Secretary Michael R. Pompeo With Erick Erickson of The Erick Erickson Show on WSB Atlanta

Michael R. Pompeo, Secretary of State

Via Teleconference

QUESTION:  Joining me out of the gate this morning, got a very special guest.  You know him as the United States Secretary of State, Mike Pompeo.  Good morning, Mr. Secretary.  How are you?

SECRETARY POMPEO:  Good morning, Erick.  How are you today?

QUESTION:  I’m great.  I’m glad you could stop by this morning, because I was thinking every conversation I’ve had with the President or Vice President the last couple of months has involved conversations on China.  And now with Apple rolling out its new iPhone next week in 5G, it just seems like we’re seeing American tech companies and even institutions in this country, like through Confucius Institutes, more and more entangled with China, and would love to pick your brain on that topic.

SECRETARY POMPEO:  Yes, sir.  Look, this risk from the Chinese Communist Party, Erick, is real.  For 40 years – and this isn’t political, remotely – Republican presidents, Republican congresses, Democrat, it didn’t make a difference – we went on bended knee.  We allowed the Chinese Communist Party to walk all over us.  And President Trump is working to right that ship.  It’ll be good for American jobs, it’ll be good for American security.

You talk about the context of technology.  We have inside our own classrooms, in K-12 institutions in Georgia and my home state of Kansas, all across America, we have the Chinese Communist Party under the veil of these things called Confucius Institutes impacting our kids, putting their propaganda on top of our children.  It’s unacceptable, and we are working to, by the end of the year, have them out of every school all across America.

QUESTION:  I’m glad to hear that.  I know we’ve had several here in Georgia, and academic institutions defending them and their funding.  But that U.S. Senate investigation, bipartisan in nature, I guess a couple of years ago, really did show how they just are pushing a communist party line as opposed to anything objective about China.

SECRETARY POMPEO:  You raised it, Erick, and we shouldn’t shy away from talking about it.  It’s often about money, whether it was the desire of our companies to sell products in China, or in this case for universities to take grant money from the Chinese Communist Party.  It’s often about economics.  We need to just face up to the fact that this money is being used to subvert our democracy, to undermine our way of life, and we should simply say it’s unacceptable, we’ll find another way to underwrite our schools, to pay for our kids to go where they need to go.  To take money from the Chinese Communist Party to keep our schools afloat is just an unacceptable tradeoff.

QUESTION:  Let me mention economics.  One of the issues I hear repeatedly and the President has raised is that China is not considered a developed nation in the World Trade Organization, so it gets all sorts of benefits.  Is there any sort of global move to try to rectify the situation now that China really is a dominant economy in the world?

SECRETARY POMPEO:  President Trump and our team have built out a real coalition on this issue, Erick.  It was the President who flagged this first, but now we can see that the world has come to understand China the same way that the United States does.  So whether it’s European countries, other countries in Southeast Asia, they all understand that this deal that was struck two decades ago that said China can get a set of rules that applied essentially only to it, a country of 1.4 billion people and a whole lot of wealth, would still get these things.  And only the poorest countries in the world are supposed to get trade deals, and the whole world I think is united.

It will take some real work to fix what happens at the World Trade Organization on this.  But I don’t think there are many defenders left that think it’s plausible for China to claim that it’s a developing country when it has one of the most advanced militaries, an advanced space program, a missile program – the list is very long, Erick.

QUESTION:  Well, I know you’re pressed for time, but before you get off here, I want to ask you – I grew up in the Middle East, in Dubai.  I have a lot of friends from the Middle East and that region of the world, have numerous friends I would – from Armenia, and I’m a little bit disturbed reading the press reports on the Armenian-Azerbaijan situation.  I know it’s having spillover effects into Russia, Iran, and elsewhere, and would love to get your thoughts on that.

SECRETARY POMPEO:  Well, I didn’t know your history there in Dubai.  Let me – two things, and then I’ll turn to Armenia.  What the Emirati leadership did in making the decision not to make hate for Israel the core piece of their foreign policy was bold and will benefit the people of every one of the Emirates, whether it’s in Abu Dhabi, or Dubai, or elsewhere.  It’s a good thing for the region.  It’s a great thing for the American people, who will have to send fewer there – fewer of their kids to go fight in faraway places in the Middle East.  The risk of terror in the area is reduced too, as we all focus on the real threat from the Islamic Republic of Iran.

When you say that, you now turn to the conflicts that are there, and you watch what’s taking place in Azerbaijan and Armenia today.  It is dangerous.  We now have the Turks, who have stepped in and provided resources to Azerbaijan, increasing the risk, increasing the firepower that’s taking place in this historic fight over this place called Nagorno-Karabakh, a small territory with about 150,000 people, but —

QUESTION:  Right, for the —

SECRETARY POMPEO:  — highly contentious.

QUESTION:  — last thousand years?

SECRETARY POMPEO:  Yeah, it’s a longstanding conflict.  The resolution of that conflict ought to be done through negotiation and peaceful discussions, not through armed conflict, and certainly not with third party countries coming in to lend their firepower to what is already a powder keg of a situation.  We – we’re hopeful that the Armenians will be able to defend against what the Azerbaijanis are doing, and that they will all, before that takes place, get the ceasefire right, and then sit down at the table and try and sort through this – that is – what is a truly historic and complicated problem set.

QUESTION:  (Laughter.)  Very much so, it is.  Listen, I know you’re pressed on time, but thank you very much for stopping by this morning.  Best of luck to you and your leadership there with the Secretary of State’s office.  I truly have been impressed with your leadership —

SECRETARY POMPEO:  Thank you, Erick.

QUESTION:  — in these Middle East peace deals.  If we weren’t pressed on time, I would have talked more about them, having grown up over there in an area where my textbooks in the Middle East were redacted and – from all references of Israel.  I never even – I’ve never even been to Israel.  I couldn’t when I lived over there.

SECRETARY POMPEO:  I know.  It’s a remarkable place.

QUESTION:  So I’m excited about what you guys have done.

SECRETARY POMPEO:  Well, I would love to have more time with you.  Thanks for having me on today.  Bless you.  Have a great day, Erick.

QUESTION:  You too.

 

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    The Department of Defense (DOD) has a general expectation that its health care beneficiaries, upon receiving an urgent referral to see a specialist, will access that specialty care in 3 days or less. GAO's analysis of 16,754 urgent referrals at military treatment facilities (MTF) shows that DOD beneficiaries accessed specialty care services in 3 days or less for more than half of the urgent referrals. About 9 percent of the urgent referrals involved beneficiaries waiting 3 weeks or longer to be seen. According to DOD officials, some beneficiaries may have waited longer than 3 days due to factors such as patient preference, appointment availability, or waiting for lab results. Time to access care varied by specialty, with beneficiaries urgently referred to ophthalmology generally seeing a specialist the fastest, and those urgently referred to mental health and oncology generally waiting the longest. According to DOD officials, MTFs are responsible for monitoring beneficiaries' access to specialty care through urgent referrals. GAO found that the monitoring processes used varied by MTF and specialty care clinic at the five selected MTFs that GAO reviewed. For example, officials from one MTF told GAO they centrally manage all urgent referrals using a daily report to address any delays, while officials from another MTF told GAO that individual specialty care clinics are responsible for managing their own urgent referrals. DOD officials acknowledged such variation and MTFs have been directed to centralize their referral management and monitoring processes—an effort that is currently underway. GAO found that DOD monitors the rates at which beneficiaries receive timely and effective care, in part, through 10 outpatient health care quality measures. These measures allow DOD to make comparisons to civilian health care systems, and they are reviewed by various DOD groups at least quarterly. However, DOD officials told GAO that since October 2017, they have been unable to monitor nine of the 10 measures for MTFs using Military Health System (MHS) Genesis, DOD's new electronic health record system. According to the officials, DOD's current data warehouse—a system that stores some MHS Genesis data and can be used by MTFs to create reports on quality measures—is not capable of producing accurate reports for those measures. DOD officials told GAO they expect to implement a new data warehouse by the end of 2020. DOD officials also said they are importing data related to quality measures into another system used for quality monitoring; however, DOD does not have a targeted date for completing these data imports. Until these actions are fully implemented, groups responsible for monitoring quality care will continue to lack the data needed to offer assurance that the growing number of MTFs using MHS Genesis are providing beneficiaries with timely and effective care that will lead to better health outcomes. A draft of this report recommended that DOD establish a timeline to complete importing the quality measure-related data from MHS Genesis into DOD's system used for quality monitoring. In its review of the draft, DOD concurred with the recommendation and established a timeline for importing the data, to be available in DOD's system no later than May 2021. After reviewing the information DOD provided, GAO removed the recommendation from the final report. DOD is responsible for ensuring that beneficiaries have access to specialty care for conditions that, while not life-threatening, require immediate attention, as well as for ensuring that beneficiaries receive timely and effective care for certain routine or other services. A report accompanying the National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to review the quality of health care in the MHS. This report examines (1) the timeliness with which beneficiaries access specialty care at MTFs through urgent referrals and DOD's efforts to monitor access, and (2) DOD's use of quality measures to monitor and improve the rates of timely and effective care received by beneficiaries at MTFs. GAO examined relevant policies, national DOD referral data (a total of 16,754 urgent referrals) for a 1-year period ending August 2019, and the most recent available quality measure data (April 2020). GAO interviewed officials from five MTFs, selected for variation in military services, geography, provision of select specialty services, and use of the electronic health record system. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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    The United States Department of Justice announced today that it has obtained a Temporary Restraining Order in federal court to combat fraud related to the coronavirus (COVID-19) pandemic. The enforcement action, filed in Tampa, Florida, is part of the Justice Department’s ongoing efforts prioritizing the detection, investigation, and prosecution of illegal conduct related to the pandemic. The action was brought based on an investigation conducted by United States Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations (HSI), in coordination with the Vietnam Ministry of Public Security.
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  • Crumbling Foundations: Extent of Homes with Defective Concrete Is Not Fully Known and Federal Options to Aid Homeowners Are Limited
    In U.S GAO News
    As of December 2019, at least 1,600 homes in Connecticut had confirmed pyrrhotite but the total number of affected homes is likely higher. According to one estimate, 4,000–6,000 more homes in Connecticut could develop crumbling foundations due to pyrrhotite. Affected homeowners may face total remediation costs of $150,000 or more and drops in property values of 25 percent or more. Connecticut established funding to provide homeowners with up to $175,000 towards the cost of foundation replacement, but affected homeowners are typically responsible for about one-third of total repair costs (which can include costs for replacing driveways and porches damaged during foundation replacement). Current funding is expected to assist 1,034 homeowners. Pyrrhotite Damage to a Basement and a Home Being Repaired Due to Pyrrhotite Damage GAO found that highly affected towns lost more than $1.6 million in tax revenue in 2018 due to lost assessment value of the houses affected by pyrrhotite, but town officials told us the losses have not yet significantly affected their budgets. However, officials were concerned that pyrrhotite could have long-term effects on their towns if the number of affected homes increased or homes were not remediated. GAO also found that homes located in highly affected towns and built when pyrrhotite-containing concrete was used sold for significantly less, on average, than similar homes in less-affected towns. Stakeholders told GAO that defaults and foreclosures related to pyrrhotite have been limited to date. Some federal funds have already been used for pyrrhotite testing and GAO identified eight additional federal programs that could be used to help mitigate financial impacts on homeowners. However, most of these programs have eligibility or funding restrictions that limit their potential for this purpose. Stakeholders with whom GAO spoke suggested other federal responses—in particular, declaring pyrrhotite damage a major disaster or establishing a federally backed insurance product. However, the Federal Emergency Management Agency determined that pyrrhotite damage did not qualify as a natural catastrophe, and a federally backed insurance program may not be feasible since it would serve a small population with high expected costs. Certain homes built in northeastern Connecticut and central Massachusetts between 1983 and 2015 have concrete foundations containing the mineral pyrrhotite. Pyrrhotite expands when it is exposed to water and oxygen and, over time, concrete foundations containing pyrrhotite may crack and crumble. The Explanatory Statement accompanying the Consolidated Appropriations Act, 2019 included a provision for GAO to study the financial impact of pyrrhotite. This report describes (1) what is known about the number of homes affected by pyrrhotite in the region; (2) the financial impact of pyrrhotite on homeowners; (3) the financial effects on towns, local housing markets, and the federal government; and (4) federal options to mitigate pyrrhotite's financial impact on affected homeowners. GAO analyzed data from state, local, and private entities about the extent of pyrrhotite in foundations and associated costs, and federal actions taken in response to pyrrhotite. GAO also interviewed federal, state, and local officials; homeowners; and other stakeholders such as banks and real estate agents. For more information, contact John Pendleton at (202) 512-8678 or pendletonj@gao.gov.
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    In U.S GAO News
    GAO Email Notification Test We are testing our notification distribution process for GAO reports. If you are able to read this information the link contained in the email notification link worked. Please confirm that you received the email notification from GAOReports@gao.gov and used the link to access the prepublication site by contacting Andrea Thomas at thomasa@gao.gov (202) 512-3147 John Miller at millerj@gao.gov (202) 512-3672 Thank you
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  • Medicare and Medicaid: COVID-19 Program Flexibilities and Considerations for Their Continuation
    In U.S GAO News
    What GAO Found In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for overseeing Medicare and Medicaid, made widespread use of program waivers and other flexibilities to expand beneficiary access to care. Some preliminary information is available on the effects of these waivers. Specifically: Medicare. CMS issued over 200 waivers and cited some of their benefits in a January 2021 report. For example, CMS reported that: Expansion of hospital capacity. More than 100 new facilities were added through the waivers that permitted hospitals to provide care in non-hospital settings, including beneficiaries' homes. Workforce expansion. Waivers and other flexibilities that relaxed certain provider enrollment requirements and allowed certain nonphysicians, such as nurse practitioners, to provide additional services expanded the provider workforce. Telehealth waivers. Utilization of telehealth services—certain services that are normally provided in-person but can also be provided using audio and audio-video technology—increased sharply. For example, utilization increased from a weekly average of about 325,000 services in mid-March to peak at about 1.9 million in mid-April 2020. Medicaid. CMS approved more than 600 waivers or other flexibilities aimed at addressing obstacles to beneficiary care, provider availability, and program enrollment. GAO has reported certain flexibilities such as telehealth as critical in reducing obstacles to care. Examples of other flexibilities included: Forty-three states suspended fee-for-service prior authorizations, which help ensure compliance with coverage and payment rules before beneficiaries can obtain certain services. Fifty states and the District of Columbia waived certain provider screening and enrollment requirements, such as criminal background checks. While likely benefitting beneficiaries and providers, these program flexibilities also increase certain risks to the Medicare and Medicaid programs and raise considerations for their continuation beyond the pandemic. For example: Increased spending. Telehealth waivers can increase spending in both programs, if telehealth services are furnished in addition to in-person services. Program integrity. The suspension of some program safeguards has increased the risks of fraud, waste, and abuse that GAO previously noted in its High-Risk report series. Beneficiary health and safety. Although telehealth has enabled the safe provision of services, the quality of telehealth services has not been fully analyzed. Why GAO Did This Study Medicare and Medicaid—two federally financed health insurance programs—spent over $1.5 trillion on health care services provided to about 140 million beneficiaries in 2020. Recognizing the critical role of these programs in providing health care services to millions of Americans, the federal government has provided for increased funding and program flexibilities, including waivers of certain federal requirements, in response to the COVID-19 pandemic. The CARES Act includes a provision for GAO to conduct monitoring and oversight of the federal government's response to the COVID-19 pandemic. In response, GAO has issued a series of government-wide reports from June 2020 through March 2021. GAO is continuing to monitor and report on these services. This testimony summarizes GAO's findings from these reports related to Medicare and Medicaid flexibilities during the COVID-19 pandemic, as well as preliminary observations from ongoing work related to telehealth waivers in both programs. Specifically, the statement focuses on what is known about the effects of these waivers and flexibilities on Medicare and Medicaid, and considerations regarding their ongoing use. To conduct this work, GAO reviewed federal laws, CMS documents and guidance, and interviewed federal and state officials. GAO also interviewed six provider and beneficiary groups, selected based on their experience with telehealth services. GAO obtained technical comments from CMS and incorporated them as appropriate. For more information, contact Jessica Farb at (202) 512-7114 or farbj@gao.gov or Carolyn L. Yocom at (202) 512-7114 or yocomc@gao.gov.
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