More Mental Health and telemedicine options. Hello and welcome to axios Virtual Event health care 2021. I am sam Baker Health Care at are coming to you from my home in washington dc. I would like to thank the United Health. For making these conversations possible and thank her audience. Follow along on twitter using the or following. Over the next three minutes we will unpack best way to unpack Health Insurance access and coverage in the United States and exactly what that path forward looks like following the election and in the midst of a pandemic getting worse every day. Our first guest is senator tina smith of minnesota. Thank you. It is terrific to be with everyone today. I would like to start off framing this conversation. Obviously, Health Care Access and coverage has been a hot topic for a long time but i think the pandemic has highlighted and illustrated some of the gaps we are dealing with in the system. We have seen millions of people lose their health determines because they lost their jobs in the economic downturn. It affects not just those people but their family members at their Health Insurance i am just curious how has that shaped or change the way you view this problem, specifically of Health Care Coverage . Raised exactly the right point. Here we are in the midst of a Global Pandemic and in fact it is a pandemic that is surging in my home state of minnesota, the upper midwest and all across the country. Yesterday, we had 56 deaths from covid19, the highest count that we had ever had. And as we see infections and hospitalizations and deaths going up everywhere. This reveals some of the systemic inequities we have in our Health Care System. This is a long story for minnesota and in particular people all over this country, the struggle to figure out how to get health care you can afford no matter where you are or live and how to have access to that health care. Covid, we know, is not the grady visor. It is revealing fundamental equities, especially in my home state and all over the country, the disparities revealed by frontline workers, black brown and indigenous people, older people, rural people who really struggled to get access to health care. So this should be a moment for us to address this. First, we have got to be focused on getting this pandemic under control and i have got lots of ideas on how to do that. But then to look at how we are building towards a Better Future for americans. One, this is probably the wrong way to discredit, but a somewhat Positive Side effect of this experience has been an increase in telemedicine, which i know is something that has been important to you. What needs to happen whether it is in congress or just a new administration to make that . That stick . Crisis, we often make a big leap forward in innovation and we need to make forward make sure that does not go away as we make our way through the racist and that is very much the case in telehealth. With the inability of people to see their doctor, we have seen this massive expansion in telehealth. Not only in physical health but also Mental Health where we have this dramatic shortage of providers and access to care all over this country. One thing i am excited about is how we can make sure these innovations dont go away when the pandemic is over. This is something that providers and patients have really appreciated and described to me as a lifeline. I hear a lot about access to Mental Health and in the midst of this pandemic, we know that the need for Mental Health has exploded, whether you are a Frontline Health care worker or a Senior Living with a lot of social isolation. The upsurge in depression and anxiety and Suicidal Ideation are going up dramatic. These are things that telehealth can also help. Not as a complete substitution but as a way of making care more accessible. Coming back to your point on mental de think the challenge here is reimbursement . As a patient attitudes . Is it something that needs to happen among providers . What . Are the moving pieces . Sen. Smith a crucial pieces reimbursement. Cnf provided waivers for reimbursement for telehealth and video telehealth and even phone telehealth, to make her access to care stood. We need to make sure i reimbursement rates on par with personal business do not go away. That will make a difference for providers who need to be able to have a reimbursement that is sustainable. It is also partly a shift in attitudes toward patients. This will vary depend on who patients are. , a story iexample heard about a person in rural minnesota, who needed a Mental Health care. Very unwilling to drive to the doctors office, because it felt so exposed. And there still is so much stigma around Mental Health. However, that ability to get care in the privacy of their own home, made it more accessible, because they were protected from some of that feeling of being exposed, that is a barrier for people getting Mental Health care. So i think it can work for patients as well as for providers, as long as we have reverse minced network. To pick up on your point about Mental Health, we have seen reports you alluded to that Mental Health and Behavioral Health issues have increased during the pandemic. Depression, substance abuse, anxiety, the list you articulated. That aong implication is lot of that has come from some of the lockdown measures, the social isolation, that is necessary to spare people from a deadly virus. I wonder, is there a way to square that . Telehealth may be part of it. What else is necessary to make sure people stay healthy in both ways . We have to be aware of all of the risks and costs of this pandemic. , youthe costs that are not could describe them as secondary, and i guess Mental Health is in that category. Being somebody looking on the bright side, i believe we are also seeing a greater recognition and greater willingness to talk about Mental Health, as something that is part of our whole health not something separate and apart. We need to take this as a moment to push through the discrimination and stigma that still exists around Mental Health. It gets to something i think is important about steps we need to take to suppress the virus. We have clearly moved past the point where the only tool we have in our toolbox is to ask everybody to stay home and not go out, that is not feasible. Particularly Front Line Health Care workers or other frontline workers. This gets white is so important we have a Robust National testing and Contact Tracing and humane isolation strategy. Can be more likely to go about their business in ways that are safe. This has got to be testing, it is not just diagnostic testing, and also surveillance testing, which will be a path toward getting our economy functioning, while we are waiting for a vaccine to be broadly available. I have a bipartisan bill to accomplish this with senator bill cassidy from louisiana. That is built around the idea of establishing state purchasing compact to dramatically ramp up access to testing, rapid testing. Not only for diagnostics, but for surveillance. Speaking of bipartisanship, one final question. Control of the stennett the senate is still up for grabs. Notth care traditionally is a wellspring of bipartisan good feelings. What is realistic that people can expect . I come from the school of thought which says Bipartisan Legislation, bipartisan laws come are the most sustainable laws. We need to find ways of coming together around these issues. Remember, earlier this year we successfully came together with the significant responses to this level pandemic, with a es act and other bright broadly Bipartisan Legislation we passed. The onus will be on all of us, democrats and republicans, and with president biden, to address the need that americans have. And put aside our partisanship. I will tell you, in the conversations i have had with minnesotans, they do not see health care as a political issue. They see it as an economic issue. They see it is a hugely personal issue about the safety and health and wellbeing of their families, their kids, their parent. Parents. I think that has to guide us as we look for Bipartisan Solutions as bill cassidy and i have around testing and tracing. And supporting role health, another place rural health, another place where the public is a democrat can come together. For senator, thank you taking the time in joining us today. Sen. Smith thank you, really appreciated. Sam up next, we have a view from the top, axios cofounder ceo of, jim, and the United Health group. Thank you very much. Sam, is now my pleasure to bring you a conversation with the ceo of optimum health part of United Health group. Heather, thank you for joining us. Great to be here, thank you, jim. Can you give people watching of an idea of what United Health curtis. United health group serves people across the globe, working to make sure people have healthier lives and make the Health System work better for everybody. We are in many aspects of health care. Our Health Insurance side of the business is called the benefits side, United Health care, many people know about, and are often services encompass our data and technology segments, rx and pharmacy specialties businesses, together with our optimum health services, where we bring Delivery Services through arra optim care through our optim care practices for Livery Services and providers and health businesses, which are military and veteran support, health goal programs and other complex Care Management programs. We offer those three United Health care and other clients and customers. And we have a global part of our business that serves the countries around the globe. It is a large enterprise with the dedication to health care. The so you have some of best data lenses into what is happening in the Health Care System. Talk about the effect of the Health Care System amid the pandemic . It is the defining topic of our generation. What has it done to the Health Care System . Heather it is a great question. Askedeciate that you about the health group and United Health groups purpose and function. A little bit of background, know that one of the things United Health group has focused on and it is more apple fire by the pandemic, is really an approach to a nextgeneration Health System and, you know, that means a couple of things. It means universal coverage. It means affordability for everyone. Means improved health care outcomes, and it means a better experience for consumers and practitioners, and we have been advocating for them for over 20 years, but also making sure we are part of the solution, working very hard, to advance those, those, those components of a nextgeneration Health System, and i guess what i would say is, what we learned from the pandemic, was that the things that already did not work in the system, you know, were even more broken, but then we learned that as we come together with private and public partnerships, we can advance very quickly, so about couple of examples. You know, we noticed that you know, we saw surprised billing. Surprised billing was an issue before the pandemic. An additional anxiety for consumers when, during the pandemic, people may have experienced a surprise bill. We know there is a solution to that, Publicprivate Partnership working together crating a median that if your great will resolve a lot of surprise billing for people and anxiety and receipt and reduce cost to consumers and employers by 40 billion,. Those are the kinds of things that continue to be exacerbated by the pandemic. On the other psych, telehealth. We needed talent on the other, telehealth. In the pandemic we saw a greater need for telehealth. We were able through federal regulatory and state regulatory support, Publicprivate Partnerships, to bridge the gap in telehealth. We were able to provide more virtually, and as a result of, you know, removing originating state requirements, state boundaries, and i can say even in her own business, take our optim care business we have 50,000 physicians, where already we have provided a million telehealth visits, as a result of being able to, just expand teleservices. So i think we have seen things we needed to address, as a result of the pandemic, we have been, United Health group, working with partners, working with policymakers, to really advance and move that faster. Last example, maybe i would give. We could see a Workforce Shortage so advancing a 21st century workforce that is more virtual, that addresses population health, and that cant really go that extra, im a extra step, to address the Health Inequities weeks grades with covid as well. Jim once the coronavirus is gone and things are back to normal, how much of my medical care, especially routine physicals, should be done by telemedicine . Saving people trips to the doctor, is that tiny percentage, have, how much . It is a great question and another thing i might point out where learning to this pandemic is that we are learning. We are learning what can be done virtually and then what is really still required to be done in person. And as we continue to adapt to better solutions, you know, we foundering the pandemic, lets take the [indiscernible] for example. Almost half our Services Today as a result of the pandemic, about half of the complaints have been virtual. Obviously that was a result of shutdowns across the country, but in many cases what he found is we are able to give, to provide even more access to people that either as a result of stigma, barriers, or just lack of access, to, appropriate Behavioral Health and specialized behavioral services, really cannot access it. So, i guess i would say, we are going to continue to learn, how much can be virtual versus inpatient, as technology and data continue to evolve, as we continue to partner across, across the spectrum of public and private partnerships. We will be able to do even more. The [indiscernible] opportunity we noticed through this pandemic is the opportunity for people to continue to get. Inventive to continue to get their preventive services. Health screenings are so important. Some of that will have to continue to be in person but we are committed to being part of the solution to make that easier to access and ringing up closer to home for people. The final question and maybe most important for people who do not have Health Insurance. I have Health Insurance so i find get sick already to get tested, i am fine. For people who do not have covered yet, how do you think about that . What is the easiest way to get to where we do have one had a percent of the populace and covered in a way 100 of the population covered in a way that does not slow down innovation in the Health Care System . Heather it is a great question on top of mind forever buddy as we look for opportunities to expand coverage. One thing that is important to start with, is that although the lets not forget 90 have coverage today. And the 90 have stable coverage. Options based on success. It is really the result of proven Publicprivate Partnerships. The medicaid program, the medicare and Medicare Advantage program and employersponsored programs. So working from what we already know works. Start with medicaid, already covering 70 million individuals. United health care is one of the largest participants in that across the country. Think about expanding that in the 12 states that can continue to expand medicaid, and ensuring those individuals who are eligible are presumptively enrolled and. Ifays have a choice, but they are eligible, they can join medicaid. That would expand coverage. Another example, Medicare Advantage. We found individual consumers save dollars on Medicare Advantage. So, continuing to fund and support a stable medicare bandage program. And then taking exchanges Medicare Advantage program. And modernizing exchanges. United health group is committed to being part of the solution, expanding them and modernizing them, giving the opportunity for individuals who would be eligible for subsidies if they can be presumptively unrolled. Butys an option to opt out, to b