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During the next 30 minutes will impact the best ways to expand Health Insurance access and coverage and exactly what that path looks like following a president ial election and in the midst of a pandemic getting worse every day. The first guest today is senator smith from minnesota thank you for joining us. Thank you i enjoy being here today. I went to frame this conversation. Obviously Health Insurance coverage has been a hot topic for a long time. And with that gap in the system with millions of people lose their Health Insurance and the economic downturn the flex not just those people that family members and their Health Insurance. So i am just curious how has a shape to change the way specifically of healthcare covege . To see that differently now . Ou raise the right point here we are in the midst oa Global Pandemic that is searching fromhe state of minnesota and the upper dwest we had 56 deaths yesterda yesterday, maintain the highest ever and as we see infections go up and hospitalations go up and thats the systemic equities in the Healthcare System and is long story for tho that struggle to figure out how to Ge Healthcare and to have access to that healthcare so with covid it with those inequities especially in my home state and of the country the disparity of frontline workers black and brown and Indigenous People and older people who struggle to get acce to healthcare so there should be a moment to addrs this to be focused on the pandemic under control but then to move tard a better future. So this is a long way to explain it bad side effect of this terrible expeence has been an increase of telemedicine which has bee very important to you so what needs to happen to make that stick . So in the midst of crisis and we need to make sure at doesnt go away as we. With the crisis that ithe case telehealth with the inability to nobe able to see the doctor but alslike ntal health with a shortage of providers and access to care so how do we make sure these innovions doesnt go away when e pandemic is over . This is something oviders and patients have appreciated and have been described toe as a lifeline. So in the midst of ts pandemic we know the need for ment health has exploded frontline Healthcare Worker anwith depression and anxiety and Suicidal Ideation go up dramatically this is what telehealth can help with not a comple substitution but the way to make it more accessible. It is a reimbursement . We have seen medicare and mediid is that patient attitude this is something that nee to happen among providers . A crucial piece is reimbursement and then to prove waivers for reimbursement for telehealth and what we need to ke sure that those are on pair on par and dont go away thats a huge difference to have that reimbursement that is sustainable. Area shift of attitude. Person and will minnesota needed mental heal care. He was very unwilling to drive to the Doctors Office because he felt soxposed. And then tget care in the privacy of their own homes so it works for patients as well as providers as long as there is reimbursement that works. So to pick up on your point of Mental Health that has really increased during the pandemic and and with the social isolation that is necessary. So im wondering is our way people can stay healthy . Well we have to be aware of the cost of the pandemic he and the cost to describe in the secondary. But is looking on the bright side, i believe that we are seeing is a greater willingness to talk that we need to take the says moment to push through the discrimination around Mental Health. And what we need to suppress the virus because we have clearly moved past the point and thats not feasible and this gets to why with Contact Tracing and humane isolation strategy so that people can be more likely to go about their business in ways that are safe. Not just diagnostic testing but also surveillance testing to get the economy functioning while waiting for a vaccine to become available this is built around the idea of establishing to dramatically ramp up access to testing not only for diagnostics but surveillance. So one final question the control of the senate is still up for grabs deeply divided washington is not a wlspring bipartisan and feelings the wod is realistic in the next few . Bipartisan laws of the most sustainae we need to find ways of comi together around these issues and remember we successfully came together with a significant response to the pandemic with the c. A. R. E. Act and Bipartisan Legislation so the onus will be on all of us andith President Biden to address then nee that americans have to put aside our paisanship. The conversations i have had th minnesotans is a political issue but econoc issue and with those bipartisan solutio like bill cassidy and i havwith Contact Tracing. Would also republicans and democrats can come together. As a like a good place to it thank you for taking the time to join us today. I appreciate it. Up next from the top of paxinos cofounder and the ceo of up to him healthcare. Now have the ceo of optimum health part the United Health group, thank you for joining us. Thank you its good to be sure. What is optimum health and United Health . Unit healthcare has people across the country and the globe working to ensure to me the whole system work better for everybody basic aspects of healthcare United Healthcare but then the services and pharmacies specialties with those Health Services me brain Delivery Services those practices of 50000 positions across the country is wrong with the military and veterans and with those management programs. And assassins the country around the globe. So with a large focus and dedication to healthcare. So its happening in the healcare system tell me the effects amid the pandemic what has it done to the heah care system . Thats a great question. And then United Health group. Son some sense with a little bit the background and amplified by the pandemic and that means a couple things like universal coverage and affordability for everyone and improve healthcare outcomes and a better experience and we have been advocating for over 20 years of those components of the next generation and what i would say it is we learned from the pandemic are even more broken but then we learned as we come together through Public Private partnership so then we notice that the billing was an issue before the pandemic we know the is a solution to that to create a median and by employers and 40 billion those are examples that continue to be exacerbated by the pandemic but on the other side we needed telehealth before the pandemic to see an even greater need and how does that show up withtate support with publicprivate partnerships to provide more virtually with those site requirements and boundaries we ha 50000 positions already provide a 1 million telehealth visits. We he seen things we needed to address as a result ofhe pandemic working with partners and policymakers to advance. We see that shortage 21st century workforce to address Population Health and then to go the extra step with the hope that equities the cid as well. How much of my medical care sure the. [chantg] by telemedine . How much . Its a great question one thing we are learning to the pandemic his were learning what can be done virtually and what is required to be done in person . As we continue to adapt almost half of our Services Today they had been virtual. Obviously that was a result of the shutdown across the country. But we found we can have even more access as a result of stigma or barriers or lack of access to behavioral Health Services. We will continue to learn as technology and data continue to evolve across the spectrum of public and private partnership and we know through this pandemic is the opportunity for people to get Preventative Services and screening is still important with the ability to do that but continues to be in person but we want to be aart of the solution to make it easier to access and closer to home for people. He most important question, question, but those that dont have coverage at what is the easiest way to get to a place with 100 percent of the population covered that doesnt slow down inside the Healthcare System . Thats a great question. One of the things thats important to start with although the goal is 100 percent many percent that have coverage has options and based on success in Public Private partnerships medicaid and Medicare Advantage in the United Healthcare and the program across the country and those that continue to expand medicaid and those that are eligible are presumptively enrolled in always have a choice to opt out but if they are eligible then that would expand coverage we found those individuals are Medicare Advantage and then to take exchanges and with the United Healthcare to be part of the solution and modernizing them to give them the opportunity those that will be eligible for subsidy always an option and with those 18 million individuals that sometimes flexible options are necessary for individuals in a certain situation. But then to make sure its more affordable for people so of these Exchange Programs and to allow help individuals and to ensuring the opportunity to continue to have coverage platforms. Thank you for a fascinating conversation and for this conversation over healthcare. Spent the final guest today is the president of the foundation for research for opportunities Senior Advisor at the policy center and a picture of the healtholicy debate here in washington thank you for joining us. How are you. Great. Just to dive right in with coveragend access the point you have made many times with universal coverage that doesnt have to an government coverag covere. Look at the us, these distinctions c get blurred that they percei and prite that millions of people get insurance from medare but theyont realize that it is private. So from a big picture level can you walkhrough and you view the private and Public Sector with the pursuit of unersal coverage . Thats a great point and the important point to make is we think of other countries as models and those that universal corage is not the same as singlepayer government run healthcare that a lot of countries in eope have achieved univerl coverage with private Insurance Companies with private insurance and thats important distinction sawhe countries in europe save universal prate insurance system an effort to provide Financial Services with the subsidies to low income folks and regulations and other elements of the system the bracket how that is defined by broadly speaking, i have tried to persuade th freemarket so what does that mean cracks ultimately you can have a broarange of choices with the assurance that you buy and from whom you buy it is just one system in one sure and you have no choice if that is rking you have nowhere else to go but like medice advantag advantage, yes it is the governments system and those who cannot afford the verage playing with dozens of choices with the plan that you buy thats why the platform approach that we talk about is called dicare advantage for all. And then abolishing what percent of seniors use which isrivate insurance. What i think the Republican Party is right now on healthcare quick. That worked well for conservatives to the beginning of the afforble care act with the oregon a scene principle why do yothink that has happened is there anything in the nearterm that can reverse that . The bottom line is where our republicans . Is the right or wrong answer they are all over the place. There is no consensus and with those ideas that i have talked about a bill introduced from indiana and the congressman from arkansas based on the work that we have done to achieve harassment coverage from a and of the spectrum and those that say lets repeal obama care which is not sustainable and then people and the middle who were certainly dont like to be human on their lack of a plan looking for answers and they havent figured that out yet. And thats why we build the foundation. Fair enough. The next question is from the audience from a breeder who asks how do we reframe the discussion not a crisis or a negotiated discount . To put a finer point on that firm paper where both parties that they agree on is that healthcare great for patients but at the same time trying to achieve that thats only useful one youthful to them is difficult is it worth doing . So lets make very clear the price of healthcare is extremely high and unaffordable and not the kind of system you would want you had a true freemarket with the singlepayer system and the prices are the best both worlds and with no accountability into the system that with monopoly providers thats a huge problem and reform on both sides Price Transparency as part of the solution first of all its it has done quite a bit on Price Transparency the world is going to affect january 2022 to require all hospitals and insurers to discuss the rates that is a revolution and i guarantee you know for a fact people in the existing Healthcare Industry to recognize how disruptive that is to the worth of data so this is the important reform better if it survives the Court Challenges it can be important. What people dont understand is that hospitals have thats not true for a couple of reasons with 80 percent 80 percent of healthcare dollars are not paid for by the patient directly to your employer on your behalf deductibles 2000 when you dont care what you the deductible the difference to you is not that great so as a consumer with the price of the Health Insurance that you buy and we dont have that you have no idea whats taken out of your wages even more so it is ironic with the Affordable Care act how much they pay for their insurance so that approach for health and then to get the reward to the insurer to negotiate and those that were carefully with hospitals and doctors and pharmaceutical companies. I need to tell you this but have a lot of incoming trying to get more people all shopping on their own and the chamber of commerce in the fortune 500 where the status quo because it is a barrier that apple playfulness expensive employerbased plan and you can buy your own Health Insurance you might be intimidated same state that apple the issue to extract more value working on your own so big business was the system they hate the Current System im tired of having to be the Health Benefits manager want to give them cash and let the buyer on Health Insurance. But now here is another thing with the Trump Administration has done to create a regulation to find Health Reimbursement arrangements like hsas to use that 35 or 10000 bucks to buy an insurance and then will require all startup fees to involve a smaller rather than hr bureaucrat. I think that is time. Thank you for joining us. Same to you. So i thank you for joining us this afternoon with the virtual conversation. Fe local news and nevers check out ask egos. Com thanks for joining. And the National Institutes of Health Director doctor Francis Collins took part in a discussion of the Washington Cathedral on the Coronavirus Response for the progress of the vaccine by the end of the year. My

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