Transcripts For CSPAN Axios Discussion On Health Care 202407

CSPAN Axios Discussion On Health Care July 11, 2024

Home in washington, d. C. I would like to thank United Health group for making these conversations possible. I would like to welcome our audiences. You can follow along on twitter using the axios events. Over the next 30 minutes we will unpack the best way to unpack Health Insurance access and Health Insurance coverage in the united states, and what that path forward looks like following the president ial election and in the midst of a pandemic that is getting worse every day. Our first guest today is senator tina smith of minnesota. Thank you for joining us. Sen. Smith thank you, sam. It is terrific to be with everyone today. Insurance has been with us for a long time but how has the pandemic shaped how you view this problem of health care coverage. Do you see that differently now . Sen. Smith here we are in the midst of a Global Pandemic. Thatt is the pandemic asserted in my home to state of minnesota and the upper midwest that is surging in my home state of minnesota in the upper midwest. We had yesterday 56 deaths from covid19, the highest count ever. As we see infections go up, we see hospitalizations go up. And we see deaths going up everywhere. This reveals some of the systemic inequities we have in our Health Care System, some of the weaknesses in our Health Care System, that we have to address. This is a long story for minnesota and people all over the country, the struggle to figure out how to get health care you can afford no matter who you are or where you live. And have access to that health care, no matter who you are or where you live. Covid we know is not the great equalizer. It is revealing these fundamental inequities. Especially as we see in my state and all over the country, the disparities that are revealed by frontline workers, black and brown and indigenous people, older people, rural people, who struggle to get access to health care. So this should be a moment for us to address this. First, we have to be focused on getting this pandemic under control. And i have a lot of ideas on how to do that. And then look how we are building toward a Better Future for have killer and for americans and then look at how we are building toward a Better Future for health care and for americans. One somewhat Positive Side effect of this terrible expense has been an increase in telemedicine, which i know has been very important to you. Side effect of this terrible experience, has been an increase in telemedicine. Ort can be done in congress the new administration to make this step . Sam this is an important point. Sen. Smith in the midst of crisis we often make big leaps forward in innovation. We need to make sure that does not go away as we work away through this crisis. That is very much the case in telehealth. People, inability of not being able to see their doctor, we have seen a massive expansion in telehealth. Four is a go health and Mental Health, where we have a dramatic shortage of providers and shortage of access to care all over the country. One thing i am excited about, how we can make sure these innovations in telehealth, and expanding it does not go away when the pandemic is over. This is something providers and patients have really appreciated and have described to me as a lifeline. Access toot about the Mental Health and in the midst of this pandemic, we know the need for Mental Health has exploded, whether you are a Frontline Health care worker, or whether you are a Senior Living with a lot of social isolation. The upsurge in depression, anxiety, and also suicidal ideation, are going up dramatically. These are things that telehealth can help heard not as a complete substitution for in person care, but as a way of making care more accessible. I want to come back to your point on Mental Health. But really quickly on telehealth, do you think the challenge here is reimbursement . We have seen medicare and medicaid bump things up to try to make change happen. Is it patient attitudes, internalizing, this is the way to see my doctor . Is it something that needs to happen among providers, what . Are the moving pieces . Sen. Smith while a crucial pieces reimbursement. Provided waivers for reimbursement for telehealth, video telehealth and phone telehealth, make sure access to care stood, you need to make sure those higher reimbursement rates are part with a personal visit do not go away. That will make a huge difference for providers who need to be able to have a reimbursement that is sustainable. It is also, i think, partly a shift in out into toward patients. And this is going to vary a lot depend on who patients are. Is one example of this. A story i heard about up person in rural minnesota. Who needed Mental Health care. This person was very unwilling officee to the doctors because it felt so exposed. And there still is so much stigma around Mental Health. However, the 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 to people getting Mental Health care, so i think it can work both for patients as well as providers as long as we have reversed mints that work. And so to pick up on your point about Mental Health. We have seen these reports you alluded to, that Mental Health and Behavioral Health issues have really increased during the pandemic, whether depression, substance abuse, anxiety, the whole list you articulated. Clearly, or at least the strong implication is, a lot of that has come from some of the locked on measures and social isolation that is necessary to spare people from a deadly virus. I wonder, is there a way to square that . Telehealth is maybe part of it. What else is necessary to ensure people can stay healthy in both ways . Sen. Smith yes. Well, we have to be aware of all of the risks and costs of the pandemic. Even the costs that are not, i guess you could describe them is secondary. I think Mental Health is in that category. Being somebody who is always looking on the bright side, i believe we are also seeing a greater recognition and willingness to talk about Mental Health as something that is part of our whole health and not something that is separate and apart. We need to take this as a moment to continue to push through the discrimination and stigma that exists around Mental Health. It gets to something i think is very important about steps we need to take to suppress the virus. We have clearly moved past the point where the only two we have in our toolbox is to ask everybody to stay home and not go out. That is just not feasible, particularly the impact of people who are Frontline Health care workers or other frontline workers and this gets to why it is so important we have a and contactting tracing and humane isolation strategy. So people can be more likely to go about their business in ways that are safe. This has to be testing that is not just diagnostic testing, but 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 compacts to dramatically ramp up access to rapid testing, naughtily for diagnostics but for surveillance. Sam speak, control of the senate is still up for grabs. We are going to be a deeply divided washington no matter what. Health care traditionally is not a wellspring of bipartisan good feeling. So what is it realistic for people to expect in the next year . Sen. Smith i come from the school of thought that 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 some significant responses to this Global Pandemic with the cares act and other broadly Bipartisan Legislation we passed. The onus will be on all of us, democrats and republicans, and with president biden, to address the needs 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 parents. And i think that has to guide us as we look for Bipartisan Solutions as bill cassidy and i have around testing and tracing. And, for example, supporting rural health another place where democrats canand come together. Sam that seems like a good place to leave it, senator thank , you for 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 and ceo, jim, and the ceo of 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. Jim can you give people watching of an idea of what United Health group is . Heather sure. 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 our optim care practices for Delivery Services and enabling providers and health businesses, which are military and veteran support, health goal programs and other complex Care Management programs. We offer those three united we offer those through 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 a focus and dedication to health care. Jim so you have some of the 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. I appreciate that you asked 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 has been amplified 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. It 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 maybe a couple of examples. You know, we noticed that you know, we saw surprise billing. Surprise billing was an issue before the pandemic. But it became 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 creating a median that if we are great will resolve a lot of surprise billing for people and anxiety 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 side, telehealth. We needed telehealth before the pandemic. In the pandemic, we saw a greater need for telehealth. How did it show up . 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 our 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. Jim one more, a couple heather 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 um, extra step, to address the Health Inequities weeks health and we with covid as experience 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, half . How much . Heather 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 claims, have been virtual. Obviously that was a result of shutdowns across the country, but in many cases what we 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 could not 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 biggest opportunity i think we noticed through this pandemic is the opportunity for people to continue to get their preventive services. Health screenings are so important. And the ability to do that. 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 bringing up closer to home for people. Jim the final question and maybe most important for people who do not have Health Insurance. How do you, like i have health orurance, so if i get sick need to get tested, i am fine. For people who do not have coverage yet, how do you think about that . What is the easiest way to get to where we do have 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 and i think it is on top of mind for everybody as we look for as we look for opportunities to , expand coverage. But i think one thing that is important to start with, is that although the goal as100 , although the goal is 100 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. Again, for example the medicaid. 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 program across the country. Think about expanding that in the 12 states that can continue to expand medicaid, and ensuring the individuals who are eligible are presumptively enrolled in it. Always have a choice, but if they are eligible, they can join medicaid. They would always have a choice to opt out but if 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 advandage program. And modernizing exchanges. United health group is

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