Example, nephews your job and have to make those decisions to go to college to pay my debt theyre all these defense that could be interacted. Satisfied to have the financial distrust with those outcomes. You bring up a very good point so there is a social cost called misallocation that allows the highcost debt does not reflect the true cost of the goods or services therefore they may consume even if it doesnt provide a benefit and like Health Insurance we dont think the cancer patient will over consume metal care but we dont want that highrisk auto driver to continue driving. But there it is a real risk of misallocation to the credit markets because the interestrate tells them something than maybe they should not take on the debt. And with the discrimination point so the a. D. It is refusing to allow employers can harm the minorities is certainly not unique to credit reports. Another one of my colleagues in virginia with a Public Policy department shows it is happening that if u. S. Restrict access to criminal records then implanted goes down because they assume that skin color coincides with crime. Then they overestimate that correlation with what is going on. Somebody has of paper that shows with restricting the use of drugtesting it goes down a few encouraging a minority testing goes up i did not mean to say that we should not allow these usages as theyre maybe some express focuses but it does have a real cost or released it could. We do the best that we can and in addition there are real benefits. The private study that should be drafting right now that seems to show as you put the laws into place before of trouble making payments people who have bad credit or missed utility payments it was a study of people in sweden one of the studies show farmers to minority employment in the census tract that also seems to go up so there is the cost and a benefit. This is about the study so pro public also did a study like this talking about the collection was not for black residents was being sued by a debt collector it is not only disproportionate to those regions across the country but what struck commis about that is inseams to correlate and they were not finding any variable that they could. But what struck me in duh differential for of the low low asset communities of the family own homes so this seems that more intuitive does it is bundled in with less access with all of these factors. V is the date the different issue like gambling or what not to put that aside to match the assets of the other regions . But also during the Great Recession nevada was one of the places where the Housing Market went down badly. One but then the damage from 2013 it could happen before that. And not at that level. Thats right. Bond that basis so for the home brest. Dependent that is a lot of assets. I have of a response to your question about the of pastors in following up in particular to justify their filings when it is consistent with date down their previous years of why they filed to get out from under the stigma and shame and also how did they get to the Legal Aid Office . That i have a financial problem to i will file for bankruptcy . One. The interesting part is there is a racial difference so this person that files against bankruptcy that they were primarily white evangelicals. So in that universe with the practice of law but convincing people it is okay to file bankruptcy. With africanamericans you just hit a wall you cannot go on with so it is a good thing that i hear that sime churches say it is okay because that this is a good thing because when and to get to this problem in the future. Also be because that is what i am talking about of those collection tactics that included threatening people with being arrested . I will take those in reverse order. People are being hounded by their creditors by have not heard a story of criminalization or criminal punishment of the tactics if there is a knock on the door i will hide under the covers were that they will threaten me criminalization basso the findings are very interesting because it is one more step aggregated to collecting the debt. For but to the question how to get it to legal a office in is interesting that dont advertise we have a sandwich board stripped people drive through. But it is like a sandwich board to get food or soup and they say i have driven past this place tender 12 i we thought about going in but i was too scared i did not think that i was ready. But then a call comes with the psychology. And i did not have time to discuss the Legal Aid Office , but then to do that purposefully to create a non judgmental atmosphere and if they take that step mayfield glad about that to bob they feel glad about that so they see the sandwich board they know a friend who has filed or a friend has filed a that is wages some of their concern about filing in the first place. I think they are coherent in the sense that to make those justifications of why people file for bankruptcy so that stigma is there. Some are getting more comfortable with filing it is not such a bad experience. Is there any way to get a sense of the water cooler effects but with a certain population of people or filing bankruptcy . Yes you can definitely see your community conditional on that what is the of likelihood . And that is almost impossible to discern to have low income, and high employment rates of homage people are influenced from those general commissions and then to end at been the Legal Aid Office. Southey information is also where you work. One of the things is generations of family members or extended family that they file bankruptcy or not extended family. Pdf. I have uh data set over the last 20 years there are legal aid families better is that network aspect but in terms of filing for bankruptcy but then they keep a secret that dont talk about it there is no water coover talks and bbb very low income everybody is very concerned how to keep this secret. So i would think that makes the networking that much less likely so that is where people are. To show people of Public Housing is not talking to their neighbors. Of course washington was a juror republican. He believed in republican government. Up next on cspan2 at the panel discussing how the Trump Administration might approach the issues of Biomedical Health care and drug pricing. Next the conversation on biomedical innovation, health care and drug pricing. Panelists include a Health Policy advisor to president obamas transition team, a former fda commissioner and the Pharmaceutical Company vice president. The milton institute hosted this event in new york city. Thank you all for being here and regardless of your politics i think its safe to say this past week has been a little tumultuous. And i think either way no matter who had won the Election Health care issues would have been front and center. You can imagine that where Hillary Clinton is the president elect and we are having a panel this morning on the drug pricing down. Instead because Donald Trumps or president elect the news has been dominated. Good news has been dominated with talk of Obamacare Repeal and some of the issues that are most important to this sector have been overshadowed so for me selfishly this is a tree. Ive had my head down and what the etas next steps will look like but im curious to know what happens to the sector and experts will talk it up this morning. What i think i would like to start with is this. Sitting in this room we are onemile exactly from trump tower. If i looked on google maps may be apple maps with a slightly different calculation but onemile walking, trump tower has 58 floors. For the sake of argument we will say it takes about a second to go up every floor so imagine you are riding the elevator with the president elect and hypothetically he might not know a lot about the inner workings of health care. [laughter] imagine you can tell him anything about this industry. What is sure whether all elevator pitch in 60 seconds and we will start with you. Im going to tell mr. Trump to think very carefully about policies that have an impact on the pharmaceutical industry because like ge brings good things to light, we bring good things to life and to people and innovation is crucially important to keeping our country healthy as well as keeping our country prosperous. Our companies employ tens of thousands of people in good paying scientific technological jobs so we do contribute to the economy but most importantly our number one priority and the thing that we make our greatest contribution to aids patients all over this country and globally whose lives we save and in those lives we make a huge and important difference. His policies could change that dynamic not only for companies individually but for every single patient in america. Thats inspirational. Do i have another few seconds . I think they actually only have 58 floors so depending on you calculate. Andy, how about you . I would tell president elected i know you were being barraged by recommendations for names and appointments but i would implore you to put policy before people and what i mean by that is that whomever you select they are going to have to deal with the fact that there are normas policy issues and changes that are going to affect the agency they are involved in, health care and Biomedical Research. We are looking for example at as former commissioners at the fda working on a recommendation to make the food and drug and frustration an independent agency and all the nuance that goes with that. There are now over 10 agencies that fund Biomedical Research to the extent there are tens of billions of dollars and there is a significant policy question around do we need to have greater coordination of that federal spending as a boost to a policy that embraces Public Private partnerships and relationships with industry. And so before making critically important decisions about personnel i believe its important for you and your leadership to pay very close attention to the mac or policy questions that will shape the future of Biomedical Research and therefore the future of health care in this country. Dora hughes from sidley austin. C i would say very eloquent elevator speeches. We need to focus on patients with as much progress we have made in areas with hepatitis and hiv. There are thousands of Rare Diseases for which there are no treatments and families are suffering. I would definitely hammer home on the economic message. I think that would resonate in a campaign in terms of the number of jobs created, what means to medical centers and other Research Centers and id certainly want to emphasize that. The other message that i think we should talk about is the need for Global Partnership and some of his comments in the context of trade or nato have suggested that we might not have the same level of collaboration globally and i would want to point out that this is not an institute than can go forward alone. They are very much depended dependent on collaboration and very much dependent on organization is another big area focus. That would be another message id want to focus on family i would want to that we do need to be mindful of the impact against all population groups being mindful and particularly given some of the rhetoric of the campaign this is the area we would have to be especially sensitive about in the days ahead. C the president elects head is still swirling with ideas. I think i would probably start off at the sixth floor of the massive elevator. Echoing a lot of things that abari been said. In a new leader in a new position has a kneejerk reaction. I think that if he has done his 90day plan one of the most important things he can do is take a step back and really listen. He is shown an uncanny ability to listen to voices that are previously been unhurt around the country. Take a step back and understand the complexity of it. We operate in 150 countries all over the world and really understand the problems that are facing them. The problems that are facing this country and our industry were the same before and after the election. The first thing he could do was really set the tone for the principle and how he wants to resolve its issues. Really wanted to stimulate an economy and provide an environment that supports innovation but also one that meets and addresses the needs of a lot of voices out there that are looking for continued options for Affordable Health care. He can also set a great tone by reaching out to all of us in the room to say the way of getting there is not just pearl with small people in her room but to really reach out and listen to the ideas that each one of the wall, each one of us in the sector may have. So, before i start i should tell you that Margaret Anderson gave me these thoughts last night and so when she said it will not your socks off i just dont quite get it. Ask her about the significance of it. Im happy to have a conversation. This is what the people came to hear. [laughter] the elevator hasnt started yet. We have a president who probably doesnt understand the nuances of health care so i would say to him that give him a little bit of history and remind him that 1945 president bush wrote at the request of roosevelt about how the federal government should relate to science having just come out of the war effort and developed robust relationships with the community. What is going to come next, do we stop at it we dont have a war anymore and the answer surprised roosevelt and many others. What he said was support basic research. The federal government must support basic research because the private sector essentially canned. Research operates on a different timescale and it asks the openended questions that cant be answered so the first answer is that. That is enunciate, use your bully pulpit to enunciate the importance of a mental discovery. Gerberding issued a call to remind us us all of the importance of that the second message would be the the bully pulpit is expanded because of the way Scientific Research has gone and the connection to patients in the health and health care and that is we know need to fill the continuum from that fundamental discovery all the way beyond the clinicians and social behavioral and population scientists into the community. Patients of course but also that of Healthy People because by operating together that person will be able to gather information. I have heard a lot of threats that i want to pull this together but maybe we should just have a base question now that we have informed the next president where we all stand. Republicans hold onto congress and now will control the white house too. Was this election ultimately good for the sector and andy as former fda commissioner from a different angle we will start with you. Was this election good for the sector . I think it has the potential to make incredible positive for the sector. I will say that in a couple of different ways first of all i think with this new administration and with the tax policies and regulatory policies i believe it gives an opportunity for enriched for the sector. On one hand addressing issues about repatriation and trillions of dollars that are available in this country. There are hundreds of billions of dollars on the Balance Sheets of major corporations in this country like google and basically that money is basically sitting on the sidelines. With the right tax policies and the right fiscal policies we have the opportunity to pull that back into an opportunity for enriched Investment Grade you can talk about infrastructure but infrastructure for the biomedical community including infrastructure around education and the next generation, those could be for the administration to the white house and congress. Then you have regulatory issues and we can talk about reforms and the regulatory process at the food and drug administration. What you get creates a much more exciting climate for earlystage investment because the pipeline is a bit more well and more precise and a little bit more optimistic. So i believe from those two standpoints when you couple that with the continued exclusion thats going to occur as pointed out in science and ecology itself than four years could he the best of times, not the worst kind. Overall optimism where the other repatriation investment do you agree with andys assessment . I agree with it and i think the Financial Market agrees with that as well. Within hours of the election it dropped and went right back up and the number of analysts in particular pointed out that this is a time to invest in the biopharmaceutical industry. I think they made that recommendation based on what and he is talking about but i also think another issue, and that is the issue of the assault on drug pricing that has been taking place and was one of the cornerstones of secretary clinton bang. That assault on drug racing could have passed a continuing down i am past on the industry. I think the expectation now that secretary clinton is not in the white house is that at least to some extent, scrum of pressure that places all of this and this list on the price of drugs in the talking about the value of drugs is going to settle down a bit and it will give our industry an opportunity to tell our story are with without a highlevel backer money is debate. Our story is and it is about the fact that our Health Care System is a multipartitioned operation , so it isnt just about the price is should it is whether patients have access to Quality Health care including the drugs that they need. I think that conversation of how all of the parts of the Health Care System can Work Together to assure access to drugs as well as to the Health Care System can take place more respectfully and a nonshrinking environment and i think that is what we can expect to have in this particular case. B something that you said, the idea that Terry Clinton was very antiprices and aggressive on bringing them down. Your point, donald trump has heard his voice is and capitalize on the populist message. He is not a stranger. Hes also campaigning on the hydro tries you too in a public has in Congress View it more than democrats we dont really know what donald trump can do. You think that we have to acknowledge that there are a lot of when they go to the pharmacy counter they have oh ensure trees that are not affordable for them. That didnt change after the election. So i think for us at the company we look at that and well know we have have to take our own actions and are on response ability to go in the last two years, classified your medicines to be added below a price to make think thats a step that we as an industry have to do to
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