mental health is a health presentation like any other health presentation. thus, if an individual feels like they've got any mental health issue or conditions or problem, they should go to the nearest mental health center, but is mental health really embedded in your primary health care system? this is what the question is. i think this is something that we're constantly investing in, and i believe this is not something that is unique to them. yeah. it's actually a global issue, but i, you know, excuse in the, you know, that in here because, well, i had to move slow answer a major area that was thought it is with primary healthcare is awareness, incest ation. i'll go back to that, i'll come back to what exactly you are doing, moving forward, but for now, which established that there is a problem is i spoke about that briefly at least. introduce yourself. yeah, i'm here bro. much in the army. so coaching nice. what we want to send to the would be and what we want to achieve as africa, as xander, is that we want men to her to be if her taste do be prioritized.

health care hopefully. i focus on the quality of the health care that is provided and i focus a lot on prevention, not just to deal with the symptoms but also working on prevtion. i also think about a right to privacy and empowering people to do things to help keep themselves healthy. when it comes to cyber security, i believe the same issues apply, which leads me to questions i'm going to ask each of you to take a moment to respond to. the first of those questions is, how can the federal government improve access to information on cyber best practices for the health care industry? that will be the first question. the second is, how can we make sure theealth care systems are doing their part to take preventive measures to protect eir own networks? mr. martin, wou you lead us off? >> thank you for yr question. in terms of providing access to best practes, there is no shortage of recommendations and guidance and things organizations could be or should be doing. the challenge we see is taking stock of all of t

behavioral health services. all through approximately 750 county behavioral health authorities and community providers across the nation. we plan and implement community based services for people with mental health issues and substance abuse conditions. counties direct resources to community based resources and services, which enables us to do three things. number one, better serve residents with behavioral conditions. number two, reduce reliance on the criminal legal system. and number three, direct valuable resources towards improving stability and health. however, despite the investments and the work we do and the partnership with other government sectors, our behavioral and mental health systems are grossly, grossly insufficient to meet the scale and urgency of the moment. this is the very reason we are all gathered here today. our nation is in a behavioral health crisis that transcends all ages, races, and backgrounds. and the need for evidence based solutions has never been more important, not just for the

officials health care associations, and health care experts. the committee chaired by vermont independent senator bernie sanders. >> -- not only is this unfair to working class and lower income americans, who cannot access a medical home when they need it, and we are losing over 60,000 people a year because they do not get to on time. but in addition to that, from a financial and cost-effective perspective, what we have now is basically insane. we have a situation where people get sick, they do not go to the doctor, you know what happens when you don't go to the doctor and you are sick? you get sick or. maybe you end up in an emergency room where the cost of primary care is ten times, or eight times more than it is if you walked into a community health center. if you can't afford prescription drugs, you get sticker, and you may end up in the hospital, and that will cost $100,000. so what we are talking about today is to, things my own personal view, and health care is a human right, and that we should emulate what goes on around the rest of the

we continued to hear about challenges with tricare and i believe mental health is our biggest health care problem. there isn't a family in america that doesn't have a mental health care problem somewhere in their midst. so i want to thank you for joining this committee this morning. i look forward to our discussion. go ahead, senator collins. >> thank you, mr. chairman. i appreciate your holding this hearing. to each of our witnesses, thank you for being here and for your service to our country. i wanted to echo the chairman's special thank you to the admiral for all of your years of service. providing for the health care of our troops and their families is a no-failed mission. unlike other health care providers, the military health care system must support and save the lives of our fighters in battlefield environments. i look forward to hearing about the department's investments both ongoing and planned to train medical units to be able to respond in contested environments far away from the safety of large hospitals or military bases. in addition, as the chairman has indicated, the

we are trying to make it so that mental health is health, period. [applause] we love to say that you don't have to get referred to a specialist to get behavioral health services. our primary care physicians should be able to do at least the initial intake of anyone coming in for a health care issue. whether it is a physical challenge or mental health challenge. you should not find your family care doctor says, i don't really deal with that. let me refer you to your psychiatrist or psychologist. that could take three months, but let me refer you while your child is hurting right now. we are going to move. that is why we moved on 988. we are fortunate the president was able to give us over $500 million. in 2020, i think the budget was $2 million. 988 is not a national hotline. it is a state based hotline. that we are standing up. we stood up the text and chat features because we figured a bunch of young folks are not going to call. sure enough, we have seen a 400% increase in the number of young people communicating through the text and chat feature.

our health. like to discuss a few of our top priority is to ensure that all people are served by our program, that they haveha a just opportunity to obtain their optimal health. marketplace coverage is now more affordable than ever, and more than 16 million people find out during this year's open enrollment. with expanded financial assistance continued by the inflation reduction act, four out of five people were able to find marketplace coverage for ten dollars or less a month after tax credits. we've also doubled down to reach people where they are. we made unprecedented investments to expand our enrollment organization footprint into nearly every county in the country. alongside our enrollment partners, we targeted of the the hardest to reach communities and communities with ait disproportionately high uninsured rate and we know that you all work hard to keep and grow thela marketplace enforcemt so thank you. there is greater affordability and accessibility that results in more people getting t

the defense health agency is charged with providing health care services to 9.6 million service members, their families, and retirees through tricare. its mission also includes the d.o.d. medical research program. and i want to acknowledge that the defense health agency has not been immune from challenging trends in the national health care industry. these include escalating costs and shortfall of providers. i hear this firsthand from service members and veterans in montana who tell me that tricare is not working for them in rural america. so today i want to have a candid discussion about the department's delivery of health care and medical readiness of our force. the defense budget has enjoyed robust top line increases in recent years. however, for this year, we have members proposing reduced and outdated funding levels. congress has repeatedly failed the department in recent years by putting you on automatic continuing resolutions and getting you a budget that's late. it's my hope in this new congress we can breakthrough the vicious cycle of c.r.'s and i wholeheartedly support efforts

it's better for the community's health. it's better for the nation's health. so having people not converge is really, it should not be an option. the states has a baseline should be providing individuals their options. if they're not enrolled in medicaid any longer, no longer eligible for medicaid. what are the other options for coverage? so this does not come as a surprise for individuals or families. >> how many states are doing that? you're saying they should be doing that, is anybody doing that? >> there are some states that are doing this thoughtfully. there are other state examples that are rushing through this process. arkansas, for example, has said that they want to do this entire process of re-enrollment for medicaid in a couple of months, versus a year. what we know, when you rush through processes like this, which is the largest shift in health insurance coverage since the passage of the affordable care act, people will fall through the cracks. we don't see people left with no. insurance >> changes to the medicaid program is what we're talking abou

building a culture of health requires a concerted focus on health equity. asking the question, who berths from our current systems and structures and who faces barriers and then working to remove those structural barriers to health that include racism and sexism, ablism and classism, discrimination based on sexual orientation and so many other barriers. so many other forms of injustice. we recognize that we shy away from energy racism and when we do that, we will not proceed in truly achieving a culture of health and in talking about racism in america is one of the most difficult things to do and so often, the conversation veers to some other form of obstruction. as much as we all want to live in a country where everyone has what they need to live their healthiest life possible, structural racism blocks that opportunity for far too many people. it was true 20 years ago when the report was written and unfortunately, it still is true today as it was then. we saw it clearly with the impact of covid and the secretary laid out what some of the impacts were, diff

health and the nation's health. having people not covered is -- should not be an option. the states should be providing individuals their options if they are not enrolled in medicaid were no longer eligible, what the other options are for coverage so it doesn't come as a surprise for individuals or families. host: how many states are doing that? is anybody doing that? guest: there are some states doing this thoughtfully. there are other state examples that are rushing to the process. arkansas has said they want to do this entire process of reenrollment for medicaid and a couple of months. we know when you rush through processes like this which is the largest shift and help insurance since the passage of the affordable care act, people will fall through the cracks and we don't want to see people who are left with no insurance. host: changes to the medicaid program is what we are talking about so here are the phone numbers. the robert wood johnson foundation, what have you found how aware medicaid recipients are about

health insurance?". if you are watching online, you can just -- join with #catohealth or post comments and questions. i served in the white house from 2017 to 2019 at the national economic council. i worked on several issues related to employer health coverage. michael chose me to moderate this discussion because of how some pathetic i am to his big proposal on large hsas as a way to replace taxes lujan. he will get to that, first, let me set the stage. what is the tax occlusion for employee sponsored health insurance? it refers to the fact the federal government does not tax health insurance people gather their federal employers. today, about half of all americans receive health insurance through their employer or the employer of a family member rated what do advocates say about the exclusion? it encourages employer-sponsored insurance. this is a national mechanism in which this affects the health status of enrollees. employee sponsorship increases the incentive to work. chicago economist casey mullig

in recent years, increasingly sophisticated cyber attacks in the health care and publ health sectors have posed alarmi threats to people in michigan as well as across our country. cyber attacks on hospitals and other providers can cause serious disruptions to their operations and pvent them from effectivy providing critical, lifesaving care to their patients. breaches can also lead to the exposure of sensitive personal and medical formation of patients and health care persnel. most recently, the health insurance marketplace for residents and lawmakers in the nati's cital expienced a cyber attack that exposed the personal data and informationf ns of thousands of people, puing victims at risk of identity theft, scs, and additional cyber attacks. earlier this year in my home state, the university michigan health system experienced a cyber attack that temporarily limited access to their public websites. thankfully, in that attack, no patieninformation was compromised and the issue was quickly solved. these relentless cyber attacks show forei adversaries and cyber criminals will stop at n

care as academic health insurance, executive health care, company and white house fellow, the first term of the obama administration in the emergency. let's by penguin random random house our moderator is kathryn katherine is the health and life sciences reporter crain's chicago business where she writes about hospitals public health pharmaceutical companies and biotech startup. she graduated from columbia college with a bachelor's degree in journalism and 2016. i hope you'll me with granting them a warm welcome as they come before us today. thank you so much for that warm introduction. hello, everyone. thank you so much for being today. i'm katherine, reporter for crain's chicago business and. thank you to dr. ansel and dr. fisher for being here today. really excited to get this conversation underway. so let's set the stage for our audience a little bit. you know, dr. ansel, your was published in 2017. can you tell us a little bit about, you know, what was happening with your work and with the health care sort market here in chicago at the time that made you want to write this book

mental health and substance abuse. so with that, thank, you mister secretary. >> thank you, and thank you denise for allowing me to be here. >> yeah. thank you. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2023] tonight the ceo of moderna testifying on the increase in price for the companies covid-19 vaccine. before the senate health committee. watch the entire hearing at 9 pm eastern, on c-span two. it is also available on c-span now, our free mobile video app. or online at c-span dot org. >> there are a lot of places to get political information. but only at c-span do you get it straight from the source. no matter where you are from, or where you stand on the issues, c-span is america's network. unfiltered, unbiased, word for word, if it happens here or here or here or anywhere that matters. america is watching on c-span. powered by cable. transportation secretary pete buttigi

to the field of health, to the ministry of health, other institutions in addition to the health sectorher organizations and institutions have given special attention to the less privileged areas. in the field of education , in the field of treatment and prevention, there are also flaws that need to be seen in the mountain program and can be resolved from the upstream documents. iskandar's documents that are specific to the health field, such as the policy document of ayar, the policy document communicated by the supreme leader in the field of general health policies, such as the law of public service insurance, among these documents, the document of general policies is a comprehensive and complete document, well written in 2013. in 14 paragraphs and all that that we and the people expect from the field of health, in the field of treatment, research and education of traditional medicine, sources of insurance, research based on real needs , my new tusi is that all the dear ones who want to speak in the field of health lie or make a decision or a legal provision i will definitely connect

offered to all health systems.and then entities to follow and push that along with us. to help in health systems in the part. we have talked about that a lot. we need to do a culture change. it is been a cultural problem for as long seven cyber security. i'm going outside the cyber security teams to cybersecurity as a cybersecurity team's job or i'm the cio, i am the ceo. i'm in administration. no it's actually everybody's job.b. right down to the clinician. indeed, one of the biggest threats cybersecurity generally is the frontline user. anybody is touching a keyboard, or a tablet, or a phone, or any kind of medical technology. >> hold it right there pretty want to give these folks an opportunity thanks for the responses though, ms. pierce? >> i agree with mr. garcia and mr. martin. there are a number of best practices available. as mr. garcia said they published many, many documents on cybersecurity. so i do not think there is a lack of information. what i think is happening especially for small and rural is ther

about health care, who has been an advocate for health care.ll move us forward. he wants to see access, so they too can have peace of mind, so with that being said, it is my privilege and the greatest honor of my life to introduce the leader of our great country, and it is a great country. the president of the united states. [cheers and applause] ♪ pres. biden: hello, hello, hello. robin, you know my dad. we love all of the nurses. do you know why? you guys help to make us live. i am not joking. when you go to the icu and you look at those machines, and you know, the line goes flat, it is over. but you never get tired. i was lying there and i had a nurse and she was from the military, she did things that i do not think you learned in medical school. she whispered in my ear, and briefed on me to make sure i had a human connection. she went home and brought back tools from her own bed. but i am not joking. dashcam back from iraq -- he came back from iraq and for 18 months he fought. the nurses were incredible. they would say toward the end, you c

i have to talk about mental health and behavior health clinics. so excited that this is something that we have done on a bipartisan basis and with senator cornyn we worked hard together on the safer communities act with the most, the strongest investment and addiction services literally so that's not an exaggeration. send working on that as well as chairman and ranking member so pivotal in all of it. we are now have a demonstration project with 10 states funded by health care with clinic's, quality clinics and 24-hour services. ray now working on the next piece announced that has a process for identifying the next 10 states and we want to get back to 50 that i would like you to elaborate more in your plan for this transformative system moving from grants and grants are good. much better to be an integral part of our health care health care system with ongoing funding and support for workers and the work of this committee did an expanding medicare access for therapists and psychiatrists at the end of the year. really important work that we have don

the women's health protection act is essential. twice now twice we stood up to codify the fundamental human rights of abortion care and by we i mean democrats and the situation has only grown more dire. mothers denied necessary medical care during her pregnancy loss, 11-year-olds forced to bear a child? an abomination. and with the maternal morbidity crisis with women four times more likely to die in childbirth or birthing complications looking at the prospects of forced birth, this is a matter of life and death. and families are threatened as they seek to criminalize patients and providers. enough. we are sick of empty rhetoric and inaccurate information. abortion bans are rooted in -- and overturning [roll call vote] has pushed apartheid in this country putting faith necessary abortion under reach for millions especially those with low incomes. lgbtq citizens and indigenous folks. congress must act and to my senate colleagues on the other side of the capitol building the thank you for your partnership on this bill and we demand t

if you go online, they have aggregated all of our mental health resources. you can find it as a one-stop shop to understand our grants in the space. we also have, in december 2022, you of jp launched its crisis response and training curriculum toolkit. this is a three hour training program that is designed to prepare police officers in the response to people in crisis. in making sure that they are paired with a behavioral health system to get people to try to divert people out of the system to begin with. and then, stepping up. and make, out this is an incredibly important thing that we are funding. i know, i understand janet that your county is a part of this. and i think you should speak about your experience at the stepping up initiative. it has been really important. it's an important partnership between nato, between the american psychiatric association, council state governments. and this is really about providing counties with the resources to be able to figure out more innovative ways to help people in crisis to bring more resources to bear. so i wou

and without the need of health literacy , the garden of health literacy in the present time is completely different compared to a few minutes ago and the topic of disease has changed. the burden of disease has become different in the form of diseases. it's very simple to say that a person of 50 and 60 years old should have the information himself about what things to take care of and monitor his health at this age. let's refer at what age should we monitor his blood pressure , at what age should he control his blood sugar, at what age at what age should suni screen himself for which cancerous diseases , at what age should he give what tests, to whom should he refer ? gentlemen have become experts and you, since we have reached 50 years, i need to know which aspect of our health we should take care of now. without helping the children, the media will help the site hiring help and every agency, every ministry, every institution in charge of this matter has happened to its own sub-category, nothing has happened, the packages are organized and organized so that they don't know that this is on

mental health is becoming the main issue. the problem of health care in ukraine is the statement of theal advisor at the world health organization, michel kozachka, on what will we do with the mental health of ukrainians and what is being done already, we are already doing it, so we understand that war really has a significant impact on the psycho-emotional state of everyone people, even if we do not recognize this. this does not mean that it does not affect us and the first months of the war, if we remember everything was seen live on the air , the movement of the column of heavy weapons from russian terrorists, the shots of destruction residential buildings, rocket attacks were all broadcasted, and even a person who was very la not in the place where the rocket attacks were flying, they saw all of this and were already worried, as were the people who lived next to the destruction, we count somewhere on the figure of 15 million plus or minus which every fourth in which in which there will be changes in the psycho-emotional state. but in order to cope with this challenge, we have alread

one i would just been a few more senses on his mental health and physical health. it's actually, i've been surprised just how much the numbers are growing in the medicare program, right. you can you think of that as a young companies i did, think of it as more of a younger population but increasingly on the medicare side we have more mental and behavioral health issues. so that is an area certain that the administration is focused on an certain that we need to work with you on about making sure people have access to providers, that they're using their care. those are a couple of needs. i would also say getting the word out. one of the things that we are all i think needing to do is really make sure that card, whatever in your cart says, you actually know how to use benefits. i think we still have a lot of seniors who don't know that there are new drug benefits coming. and so educating the people that are served by your programs is just an incredible, an incredible way of partnership. because you more than anyone probably know where people are because you are seeing

, mental health, maternal and child health. it also has a significant global health presence we have not talked about yet. i want to talk about that for a moment. cdc has country offices and staff around the world. they play a critical role in programs and oversee training programs. there are staff serving in the world health organization and its regional entities. it's not necessarily straightforward with career paths within cdc. we talked a little bit about some of the training around international relations and cultural competencies that other agencies have that may not be relevant for cdc, or haven't been so far. i wanted to ask you to reflect on this process of the recess that has been proposed here. what steps can be taken to better integrate and strengthen cdc's global and domestic health security agendas. what will it take from a budgetary perspective but also from an operational perspective to protect that global health action that cdc undertakes? that is so respected around the world. >> thank you, catherine. there's

i can't speafor the secretary, that mental health is health. it is like anything else we need. so we need to remove that stigma. everybody will be very easy to get just like a call for an ingrown toenail or somethi like that. i will tell you that still is an oning challenge that we are really making headways, but we are not done yet. >> i can see that point very easily in my own family circumstance. a number of my family served in vietnam and came back from military service a changed person. we never could quite understand what happened. he did some things which were not good for his family, for himself. took him many years to come to grips with his experience in vietnam. we refer to them as the vietnam generation, and was go into deal, but you know what i'm speaking of. contrast that with those who served in iraq. many times, these same military veterans would come home and be very open and honest about their need for help and counseling. what a dmatic reversal that was over the vietnam generation. i hope the military is looking at this moving forward. >> absolutely. we are co

the health of society is dependent on the health of our relationships. that is why my hope is that we can also think about rebuilding social connections in part of what we do to help advance mental health in america. [applause] dr. breland-noble: i am so grateful for that response. i am so grateful for that response. i wanted turn to you and love to hear about your and love to hear about your thoughts on the issue that you have chosen of maternal child health. what have you learned since starting this work? >> thank you so much for taking an interest in this. i think that looking at the big picture you should know if you don't already that the united states is 55th in the world for maternal mortality rates. once you understand that and dig a little bit below the surface, you will find the inequities are vast. if you are a black woman in the united states your chances of dying from maternity related complications are five times greater than that of a white woman. if you are an indigenous woman, your chances of dying are slightly less but nonetheless multi

because a year ago in march , we, the ministry of health, the minister of health addressed a letter to all the ministers of health of the european union and the european commission regarding the possibility of accepting our wounded for treatment in the country of the european union and today, as the ministry of health, we have direct cooperation with the european commission, which is like the government of the european union and directs for treatment to the countries of the european union those who are submitted to us by the command of the medical forces, i.e. the military submits lists of wounded who need treatment outside of ukraine, and the ministry of health organizes all further logistics and referrals, payment for this treatment is made at the expense of the receiving party. that is, we as a state do not currently pay for treatment abroad, it is paid by the countries of the european union, and when this patient gets injured abroad and the treatment and rehabilitation required for this patient is covered by the receiving party, i.e. most fish as those who receive rehabilitation

we launched several years ago in 2006 justice and mental health collaboration. that really supports partnerships across government to improve public safety responses in outcomes for people with mental health arco occurring disorders. we've been able to provide 600 grants to over 49 states and as i'm speaking, every grant on mentioning is right now open for solicitation for the fy 23 grant, and we hope we will see more jurisdictions that may not have already taken advantage of them apply. we recently launched as part of that an initiative that is aimed at specifically supporting cross sector partnerships between law enforcement and mental health providers, aimed at getting at the interaction on patrol, it's about peer-to-peer learning opportunities. it's funding and training guys to promote best practices. another solicitation that is currently open and available and i hope naco members will take advantage of it. i want to name a couple more programs, we have through our knowledge lab, if you go online, we have aggregated all our mental health resources. you can