Hello, and welcome back. Im steve clemons. We are delighted to have you join us for the second hour of the future of the health care summit. I would like to thank the their support of todays great program. We are going to expand our lens in the session to look at policymaking breakthroughs and innovation in the face of seen and unseen challenges. Before we get underway, a few housekeeping notes. You can tweet us at thehillhealth. We are taking questions there. You can see i have a bunch here that have already come in. Speakers, beware. If you experience a problem with the livestream, refresh. It should be a quick fix. I dont believe them, but thats what they say. Lets get started. Im least introduce my first thethe health of secretary of health and human services. Alex azar has a breadth of experience of both the public and private sectors. His key focuses on health care and innovation, all assuming added significance in the coronavirus era. Thank you for joining us today. We have had a really fantastic forum and it wouldnt be what it would be without you. 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. Theres a lot of confusion out there about what we are going to do, but vaccines seem to be vital in getting to that point. Is there anything you can tell us about where we are at on that front, operation warp speed and your oversight and encouragement of a vaccine . Secretary azar absolutely. Thanks for asking about warp speed. I have heard the Pharma Company timelines. They are also drawn out. I used to work at a Pharmaceutical Company and i know these timelines. Why they are drawn out. The president said 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 can compress the Development Timeline by reducing any unnecessary delay or inefficiency in that system. The second is to invest in at scale upfront commercial delivery rather than waiting until phase 2, 3, or final fda approval. You build a 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 have four Major Investments that we have made in vaccine candidates. We have the modernity vaccine that came out of dr. Faucis lab originally. It is an mrna that form platform vaccine. We have an antivirus vaccine candidate. Jj jensen which is also an antivirus platform candidate. And we recently announced a one point 6 billion additional investment of a novavax protein vaccine. We now have major bets in all three of the major potential platforms of 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 next year. Phase two and three Clinical Trials 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 that we may not have even talked about might be flops . Mr. 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 will necessarily hit. That is why we place the investments. The same country that does the apollo project can radically change the speed of a vaccine given the urgency. We have spent 3 trillion just in governments building 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 what we are talking about today. Not everything is covid. There are other pieces of the puzzle that i would love to get your insight. I would like to ask about the manufacturing side and the researchbased of this. It is not just an american problem. It is a global problem. Some firms have Global Manufacturing deals. How does america position itself so that it gets vaccines developed and produced here, but doesnt give the finger to the rest of the world . How do you manage the international science, production, and global need . Mr. Azar linda give you the astrazeneca platform. They took the oxford vaccine and astrazeneca has the Development Rights in most of the world that they contracted with oxford four. What we have done his contract with research and development to work with the United States of Clinical Trials. And also manufacturing in the United States. I think they have talked about several billion doses to be manufactured in india and elsewhere. We dont 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. 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 . Mr. 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. It we are working in collaboration with the world as i just mentioned. One of the other dimensions we are looking at is the broader state of health care in america. There are a lot of moving pieces to that and people look for silver bullets. 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 . Mr. 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 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 . How do we deliver lower cost 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 health care crisis, solving the mortality crisis. Ending the opioid epidemic. Addressing and tackling renal disease. We look at health care. 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 partner for congress. Steve 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 and how this all works, but they worry about losing coverage of preexisting conditions. The administration has, in my view, there have been different moments where you read to different things. They are committed to maintaining coverage of existing conditions. Mr. Azar it is a statute and hit by 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 milk land of milk and honey with obamacare. If you are a couple that makes 70,000 a year in your 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. One of the fatal conceit of 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 allowing Healthy People, those that dont have preexisting conditions, have insurance that meets their needs at the cost that they need also. Steve i dont know what its like during your time of covid. My life has moved to zoom and to skype, the digital platforms. 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. But there is a worry that that will fall back. How much of this new world we have entered into, 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 area era. Mr. Azar this pandemic has led to a lot of innovation in health care through the president upon leadership, the National Emergency authority to be able to waive some of the embedded requirements that have kept 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 act to make medicare and medicaid available for 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 back on this. 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 as needed to make sure that we keep whatever is required by statute. Steve 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 . Mr. Azar what we are experiencing in the southeast and southwest, seeing emergence is a very Serious Public Health situation. It often is phrased as a question of reopening. It we dont believe it is about the fact of reopening in terms of a legal or regulatory structure. Rather, how are we behaving within that context . Are we practicing social distancing . Are we wearing facial coverings in circumstances where we cant serve show social distance . We have to take individual responsibility in the construct of reopening work, school, and Health Care Systems again. It is definitely the feedback we are getting on the ground. That is why we have been acting with good individual responsibility here. Steve mr. Secretary, great to see you, even virtually. Thanks very much for joining us today and sharing your insights. Good luck with the challenges ahead. Mr. Azar good to be with all of you. The president s from public affairs, available now in paperback and ebook. It presents biographies of every president organized by their ranking by noted historians from best to worst and futures perspectives into the lives of our nations chief executives and their leadership styles. Visit our website to learn more about each president and historian featured an order your copy today wherever books and ebooks are sold. Earlier today, president with reporters when departing the white house to visit walter reed medical center. Hello, everybody. Its very hot. Its very hot, so we are going to walter reed hospital, and we are going to be seeing soldiers, some badlyeroes, wounded, and they are incredibly brave and great people, and we are going to see also the warriors on the front line of covid and what fuels them, and we are going to spend some time with them. I loorw