Press Briefing by Press Secretary Jay Carney and Chief Technology Officer Todd Park, 5/8/2013
James S. Brady Press Briefing Room
12:40 P.M. EDT
MR. CARNEY: Good afternoon. Thank you for being here, as ever. Before I take your questions I wanted to have you notice, if you haven't already, the stories this morning about a data release by the Centers for Medicare and Medicaid Services, data on pricing for 3,300 hospitals.
And as you may know, the Affordable Care Act requires all hospitals to establish and make public their standard charges for items and services. And today’s data release by CMS is one step towards putting people and families in charge of their own health care. By making this data available we are allowing everyone to see the huge pricing variations from hospital to hospital for the same procedures, sometimes from one hospital that's just in the next neighborhood over to another.
With me today is Todd Park, Assistant to the President and Chief Technology Officer, and Todd can say a few words about how the Affordable Care Act is driving this data accessibility and how the data is an important step towards improving pricing and care for consumers. It is a question that I think consumers, justifiably, ask -- why am I paying at hospital X three times -- or why is that hospital charging three times more for the same service that a hospital in the next town over may be charging? And providing this data to the public allows for consumers to know the facts and empowers them.
And with that, I will turn it over to Todd. If you could, hear what he has to say, direct questions on his topic area to him at the top, and then he’ll step aside and I’ll take your questions on other issues.
Q Jay, what’s Todd’s title? I'm sorry -- what’s your title?
MR. CARNEY: Todd is Assistant to the President and Chief Technology Officer.
MR. PARK: Hello, everybody. Today, CMS is releasing new data on hospital charges, as Jay was just describing -- what hospitals charge for in-patient services associated with the hundred most common kinds of hospital stays. The data show a huge variation in charges from hospital to hospital, including those within the same community. And hospitals determine what they’ll charge for items or services provided to patients and these charges are the amounts that the hospital then bills for an item or service.
As a note, these charges are the starting point for how much hospitals get paid. What’s ultimately paid depends on whether the patient is insured and who the insurer is. Patients who are uninsured or underinsured could be asked to pay these full charges.
By making this data available we're allowing everyone to see huge variations in hospital charges across the country. For example, the map behind me illustrates average in-patient hospital charges for hip and knee replacements across the country. Average in-patient charges for hip and knee replacements can vary from $5,300 on average at a hospital in Ada, Oklahoma, to a high of $223,000 at a hospital in Monterrey Park, California. So you can see on the map how average charges by region vary enormously. But even within a given metro area, there is big variation. For example, in Birmingham, Alabama, the average hospital charge for hip and knee replacement varies from $23,000 at one hospital to $141,000 at another.
So today CMS is making this massive hospital charges data set publicly available and downloadable by anybody. And if our experience with other open data efforts is any guide, innovators and entrepreneurs will take this data and use it to power consumer-friendly apps that can help folks across the country make the health care decisions that work best for them. Researchers, analysts and journalists will comb through the data and bring you insight as to why this kind of charge variation is happening. The marketplace will become more transparent. And the American public will benefit. It's another example of how the Affordable Care Act is advancing transparency, innovation, and putting consumers in charge of their own health care.
And with that, let's open it up for questions.
MR. CARNEY: Any questions for Todd?
Q Beyond this information out there, is there any move on the administration's part -- do you feel like there needs to be any changes in the law to address these vast disparities?
MR. PARK: So there are a couple things actually happening -- and I'd refer you to CMS for more detailed info -- but we're also announcing today $87 million in grants to establish and fund our research centers across the country operated by state governments that actually take our data and other data and do research into price variation, and make prices transparent and help make the marketplace more transparent and competitive.
Also, there is work that’s being done by CMS around trying to help folks who actually need financial assistance not be subjected to these massive charges, but charges more along the lines of what Medicare actually pays or what folks who are insured actually pay.
Q Are you publishing or can you publish the different rates paid by Medicaid, Medicare for these services, and the rates paid by the insurance companies?
MR. PARK: So we can publish the data that we've got. And actually, the data set that we've released includes both the hospitals’ bill charges and what Medicare pays for each of these services across the country, by hospital.
Q But private insurance?
MR. PARK: We actually don’t have that data in-house. But these state government operated price and research centers in a lot of cases will have access to that kind of data potentially and be able to do work in that area.
Q And, Todd, a variation to his question -- in terms of driving the cost down, do you think by publishing this -- when you say transparent, does that -- some people would be shamed into lowering their prices? Are there parts of the President's law that you contend will actually help lower some of these prices so it becomes more fair? I'm trying to understand -- after the transparency, how do you think it drives costs down?
MR. PARK: So the history of marketplaces is that transparent marketplaces are more competitive, and more competitive marketplaces drive down costs. And that’s certainly the hope here.
Q So it's a variation on that. So if you're insured, are you shielded from these vast differences? I mean, if your knee replacement is going to be covered anyway, does it --
MR. PARK: So these charges actually, again, are a starting point for the prices ultimately paid to hospitals. So if you have insurance, you have a negotiated rate, typically, that is lower than these charges. And you'll see the Medicare payment is obviously a lot lower than these charges. But even if you actually have insurance, in a lot of cases the insurance doesn’t necessarily protect you from the charges. It will actually cover some chunk of them, but then you're subject to the rest, again, depending upon the insurance that you have. And even if you actually have the kind of insurance where the negotiated rate is actually kind of your full exposure, the charges that we published today are frequently the starting point for negotiating those rates and so it’s super relevant for those situations as well.
MR. CARNEY: Mark, and then April.
Q Todd, is it your assumption that a hospital that charges $5,300 for a surgery provides the same level of quality as one that charges $223,000 for the same operation?
MR. PARK: So these are questions that we are really excited to see you guys investigate and check out. (Laughter.) And actually to help you out, CMS has also previously made hospital quality data downloadable for virtually every American hospital as well -- the Hospitalcompare data set with a vast number of quality metrics for these hospitals. So check that out. Check this data out, match it up, and see what you can come up with.
Q How would you even go about doing that? I mean, assessing the quality of the service?
MR. PARK: So there are a variety of metrics actually that have been developed by public-private collaborations over the years, and these metrics are then generated based on a whole variety of data and reported by hospitals. And so go to hospitalcompare@CMS to learn more. It’s really, really cool stuff. And I think looking at that data and looking at this data and the combination is going to be really interesting.
MR. CARNEY: April.
Q Following up on what Mark was saying, do you think that this could be a disadvantage for some hospitals as you’re putting out quality of care ratio and the cost versus another hospital in the area?
MR. PARK: I think as a fundamental principle we believe that the marketplace should be transparent and that it’s a consumer’s right to know what these prices are and what the quality levels are. So that’s why we made this data available to everybody.
Now, there will be lots of researchers and analysts and innovators that take this data and come up with insights and come up with tools that help people act upon the data. But as a fundamental principle, we think this data needs to be out there in the open and that makes for a better, more functional, more competitive health care marketplace who does the right thing by the American public.
Q So it might not necessarily drive down costs? It would make those who have the better quality care keep their prices, and maybe even go even higher, do you think? I think it could be the opposite of what you intend it to do.
MR. PARK: I think, in general, and again just from borrowing lessons learned from other marketplaces, when you actually make quality and cost and value transparent, that added level of transparency and competition does actually, net/net, produce better results for consumers. And I think that that’s actually very likely to happen here.
MR. CARNEY: Victoria.
Q In seeing some of these big discrepancies for the same operations, say, in the same town, did you look at taking it to the set where you could see, is it anesthetic, is it the actual operation, is it the time in the -- is it the hospital stay -- did you see that?
MR. PARK: So the data we’ve released is actually on the state overall and in-patient service actually bundled with it. We’re actually looking at potential additional steps, looking, for example, at out-patient services as well. But for detailed questions I would refer you to CMS.
Q Do they have it? They have that breakdown?
MR. PARK: They have the underlying claims that they’ve used to then -- right.
Q Do you have any message for U.S. citizens who do medical tours and go out of the country to get their medical procedures accomplished?
MR. PARK: I’m sorry, say it one more time.
Q Do you have any message for Americans who go out of America and go to other countries to get their surgical procedures -- it’s much cheaper in other countries.
MR. PARK: Well, I think -- I don’t really have any comment on medical tourism, but what I will say is that it's going to be incredibly helpful I think to consumers to have an increasing amount of information available about the charges, the pricing, the quality of health care here. And that will help them make better decisions for them and their families.
MR. CARNEY: Bill.
Q What is the connection between what the hospital charges, no matter what it is, and what you're willing to pay under Medicare or Medicaid?
MR. PARK: As you'll see, Medicare across the board pays a much, much, much lower rate than charges. And so Medicare is getting a great deal for Medicare beneficiaries. The variation is massive in terms of the multiple on what Medicare pays. And it's a really good question as to why that is.
Q Just so I understand, no matter what the hospital charges, Medicare says, this is what we're going to pay, period.
MR. PARK: Correct. That’s right. And why there is that huge gap, you'll figure out.
Q Slightly related -- since you're here -- yesterday some of us reported that the White House is hiring a new Internet and privacy advisor, who I think is someone who is going to work with you. Can you tell us a little bit more about that position, what gap it fills?
MR. PARK: That’s an ongoing personnel situation. I can't comment on that right now.
MR. CARNEY: All right, Todd.
Q You could be a spokesman. (Laughter.)
MR. CARNEY: You're good, man. I just trained him for 10 minutes. Look at that.
MR. PARK: Thank you for your interest. (Laughter.) Take good care.
MR. CARNEY: In answer to some of the questions about how we can sort of process this information that Todd was talking about in data and make assessments about it, there was -- and he referred to journalism as a tool to doing that -- there was an excellent article that my former employer, Time Magazine did, Stephen Brill, that went at length into this subject a number of months ago. It's a good read.
With that, I'll go to your other questions. Nedra.
Q On a couple topics -- first, on Syria, Secretary Kerry said yesterday it was up to the Syrian people whether Assad should go. And I just wonder if that indicates any change in administrative position on Assad's future.
MR. CARNEY: No. Our position is that Syria's future cannot include Bashar al-Assad. But we have also been clear, in addition to making our views known that Assad has lost all legitimacy and must step aside, that the Syrian people must negotiate the makeup of a transition governing body and determine which elements of the regime they would be willing to work with in that transition governing body. But in terms of our views on Syria's future, it is a post-Assad future. Assad himself has given up all rights to represent the Syrian people.
Q So the language that Secretary Kerry used, is that something that was appropriate, or does it maybe send a mixed signal?
MR. CARNEY: I think he was making the point that we've made all along that it is our view and it is our position that Assad cannot be the leader of Syria in the future and that he must step aside. That is the view of the Syrian people as well. We have also made clear that the decisions about how that transition takes place and who participates in it is something for the Syrian people to decide.
So that has always been our position, and the two statements are compatible. Ultimately, obviously, the Syrian people decide and the opposition decides who will be -- there has to be a negotiated process, but the Syrian people decide who will be represented from the regime in a transition governing body.
Q On another topic -- the rescue of these three women in Ohio that had been -- were kidnapped for a decade or more -- has the President been updated on that situation? Is he following it closely? And is there any sort of response that he had?
MR. CARNEY: I don’t have any specific response from the President. I think it would be impossible to read or watch the news and not be aware of this extraordinary story, so I'm confident that he knows about it and knows about this tremendous development that these women who have been missing for so long have been found and returned to their families. And that’s obviously a great thing.
Q But he's not getting any official briefings on it or anything.
MR. CARNEY: Not that I'm aware of, no.
Q This morning, Senator McConnell gave a pretty tough speech about what he argued are red flags about the nomination of Tom Perez, and I think that just before the briefing started, Republicans invoked a rule -- procedural rule that prevents the committee from dealing with his nomination today. And I guess I'm wondering if the White House has any response to Senator McConnell's arguments, and how concerned the White House is that his arguments and these procedural moves today, what impact those ultimately will have on the nomination, whether you anticipated a lengthy delay or ultimately a block of it.
MR. CARNEY: Well, I appreciate the question, because it is unfortunate that some Republicans on the Hill are politicizing this nomination. But the bottom line is that Tom Perez is a dedicated public servant who has spent his career fighting to keep the American Dream within reach for hardworking, middle-class families and those striving to get into the middle class.
We expect the Senate to move forward on his nomination, through committee and on to the floor. He is enormously qualified. He's known as a pragmatic leader and a consensus-builder. He has served as Assistant Attorney General for the Civil Rights Division, and, as you know, served as the Secretary of Maryland's Department of Labor, Licensing and Regulation, and has a long and distinguished record.
And opposition to or throwing up roadblocks to his nomination is part of an unfortunate process of politicization of these nominees that does not serve the American people well, certainly does not serve, in this case, the work that the Department of Labor needs to do.
Q So you don’t think that Senator McConnell's arguments are substantive, you're saying that they're politicized?
MR. CARNEY: Yes.
Q Are you concerned that this will mean that his nomination does not ultimately move forward?
MR. CARNEY: No, we believe that the Senate will move forward on the nomination -- should move forward on the nomination. He is enormously qualified, and there has not been a case made that is not political and partisan against his nomination. And we hope and expect the Senate will move forward.
Q On another note -- does the President support this effort -- there's been reports about this effort by the FBI to change laws to make it easier to wiretap Internet-based phone services.
MR. CARNEY: Yes, I do have something on that. The so-called going dark issue and how best to ensure that our law enforcement and legal authorities keep pace with technological advancements have been under discussion for some time. And the Department of Justice is working with other agencies on a way forward that protects the privacy of Americans, preserves corporate innovation, and provides the tools that our law enforcement and counterterrorism professionals require.
We don’t have anything new to announce on this. DOJ is working on this with other agencies, and I would refer you to the Department of Justice.
Q Jay, in advance of today’s hearing on Benghazi, Senator Lindsey Graham said, I think the dam is about to break on Benghazi. We’re going to find people asleep at the switch when it comes to the State Department, including Hillary Clinton. What do you say to this allegation from top Republicans that Hillary Clinton was asleep at the switch?
MR. CARNEY: Well, I’d say a couple of things. This administration has made extraordinary efforts to work with five different congressional committees investigating what happened before, during, and after the Benghazi attacks, including, over the past eight months, testifying in 10 congressional hearings, holding 20 staff briefings, and providing over 25,000 pages of documents.
Another leading Senate Republican, Senator Corker, said today that he feels like he knows what happened in Benghazi and he is, “fairly satisfied.” And as The New York Times reported this morning, much of what the witnesses were expected to raise in the hearings today has already been addressed both in hearings and in the Accountability Review Board report.
I mean this is a subject that has, from its beginning, been subject to attempts to politicize it by Republicans, when, in fact, what happened in Benghazi was a tragedy. And the President has been committed from day one to two things -- making sure that those who are responsible for the deaths of four Americans are found and brought to justice, and that we do everything we need to do to ensure that this kind of attack cannot happen again. And the standing up of the Accountability Review Board by then-Secretary Clinton, with the full support of the President, demonstrates the seriousness with which she took this issue.
That review board issued a report that was unsparing and highly critical in some areas, and was led by two highly respected nonpartisan experts in the field of national security, Admiral Mullen and Ambassador Pickering. And that report issued contained within it a series of recommendations, every single one of which has been acted on or is being acted on by the State Department. And I think, again, that demonstrates the seriousness with which we took the true issues here.
It also, given the remarkable level of cooperation that we’ve demonstrated with congressional committees and investigators thus far, demonstrates again that we’re at a place where there are attempts to politicize this when that should not be the case.
Q Why do you think they’re going after Hillary Clinton?
MR. CARNEY: Well, I’m not sure that they are. I will note that in the report issued by the committee, Chairman Issa’s committee -- which was, again -- deliberately excluded Democrats, was highly partisan -- it included a main allegation within it that was described by The Washington Post Factchecker this way: “Issa has no basis or evidence to show that Clinton [then-Secretary Clinton] had anything to do with this cable any more than she personally approved a cable on proper email etiquette. The odds are extremely long that Secretary Clinton ever saw or approved this memo, giving us confidence that his inflammatory and reckless language qualifies as a whopper” -- that would be Chairman Issa’s language.
Q So the White House is confident that Hillary Clinton acted appropriately throughout this process?
MR. CARNEY: We are. And I think I would point you to the Accountability Review Board and what --
Q Which didn’t --
MR. CARNEY: I think I would point you to the report the put out. I would point you to what the two heads of that board, Ambassador Pickering and Admiral Mullen -- each highly praised by both sides of the aisle for their long, distinguished careers -- put out in a statement this week: “From the beginning of the ARB process, we had unfettered access to everyone and everything, including all of the documentation we needed. Our marching orders were to get to the bottom of what happened, and that is what we did.”
Again, this is an unsparing report done by two career professionals, nonpartisan career professionals, that contain within it very serious recommendations, found shortcomings that needed to be corrected, and the State Department acted immediately on that.
Q So I wanted to ask you also about something you said on November 28th. You said that the talking points that were prepared for Ambassador Rice and the administration were given, as you pointed out at the time to the Hill, were compiled, written up by the intelligence community -- that there was no change that was asked for by the White House or by the State Department except for a single word. But now the Weekly Standard has obtained three revisions to these talking points that show substantial changes that were done and asked for specifically by the State Department. Were you incorrect when you said that only a single word had been changed?
MR. CARNEY: No, I was not. I think what remains the case is that the intelligence community, CIA, drafted these talking points and redrafted these talking points. The fact that there are inputs is always the case in a process like this. But the only edits made by anyone here at the White House were stylistic and non-substantive. They corrected the description of the building or the facility in Benghazi from “consulate” to “diplomatic facility” and the like.
And ultimately, this all has been discussed and reviewed and provided in enormous levels of detail by the administration to congressional investigators, and the attempt to politicize the talking points, again, is part of an effort to chase after what isn't the substance here. The substance is the diplomatic facility in Benghazi was attacked; four Americans were killed; the President has been committed from day one to finding and bringing to justice those responsible, and committed from day one to ensuring that we take every step we can to protect our diplomats in the future and to ensure that this kind of event doesn’t happen again.
And you know within the hours of the attack, beginning with a press release that was much maligned even by members of his own party, the Republican nominee for President tried to politicize this, and that has been the case ever since. And it, unfortunately, continues to this day.
I mean, again, you’ve seen levels of cooperation here that are rather extraordinary -- 25,000 pages of documents; 20 staff briefings; 10 congressional hearings. And nothing that we expect to hear today in this hearing contradicts anything that has already been discussed and revealed, assessed by the Accountability Review Board. I mean, if it is the position of critics that that review board and its two chairs are not being faithful to the facts and the truth, then I think they have to discuss that with the chairs of the board. But the fact is that this has been looked at exhaustively.
Q But, Jay, I'm specifically asking about what you said. And even what you just said about stylistic changes -- these changes look much more than stylistic. I mean, there’s references to security concerns expressed on September 10th, the day before the attack, being taken out. There’s references to al Qaeda being taken out --
MR. CARNEY: What we said and what remains true to this day is that the intelligence community drafted and redrafted these points. They were not -- and I think that that is what the Deputy Director of the CIA has said. And the fact that there is input from others doesn’t change the fact that the CIA or the intelligence community drafts these points consistent with what they know -- they’re drafting points to provide information to members of Congress as well as members of the administration so that they can speak publicly about it.
And again, if you look substantively at the information provided in the talking points about what happened in Benghazi, I think that reflects everything that we've said. I mean, to this day, it has to be acknowledged that those talking points that Susan Rice -- Ambassador Rice went out and used on those Sunday shows, and that I, of course, used when I discussed it, made clear, A, that we believed that extremists were involved in the attack, and B, that we knew that more information would come to light and that our understanding of what happened would be affected as that information became available. And every bit of information that's become available about it in those days following and weeks following was provided by us, because we were committed then and now to making sure we found out what happened, who was responsible, and make sure that we could take steps to prevent it from happening again.
Q Jay, do you still believe that an anti-Muslim video sparked the terror attack then?
MR. CARNEY: No, Ed. I think this has been, again, adjudicated and assessed and litigated many times. And that is -- when you look at those talking points, the one reference there is to protests that turned out not to be the case. But I would remind you that on the Friday before the Sunday appearances, we had violent demonstrations going on at embassy facilities around the world. We had a black flag raised at one of our embassies. We had breaches of walls at another embassy. We had a great deal of concern as a result of the protests surrounding these videos about the safety and security of diplomatic personnel around the region and the world. And it is entirely appropriate that there was concern about that, and I think understandable that there was some possibility of a connection between the kind of violent demonstrations we were seeing in Cairo and what took place in Benghazi.
But in the end, if you look at what was said -- and let’s just review the facts because it gets a little simplistic. Here is what Ambassador Rice said on “Face the Nation” that Sunday: “It is clear that there were extremist elements that joined and escalated the violence. Whether they were al Qaeda affiliates, whether they were Libyan-based extremists or al Qaeda itself I think is one of the things we'll have to determine.”
That is a simple statement of the facts that we knew when we knew them. And that is on the Sunday about which so much has been discussed and misrepresented.
Q Another fact is that she and you from this podium around that time period would not call it a terror attack. And among the things Mr. Hicks is testifying under oath about today is he’s saying that -- quote -- “from the get-go, the people in authority” -- not just on the ground, but people in authority who were following this back in Washington knew this was a terror attack.
MR. CARNEY: What did the President say when he spoke about it for the first time?
Q He referred to terror, generally, I believe -- acts of terror.
MR. CARNEY: An act of terror. Because that's what it was, by definition --
Q On the Daily Show a few days later he said we still don't know -- right?
MR. CARNEY: Ed, everything we said --
Q I mean, you're talking about facts. Did he say that on the Daily Show?
MR. CARNEY: He said the first time he talked about this publicly that it was an act of terror -- by definition, a violent assault on a diplomatic facility is an act of terror. What we did not know right away was who was responsible. And that's why there is an investigation and why there was an investigation that was launched right away. And that's absolutely the responsible thing to do.
Q On the question of the Accountability Review Board, you keep saying it was unsparing and you said they had unfettered access. Did Admiral Mullen and Mr. Pickering interview the President about what he did on the night of September 11th?
MR. CARNEY: Again, I will point you to what Admiral Mullen and Ambassador Pickering said and what the report said, beginning with the fact that -- this is useful here. The Accountability Review Board investigation, headed by, as I said, two of the most respected, non-partisan leaders in Washington, found that the interagency response was timely and appropriate and “helped save the lives of two severely wounded Americans.”
The ARB interviewed more than 100 people, reviewed thousands of documents, and watched hours of video. The ARB interviewed Gregory Hicks -- who’s testifying today -- and Eric Nordstrom, as well as the head of the State Department’s Counterterrorism Bureau, Ambassador Daniel Benjamin.
The ARB report was unsparing in its critique and criticisms, but the State Department accepted it and is in the process of implementing each of its 29 recommendations to improve embassy security and help ensure that this tragedy is not repeated.
As I said, quoting Ambassador Pickering and Admiral Mullen, “From the beginning of the ARB process, we had unfettered access to everyone and everything, including all the documentation we needed. Our marching orders were to get to the bottom of what happened, and that is what we did.”
As you know, when the President heard about the attack as it was underway in Benghazi, he was with the Secretary of Defense and ordered instantly that every resource be brought to bear to deal with that situation in Benghazi and to make sure that steps were taken to ensure the safety of our diplomatic personnel around the region and the world. And that is what happened, and that is what the ARB assessed to have happened.
Q Last one. You were talking about Syria a couple days ago and you said the lessons of Iraq are not too far in the distant past, that lessons are to be learned from Iraq at the start of the war more than a decade ago. How does that square with last week when you were talking about Benghazi, you said Benghazi was a long time ago? It was only eight months ago. Do you regret saying that, or do you want to --
MR. CARNEY: I'm not sure what the point you're trying to make --
Q You were saying Benghazi was a long time ago and this has been --
MR. CARNEY: What I'm saying -- what I was saying then and what I'm saying now is that we have assessed a great deal of information provided by the administration to congressional investigators -- 25,000 pages of documents, congressional hearings, staff briefings -- and that attempts to politicize this, which have guided Republicans, unfortunately, since the hours after the attack and the Republican nominee for President issued a highly misguided press release about it in an attempt to turn it into a political issue, have been unfortunate and haven't been focused on the problem itself, which is that four Americans were killed in an attack on our diplomatic facility in Benghazi, and that the people responsible need to be brought to justice and steps need to be taken to ensure that that kind of attack never happens again. And that’s been the President's focus. And he remains committed to both propositions.
Q Jay, you've talked about the motivations of the Republicans who are leading the House hearings on Benghazi. What about the witnesses? Do you think they're politicizing what happened?
MR. CARNEY: I can only say -- I don’t have any insight into that. And all I can say is that we have been unaware of anyone being blocked from talking to the Congress if they choose to do so. The fact is that two of the witnesses that I mentioned earlier were interviewed by ARB, which investigated what happened in Benghazi, and we don’t expect that anything we'll hear today will conflict with the vast amount of information we already know about what happened in Benghazi. That’s reflected in the ARB report. And in the investigation into who perpetrated these attacks, who's responsible for the deaths of Americans continues. And this President is committed to bringing to justice those who are responsible.
Q But they're saying things, obviously, that are very critical of certainly how the White House and the administration responded. You don’t think that -- you don’t question their motivations?
MR. CARNEY: I don’t. I'm simply saying that --
Q Do you think they’re simply just raising concerns and looking --
MR. CARNEY: I would say that there is -- there has been ongoing an effort underway by Republicans to politicize this. But beyond that, I'm not going to question the motivations of those who are testifying. I would simply note that we have been enormously cooperative with congressional investigators into this matter, provided an enormous amount of information -- both documentation and videos and staff briefings, as well congressional testimony.
The Accountability Review Board that was stood up by the Secretary of State and endorsed by the President did a thorough investigation, according to Admiral Mullen and Ambassador Pickering. They were tasked with getting to the bottom of what happened, and that is what they did, according to the statement by Admiral Mullen and Ambassador Pickering. And that review was, as I think I've said, unsparing and critical, and held people accountable, and demanded action -- action that the State Department has taken and is taking.
So that’s our view of it.
Q I guess I -- because you won't say that about the motivation, it just makes me wonder if just because, let's say it is being politicized, doesn’t mean that there wasn't a substantial mess-up.
MR. CARNEY: I think the Accountability Review Board -- and I think this is the point I've been trying to make -- made clear that there were failures, made clear that there were problems, and made clear who was responsible and what needed to be done to fix them. And what seems to be the case is that that’s not satisfying politically to some in Congress, and therefore there's an effort to go further, perhaps along the line that Jon was talking about.
But the efforts -- they keep overshooting their mark here, like with this effort last week to turn a pro-forma signature on a cable into a scandal, which -- an accusation that’s been laughed out of that room, appropriately, because it doesn’t hold water.
Q U.S. envoy Greg Hicks just testified a short time ago that when he heard Ambassador Rice on the Sunday talk shows saying that this started as a protest, he said he was stunned, that his jaw dropped, that he was embarrassed. Why then was she dispatched to say what she said? Why didn’t she represent what Hicks and others knew?
MR. CARNEY: Brianna, I think we've been through this so many times. These were talking points written by and drafted by the intelligence community. I just discussed this with --
Q With input from the State Department?
MR. CARNEY: Not on this issue, as I understand it. And the fact is that there were demonstrations around the region and the world, there were violent demonstrations at embassy facilities around the region and the world. There was great concern about the possibility that those demonstrations would flare up and cause even more danger to diplomats -- American diplomats around the world. And this is the information that we had at the time.
And as we got more information, and as Ambassador Rice made clear that Sunday, once we got more information we would make it available, and clearly, the picture of what we knew to have happened would change. And that’s the case.
But, again, if you look at what she said on Sunday -- I just quoted some of it -- we knew there were extremists involved. And I think it's pretty clear when we say extremists, in a place like Libya, what we're talking about. We knew there were extremists involved, but we did not know with any precision at that time, in those days after, exactly their affiliations or their motivations; whether they were al Qaeda or al Qaeda affiliates or just Libyan-based extremists. And at the time, we were telling -- we were being very transparent about what we knew and what we didn’t know. And I think that’s reflected in what Ambassador Rice, in what I said and what others said at the time.
Q Just very quickly, I wanted -- can you characterize the White House's input, then, on those talking points you said? Is it exclusively stylistic? Did the White House have some role in terms of input?
MR. CARNEY: This has been reported ad nauseam I think, but, yes, there was a change from referring to the structure of the building, the facility in Benghazi, from a “consulate” to a “diplomatic facility” because it was not a consulate. And I think there was input on describing an “ongoing investigation,” which is the kind of language we always use when there is an ongoing investigation.
Q So then in response to the Weekly Standard’s reporting that demonstrates language that they think is more than just that, what is the White House’s --
MR. CARNEY: Well, again, I would -- first of all, I would point you to -- these are emails, Peter. It’s really worth looking at them.
Q I'm sure -- I have.
MR. CARNEY: Well, I’m not sure you have, because if you look at them you’d recognize, A, we’ve provided -- the administration has provided all this information to congressional investigators. And nothing in that article written even by the Weekly Standard contradicts anything we’ve said about the development of the talking points, who drafted them. And on the issue of what happened in Benghazi and what we knew and what was put out for public discussion by officials both in Congress and in the administration reflects what the intelligence community felt comfortable we could say about what we knew. And that included the fact that we believed extremists were participants in the attack.
Q I’ll ask on a separate topic briefly -- police officials in Massachusetts said that the FBI has reluctantly been dragged into the effort to try to find a proper burial place for Tamerlan Tsarnaev. First question is should the FBI or the U.S. government in any form be involved in that process?
MR. CARNEY: I I haven’t -- I’m not on top of this. I would refer you to the FBI.
Q Does the White House have any position on whether the government should play any role in this process? It’s been a very heated --
MR. CARNEY: I don’t have a position on it at this time. I would refer you to the FBI.
Q Then I guess just as a quick aside, given recent events over the last 24 hours, does the White House have any thoughts or any comment on Mark Sanford becoming Representative-elect?
MR. CARNEY: I don’t have any to convey from here.
Q A question about tomorrow. It seems like the events and the company he’s visiting, he could have done it in any other state. Why Texas?
MR. CARNEY: Well, I think it’s a -- I think and hope that you’re right that he could have done it in every state and that would be --
Q Many other states.
MR. CARNEY: That would reflect what the President believes that in spite of the fact that Washington is, on occasion, throwing up obstacles to economic growth and job creation, that there are areas across the country where positive steps are being taken towards the kind of economic growth and job creation that the President talked about in the State of the Union; the kind of efforts underway to have the jobs of the future created here; efforts underway to ensure that the skills Americans need to take those jobs are provided to Americans who seek those skills; and that the jobs themselves provide the kind of wage and earnings that would give Americans the kind of security that a middle-class life is traditionally given in this country.
That’s the focus. You heard the President talk about these three areas of concern when it comes to creating a thriving and rising middle class in America, and I think that’s what you’ll hear him talk about in Austin tomorrow. I think that --
Q Texas is the only place you could find as an example?
MR. CARNEY: Well, why not Texas? Austin is a hub of innovation and technology. It’s also a hub of education. And the President, as you know, will have a series of events tomorrow that reflect these three areas that he’s talked about since the State of the Union -- the need to make sure that we have these kinds of jobs of the future here in the United States, the need to ensure that our workers have the skills they need to fill those jobs, and the necessity that those jobs pay well enough to sustain a middle-class life. And Austin is a great place to go for that.
Q So does this have anything to do with the Democrats long-term hopes about Texas?
MR. CARNEY: It does strike me that suggestions that people sometimes in Washington see everything through an electoral lens are true, but I can guarantee you that is not what this is about.
Q Yes, and just quick. There are two things that certainly were in the President’s budget and State of the Union address that he hasn’t talked about much, and I’m wondering if it will come up tomorrow -- the minimum wage and the tobacco tax to pay for universal pre-K.
MR. CARNEY: Well, I don't want to overly preview the President’s remarks. I think they’ll be more exciting if you don't have all of the content. I think that minimum wage does go the point -- the third point that I’ve been talking about, which is the need to ensure that the jobs that are created here that are jobs of the future, that both are -- that Americans have the skills they need to hold those jobs and get those jobs, but also that the jobs pay the kind of living and wage that allows for entrance into and the ability to remain in the middle class.
Q What about the tobacco tax?
MR. CARNEY: Well, again, I’m not -- in either case I’m not previewing the remarks. You know the President --
Q He doesn’t talk about --
MR. CARNEY: The President talks and will talk a lot about the value of early education, the need to provide pre-K for all in this country, and the investment that represents, and the quality investment that represents for our country in terms of our future. Getting that early start on education for our children will pay dividends for decades in terms of economic growth and job creation. So again I’m not going to preview specifically the remarks he’ll make in Austin, but that is certainly a priority of the President’s.
Mark, and then April.
Q Jay, back on Syria. Secretary Kerry and the Russian Foreign Minister announced a conference on Syria where there will try to be yet another effort to find sort of a political or diplomatic transition. The President yesterday when asked about Syria did not mention at all deliberations in the White House about supplying the rebels with lethal weapons. And some European diplomats in recent days have begun expressing more caution about moving toward providing lethal weapons themselves. Does the White House see all this as adding up to a belief that where we are in Syria now, it might be worth making one more big diplomatic push, and that, indeed, the conversation in the last couple of weeks has moved away a bit from changing the military equation on the ground to trying to find a political and diplomatic solution?
MR. CARNEY: Well, these are excellent questions. And, Mark, I would say that the tracks that we’ve pursued have been operative all along, that we have pursued from the beginning a political transition. We made clear from the beginning that we felt that that was the best way to bring about a positive outcome to this, a future -- a transition in Syria that provided the potential for a future in Syria that was more democratic and better for the Syrian people.
And as you noted, yesterday in Moscow, Secretary Kerry reiterated our belief that the Geneva Communiqué framework is the best way to find a durable solution to the Syrian crisis and should be the road map by which the international community and the Syrian people work to hasten an end to the conflict through a political transition to a democratic, unified and inclusive post-Assad Syria.
Now, the United States and Russia have recommitted to that framework, which calls for a transitional governing body formed on the basis of mutual consent and exercising full executive powers. So we have been and we continue to pursue that track. We have been and continue to have conversations with the Russians about the important role they can play in helping bring about the necessary political transition in Syria.
We have been and continue to provide and step up aid to the Syrian people, humanitarian aid as well as assistance to the Syrian opposition and the Supreme Military Council, that's part of the opposition, nonlethal aid. But we have stepped that up, and I think you’ve seen an increasing level of assistance. So these are separate but related tracks that we’re pursuing at the same time.
Q And does lethal weapons remain an option in that trajectory of aid to the military?
MR. CARNEY: They do in the sense that, as the President has said, every option remains on the table. Even prior to the last couple of weeks when we had the questions about possible chemical weapons use in Syria, I have made clear and others have made clear that we are constantly reviewing our options on Syria, including the question of providing lethal aid thus far. And at this point we have concluded that we will limit our provision of aid to nonlethal assistance. But that is something we are constantly reviewing.
Q Jay, back on the Benghazi issue. What has happened, what concrete steps have come out of the Benghazi situation as far as securing and protecting embassies around the world, especially after it’s been told that there was no way to get help to those who were killed in Benghazi in time?
MR. CARNEY: Well, I would point you to the 29 recommendations that were made by the Accountability Review Board, and the fact that the State Department is acting on all of them -- implementing some of them already, and acting on the others. I don't have a detailed list of what those actions are and what actions have been taken, but I’m sure the State Department does.
But there’s no question that it is clearly unacceptable when four Americans are killed in an attack like this, and it represents the need to assess our security for our diplomats and diplomatic facilities and make changes. And I think that’s what the Accountability Review Board recommended, and I know that's what the State Department is adopting.
Q So the White House is not overseeing to see if some of these steps have been concretely put into place, like stepped-up security? Because many embassies around the world have very little -- or had very little security.
MR. CARNEY: Well, I know that in terms of specific security measures that were taken in the wake of the attacks and at various times since that that has happened. I would refer you -- State would have the breakdown on where that's happened.
On the recommendations made by the ARB, there were some more institutional recommendations, as well as specific steps. And the State Department could fill you in on the details.
What I know the President believes and was pleased to see is that steps needed to be taken, and he was very supportive of then-Secretary Clinton’s approach, which was to accept the report and act on every one of the recommendations.
Q Thanks, Jay. The President said yesterday that the United States has a moral obligation to do something in Syria. Does providing humanitarian aid and the diplomacy that the President is involved in around Syria meet that moral obligation in his view?
MR. CARNEY: Well, I think that providing humanitarian aid, as we do as the largest provider of humanitarian aid to the Syrian people, represents our belief that we here in the United States and other nations around the world have a moral obligation to assist the Syrian people in this terrible time. But I think that, as the President made clear yesterday and has made clear repeatedly over the last several days, we are constantly assessing what other steps we can take or might take, and that has included both stepping up our humanitarian aid and stepping up our assistance to the opposition.
It includes reviewing options as I just discussed with Mark, like military options, a provision of lethal aid.
But it’s all done also through the prism that the President discussed yesterday, which is making decisions that are in the best interest of the American people and the national security of the United States. So I think that all of these considerations are ones that he weighs as he deliberates over the options available to him and over the developments in Syria.
Q There are differences obviously between Syria and Libya. But in explaining to the American people the Libyan intervention, he said that other countries may turn a blind eye to Qaddafi’s threats, that the United States was different. I know the United States is not doing -- is doing things in Syria, but again, isn’t there an American interest to some degree in doing more there to demonstrate what he feels is a moral obligation in a place like Syria where now 70,000 people have been --
MR. CARNEY: First of all, I think a couple of things are important to note, which is that the United States did take the lead and act in response to the situation in Libya in concert with a number of allies. So I don't think that it’s fair to say that others did not. The French and the British were key partners in that effort, as were other nations.
The fact of the matter is in Syria that it is, the President believes, an obligation of ours to act, and that's why we have acted. That's why we have provided more humanitarian aid than any other country. That's why we have led the effort to help stand up the opposition and help the opposition organize itself. It’s why we’ve recognized the Syrian Opposition Coalition, and why we’ve provided direct assistance to the Supreme Military Council, I believe it’s called, of the opposition.
And it’s why we’re assessing other options all the time. But the President made clear, I think if not yesterday then in the days preceding, that we have to make sure that the things that we do are the right choices and help bring about the ultimate goal here, which is the transition in Syria to a post-Assad future and that things that help bring about a reduction and ultimate end to the violence in Syria. And you don't want to do something that has the opposite effect, and that is something that we assess all the time.
Q Finally last thing, has the President talked with President Clinton at all about this in terms of his experience in the Balkan war and Kosovo and his decision to finally --
MR. CARNEY: I don't know the answer to that. They speak with some regularity, but I just don't know if they’ve had that conversation.
Lisa, and then Mark.
Q On the immigration bill, it’s moving into the mark-up. Is the President concerned at all that the hundreds of amendments being introduced could undermine the sort of bipartisan basis of the bill? And also will he be more specific about his views on the various parts of the legislation, the amendments, things like that now that we’re in this new phase?
MR. CARNEY: We are monitoring this very closely. We are engaged with both the leaders in the Senate of this effort as well as staff who are engaged in this effort. And we remain optimistic that the Senate can and will produce bipartisan comprehensive immigration reform legislation that would represent a huge advance in this country and would be in keeping with the principles the President laid out.
But it is important to note, and I think this goes to your question, that we are still a long way from that -- achieving that goal, and a lot of work remains to be done. And that’s why we’re engaged in this process with the Senate and monitoring very closely the developments that you talk about. I don’t have an assessment to make of any of the many amendments.
I only would say that it’s the President’s belief and hope that it is essential for a bill to emerge that is bipartisan in nature that achieves the principles that he laid forward, the principles that are shared by the bipartisan Gang of Eight. And he believes that if that does happen that we can see a bill pass out of the Senate with substantial support, which would be enormous progress towards the goal of having a law emerge from Congress that he can sign. But we’re working every day to help bring that about.
Q I noticed that you guys haven’t -- in the previews of the trip tomorrow, there hasn’t been much mention of immigration. Why is that? Is he not going to talk about it? It seems like a natural place, given the Latino population, the tech companies.
MR. CARNEY: I thought we were going there for political reasons. I can’t keep track. (Laughter.)
I can assure you the President is making a trip tomorrow that’s about middle-class jobs and opportunity. And he’s focusing on economic issues that are at the core of his agenda and have always been at the core of his agenda. And they go directly to the questions he raised in the State of the Union address that need to be answered -- are we creating these jobs; are we providing the skills to our people that they need to hold these jobs; and are those jobs paying the kind of wage that allows for a middle-class life in America. And this is sort of the essence of what has been the primary focus of this President since he came into office amidst the worst recession of our lifetimes.
So that’s what this trip will be about. You have heard him and will hear him on many occasions talk about comprehensive immigration reform. But tomorrow will be about economic matters.
Mark, and then Jared.
Q Jay, what is the President’s objective tonight at this dinner with House Democratic leaders?
MR. CARNEY: Well, this is part of the ongoing conversations he’s had with lawmakers of both parties in both houses. He looks forward to it. He expects the conversation to range over the numerous issues that are confronting Congress right now and that the President is engaged in, all of his priorities. But there’s nothing specific beyond that. I mean, he looks forward to it as he has to every dinner or meeting or golf game that he’s had with lawmakers of late.
Q Who pays for these dinners?
MR. CARNEY: I think it changes, but in this case I’m pretty sure the DNC is paying for it. But I will have to check. Yes, we’ll check, yes. I know at the first one the President picked up the bill.
Q Is the President satisfied with the level of support that he gets from House Democratic leaders?
MR. CARNEY: He is. Look, I think that he believes that when it comes to making sure that middle-class Americans and those who aspire to the middle class are given the opportunities and the tools that they need is a goal that he and Democrats in the House and the Senate all share, and that Republicans by and large share, and that that is why there should be and maybe could be an opportunity to find some common ground on these economic issues.
I mean, when we talk about the -- what some have called a rebirth, a renaissance of manufacturing in this country, and the element of that that has been focused on high-tech innovation, that’s something that shouldn’t and generally has not been a partisan goal or pursuit. It's something that Republicans and Democrats alike have supported investments in that kind of economic growth and development.
The same is true of the kind of infrastructure investments that we need to make in a country like ours to ensure that, as the President lamented the other day, we are not faced with a situation where not a single American airport makes the list of the best 25 airports in the world. That’s not who we are. We used to build and we should build the best airports, and the best ports, and the best highways. And we need to make the investments to ensure that that’s the case in the 21st century as it was in the 20th.
Jared, I think I called -- yes, and then Susan.
Q Jay, when -- 11 states now have moved forward on marriage equality -- Rhode Island and of course Delaware, most recently. So does the President -- one, does the President think that this is the -- does he have a reaction to that? And two, does he still think that state by state is the best way that we should be pursuing that civil rights movement?
MR. CARNEY: Well, there has been enormous progress made. And I think that the facts, as you just recited them, demonstrate the progress made. The President's views are known. He's expressed them. Our views on issues like DOMA and Prop 8 have been expressed in legal filings, so I would point you to those.
For him, it's a fundamental issue of equal rights, and that’s why he has taken the position he's taken. But for our legal approach to some of these issues, I would refer you to the Department of Justice.
Q And then on -- just on Benghazi really quickly. Is it the administration's position or your position that the only criticism that’s coming from lawmakers of both parties or from media outlets is politically motivated?
MR. CARNEY: Generally speaking, Jared, I don’t come up here and give just my position; I give the administration and the White House position.
Q So is that the administration’s position?
MR. CARNEY: It is our view, and it is a simple fact, that from the early hours of the attack there have been attempts by the Republicans to politicize what was a tragic attack on our facility in Benghazi that led to the deaths of four Americans, including our ambassador to Libya. That has been demonstrated again and again. And we have cooperated with congressional investigators, providing 25,000 pages of documents, numerous staff briefings, numerous appearances for testimony before congressional committees --
Q And because of that effort that you’ve undertaken, you don’t feel like there’s any window for legitimate criticism left?
MR. CARNEY: I think there was legitimate criticism that was amply aired in the Accountability Review Board report that was unsparing and critical, and that the State Department, instead of being defensive about it, accepted in whole and is acting on every recommendation contained therein. So I think our response to this demonstrates the President’s commitment to finding out what happened, who was responsible, bringing them to justice, and ensuring that it doesn’t happen again. That’s been our focus. There has been -- there have been other focuses -- there’s been another focus by others, but it has not been ours.
Susan, last one. And then George.
Q Thanks, Jay. Two questions on Benghazi. Envoy Hicks said today in his testimony that, unfortunately, the ambassador’s body was carried to a hospital run by Ansar al-Sharia, a known terrorist group, that night. And that he knew this and he was conveying that message to the State Department. And so if that was the case, then why was there any dispute whether it was a terrorist act or not the next -- the following Sunday?
MR. CARNEY: Because of the nature of the hospital? Again, I think that --
Q Because it was run by a known terrorist group.
MR. CARNEY: Well, again, I don’t have -- I’m not going to be able to respond to live reports on what’s being said on Capitol Hill. What I can tell you is that it was the assessment of our intelligence community that the attacks were participated in by extremists. That’s what I said, that’s what Ambassador Rice said. She said on that Sunday that extremists were involved, what we didn’t know is what their exact affiliation was.
As you know, with regard to this group, there was a claim of responsibility, then there was a disowning of responsibility. So anybody who pretends to have known all the facts instantly is just mistaken. And it is always the case that things like this require careful investigation, and that is what’s been undertaken.
Q And the second question I had was on the stylistic, not substantive, edits to the talking points. And from testimony today we are seeing that those edits struck any and all suggestions that the State Department had been previously warned of threats in the region; that there had been previous attacks in Benghazi by al Qaeda-linked groups in Benghazi and eastern Libya; and that extremists linked to al Qaeda may have participated in the attack on the Benghazi mission. Is that substance or stylistic?
MR. CARNEY: Well, first of all, again, I would point you to the intelligence community and the fact that they made the drafts and they issued the points. Secondly, I would say when it comes to stylistic edits we’ve been very clear about the specific edits that were made at the suggestion of the White House. And, again, when it comes to -- one of the edits you just mentioned, the talking points as delivered referred to extremists and we’re not talking about -- when we talk about extremists in the region that Libya is in, it’s clear what we’re talking about. But assertions that people knew --
Q Can you tell me why --
MR. CARNEY: I would refer you to the intelligence community.
Q It was made by a CIA official. I want to make that clear. But I do --
MR. CARNEY: So I would refer you to the CIA.
Q Thanks, Jay. Did the President watch any of the hearing this morning? Did you watch any of it?
MR. CARNEY: I did not. I don’t know whether he did, but I doubt it. He tends not to watch TV during the day.
I think that was the last, but I’ll get Cheryl because I haven’t called on her in a while. (Laughter.)
Q Thank you. Just to follow up, without using any names, can you just tell me if the President is planning to appoint an advisor to Todd Park? Is he vetting --
MR. CARNEY: I don’t have any more information about that than Todd himself was able to provide. Sorry.
Thanks very much.
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