The opinion that matters the most iyour own. This is what democracy looks like. Cspan powered by cable. Leaders in the Health Industry add policy advocates assess the current state of the u. S. Health care system. They talk about health care affordability, innovation, Prescription Drug prices, and the need to increase accessibility. This is from the Milken Institute future of Health Summit in washington, d. C. Welcome to the Milken Institute future of heal summit. We are delighted to have you join us and look forward to your participation over the next few days to kick off the event, please welcome executive Vice President of health at the Milken Institute, esther crawford. Welcome to the Milken Institute future of Health Summit. We are delighted to have you join us and look forward to your participation over the next few days. Please welcome executive Vice President of health, esther krofah. Good morning and welcome to the 2023 future of Health Summit. Whether you are here in the realm or watching online, we are delighted to have you join us. Gathered are hundreds of leaders from across the health sector, representing government, philanthropy, care delivery, academia, research, the investment community, and more. Anthropy, care, delivery industry, academia, research. Patient advocacy. The investment community. And more. We come together because we recognize we can do more collectively to achieve Better Health for individuals and patients than we can do alone. I have engaged with many of you across our work at Milken Institute health throughout the year, and what i have found to be the Common Thread is partnership. Collaboration across disciplines and sectors is not just good practice, it is essential for government and industry, academe, mere health care, delivery systems, nonprofit, retail and more are leading the way in forming new partnerships to address growing domestic and Global Health challenges. Our theme for this summit is closing the gap. Better health for more people. This theme is particularly timely as we more fully emerg from the covid 19 pandemic and survey the landscape. We see widening inequities in health here in the United States and around the world. The trends in the United States are particularly stark. Despite spending more than 4. 1 trillion on health care, the most in the world, Health Outcomes are on the decline. The washington posts recent analysis revealed Life Expectancy is the srtest it has been in two decades. 76. 4 years. Taking us back to the mid 1990s. In 25 of our counties people are dying at a higher rate than 40 years ago, particularly in the nations interior, the miest and the south. The gap in mortality between the rich and the poor isrowing significantly wider. Taking one step further, people in both the poorest and wealthiest communities in the u. S. Live shorter lives compared to tir peers in canada, france and japan. An epidemic of chronic illness is our greatest threat. Heart disease, cancer, diabetes, Liver Disease and obesity are among the primary reasons for poor Life Expectancy in adults. Age 35 to 64. Compared to other high Income Countries and this is despite the tragic deaths related to covid 19, the Opioid Crisis and gun violence. Life expectancy, however, is Just One Health outcome. Unfortunately, the Health Burden on communities across the country is also taking an economic toll. Increased povert unemployment, inadequate housing, violence and more. At the same time, we live in the golden era of science and technology. The breakthroughs and rapid pace of innovations in medicines, vaccines, diagnostics, new modalities of care, delivery and application of technology should be boosting lifespan and quality ofife across all communities. The challenge and the opportunity i pose to you tod is how do we close the persistent gaps between innovation, access and outcomes . How do we innovate our innovation to reach more people . Though we me to the table with different perspectives on how to close the gaps, we are united by a sense of urgency and a common goal for Better Health, for more people. I have seen firsthand how bringing together crosscutting sectors in medical research, Public Health, food systems and healthy longevity enables us to live to develop better, more holistic solutions. And as we look across the lifespan, we must also consider how to maxize the quality of life for an aging population by 2031, in six people in the world will be aged 60 years or over. While this shift ian aging population began in high Income Countries, it is now low and middle income couries that are experiencing the greatest change. To elevate and prepare for an aging population, an ongoing area of priority for the Milken Institute. I am pleased to announce today the new aging innovation collaborative. This collaborative. Thank you. This collaborative is led by the Milken Institutes future of aging and established with a 3 milliocontrave auction from the National Investment center for Seniors Housing and care, which includes the contribution of the intellectual capital and fellows at nexis insights. Joining me on stage now is ray bruin, president and ceo of nec. Bob kramer, founder and fellow at nexis insights and cofounder and Strategic Advisor of nec. Susan barlow, cofounder and managing partner of bloomin capital and board chair of nick. And diane tice, senior director Milken Institute. Future of aging. Welcome. Thank you so much. Thank you, esther. As chair of the nec board of directors, i first want to say how pleased we are to provide the seed capital for the aging innovation collaborative in connection with the Milken Institute. But nick, representing the Senior Housing and care industry, shares the milken view that public and institutional private companies propeing health care, housing a and communities as our as our for our aging population are not adequately prepared meet the opportunities and challenge is preparing for an aging population ia priority. The Milken Institute. Improving access and choice in housing and pport services for older adults is next mission. Were excited for the aging innovation. Collorate mission to identify Scalable Solutions and then fast track their implementatn. Time is of the essence. Thk you r the opportunity to collaborate. Im excited about the impact we will have working together. Thank you. Thank you, susan. Id like to thank all of our sponsors for making this event possible. I hope that over the next three days you will walk away with fresh ideas, new solutions and examples of how to implement them on the ground. I encourage you to move beyond your traditional areas owork to explore new areas and potentially form new partnerships and collaborative efforts. Thank you very much and i hope you enjoy the conference. And you fully acknowledge the participation of the following organization whose generous support makes this conference possible. We thank the following media partner for their participation at this event. We thank the Milken InstituteStrategic Partners for their year round support of our work around the world. Please welcome the panel to discuss closing gaps in health and health care moderated by cn medical correspondent maggie terrell. L right. Well, hi, everybody. Excited to get started. This is going to be a really fantastic few days with some really fascinating looki panelsoming up. Im ally delighted to get to have this panel ofolks rlly spanning all aspectsf the health carsystem and to to start this conversation. So im going to introduce everybody. And then i thought maybe we could start by kind of setting the stage and framing the question that well be talking out this morning by having everybody kind of tell us where theyre coming to it. So to my left is dr. John rue, president and ceo of geisinger, herr. We have amr ali tauzin, cofounder and coceo of guardant health, and dr. Ashwin vasan, the commissioner of the new York City Department of health and mental hygiene, hubertus von baumbach, the ceo and chairman of boehringer ingelheim. And ange williams, president and ceo of united way worldwide. And angela, why dont we start with you. Tell us about sort of a little bit about your organization and how youre coming to this question were talking about day. Thank you. Good morning, everybody. Its good to see all of you. Youreautif, smiling faces. I am so pleased to be this president and ceo of united way worldwide. Many of you have probably heard the name but didnt ally understand the scope of our organization. We have 1100 local united ys operating in 37 countries here in the United States. We cover approximately. 98 of communities. En i think about our organization andur areas of focus around health, education and economic mobility as well as climate and disaster relief, what really strikes me is that have an asset that i want you all to know about, and that is to one onehich is health care, mental hlth, social Services Call center, united way. About of tse in the u. S. And it is the ngle most important tool th you all should recognize and know abou and engage with, because w touch 20 million america a year that call us for support for health care resources, to be connected to cariver resources and so forth. Here it is. So we are a Research Driven pharmaceutical company. We develop, we research, develop and bring to the market the products we produce. On the animahealth side, as well as the human side. Weve been doing this for almost 140 yes now, so weve been ilding an organization that is rather diverse and the target we look after, whether its oncology, whether its depression, whether its cardio, metabolic diseases, lung insuffiency. So we rather broaden to have about almost 10,000 people helping us to develop those new products, really excited to able to touch patients around the globe with our organization and pretty much everyajor country that is cessible to us and without hoping to be able to contribute to the cause which we all share around. Its great to be here. Thank you for having me, esther. And the entire milken team. And good to be with all of you. Im ashwin vasan. Im the Health Commissioner of new york city, a small city to the north where we face many challenges. You know, our department has a 200 year old history of really improving and protecting the health of our residents and facing whatever challenges come our way and responding with innovation, with aplomb and our work has influenced not only national, but Global Public health. And im very glad to be here with representatives from the private sector, from nonprofits, from other Public Sector actors, because if one thing is clear and that covid brought to bear was that when we are aligned, we can do pretty impressive things. When we have common goals in health, we can do impressive things by unlocking our respective strengths. So im very excited that this is the focus of of this several days here and that esther led us off with the discussion on Life Expectancy, because believe certainly and we are putting this into practice in new york, that that is indeed our common challenge. And we can unlock a new generation of collaborati in health if we all agree that this is something we want to work on together. And really, im here t italicize. Im cofounder cochair of garden hped advance health is a prision agnostic cpaign. Named work wh the Mission Clean curing cancer and bringing more time to cancer pients. We do blood testing acrs ntinuum of car weave blood tests for advanced Cancer Patients where we tl e physician patients wh kind of tatments gointo work for em, wh kind of trement is not going to work othem anymor about 20 ofll advanced cancer patient united stes are getting mane by ung our blood tests. And then we have blood tests for ncers rvivor if theiriseases comi back or not. And most recently, a blood test for colon caer screening and coectingur mission to th topic of this panel. So when you think about, for stance, colon cancer screenin where 60 million of people who should be screened are not getting screened, although we have a lot of solutions for the including colonoscopy and othereans. And when you look at underserved patient population, when you look at people of color, those arthe people who are more noncompliant tthe cancer risk reenin takingwo days off to get through coloncopy fees or having access to some kind of seice sa in order to get prevent table colon Cancer Screening, we bring a new optionality. Yohave a simple blood test. We can go where they work. We can go where they leaveo get this Cancer Screening done. And the and decrease their mortality of colonancer. Excited to be part of manner and you yeah im excited as well itgreat to join everybody today big thanks to the milken team for having me a little bit about geisinger we are system in central and northeastern pennsylvania. I think some folks we are what you might call a provider, meaning we are a payer, but also a provider. I think were operating in both worlds and that allows to build and focus on Clinical Program so that sometimes dont happen in our industry because the incentives dont quite line up. And so in our world, for the portion of the population that is both our patient and our member on our health plan side, we have an awful lot of flexibility to focus on programs that simply improve health. We dont have to worry of a food program, for example, as a billable event or not. We could just do it. We still have the half of what we do where it resembles most others in the health care industry, where where youre or still partnering with other Insurance Companies and as an insurance company, also partnering with other delivery systems. I think a big part of our focu especially over the last handful of years, has been building clinical capabilities of Clinical Programs and trying to bring those into settings that meet people and communities closer to where theyre at. And oftentimes thats either the home or the work environment, Community Programs or even clinics. You know, if you walk the halls of geisinger, youll hear us often talk about moving care. One click to the left. And i put at in quotes, because what it means is, folks that were seen in the e. R. And maybe hospitalized, is there a way to discharge them from the e. R. And send them home with proper supports so that they dont need a hospitalization instead of seeing them in the e. R. . Is there a way to have access be so fast that they could be seen in a clinic instead of Specialty Care . Could you take care of something in primary care instead of even an actual visit . Could it be a virtual visit . Could it be prevention that gets ahead of an issue altogether . Thats what we mean when we talk about one click to the left. We know that theres always place for very sick people inside the hospital. So were going to continue to develop those programs as wel but to the extent were able to get ahead and move things further upstream, thats what were trying to do. And then i think preventiois one of the common themes i think i hear from all of you in ho you approach this topic, and i guess im curious. J one ill come right back to u. What are the roadblocks in reaching that more universally to getting more people into the sort of Preventive Care setting where youre not then seeing people really farther downstream . Yeah, i think there are a couple things i would say. The big one, id start with t payment model. You know, we have a payment model in this country and you all have hea it. I know im talking to preaching to the choir here, but the payment models tend drive re further downstream, especially if youre in a traditial fee for Service Reimbursement model. And so i think sometimes and food is just a reay good example. Theres no cpt code for food programs, so how to invest in that really those whbear the risk, those who have sort of a lue bad payment environment where theyre looki at total health, total of re. Those are the folks have a natural incentive to Pay Attention d invest in food programs and i think in the absence of those kinds of environment you have a set of incentives th make it really tough to invest in those upstream tivities, whether in food isust one example. But this is true for housing, transportation or even primary care or services in the homer even lonr physician visits for seniors who may have multie chronic morbidities. I