Speaker 1: Welcome to the Bloomberg pim L Podcast. I'm pim Fox
Speaker 1: along with my co host Lisa A. Brahmowitz. Each day
Speaker 1: we bring you the most important, noteworthy, and useful interviews
Speaker 1: for you and your money, whether you're at the grocery
Speaker 1: store or the trading floor. Find the Bloomberg p m
Speaker 1: L Podcast on Apple Podcasts, SoundCloud, and Bloomberg dot com.
Speaker 1: Phil Orlando joining us now in our Bloomberg Interactive Broker Studios.
Speaker 1: Phil Orlando, of course, chief Equity market Strategistic Federated Investors.
Speaker 1: He brought his blood pressure medication with him because it's
Speaker 1: been that kind of that kind of weak. Um, so
Speaker 1: is this enough. It's a step in the right direction.
Speaker 1: I mean, we've seen this movie before. We we think
Speaker 1: we know how it ends. The beginning of October, Powell
Speaker 1: makes a rookie mistake saying we're a ways away from
Speaker 1: neutral in the market. That's when we started to roll
Speaker 1: over and I and then he has that special technical term.
Speaker 1: So then he has this the lunch at the New
Speaker 1: York on November right. I was at that lunch along
Speaker 1: with my closest friends, and he did the right thing.
Speaker 1: He explained to us in a little bit more detail
Speaker 1: exactly what he meant, uh, we're very close to neutral.
Speaker 1: And and as I walked out of that meeting, having
Speaker 1: read his transcript, having listened to his speech, in my
Speaker 1: mind it was like, Okay, we're gonna get a hike
Speaker 1: in December. That's fine, We're gonna get one more hike
Speaker 1: later in ten. I think we're gonna skip March because
Speaker 1: of the March first deadline with the China trade deal
Speaker 1: and breaks it coming at the end of March and
Speaker 1: ceiling debate, and exactly so. So in my mind, I
Speaker 1: walked out of that lunch in November saying, the Fed's
Speaker 1: got one, maybe two hikes left and then we're done.
Speaker 1: And what did the market do? They rallied? Okay. So
Speaker 1: then we fast forward to fo MC meeting and everyone
Speaker 1: myself at the top of this list or expecting the
Speaker 1: FED to come in adjust the dot plots from what
Speaker 1: we saw at the September f MC meeting, literally pull
Speaker 1: in their horns. And then during the Q and A,
Speaker 1: we were expecting Powell to sort of put some some
Speaker 1: flesh on those bones and explain, all right, we just
Speaker 1: got a hike, We're probably gonna skip March for a
Speaker 1: couple of reasons. We've got one more hike next year
Speaker 1: and then we're probably done. That's not what he did,
Speaker 1: and and that's why the market responded is violently to
Speaker 1: the downside, as they did the last couple of days.
Speaker 1: So fast forward to this morning. Uh, John Williams is
Speaker 1: is trotted out on Steve Leesman Show, and and he's
Speaker 1: trying to reset what what the chairman perhaps had intended
Speaker 1: to say with that answer? All right, let's let's roll
Speaker 1: it to the balance sheet? What do you think the
Speaker 1: Fed is looking to do as it relates to, you know,
Speaker 1: quantitative tightening as we roll into do you think this
Speaker 1: is gonna play out? So I think we've got a
Speaker 1: pretty good beat on this that that the Fed's balance
Speaker 1: sheet peeked out about four and a half trillion dollars,
Speaker 1: up from a number below one trillion at the beginning.
Speaker 1: So they've got to pull that in and I think
Speaker 1: create dry powder. They need to prepare for the next recession,
Speaker 1: which we don't think is next year. We still think two.
Speaker 1: And I think they need to pull that back to
Speaker 1: about the three trillion dollar level. Right now, they're rolling
Speaker 1: it off at a pace of about fifty billion dollars
Speaker 1: a month. So where we are right now I think
Speaker 1: is just a shade over four trillion dollars. We're gonna
Speaker 1: roll off six hundred billion next year. That gets us
Speaker 1: to about three four or so, and then if we
Speaker 1: rolled another six hundred billion off in twenty, that takes
Speaker 1: us down about two point eight. Somewhere in there, somewhere
Speaker 1: between two eight and three four, you know, let's call
Speaker 1: it three three and a quarter or something like that.
Speaker 1: That's where I think the Fed stops. But when he
Speaker 1: got the question during the press conference, what are you
Speaker 1: doing with the balance sheet, he was like, Oh, we're
Speaker 1: on autopilot. Explain to us what that means. That Hold
Speaker 1: on a second. I think he did more than that.
Speaker 1: I think it wasn't just that we're on a pilot.
Speaker 1: He seemed to dismiss the significance that quantitative tightening or
Speaker 1: letting the balance sheet roll off had on markets, that
Speaker 1: the reality is that the market is very concerned about
Speaker 1: that because we don't have a full sense. Are they
Speaker 1: going back to you know, a trillion dollars, are they
Speaker 1: going to zero, or were they going to some intermediate
Speaker 1: level at which everyone is comfortable I think some more
Speaker 1: discussion around that point would have been more helpful to
Speaker 1: keep the market calm. Do you think Chairman pal has
Speaker 1: lost the market And by that I mean as he
Speaker 1: lost the confidence at market participants, And if so, what
Speaker 1: do we do? So? I was on Maria Bromo show
Speaker 1: Monday morning, and we were laughing over the rookie mistake
Speaker 1: that Ben Bernanke had made with her at a cocktail party,
Speaker 1: talking about stuff he shouldn't have been talking about. But
Speaker 1: he learned from that mistake and improved. Jenny Yellen made
Speaker 1: a mistake in her first year telling everyone they should
Speaker 1: sell biotechnology stocks that obviously didn't work very well. So
Speaker 1: well had his rookie mistake in in October, he should
Speaker 1: have learned from that. And and you know, I, you know,
Speaker 1: speaking personally, and disappointed that we got the performance we
Speaker 1: got two days ago with three days ago, we should
Speaker 1: have gotten a better, tighter presentation. And I think that's
Speaker 1: why the Williams comment this morning was so important. Honestly,
Speaker 1: I could easily see somebody saying he gave us exactly
Speaker 1: what he should have given us. He was saying that
Speaker 1: the economy looks pretty strong. Their data dependent they're convicting
Speaker 1: they have you know, right now it appears that things
Speaker 1: are going well. They don't want to respond too much
Speaker 1: to markets and use, you know, the stock market as
Speaker 1: a barometer of whether or not they should hike. What
Speaker 1: did you say that was that different? Number one and
Speaker 1: number two? You know, honestly, at a certain point, aren't
Speaker 1: we just seeing price discovery for the first time in
Speaker 1: a decade? Lisa, You're you're a thousand percent correct that
Speaker 1: the context of the environment you're in is something that
Speaker 1: that he's oblivious to. The the S and P five
Speaker 1: hundreds down sixteen since the middle of September, rustles down twenty.
Speaker 1: We're sort of in a free fall here at a
Speaker 1: point in the seasonal cycle where the market should be
Speaker 1: going up. The economic that is pretty good, corporate earning
Speaker 1: is a pretty good GDP growth is pretty good. Yet
Speaker 1: we're in a free fall. That suggested that the market
Speaker 1: is skittish, it's nervous, it's concerned, and and the Fed
Speaker 1: should have recognized that. And I think Williams sort of
Speaker 1: made that comment today. We we we we are looking
Speaker 1: at what the markets telling us. Where we're we're cognizant
Speaker 1: of what the market is telling us, and I think
Speaker 1: that the market perceived Wednesday that the Powell was sort
Speaker 1: of oblivious to what's going on right now. So real quickly,
Speaker 1: given all of that, all that uncertainty that maybe have
Speaker 1: been contributed by the Fed, what are you telling your
Speaker 1: clients in Well, we're telling them that that when we
Speaker 1: once we get work our way through all of this
Speaker 1: noise and nonsense, there's gonna be a massive buying opportunity.
Speaker 1: And as we look at the fundamentals, and ultimately that's
Speaker 1: what we're trying to do. And over the course of
Speaker 1: the next year, we think that corp earnings in twenty
Speaker 1: nine are going to be a hundred and seventy dollars
Speaker 1: off of a hundred and sixty dollars this year. Now
Speaker 1: that's only up five or six percent as opposed to
Speaker 1: five percent this year, So will there'll be a deceleration
Speaker 1: and earnings growth? Yes. Multiples Price earnings ratios over the
Speaker 1: last three or four months have contracted from eighteen times
Speaker 1: earnings trading a little over fourteen times earnings right now,
Speaker 1: we've lost four multiple points. We believe that an eighteen
Speaker 1: multiple is the appropriate multiple given the relatively benign nature
Speaker 1: of both interest rates and inflation. So if that's right,
Speaker 1: and we're slapping an eighteen multiple on a hundred and
Speaker 1: seventy dollars and earnings, that's thirty one the SMP. We're
Speaker 1: sitting here in what dred I mean that you're looking
Speaker 1: at at, you know, a twenty plus kind of return.
Speaker 1: But there's a lot of stuff that's got to happen
Speaker 1: in between now and declaring a bottom. And and the
Speaker 1: things I'd look at are going to happen next spring
Speaker 1: and or next March in terms of the Breggit deadline
Speaker 1: and our Trump and she gonna be able to successfully
Speaker 1: navigate the um you know, the trade and teriff situation. Yea.
Speaker 1: So just wait for those politicians do come together and
Speaker 1: and then that'll be the time. Merry Christmas, Merry Christmas.
Speaker 1: Would love your Christmas time Fill Orlando. What a suspenders
Speaker 1: that are so good? Orlando, chief faculty markets strategist at
Speaker 1: Federated Investors, full on with the holiday gear. General Maddis,
Speaker 1: who has long been thought to be the ballast in
Speaker 1: the current White House administration, is set to retire. He
Speaker 1: released a memo explaining why it was rather scathing. Did
Speaker 1: not mention President Trump by name once joining us now
Speaker 1: here in our Bloomberg Interactive Broker Studios is Clint Watt's
Speaker 1: Distinguished Research Fellow for Foreign Policy Research Institute, also a
Speaker 1: Senior Fellow at the Center for Cyber and Home and
Speaker 1: Security at the George Washington University. Former formerly an FBI
Speaker 1: Special Agent on a Joint Terrorism Task Force, served in
Speaker 1: the Army. He's joining me and Paul Sweeney, who is
Speaker 1: filling in for Pim Fox. Clint, what do you make
Speaker 1: of General Madis's resignation. It's frightening, I think for just
Speaker 1: about anybody, Republican or Democrat, all the way up until now,
Speaker 1: there was some sort of comfort in knowing that General
Speaker 1: Madis was there. Very experienced, level headed executive can seem
Speaker 1: to communicate with President Trump and the rest of the
Speaker 1: executive branch. He's good in terms of building relationships. He's
Speaker 1: got strong bipartisan support even on the Hill. And yet
Speaker 1: he leaves in a very precipitous way at a time
Speaker 1: where we've got a lot of foreign policy chaos, whether
Speaker 1: you look across the board, Russia, China, ran Syria with
Speaker 1: this rapid pull out, the creation of a space force,
Speaker 1: which kind of came out of nowhere. Just every day
Speaker 1: there seems to be a major foreign policy shift or move.
Speaker 1: Yesterday was withdrawing soldiers from Afghanistan after we were just
Speaker 1: talking about, you know, staying there in the fight. And
Speaker 1: so it's hard for people in the executive branch, in
Speaker 1: the defensive department, I think, to execute any sort of
Speaker 1: a plan because it changes on the web based on
Speaker 1: a phone call or an impromptu meeting the president might have.
Speaker 1: And so I think that resignation letter uh sends a
Speaker 1: shock to to the rest of the executive branch and
Speaker 1: and to the legislative branches that we are in a
Speaker 1: very troublesome space right now. So Clint tell us in
Speaker 1: your mind, how correlated was the resignation of General Mattis
Speaker 1: to Trump's announcement about pulling out of Syria, And related
Speaker 1: to that is is isis defeated, as the President claims,
Speaker 1: that would be news to a lot of people. I believe. Yeah.
Speaker 1: I'll start with the second one, which isis is not defeated.
Speaker 1: In President Trump has been so negative about President Obama
Speaker 1: Is handling where he said that essentially al Qaeda had
Speaker 1: been defeated. That was going back into the last administration,
Speaker 1: which seemed very foolish as ISIS sort of rose out
Speaker 1: of the ashes of al Qaeda, out of nowhere and
Speaker 1: became such a more powerful threat, and we're seeing President
Speaker 1: Trump followed that same pattern. It's really crazy. There's a
Speaker 1: lot of detainees there, the Kurds to actually have a
Speaker 1: lot of ISIS detainees. And this really goes to I
Speaker 1: think the Secretary Maddis decision, which is pulling out a
Speaker 1: Syria precipitously like that may have been a good strategy
Speaker 1: over a year or two, but you want to have
Speaker 1: a plan in place to do that, because otherwise you're
Speaker 1: releasing IIS back onto the battlefield. You're empowering a run
Speaker 1: of Russia, two of our you know, biggest adversaries at
Speaker 1: the moment, and we're not really getting anything in return.
Speaker 1: And by the way, we're also turning our back on
Speaker 1: allies that have gone and done the fighting for US.
Speaker 1: Part of the Syria strategy to counter ISIS was to
Speaker 1: have a limited US footprint on the ground. We didn't
Speaker 1: want to send soldiers back into a rocket Syria. We
Speaker 1: we wanted to do it with just a series of
Speaker 1: special Forces operations and air power and we did took
Speaker 1: a little bit longer than everybody wanted. But other people
Speaker 1: did the fighting on the ground force, the Rocky military,
Speaker 1: the Kurds, uh Syrian militias that we started to train,
Speaker 1: and we have just turned our backs on all of them. Uh.
Speaker 1: And I just really wonder that you know, how we
Speaker 1: move forward if anything ever pops up that we want
Speaker 1: to do. Who would stand with us after we've just
Speaker 1: walked away from them? Well, but that's where I wanted
Speaker 1: to go with this, Clint, how permanent is a damage
Speaker 1: in your mind to the relationship of the U. S
Speaker 1: has with its allies. Our allies don't understand what our
Speaker 1: foreign policy is, and it sounds like sective madness doesn't
Speaker 1: understand it either. You know. In the letter he sort
Speaker 1: of said, you deserve a Secretary of Defense that you
Speaker 1: know supports and works towards your views. But I don't
Speaker 1: think anyone really knows what that is. And so if
Speaker 1: you're an ally, you continue to look at the US
Speaker 1: and say, what are you about? What are you pursuing?
Speaker 1: You know what our interest? Because it pivots back and forth.
Speaker 1: Let's take a Afghanistan. We've seen President Trump take General
Speaker 1: McMaster's sort of strategy a year ago and implement, you know,
Speaker 1: say we're going to do this. Now he's already backtracking
Speaker 1: from it. So what does that tell people on the
Speaker 1: ground there? Look at Isis and Syria. You know, we
Speaker 1: said we'll do one thing, then we do another. North Korea.
Speaker 1: We're going to denuclearise North creates as we want. You know,
Speaker 1: every one of these foreign policy matches that we've gone
Speaker 1: up against uh Vladimir Putin in Helsinki, we've come out
Speaker 1: the other side with no real understanding of what we've gained.
Speaker 1: What is America First Defense our strategy? But what do
Speaker 1: we want to achieve? What we've done is alienate literally
Speaker 1: all of our allies to where the strength of US
Speaker 1: as a country over the past five six decades have
Speaker 1: been we've been able to leverage the entire world against
Speaker 1: whatever evil that might arise. I don't think we can
Speaker 1: do that going forward, and I don't think any ally
Speaker 1: would want to engage with us in a sustained way
Speaker 1: when they can't know if we're really going to be
Speaker 1: in it for the long haul or what we actually
Speaker 1: believe in Clint, I just want to challenge you a
Speaker 1: little bit because a lot of people have been saying
Speaker 1: that the U s should not be fighting in the
Speaker 1: war in Syria and that the Afghanistan UH mission has
Speaker 1: been badly handled, with deaths that really shouldn't be happening.
Speaker 1: So isn't isn't Trump right on that part. The part
Speaker 1: with Syria which is fascinating is the Obama administration took
Speaker 1: a very limited stands. They would not put US soldiers
Speaker 1: into Syria, if you remember, for that exact name reason.
Speaker 1: We don't want to be there permanently trying to solve
Speaker 1: serious problems. President Trump's one of his first actions of
Speaker 1: his administration was to send US soldiers and four straight
Speaker 1: into Syria and into that combat zone. He actually took
Speaker 1: the reverse of that. So if if the strategy is
Speaker 1: to just deal with ISIS and also not get stuck
Speaker 1: in this quagmire, you have to do that in a
Speaker 1: very deliberate way. I think that's what the issue is
Speaker 1: with the Syria debate. People don't doubt that Iran and
Speaker 1: Russia we are mostly going to get their way over
Speaker 1: the long term. But what do we want in that fight?
Speaker 1: Because right now, Russia and Iran and anyone else, if
Speaker 1: they don't take care of that ISIS fight. We'll have
Speaker 1: what we had in foreign fighters showing up around the world,
Speaker 1: terrorists checks and our strategy has always been fight them there,
Speaker 1: rather them fight them here. This goes to Afghanistan as well,
Speaker 1: So to make that bridge, the Afghan war has needed
Speaker 1: to wind down for a long long time. But the
Speaker 1: thing is that it's Hotel California. You you can check in,
Speaker 1: but you can never leave. That's the problem in these
Speaker 1: counter terrorism fights is anytime we put ourselves in a
Speaker 1: footprint like that, we're going to have to be there
Speaker 1: or have a proxy or an ally or a surrogate
Speaker 1: someone help us keep that counter terrorism security mission going forever.
Speaker 1: And we don't have that plan hammered out in Afghanistan
Speaker 1: right now, So we don't have that that raises the
Speaker 1: risk of anything happening on our soil. Yes, over time,
Speaker 1: I mean it won't happen instantaneously. These networks, you know,
Speaker 1: they tend to rise, they evolve, and they show up
Speaker 1: in other places and in other ways. I mean, we
Speaker 1: saw an attack in Morocco just this week where two
Speaker 1: women were brutally murdered by four ISIS supporters, which hasn't
Speaker 1: happened quite some time, and so what will tend to
Speaker 1: happen is they will coalesce in a different way. I
Speaker 1: think another big challenge that we've got that we haven't
Speaker 1: thought through is state sponsored terrorism using these proxies, using
Speaker 1: these former foreign fighters around the world against the United
Speaker 1: States or Western interest shars me to death. Right now,
Speaker 1: we're unfortunately, we're gonna have to leave it there. A
Speaker 1: lot to talk about. We'll have to have you back
Speaker 1: on happy holidays, a lot to think about this year.
Speaker 1: Clint Watt's Distinguished Research Fellow at the Foreign Policy Research Institute,
Speaker 1: also a former FBI Special Agent in the counter Terrorism
Speaker 1: Unit One as a class that has been absolutely pummeled.
Speaker 1: Paul has been bitcoin at least this year, and joining
Speaker 1: us now is somebody who is a believer in the
Speaker 1: blockchain technology, a believer, believer in crypto assets and has
Speaker 1: a lot of money invested in the securities. Daniel Masters,
Speaker 1: chairman of coin Shares Group, joining us now from London. Danny,
Speaker 1: thank you so much for being with us. I thought
Speaker 1: it was really interesting a move that Switzerland made. It
Speaker 1: seems to give some edification to the Christian crypto acid world. Yes, him,
Speaker 1: nice to be with you again. It's been a very
Speaker 1: very interesting see days in crypto following what's been obviously
Speaker 1: a terrible year. Now, Switzerland might not be the most
Speaker 1: prominent nation from the US perspective, but it is the
Speaker 1: eighteenth largest economy in the world, bigger than Belgium and Argentina.
Speaker 1: The Swiss Federal Council just issue that framework entitled the
Speaker 1: Legal Framework for Districted Lleged Technology and Blockchain UM and
Speaker 1: it's been issued by the Swiss Federal Council, the most
Speaker 1: senior office in that Swiss nature nation. This for Switzerland,
Speaker 1: in my opinion, is a new crypto constitution. It is
Speaker 1: a global precedent, and it reminds me a lot of
Speaker 1: the US Jobs Act. So, Daniel, I guess when I
Speaker 1: read that about Switzerland, even though it is a relatively
Speaker 1: smaller economy from a banking perspective, it's been a global
Speaker 1: leader forever. So I kind of viewed it maybe as
Speaker 1: a validation, if you will, of the blockchain technology and cryptocurrencies,
Speaker 1: you know, giving the leadership position that Switzerland's kind of
Speaker 1: always had in financial services. You're correct, they are, indeed,
Speaker 1: who have been for many decades leaders in financial services
Speaker 1: that makes this report that much more credible. The report
Speaker 1: itself is very substantial, colors a hundred and sixty two pages,
Speaker 1: over eight hund legal cross references, and what really drew
Speaker 1: our attention to it was that on my professional network
Speaker 1: this was viewed by over three hundred and seventy five
Speaker 1: thousand people that happened to correspond with the rally in
Speaker 1: crypto measured for example, in bitcoin between life than two
Speaker 1: hundred dollars and four thousand dollars. So I think this
Speaker 1: is a meaningful development. Um. Yeah, So, Danny Um, your
Speaker 1: coin shares has combined one billion dollars of assets under
Speaker 1: management focused on cryptocurrencies and their crypto assets. And I'm
Speaker 1: just wondering what are you expecting next year? I mean,
Speaker 1: are we gonna be talking more about bitcoin as a
Speaker 1: viable long term asset class next year? And will it
Speaker 1: rally or is it going to be another difficult period
Speaker 1: for for it? Well, you know, I think this, this
Speaker 1: report is actually possibly a catalyst for some interesting developments
Speaker 1: seen Cryptova were driven by non institutional investors. This current
Speaker 1: year end rally we're seeing in per our inflows and
Speaker 1: per information from our peers is institutionally driven. This is
Speaker 1: supported by the Swiss government stance because it's a sort
Speaker 1: of encouragement the institutional investment committees can buy into. In
Speaker 1: terms of the likely shape of the rally that we
Speaker 1: may see next year, I think it will be much
Speaker 1: narrower than we saw in the past. The proliferation of tokens,
Speaker 1: many of which will fail, but from that wreckage, similar
Speaker 1: to what happened after the Mastack rash in two thousand one,
Speaker 1: I think we're going to see a narrow band of
Speaker 1: some protocol coins and some asset coins that are going
Speaker 1: to do quite well. Daniel, what else would the crypto
Speaker 1: market broadley define like to see too? I guess further
Speaker 1: validate the technology and the potential use cases. Um, you
Speaker 1: know Switzerland, maybe one of those mile post What else
Speaker 1: do you think the market is really looking forward to
Speaker 1: provide some support for this technology discurrency? Yeah, you're right.
Speaker 1: I think that the the evolutionary big bang that we
Speaker 1: saw in crypto over the last few years has been
Speaker 1: largely aspirational. The technology companies that were directly involved with
Speaker 1: are developing really interesting technology. It has been slow to
Speaker 1: come to the market, and that's what the market needs
Speaker 1: to see now. The head winds that these kind of
Speaker 1: technology companies actually face is being addressed by some of
Speaker 1: these Swiss government measures, so just quickly. Money laundering and
Speaker 1: terrorist financing is always a concern. The Swiss have taken
Speaker 1: this an account, recognized its importance and said in their
Speaker 1: studies and tech detection, so far it's not been a
Speaker 1: big issue, so they're going to keep a watching lie
Speaker 1: but allow a more fluid environment. Banking has been a
Speaker 1: headwind for these companies. This document actually talks about Swissland's
Speaker 1: should get this Swiss Bankers Association to buy into this initiative,
Speaker 1: and cleverly the way that the Swiss are looking at
Speaker 1: securities and physical assets which are usually represented in a
Speaker 1: in a de materialized form like trading rights for securities
Speaker 1: or depository seats for commodity, and they're looking at those
Speaker 1: instruments to be digitized. Thank you so much for being
Speaker 1: with us, Jenny Masters, chairman of Chairman of Coin Shares
Speaker 1: Group in London. Right now we're going to turn our
Speaker 1: focus to healthcare. We've seen healthcare shares getting beaten up
Speaker 1: pretty badly as a result of this Texas judge basically
Speaker 1: overturning Obamacare, joining us now to talk about that and
Speaker 1: whatever else is facing the healthcare industry. Heading into Susan
Speaker 1: of Or, chief executive officer of Premier based in Charlotte,
Speaker 1: but here with us today in our eleven three our studios. So, Susan,
Speaker 1: what did you make of this court ruling and how
Speaker 1: much does it make your life more difficult? You know,
Speaker 1: I think the court ruling is a short term headline.
Speaker 1: It'll go through the process. There have been multiple attempts
Speaker 1: to repeal, replace, or do something with oback Obamacare. The
Speaker 1: truth is you got seventeen million people who have access now.
Speaker 1: And I think the regulators are going to continue to
Speaker 1: implement initiatives that really try to solve the core problems,
Speaker 1: which are the cost of healthcare, the quality and the
Speaker 1: outcomes of healthcare. And so I think I think this
Speaker 1: will just be a background theme while the rest of
Speaker 1: the regulators move forward. And what do you expect and
Speaker 1: what do you expect the rest of those regulators to do?
Speaker 1: What's the I guess the theme for nineteen in terms
Speaker 1: of a regulatory perspective, because when I think about healthcare,
Speaker 1: it always starts and ends with the regulatory framework. Yes,
Speaker 1: there are a couple of themes. The first one is
Speaker 1: they want to move all hospitals and doctors to being
Speaker 1: paid based on a bonus or penalty system based on
Speaker 1: their outcomes, based on their costs, based on their complication rates.
Speaker 1: That will continue in full force. I think they're also
Speaker 1: very focused on drug pricing. There are several initiatives that
Speaker 1: are underway around redesigning the way drug pricing happens um.
Speaker 1: I actually think not only in the public sector, but
Speaker 1: the private sector is very active. Employers are getting a
Speaker 1: lot more engaged in going directly to provider networks like
Speaker 1: a Premiere, where you have a large national footprint of
Speaker 1: providers and they're not satisfied with the value that insurance
Speaker 1: companies have been able to bring in truly changing the
Speaker 1: outcomes in healthcare. How do you lower the costs and
Speaker 1: improve outcomes? What do you do? So it's complicated, right,
Speaker 1: we all know it's complicated now in healthcare, you have
Speaker 1: to have data, you have to have transparency, you have
Speaker 1: to have aggregation ability. So what Premiere does is actually
Speaker 1: aggregate their buying power, aggregate the data, find the root
Speaker 1: cause problems, measure it transparently reported. And I think the
Speaker 1: federal government, state government and insurance companies need to pay
Speaker 1: based on that performance. One thing that I find interesting
Speaker 1: is we're hearing more about artificial intelligence and how it
Speaker 1: can be used in healthcare, and I'm wondering, when you
Speaker 1: talk about data, are you using either artificial intelligence programs
Speaker 1: to try to understand and predict outcomes better or move
Speaker 1: it forward? And also are you are you see any
Speaker 1: of the providers using things like chips that can help
Speaker 1: people measure themselves and things like that. So absolutely, and
Speaker 1: we think it's a theme that will continue into two
Speaker 1: thousand nineteen. All the disruption around technology, the challenges. Everybody
Speaker 1: now has lots of big data. The challenges how do
Speaker 1: you turn that big data into small data so that
Speaker 1: when you're at the doctor and that doctor is interacting
Speaker 1: with you, he can be or she can be alerted
Speaker 1: to change the decisions that are being made based on quality,
Speaker 1: based on safety, based on a new clinical trial. We
Speaker 1: Premier have just acquired a company called Stance and Health
Speaker 1: that helps physicians in real time, in the moment, change
Speaker 1: the way cares being delivered. And that's what we all
Speaker 1: have to get to. But at the at the hospital
Speaker 1: um experience, what are some of the trends there that
Speaker 1: can improve that lower the cost, make it more efficient. Um,
Speaker 1: because it seems like, um, you know that the hospital
Speaker 1: experience is one that that needs to change as well. Yeah,
Speaker 1: so the hospital experience and the doctor experience, I think
Speaker 1: both need to change. One. They need data at their
Speaker 1: fingertips as opposed to these systems that couldn't be connected.
Speaker 1: You know, it's kind of like somebody has an Xbox,
Speaker 1: somebody as a PlayStation, they can't play the same game
Speaker 1: because they're not on the same system. So with cloud
Speaker 1: based computing and all the technology and artificial intelligence, you
Speaker 1: have much more ability to get that data to the patient,
Speaker 1: to the doctor, to the hospital to improve what they're
Speaker 1: doing in real time. What's for that? The for profit hospitals,
Speaker 1: how what are the business trends bidden for them over
Speaker 1: the last several years and how do you expect that
Speaker 1: to play out over the next couple of years. You know,
Speaker 1: the for profit hospitals compete in many of the same
Speaker 1: markets as not for profit hospitals. They all have the
Speaker 1: same problems, which is costs are growing too fast, they
Speaker 1: have they have bad debt charity care. Maybe the for
Speaker 1: profits have some less of that than the not for profits.
Speaker 1: They're trying to integrate the data, they're trying to adjust
Speaker 1: to these risk based payment models. They're trying to improve
Speaker 1: quality and safety, a lot of the same issues. Actually,
Speaker 1: But if we could really implement some of what you're
Speaker 1: talking about, these sort of monitoring devices and computer programs
Speaker 1: that could aggregate and have predictive power, how many hospitals
Speaker 1: would go away? I mean how many? How many of
Speaker 1: the current how much of the current infrastructure that we
Speaker 1: have our healthcare which we rendered obsolete. So there are
Speaker 1: some estimates that there is thirty percent ways still in
Speaker 1: the health care system, meaning overuse, duplication, all of that.
Speaker 1: You complicate that by all these other technologies and capabilities, right,
Speaker 1: and and then you complicated by the demographics of the
Speaker 1: population because twelve thousand people are entering Medicare every single day.
Speaker 1: We're living with chronic conditions longer. Healthcare systems aren't hospitals
Speaker 1: anymore by themselves. They're actually integrated systems of doctors offices
Speaker 1: and surgery centers and retail pharmacies and hospitals and nursing homes.
Speaker 1: And I don't think the need for that that system
Speaker 1: goes away. I actually think As we live longer with
Speaker 1: chronic conditions, it increases. I think that the high cost settings,
Speaker 1: we may need fewer of those, and we may need
Speaker 1: to spend a lot more time and money preventing and
Speaker 1: dealing with chronic conditions in different ways. Susan Davore, thank
Speaker 1: you so much for being with us. Happy holidays to you.
Speaker 1: Thank you YouTube. Susan Diavore is chief executive of Premiere.
Speaker 1: Coming to us here in our eleven three oh studios.
Speaker 1: Thanks for listening to the Bloomberg p m L podcast.
Speaker 1: You can subscribe and listen to interviews at Apple Podcasts, SoundCloud,
Speaker 1: or whatever podcast platform you prefer. I'm pim Fox. I'm
Speaker 1: on Twitter at pim Fox. I'm on Twitter at Lisa Abram.
Speaker 1: It's one before the podcast. You can always catch us
Speaker 1: worldwide on Bloomberg Radio.