Nations distinguished thinkers an innovators. It is my privilege to introduce todays participant to engage us in a captivating discussion of health care. Let me start by introducing the guest speaker who i have known for many years and consider him a mentor and friend. Scott serota is the ceo of Blue Cross Blue Shield, and a National Federation of supporting 36 independent communitybased and locallyowned Blue Cross Blue Shield companies and including Blue Cross Blue Shield of michigan. The Blue Cross Blue Shield system through its federation of insurers covers 1 of 3 americans, and i think that this is a very important statistic, because nobody else does this frankly, it serves every zip code in the united states, meaning in every zip code in america, someone has a Blue Cross Blue Shield card. He is overseeing one of the most trusted brands in health care, and scott is one of the most influential leaders driving Public Policy and conversations on health care and health care reform, and so everyone has access to equality, Affordable Health care, and importantly, scott has devoted the career to the health of all americans through innovations through the bcbs health index and the health of america reports which identifies Health Challenges and issues and provide the insights to improve the quality of care across america. Scott was named the president and ceo of bcbsa after serving four years as the Senior ExecutiveVice President including two years as chief operating officer. Prior to that in charge of the system development, he was in charge of the Technical Evaluation center which is renowned for evaluating safety and effectiveness of merging medical treatment. During scotts tenure the Blue Card Program was introduced and through this national program, which allows blue plan members to receive Health Benefits while travel org living in another part or blue service area, and our nationwide membership in the system has increased from 65 million from the beginning to 106 million members today. Scott was at the helm throughout many of the policy debates and including the implementation of the Affordable Care act, and it was his vision to use the available data to develop the en sights of what is happening in the Health Across america in driving solutions on Health Care Trends like Millennial Health. Before joining bcbsa scott served as the ceo of the chicagobased Prudential Health plans, and also led preferred health, inc. , and missouribased pho. Scott is the leader with strong commitment to Corporate Responsibility and driven to be civically active professionally and personally. In addition to serving on numerous Blue Cross Blue Shield boards he is a member of the National Founding group of the Health Institute and health cost and Advisory Board of paragon biosciences. He serves on the leardship council and the Health Financial association, and the American College of Health Executives and the dean Leadership College for science at Purdue University, and the Washington University national council. And he has advised the white house and congress on policies and programs and services affecting our senior citizens, and a charter member of the health committee, and the advancement of health technology. He serves on the ceo Advisory Board for building a healthier chicago. Scott earned a bachelors degree from Purdue University where he is a proud boilermaker, and holds a masters in Health Administration planning from the Washington School of medicine. Also holds an honorary doctor of science degree from purdue. Id also like to introduce our moderator today dr. Deanna lights an awardwinning Health Reporter at wwj news 950. She was a reporter for medical news in miami and boston. She has received multiple awards for the reporting including six emmy award nominations and Michigan Association of broadca Broadcasters Award and two American Heart Association awards. She holds a bachelor of science degree in nutrition from Michigan State university and also in podiatrist college, and holds a fellow at phoenix hospital. So it is my please suure to introduce scott serota and deanna lights and we look forward to their conversation. Hi. Good afternoon. Im thrilled to be here with the detroit economic club. Thank you for having me and scott. I wanted to officially welcome you. Thank you. So we are going to be talking about the vision for the future of health care and when a lot of people that i talk to over the past few weeks found out that i was going to be meeting with you today, they all had some questions that i should ask you. Ugh oh. And one question kept showing up over and over and over, so, lets start with this, and i am sure it is something that you have never heard. They want to know why is health care so expensive for consumers and businesses in our country. Well, that is an easy question. I will get to the question, but i did not get a lot of applause when you said that i am a proud boilermaker, so i have to go on record that my daughter did not see the light, and she is a proud spartan, and you have to do something to get the audience on your side. Okay. Why is health care so expensive. Health care is unique in that the consumer of services is typically not the person paying for the service. So you have got a strange dynamic in that environment. You have organizations whether it is the government or insurers like the blues who are paying for service, but the manufacturing plant, the physicians and the hospitals and the others who are delivering the service. So you have lots of disconnects and lots of missing checks and balances. So that is point one. The second point is that we have built the Health Care System on a piecework basis. And that is the more you do, the more you get paid. So we have created incentives in the system for delivering excessive care so long as that care is not going to do any harm. And so we have a scenario where providers are incented to deliver more care, and patients have no buffer not to accept the care, because they are typically not paying for it, and the payers are after the fact trying to manage the care in a remote basis. So that is driving the price up. Second, what is more important than health . Nothing. So we invest as a society, i believe appropriately lots of dollars in creating innovation in finding new pharmaceutical breakthroughs and new ways in which to drive better value in the system. I hope that is not an alarm of some kind. To drive better value in them is, and those innovations and those breakthroughs have a price attached to them. We have increased the Life Expectancy and increased the Health Outcomes and eradicated diseases and done a lot of good things with the dollars. The next evolution, and the logical question is what we can do to make it more affordable. And the evolution there is to move our Health Care System to one that is less focused on the inputs and more focused on the value and to begin to construct relationships between the payers and the providers that are focused on the outcomes of the care that are received rather than the inputs. And in fact, the Blue Cross Blue Shield of michigan is one of the leaders in that movement and about 5,000 physicians operate here on the patientcentered medical home, on the environment where the primary care physician begins to manage or take ownership of the full spectrum of care of the people who are part of his her practice. And we try to do that and in fact, 70 million americans get the care through some form of a valuebased care arrangement. And the goal there is to focus our reimbursement on improving the outcomes that our patients receive, and it is showing results. We have had diminished readmissions to the hospital, and diminished emergency room utilization, and increased compliance with chronic disease treatments and protocols and so we have a whole host of activities that are beginning to show positive results. Long answer to the short question. Well, a lot of the Insurance Companies and businesses offer the Wellness Programs and incentives so if you quit smoke org lose weight, and smokeing or losing weight, and how effective are these and are they worth businesses investing in . Well, any investment that you make in your workforces health is a benefit. I think that in improving the lifestyle and having people lose weight and reducing smoking and those kinds of things all have positive outcomes. The jury is still out on whether the investment of the programs is actually going to be paying out in the real dollar benefit, but i think that in, if you are factoring in the noneconomic or the nonheart economic factors like reduced sick days and productivity measures, it is clearly an investment that we should all be making and worth making. So, just over about a year from now, we are going to be having a big election, and health care is always a big issue. If you were running or you were advising a candidate the former is never going to happen. So lets say that you were advising someone or what would make a Good Health Plan and what as voters should we be looking at . Well, i am a believer in looking on what works and not just tearing things up for the sake of tearing things up, and if i were advising any of the candidates, i would say we spent as a nation a long time working on and debating and implementing the Affordable Care act. I would build on its successes. I would look at the fact that as of this moment in excess of 90 of americans have Health Insurance today. So i would look at ways to close the gap to get the last 10 or the number i saw this morning was 7. 5 . But how do we close that gap to get those folks without disrupting the care that the rest are receiving . So there is a number of Public Policy initiatives that we could do that would improve lower costs, and improve our ability to access care in that regard. I would encourage candidates to look at the issue of pharmaceutical costs and promote the idea not just in pharmacy, but in the entire Health Care System of transparency and allowing the patients, employers and insurers who have real line of sight understanding of what the components of the health care really cost, and how we, and therefore identify where the opportunities are for improvement, and so how the pharma drugs are priced. Lets get some transparency and into what the are the costs and the developmental costs and real costs and what are the research costs, and how are those prices developed so we can have a better Public Policy discussion about how much we as a society can afford to spend on that regard. We have to develop Public Policy initiatives on high cost drugs. We now have our first drug that exceeds 2 million for treatment. We have to as a country learn how the deal with those particular issues and we have to improve access in communities and make sure that the rural hospitals survive. There is no shortage of the agenda i guess is the answer to your question in this regard, but as a priority, i would say focus on building on what is working today as opposed to disrupting what is working today just for the sake of disruption. Okay. So there have been some major Health Issues in the news lately and i wanted to get your take on it as we are talking about the future of health care, and how the blues combat these things. For example the vaping ecigarettes and 450 hospitalized with a respiratory illness and we have deaths, and an issue that you dont have a lot of data on . Well, the issue of how to deal with vape iing i put in a broader category of how do you deal with society issues and we as the blues as dan said earlier, we are in every community, and what makes us unique, the unique qualifications of the program czar is how people are living in the communities of which they operate. So when we make decisions and we make policies and when we decide what are our priority issue, it is impacting the neighbors. It is impacti ining our friends families and it is in our community, and so we are committed to the community activities, and so i put all of these things be it smoking, vaping, nutritional issues and all of these categories of the determinants of health, and we as a blue system feel committed to take the resources and the insights and the information that we have in how to work with local communities to solve those problems, and we wanted to be certain that peoples genetic code is more important than the zip code as we are looking at how we attack health care issues. So, again, we are trying to take the data that we have and take it to the policy makers in washington and the state capi l capitals to understand the depth of the problem, and the communities impacted with the problem, and then try to work with the communities to actually take our resources and staffs to invest in those communities to solve those problems, and you know, it is vaping today, and opioids yesterday, and so, unfortunately it is going to be opioids for a long time. The measles outbreak. Vaccination rates. The best way to deal with it is with facts and data and information that we try to bring to bear in the communities and blessed with the Data Resource because of 107 million americans in the zip codes and demographic, and blessed with the data to provide us great insight into that, and the trick is to take the insight and provide it back to the people who can make a difference. When we think of health care, a lot of times people think of the elderly are the ones that are the sickest, but i saw a blue cross report where the millennials are not the healthiest group, and can you talk about that . Sure. We have a program that we all the health of america. And we have done 27 different reports on various Health Conditions given that we are in the beautiful stadium i would say, and the ones that hit the headlines early on was the concussion report on espn, and on the front page of u. S. Today and a whole host of reports, and the latest was on Millennial Health. I will tell you that we were very surprised that we found that the millennial generation which is 50 of the workforce in 2020 is at this stage of life the sickest generation of any other cohort group. It relates 6 of the 10, and 7 of the 10 top conditions are Mental Health or emotional healthrelated conditions. Generally stemming from the detachment issues and lots of virtual contact but not enough human contact, and we are seeing chronic conditions arise like high Blood Pressure and high cholesterol and things of that 2345i chur in the generation that we would fully expect to see in people 20, 25 years older. It is an issue of the vital importance to us, and we have done, we the blues have taken it on as mission of ours to try to address this issue. We have had listening sessions, because the data only tells you so much. So, we went out and spoke to 11 communities in the u. S. , and spoke to the millennials and asked them what they were looking for. Interestingly, people of my generation, seniors unfortunately, are very concerned about privacy and data and not an issue for the millennials, and not an issue. What they want is a compassionate medical professional who is willing to treat them as a whole person and look at their conditions in a comprehensive, in the context of their life as opposed to treating each disease conditioned independently. Which is like the set of medical homes that you are doing here in michigan and they are free to share information and they will seek the sources of information anywhere to try to Seek Solutions to their problems, but they are really craving human contact, and they are really craving that ability to interact and communicate with people. So, 11 cities in november, were having a national culmination event in philadelphia where we are bringing leading experts in Millennial Health where we can begin to embark on the campaign to try to address the issue, because i dont know about you, but i am counting on the miamis millennials to support the Health Care System to take care of me, and so we have to be sure that the generation is as healthy as they can be and should be given their physical age, physical age. Are most, or do most even have a primary care physician . No, i would say that the number of millennials with a primary care physician is markedly lower than the seniors. But they crave that. They are looking for that connection, and so that may be one of the shortterm solutions to try to help to make those connections, but they are much more comfortable with the virtual care than we would be, and much more comfortable with the telehealth programs than other generation, so we have to find the sweet spot to get them connected to the Health Care System. What about Artificial Intelligence and the future of health care . You know, Artificial Intelligence and Machine Learning, i think that they have a wonderful opportunity to do a number of things. First in underserved countries around the world, Artificial Intelligence can serve as a screening that might not get done because of the lack of medical professionals. I was at a conference recently where some executives from google and i know that there are some googlers in the room here, but we were talking about working with Artificial IntelligenceMachine Learning to do the retinal scanning in india which is grossly underserved from the ophthalmologist standpoint and we found that the scanning and the screening they have done or they did compared to the human screening was actually better in the preliminary screening. If you multiply those kinds of activities in various areas, you can envision a time to get trained radiologists and pathologists and in my words out of the basement and into the bedside and have a lot of the screening work done by the machines work done by machines and have the Trained Medical professionals overread and actually get more involved in the more complex matters, leaving the routine matters to machines. So i think theres a wonderful opportunity for us to be more efficient and more effective in the delivery of care and to free up our medical professionals to deal with much more complex problems. So i think it has an incredibly bright future. How about as were moving, we have more electronic records, patient portals, were using wearable devices for medical testing. What about our security with our Health Information . Yeah, a couple comments on that. First, one of the greatest challenges in my professional life has been or frustrations, i should day, has been the lack of interoperability of health care data, the inability for us to share data between hospitals, between physicians in hospitals, between our devices and our physicians. Electronic medical records. Take your pick. Weve had very little success in spite of enormous investments. You heard dan mention that i was part of the very first Health Information community. It is not one of the stellar successes of my professional life. We were charged by the Bush Administration to try to find to try to create a national interoperable standard. Still working on it. People point to banking and say weve created those kinds of standards. Were not there in health care, and we need to be. So interoperability is a challenge for the next generation for the next administration, and unfortunately probably will be for the generation after that and after that. We have to create these data superhighways that we can move information seamlessly amongst and between people so we can have a better understanding of Health Conditions that people have building off of an individual record. From a security standpoint, theres a lot of concern and fear about concentrating that health data in any location. People, at least our generation, not necessarily the millennials, a, are very protective of that data, and b, Identity Theft is clearly easier if you have access to all of this kind of information. And unfortunately, the bad guys are usually a step ahead of the good guys in that fight. But we invest in the blue system enormous amounts of money trying to ensure protection of health data. Weve established National Standards. Weve adopted National Standards established by others to protect that kind of Health Information. I know others do the same. And its just a neverending battle that we have to fight to ensure that that data is protected as much as it can be. What about Precision Medicine and the future of health care . Precision medicine affords us for those of you that are unfamiliar with the term, its really developing interventions that are focused on your own personal genetic code. So its understanding your genome, understanding your genetic makeup and targeting treatments to you specifically. Obviously extremely expensive but has the potential to be curative. I think that were just beginning to see the potential of that, which means nows the time to establish National Policies about how to deal with that, how to protect that precious data that is necessary to develop those targets, and how to pay for it because its going to be astronomically expensive. But again, if its curative and substitutional for other treatments, it may not necessarily have to be additive to the total cost of health care. But we have to have the national debate. Now, i wish i had a solution. I dont, but it is something that we as a society need to wrestle with now before it becomes so ubiquitous that its treating all kinds of conditions. Well, how do we get we have all this information. We offer a lot. How do we get patients to take some responsibility for their health care . Because we have, you know, obesity epidemics, even Childhood Obesity is on the rise. If i had the answer to that question. But personal accountability is a cornerstone of any Successful Health policy. Some would argue you need to have skin in the game, you need to be paying some of the premium, you need to understand the economic implications of the decisions you make. Some others would argue that the implications dont always need to be economic. The Health Implications themselves should be a sufficient deterrent, but weve watched generation after generation continue to smoke and continue to eat unhealthily and not exercise and do all those things. So obviously the Health Implications are an insufficient motivator. So i think we have to create a Health Care System which has accountability and consequences. The difficulty is, how do you really create those consequences, and how do you make them relevant . If the Health Conditions themselves are not consequence enough, what can you do to create that consequence . I think it starts with education. I think it starts with education at the preschool level. You begin to educate the children, the families, the communities about the importance of health, but you do it in a fashion that not only educates them about what they need to be doing but facilitates them doing it. And that, again, gets back to this social determinance of health. In the Blue Cross Blue Shield world, we view this we take this very seriously. Weve created a Blue Cross Blue Shield institute whose focus is on social determinants of health. The first area we started with was transportation because we found that a number of people were noncompliant with medications or appointments because they just couldnt get there. So we partnered with lyft and with uber so that when physicians make appointments for their patients, they can also ask them, do you have a ride . If not, we can arrange for transportation to and from. We can arrange for the cars to take them to the pharmacy and back so they can get their medications. We also recognize many communities dont have access to healthy food. So weve created a program, we call it food queue, which will deliver healthy meals at very low cost to communities that have deficiencies in access to fresh fruits and vegetables and things. Again, because were in every community, because we have patients in every zip code, this matters to us everywhere, so were trying to develop programs that are portable and that are repeatable and that can live with the scale of those kinds of programs. Our next efforts on the horizon are fitness deserts where were going to begin to look at areas where there are insufficient either places to exercise or programs and begin to invest back, whether its building playgrounds or doing other things so there are opportunities. Its one thing to tell people they need to do it. Its another thing to show them a path. And we want to be able to do both. Okay. So we only have a few seconds left. What is your vision for the future of health care . Is it positive . Oh, im extremely bullish, a, on the future of health care and the future of our industry. First of all, as i said earlier, what could be more important than health . So i know we wring our hands about what percent of the gdp is going to health and all of those kinds of things. But its hard for me to think of something thats more important than that. So investing in health, i think, is appropriate. So long as youre getting outcomes, so long as youre getting value for that investment. So im very bullish on that. Its a huge employer in the marketplace. Were very committed. Most Health Care Professionals are very committed to their communities, et cetera. Im also bullish that there are opportunities to make dramatic savings in the cost of health care today, just the financing of health care by building on the successes of the Affordable Care act. And by investing at the National Level perhaps in catastrophic insurance where our sickest people would be covered by a catastrophic policy that the government would be responsible for and the rest of us would operate underneath that. We could reduce premiums by a third in a program like that and improve outcomes. So theres wonderful opportunities for us to make great improvements, both in the delivery and the financing of health care. Its a great time to be a health care professional. Thank you so much. Thank you. [ applause ] now its my pleasure to ask some questions from the audience. So well start off, scott, the aca, how would you rate it, and whats coming . Well, i think when it started, id have probably given it a cminus. It had kind of a rocky rollout. Systems didnt work, et cetera. I think over time, weve all committed to improving it. I mean, all Health Care Professionals, government alike. I think its approaching a b, bplus. I think it has an upward trajectory. I think that if Congress Acts in a responsible fashion and builds on those successes, some of the things that i talked about with regard to shoring up the idea of a Reinsurance Program and investing in making sure that the subsidies are appropriately administers for a relatively modest investment, we can have a dramatically positive impact. Remember the statistic i said earlier. Its somewhere between 7. 5 and 10 of the people are uninsured. That means 90 to 93 are currently covered. And the Affordable Care act has played a role in making that happen. We have a student question here. How do you think Blue Cross Blue Shield and the Health Care Industry as a whole will advance and change over the next five to ten years . Well, first, ill be retired. So itll be somebody elses vision that youll be discussing. I think that from the blues perspective, i think youll see us investing much more in technology, much more in our ability to use data, to predict outcomes and assist providers in intervening early in the treatment of care. Youll see Greater Movement toward valuebased contracting. We have 70 million of our members connected through a valuebased contract today. I would assume itll be all of our members within the next five or so years. Virtually every relationship we develop with providers will be focused on outcomes and successes as opposed to inputs. Its a vital way to go. I think that the Health Care Industry will be much more rapid to adapt technology. We will eventually within that time frame solve the interoperability problem so we can share and communicate information. Information will be much more transparent. Well have a much deeper understanding of pricing structures and outcomes so that patients will be able to shop for Health Care Like they shop for televisions and cars and other things, where youll be able to do comparison shopping. Well be directing people toward the bestperforming institutions, which will raise all boats. So i think its it will be an exciting time for the industry. Sort of to piggy back on that as technology continues to accelerate, a question that we are clearly replacing the old with the new but the problem is unlocking innovation is hard. What are your thoughts about sort of that innovation end of all this and how we can make breakthroughs a little easier than we have . The issue in health care today is not necessarily the breakthroughs. Its the adoption of the breakthroughs in rapid fashion and its scaleability. One of the benefits of being as large a piece of the economy as we are today, health care, is it attracts a lot of money and a lot of entrepreneurs. So theres a lot of very smart people trying to solve some really complex problems. And weve seen some incredible breakthroughs. Weve seen some, you know, promises unfulfilled as well as a result of that. But i think that Health Care Innovation will be sparked by patient demand and by a Movement Toward a much more patientfocused, patientcentered delivery system. And as we look at our Health Care System from the patient out instead of historically weve looked at it from the professionals in, as we start to look at it from the patient out, were going to find that there are incredible opportunities for us to improve communication, improve education, improve the information flow, and unlock the power of entrepreneurship into the Health Care System. Once we do that, i think well find wider spread adoption. In the current medicare for all act and similar bills in congress, and if they were to pass, what impact would that have on blue cross organizations, and what role could or would Medicare Advantage play in all of this . Well, medicare for all takes many shapes and means many things to many people. As you can well imagine, i think that the disruption that would be caused by a medicare for all Program Makes it, a, unfeasible to implement and not in the best interests of our nation. I think the American People are used to choice. I think its important that the Health Care System of the future is a Public Private partnership. Each play a very Important Role in sparking innovation, sparking creativity, managing costs. I think a Tighter Partnership between the government and the private sector is necessary better communication and sharing of information and data, building on the success of the Affordable Care act. I think all our critical pieces. Some define medicare for all as literally medicare for all. Every american is automatically enrolled in the medicare program. In that environment and some have said eliminate private insurers. If you take that extreme measure, obviously Medicare Advantage goes away and you become a feeforservice reimburser for everybody. In the more traditional, if there is such a thing, in the less aggressive implementation would be a medicarelike program, a singlepayer type program in which case there would be robust competition amongst the Fastest Growing program today in medicare, Medicare Advantage. Medicare advantage is a program by which the government reimburses private insurers. We compete for patients by creating by establishing and creating Innovative New mechanisms, new benefits, and were evaluated on our performance on a star system. We get reimbursed based on our successes and how well we treat patients and how well they evaluate us. A brief unpaid commercial, the michigan plan is one of the nations leaders in Medicare Advantage. They do a spectacular job in doing that and in embracing that particular program. But it will be a vital piece of a medicare for all. It would allow the private sector to continue to compete for patients in that environment. They would be the advantage programs would be reimbursed by the government. The government would pay the Medicare Advantage programs, who in turn would contract and pay and incentivize the providers. So it could be a cornerstone link just as it is today in the existing medicare programs. Scott, before we get to the lightning round, how about pharmaceutical costs . Is there an answer . It is almost on a daily basis you see stories and the politics of washington around pharma. Where is this going, and is there a solution . Well, there must be a solution because we cannot afford the current trajectory of the pharmacy benefit. I think that the answer lies in a couple things. Transparency. It lies in understanding the pricing formulas, and it lies in injecting some new competitors into the marketplace. And i think all of those are coming. Id say stay tuned for some rather exciting announcements in that space with regard to injecting new competitors into the marketplace. So were going to move now to the lightning round, which is a quick question, quick answer to get to know you. I dont do quick answers really well, but ill try. Whats something on your bucket list . A hole in one. Whats your Favorite Team growing up . It was and is the chicago bears. So if i asked you on sorry. On october 27th, bears and lions. Youve answered the question. Yes. Whats the last book you read . You know, the last book i read was im blanking on the name of it, but its one of these spy novels. I dont have a lot of time to read, so when i do, i try to read something that catches my attention. I dont know, i think its called red zone. Its one of these cia types. Ive been carrying it in my briefcase, business adventures. Its an old book, old new yorker articles about successes and failures in the Business Community that ive been meaning to read and kind of read one story every now and then. I think gates and buffett had it high on their list as if you get brownie points for carrying it, ive had it in my briefcase for about six months. Favorite movie . The godfather. Favorite vacation spot . Jackson hole, wyoming. Whats what advice would you give yourself as a 25yearold . Lighten up. I took life way too seriously when i was young. Best sport when you were growing up. Football. What person, other than a family member, would you like to have lunch with . Thats a really good question. Unfortunately, hes not here anymore, but i would have said ronald reagan. Lets see. What else we got here . Final question. Youve been here many times. Describe detroit in a word or two. Im not pandering here, but amazing and resurgent. The downtown ive told this story before. Ten years ago, 12 years ago, probably more than that now since youve been there 14 years. Its probably 18 years ago when i came here, i stayed at the d. A. C. I wanted to get some food, and they said, well bring it to you, dont leave. Today you go to the d. A. C. , you can walk around, you can go to restaurants. It is a remarkable resurgence. It is truly an american success story. You all should be very proud of your community. It is amazing. [ applause ] again, thanks, scott. Ill turn it back to steve. Thank you. One quick announcement before we say thank you and adjourn. If you liked todays program and want to hear it again, you can download the audio podcast tomorrow about this time. In fact, we were just recently named as one of the top podcasts in metro detroit. So i hope you can punch that up on your phone and listen again. So how about another round of applause for scott, deanna, and dan. You guys all did an amazing job. Thank you for being with us. Scott, particularly you. Thanks for traveling with us and giving us your thought leadership. So ladies and gentlemen, thank you for coming today, on time every time. This meeting is now adjourned. Thank you. U. S. Coast guard admiral karl schultz spoke about Maritime Security this morning. Well have his remarks at the center for strategic and International Studies tonight at 8 00 eastern here on cspan3. Commerce secretary wilbur ross and other policy officials gave an update on u. S. Trade policy. You can watch that at 8 00 p. M. Eastern on cspan2. A reminder that you can watch all of our programs online at cspan. Org or listen with the free cspan radio app. The house will be in order. For 40 years, cspan has been providing america unfiltered coverage of congress, the white house, the supreme court, and Public Policy events from washington, d. C. And around the country so you can make up your own mind. Created by cable in 1979, cspan is brought to you by your local cable or satellite provider. Cspan, your unfiltered view of government. Former Federal Reserve chairs janet yellen and ben bernanke, among others, discussed the impact of inflation on monetary policy. During this portion of the event, the focus of the discussion was on the Role Technology and globalization play in dictating the economy. The Brookings Institution is the host of this forum. Good morning. My name is glen hutchins