So, and I can tell you right away what this one particle irreducible is. So, we already saw that disconnected simply means two diagrams that do not talk to each other right. I can have, but I can simultaneously have something else going on here ok. So, this is and so there is a multiplication between the two, but they are disconnected. Connected diagrams can be of three types and for argument sake I am taking some from some book, but this is of course, connected because everything is connected to everything. Then we have no specific theory I am writing, but I am just drawing some graphs like graph theory. These are all connected, but the point is we say oh this only has a two point function on the external leg that just gets reinterpreted as the if you that just gets reabsorbed into the mass of the particle. We just say the correct propagator is such that these things are all absorbed into the. So, whatever higher order effects generate things like this where there are only two external legs, we just reabsorb it into the propagator and we do not consider it as new physics. This thing is said that it can be cut into two ok. So, becomes disconnected by cutting one line. So, we do not like this we said that is too simple, but this last one is what we call one particle irreducible, one particle meaning one line something that cannot be made disconnected by cutting one line is called one particle irreducible, any one internal line. So, for this reason it is useful to keep track of what is connected disconnected and what is one particle irreducible. And it also goes to the core of this locality and cluster decomposition. So, if physics is local ultimately then you want that if you start with a larger greens function endpoint function and if I separate first five and the next seven particles and send them far away it should just become product of a five point and a seven point greens function that property is assumed of. So, it can be proved that so long as you write your Lagrangian as local products of fields and derivatives and just to not stress you with unbalanced Lorentz indices something like this products of is just a generic example of products. So, this has one field and two derivatives, but you could have powers of you know just make it square if you like. So, that it is no charges are hanging, but the point is so long as this is a product of at the same space time point ok. So, I will not try to write the definition of cluster decomposition because to be precise one has to write a lot, but you got the idea that if I separate out particles then they become products of individual scatterings. So, this kind of locality of the theory again goes back to the possibility that higher order greens functions contain products of lower order ones, but they are just nuisance they are because they follow because after all it is a local field theory. And the only nontrivial thing that we have to worry about while renormalizing is to worry about the one particle irreducible diagrams that to there will not be too many of them. If there are too many of them then you are sunk in the sense that you have a large number of unrenormalizable terms and the theory reduces in its ability to predict. At present we have theory of pions and nucleons in terms of what is called a chiral Lagrangian. And this chiral field theories you have to include all possible higher order terms consistent with symmetries of the theory. And each coefficient then gets renormalized if you do higher order scattering. So, you have to just determine each coefficient by doing scattering at the required energy. And so, its predictivity goes because you cannot predict what the coefficients are. So, if the theory has only finite number of one particle irreducible diagrams needing renormalization then you have a renormalizable theory. And then you have lot of predictive power like the standard model has bit which gives us confidence to build a machine like LHC. So, those are the advantages of this and that is why this kind of formalism is developed. So, now you may ask. So, last time we introduced what is called effective potential and that is what we are going towards now or effective action. So, so far we got a functional which is a functional of some auxiliary thing j. So, what do we deal with what are we dealing with? So, instead of w of j we would like gamma phi a functional of space time field phi which can have such that we get the dual interpretation by which I mean class expectation value right, vacuum expectation value of the quantum field phi. So, we want to construct an energy and that gamma has a interpretation of governing the dynamics of phi. So, in particular we expect to recover S of ordinary phi the ordinary action of the ordinary phi as the lowest order the zeroth order approximation in gamma I should not write gamma 2, but whatever ok. So, so this is what we would expect. If there is no quantum if there are no quantum corrections then the field theory should just remain classical field theory we will see. So, if you do the quantum action principle for the that is this gamma for our free field theory we will simply recover the same equations of motion for the correctly defined classical field which can now be interpreted as vacuum expectation value of the quantum field ok. So, we are in search of such a formalism and of course, gamma will have gamma will be of the form T minus V where T is kinetic term, but I should say kinetic and derivative terms and V a polynomial well power series in phi alone not the derivatives. So, that is what we call the potential and this is what we call the effective potential. So, this is called effective action and this is called effective potential because if you deal with. So, after you construct this. So, these are exactly like I have been trying to say in thermodynamics you have some gas and whatever complicated dynamics it has the variables that you see for the gas as a whole are pressure, volume, temperature etcetera. Volume is an extensive parameter if you change if you add something then the volume also increases pressure is only local it does not if you have more gas the pressure at that point does not change. So, those are intensive versus extensive variables and you can construct free energy of the system and ask what is its dependence on volume. So, this phi acts like some kind of an extensive variable you ask for it ask for the dependence of field on well this is an intensive variable you ask for its dependence on this particular collective variable phi and it tells you the answer if you switch off the derivatives then it tells you the energy it has and it can be then thought of as a question of suppose I constrained my phi to acquire a part it need not even be a vacuum I could just take. So, typical plot of V effective is something like this ok. What this means is this is the minimum this will be actually the vacuum expectation value because that is where V is 0. So, we take this is how it is done right whoever has seen simple examples of symmetry breaking and so on you vary with respect to phi and wherever you find minimum that is the vacuum expectation value. You may ask what are the what is the meaning of this part of the curve well the answer is suppose I constrained my phi to have this value somehow I arrange it because after all I have that external current J in hand. So, I could crank up the J in such a way that phi gets this value what will be the energy of the system for that value of phi. So, we trade the auxiliary variable J for the actual physical variable phi then we can ask such questions and then we can constrain the value of phi to be where we like or we can make it both space and time dependent then we will have an action for it and we can ask if my phi has this particular space time behavior what is the value of the action and so on. So, that will be the meaning of that. So, the question is how do we go from this description w of J to gamma phi and it is a very interesting and elegant mathematical connection because it uses the Legendre transform. What we observe is that sorry the two point function that we had is something that has two phi's in it G 2 is expectation value of two phi's. So, somehow if we vary this G with respect to phi once we should have information corresponding to one phi left. So, the way this is done is we start. So, I will now try to follow the calculation I have. So, we go back to this free theory example. So, we have to motivate firstly what this phi is. So, we take this w of J which is w 0 times e raise to minus i times this propagator i over 2 times integral d 4 x 1 d 4 x 2 J x 1 delta of x 1 minus x 2 times J of x 2. Now, we see that if I do d w by d J then I get down minus i over 2 integral d 4 x 2 and this is x 1. So, n times the w J back. Therefore, we divide out by w 0 we had that little annoyance there. So, now we divide out by w 0. So, now we say therefore, 1 over w J times d by d J of w that is carrying this to this side which becomes d by d J of log of w and remember log of w we define to be Z aside from an i one should put an i there. So, I can put i here from the beginning. So, I will put supply there is a minus i here. So, if I keep i in the denominator that is bad. So, let us do this and that will produce correctly it will remove the minus i and that would leave a minus sign does not matter what will leave that sign it is ok. So, it is equal to minus d by d J of Z, but now we note that that box plus m square acting on delta was equal to minus delta 4 and therefore, this x 1 we can write, but since it is a symmetric function I can even write x 2 in anticipation of what we are going to do here. This expression is a yeah. So, x 1 is fine correct. So, if I this thing is a function of x 1 it is a functional of a function of x 1. So, if I hit this now which is I mean this refined one the one without the w. So, if I therefore, box x plus m square x 1 plus m square on this I may withdraw the minus sign later by changing the convention, but right now to avoid ok. So, if I hit it with this then this you know is nothing, but what is in this curly bracket this box plus m square can be carried inside the x 2 integral it will produce a negative delta function here remove this minus sign and yeah and leave behind J right and set it equal to x 1 with perhaps an I left over certainly it is proportional to J of x 1 this is and I have to decide whether there is an I or I have lost track of what sorry what is happening here. My book says minus I right. So, this is the correct expression. So, we will define there is no I anywhere because I put an I over here and that tell is correctly with this definition right because we set w to be equal to e raise to I times z. So, very good. So, I am going to now announce that this expression is what I call phi classical because indeed that is the one that was going to obey this Klein Gordon equation the from the original action which was kg action what is the equation of motion we get well we get box minus m squared box plus m squared phi equal to minus j I guess how do all the Lagrange equations work. So, we get d.  So, if I put this here I would have got minus j here. So, I get plus j here. So, this is fine right. So, when I have this this is exactly what should be called phi classical. So, phi classical is nothing, but variation of that log of the w with respect to the external current carry out. So, now what we do is we declare this phi to be the real the actual variable in terms of which I want to deal with the theory and I want to throw away the j. So, what we do is we do a Legendre transform. So we define gamma phi to be where phi classical x is d z by d j. Now here we have to remember. So, phi classical equal to aside from a minus sign later the minus sign disappears. So, I mean in Ramon's book the minus sign is not there. So, how do I get rid I will call this minus phi classical here. So, I want this definition. So, phi classical is just d z by d j right. And the meaning of this expression is that this gamma is a functional of phi, but you see here j's the point is wherever you see j you have to invert this equation. So, this implies that j of phi ok. So, we have an expression phi classical equal to which will come out to be an expression in j z is a some functional of j. So, if I vary with respect to j I will have some functional of j I have to invert this and express j in terms of phi classical and then plug that j everywhere. So, this j and this j will be this j substituted there that is when gamma will be defined in its correct domain phi classical right. This is the usual Legendre transform trick, but that is what we are now going to propose. So, now we can see we can actually prove that we recover the effective action we will recover by systematically plugging this in we will exactly get what we expect we will get just s because there are no quantum corrections and it is in two steps. So, in the present case we check the utility of this in the free case we find gamma phi. So, first I have to write z of j, but z of j was nothing, but minus j delta j right that is the z j and I have to write minus integral j phi symbolically this is the starting point, but j is nothing, but I substitute from here j is box plus m square acting on phi. So, that is the process of re-expressing j in terms of phi classical. So, here instead of having to quote invert this and all that we can simply read this equation backwards to express j in terms of phi classical and this will be 1 phi 1 and then delta 1 2 and then box 2 plus m squared times phi 2 right in shortened notation that is what the first term becomes and minus again j phi I replace by box plus m squared phi times phi this will be 1 and this will be 2, but well they are local they are the same. So, I do not have to do 1 and 2. So, if we make this act on the delta we will get a delta function because there are second this is second derivative if we transfer both derivatives in succession the sign will not change and it will act on this, but that will produce a delta 4 function and that will set the 2 that will set the argument the same for both. So, what I am saying is that this can be reduced to being simply phi box plus m square phi with all 1 I will do it in a minute with a half factor, but the second one and minus delta function. So, this will become plus half and there is a minus this same thing yeah, but we do it twice because it is a second order derivative. So, that sign does not change and so, we will recover exactly half, but with a sign aside from a sign we will just recover the classical action. So, now let us just see what we are saying over there I think all of you got the idea, but let us write it out. So, what we are claiming is that if I have integral d 4 x 1 d 4 x 2 box 1 plus m 1 square box 1 plus m square phi 1 times this delta 1 2 and then box 2 plus m square phi x phi 2 what I claim is that integral delta x 1 minus x 2 and let me put in the d 4 x 2 here. So, d 4 x 2 delta x 1 minus x 2 times this box operator which is d t square minus grad square plus m square on acting on this phi of x 2 these are both 2 I transfer them both to this side. So, I will get some boundary term which I am going to throw anyway. So, right so, if I turn it once if I turn it twice boundary terms will be of the form integrated values of delta. So, there could be one derivative of delta minus x 1 minus x 2 times of phi evaluated on the boundary of the domain whatever the domain is how do we write a domain some call it d. We will claim that this is 0 the phi is such that the asymptotically phi and its derivatives all go to 0. So, having transfer this derivative twice on this side I will get a plus sign d 4 x 2 times box minus box plus m square and this time 2 acting on delta of x 1 minus x 2 and phi of x 2 sorry this is. So, I this is what was untouched I am sorry. So, I want to write d 4 x 1 times box 1 plus m square phi 1 and then from the d 4 x 2 I got this, but now this became minus delta 4. So, then using up the x 2 integral it just became box plus it just became phi of x 1 and you can then do a partial transfer of a derivative. So, the minus sign should eventually go. So, this is correct. So, right. So, this manipulation all leads to this basically and therefore, we are left with minus a half of this integral, but now I transfer one derivative not both to get my usual form with a plus sign, but that would change the relative sign, but which is exactly my classical action. So, modulo some sleight of hand I may have done with minus signs this is the this is the basic concept involved. So, this is the idea of effective action and we can actually carry out the manipulations and see that for free field theory such a abstractly defined process actually gives you back your original action. So, this is the grand definition with all this legal text attached to it because without that it does not make sense. Lot of people end up writing Hamiltonian as function of velocities. So, you have to remember that whenever you would say h equal to p q dot minus l well how does it work well it works because you have to say q dot is evaluated at p's and this q dot by inverting the definition p equal to d l by d q dot. So, this has to be transferred to read q dot as function of p in it has to be inverted to give q dot as function of p and then substituted here that is when it becomes Hamiltonian until then it is not Hamiltonian function. So, by inverting when you put it back you get the domain of dependence of gamma correctly domain of dependence of gamma is not J. So, you have to replace J by its dependence on phi classical then you recover everything right.


Ladies and gentlemen, good morning. I want to welcome not only the students from the U.S. Naval War College, but the multitude of tenant commands here on the base here in Newport, from the base itself, Naval Academy Prep School, Officer Candidate School, Naval Supply Officer School, as well as the other commands. Today it's my distinct pleasure to introduce to you our Secretary of the Navy. Secretary Mabus is a native of Mississippi. He went to the University of Mississippi. He got his graduate degree from Johns Hopkins. And then he did this small thing at Harvard and got his law degree. He has had a lifetime of service to our United States here and abroad. In 1988, he was elected the governor of Mississippi. He was the youngest in 150 years to be elected to that office. And from 1988 to 1992, he stood on a record of improving education in that great state and was awarded and recognized many times. So he is no stranger to the academics of which we profess here and how important that is in our country. Two years later, President Clinton asked him to go overseas and be our ambassador to the Kingdom of Saudi Arabia. Now, what you may not know is the Secretary has also served as a naval officer. In fact, he was home ported right here in Newport, Rhode Island. I'm aboard the USS Little Rock, a cruiser. And he's very proud of his time on a bridge as an officer of the deck in his service in the United States Navy. On May 19th, it became our 75th Secretary of the Navy. Ladies and gentlemen, please give a warm welcome to our Secretary of the Navy, the Honorable Ray Mabus. Ray McArthur, thank you. And I'm glad to be back in Newport. He and I were talking on the drive over. I set where you did, where you're sitting now. I went to communication school here, although we didn't have quite this nice of building. I hope they've torn that one down. And it's been a few years.  Going to, putting out to sea, the reason we called it the $2 bridge was then in the early 70s, the toll was $2. It was astounding that it was that much. And we would take bearings and call it the $2 bridge.  I did ROTC at Ole Miss and I went through Ole Miss in three years and I took the last two years of Naval ROTC as one year. So I had to take my midshipman cruise after I graduate. It was the summer of 1969. I went to the med, did my cruise and when it came time for me to leave, I had orders to, I was flying back into New York from Naples and I was told to go to Columbia University and be commissioned at the ROTC unit there. So I did and I got to New York the night before and the next morning called the captain who was commanding the Columbia ROTC unit about arranging to come out and be commissioned and one of the things he said, he said, now you don't have to wear a uniform if you don't want to, which is a strange thing to tell somebody about to be commissioned into the Armed Forces of the United States and ask him why not. He said, well, there have been riots about ROTC the year before at Columbia and he was a little bit concerned about safety and he said that nobody wore their uniforms out around campus. My notion was that if I was going to be commissioned, I was pretty clearly going to do it in uniform. So I put on my uniform, got on the subway, went up to Columbia. Nothing happened but the notion that you shouldn't wear a military uniform even on the day you were getting commissioned was not a strange notion in 1969. You're in a very different Navy. You're in a very different military from the one I was in. The relationship that the Navy today and the military today has to the American people is a fundamentally different one than when I was in. During and immediately after Vietnam, the military frankly was not very trusted. It was not something that a lot of people looked at as something to be trusted or emulated or to identify with. Now in that period of time from 69 until now, the American military has gone from that relationship to being the most trusted institution in America. Americans have separated the warrior from the war, regardless of what Americans think about any conflicts we're in. The trust, the confidence, the level of respect for the military is higher than for any other institution in this country and that just didn't happen. That wasn't an accident. A lot of people who wore the uniform worked very hard. A lot of people sacrificed a lot. They lived up to a very high standard. They held themselves and others accountable. And because of that, the level of trust, the level of respect, level of confidence in the military is as high as it is. But that's a fragile thing. And it can be undone. Now the people I'm talking to here today, you're the current and the future leaders, not just our Navy but our military. And Admiral Carter talked about the various commands here, starting with the War College but also the Department Head's School for Surface Warfare, the Command Leadership School, Supply School, and so many other commands. You're all on your way back to the fleet for command or very high levels of responsibility jobs. And that's the reason the War College was founded, to prepare people for that responsibility, to prepare people to command, to prepare people to lead. And to do so with ethics, with integrity, to measure up to the exceptionally high standards that we do and should hold people to. Every time a commanding officer gets relieved for bad behavior. Every time there's an ethical lapse. And I'm talking now about whether uniformed or severe. Every time it erodes that trust that the American people have in us. And the misdeeds of the very few. And I want to emphasize I am talking about the very few now, both in terms of numbers and in terms of percentages. But the misdeeds of the very few have the potential to undermine the great work of the many. Every bad headline about unethical behavior, about unprofessional behavior has the potential to do great damage. Now having said that, I will repeat what I said at a press conference in December at the Pentagon.  I think those things, the way to keep the trust in the face of some bad acts, in the face of unethical behavior is by that long-neighbor tradition of being absolutely transparent. When we find misconduct, pretty unique, not only in the military, but also in America, we announce it. We are completely transparent, particularly for those in places of high responsibility. We do it for a couple of reasons, partly to actors of deterrent, but mainly because it's just the right thing to do. Now, some of the cases that we've been dealing with, all the ethics classes, all the speeches, all the instruction, all the guidelines, all the rules aren't going to help one bit. If you don't know it's wrong to cheat, if you don't know it's wrong to steal, if you don't know it's wrong to take a bribe, ethics training probably ain't going to help you.  And so the only way we're going to reach those people is to set up a system of oversight, of accountability to find these acts when they happen and to hold people accountable for it. I've spent a lot of my public life trying to do that. My first elective office, before I was governor, I was state auditor of Mississippi, charged with looking at every dollar of money, taxpayer money, that was spent in that state, whether local or federal, or state money. There have been two cases that have gotten a lot of ink, a lot of attention, and I'm going to talk about them very briefly. One is Glen Defense Marine Asia, husband and contract, that the allegations are that the head of Glen Defense Marine bribed people, including an NCIS agent, bribe officers to tell him what our classified ship movements were so he could bid on, he'd know what ports to get ready to bid on, bribe people to give him the contracts, gave gifts lavish, completely inappropriate gifts to higher level people. But the thing that has not come out as much as it should have is that the reason you're reading these headlines, the reason you're hearing about Glen Defense Marine is that we did it. Activities that that company engaged in moved across some trip wires and caused NCIS to begin an investigation. That investigation went on for three years and it never leaked. And one of the things that that investigation found was that there was an NCIS agent who was taking money and providing information on where the investigation was going. So NCIS, I'll put it this way, gave him information that wasn't completely accurate. We did it. We found this. And that's what I meant about I would rather have a bad headline that allows somebody that's doing this to get away. Right now that case is with the U.S. Attorney for the Southern District of California. But whatever action, criminal action that the U.S. Attorney takes, if there are people involved for whom the statute of limitations has passed or that didn't do anything criminal but violated Navy ethics or may have violated Navy ethics, I've set up a consolidated disposition authority and we will hold those people accountable. And it's a higher standard than just criminal acts. The other thing that's gotten some attention lately is the cheating of the nuclear power school. And once again, the reason that came to light was a sailor was approached about participating in the cheating and he said no and he not only said no, he reported it. And in both cases, we were the ones that made it public. In both cases, we didn't try to hide it, didn't try to sweep anything under the rug. And in fact, in the nuclear power school, we announced it two days after we found out about it. And as I said, if you don't know what's wrong to cheat, if you don't know what's wrong to take bribes, you're not going to respond much to ethics or rules. But we can set up a system to make sure that whatever those bad acts are, that they don't go unaccounted for and that when we find them, that people are held accountable and held publicly accountable. But when you get past that obvious stuff, when you get down to the day-to-day, some of the hard choices that we all have to make, we hold people, and we should, to a much higher standard than any other organization, any other part of society. And that's the reason, that's the bedrock reason that that trust is there from the American people. They know we hold people to a higher standard. They expect us to, and we expect us to. And that's what a big part of leadership is all about. It's about upholding those higher standards, not just for other people, but for yourself.  It's about not cutting corners. It's about not giving excuses. And there's a lot of levels and types of leadership. I mean, one is speaking up. If you see something, that's going wrong. Another is listening to what other people are trying to tell you. Something's going off the rails. And it's about loyalty to an institution, making decisions that's good for Navy or Marine Corps, making decisions that are good for the nation. And it pops up in some interesting places. One of the things that I get to do, it is not my favorite task by any means, but I get packages of promotion cases where somebody has done something that's just not acceptable, a DUI, things like that. And the question is whether to promote or not. And on the package that comes to me, there is a chain of command. Does the commanding officer recommend promotion? Does the next in the chain recommend promotion all the way up to the C&O? And I have to say it is very rare, very rare for the immediate superior to recommend not to promote. And in the times when I've just asked out of curiosity, it's usually, well, I didn't want to hurt somebody's career. He's a good guy. She's a good person. I didn't want to rock the boat. That's not making decisions based on institutional integrity. Now, you ought to do it on a case-by-case basis. I'm not saying that there ought to be a lot of non-promote things here, but it ought to be done with the notion, would you like to be commanded by that person? Would you like to have your son or daughter commanded by that person, supervised by that person? And it comes out in fitness reports too. Nobody wants to be the bad person. Nobody wants to upset a career. And it's a little bit like school when teachers just say all I got to do is make it to May and then that kid's going to be somebody else's problem. It's just passing along the problem. That's what you've got to think about. That's what you've got to, that's a test of leadership. And I'm also not saying be bad to people, be nasty to people, try to ruin careers, but do hold people accountable, do hold yourself accountable. Now, the one thing I'm definitely not talking about, the goal is not sort of a defect-free force, a mistake-free force. When Admiral Ruffhead was C&O, he kept a copy of Chester Nimitz's fitness report. As a young officer, after he'd run a ship of ground, he was court-martialed for it. He was exonerated at court-martial. He was a destroyer captain and he said, his defense at court-martial was, I have been trained to be aggressive and I was being aggressive using my ship, getting close to shore in order to support troops on the ground. I don't know what would have happened in World War II if we had been this mistake-free force then and Chester Nimitz hadn't continued his Navy career. That's not the goal, but there's a big difference. There's a big difference between taking measured risk, which we want to encourage. We don't want to encourage just conformity. We don't want to encourage just doing exactly what you have to do without taking any sort of risk or taking any sort of initiative. There's a big difference between that lapses. Now, it is not easy today. It's not easy today to be a leader. It's not easy today in the Navy or the Marine Corps or in the military. Our deployments are long and they're getting longer. Marine Corps is drawing down. If you, what's in use, as I suspect most of you do, you know that there are financial issues about the military in Washington and what we're going to be able to do. But hard times make leadership even more crucial. It's pretty easy to manage in good times. Hard times is not a reason not to make some of the hard decisions. Hard times is not an excuse to become lax to say, well, one little thing won't hurt. And I'll tell you one more political story. When I was running for state auditor, a guy was trying to get his support and said, well, I got a question for you. He said, do you think stealing $5 is as bad as stealing $5 million? I said, yes, just a matter of degree. It's not a matter of kind. And he said, that was the answer he was looking for. He said, I'll support you. A lot of cities have driven down crime because they started enforcing all the laws. Small ones as well as big ones. Mr. Meaners as well as fellowies. It's really hard to tell people they ought to pay attention to the big things when you're not willing to pay attention to the small things because people notice and they learn and they act accordingly. Finally, you have earned the positions that you have and the positions you're going to. You've earned the right to be here.  You are absolutely the right people to be assuming these positions of leadership. But as you do, remember the long journey. Remember the journey from the middle of Vietnam until today. Remember those that came before you that had to repair the relationship between the American people and the American military. Remember those who had to do that work to make sure that the trust was there with the people that you defend with your lives and with your careers. So I'll go back to that day in 1969. That day when I was commissioned, I was given a piece of paper and it was my commission. Same piece of paper. Every one of you who are wearing a uniform got reposing special trust and confidence. It's on that commission and you uphold that every single day by leadership, by integrity, by your willingness to serve America. So from the Navy, Semper Fortis, Forever Courageous, from the Marine Corps, Semper Fidelis, Forever Faithful. Thank you all. Who's got a question? If any of you all have been on all hands calls with me, as some of you have, first question gets a coin. But only the first. So first of all, thanks for coming to talk to us today. Mr. Secretary, it's truly a pleasure. My name is Lieutenant Commander Rob Crosby and I'm from Hot Coffee, Mississippi. You and Stella Stevens. An actress that none of you remember because you're not old enough. But High Coffee, Mississippi to me is sort of like the guy who was asked if he believed in baptism. He said believe in it. Well, I've seen it done. I don't even know about Hot Coffee. I've been to Hot Coffee, Mississippi. You're the first person to tell me they know of Hot Coffee. When I was 18 years old, I cast my first vote for then candidate Ray Mavis when he was running for governor of Mississippi. So I feel a connection with yourself. You get another coin for that. I joined the Navy as a cook. And if it had not been for servant leaders in the Navy helping me think beyond my socioeconomics, I would not have made it to be a nuclear submarine officer today. How has servant leadership impacted your career? And do you believe this type of leadership will help the president and his agenda in reaching out to some of the underserved youth of today? All I can say is that when I came into the Navy, I was 20 years old when I was commissioned. And I didn't serve for very long. Sure, one very distinguished, but it was the most consequential time of my life. Suddenly, I was a division officer. I was responsible for a whole group of folks. I was their priest, rabbi, psychiatrist, banker sometimes. I became an officer of the deck. There was nobody to blame. I was responsible. I grew up and whatever success I've had in my life, I do not think would have happened absent my service in the United States Navy. You know, I went to law school after I was in the Navy. People were complaining about how hard it was. It didn't seem that hard to me. It was always at exactly the same place. You could wear whatever you wanted to. Nobody's going to put you in jail if you didn't show up. And you could quit. None of those things is true about the military. But I mean, and I've said this publicly on a lot of occasions. It's not only great for the country, but it's equally great for the people who serve. At least it was in my experience. And, you know, I do a lot of college graduations now. I say, you don't have to join the Marine Corps, although we need good people. But do something. Join the Peace Corps. Do something bigger than yourself. Be a part of something bigger than yourself. So that nothing wrong with making a lot of money. Nothing wrong with providing for your family. A lot right for them about that. But I've never seen a hearse with a U-Haul. You just don't. I think the things that matter in your life are what you've done to touch people. What you've done to serve other people. And I'll tell one more story. And I know I'm talking too much here. But my father owned a hardware store, a town of 1,000 people. I'm from Ackerman, not much bigger than Hot Coffee. And he was really the only true hero I think I've ever had. He grew timber when he sold the hardware store. He died 1986 when he was 85 years old after a long and very good life. The year before he died he planted trees. Now he knew for a fact that not a one of those trees would do him any good. He knew for a fact that he would never see any benefit from. He knew for a fact that he would be long gone by the time they were grown. But he did it. He didn't cut a single tree that year. And he did it as a matter of faith. He did it as a matter of hope. He did it for me. He did it for his granddaughters that he never met. He did it for the future. And that's the same reason I think a lot of us serve. Sir Kepp and Carl Tescombe on the faculty here. Mr. Secretary, the QDR was released this week. And I believe two days ago the chairman of the House Armed Services Committee put out a short letter that said that the QDR did not meet Congress' intent. And if I remember the wording right he said it was actually in violation of the legislation that Congress passed. And we expect to see a redo on the QDR. Sir, if not, how do we square that with the organizational integrity that you spoke of earlier? I think that the QDR is supposed to be and is just an overall overarching strategy that we're going to pursue for the next four years and beyond. But it's to give a sense of what the military structure ought to look like. And this is the second QDR I've been in the Pentagon for. And I think it's fair to say that every time there are complaints about, concerns about the QDR and criticisms of the QDR. And one of the things that I have pointed out is that no matter how smart you are, and there are a lot of smart people working on the QDR four years ago and this time, no matter how foresighted you are, you're not going to know what's coming at you. If we'd have done a QDR right before the wall came down in 1989, we would have been 100% wrong as to what challenges we're going to face the military. If we'd done a QDR on September 10, 2001, we'd have been a lot more wrong than right over what challenges. So I think if you view the QDR as here is with the best knowledge that we have today, what we're going to face. I also think it underscores the fact that because we don't know what we're going to face, we have to give ourselves, we have to make sure that we are agile, that we are adaptable, that we are flexible, and that we don't get sort of stuck in, well, this is what's going to happen. I take a brief from every carrier strike group that comes back and also from every amphibious-ready group and the one constant is that they had to deal with something that was not foreseen when they left port. So I am testifying in front of that committee next Wednesday. And while I'm sure there will be some questions on it, and I have enormous respect for the chairman of that committee, I think that not only looking at this QDR, but looking at QDRs in the past and the concerns, the criticisms about those QDRs is helpful. And I think it also, regardless of what concerns there are, regardless, should not keep us from focusing on making sure that we have that adaptive capability to, and I think that maritime services are particularly suited for that, to do whatever the nation calls on us to do, that we're not sure what the future is going to hold, all we can be sure about is we have to be ready and that goes back to the thing I was talking about. We've got to have the trust of the American people that we are, that we are this ethical, this professional, this force that can be counted on to protect them, to defend them, and to do so in a way that honors who we are as Americans. Mr. Secretary, thank you so much for speaking with us today. Lieutenant Jamie Talbot from the Navy Supply Corps School. Mr. Secretary, my question is regarding cases of ethical issues. Are there any concerns with swift prosecution and are there any plans in place to improve investigative efficiency? I've always got a concern about swift prosecution or swift resolution, I'll put it that way. We need to, the resolution needs to be quick. So not only for the person involved, but also for the command or the institution, so that either way it goes, exoneration or accountability, that people know things have happened. Sometimes that's out of our hands, but to the extent I can, we make those determinations as quickly as we can without sacrificing making sure we got all the facts, making sure there's not a rush to judgment. In terms of investigations, in one area we've hired 54 new NCIS agents to investigate sexual assaults in particular, because the time that it was taking to investigate those assaults was just far too long. And it was damaging to the institution, it was damaging to the investigation. And so we have brought those times down pretty significantly. If we can do investigations quicker, if we can reach a resolution quicker, we will. But it does have to be balanced against making sure that we do know all the facts, making sure that the investigation was done correctly, and making sure that the whatever accountability is assessed is appropriate. We've got two right in a row, so we'll do the first one. Good morning, Mr. Secretary. Thank you so much for giving us your time this morning. Senior Chief Rametta currently attending the SEA station at Strike Fighter Squadron 2-5. My question is about tuition assistance. Obviously that's a huge topic that's been brought up with possibly going away, not only in the United States Navy, but in other armed forces. What are you and the other Secretaries doing to ensure that that stays within our grasp to continue education because of how important it is for all of the armed forces? You're correct that last year there was a movement. Different services were looking at it in different ways in terms of tuition assistance. It was a purely budgetary driven thing. There is passed a law that said that tuition assistance had to continue basically in its current form. So it's sort of like gravity. It's not just a good idea. It's a law. I do think that as we go forward there's some things we should look at. We would have to get Congresses okay to do it. But things like making sure that the education you're getting with tuition assistance is leading somewhere. It's leading toward a degree or toward a skill that you can use either in the Navy or outside the Navy. Things like that. But it's tweaking. It's not ending. Good morning, Mr. Secretary. Senior Chief Adrian Watkins, I'm also an SEA student coming from the Native Personnel Command. My question is the current status of the Ohio Replacement Program. Is that still progressing and how is the Common Mist Department development coming along? The Ohio Class Replacement is the top priority. We're doing engineering work right now. We're doing R&D work right now. We'll start doing acquisitions, buying stuff to begin building the first Ohio Class Replacement in 19. She'll go to SEA in 29. That's on track. We've protected that in the budget. The Common Mistal Compartment call that because the British are also buying the same missile compartment is also on track. They will need it before we do. They will get the first of these. They will do the initial testing of the Common Mistal Compartment. And we're also on track for that. Now, it's also true. And I think that a discussion has to be had or needs to be had. If the Ohio Class Replacement is paid for completely out of Navy Shipbuilding, it will take up about half of all Navy Shipbuilding funds for more than a decade. It will devastate every other type of ship in the Navy, including other submarines, the attack submarines, but surface subs. The Ohio Class Replacement is part of our strategic deterrence and as that is a national program. And I think that that discussion needs to be had about what's the appropriate way to pay for it. And are we willing to so completely cut into the Navy's other Shipbuilding accounts, other Shipbuilding lines, other responsibilities to do that? How should we approach that to keep the other missions of Navy that are so vital to this country whole? All right. We got one more. If anybody wants to do it. Good morning, Mr. Secretary of the News. It's Nick Manna Curtis. I'm a student here at the War College. Thank you for coming this morning. My question is about the cuts to personnel costs. Secretary Hagel spoke last week and admitted it's a tough sell to tell us that it's for our safety and for our readiness that personnel costs are being cut. And my question is to you, sir, when I look at an acquisition world that is very much still stuck in the preparation for another Cold War, fraught with overrun costs, fraught with behind programs, how do you help the Secretary sell that pitch to us that cutting personnel costs, pay, and benefits is what really needs to be done when we can look across the way at an acquisition program that many could argue is broken? Well, the first way is that we have fixed virtually every major acquisition program in Navy. If you look at shipbuilding, Virginia-class submarines coming in under budget ahead of schedule. DDG-51s, we've gotten competition put into that. And we're saving over $100 million a ship. And ships in DDG-51s are cheaper today than they were a couple of years ago. Amphibs, the cost also is being cost and schedule are under control. The withdrawal combat ship costs are down more than half from the lead ship in that class. The last of the 10 ships in a block by that are coming out of the LCS, the first ones that were built 10 years ago or so cost over $750 million. The last one coming off the line will cost $350 million. We're doing, we're attacking that acquisition program in a lot of ways. Firm fixed price contracts instead of cost plus. The Navy acquisition professionals had just been gutted. We're hiring those back. Private companies were being asked over to the other private companies. So protecting taxpayer money was not one of the really high priorities. We're doing multi-years. We're doing block buys. And we're not just looking at programs like that. We're also taking a very hard look at service contracts. We spend more in service contracts than we do in acquisition contracts. And very frankly, it was really hard to follow a dollar from appropriation to expenditure. What were we getting for that dollar? So we've set up a lot of things including something that sort of informally is called contract courts. Contracting officers got to bring in all their contracts every year, make a decision, do we need those or not. And so we're stripping out big ins of dollars in service contracts going forward. And we have gotten some of those savings already. And I'm confident that the rest of those savings will be had. And that's not easy.  One of the things that the government shutdown did was I did not delegate the authority to contract out of my office. Every contract the Navy had during the shutdown came up to me. And it was interesting. A number of contracts went way down because just a bunch of folks didn't want me to know what was going on. So I think there's one program that is still running over budget and that's the carrier. Some decisions were made 10 years ago in terms of trying to put a lot of new technology onto the first ship of the class. We've reigned in a lot of those cost overruns, but we're not going to be able to keep that from happening in that program. What we can do is on the next one, on CVN 79, we're taking those lessons and learning them and pushing costs down. We have done things like claw back some of the profit for the shipbuilder on CVN 78. So I say all that to say that I think it's a fair criticism about acquisition, but I also think we've done a whole lot to attack some of the waste, some of the unnecessary expenditures. And I'll go to the second part of your question. Personnel costs are now more than about 50% of the defense budget and they're rising. And the request that went in with the budget isn't a cut, it's just slowing the rate of growth a little bit. Personnel costs in the military have gone up 40% more than in the private sector and more than inflation over the last 10 years. So if you, you know, CNO talks about not only quality of life that salary and benefits pay, but also quality of work. Do you have the tools that you need? Do you have the equipment that you need? There are only a couple of places if personnel costs keep rising to go to replace that money. And it's not just rising for people on active duty. It's rising also for working age retirees. So are we going to take platforms? Are we going to take weapons systems? Are we going to take the tools that you need to do the job that you do? Or the other way to do it is take personnel. So would you rather be in a much smaller military that really doesn't have all the tools or all the people it needs to get the work done? And we are there. This is not something for the future. We are there. And the final thing that I'll say is I've done, I don't know, I've lost count, hundreds of all hands' costs. And it is at least my sense that while money, pay, benefits are important, that's not the only reason people join the military. And to make it all about the money, I think also risk that trust with the American people because the people in this room and the people that I know that have joined the military have joined it. I don't want to undercut the patriotism, the service, the sacrifice by making it just about money. But we're going to have to control personnel costs or the decisions that we're going to have to make are not going to be good for the individuals. And they're certainly not going to be good for the Navy and Marine Corps or any of our services. So I want to thank you all again. Thank you for your questions. Thank you for being here today. And more than that, thank you for what you do every single day. I really meant what I said. It's a very small number. It's a very small percentage of people who don't live up to the standards that we do. They get outsized attention. But the huge, huge majority of people in the military are professional. They're skilled. They're patriotic. And it is not easy. And it is a sacrifice in so many ways to wear the uniform of this country. And for that, the country and I am profoundly grateful. Thank you.


Let's just take a look at the general rules for line 1A on the form 1040. Total amount from forms W2 will be in that box so we're going to be having possibly multiple W2s if someone worked at multiple jobs and or if you had a married filing joint situation you could have multiple W2s that are comprising the amount that's going to be on the first page of the form 1040 box 1. Enter the total amount from forms W2 box 1 if a joint return also includes your spouse's income from forms W2 box 1. Caution 1, if you earned wages while you were an inmate in a penal institution you will now report these amounts on schedule 1 line 8U so that would be obviously somewhat of an unusual situation but possibly one to keep in mind. Do not report those wages on line 1A, see the instructions for schedule 1 line 8U if you're in that situation. Caution number 2, if you received a pension or annuity from a non-qualified deferred compensation plan or a non-government section 457B plan and it was reported in box 1 of form W2 do not include this amount on form 1040 of line 1A this amount is reported on schedule 1 line 18 so somewhat unusual situations those two. Line 1B, household employee wages not reported on forms W2 so if you have a household if you got wages as like a household employee or doing taxes in that situation it's possible that there's no W2 information because of the rules and regulations due to that type of work and therefore you'd be putting it in line 1B instead of where you'd put one the first line with the W2 wages so enter the total of your wages received as a household employee that was not reported on forms W2 and employer isn't required to provide a form W2 to you if they paid you wages of less than $2,400 in 2022 so that's one of those situations remember the general rule the IRS is always trying to force the payer to issue some kind of report such as a W2 or 1099 but in some cases they can't they don't do that or they're they're not forcing in that case because in this case you're not talking about a business situation you're talking about more of a personal like type of situation and therefore and the income is fairly low under a certain threshold and therefore even though you don't get a W2 you should still need to report the income for information on employment taxes for household employees you can see tax topic 756 tax line line 1C tip income not reported on line 1A so enter the total of your tip income that was not reported on form 1040 line 1A


First question is from M. Oat five when trying to build the legging body part How do you incorporate it into your routine or do you just have to change up your workout more dedicated to the legging body part? This person obviously does not have maps aesthetic. Yeah. Oh, yeah maps aesthetic or maps prime Yeah, yeah, but I mean maps aesthetic was literally designed with this in mind like it was literally Created around how I would train for a show and each time I train for a show I would focus on one or two muscle groups that were lagging body parts that I was trying to develop and bring up and How we implement The increased volume in a program to do that specifically isn't there and it's customizable So if you know the program's designed that if you know if yours is shoulders and somebody else's butt and hamstring That you just kind of plug-and-play and we teach you how to build that volume in yeah So essentially with the traditional advice which is good advice is what Adam's talking about which is you do more volume We do more sets for that lagging body part You actually put more work in for that specific lagging body part and the way we do it maps aesthetic And this is something you can do even on your own is on the days that you're not supposed to work that body part You throw in a few extra Moderate intensity sets to increase the volume, but here's the deal If you have a lagging body part because you're you don't connect well to that muscle group, which is common Okay, it's it's oftentimes like let's say glutes are your weak body part and you're thinking okay I'm gonna do more of the glute exercises squats and deadlifts and single leg deadlifts and all that stuff If you don't connect well to the glutes You're still gonna have trouble because all that extra volume might actually develop All the work's still gonna go into the quad. Yeah, and it's exactly it might go into other body parts So what you might want to do is rather than just adding more work is focus on how you connect To that new body part how you can feel that new body part through squeezing more through slowing down the reps Really focus on feeling that muscle do the work rather than just going through the motions of the exercise Now that can be done with really really good Proper mobility work. I'm not talking about flexibility. I'm talking about connecting to those muscle groups 9090 for example if done properly will help you connect to your glutes You can do this with almost any body part You can go through a mobility workout for these areas and connect to these muscle groups Then when you go work out you'll feel them more so maps prime believe or not I know it's a priming workout helps you connect to the exercise It's also phenomenal for bringing up lagging body parts because oftentimes what you'll find when you do your assessments Is oh, I'm not moving right and oftentimes that's because I'm not connecting Well, almost always it's almost always the the root reason why a muscle group is not developing if you're working it out Right, so if you're evenly working it out with all the other muscles There's you know and people are like it doesn't make sense I you know I train my butt as much or more than I trained legs and all these other muscle groups And yet it's not developing at the same rate. It's always a connection issue It's always you're not connecting to it very well. So that's where priming I mean prime and aesthetic Like if you if you don't have those it's an incredible investment And and it bare minimum if you don't do either one of those then at least it go to Justin and the webinar that I did so those two webinars that are free Go through that and utilize that and apply some of those tools if you don't want to invest in anything Yeah, and that's the maps prime webinar. I believe and there's there's assessments in there He actually teaches you how to do this and what priming looks like but really The focus is if you have a lagging body part Feel that muscle when you do exercises get get to a point We can really feel it doing the the exercise and then when you add volume The extra volume is going to go to the body part that you're trying to target


where you started out one for nine and then had a pretty hot fourth quarter kind of closes out. Just what would change for you in that fourth? Staying aggressive. Yeah, I felt like some shots and I shot through the first two, three quarters with good ones. Could have got some better ones, better looks. I settled a little bit. I didn't really attack the rim as often as I would have liked. But I'm just finding my place, you know, where I can attack throughout the game. Not really panicking about getting my points or getting my stats, just trying to play the game the right way. The stats come by the way I prepare and how hard I work out there. So just trying to be rewarded playing the game the right way. And just early on this win streak, it was kind of like Groundhog Day where you guys would, most games. You'd say Groundhog Day? Is it the movie? Okay. Just repetitive where you guys have a hot start and, you know, lead would go away a bit in the second and third quarter and then down to the wide end. It seems like these past few times, I'm ignoring them.  What do you think is changing that aspect? Okay. My bad. I've never, you say Groundhog Day the movie? I've never seen it. I've never seen it. Yeah. How old are we? How old are you? I'm 30. Okay. So yeah, we're the same generation, right? Freak. I don't have seen Groundhog Day. Okay. Maybe I'm watching this holidays. Yeah. I mean, you're watching on Netflix, man. But yeah, when the lead was going back and forth, I think the key for us is staying poised and throughout this winning streak or throughout this time that we've been putting some good games together. I think we just, we've established an identity where defensively we know we can ramp it up at times when we're giving up some easy baskets and we make some adjustments. So I think we just stay consistent, stay disciplined in our effort. And Jock does a great job of calling these timeouts and holding us all accountable, which helps us out. So I'm grateful for that. Kari, 45 to 45 rebounding against the Bucks were team known to kind of dominate on the boards. Jock said that not too long ago, he showed everybody their individual boxout percentage. First, do you remember what yours was? Yeah, I was second to last on a boxout list. So if you want to talk about holding people accountable, boxing out is definitely something that I have to work on and I have to get my percentage up in terms of the league average. So yeah. What's that feeling when he shows you your percentage and your second to last and you kind of work to work that up? I think the initial reaction is, who's making these stats? Just calling cap on the stats. You know, that was my initial reaction, but then getting to the serious stuff, when I'm able to hold myself accountable, Jock's able to hold me accountable, my teammates are able to hold me accountable, then it makes it easier for us to hold each other accountable when we're not doing the little things. These are things that we have to do every night to win. So boxing out is definitely something that I have to do in order for us to be successful as a team. So it was fun at first, but then we got serious after we left out of there. Yeah, one more.  They've had that same core together for about five years. They know how to play when guys are out. You guys haven't had that luxury for the past however many seasons, you guys have had guys in and out of the rotation even this season. Just what does it say about the chemistry and cohesion that you guys are building to be able to beat that team so handily given that they have that chemistry and cohesion for years? I think we're just putting together a consistent game plan right now. Guys are filling their roles at a high level. No matter who's in the lineup, this is our group. So we're just rocking. Having fun playing a great brand of basketball, doing the little things and it's resulting in some wins. And we just want to keep it up. We don't want to take our foot off the gas pedal. We know it's a long season, but this is a great pace we're at right now and we feel good. Kyrie, to that point, you guys are rolling in such a way the last couple of weeks but you haven't been beating the top level teams. Does this win mean a little more to the room because of who you beat and what they did in the past? No, I think the object of the game is to win. So as long as we put in some wins together, whether it's the top teams or I don't know, the other teams that are fighting for a position in the standings, just want to win this object of the game. Kyrie, you guys have been a smaller team in recent seasons. And this year, you guys have that added size with Ben, Royce, TJ, Utah. Does that, for you, when you're out there, does having that added length and athleticism, does that just make the feel of the game different for you? Absolutely, I mean, I can't necessarily guard everybody on the court in terms of the perimeter. So when Katie can guard Drew, I can guard John Carter and Royce can guard Giannis or Ben can guard Giannis. I think our lineup is so interchangeable that it's a positive for us, it's a strength of ours. And then you have two of the top guys, Garden Isos and Nick and KD. I mean, it makes a huge difference out there. They're leading the league in Garden Isos, so anytime people are going at them, we know that we had a great chance to make a miss. And when you can make professionals miss at a high level, then pretty much we're getting out on the offensive end and putting together some quality possessions. I feel like we still leave a lot of points out there, just miss Q's, turnovers. We can't play perfect, but we're definitely striving for greatness in the aspect of just getting better over the course of the eight-two game season, preparing for something bigger. Kyrie, Kevin's putting up a bunch of career highs and field goal percentage from mid-range pull-ups. Is this the best you've seen him as a shooter, at least that you've played with him or even just in his career? Man, I'm thinking of all the superlatives so I can keep going at what Kay's doing right now. But again, I just want us to all play well around him. When someone's playing at a special level like that, we don't want him to feel alone. So when he's shooting a ball like that and doing it so effortlessly and doing it at a consistent level, shooting high percentage, I think he's shooting the top true shooting percentage right now. So I just want him to keep it up and keep working hard, keep preparing. And he's one of our leaders and when he's playing well, and we're all playing well and clicking. I mean, we're a tough team to beat.


Hello, and welcome to Health Information Privacy Ask an Expert. I'm Lucia Savage. I'm currently Chief Privacy and Regulatory Officer at Omata Health. Before joining Omata Health, I was Chief Privacy Officer at the Health and Human Services Office of the National Coordinator for Health IT. Yes, that's a mouthful. You can just say ONC for short. And that is the agency that not only brought you regulated electronic health records, but also brought you app-based access to your information. And we'll talk more about that later today. I'm really happy to be here today recording live for the Biohacking Village at DEFCON. As you know, the format of the show is to cover the basics of a topic and then open the mailbag on that topic. Today we're covering how health information privacy is regulated in the U.S. and the difference between health information in the health care system and outside of it, like on social media. We're also going to cover why there are lots of news headlines on the topic and what the headlines mean for ordinary people. Let's get started. I think the best place to start is why do people want health information privacy? It's pretty simple. People want health information privacy to prevent them from being treated badly because of their health status. There's a few very current examples of that. Just look at Kim Kardashian's note about her husband's mental health situation. Or if you want a deeper dive, you can read Carrie Fisher's autobiography. Or you can check out on social media the Royal Highnesses campaign to remove mental health stigma in Britain. All of those are areas where we have specialized privacy rules because we treat people badly when the health information gets out in public. And there's many, many areas as well, but those are three current examples. At the same time, it's really important to remember that here, the fifth of the way through the 21st century, digital health information can be used for really, really important purposes to help us address inequities, address discrimination, improve the care system. You can't fix what you can't measure. One example would be many years ago, we started measuring the rate of breast cancer screening in women. And because we could measure it and identify the physicians that were not ordering mammograms for their patients, we increased the rate of screening and we saved lives. That's a really early example. But some more current examples are things like using the data to measure what kind of languages the healthcare providers speak compared to their patients or using the data to figure out immunization rates. So using it is important, but keeping it private is important. And therefore we have regulation. And I thought today I'd talk a little bit about how is health information regulated and then open it up to questions from the mailbag. So the first thing I wanted to say is within the healthcare system there's a very specific set of rules. You guys will all have heard the acronym HIPAA. It stands for Health Insurance Portability and Accountability Act. And you'll notice that there's no privacy in that acronym. Privacy is a side product of the original effort, which was to digitize the claims data so we could do this measurement. But we do have a very robust privacy rule. And in fact people equate HIPAA with privacy. And the way that works is the digital health information within the healthcare system is designed by regulation to move around for ordinary healthcare purposes. For example, if you go to the doctor's office and you have insurance, you want your doctor to build the insurance company without you having to do extra paperwork. Or at least most people do. There are definitely a subsection of the American population that wants to manage it all themselves, but that's not most of us.  And we know that could be high. That's a different panel. But you don't have to do anything. You don't have to collect the data. You don't have to send it somewhere. It doesn't have to be printed out. And all that is designed to happen normally. In addition, the regulations are also designed to let us do this normalized measurement, to measure that breast cancer screening rate, to measure the immunization rates, to measure language, to measure how expensive it is. And there's lots and lots of examples of that. But the last thing is the regulations are designed to not allow the data outside of the healthcare system in an identifiable way without you giving permission to it. And I don't have time today to give you very specific and detailed technicalities of the regulations, but I will be providing a list of public resources where you can dig in yourself about that. That's the basics of within the healthcare system. But again, here we are. It's 2020, almost 2021. And we have lots and lots of health information that's either directly collected from individuals that's outside the healthcare system, like fitness trackers and social media sites, or where we use data that's like grocery shopping data, or banking data, or driving data to impute health information about people from other data sets. And all of that, not being in the regular healthcare system is subject to a completely different regulatory scheme. So that regulatory scheme is basically about consumer privacy protection. So it's really the same rules apply to the health information Facebook collects, as applied to the fashion information Facebook collects, or the dining information your social media account collects, it's all the same set of rules. And that basic construct is, did the organization tell you what it was going to collect? We can have a long conversation about notice. And were they honest about it? So were there actions, what they said they were going to be, or did they lie about their actions or mislead you about their actions? So it sounds really good in concept, but very, very hard to prove in the detail. The ability to prove those consumer violations lies primarily with the Federal Trade Commission, which is a federal agency not in the healthcare system, and as well with state attorneys general. Then as the 21st century has gone on from 2000 to the present, states have begun to take a role. And so we have state breach notification laws to protect us from consumer harm, when our consumer data is collected and then breached or misused or misdisclosed. And we have states also beginning to take specific action about health information outside of the healthcare system. The last thing I want to say about this interplay between inside the healthcare system and outside the healthcare system has to do with states. So the federal law HIPAA is a baseline. It's the floor of regulation. And many states have very specific laws about in general clinical verticals. So they'll have specific laws about HIV AIDS or specific laws about mental health data, or specific laws about domestic violence or sexually transmitted diseases. There's eight or so key areas. And they'll have a specialized rule about that and who gets to use it and what is permission required and do you have to consent to the release of your data. And all of those rules sit on top of HIPAA.  But again, those laws are about the healthcare system itself and not about particular kinds of data outside the health system in the consumer setting. Finally, we have an emerging set of laws. Many people here will have heard of the California Consumer Privacy Act. And many people on the California resident will know that we have a ballot initiative coming to us in November where we can vote on a additional privacy law that ironically enough, the privacy advocates are fighting about whether it's any good. That's also a conversation for another day. You can look that up on social media. But other states are looking to California to see what it does and whether there are things those states can copy from the California landscape to protect their own residents in the absence of federal regulation, which takes me to my final point. There have been a lot of headlines about this. Mr. Zuckerberg has been in front of Congress many times. Leaders from Google, leaders from Twitter all have been in front of Congress talking about privacy. It is an important federal policy question and the important question is, will the federal government change anything in the federal landscape to augment the FTC powers to make the consumer rights more meaningful, to make the consumer rights more particularized, to help care information outside of the health care system? So these conversations started in the wake of Cambridge Analytica. A lot of us privacy advocates had great hopes for something happening. Remind you, Cambridge Analytica was two years ago now, a little bit more than two years ago now. So politics moves very, very slowly. It's an election year. We have COVID. Conventional wisdom says nothing's going to happen this year. And then it's very complicated politically. There are three or four committees on the Senate side. Another half a dozen committees on the House side. Each of them has jurisdiction. If you went back to, I'm just a bill from Schoolhouse Rock, you would realize you have to have a bill on each side. Then they have to come together and come to a compromise bill. And then both houses have to pass it again. And then the president has to sign it. So lots and lots of moving parts. Lots of opportunities there for people are interested to still make their voices heard. And we'll talk about that a little bit later. Eventually, I think we will have something national that it could take another two to four years. So I have somebody with me today to help me read the mail. My friend Nina. Nina, what's in the mail bag? First question. What are the big issues that are being debated in Congress about a nationwide privacy law? I think the two biggest issues are one is what we call preemption. So that is the idea that the federal law overtakes and supersedes any active state law. So if you think about the CCPA construct, if there were a federal law and if it were preemptive, it would override whatever California enacts in its own law. So you can see that that could be really contentious because some states might want to be more aggressive or more protective of their consumers than other states or than the federal government. On the flip side, however, is the more laws there are, the harder it is to assure compliance. So from a consumer perspective, it might actually be better to have one single law that applies the same everywhere. So you don't have to be confused or have your rights change as you cross state lines. Many, many complex tradeoffs there. The other big issue is should individuals be able to bring their own lawsuits for breaches of privacy? Now, there's a very long complicated history about lawsuits and privacy and damages. But at the end of the day, it's about how does this get enforced? So right now, outside of health care, the FTC brings an action. Consumers under their individual state laws may or may not have the right to sue. And in health care, consumers have no personal rights under HIPAA to sue. A federal law could change all that by giving individuals the right to sue. That can be a really effective enforcement mechanism, as has been true for automobile safety, for example. Right? Cars are safer because Ford got sued over the canto. But it also can make the cost of the business much more expensive. It can be a barrier to innovation because you have to worry about being sued. There are a lot of downstreams too widely available, empowering a lot of people to bring a lawsuit. So again, tradeoffs there. Those are probably the two biggest issues that people cannot agree on. Why can't people get to yes? There are a lot of economic interests involved in that. So you can see that the trial attorneys want to make money off the lawsuits, but the small businesses and the innovation community and the venture capitalists want to keep growing new businesses with new ideas, and they don't want the threat of lawsuits hanging over their heads. Compliance can be complicated. There are philosophical differences. There are people who definitely believe in empowering consumers to sue, and people who don't believe in empowering consumers to sue. Those fall across the political spectrum. And that's probably why we can't get to yes, is there isn't enough people in any one particular place on that spectrum to balance the scales to a yes. You have to have a majority vote in both sides. So what's the impact of CCPA? So in the healthcare system, CCPA has a very specific carve out for organizations that are actually already covered by HIPAA. For example, OMADA would fall into that bucket, except for our public website that in a casual, you guys might be browsing it right now. But our program itself is healthcare delivering, it's within HIPAA. But if you are a company who is collecting health information, for example, because you are running a business that offers consumers gift cards to answer surveys about their health conditions, that might be a business model, that's not within the healthcare system and CCPA is going to apply and all the rules that are going to apply. And of course, it's a little bit of a moving target because the law was enacted a year ago, it took effect in January, but the regulations didn't take effect until July and actually they didn't get finalized till last week and that might be upended by, you know, a ballot initiative and who knows what's going to happen if there's court action about the ballot initiative. I'm not an expert on CCPA. I think it's something that's really important to people. But to me, the most important part of it from a consumer is knowing that I can go and say to that organization, what did you collect about me and can I please have a copy of it? That's a really important thing for consumers who want to take action. I completely agree with that. So if anything, did COVID change? You know, COVID hasn't changed very much in the landscape, the overall regulatory landscape. There have been a couple of little things that have eased because of the public health emergency, but that easement is temporary. But I think in terms of health information, what the impact COVID has had is really given more people a stronger sense of the possibility that digital health has for us as a way of getting care, maintaining our health, getting the coaching or the assistance we need when we can't go to the doctor's office. And because of that, I mean, it's great for a digital health company like OMARA, but because of that people are now going to be thinking about their health information a lot more. That's one. The second one is I think that the arrival of big tech at the COVID moment with their wide variety of contact tracing apps, you know, that Facebook both runs ads for legitimate academic research about COVID and also runs not legitimate, you know, links to things that are not legitimate research. Arriving as it has two years after Cambridge Analytica, I think we're suffering from the skepticism that Cambridge Analytica brought to the doorstep of health information outside of HIPAA really and truly. People are concerned about the contact tracing apps. The uptake is very low.  We've been doing it for decades, really centuries because we do contact tracing for sexually transmitted diseases that are contagious. And so we also have erosion of trust of the human-to-human contact tracing and we'll suffer from that as a society for a while. How important is this issue to Congress? You know, it's a little bit of water before this question. You know, it's a little bit of Kentucky windage, right? Issues are important that constituents care about and that's pretty much how the democratic process works. So right now constituents care about COVID and some constituents care about election security, which is hugely important. We won't get a privacy anything this year, although I know there are still people working on little pieces of privacy. I saw a draft bill the other day about COVID and contact tracing apps about a month ago. But if you as a constituent think this is important, you should tell your Congressperson, House or Senate. And in fact, if you have a senator or a representative who's on a committee of jurisdiction, you should most definitely tell them. If you think back to 2017 and the original attempts in the current administration to undermine the Affordable Care Act, who went to Congress, people with six children and six family members, and they were constituents. So, you know, you call over there and they will ask what your zip code is. And you should be honest about that. I happen to have a representative who chugs along doing what I think is right without ever having the ever having to call her, but I can imagine being in a different state and having to call my representative every week or ask for an appointment for the office to the office with local staff to say, hey, did you know this is happening? And this is how it's impacting our community and me, and you should fix it. Noi squeaky wheels totally get the grease in politics. So that's when it becomes important. Perfect segue. So how can the biohacking community get involved and move the needle on issues in privacy? I think there are a few things. I'm going to sort of try to list as many as I can in this materials, Nina, of, you know, bills that people might want to look at and committees of jurisdiction and where you go. But it's pretty simple. If you want to know, you go to finance.senate.gov and you look at the members and you figure out if they're your senator. And then you call your Senate's office. You call them and you say, I'm Lucia Savage and I'm a resident of blah, blah, blah state. And I understand that you're looking at such and such an issue. Here's what I think about it.  You can call serially. You can email, but it's probably not as carefully read or paid attention to as a phone call. Can do a house party after COVID. You can do it. Well, well, you could do a virtual house party, right? Like set it up on zoom. You can have all the contact information on a document that you're sharing. People can just, you know, call on mute. They were talking have a good time. So how can biohackers be more involved in the privacy needs and changes that are taking place? How do we get people to listen aside from talking to our congressional person? So I think stories are really, really important. People listen to stories. So I'm always compelled by, that's why I love the reference to Kim Kardashian or Kerry Fisher, right? It gives us a context for why people have privacy issues. Why are we working on mental health? Why is there so much stigma? How do we remove the stigma? And we analogize that to privacy. So in your family or in your community, what has been a bad impact of poor privacy practices or poor security practices for that matter? How has it impacted people? Whether it's a neighbor who got doxed and somebody, you know, something terrible happened to them or people that you know, or even yourself. That's how we got anti-doxing legislation is people went to their representative and said, Hey, this happened to me and there ought to be a law. So it's really about stories and it's very politics is very personal. It's, you know, there are white papers, there are studies, there is data. We can explain all that. But it's really the compelling personal stories that tip the scales when somebody's on the edge. It's the story about the constituent that's going to push somebody where you want them to go. And since I don't know about everyone's personal life who might be listening to this, it's really hard for me to know after that, like what would be a story that would be compelling. But I know I had a, my mother was bipolar and in all my work as a privacy advocate, particularly the work I did in the last administration, I would always talk about that. Like, I get it. I get stigma. I get why this is important and I get why we need to understand it better. Can I get my personal moment in here? Absolutely. So I give this story a lot about why I'm in healthcare and why this matters so much to me. My father, fire department of New York, paramedic captain, he was at 9-11. My mother, stage four, one of the rarest cancers in the world, and I learned about it. I learned about both of their health issues the same week. Oh my God. So my father's issue was that he has bilateral lung nodes from being at the World Trade Center. Right. And it's that very compelling story of I suddenly became a caretaker. My parents were super independent. They were doing their things and now it's I own all of their medical data. I have all of their physician numbers in my phone and if something happens, I immediately make a call for them. And if I'm not available, they understand that the physicians will call me right after to give me that data and the update of their condition. So I'm complete agreement with the story is so compelling because we all have something that we can talk about and gives us that emotion to say there needs to be a change. It's not a question I'm not asking you and telling you that moment. Two things. If you think back about the 9 11 fund and you remember that John Stewart was on that like a dog on a bone week after week, it was embarrassing. He was intentionally embarrassing the politicians with these really compelling stories and it worked. So think about that. The thing I would say just on a personal note, Nina, and I don't know if we have time today, but you know, caretakers, we are, we baby rumors are a pretty big population and our kids are going to be taking care of us and we should all have the ability as a caretaker not just to call your parents doctor and have them call back, but have online on your phone access to their records if they want you to have it. I had that for my mom through the Kaiser app. She authorized it. It meant I could help care for her and she could call me and say I don't understand this thing. What does it mean? And that is what digital health really means is not keeping data sacrosanct in a box under a cement floor, but putting it where it needs to be and where the patient wants it to be to get the care that they need. And if that's what the family member, let the family member know. If that's with a friend from church, let the friend from church know.  It's your data. How do the agencies that command and control healthcare, how do they work together or how do they not work together? Sure. That's a great question and something I forgot earlier on. I wanted to be super clear about who really has authority over privacy. So in the federal realm, it is solely the Health and Human Services Office for Civil Rights. They write the privacy regulation. They write the security regulation. They investigate those. They find people for them and they enforce them. Now, the FDA, which has a lot to say about digital tools, their remit or their jurisdiction is really about, is the thing safe, clinically safe?  And is it doing clinically what you say it's going to do? So remember, it's the Food, Drug Action, Cosmetics Act. And the enabling legislation, which dates back to Teddy Roosevelt, is about not having health products in the field that are dangerous, right? And actually the FDA covers veterinary science as well. So just think about that in totality. So I love the cool. I know everybody over there, great crowd, really interested in privacy as a concept, but they don't actually regulate privacy. What they regulate is, did your device that has software in it secure that software sufficiently that the device data is still accurate and has integrity? That's pretty much what they regulate. So that's the FDA. And then HHS OCR writes the privacy rule and that applies to health insurance companies, employer-sponsored coverage if you have like a big employer, like you're at an Apple or Google or health health monster coverage physicians or any other provider who bills the government electronically. And then some additional sort of intermediate companies called clearing houses. There's always a lot of talk around the medical devices and the security that surround those. But one of the parts that are normally lacking in conversation are the electronic medical records. And you talked before about the O&C owning them. So what's, how does that link in with the... So the O&C has three specific powers. The first one is they write a regulation about what the software in a certified EHR has to do. And they're EHRs that are not certified, by the way. So if you have a certified EHR, it has to have these minimum functional requirements and they've been getting more and more rigorous as time has gone by. The second thing they have is to educate the provider workforce primarily, especially the small doctor's offices. Remember, while there are some really big systems, most healthcare is provided in very small business practices that have two or three physicians in them. So educate the physicians and the nurses and the people out in the field about how to safely, privately and securely use certified EHRs to deliver care. And the third is to run sort of the policy making for the agency about both what that software package should be. It's a very unusual power, a federal agency that writes a prescriptive rule for software, but also in general about health information technology policy writ large. So for example, O&C has a specific duty of coordinating Office of the National Partner across agencies. And I might bring people to the table that would be the FDA and the FTC and Office of Civil Rights to stand up a tool that in fact exists. So on the FTC website is the Mobile Health App Developer Tool. And if you were to go to that tool, you would see in kind of a Q&A fashion, it moves you through a flowchart to help you make sure if you're a developer, you know which rules you have to deal with for the thing you're envisioning. So that's an example of coordinating across the agencies. Enforcement is not really a coordinating event in federal law generally. I'm making a very broad statement, but OCR has its remit and a privacy breach is investigated by OCR and they investigate every single one that's reported to them. A safety violation by a device would be investigated by the FDA, if that makes sense. And then of course, all of these agencies are within Health and Human Services, which is an agency run by Secretary Azar. And so how the agencies work together is really a factor of whether the secretary is making them work together and how much. Different secretaries have different approaches to that. The FDA is a very big agency. It's called an operating division that's kind of freestanding and runs on its own, but the FDA administrator would be part of Azar's sort of kitchen cabinet or his cabinet. Similarly, CMS, operating division, kitchen cabinet, NIH operating division, but in the cabinet. And then ONC, Office for Civil Rights, actually report directly up through the secretary, also in the cabinet, but literally under more of the secretarial vertical, if you can imagine that. So how do they work together? Let me just summarize it up. I think the staff work really well together when they're asked to, but people also have very specific portfolios and work that needs to get done. And so they really focus on that.  And I instantly knew that you had so much information that you needed to share it. And the, I feel like the community that we work in, we focus a lot on the medical devices because it's something very tangible that we can get our hands on. And this, even with all the knowledge that I have on how things function, this has engaged me and enlightened me. And now it's, okay, I can't focus so much here because they don't control this one thing that I'm working on. It's, I need to move over here. And maybe if I'm working over here, I can gauge this and make things happen. So that said, what other resources can we find for everything that you're talking about? So I'll put all these links in a document that you can hand out me now, but I will tick off a few of them that are going to be in that document. The first one is when I was at ONC, we published actually a long white paper for Congress. So let's just say it's like publication book level clearance and editorial accuracy for 2016 about the way health privacy is regulated in healthcare and outside of healthcare. And while the names of the companies may have evolved over time, Twitter is still Twitter, you know, Facebook still operates the same way. None of the rules or laws that, that characterize that description have changed. So that is a public document. If you wanted to look for it right now, you'd Google ONC non-covered entity report, and it would pop right up free, paid by the American taxpayer, no matter who else produces anything, the law firms, the consulting houses, the hacker community. This one is going to be the definitive source because it has to go through so many layers, including approval by the White House before it gets released to Congress. So that will be in there. I will provide some links to educational materials that ONC and Office for Civil Rights publish about more details about how HIPAA works, not only what people's individual rights are like you as the caregiver, what are your rights for you and your parents to collectively get the information you need to help them with their care, but also for people to understand what are the ordinary disclosures that happen within the healthcare system to make it run between physicians, between physicians and health plans, etc. So there'll be some of that material in there. And then I'll probably link to some other think tanks in DC that are working on the federal privacy law space, and people can look at those organizations' websites and decide what's of interest to them, but it would be Brookings Institute Future Privacy Forum, Electronic Frontier Foundation, Epic, potentially American Enterprise, New America Foundation, they've all kind of worked in this space. So we'll put some links together that are those people's websites, and you can just go to them and check it out. Yeah. Thank you so much. This is the stuff we don't talk about, and that is why this is so important. So thank you for coming. I completely and utterly appreciate your brain space. I'm really happy to be here. I think that the more people who can bring the stories to the floor, the more likely we are to have traction. There's a lot of times when it's the same 300 people having this conversation and bringing the new voices, especially of the next generation, when they've been specifically impacted by this, or they understand the technology better than some of our older congresspeople. Awesome. Fully awesome. Thank you. You're welcome. Thanks for having me.


so you don't know how to control your visibility not a problem let's say when you click the garage button you want the pose button to hide well to do that click the button and on the right down under on clicked add and up here drag out a set visibility drag the pose button that we want to hide put them together set visibility you're done now when you click garage the pose button turns invisible hope that helps and as always hope you have a fantastic day and i'll see you around