out -- outsourcing, as far as medical. i was laughed at so gently, and told they don't treat help tights-b. i said you're full of crap. they do treat it which it's chronic, and since you gave me such a megadose, my body is collapsing, appeared hepatitis-c, so thank you very much. i don't appreciate it, i said, but i'll deal with it. what they did -- and this is what i refer to as, quote, engineered -- engineered crap. they do this on a regular basis up in utah. first thing you feel is a pain in the knees and hips. oh, gee whiz, now who replaces thor knees and hips? oh, that's right, doctors.

doctors on the scam. well, while i was, quote, dealing with medical -- being in the hospital and from a hospital to a nursing home, and here they thought they were going to go ahead and own my house. that's part of the game. it's a lot of, quote, investors. they pay certain groups. they use a lot of youngsters as well to basically intimidate people to move out of the neighborhood. they sell their house cheap, because they're getting harassed. i was called up in utah by my name ra and said, do you have your camera on? i said, no, my cameras? no. they broke into my house. so you don't know who you're living next door to. i dealt with one individual across the street. i guess his specialty is, quote,

insurance, you know, as one would say. v.a. related. >> yes, v.a. related. he's the one that told me to go ahead -- since i was in the navy, and a vet, go ahead and apply. so the corruption runs deep, as one would say. i think the v.a. hospital, when i came to the v.a. hospital here, it wasn't so bad. i admit that. although i know it was a scam, because they said there was nothing wrong with my left lung. now, that lung was collapsed back in 2011, when i was basically forced off the road. okay. i flipped around. could i honestly say i was going to work? that's what they told me. they told me in the hospital i was going to work. they said i never arrived on friday night. well, i did arrive a friday

night. it was saturday morning that i was sent home an hour early. i should have been escorted home. but would i say on a bible that was i going to work? i have no idea, because i was basically com atoes. while my insurance was sucked dry. they rearranged my face. when i say rearranged, one doctor had it, quote, 48 screws, 10 plates. next time i get my medical records, because they were stolen from my home -- was it by the v.a.? i don't know by who. records were stolen.

next time, it says i had 26 screws and only, quote, 6 plates. well, i can tell you this much. i don't feel anything on my face, under my eyes. totally numb. my nose, it certainly isn't my nose. it looks exactly like quote a exactly like someone i dealt with. she has my towels. her mother has my aunt's sewing machine in her house. you know, a whole theft ring. it's called theft by advancement. that's how you advance. that's the department of corrections.

>> okay. i was in the navy. i was a corpsman. i joined the military, because -- i joined the military because i wanted to serve this great country of ours, and you know, i would die for my country. i just didn't think that it might be at one of the vas that i had to do that at. 18 months ago i went -- i was noticing some swelling in my feet, in my one foot. it got progressively worse. i called my primary care. i got his nurse. that was at the time where you could actually get through the telephone. well, he kept putting me off. the doctor is not here, blah blah blah. well, i managed to get a copy of my medical records, and it said

that -- it said in there the doctor had wanted me to come in on an emergency appointment, call her and -- so he put a message back to the doctor that said, called patient trying to tell her to come in for an emergency appointment with the doctor. she refused because she can't find child care for her four children. i ain't never had a child in my life. then he tries to back it up when i confront him with it. he says, but you told me you couldn't find child care for your four children. that shows you right there, dumb, dumber and oh, my god. well, finally after about, what, nine months, they finally did -- the message was getting to my doctor, which imthe best primary care there is here. oh, yeah, i went to john mccain's office, and that somehow just opened up the doors. well, they did an mri, and they

found out i had a torn peroneus brevis, which is the tendon from your toe. over the years after jumping out of airplanes and that stupid stuff we like to do in the military, it took a toll. well, january 10th, they set up for me to have surgery. i was so excited. january the 8th el get a phone call from the surgeon. he's wanting to know if we can postpone -- or reschedule the surgery, because he has to go to the airport to pick up hi family members. i've never heard of a doctor calling and asking something like that. so i said, well, i really don't want to do that. he goes, well -- it was the 15th. in the meantime i had a heart attack, and that -- what was really funny, i had gotten out of the hospital all right.

when he called back to reschedule it again. i go, did you know we had a heart attack? he said, well, we can't do it at all. i've had five cancellations, two when i was right there ready to have it done. then the third one -- or the fifth one was just, what, 2 1/2 weeks ago, 3 weeks ago? i was on the table butt naked ready go, and they stop the surgery because my blood sugar -- which i did the preop on the 18th, this was the 29th. i did the preop on the 18th. so they knew all my bloodwork. nobody called me, and i kept trying to get it on my healthy vet but that blood work would not come up. i don't know if it was because it was a preop or what, but i never got it. of course, you can't call these clinics, because you get big spring texas with somebody named john who speaks some other

language that you can't even understand. so i get in there thinking they didn't call me, so everything must be okay. well, my blood sugar was high then. nobody called me to let me know. there was enough time to do that. so they stopped the surgery. well, for the preop, i had gone in, and i don't understand this, how these nurse practitioners -- or these rns -- actually it wasn't a nurse practitioners. it was an rn. he was actually giving me, okay, i want you off your plavix, this, this, and this. i said, well, does the doctor know about this? i'm not on anything else to sustain me. i can't take aspirin -- >> eerks no, this is regular protocol. you don't need to talk to the doctor. i didn't talk to the doctor. they took me off plavix, like i said i was supposed to have surgery the 29th. i ended up in channela regional

with a heart attack again, because when they took the plavix away for the five days i formed two blood clots, one of them stuck to my extent that i had gotten in january, and basically i was 100% occluded. i would have died in my sleep that night if el hadn't got that severe pain. so they put in another stent. i tried to call the pod atrick clinic, well, you call us in a year and we'll talk to you. you know, i did not -- i didn't join the military because, you know, i knew that 20 years later i would need medical care. i joined the military because i felt proud of this country. i wanted to be part of this count country, you know, no matter what. so i ghif all the way, like they say you sign the check all the

way up to and including your death, but we're not getting that back. we're getting people that are giving us a bunch of baloney, you know, talking out of both sides of their mouth. i see that done -- i'm in here quite a bit, at least three times a month. i'm just getting sick and tired of it. i'm sick and tired of seeing these little non-veteran kids talking to these older veterans like they're dogs. believe me, if i'm here and i hear it, you probably heard my name. i stand up, and let me tell you, they don't get away with it, nothing on my time. you know, these people up on the front lines when they check you in and all that, they should t not -- i swear. i went to nursing school, paramedic school. i have all these things.

these people have never gone -- they have no medical training at all. but they can stand up and tell you, go home and we'll call you. that's not the way that works. if you were in a civilian hospital or civilian doctor's office and a patient came in and said i'm having chest pains and you go, go home, we'll call you? that's termination right there. these people are allowed to turn people away. i was here the other day, a little 17, 18-year-old just gotten out. she's tim mid and said i'm having a bad time. i feel like i'm going to hurt myself. it's like oh, my god. well, the girls told her we don't have any of your paperwork. you need to go home and called you. this poor child walking out of there. we're trying to tell her about the opal clinic. you know the people in the primary care didn't even no it existed. where is that add? you dumb ass, it's right around

the corner. i just don't get it. turned that poor little girl away. the whole night i had a friend who was with me, the whole night that's all i worried about, am i going to read about this poor girl who's gone out, you know, death by cop or death by whatever, and all because you don't have the time to take the time. that's not right. if it weren't for the veterans, before and after and now, there wouldn't be a job for these civilians to have and to treat people that way, and they need to understand that. we're not here for them. they're here for us, and by damn it they're going to do it if i have my way about it. don't ever say something bad to a veteran, because i will clock you, and i will take your name and number. i have someone else with me that will do the same thing, only she hits harder.

patient advocate, that's an oxymoron to me, because how can you have somebody help somebody who works for the v.a.? they're complaining about the v.a. and they're helping them for the v.a. i had a bad experience with them. when i heard her go into a room and tell the doctor, well, what do you want me to do to get rid of her? that pissed me off and i let her know about it. that is not right. that's all i've got to say. >> all right. thank you. >> hello. i'm dave. i'm a bit overwhelmed, kind of tired. more importantly, besides the bitch session, which i might have a couple bitches about, we

need -- easy money in the -- in the things going in one ear and out the other. more importantly, with all the money they're putting into the v.a. and stuff, this is phoenix. we're a huge city. veterans made arizona what it is, and at this time there's no doubt in my military mind that there should be two shifts. instead of everyone living the luxurious life and going home at 4: 4:00. secondly patient advocate, as we've discussed a few times, should have like a patient advocate that can -- you can kind of communicate with.

as a team player that we were taught so much in the military, someone that, again, can help you with your treatment plan. trying to keep it as short as i can. i've got third-stage lung disease, yada, yada, yada, and what is happening to all these people? sharon helmman, is she still collecting money? what the hell is going on? dr. bloom was my pulmonologist, and just like the rest of the v.a., he conveniently retired. that's what -- they just conveniently do this and that. i'm a licensed aircraft mechanic, licensed electric trunk mechanic, united airlines since 1990, been seeing these pieces of shit for 2 1/2 years.

i was finally terminated with united airlines may 31st of this year, and i'm blackballed. again, the police officers not the last like four times, but previous to that, have always like, again, messed with. the whoa thing is a big fucking joke. it's a big fucking joke. it's like the walnut shell game, or hot potato. there's so many people here, that no one is accountable. they just pass the buck to another person. but if we're going to keep having these town meetings, we need -- we need the v.a. staff in here, you know, because we can bitch and complain all we

want, whatever. >> okay. thank you. >> i don't know if anybody knows it, it's international peace day today. how perfect i'm honored as a mother of a veteran who served in desert storm to speak to all of you. what he would say -- he died last october. what he would say to me, through the eight years that he went on the waiting list and died october 25th, i was with the personal advocate here at the hospital when he died, the phone call came. he would say, mom, don't do it for me. do it for the other veterans. and that's why i'm here.

and i'm appalled to hear what all is going on here. i want to tell i my medical experience, at 10 years old i was changing diapers of a baby that was born with his bladder out and his even is on the side. at 16 i was my mother's, my father's nurse, because my mother wouldn't assist him. so i changed his trach. i cleaned it, i showed him a mirror after he had four places in his jaw broken, two broken wrists and a broken leg. he's an irishman from illinois, and i'm proud to say i'm a farmer's daughter. i want you all to know the crisis in medical care that we're in. i've assisted five or six people in hospice to die.

so we all are here for temporary reasons. what we do with that short span of time that we're here, assist everybody, be as advocate for civil rights. learn the gettysburg address. get out there in your community and establish help. go get a degree in medical professions. you know we're overloaded. everybody knows we're overloaded. the v.a. knows we're overloaded. we're all overloaded. everybody's overworked. do you get it? do you get it? everybody should get it. do your part. do your part to assist. i know, i understand. i hear you. i know there's mistakes. and i know there's people that didn't hear my son when he had a tumor in his face and he had to

get on the waiting list. and so he proceeded to go to the state hospital and say i'm nuts, i know i am, help me. three times. at the state hospital. no help, nothing. value options. go to value options. we'll give you a good drug. oh, no, they went out of business. they had to hide and change the name for magellan. yes, my father worked at the state hospital. i spent six years visiting my son, and i got to watch. i got to watch him die. i got to watch the doctors over-drug him and give him bladder cancer. when i requested the records, i was told i had to pay 50 cents a

page. can you imagine six years? of medical records at the state hospital? i requested when the governor -- from the department of health, from the state hospital, from the v.a., everybody that i could, can we please have his record? yeah, the first records are supposed to be free from the v.a., but guess what? he knew there was no assistance at that time. he entered in peacetime as a mine man. does anybody know what a mine man is? who knows what a mine man is? nobody. they don't tell you what a mine man is. a mine man hauls explosives and bombs. he delivers bombs. it was peacetime.

i married his chicago cub father because president kennedy said if you got married, you didn't have to go to war. where are we now? thank you. >> my name is staff sergeant richard harris, retired. 23 years army national guard, army reserve, afghanistan 2002, iraq '06, '07. standing here pretty able-bodied. okay? i'm 40% disabled. i've got all my limbs, thankfully. i just want to say i filed. i filed my claims after i

retired, because there's a stigma of they bond want any broke soldiers. i was a mid level nco, had soldiers reporting, i was counseling, encouraging, mentoring, still in the reserves after afghanistan and iraq for another two years before i retired after 23 years. going to do pt tests and everything, and you go in the locker room afterwards, and people were cleaning up, it looks like a damn pharmaceutical convention, because you have half the units on the psychotropics, trying to deal with the stress. i was a triathlete. now i get winded after about 45 minutes of a workout. i used to be able to work out eight hours a day and longer. okay?

i was just solid. now my wife complains because i'm fatigued all the time. i don't want to complaint, i want to solve the problem. i haven't been to the v.a., except for today, because i had registered with the -- what was it, the gulf war registry. something i wasn't told about in 2010 when i first filed my claims. i filed nine claims, two were approved, two were denied, five were forgotten, okay? i've overcame another four of those, and the two that were declined through naturopathic means out of my own pocket. thank god i am employed, and thank god i do have insurance outside of the v.a. and i even changed my whole career to go into psychology and

everything to help vets, to deal with this stuff. i'm working on applying for my master's and i help -- volunteer for encouraging vets and different things like that. >> like a peer-to-peer type of thing? >> most definitely. >> good. but i just want to say your system is broke. if i can help, i will. you know, if there's anybody who needs somebody to talk to, some other medical advice, i've saved myself from surgeries through naturopathic means, and i've overcame a few things. it's funny, the two things -- or one of the things that was approved was ibs, and it's kind of fitting, because the army and the v.a. has been a pain in the ass ever since. that's about it.

i do like this. i mean you're asking for suggestions, what's going good, what's going bad. i will say just kind of real quick that gulf war registry, you have -- it's a study, it's not necessarily there to help with your claims, although it will hopefully long term. i think it's kind of misguided. i mean, if you do your research, there was chemical exposure in afghanistan before i know -- if i read my history right, the russians when they left bagram airfield, they sprayed commercial pesticides, killing tens of thousands of people. i've seen the grave yards. i was there early. we were kicking around in the dust a foot thick, breathing it.

that was one of the my first concerns when i left my exit eval. i've suffered from different things ever sinced. so i'm here to help with that study. you know, i've volunteered for a lot of different thing, but i don't know, the whole system is broke. thanks. >> thank you. >> hi. my name is ed. i'm an army veteran. i had a whole bunch of things i want to do go over, but it seems like everybody has already hit on everything. so a couple things i really wanted to touch on is the papers you're passing out on how these people fill it out, this is the first time this has happened. you know, they've had these

suggestions boxes all over the v.a. that the people have never did anything with. as a matter of fact, some of them are still up. who's going to be following up on these? >> what i do is i go through them. i have to figure out a way to communicate with all of you. i really don't have an easy way to do it. like with my employees, i'll e-mail them the actual cards and we provide updates on what's happening with the various suggestions. i'm going to try to figure out a way to do that, maybe at a subsequent meeting to tie some invite things that were raised, show that we're trying to fix them and move forward with new comments. >> another question i had, why isn't somebody taking minutes on what's going on here? >> we've got lots of staff. >> and is this going to be -- are we going to be able to have

access to it? >> i don't know. i'll talk to the director over there. i think there was a request from c-span, right? so c pan is recording this. i don't know what they're going to use it for, but they asked to come tonight and record it. >> record it while it's being watched -- >> i guess c-span is going to show this, you could watch it on tv, yeah. >> okay. as far as my health goes, i've been coming here since 1974. i would have to say on a scale of 1 to 10, i'm concerned -- it's always been a 7 or an 8, okay? my biggest issue is with some of these employees, and an example of that is something that happened to me just wednesday. i was called -- i had an appointment for thursday for

a -- you know, before you go for an operation, what's it called? a preop. a preop appointment for thursday. they called me tuesday night and asked me if they could change it to wednesday or friday. i said, yeah, i have an appointment wednesday at 10:30 after the appointment. she said no, we need you in here early. i said, okay. what's early? she said about 8:30 or earlier. she scheduled me for 8:30. we'll get to you so you don't miss your 10:30 appointment. this is my first experience with these people. i was going to have my hands operated on. okay. i go in -- i leave my house at 6:30 from mesa. i get here about 7:30, by 7:40 i was signed in. i asked the person -- there's only two people behind the counter, only me and another person sitting in the waiting

room. the person says i'll see that she gets it right away. i sit down, 8:00, no action. 8:30, still nobody. 8:45, maybe 8:50, i hears a lady call my name out from behind the counter. she says, sir, what are you doing here? i didn't know you were here. i walked up to her, and this guy that i signed in with is there. she's standing behind him. i just looked at him a little funny. she says something to me. i says you guys are going to have to feed me after this. by that, i meant getting me a meal ticket. i'm also diabetic, and bipolar. but anyway, this guy gives me a funny look. this lady is talking i can't give you a meal ticket, we don't do that anymore.

and she's trying to hand me this paper, i've got to go down the hall. i took that paper and handed it back to her and i walked out like this. they're calling my name, saying you won't be operated on, this shit and that shit. i left. i'm thinking i'm going to let these people operate on me? and they can't even get the -- get me in there right? i was a little afraid. i started to leave, and i thought, you know, i better find out who this person was, who that person was before i walk out of here. so i walked back upstairs, go to the counter, asked this guy for my time -- for my sign-in sheet, what time did i sign in? he started getting smart with me. talking about him being an ex-rent acop.

i don't know what he was trying to do, intimidate me, i don't know. but i said, can i speak to your supervisor? what do you want me to do? give you a copy? or get my supervisor? and i'm thinking, can't you do both? well, what do you want first? this is for real happening. i'm not kidding you. this happened. i want you're right there in on the computer, give me the copy first. meanwhile, this guy comes up to me, as big as you, says what's the problem here? i think to myself who the -- are you now? he says i'm the supervisor. i didn't say that, i know i didn't say it. i know i thought it, but i didn't say it. i said, well, how do i know you're the supervisor? because i'm telling you i'm the supervisor. i says, okay. get me your supervisor.

i don't like the way this is going, you know what i mean? okay, i'll handle this right now. he calls the freaking police, and -- wait a minute. i says, are you calling the police? he says, yeah, you know what? crew it. i don't need this. i started to walk away, and i'll be a son of a bitch if there weren't three cops running up the steps. okay. better than this. today, tonight i'm sitting down in the lobby, one of these police officers walks by me, looks me dead in the fucking eye -- excuse me, i don't mean toe swearing, look mess dead in the eye, doesn't say a word. walk back to the police station, comes back with two other police officers. i had two witnesses sitting

there with me. he gets sneaky, come up to me and says mr. lez, we've got to talk with you. i said, what's up? he says you've got to come with us. i said, what the -- this was tonight. i said, are you serious? one of the police officers opens up the door to the diamond clinic, unlocked it, says you've got to come in here with us, we don't want to talk with you out here. he handed me a fucking ticket for disorderly conduct because of that incident that happened two days ago. two days. so my question -- one of my questions was -- who is policing these police? where do they get off pulling that shit? you know? there's three or four of them here now, you know what i mean? there should be three or four

veterans there, not these guys getting paid $100 an hour or whatever the hell they're getting paid for this. you know, they're on overtime. >> so what about your surgery? >> would you get surgery here? after what just happened to me? no fucking way. i'm sorry. i wanted to go today -- this is something else i wanted to touch on. i wanted to go up to that clinic today to get that kid's name so i could have it for you guys, and his manager's name. i was afraid to go up there. i'm serious. i didn't want to do it. so i said to myself, i'm going to go to the front desk, you go in there in a wheelchair, they wheel you around, they'll take you here, take you there. i have a disability, which is a mental health disorder. i said, what if somebody comes in here and asks you to walk

them up there, be my escort, so that i don't get out of hand. i'll respect the person that's with me. i'm not going to respect the people behind the counter. so they told me they couldn't get involved in that, because it was an employee thing. that should be changed. i'm going to tell you a real quick thing here. i have a friend of mine that was with me 20 years ago on 24th stre street. her name was michelle. she was killed a month ago by a police officer who didn't know how to take a fucking hammer out of your hand. that same thing could happen here. that same thing could happen here. that for real happened. thank you for listening. >> thank you.

>> wouldn't you know, a phone is going off? i started this off tonight, but -- i had to come back after hearing everybody's distress. my family has been a family of analysts for many, many years. some of that has kind of rubbed off on me, though i never get paid for it, you know. what we're talking about, what everybody is saying here is there is a problem with gross n incompetence on a -- on a light note, the doctor always asks you these questions when you come in? are you suicidal? do you have any weapons on you? yeah, do you have any weapons? what kind would you like?

you know. so i told my doctor once are you depressed? i said, i'm getting that way. he said, can we set you up an appointment for the psychiatric care? i said, yeah, let's go see him. the day came, i got down to whatever their clinic is, i don't even know the name of it anymore. this woman comes in, she's a psychologist, and she says -- talks to me for a few minutes, and she says are you here for medication? i said, no, ma'am. well, why are you here? i said, well, here's the thing. i'm looking for some insight as to how to deal with the v.a. hospital. yeah. yeah. now, which brings me to another thing i have to direct it to you and mike -- did i see rex back there? yeah. okay. some of you people that have

pretty decent what i call -- pretty decent jobs. you know that what i'm about to say is true. please acknowledge it or call me a liar. i had a friend, his name was joe. he was a volunteer here at this hospital for many, many years. he helped a lot of people get to where they needed to go, not just to clinically, but he says, oh, see this person, this person can help you do this. i had another friend rick, he retired recently. that he would tell me, can't you put that a different way so it's not slamming at somebody? it's not confrontational? and he taught me a lot that way. but now my point that i'm getting to is the v.a., if you're going to be employed by the v.a., bob told me this, you have to go to their classes -- >> you mean our boss bob? >> yeah. >> okay. >> that's true, right?

>> right. >> prcc for a year asking if you're happy, sad, bad or glad. they should put sharon helmman through that. >> more than that. a permanent opening came up for a my friend bob, and everybody says, put in for this job at the v.a. it's a pretty nice-paying job. i've been working there as a volunteer. you know what? they turned him down, because they told him you know too much about the way we tell people -- teach people how to turn everybody down. you know, because this paper wasn't filled out exactly right, or something was omitted for any reason whatsoever, they teach you people and the classes that you have to attend -- am i okay so far? >> it sounds like the benefits side, which i don't have any role with that, but -- i'm writing it down.

>> no, no, no, this is not -- this is in order to work here, they wouldn't hire bob, because he had helped too many people obtain the goal that they were trying to work for, whether it be a doctor or -- okay. enough. that. recently they did a lung biopsiy on me here in this hospital. oh, yeah, a nightmare. they used this long needle to do this biopsy procedure. guess what? they ruptured a blood vessel and my lung started filling up with blood. scared me and scared the doctor too. okay? >> um-hmm. >> after many, many hours, they sent me home. they said, now, if i have trouble breathing, if you have chest pains, if you're bleeding,

come back. well, the next day i started having all kinds of trouble. i couldn't hardly breathe. my chest hurt and i was coughing up great big old blood clots. i told my why take me to the hospital. aisle getting bad. the emergency room here, somebody else said it, too, the emergency room was a joke. a joke. totally, totally incompetent. i sat there for seven hours, seven hours, couldn't breathe, chest pains. their excuse was the doctor, when i finally seen a doctor, he says i'm sorry, mr. christianson, i don't know what to do for you. i'm going to pass you over to pulmonary department, but i'm going to put you in the hospital tonight, and ben then it's 4:00 in the morning, okay? and this nurse comes in, and he says, i need to ask all these questions in the meantime these gave me a shot of demerol.

thank god. thank god. after seven hours in the emergency room sitting there in the lobby, not even back in the back, in the lobby. they gave me a shot of demerol. man, i'm just relaxing. they get me upstairs to a room, and the nurse says i have to ask you all these questions -- do you have any weapons? yeah. yeah. right now i'd like to have one. why don't you come back about noon tomorrow at 4:00 in the morning i'm sedated. i can't keep my eyes open. he sits there and grills me question after question until 7:00 in the morning. that's incompetent, insensitive. the key ingredient i believe that is lacking around this hospital,ite good news for you in a minute. is personal caring. if you don't -- if these doctors don't care about the person as a person enough to try and improve

their quality of life, that's totally absent. in this hospital. when you do get one that cares enough about you, somebody mentioned their doctor called and asked -- well, if you do get one to care, they're only here until their little contract is gone and then they have a good job somewhere. the v.a. doesn't want to pay anybody. now, for all of us here that think this hospital is so bad, one good piece of news for you. recently i had to go to iowa to take care of some business. this was after this biopsy. they wouldn't let me fly. i had to go tucson, across to texas and around to get to iowa. because they want, oh, your lung will burst wide open, you might have a heart attack, all these things. okay. i got there, i done that. while i was there, i had a round with my pancreas, had to be

admitted to the v.a. hospital up there for five days. guess what? is v.a. is like heaven here compared to des moines, iowa. yeah. yeah. yeah. i had a woman for four days up there, i had a liquid diet, so the fifth day they let me eat, okay? at the end of that fifth day, a woman comes around and she says, i'm from so-and-so can teen services, and i want to do a report and question you about how good your food was. i says, you've got to be kidding me, lady? how can you mess up a grilled cheese sandwich? it tasted like it had been through five fires. you know? tomato soup tasted like the dishrag that somebody forget to take the dishrag out of the soup pan. you know? so what i'm trying to say is

there are some good things here at this hospital, there are some good things, but it's certainly not the doctors. thanks. >> how would everybody feel if this is the last comment? i've got within more. all right. all right. >> you know, we were scheduled for an hour, so we've been here -- it will be 10:00, i'll go two more and then we'll wrap it up, all right? >> i wasn't going to make a comments, but so many things have happened to me that happened to other people here. i have been escorted out of this hospital three times with police, and each time one was my mother when i brought her to the emergency and they didn't see her.

she sat there for an hour with an open sore on her leg down to the bone. and i've got witnesses for this. we got a chance to go back in the back there, and the two nurses back there were playing cards, and the nurse -- person that admitted her tried to get them to take her back there and put her in a bed. they said no, we ain't got none. so when we started questioning about it, they called the police, and we was kindly escorted out. the other kay, what happened to me, i come here on a saturday for emergency with a bad prostate problem. u and they worked on me saturday, and put tubes in me and a bag and everything on me, and told me to come back monday and see my primary doctor. when i got back monday to see

the primary doctor, they said, no, you've got to make an appointment and wait a month. and these tubes all was wet and i got to wait a month to see the doctor. and first they say your doctor's not here. and then i look up and see the doctor coming down the hall, being escorted with three big burly policemen. and so after i raised so much cane, then they put me out and i went out, but, see, i had private insurance, and i went out to the hospital and they said you better get this worked on as soon as possible. and i got the prostates taken care of with an outside hospital. but here at the va, instead of them giving me service, they're going to have the police to

escort you out. and it looks like it's a -- whenever you go to one of these clinics, and you don't agree with them and get down on your knees to them. the first thing they do is they say you're crazy, they send you down to the crazy clinic or else they get the police and they escort you out. and that's what happened to he here. and i got a case four years, that's been on appeal and i don't know what, i don't know what they're going to do with it, but it's been there for four years and can't nobody tell me nothing about it and, see, i got the papers. and what happened to me, the reason i can prove this, all the times that i have been coming there mostly whenever a doctor do anything for me, i go to the

patient relief of information and i got all of these cases at my house now. by the way that they are treat meg. thank you. >> thank you. yes, sir. >> good evening, sir, thank you for your patience, you put up with a great litany of individual story this is evening. robert blakesly, i'm an army medic, i've been a lab tech, x ray tech, emergency room nurse, i've done independent duty as a physician's assistant, have a premed degree from arizona state university, some post graduation classes in health care administration. i wrote some health plans for the feds back in the '80s. i'm also a disabled vet. i've been a patient a va patient since 1972, i've been a patient at this facility since 1973.

i have seen a whole lot of changes. most of them for the good. we have a -- okay. we have a bit of a problem with disrespect for the veterans, i think, is a large portion of what goes on here. a large portion of our problem that we're trying to discuss here. the waiting lists, i have been patient for a long time. it doesn't really affect me that much. but internal problems, sergeant foster over there, he's the only guy who's been here with a smile. the corporal in the corner, the other officer, plain clothes guys all have scowls on their face all night long. why do we need such a police presence for a bunch of guys in wheelchairs? i don't know. but then i have had my own

encounters with the va police, i've been treated like a perpetrator instead of a victim, i've been thrown against the wall and questioned when i was a victim, okay. for the most part, they don't treat patients like patients or veterans. they treat everything like a perpetrator. their overwhelming force and presence is intimidating when they all hang around the cop shop in the main lobby. my main question tonight is why do we have to have town meetings like this? why don't we have an onmbudsman or an independent representative. i think they should have a desk out in the front lobby.

i think veteran or anyone that thinks they are not getting their care in time or in a timely manner or is not being available for care, should be able to walk through that front door and get fast tracked to what they need. i have been an emergency room nurse, i have done triage, i know you take someone with a week-long cold back or a guy with chest pain and has trouble breathing, needs help first. our emergency room here is not an emergency room. it's a life support center. it's a level 4. it's not equipped to handle most things. it's ambulatory care, you walk in to see folks here at the emergency room. or you get wheeled in. they don't accept ambulance patients. ambulance patients, someone who's level one, level two, scooped off the street, they go to st. joe's or down to county

or the appropriate facility. why somebody thinks that, well, i know why somebody thinks because they don't have the medical training, they don't understand all the ramifications. i have worked for back office, i know when a nurse here isn't doing her job. i have had my own problems here. records getting lost? yes. incomp tent doctors? yes. but that's what the patient representatives are for. and for the most part, if you can get to them, they do a good job. the biggest problem i can identify other than the lack of respect in general is the bureaucracy that is embodied in the unit clerks, they check you in in the clinics. i have had more problems with them than anything in the va system in 40-odd years.

it doesn't make sense that people pay -- people think their computer is more important than their patient. >> right. >> and i think that embodies pretty much what the problem is with our system now. we need more respect for the veterans, we need to understand that especially the older veterans don't always have their faculties anymore, they need to be held by the hand, they need to be guided, they need an ombudsman, sometimes they need a personal rep to guide them through the system. it's not an easy system to navigate. i've been here a long time, i know how to do it. when i have a problem with a nurse interfering with my communication with my doctor, i know to go to the library and talk to victoria, who's in charge of my health ebay, she's

the one to make sure the communications get through. if i have a nurse that tries to give me the wrong thing, no, i know i can go to the patient representative or i can even ask for another physician. there are far too many options available in the system that people do not avail themselves of that perhaps just something that would help them navigate it, i have a hard time believing -- >> they need a veteran navigator. >> that would -- that might be an excellent idea. >> like a peer to peer navigator type, yeah. >> yeah. i mean, you want to start a pilot program, i live across the street, we talked about outreich and notification of this town hall meeting, i found out at 10

after 6:00 tonight, the fact that i love across the street is the only reason i'm here. i walk ed over here, you want somebody? i'll talk to you afterward. i'll be glad to give you further ideas on it if you would like. >> thank you, sir. >> again, thank you very much for your patience. >> all right u folks, i want to thank you-all folks for coming out. >> may i say something? >> you may? >> this is for the veterans, we got to help each other, if you would like to start a veteran's aid or something, as a group, we can work with the director, we can work with patients, but as a group we'll have more power than what you would by yourselves.

tonight on cspan 3, we'll take a look at the health care system, with a discussion on the health system in the u.s. followed by a discussion of pesticides and genetically modified foods. and what health care systems are doing in other countries. >> the clinton foundation hosted

its health matters conference in california. bill clinton moderated a panel with health care executives talking about how the u.s. can move to a more efficient effective system for delivering health services. this is a little less than an hour and a half. thank you very enough. thank you. thank you. thank you. thank you. thank you. thank you and good morning. i'm sorry we're starting a little late but you gathered a little late. and i was told it was because of the workouts. and a lot of you are nodding your head. and i thought he can just wait. we're getting into this silly season. you know, everything is reported in a political context. so i can just see the headline, clinton hospitalizes attendees to health conference. tries to make money for sponsor. it's not a bad headline.

we have two of the three hospitals out here. maybe it's a good deal. i want to thank you for being here. in our third conference i thank tena as always for their support. i want to thank espn for the great town hall meeting we had last night. i don't know how many of you were there or saw it, but it was amazing. they did a wonderful job. kobe bryant was great. the other athletes were great. and the children were wonderful. so i thank them for that. i also want to thank our other sponsors. pga tour, g.e., massimo, pricewaterhousecoopers, technogym, astrazeneca, california endowment and santa fe. they all support the work we do trying to improve the health of people around america. i want to thank humana for

working with us and the pga tour to put on this challenge that starts thursday. our golf tournament tries to build on bob hope's legacy and keep it alive here in the valley. i think bob hope would appreciate our focus on wellness. i first met bob hope when he was had he 78 years old, a young man. i was the governor of arkansas. and he did a gig at the university. i went up and had dinner with him. and i said, how do you keep doing this? and he said, well, i played golf as long as i could. but i walk an hour a day no matter where i am or no matter how rainy, slippery it is. i carry every conceivable footwear and a big umbrella. and if i have to walk after midnight, i do it.

i never, ever go to bed unless i walk an hour. and he made it to nearly 100, you know? so it's not a bad prescription. what we try to do with this conference is to think about how we can have wellness in every generation. most of you here now that this health matters idea grew out of the good results we had in trying to tackle the childhood obesity epidemic. and that's what it is. at the time we started certainly our biggest health problem. perhaps it still is. and i want to thank for all the people who work in the alliance. i was introduced to one of the young advisory board members last night who came all the way from miami. but after doing what we could to reduce the number of bad

calories and drinks going to our schools by 90% and trying to lead the way to what is now a new nationwide movement to upgrade the quality of health in the schools through the cafeteria offerings and working in 20,000 schools on exercise programs, we're now moving outside the schools on that. it was clear to me, way more was needed to be done if we were going to improve the health and wellness of americans and bring the percentage of our income we're spending on health care closer to the global average. one of the reasons for growing income in equality in america, which is a dot most people never connect, is that as recently as three years ago we were spending

17.8% of our income on health care and no other country was spending more than 11.8% of their income on health care. no other rich country. so that was a trillion dollars a year going to health care that otherwise might have gone into not only hiring more people but raising the incomes of people who were at work. it reduced the disposable income of virtually every american who either had health insurance and was paying for it or had to pay out of pocket for costs. i'll say more about that in a moment. the good news is for all this trouble in the individual market, we are down to 17.2% of our income being spent on health care. because for the last four years we have had inflation under 4% for the first time in half a century. but there are economic as well as health care implications to the health care trajectory we were on. it was clear to me that unless we started on this we were going to have real problems with the aging of the baby boomers.

i am the oldest of the baby boomers. i hate that. anyway, there it is. so we're just getting started on this. and if you live to be 65 in america, you already have a life expectancy. if you're a woman of 85 and if you're a man of about 82 1/2. and it's just going to get -- we're going to live longer. if we don't live better, we're going to impose an unconscionable burden on our children and their ability to raise our grand children and reverse all these trends that are now on the way toward greater health and being closer to our global competitors in the actual money we have to allocate

to caring for people who are sick. so that's why we're doing this. today you will hear announcements from people designed to fill in the blanks how we can improve the health of all americans that include partners like humana, mtv, james beard foundation and many others. i am excited about them. we are announcing today that the health matters initiative partners are making $100 million in new commitments that will impact more than 50 million people. that's about one in six americans -- in a positive way. i want us to just keep doing this. this is -- we are trying to change the whole ecosystem of america as it relates to health and wellness. and i'm thrilled about it. i'm particularly thrilled because of the commitments that were announced last year. 90% of them, 90% of them have

either been completed or are under way and on their way to completion. that's a wonderful thing when 9 out of 10 people tell you they are going to do something and do it. so, we still have a long way to go. every international ranking says that we're great at some things. like cancer treatments. but we are light years ahead of every other country in the percentage of our income that we devote to health care. if you measure us in terms of life expectancy and heating and wellness indicators we have on every international survey i have seen in the last 12 years ranked somewhere between 25th and 33rd. of all the rich countries in the world. we can do better. and we have to change it ourselves.

so, we are going to focus now on our panel on what else can be done. i want to make just one final point. chronic diseases, many of which are entirely preventable, claim 7 out of 10 lives and 75% of our health care spending every single year. over the last generation, the prevalence of diabetes, heart disease, obesity and other chronic diseases have all risen. the last two decades, the number of people suffering from diabetes has tripled, affecting more than 25 million people. it is now the leading cause of a number of complications, including kidney failure and blindness. the elements that play relate to our habits, our lifestyles, our environments. and they result in the health outcome disparities that we all

see, including those that are income based. so i'm looking forward to talking about the transformation as we kick off our conference. our first panelists have some interesting think things to say. and i want to bring them on now. i'll be introduced by -- when you hear one of those voices, do you know what they call those voices on every stage in america? the voice of god. if anybody ever asks if you're a believer or whether you have heard the voice of god, you can say yes incident to breck our panelists out now so we can get to work. thanks very much. >> please welcome the panelists of the health transformation panel, trevor fetter, ceo of tenet healthcare. dr. patrick soon-shiong,

chairman and ceo of nantworks health and chan soon-shiong family foundation. tim finchem, commissioner of the pga tour. sue siegel, ceo, g.e. ventures and healthymagination. bruce broussard, president and chief executive officer of humana, inc. to join president clinton on the stage. [ applause ]. >> those of you who have been at our previous conferences will recognize some of the people on the stage. and what i would like to do is begin by giving everybody a couple of minutes just to talk about what they intend to do in the coming year, how they analyze this and the point they want to make about the contributions they believe they can make to deal with this

issue. want to start? >> i would love to start. thanks for having us. we have worked with the clinton foundation over the last few years at humana. we're excited to say we're going to focus on a community to help improve their health by 20%, by 2020 by making individuals easier to achieve their health. now i want to point out that the important part of that is not just the 20% improvement, but i think the health care system in general needs to focus on how we can help people achieve their health in an easier way. we as i think a society, health is hard. it's hard to stay healthy. i think it's easy to have formed bad habits. when you look at the underresourced areas it's hard for them to maintain health. they don't have health literacy. they sometimes don't have access to good foods. they don't have the economic conditions that promote health. i think as an organization and

health care system, partnering together with organizations that are on this stage and throughout the industry is one of our obligations. we look forward in working with you to improve the health of our community. >> i'm sue segal representing g.e. what we would like to do at g.e. is really utilize the employer bases for catalyst change. we represent health in a number of ways. one as one of the biggest medical device manufacturers and so we have the spongtd of technology. in addition to that, we have our health foundation, our g.e. foundation. and there we make grants as it relates to major issues surrounding health. as an example, the area of primary care shortage and underserved regions where we have put our clinical health clinics in some of those areas. in addition to that, when you

think about our own employer base, we have 500,000 covered lives, we have to really think about how do we manage the cost of health care while we continue to make sure our employee health and the quality of their health are either the same or raised. and that's a major issue for us. we have been working on that for quite some time. i'm most excited working on healthy cities with the clinton health matters initiative. wire working very closely with a team in houston. one of the reasons why this is so interesting is houston, as you might think about it, has some of the best medical centers in the u.s. or in the world. yet it is one of the most challenged as it relates to stats. and health stats. and we're looking forward to working on this together with clinton health matters to actually make a difference. and my sense is that employers are real catalysts to allow this to happen.

employers foot 50% of the health care in this country, from a major customer, a lot of the folks on stage, for example. when customers are in the room and convening, it's amazing how people want to collaborate. so looking forward to talking about that. >> thanks. i just have to say houston is about to face a new challenge too. because there are so many low-income people there. the state of texas has refused to accept federal medicare money. but houstons hospitals are going to lose their disproportionate share payments, they're going to be in a much more difficult situation than they were before. i know that some of the big hospitals in houston and dallas principally have actually asked the federal government if they could take their county out of texas for purposes of medicaid treatment. i thought it was interesting because the governor of texas used to talk about how he wanted to succeed from the union.

since i was raised in arkansas, i wanted to tell him not to let the doorknob hit him on the way out. now you got some of these big urban hospitals wanting to sucede from texas, get back into the union so i can get this medicaid coverage. we're laughing, but it's an extremely serious issue if you're trying to manage a big health care system and you're going to all of a sudden see an increase in your uncompensated care bill when the program for uncompensated care has been eliminated because those people, it was assumed, would all have compensated care. and this is -- you can laugh. but laughing i find sometimes clears the mind. this is a very serious issue. so tim? >> mr. president, let me just start by thanking you for all you've done for the game of golf. i don't know if many are aware

that the president, chairman of the presidents cup. he's been to many, many ryder cups and presidents cups over the years. and i remember a ryder cup over in the uk when he came and watched the teams go off. after the last match, there was a little rustling around on the tee. five minutes later i looked down the fairway. in the middle of the first fairway at the ryder cup, the applause, president clinton had stolen the show. fabulous. last night there was a discussion about your athletic prowess. you talked about double digits in a basketball game. i have to tell you, mr. president, i have to believe you're a better golfer today than a baseball player. thank for your commitment to us and your friendship for many years. people wonder why we are involved in all of this. obviously the partnership

between humana and the clinton foundation is very important to our pga tour and to our players. but from a health and wellness standpoint activity here fits with our culture. let me explain that quickly. as most of you know, all our tournaments raise money for charity. this year they will raise $130 million for charity. 80% of those charitable efforts, tournaments are focused on some health-related activity. arrest arnold palmer medical center in florida, eisenhower medical hospital here, st. jude's and increasing wellness as well. among our players, the vast majority of the top 150 players have their own foundations, their own fund-raising activities. last year they raised among them about $35 million and at least three-quarters to 80% of their activity is focused on juniors

development, health, wellness and the future. and then our employees who pushed back a little bit 22 years ago when we announced there wouldn't be any speaking in our headquarters, today are focusing on wellness, partnering with humana. with their wellness programs, over 90% of our employees are voluntarily scanned. scanning resulted in a wide range of activity changes and behavioral changes in our employee base. and they are totally into it. so initiatives and effort and energy behind things that relate to what the health matters conference is all about and the clinton foundation is all about is a natural for us. and given our players walk on

average 30 miles a week, they are great role models on the fitness side of the equation. so what are we doing? well, i think as the president has often talked about on the global scale of doing things like reducing sugar content in drinks available to schoolchildren, that's a mega, colossal, global countrywide effort that needs to be married with lots of little activity at the local level. so for us it's contributing to using our players as role models, telling the story of things like what comes out of this conference on a national basis. at the same time, we're looking at the police places are we play tourlts, in so many markets

about how we can generate more activity there. so this year we promised the president we would underwrite for the next five years as a part of the players championship proceeds. the same thing is going on in houston. ashley juarez-smith at a very young age has already become extremely prominent on the education side of the education site in northeast florida has agreed to take on that role of coordinator. and we will work and be behind her in supporting the effort of exchanges best practices, bringing governmental leaders together and making things happen. i think that the other thing i think longer term we can do is try to -- you know, a lot of this discussion is about defense and how much it's costing us, how it's going to bankrupt us if we don't do something, how it affects the educational system,

how it increases the disparity between income levels in our country. not enough i think is talked about in terms of the positive about what can happen? relating diet and wellness and physical fitness to success. and i see increasingly young people getting that. but to me more focus on that that we can help with i think is a goal of ours as well, mr. president. thank you. >> thank you. tim said something that made me think of something i should have said in my opening remarks, and that is this is really about getting hundreds of millions of people to do specific small things one day after the next until you change the whole structure of consumption of food and the same thing about our exercise and activities and then about obviously the changes we have gone in in health care delivery.

but i noticed the other day i haven't heard anyone else mention, with almost no fanfare, the food producers of america are selling slightly fewer calories per capita to people this year than they have been. and there was an article i read that said that, you know, if it's now like literally not an enormous amount, like 80 or 90 calories a day. if you did 100 calories a day for a year how much weight you would lose. and so i think that all these things -- there is a greater awareness. everybody needs to step up and do something. so i thank you very much. and i never -- i like to ride a golf cart. but tim has basically shamed me into walking more on the golf course. you heard that 30 miles a week thing. so patrick?

>> mr. president, thank you for the honor for inviting us here. i think i was just mentioning that the power of one man's ability to actually lead, president clinton was responsible for forming the funding for the human genome approximate and supporting technology like mist. so how does that relate to what we're doing? out of that came the human genome. we were presenting the cancer genome. we were presenting the work that we developed the first nano particle that affected lung cancer, breast cancer and pancreatic cancer. so we are trying to address i think what is going to be a major infliction in this country and the world frankly is cancer. if you can imagine now for the first time you can measure cancer from the blood, imagine if you could identify what

exactly is ailing and then give the right treatment. i don't think we need to imagine that anymore. we have patients free of metastasis after having mat static disease five years out. this is very permanent to me. i have a cousin who came to me who in canada was going to get the wrong treatment. she said she had two months. she is now 13 months and now almost free of disease. i want that confirmation for the world to see and understand through this conference i'll be describing some of that work. how do we get this kind of information into the hands of a practicing physician? and i'm proud to say there's a collaborative being formed today where the best care of such kind

of very high level sophisticated information is populated. if netflix can obsolete blockbuster, we will continue with our project. so today we will announce an operating system that's 3.3 million cancer patients. it's been running the last five years. and bruce broussard will take credit for that in oncology. because we have launched that and now in real time patients will have actually information in real time at points of care and time of need, anywhere, any time. and that's the goal. but it's more than the goal. we are actually launching that in this country. [ applause ]. >> thank you.

>> i love being around patrick because i feel so dumb and yet he makes me think that, like a blind man -- i was raised in the south. they say even a blind hog can find an acre. he makes me feel i have found an acre. by fundinging the human genome and first nanotechnology research we ever did. one of the few things newt gingrich and i agreed on. the first $500 million of your money in nano technology research. but i think to bring this home you should take just a couple of minutes here about the actual health care revolution you're trying to affect in south central l.a. the last time patrick and i were together was in los angeles. and he said i am convinced that we can give poor people in south central l.a. the same quality of

health care you get in beverly hills. so it's a laudable goal, but how can you do it? can you give a couple of minutes on how you are trying to do that. >> first of all, i came from south africa. lived in the area of apartheid. i was the first white-chinese person to work in the white hospital. i had to take 50% salary to have the honor of actually working in that hospital. i have been brought up in this area of oppression. i was astounded to find here that a woman went to martin luther king hospital in south central l.a., entered the emergency room and called 911 from the floor of the emergency asking for help to get her out of there. and she died on the floor of that emergency room. they shut the hospital down and

said there -- the solution was have no care in south central l.a. so we were able to frankly to embarrass the system and help us open up martin luther king. it now will be open, i'm glad to say, in 2015. the issue, however, is not a physical building. the issue is access to information and access to best care and education and bringing doctors to that community. and that they could have information -- a patient in south central l.a., through a software system that is ubiquitous, that transfers information about the patient's condition in real-time to a specialist saying sitting in beverly hills and have that transmitted, communicated and the doctor being educated is

going live. dr. david feinberg is in the audience. we're going to institute the first institute of molecular medicine, where this 21st century medicine, whether you're rich or poor, if you have cancer, this is what you deszczerbiak. -- deserve. and martin luther king, it's his birthday this week. health care is a human right. so i think this is something we will be pursuing. and thank you, mr. president, for that encouragement. i think with a voice like the clinton foundation we also have this -- the system of electronic medical records which where the electronic records unfortunately do not speak. if you're in the hospital, there's no way for you transferring your information from one hospital to another. yet the system creates a ubiquitous system. we're about to launch this into the navajo nation.

so our idea is if you can address this in the poorest of the poor, we can make this work for the rest of the country. [ applause ]. >> thank you again for this opportunity. as my introductory comments had the opportunity to say a little bit about what we do. but i would like to tie together a couple of points that have been made and elaborate a little bit on our mission. as i mentioned, we're in the business of operating hospitals. and hospitals in our health care delivery system are really the front line in providing care to people, particularly when they need it urgently in an emergency. and i also mentioned in my introduction that our company alone is spending $800 million a year in compensated care. i was pleased, president clinton, that you mentioned we have succeeded in bending the

cost curve a bit in this country. we're spending a little bit less as a percent of gdp, and the rate of inflation has reached historic low legals, probably lower than anybody in the audience can remember. so how are we doing this and what is the role of the hospital? because it is an essential role. science is incredibly important. and the innovations patrick was talking about will be transform magsal for the health and well-being of the country. in the end you know the emergency room there and you want it available at 2:00 in the morning to treat just about any condition you can think of. so our interest, in addition to wellness, which is obviously the topic today, is in providing greater value. our country spends more than enough money on health care. but the value isn't there. and i'm please said -- and we can get into examples as we go along in the panel, all sorts of

innovations are taking place enabling us to increase steadily the quality of care we're providing, the reliability of care. the type of reliability in the emergency settings in rich or poor communities that would not ever allow the kind of case that you mentioned to occur, at least in one of our hospitals. so i'm quite optimistic about the future for the health system. in this year, 2014, where we are embarking on this grand experiment in health reform, our hospitals are right at the epi center and bruce's plans as well. that laudable goal was issued by you during your administration of trying to improve access to care and the percentage of people covered by some form of insurance program.

ultimately that will lead to better health very, very quickly. so i just would like to say hospitals are an incredibly important part of the equation. and i think we're doing a good job. we're improving value. we have been successful in the reducing the rate of cost. we have a lot of demographic issues putting it higher. i'm very proud of the business we're in and the jobs the hospitals are doing in the health care system in america today. >> all these people are really smart. i don't need to ask them probing questions. i prefer to let them talk. but i want to ask you -- i want to take the next step here. and if you're basically the only layman besides me who is here in that sense.

okay. we were sort of stumbling in the right direction. and science is out there, as patrick says. but we have to figure out a way to make it accessible and usable to all of us. given where we are, either in public health or in the health care system itself and the delivery system, as concise as you can, what do you think the greatest challenges we still face are and what are the greatest opportunities, one or two of each? because i'll just give you an example. you mentioned that we needed to do more with primary care. there's a lot of worry that we don't have enough primary care physicians, nurses, health care workers. i even saw a great article the other day in one of my blogs about how we ought to look at some of these developing countries that have done a great job with trained health care

workers and send them to the most rural areas of the country and hook them via the internet back to all the stuff that pat tricks wants to do. let me just give you an example that i personally saw in the last six weeks. a friend of mine -- i just went home to a funeral. and a friend of mine went to one of these clinics in a small and remote rural area instead of going to the nearest city to a hospital. and it appeared that it was she just had the flu. but in fact, she had sepsis, an infection in the blood. by the time she got to the hospital she only lasted three days. now, she was older and also very depleted in energy.

so this is not a malpractice issue. this is if we're going to have distance health care, if we're going to have clinics, if we're going to have all this, do we have a system in america that will train people adequately to do it? that's the kind of thing i'm thinking. so what do you think the greatest opportunities and the greatest challenges out there are? >> i'll start. i think it's -- i'll put it in general. reducing the barriers. i think there's a lot of barriers we have. i'll give you an example. a number of months ago i was in south florida, which is a large market for us. and i always find it both motivating and educational to go visit some of our members. and i went and visited one of our members that was in south florida. and i went in there, bars on the windows. a lady was in there. and i went with a nurse. i spent about an hour with her. and we went over her medicine.

we looked in the refrigerator to see what her nutrition was. we do this at humana. this is part of our humana cares program. she didn't know who i was. i just did this sort of on my own. when i walked out, mr. president, there is a thing that will stay with me probably the rest of my life. she said, i'm lonely. that was her comment. she was 80 years old. she lived alone. and i say there was a barrier in her life that she could not connect with society because of transportation, because of resources she had. and loneliness for her was a health problem. now, we don't diagnose that as a health program. we diagnose a heart condition, we diagnose diabetes. when i walked out, i said get her transportation to a social community. sure enough we did. that had an impact. when i think about barriers in

health care, i think the things that patrick is doing. patrick mentioned we partner with the organization that he owns a years ago and created that. technology is a very important aspect of the future. but when i think about the impact of small things that's hard to do in health care, that's a great target for us. and i look at lifestyle. i look at social. and i look at economics being an area that we as a health care system should focus on. because i think that will have a large impact on what we do. [ applause ]. >> what an inspiring story. >> but i just want to say one thing to support you. there have been a lot of studies and several books written about societies with high percentages in certain areas.

and the island of okinawa has the highest percentage. it's kind of going down because it is being penetrated by fast food places. that's the only change that's happened. the more mountainous areas, in sardinia, there is an isthmus that comes out with an indian tribe. there are five or six areas. without exception, one thing they all have in common is they don't let older people get lonely. and if their families die under them, that is their children and grandchildren, they are given almost ceremonial status within their communities with roles to play and meaningful contacts on a consistent basis. there's huge amounts of evidence to support what you said. loneliness is a health matter. >> just to add to that, but our system doesn't pay for it.

it doesn't help bring it. if you think about the impact that you just talked about. >> it wouldn't be very expensive if we were organized. other societies do more simple and rural areas. >> there's many areas we can talk about. i want to build on what you were talking about, bruce. utilizing technology to start helping exactly what you talked about. and that is, for some reason we have not allowed the likes of telemedicine or telehealth to become just part of our fabric as it relates to the health care system. it could tackle some of the issues you're talking about. it could help being understand very, very quickly it was much more serious than she thought when it became sepsis earlier on. it's a technology but it's also policy issues.

it's the state allowing technologies to cross borders and being able to tackle that on a national basis is something i think we absolutely have to do. because that really will decrease cost, increase health, address some of these issues around loneliness, which you talked about which i hadn't thought about as a health determine gnat. i monday fundamentally believe he can do it on a national level and execute at the local level. >> let me ask you this. patrick, following up on her comments, do you think all medical records should be stored in cloud the under certain circumstances? how are we going to do that? and are there national and local policy issues that have to be addressed? anything left that government can do to accelerate this process? >> when you talked about the challenges and the opportunities. i spent the last 10 years of my life actually trying to figure this out.

and i have had this very strange, wonderful privilege of being in this country coming from a socialized so to speak country where the the doctor saw me at home with a bag in his hand. i came to this country in 1991, gave to nci. it's 2013. it is approved for pancreatic cancer. so think about the time frame. so from the knowledge to the application. i then ran with bruce broussard and created this injectable company. and i took over this injectable company in chicago for the sole purpose to invent an antibiotical. when i took over this company as a surgeon, i recognized there were drugs that were not being made because there was no

revenue for the drugs, heparin. i was the only safe supply of heparin for this country in 2008. i understood in the supply chain what was happening with that. i went and came back full circle and have gone back to academia so to speak. and this is how i see the challenge of the country. nobody has looked at health care as a systems approach. on the one hand you have the knowledge. on the other hand, the delivery system. and the third, payment system. the knowledge is in today's world we cannot afford to wait 17 years for a molecule to be get into the hands or even the insight into the hands of a person dying with cancer that has a year to live. on the delivery system, it's completely disorganized, disintegrated. there's no coordination of care. you cannot tell where the patient at home, clinic or hospital. under payment system, and if the delivery system, however, doctors want to actually provide care by keeping the patient out of the hospital or in a home, they are disincentivized to do that.

on the payment system, there's no icd-9 code for health. there's icd-9 codes for turn. so you turn. so if you look within the knowledge and delivery and payment system and say you need to integrate that seamlessly and put that together as one unit, how do you do that? that's what i've been doing for 10 years. you need to create a seamless overarching system that allows communications seamlessly to happen in real-time. so when president obama had this $800 billion and the $4 billion in 2008, i started this program in 2005, i met with him before kathleen sebelius. i said, mr. president, please do not fund the electronic medical records system. it will create what i call medical bridges to nowhere.

and unfortunately, it's done exactly that, because we funded software systems that do not talk to each other. this is proprietary not to talk to each other. you've got to fund a middle ware, a grid computer software system that the large engines collider is running on. i then convened with the institute of medicine and he says, kathleen met with me and she said i'm going to introdpuc you to the national coordinator. he said i don't know anything about this, i'm head of it. i condition screened a symposium for two days. i had the best minds, i said, fund, for less than $100 million, what's running the large headron collider and we will be able to fund the entire

nation. unfortunately, it's gone completely the other way, the hospital is incentivized, we went ahead and quietly then said, we need to do this. we, meaning my family foundation, and serves as a great country, i was able to sell both of these companies, not because i built the companies to make money, but built the company to have a product which actually then became very valuable and decided we will take a billion dollars of that and actually fund internally the development of this. so what have we done? we have actually built an operating system that currently talks to any software, whether it be epic, and it now is running 3 million cancer lives for the past three years, across the pathways, across the delivery system and we know in

real time. we have built a software system that actually takes 10,000 software pro focals and tells the doctor which cancer treatment to give to the patient. with regard to technology, it is the job, actually for us is to actually make this health care system, where he makes money where patients don't come into the hospital, where we actually have patients at home, i call this icu at home, which means, you need icus at home. and then this whole world of machine to machine technology is upon us. it's right here. so i partner with verizon and att and i built an electronics company that could have boxes that could talk to each other, the blood pressure machine, pulse ox simm ters, scale, we have now adopted this and now we went into every hospital that

has 6,000 medical devices, made from every different vendor, including ge, we went and wrote the apis for 6,000 medical capt vital signs realtime. so, if you got an icu in the hospital and you got the same box in the home, which you create call the health box, you can then create an icu at home. this elderly lady, we can pat pulse scale at home and know what's going on with her in realtime and we've created a tlemedicine device where you have four, five-way conferences. if you can manage a patient from the home, the clinic, hospital and through a super computer do the analysis in 47 seconds which

we've now accomplished, we've doing 1,000 g noems a month, you then have an engineered system for the nation. which then says frankly you have the ability to create what i call norads of health care. you have the ability to create a building with three cardiologists, 10 oncologists, two path oilgs, one pediatrician can manage an entire city. >> so is this going to happen any way or is there something we should change about the laws to make it happen faster? >> so, what is preventing this? so the issue is to actually create what i call outcomes based value based care change the payment system. we created the ceo council for policy center, bank of america, mckenzie and the single largest barrier now is disincentivizing

care with fifa service actually, ironically. so, if you can then say your job, mr. provider, is to keep this person healthy, we can measure the outcomes in realtime. if you keep this patient healthy, this is your patient per month and at the end of the year, this patient is healthy, here is your bonus. and whether the patient is in the hospital, in fact, you don't want the patient in the hospital. the patient is at home and that's where we need to change the providers of this nation and that's what we'll be announcing after this event this cancer collaborative with the nations of the world. we have the unions also with us and we have the food worker's union also participating here in the audience here with us. this is what this nation is going to need and this is what we think there is the potential -- not the potential, we are actually doing it. the opportunity is not the opportunity. we're actually doing it.

the obstacle is the payment system. ironically medicare advantage was the best system you had. and it's a system that's being penalized because they don't understand the actual system. [ applause ]. >> well, there are -- it's interesting. we're doing more and more of this, paying to keep people healthy instead of paying for procedures. but there are -- and there are incentives in this health care law to do it, but there's no mandated pace to get to everybody doing it. i don't think it makes sense to pay for anything else really unless you have some hugely expensive thing that can't be covered by the size of the pool people are involved in. no question, in a much more mundane world than the one you

just painted for us, it also works. it works everywhere, not paying for procedure but paying for people to be healthy. do you agree with that? >> yeah, i would agree. i will speak from a very practical point of view. we're actually on the ground treating thousands of patients a day, millions of patients per year. we're in a period of transition from the fifa service environment, which is absolutely pervasive throughout physicians offices and imaging centers and kind of every health care node that you can think of in the system toward a system where there is accountable care and payment for health, but it's going to take a very long time. we all need to be realistic about this. the conditions have to exist in a particular community in order to enable that. now, we have some examples in our own organization where this has been very effective. so, in northern california in a

farming and light industrial community in modesto, california, we've actually been running an accountable care organization now for over two years. it's been very successful. actually reduced the incidence of the hospitalization of the population there that has participated in this program. and actually we've done just fine as a hospital provider because, you know, we've been able to earn incentives, as you mentioned, through better health outcomes. i think that is a model for the future. but i think we all ought to be realistic about how long that will take. meanwhile, there's some great innovations taking place among the providers. you know, putting in place these advanced clinical systems to even capture the type of data that we're capturing, that just didn't exist six or seven years ago. you mentioned government policy and incentives. the incentives for adopting

these clinical systems has been very effective in our own company's case in total we're spending about $1 billion in advanced clinical systems and the government incentives are making that -- it possible for us to do that by offsetting about half of that cost. and although the op rablt and sharing of data doesn't yet exist freely, there are other great things that are happening. so, you know, we're -- just in our company we've avoided hundreds of thousands -- several hundreds of thousands of unnecessary tests, unnecessary because they were duplicates. we've all been in hospital environments when a physician walks in and is looking for a result of a test that he or she ordered and the result isn't there, what do they do? they order another test. and we're able to avoid that. we're able to avoid medication errors. maybe the wrong dose or even the wrong medication or at the wrong time being given to patients. so these are really important

innovations and improvements in safety and quality in hospitals that are being driven by this technology. everything patrick described is possible and i think it will occur. but i think we need to give it a little time. >> let me ask you this -- i know -- you can say whatever you're going to say but i want to follow up on this. your position is, i take it, that if we completely stop paying for procedures and pay for performance for health care, that the government wouldn't have to do much more to end the siloization, if you will, of electronic medical records then there would be literally no incentive in the world to not share a medical records with, you know, appropriate privacy protections for the patients but -- is that what you're saying? >> correct. that's exactly right. i think we have completely disincentivized the system and,

in fact, perversely incentivize it. you hear -- with all due respect, the incentives of getting the money to actually put in systems that actually don't talk to another system is a perverse incentive that the government has actually funded. so, and i think when we talk about the time -- i want to emphasize, not the time, that this is not some hypothetical. we actually are installed, as we sit and speak as you said, in 50 practices -- 155 systems, 3.3 million lives, we're capturing 40 million claims a day, 3 billion vital signs, it's being adopted by the nhs as we sit and speak. the software system that is intelligent is running 70% of the emergency rooms of portugal. it's running the largest hospital brighten in the united kingdom. running the largest cancer center in brazil. so, this is not some

hypothetical. what it is a will of us actually integrating a platform that gives you actual knowledge in realtime anywhere, any time and is evidence based. but it also needs to incentivize the provider to give the best care. and the marketplace will do that if you actually provide and you will sift out. you hear problems like accountable care organization and i will challenge anybody, how can you have an accountable care organization when in no realtime can you tell who is accountable for that patient? if you have surgery and you're elderly, you see just as one person 27 health care providers. an elderly person has 19 medications. who is accountable? so, you can't have accountable care organization when you can't measure who is accountable. then you want to give this thing

a value-based care. value-based care is outcomes divided by cost. if you can't measure outcomes in pathways in realtime, how can you know whether you're giving value-based care and you have no idea about the cost in realtime. so we have now built a system that can measure outcomes in realtime and costs in realtime in st. john's hospital, a patient walks into the hospital. the minute he walks into the hospital, we know exactly where he is, what doctor is touching him, what is being used by the minute. so, if you can measure outcomes in realtime and cost in realtime, you can give value-based care and create accountable care. but the accountability gives you outcomes for health and that's how they will actually be bonused. so that's a system that i've -- i don't think is hypothetical. i think it's actually real. we just need the courage and organizations like yourselves to actually be the