caroline: from bloomberg world headquarters in new york, i'm caroline hyde. romaine: we are awaiting comments from president joe biden here about u.s. policy towards afghanistan as well as other issues going on in d.c. whether it is about the budget and the delta variant and covid. we will bring you those remarks live when it starts, but we want to dig deeper into what is going on with covid. a big concern for the president, trying to get that under control

as a way to get the economy back up and moving. the fda has approved the pfizer vaccine, full approval. that means governments and corporations are starting to require, mandate vaccines for their employees. goldman sachs the latest to make that move. we are going to start on distrust with the health-care system. we want to talk what is going on with the hospitals and the burden they are under. of course, caroline, you brought this up earlier about some of the insurance issues. if those folks decide not to get vaccinated, what happens when they get covid and go to the hospital? does insurance cover it? caroline: that is a key question to ask. the point that they feel that will perhaps be the biggest wave , the vaccine mandates, and other things vaccines potentially bring to bear. it hasn't been the campaign to save your grandparents or the health risks for those around you. perhaps it might be the

financial burden if you don't get vaccinated. taylor: some really cool charts that i know we are going to bring up here on if the fda approval moved the needle. a conversation we have been having a lot on this program. on vaccinated only say 31% more likely. 49%, wait and see. there was a certain cohort with legitimate medical issues one at the full fda approval. certainly looks like it does move the needle. romaine: we are a show about the markets and economy and issues here but you have to tip the numbers here. we track the numbers on the bloomberg terminal every day. you talk about something like 13% of hospital beds right now nationwide are filled with covid patients. when you get to florida and georgia, that is 30%, the highest level we have seen going back to january of this year. you think about how we got to january this year and we saw the

curve flattening and we were out of the woods. we were buying tickets and ready to get back out. caroline: homecoming events. romaine: this is a concern because this is an economic issue. i want to bring our first guests into the program. he knows a lot about this. he is the president and ceo at northwell health. the largest private employer in the state. welcome to the program. i want to start off first with what your general capacity is or handling is of covid patients. have you seen a significant uptick in your hospital system? >> yes. we are in a position where we are able to handle it at the moment. we saw an increase the last couple weeks. we have about 300 patients today with covid in the hospital. that jumped from about 60 patients on a daily basis two weeks ago. the numbers are relatively small, staying relatively flat. not seeing much of an increase

on a day-to-day basis right now. we are easily able to take care of this. we have all of the capabilities, the beds, icu's, etc. not under major stress at the moment. taylor: for someone who has hesitancy, what do you tell those about the vaccine, that it is reducing the severe symptoms, hospitalizations, the need for ventilators? >> the big issue that we are focusing on obviously is getting people vaccinated. we have over 81% of our employees vaccinated at the moment. obviously, there is the hesitancy which you are unaware of. we continue to educate people about the importance that the vaccine is safe, that the vaccine works, masks work. you know, what is interesting here and is relevant to the discussions going on around the country, we are fighting a very, very clever enemy here. but we have all the armaments to deal with it, like the vaccines,

like masking, like having restricting large gatherings without masks. so we know how to beat this. the fact that we have leadership across the united states in different places not taking actions that are proven to work against an enemy that we know we can beat, it is astonishing to me. we are in a better position in new york because we are complying with science mostly and we have complied and listened to public health officials. if every other state followed in many ways what new york has been doing, we would not have the problem that many states are currently experiencing. caroline: michael, when you talk to those that have had some hesitancy in getting vaccinated, does the fda approval help at all in convincing those that are still waiting? michael: i think the fda approval will help because one of the arguments that people were giving us was that if it was such a great science and it

really worked, why doesn't the fda finally approve it? now that has happened. that excuse that many people give us should be off the table. i think it will make a difference. but there is lack of trust of government in general, and there are people who listened and read an awful lot on the internet and listen to all the conspiracy theories. i have had letters sent to me saying there is a chip inside the vaccine. that is a conspiracy by somebody to control your body the rest of your life. you just have to continue to educate and inform. do it face-to-face, small group sessions, use other people in the communities to provide the education. but there are some people that you probably will never fully convince. there are people in health care

that you will never fully convince. if that is the case, they will not work in health care anymore. romaine: let's talk about that because some employees are actually protesting outside of some of your hospitals in new york. i know it is a small percentage of employees here, but what is your next move with these people if they are resistant to getting the vaccine and even being tested here? are you going to let them go? are you going to push them out? michael: we are going to do everything possible to convince them to do the right thing. as a medical professional, you have a response ability to the medical community and patients and family and friends. we will require that they get tested every week. if they continue to refuse, the ultimate result can be termination. we are not shy in doing that. if that is the end result, that is what we will do. but we are trying to avoid that possibility by getting people to make the right decisions. the governor's mandate, as you

know, says everybody has to have a vaccine by september 27, so we have between now and subtopic 27. september 27 comes and we still have people against it. taylor: can you talk about taking drastic action? changes you are seeing in covid 2020 versus this new delta variant. are you seeing other variants emerge? are we over the peak? and how this variant might be different from original virus that we saw a rigell. michael: the virus mutates all the time so we will get different variations. the delta variant is obviously more difficult to deal with than the one that was there before, but remember, if you are vaccinated, and it is simple

because this issue is not complicated. if you are vaccinated, the likelihood of you ending up in the hospital is dramatically, dramatically reduced. if you are not vaccinated, in all likelihood you will get it and in all likelihood you will end up being hospitalized. so the answer is vaccination irrespective of what kind of variant exists. vaccination works. we are fortunate that science gives us a cure, a process where you can eliminate the difficulty, if only people could comply. convincing people to comply is the difficult situation. leadership and many other parts of the country are arguing the opposite, which i think is leadership malpractice. caroline: it is free to get vaccinated, but it is not free to get health care in the united states. like perhaps where i come from in the u.k.

do you think money will eventually talk if you have to pay out for getting the virus? michael: if you come to the hospital and you have the virus, you will be covered by insurance. if you come and you are not, we will take care of you anyway, irrespective of whether you have insurance or not. you will get full treatment. we don't make distinctions based upon whether you have insurance or not. at least at northwell we don't. at other institutions i am aware of, you don't. some people are giving money to people to get vaccinated. and i think that will be great so we use every avenue we possibly can. we are not personally providing money to people to get vaccinated at the moment, but if you end up in the hospital, we will take care of you, irrespective of your insurance. romaine: i am curious if you talk to other hospital executives, particularly those outside of new york state. we know new york with regards to

the vaccination rate in new york city are relatively higher, higher than the national average. you go to florida and georgia, vaccination rates are abysmal. i wonder if you have spoken to other executives out there and got their take on what they want to do or need to do to clear that up. michael: many of the people i speak to, they are very frustrated. they want to do the right thing. they are in the business of health care. this is what we do. i think they are terribly frustrated with the leadership, the political leadership, the toxic nature of politics, and the fact that they want to be out there vaccinated. there have been situations in one state where the person who was advocating vaccination was fired by the political leader ship. that is unbelievably frustrating

and makes them angry that you have people out there in leadership in the political circumstances arguing directly against that which we all know in health care works. you have some of those political leaders saying we don't want to win here because we are going to do the opposite. we don't fight anymore without using the armaments that you have to win. so it is an expert in every frustration among the staff. there was one hospital in one of the states recently where you had a slow down of work by the doctors and others who were just completely frustrated. it was their way of saying this is awful. let's unify here. let's get our act together and do what we know we can do. because this is winnable. if we just pull together and unify. but the toxicity about politics is the biggest enemy we currently have right now. caroline: michael dowling, so great to have you. thank you.

president and ceo of northwell health. thoughtful commentary there. we want to now be talking about the onset of the pandemic. most insurers waived out-of-pocket costs for covid treatment but with the wide availability of vaccines, many are pushing. we discussed that with an er chief. this is bloomberg. ♪

caroline: we have been talking about vaccine hesitancy. many feel that money could be that way that people start to get vaccinated. we are seeing companies start to mandate vaccine, but could the fact that your insurance does

not pay out in the future could be an issue? dr. elisabeth rosenthal has been writing about that. author of "un-american sickness: how health care became big business and how you can take it back." we want to dig into the future perspective. insurers have been waving patient payment when it comes to covid at the moment. of course the right thing to do in a pandemic. but now we have medicine to fight that in the vaccine. what do you think will happen? elisabeth: insurers have been excepting people from paying their co-pays and deductibles, but most of them have stopped that now that there is a vaccine and there is a way to prevent getting covid. i think people don't understand how financially vulnerable they are. covid admission to the hospital, which is what the vaccine prevents, are hugely expensive. even a trip to the er can be $10,000, which may mean $2000

out of your pocket. if you got covid hospitalized, you are talking hundreds of thousands of dollars often. it could be financially disastrous. i think people will sometimes say, oh, we ensure people who are obese or are smokers or drinkers. those are things we consider diseases that are hard to overcome. getting a shot is quick, easy, and free. it is a different ballgame. i expect that if the mandates don't work, some companies don't want to impose them. some insurers may say if you are not going to get vaccinated, maybe you should pay a higher premium. taylor: can you explain to us more of why you think this is a different ballgame? because some could argue they are healthy, they are taking care of themselves, why should they be punished versus somebody who gets the vaccine but is a

smoker or extremely obese and then we are subsidizing those health care costs? what do you say to people who argue that? elisabeth: i think the thing is your choice to get a vaccine puts a burden on the rest of us. your choice not to get a vaccine impacts the health of the vulnerable around you and little kids who cannot get vaccinated yet, those under 12. and also, if you are in my company and choose not to get a vaccine and you get really sick with covid, my premiums are going to skyrocket next year because that is how insurance works. among all the employees, if one person's costs go through the roof, it impacts everyone. that is why even the affordable care act allowed small companies to charge 50% more for people who are smokers for their

insurance premiums. so i think there is precedent. romaine: i am curious. you bring up the affordable care act and the idea how one person's premium interact with someone else's and it balances itself out. there is a general political climate here that i think is pushing back against a lot of the principal proposals with regards to our health care system. i am wondering, for you and the other folks at kaiser, when you are out there trying to gauge what can actually get done in our society here, do you actually think any of this is possible? elisabeth: i think money talks. i would have thought that people's health would speak to them, being afraid of what they are seeing out of covid patients in the hospital, but that does not seem to work, so maybe the money argument will. i am pretty desperate. we are the first country or one of the first countries that had

widespread access to this vaccine. it was developed and approved by the trump administration. it is free. our vaccine risks are lagging behind many other developed countries. romaine: do you think there should be a federal mandate? elisabeth: you know, the u.s. does not like mandates generally, right? we believe in individual freedom. but we do mandate a whole lot of vaccines to go to school. i think for the good of society, for the health of society, we mandate seatbelts, even though a lot of people when that first came into effect said, you can't tell me what to do. now everyone does. i just think there is precedent. i am desperate to get our society vaccinated and back to normal. i think that's got to be the end goal. caroline: at the moment, it feels like normal is not insight. every time we start to think it is, something else comes from

the side and destabilizes us. are you positive at the moment, hopeful, optimistic that we will kick this in some way and be able to reopen more fully and consistently? elisabeth: i know we can, but whether we have the will politically and companies have the will to do it is another question. the problem with the large percentage of us vaccinated in some places, it is not just that they are putting other people at risk, but that leads to more people getting covid and the more variants it breeds. we are already dealing with the delta variant, which is a more contagious one. what if something worse comes along? that is a really scary thought. taylor: elisabeth rosenthal, really appreciate your time and that perspective. meanwhile, president biden speaking yesterday right after

the fda approved the pfizer vaccine, urging corporations to join the rush to get eligible populations vaccinated. goldman sachs listened to that call today. the firm requiring employees to wear masks or prove they have been vaccinated against covid to enter the workplace. and some of the visitors as well. it is a new twist. let's discuss the corporate response to vaccines. we just got off of a previous conversation talking about how in this country we love individual freedoms. of course in terms of health, those are being questioned if you will. what do you make of some of this corporate response, and is it right that the private sector is taking the lead on this versus a federal mandate? >> we thought when the vaccines were first issued with employers thinking of it as may be a

modest incentive would do the trick and push employees to get vaccinated. so a gift card or a few extra dollars in their paycheck, but vaccine doubles have stalled out, and with the emergence of the delta variant, we are seeing employers be more willing to go further. if not all the way to a mandate, may be a middle step like a vaccine surcharge for example, where as discussed before, employers will play -- employees will pay a little more further health insurance. certainly that discussion has changed a lot. romaine: do you think that some of these employers are preparing for the possibility there would be a significant number of people, a significant percentage of people who just are not going to do it and there is no amount of incentives?

are they prepared for the idea they may have to cut some of those people lose if they are not willing to comply? wade: yeah. that is why these are weighty decisions and why they are taking time to process. it deals with our culture. how many employees are we talking about here? if we are going to go all the way to a mandate, we have to have senior leadership. -- senior leadership on board, hr on board. we have to know that the consequent is of doing this are worth it. it is a tight labor market. employees are thinking, if i don't like the policies of my employer, i want to have options down the street employers are certainly considering all of those when making decisions about whether to implement something like a vaccine mandate or surcharge. caroline: not to sound harsh or callous about this, but what about the legal precedent? are they able to support letting

someone go because they refused to get a mandated vaccine? wade: yeah. we have had court cases in the past that have permitted vaccine mandates for health care and schools. it came out earlier this year that employers could do it. the department of justice has weighed in. with the president coming out yesterday and saying he wants employers to mandate the vaccine , pretty strong statements. something that employers can really hold onto when they are implement in these things, that they are hearing it all the way up from the top. taylor: it is interesting. we are also coming up another conversation about charging corporations with some of the insurance companies charging a premium surcharge for those not vaccinated. the last guest liking --

likening it to you can charge smokers to encourage different behavior. what would be the legal precedents of that? wade: yeah. employers have gotten comfortable with tobacco surcharges and well risk plan surcharges. if employees are not willing to engage in healthy behaviors, they can pay more. that is part of the legal framework under the affordable care act. this is really along the same lines where as long as employers are willing to accommodate those that can't get vaccinated because of a disability or religious beliefs, they are on firm legal footing in charging employees more. the one standard to be aware of, the employer is facilitating the vaccine unless you have the

employer offering on-site vaccination. caroline: we want to thank you so much. wade from mercer, great to have your perspective. what a fascinating discussion across the board. that is it for "what'd you miss?" taylor: not does it, but "bloomberg technology" is up next. romaine: have a great day. ♪ so...i know you and george were struggling

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>> from the heart of where innovation, money, and power collide, in silicon valley and beyond, this is "bloomberg technology" with emily chang. ♪ emily: i'm emily chang in san francisco. this is "bloomberg technology." coming up in the next hour, chinese tech giants store as investors try to get in at the bottom of rigell joy scrutiny from both beijing and washington.