Welcome to the virtual healthcare 20 21 a. M. Sam baker the editor hear from axios think of making this possible and welcome to our audience on you to twitter and axios. Com. Also follow along on twitter 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 coverage . To see that differently now . You raise the right point here we are in the midst of a Global Pandemic that is searching from the state of minnesota and the upper midwest we had 56 deaths yesterda yesterday, maintain the highest ever and as we see infections go up and hospitalizations go up and that is the systemic equities in the Healthcare System and is a long story for those that struggle to figure out how to get 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 access to healthcare so there should be a moment to address this to be focused on the pandemic under control but then to move toward a better future. So this is a long way to explain it bad side effect of this terrible experience has been an increase of telemedicine which has been 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 that doesnt go away as we. With the crisis that is the case telehealth with the inability to not be able to see the doctor but also Like Mental Health with a shortage of providers and access to care so how do we make sure these innovations doesnt go away when the pandemic is over . This is something providers and patients have appreciated and have been described to me as a lifeline. So in the midst of this pandemic we know the need for Mental Health has exploded frontline Healthcare Worker and with depression and anxiety and Suicidal Ideation go up dramatically this is what telehealth can help with not a complete substitution but the way to make it more accessible. It is a reimbursement . We have seen medicare and medicaid is that patient attitude this is something that needs to happen among providers . A crucial piece is reimbursement and then to provide waivers for reimbursement for telehealth and what we need to make sure that those are on pair on 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 Health care. He was very unwilling to drive to the Doctors Office because he felt so exposed. And then to get care in the privacy of their own homes so it works for patients as well as providerss long as there is reimbursement that works. O to pick up on your point of Mental Health that has real 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 dcribe in the secondary. But is looking on the bright side, i believe at we are seeing is a greater willingns to talk that we needo take the says moment to push through the discrimination aund Mental Health. And what we need to suppress the virus because we have clearly moved st the point and thats not feasible and this gets to why with Contact Tracing and humane isolation strategy so that people c be more likely to go about their busiss in ways that are safe. Not just diaostic testing but also surveillance testing to get the economy functioning while waiting for a vaccine to become available this is built ound the idea of establishing to dramatically ramp up access to testing t only for diagnostics but surveillance. So e final question the control the senate is still up for grabs deeply divided washington is not a wellspring bipartisan and feelings the world is realistic in the next few . Bipartisan laws of the most sustainable we need to find ways of coming together around these issues and remember we successfully came together with a significant response to the pandemic with the c. A. R. E. S. Act and Bipartisan Legislation so the onus will be on all of us and with President Biden to address then needs that americans have to put aside our partisanship. The conversations i have had with minnesotans is a political issue but economic issue and with those Bipartisan Solutions like bill cassidy and i have with 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 cntry and the globe working to ensure to me the whole system work better for everybody basic aspects of healthcare United Healthce but then the services and pharmacies specialties with those alth services me brain Delivery Services those prtices of 50000 positions across the country is wrong with the military and veterans and with those management prrams. And assassins the country around the globe. So with a large focus and dedication to healthcare. So its happening in the Healthcare System tell me the effects amid the pandemic what has it done to the Health Care System . Thats a great question. And then United Health group. So in 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 event greater need and how does that show up with state support with publicprivate partnerships to provide more virtually with those site requirements and boundaries we have 50000 positions already provide a 1 million telehealth visits. We have seen things we needed to address as a result of the 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 covid as well. How much of my medical care sure the. [chanting] by telemedicine . How much . Its a great queion one thing we are learning to t pandemic his were learning what can be done virtually and what is requed to be done in person . As we continueodapt almost half of our Services Today they had been virtual. Obviously that was a rult of the shutdown across the untry. But we found we cahave even moreccess as a resulof stigma or barriers or lack of access to Behavioral Health rvices. 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 scening is still important with the ability to do that but continues to be in person but we want to be a part of the solution to make it easier to access and closer to home for people. The most important question question, but those that dont have coveragat what is the easiest way to get to a place with 100 percent of the population covered tha doesnt slow down inside the Healthcare System . Thats a great question. One of the things thats important to start with although the goa is 100 percent man percent that have coverage has options and based on success in Public Private partnerships medicaid and Medicare Advantage in the United Healthcare and the prram across the country and those that continue to expand medicaid and those that are eligible are presumptively enrolled in always he 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 uned healthcare to be part of the solution and modernizing them to give them the opportunity the that will be eligible for subsidy always an optio and with those 18 million individuals that sometimes flexible optio are necessary for individuals in a certain situation. But then to make sure its more affordable for people so of these ehange programs and to allow hel individuals and to ensuring the opportunity to continue to he coverage platforms. Thank you for a fascinating conversation and for this conversation over healthcare. Spent thfinal guest today is the president of the foundation for research for opportunities sior advisor at the policy center and a picture of the Health Policy debate here in washington. Thank you for joining us. How are you. Great. Just to dive right in with coverage and access the point you have made many times with universal coverage that doesnt have to mean government coverag coverage. Look at the us, these distinctions can get blurred that they perceive and private that millions of people get insurance from medicare but they dont realize that it is private. So from a big picture level can you walk through and you view the private and Public Sector with the pursuit of universal coverage . Thats a great point and the important point to make is we think of other countries as models and those that universal coverage is not the same as singlepayer government run healthcare that a lot of countries in europe have achieved universal coverage with private Insurance Companies with private insurance and thats important distinction saw the countries in europe save universal private 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 the freemarket so what does that mean cracks ultimately you can have a broad range of choices with the assurance that you buy and from whom you buy it is just one system in one ensure and you have no choice if that is working you have nowhere else to go but like medicare advantag advantage, yes it is the governments system and those who cannot afford the coverage playing with dozens of choices with the plan that you buy thats why the platform approach that we talk about is called Medicare Advantage for all. And then abolishing what percent of seniors use which is private insurance. What i think the Republican Party is right now on healthcare quick. That worked well for conservatives to the beginning of the Affordable Care act with the oregon a scene principle why do you think that has happened is there anything in the nearterm that can reverse that . The bottoline 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 spectrumnd those that say lets repeal obama care which is not sustainable and then people and the middle who were certaiy dont like to be human on their lack of a pn looking for answers and they havent gured that out yet. And thats why we build the foundation. Fair enough. The next question is from the audience from a breer who asks how do we reframe the discuson not a crisis or a negotiated discount . To put a fineroint on that firm per where both parties that they agree on is that hlthcare great for patients but at the same time trying to achieve that tts only useful one youthful to them is difficult is it worth doing . So lets make very clear the price of healthcare is extremy 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 accountabity into the system that with monopoly providers thats a huge problem and reform on both sides price transpency as part of the solution fst of all its it has done quite a bit on price tranarency the world is going to affect january 2022 to require all hospitals and insurers to discuss the rates that is a volution and i guarantee you know for a fact people in the existi Healthcare Industry to recognize how diuptive that is to the worth of data so this is the important reform better if it survives the Court Challenges it can be impoant what people dont understand is tt 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 carwhat you the deductible the difference you is not that great so as a consumer with the price of e Health Insurance that you buy and we dont have that you have no idea whats taken out of your wages even more so i is ironic with the Affordable Care act how much th pay for thr 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 toet 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 pensive employerbased plan and you n buy your own Health Insurance you might be intimidated same state that apple the issue to extract more value working on your own soig business was the system they hate the Current System im tired of having to be the Health Benefits manag want to give them cash and let the buyer on Health Insurance. But now here is anher 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 y an insurance and then will require all startup fees to involve a smaller rather than hr burucrat. I think that is time. Thanyou for joining us. Se to you. So i tha you for joining us this afternoon with the virtual conversation. Fe local newsnd nevers check out ask