Aloha welcome to healthcare in Hawaii. I'm Josh green your host senator from the big island work with the Hawaii IPA And as an emergency room doctor today I'm joined for part two of a really interesting conversation with a health expert here in the state of Hawaii I'm joined by Reg Baker who was chief operating officer and chief financial officer at HMA a Prominent CPA in our community leader at the chamber terrific guy a great deal of knowledge, and we spoke about macroeconomics So in healthcare, it's good to see you again to be back Reg You're a terrific wealth of knowledge We went over some really interesting points about the impact of the national experiment with the Affordable Care Act We talked about healthcare costs. We've talked about so many different things But today we have an opportunity at your advice, and I think it's very smart to talk about more of the micro System of health care in our state. Why don't we start by unpacking this a little bit when you say micro Microeconomics of health care. What do you mean? I think you know just driving down or diving down into the The local aspects of providing health care in Hawaii, you know You know whether it be in a metropolitan area or in a rural area underserved area You know, what are the challenges at the state level and the provider level that's encountered in trying to provide quality health And that's that's been kind of a frequent concern that we have and I come from the neighbor islands and a lot of people will say Can't find a doctor. I can't find a nurse What's your perspective on that? Where are we with the provider population in our in our state? This may not be politically correct, but I think it's getting worse before it's gonna get any better You know, I'm seeing more physicians Talking about leaving the profession. You know the challenges are great The profits aren't as good as they used to be I know that they just came out with this great survey and said that the eight of the top ten highest paid Professions in Hawaii are in health care and that may be the case But it's significantly down from what it was five or ten years ago And so a lot of people I think a lot of the professions the providers that are out there If you're over 50 or 55 60 years old You're beginning to give some serious thought about getting out of practice and moving on Yeah, that's a big that's a huge problem. I'm glad you bring that point up. I I remember statistic from a couple a couple years ago and had some it ran something like this that the average health care provider in Hawaii was about Four years older than the average health care provider in the mainland Which was to say our average age was closer to like mid fifties and theirs were closer to 50 So like you say we could see a wave of retirement if people can't Muster up the energy or or business acumen to stick in business Well, and I think the youth the younger ones that are coming out are not particularly Keen on going into some of the underserved areas. They they have different values You know that that maybe some of the older practitioners had and they're looking more equality of life They're looking at a better education system something that May not be available out in some of these underserved or rural areas Yeah, that's complete. I can tell you from experience. That's true when I came to Hawaii at age 30 This was in year 2000. I'm 46 now. I came and worked with the National Health Corps scholarship Which paid my medical school loans back, which was terrific and I one of the best experiences of my life However, I came in I was single. I didn't have any debt because of that and I was able to take essentially the lowest salary in the state to go and work in Ka'u and It worked out for me because I didn't have a family. I didn't have a house. I didn't have any of those things I didn't have children to educate which is one of the big challenges people want to have good schools around their kids and Then a few years past after I did my service now, I still practice on the big island But I have to split my time between a wahoo, of course and and big island And I think had I come in as a 30 year old already married to Jamie My wife and already with a couple kids and say with a lot of loans I don't know how I would have practiced in a rural area more than likely you wouldn't have You know just it would have been extremely difficult if not impossible to justify You know, I'm you know giving up what you could have had here that would help with with the wife and the children To go there where there's very limited resources. Yeah, it's it'd be tough And you know, there's a lot to love about the rural areas I mean, I love the teachers in the schools and the principals there and what have you but sometimes you can't get your car fixed or sometimes you just You know, you can't find other services like specialty services and all of those things pile on so I think you're totally right the providers are One reluctant to go work in rural areas Big Island the economics are a problem 51% of the individuals on Big Island are on Medicaid Which means that the economics as you pointed out last show just don't work for businesses in health care They're gonna have to be subsidized but also We're short on providers anyway. So if they have a choice Like I still work all my clinical time up in Javi or Kona, but a lot of people don't have that luxury of having their loans Already repaid or what have you and you're very fortunate. Yeah I I wonder if that's not gonna have to be part of the solution. It'll have to be I think there's two or three things that could be done that Maybe we're doing a little bit of it now, but we need to be doing a lot more of it But we touched on it a little bit the last you know the session that we had but You know having you know, the PA's any MPs maybe get more involved. They come in a different type of structure All right, they may not have the same issues. It's a Somebody who's gone through, you know, 12 years of additional education to become a physician You know, they'd have a different cost structure that they could maybe you know a nurse practitioner or a physician assistant Could provide some of that care, but you also get into telemedicine a little bit more right, you know And provide some of the more specialty care, you know through telemedicine type applications Well, we just passed that you know We do a lot of things that the legislature which even give me heartburn and I sit in the legislature But we did pass a bill this year mandating all the plans to cover Like they cover other services telehealth So I'm hoping that your vision like on that issue may come to pass that maybe we will have centers of excellence straw up Queens Kaiser's programs, but that they're able to reach out with those specialists and use either primary care people or you are people like me in The rural areas or the nurse practitioners with that telehealth with these extenders so that we get the benefit of Extremely intense highly trained individuals where there's a lot of them In Honolulu a lot more, you know, I can't help but think that you know for for 50,000 Yeah, a hundred thousand at the top end. Yeah, you could have a very Sophisticated satellite type office that has an MP or a PA in there that's got all the technology that the telemedicine can be done The way it and that hundred thousand dollar investment in a rural community would provide you with most Yes of the type of you know care that needs to be done out there I'm sure that's true because look the money's alone that you say from not having to travel every time someone travels to a wahoo It's five hundred to a thousand dollars I don't care what you say between plane tickets and maybe a hotel and your extra tests and all that stuff If you can get basic follow-up basic care, of course there's always a need for a stethoscope on the chest and some things are surgical, but There's no question that 95% of the healthcare that I've ever delivered could be delivered through at least some kind of relationship Like that and and I would appreciate it. Okay, so so that's one providers practitioners. We have to have an expansion You like telehealth What about our hospitals the local hospitals? How would you look at them? What's your what's your assessment? We have to Somehow make them I won't even use the word profitable, but more cost efficient You know, there's I think I look at what's going on over on Maui And there's a great opportunity over there to bring some very high-quality health care. Yeah to the island And it keeps bumping into roadblocks, you know, and it's baffling to me Why we're not able to come together and provide a hundred and thirty thousand people with good quality health care And letting you know one obstacle that might benefit less than a thousand people prevent that Yeah, yeah, you know, so I think you know using that model on other islands Once we get it to work on Maui. I think could Address some of the facility issues that we've got it may happen I think the sheer economics of our health care system where we've our our subsidy of HHSC Hawaii Health System Corporation for those out there who don't know that acronym it's gotten pretty significant it's over a hundred million dollars and It's money well spent in the care of people But if we could spend 50 or 40 million dollars instead and have whether it's Kaiser or HPH or Queens partnering It seems to me it would be beneficial. For instance some Like give me your opinion of Queens taking over North Hawaii community hospital Is that the kind of model that you think could work? I think if we see patient outcomes improve I think if we see Additional services being provided in a better level level of health care. Yeah, then yes. Yeah, I think I think it's necessary. I mean people People in the neighbor islands already understand that if you have a severe problem We're going to get you over to a wahoo where there's more where there are trauma surgeons or neurosurgeons or Super specialists. We all want that for our loved ones our children, you know, of course immediately And I I hate to ever have to transfer patients but what's most important is someone get well and I think that if we do establish centers of excellence and Do a better job of providing the kind of hardcore bedrock essentials at our Neighbor island hospitals will prevent first of all many of those transfers But when we need them will be better fortified and so I I hope that this Queens Experiment works and I I don't know what to tell you I guess I should give people a little update today. We had special session and the governor did veto the measure that would have provided resources to Kind of bridge the impasse on the workforce in Maui Be quite frank. I would have voted to override that veto. We didn't have a vote on it today instead we're going to look at an amendment next week and I think something has to be done. It's an imperfect situation You were an executive What would you would you support something like that in general? You know, I'd have to spend a little bit more time looking at the details of it Yeah, but I heard that it was an additional 40 million It was it was an additional 40 million that was proposed I think right now he'd like to see a cap at 25 million to Get people essentially severance so that they can move into the next model. You're pretty, you know, you're pretty economically Frugal, I would guess but on the other hand we want the system to at least be tried Well, we need to get to health care. Yeah to the point where we're gonna be proud of it on Maui Yeah, that's number one If we could do it if we have to do it for 40 million and you do what you got to do But I think that if we were to explore ways of maybe making it a little bit more economical Maybe even getting Kaiser to participate in some of the offset You know that there could be other options that we could explore and see if we could work something out Yeah, you know, we've got basically three different parties involved. We've got the state. We've got Kaiser We've got the union but we can't forget probably the most important is the population on Maui Right and somehow there's got to be a compromise or a little bit of compromise on all different parties Where nobody's happy, but it gets the job done I agree because I what I don't think some of those three parties realize and I'll I'll claim myself to understand this is you can spend 25 or 30 million dollars real quickly if you Have some terrible outcomes on some people's health. If you if you really Diagnose someone or you don't have services available because you've had to downsize or close a unit or award You could you could have a catastrophic lawsuit or changes in care And so I think it's probably better to move forward Yeah, and this is you know, this will provide a trial balloon to see what's next what whether it's Big Island or Kauai I know that you had thought about that. I think that we're gonna have to get ready for at least some more innovation I think we do I think we got to start getting creative and try to figure out a way to address some of these issues In a different way because the old way just doesn't seem to be clicking anymore, right? yeah, the old way of just pure subsidies and No pressure to add new programs or to streamline programs in kind of a confederated state model just We limp along I guess it's the way to put it and I don't I'm not sure that the neighbor Island folks like that Now let me ask you a quick at the normal hospital environment, and then we've got the clinics and the physicians What's your feelings about the skirt skilled nursing facilities the sniffs that are maybe Can be a middle ground somewhere in between to provide a bridge that maybe not everybody has to go into a hospital environment They can go into a different environment. I'll I first of all I Really like the model Very much to use that I would even go one step further than sniffs I even like the concept of having Like LTACs long-term acute care facilities, which for those of you again to throw a healthcare acronym out there Those facilities can bridge even some of the more serious acute stuff that the hospitals If it's a Medicare patient and they've already been there for a long time and they need more services But it's just simply way too expensive to be still in Queens and Queens isn't getting reimbursed any longer having LTACs in a whole Whole spectrum is what I kind of would advocate for of healthcare services Health care is in general a good business to go into it provided the reimbursements are good enough But I think that with our aging population We better get ready instead of having just like the doctor's office and the hospital and nothing in between We better start inventing this system. I think we better agree. So we're about halfway through. I'm gonna take a one-minute break This is Josh Green with healthcare in Hawaii I'm joined by Reg Baker who is a health economist in my mind and a leader in our in our business community Aloha, I'm Chantel Seville the host of the Savvy Chick show You can watch the show every Wednesday at 11 a.m Honolulu time and enjoy how to be inspired and powered if you're a woman or girl Everyone is welcome, but it's really dedicated to you and we look forward to seeing you You can also find us on thinktech Hawaii comm see you soon. Aloha Hi, my name is Justini spirit to this is my co-host Matthew Johnson every Thursday at 4 p.m We host the Hawaii food and farmers series. This is the place you can come to for insight on the perspective and history and passions of Hawaii's farmers and all folks involved in Hawaii's local food system What kind of folks we have on so we have everyone from local farmers We have foodies chefs. We also have journalists Researchers anyone who's actually working to help make Hawaii's local food system that much better so join us every Thursday and Tweet in us and ask us some questions and leave your comments as well Hi, welcome back to healthcare in Hawaii I'm your host Josh Green state senator and ER physician joined today by Reg Baker who in my mind is one of the best thinkers in healthcare We've had already a part one discussion about the macroeconomics of healthcare in our state We've now moved on to the microeconomics of healthcare in Hawaii We were speaking just a moment ago about what happens in hospitals and health centers and physicians offices Economically, where is that space in between? What do we do for people that might need? Long-term care skilled nursing care. How do we pay for that rich? What would you say? How do we do it? Well, you know, you got the standard reimbursements that you would get from the payers and from Medicare and Medicaid, but then You'd also I think Have some of the hospitals interested in taking a closer look at this because if we can get some of these patients Out of the hospital beds. Yes and move them into a Long-term care facility or a skilled nursing facility That allows them to open those beds up and have more of a turn in there to be able to generate more of that First-day revenue, which is the highest amount of revenue that a hospital can generate And if they can get rid of those dead beds and have more first-day revenue in there They're gonna come out way ahead and they might be receptive to helping fund a little bit of this To get these different facilities up and running to give them those beds so partnerships partnerships Potentially between the strobs or well, I guess we should say the Queens and the Kaisers and Yeah, the Hawaii Pacific Health of the world Yeah, I I see that there'd be mutual benefit and with an aging population that the projection is that by 2050 a Full 22% of all of our citizens will be senior citizens people are gonna have health problems They're gonna have heart problems and cancers. Yeah, and if that's gonna happen in 2050 and this is 2016 right now We better get going otherwise. We're not gonna make it work. Sure Yeah, and people have a lot of needs and we've seen an increase in diabetes We've seen an increase in all kinds of health problems where we do better Americans are living in many ways Healthier lives as opposed to 30 years ago, of course, and they're gonna be living longer by 2050 Who knows what that average life expectancy is gonna be it could be in the 90s by then Wow That would be amazing and people are gonna need a lot of care And and I think that the model is changing some as you alluded to earlier We are seeing some mid-level providers provide care in Hawaii. We've kind of maybe been a little bit ahead of the curve We've empowered nurse practitioners to be PCPs. We've Experimented with some of these alternative payment models We've looked at some of the things that the feds are talking about and tried to tease out what might be suitable for us but we've got a long way to go because I I like you have seen a lot of angst amongst the provider community and Right now we're already seven eight hundred dollars doctors short if that Continues to grow and our population grows people love coming to Hawaii. Oh, well whammy. It's gonna be tough Well, we only have a few more minutes left and you have so many different insights. Talk to me about What you think the Affordable Care Act ramifications are on Hawaii? What's your what's your feeling and we're heading into a new presidency? In the next few years in the next few months rather. Well, what's your what's your guess on what's gonna start happening? well, we've already seen One payer fail as a result of the Affordable Care Act I think we're seeing a lot more of that on the mainland. Yeah, I think we'll still see some Consolidation, I think I see that there are some large losses being generated. I'm not long I'm not sure how long we can continue with that. Yeah You're talking about like HMSA losing a lot of money. Yeah, HMSA has lost a lot of money I think some of the others have You know some maybe not as much as others, but you've got this Requirement that you have to risk payment process that if somebody has more of the Fully loaded Affordable Care Act Policies and others don't There's a risk adjustment payment that ship money and so right yes And so that there's a lot of that going on right now matter of fact there was a Healthcare Co-op. I think in Oregon that just this week Declared insolvency because of that payment that I had to make Wow And so it's it's beginning to have that ripple effect. It's you know starting to sting a little bit And I'm not sure how long we can continue to do that You know so that the Affordable Care Act though in general I would say Really has an impact at Hawaii too much. It has created some increased costs, right? You know because now we've got insurance policies. We've got a lot more Covered that's going to cost some money and that's where the disconnect happened because they didn't project Exactly how much they need to charge in order to cover these costs. They were in some ways, but beneath that That's where those losses are coming from But you know we've had pretty good healthcare in Hawaii for 30 years And I think we've had one of the lowest uninsured rates in the country, right? And so we we had a good model. It seemed to be working. I Think this may have set us back a little bit, but you know I'm hopeful that we will recover and get our footing and move forward Do you think there's any chance that in let's call it healthcare 2.0 under under the next administration? I think they would entertain taking any of the lessons learned from Hawaii Say prior to the passage of Affordable Care Act and you'd lie some of our prepaid health experiences or other Experiences in these other markets to to be effective. I would sure hope so And regardless of who you support or don't support Hillary was out here many years ago when when Bill was the president and took a look at our pre-cared model prepaid healthcare model and She liked it and she wanted to take it back to Washington and use it as a model for the country That didn't happen then maybe it was too much ahead of the times And then when President Obama came into office He had his Affordable Care Act, which was quite different from what Hillary had wanted There's going to be a big push by the Republicans To try and tweak that affordable care model in some form or fashion If Hillary is the president at that time There would be some room for maybe to come back and revisit that interesting. We'll have to rely on our administration and our delegation, but also people like you who are very you know well thought-out and trusted advisors to many of these decision-makers to Push some of these ideas because I interestingly I don't think they're particularly partisan I think they're more about people and if I may Probably a lot simpler to have implemented than what we ended up getting with the Affordable Care Act It's gotten simple as good, you know if you can achieve this desired results and keep it simple Yeah, that's the best model to have. Okay. Well, I think that's just about the perfect note to end on I've been really pleased to talk to hope we can do this again You are a terrific mind and you've experienced so much in healthcare So we will come back in the coming months and years to talk more about health care Look forward to it. This is really this is the way I want this show to work Which is to bring experts like Reg Baker here who is served as a COO as a CFO at a major health Company who also is in the trenches with businesses. He knows what the chambers have experienced He knows what small businesses need again I'm your host Josh Green with healthcare in Hawaii and we're gonna keep exploring a better way to get healthcare for our people in Hawaii. Thanks for joining us


Hello, my friends, Ryan Van Duzer here from my bedroom where I have spent a lot of time lately. So there's some serious stuff going on all over the world. This is the real deal. And it's scary. And I personally have been looking toward thought leaders for some inspiration. And one of my favorites is good old Mr. Rogers. Yeah, that's right. Mr. Rogers Neighborhood, Mr. Rogers. And one of his quotes really is poignant to me. And actually, it's not his quote, it's his mother's quote, and it goes like this. When I was a boy and I would see scary things in the news, my mother would tell me to look for the helpers. There are always people who are helping. And that is so true. We can look to the news or social media and see so many scary statistics and numbers and stories that it's overwhelming. But there's so many good things happening as well. So I thought it'd be a great idea to look for the helpers here in Boulder. So I made a Facebook post asking for people who were doing interesting things. I got a nice list together and I rode my bike all over town, filming people doing good deeds. And I wasn't able to film them all, so I'm going to share a few of them right here first. But there's a lot of kids doing very cute things. My friend Stephanie's daughter is writing letters to her friends. My friend Amy's daughter made like a picnic table full of goodies and it was like, you know, take one, if you need it, leave something, if you don't need it. I got some photos sent to me of some kids drawing pictures on sidewalks with chalk with no other reason than to put a smile on somebody's face. And a smile right now is worth a million dollars. But I truly believe at the end of this, whenever the end is, we're going to be a lot closer as communities on a small level, but also a state level, national level, and a worldwide level. I think we're going to really come together and that is what is inspiring me right now. We're going to think more about our environment, about animals, about our friends and family and what we can do to build stronger relationships and communities. So without further ado, I'm going to show you some of the stories that I went around and filmed. I hope you like them. Thank you so much for watching my channel. Please like and subscribe. I've lost a lot of projects over the next few months. So my YouTube channel is more important to me than ever. Please comment and do all that fun stuff you do on YouTube. And I hope you enjoy these stories. What do you got there, Adam? Yeah, we got some food for some people. We got a toilet paper hookup. We got some hand sanitizer. We're able to find that at an auction. Some avocados, some yogurt. Hey, what's going on? My name is Adam Kulakowsk, I've been in Boulder my whole life, born and raised. So what we're doing is we are basically getting donations and then we are getting the food within like, you know, 24 to 78 hours to the people who need it. And so what we've been doing is we've organized with some people involved with the Boulder Valley School District, a lot around kind of families with kids and is how can we make sure these people have what they need. You know, originally like the first list that we had was like a couple of people in the family and these families had cancer. One of these kids had like severe brain damage. Some people have auto, a couple of people had autoimmune deficiency stuff. And then just other things as far as being just like really scared to leave their house, go get what they need. You can't see but I'm smiling behind this mask.  I want to get back. I want to contribute. I want to help. What's up, dude? What's up? What's up? What's up? What's up? Hola. Yeah, do it. That's what I'm talking about. Yeah. I love it. It's just good to be out here. Good to be helping people, you know, be in part of the community, giving back. You know, I feel very fortunate that I have the time and the ability to, you know, kind of help put this thing together and not be part of the fear, be part of the hope. Can I have a piece of that? Hi, my name is Dana Dee. I've been in Boulder 36 years. I'm at the original Walnut Cafe. I've been here that long too. And today what we're doing for our employees at each store is we're giving them hot meals, soup, casserole, quiche like whole foods, and then fresh fruit, vegetables, bread, everything they need like milk, eggs, butter, like we're just doing what we can and that's feeding people so we figured we'd better take care of our employees first. We pretty much know how we can keep this going for at least six weeks and feed our people. This is our Walnut Cafe family and when we say family, we mean family. Like I have a kitchen manager that has been with me for 30 years so, you know, we really take care of each other. Like we're walking the talk. We say to our employees every single day, we've got you because that's what family does. Get things cleaned up, run it through the chains. Hey, I'm Ray Keener. I've been in Boulder since 1986 and worked in the bike industry since 1975. And I'm doing what I can to help my friends and neighbors keep rolling on their bikes. I've been doing one bike tune a day where people just come over with their bikes, maintain social distance, we fill up the tires, oil the chain, and it's not just, you know, oh boy, I need to go for a bike ride. It's for health, for fitness, for escape, for transportation. I mean one great thing and I'm not particularly concerned about car traffic but I go out on rides right now. There's no cars out there people. If you're someone who's hesitant to ride your bike around Boulder because of the car traffic, now's the time to get out there. My name is Lonnie. I've lived in Boulder for 10 years and I'm in our donation closet getting bags ready and together for people that are being released from jail. Cosmos Pizza. Oh yeah. So because of COVID-19, they're starting to release some people from the jail that are about to get, that would be released in the somewhat near future but they're releasing them all in a short period of time so that they can limit the amount of people in the jail and therefore reduce the risk of spreading it in the jail. Then we're trying to give everybody food because right now food is super backed up with food stamps and Medicaid so food donations are really awesome and so we're getting a lot more people that are coming out and many of them are homeless and so getting them whatever we can, they're still cold nights so getting them warm things, getting them sleeping bags, tents, backpacks, hygiene, bus passes for transportation, basic clothes, all of that. And how are people getting this to you, the donation? I made some Facebook posts, have kind of reached out to different angles and so people have been putting them on their porch and I've been driving around with gloves and picking them up and bringing them back here for a few days and then dispersing them back out.  So yeah. What is it? It's just a symbol of hope. I'm giving them to a lot of residents around Boulder. My name is Somerset and I'm a Boulder native. I own a holiday lighting company, we're based out of Boulder. My focus is to spread light during this difficult time and my hope is that we can create a little bit of light for the community with a symbol of hope and so today I'm out delivering these little globes that are a light of life for people that they can hang outside their home and for neighbors and the community to enjoy. We hope to put about 7 to 800 of these around Boulder. So John Tehr, I am President and CEO of the Boulder Chamber and I'm so glad to be just talking about something that gives us all a little lift. That is the Boulder Star. We are the stewards at the Boulder Chamber of the Boulder Star annually which is lit usually at the holiday season only but we understood the power of the Boulder Star. We worked with the partners at the City of Boulder and said let's get this thing lit and there it is, voila. It is just a beautiful symbol of hope and community all of us during what is one of the most difficult times I think most of us have ever experienced. We can all look up at the Flagstaff Mountain at the Boulder Star and celebrate the future ahead for all of us which is going to be bright and beautiful. Go Boulder, we're in it together.


everyone and welcome. This is Melissa Arma with the Stock Swoosh. And today I wanted to talk to you about inflation. Now, while I'm not one of those people that makes trading decisions based on fundamentals, in fact, I make trading decisions based on technical analysis. What is technical analysis? Technical analysis is looking at past price data to predict future price data. Why? Because if you know where somebody's going to go in the future, you could enter the trade now and then make money, whether the stock gets bought or sells off. So that's why I believe that technical analysis really is the right thing to be watching, specifically in gaps, which is what I do. But I am aware of inflation, obviously, as a consumer. And I live in the United States and I live in New York and I do speak on television about these topics. So sometimes I have to talk about the economy and inflation. So I give my thoughts on it. And I think that people love fundamentals. Even the people that follow technicals tend to love fundamentals and they like it when the fundamentals match up with the technicals. The danger of following fundamentals is if you're so, what's the word, influenced by the fundamentals that you misinterpret or misread the chart so the technical analysis, then you can screw up in a trade. So I'm fine if you want to follow fundamentals, if it helps you with a technical aspect of it to get the conviction of confidence to do the trade or stay with it. But if they don't match up, you better be careful. You better be careful. We've had good economic data in the market so long. We've had bad economic data and in the market rally. So sometimes it doesn't make any sense. But I do want to talk specifically in this conversation even though I'll talk more about technical analysis versus fundamental analysis another time but I do want to talk a little bit today about inflation because I found something online here. I just want to pull this up that I just want to read. Because everyone's talking about inflation and inflation is bad, which I happen to agree with. What is inflation? That's basically when prices are rising. Okay, so you're paying more for things than you did in the past. Could be food, could be gas, could be housing, could be lumber, a cost of many things have been going up recently. And this is again, we're in 2021. But anyways, I saw something online today that said inflation is good. So I just wanted to read this. When the economy is not running that capacity, meaning, which it's not right now, it's not right now, okay? Meaning there is unused labor resources. Inflation theoretically helps increase production. Now I didn't write this, I found this online. And it's an argument for when inflation is good. Let me just finish. More dollars translates to more spending which equates to more aggregated demand. More demand in turn triggers more production to meet that demand. Now normally that might be the case. Normally, but it's not right now. Why? Because, let me just read that one part again here. More demand in turn triggers more production. The problem with that is, when we have the demand, so we're having the inflation and we're having the demand, but guess what? It's not triggering more production because people don't want to come back to work. People don't want to come back to work. Not everyone is open, fully. And people are choosing not to come back to work. Why? Because of the stimulus. Because of the government stimulus. Some people are making more money at home living off of stimulus, living off of the government than they are going back to work. And some people are afraid still to get COVID so they don't want to go to work. So maybe they're making slightly less or the same living off of stimulus as they would at work. And again, it depends on the different industry that it happens to be. So normally this statement, again, I found this online, normally you could say, well, that's an argument that inflation is good, not that inflation is bad because eventually it would stimulate more production and thriving in the economy. And so you'd have a short-term inflation rise and then it would drop off after more production is going up and things are going normal. But the problem is that's not the reason we have the inflation. We have the inflation right now. Okay, well, we have the inflation right now for a lot of reasons. But one of the reasons that we have a problem right now where we have more demand is and the lack of production is that people simply are choosing not to come back to work. And that is a problem. That is a problem that I don't know how it's gonna get resolved until everybody realizes that in fact is a problem that needs a resolution because today, so far, the government hasn't come to terms with the fact that that's even a reality. Now, many business owners, particularly here in New York, depending on the industry or business, have come to that reality and it's a problem, it's a struggle. And again, not every industry is open 100% and until the economy is back open and people are back at work, we're probably going to have this continued inflationary period and I don't know how long it lasts. And until it's fixed, where the stimulus ends, okay, where we stop paying people not to go to work, I think there's gonna be a problem.  We can argue about that all day long but the reality is, here we are, it's past 12 months since we shut down, we're getting into the summer of 2021, prices are going up and again, it's the vacation time for people. So prices are going up in gas, for example, when people are driving around where they were gonna spend more money on gas to drive on vacations, and again, it all comes out of people's pocketbooks. So I just wanted to talk about it because I saw that online and I wanted to make that statement and that's my thoughts on that. Again, I make trading decisions based on technical analysis, not fundamentals but if the technicals match up with the fundamentals that very often gives people a high level of conviction to trade. For me, again, it's just information that I have where I make my own choices and I have my own opinions about these types of things, like I said. Overall, I think inflation is bad for the economy and in the instance that I described, it potentially could be good if it's short-term and doesn't last and increases production but that's not the reason that we're having the inflation now and I don't think we're gonna have some of these problems fixed until the government stimulus goes away. Thanks everyone, have a great day.


So Lauren do you remember who the first super user award winner was well, of course it was the CERN team It's hard to believe it's been two years since they won it in Paris Wow, okay, so I think that's Tim Bell. I've been talking about him lately, but you know you can say I guess that OpenStack synonymous with science and science and OpenStack go together So OpenStack was founded by Rackspace and NASA so you could say that Scientific research is really part of the DNA of the community Amazing. Well without further ado, I will introduce you to Tim Bell from CERN to tell us what they're up to these days Hello, and thank you for the chance to come along and give you an update on where we are with OpenStack at CERN So if you were driving between Geneva and the Jura Mountains, you might go past this strange globe This is a CERN conference center But behind it are the Atlas experiment control buildings So these are the surface buildings that are a hundred meters above the largest machine on earth This is the Large Hadron Collider 27 kilometers around for experiments and We fire around beams of protons in opposite directions and then collide them at the experiments The experiments so there are four this one is CMS It stands for compact muon solenoid It's a bit of a strange term given that it weighs 14,000 tons to call it compact So when we fire these beams of protons round, what do we get? We get around one billion collisions every second So each beam has bunches around a hundred billion protons They pass through each other at the experiments and then out of that We then get simultaneous collisions occurring inside the experiments and this is one of the things that's driving the computing needs Which is that we have to be able to handle all those collisions and then separate them out into separate different and distinct collisions But CERN isn't just the Large Hadron Collider I have the honor of having an antimatter factory just down the road from my office and There what we do is we take anti protons positrons, anti electrons and slow them down Put them into orbit around each other and create anti hydrogen This allows us to study items like does antimatter go up or down under gravity We host at CERN also the control center for the AMS experiment, which is actually on the outside of the International Space Station Looking at the solar winds and particles from space without the problems of them having to come through the atmosphere 2016 has been a great year for the LHC We've had extremely good performance the beam has been very successful in staying in for extended periods of time which leads to more collisions We've got about half a petabyte a day coming in at the moment And with this we're accumulating more currently the data stores about a hundred and sixty petabytes in total But looking out When we have a look at how we're going to be distracting these collisions from each other Then we're looking at about sixty times larger compute capacity required by 2023 Moore's law will only get us about a factor five less than that even if we manage to keep that going So how are we looking to address this need for scalability? So we started production with OpenStack in 2013 in 2014 in Paris. We had 70,000 cores We're now a hundred and ninety thousand Which is roughly 90% of the compute capacity at CERN running on top of OpenStack We do migration of long-running service VMs. We're doing around 5,000 this year and We're currently looking in place the process to get around another hundred thousand in the next six months So with this we have to have a platform that is scalable and that allows us to grow But at the same time the users are looking for more functionality not just more capacity So we've been looking at containers the users been very enthusiastic about reworking their applications for microservices We've also had a number of collaborations with rack space and with the European Union Indigo data clouds To try and work out how best to apply containers to science We've used the OpenStack Magnum project This is attractive for us because we can use the existing OpenStack infrastructure our security arrangements our capacity planning our accounting I just add Magnum as an additional functionality rather than having to do the same thing with mesos One place Kubernetes and other technologies But at the same time we have to look at how can we grow and we've been looking at public clouds here For a couple of years we've been running the Large Hadron Collider workloads on public clouds We've tried around 10 in total the vast majority of these are OpenStack based and what this allows us to do is to take The in-house tooling that we've been using for the on-premise cloud and use the same tooling for running on the public clouds So thank you very much for all of your help With communities like this working groups like the scientific working group and the large deployment teams We're going to be able to take on the computing challenges of CERN's experiments going forward. Thank you


Jeff, you've been with PDAC now for over five years. I've seen your background and you can do anything you want. What has kept you at PDAC? Yeah, it's an interesting question and I think a great place to start. For me, it's been about coming full circle, really, Tracy. Knowing my background, I am a geoscientist and geologist by training. And I started my career on the floor of PDAC about 20, 21 years ago. So I've been coming to the convention for that amount of time. And I got my first job, as I said, on the floor of the PDAC convention as a geologist student looking for opportunities in the industry. And it really did. This convention and this organization helped open that door from, gave me that start, gave me that opportunity to get into mineral exploration. I spent the better part of a decade in exploration and mining before moving into capital markets. So that gave me a bit of a different cut at what the industry looks like, looking at it from the financial side. And I did find over my time there, realizing the significant weight that things like policy, like legislation, like regulations, how they influence the way that the sector works. So that sparked an interest in my own path. And then when the opportunity came just to come to PDAC, I certainly took that on because I did, as I say, saw that as kind of a full circle, coming back to where I started and for good reason. So what is your vision for PDAC? Or what would be the Jeff angle that you're bringing to PDAC? Or you'd like to bring to PDAC moving forward? When I think about what we do as an organization, it's quite a broad spectrum. I mean, we are the world's leading event every year from mineral exploration and mining. We do a lot of advocacy. So within that, I think there's a lot of breadth for my vision or our vision to take place. I have been fortunate enough now being here for a little over five years, that I've been a part of two different strategic plan constructions, if you will. In the organization, we just created or reaffirmed our strategic plan in the fall of last year that helps reestablish what our vision, what our values are, what our mission is. And I really truly do believe in those. And when we think about what is that, while it's really about trying to win the hearts and minds of the public, of folks within Canada to understand what do we really do as an industry? How does that industry link with what they do, how they walk around on the street every day and the business that they conduct and all the things that are involved in modern life. But I also see a big change that's occurred over this number of years with that understanding within the public domain of why this industry exists is starting to rise, it's starting to boil to the surface. And I feel like that's a part of our vision going into the future is making sure that that wave is sustained, making sure that minerals don't become again, let's say a back pocket issue or something that's outside of the public domain, that there's an awareness there. There's an inherent link between everything that we do each day and what gets brought out of the ground to help us make us do those things. So I mean, I think put it simply, my vision is to ensure that PDAC can be that connector between industry and the public so that people are just aware of what the industry actually looks like. Well, I appreciate such a modest and collaborative answer, Jeff. It's not what I want. So I'm gonna comment you from another angle in just a second then. And let me ask you, what is the number one question that you wish more people would ask you about PDAC? What's your favorite thing you love to talk about PDAC that nobody ever asks you about? I'll take it from the, like, what don't people, what aren't people aware of when they think of the PDAC? I mean, the immediate thing people think of is, it's a place and time, it's an event. But we are a lot more than that. And my role, 360 some days a year is outside of the convention that's trying to be a voice for that junior exploration company or that mid-tier developer and making sure that one is the public, a provincial and really the federal government understands where pain points are, where opportunities lie and how do we make sure that those channels of opportunity actually line up. So it's just being an advocate, lobbying on behalf of the industry. I think many of our members aren't aware that we actually do that. We often get associated with some of the largest pieces in industry, like incentives, like the flow through share mechanism and the things that exist around that. But we do a lot more than just lobby for flow through. There's been so many things over this last couple of years with critical mineral strategy being developed, critical mineralists being developed, new incentives that are being put in place, new investment funds or support funds that are out there now. And the PDAC has played a real integral role in those coming to fruition, both in identifying the issue to governments and then making sure that they're structured in a way that's usable. And I would want people to know that we'll continue to do that, be confident that we are a source of information, but also a repository of ideas and people with good ideas, people with issues that should come to us with both of those things. So undoubtedly you're on the front lines for trends or surprise trends. What would be the number one surprise trend you've noticed lately? And since I've thrown you a surprise question here, let me give you an example for our media platform. We've seen a significant uptick in interest in people coming to our media platform, searching for information on critical minerals in Africa and tied into Middle Eastern investments. That was something that wasn't on my docket for media planning last month. Is there something you've noticed for PDAC for 2024 that you went, that's interesting. We have a lot more interest in aphthium, for instance. Or is there something that you noticed recently? Oh my goodness, increase sales at Costco for Gold Dory bars. We're gonna be selling a lot of Gold at PDAC this year. Is there anything you can give us? Thinking of a couple of things. In the preface, we talked a bit about uranium and that's been a standout in terms of its price performance over the last year in 2023. And that's really seeing uranium at the top of the bracket with respect to commodity prices zero over here, something we haven't seen for quite some time. We're starting to see that leak out into the marketplace as well, we're starting to see more financing in that space. Or junior uranium exploration that's coming back into favor. I think Saskatchewan in particular, you've seen a few hundred million dollar increase just over the last few years in terms of exploration dollars being spent in that province, say from 2020, 2021 levels to where we are today. And that's a recognition of the commodities in a strong position. A lot of our own and other countries around the world are recognizing that nuclear power is going to be a part of a low emission solution of the future. So I think that turn has been one that a lot of the industry has been maybe anticipating for some time, but it's actually starting to translate into commodity price and real activity on the ground in 2023. So that was a bit of a surprise. So are we at capacity already or can we get in? Because I just spoke to several, at least half a dozen people this week with what you haven't prepared for PDAC. Get yourself a hotel at the airport, okay? Because that's all that's left. What is the current status for arranging, you know, getting into PDAC? Well, I'll suggest there is no capacity for being in the convention. So, you know, certainly more than able for people to get registered for the convention. I think it's probably a good point. Just a small plug for us. The early bird sales are still open for about another month or so. So people are just looking to attend the convention. You know, it is more affordable now than it will be in about a month's time. From an exhibit standpoint, it is fortunately for us a very popular show. As you noted, Tracy, and I think our boot sales have been very strong. We always do a renewal process in the fall and many people have come back year over year and that's the case again this year. So I think we are nearly sold out, if not fully sold out when it comes to both the trade show and investor exchange. But that doesn't preclude somebody from coming to the convention, somebody being able to do some of that networking activity they're hoping for. Doesn't mean they can't still have one-on-one meetings. Doesn't mean they're still gonna be able to potentially link with other corporates that they know are going to be there. So while the exhibition space is fast or fully gone, the ability to get into the confines of the convention and have meaningful interactions that still doors wide open. And so finally, can you just mention any other last minute item that you would like us to prepare for for PDAC? I mean, we're currently doing a series on marketable commodities and booths you should find and track down and meet the CEOs. Is there anything additionally you'd like to throw out and thank you for your time? Of course, and I'd like to see us as a thought leader in this industry and a lot of our programming is at the leading edge of sort of those thoughts or the best practices that get used in the industry. So to your points, within our program, we've got lots of things that talk about commodity performance over the last year. We outlooks from a number of the major banks or those folks that have influence on the way the market moves. We've got a number of sessions on critical minerals, where they're being sourced, what sort of public supports there are for development and how are these different policies around the world influencing what happens in Canada. And then we certainly have an extensive list of programming that talks about community relations, indigenous and industry interactions and how you actually move projects forward in a fully holistic way in Canada. So I'd like to think that there's a lot on offer for folks who want to learn about the industry. And obviously, as you point out the trade show and investor exchange floors are highly active. And so there's still tons of opportunity I would say to be able to come to the convention, meet with interesting companies, whether that's for employment opportunities or for an investment opportunity. Well, Jeff, thank you so much for your time. We're all counting down to PDAC as we speak. I actually put some time to PDAC again today. And for those of you seeking more information, please go to the following website on this screen. Thank you, Jeff. Thank you, Tracy.