvements we do is to renegotiate those contracts so they can get 120-day terms and they can get the cash flow to have the methods. there are ways we can work within the system to make sure the cost is not the barrier. mr. haskins: ok, bringing up politics, always fascinating and fun to talk about politics at brookings and the politics of this issue especially good but they are kind of serious. "fear," thatord
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republicans say in interviews that they would ordinarily support this am i think you said, fantastic policy, yada yada, but they are fearful. what are they fearful of? >> losing. [laughter] becoming unemployed. ms. kane: i think they are fearful of challenges, primary challenges, from the far right, and i think that was in the "national journal" article. i've heard that from republicans on the hill i have talked to. i don't know if that is true. i wish one of them would stand up for what is right and test proposition and we would find out. those are extreme views that are not where most voters are. but obviously, we have a very gerrymandered districts. it depends on where you are from. we often call this the lacrimal -a-mole problem.
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on different days they are afraid of different things. if you're talking about teenagers, it is about encouraging every 14-year-old, forng an iud available them, although there was absolutely no evidence that is true, or they are afraid we are condoning sex outside of marriage, or afraid that we are doing something that is inconsistent with people's religious values, or afraid of certain methods of contraception may act as abortifacients, or or or. the argument just changes on different days, but there was a lot of fear. ms. sawhill: i think the fact that mark udall lost his bid for the senate in colorado after talking about family planning and being attacked by "the denver post," a liberal newspaper, for being a one-issue candidate, was probably a big element in colorado.
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don't you think, andrea? ms. kane: i do, and i also think it is fascinating he was beat by a republican who went out of his way to show that he supported contraception, said it was a very valuable thing for women. his particular policy solution was different. it was to propose over-the-counter contraception, which, by the way, doesn't help at all with iud's and implants, but he went out of his way to say no, no, i am for contraception, too. that was a very interesting election and one that has gotten more republicans to think about ways to beat for something when it comes to contraception. i don't think we have seen that yet in terms of iud's and implants of the federal level, but certainly a number of republicans have supported over-the-counter access. ms. sawhill: the other issue that comes in year and is related to what you said about the number of adults who have very limited knowledge of this , the forms of
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contraception, is that there has been very little use up until now. when i first started working on onlyok, they were saying 2% of women using contraception were using a long-acting form. you probably know the data better than i do now, up to something like 12% now. it is higher than that if you look at young women. the word is spreading very rapidly. i think that will play into the politics because once more, and it goes back to your very good question about young women maybe notvoting is much, -- voting as much, but as this becomes better m known and more women are using it, and it by the medical community, that will make a difference politically. but we have to be patient about that. we have not andrea,
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talked enough about teen pregnancy, which is a great story. the teen pregnancy rate has to fight every year since 1991 except for two years, down 60%. 10 times theave teen pregnancy rate of japan, greater than most european countries. so there is room for a lot of progress here. this in administration at the beginning started a program called teen pregnancy prevention, giving the most thorough evaluation that i know of, in 102 places around the country. we have already talked about all the potential advantages of more effective forms of birth control, especially with young, with teenagers. and yet the house killed it and they senate cut it by 80%. or they fearful -- were they fearful? i don't understand why this is happening. ms. kane: first, i want to mention that the program is not a program that provides
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contraception. it is an educational program. it is helpful to educate people on why to wait to have children and how to do that from the actual delivery from contraceptive services. that said, it is an evidence-based program, one of the gold standard evidence-based programs, and it is mind-boggling that it would have been proposed for elimination. i think of everything we have heard, it has gotten caught up in politics. shocking. i think the larger politics around planned parenthood has sort of shifted into putting that tpp program at risk. we are hopeful it can get restored, and that science and evidence will prevail. mr. haskins: science and evidence prevail. that has a ring to it, right? it is one time that i have been very pleased that the bill is not going to pass.
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the continuing resolution and maybe we will get the money for another year, because this is a brilliant program. question and it want to open it up to the audience. briefly, what is the number one thing we could do to make these long-acting reversible forms of contraception more available especially to low income women? what is the single most important thing we should do? go ahead, rachel. working: i think it is at the service delivery level, and i think it is a lot of training. i think it is a lot of the stuff -- staff are older and are schlepping around baggage from 20 years ago, and the transition to get into the place we are thinking these methods are appropriate and find for teenagers and young adults is a long transition.
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i think it is the hands-on training of how to do it. i think it is also talking to people and helping people understand that this needs to be part and parcel of the service delivery package at every one of these sites. mr. haskins: ritual just said, mark, you are doing the most important thing that needs to be done. one is the next thing we should do? mr. edwards: i will take that and raise it one step forward. establish quality family planning guidelines for the kind of work that should be going in health centers, and time medicaid payments to meeting this guidelines, that would be a great thing. mr. haskins: this is version of training because he would have good guidelines and then -- mr. edwards: tie the payments? mr. haskins: here, let me ask the question. mr. edwards: sorry. mr. haskins: this is really a version of training that has the guidelines, but then there would be some way to train clinics on
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how to follow -- mr. edwards: create some incentives. mr. haskins: what do you think ? ms. sawhill: i very much agree with this. this is the supply-side good since it has only been covered, we have to work on the demand side. educating the public more broadly and getting young women knowledgeable about the fact that it is safe and effective and so forth is really, really important. ms. gold: i am all for the quality family planning guidelines. i get very uncomfortable with performance standards. what the level is of uptake of these methods, and then they tie that to payment, which then can have the impact of giving providers a financial stake in the methods that women shoes.
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that makes me really uncomfortable. in one performance standards where we spot low numbers and use performance standards to spot low uptake as may be sign of a barrier to access. i get nervous when we have a performance that could end up in this world of pay-for-performance that is the rage in health care at the moment. i get nervous when we end up in a system where providers have a financial stake in what methods women shoes. ms. sawhill: let me ask a follow-up on that that might be slightly push back, which is marked talked about having a screening question that is on every health care form. when you go to your doctor for just an annual checkup, and you are a woman of reproductive age, there should be a screening questionnaire on do you intend to get pregnant, want to get pregnant in the next year.
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i think that that could be a game changer. doctors and other providers to do that, you might have to regulate or provide a financial incentive. would that be going too far, i your view? ms. gold: no, where i get uncomfortable is when it affects the choices -- ms. sawhill: just wanted to clarify. ms. gold: absolutely foundational to me that women should have the unfettered ability to choose the method that is best for them. mr. haskins: audience, let's start off here. nick, you can't tell us about your magnificent adoption study, ok? ofapart from your mention the shield, you had no discussion of medical complications of these methods. also, the media coverage of those medical complications.
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it seems to me that the stories i've seen tend to be very one-sided. they talk about the risks and do not -- at the end of the article say that these are the most effective contraceptive methods. maybe part of what we need to do is balance what journalists do about the complications and the benefits. mr. haskins: that is an excellent point. a really good's point, and you are right, the intensity a lot of attention to the side effects and the problems. you have to remember, the doctor/lieutenant governor would remind us of this, that risks.ical device has but the key point in counseling with women is to talk about that, to talk very honestly about the benefits and the downsides of these methods so they can make an informed choice, and in our public messaging to put those risks in context. from the qualitative research we have done with young women, also
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from the national survey work we have done, those negative stories, even the fine print that you hear in anne's on tv about all the side effects, loom limp gary locke -- very large in women's minds, and that is often all they know about the method. mr. haskins: that makes the point even more important. mr. edwards: and there are a lot of risks associated with pregnancy. [laughter] mr. haskins: all the way in the back. ler.y name is lauren hage on risks and the coercion that is to become what about when they came out and, for instance, my personal expense -- experience, my mom was like, why would you want to do that, it is really unsafe? based on bad experiences she had. what you guys think about that? ms. sawhill: i think we should
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just reiterate something that mark already said, that if the american college of ob/gyn and the american academy of pediatricians has said that this is not only safe, but should be the first line of defense for any woman who wants to avoid a pregnancy, what more medical certitude can you get about safety? now, it is true, and mark, i'm sure you know more about this than i do, that a lot of providers out there, including existing gynecologists who are in practice and are well --pected, will tell of women will tell a woman when she comes in, i don't do that, it is not safe. i have friends, younger friends, theirsly, who spoke to gynecologist after they read my book and asked for an iud and were told by their doctor, oh,
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no, we don't do that, it is not safe. there is an education job to be done here. mr. edwards: it is so important that these are called the same thing but i think the evidence is really clear. research shows, particularly out of stimulus, is ,hen women choose these methods they tend to like them much more than the pill, they tend to stay with them longer, which is one of the reasons it lowers the rates of unintended urgency, and they also returned to their original fertility faster than they do with other methods of contraception. there are lots of things about these methods that women like better. next question. up here in the front. hello, thank you. i was wondering my is it -- wondering why is it there seems to be hesitation about focusing with education,
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the method, the lack, and all that. one of you said you want to just , not teens.n i have experience in the minority communities. i am a ghanaian and they: sells girls more than women. -- call themselves girls more than women. they don't see a path belonging to them. why does there seem to be hesitation to talk about it in terms of teens? you --kins: andrea, will repeat the question quickly. ms. kane: i think the question was why the hesitation to talk about teens, and sometimes we talk about women, which includes teens, and teens may not hear themselves in that. they think of themselves as girls, not women -- is that the question?
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i think it is a good point. i think it is a political hesitation more than anything else. from the medical point of view, the american academy of 's, implants,ys iud are perfectly appropriate, and first line options for teenagers . i think it is more of a messaging issue in terms of the political and policy discussion. i also feel like we are trying to have this conversation on two levels and we need to. there is how we talk about it in a policy and political space, and then there is how we talk about it when we are trained to actually reach girls and women -- trying to actually reach girls and women. it would be convenient and a lot simpler if we could use the same terms all the time. but i think we need to treat air methods. -- tweak our methods. we are using this term because it is a convenient way of packaging categories of contraception. the research we have done with women shows that that packaging
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no sense to them. why would you treat something that goes in your arm and something that goes in your uterus as one category of thing? we talk about iud's and in plus, a few more larc, but if we were talking to a natural young woman who is thinking about getting one of these methods, that is probably not the best way to talk about. mr. haskins: last question. mr. edwards: just to add onto that? the vast majority of pregnancy occurs to women who are not teens. we tend to focus on teens but it is really single women in their 20's. it is important to keep in mind. mr. haskins: right in theirmr. haskins:, second one. >> you had mentioned that there is a lot of great provider education with mentorship, but what is being done more on the primary care level?
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a lot of women won't see a gynecologist until they are 21 years old and most women by that time are already sexually active. primarying done at the provider level. >> not enough. ms. sawhill: that is where having a screening question becomes important. mr. edwards: the bulk of it occurs in primary settings. that is where the volume patients are. we are seeing them early. there's a big gap between what is best and what is actually happening. to add onto that, not to take on the pediatrician in the audience, but at the primary care level we need to focus much more on the pediatricians, the adolescent docs seeing women in their teens who can really set them up for being able to make responsible decisions going forward. mr. haskins: ok, so at least i hope we convince you that this is a really, really important issue, and there is tiny of
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evidence that we could do some thing about it if we got the we ares right, and moving fairly rapidly in that direction. this is generally a good story for me to keep going in the same direction. thank you very much for coming, and join me in thanking the panel. good today. [applause] [captions copyright national cable satellite corp. 2015] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> a top aide to hillary clinton met behind closed doors with the benghazi committee today. the panel created to investigate the 2012 terrorist attack in benghazi, libya. edin went into the
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meeting at 10:00 a.m. eastern. she was not opposed and has not been accused of wrongdoing. reportedly republicans and democrats questioned ms. abedin separately. she reentered the hearing room moments ago. sayset from "the hill" "clinton camp warns gop against leaks." tweet from speaker john boehner says "reporters and journalists have ridiculed the clinton team's claim that there was a partisan witchhunt." with humabit of video abedin arriving at the meeting earlier this morning.
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nbc correspondent luke russert -- out this tweet elijah cummings came out of the meeting, "the question becomes is this a taxpayer-funded effort to derail hrc?" more from congressman cummings. rep. cummings: we have a situation where we have had mr. mccarthy, congressman mccarthy, make it clear that what this is all about. we then of course have been hand-picked -- have the hand-picked member of the to affirm whatf already stated. the congressman to
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reaffirm all that. words toe want to put the side, the question becomes, we have been asked to not listen to the words of mccarthy, not listen to the words of podliska, not listen to the words of hannah, but look at the actions of the committee. and this morning again we have a situation where it is clear that when we look at the actions, in, lettingabedin the press know about the time, interview,n, of her when she, based on the other testimony we have gotten, has no policy responsibilities, no operational responsibilities,
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was not with secretary clinton on the night on this phenomenal -- night of this phenomenal tragedy, only leads , did thek the question gentleman, congressman mccarthy, pogressman hanna, and mr. dliska, tell the truth? that is the question. the question also becomes whether this is a taxpayer-funded effort to derail the candidacy of hillary clinton. frank be very with you, when i take the statements of those three gentlemen and i mash them up with what we have been saying all along, when we look at what we do and what these gentlemen
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said, they'll match. it comes together. note thatresting to those people most closely associated with hillary clinton seem to be treated differently. , cheryl mills, m s. abedin, jake sullivan. treated differently. and so i think -- i have said from the very beginning that it wevery important that when joined this committee, when the democrats joined this committee, i said that we would be defenders of the truth, the whole truth, and nothing but the truth. and that's exactly what we
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intend to do. , think it is sad, i really do that when the families came to us and we met with all for families,- all four ,f chris stevens, sean smith dohertyoods, and glenn -- i want to mention their names because sometimes they get lost in all of this, but when we met with the families, they only asked for three things, that's all, and they basically begged us. not make this a political football. we beg you." some of them with tears in their eyes. the second thing they asked for, "find out what happened that night." thing, to for a third do everything in your power to make sure this does not happen to someone else. ladies and gentlemen, no matter
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how you look at it, when you have the number two person in the republican party who comes forward, the person who makes plans with the speaker, and the person who will continue -- who is one step away from becoming the speaker, to tell you that this is all about a taxpayer-funded political effort to derail the campaign of hillary clinton, ladies and jamming, that is a problem. i'm not as -- ladies and gentlemen, that is a problem. i'm not answering any questions. again, i came here today out of respect for ms. abedin, and i'm not bethat there will very targeted leaks that only story, but of the the whole story. this is the last point. i've said it over and over again
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e-mails of mr. blumenthal were released, i said, look, don't just released e-mails. release the whole transcript, so that the press and the american people can see the whole story. and we did not get a vote, did not get an opportunity to do that. thursday, come secretary clinton will have her day to explain all of this. i look forward to her testimony, and i want to thank all of you for being here. aju tweeted a r comment from another member of the benghazi committee -- "representative lynn westmoreland tells us huma abedin did not recall the number
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of episodes from the benghazi response." huma abedin met today behind closed doors. former secretary of state hilliker and he will testify before the committee in a public hearing next week. we will have coverage on our companion network c-span3. also, c-span radio and cspan.org . >> every weekend, the c-span networks feature programs on politics, nonfiction books, and american history. saturday at 8:30 p.m. eastern on c-span, editorial cartoonists describe their expenses covering the george w. bush administration. sunday afternoon at 4:45, an event honoring the life and political career of former british prime minister margaret thatcher on what would have been her 90th birthday. live this saturday morning beginning at 11:00 on c-span2's book tv, the texas book festival from austin, featuring interviews with authors hisuding h.w. brands and
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book on president reagan, harriet washington on how we can catch mental illness, and dennis ross on the relationship between the u.s. and israel through the truman and obama administrations. sunday, our coverage of the texas book festival continues with an author on the terrorist group isis, then and discussion of artificial intelligence, and president lyndon and lady bird johnson. saturday afternoon just before 5:00, and a story on the richardship between nixon and the shah of iran and its effect on foreign policy. a georgeening at 6:40, mason university history professor on the confederate flag and its history and relationship the legacy of slavery. get the complete we can schedule at -- weekend schedule at cspan.org. >> next, a discussion of u.s.-iraq relations. first, a view from baghdad with
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the iraq ambassador to the u.s., look on faily -- lukman faily. it is hosted by the national council on u.s.-arab relations. >> ladies and gentlemen, you heard yesterday several passing .emarks pertaining to iraq they came from every different direction almost imaginable. at least four or five spoke about how, in terms of what the united states did to iraq, starting on march 19, 2003, the
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price is still being paid. neighborly, beyond whole.nd the region as a so that was just one aspect of it. people spoke of how it had , and endlessly that -- implicitly annexed leslie that tehran now has the best government in baghdad that it has had in modern history. there were others who are explicit in the sense that the united states invaded iraq, and iran won. i'm preparing the ambassador for some of the heat here. fourthly, there were those who spoke at some length about the roleias of iran, and their , either directly or indirectly,
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in taking on the fight to isis, to daesh. and then there were yet additional commentaries from the energy section about what might 's oil when not just iran comes back to the market, will not have a depressive effect on what over the past year has been a series of depressive effects on the price of oil, but when iraq's oil comes back to a level of which it is capable, and to what extent is it all is true that iraq's reserves are the second largest in the world, and some would say would rival those of saudi arabia. these are just five aspects, mr. ambassador. our ambassador is here for the long term and he is also long
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distance -- you might not know that. he participates in marathons, not necessarily to win, so that that be nice, -- though would be nice, but to remain fit and be an example, and he is fit and he is an example. he presented his credentials after 2013, and for the three years prior to that he was iraq's ambassador to japan. he was anhat, ambassador in the ministry of foreign affairs in iraq. for nearly 20 years he lived outside iraq, as did so many during the long regime and rain of theimen and rule realm of saddam hussein, where he got his masters in business administration from the university of manchester, and was involved in two fortune 100
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e ownedes, including on by hewlett-packard, whose former onlys an illustrious, serious female candidate among the republican party hopefuls for their party's nomination for the presidency. please join me in welcoming a master -- welcoming ambassador lukman faily. [applause] mr. faily: good morning, ladies and gentlemen. excellencies, dr. anthony. let me first thank you for your kind introduction, and thank you
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for -- you guys for coming over 24th annuals week's policymaking conference. i've been asked to discuss the state of relationship between iraq and the united states, and i will also address this issue in the context of the theme of this year's conference, which relates to the way forward, or the path forward. much like the broader middle iraqi-u.s. relationship is at a crossroads.and the path forward begins with our military and security cooperation to defeat daesh, or as his excellency called it yesterday, faesh, the right word. our corporation must to be swift so we can achieve our broader ,ong-term goals of a unified
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secure, and democratic iraq, within a safe and stable middle east. as ambassadorod to this country, i've found that here in washington there are euro two schools of thought -- there are 2 schools of thought about how the united states can best achieve its objectives and withe its own interests iraq and the region. correctly, in my view, that the united states should bolster his engagement within iraq. as it stands, our common interests, are common enemies, and common values will inevitably increase the cooperation between our two countries. as the u.s. and iraq work ever closely together, iraq will
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emerge as a stronger, more self-reliant partner, and other actors will find their roles. in contrast, the second school of thought believes that american support to iraq should c reduced in order to oerce iraq into the building is dependency on actors in competition with the united states. i firmly believe that this second approach is fated to fail , because in geopolitics, as in physics, vacuums will always be filled by others. vacuums will be filled by others. at this critical moment, iraq is on the front lines of the fight against the best funded, best equipped, and best organized
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transnational terrorist organizations on earth. we are not in a position to take half measures. and we are not in a position to turn away potential allies. day, daeshassing kills, tortures more than innocent people -- sorry, more of our innocent people. among them are those who are targeted by car bombs in the busy markets and streets across iraq. and those who are held hostage and subjugated to medieval rules that have no resemblance to islam in any way, shape, or form. so we will welcome whatever help we can get that degrades daesh's ability to inflict harm on our itple, provided that
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compliments, and hinders, our existing -- not hinders, our existing efforts. the struggle against daesh is humanity struggle. and we must not allow regional and international divisions to divide or delay us in this endeavor. now let me be clear -- the united states is our military, economical, and lamented partner of choice -- and diplomatic partner of choice. and there is a clear path for the united states to broaden and strengthen cooperation with our country. efforts to up your defeat daesh. to those who still entertain the thought that there is no , that isnt to daesh
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not a policy we could ever live with. we must defeat daesh and we must do it together. second, increase investment in building our unified, secure, and democratic iraq as a cornerstone of a peaceful and prosperous middle east that will never again give rise to violent extremists so powerful that they threaten our region and the globe. in that spirit, let me address our full range of challenges from the military to the security fronts to the political, social, and economical horizons. on the military and security twot, there are currently key battles that are being waged in the fight against daesh in iraq.
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and it is strategic in many ways. situated roughly 130 miles north of baghdad on the main road to osul, it is a major centered with the largest oil refinery in iraq. -- for moreyear than your, this terrain has been .losely contested iraqi security forces have paid a heavy price defending the refinery. but as i speak before you today, security forces, backed by volunteer fighters, or making encouragement and significant gains that could mark another major milestone in our effort to liberate mosul. to the west of baghdad, iraq he forces have surrounded the city
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of ramadi, the provisional capital of al anbar. forces joined the popular have beenon force, trained by u.s. and iraqi forces, and are fighting --ngside the iraq he army iraq army, federal and local police. together these troops are gradually edging closer towards the center of the city, and u.s. air support has been vital throughout these operations. as our counterattacks against daesh reaches a crucial point, now it is time for the u.s.-led coalition and the broad international communities to double their efforts. under fighting daesh difficult financial circumstances. -- world oil prices
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whileng $50 a barrel, part of our country is still occupied by the terrorists, and our government is bearing the burden of assisting more than 3 million -- 3 million displaced persons. the financial burden of our defense budget has been immense. in september alone, the iraqi government purchased more than 2.5 million rounds of ammunition from the united states through program, in addition to armored humvees, and alliances, and mine resistant vehicles. our soldiers are sacrificing their lives and limbs in the struggle against transnational terrorist. unreasonable if our international partners contribute the bullets and other
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hardware that are so sorely needed by our fighters on the ground? let me address an important reoccurring theme were issued -- theme or issue. some people refer to characterize the rise of daesh in iraq is merely a symptom of our countries to mr. problems -- our country's domestic problems. this is a conveniently over some will find narrative -- oversimplified narrative. over simple five narrative. it overlooks the fact that daesh is a global phenomenon. it's international financial and additionnt network, in to its sick ideology, has been recognized by the united nations resolutions,cil's both resolution 2170 and 2199
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from february of this year, by all member states, under chapter .even of the u.n. charter to meet their obligations in tackling this global menace. -- in other words iraq can do its part, but there are key external factors beyond iraq's control that require concentrated efforts by the international community, and specifically by our own neighbors. securinghat extremist ideologies have been openly propagated in our parts of the muslim world, and it must not be tolerated any longer. northion members from america and europe most also continue working with our
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neighbors to hold the influx of foreign fighters into iraq. together we can and must make sure that the terrorists' crimes, which take us back to the most barbaric in human ,istory, must not pay off through keystrokes of 21st century technology. be waged will not be one only on the battlefields or at screening centers at airports across the world, and not only through technology and cyberspace. on the also defeat daesh political, ideological, economical, and automatic fronts. focus on these fronts is also part of the path forward that we charging and we are talking
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about today during this conference. because terrorism appeals to those who are filled with hatred, not hope. we all need to work together to counter the messages that daesh to solve the and social and economical problems that can be conducive to violent extremism. to return to the observation with which i framed this talk, there are two schools of thought about how the u.s. can best advance its agenda. some strategists call for increased engagement with iraq. others argue for tactical withdrawals of support even a crucial points in our common struggle. since i addressed this annual conference last year, iraq has
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been reforming its government and economical system, and our progress points to the importance of america and all of our allies working together with our people mr. faily: iraqi was a move forward together as one country. , ourhe past year government has been adopting reforms that will strengthen the struggle from the battlefield to the homefront. during what could have been polarizing protests in baghdad and other major cities, those of you who look at the photographs of these protesters must've been
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impressed. as i was. by the sea of iraq he flags. iragi flags. these demonstrations were peaceful and our government respected the rights and made sure their voices and views were heard in known to all. throughout the demonstrations the security forces were deployed to protect the protesters rather than suppress them. the police were disturbing bottles of water to the protesters. home aconic images bring basic and inescapable truth, iraqis do not want a revolution that overturns the democratic system that we have been building together since 2003.
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want reform that will strengthen our country, the inclusiveness, and effectiveness of a government not hampered by corruption. this new dynamic between citizens and their government represents a paradigm shift that is emblematic of the new iraq. to anyone who questions whether life was better under saddam hussein, just asked them how this security apparatus would've responded to a suspicion of dissent. ofe no mistake, in the midst economy, iraqand is moving together forward. and threear in office elections and a peaceful transition of power, the government is doing something
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that governments elsewhere have difficulty doing, streamlining. costlyeliminating ceremonial -- and sectarian quotas. we are streamlining decision-making to the provision level so that local communities can determine what the response is and what resources are best suited for. and we are also addressing the created byis bureaucracy and oil revenue overreliance. together, these reforms will make our society more democratic , more stable, and more secure. stability,nhances and stability enhances security. yes, there are those who are
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saying that we must choose between democracy on one hand and stability and security on another, but that is a false choice that we must move way beyond from. cannot achieve security and stability in isolation from our neighbors. we are resolving our relations other countries throughout the middle east. we are restoring our relations with other countries throughout the middle east within the framework of mutual respect and a concerted effort to explore deepening economic and security ties. as we move forward, national and region reconciliation and reconstruction, the u.s. coalition countries can help us to stabilize iraq and facilitate the return of idps safe return
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thither towns. you can help us streamline government, combat corruption, improving public services, and infrastructure. and you can provide us with health and investment rebuilding -- with help and investment rebuilding our highways, schools, and others. that me thank you, united states, for all the help you have done so far and will do in the future to support our democratic system. iraqis and americans have shed blood together in defense of our common values. that is not something that should be taken lightly. through thoseip difficult years is enduring, and no matter how hard sometimes trying to do miss iraqi democracy as a failed project, the sacrifices that were made by our two countries in pursuant of
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this ideal will continue to shape the fact that iraq chose to take for generations to come. my american and international friends, let me be clear, i have given you a view from baghdad. our journey to this moment has been rocky, but our path to the future of its forward and upward , and we want to work this together for the sake of our country, for the sake of our world, and for the better that we all need to get it moving forward. thank you all for giving the opportunity to share my thoughts. [applause] minutes, eight minutes, for some questions.
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please feel free to comment on any of them. you don't have to do them in any order either. oil, and how the do they do it? that isis has come to control here and there? fighters, howign would you rank the top three countries in terms of the numbers or the percentage of fighters that they have been sending. thatxample, we read often tunisia is tiny in comparison to other countries, 8000 or more fighters have gone to syria, and presumably some to iraq as well.
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so how you rank them. no mention of the impact on iraq, if any, the nuclear the securityween council countries, united states, great britain, france, soviet union, and china. ?hat impact if any not exactlytates is been the olympic champion of displaced people or refugees. people here forget that syria , andin 1.3 million iraqis after three years of the u.s. invasion, something fewer than 30,000 iraqis seemed to have ,ade it into the united states visa system, security checks, and the like.
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, some say, as many as 700,000. the supremeddress leader next door saying that iran has every intent to , andnue its revolution when it looks west, you are the nearest one where its impact and influence has been largest, massive, invasive, more so than elsewhere. ? the iragiyou estimate west business council? during the time of saddam hussein, the more than 50 members of that counsel. checked, the were fewer than 15, and the numbers seem to be going down to 10.
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how would you educate us on these kinds of questions. one last one, how would you -- the criteria for countries being admitted to the united nations being they must demonstrate their national sovereignty, political independence, territorial integrity. a country that cannot protect its airspace would be questionably sovereign nationally. one that has foreign militias fighting on its soil would be questionable in terms of its political independence. and one that has the northern part of the country, the kurdish autonomousty much tos is questioning extent territorial integrity. or in terms of the american constitution, the united states is a government for four reasons
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in terms of the constitution, to provide the messick safety for its people, -- domestic safety for its people, external defense, enhance the senator living and material well-being for its people, and to administer for its people a civil system of justice. how would you educate us on any of these thorny, difficult, controversial questions? mr. faily: how long do i have? >> a day and a half. mr. faily: always challenging to hear dr. anthony's questions. i'm not troubled with it. regarding the topics. us, weng isis, and for need to have a -- approach to
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it, whether it is smuggling religious artifacts, then it needs to be stopped. if it smuggling oil or other materials, it needs to be stopped. human trafficking, needs to be stopped. this is where we are talking about cooperation from others. more so, when we talk about oil, international, domestic, not .o y to transport obviously, a clear demand and customer base for it. it's usually purchased by countries. to that effect, it is a question , there aren raising resolutions which talk about that. , do we the key question want to coexist with isis as an ideology? -- iraqist want to
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don't want to. who talk contextually or it is anogically issue, we say it is more than an ideology. enslaved,ople being here toho did not it this sick ideology, threatened physically, and so on. to that effect, any method of suppressing, degrading isis needsy to finance an arm to be challenged. he re-are saying that this challenge is for others, not just iraq. it is a keyuestion. -- here we are saying that this for others, not just iraq. it is a key question.
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support this, and we see what was the heritage of telegram. -- of taliban. don't let countries in the region support it or tolerated for scoring small points here and there. our going to russia and other support is based on that, don't corner us so that we need to go elsewhere. the coalitionsnd are the strong base we are choosing, but at the same time, do not allow isis to purchase oil or smuggled their artifacts elsewhere. oft to us is a sign weakness, let's call it the weak cohesion of the international community, and that is where we question this. fighters is strange in one way. we have people from chechnya,
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.hina, and from europe for example, the chinese are good at one level. they are not the suicide bombers. we have people from north iraq -- africa who are suicide bombers. iraqis are good as suicide bombers. -- are not good as suicide bombers. there in action is an action. in facilitating these is coming into syria and iraq. to us, that is a crime against humanity. countries should not allow their young ones together. thirdly, when they are finished in iraq and still in one piece, they will go back home and take the havoc back home. this is something which can't be exported, nor should they want them to be imported. ofocracy is not in a sense
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who has the highest. the sense oft in what actions are they doing, engineers, bomb makers, or so on, and this is where the expertise comes in as well. by the way, syria versus iraq is different, majority of command -- control are iragi baptist bathist army. ofse who have shown signs weakening going back were executed as well. there is terrorism going on within a terrorism organization. nuclear p5 to plus one, we support whatever methods are required to reduce tensions in the region. it is important that iran is not
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isolated, because we think it is an important country in the region, but it is important that all countries feel not ideological -- what we talked about as well. sovereignty needs to be respected, but no double standard should be faced with iran or others as well. to that effect, a bit of byl-searching is required the national committee, including iran. iran is much of a neighbor as canada or mexico, own challenges, different challenges. for us, iran is that neighbor. we share strategic concerns in relation to isis. isis has made a threat to the religious sites of iraq as much , and other mecca strategic interests. to that effect, we understand it. at the same time, we have been clear that whatever support has
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been provided by iran we certainly have maker to the iranians and others, don't pick your fights in iraq. work with each other. the threat is too big. the stability of iraq is too important to the region and the globe, so that is what we are basing it on. iraq has been one of the very who has strong relationships with iran and the united states, and we have not compromised on both, because we think we need both and hope both appreciate each other. to the iranian revolution exportation being talked about, we appreciate our also understand they have to have a global geopolitics, regional geopolitical role, for them and others to challenge.
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for us, it is important that all the efforts are in the fight against isis. we see that as an existential threat to us in the region, and to all in the region. your definition regarding countries and integrity of the saytry and so on, what we is that iraq is not a new country just being put together. iraq is one of the oldest civilizations in the world, been through transformations, world war, changes systems from kingdom to republican so on, so don't dismiss its existence and say let's reshape its history. there are certain facts on the ground that we -- you cannot dismiss, and that has to do with the people, heritage, history, cohesion, tribal system, and others as well. iraqve no single tried in
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which is only sunni or shia, mixed. we have no system that is only one demography and so on. it is mixed. that's how we want it to that is what we have lived with. that is what we want to move for together. however, since 2003, or has been a new social contract, trying to read look at how we can work with each other and others as well. nobody is denying that. nobody is saying we are in full harmony. no one in iraq is saying we need to divide the country. even when you talk about the kurdish question, i am occurred myself, i would say that the iraqi constitution allows for it. i rememberoted, if correctly, 95% of kurds voted for the constitution. we talk about decentralization, a new formula in the region, yes.
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it's not a democratic region, yes, but that is our position and that is what we will move towards moving forward. the one about american investment, companies, corporations, investment. 2011, u.s. troops left, some of the companies felt they don't have the security they were seeking for or opportunities that were seeking for. since then, there have been issues primarily with isis, and as far as i know investment in the region -- not just in iraq. it is important for us as a player in the region to make sure that we provide the right environment for investors, security provisions, legislations, and others. at the moment, the majority of corporations are based on security and energy sectors. there are some transportation project moving on.
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it is not to the level i want. as an ambassador, i would rather -- but i know the reality on the ground. we think at this moment, if we get the right relationship, focused on what is the common economicalhink the development will become a natural development of that relationship. mr. anthony: super. thank you. mr. faily: thank you. [applause] good morning. i'm on the board of national council of u.s.-arab relations. it is my pleasure to welcome you believe is one of the most timely topics today in light of what is going on right now in the middle east.
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is title of our panel today ihe palestinian future" and would venture to say it is best k, becauseuestion mar i'm not sure what the path forward is in light of current events. luckily, we have expert panelist who will answer some of those questions. the questions have to do with what is the palestinian authority doing right now, and we are honored to have the ambassador and the representative for the palestine iberation organization, who had the pleasure of working with over the past two years, and i venture to say that he is one of the best, if not the best, representatives for the palestinians here in washington and around the country. of the have the pleasure president of the air of-american institute, but hopefully help us understand today not only what
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air of americans are thinking, and he has written a terrific book about this, what the arab world is taking about palestine, but also due to his political activity, he has close relationships with the administration and with members of congress, and so we are hoping to hear a little bit about what secretary kerry and president obama intend to do on the path forward. we also have a very important individual here today, matt reynolds, who is the representative, the north theican representative, for key u.n. organization that provides the incredible humanitarian relief needed by palestinian refugees. the pleasure i think of formerly working as the assistant secretary for legislative affairs and a former administration, and i hope can give us some insight on what the administration is thinking, particularly about the humanitarian crisis going on right now. we have one of the most foremost
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experts, a senior scholar here with us at the national council, to talk a little bit about the issues that policy issues in particular that are vexing with respect to the israeli-palestinian issue, and we also have the pleasure of working onperson this issue, now the executive director of the middle east policy council, and if i can just throw out an issue for discussion in light of the fact that we do have media coverage here. wille one of our panelists talk about u.s. media coverage of this issue, which i think has been quite unfair in light of the violence that has been going on in the region. with that, i had the pleasure of introducing our first speaker. [applause] >> thank you. good morning. let me first of all commend the national council for keeping
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this tradition of ringing experts and academicians to issues a very important that seems to have been forgotten in the middle of what is going on in the middle east region as a whole. today's session comes at a difficult time. tensionlast two weeks, and violence has escalated in jerusalem and other parts of the west bank. it is funny how the media in this country and israeli apologists just take things when it started, as if nothing existed on the ground six months before, a year before, 48 years
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before, and they wonder why the palestinians are reacting to what israeli occupation policies . this whole episode started more than one year ago when [laughter] israel started allowing for [laughter] forel start allowing extremists, members of its cabinet, neighbors of its parliament, to go there to provoke, instigate, insight muslims in the hope of pushing the situation to the point where it is today. this did not happen in a vacuum. it was a series of provocations thatwe warned repeatedly is a very dangerous game to play by israel, that they are playing
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with fire, and they are turning this political conflict into a religious conflict. at the time when the whole region is trying to stand up for extremists in iraq, syria, yemen, libya, everywhere. so one wonders why with this current israeli government push conflictn and tell a like this from a religious and political conflict. whose interests will be served by doing such a thing? and why continue to insist on the jewish state and a time when we are trying to neutralize, i say neutralize because many will attack me, but neutralize religion from politics and try to separate the two. two big questions that this
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israeli government must be asked , why turning it into a religious conflict? and whose interest are served, something the palestinians will never do, so they need to put it on the side. in addition to that, we have witnessed an an escalation of violence against palestinians. one is controlled by the secular settlements, and the other is ,ontrolled by the palestinians which is the smallest of all. we only have total control over 18% of the west bank. , civiliane security control, with israel over 22% of the west bank, while the bulk of
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the west bank, 60%, remains to israeli and civilian military control. so basically we only have control of 18% of our land. most of the escalation is jerusalem,n occupied under total israeli control, and the fact that the settlers have been carrying out attacks against palestinians, the most worst, the israelis have not even captured one single perpetrator. the chief of staff of israel declared that they know who the culprits were, but they don't want to arrest or interfere with the investigation. even if they caught

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