What they say. I am pleased to introduce my first guest, the highest Health Official in the land. Alex azar has a breath of experience of both the public and private sectors. His key areas of focus include health care, research and innovation, all of which assume added significance in the coronavirus era. We had a really fantastic forum and it wouldnt be what it would be without you. Thank you bro being here. Let me start thank you for being here. Let me start off and ask you, we have had various discussions of coronavirus challenges from the frontline, what is going on in communities, the debate around school. What i am interested in right now are vaccines. There is a lot of confusion out there about we are going to do. Vaccines seem to be vital. Is there anything you can tell us about where we are addled that front, operation warp speed and your oversight and encouragement about a vaccine that is going to save us . Thank you for asking about lightspeed. The president commissioned us to say, i have heard the final company timelines. I used to be at a pharmaceutical company. I know these timelines. I know they are drawn out. Can we, with the full might of the u. S. Government and all of the Financial Resources that we can bring to bear, can we compress those timelines while still delivering safety and efficacy on vaccines . We said, yes, we can. We are following two tracks. The first is, you compress the Development Timeline by reducing any unnecessary delay or inefficiency in that system. The second is, you invest at scale upfront commercial delivery rather than waiting until phase 2, 3, or final fda approval. You build scale and you manufacture product now at risk with that kind of investment. That is what enables us to fairly dramatically reduce the estimated timelines. So what have we done . We currently have four Major Investments that we have made in vaccine candidates. We have the Moderna Vaccine that came out of dr. Faucis lab originally. Mrna platform vaccine. We have an antivirus vaccine candidate. Jj jensen, which is also an antivirus platform candidate. We just this week announced a 1. 6 billion additional investment of a novavax protein vaccine. We now have major bets in all three of the major potential platforms for vaccine. With each of them, we will drive towards manufacturing to have tens of millions of doses by this fall and hundreds of millions into the beginning of next year. Phase two and three Clinical Trials for many of them will be beginning later this month, probably. Steve do you think its important to communicate to the public more of what you just said . That there is some risk in this that you could invest so much in , one because that is what we need to do today, but one of these vaccine candidates or others might be flops . Secretary azar we have and we will continue to do so. We are placing multiple investments across a portfolio and we are not done. We know that it is science. It is biopharmaceutical development. Not everything one necessarily had. That is why we are replacing these investments. When the same country that can do the apollo project can radically change the speed of development of a vaccine given the urgencies look, we spent 3 trillion just in Government Spending connected to coronavirus, not even considering the economic impact. The return for a vaccine is almost infinite in terms of the investment that you would make. Steve i want to move in a moment to the Broader Health care ecosystem. That is also what we are talking about today. Not everything is covid. There are other pieces of the puzzle. I do want to ask you about the manufacturing side and International Research base because this is not just an american problem. Some of the firms you talked about have Global Manufacturing deals. How does america position itself both so that it gets vaccines developed and produced here, but it does not excuse my language give the finger to the rest of the world . How do you manage global need today . Secretary azar let me give you and example of the astrazeneca platform. They took the oxford vaccine and astrazeneca has the Development Rights in most of the world that they contracted with oxford for. What we have done his contract with research and development to work with the United States of Clinical Trials. But also then for manufacturing in the United States. That does not preclude them doing manufacturing elsewhere in the world. I think they have talked about several billion doses to be manufactured in india and elsewhere for the rest of the world. We do not stand in the way of that. We encourage that. We are investing in u. S. Manufacturing and u. S. Finish capacity so that we are not dependent on any movement of product across borders from outside the United States. But in no way would we do anything to preclude development for the rest of the world. We coordinate closely with the gseven, the european union. Andrew witty is leading the accelerator project. It is a very tight international collaboration. We are all working towards a common goal. Steve and because of current tensions, are we putting a fence around china right now and leaving china out of this puzzle . Secretary azar china is not a participant in the act accelerator project and we are not collaborating with them in any direct way on our vaccine or therapeutic manufacturing. I believe they are doing their own thing. We are working in collaboration with the rest of the world as i mentioned. Steven one of the other dimensions we are looking at is the broad state of health care in america. There are a lot of moving pieces to that and people look for silver bullets. There has also been this administration the Trump Administration has wanted to replace obamacare with something. How have you been managing that . Is there an alternative you have been working on as you look at how we provide Health Care Insurance and an alternative to obamacare . Secretary azar steve, you said something really interesting. You referred to silver bullets in health care. What we have learned as part of the experience with the promises that failed with obama care is the American People with health care, they dont really like utopian visions. Most people when it comes to their health care are actually relatively happy with what they have and they dont want that taken away. They would like to see continued incremental improvement, but they dont want their settled expectations, their relationships with their hospitals or relationships with doctors, they dont want those taken away. How do we deliver more choice and more options for people in the individual market . More options in medicare for people. How can we deliver lower cost reducing Prescription Drug prices, and ending Surprise Medical Bills . How do we deliver Better Health by tackling some of the real discrete and impeccable Health Challenges like ending the hiv aids epidemic, solving the Rural Health Care crisis, solving the mortality crisis. Ending the opioid epidemic. Addressing and tackling social determinants of health, preventing renal disease in the first place. We look at health care. Health for 300 million americans instead of only thinking about the important issues, but the more limited issues of the 10 million in the individual market. We will be a ready and willing addressfor congress to the caren act with congress. Steven one of the big zinger items, i largely agree with you that most people want to keep what theyve got. They do worry about those that are not covered. Losingy worry about coverage of preexisting conditions. The administration in my view, you can look at what you like, but there have been different moments where you read different things. Is your administration is your tenure committed to maintaining coverage of preexisting conditions . The president has made this an ironclad commitment. It is in statute already that preexisting conditions are covered. We add to that the commitment that people with preexisting conditions will have access to Affordable Health care financing options. And so that commitment is there. Obamacare, while it has insurance for individuals with preexisting conditions, it is not always an affordable solution for them. Weve got to stop talking about this as if we are living in the land of milk and honey with obamacare. If you are a couple that makes 70,000 a year and you are living in nebraska and you are having to spend 38,000 a year on premiums and 12,000 in deductibles and you have preexisting conditions, that is not actual Affordable Health care financing for you. We do believe there are ways to approach this working with congress. We believe there are proven mechanisms. Conceits ofatal obamacare was that you will make the Healthy People in the individual market pay more, excessively more, to fund affordable insurance for the less Healthy People in that same individual market. We believe in the protection and the Affordable Access for people with preexisting conditions. But we think of that as a societal obligation to help them. We will work with congress if the time comes to find solutions that help those people get real insurance, real affordable insurance, allow them to have the coverage they need while letting Healthy People, those that dont have preexisting conditions, have insurance that meets their needs at the cost that they need also. Steven mr. Secretary i dont , know what its like during your time of covid. My life has moved to zoom and to skype in the digital platforms. We used talk about it, but now we are doing it. Health care is there. We have the ceo of tele doc joining us in a bit. I think theres a lot of nervousness out there among some people that have been getting health through new media, new mediums. They are getting coverage through things you have laid out for people to get that covered. But there is a worry that that will fall back. How much of this new world we have entered into of Health Consultations and Health Online is going to remain and remain paid for under our system after we move past, at some point, god willing, the covid era. Secretary azar this pandemic has led to a lot of innovation in health care through the president s leadership the , National Emergency authority to be able to waive some of the embedded requirements that have ossified and kept the health care in a 1960s style of delivery. We have been able to break through that with the regulation. Telehealth is something we wanted to do for so long, but congress has been unable to change the Social Security act to make medicare and medicaid amenable to telehealth. I have been traveling all over the country. I visit with doctors and hospitals and nursing homes. I think we would have a revolution if anybody tried to go backwards on this. This is now an embedded part of our Health Care System should part of our Health Care System. It has changed the nature of delivery and has brought us uptodate. We will do everything we can by regulation to keep the gains that we had in the center and work with congress to get statutory changes needed to make sure that we keep whatever is required by statute. Steven final question. Dr. Fauci this morning was blowing the whistle as loudly as he could, worried about what is happening in certain states in the country. That a lot of folks need to take this a lot more seriously. How worried are you that america is not getting this right and we are going the wrong direction on covid . Secretary azar what we are experiencing in the southeast and southwest and seeing emerge in other areas of the country is a very Serious Public Health situation. It often is phrased as a question of reopening. We dont believe it is about the fact of reopening in terms of a legal or regulatory structure. It is rather, how are we behaving within that context . Re practicing appropriate social distancing . Are we wearing facial coverings especially in circumstances where we cannot social distance . Are we good, personal social hygiene . We have to take individual responsibility in the construct of reopening work, school, and Health Care Systems again. If we do not, we are going to see results like this. That is not to say that is every aspect of what we are experiencing, but that is definitely the feedback we are getting on the ground from these impacted areas. That is why we have been acting with good individual responsibility here. Steven mr. Secretary, great to see you, even virtually. Thanks very