To introduce todays participants. We will discuss the future of health care and i will begin by introducing our guest speaker, someone i have known for many years and consider a mentor and friend. Also, a National Federation that supports Blue Cross Blue Shield crossies, including blue shield michigan. The system, through its coversion of insurers one out of every three americans. I think that it is a very important statistic. It serves every zip code in the coded states and every zip in america, someone has a blue cross card. It is one of the most trusted brands in health care [no audio] and conversations on health care and health care reform, so everyone has access to quality, Affordable Health care. They are committed to improving the health of all americans. Health issuesd and challenges and insights to improve the quality of care. Scott was named president and years as serving four Senior ExecutiveVice President , including two years as chief operating officer. Prior to that, the executive Vice President was charged with new Business Strategy and Technology Evaluation which is renowned for a violating safety and effectiveness of emerging medical treatments. The blueotts tenure, card program was introduced through this National Program which allows plan members to receive Health Benefits while traveling or living in another part of the blue service area. Our nationwide cost has 65,000 65,000 to over one million. Was his vision to use available data about what is happening and the Health Across america and driving solutions on Health Care Like millennial , he servedre running as president and ceo. He also created and led at a missouribased pho. Be civico driven to leader active both professionally and personally. Hes a Founding Member of the and aal Business Group board member of the Brain Research foundation. He also serves on the Leadership Council of the Health Care Management association, the deans Leadership Council of college and science and the Washington University school of medicine. He has also advised the white house policy and programs and services affecting our older citizens and was a charter member of the community, a commission to advance Health Information and technology. He also serves as the ceo Advisory Board in chicago and he earned a bachelors degree where he is a proud boilermaker and holds a masters in Health Administration planning at the Washington University school of medicine and also holds a dr. Of science degree at perdue. I would also like to introduced an awardwinning health reporter. Previously, she was the medical reporter for a major station in miami, chicago and boston. She has received multiple awards. A Michigan Association of broadcasters and to american art associations. She holds a bachelor of science degree from Michigan State university and from the dr. Williams school of medicine in chicago. She completed her residency at the hospital the phoenix hospital. It is my pleasure to introduce them. Lets give them a warm welcome threat we are looking forward to their conversation. [applause] good afternoon. Im thrilled to be here with the detroit economic club. Thank you for having me and scott. I want to officially welcome you. We are going to be talking about the vision of the future of health care and when a lot of people i talked to over the last few weeks found out i was going to be meeting with you today, they all had some questions i should ask you. Up question kept showing over and over, so i will start with this. Im sure it is something you have never heard. They want to know why is health care so expensive for consumers and businesses in our country . Thats an easy question. Of applauset a lot when you said im a proud boilermaker, so i have to go on record, my daughter is a proud spartan. You have to do something to get the audience on your side. Why is health care so unsafe the expensive . Ve consumerque that the of the service is not paying for the service. You have a strange dynamic in that environment. You have organizations, whether it is the government or insurers service,aying for the but the manufacturing plant who are the physicians and hospitals delivering the service. I think the second point is we built the Health Care System on a piece work basis for it that is, the more you do, the more you get paid, so we have created incentives for delivering excess of care, so long that care is not going to do any harm. We have a scenario where providers are incentives to care anddeliver more payers are afterthefact in a remote basis. Second, what is more important than health . We invest as a society i believe, lots of dollars in new breakthroughs in new ways to drive better value in the system. I hope that is not an alarm of some kind to drive better value in the system and those innovations and breakthroughs have a price attached. We have also increased life expectancy, eradicated diseases, so we have done a lot of good things with those dollars. The logical question is what can we do to make it more affordable . The evolution there is to move our Health Care System to one that is less focused on inputs and more focused on values and begin to construct relationships between payers and providers that are focused on the outcomes rather than the inputs. Blue cross blue shield is one of movement,s of that about 5000 positions operate here, an 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 or her practice. We try to do that across the country. In fact, in our system alone, 70 million americans get their character some form of a valuebased care Arrangement Health care from some form of a valuebased care arrangement. It is showing results. We have diminished readmissions to the hospital, increased compliance with chronic disease treatments and protocols. We have a whole host of activities beginning to show positive results. Long answer to a short question. Of Companies Offer incentives so if you and a lot of Companies Offer incentives so if you quit smoking or lose weight. Are they worth businesses investing in . Investment that improves health is a benefit. I think they all have positive outcomes. The jury still out is if the investment is still paying out a real dollar benefit, but i think if you factor in the noneconomic likerd economic factors sick days and productivity measures, i think it is an investment we should all be making. About a year from now, we will be having a big election and health care is always a big issue. If you were running or advising a candidate the former will never happen. Lets say you word rising someone. What are some things that would make a Good Health Plan and what are some things as voters we should be looking for . Im a big believer in building on what works and not just carrying things up for the sake of tearing things up. Say we spent, as a working on,ngtime debating and implementing the Affordable Care act. I would build on its successes and look at the fact that as of of 90 oft in excess americans have Health Insurance today, so i would look at ways to close that gap and get the lat 10 . I think the number i saw this morning was 7. 5 , but how do we close that gap without disrupting the care that the rest are receiving . There are a number of Public Policy initiatives that would improve lower costs and improve ability to access care. I would encourage candidates to look at the issue of pharmaceutical costs and promote the idea not just of the pharmacy, but the entire Health Care System of transparency, allowing patients, employers, insurers to have a real line of sight and understand what the components of health care really therefore identify where the opportunities are for improvement, so how are pharma drugs priced . Lets get some transparency. What are the real delegate developmental costs . So we can have a better canussion on how much we afford to spend in that regard. Can afford to spend in that regard. We have our first drug that on building what is working today as opposed to disrupting what is working today just for the sake of disruption. There has been some major Health Issues in the news lately and i kind of wanted to get your take on the future of health how does the blues combat these things . Have, five people that died, only over 450 people have been hospitalized with respiratory illness. You or do that something you dont have a lot of data on . The issue on how to deal with broad, i put it in a category, how do you deal with lifestyle issues . Are a said earlier, we community and what makes us , the unique qualifications of our programs are People Living in the communities in which they operate question mark when we make decisions and we make policies in which they operate . Decision that a we make policies, it is impacting our neighbors, families and communities, so we are very committed. Ut all of these things smoking, vaping, all of these feels into health and we very committed to take the resources, the insights and information we have and try to work with local communities to solve those problems. Thatnt to be certain peoples genetic code is more important than their zip code as we look out to attack health care issues. Again, we try to take the information we have and work washingtonmakers in and state capitals so they can understand the depth of the problem and the communities impacted with the problem and then we try to work with those communities to actually take our resources and staff to investigate those communities and solve the problems. Opioidsking today, yesterday vaping today, opioids yesterday. The best way to deal with it is with information. We are blessed with a Data Resource because of 107 million members in every zip code and every demographic. We are blessed with the data that provides us great insight, forhe trick is to take that the people who can really make a difference. When we think of health care, people often think of the elderly as the ones who are the sickest, the i saw a report that say the millennials are not the healthiest. Can you talk about that . We have a program and have done 27 different kinds of reports on various health , given that we are in this beautiful stadium, i would wasthe headlines earlier on the concussion report. Did wasst one that we on Millennial Health and we were very surprised that we found the millennial generation, which will be 50 of the workforce in 2020 is at this stage the sickest generation of any other cohort group. Seven of the top 10 conditions are Mental Health or Emotional Health related conditions. Lots of virtual contact emma but not enough human contact. We are seeing chronic conditions arise, things like high cholesterol and high Blood Pressure that we would expect to see people 25 or older. On as ataken that mission of hours to try to hours is issue ours to address that issue. [no audio] we went out and spoke to the millennials and ask them what they were looking for. Interestingly, people of my , are very, seniors concerned about privacy and data. Not an issue for millennials. What they want is a compassionate medical professional who is willing to treat them as a whole person, but to look at their conditions in the context of their life as opposed to treating each disease. Ondition independently willing to share permission. They will seek sources anywhere to get solutions to their problems, but they are craving toan contact and the ability interact and communicate with people. 11 cities in november were having a national culmination event in philadelphia where we are bringing leading experts where we can begin to embark on a campaign to try to address these issues. Im counting on millennials to support the Health Care System, so we need to be sure that that generation is as healthy as they can be and should be given their physical age. The most even have a primary care physician . No, i would say that the number of millennials with a primary care physician is seniors,lower than the but they crave that and they are looking for that. I think that might be one of the shortterm solutions. They are much more comfortable programs thanare other generations, so we have to find that sweet spot where we can get connected to the Health Care System. About Artificial Intelligence and the future of health care . Artificial intelligence and Machine Learning have a wonderful opportunity to do a number of things. Countriesunderserved around the world, Artificial Intelligence conserve as an screening thato may not get done because of the lack of medical professionals. I was on a conference where some executives run google from about were talking working with Artificial Intelligence to do retinal scanning. I found that what they did compared to human screening was [indiscernible] if you multiply those kinds of , youities in various areas can envision a time where you can get a trained radiologist and others out of the basement and have a lot of the screening and have by machines the trains dr. Over read and actually get more involved with the more complex matters leaving routine matters to machines. I think theres a wonderful opportunity for us to be more toicient and effective and free up our medical professionals to deal with more complex problems, so i think it has an incredibly bright future. How about as we are moving, we have more electronic records. We are using wearable devices for medical to assessing medical devices for testing. [no audio] one of the greatest challenges in my professional , or frustrations the ability to share data between physicians and hospitals, between our devices and our physicians. We have had very little success despite enormous investments. Was part of the very first Health Information community. It is not one of the stellar successes of my life. We were charged by the Bush Administration to try to create a national standard. Still working on it. People point and say we have created those kinds of standards. We are not there with health care where we need to be. We have to create these data superhighways that we can move information seamlessly and have a better understanding of conditions people have. From a privacy and security standpoint, there is a lot of. Oncern and fear people of our generation is very protective of that. 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. We have adopted National Standards to protect that kind of Health Information. Battleust a never ending that we have, the fight to ensure that that data is protected as much as it can be. Medicinebout precision and the future of health care . For those of you not familiar, it is really developing interventions that are focused on your own personal genetic code, so it is understanding your genetic makeup and then targeting treatments to use specifically. Obviously, extremely expensive. I think we are just beginning to see the potential of that which means nows the time to establish National Policies about how to deal with that and protect precious data that is necessary to develop those targets and how to pay for it because it is going to be astronomically expensive, but again, it is substitutional for other treatments. It may not need to be added to the total cost of health care, but we have to have the national debate. I wish i had a solution. I dont, but it is something that we as a society need to soress now before it becomes ubiquitous that it becomes [indiscernible] we have all of this information. How to get patients to take some responsibility for their health care . Academics esity epidemics and child obesity on the rise. Accountability is a cornerstone of any Successful Health policy. Some would argue that you need to have skin in the game and understand the decisions you make. Some would argue that the Health Implications themselves should be a sufficient deterrent, but we have walked generation after generation to eat unhealthy, so obviously the Health Implications are insufficient motivators, 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 the relevant if the Health Conditions themselves are not consequential enough, they what can you do to create that consequence . I think it starts with education at the preschool level. You begin