Billionaire. This is just over an hour. Mr. Clinton we have here a fascinating opening panel. I want to bring them out and talk about, not only the disruptions in a positive way that they have made in health care, why they do it and how they measure success in terms of people. So, let me first introduced the panelists. I would like to bring out Elizabeth Holmes, the founder of theranos. She dropped out of stanford to start this company, a blood Analytical Company that has more than 500 people employed and is valued at 9 billion. Not bad work. And, as you see, she is quite young. When i met her at Henry Kissingers birthday party, with George Scholz who was 92 years old, i thought anyone with that agent span has a bright future. Since im closer to 92 than her age, it looked like a wise move. Lets bring her out. Give her a hand. [applause] Joshua Kushner is the cofounder of oscar health. He wants to do something really interesting, which is reinvent Health Insurance. And how people interact with other physical Health Systems. I cannot wait to hear about it. I had a highly unusual conversational conversation with the chairman of a European Health company who happened to be dutch. I asked him if they wrote Health Insurance, he said yes they do but they dont make any money on it. He said, we dont have Health Insurance here, we ride it, and the government subsidizes based on need. But he said, we shouldnt make money on this, we should make money on traditional insurance lines. I thought, i wonder if there is a single soul in america who would say that. Interesting. This guy has some interesting ideas, lets bring out josh kushner. [applause] joe kaini is the founder of masimo corporation, that employs 3000 people worldwide. It is a startup. It is the production and distribution of symmetry technology another noninvasive medical breakthrough. I most know joe through his commitment to build a coalition to eliminate preventable patient deaths entirely by the year 2020. He just had his annual conference not far from here in irvine. It is a fascinating struggle with so far, very good results. It is an amazing thing, it is interesting to know how we can do that. Lets bring joe kiani out. [applause] and, the last panelist is Jeffrey Selberg who is at the Peterson Center of health care. Michael peterson, who is here, and his dad are great friends of mine and they have a worked for years to get americans to focus on the longterm consequences of sustainable debt and how we can bring debt, especially debt that we run up every year consuming down. So that we can invest in our future and secure it. After years of beating their heads against the wall, they look at the numbers of the federal budget and decided, all structural problems are in health care. That is combined with the aging of the population. They decided that they would try to be a part of the solution instead of just sitting on the sidelines complaining. So they are developing a growing program of initiatives aimed to improve the Health Care System. Lets bring Jeffrey Selberg out and thank the Peterson Center for what they are doing. [applause] lets begin with something elemental, why did you decide to do what you are doing in health care . Lets ask the three reformers in the middle, what possessed you while you were a teenager to do this . Elizabeth holmes i had the opportunity to think about what i can do in my life to make a difference. I thought the purpose of building a business is to make an impact on the world, we are here for that reason. To me, nothing matters more than the reality and our Health Care System today, which is that when someone you love gets really sick, by the time we find out about it, it is often too late to do something about it. And, in those moments nothing matters more. If i could spend my life trying to change that, we can make a difference in the world. And spending a lot of time thinking about that led to the relies nation that we live in a system in which people can only get a diagnostic test paid for by insurance once they are systematic for a condition. So, the ability to create a Preventative Care infrastructure where people have access to the information that can change outcomes by making it incredibly inexpensive, by making it less invasive, could help realize change. That is where people would start getting access to Actual Health information at the time that it matters, that is what our life work is about. [applause] mr. Clinton what does it mean to reinvent Health Insurance . We thought we were doing good just to get 10 million more people Health Insurance last year. Some people did. It is an interesting idea. Explain what you mean when you reinvent Health Insurance. Joshua kushner the vision for oscar came about when i opened my Health Insurance bill about three years ago, and i realized i had no idea what it meant. Overeducated at the time was starting a business, i didnt know what my benefits were the doctors or hospitals i had access to, the list goes on. If you think about Health Insurance, in reality it is one of the most important relationships that we have, from both a human perspective and a cost perspective. The idea that we had when we set out was to use technology and data to make the experience more simple and transparent and understandable and relatable. But, what we have been able to accomplish is we have been able to take data and not only provide a better Consumer Experience but also provide People Better access to better care, primarily because we actually know a lot more about them. So, there is not been a ton of innovation within the first new Health Insurance companies in new york and 15 years. We feel grateful that we are going after the consumer market, because Health Insurance has been primarily sold from brokers to companies. For the first time ever, the consumer actually matters, so our mission is to create the best Consumer Product possible and do whatever we can to enable people to make educated decisions about their health. Mr. Clinton you are marketing to the individual, in the individual market, which is about 910 of the total number of people with you could buy Health Insurance in this country . Most people are covered by bigger plans. Joshua kushner yes, today. But we didnt start the company because we got there was a void to be filled in the individual market, we started it because we felt that people deserved a Consumer Experience in health care. And health care, as we say often, health care Insurance Companies do everything they can to acquire customers, but afterwards, they do everything they can to them. We want to be proactive, give people access to care to give them things for free. It are paying people to go to the doctor, get shots, we are giving away free generic medicine, free physician visits, so being proactive is about what we are hoping to accomplish. Mr. Clinton what percentage of your potential market knows you exist . Joshua kushner right now we are only in new york. Mr. Clinton even in new york, new york insurance is generally higher than the rest of the country and one thing that burns me up in the health care debate, everyone is saying that the government is lying about their policy, because it went away. Because the Health Care Law when it was passed, 80 of the policies in the individual market lasted two years. Or less. So, i will be very interested to see how you modify the policies how you continue outreach. Talk about that, because there is almost no understanding of who these people are and how they struggle to become insured. Joshua kushner sure, so right now about 10 of all those who are eligible for insurance, who signed up, are insured by oscar, which is it decent market share for a new entrance. But the most interesting fact about us, which we have not disclose, which is that 40 of our members signed up for us because they heard about us through existing members. No pun intended, we claim to be the first ever role Insurance Company. [laughter] the best way to acquire customers is by having a really good product. That is what we have been spending all of our time and attention to a conflict. To accomplish. Mr. Clinton joe, talk a little bit about how you moved from your core business into this audacious effort to try and eliminate every terminable death preventable death in the Health Care System in america . Why did he do it, how did you do it, why do you think you can do it . Joe kiani first of all since the topic is innovation for helping people, i want to congratulate you for your innovation. With this commitment based approach your last count has affected millions of people around the globe. I learned from that. I think in life, it is interesting to know why you do what you do. It is more important what you do and how you do it, because how you do it teaches others what to do in their own world. So, i have been around the medical space for about 20 years. I remember when the journal of medicine reported 100,000 people were dying from preventable causes in the u. S. Every year. I was shocked. A lot of good smart people jumped in and i thought, they will take care of it. I went on doing what i did making. Within a few years ago, new data came out showing that over 200,000 people were getting killed in hospitals from preventable causes. That is when i realized, maybe it is time i step up and do something about it. I have been fortunate enough to get to know companies in the medical technology space, great hospitals, amazing people like you, president clinton, and i thought if i brought everybody together, bring in the med Tech Companies, hospitals government, Patient Advocates who provide powerful voices because if you think about 200,000 people dying every year it is a number that runs through your head, unfortunately. Stalin said that one death is a tragedy, one million is a statistic. If you think about how that impacts a family once left behind, impacts you. We borrowed shamelessly, from the initiative, created this approach that if you will come to our meetings, you will make a commitment. From my background, we started on peeling the problem seeing what is causing these preventable deaths, from infection to medication errors, from lack of modern monitoring and we created solutions. These solutions, we asked the hospitals to implement them, we asked med Tech Companies to share data to anyone, anyone who could use it, to come up with algorithms to predict it and unfortunately it has worked. I think we reported last summit the last two years we have gone from to 6000. Maybe we can report next year 60,000 lives saved. Mr. Clinton i will ask all innovators, before i come to jeffrey, is technology what role does it play in creating the Health Care System that we want . What, if any it economic imperatives actually block it from creating the system that we want . Of all the disrupted markets with noninvasive technology, if you have ever heard of a an Insurance Company giving medicine, all of this, how are we how will it all come out. How will you measure what you are trying to do and how much of it does depend your definition of success, depend on the whole system transforming itself . How much do you think about the Health Outcomes in america and how they are not as good as in other countries, but we spend more money. Where is the end of this and where is the role of Technology Going to be . How do you think other people in your line of work, they say hey where is this going . Elizabeth holmes we have only Seen Technology as a tool something to empower the individual because we believe strongly that the answer is to our health care, it lies in consumers and enabling people to take control over their own health and therefore their own outcomes. So what has been interesting to us about our model is we decided that we would start what we started our lab, 50 off of medicare reimbursement rates. Increasingly, now at 90 off of the reimbursement rates. That is lowering medicare and medicaid reimbursement rates over time, by definition, based on the way that we are billing. Technology can serve as a tool for facilitating change in policy and for empowering the individual to then get better access to, in our case that i do the diagnostic space, 80 of decisions in health care are driven by laboratory data, so if you can facilitate that in a preventative contact context, you can change outcomes. We strongly believe that one of the things that this country is great at, is innovation and creativity and applying that toward helping solve issues, in this case, with our work without having to raise taxes, cut programs, to realize the same kind of changes. Mr. Clinton i will come back to you. Joe, you have made money and you have done a lot of good, would your medical device work one of the things he said that some people in your line of work think that if they share information and we have confidence in medical records Electronic Medical records which is necessary to do to save lives and lower cost, how do you get other people to join . How come you think you can do this and still be successful if so many people dont, how do we break down the illusion that nontransparency is good economics, but disasters over the long run disastrous over the long run . Joe kiani with your help. With your help we started this movement. We have to think about at the end, sooner rather than later, we will become either victims or recipients of a great Health Care System. That not only has amazing technology, doctors, nurses, but provides safety and quality care with dignity. I tried to reach out to the ceos of medical Technology Companies and say to them, 20 years from now after you retire how much would you have liked to have left this industry . Because if we dont share data we cannot get to the superhighway where we can create predictive algorithms i can tell us where we are going. For example, if we are in a hospital and we are looking at vital signs data, that is helpful to predict where we are going, and a doctor could see it, but not everyone will see it. If we get data from Electronic Medical records, from xrays from imaging from labs, smart algorithms in the computer can predict it and we have 50 companies who have made the pledge so far. Ge phillips, maximo, we need the rest. If we do not get everyone to agree to share data, there we are not asking for internal data, but we wont be able to get the things were looking for. I made an analogy about men helping an elephant, we will not know what we are touching. Mr. Clinton josh, this insurance model that you described to us, just as a normal person listening, from a naked Business Model point of view, it sounds like you are saying if i do this well, i can ensure people for less money. That is what you are trying to do . So what we want to do is ensure for wellness insurer for wellness. Since im a presumably since presumably the problems for medicare and medicaid and the federal Health Insurance program , if they follow your lead, if you can do this, that way you can be truly disruptive what do you need to happen beyond your control for your Business Model to have a good chance succeed to succeed . Joshua kushner i think it is about incentives. Think there is a lot of things we are doing that are very differentiated. To go back to the question you asked before, how does Technology Impact our businesses, or the industry, i am under the belief that you are if you are not a Technology Company in the next decade, you will not be a tent you will not be around in the next 10 years. Everyone in the world needs to adapt or move on. There is so much that we can do for example, amazon and google know when a woman is pregnant almost immediately, based on what she is searching for. But a Health Insurance company does not know until the claim is paid three months after birth. So, you know, our ability [laughter] [applause] Joshua Kushner our ability to understand what is happening in the system in realtime and enables us to actually take something that is real, that we cant prevent giving away free medicine if they are sick they are sick. If we understand what is happening, we can point them in the right direction. Our ambition is to work more intimately with systems and we are starting to have conversations around that. How can we Work Together . How can we enable you to work with customers in a way in which you are capable of doing, working together to make sure that we are providing the best Consumer Experience . And the best overall experience. I think in many ways, the Insurance Companies and hospitals are butting heads because incentives are not aligned, but ho