with everything else. And again, for those of you in technology, this is probably nothing new to think of it this way. You can put anything at the hub of this figure. But what's different in this case is that in healthcare, too many of us are not used to thinking about it this way. And in healthcare, unfortunately, more than in many other fields, we have a lot of regulation and a lot of requirements that make it a little bit tougher. But essentially on the vertical axis, we've got internal data that lives inside our system, gets created in our system. We've got external data coming from outside the system. And this is important stuff. This could be stuff that we have locally and we're interfacing it from another system or that we're scanning in. But much more importantly, it could be data that our patients are sending us or that we're getting from devices from our patients, stuff that we're maybe sending out and getting back in through an API, information stored in a data warehouse, anywhere else. There's a lot of external data that we need to handle and massage and make good use of. And then on the other axis, we have the internal users, clinicians, researchers, administrators in our system with security rights that are fairly easy to manage. But very importantly on the other side, we have our external users. That's administrators and clinicians and researchers at other institutions who want to share the data or give us data. But most importantly, it's our patients and their caregivers, what we call proxies, with whom we very much need to interact. So I have a rhetorical question. I don't have an audience response system. But I want you to think for a moment, what does a good EHR system or really any good IT system have in common with a baseball umpire? And if any of you are baseball fans, you know that the answer is, if they do their job well, they fade into the background and get unnoticed. They just work and you don't really know they're there unless you really need to know they're there. But the information still flows and in the EHR condition, it flows with proper security. So when it needs to flow, it does. And when the figure updates, it just is going to show you some arrows. Maybe I didn't click the button well enough. There it is. There's the arrow. So the information flows and circulates and no one needs to know that the EHR was doing all that. It just happens seamlessly, integrated, without having to think about it. That's the vision. Now with Johns Hopkins, again, we're focusing on our external users. We're focusing on our patients and their proxies. And we're also focusing on the data they're providing us. So we really want to emphasize patient-centered care. And of course, that's just medicalization of client-centered service. And all of you know about the importance of that. So we're trying to do that. So now I want to be a little more interactive by show of hands, just thinking about technology and client-centered service. How many of you interacted personally with a travel agent to get here to this meeting? I see maybe a dozen hands at the most. Okay? How many of you have walked into a bank and interacted personally with a bank teller in the last 30 days? A few more hands. But a tiny minority. You're using technology instead. Why aren't we doing that in healthcare? Well, we're getting there. We're catching up fast. We now have patient portals. We can now enable our patients to schedule appointments, view their upcoming appointments, cancel and reschedule their appointments. We're letting people check in remotely from home, from a kiosk, provide some information while they're checking in, review the data that we've got in the system already, notify us when there's an error in the system, update us when there's new data coming in, send messages back and forth in a secure way, protecting all the privacy and following all the regulatory rules. And we can go beyond that. We can make the medical office visit unnecessary in many cases. If we just need to exchange some information, we can do that remotely with asynchronous messaging and capture that as part of the medical record. And why not capture telemedicine technology as well, capture the video, capture screenshots, make notes about that interaction electronically and not make the patient come in if we don't have to actually physically touch them. So again, we're playing catch up, but we're catching up fast. Currently at Johns Hopkins, we have 165,000 patients enrolled in our portal. That's just in the last 18, 19 months. We're adding another 10,000 every month. And we currently have an average signup of 26%, which is good. I'm not nearly satisfied with that. Some of our providers are up around 80, 85% patients signed up. Some are lagging behind and we're working to bring them along. And our activation rate is constantly rising about a percentage point higher every month. And we're trading a lot of messages.  And that's ramping up quickly. So a year ago in October of 2013, 34,000 messages back and forth in that one month. Last month, October of 2014, 81,000 messages, one tenth of all our messages happened last month. And that's going to keep rising exponentially. So we're getting better. We're playing the game better to catch up with our technology and provide health care the way other industries use IT for their services. We're stealing bases. We're moving the runner over. Every now and then we had a home run or even a grand slam. But that's not good enough either. We want to do what Billy Bean did with the Oakland A's. We want to do what Earl Weaver did with my favorite baseball team, the Orioles back in the 70s. And now Buck Shaw-Walter is doing with the Orioles. We want to use statistics and evidence and above all else data and data and more data to disrupt and innovate and change the game fundamentally. We're still playing the same game, but we want to play it so much better that it looks different and it works better. So how do we do that? Again, it's about the data. And let's just think about a few areas. I don't have time. I could stand up here all day and tell you cool ideas, but I don't have that time. What about medications? We already have pill bottles that can count how many times they were opened. We have inhalers that can count how many times they were activated. That data can be transmitted to a mobile device, to a wristband, to a desktop computer. It doesn't matter where. But why stop with that? Why can't we have medicines themselves know their status and broadcast that status? Why can't the medicine actually tell the patient and the healthcare system as it's sitting in the bottle? Is it still active or has it started to deteriorate and lose its potency? Not the standard expiration date that's printed on everything.  It has an expiration date. I've never figured that out. I don't care if an artificial date has passed. I'd love the medicine to tell me if it's still potent or not. I'd like to know, is the medicine still on the bottle or is it in the patient? Once it's in the patient, I want to know, has it been activated or inactivated? Has it been properly absorbed? Has it been excreted? And not only do I want to know that as the doctor, I want my patient to know that so we can all work together as a team to use medicines more intelligently and to help us understand what's going on medically. What about monitoring? Biometrics? A wealth of data. Most of you know that you can check your blood pressure at home. You can check your blood sugar. You can check your temperature, weight. You can use a Fitbit and a Y things and a smart scale. And you can get all this data back and we can bring that into the medical record system also. But why stop there? Many of you probably know that smart contact lenses are being developed that can monitor the sugar content of the fluid around the eye, the tears. But why not go beyond that? Why not think about other therapeutic devices, whether wearable or implantable, and make those monitoring and reporting devices also? Why not hearing aids, pacemakers, implantable distribulators, artificial joints, stents in arteries? They should be able to report back their own status. Are they functioning properly or malfunctioning? But they should also be able to monitor the fluid surrounding them, measure those biometrics, report it back to the patient. Here's how you're doing. It looks like you're getting sick. Report it back to us on the healthcare side again so we can all work together and improve health. That's just technology. It just needs to be built. And what about the genome? You've heard about the genome a couple of times already. The genome is a really big place. One cell has six billion nucleotides. This is big data. It's now fairly trivial to get that information. And again, you heard that yesterday about TGen. We can actually sequence a genome for the price of an MRI. The price of an MRI. Now, we need to manage that data. And actually, it's a fairly trivial concept to just access it, store it, manage it. That's not so bad. But we need to do better. We have to interpret it. We have to display it in a way that's usable both for the clinicians and the patients. And even that's not enough because everyone's unique. We need to know for this patient, what does that genetic change mean in the context of all the other things that we know about their health care? We need to integrate that data with their medical history and everything else we know about them, including their environment, to finally bring it together and deliver personalized or precision medicine. We need to think about the genomics, the medicines, the allergies, the biometric data, all the stuff I just told you about. All of the other test results. But that's just scratching the surface. We need to think about the physical exam findings. We need to think about everything we know about the environmental exposures, the known past diagnoses, the family history and other medical history, all the medical literature. And this is a problem too. Because most of what we have documented in the medical record is unstructured or at best semi-structured data. So this isn't just okay building into the algorithm. We need huge technological advances on text analytics and natural language processing and massaging all this unstructured stuff into discreet machine-readable language that then allows us to pivot the whole thing and deliver enhanced research and generation of new knowledge by pulling all this together and asking the statistical question what matters and what doesn't. And then returning that back to the healthcare environment to provide clinical decision support exactly when it's needed. And have the system notify both the patient and the healthcare provider. It looks like you're getting sick. You might want to take this medicine. You might want to get an appointment. The computer, we heard some about what Watson can do. Watson can do great things. But why not enhance that and really personalize and use that clinical decision support just in time to really change all of medicine. Change the game. Improve assessment of any one person's risk of developing disease. Develop personalized screening and surveillance approaches tailored to that person's individual risks. When symptoms develop use all that information to prioritize the possible explanations the differential diagnosis. And then go beyond that to developing a personalized therapeutic plan that we have much greater confidence will succeed and achieve the desired goal with minimal side effects. That's my vision of the future. I want to thank Dell for inviting me out here to share it with you. I want to thank you for your attention. But most of all I want to thank you in advance for the work that I'm hoping many of you will do to try to bring that vision to reality. Thank you very much. Thank you Howard. That was absolutely fantastic. And let me introduce you to Dwight Rahm. He's the chief technology officer at Johns Hopkins and we're going to have a brief conversation on this amazing vision that you just laid out around how IT and technology and patient data can really come together to deliver amazing things for patients at Johns Hopkins and everywhere. Yeah. Yeah. Yeah. So Dwight let me start with you. How has this vision and what Johns Hopkins has been working so hard on doing? How has it changed how you and Howard and the medical staff partner together? Sure. So you have to understand that to roll out a large application like our EHR requires literally hundreds of people and the communication and collaboration that's necessary to do that is pretty immense. And it really requires a true team effort between IT and our clinical staff on a very much ongoing basis to achieve all these wonderful things that we've done so far. And that means I may interrupt by ongoing at six o'clock this morning. I was on a phone call and I've got another one two o'clock this afternoon and typically around one o'clock every morning. I'm emailing back and forth with my IT counterparts. That's part of building new things. Yes. Great partnership ongoing. I'm going on go all the time. So yeah. And has anything kind of changed in that relationship when you think about what IT needs to be doing and how you continue to evolve the role of IT. Yeah absolutely. I think bimodal is a very popular buzzword right now. And I think it describes the situation almost precisely for us. Howard used the analogy of baseball. I'm going to run with that for a second. What we're doing in health care right now and Hopkins is really just trying to get to 500. The EHR is a new system but it's not really novel or unique. Many other industries have already done these kinds of things very successfully. And I would I would argue that getting a successful implementation of an EHR is just getting to 500. That's important. Right. That makes us competitive with everybody else. But we've got to work to to fine tune that system. Fine tune our process is make sure it's as efficient as possible. But to really become a contender to really change medicine and the vision and delivery of health care. We've got to move beyond just 500. We have to innovate. Now health care is very much an industry that's been driven by vendors. We're so highly regulated that our our our space is dictated by a few major vendors out there. But it's important for us to not allow them to be the only ones that define innovation for us. We really have to I think take the initiative and provide an environment and an ecosystem that allows not only ourselves to innovate but also new startups to actually create new ideas that actually transform the way we deliver medicine. Wow. Wow. So there's a real cultural element of what you all are doing at Johns Hopkins to really kind of embrace and incorporate that entrepreneurial spirit is what we call it Adele in in everything that you do. Again it was it was very clear from the beginning and it still is we have a clinical project with I.T. support. And that's critical because you're not going to get the buy in. And it's this whole concept of change culture and getting people ready for change. And if we've got a clinician who's just stuck in the mud and says the way I do it works. I don't see why I have to change just because meaning for use came along and I'm supposed to submit some data. That's nonsense. It doesn't make my patient healthier show me the data. Right. We need everyone on board. We need everyone to feel included and like they're part of the team. And really coming back to the question of how does the economy change and how do jobs change. We all need to be a little malleable in what we do and what we specialize in. So a lot of our I.T. folks on the project are nurses and physicians and and social workers and health care providers who are really strong in I.T. and they were on the I.T. side of it. Sides is the wrong word. But there's also folks like myself. I see patients every day. But I've also gone to class and learn how to do some of the build myself. So I've got a short leash but they let me raise the hood and change the oil. I'm not allowed to rebuild the engine but I'm allowed to go in and tinker a little bit. So I understand some of the complexities of the I.T. build and the I.T. folks understand why it's not so simple to just tell a clinician to go do it and it happens. We need to work together. It's truly a partnership. I mean we in I.T. I think our role is to not only articulate the art of the possible but then also to just not accept the status quo. We have to continuously improve our delivery and our execution of the EHR but then also look for new ways to really just change the entire dynamic. One thing I also mentioned Hopkins is not unique in this respect but we've just launched a new innovation center. It's a technology innovation center and the idea is that we'll partner not only within Hopkins with researchers and with people have great ideas and find ways to innovate and create new technologies but we'll also partner with industry. I think one of the real challenges of I.T. in health care is that it is such a regulated space that it's very hard for startups to get any kind of penetration into the market. So this innovation center and many others like it are intended to provide a nice warm and cozy place if you will for innovation to occur and for partnerships to occur. That's fantastic. It's fantastic. Clearly the examples that you've given the audience are a real testament to why Johns Hopkins has been such a successful institution for 125 years. So Howard Dwight thank you very much. Thank you. That was a great look at abundance in health care in an established market. Now we're going to shift gears a little bit and our next speaker is going to be sharing some incredible experience working to grow abundance in emerging markets. Jessica Jackley is an entrepreneur and an investor focused on financial inclusion and the sharing economy. Many of you probably know Jessica as the co-founder of Kiva the world's first crowd funded micro lending website. Please give me a warm welcome and help me welcome Jessica to the stage. I'm going to be the camp counselor and ask you to say it again. Good morning. Thank you. It's great to be here. I'm really I was so honored to be invited to join you all today. I've admired Michael Dahl for a long time what he's built what he stands for what this amazing company does and some of the things that I've heard over the years have really inspired me. One thing in particular that is really resonated deeply with me is this. He said that technology is really about enabling human potential. Until my early 20s I was not somebody who would have said that I was interested much in technology if I'm quite honest but I became a believer over time as my entrepreneurial journey unfolded and as I saw the power of technology to do just this to tap into human potential especially for some of the most overlooked entrepreneurs in the world. Ten years ago I started Kiva first person to person online micro lending platform because I wanted to tell my friends and family is a simple reason I wanted to tell my friends and family a new story about poverty and about potential. Now new story what was the old story well for me it was a story that I heard again and again growing up from well intentioned nonprofits that focused on a thread of the story for so many people on the planet that was based on sadness and suffering desperation and hopelessness. For me as I heard these stories I mean I think I had a natural human reaction I felt sad I felt terrified overwhelmed disappointed maybe even a little bit angry kind of hopeless and even in places where I thought I might hear a slightly more encouraging message I still took in for better or worse I took in the parts that made me feel panicked and bad about the situation of poverty in the world. Even in Sunday school as a kid I remember my Sunday school teacher talking about how Jesus said the poor would always be with us. And I found a long line of people who needed me to share my stuff with them who were never going away and it scared the pants off me. I imagine that they would never go away and that the problem of poverty would never go away with this long line of folks always over my shoulder. So my response to the story of course was that emotional one that I talked about and I was feeling as I felt heartbroken and sad and guilty if not shameful about that. Those feelings actually were exactly what I was supposed to be feeling according to the carefully crafted marketing campaigns of so many again well-intentioned non-profits that wanted me to feel enough. They wanted me to push me enough, all of us I think, enough so that we wouldn't change the channel but instead would just want a way out and of course at the last minute of the commercial or the message there would be the perfect solution so don't worry, let us solve the problem for you, not necessarily with you but for you. And so I did but at its worst this was really just a transaction that my deep desire to serve the poor, to be connected with other human beings on the planet, to be useful in their lives had become a bit of a transaction. I was throwing my change in the jar so to speak sometimes quite literally so I could go on with my day, go on with my life and not have to hear those sad stories anymore at least for a minute and it worked temporarily, I felt a little bit better every time I did that but there was a consequence to that reaction. I mean in the short term yes, a lot of great organizations got my time and my money and that was good. I know that many of them have done good work and some people were helped because of those small efforts growing up but the relationship that I had as I look back over the first two decades of my life the relationship that I ended up having with the poor didn't exist anymore because again I think many of us do, as a defense mechanism I sort of created a barrier I rolled up the window, you can always see it but there was a distance and a barrier between me and other human beings on the planet, it's kind of a sad thing but thankfully as a recent college graduate I started to hear I glimpse a little bit of a news story and it was thanks to this gentleman I was working at the Stanford Graduate School of Business as an administrative assistant and I was around a lot of amazing individuals who were doing my dream jobs that I wanted to go do some day I had no idea how to get there I didn't know how to go from where I was to what they were doing but I was doing my best to learn and to absorb everything that I could and kind of get a free MBA on the side as a staff person, didn't work I ended up going back and paying for it and it was good. But one day after work I heard this gentleman Dr. Muhammad Yunus speak and he talked of course about the time it was the fall of 2003 three years before he and his Grumming Bank would win the Nobel Peace Prize for their pioneering work so I'd never heard of him before I just went and crashed this lecture and he talked about microfinance financial services and products for the poor talked about microcredit in particular one such product, small small loan for the entrepreneurial poor often to starter to grow their businesses and maybe most importantly he told a story in an incredibly accessible way and he talked about connecting with the poor in a way that wasn't scary or intimidating to me and I had no desire to create a barrier with the people that he was describing he talked about individuals who yes had financial needs but they were smart strong hard-working individuals who actually just needed access to a resource that I had had access to my whole life, they needed a small loan and they in fact didn't want endless handouts they didn't want to stand in line forever behind me and follow me around all they wanted was access to this resource out of poverty I was so intrigued that I quit that job and I moved to East Africa to spend time with these people that I've wondered about for my whole life and I spent a few months in Kenyon, Uganda and Tanzania interviewing them hearing their stories and in fact validating that Dr. Yunus hadn't been lying he had been telling the truth there was another side to the stories their stories that I hadn't heard before I met people that you know God forbid were smiling and happy with their lives yes had needs but were worried about what was next for them I met people who had already had great success maybe had started with a needle and thread under the shade of a tree and now had an office in capital equipment I met people who just I would encounter them in a scene of abundance versus a well crafted photograph of somebody with scarcity all around for a marketing brochure and that changed how I felt I met people who offered me things I was shocking they didn't have empty hands waiting for me to give to them they were offering me things incredible generosity even in the midst of great need so these stories changed how I felt they changed what I believed they changed what I thought was possible for other people on the planet and they led to the creation of Kiva we put these stories as the entrepreneurs themselves told us myself and my co-founder Matt onto a website spammed our friends and family said hey this person doesn't even need a donation they need a loan do you want to chip in and overnight about $3,000 came in for our pilot round of loans as those entrepreneurs paid back we took the word beta off of the site I always like to talk about our very illustrious beginnings that was our big launch take a word off of the website and then you're real right that next year somehow we facilitated $500,000 in loans the following year it was about $15 million the next year $40 million and on and on today Kiva's facilitated around $630 million in loans across the planet with very yay lenders thank you so much it's been so fun to watch and these are just some shots of Kiva today now and it's not just on the other side of the planet it's all over the world we're in the US to small businesses create two-thirds of jobs in this country and yet 7 out of 10 are turned down for bank loans every day that's 8,000 that are turned down for loans to grow so Kiva and Kiva zipper are participating in filling that gap as well so that's Kiva what I want to talk about what I realize now is that while Kiva was the specific passion project over the last few years I've been able to step back and get some perspective and realize that we were early in the trend toward a sharing economy and when I talk about sharing economy just think the easy way to think about it is a world moving more towards access and away from an obsession with ownership there is enough to go around it's just a matter of unlocking the assets that exist out there and the resources that exist and of course technology is what enables us to do this now if you think about what this means for you what does the sharing economy mean in my life well you might start to ask yourself questions more and more like why would I go through the hassle of buying a car when I can just rent from my neighbor or hit your head with a lift driver or Uber my way somewhere you might ask why would I buy an expensive outfit if I can just rent it from an organization from somebody else on the other side of the country and give it back one amount of town why not rent out my home or my apartment and make things like that so all the assets all the resources that we have that are so often left unused I think are going to be we believe in the sharing economy are going to be utilized more and more and I believe that will be good for the world excuse me so for the last few years one of the things I've been doing is working with a fund called the collaborative fund that really is focused on investing in these entrepreneurs that are championing the sharing economy that believe that this story is going to be the world again towards access, wave, ownership and of course they're utilizing technology and really fun incredible ways to make this sharing happen quickly, efficiently and inexpensively so what's the point of all this and by the way I'm one slide off so can you stick on this slide after I say what I'm going to say so don't ignore my next forward button I'm talking to God I guess so what's the point of all this of all these exciting new platforms that allow us to exchange resources that are in different ways bartering, renting, swapping even giving things away for free I think the point is about what I opened with it's about unlocking human potential it's about allowing people to have access to resources they might need to realize their own potential to pursue opportunities so why isn't it happening more quickly I think it's because we get focused on the wrong stories of course technology allows us to have access to so much information I'm preaching to the choir here and that's a good thing and information is good at that level of big statistics and I look at something like this versus a specific story of a specific person I don't feel much I feel a little bit numb I experience what has been called compassion collapse when you just get inundated by big, scary sometimes very heartbreaking statistics about the world it's hard to think about what change really looks like but I think and then sometimes when we thank you we're all caught up sometimes when we do hear stories of individuals the truest version of the story so I think the work for all of us is to really believe deeply and thoughtfully without hesitation in the potential of other people, everyone every single person and that every other person out there in the world is worth investing in and sharing with and from so I think we need to practice seeing possibility and seeing potential in every person around us so as we think about what we the lucky ones that get to build and design and create and invest in these great new technologies and designing for whom why is it based on trust and a real belief in the potential of every every single person out there I think for me when I do lose sight of that or when I hesitate at all the cure is to zoom back in to zoom back in and savor the details of one individual story there's one that I love to tell of a brick maker that I met in Uganda his name is Patrick and he literally started he fled the northern area of the country after rebels attacked his village and he started with nothing in a new village in the Kenyuganda border and he described it was years earlier after I met him but he describes how he sat on the ground wondering how he would feed himself and his younger brother that day and like he did every day and he digs into the earth with his bare hands realizes he's found some clay deposits digs that up gets a stick gets other implements starts to mix that with water makes a very rough shape and brick and does that again and again starts a brick making business by the time I had met him you can imagine how the strain folds saves enough money from those rough sun-dried bricks to buy a brick mold makes two at a time then makes four at a time they're more evenly and smoothly and consistently shaped in size he can sell them for more learns how to make a self-contained kiln and on and on and on when I met him he had several employees and that's not an entrepreneur, I don't know what it is that's what I do when I start to doubt or start to wonder about whether or not things can really get better in the world whether or not human potential really exists I think of people like Patrick and to close I believe stories shape us they shape how we feel, what we believe and how we choose to live our lives and they're how we teach each other these are my two kids of course we have one more coming when we're coming quite soon but my husband and I tell them stories every night and we were reading through is the longest book ever for them yet we read through Charlie and the chocolate factory a few weeks ago and it just turned through but they have so many questions and they ask mom why is Charlie Bucket poor? I'm not kidding and I thought oh my gosh I'm not ready for this question but I explained that unfortunately not everybody gets to have the same things in life, not everybody gets to have the same opportunities mama what's opportunity I told them it's like a turn they're really good at taking turns when you get an opportunity it's like you're getting a turn to play or to learn or to try to be your best mama why doesn't everybody get a turn well I guess I told them some people aren't really good at sharing sometimes and that's probably the biggest reason why not everyone has enough turns and they said well that's not very nice and I would agree I think we have what we need to share I want to encourage us to build things that help us be nicer to each other and we can use the incredibly powerful tools that we have today to give each other more turns we'll all be better for it thank you thank you Jessica that was awesome so hopefully you're going to return here on stage at Delworld next year and there'll be three little ones I'll be differently shaped up there thank you you just talked about the power of technology to bring so many people out of poverty through something as simple as kind of the mobile phone what advice would you give folks in this audience some of the most technologically savvy as leaders in the world and what they can do to accelerate social entrepreneurship it's a wonderful question I think entrepreneurship of course isn't just about going off and starting an organization from scratch I think we can live and work no matter what our work is you'll have particularly amazing opportunities to do that, you and your teams so I think to promote entrepreneurship to encourage people to take risks to brainstorm new ideas to try things particularly where it's maybe not clear if there's a traditional market that exists already but it could be of real value to the world I think that's really important to do what you see out there find a few to just make your people encourage them, mentor them give them specific positive feedback and support as they go along their journey and celebrate the ups and downs with them I know that for me and for every other entrepreneur that I know every other social entrepreneur that I know it's a little crazy making and so to have people that really support you as an individual human being along the way I think is one of the most important things you can do I was just talking to our next speaker so what's next for you so I besides this this is a kind of important thing thank you for asking that too I've been working with the collaborative fund I have a book coming out in June lots of fun small things going on but I started a consultancy in a design firm with a friend called her up last year when she was having twin boys and I said you're going to be okay but I'm here if you need me and we reconnected over a topic that is near and dear to both of us we've been watching our business school friends and so many others especially women right as parenthood hits and other life changes, other transitions not be able to stay with the work that they're very good at doing and that they want to do simply because company policies don't allow there aren't technology solutions there aren't the logistics in place to allow them to job share or something else so we started this firm to work with companies to encourage new ways of thinking to design new programs and innovations around supporting those working parents and our work with the company and the business community and the community and everybody that wants to have things outside of life that require a little bit more flexibility so we've been having a lot of fun with that and a lot of success with that good for you, thank you so much good luck in the next couple of weeks and it's fantastic to have you here thank you so much, it's such a pleasure thank you Jessica so now we'll move from micro financing entrepreneurship to dramatically improving local health care our next guest is Shivani Garpatal she is the co-founder of Sama Hope an organization with the mission of connecting doctors to patients who are in desperate need of care through the power of technology and people please help me welcome Shivani to the stage pleasure to be here today, thank you Karen I'd like to introduce you to Dr. Shankar Rai I met Dr. Rai a year ago in Kathmandu, Nepal there I learned that Dr. Rai grew up from pretty humble beginnings in Nepal he worked his way through a lot of dedication, hard work determination to become a physician then a surgeon and now a world renowned reconstructive plastic surgeon and a humanitarian see Dr. Rai has dedicated his professional life in the poorest of the poor in his country he exclusively treats children with congenital deformities like cleft palates and cleft lips and women and children suffering from severe burns these are the conditions that play the poorest of his country preventing these patients from economic progress forcing them to suffer needlessly from conditions that are in fact treatable Dr. Rai treats patients like Vishal Vishal sits here in his mother Basanti's lap he's two years old now Vishal comes from the western hills of Nepal and as you can imagine it gets really cold there especially in those cold winter months one of those cold nights Vishal accidentally crawled into the fire that the family uses for heat and for cooking tragically he suffered from multiple burns and wounds on his face his arms and his hands now Basanti is a sole caretaker and income earner for Vishal she works at a brick factory in the hopes of one day earning a living wage she traveled for six hours to seek emergency care for Vishal unfortunately she was not successful no one in her village the local health posts or the district hospital were able to treat Vishal's wounds now Basanti knew that without treatment Vishal faced a life of disfigurement disability probably wouldn't be able to go to school and given the fact that his vision and his breathing were becoming compromised it was very likely that Vishal was going to have a shortened life span this was not the future that Basanti had envisioned for her son she was determined to get care for him and in time she found out about Dr. Rai she did everything in her power to get Vishal to Dr. Rai and Katmandu she actually also sold half of her family's farm for transportation to Katmandu once she got to Dr. Rai Dr. Rai was miraculously able to help treat Vishal Vishal is now on his way to recovery and very soon he will be going to school now Vishal is one of the lucky ones Dr. Rai tells me he sees patients like him every day in fact he could treat a hundred more patients like Vishal each year if he just had the funds to do so that's where Sama Hope comes in Sama Hope is a crowdfunding platform where anyone anywhere can fund the work of doctors like Dr. Rai doctors who are treating patients living in the poorest communities around the world these doctors to me they're entrepreneurs they see the reality of global healthcare delivery in their country of healthcare delivery in their country and they refuse to accept it they see opportunity where scarcity is where others see scarcity where they're inspiring and unsung heroes take Dr. Jovic for example Dr. Jovic is the only reconstructive plastic surgeon for all of Zambia a country of over 15 million people Dr. Jovic actually taught himself to become a pilot so that he could fly a small prop plane out to the outskirts of Zambia in the rural areas to treat more patients in need to me that's pretty entrepreneurial and now he's focused on training the next generation of reconstructive surgeons so that access can increase in the country and they don't have to rely on one person at some hope we focus on funding doctors like Dr. Rai and Dr. Jovic so that donors can connect directly to them let me share a story with you this is Tiange Tiange is 17 years old and she comes from a rural village in Sierra Leone now before the Ebola epidemic Tiange still had a really difficult life at the age of 12 she was raped by her English teacher and became pregnant now like many African women living in rural Africa she delivered at home without any skilled birth attendant by her side Tiange was in labor for 5 days 5 days without any painkillers without any sterilization as a result she lost her child and she suffered from her birth injury that left her incontinent this birth injury prevented Tiange from being able to go back to school she suffered silently for 4 years after 4 years a van pulled up to her village it was full of community health workers who came to share a story about Dr. Maggie a doctor a few hundred miles away who actually could treat the same birth injury that Tiange had they were able to bring them in dry give them back their hope enable them to realize their potential Tiange's uncle heard about this and found ways to get Tiange to Dr. Maggie with the help of 20 donors on Sama Hope Dr. Maggie was able to get the resources he needed to treat Tiange Tiange is now back in school thanks to donors like Peter a retired zoology professor from Norway a college student from Wisconsin studying political science with the power of the internet Sama Hope was able to connect Amy and Peter and Dr. Maggie to change Tiange's life this is the power of the crowd this is the power that each one of us has now Peter and Amy they receive reports from Dr. Maggie every month they hear about patients he was able to treat the impact that their donors has had on his work the relationships the challenges he faces and the success stories that's the communication and the relationship that will now build over time now we're just getting started at Sama Hope and we've been able to fund treatments for nearly 1000 patients with the support of 8000 donors providing access to care to patients who otherwise would not be able to afford it these patients are able to go back to work go back to school with the economic implications on their families and their communities at Sama Hope we aim to reach 1 million patients via our platform we look to fund additional neglected needs in global health such as funding the training of medical talent locally so that we can further increase capacity and access to care or medical infrastructure that is designed specifically for these low resource settings by democratizing giving Sama Hope empowers each one of us to end the needless suffering for millions of women and children and I hope that today each of you will consider and realize the power that each of you have to change a life thank you Shavani that was incredible I was sitting backstage with the other speakers just so inspired by all of your stories and all of the great work that you have done thank you you and Jessica just spoke about the power of crowdfunding and the role that technology is playing to democratize all of what it is that you all are doing we heard from Johns Hopkins and the great work their hospital is doing and their passion around advancing technology to improve the outcomes for patients how do we take all of this great work and these amazing visions and make it a reality well I have one idea and I think we can do it right here in this room so if everyone does everyone here have a mobile phone can everybody here put your mobile phone up in there I see a lot of phones that's pretty incredible right we all here have mobile phones if everyone goes to samahope.org slash doctors right now and picks a doctor that they would like to fund if each person here gave $5 we could change the lives of hundreds of women and children today right now in this room that's pretty incredible I actually love how you've made it real right putting a name with a face giving them a sense of hope and everything just kind of one final question your inspiration to so many and a successful entrepreneur what advice would you give to other entrepreneurs sure that's a great question I think that there are many highs and lows that you face through an entrepreneurial journey and when you have life's changes matched with that it becomes even more difficult or more challenging and more exciting more of an adventure so I just recently gave birth to my first child I'm a proud mother of a six month old daughter that's a whole other level of highs and lows and I think that the one thing that has stood out to me and one piece of advice that I would give to other entrepreneurs is that during those moments you need to surround yourself with your biggest champions your biggest supporters be it your mentors your family, your friends, your advisors because those are the people who will pick you up and encourage you in those times and reinforce why you did this to begin with yeah very good very good thank you Shavani thank you very much so we just heard three incredible examples of the power that technology has to foster hope progress and global achievements and many many markets to close I'm honored to welcome up our final speaker for the day from established markets to emerging markets technology is clearly enabling this next era of abundance to tell us more about humanity's greatest challenge abundance for all and the role that technology will play please help me welcome the Amandus to the stage thank you Karen so I have had the pleasure to run a couple of extraordinary organizations the X Prize Foundation and Singularity University and during the course of this it's become clear to me what I've been seeing is that we're heading towards an extraordinary world a world in which we're going to be able to meet the needs of every man woman and child on this planet and I remember hearing this young couple talking about whether it's moral to bring a child into this world and I said what world are you looking at the world I'm looking at is extraordinary and so I took the time and it really flowed out of me with a passion to write this book called abundance the future is better than you think and the book really talks about when I share with you is this extraordinary future that we're heading towards that we're hurtling towards and I had the pleasure just last month to be the closing speaker at the Clinton Global Initiative and there's nothing better than having the president of the United States thump your book for you and as I and he did this and he interviewed me at the end of CGI he said Peter why are you so positive about the future and I said you know two reasons one I look at the data and the second is I try and not watch the news and so let me start with that second one first and it's something very serious every day and age where the news media is a drug pusher and negative news is their drug and in every device that you have your smart phone your tablet your computer your newspaper your radio or TV you're being fed negative news over and over and over again 24 7 every murder on the planet delivered to you directly in high definition in your living room and if you ask yourself the question is there a reason for this is that really the worry the world really is and I would posit it's not but the fact the matter is as we were evolving on the savannas of Africa as humans back then if you missed a piece of bad news your genes were out of the gene pool and for that reason we evolved an ancient piece of our temporal lobe called the amygdala and the amygdala scans everything you see and everything you hear for negative news and when it sees negative news it puts you on high alert you pay 10 times more attention to negative news and you do positive news and it's for that reason that the news media feeds it to you to deliver your eyeballs to their advertisers and so the question again is is that the way the world truly is and I would posit it's not I would posit that today if you look at the last 100 years and look at the data it's been an extraordinary century the per capita income for every nation on this planet is more than tripled the human lifespan is more than doubled the cost of food is dropped 13 fold the cost of energy is dropped 20 fold cost transportation 100 fold and of course communications thousands of fold this was the cover of the economist from last year we're heading towards the end of poverty we've taken billions of people out of poverty with the tremendous work they've just seen on the stage and more coming every single day my friend Steven Pinkard at Harvard just wrote this book called the better angels of our nature which he shows us we are living during the most peaceful time ever in human history right but you wouldn't know that watching the crisis news network or the constantly negative news network we're going to call CNN these days when you look at the data it's extraordinary even the people below the poverty line here in the United States the poorest 99% have electricity flushing toilets running water roof over their heads 85% have a television 88% have a telephone and nearly three quarters have a car and air conditioning the robber barons the wealthiest on this planet didn't have that 150 years ago we are raising the poverty line and so I studied this the question is why is this happening and it's not we got better politicians we haven't gotten smarter it's been the impact of technology the technology that you use that you help create on transforming this planet and so I studied this at a university I had a chance to co-found with Ray Kurzweil called Singular University in Silicon Valley where we study exponential technologies for our graduate programs our executive programs and it's these technologies that are tremendous levers to change the world in fact at this university we challenge our graduate students who are starting about 15 to 20 companies every year to start a company that can positively impact the lives of a billion people within a decade because that's the world we're living in today where you can start a company a product or service that can touch the lives of a billion people and he's never liked that before and so as I look forward to this all of this is being driven by this curve this curve is out of Ray Kurzweil's book Singularity is Near and it shows the five paradigms of computational power it's the amount of computational power that a thousand dollars could buy you over the course of the last 110 years and on this curve what you see in this smooth curve that we're using faster computers to design to build faster computers to build and design faster computers and it's likely to continue for some time and what's driving this is what I want to show you here so this is the first integrated circuit from Intel you know circa 1958 it's two transistors connected together and therefore an integrated circuit when Intel put their first 4000 and four processor out in 1971 here we see it with 2300 transistors you know about a buck of transistor the 2012 NVIDIA GPU the Graphical Processing Unit had 7.8 billion transistors it is literally a hundred billion fold improvement and it's this huge capability that's underlying if you would a whole slew of different technologies infinite computing AI, robotics, synthetic biology are all riding on top of Moore's Law if you would it's the substrate the foundation upon which the tools that we have to change the world are growing exponentially and again as I said it's these tools that are ultimately giving us the power to solve the world's biggest problems and just to give you a couple of examples to bring this home I love this Steven Cessan the guy who came up with the first digital camera at Kodak in 1976 was .01 megapixels right you can imagine walking in the board room of Kodak and saying here it is the future of Kodak and of course they ignored this and filed chapter 11 in 2012 and this is where the digital camera is today it's a billion times better but this is where it is today doesn't stop here the march of technology continues and what's it going to be 10 years from now it's a thousand times better or 20 years what's a million times better or 30 years what's a billion times better maybe it will be sort of high definition insect eyes woven into the fabric of your clothing or in micro drones in the air or on the walls whatever it is it's the march of technology continuing this is the first inertial measurement unit that got us to orbit got us to the moon you're able to tell velocity and acceleration of course where it is today is you know you're a buck on your phone and where it's going is molecular machinery again woven into everything that's manufactured and we forget and take for granted this extraordinary rate of technological progress that makes this kind of power available to a teenager in Mumbai for nothing where it was really the consummate total of the entire Apollo program to get something like this and of course this is the first GPS 120,000 bucks 53 pounds imagine this thing on a dashboard of your SUV right and here it is today a few bucks on your phone so when I think about this I realize that technology is a resource liberating force technology is what takes what used to be scarce and makes it abundant so in my book I open with a story of aluminum the guy on the left is Napoleon the third the year is 1840 and he's invited the dude on the right over for dinner the king of Siam and he's the royal guest and to try and impress the king of Siam Napoleon at the palace of Versailles feeds all of the troops with silver utensils Napoleon himself eats with gold utensils but the royal guest the king of Siam he's fed with aluminum utensils because in that year aluminum was the most precious metal on the planet even though the earth's crust is 8.3 percent aluminum by weight all of the aluminum is bound with oxygen and silica to form bauxite you can't go dig it up out of the ground there's no pure aluminum there you can pull out in the chunks and it was so energetically difficult to extract the aluminum from the bauxite it was worth more than gold and platinum which is why in that same decade the tip of the Washington Monument in DC is capped with aluminum and then we invented this technology called electrolysis that made it so easy to extract the aluminum from the bauxite we now use it with throw-away mentality you know aluminum cans aluminum foil and think nothing of it so the question is where else is there something that we think of as scarce that truly can be abundant with the available technology I love this story friends of mine in Silicon Valley right now are working on creating artificial perfect diamonds at well not 5 bucks a carat but 20 bucks a carat imagine when you know for the women here when your fiance comes in with a 10 carat ring and you go come on that's 200 bucks so what else do we think of as scarce that is contextually wrong because I would posit that there is nothing that is scarce it's a matter of how you think about it and almost anything can be turned into abundance so I'll give you one fun example one of my companies that I'm very proud to be the co-founder and co-chairman of is a company called Planetary Resources the question is are strategic metals or platinum group metals scarce well it turns out that in our solar system there are some 60 million asteroids and of those about one and a half million are the size of a kilometer larger and of those a thousand or so come very close to the earth and it really sucks when they hit us but a lot of them don't and when you look at it there is a number of Manhattan islands very low hanging fruit that come close to the earth about 11 of these and these 11 asteroids are extraordinarily valuable in fuels and in platinum group metals so here's just one example of one of those asteroids it's got a great name 2011 UW 158 it sort of rolls off the tongue and onto the floor it's a half a kilometer by kilometer in size it comes by the earth every 1.9 years and its value is $5.4 trillion so my goal is to go out there and capture this thing of course I'll buy I'll buy puts on the platinum market before we do that but I'm serious we are building the spacecraft right now in fact here's the ARCID 300 Chris Lewicki our president chief engineer with Larry Page one of our first investors and we're building these kinds of spacecraft to go out there and prospect these resources because really it's contextual maybe it scares here but the earth is a crumb filled with resources what about energy is energy scarce the answer is of course not we are living on a planet that is bathed in 5,000 times more energy from the sun than we consume as a species in a year and if you've got abundant energy you have abundant water and here are the numbers right it's the plummeting cost of solar globally around the world at the same time that production rates are exploding Ray Kurzweil and Elon Musk tell us that we're probably within the next 20 years able to meet 50 to 100% of our energy needs in the US from solar and if we have abundant energy with abundant water we live on a water planet 2 thirds of our planet is covered with water yes 97.5% is salt and 2% is ice and we fight over half a percent but there's extraordinary technologies coming down the bike with nanomaterials like graphene or my friend Dean came and slingshot this is a device about the size of a dorm room refrigerator that operates on 100 watts less than a hair dryer and generates a thousand liters per day of clean drinking water as two hoses you stick one hose into anything wet the latrine arsenic infected water the pacific ocean and out the other hose comes water so clear so pure it meets the medical standards for injectable water and right now Dr. Candidate Coca-Cola the chairman of Coca-Cola has put these devices into test in countries around the world and the goal is put one of these devices in every village this Masai warrior on a cell phone has got better mobile calm than the president of the United States did 25 years ago and on google on a smart phone has access to more knowledge and information than president Clinton had 20 years ago and by the way on that smart phone as well as the information that Masai warrior also has two-way video conferencing HD video HD stills you know literally stuff we would have spent thousands of dollars for hundreds of thousands of dollars for 20 years ago they are living in a world of information and communications abundance what I'm most excited about this next decade is the disruption and transformation of information and health so as an example I run the X Prize foundation I'm very proud of that and it was two and a half years ago that I had lunch with Paul Jacobs the chairman of Qualcomm and over lunch we're talking about wouldn't it be great if the Star Trek tricorder existed remember that thing that Dr. McCoy Bones would say Jim he's an alien you know be able to diagnose you instantly and so we shook hands on it and then developed what is now the 10 million dollar Qualcomm tricorder X Prize and this is an X Prize that asks teams to build a handheld mobile device not for doctor or nurses but for you for all of us for the consumer for the mom or dad at two o'clock in the morning when your kid is sick this is a device you can talk to it's got AI on the cloud you can cough on it it can do the RNA or DNA analysis of the bacteria in your saliva blood chemistry and in success this can diagnose you better than a team of board certified doctors now we announced this X Prize at CES two and a half years ago and had 330 teams enter in the first year we're down to the top 10 and we'll have a winner by this time next year at the Clinton Global Initiative at the Social Good Summit at the UN General Assembly last month I had the honor and pleasure to announce our latest X Prize called the $15 million Global Learning X Prize and today we're living in a world of nearly a billion illiterate people people who cannot read or write or do basic math two thirds of them are women 250 million of them are kids and the challenge is that we can't build enough schools or teach enough teachers to scale to that level so this X Prize is asking teams to build a piece of software that can operate any Android device a phablet, a tablet, a phone that can take a child where there is nothing no literate adult, no schools, nothing from a literacy to basic reading, writing and numeracy in 18 months and unlike our other X Prize is in this X Prize the winning software is going to be open sourced our goal is to put it on every device that's manufactured so every device out there becomes a teacher thank you we'll wrap on these last few slides which I think is one of the most important for all of us so this is the world's population we just crossed a 7 billion mark if you're worried about population don't be, there's two things that go help a nation go from positive growth to negative growth rates and Bill Gates has an amazing TED talk on this which I commend to you and that is making the world healthier and better educated, you do that and population growth rates plummet but that's not the point of the slide the point of the slide is this in 2010 we had just shy of 1.8 billion people connected online by 2020 that number will go to at least 5 billion, if my friends at google and facebook have their way it'll be 7 billion so the question is when 3 billion new minds enter the global economy what are they going to want what are they going to buy what are they going to invent for me this represents the greatest era of innovation ever because these 3 billion new minds are coming online at a time where they have access to the world's information cloud printing, AI robotic synthetic biology extraordinary capabilities they also represent tens of trillions of dollars flowing to the global economy so they're your customers they're your customers customers so if you'd like to copy the slide deck you're welcome to it if you just text your first name and email to this number my server will download it to you but let me close on this notion we're living during an extraordinary time perhaps the most extraordinary time ever to be alive today the world's biggest problems are the world's biggest business opportunities that help a billion people and the ability to do that is like never before thousands of years ago if you wanted to touch the lives of a nation or a region you had to be the king or the queen 100 years ago you had to be a robber baron an industrialist today all of us any of us passionate about solving a problem can it's an extraordinary time to be alive truly the world of abundance is ahead of us an honor to pleasure thank you very much thank you Peter that was fantastic and you know if you haven't read Peter's book I would strongly recommend it I have read his book and it inspired me and as I've thought about our business and our future you know the kind of ideas that he talks about are tremendous you heard terrific insights tremendous reasons for optimism the future is incredibly bright and you are customers and partners and our team members at Dell are why so thank you for letting us be a part of your stories and your success we want to thank you for spending your valuable time with us here at Dell world and with that we look forward to seeing you next year thank you good morning and welcome to Dell world everything's changing every day coming to events like this really keeps us on top of the ball and what's happening in the marketplace Dell in general has brought together a lot of partners and a lot of customers I found it very resourceful from information that I've learned while I've been here and the people I've met as well too in Dell world this year we're going to tell a story about practical innovation and scale we're just transforming our own corner of the world but collectively transforming the world itself so I think that there's a lot more around solutions Dell is coming to customers and providing something kind of end to end software to stack, to hardware, to services to really combine to meet customers needs Dell has traditionally been known mainly as a motor of boxes, hardware manufacturers but now it's much more with all these partners individually we're doing amazing things but together we are a movement actually it's a little bit more exciting this year I like the fact that they bumped up the entertainment a little bit I was just telling one of my contemporaries it's like coming to a mall for IT it's one stop shopping it is very useful because all the vendors that are here you can just talk to them one on one and if you have any questions it's a great opportunity to meet other entrepreneurs and other companies some of them very established very innovative people, very innovative minds and always thinking about how we can all work together I think Dell is more of a community than a company sometimes I wind up talking to people that I may not have expected to meet, you know, I'll walk the way thinking I was just going to come and hang out and walk away with, I understand something I'll just pass it to you whether it be a VP of sales at Dell or a sales rep or some of their partners for the most part these relationships have all turned into good friendships I would definitely say if anybody gets a chance to come they should get on down to Austin My experience at Dell World has been phenomenal Today we are the fastest growing large integrated IT company in the world and I want to thank you for your business Hi, I'm George Matthew, president CEO of Altrix and you're watching The Cube I'm Dimitri Zemin, I'm the CTO and co-founder of Stackstorm and you're watching The Cube


And another one. What's up people, Manit here. Coming to you with a video. This time we are going to be unboxing and reviewing an outdoor item that looks cool and will make you the center of attraction that item being. Magic NetLife portable USB speaker. This is the product DPC code. Let's get started with the unboxing experience. I like the color combination. A very MKBHD isk vibe. I have not seen him unbox this.  Let's get going with the unboxing experience. Very satisfying. Nicely packaged. Very aesthetically appealing. Going with the black and red theme. Again MKBHD inspired looks tight man. I like the style. That's the speaker. Really soft plastic. And this is the device. We have the power button. The volume up and down. A USB charge connector with a heavy duty cover on it. Let's see what else is included. We do have a micro USB cable for charging. Very neat. Very neat. I like it already. A carabiner. So if you are out and camping you can have this connected.  So you can put it on your backpack and go for a walk about. A contact card with the warranty information of the device. Along with the contact information for the company. A pretty light read M7 Bluetooth speaker operating guide. Without further delay let's boot up the device. Let's pair it up with my smartphone. And the blue button is on. I am going to turn my Bluetooth on the phone. And M7 comes right up. And we got an audio tone. And it's giving us the warning. That's okay. The dog listened it to it at a high volume. Interesting. The volume up and down rocker on the device controls the volume on your phone. So that is a pretty lifty thing. Let me find some copyright free music. Alright pretty loud but that's more than enough. I need to put something else. Alright. Pretty heavy sound. Pretty nice sound. It fills the room. I definitely like it. And it actually reverberates from all sides. I have reviewed other Bluetooth speakers before. This one has one bigger advantage. It has a carabiner. So it can be connected right to your backpack. So you can go camping. It is waterproof. So it's not going to get lit up or bothered by water or rain. So if you're going hiking, if you're going camping you can just carry it along and it will get the job done. And with a playing capacity of 10 hours you'll have endless music at your disposal. Definitely a big thumbs up for me. Definitely plan to use it. I do like the accent that this device is giving. Thank you again so much for watching. And I will see you guys on the next video. Take care people. Bye.


Okay, this is fiscal policy in Hawaii, part two in talking tax with Tom Yamachika. Hi, Tom. Hi, Jay. Tax Foundation of Hawaii, we think about fiscal policy here in the show, we think about tax. And today we want to talk about, you know, part two of our discussion from last week. And let me frame it a little bit, Tom. Okay, so we haven't paid, the state has not been able to pay the arrearage, the employees retirement fund, I don't know what it, 10, 12 billion dollars. People estimate that the cost of dealing with repatriating or otherwise taking care of the homeless is another 10, 15 billion dollars, and maybe that's undoable anyway, you know, we have more per capita than any other place. We also have more credit card charging. We have the highest credit card balances, you know, in the country. And we are interesting that we are a mono economy. It's all about tourism. There is nothing else. Efforts from the Burns administration on forward to Kaitano were to build a tech industry to build an alternative economy all failed, failed, okay. And now in the odd years, Linda Lingle brought the tax incentive for technology down. She brought it down. And by 2010, it was gone gone. And the tech industry has shrunk since then, I'm sorry to say. So yeah, there's a glimmer here and a glimmer there, you know, there are incubators and accelerators and whatnot. A lot of that helps people offshore, it doesn't really help developing an industry here. So then we have the risk of extreme weather in climate change. We have the risk of tsunami, our background here, yeah, right there, right there. And so the fragility of a mono economy is accentuated. And then add to that the fact that the National Tax Foundation just came out earlier this month with a report saying $100 is worth $84.39 here, worst in the country. Yeah, yeah. Worst in anywhere in the country. We have our own special inflation. Right. Yeah, it doesn't go as far. So people have to work harder at lower salaries here that work harder to buy what a dollar would buy in the main. This is not so good. This is not so good. Yeah. At the same time, you know, we're not concerned about building any alternative industry. So the only way the government can get money is through taxing the existing tax base. Am I right? Taxing and more taxing. So they, you know, they're looking at different types of taxes, escalating the taxes that are there, replacing, you know, one tax type with another. For example, Department of Transportation, they want to replace the gas tax with a road usage charge. We've already increased the estate tax that happened last year. We increased the income tax the year before. Just more and more things that help bring us down. Yeah. So the middle class gets, you know, hollowed out when I've been talking about the federal effect here. The middle class gets hollowed out. You get a greater disparity of income. You get more homeless who can't handle it, even if they're working. And you get more government services that fail because the government doesn't have enough money to carry on its mission. This is that, you know, this is kind of like the story of Puerto Rico, how it all of a sudden, you know, found itself, what, $80 billion in debt, and then the storm happened. What a combination of things. That could happen here. That could happen here. It's possible, yeah.  Would I go to college on the mainland? Or if I was a kid and I graduated college here, would I stay here or go to the mainland? If I was a businessman here, trying to make a business and finding it hard, a lot of bureaucracy and red tape of all kinds, you know, I'd think about going to the mainland. And this is the most interesting thing. If I was a businessman or a business on the mainland, I'd think real careful now about coming to Hawaii. We have no idea, there are no stats at all about the telescopes that might have come here, except for all this trouble on Mauna Kea. And they're not going to come here.  People see what we're doing. Yeah, and the temperature isn't good. So we're on the world stage because of this telescope fiasco, the picture that's going out to the world is not so great. Yeah. So if I'm a telescope consortium involving countries and universities who control billions of dollars on projects of this nature, seems to me, and I'm reasonably well informed about what is happening here, on top of Mauna Kea with all the protests, I would not come. I wouldn't spend one farthing trying to make a project here, because Hawaii has a brand that will only lead to, you know, the destruction of my project. Have you read like the article about what the Maui mayor did when a telescope was coming up in Haleakala and he had the same, you know, protest project? I did see that, yeah. You stop it right away. I mean, you stop the protests right away. Yeah, he basically said, look, you know, we have to go by the rule of law here.  Yeah, and the protests were stopped. He succeeded. He succeeded. We didn't, David, he didn't do that. He kind of did the reverse, and at the end of the day, between him and Josh Green, they have encouraged the protest, and then we have all these people who really don't know what's going on, who also likewise encourage, you know, people come from out of state, celebrities come and encourage, becomes the cause celeb for the moment. People don't realize the effect on the economy and on taxes. So what struck me to suggest this topic today was I went to the Made in Hawaii fair over the weekend at Blaisdell. And we filmed, you know, a lot of it and filmed people there and the, you know, the people who had the exhibits, paid plenty of money for those exhibits. And a lot of them were from the Big Island. And some of them were selling t-shirts, you know, that favorite protest at Montaguea. And there were a number of people, I asked them, you know, what about technology, don't you want to see astronomy in the state? The answer was, an answer I've heard before, the answer was, we don't want technology in the state. We don't want astronomy in the state. It can all go away as far as we're concerned. And that's what I wanted to talk to you about, because the title that I put on this is Hawaii, the Land of Extravagance and Complacency. We spend, we don't pay our bills and we are complacent about it. We're happy enough to do that. But that's not sustainable fiscal policy, is it? Yeah, the thing that I try to impress upon lawmaker at any chance I get is that, you know, every place has to have an economic engine. You don't have an engine, where is that tax revenue that you depend on coming from? Because most tax systems, including ours, depends on the ability to create income. If you don't have income, you'll be taxed. So that's especially true for us, where a lot of what we're, you know, close to half of our government is funded by general excise tax. That's a tax on business activity, and it's premised on the business getting income. And it's regressive. Sure. Whatever it is, if there's no income, there's no tax revenue. And we highly, we, our government is highly dependent on that tax revenue. So let's kind of go back to, all right, what is in our economic engine? We got tourism, drop your voice. We tried to start some other activities. We may have a little bit of manufacturing. You know, we have some diversified agriculture, not a whole lot. Yeah, they made it Hawaii fair over the weekend. It's arts and crafts. It's not serious industry, I'm sorry. Yeah, it highlights your specialty goods, your maybe a little bit of manufacturing, but it's basically a blip on the radar screen. And it's not going to make any money for the state. It's not really sustainable. It's family owned, and it doesn't last, you know, but a few years in each case. It's great fun, and it supports the, you know, a lot of the notion about, you know, having good relations, aloha and all that in Hawaii, but you can't live on that. The state cannot, they can't pay the bills that way. To pay the bills, you've got to have industries that will generate lots of income, and the income will pay the tax. Right.  I kind of got scared by the prospect of having employees, because of all the mandates, all of the compliance requirements, all of the, you know, payments you have to make, not only taxes, but health care, temporary disability, all this kind of stuff in the, you know, in the legal mandates once you have an employee.  Right.  You have money that goes, you know, the unlimited supplies of money, which is not true. Which is not true. Most of all, this is a struggle.  This is going to be problematic if this happens. It was a piece recently about what happens in restaurants if you have a $15 minimum wage. You as a patron, you still tip the same way at 20, 30 percent.  Where do you get the money? Where do you get the money from? Yeah, that's a... From you? Right. Sure. From the guy who's struggling to keep his restaurant going. Yeah. That guy. I mean, that's what I say. The extravagance here is to believe that this can work and continue that it is sustainable. It is not sustainable. And worse yet is that any single day we could have that wave. Any single day we could have extreme weather. In fact, it's more likely now in climate change, which we as a world is not doing enough. Neither is Hawaii doing enough, honestly. And if our industry is only one thing, tourism along the beach, what are we going to do with sea level rise? What are we going to do? It's already scientifically established that it's going to inundate a good part of Oahu anyway. What are we going to do? What about all those buildings they built in Kakaako? They're going to be inundated, too. So even that related industry, it's related to tourism of building high-priced condominiums, that's going to be at risk. This is the way we earn revenue. And let me add that the tourism doesn't necessarily result in income to the state. We don't have a REIT tax that failed in the legislature yet again. We have the TAT. Is that enough? These are mostly REITs, and they're taking that money offshore and paying minimum wage here for hospital corners in all the rooms. Well, in all fairness, they are paying some hefty taxes, like the TAT at 10 and a quarter. Who imposes TAT at that kind of rate, along with a GET on top of it? I mean, that's 14, 15 percent right there. How do you compare that with other tourism? Do you think it's fair? They're the biggest single industry in the state, by far, by far, not even a plurality. So they're the biggest fat cats, and we can squeeze them, right? Well, I don't know. And that seems to be what the mentality is. I don't think we'll rely on that, because if they go down by a wave or extreme weather, or extreme weather somewhere else, you know, where people are no longer interested in traveling to Hawaii for a vacation, that would empty our beaches, too. And if that's the case, that whatever we're earning, whatever we could earn from tourism is gone immediately. What happens then? Same thing with anything that could stop tourism, but we haven't really followed through on any alternative industry at all. Yeah, and we continue to squeeze the one that's there.  Oh, corruption. Yeah. Sorry. Yeah. There's also a piece about rail I thought was really interesting. Somebody now wants to make first class and coach in rail, you pay more if you want to sit in the good seats. Well, they do that in other countries, too, so I don't see why not. Sure. But you know, what it accentuates is the point where, you know, what do you think rail is going to cost, aside from what's the expectation, you know, 10 billion, 12 billion by the time it's all done and all the trouble is resolved, if it ever is resolved, then we got to get on the rail in the morning and come to work or whatever we're using it for. And how do you know what that's going to cost? Because if the city cannot afford to maintain the rail or pay the debt service on the cost of building the rail, it's you and me or whoever takes the rail is going to have to make up the difference. No, it's taxpayers who have to take the rail. It's the taxpayers in general, isn't it? Even if we don't take the rail, we're going to have to take the cost. I live in East Honolulu. Rail is never going to come to me, never, and yet I'm paying. Okay. Well, there's so many problems. It just doesn't stop. And you know, even now, if we stop, we have spent what, at least five, six, seven billion already, and we don't have a product that is even worth a while. Except for maybe some criminal investigations and possible indictments, you know. It's a kind of industry, and it's on the legal industry, if you will. So I mean, so this is really not sustainable. And I... But even that, they're going out of state, right? So the city council is now considering a resolution to employ California defense attorneys for the heart people at a cost of like $300,000. Send the money offshore. Send the money offshore. You've taxed the local people. And send the money offshore. And send the money offshore. I do not understand that. At the same time, you don't build anything that will generate greater industrial capacity or income that can be taxed. Instead, you take a limited population, which is actually declining, I think. A limited population. It is declining, yes. And you just increase the tax on them.   So after the break time, I'd like to make you either a benign, a despot, or, I know you'd be a benign, or maybe governor or mayor and ask you what the solutions are. If we hunker down right now and we won't worry about political correctness, we'll just come up with fiscal policy, tax policy that will save the state. That'll be an exciting discussion. We'll be, are you going to hang around for this? We'll be right back with Tom Yamachika. Thanks to our ThinkTech underwriters and grand tours. The Atherton Family Foundation, Carol Mun Lee and the Friends of ThinkTech, the Center for Microbial Oceanography Research and Education, Collateral Analytics, The Cook Foundation, Dwayne Kurisu, The Hawaii Community Foundation, The Hawaii Council of Associations of Abarbon Owners, Hawaii Energy, The Hawaii Energy Policy Forum, Hawaiian Electric Company, Integrated Security Technologies, Galen Ho of BAE Systems, Kamehameha Schools, MW Group, The Shidler Family Foundation, The Sydney Stern Memorial Trust, VOLO Foundation, Yuriko J. Sugimura, thanks so much to you all. Okay, well, with Tom Yamachika, we've identified some big problems going forward, problems that can actually ruin the state as an economic engine. So let's talk about how we can improve the situation here, because we really haven't improved it over the past 20 years or so. So what about encouraging offshore investment? To invest in our companies, our local businesses, to build an industry here? You know, in order to have something to invest in, you have to have a product or an industry. If you have something that's kind of destined to fail, who would invest in it? So yes, I think the answer has to be something along the lines of getting that engine going again. So if you want to start some industries where we have natural advantages, for example, and we can produce premium coffee, there are places in the world that will buy premium coffee at premium prices. I mean, it's possible we can replicate that with other types of products or other types of vegetables, maybe not so much meats, because that requires a lot of transportation of… Agricultural products. We haven't actually been successful at that. Been a lot of talk about it, but it hasn't actually turned any significant money. So when the plantations ended, for all practical purposes, scaled up agriculture ended. Yeah, that's, I think, a possibility of getting it started again. The other possibility is the research agriculture, right? I mean, that's kind of what we have on Kauai already, although people are kind of shunning it and going like this, oh my god, GMOs, genetically modified stuff. And do we really want to do that? I mean, not necessarily, but at least we do have the luxury of being in a climate where we've got three growing seasons instead of just one, right? So if you want to experiment with the growing crops or growing animals, we've got ways to do it that are perhaps three times as efficient as any other place in the nation. Not cows though. Not dairy cows. Not dairy cows. Squashed dairies, the resurrection of dairies in Hawaii, protesters have made them go away. Nobody would start a dairy now. You know, I remember, we think tech did a program on agriculture, on the prospect of agriculture as an industry in Hawaii. We did a number of them, and there was a guy, very wealthy investor, who flew out here from the West Coast to come and see this program about developing agriculture in Hawaii. He was interested in investing, and he was interested in getting his friends to invest, also well-heeled. And he approached me in the course of this program, and he said, I want to talk to you, I want you to put me in touch with everyone who is a prospect or an investment in agriculture in Hawaii. And I did. And he spent months here looking it over very carefully. And finally we had a meeting, he took me out for a little meeting, and he said, well, I've looked at everything about agriculture in Hawaii, looked at it very carefully. I've talked to my potential co-investors, and we've decided we're going to invest in hotels. Yeah, you have to have the product before you can sell it. So, you know, that, of course, you have this whole anti-tech, anti-astronomy, anti-science kind of thing. It's very hard to invest in science and technology when, you know, you can, in the case of TMT, they've gone through 10 or 15 years of litigation and regulatory process and Supreme Court cases and arbitration and what have. And at the end of that time, and they've got the time. At the end of that time, what happened to our rule of law? Well, yeah. I mean, we're supposed to be in a society where we have laws, we have processes, we follow these, we get to a result. Now, people say, oh, I don't like the result. And they, you know, camp down on the, on monarchy access road, among other places. Yeah, and that's the complacency I'm talking about. It's complacent and it's extravagant to say, well, you know, we'll take a whack at TMT, we'll try to stop it. And it'll be our little ball game and we'll win. But I don't think that people see that in a statewide context. What it'll do to the economy, what it'll do to offshore investment. You know, if you were a consortium looking to, looking to organize another telescope, would you come to Hawaii? No, the government won't protect us.  Yeah, so why would they want to invest in something that's going to become toast? We have no stats to know how many wouldn't come here anymore, because we don't know who they are. They decided not to. And my guess is that we won't see another telescope here. Whatever happens in TMT, we won't see another telescope. And Mama Kea is really, is going to be history soon enough. So then the question is, well, doesn't it have a secondary effect for anyone who wants to invest in science and technology? Or anything else for that matter. Or anything else. Yeah, I think, like I said, to get investment, you've got to have a product to sell. And we need to get an economic engine running. What's our product, and how do we sell it? That's what we've got to ask. So here we are in a real pickle, so to speak, because the people at Wall Street and on the West Coast look at us and they say, you guys are not worthy. We're not going to come around. You're backwoods honkeys, man. Yeah, you're backwater is what you are. And so how do we get, this is a hard one, maybe it deserves another show, another discussion, how do we get to a position where they see us differently? I mean, for example, you've got 100 million plus going to a white tourism authority to sell hotel rooms. But how much is going to show the world that we're a worthy place to invest? How much is going to show that, yes, they should bring their telescopes here. They should do their scientific development. Big farmers should come here, surround the medical school, just as Ed Cadman wanted years ago to have them. I mean, we've made advances about positioning our state as a health care state. And we are kind of ahead of the game already, because we do have very good statistics among the whole country about having healthy people. We could capitalize on that. Yeah. So that's part of a product that we can develop. But we need the leadership to get people together, make a product, then market the darn thing. OK, I'm making you the benign despot. What do you do? You have total authority. You can tell the legislature what to do. You can make laws and regulations right now today. What do you do to improve our position, improve our image, so to speak, and make offshore investment come and build industry here? Well, one thing is that we got to identify products that we have a natural advantage of. Health care, for example, premium agriculture, exotic species of animals, plants, whatever it is, microbes that can produce wonderful chemicals like the gastroesanthin. We get these industries targeted. We give them incentives to say, grow, grow, grow, and then nurture them and basically put them in the flower pot, put some water on them, and wait for them to grow. Once they grow, then we can at least hope to get our engine running again. We have to encourage them and incentivize them. So now the last question, Tom, and then we'll have to go. And that is this. This is the ghost of Christmas future. Suppose we do nothing. We have $40, $50 billion of unliquidated liability out there. We do not have a prospect of paying that down. It's the rail, it's homeless, it's the ERS fund, and anything else that might come up. I mean, if we have a storm, that's going to be a multi-million-dollar effort to get back on track, at least. Remember Puerto Rico? Remember Puerto Rico. And Puerto Rico is in terrible shape. Terrible, terrible shape now. They have three governors in the past three months or something. It's really terrible. And corruption begins to get worse in a state that has no money to pay the bills. That's the rule of thumb. So the question I put to you is, if we do nothing, if we just go on with our extravagance and our complacency, what happens to us? We become Puerto Rico, essentially. That's what I think. If you don't want it to happen, if I don't want it to happen, I do something about it. And that entails getting into the right positions, leaders who have the vision to carry this out, the people who have the desire and the passion to follow what this leader says. Because we are going to need some vision and some following in order to get ourselves out of this mess. Jack Burns, where are you now? Exactly. Well, thank you very much, Tom. Really enjoyed. I can't say I enjoyed, but I think it was a worthy discussion. I hope we can do something else on this later. Thanks for having me on the show, Jane. Hello, Tom.


Attention Illyria Swanzia residents, this is a community notification of a new sexually violent predator in your area. Please stay tuned to the following short program for more information. Hi, I'm Technician Ron Hackett with the Denver Police Department. The Sex Offender Registration and Compliance Unit at DPD is responsible for the registration, monitoring, and tracking of all registered sex offenders and sexually violent predators who live in the city and county of Denver. Here's a brief history of sex offender legislation in Colorado. Our state laws trickle down from federal government mandates. In 1994, we had the Jacob Wetterling Act, which mandated that states would establish a sex offender list. Megan's law of 1996 said that the public would have access to those sex offender registration lists. The Pam Litchner Act of 1996 stated that some offenders might have to have lifetime registrations. And the Adam Walsh Act of 2006 unified sex offender laws across the country. In Colorado, the legislature has determined that sexually violent predators by definition pose a higher risk to the community at large and therefore mandated that upon their release from the Department of Corrections, the community must be notified. Sex offender notification in Colorado happens in two ways. The first is passive and ongoing through the sex offender registration process, which is a list maintained by local police departments. The second way is active via community notification for those offenders determined to be sexually violent predators by the courts or by the parole board. Most sex offenders in Colorado are supervised by the criminal justice system in our communities. Most sex offenders engage in crossover behavior, which means they may have been arrested for one type of crime, but be apt to commit another.  There is no typical sex offender, but all tend to be deceptive, manipulative, and secretive. 80 to 93 percent of sex offenses are committed by someone known to the victim. Sexual deviancy begins in mid to late adolescence. Sex offenses are not impulsive.  The community has a vested interest in helping offenders to be successfully managed in the community. Sex offenders have the same need for housing and employment as any other citizen. Any citizen who uses sex offender information to harass, threaten, or intimidate an offender will be subject to criminal prosecution. There are approximately 16,500 registered sex offenders in the state of Colorado. About 65 percent of convicted sex offenders are placed in the community on probation. The remainder are in the Department of Corrections or Community Corrections. Offenders may be caught for one type of offense, but be at a high risk to commit another type. Crime of conviction is only one indicator of risk.  The offender's residence must be verified quarterly by the Denver Police Department. The full sex offender registration list is available by calling the Denver Police Department Identification Bureau at<PHONE_NUMBER>. Convicted felons and those with multiple convictions are posted online at denvergov.org-police.   Now, here's a look at the newest sexually violent predator living in Denver. Here's an overview of the registered sex offenders currently living in Denver. There are 2,372 total living within city limits. In Denver Police District 2, there are 358. Precinct 212 has 51 registered sex offenders. Of those 34 have felony convictions and 17 have misdemeanor convictions. Christopher Allen Welvert is a sexually violent predator currently living in Denver. He's 41 years old and was born on June 30, 1981.  He's currently a transient living in the area of East 46th Avenue and Humboldt Street in the Illyria-Swansea neighborhood of Denver. Schools located within 1 mile of this offender include Swansea Elementary at 4650 Columbine Street, Wyatt Academy at 3620 Franklin Street, Garden Place Elementary at 4425 Lincoln Street, Annunciation Catholic School at 3536 North Lafayette Street. Parks located within 1 mile of this offender include Swansea Park, Illyria Park, Dunham Park, Russell Square Park, Carpiosanguinette Park, St. Charles Place Park, Argo Park, Herron Pond Heller Open Space, Plat Farm Open Space, Globeville Landing Park, 39th Avenue Greenway, Arkins Park, Arkins Promenade, I-70 Cover Park. Recreation centers located within 1 mile of this offender include Globeville Rec Center at 4496 Grant Street, St. Charles Rec Center at 3777 North Lafayette Street, Johnson Rec Center at 4809 Race Street, Swansea Rec Center at 2650 East 49th Avenue, Bus routes located within 1 mile of this offender include Route 7 Washington Street and 47th Avenue, Route 48, 48th Avenue and Brighton Boulevard, 48th Avenue and Race Street, 47th Avenue and Brighton Boulevard, 41st Street and Brighton Boulevard, N-Line, National Western Center Station.  He's not currently on parole or probation and registered with the Denver Police Department on March 23rd, 2023 as a transient living in the area of East 46th Avenue and Humboldt Street in the Illyria, Swansea neighborhood of Denver.  Christopher Allen Welvert has been determined as sexually violent predator after meeting the following criteria. Criteria 1, age 18 or older on the date of the offense or under 18 and tried as an adult. The offender was age 25 at the time of the offense. Criteria 2, the crime must have been committed on or after July 1st, 1997 and convicted on or after July 1st, 1999.  The offender was convicted on November 6, 2007 for attempted sexual assault on a child and child abuse negligently caused serious bodily injury. Criteria 3, the relationship to the victim was one of the following. The victim was a stranger to the offender or the offender established or promoted a relationship with the victim primarily for the purpose of sexual victimization. The juvenile female victims were the offender's daughter and stepdaughter. Criteria 4, positive results or the passing of a risk assessment instrument administered by probation parole staff and a qualified treatment evaluator. Positive results include an assessment for the presence of a mental abnormality, a level of denial regarding the offense, treatment appropriateness and motivation, presence of sexual deviant interests. The offender was evaluated by the Adams County Courts with positive results, determining him to be a sexually violent predator.