WEBVTT - Why U.S. Health Care Systems Weren’t Prepared for COVID-19 0:00:00.720 --> 0:00:03.720 This is Bloomberg Business Week. I'm Carol Masser and I'm 0:00:03.800 --> 0:00:06.320 Jason Kelly. We're right here every day bringing you the 0:00:06.360 --> 0:00:11.160 latest news from the world's of business and finance, plus technology, politics, economics, 0:00:11.240 --> 0:00:14.280 all harnessing the power of Business Week reporters and editors, 0:00:14.440 --> 0:00:16.439 and of course Carol that's part of a team of 0:00:16.520 --> 0:00:20.439 twenty seven hundred journalists and analysts more than a hundred 0:00:20.480 --> 0:00:23.280 and twenty countries and Jason. You can download Bloomberg Business 0:00:23.280 --> 0:00:26.239 Week on iTunes, SoundCloud, bl Bloomberg dot com. You can 0:00:26.280 --> 0:00:28.640 also listen to our radio show at two pm Eastern 0:00:28.680 --> 0:00:31.560 on Bloomberg Radio every weekday, or watch us on YouTube 0:00:31.600 --> 0:00:36.239 by searching Bloomberg Global News. Let's talk about where we 0:00:36.280 --> 0:00:40.080 are when it comes to the virus, and especially given 0:00:40.120 --> 0:00:44.400 the backdrop, Carol, of the broader healthcare crisis. We've been 0:00:44.440 --> 0:00:47.320 in the midst of a broader healthcare crisis for a 0:00:47.360 --> 0:00:50.800 long time now, and we're in a very specific one here. 0:00:51.159 --> 0:00:53.519 Let's get into it with Vivian Lee. Dr Vivian Lee, 0:00:53.640 --> 0:00:57.120 president of Health Platforms over at Verily Life Sciences. She 0:00:57.240 --> 0:01:00.320 joins us on the phone from New York. She's the 0:01:00.360 --> 0:01:03.200 author of a book The long fix solving America's healthcare 0:01:03.240 --> 0:01:06.960 crisis with strategies that work for everyone. Man, if this 0:01:07.040 --> 0:01:11.479 pandemic hasn't laid bare everything that you're writing about, Dr Lee, 0:01:11.520 --> 0:01:14.600 I don't know what does. First of all, congratulations on 0:01:14.680 --> 0:01:17.520 the book. Tell us what you're seeing out there and 0:01:17.600 --> 0:01:19.840 sort of how it fits in what we're experiencing right 0:01:19.880 --> 0:01:24.440 now fits into your longer term thesis. Well, thanks so 0:01:24.520 --> 0:01:26.880 much for having me. And I think you couldn't have 0:01:26.920 --> 0:01:29.960 said it better. This is like a giant stress test 0:01:30.760 --> 0:01:33.920 for our healthcare system, and I think we're having some 0:01:34.000 --> 0:01:37.440 pretty serious chest pain. You know, we're pretty much struggling 0:01:37.480 --> 0:01:39.480 on almost all fronts except for one, which is I 0:01:39.520 --> 0:01:43.640 have to say that I think that the heroic measures 0:01:43.640 --> 0:01:46.479 that are frontline healthcare workers have been demonstrating. I think 0:01:46.520 --> 0:01:49.680 that that is something that we should all continue to celebrate. 0:01:49.920 --> 0:01:52.360 But in terms of the system itself, I think we 0:01:52.440 --> 0:01:54.760 we are seeing, as you say, so many of its 0:01:54.800 --> 0:01:57.160 flaws right now. All right, so listen, vision that we 0:01:57.240 --> 0:01:59.800 have a strategy session right of all the great minds 0:01:59.800 --> 0:02:03.640 in medical community, global medical community for that matter, and 0:02:03.680 --> 0:02:05.960 we can make this system better. What would be the 0:02:06.040 --> 0:02:10.440 three things you would change from day one. Well, for 0:02:10.520 --> 0:02:13.520 the for to start with, we have to really change 0:02:13.800 --> 0:02:17.040 how we're paying for healthcare and what we're paying for. 0:02:17.160 --> 0:02:19.600 Right now, we are paying in a fee for service 0:02:19.639 --> 0:02:22.920 model for things to be done to us regardless of 0:02:22.960 --> 0:02:25.720 whether they make us healthier or not. And that fee 0:02:25.720 --> 0:02:28.799 for service kind of model means that our health care 0:02:28.919 --> 0:02:31.920 systems just live from fee to fee, and as you 0:02:31.919 --> 0:02:34.800 can see with COVID, as many of them have been having, 0:02:34.919 --> 0:02:37.959 you know, empty clinics and empty hospitals, they're actually being 0:02:38.240 --> 0:02:40.440 forced to shut down or even lay off people in 0:02:40.520 --> 0:02:42.919 so many in so many different parts of the country, 0:02:43.000 --> 0:02:45.480 especially rule parts of the country. So first is we 0:02:45.600 --> 0:02:47.200 really have to change the way in which we are 0:02:47.280 --> 0:02:50.040 paying for healthcare. The second thing is we really have 0:02:50.200 --> 0:02:55.000 to um take advantage of the new technologies. Telehealth is 0:02:55.040 --> 0:02:57.560 one example. We're seeing a lot greater use of that 0:02:58.200 --> 0:03:00.959 more digital health solutions so that people can look after 0:03:01.000 --> 0:03:03.799 their own health in their homes, in their in their 0:03:03.800 --> 0:03:07.400 workplace environments for example. But those have to again be 0:03:07.520 --> 0:03:11.040 used in a way in which they're paid for generating 0:03:11.120 --> 0:03:13.640 better health, not just for doing more things to people. 0:03:13.720 --> 0:03:16.240 So take advantage of more of the technology. And then 0:03:16.240 --> 0:03:17.839 the third is. I think we need a lot more 0:03:17.919 --> 0:03:21.280 transparency about what it is we're going to have to 0:03:21.360 --> 0:03:24.120 pay for, how much it's going to cost, why it cost, 0:03:24.240 --> 0:03:26.720 what it does, so that we can really start to 0:03:26.800 --> 0:03:30.320 link up the costs with what we're actually getting for 0:03:30.480 --> 0:03:34.960 those dollars. And so, dr Lee, part of what you're 0:03:35.000 --> 0:03:37.320 talking about. A lot of what you're talking about, especially 0:03:37.320 --> 0:03:42.360 in that description, goes against some very entrenched economic interests. Uh. 0:03:42.560 --> 0:03:46.560 There are a lot of folks, especially big companies on 0:03:46.640 --> 0:03:49.920 the managed care side, on the healthcare system side, on 0:03:49.960 --> 0:03:54.000 the pharmaceutical side, they and maybe they wouldn't admit this 0:03:54.080 --> 0:03:56.800 in the cold light of day, they kind of like 0:03:56.880 --> 0:03:58.520 the way it works. They're making a lot of money. 0:03:58.800 --> 0:04:04.200 How do you essentially make the case to policy officials, 0:04:04.240 --> 0:04:08.040 many of whom hear from these companies through lobbying. How 0:04:08.080 --> 0:04:10.280 do you sort of make this change? How do you 0:04:10.440 --> 0:04:12.960 break the system in a way that people might be 0:04:13.000 --> 0:04:17.320 okay with? Well, there's no question that changes hard. But 0:04:17.360 --> 0:04:21.320 I think you'd be surprised at how much support there 0:04:21.520 --> 0:04:25.320 is for change, especially right now. So when you talk 0:04:25.360 --> 0:04:29.119 about managed care, companies are insurers. They actually really want 0:04:29.200 --> 0:04:32.320 people to stay healthy. The healthier people are the less 0:04:32.400 --> 0:04:34.280 they have to pay out and the better they do. 0:04:34.839 --> 0:04:40.839 Most health care systems, most people who come into health care, physicians, nurses, therapists, 0:04:40.920 --> 0:04:43.360 we want our patients to be healthy. We are not 0:04:43.480 --> 0:04:46.240 hoping for them to be sick. But what we want 0:04:46.240 --> 0:04:49.520 to do is to have just better alignment, so we're 0:04:49.600 --> 0:04:52.200 paid for them to be healthier. You know, right now, 0:04:52.240 --> 0:04:54.040 we just have the wrong incentives, right we are only 0:04:54.040 --> 0:04:56.919 paid if they're sick. But actually in some cases, like 0:04:57.080 --> 0:05:01.080 some clinics that are working in a Medicare advantage model, 0:05:01.400 --> 0:05:02.919 and there are these clinics that are all over the 0:05:02.920 --> 0:05:05.040 country where they're just paid a fixed amount of money 0:05:05.120 --> 0:05:08.400 to keep their UH seniors healthy, and they get paid 0:05:08.440 --> 0:05:11.640 that fixed amount no matter what happens, they actually are 0:05:11.760 --> 0:05:14.799 are doing much better. They're actually spending more time with patients, 0:05:15.120 --> 0:05:19.760 there's less burnout, the patients are hospitalized much less, and 0:05:19.800 --> 0:05:22.360 so they actually do better. So there really are some 0:05:22.360 --> 0:05:26.440 some strong incentives right now for moving to what we 0:05:26.520 --> 0:05:30.200 call it paying for better health or paying for outcomes model. 0:05:30.279 --> 0:05:31.800 But we just have to get it all aligned at 0:05:31.800 --> 0:05:34.760 the same time so that we all make that transition together. 0:05:35.120 --> 0:05:36.720 Dr viving Lee, we have about a minute and we'll 0:05:36.760 --> 0:05:38.400 do some news and then we'll come back. But in 0:05:38.400 --> 0:05:40.719 a minute or so, can you say, who's not buying 0:05:40.720 --> 0:05:43.160 into this whole idea of let's just keep people well 0:05:43.720 --> 0:05:46.240 and that's a smarter system. Who's not buying into that. 0:05:48.600 --> 0:05:50.839 I'm not sure that anyone's not buying into it, but 0:05:50.880 --> 0:05:52.440 I think that we have to make it a little 0:05:52.440 --> 0:05:55.800 bit easier to make that transition. It's almost impossible to 0:05:55.839 --> 0:05:58.560 live in a world where you're getting paid for doing 0:05:58.560 --> 0:06:00.560 a lot of things to people and then Soto getting 0:06:00.560 --> 0:06:02.480 paid for keeping them out of the hospital at the 0:06:02.520 --> 0:06:05.360 same time. That's almost impossible. So we have to make 0:06:05.400 --> 0:06:08.400 that change pretty decisively and help those systems change. But 0:06:08.440 --> 0:06:10.240 I think most people are supportive of it. We do 0:06:10.279 --> 0:06:12.400 want to bring you a little piece of an interview 0:06:12.400 --> 0:06:14.960 that our David Weston did with Dr Anthony Fauci. Check 0:06:14.960 --> 0:06:18.720 it out. Everybody, if you're talking about a medical question, 0:06:19.480 --> 0:06:23.479 listen to the medical experts. That's the advice, and you 0:06:23.520 --> 0:06:27.800 won't get it. You will not get a conflicting message 0:06:28.120 --> 0:06:32.719 from the medical experts about things like hydroxy chloroquine, about 0:06:32.839 --> 0:06:35.760 what the results of the vaccine trial aw or what 0:06:35.880 --> 0:06:38.839 the results of monoclonal anybody. So when it comes to 0:06:39.000 --> 0:06:42.960 pure public health medical things, listen to what the medical 0:06:43.000 --> 0:06:46.240 experts say. All right, and we've got a medical expert 0:06:46.279 --> 0:06:48.520 with us. Dr Vivian Lee still with us, President of 0:06:48.520 --> 0:06:51.800 health Platforms at Verily Life Science, former CEO of the 0:06:51.839 --> 0:06:54.159 three and a half billion dollar healthcare system University of 0:06:54.240 --> 0:06:56.960 Utah Health, still with us on the phone in New York. So, 0:06:57.080 --> 0:07:00.360 Dr Lee, you are a medical expert. I'm a assuming 0:07:00.400 --> 0:07:03.080 you agree with what we heard from Dr Fauci. What 0:07:03.200 --> 0:07:05.800 would you say then, is the right thing to do 0:07:05.839 --> 0:07:10.160 when it comes to reopening schools and colleges and universities. 0:07:12.480 --> 0:07:15.240 You know, we are in such a difficult situation right 0:07:15.240 --> 0:07:18.640 now because we need to keep our economy going. We 0:07:18.680 --> 0:07:20.760 actually need to invest in our future, which is I 0:07:20.800 --> 0:07:22.960 think a big part of why we need to get 0:07:22.960 --> 0:07:27.320 our universities back up this fall. Those students need to 0:07:27.360 --> 0:07:30.400 continue study because there are future and at the same time, 0:07:30.880 --> 0:07:34.400 we have this massive upswing in COVID across the country 0:07:34.400 --> 0:07:35.960 and we have to keep healthy. We have to keep 0:07:36.000 --> 0:07:39.240 everyone healthy, So there's a tension. I think it's pretty 0:07:39.240 --> 0:07:44.240 clear that wearing masks social distancing, hand washing, making sure 0:07:44.320 --> 0:07:46.320 that if you're sick or have been exposed that you 0:07:46.400 --> 0:07:51.600 isolate UM that these precautions or these measures do work 0:07:52.480 --> 0:07:56.360 UM for college campuses. We actually just put out a 0:07:56.400 --> 0:08:00.280 paper last week recommending putting forward a series of four 0:08:00.320 --> 0:08:04.480 recommendations for reopening our college campuses, and I'm happy to 0:08:04.520 --> 0:08:07.320 just go through those very quickly. UM. The first is 0:08:07.360 --> 0:08:09.720 that we're really recommending that on top of all of 0:08:09.720 --> 0:08:12.000 the social discigs and mask and everything, this is specifically 0:08:12.040 --> 0:08:16.840 around COVID nineteen testing. It's recognizing that so many people, 0:08:17.040 --> 0:08:21.960 especially and including college aged kids, UM, are asymptomatic even 0:08:21.960 --> 0:08:24.240 though they may be COVID nineteen positive and may be 0:08:24.320 --> 0:08:27.040 able to infect other people. And so as a result, 0:08:27.600 --> 0:08:31.280 testing is really central to our strategies. So first, we're 0:08:31.280 --> 0:08:34.960 recommending that everyone get tested before they really engage back 0:08:34.960 --> 0:08:37.439 in the college campus, so either before they arrived back 0:08:37.520 --> 0:08:40.880 or right after they arrive. Secondly, we're recommending that they 0:08:40.880 --> 0:08:43.480 get tested about a week afterwards to pick up those 0:08:43.520 --> 0:08:45.760 people who might have gotten sick along the way or 0:08:45.800 --> 0:08:49.640 whose tests were inaccurate, because there are sometimes people may 0:08:49.679 --> 0:08:51.760 have the exposure but the test might not be positive. 0:08:52.040 --> 0:08:55.480 Then we recommend everyone who does become symptomatic get tested 0:08:55.679 --> 0:08:59.360 of course, and then finally we're also recommending that at 0:08:59.400 --> 0:09:02.640 least a sub set of people who are asymptomatic get 0:09:02.720 --> 0:09:06.080 tested regularly throughout the semester. So those are some of 0:09:06.080 --> 0:09:09.680 our recommendations. And so how feasible is that, I mean, 0:09:10.000 --> 0:09:14.040 you understand the business side of this very well, doctor Lee. 0:09:14.040 --> 0:09:18.840 How feasible is it for a regular, sort of everyday 0:09:19.120 --> 0:09:24.880 college or university to to really execute that plan? Yeah. 0:09:24.920 --> 0:09:27.040 I think most universities have been spending a lot of 0:09:27.040 --> 0:09:29.600 their summers not on holiday and not on break, but 0:09:29.679 --> 0:09:32.560 really studying this problem and figuring out how to manage 0:09:32.600 --> 0:09:35.000 their campuses. And I really have to have to give 0:09:35.080 --> 0:09:36.640 them a ton of credit for all the work that 0:09:36.679 --> 0:09:40.480 they've been doing. Um, there's the practical aspect of it 0:09:40.800 --> 0:09:44.120 which is challenging, but they all have student health services. 0:09:44.559 --> 0:09:47.560 There are a number of companies, including our own Verily, 0:09:47.720 --> 0:09:50.360 who are working on in these areas to try to 0:09:50.360 --> 0:09:53.600 support this effort. A lot of the lab testing companies 0:09:53.600 --> 0:09:56.119 have really stepped up as well to offer these services. 0:09:56.559 --> 0:09:59.280 In terms of the financial impact, the cost of the 0:09:59.320 --> 0:10:02.200 tests are coming down. There are a number of different 0:10:02.800 --> 0:10:05.720 companies that are in the space now and that's helping 0:10:05.760 --> 0:10:09.479 to increase competition and reduce the costs. So it's financially 0:10:09.679 --> 0:10:12.360 you know, I've estimated in this paper that we wrote 0:10:12.600 --> 0:10:16.480 maybe about five dollars per student for the semester for 0:10:16.559 --> 0:10:19.160 the testing, and you know, that's less than a couple 0:10:19.200 --> 0:10:21.679 of weeks of unemployment pay. So just sort of weighing 0:10:21.720 --> 0:10:24.000 up the trade offs, I think it is definitely worth 0:10:24.040 --> 0:10:26.160 that investment, but it sounds like bottom line, just got 0:10:26.160 --> 0:10:28.319 twenty seconds here, doctor Lee, that we need to have 0:10:28.679 --> 0:10:32.480 tests that are readibly available so we can almost every day, 0:10:32.559 --> 0:10:35.040 every week be taking them and quickly get the results. 0:10:35.080 --> 0:10:37.520 That's what it comes down to. That's right, until we 0:10:37.559 --> 0:10:39.720 have a good treatment or a vaccine, as we heard, 0:10:39.760 --> 0:10:42.960 we need tests that are available and turn around times 0:10:42.960 --> 0:10:45.559 that are quick. There's we can't wait weeks for the 0:10:45.600 --> 0:10:47.679 turnaround and needs to come back right away so that 0:10:47.679 --> 0:10:49.640 we know how to act and how to respond. That's 0:10:49.640 --> 0:10:51.960 a critical part for sure. Great to catch up with you. 0:10:52.000 --> 0:10:53.800 We hope you'll come back and spend more time with us. 0:10:53.840 --> 0:10:57.120 Vivian Ly, president of health Platforms that Verily Life Science, 0:10:57.200 --> 0:10:59.280 is also the author of The Long Fix Solving America's 0:10:59.320 --> 0:11:02.040 healthcare Crisis with strategies of work for everyone and giving 0:11:02.120 --> 0:11:05.240 us a strategy for back to school that it sounds 0:11:05.280 --> 0:11:07.920 like a lot of people maybe following our Thanks to her, 0:11:08.080 --> 0:11:10.240 we do have Joel Webber with us, of course, the 0:11:10.320 --> 0:11:13.080 editor of Bloomberg Business Week. He joins us from Massachusetts, 0:11:13.400 --> 0:11:16.720 along with Shelley Banjo, senior writer for Bloomberg. She's down 0:11:16.760 --> 0:11:20.520 in gorgeous Asheville, North Carolina. Lucky her, and she's got 0:11:20.520 --> 0:11:25.320 a terrific story along with Mark Bergen in the issue 0:11:25.440 --> 0:11:27.640 this current issue of Bloomberg Business Week. It's on the 0:11:27.720 --> 0:11:30.840 terminal and online today. Joel t this up. This is 0:11:30.880 --> 0:11:33.520 such an important topic. We've been talking so much about 0:11:33.559 --> 0:11:37.120 big tech and this is a slightly different twist but 0:11:37.240 --> 0:11:41.360 goes to so many of the big issues around big tech. So, 0:11:41.600 --> 0:11:44.640 you know, a week ago now, big tech sort of 0:11:44.640 --> 0:11:49.800 got grilled in front of lawmakers virtually. UM, and I 0:11:49.840 --> 0:11:53.360 think that it was part of uh something that we're 0:11:53.360 --> 0:11:55.400 going to see in a conversation that we're going to 0:11:55.600 --> 0:11:58.400 continue to have in the weeks and months ahead. UM 0:11:58.600 --> 0:12:01.560 And for Google SpeI typically that conversation is gonna be 0:12:01.559 --> 0:12:06.120 a lot about anti trust and what Mark and Shelley 0:12:06.240 --> 0:12:09.120 did in this story was not not so much to 0:12:09.120 --> 0:12:13.000 take the anti trust conversation head on, but to look 0:12:13.040 --> 0:12:18.880 at a corner of Google's business search ads that's literally 0:12:18.920 --> 0:12:23.760 what makes it such a power house and for certain 0:12:23.800 --> 0:12:27.120 small businesses, especially those in the service world, and get 0:12:27.160 --> 0:12:29.400 this in the middle of the pandemic, the ones that 0:12:29.760 --> 0:12:33.400 Mark and Shelley were wise to look at. Specifically, we're 0:12:33.760 --> 0:12:37.880 therapists and mental health professionals who have actually felt the 0:12:38.000 --> 0:12:41.600 impact of of Google's pricing power in a way that 0:12:41.720 --> 0:12:43.880 really resembles attacks. And I think this is gonna be 0:12:43.880 --> 0:12:47.640 something that will be fascinating how much lawmakers want to 0:12:47.679 --> 0:12:50.480 look at that. So, Shelly, what what are the nuances 0:12:50.520 --> 0:12:52.640 that you and Mark discovered as you sort of dug 0:12:52.640 --> 0:12:55.560 into how much power and dominance Google has in the 0:12:55.559 --> 0:13:00.360 search world. Yeah. The craziest thing about the story is that, um, 0:13:00.400 --> 0:13:02.480 you know, as these things go, is that we didn't 0:13:02.480 --> 0:13:04.520 actually sit out to right shut out to write an 0:13:04.520 --> 0:13:06.679 antitrust story. We were kind of curious with all these 0:13:06.679 --> 0:13:09.960 ads that kept popping up during the pandemic around mental health. 0:13:09.960 --> 0:13:13.200 I wanted to figure out like someone profiting off of 0:13:13.200 --> 0:13:16.760 this pandemic from like a mental health perspective, and we 0:13:16.840 --> 0:13:21.079 just started talking to therapists, and every big, single time 0:13:21.120 --> 0:13:23.679 we spoke to a therapist, it was Google, Google, Google, 0:13:23.760 --> 0:13:27.200 Google and UM. Particularly the one that we UM end 0:13:27.280 --> 0:13:30.240 up featuring the most in our story is this therapist 0:13:30.400 --> 0:13:33.280 UM named Ellen Ross who said, UM, you know, you 0:13:33.320 --> 0:13:36.880 can't have a business, my kind of business without without 0:13:36.920 --> 0:13:39.960 Google search. It's UM. You know, it's just like you know, 0:13:40.880 --> 0:13:43.960 she goes through her list of monthly bills and it's 0:13:44.080 --> 0:13:47.920 you know rent, uh, you know, heating or air conditioning, 0:13:48.080 --> 0:13:52.960 power and and Google. But what you noticed, Shelley, this 0:13:53.040 --> 0:13:57.160 is such a great story is that during the pandemic, UM. 0:13:57.200 --> 0:13:59.120 I think you know, you guys know in your story 0:13:59.200 --> 0:14:02.520 that the prices for regular keywords UM sharply And this 0:14:02.600 --> 0:14:05.200 is kind of a key way of getting noticed uh 0:14:05.240 --> 0:14:09.520 in the online world. Right, So during the pandemic, everything 0:14:09.559 --> 0:14:12.560 else shut down except for the Internet, and so UM 0:14:12.600 --> 0:14:14.839 that was really the only way for people to find 0:14:14.880 --> 0:14:18.600 you UM. And all of a sudden, searches for online 0:14:18.600 --> 0:14:21.720 therapy shot up as people started to realize, oh, shoot, 0:14:21.800 --> 0:14:24.000 like this is not something that's going to be over quickly. 0:14:24.400 --> 0:14:27.000 I'm going to need some help with this, UM. And 0:14:27.080 --> 0:14:30.920 it just became prohibitively expensive for um, some of these 0:14:30.920 --> 0:14:34.480 therapists to keep putting Google search ads and keep paying 0:14:34.520 --> 0:14:36.920 for them. That the problem is if you don't pay 0:14:36.960 --> 0:14:38.560 for the search ads, you're not going to get touch 0:14:38.600 --> 0:14:43.560 the customers. And Google's really pushing this. I mean you 0:14:43.560 --> 0:14:46.400 you have some great anecdotes about you know, the sales 0:14:46.400 --> 0:14:49.760 reps calling up you know, these therapists and and kind 0:14:49.760 --> 0:14:52.760 of putting the hard sell in them and using the 0:14:53.240 --> 0:14:57.800 economics and the economics of crisis really uh in many 0:14:57.840 --> 0:15:01.840 ways to to drive the business. Yeah, I mean, it's 0:15:01.840 --> 0:15:05.280 an interesting nuance because it's there's something wrong or illegal 0:15:05.400 --> 0:15:09.400 about making money especially during um, you know, pandemics or 0:15:09.520 --> 0:15:14.240 natural disasters. Every Bloomberg uh story regarding natural disasters will 0:15:14.240 --> 0:15:16.200 look into who's making money off of off of these 0:15:16.280 --> 0:15:20.120 kinds of things. Um. But at the same time, these 0:15:20.120 --> 0:15:23.480 people have no other choice, and Google can kind of 0:15:23.480 --> 0:15:29.080 take advantage of that by pushing things like automation um um, 0:15:29.120 --> 0:15:32.000 you know, not having as good as customer service and 0:15:32.240 --> 0:15:34.520 thinks that these people really rely on because there's no 0:15:34.600 --> 0:15:37.240 other place to go. And so the question is, once 0:15:37.240 --> 0:15:40.400 you become that monopoly and you have so much power, 0:15:40.760 --> 0:15:45.240 does it become then an antitrust issue, and so play 0:15:45.280 --> 0:15:47.800 that out a little bit, Shelly, Where where will lawmakers 0:15:48.040 --> 0:15:51.960 put their gaze? Um? And how does how does all 0:15:52.000 --> 0:15:55.440 of this fit together in the weeks ahead? Yeah, So, 0:15:55.480 --> 0:15:58.800 I mean search dominance in itself is not illegal, UM, 0:15:58.920 --> 0:16:01.560 And so the issue for lawmakers is trying to take 0:16:01.600 --> 0:16:06.080 her out. UM. Is Google actually abusing that power? And 0:16:06.120 --> 0:16:07.840 so one other part of the story that we look 0:16:07.880 --> 0:16:11.800 into is this idea of Google directing people to certain 0:16:11.800 --> 0:16:14.360 places that make the most money for them. So with 0:16:14.480 --> 0:16:17.920 therapy for example, now if you type in therapists, it's 0:16:17.960 --> 0:16:20.880 going to go up to UM. You're you're gonna spit 0:16:20.920 --> 0:16:25.960 out some UM therapists near you that on Google Maps 0:16:26.000 --> 0:16:29.480 that have paid for these services, and so UM, you know, 0:16:29.560 --> 0:16:34.280 just Google then take take over UM healthcare and search 0:16:34.480 --> 0:16:37.240 and and those types of things that previously might have 0:16:37.360 --> 0:16:40.200 gone UM to to other businesses. Are they going to 0:16:40.240 --> 0:16:43.560 be abusing that power? And what law lawmakers need to 0:16:43.560 --> 0:16:46.960 find out is, you know, does it go beyond just 0:16:47.040 --> 0:16:50.680 being big? Does it go beyond just UM having power? 0:16:50.840 --> 0:16:53.600 It's what do you do with that power? And UM 0:16:53.920 --> 0:16:58.720 is that part of that illegal? And so should we 0:16:58.800 --> 0:17:02.600 be you know what the Google conversation is one that 0:17:02.760 --> 0:17:07.400 is um obviously uh, something that the latmakers will probably 0:17:07.960 --> 0:17:13.200 focus on more more so than other big tech companies 0:17:13.240 --> 0:17:16.639 even perhaps, and and that that power that they have. 0:17:16.720 --> 0:17:19.720 When you actually talked to the small business owners and 0:17:19.720 --> 0:17:22.480 and the therapists that are in the story, you know, 0:17:22.520 --> 0:17:24.960 the thing that I found sort of so fascinating about 0:17:25.000 --> 0:17:27.080 it was like, at the end of the day, this 0:17:27.160 --> 0:17:30.440 is the option for them, right, So what other options 0:17:30.480 --> 0:17:34.680 do do they feel like they even have? Yeah, I 0:17:34.680 --> 0:17:37.119 mean when you ask about being which is the second 0:17:37.359 --> 0:17:40.200 church engine, the therapist would just laugh, honestly, they would 0:17:40.200 --> 0:17:42.239 just beee like that's not a thing. Um, we we 0:17:42.280 --> 0:17:45.479 only have Google. Um. And the interesting thing is that 0:17:45.520 --> 0:17:48.760 Google likes to paint this big picture of competition. Would add, oh, 0:17:48.800 --> 0:17:52.000 there's Facebook, and there's um all sorts of different companies 0:17:52.040 --> 0:17:55.960 that even television and billboards like we fight with everyone. Um, 0:17:56.040 --> 0:17:59.159 but you know, uh at Amazon, but like as we 0:17:59.240 --> 0:18:01.680 point out in the store, like nobody's going on Amazon 0:18:01.720 --> 0:18:03.960 to search for a therapist, but at least not yet. 0:18:04.240 --> 0:18:07.760 And um, and so for these service providers, um, you 0:18:07.800 --> 0:18:10.239 know they really there really is no other option. And 0:18:10.280 --> 0:18:12.600 so you know, Google can talk about all the different 0:18:12.600 --> 0:18:15.679 competition that they fake, but in a lot of industries 0:18:15.840 --> 0:18:17.919 they're really the only game in town, and it's up 0:18:17.960 --> 0:18:20.840 to them to to, you know, kind of keep coloring 0:18:20.920 --> 0:18:24.480 in within the lines or or not, and if they don't, 0:18:24.560 --> 0:18:27.639 then the government can go after them. As as one 0:18:27.680 --> 0:18:29.920 source in your story, it's this says, the bigger question 0:18:29.960 --> 0:18:32.200 is whether Google is abusing its power. It really comes 0:18:32.240 --> 0:18:34.560 down to that. It's a great read. It's the cover 0:18:34.640 --> 0:18:36.920 story of the magazine. Shelley Banjo, thank you so much, 0:18:36.960 --> 0:18:39.560 senior writer at Bloomberg News, and thanks to Joe Webber, 0:18:39.680 --> 0:18:42.760 editor at Bloomberg Business Week. Well, and what's interesting is 0:18:43.400 --> 0:18:45.920 check out that story because it also points out that, 0:18:46.040 --> 0:18:49.720 you know, people are also taking advantage of YouTube owned 0:18:49.720 --> 0:18:53.240 by Google, and maybe they're doing a therapy session on 0:18:53.320 --> 0:18:57.680 a Google meet. So you know, this all encompassing nature 0:18:57.720 --> 0:18:59.960 is really something worth expoy. It's a great story by 0:19:00.000 --> 0:19:02.199 Shelly Panjo. Are thanks to her. Let's check in with 0:19:02.240 --> 0:19:05.200 our pal Emily Chason. She is back with us to 0:19:05.280 --> 0:19:09.199 talk a little bit about the world of green that 0:19:09.320 --> 0:19:12.280 is her vi is Sustainability editor for Blueberg, joiningus on 0:19:12.280 --> 0:19:17.040 the phone from New York City. Big green mortgage dilemma. 0:19:17.119 --> 0:19:20.040 All right, I know about a big green egg Emily Chason, 0:19:20.119 --> 0:19:22.760 I love grilling on that, But big green mortgage dilemma. 0:19:22.840 --> 0:19:26.119 This is a whole other thing. Talk about what's going 0:19:26.200 --> 0:19:28.880 on when it comes to mortgages, because people are thinking 0:19:28.920 --> 0:19:32.880 a lot about that right now, especially with right solo. Yeah, 0:19:32.880 --> 0:19:35.240 well it's interesting. You know, you go out and finance 0:19:35.280 --> 0:19:37.000 your mortgage today and it has nothing to do with 0:19:37.080 --> 0:19:39.840 how green your home is. And this is the thing 0:19:39.880 --> 0:19:42.760 that has actually happened more in the multi family housing 0:19:42.760 --> 0:19:45.240 market for apartment buildings and stuff, is that you can 0:19:45.480 --> 0:19:47.520 get lower race than your refinance or something if you're 0:19:47.520 --> 0:19:50.600 going to do um green improvements to your building as 0:19:50.600 --> 0:19:53.680 a landlord. But it hasn't quite made its way into 0:19:53.720 --> 0:19:57.520 residential mortgages. Yea, so um. This is a big question 0:19:57.560 --> 0:20:00.480 for banks in particular because when they look at trying 0:20:00.520 --> 0:20:04.000 to figure out the climate impact of their loans, um 0:20:04.160 --> 0:20:06.200 mortgages are sort of a big question mark. You don't 0:20:06.200 --> 0:20:10.480 really know which houses more energy efficients than others. So 0:20:10.720 --> 0:20:12.919 is it banks just not on board? We need the 0:20:13.040 --> 0:20:15.919 government to incent banks to do it, Like I feel like, 0:20:16.160 --> 0:20:18.240 you know, this is where tax policy right can be 0:20:18.359 --> 0:20:21.879 very persuasive, um, in terms of getting people to do something. 0:20:22.000 --> 0:20:26.199 So where's the breakdown, Emily? Yeah, Well, you know, Europe 0:20:26.240 --> 0:20:28.200 is further ahead, of course, as they normally are in 0:20:28.280 --> 0:20:31.840 this stuff, but they have an energy efficient Mortgages action plan. 0:20:32.119 --> 0:20:35.520 Their COVID nineteen green recovery plan could include you know, 0:20:35.640 --> 0:20:38.080 billions of euros a year and grants and guarantees for 0:20:38.280 --> 0:20:43.360 stealing up draft fee buildings or offering green mortgages. So, um, 0:20:43.400 --> 0:20:45.439 there is thf that can happen. What was really exciting 0:20:45.480 --> 0:20:50.200 this past week was that Fanny May sold its first 0:20:50.320 --> 0:20:53.399 um single family home green bonds, which could create a 0:20:53.480 --> 0:20:57.360 market for banks to sell green mortgages in the future. 0:20:58.520 --> 0:21:01.080 All Right, so if I May, I'm going to shift 0:21:01.119 --> 0:21:04.719 gears because I'm obsessed. Probably hungry. Are you hungry? I'm 0:21:04.720 --> 0:21:09.840 a little hungry. Um foe meat. Uh. I love impossible. 0:21:09.840 --> 0:21:12.159 In fact, I love impossible and beyond. In fact, on 0:21:12.200 --> 0:21:14.239 my way into the office this morning, I grabbed the 0:21:14.280 --> 0:21:17.359 Impossible sausage from Starbucks, which I have to say, I've 0:21:17.400 --> 0:21:18.920 said it on this program before. This is not a 0:21:18.960 --> 0:21:23.960 product endorsement. Impossible sausage at Starbucks better than the Beyond sausage. 0:21:23.960 --> 0:21:26.800 At Duncan. I've tried in both, trying to both multiple times, 0:21:27.520 --> 0:21:31.520 very tasty. We also know, Emily Jason, you know better 0:21:31.520 --> 0:21:36.040 than I that the venture world they see something work 0:21:36.119 --> 0:21:37.960