WEBVTT - Bank Executives Hope to Leave Remote Work Behind 0:00:01.800 --> 0:00:04.440 This is Bloomberg Business Week. I'm Carol Masser and I'm 0:00:04.480 --> 0:00:07.280 Bloomberg Quick Takes Tim Stanovk. We're here every day bringing 0:00:07.320 --> 0:00:09.840 you the latest news from the world to business and finance, 0:00:09.840 --> 0:00:13.640 plus technology, politics, economics, all partnising the power of Business 0:00:13.680 --> 0:00:17.160 Week reporters and editors, not to mention our journalists and 0:00:17.160 --> 0:00:20.000 analyst in more than one twenty countries. You can download 0:00:20.000 --> 0:00:23.239 Bloomberg Business Week and iTunes, SoundCloud, or Bloomberg dot Com. 0:00:23.400 --> 0:00:25.160 You can also listen to our radio show at two 0:00:25.200 --> 0:00:27.880 pm Eastern Time on Bloomberg Radio, or watch us on 0:00:27.920 --> 0:00:31.760 YouTube search Bloomberg Global News. Let's get some thoughts on 0:00:31.800 --> 0:00:34.840 where we are today regarding the global health pandemic. Dr 0:00:34.880 --> 0:00:38.240 Shantown new Nandie is chief medical officer at the private 0:00:38.240 --> 0:00:41.400 healthcare data and solutions company Accolade. His former health technology 0:00:41.400 --> 0:00:43.640 advisor to the World Bank. His new book, Here After 0:00:43.760 --> 0:00:46.920 COVID with the Pandemic Revealed, is Broken in Healthcare and 0:00:46.960 --> 0:00:49.320 How to Reinvent It. He joins us on this Tuesday 0:00:49.320 --> 0:00:52.000 on the phone in Washington, d c um, it is 0:00:52.040 --> 0:00:54.600 so nice to have you here with us. Dr Nundee. 0:00:54.840 --> 0:00:57.400 Tell us, first of all, how are you and what 0:00:57.480 --> 0:00:59.160 are you seeing when it comes to COVID and the 0:00:59.240 --> 0:01:02.880 vaccine rollout and kind of where we are so far. Yeah, 0:01:02.920 --> 0:01:04.920 I'm doing great. Thanks so much for the opportunity to 0:01:04.959 --> 0:01:09.920 be here. UM and uh yeah, I mean absolutely, uh 0:01:09.959 --> 0:01:12.840 you know, incredible times we live in. UM. You know, 0:01:13.040 --> 0:01:15.200 I think what we're seeing is, you know, certainly so 0:01:15.240 --> 0:01:17.360 I still get a chance to practice UM at a 0:01:17.520 --> 0:01:20.800 small safety net clinic outside of d C, largely serving 0:01:21.120 --> 0:01:24.240 a pretty vulnerable and uninsured population, and it's it's been 0:01:24.280 --> 0:01:27.399 really promising, I would say, you know, increasingly, I'm I'm 0:01:27.400 --> 0:01:30.360 seeing patients who have been fully vaccinated. UM. I think 0:01:30.920 --> 0:01:34.840 hesitancy has come down significantly. UM. And I think it's 0:01:34.880 --> 0:01:38.039 we're seeing many more people coming back for routine medical care, 0:01:38.080 --> 0:01:40.520 which has been good to see. UM. And my other 0:01:40.560 --> 0:01:43.840 hat at Accolade, where we work with employers large and 0:01:43.840 --> 0:01:47.960 small all around the country. I think real major topic 0:01:48.000 --> 0:01:51.200 of conversation right now is Okay, well, what's next, Like, 0:01:51.400 --> 0:01:53.600 what do we have to do now to safely get 0:01:53.640 --> 0:01:56.160 our employees back in the office and how do we 0:01:56.200 --> 0:01:58.680 start to loosen the reins on what's been a pretty 0:01:58.920 --> 0:02:02.000 strict UH control up until now. Well, Dr Nundy what 0:02:02.040 --> 0:02:04.559 do we have to do Because we know that the 0:02:04.640 --> 0:02:08.600 US will not reach vaccinations for many reasons. One, it's 0:02:08.600 --> 0:02:10.320 not a proof for kids, but to there are still 0:02:10.320 --> 0:02:13.200 adults who are hesitant. The President does plan to announce 0:02:13.240 --> 0:02:16.000 today that he's targeting seventy of US adults getting the 0:02:16.080 --> 0:02:18.639 vaccine shot by July fourth. How is he going to 0:02:18.760 --> 0:02:22.320 do that? Yeah, I mean, I think what we've seen 0:02:22.360 --> 0:02:25.640 around the country is that really that hesitancy and access 0:02:25.639 --> 0:02:28.480 are heavily correlated. Right if we can make it too 0:02:28.600 --> 0:02:31.600 dead simple for people to get the vaccine, that itself 0:02:31.720 --> 0:02:34.320 moves a significant portion of the population board to wanting 0:02:34.360 --> 0:02:36.639 to get vaccinated. And so I think the idea of 0:02:37.160 --> 0:02:40.680 taking sort of mass vaccination sites that in some places 0:02:40.680 --> 0:02:43.440 aren't needed anymore and sort of deconstructing them and saying, hey, 0:02:43.480 --> 0:02:46.399 how do we actually just push this out into communities 0:02:46.400 --> 0:02:48.760 and maybe directly into holp um so that you have 0:02:48.760 --> 0:02:50.760 so much showing up in your doorstep saying hey, I 0:02:50.840 --> 0:02:53.440 have the vaccine right now if you want it. I 0:02:53.480 --> 0:02:55.600 think that's going to help us get to that next 0:02:55.840 --> 0:02:58.360 sort of uh, you know, five percent that we need 0:02:58.400 --> 0:03:00.679 to to continue to push forward. Sounds like a Jane 0:03:00.720 --> 0:03:05.200 J one shot would be the perfect vaccine for that. Absolutely, 0:03:05.560 --> 0:03:07.600 I think you know that. It's really interesting that you 0:03:07.600 --> 0:03:09.600 say that, because I think the science of the Jane 0:03:09.639 --> 0:03:12.040 J vers the other vaccines are are somewhat similar. But 0:03:12.120 --> 0:03:14.720 I think from a delivery perspective that's sort of blast 0:03:14.800 --> 0:03:17.360 mild perspective. I think Jane J would be a really 0:03:17.360 --> 0:03:22.400 powerful tool in our tool hit. So okay, so what 0:03:22.480 --> 0:03:25.480 do you think we need to do to get those 0:03:25.480 --> 0:03:28.040 people who are hesitant? We've made a lot of progress 0:03:28.320 --> 0:03:30.320 in a relatively short period of time in terms of 0:03:30.360 --> 0:03:34.760 getting vaccines into American's arms. So what is the thing 0:03:34.800 --> 0:03:37.520 that is ultimately holding it people back at this point? 0:03:37.920 --> 0:03:42.360 Is it access or is it just discomfort? Yeah, it's 0:03:42.360 --> 0:03:44.560 a good question. It's it's definitely multiple things. I mean, 0:03:44.600 --> 0:03:48.080 I think access is still an issue, you know, I think, um, 0:03:48.120 --> 0:03:50.400 particularly when you think about you know, for some people, 0:03:50.400 --> 0:03:52.520 particularly those are more residents, where they want to learn 0:03:52.560 --> 0:03:54.760 about the vaccine, where they want to get it, frankly, 0:03:55.040 --> 0:03:57.320 is what their primary here doctors are an healthcare setting 0:03:57.400 --> 0:04:00.000 and still you know, like my clinic as an example, 0:04:00.640 --> 0:04:03.400 we actually have community partnership. We can we have a 0:04:03.600 --> 0:04:05.800 sort of a large vaccination side at a church that 0:04:05.880 --> 0:04:08.160 we have. But if you see me today in clinic, 0:04:09.200 --> 0:04:11.240 I can give you a flu shot, I can get 0:04:11.240 --> 0:04:14.520 to a shingle shot. I cannot give you the COVID 0:04:14.600 --> 0:04:17.159 vaccine in the course of a normal clinic visit. And 0:04:17.160 --> 0:04:19.719 so I think that's one piece of it, um for sure. 0:04:19.760 --> 0:04:22.560 I think another pieces we needed to make the incentive 0:04:23.040 --> 0:04:26.000 of getting vaccinated much clearer for people. I think we've 0:04:26.040 --> 0:04:28.560 been cautious. I think that's been good, but I think 0:04:28.560 --> 0:04:31.000 we need to make much clearer if you get vaccinated, 0:04:31.040 --> 0:04:33.119 here's what that's going to mean for your life, whether 0:04:33.160 --> 0:04:34.919 that's your work or your personal life. We need to 0:04:34.960 --> 0:04:37.520 sort of up to the annie on the benefits for 0:04:37.560 --> 0:04:39.800 those who are vaccinating. Do you think the CDC has 0:04:39.839 --> 0:04:42.599 been too hesitant to do that? With messaging like this 0:04:42.600 --> 0:04:44.760 would have been more effective had the CDC from early 0:04:44.760 --> 0:04:46.680 on come out and said, hey, when you are six 0:04:46.720 --> 0:04:48.840 weeks past that first shot, when you're two weeks past 0:04:48.920 --> 0:04:51.160 that second shot, you are free to go back to 0:04:51.200 --> 0:04:55.880 living your normal life. Yeah, I think they've been more 0:04:56.000 --> 0:04:57.880 I think they've been a little too cautious, and that's right. 0:04:57.880 --> 0:05:00.440 I don't know if the exact guidances is is what 0:05:00.480 --> 0:05:02.800 you're saying, But I think it's right. What I'm saying 0:05:02.839 --> 0:05:05.719 is like should should they? Should they be doing that? 0:05:05.839 --> 0:05:09.240 Should they be? Or or some sort of closer return 0:05:09.279 --> 0:05:14.320 to normalcy and something sooner. Yeah, I think that's exactly right. 0:05:14.600 --> 0:05:17.000 Uh And and I think part of the messaging too 0:05:17.040 --> 0:05:20.560 is it's got to be just much more understandable for 0:05:20.600 --> 0:05:22.400 people about what it means for the things that matter 0:05:22.480 --> 0:05:25.200 to them. There's sort of a design element, if you would, 0:05:25.320 --> 0:05:28.000 how we're communicating that I think is also been missed 0:05:28.000 --> 0:05:30.240 as well. So I want to talk about your book, 0:05:30.279 --> 0:05:32.360 if we may, because it's called Care after COVID with 0:05:32.400 --> 0:05:34.960 the pandemic revealed? Is broken in healthcare and how to 0:05:35.000 --> 0:05:36.720 reinvent it? And safe to say that we've had a 0:05:36.760 --> 0:05:39.839 lot of conversations about disruption we have left for you know, 0:05:39.880 --> 0:05:44.159 reporting after the close, like they disrupt transportation and kind 0:05:44.200 --> 0:05:48.120 of the driving world, if you will. What's interesting is 0:05:48.200 --> 0:05:50.680 healthcare has been I think one of those areas that 0:05:50.720 --> 0:05:52.599 most people would agree it's taken a while for it 0:05:52.680 --> 0:05:54.560 to be disrupted and still has a long way to go. 0:05:55.240 --> 0:05:57.160 You talk about in this book that if the health 0:05:57.160 --> 0:06:00.200 care system were an Emperor COVID nineteen tragically review that 0:06:00.240 --> 0:06:04.440 it had no clothes. So what do we learn from 0:06:04.600 --> 0:06:08.719 these past twelve thirteen months. Obviously telemedicine, that's the obvious one, 0:06:08.760 --> 0:06:10.840 and I'm guessing it's going to stay with us. But 0:06:10.880 --> 0:06:14.360 what else? How do we move towards a more transparent, efficient, 0:06:14.360 --> 0:06:19.520 productive healthcare system? Yeah, so I think there's two elements 0:06:19.560 --> 0:06:21.440 of what we learned, right. I think one is just 0:06:21.520 --> 0:06:25.120 this idea, this sort of magnification of the longstanding failures 0:06:25.120 --> 0:06:27.440 of the health care system. Right. I think it's hard 0:06:27.480 --> 0:06:30.839 to find people these days that don't deeply understand how 0:06:30.920 --> 0:06:35.719 inaccessible health care is, how inequitable health care is, how 0:06:35.720 --> 0:06:38.640 inefficient it is. And I think that matters because I 0:06:38.680 --> 0:06:41.320 think what was a reality for pockets of Americans for 0:06:41.360 --> 0:06:43.880 a while, you know, those with multiple chronic conditions, those 0:06:43.920 --> 0:06:46.760 who are lower income. I think now is a shared 0:06:46.839 --> 0:06:49.720 lived experience of nearly all of us, Right, We've all 0:06:49.760 --> 0:06:52.000 had that experience of you know, how do I get 0:06:52.040 --> 0:06:55.320 a vaccine um and navigating that, how do I get 0:06:55.320 --> 0:06:58.160 a task? And and I think that that actually matters 0:06:58.200 --> 0:07:01.680 in terms of the sort of public being able to 0:07:01.720 --> 0:07:04.479 move forward to better care models. The second thing we 0:07:04.560 --> 0:07:06.920 learned is that actually health care can be way more 0:07:06.960 --> 0:07:09.920 flexible in a crisis than we thought. Right. I think 0:07:09.960 --> 0:07:12.960 even the most sort of expert folks didn't expect that 0:07:13.080 --> 0:07:15.480 clinics like mind, in the course of two weeks would 0:07:15.520 --> 0:07:19.920 go from never doing any virtual visits to nearly virtual 0:07:20.600 --> 0:07:23.400 um within a two week span. Right. I don't think 0:07:23.440 --> 0:07:26.000 we expected that we'd be able to spin up drive 0:07:26.040 --> 0:07:29.400 through testing. Right. We've for for decades now we take 0:07:29.480 --> 0:07:31.480 people that are sick, coughing and sneezing on each other 0:07:31.480 --> 0:07:33.320 and we put them in a waiting room to cope 0:07:33.680 --> 0:07:36.040 on each other. And now we have a better way 0:07:36.280 --> 0:07:38.760 to do that. We scale that. We're also using data 0:07:38.800 --> 0:07:40.800 in new ways. Right, So in my clinic, we've had 0:07:40.840 --> 0:07:43.240 an electronic record for a long time. This is one 0:07:43.240 --> 0:07:45.560 of the first times we've taken data out of there 0:07:46.000 --> 0:07:48.680 and used it to proactively call people who are who 0:07:48.680 --> 0:07:51.040 are sicker or higher risks that needed a vaccine. And 0:07:51.080 --> 0:07:53.520 so I think that that's a huge part of what 0:07:53.560 --> 0:07:56.640 we've learned too, is that change is possible, and I 0:07:56.680 --> 0:07:59.840 think that the demand for that change is greater than ever. 0:08:00.320 --> 0:08:02.760 And I have to say that having experienced a virtual 0:08:02.840 --> 0:08:04.800 visit with a doctor and I thought, this isn't gonna work. 0:08:04.840 --> 0:08:07.600 How is he going? You know? And it was pretty 0:08:07.720 --> 0:08:11.880 comprehensive and incredible, And as a result, I was much 0:08:11.920 --> 0:08:14.520 more involved because I had to do things that he 0:08:14.560 --> 0:08:17.640 would have been normally doing to be without getting too specific, 0:08:17.680 --> 0:08:20.240 but it but it was interesting that I was much 0:08:20.280 --> 0:08:22.720 more involved and thoughtful in my questions as a result 0:08:22.760 --> 0:08:24.960 because I was understanding what was going on. It's been 0:08:25.040 --> 0:08:26.480 I mean for me, it's been hit or miss. It's 0:08:26.520 --> 0:08:29.720 been really good. Yeah, from a pediatrician perspective. Being able 0:08:29.760 --> 0:08:31.960 to connect with our pediatrition has been really good. But 0:08:32.040 --> 0:08:34.720 for for you know, I thought I hurt myself riding 0:08:34.720 --> 0:08:36.680 my bike over the summer, and it was like, you know, 0:08:36.800 --> 0:08:39.400 the doctor couldn't like actually check to see if I 0:08:39.440 --> 0:08:41.679 was heard by pressing on all the areas that he 0:08:41.679 --> 0:08:45.520 would normally press on. Right, it's not perfect. So so 0:08:45.800 --> 0:08:50.400 what is the next iteration of this? Dr Nundee. Yeah, 0:08:50.440 --> 0:08:52.160 I think we're healthier needs to go and I think 0:08:52.200 --> 0:08:53.880 we one of the things that we're missing is a 0:08:53.920 --> 0:08:57.040 clear vision of where we need to go. And what 0:08:57.080 --> 0:08:58.640 I've sort of described in the book is that I 0:08:58.640 --> 0:09:01.319 think healthier needs to become just pributed. It needs to 0:09:01.360 --> 0:09:04.400 become digitally enabled, and needs to become decentralized. And what 0:09:04.440 --> 0:09:07.920 I mean by that is distributed means care is is 0:09:08.440 --> 0:09:11.720 care happens, where health happens. It's closer to where patients 0:09:11.760 --> 0:09:14.280 are at home, in the community, increasingly on their phone. 0:09:14.600 --> 0:09:17.199 To your point, it can't just be about virtual only. 0:09:17.600 --> 0:09:20.400 That's an important one, but that sometimes you're going to 0:09:20.480 --> 0:09:22.480 need to see a doctor in person. But it doesn't 0:09:22.520 --> 0:09:25.840 mean that care can't start closer to home. And then 0:09:25.840 --> 0:09:28.520 in some cases maybe home visits that makes sense. In 0:09:28.559 --> 0:09:31.560 some cases that may mean employer on site clinic, So 0:09:31.600 --> 0:09:34.400 that's sort of distributed. Digitally enabled is really thing. Look, 0:09:34.440 --> 0:09:38.000 the real role of data and technology and healthcare is 0:09:38.160 --> 0:09:41.440 to extend the relationships that are central to care. Right. 0:09:41.480 --> 0:09:43.640 We think we've all learned during the pandemic that trust 0:09:43.720 --> 0:09:46.880 is essential and that trust between a patient and provider 0:09:46.920 --> 0:09:49.320 is ultimately what drives a lot of the outcomes. But 0:09:49.400 --> 0:09:51.480 up until now, a lot of the technology investments you've made, 0:09:51.520 --> 0:09:55.000 it's frankly been neutral to negative on that relationship. The 0:09:55.040 --> 0:09:57.360 e m R, the Electronic medical record being the best 0:09:57.400 --> 0:10:00.280 example of that. And then decentralized. We need to put 0:10:00.360 --> 0:10:03.600 way more resources in the hands of frontline health workers 0:10:03.600 --> 0:10:06.000 and patients. Right. So, one of the things I advocated 0:10:06.040 --> 0:10:08.600 on early on was, you know, when everyone was concerned 0:10:08.600 --> 0:10:11.240 about testing, testing, test, and they said, well, we said, well, 0:10:11.240 --> 0:10:13.440 why don't Why can't patients just test themselves at home? 0:10:13.880 --> 0:10:16.320 Because a lot's absurd, you know, the patients can't do that, 0:10:16.400 --> 0:10:19.080 and and and and so we had these stories of 0:10:19.080 --> 0:10:22.240 people saying hundreds, sometimes over a thousand dollars just to 0:10:22.280 --> 0:10:25.400 get a test for COVID. Today, you can walk into 0:10:25.400 --> 0:10:28.959 a CBS from Walgrain and for for fourteen dollars, you 0:10:28.960 --> 0:10:31.760 can get two kids of fourteen dollars of kids, and 0:10:31.760 --> 0:10:34.520 in fifteen minutes on your kitchen table, you can test 0:10:34.520 --> 0:10:38.400 yourself for COVID and get a pretty accurate answer. That's 0:10:38.440 --> 0:10:40.160 the direction I think we need to go. So, so, 0:10:40.240 --> 0:10:42.080 what are the permanent changes that you would like to 0:10:42.120 --> 0:10:44.560 see in order for us to be prepared for what 0:10:44.600 --> 0:10:48.320 we not affectionately, not so affectionately called the next pandemic? Like, 0:10:48.400 --> 0:10:51.520 do we need to have the vaccination infrastructure already in 0:10:51.559 --> 0:10:53.600 place so we can respond right away? Do we need 0:10:53.640 --> 0:10:55.960 to have the testing infrastructure already in place so we 0:10:55.960 --> 0:10:57.360 can respond. Do we need to change the way we 0:10:57.400 --> 0:11:02.440 do emergency use authorization with the FDA so they can nimble? Yeah? 0:11:02.520 --> 0:11:04.880 I mean, honestly, it's all of the above, I think. 0:11:04.960 --> 0:11:07.080 In addition, I think a lot of the ones that 0:11:07.120 --> 0:11:10.000 you just suggested or from a public health perspective, I 0:11:10.040 --> 0:11:13.520 think about it also from a healthcare deliveries perspective. Right, So, 0:11:13.600 --> 0:11:16.839 for example, if we can distribute more care to people's homes, 0:11:17.000 --> 0:11:19.640 what that means. It's like the classics, you don't want 0:11:19.640 --> 0:11:22.680 to put all your eggs in one basket. It's when 0:11:22.720 --> 0:11:25.640 you rely on a hospital and that hospital, funnily is overwhelmed. 0:11:25.640 --> 0:11:29.240 Guess what happens? Like you can't do elective care, you 0:11:29.280 --> 0:11:31.440 can't safely hospitalize people. And we saw that too, and 0:11:31.480 --> 0:11:35.800 so actually sort of spreading out where care happens into 0:11:35.840 --> 0:11:38.120 more sites would actually enable us to be much more 0:11:38.160 --> 0:11:40.840 resilient when those things happen. UM. A big part of 0:11:40.840 --> 0:11:43.120 this is about data. I mean the fact that we 0:11:43.240 --> 0:11:46.480 couldn't even answer simple questions like at any given day, 0:11:46.520 --> 0:11:49.439 how many people in this country are hospitalized with COVID, 0:11:49.520 --> 0:11:52.000 let alone, how many of them are or African American 0:11:52.080 --> 0:11:55.480 or Latino or let alone what your outcomes are. It 0:11:55.679 --> 0:11:58.440 is an absolute travesty, especially given that we've just spent 0:11:58.559 --> 0:12:01.680 billions and billions of dollars on taking health information and 0:12:01.720 --> 0:12:05.200 making a digital and so we absolutely need finally solve 0:12:05.280 --> 0:12:08.559 this interoperability issue for many reasons, but one of them 0:12:08.600 --> 0:12:10.400 is so that you know, we can be much more 0:12:10.440 --> 0:12:13.319 responsive so that when we have a pandemic, we're seeing 0:12:13.320 --> 0:12:15.800 the data, we're understanding the complications, and we're being able 0:12:15.840 --> 0:12:20.680 to understand what treatment are and are not working. Isn't 0:12:20.720 --> 0:12:23.440 the endgame here in terms of what we've learned over 0:12:23.440 --> 0:12:27.360 the last year that if you're a healthy individual, no guarantee, 0:12:27.480 --> 0:12:30.520 but you're much more likely to be able to fight 0:12:30.559 --> 0:12:33.640 a virus or some other disease or ailment. You've got 0:12:33.640 --> 0:12:36.400 a chapter and here about patient directed empowering people to 0:12:36.400 --> 0:12:38.400 guide their own care, and you talked about being a 0:12:38.440 --> 0:12:41.040 third year medical student going through the hospital and how 0:12:41.080 --> 0:12:43.520 you kept seeing patient after patients suffering from health problems 0:12:43.720 --> 0:12:49.880 that were completely preventable. And are we ready for a 0:12:49.960 --> 0:12:54.080 wellness health care system that's about keeping people away from 0:12:54.160 --> 0:12:57.679 doctors out of hospitals, which, as you know, is quite 0:12:57.720 --> 0:13:02.880 the financial and business Jugger not right now, Yeah, absolutely. 0:13:02.880 --> 0:13:05.080 I Mean one of the other stories in the book, 0:13:05.080 --> 0:13:07.040 and one that's really close to me because involves my 0:13:07.040 --> 0:13:08.839 own mom, is the fact that you know, my mom 0:13:09.000 --> 0:13:11.240 is that diabetes types of diabetes for twenty years and 0:13:11.320 --> 0:13:14.199 on inflant for ten she kept hearing all these reports 0:13:14.200 --> 0:13:16.439 that hey, you have diabetes, your risk of COVID higher 0:13:16.480 --> 0:13:19.000 to your point, right, and she said, I can't, I 0:13:19.040 --> 0:13:21.240 can't handle this anymore. And so she signed up for 0:13:21.280 --> 0:13:26.679 a program that got her seven help coach, connected her 0:13:26.679 --> 0:13:29.160 with the peer someone else who also has diabetes and 0:13:29.480 --> 0:13:31.800 comes from the same culture that we do, got our 0:13:31.920 --> 0:13:34.800 virtual care doctor, and within a month, my mom went 0:13:34.840 --> 0:13:37.920 from being on influence for ten years, never having your 0:13:37.960 --> 0:13:41.640 sugar control, to being completely off of influence and and 0:13:41.640 --> 0:13:44.960 and achieving a state we call diabetes reversal. And so 0:13:45.000 --> 0:13:46.720 I think that you know, with the third wave of 0:13:46.760 --> 0:13:50.160 digital help that we've seen, um, some of these models 0:13:50.160 --> 0:13:53.040 that are coming out, I think are exactly the direction 0:13:53.080 --> 0:13:55.920 we need to go to say, we don't need yet 0:13:56.080 --> 0:14:00.240 necessarily another drug for diabetes that's one percent better for 0:14:00.640 --> 0:14:02.640 you know, a hundred times the cost, but we need 0:14:02.679 --> 0:14:05.520 to start putting our investment from an ni AH perspective, 0:14:05.520 --> 0:14:08.760 from a payer perspective is and the idea of actually 0:14:09.240 --> 0:14:13.559 preventing disease or or actually reversing or controlling disease. So 0:14:13.640 --> 0:14:16.839 where does that education start though, because it doesn't necessarily 0:14:17.400 --> 0:14:19.360 we don't want it to take a pandemic for for 0:14:19.400 --> 0:14:26.440 that to happen yesterday, right, absolutely not, absolutely not. And 0:14:26.920 --> 0:14:28.840 where does it start? I mean, I think it starts 0:14:28.920 --> 0:14:31.560 in a lot of places. But I think at least 0:14:31.600 --> 0:14:33.240 the world that I think a lot about is is 0:14:33.280 --> 0:14:37.000 the employer world. I think employers are are are heavily 0:14:37.040 --> 0:14:40.120 incentivized to manage the health of employees, not only because 0:14:40.200 --> 0:14:44.440 they manage their medical costs, but also because that that productivity, 0:14:44.520 --> 0:14:47.720 whether it's you know, missing uh, you know, work for appointment, 0:14:47.800 --> 0:14:52.120 whether it's mental health, those things affect their bottom line significantly. 0:14:52.760 --> 0:14:55.560 And but I think that, you know, there's been a 0:14:55.600 --> 0:14:58.040 little bit of a lag in that world where you know, 0:14:58.320 --> 0:15:01.680 some of the solutions that they're that they they're supporting 0:15:01.680 --> 0:15:04.280 aren't necessarily the ones that are getting to that. There's 0:15:04.320 --> 0:15:06.880 this whole cottage industry of people that are still saying, hey, 0:15:06.920 --> 0:15:09.240 you know, by fit for all your employees, I mean, 0:15:09.240 --> 0:15:11.800 that's not really been proven to work, and so I 0:15:11.800 --> 0:15:14.720 think that's where I think some education needs to happen. 0:15:15.240 --> 0:15:18.000 It's actually unlocked in scale. Well, I gotta tell you, 0:15:18.120 --> 0:15:21.400 interesting conversation. Interesting book you talk about checklist for every 0:15:21.440 --> 0:15:23.360 decade of life you know of just how to keep 0:15:23.400 --> 0:15:26.000 yourself healthy so that you don't get to a situation 0:15:26.080 --> 0:15:30.440 where you're ill. Really great conversation. Dr Shantau Nandie. He's 0:15:30.680 --> 0:15:32.880 chief medical officer at the private health care data solutions 0:15:32.880 --> 0:15:35.800 company Accolaid, former health technology advisor to the World Bank. 0:15:36.200 --> 0:15:38.520 And that book that we talked about care after COVID 0:15:38.560 --> 0:15:40.800 with the pandemic revealed is broken in healthcare and how 0:15:40.800 --> 0:15:43.480 to even invent it. My guesses will continue the conversation 0:15:44.120 --> 0:15:46.640 he has here in his book in the future. Look, 0:15:47.000 --> 0:15:48.760 one thing that I was thinking about the entire time 0:15:48.840 --> 0:15:52.640 Dr Nundie was speaking is about education and thinking about 0:15:52.640 --> 0:15:54.920 how healthy lifestyle starts at such a young age in 0:15:54.960 --> 0:16:00.280 the connection between mortality, comorbidities, and um. Well, we need 0:16:00.320 --> 0:16:03.040 to do as Americans in order to make sure that 0:16:03.080 --> 0:16:06.560 we become healthier as a whole in order to be 0:16:06.560 --> 0:16:10.960 because look, it's all about being on the defensive when 0:16:10.960 --> 0:16:12.680 it comes to our health. We do with driving, we 0:16:12.720 --> 0:16:15.000 do with other things, and it makes sense with healthcare. 0:16:15.720 --> 0:16:19.760 This is Bloomberg Business Week with Carol Messer and Bloomberg 0:16:19.800 --> 0:16:24.840 Quick Takes Tim Stinovic on Bloomberg Radio. Yes, Bloomberg terminal 0:16:24.880 --> 0:16:28.000 readers and users are reading this big time. It's the 0:16:28.000 --> 0:16:30.160 most read story about the bank. But bosses who are 0:16:30.200 --> 0:16:33.640 looking to say so long to remote working, Tim, well, 0:16:33.680 --> 0:16:36.240 you know what, It turns out that the bosses wanted 0:16:36.520 --> 0:16:40.440 the underlings don't really want it as much. Jenny Serena's 0:16:40.480 --> 0:16:43.040 finance reporter for Bloomberg News and joins us on the 0:16:43.080 --> 0:16:46.400 phone from here in New York. Jenny, Okay, what is 0:16:46.440 --> 0:16:51.760 the disconnect between management and employees. Management wants people back, 0:16:51.840 --> 0:16:55.720 but employees are saying, hey, not so fast. I think 0:16:56.000 --> 0:17:00.480 the disconnect really comes in that employees are, um, just 0:17:00.480 --> 0:17:03.760 wanting more flexibility on a more permanent basis. So even 0:17:03.760 --> 0:17:05.960 if they're open to coming back, and even if they 0:17:06.080 --> 0:17:08.480 you know, are wanting to see their colleagues and be 0:17:08.480 --> 0:17:10.880 in the office again, they want the ability to work 0:17:10.920 --> 0:17:13.199 from home, um, you know, one or two days a 0:17:13.200 --> 0:17:15.359 week and kind of decide when that is an option 0:17:15.400 --> 0:17:17.680 for them. Um, I think a lot of the web 0:17:17.760 --> 0:17:19.800 just comes from the fact that we've had obviously this 0:17:19.920 --> 0:17:23.399 really terrible hard years. Thanks process have been you know, 0:17:23.480 --> 0:17:26.480 storing through the roots. People are obviously productive. Um, so 0:17:26.480 --> 0:17:29.000 they're just like, hey, we've we've done our best, We've 0:17:29.040 --> 0:17:31.600 done a great job. Can't you trust us with this decision? 0:17:31.760 --> 0:17:33.840 This is like I could see a toddler. Okay, um, 0:17:34.440 --> 0:17:36.840 little little Johnny, I need you to do this? Why 0:17:36.960 --> 0:17:40.000 well because I need you back? Why well, because I 0:17:40.040 --> 0:17:42.679 need you back? Um well, we're productive, so why do 0:17:42.720 --> 0:17:45.960 you need me back? Like I could, like, you know, profitable. 0:17:46.160 --> 0:17:48.560 The banks have done really well. We know that you 0:17:48.600 --> 0:17:51.840 know that, Um, it's working. We heard from a lot 0:17:51.880 --> 0:17:54.399 of these big bank execs early on are saying listen. 0:17:54.440 --> 0:17:57.440 I think I remember James Gorman work in Stanley saying, hey, 0:17:57.440 --> 0:17:59.320 this is kind of working. Maybe we reduce our real 0:17:59.440 --> 0:18:03.439 estate footprints. So do they need to make the case 0:18:03.760 --> 0:18:06.440 to the underlings in order to get them back and 0:18:06.680 --> 0:18:09.280 you know, or does it not really matter that underlings 0:18:09.359 --> 0:18:13.159 ultimately you've got to come back. No, I think it 0:18:13.280 --> 0:18:16.199 definitely matters. I mean, I think these these executives are 0:18:16.240 --> 0:18:19.320 realizing that a lot of this just messaging and kind 0:18:19.359 --> 0:18:22.280 of making it clear you know, why they want folks back, 0:18:22.440 --> 0:18:24.280 not just you know, this is the day we expect 0:18:24.320 --> 0:18:26.360 you to be here. Um. And I think a big 0:18:26.400 --> 0:18:29.640 thing that's driving that actually is um. You know, it's 0:18:29.640 --> 0:18:32.200 not that they really think that every single person needs 0:18:32.200 --> 0:18:33.920 to be in the office so that they can monitor 0:18:33.960 --> 0:18:36.720 them and track them. I think a large thing is culture. 0:18:36.840 --> 0:18:38.960 You know, these thanks that really are seeing their cultures 0:18:39.000 --> 0:18:42.119 kind of break down and degrade, um young people. You know, 0:18:42.280 --> 0:18:45.040 there's so much training that happens kind of in person. 0:18:45.440 --> 0:18:47.240 They haven't really been able to replace that in the 0:18:47.320 --> 0:18:49.639 remote world. So I think that those are things that 0:18:49.640 --> 0:18:51.720 they're trying to kind of align people around and make 0:18:51.720 --> 0:18:54.240 them realize like, hey, someone did this for you, you 0:18:54.320 --> 0:18:57.080 kind of need to pass it on to the next generation. Um. 0:18:57.119 --> 0:18:58.840 But so much of that is just the messaging, and 0:18:58.880 --> 0:19:01.360 I think these like be handed memos that come out 0:19:01.760 --> 0:19:04.280 that's really where the rob is is kind of um 0:19:04.320 --> 0:19:06.920 you know taking place. Hey Jenny, where does burnout come 0:19:06.960 --> 0:19:09.280 into this? And to what extent can can burnout be 0:19:09.359 --> 0:19:13.480 tied to remote work? Yeah? I think I mean that 0:19:13.640 --> 0:19:16.360 is a huge one. I think, especially given the burnout 0:19:16.359 --> 0:19:19.280 that we're seeing among junior bankers. UM. I think a 0:19:19.280 --> 0:19:21.359 lot of bankbots just seem to think that that is 0:19:21.400 --> 0:19:24.960 really because there's no outlets for these guys, um you know, 0:19:25.040 --> 0:19:27.000 on the weekends or anything like that, and so they're 0:19:27.040 --> 0:19:30.359 just always working and always on, always logged in. And 0:19:30.400 --> 0:19:32.560 for some reason, I'm just thinking of the show industry. 0:19:32.720 --> 0:19:37.000 I don't know, but I mean it's very it's very Hollywood. 0:19:37.040 --> 0:19:39.119