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Thursday, January 24, 2013

Benghazi Hearings, Healthcare, and Guns…Framing the Issue

Even if you didn’t watch the Senate Foreign Relations Committee hearing, by now you’ve heard Hillary Clinton raging, “…the fact is we had four dead Americans. Was it because of a protest, or was it because of guys out for a walk one night who decided they’d go kill some Americans? What difference at this point does it make?”

Before saying, “She’s right,” consider Chairman of the Foreign Affairs Committee, John Kerry’s remarks about the hearings and their PURPOSE.

In his opening statement on December 20, 2012, posted on the US Foreign Relations Committee website, John Kerry explained, “Clearly mistakes were made…and going forward it is important, and I think it’s important for all of us to think in terms of going forward, that we need to do a better job of ensuring a free and open dialogue among ambassadors, their embassy security personnel and officials in Washington where decisions on security, staffing levels and funding are made.”

Senator Kerry points out, that the Committee shared, “…our determination to get all the facts about what happened and why in Benghazi.” Part of this determination resulted in the ARB Hillary Clinton kept referring to, as Senator Kerry explained, the “…very frank and comprehensive set of findings of the Accountability Review Board.”

In framing the Report’s findings Senator Kerry said there were “…29 recommendations in total, five of which are classified.” He noted, “Secretary Clinton has embraced every one of them. In fact she’s gone above and beyond the Board’s recommendation by taking immediate steps to strengthen security at high-threat posts and request from Congress the authority to reprogram funds to increase diplomatic security spending by $1.3 billion.”

It is argued here that defining a problem frames the solution so that for the Committee on Foreign Relations and its House committee counterpart, the Committee on Foreign Affairs, identifying what went wrong in terms of coming up with solutions to prevent the problem in the future is very valid, and was in fact the only reason that taxpayers paid for the time of all Congress people and Hillary Clinton herself to participate in the hearings.

While Hillary Clinton considered her reaction to the ARB, the Accountability Review Board in terms of its 29 recommendations adequate and worthy of no further discussion post-ARB, which left her free to pursue only additional funding at the hearings, Republicans, wanted a public acknowledgment that there were administrative and procedural missteps that caused the murders, and that a consideration of policy and administrative reforms in response to policy and administrative failures required further consideration post-ARB report.

In terms of healthcare and gun laws, the hearings were informative in terms of understanding how the government’s understanding of a problem is the single most important indicator of what a government solution will be. All sides must contribute to the identification of the problem in order to have their interests represented rather than deny the problem.

Currently, some of those involved in the gun debate who argue for NO change in laws are removing their own opportunity to participate in a change that’s going to occur because whether they acknowledge a problem, the sentiment of the majority is that there is a problem.

In healthcare, by denying that the healthcare crisis required government action rather than leaving it to the “free market” forces, Republicans removed themselves from the ability to engage in meaningful contributions to the Affordable Care Act. This left Republicans mostly scrambling and stuttering against accusations that they were out of touch and placing all their eggs in one basket and hoping that the law would be declared unconstitutional, which it was not.

Yesterday, Hillary Clinton defined what she believed was NOT RELEVANT in her address about the Benghazi murders, who did them and who the public was told had done them. Republicans found this information important and did not back down.

In answer to the question why did Benghazi happen? Hillary Clinton answered, "funding," and the Republicans answered, "Personnel and administrative failure."

It was an important identification of problems as seen by the two parties. Each side was heard and the American people have a better understanding of what to expect in response, the ARB, Accountability Review Board’s recommendations would or are being implemented AND more money will be allocated for embassies and embassy processes.

The result is that to some extent both sides conceded that the other side’s concerns were valid, in spite of their assertions that their view of the PROBLEM was the right and important one.

This is the key opportunity that was missed in healthcare reform and continues to be lost by Republicans as we face the issues of implementing the Affordable Care Act in years to come. Abdicating opportunities to create health benefits exchanges is another instance of “not playing” the game rather than working to play the game and shaping it to their own vision. Instead, Republicans will likely complain about the Federal exchange after it’s created after choosing to abdicate a role in implementing state exchanges.

The American people count on our lawmakers to make balanced decisions with voices representing varied points of view, the absence of voices results in skewed legislation, i.e. the Affordable Care Act which represented a government generated answer to a government defined hyper-focus on a single problem, the uninsured.

Ultimately, under Affordable Care, yes, there are provisions for doing away with lifetime limits, and pre-existing conditions, and for including essential health benefits, but these provisions will come at an increased price tag to citizens in the form of greater insurance costs of premiums, co-payments, and co-insurance.

Quality controls are addressed in terms of health records and audits with vague benchmark goals that operate on rewarding compliance with money for providers and institutions rather than punishing with fines.

But, the public option, the keystone provision that opened the door for the Affordable Care Act in the public's mind, and a concept (that many still believe was accomplished by the Act in terms of getting everyone insured,} was NOT achieved and in fact was one of the first concepts Democrats were willing to give up on because for them the problem was the UNINSURED whereas for most of the public the problem was unaffordable and inadequate insurance coverage.


Many individual democrats would have rejected Affordable Care based on the absence of this provision. Republicans, too bitter and too bull-headed to listen to the American people could have argued against Affordable Care focusing on the Democrats' willingness to sacrifice this essential promise, but in the void of silence from Republicans who were busy arguing against healthcare reform, they missed the chance.

This was not the only weakness Republicans could have addressed if they'd focused on the right issue. We have little in Affordable Care that will make our care more affordable because there is no limit to the “whatever the market can bear” pricing of medical services. We have little in Affordable Care that will address bankruptcies from insufficient coverage UNLESS we’re sick enough to reach lifetime limits. Every other cost of obtaining healthcare, insurance premium, co-pay, and co-insurance will go UP under Affordable Care.

Instead, Republicans allowed democrats to identify the problem and create the solution. When Americans asked what’s causing the healthcare crisis? Democrats answered, “The uninsured.” Republicans were silent, merely asserting that the market would work itself out and proposing to slash “entitlements”.


We knew there was a healthcare crisis, any American paying for healthcare knew that coverage had gone down and expenses had gone up. But the Republicans denied the existence of the crisis and therefore took themselves out of the game in terms of helping frame policy in many ways.


America was left to choose between identifying the uninsured as the problem or choosing to deny there was a problem with our healthcare industry. By choosing the former, identifying the uninsured as the problem, for Americans the solution was easy, provide insurance.


Instead of addressing the American people and talking about the fact that costs were being shifted, that prices would go up, and that ultimately Affordable Care would rely on government subsidies forevermore in order to function, Republicans were mute and Americans listened to the only authoritative voice, that of the democrats that stated the healthcare crisis would be “SOLVED” by getting individuals insured.


We no longer scrutinized proposals because we believed that they would be designed to make sure that everyone had insurance.


So, in the words of Hillary Clinton, “What difference at this point does it make?” No legislation is carved in stone. We are only beginning to experience Affordable Health Care. Already we’ve seen changes to the Affordable Care Act including those decided by the Supreme Court regarding Medicaid provisions and the tax on individuals, and those decided by the Department of Health and Human Services regarding deadlines for participation in health care exchanges. Legislative changes are also possible. By demanding our representatives participate rather than opting out, we can gauge and modify Affordable Care based on OUR concerns.

And for the Benghazi murders? At this POINT, it's obvious that there were huge mistakes made that had nothing to do with money, including the false communications made to the public that Hillary Clinton still tried to slip by because of the lucky usage of the words "acts of terror" incorporated into the President's speech about the video. It's also obvious that more money is not the single answer to preventing murders.