tv Key Capitol Hill Hearings CSPAN August 5, 2016 5:37am-6:16am EDT
need to consider. to highlight puerto rico, the unplanned pregnancy rate is incredibly high but some of that is cultural. they just don't believe in contraception and some of it is religious background. we face some of the same issues in the mainland u.s. so it is critical that we get the importance of the education out that this is a public health crisis and contraception is not just a pregnancy prevention because of having sex. it's prevention because of this incredible illness that can where the unborn fetus. peace, certainly looking from our perspective we , have to educate our providers to get the word out and talk to their patients and work on the local communities but we've got to educate the patient's best what the risk really is and try to address some of these cultural and various misperceptions about contraception and the dangers.
we've got another battle to fight as well. >> it also comes home that notion of institutional racism in our society. when we talk about building trust people who are in the , community, whether they are an institution providing health care or are a community resource, this is a place where people go to trust. it's not going to be earned in a crisis. there is concern in puerto rico that they are being experimented on for prevention. if we are not honest about that -- if you not honest about that, if you don't go into that conversation saying we recognize there has to be a reckoning then there is no way we can engage patients appropriately to make the decisions based on the risk that are right for them and sensitive to their needs and respect their autonomy. >> think about it also. to your point about education,
think about women who think about these things on unwanted pregnancies. think about the ones that want pregnancies. it's impossible to believe that every woman is going to say, i will take off for a year when it is time for them to get pregnant. we have to get information and have to provide services and medical facilities for women who do want to have babies even in an endemic area with zika. we're we're just highlighting together that the public health infrastructure and the resources that go into this under zika have to be thought about there is no time for politics. serious. it's something we need to do soon and it should have been done before. >> to build on the public health infrastructure, sex education is is a huge component, that also recognizing that not everybody has the ability to access care because there is a policy in
place like undocumented individuals cannot purchase into obamacare. they also cannot purchase it along with the help of subsidies they can't have affordable health care. we have to look at all the components to make it battle ready. i would be remiss to say in terms of contraception and latinos, a lot of is not being able to get to a clinic. texas implemented hb2 partially and a lot of those clinics shut down. to drive to a clinic as far away and you have to take time off of work if you have a job to be able to do it. access to contraception is a huge component of white latinos -- why latinos don't have the ability to access care. i would argue that what we have known is that 96% of latinos who are catholic say they use contraception. we need to debunk the myth about our community about why or why not we're using contraception.
that is part of building this public health infrastructure so we can respond to emergencies in a timely way like sica. i will add, and we will deftly get to questions from the audience after this last point. the bella bond the point -- build upon the point of restrictions and policies that keep folks from accessing health services, a lot of the states, the cdc has estimated could see an uptick in zika related cases. those are states that have highly restrictive abortion laws. access to safe abortion should be a part of the full spectrum of reproductive health care for women in the situation. it' with that said, we will pass things over to the audience for questions. the floors open. go ahead.
>> my question is around the last point. it's about access to safe abortions particularly if zika cannot be diagnosed until the fourth month. in so many states, access is only for the first trimester. would you comment on that and also the issue globally? >> i can quickly talk about the fight for safe abortion continues. what happens here is we have been talking about these issues for a long time so whether it is zika or some other kind of issue that a woman has to have when she makes these decisions with her doctor, it is very clear that we have to ensure that there is an availability of safe abortion for every woman and
access to it and not her jumping through hurdles. now, weecially true could talk about texas which might be a good example. there is no clinics and you have their soon will be a situation where it's endemic there as well. what does a woman do? i go back to what planned parenthood has had for a long time -- we have to be in places where safe abortion is legal and provide access to the most marginalized women who cannot get it and overseas, i think it's exactly the same thing. we probably have a bigger conversation because in many of those countries if not most, it's illegal to have an abortion period and it has to be something very serious where the country allows it in certain circumstances of health and is zika one of those? then you get into a policy question which many our partners are starting to look at now.
>> i would add that all of the state policies focusing and attacking abortion, what is happening is limiting the full spectrum of comprehensive reproductive health care would also impacting access to care. your closing down clinics like texas. florida has passed a bill which has not been implemented but it would defund planned parenthood. that is a huge concern. you see the trickle impact and how it impacts people's ability to have full autonomy of their bodies and therefore cannot protect themselves when things like this happen. we see an onslaught of this. many of us are working on the forefront to fight these state-level laws that are negatively impacting women's care. >> right here. the one in the back.
>> had there. -- hello there. i feel very concerned for the young women in texas and their access to abortion. my question is to you, sir. as the position. procedures a medical and i would imagine between a psychiatrist and an obstetrician, if a woman's fetus is claimed to have, if evidence indicates microcephaly, certainly in abortion would be medically necessary if not for the emotional health of the family, etc., do you follow? . it's a difficult question. is a difficult predicament. thank you for reading between -- and has beennd
said, we certainly support as an organization as well as our providers for the raw range of -- for range of reproductive care available which includes abortion. part of the challenge has also been when a woman manifests these findings by ultrasound, it may be late in their pregnancy and there are clearly state laws that impact the upper limit when they can be done. that is a separate problem. your point, i don't think i would use the term medically necessary. the determination is it should be an option. there should be an informed and shared decision-making process between the patient and their provider. it's the patient that ultimately make that decision. i don't think there would be any clinician that would say it's medically necessary you terminate this pregnancy for whatever reason. it could be a genetic abnormality or chromosomal or a congenital defect or even a and
-- a lethal defect after birth. we don't tell patients that are going to die after they are born. as quit a patient's decision. there are women who want to know so they can prepare to take care of an infected infant. there are women who choose to terminate. it is the patient's choice after a fully informed decision making process. and time for her to process that and talk with family and her support system to make that decision. >> we have time for one more question back here. thank you so much. one of the questions i wanted to ask is about making sure women have the information they need.
supporteri'm a strong of women having access to contraception. my question is more of a technical one. the cdc has been putting out guidelines for women who are exposed or testing positive for zika. when they might give information about potential problems for the fetus. initially they had been saying 28 to 30 weeks is when they might be able to detect. some information that it might be sooner. i was wondering if you could comment on the state of the research, when women are getting information. biters, is it a training issue? or is it really just dependent on individual pregnancy. >> the unfortunate thing, this goes back to what i said earlier, there are far more in unknown been known. there is no answer to question.
even in those patients, the little did out there, presumably infected during the first trimester. when it is manifested in the fetus, it is a wide range. there is one case report where, i forget the exact timing, it was roughly around 19 weeks and all caps on was normal and three weeks later the fetus was infected. we don't have the ability to counsel women that even if she tested positive to say, first of all, your likelihood of developing the microcephaly is this, secondly, even if that were to happen, how long it might take to develop. unfortunately difficult. >> and the access to care.
the stage of pregnancy for many of us have gone to this where you are not getting regular ultrasounds. the knot indicated that bested the pregnancy. you are talking ahead to access resources much more often. though the difficult even insurance context because insurance has limits how often and the expectations. in these situations, we are going to be scrambling to figure , how does get access it get paid for etc.. i'm qualified to speak to that part of this consideration. regardless of how much money you have, you will be in the situation were known can really tell you how often testing will be required and i think that is also what we have to bear in mind. --internationally,
>> even in the context of florida, there are new guidelines asking women to get tested for sycamore often throughout their pregnant too. insurance coverage has also been an issue, even in that context. we will continue to talk about this issue and i thank everyone for being here today. this was such a good panel and conversation. i also want to thank dr. mullen. and dr. berger gave opening remarks. cap will continue to work on this issue and think of new analysis, especially around the house -- how zika will disproportionately impacts low income communities. thank you all for being here. [applause]
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>> more road to the white house coverage this afternoon. theary clinton will speak annual convention. we will take you there on c-span. tothe evening it is on wisconsin where donald trump will hold a rally. on a visit to the pentagon yesterday president obama addressed members of the press after meeting with his national security staff. an hour.bout
i just met with my national security council on the campaign to destroy isil. i was to thank secretary carter and chairman of vertro just returned from meetings with our coalition partners in the middle east for hosting us and their continued leadership of our men and women in uniform. i last updated the american people in june, shortly after the horrifying attack in orlando. in the week sinse we have continued to be relentless in our fight against isil. on the ground in syria and iraq, isil continues to lose advertorial. tragically however, we have seen that isil still has the ability to direct and inspire terrible attacks. we have seen terrible bombings in iraq, jordan, lebanon, saudi arabia, yemen, afghanistan, istanbul airport, a restaurant in bangladesh. bastille day celebrations in a church in france, and the musical festival in germany. in fact, the decline of isil in syria and iraq appears to be causing them to shift to tactics we have seen before in encouraging high-profile terrorist attacks. as always, our military, diplomatic, intelligence, homeland security, law enforcement professionals are
working around the clock with other countries and with communities here at home to share information and prevent such attacks. over the years, they have prevented many, but it is still very difficult to detect and prevent lone actors or small cells who are determined to kill the innocent and willing to die. that is why we will keep going after isil aggressively over every front of this campaign. our air campaign continues to hammer isil targets, 14,000 strikes so far, 100,000 sorties, including those hitting isil core. in stark contrast to isil, america's armed forces would do everything in our power to avoid civilian casualties.
with our extraordinary technology, we are conducting the most per air campaign in history. after all it is the innocent civilians of iraq and syria who are suffering the most. you need to be saved from isil terror cylinder allegations of civilian casualties, we take it seriously. we work to find the facts, be transparent, and hold ourselves accountable to doing better in the future. we continue to take out senior isil leaders and commanders, including the deputy minister of war, a top commander in the mosul, and its minister of war. isil leaders are not safe and we will keep going after them. on the ground in iraq, forces with coalition support liberated falluja. now they are clearing areas near the euphrates valley and a iraqi force retook the strategic air base 40 miles from mosul, the last major stronghold for isil in iraq.
given the success, the additional personnel i ordered to iraq last month will help turn this base into a logistical hub and launchpad for iragi forces. meanwhile in syria, a coalition of forces backed by special operations forces and airstrikes continues to take the fight to isil as well. the coalition is fighting its way into a town that is a gateway for terrorists coming in and heading out to go to europe. as isil is beaten back, we are gaining vast amounts of intelligence, documents, thumb drives, digital files, which we will use to continue to destroy networks and stop foreign fighters. we continue to intensify efforts against al qaeda in syria.
no matter what name it calls itself it cannot be allowed to maintain a safe haven to train and plot attacks. i do want to note the broader progress that has been made in this campaign so far. two years ago, isil was racing across iraq to baghdad itself, and to many, looked invincible. isil has lost at tikrit and now falluja. in syria, they have lost in numerous locations, losing territory across vast stretches of the border with turkey and major transit routes. isil has not been able to reclaim any significant territory they have lost. i want to repeat, isil has not had a major successful offensive operation in syria or iraq in a year.
even isil's leaders know they will be losing. they are increasingly acknowledging they may lose key cities. they are right. they will lose them. we will keep hitting them, pushing them back, and driving them out until they do. in other words, isil turns out not to be invincible. they will inevitably be defeated. we do recognize that the same time that the situation is complex and this cannot be solved by military force alone. that is why the united states and countries around the world pledged more than $2 billion in new funds to help iraq stabilize and rebuild communities. it is why we are working with
iraq so that the military campaign is matched with political and humanitarian efforts so isil cannot return by exploiting divisions or grievances. in syria, defeating isil and al qaeda requires an end to the civil war and brutality against the syrian people which pushing them to extremes. the regime and allies continue to violate the cessation of hostilities. including medieval sieges against cities, blocking them from food, family starving. it is deplorable. the syrian regime has rightly earned the condemnation of the world. russia's direct involvement raises questions about their commitment to pulling the situation back from the brink. the u.s. is prepared to work with russia. it is time for them to show they are serious about pursuing these objectives. beyond syria and iraq, we will continue working with allies and
partners to go after isil. at the request of libya's government, we are conducting strikes and support, and we will continue to support the government's efforts to secure their country. in afghanistan, one of the reasons i decided to largely maintain our current force posture was to keep eliminating isil's presence there. we delivered another blow last month only to get a top leader in afghanistan. finally, it should be clear by
now, and no one knows this better than our military leaders that even as we need to crush isil on the battlefield, the military defeat will not be enough. so long as their twisted ideology persists and drives people to violence, groups like isil will keep emerging and the international community will continue to be at risk where we are always reacting to the latest threat or lone actor. that is why we are working to counter violent extremism more broadly, including social, economic, and political factors that help fuel groups like isil and al qaeda in the first place. nothing would do more to discredit isil than when it loses its base. we will work with partners, including muslim communities, especially online, to expose isil for what they are, murders who kill innocent people, who
set off bombs near mosques. moreover, we refused to let terrorists undermine the unity, values of diversity and pluralism that keeps our nation strong. one of the reasons america's armed forcesre the best in the world is that we draw on skills and talents from all backgrounds and faiths. including patriotic muslim americans. i think the entire world was inspired this past sunday when muslims across france joined our catholic neighbors at mass in a moving display of solidarity, praying together. it has to be the message we echo in all countries and communities. peace be with you, and also with you. before i take questions, i want to say a few words on another topic. as our public health experts have been warning for some time, we are now seeing the first globally transmitted cases of
the zika virus by mosquitoes in the continental united states. this was predicted and predictable. so far, 15 cases in the miami area. we are taking this extremely seriously. our cdc experts are working shoulder to shoulder with florida health authorities. there is an aggressive effort under way there, and pregnant women have been urged to stay away from a particular neighborhood we are focused on. we will continue to work as a team to limit and slow the spread of the virus. i want to be very clear, our public health experts do not expect a widespread outbreak of zika here that we have seen in brazil or puerto rico. the kind of mosquitoes are limited to certain regions of our country, but we cannot
be complacent because we do expect to see more zika cases. even though symptoms are mild for most people, many not knowing they have it, we have seen the complications for pregnant women and their babies can be severe, so i again want to encourage every american to go to cdc.gov. in addition, congress needs to do its job. fighting zika cost money. helping puerto rico deal with the crisis cost money. research into new vaccines, nih just announced the first clinical trials in humans. that costs money. that's why my administration proposed more funding back in february. not only did the republican-led congress not pass our request, they worked to cut it, then they left for summer recess. meanwhile, the folks on the front lines have been doing their best by moving funding from other areas, but now the money we need to fight zika is running out. the situation is getting
critical. without sufficient funding, nih clinical trials could be delayed. this is not the time for politics. in 50 u.s. states, we know of more than 1800 cases of zika connected to travel to affected areas, including 500 pregnant women. zika is now present in a most every part of puerto rico, and now we have the first local transmission in florida, and there will certainly be more. meanwhile, congress is on a summer recess. a lot of folks talk about protecting americans from threats, well, zika is a threat to americans, especially babies, right now. once again i urge the american people to call congress and tell them to do their job, deal with
this threat, protect the american people from zika. with that, i will take some questions. start with someone who just assumed the the second most powerful office in the land. jeff mason. reporter: happy birthday. as islamic state loses territory, you and other officials have said it is becoming a more traditional terrorist group. are you satisfd strategy has shifted sufficiently to address that change? are you concerned that donald trump will be receiving sensitive national security briefings?
pres. obama: i am never satisfied with our response. if you are satisfied, that means problem is solved, and it is not. we just spent a couple of hours meeting with the top national security advisers to look at what more can be done. it is absolutely necessary for us to defeat isil in iraq and syria. it is not sufficient, but it is necessary, because so long as they have those bases they can use their propaganda to suggest that somehow there is still some caliphate being born,
and that can insinuate itself in the minds of folks who may be willing to travel there or carry out terrorist attacks. it is also destabilizing for countries in the region at a time when the region is already unstable. i am pleased with the progress we have made on the ground in iraq and syria. we are far from freeing mosul and rocca. some can be eaten with partners on the ground as long as they have support from coalition forces which we have been providing. in the meantime, you are seeing isil carry out external terrorist acts. they have learned something. they have adapted from al qaeda, which at a more centralized operation and trying to plan elaborate attacks. what isil has figured out is that if they can convince a
handful of people or even one person to carry out an attack on a subway or in a parade or some other public venue and kill scores of people as opposed to thousands of people, it still creates the kinds of fear and concern that elevates their profile. in some ways, rooting out these networks for smaller, less complicated attacks is tougher because it does not require as many resources on their part or preparation, but it does mean that we have to do even more to generate the intelligence and to work with our partners in order to degrade those networks. the fact is that those networks will probably sustain themselves even after they are defeated. what we learned from our efforts to defeat al qaeda is that we will adapt as well. eventually, we will dismantle these networks also. this is part of the reason why it is so important to keep our eye on the ball and not panic, not succumb to fear, because isil can't defeat the united states of america or our nato partners.
we can defeat ourselves though if we make bad decisions. we have to understand that as painful and as tragic as these attacks are that we are going to keep on grinding away, preventing them wherever we can, using a hold government effort to not down their propaganda, to disrupt their networks, take the key operatives off the battlefield, and that eventually we will win.
if we start making bad decisions, indiscriminately killing civilians for example in some of these areas, instituting offensive religious tests on who can enter the country those kinds of strategies and up backfiring, because in order for us to ultimately win this fight, we cannot frame this as a clash of civilizations to between the west and islam. that plays exactly into the hands of isil and the perverse interpretations of islam there putting forward. as for mr. trump, we will go by the law, which is that if
somebody is the nominee for president, they need to get security briefings so that if they were to win, they are not starting from scratch in terms of being prepared for this office. i am not going into details on the nature of the security briefings that both candidates receive. what i will say is that they have been told that these are classified briefings. if they want to be president, they have to start acting like president. that means being able to receive these briefings and not spread
them around. i think i have said enough on it. mary bruce. reporter: what is your response that the $400 million sent to iran was a ransom payment. a pure coincidence? a payment that was held up for almost four decades was sent at the same time that americans were released. can you assure the american people that none of that money went to support terrorism? pres. obama: some of you may recall that we announced these payments in january. there was not a secret. we announced of them to all of you. josh did a briefing on them. this wasn't some nefarious deal. at the time we explained that iran had pressed a claim before an international tribunal about them recovermo