Bump bump bump bump bump bump everybody come on in here. If you get in your quickly, you can be part of the simultaneous it ain't gettin a time all gonna come on in here, since we get two thousand we're. Gonna booed off are exciting morning programme and almost there everybody go, get your coffee. You mug your vessel, your glass here full filled with the beverage of your choice, ensues. We had two thousand, which is gonna, be in about thirty seconds, we're going to join the simultaneous and then will you hear from Doktor Shiva some ideas on lowering healthcare costs, but first get ready, grubby glass, your mug

get ready. Let's do it now. Simultaneous those good like to introduce a doctor Shiva and would be most of you have already seen our first programme, but we're gonna do a little deeper dive into the health care and health care costs and tat either you are running S. Elizabeth, worn for the Senate in Massachusetts. Correct yes, I got in fact other already on the ballast stop running his independence, and then irish republican democratic parties had their primaries on September four and what's interesting- has got literally on the midnight Thee primaries. Elizabeth worn at that. I said that she was agreed. Three debates, but guess why, with

republican and I completely excluded from so where, if you people seen on Twitter, whereby The university Massachusetts, which is a government funded public institution which It would allow this to occur back and let him get away with it the next stage Scott. No, you know- I probably I know I wouldn't give Elizabeth Warner run through our money. Exposure on many many levels, particularly here and now, she's colluded with big farm on big hospitals, resources should keep the cost of health care. I won't one would not want to be under debate stage with you, as my opponent can now. If you can this is modestly as possible, because it is important for a context to just list your academic credentials, because when we start talking about healthcare, people say well. What do you know about things? And this will help give us in context good? He just

This just your degrees, ninety degrees sky, from MIT undergraduate degrees in electrical engineering in computer science. I might degree suggest two degrees to masters. One is in applied mechanics from the department, chemical engineering and another is actually in architecture and design the MIT Media lab my fourth degrees, which is my each day, and was called biological engineer or systems biology right. So I talk about Helen stack all the time and have you combine the raising of talent? You can guess something. Special and you ve combined in you ve combined now the engineering way of thinking what you might call out, assistance way of thinking, a very rigorous way of analyzing problems and solutions. Where the pretty vast knowledge of the health scares situation would that be fair to say

yeah I mean I had a deep interest in Healthcare Scott, since I grew up in India as a kid. Western system without even are also has a traditional Easter. As a traditional resources has helped. Here? Is my grandmother actual practice? I saw your loss of people's eyes very marriages in healthcare as a child. I, when I came to station nineteen. Seventeen by the time was fourteen us doing medical research, now known as wreckers medical school MIT. My entire search was actually did really look at healthcare situation for assistance approach and only two as an entry did, I have the opportunity to come back to my team. Do my page you, as does you'd, noted the still call systems biology. Before we get into it. Just know how important this is. Normally, when you talk about healthcare you're talking to you, are you listening to just a politician, or maybe just a dark

rarely Reagan get this many, this many skills and the same person. So he should pay attention to what Doktor Shiva has to tell us today, so jump right in tell us what what's broken about healthcare or what you plan? What would be the ideal solution? How can we get to a better situation? I think scum wanna start. Where is really help Yours in your eyes understand. How are you health care? We call it the health care system, in the modern world. Right now we have to recognise that the problems we have very, very complex problems, and I want to talk about a few minutes debate of course, thinking at MIT literally in about lesson and then- and I think I figured out a way to do that. But the point is we systems thinkers. We can, do you like

in other king who brings us explore? look at the other and each person changes the alpha. Stealing what they're looking ass, the one guy touches Atossa thinks it's a sphere another guy She's talent thinks it's a brush, but that's how politicians obvious us to look the health care system. They just want to look at the parts of what is convenient for them at that point and then direct ass to frankly would solutions which really don't get us anywhere and that Let us take the viewers What is systems thinking and analysed Think about it is that a system is the sum of its parts, but more importantly, easy interconnections, systems, the current system Where are you actually find the truth? So I ll just give you a really really simple example: several

Example, these little balls here that I have drawn we're doing it in a very work, a headache way these. I bought it can be connected it very, very different ways right. We can connect them like this. You know each ball has at least or we can connect them like this right? where each all as two or three connections or we can connect them like this it's a lot on line. Is you end up with very very different systems, based on These parts are connected. In the health care? Veal, where things really changed? A lot was in two thousand and three this night, we thought that complex verses? There was a number, of course call the genes sentiment, united, we start the human genome project. We thought it. Being out about a half a million genes or art and a war.

Twenty thousand genes, the IRA, thanks guys we're only twenty thousand genes. We have the same number of genes as war eyes. I sometimes feel they were gone. The whole thing is is not the number of Jesus attack that genes interact with other chemicals, a human being, they interact in much more complex raises a complex diagram. I showed you verses in a word. Laxity assistance. Mine is a function connections and ass were truth emerges from under their everyone's learned systems, theory and in one So that's the way of looking at the world. We start looking at how Things are connected: look here to get these is This also is how do we create a system to solve abroad,

Well, first of all, you have to look at what properties system determines the system, and you get so so we had to start with. The problem is so let s take a big view and what the cost is it. Here's a diagram away to do them, powerpoint you, but if you can see this guy, you know that Healthcare Was- is one point two trillion: that's how much we were spending. The United States in two thousand it. Two point: six, China, two thousand and eleven word about three three trillion now added Forty is expected at one out of three dollars. We stand will be for healthcare spending, one out of three dollars: three trillion dollars. Roughly, is seventeen point. Ten percent of GDP Gdp. Twenty trillion dollars, so eight is what we spend on healthcare.

Health care costs is not just manicure medicate dashes one piece of it. So if you look at a person here, were you know in? all scale. A person may be the service. I met a k if there, to have economic issues. Medicare is get older out of pocket They may also for Jeffrey of course it is spending in healthcare, When I talk earlier Dreamer sky, he said: hey is in the cost of health care, never end of life. Member that question you asked me, and I thought so politicians, I have always control the cost of health care. Less go after that. That's really high cost and Britain, We saw area of healthcare. This is then love, is a politician thinking. So

redrawing twenty very medical papers, Everyday Scott. In two thousand and eleven there was probably them research, John. I'm really look costed and life care, the politician promoting anti terrorist biggest saying we gotta go. Right, all heard. This well is hard to see this diagram, but I think you can see part of the global that three hundred million people- and it turns out that eighteen million people twenty million rapid eighteen million people are basis Cost of healthcare goes and nearly one WWW goes it you take the two point six in two thousand and eleven, the two point: six trillion. One point Seven trillion was personal health care costs. We check out.

Stuff, like health care programmes, public health. But what point seventeen It was the actual announced, an actual personal healthcare cos one trillion was for these very ah ha. Cost. Three people were spending twenty thousand hours per year. Okay said said: Five percent of the public to eighteen million people were really sixty percent of their costs, and if you break that down in the circle, you find that only two million people are end of which is about ten percent. Fifty per cent wages million people were catastrophic it I said sudden heart attack right or Jimmy Disease, and that forty percent were chronic so only ten percent of that eighty million, which is to people were the people

one year left land NASA, they're doing so as it is, Bottom line is that the we are hearing about. All the costs being an end of life is deeply exaggerated. Based on the blind man touching the parts of the elephant and people like the issues to a problem where they say This is where the high cost of health care and by way of life, is where it's not. Prevention is not about. Wellness is specialization right, myself, It may be Saint tired specialists. They're. Probably I failure on the United States is not twelve different rocks. Twelve different drugs, ok Looking at a very small piece which lots of drugs, lots of specialization fifty per cent. Among the people spending a lot in that year. Those Let's have a heart attack,

fascinating one rebound if they get on good programmes change, diet, Go back to reducing our cause internet into the lower per cent per cent are very, very quickly Scott, So I wanted to share with people s a very small said: if you read this high cost, but Ass people are chronic and catastrophic, much of which can be addressed through preventive professional. Get back in the innovation again, the problem, Very good rat really talks about the fact how nice eight of this all system is here. Here you can see this graph. We spend thirty four every increase, funding for pharmaceutical drug development, etc. What you see the raft coming down. We are finding less and less new discoveries, in fact, every

Here you are aware: the FDA is not allowing or approving new drugs, which we were spending a lot more drug development and we're not discovering a lot a new trucks. Ok, it's a broken system innovation, that it is her anything to the fact that maybe the easy stuff you fine first and then harder to find new things, Yes, as it is my sincere one of the companies, I jus renounced Cocytus onward focused on drug development. The way drug development works in the end western world. Is it's about a single synthetic compound we haven't? thirty thousand synthetic compound Caesar compounds that do occur, nature and the way the test in our text. For years for some to see if it works any help. That period is called Preclinical worked six years, then he had to file

allowance and approved by the agitated and clinical trials. Another nine airspace, my face to face three and only twenty four the drugs going to face might make it. Our bottom line is fine. And a lot of stuff comes out as a lot of cyber attacks, and your point is because you're looking at a synthetic bill. Big area research paper saying is: we need to give the combined how path which is called company? your cocktails at by the car innovation combinations of you do too combinations of dogs are three or four Imagine the amount of tests to trials you have to kill right. It's a bacterial problem, so the modern system of drug discovery was designed for something. Two years ago,

Combination therapy said, therefore their stock. The other interesting problem is again. These are just very does. In fact, How well is art here doing even now over delivering care wall. The cause is medical errors number one day: second cancer and the third: is you go into a hospital and be careful what happened? asked the young people read books about this but the reality is a hospital environment because they hospitals, the kind of care to kind of mistakes. Second occur is quite significant, is not something to be taken lightly. Other aspect of the causes and areas is to live in the EU. Are thirty dollar you you, you will pay thirty

where's for what till aspirin thirty dollars per one pill which you can get at sea? He s finalize problem the example of is this is, it seems pretty outrageous, but you get extrapolated hospital. Every supply, that's coming into hospital from stabler to to say now to axe to two hundred acts that are being marked. Now is. It is one, but is all this happening is at the hospital is just writing there already having across all their costs and matter how they got their money, whether they overcharge you for the pill or overcharge you for the doktor. They still to make the same amendment eighty at their profit? Alright

I care of workable. How pact there was a lad insurance companies revelling charge. Fifteen percent above cost this work is interesting, so the goal was to bring the cost. Very high because you get your percent is basically giving people easy money. Too much like one even if you said some law and you have to give way all your pills for free, so the hour couldn't overcharge. They would just move that charge to something else. Because it's, The other issue is irrespective of that one of the important things to bring up very rarely talked about in the media. The trunk was the first one and then This is where a college and our talk a little bit about that. This is something I've learned recently in.

Eighty, seven days, a bunch of hospitals, I say you and I do you. I ran a hospital. You ran on hospital in the in the tens of thousands of people. Each were hospital owners when we were by supplies, meaning the bed or even drugs. Are we using your group purchasing it was like Kafka, when got together. Purchasing organizations got critical JP owes these Initially, we ve got purchased in bulk, so we all benefited savings to our patients. Ah, to laws. That allow JP hours they started flipping, because now they were these central in the supply chain for hospitals, a flip dead, where Jean so much of the supply of hospital as well as rights into these hospitals. They aren't I

we started cracking up the does another half a truly sky to cause a response the administrators daddy, anything they distribute anything, they actually write the contracts between the supplier after supplier and I see by the time to the pharmacy also shouting I get and give kickbacks strangers, for example, get set aside seriously. Dj all sorts of perks for and which they call by the way rebate, which is a code word for kickbacks, so supply chain is sound and me tv ass.

So let me just the sunrise. What I think are there so yeah, bunch hospitals and he had a bunch of suppliers of parts and product the hospital use, and they have- surveillance have a middle man. It'll help us get bulk purchases and will be good for husband but the middle man became so powerful that the middlemen just started, taking the huge profits and could control both the hospital buyers through kickbacks and right all the contracts and have exclusive, probably with some of the suppliers. Until these solution, which was the middle man, became the problem, is that you I think, the other part a basket was drugs? Never, if you change your advice, I say I created a drug over twenty year. Pat not will the girl was the cost considerably lower, because many people could manufacture that drug generic when,

Let's say there were five manufacturers of that generic drugs one. To the end user, be it through the hospital which is impatient or through the pharmacy allocation, GPS and premiums. Road exclusive contracts. So one guy. Liar, tyres, which means a crank up the cost of a tutor. Dollar generic, sometimes to twenty thirty thousand dollars, not literally zones another. We. We know someone about the landscape. Of course, what we, What would be the approach to go after them? What what's the most was? the biggest lever yes, it is a great so just to little things. I just want to you guys are people. Women women, The mortality rate in the United States the highest of nations. Twenty six out of a hundred thousand

our world is eight point. Four ok says now great care for women. I am who's gonna, be something else behind that normal remember that there is probably a dead, but I just my shirt and also on the infant mortality rate. United States is a success, others have sex. So I wanted to share that in a broad level we could discuss. We can go into the details of a statistic like that and others, but the point is that it's not like with all this money were spending bitterly. Three trillion dollars agent percent of GDP, where gas amazing type of healthcare. Right is not like we're getting so to your point, how we haven't you look at a system and how do we make a better right, going back to basics systems, theory, water, the properties of assistance, so here some interesting properties. We want to look at. Why are we cost

low cost? We want a lot of innovation taking place. We want responsive chairman one great care. When you go visit a doctor, you want to feel like the person's. Really we don't want, always be crisis or specialised, the other pieces? We focus on prevention where possible. So if you look today apart dear me, still centralized- and I will talk about this- is so and what we the high cost of healthcare Produce innovation law, responsive care, reduce increase We spend a lot of money, especially and very little on prevention, and where we really want to goes here sky healthcare. We want we want to see more doctor patient

Opportunity right now adopted in less than five fifteen minutes. You know with the patient healthcare industries. We want to have less On and more on prevention side? We get there I mean there other properties we can think about, but I would argue these are probably the most important ones, so I think most people agree with those objectives. What do we do about it? the system when we talk about the system as a connection with apart, if you are a patient the doktor to get medicines or food. We don't talk about great right. We have a little insurance companies, PBS Gps, we ve created all really. What is this? Ok,

technology allows us to do. The patient should be directly able to go. No doctor patient should be directly able to give medicine for money. Pursued in this which people may not, but I think the idea of direct local really want to go. Very different, interconnected system verses. You, lower just just going back you earlier boy. The You showed where people could get direct access to a document without the middlemen isn't going to help them for the crisis, things that ended life, the big, The entire basis of the conventional medical model is always focused on crisis, specialization, psychiatry I see a doctor

instead of here's to always to send you to, especially, if you have a headache you may have seen three or four specialist got under all adjacent under chronology. Is psychiatry six era. Look, but don't need them well, here's issues. Again, there is a huge room and rain. Our growing movement called direct in direct pay too to a doctor were p. Other things You have only to go to the hospital, can be handled by the primary The twenty percent is the specialty stuff. Hi people. Obvious. If you get a heart attack, you need to go right, you get into it. Relax you usually, if you do, you do need that specialized here how'd, you know in the light of primary care physician who, so we have evidence to suggest that there are people, say specialists when

primary care doctor would have handled it easily yeah. I think it's a long discussion. To put it simply, you know if you look at you trace back in history of our modern western medical care system. It goes back to me and there's a great piece of work Nightingale wish wasn't. Just a nurse shows a member there. Society is just explore signing. It was one of the great should it appeared translation. The eighteen hundred looking in the Crimea in war and she's The soldiers were not dying from being shot sky, but there were guy because I asked in those days were people ices division creating a modern healthcare system, and despite the millennium, the soldier back onto feel so philosophically are Healthcare was really came out. A wartime medicine. Ok,

I gotta get back on the field antibiotic stairway surgery, it wasn't based on prevent. Large service, yeah, ok, so I think I'm watching from the comments coming in from the folks and there they are hungry for specific solutions. So I think that good sense, background, and one of my questions is less safe We changed things. Other people started going directly to doctors the middle man a lot of those middle men are hospitals in such wouldn't those US those either have to stop operating because loosened much income. Isn't there a secondary effect where, if you so bunch of money out of one part of the system that part of the system gets smaller and less accessible and a mighty hospitals of mighty pharmaceutical companies making drugs etc. Can we be sure that the economic war have unintended consequence.

Solution related to that, so now a a set of primary care positions which, as you do concierge service only further the wealthy. Where are you a doktor sending five bucks, a mark that we and our town all, but a great the doktor Carr Jeff Gold, who talked about who say a direct pay? you just take assurance, its direct pay. You pay fifty percent dollars, any completely I call on you escaped. Whenever you need that is basically saying that eighty percent of the things adaptation needs can be many many many examples of the sky, and this it takes away you're, so the direct model is one thing. Police force. That is actually a solution for this issue.

Look. This is really why We have this big cause high. The solution I see emerging as you had a direct relationship, Your doctors say about eight hundred dollars a month for insurance, I most Conway, I suggest page eighteen, twenty bucks so my daughter write down the street of primary care position by in the modern model I have a copy was having deductible I am also dollars a month. A you model looks like this where we as citizens, neg good choice primary positions, and traffic insurance.

Reassurance for a certain amount for a situations in it. There are some of the US that can be as low as around a hundred? hundred twenty bucks so when you want. This catastrophic situation that It looks at international level by suffer from it we need to lower the costs, because Iraq, cause you, I thought I was two months pause so If we were to go to the model you're suggesting, which is everybody, has a direct pay, doctors say seventy five dollars a month and listen got a hundred and twenty dollars a month on top of that of catastrophic insurance, which would cover everything else, so there per there's there somewhere in the under three hundred dollars for what might plus eight hundred dollars is everywhere

we're heading to the average person spending by ten thousand dollars per year per person. That's where we're at right now, so just so, the audience gets a sense of the magnitude of that. This is just one suggestion that could take your healthcare from eight month down to three hundred a month and that we have a new talked about lowering costs beyond that. So go ahead Right now we have this, and that is what you would pay. We have talked about the fundamental issue of lowering costs in that the soaked part of it. Is this this collusion this cost collusion. East busted up Elizabeth worn, knows Ps Jams, wishes we talk about which control between big, ensures the farmer and dig as an aside, there are only three gps, the biggest interesting thing is based Yours,

this year and next year will be merging with the three biggest insurance companies. So we'll just this ok, Solly Elizabeth about this Elizabeth Ward is actually ok, which he believes gonna kick back to. Something were to bring up and in fact, probably both political parties. Are you one of those subjects, Talk about tromp was a first going to bring this out to the public. Can I make a suggestion view? the average person is. We welcomed by this kind of discussion. Most people in this periscope can can hang with you. This is a smarter group, but if you're trying to convince people, I think you're gonna have to start with the outcome, which is, I think I can take your insurance for an eight hundred doubt dollars. Down to three hundred and and then tell them how, because a year, the first part and they say I like that. I don't really understand the details, but it looks like you're smart, so you probably do so

I would start with the answer and then then tell them why terms since I started ten thousand, two thousand and twenty five hundred yeah and enemies. And then explain why, because even in people's eyes glaze over in the explanation- and that would be most people can't handle complexity, they can still say I'd. Rather, he seems to have an idea that makes sense. I don't see anything wrong with it. Ten thousand to two thousand the velocity there, Also, we as individuals are more involved in our health care. Outsourcing are most important things over her own personal. To some other centralize entity and that's part of taking our power back

when one more suggestion just came through on and the comments, and I like that somebody said talk about costs in terms of per month, because I think we just we're just a little bit more organised to think about a monthly expenses? Yes, oh now, all you're, looking at seventy five, looking at the two hundred bucks, a martyr, her lap, two hundred dollars a month in my case versus eight hundred dollars a month. That number not myself, and then I'm already on your side, and I want to hear what you want is it since I want that to be true, and I want to spend less money, press alt and then giving the reasons? where this gang is to refine the communication of people they get it matters. I appreciate were doing this. The obvious feedback. We have also to the cost of innovation. You know it

innovation. In addition, innovation, part of drawing up is again in a pretty smart audience. Ah I want to show also the innovation collusion that takes place in the United States something I pretty and because I apply for grass dry. Might No, in the world, but there's a anti Pollution, age. By the way, which is one that fines billions of dollars and scientific research? universities, and I d another big guy Stanford, and what I hope you few journals Scott. If you're an eye are research, an institution and we're both compete: our future is determined by how many papers,

publishing these pure journals and how many people said we did great work at home funding we got from the, and so that's why researchers. Hospitals are big medical universities and send it get funding, publish, publish palate, that determines your So that's what data innovation is interesting, is tat. And I it's become It's all based on this click which makes a decision at the end. I age grant find people who make the scores when you open are the same people set out the journal, review boards or the editors and this The major said percent of funding flows back to the big big universities and then there's a big discussion we're doing a lot of innovation, because most

most of the ideas and those, science is controlled by a very small. Funding system needs to really be explored We need to also look at what we call peer review journals by the way. Never one journal, one paper appear view Journal: Peer Review was away shock, Well, if we can be there I really have appear Here's what you said when you jus innovative, were ah your peers, are the first to be against the innovative work? You are right to call pure to rise, Why where we started really pushing pure GEO strong scientific

Otherwise it is publicly funded, publish it and let the public decide let the public discourse take place well, but the bubbling here so while not want a public meeting of the broad mass of researchers except a finite set of people who control the Peer Review, Boris right, so we did there's a lot of smart people may be in a small state university somewhere who may right of varying. Were research paper research paper may never get excited because of the few who they say the narrative on Alzheimer's takes place. Yeah. Just one scientific picture, there's various approaches, you're that have one journal and Europe. You're very, very, very cheerful that a new theory may com which may ask these guys that determines the funding that you who, which grudges.

So that all mine innovation is a very mediaeval futile more on how we ever so so, the answer to go to more of a public, anybody can publish and let the public way and Rice the Eighty percent of the funding should go to the universities. Then it should be much more. First of all, Ngos there's a lot integration should apply for an age grass thought the first thing then you have to show is: have you already done this before? Ok, it's called the civic aim: so you're already submitting for research. It is surely not data, so they don't really. Some were really knew. I certain research is already pre regret. Sir said the innovation that they allow is innovation is just like nothing. You did before

In fact? So when you apply for an age grand you have to submit what are all the same? Three specific games specific aim, one two and three and specific game. Why you probably already Mary Data to show that you're, an already achieve specific game Y, know, listen It's nice innovative system. So what? what I have heard so far, this country and then the earlier one I dont see. Anything that couldn't be run as a as occurred. Process or something that you do in one state or what, Asian we'd better. This doesn't require changing anything it just so require having just a new thing and let the nuisance live on his own deciding in general, The government model of trying to modulate vis and regulate them,

which is what they ve been doing. If anything, it is actually concentrated more power, and where did the growth of this collusion so doctors sources using less, do directly you in it I know that you will, for example, which less people go. Direct is an interest, enabling application were I as a doctor and use that application to come up direct service, so I see a real innovation coming. What we don't want to see happening through Washington is restricting not right pudding. Those people, children regulations, to keep them, people? what's so

All the things we ve talked about so far is raising the government even needs to do exactly the sea. In a role for governments, two thousand doctors, the United States. If you're a doctor, you typically you're in this ecosystem university our universe, you to go back to school, any active you're specialization training in hospital, for years university training for years America, solitude of warriors and specialization. What am I solutions? We should did you go to four years of? Why am I saying that we don't produce a primary care positions in the United States and the cost Primary care vicious two to three times that of it: nations in this country in the world, so I need to lower the cost and major primary care, physicians, doing local, smaller practices,

my sister, for example, went Harvard Medical School right for years now back in school you too, for your specialization and she says she there I can be a mouse. Those whose stopping anybody from it says me to go enjoying a big hospital and there are also having a massive Denver. So Here's guys why Forty four, a number in countries with high school right here, those whose stopping anybody from having the solution that you're suggesting that you're a law. Yes, yes right now, there are some sort of laws and their some sort of incentives right. Industrial complex, really losses. Saki blended is

Some of you have to do the four year, because the way a structure before you can go back to school? ass, a series of Chad Exams right, which day force you to get in. Thank then you have to do university system right it has only use organic chemistry- is who is forcing anybody to do anything were? Who is the authority that the American National Association, the animated you now is private strongest lobbies and in the end and the world the United States, so and should be properly? controls a lot of these processes. Now there are some problems: just recently emerge where you can go from high school. It's called a six year programme, you did your for your programme, and I think there are certain things that government can do that

Those barriers, for example accreditation of surgery. Is an interesting thing right. In addition, universities, types of schools and other. Like those rules. Where we going frictionless way. So I think it to your point is now. The government should get out of the way of doing so. Who does it really Asian right now for four years, time state level narrative is thoroughly funded I think involved in that wish- which I don't know what we saw but maybe some set of rules that the government could just do think an executive order. While some away with them. I think so, but I think it also take your philosophically. Why do you need is in some ways

wasters spent four years undergraduate. Education is part of a solution. I think some word is all kinds of skills base: more about tat, the cause of medicine, anyways vocational training as Europe has no who would have to change what they're doing in order to get sail a six year. Accredited medical degree is at this stage it has changed and laws it is probably a variety of things, so others yes, sir in writing. It the trigger state. You take born exams in a particular state, even practice in a particular state, since a combination, so would it be possible? Oh by the way we ve got just more minutes here, because I don't like to go over an hour cuz than to replace a much lower,

let me was do up. You have other specific suggestions and then you know earlier feedback. If we can bring down the costs you're. From my case. Eight hundred dollars a month down a two hundred- let's say that is what I'm really proposing, and that solution means people taking control of their own healthcare healthcare by doing direct paying with Doktor and this crisis scared. I started a whore, a solution that, and we cannot, Lowering the cost of healthcare and lowering the cost of health care is a function of recognising putting more more emphasis on it. Who control the blossom, I drive through the supply chain which are cracking up. The costumes levels, research and innovation itself is done in a very much

you away and I think We can do that with government into versus getting involved. Arising get out innovation Start ups, which can offer the ability for the patient to go direct to medicine. Support you now dealing wellness, be it doctors, but if funding allocation your health care is done through quivering couple cover my questions. Wicked lower individual healthcare costs as much as you say, safe from eight hundred monster to three hundred a month with this system have produced enough access to cover everybody, In other words, could you get to something like universal health coverage, just through cost reductions, without look without increasing anybody's taxes

in the other, what do both because not only the biggest but I also allows unleash innovation, a lower these costs and doing things to eliminate the system? So when you and multi processes propose we can do. This is just a matter of doing it because of you recognizing many many which caused the way that innovation is done. I think both are completely feasible implausible, a couple of questions. I people are gonna, wonder about legalization or a decriminalization of marijuana. Yes or no a proponent of medical cannabis and I'm a big proponent of putting in a lot more research

my sisters, you gonna top leading cannabis doctors in the country and shit arguments on this, but I think that we should be criminalizing, but we a lot more research on account of his is a medicine and we need to put this on ongoing research. I too understand in others by eight hundred Cathay eighty different kind of the noise and molecular substances in cannabis, and we all even understand all the functional uses of it. So I'm a big big proponent of I definitely realising dramatically use decriminalization watching the commons goodbye and it looks like you- picked up some votes, by the way that you say it's nice and unacceptable working, then there is the biggest freedom rally I'll be speaking added all day. So speaking to you, sponsor and so

I think we are a big points under look at the comments here. If we ve got in the closing comments from people, serve as a final question, to ask whether there are making comments about marijuana now what do you think you're, the Baisers Buffet J, P Morgan Healthcare initiative. Do we know enough about My only we know now. I just don't want it to be very keen to point out of GPS ruined and much more consolidated version of the GPA. Doing with a reducing like a cheap yo was version, one point out, as all of us as middle name My concern is, is a sort of urgent to why now a much more efficient and eight days, as is very good at controlling supply chain. That is war, somebody said somebody asked governments year. How would we start to get some of this guy? The star We need to put you in the Senate right

I don't know one thing as we need people like myself, who understand that these systems are complex. We just started doing on sky. Adopting Elizabeth WAR can even come. Your articulating this, but more importantly, Elizabeth Worn, actually wants, decentralized system. She was more readily. She was less. Innovation is not so either Secondly, we should act alone, go out and get that no matter what you doing so so here is my comment about the Senate. In general, even if they say you're in Massachusetts, your Massachusetts voter and you choose between Lisbon, weren't and Doktor Shiva here, even if you thought Elizabeth Worm was candidate, because Natsir Social preferences or whatever it doesn't make sense,

to have everybody in Senate the same kind of person or or two kinds of people, your traditional republican, traditional demographic, you didn't you you're gonna, have to diversify their talents stack, within Senate to get anything done. You know that's why I'm always appreciative of rampant, for example, this is so obvious that what he brings than the mix is not what the mix already had. So you, if you agree or disagree with rampant, he's bringing some new all the time, What I see you daggers Ebay is, you know, If you were running guess again today, the somebody preferred think about the whole

Are you putting a senator in news not just taking care of the year of your one import projects in your state or something? If you want the Senate to work? Well, you're going to have to inject some new kind of thinking, otherwise you're going to get the same result every time, and I don't think you seem more innovative thinking, then we just saw the last forty five minutes or so so we should re wrap up here in the next. Sixty seconds is raising else you'd like to say as a yeah. I just wanna when I want to say Scott is wearing a world now in the modern the problems of the world. He understood politicians who essentially, as I said before, certain I would clarify story retail check out clerk right serving. Dangerous to stay in office and stay off. Stay in office

The girls like live where listener myself, actually to solve problems in those problems can could be. When you take the system's approach. A much more deeper approach- and you really she's out which really done, as we just did in this conversation and Americans. I believe, deserve this kind of conversation with their elected officials and that's help. Solutions and truth is a virtue. By having this open discourse, looking at these interconnection, so she riverside. Wanna go find out more for ourselves, I'll, be putting this up Scott and a white, a grub short legs almost done upon the way Our second link out you guys all great now old we around was on the look out. Was I wrap up? Thank you. So much. I think people are gonna agree. This was insanely useful in terms of what I understood before

this is what I understand now. I feel like I'm just a huge move forward. So thank you for that and I will I'll stay in touch. That's your audience to ride back was I probably do another periscope a little bit later this morning. Politics- because I know you love your balls but I'm going to sign off for this- for your comments on Twitter. I hope this was as useful to you as I felt like it was to me and by for now