Secretary Antony J. Blinken with Judy Woodruff of PBS NewsHour

Antony J. Blinken, Secretary of State

Washington, D.C.

QUESTION: Secretary of State Tony Blinken, welcome to the NewsHour. Thank you very much for joining us. The world looks a lot more complicated today, I think it’s fair to say, than it did just a few months ago. There are problems bubbling up just about everywhere. And in your statement today, you made a clear focus on American workers right here at home. Explain how that connects to what the U.S. challenges are around the world.

SECRETARY BLINKEN: Well, first, Judy, it’s great to be with you. Thanks so much for having me. And what I tried to do today is to really lay out the President’s priority that our foreign policy has to have the American people first and foremost in mind, and he’s basically asked us to make sure that in anything we’re doing around the world, the first question we ask ourselves is: How is this going to make life a little bit better, a little bit more secure, a little bit more prosperous, a little bit more hopeful for our fellow citizens? And of course, the economic aspect is critical to that. But this has to be a foreign policy that’s grounded in making a real difference in the lives of Americans. That’s the first question we ask ourselves.

QUESTION: You said today that the first priority has to be around COVID-19, making sure that the world addresses it. But as we know, the country where it originated, China, has not been transparent, and right now China is taking the lead in supplying vaccines to poorer countries. So I know many people are looking at this and wondering if the U.S. is ceding its leadership in COVID to China, which is a country your administration is calling the chief threat to the United States in the coming years.

SECRETARY BLINKEN: Well, you’re right, Judy, that China has not been fully and effectively transparent either at the start of this crisis, when it mattered most, or even today as investigations are going forward trying to get to the bottom of what happened. And it is vitally important that we see real transparency, we see real access for international experts where it counts, we see real information sharing – not just with regard to the past but, critically, going forward to make sure we can avoid another pandemic in the future.

We’re leaning in, the United States is leaning in on dealing with this, of course, both at home, where we’re making very significant progress – you heard the President address that just yesterday – but also around the world. We have joined this COVAX arrangement. We’re contributing billions of dollars to creating greater access to vaccines. And I think as the months go on and as we vaccinate our own people and make sure that every American is protected, we’ll also be engaged in helping the world get vaccinated. Because at the end of the day, we will not be fully secure until the world is vaccinated, not just Americans.

QUESTION: Another China question, Mr. Secretary: The U.S. has said that China is guilty of genocide when it comes to the Uyghur minority population in that country. If that’s the case, what should the penalty be? China denies it. But what should the penalty be for that?

SECRETARY BLINKEN: When it comes to specific issues like the – like the Uyghurs, I think there are a number of things that we can and should be focused on. We’ve got to make sure that products and technology being exported to China, whether it’s by us or anyone else, can’t be used for repressing their minority populations. Similarly, if products are being made as a result of forced labor, including from Xinjiang, we shouldn’t be buying those and we should get other countries to do the same. And of course, we should make sure that the world is speaking out with one voice in opposition to what’s happening.

QUESTION: So much to ask you about, Mr. Secretary. I’m going to try to fly through several more parts of the world. But Iran is next. As you know, just a few days after the United States launched an attack on Iranian-backed militias in Syria because of their attack on a – on U.S. forces based in Iraq, Iranian-backed militias have again today fired a rocket attack on U.S. forces at a base in Iraq. Another attack by them. What should the penalty be for Iran? How should they pay the price for this?

SECRETARY BLINKEN: Well, Judy, we’ve made very clear that – and President Biden has made very clear – that his first and most important obligation is to protect the lives and safety of the – of Americans as well as our partners. And in the case of the earlier attacks, the first thing we did was to make sure we understood who was responsible, and that took – took some time. And then we worked very closely with our Iraqi partners to make that determination, and then to take clear action to demonstrate that these things could not go forward with impunity.

Now, you’re right: We have another attack in the last 24 hours. The first thing we have to do is get to the bottom of it and find out to the best of our ability who in fact is responsible, and then I think the President’s been very clear that we will take appropriate action in a place and at the time of our choosing.

QUESTION: Will that have any bearing on the attempt by the United States to get Iran back to the negotiating table when it comes to the Iran nuclear talks? And is the U.S. prepared to relieve Iran of some sanctions in order to get them back?

SECRETARY BLINKEN: So with regard to the nuclear talks, when we pulled out of the nuclear agreement, the so-called JCPOA, that it put Iran’s nuclear program in a box, Iran then started to break out from that box. And it is now in a position where it is closer to having the ability to produce fissile material for a nuclear weapon on short order, in a matter of months. The agreement had pushed it past a year. So we have a real interest in trying to put Iran back into that box, and diplomacy is the way to do it.

We have made clear that the path of diplomacy is open. The European Union, which is one of the parties to the original agreement, invited all of the other parties – our European partners, Russia, China, and Iran, and us – to come to start to talk about the possible return to the nuclear agreement. We said yes; Iran said no. We’ll see what they do going forward. We’ve been clear that the path of diplomacy is open. The ball’s in Iran’s court to decide if it agrees.

QUESTION: But yes or no, the U.S. considering lifting sanctions?

SECRETARY BLINKEN: We’ve been very clear that Iran has to come back into compliance with its obligations under the nuclear agreement, and if it does, we’ll do the same thing. And that would – that would involve, if they do it, some sanctions relief. But again, we’re a long ways from that. Unfortunately, Iran’s moving in the wrong direction. It continues to take steps that lift the various constraints of the agreement and is making its program more dangerous, not less dangerous. So first and foremost, we want to see Iran come back into compliance with its obligations.

QUESTION: Saudi Arabia. A lot of attention there. As you know, the U.S. Intelligence Community report released just a few days ago putting the responsibility on the crown prince, Mohammed bin Salman, for authorizing, directing the killing – the murder – of the journalist Jamal Khashoggi. The administration has imposed sanctions but not on the crown prince himself. President Biden said during the campaign that Saudi Arabia would be a pariah based on what happened. Has he blinked on this?

SECRETARY BLINKEN: Let’s look at what we did. First of all, as you noted, we put out a report, a report that was not written yesterday. It’s been there for well over a year. We released it, and that made clear, as you said, the responsibility for the heinous murder of Mr. Khashoggi. And obviously this has been reported before; it’s not that there were any very new facts in there that hadn’t been reported. But it makes a big difference when that comes out with the full imprimatur of the United States Government behind it. I think that in and of itself is important.

We sanctioned, including using the so-called Magnitsky sanctions, some of the people directly involved in the killing of Mr. Khashoggi, and, critically, we also denied visas to about 76 Saudis also involved. And maybe most important, going forward – because as much as this is about accountability for the past, it’s trying to do everything we can to make sure this never happens again in the future – we put in place a new rule, the Khashoggi Ban, that basically says that if, at the direction of a foreign government, an individual does anything to harass, surveil, or harm a political opponent of that country in the United States, that person will not set foot in our country. And that applies not just to Saudi Arabia, it applies to the entire world.

So I think there are clear, demonstrative actions that we’ve taken that not only shed a light on what happened in the past but also put us in a stronger position going forward to prevent it from ever happening again.

QUESTION: When you combine that, however, with the – not holding him personally responsible with not imposing sanctions against Russia’s president, Vladimir Putin, for the poisoning and then again now the imprisoning again of the chief – the lead opposition leader, Aleksey Navalny, does that send a signal that the U.S. is waffling when it comes to abusing human rights – that human rights are not the priority that this administration says they are?

SECRETARY BLINKEN: Whether we like it or not, we don’t choose Saudi Arabia’s leaders. They do. And the crown prince is likely to be in a position of leadership for years, decades to come. We’ve gone back to clear, regular order. The President engaged with the king, and various Cabinet secretaries have engaged with their counterparts.

We deal, unfortunately, every single day with leaders of countries who are responsible for actions we find either objectionable or abhorrent, whether it’s Vladimir Putin, whether it’s Xi Jinping, whether it’s any others on a long list of people I could name. But we find ways to deal with them.

And the question I think we have to ask ourselves, and we did ask ourselves, is: In terms of advancing not just our interests, but our values, are we better off rupturing the relationship with Saudi Arabia or recalibrating it, as we did? In terms of ending the war in Yemen, are we better off having recalibrated the relationship or rupturing it? I think the answer is clear.

QUESTION: Final question, Mr. Secretary: Afghanistan. As you know, the U.S. is scheduled to pull troops finally out of that country after 20 years of war in less than 60 days. Today, the White House made public what it’s calling its Interim National Security Strategic Guidance document, which says among other things, and I’m quoting, “The United States should not, and will not, engage in ‘forever wars’ that have cost thousands of lives and trillions of dollars. work to responsibly end America’s longest war in Afghanistan while ensuring that does not again become a safe haven for terrorist attacks against the United States.”

What does that mean exactly in terms of keeping troops there?

SECRETARY BLINKEN: Well, that’s exactly what we’re looking at now, and we haven’t made any decisions about the May 1st deadline to withdraw the remaining roughly 2,500 troops that are in Afghanistan, as well as, of course, partner troops, NATO forces that are there. We’re in very close consultation with our NATO allies, with all of the countries in the region. And what we – what we’re looking at very carefully is what further progress can and must be made on the agreements that, for example, we reached with the Taliban under the previous administration, and the Taliban and the Government of Afghanistan are working on, to see if the conditions can be in place for a durable peace. All of those things are what we’re looking at. We’re making the effort to advance them, but right now, we’re reviewing the question of our troop presence, and we’re doing it in full consultation and coordination with our allies.

QUESTION: Secretary of State Tony Blinken with a very full plate. Thank you.

SECRETARY BLINKEN: Thanks, Judy.

QUESTION: Thank you so much for joining us.

SECRETARY BLINKEN: Great to be with you. Thank you.

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    Agencies compiled a variety of data on time and attendance misconduct and fraud. Specifically, 22 of the 24 agencies covered by the Chief Financial Officers Act of 1990 (CFO Act) had some data on instances of time and attendance misconduct—including potential fraud—from fiscal years 2015 through 2019. However, because agencies tracked data differently, the data could not be aggregated across the 22 agencies (see table). The remaining two agencies reported that they did not compile misconduct data agency-wide but began using systems to collect this data in fiscal year 2020. Scope of Agency Data on Time and Attendance Misconduct for Fiscal Years 2015–2019 Level of data compiled; number of years included Number of agencies Data compiled 22 Agency-wide data; all 5 years included 13 Agency-wide data; less than 5 years of data 5 Component-level data; all 5 years included 4 Data not compiled 2 Source: GAO analysis of agency data. | GAO-20-640 Most (19 of 24) agency Inspectors General (IG) reported that they substantiated five or fewer allegations of time and attendance misconduct or fraud over the 5-year period. In total, these IGs substantiated 100 allegations, ranging from zero substantiated allegations at six agencies to more than 10 at four agencies. IGs stated that they might not investigate allegations for several reasons, including resource constraints and limited financial impact. In addition, 20 of 24 agencies reported that they considered fraud risks in payroll or time and attendance, either through assessments of these functions, or as part of a broader agency risk management process, including their annual agency financial reports. Also, 14 of 15 agencies that reported a risk level determined that time and attendance fraud risk was low once they accounted for existing controls. Agencies reported using various internal controls, including technologies, to monitor time and attendance, which can also prevent and detect misconduct. According to agencies and IGs, first-line supervisors have primary responsibility for monitoring employee time and attendance. Additional internal controls include policies, procedures, guidance, and training. Agencies also reported using controls built into their timekeeping system to provide reasonable assurance that time and attendance information is recorded completely and accurately. These controls include requiring supervisory approval of timecards, and using time and attendance system reports to review abnormal reporting. According to agencies and stakeholders GAO spoke with, technology for monitoring time and attendance can help prevent and detect fraud, but may not help when an employee is intent on circumventing controls. Technology alone, they said, cannot prevent fraud. Agencies and IGs also reported using a mix of other technologies to assess allegations of time and attendance misconduct, such as badge-in and -out data, video surveillance, network login information, and government-issued routers. However, agency and IG officials also stated that these technologies have limitations. For example, many of the technologies may not account for when an employee is in training or at an off-site meeting. The federal government is the nation's biggest employer, with about 2.1 million non-postal civilian employees. Misconduct is generally considered an action by an employee that impedes the efficiency of the agency's service or mission. Fraud involves obtaining something of value through willful misrepresentation. In 2018, GAO reported that, on average, less than 1 percent of the federal workforce each year is formally disciplined for misconduct—of which time and attendance misconduct is a subcomponent. Misconduct can hinder an agency's efforts to achieve its mission, and fraud poses a significant risk to the integrity of federal programs and erodes public trust in government. GAO was asked to review agencies' efforts to prevent and address time and attendance misconduct, including fraud. This report describes 1) what is known about the extent of time and attendance misconduct and potential fraud across the 24 CFO Act agencies, and 2) controls and technologies these agencies reported using to monitor employee time and attendance. GAO collected misconduct data from the 24 CFO Act agencies and their IGs. GAO also collected information on fraud risk reporting but did not independently assess agencies' fraud risk. Using a semi-structured questionnaire, GAO obtained information on controls and technologies that agencies reported using to monitor time and attendance and any challenges associated with their use. For more information, contact Chelsa Kenney Gurkin at (202) 512-2964 or gurkinc@gao.gov, or Vijay A. D'Souza at (202) 512-6240 or dsouzav@gao.gov.
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    In fiscal year 2019, debt held by the public reached 79 percent of gross domestic product (GDP). The government's fiscal response to COVID-19 combined with the severe economic contraction from the pandemic will substantially increase federal debt. The Congressional Budget Office (CBO) projected that debt held by the public will reach 98 percent of GDP by the end of fiscal year 2020. The nation's fiscal challenges will require attention once the economy has substantially recovered and public health goals have been attained. GAO has previously reported that a long-term plan is needed to put the government on a sustainable fiscal path. Other countries have used well-designed fiscal rules and targets—which constrain fiscal policy by controlling factors like expenditures or revenue—to contain excessive deficits. For example, Germany's constitution places limits on its deficits. The U.S. federal government has previously enacted fiscal rules, such as those in the Budget Control Act of 2011. However, current fiscal rules have not effectively addressed the misalignment between spending and revenues over time. GAO identified key considerations to help Congress if it were to adopt new fiscal rules and targets, as part of a long-term plan for fiscal sustainability (see table). Key Considerations for Designing, Implementing, and Enforcing Fiscal Rules and Targets Setting clear goals and objectives can anchor a country's fiscal policy. Fiscal rules and targets can help ensure that spending and revenue decisions align with agreed-upon goals and objectives. The weight given to tradeoffs among simplicity, flexibility, and enforceability depends on the goals a country is trying to achieve with a fiscal rule. In addition, there are tradeoffs between the types and combinations of rules, and the time frames over which the rules apply. The degree to which fiscal rules and targets are binding, such as being supported through a country's constitution or nonbinding political agreements, can impact their permanence, as well as the extent to which ongoing political commitment is needed to uphold them. Integrating fiscal rules and targets into budget discussions can contribute to their ongoing use and provide for a built-in enforcement mechanism. The budget process can include reviews of fiscal rules and targets. Fiscal rules and targets with limited, well-defined exemptions, clear escape clauses for events such as national emergencies, and adjustments for the economic cycle can help a country address future crises. Institutions supporting fiscal rules and targets need clear roles and responsibilities for supporting their implementation and measuring their effectiveness. Independently analyzed data and assessments can help institutions monitor compliance with fiscal rules and targets. Having clear, transparent fiscal rules and targets that a government communicates to the public and that the public understands can contribute to a culture of fiscal transparency and promote fiscal sustainability for the country. Source: GAO analysis of literature review and interviews. | GAO-20-561 Our nation faces serious challenges at a time when the federal government is highly leveraged in debt by historical norms. The imbalance between revenue and spending built into current law and policy have placed the nation on an unsustainable long-term fiscal path. Fiscal rules and targets can be used to help frame and control the overall results of spending and revenue decisions that affect the debt. GAO was asked to review fiscal rules and targets. This report (1) assesses the extent to which the federal government has taken action to contribute to long-term fiscal sustainability through fiscal rules and targets, and (2) identifies key considerations for designing, implementing, and enforcing fiscal rules and targets in the U.S. GAO compared current and former U.S. fiscal rules to literature on the effective use of rules and targets; reviewed CBO reports and relevant laws; and interviewed experts. GAO conducted case studies of national fiscal rules in Australia, Germany, and the Netherlands. Congress should consider establishing a long-term fiscal plan that includes fiscal rules and targets, such as a debt-to-GDP target, and weigh GAO's key considerations to ensure proper design, implementation, and enforcement of these rules and targets. The Department of the Treasury and other entities provided technical comments, which GAO incorporated as appropriate. For more information, contact Jeff Arkin, at (202) 512-6806 or arkinj@gao.gov.
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    The Department of Commerce (Commerce) has a four-phase process to review companies' requests to be excluded from having to pay Section 232 steel and aluminum tariffs. Commerce ensures an exclusion request is complete, accepts public input, evaluates materials submitted, and issues a final decision. Between March 2018 and November 2019, Commerce received over 106,000 requests; it rejected over 19,000 of them prior to decision due to incorrect or incomplete information. Although rejections may delay relief for requesters and can increase work for Commerce, the agency has not identified, analyzed, or taken steps to fully address the causes of these submission errors. In deciding exclusion requests, Commerce examines objections from steel and aluminum producers to find whether the requested products are reasonably available domestically in a sufficient amount. Commerce may also decide exclusion requests based on national security issues, but has not done so. While Commerce approved two-thirds of exclusion requests, it most often denied requests that had technical errors or where a domestic producer had objected. Commerce did not decide about three quarters of requests within its established timeliness guidelines, as shown in the figure, taking more than a year to decide 841 requests. Commerce took steps to improve timeliness, such as streamlining the review process for some requests and creating a new submission website, but continues not to meet guidelines and had a backlog of 28,000 requests as of November 2019. Until Commerce takes additional steps, companies will continue to encounter delays in obtaining relief. Most Steel and Aluminum Exclusion Decisions Did Not Meet the Department of Commerce's Established Timeliness Guidelines from March 2018 to November 2019 Commerce has not documented the results from any reviews of the tariffs' impacts or assigned responsibility for conducting regular reviews. GAO found evidence of changes in U.S. steel and aluminum imports and markets. For example, imports covered by the tariffs declined after an initial surge and prices dropped after significant increases in earlier years. Evaluating whether the tariffs have achieved the intended goals and how they affect downstream sectors requires more in-depth economic analysis. Without assigning responsibility for conducting regular reviews and documenting the results, Commerce may be unable to consistently assess if adjustments to the tariffs are needed. Citing national security concerns over excess global supply of steel and aluminum, in March 2018 the President placed tariffs on the import of some products using Section 232 of the Trade Expansion Act of 1962. At the President's direction, Commerce established a process to provide relief, or exclusion, from the tariffs. GAO was asked to review Commerce's Section 232 tariff exclusion process. This report assesses (1) the process Commerce uses to decide exclusion requests and to what degree it has accepted submitted requests; (2) what criteria and factors affected Commerce's decisions; (3) how often Commerce met established guidelines for the timely resolution of requests; and (4) the extent to which Commerce reviewed the impacts of the tariffs on steel and aluminum imports, as directed. GAO analyzed Commerce's Bureau of Industry and Security and International Trade Administration records from March 2018 to November 2019, as well as data from the U.S. Census Bureau and the Department of Homeland Security, and spoke with agency officials. GAO recommends that Commerce (1) identify, analyze, and respond to factors in the process that may cause submission errors; (2) take steps to improve timeliness of exclusion request decisions and address the backlog; and (3) assign responsibility for reviewing the tariffs' impact and document the results. Commerce concurred with all three recommendations. For more information, contact Kimberly Gianopoulos at (202) 512-8612 or GianopoulosK@gao.gov .
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    Hospital outpatient departments perform a wide range of procedures, including diagnostic and surgical procedures, which may use drugs that Medicare considers to function as supplies. If the drug is new, and its cost is high relative to Medicare's payment for the procedure, then hospitals can receive a separate “pass-through” payment for the drug in addition to Medicare's payment for the procedure. These pass-through payments are in effect for 2 to 3 years. When the pass-through payments expire, Medicare no longer pays separately for the drug, and payment for the drug is “packaged” with the payment for the related procedure. The payment rate for the procedure does not vary by whether or not the drug is used. Medicare intends this payment rate to be an incentive for hospitals to furnish services efficiently, such as using the most cost-efficient items that meet the patient's needs. Examples of Types of Drugs that Medicare Considers to Function as Supplies GAO's analysis of Medicare data showed that higher payments were associated with six of seven selected drugs when they were eligible for pass-through payments versus when their payments were packaged. For example, one drug used in cataract removal procedures was eligible for pass-through payments in 2017. That year, Medicare paid $1,824 for the procedure and $463 for the drug pass-through payment—a total payment of $2,287. If a hospital performed the same cataract removal procedure when the drug was packaged the following year, there was no longer a separate payment for the drug. Instead, Medicare paid $1,921 for the procedure whether or not the hospital used the drug. Of the seven selected drugs, GAO also reviewed differences in use for four of them that did not have limitations on Medicare coverage during the time frame of GAO's analysis, such as coverage that was limited to certain clinical trials. GAO found that hospitals' use of three of the four drugs was lower when payments for the drugs were packaged. This was consistent with the financial incentives created by the payment system. In particular, given the lower total payment for the drug and procedure when the drug is packaged, hospitals may have a greater incentive to use a lower-cost alternative for the procedure. Hospitals' use of a fourth drug increased regardless of payment status. The financial incentives for that drug appeared minimal because the total payment for it and its related procedure was about the same when it was eligible for pass-through payments and when packaged. Other factors that can affect use of the drugs include the use of the drugs for certain populations and whether hospitals put the drugs on their formularies, which guide, in part, whether the drug is used at that hospital. The Department of Health and Human Services reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate. Medicare makes “pass-through” payments under Medicare Part B when hospital outpatient departments use certain new, high-cost drugs. These temporary payments are in addition to Medicare's payments for the procedures using the drugs. They may help make the new drugs accessible for beneficiaries and also allow Medicare to collect information on the drugs' use and costs. The Consolidated Appropriations Act, 2018 included a provision for GAO to review the effect of Medicare's policy for packaging high-cost drugs after their pass-through payments have expired. This report describes (1) the payments associated with selected high-cost drugs when eligible for pass-through payments versus when packaged, and (2) hospitals' use of those drugs when eligible for pass-through payments versus when packaged. GAO reviewed federal regulations on pass-through payments and Medicare payment files for all seven drugs whose pass-through payments expired in 2017 or 2018 and that were subsequently packaged. All of these drugs met Medicare's definition for having a high cost relative to Medicare's payment rate for the procedure using the drug. GAO also reviewed Medicare claims data on the use of the drugs for 2017 through 2019 (the most recent available). To supplement this information, GAO also interviewed Medicare officials, as well officials from 11 organizations representing hospitals, physicians, and drug manufacturers, about payment rates, use, reporting, and clinical context for the drugs. For more information, contact James Cosgrove at (202) 512-7114 or cosgrovej@gao.gov.
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