Hello and welcome to the session. In this session we will discuss derivatives. In many cases we need to know how a particular parameter is changing with respect to some other parameter. For this purpose we use derivatives. Derivative of a function fx at a is denoted by f dash a and this is equal to limit h tends to 0 f of a plus h minus f of a upon h, where f is a real valued function and a is the point in its domain of definition. We observe that f dash a quantifies the change in fx at a with respect to x. Consider the function fx equal to 2x. We need to find the derivative of fx at x equal to 2 that is we need to find f dash 2. Here we have a is equal to 2. Now we have f dash 2 is equal to limit f tends to 0 f of a plus h minus f of a upon h. This becomes equal to limit h tends to 0 2 into 2 plus h minus 2 into 2 upon h that is equal to limit h tends to 0 4 plus 2h minus 4 upon h that is we have limit h tends to 0 2h upon h. Now h and h gets cancelled. So this is equal to limit h tends to 0 2 and this is equal to 2. So we have f dash 2 is equal to 2. Next we discuss first principle of derivative. Derivative of a function f at any point x is defined by f dash x which can also be written as dfx upon dx. This is equal to limit h tends to 0 f of x plus h minus fx upon h where again f is a real valued function. Consider fx equal to 11x. Now f dash x would be equal to limit h tends to 0 f of x plus h minus fx upon h that is this is equal to limit h tends to 0 11x plus h minus 11x upon h. This is equal to limit h tends to 0 11h upon h now h and h gets cancelled. So this is equal to limit h tends to 0 11 so we get f dash x is equal to 11. This is how we use first principle of derivative to find the derivative of a function f at any point x. Next we discuss algebra of derivative of functions. Consider u and v the two functions such that their derivatives exist and are defined in a common domain. Then we have u plus v dash is equal to u dash plus v dash that is derivative of sum of two functions is the sum of the derivatives of the functions. Then next we have u minus v dash is equal to u dash minus v dash that is derivative of difference of two functions is difference of the derivatives of the function. Next is u v dash is equal to u dash v plus u v dash derivative of product of two function is given by this product rule.  Let's find the derivative of the function given by fx equal to sin x into cos x. Here we consider u equal to sin x and v equal to cos x. Then f dash x would be equal to u dash that is derivative of sin x that is cos x into v that is cos x plus u that is sin x into v dash that is derivative of cos x and that is minus sin x and this is equal to cos square x minus sin square x and this is equal to cos 2x that is f dash x is equal to cos 2x. Derivative of the function sin x into cos x is cos 2x. Then next very important result is derivative of the function fx equal to x to the power n is given by n into x to the power n minus 1 for any positive integer n. Consider fx to be equal to x to the power 5 then f dash x is equal to n that is 5 into x to the power n minus 1 which is equal to 5 into x to the power 4. This result is true for all powers of x that is n can be any real number. Next is another very important result according to which we have let fx be equal to a n x to the power n plus a n minus 1 x to the power n minus 1 plus and so on a 1 x plus a naught this be a polynomial function where a i's are real numbers and we have a n is not equal to 0 then the derivative function is given by dfx upon dx and this is equal to n into a n x to the power n minus 1 plus n minus 1 into a n minus 1 into x to the power n minus 2 plus and so on up to 2 a 2 x plus a 1. Consider the polynomial function given by fx equal to x to the power 10 minus 5 into x to the power 2 plus x. So derivative of this function fx is given by f dash x is equal to 10 into x to the power 10 minus 1 that is 9 minus 5 into 2 into x to the power 2 minus 1 that is 1 plus 1. This is equal to 10 into x to the power 9 minus 10 into x plus 1. This is f dash x. This completes the session hope you have understood the concept of derivatives.


According to medical records, we need a sufficient supply of Vitamin D, now more than ever. Why? With the advent of the coronavirus, having an insufficient level of Vitamin is associated with an 80% increased risk of contracting COVID-19. As a result, it is very crucial now for you to get enough of this Vitamin D nutrients. It is not easy to get Vitamin D, especially now that working from home is becoming uncommon, of course. To get more of this Vitamin, you can change your diet or add some supplements but you still need the right amount of sunshine to keep up with the level of this Vitamin D you need for yourself. Vitamin D deficiency has become an increasingly common problem for millions of people all over the world. According to 2018 data from Ohio's Mercy Medical Center, more than 42% of Americans are Vitamin D deficient, which they are often unaware of until they start experiencing health issues as a result. If you would like to know if you are Vitamin D deficient, there are certain signs to watch for. 1. Fatigue If you are experiencing general fatigue around your body, it could be a sign of Vitamin D deficiency. Ashes related to muscle weakness in certain areas may not be noticed for a long time. The symptoms you experience become stronger and more difficult to ignore as Vitamin D deficiency becomes worse. Instead of general pains and aches in the body, one starts the muscle and bone pain. At this point, tiredness may progress the muscle weakness. If you are not careful, you can seek answers in the wrong direction. You may feel tired because of certain factors in life. You may not be able to remove all of them but you can control some. However, according to a 2015 study published in the Global General for Health Science, deficiency in Vitamin D may be contributing to that feeling of constant tiredness. About 89% of participants who reported fatigue had inadequate Vitamin D levels. That's not a coincidence. 2. Lower Back Pain Each of us experiences lower back pain occasionally, which is normal. However, suppose you experience constant lower back pain. In that case especially, you may need to go test for your level of Vitamin D. A 2008 study published in the Journal of the American Geriatric Society concluded that lower concentration of Vitamin D were linked to significant back pain in women. However, the same connection was not found in men. 3. Muscle Weakness If you have been exercising a lot, you might experience muscle weakness. In the same way, if you have been restricting your calories to lose weight or you aren't sleeping enough, you may feel muscle weakness. Be sure to see your doctor if you have these symptoms consistently alongside the other symptoms mentioned here. According to Cleveland Clinic, if your muscles regularly feel weaker or are cramping unusually, you may not be getting enough Vitamin D. Although these symptoms may not be applicable to everyone, they are more disturbing in children who are Vitamin D deficient because low levels can lead to rickets, a painful and severe condition. 4. Aching Muscles According to 2003 research published in Mayo Clinic Proceedings, when you have persistent pain with no real explanation especially during the winter as opposed to in the summer, a Vitamin D deficiency could be the culprit no matter your age. 5. Bone Discomfort Dr. Dana Huns, the senior dietician at Ronald Reagan UCLA Medical Center, admits bone pain is one of the most common and severe symptoms of Vitamin D deficiency. Another study showed that this is also likely to be experienced especially as back pain. In the study, the expert observed over 9,000 participants and found an association between back pain and Vitamin D deficiency. According to a 2009 study published in the journal American Family Physician, any aches and painful tenderness in your bone could be due to a Vitamin D deficiency especially if you feel discomfort when you put pressure over the breast bone or shin bone areas. 6. Trouble Slipping A sleep expert, Michael Brose, MD, has identified that low Vitamin D levels can directly affect the quality and quantity of your sleep. Thus, making it difficult to get the kind of rest necessary for your body to stay healthy. A 2008 meta-analysis published in the journal Neutrons of 9,397 subjects supports that fact by admitting that Vitamin D deficiency is associated with higher risk of sleep disorders. 7. Hellos It is not unusual for men to lose their hair at a certain age, however, for women it is unusual. Women may experience hair loss for other reasons and one of them could be a Vitamin D deficiency. A 2013 study published in the journal Skin for Macology and Physiology showed that women with hair loss had much lower Vitamin D levels than those who weren't losing their hair. 8. Eczema A 2011 study published in the British Journal for dermatology found that those with low levels of Vitamin D tended to have more severe symptoms of the skin issue. Atopic dermatitis is a common type of eczema that causes red in each skin. Having this type of eczema may indicate a deficiency in Vitamin D. 9. Slow Healing Wounds Are you struggling with wounds that seem not to heal fast or they always seem to take weeks before they heal? It may be an indication of Vitamin D deficiency. A 2011 study published in the Journal of Dental Research proved that Vitamin D levels are critical to post-surgical healing. Other researchers have revealed that slow healing wounds could be from low levels of the essential Vitamin D. 10. Getting Sick Regularly According to a 2010 study published in the Journal Molecular Nutrition and Food Research, if you are constantly getting sick, it could be due to the Vitamin D deficiency. According to research, there is a connection between the response of your immune system to infections and viruses and the essential Vitamin D. And a chronologist concluded in a 2008 study published in the American Journal of Clinical Nutrition that having inadequate levels of Vitamin D was associated with an increased risk of cancer or to immune diseases, hypertension and infectious diseases. 11. Dizziness According to a 2018 study published in the European Archives of Autorhinolaryngology, not getting an adequate amount of Vitamin D can cause Benign Paroxymer Position Vertigo BPPV disorder to develop. If you don't increase your intake of Vitamin D, the disorder will continue.  This could clearly indicate your level of Vitamin D. 12. Erectile Dysfunction According to the 2015 research conducted by John Hopkins University, Vitamin D can be a direct cause of erectile dysfunction. The research found that men who were Vitamin D deficient were 32% more likely to have ED than men with normal levels of the sunshine vitamin. However, it should be added that a lot of other factors are responsible for erectile dysfunction ED. Those factors may include alcohol, smoky, high blood pressure, and diabetes, etc. 13.  Urinary tract infection is caused by bacteria getting into the urinary tract and multiplying. However, research has also discovered that deficiencies in Vitamin D can also be responsible for the infection. According to a 2013 study published in the International Journal of Infectious Diseases, researchers found that recurrent UTIs in women were associated with a Vitamin D deficiency. 14. Severe PMS Symptoms Women do not only experience urinary tract infections when they are low in Vitamin D. Julian Wittaker, MD, says severe PMS symptoms like mood swings, food cravings, and tender breast could result from not having enough Vitamin D in your body. Julian says those who improve their Vitamin D intake reduce the risk of developing those sometimes unbearable eggs and pains by 40% than those who didn't. 15. Digestive Problems According to a 2013 study published in the Journal Elementary Pharmacology and Therapeutics, being Vitamin D deficient might increase not only your risk of developing IBD but also factor into its severity. When a person is struggling with inflammatory bowel disease IBD, it means their digestive tract is inflamed on a daily basis. This automatically leads to diarrhea, abdominal pain, fatigue. However, if you make sure you get the right amount of Vitamin D, you can lower your risk of dealing with this difficult condition. 16. Nimonier A medical expert says there is a link between Vitamin D and Nimonier. Deficient individuals are 2.5 times more likely to get Nimonier due to a weakened immune system. If you constantly have Nimonier, it may also be caused by deficiency in Vitamin D. Senior doctors and increasing your intake could resolve this in no time. 17. Excessive Sweatting It is natural to sweat if you are undergoing any demanding physical activities or you are undergoing the sweatering sun. However, if sweating occurs when the conditions are less serious, that could mean something is wrong. Medical expert says with normal or moderate activity, a normal body temperature and a mild temperature environment, excessive sweating could be a sign of Vitamin D deficiency. If this video has helped you to understand the signs of Vitamin D deficiency, subscribe to this channel to receive notification for other helpful videos. We love you.


It is really a pleasure to introduce Chairman Tenenbaum. I know everybody in this room already knows her and the incredible work of her staff and the chairman and the commissioners and their staff. And this morning, we've heard a lot about what they're doing more recently. I just thought I'd take a couple of seconds to highlight just a few things about her administration and how she has really elevated the agency in the past few years that she has been there. We've heard this morning a few of these things, but the increase in accessibility and transparency at the agency is really noteworthy. Those of us in industries that are regulated by any agency or department in Washington can only ask for things like information and an opportunity to know what's going on there. And we certainly have that much more than ever before under the chairman's guidance. So we really appreciate that. This morning in Ken's remarks, he mentioned the increase in education and advocacy at the agency. That's also something very noteworthy under the chairman's guidance. And finally, something very important to all of us is just the chairman's support, the strong support for reasonable and effective new regulations and standards. And she's not only been that way here in the United States working with Congress and other departments and agencies, but she's done that around the world. If you look at her bio, there's a long list of countries. And Carol, I'm not going to sing them. You did a great job this morning. But she really has going around meeting with regulators around the world, touring factories, and really taking her message of safety around the world to a global audience. So those are, I think, some of the highlights from our toy industry perspective. She just had an incredible experience working with the chairman, a number of her staff that are here. And let me also take just a minute because it also applies to Commissioner Adler and Jason and the entire staff of the other commissioners as well. So it's great to have you all here too. Just two weeks ago, the chairman and some of her staff came up to New York to our trade show Toy Fair. She participated in our safety seminar and then took a lot of time to walk around, meet with a lot of the members there. And also look at some of the new products that will be hitting the market in the months ahead. So it's that kind of interaction with the chairman and her staff and the agency that has really meant a lot to the toy industry over the years. So with that, this is really not an introduction. It's more of a welcome back because you spoke to us in Brussels at the last Iqbal so meeting. So please help me in giving a warm welcome back to Chairman Tenenbaum. Good afternoon, everyone. And thank you so much for those very kind words and that really gracious introduction. I really appreciate it. And to my colleague, Commissioner Adler, I'm so glad you're here with us. Commissioner Nord has been here throughout the meetings. I don't know if she's here today. I haven't seen her, but she's been here at the conference. So to the Iqbal Board of Directors and to the members, to the CPSC staff and alumni and to the special guests from around the world, I am so pleased to join you in celebrating the 20th anniversary of this distinguished organization. So much has changed since I first joined the Iqbal community in Toronto in October 2009. To attend that conference, I had to fly overnight over the Pacific Ocean from a safety summit with the AQSIQ in Beijing. I was a little bleary-eyed that morning, but determined. I was determined to tell everyone about the CPSC's new direction and determined to show everyone that I can say Iqbal so. I'll never forget Mark Shum standing in my office saying it's Iqbal so. So fast forward almost four years. And today marks my eighth Iqbal so conference. Thankfully, it was just a short drive from the right over the Potomac River from Bethesda to Crystal City. In the past four years, things have changed for the better. Today, CPSC stands in the rightful places the global leader in consumer product safety. Today, consumer protection has advanced so that parents can have faith in the institutions of government. Today, industries and markets have evolved and kept pace with changes in product safety rules, and consumers are better off for it. To compare and contrast the past to the present. Out are the days of lead lace toys sneaking into children's toy boxes before authorities could put up roadblocks. What's in is CPSC's implementing and enforcing some of the lowest lead limits in children's products from around the world. Down are recalls of toys due to lead violations, down 80% since 2008. And up are the numbers of violative toys caught at import before they can make it to the store shelves. Out are traditional drop side cribs which entrapped and took the lives of beautiful little children. In is CPSC implementing and enforcing a crib standard that is the model for the rest of the world. The memories of Bobby and Liam and Tyler and so many other children live on through the safer, stronger cribs in the stores today. Out are companies thinking that regulators will turn a blind eye to corruption of materials along the supply chain. Children sometimes pay the ultimate price in the race to offer the lowest unit price. What is in, I'm proud to say, is independent testing of children's products at CPSC accredited laboratories. Children's toys, games, and apparel are coming off assembly lines in Guangzhou, Hong Kong, and Mexico City. But before they are shipped to our homeland, they are being third party tested for conformity with U.S. standards. What is in are companies building safety into the design and anticipating foreseeable use and foreseeable misuse of their products. What is in are Chinese manufacturers using best practices in their factories and the Chinese government holding manufacturers accountable when they do not play by the rules. These are the components of a global market system of safety. A system of safety that parents and consumers thought was in place years ago. They spoke out to their elected officials when they realized that it wasn't in place. And now their expectations for safe products are being met and they can shop with more confidence. Many of you in this room are the key players in making this system of safety work. You set a corporate culture of quality and safety in design specifications. You travel halfway around the world to do QA and QC checks of the factories of your suppliers. You run the testing laboratories that adhere to ILACS and ISO 17025 standards for quality. You protect against undue influence and ensure staff is trained to carry the CPSC's latest testing protocols. You are the innovators. You are the voices that deserve to be heard in your companies. I've seen the next generation of innovators and innovations and the future of safety looks promising. I know that a coin cell battery can be built one day so that it will not cause severe burns to a child's throat if ingested. I know that affordable cordless window coverings can be made and that existing window coverings can be retrofitted to eliminate the strangulation hazard. I know that ATVs and ROVs can be made more stable and less prone to rollovers. We can do this. We can make our culture of safety the best in the world. Advancements in manufacturing are vital to the United States being a leader in product safety. As is information sharing. I believe that these past four years have seen great improvements in communication between consumers and all of us, the experts in safety. A guiding belief that I have promoted during my tenure as chairman is that effective communication and education can be empowering and life-saving. We have used that approach at the CPSC. We have doubled the number of members of the Neighborhood Safety Network during my tenure to 7,500. We have launched a minority outreach campaign for underserved communities. We have put information about safe sleep and drowning prevention and poison prevention in the hands of people who have never before heard of the CPSC. Consumers can search and report on product instances via the trusted website, SaferProducts.gov. And they are. There are more than 200,000 visits to the site each month and more than 12,000 reports of harm or potential harm are alive on the site. And those who won't recall information can download an app for their smartphone, a widget for their website, and tweets from on safety. But we're not alone in the information-sharing empowerment business. Consumers Union launched the National School Safety Program to put vital information into the hands of the PTA, school systems, and educators. CU is disseminating information from CPSC, the FDA, and others up to towards 90 million people. The Department of Health and Human Services launched Text for Baby, which provides free text messages to tens of thousands of women during and after their pregnancy. Many of us in this room are supporting members of Text for Baby. And the Consumers Federations of America and Kids in Danger join forces to create an online registry of juvenile product manufacturers who provide product registration cards as the law allows and requires. The result of all these efforts is a more informed and a more empowered consumer class. And a more informed and more empowered consumer class means safer homes and safer families. Many of you are key players in companies and organizations that are contributing to the empowerment of consumers. You blog on safety issues, include safety alerts and newsletters, incentivize consumers to respond to recalls, and support foundations working to help the needy. I applaud you for your efforts. Yet there's still more that we can do. An empowered consumer class should include consumers from every economic and social strata. We have to work harder to communicate to those who have not trusted government as the source of information. And we have to recognize that certain people hear about a product incident but take no remedial action because they believe this won't happen in my family. CPSC's door is always open to hearing from those who have proven methods of new ideas on how to change consumer behavior and advance the cause of safety. Our cause and our commitment is not confined to the United States only. Information sharing and capacity building with our regulatory partners and other jurisdictions has benefited consumers here and at home and abroad. The CPSC has forged new partnerships with regulators in the Pacific region, Latin America and South America. And longstanding agreements with regulators in North America, Europe and China have been modernized and strengthened through collaborative safety summits. That regulators and safety advocates for more than 30 countries are here today, 30 countries. And it speaks to the power of Iqviso as a unifying source for the product safety community. I believe that cooperation is the key. No one organization, no one country can solve all the challenges posed by the global economy. I believe that we must move forward together, government and industry, advocates and associations, but we must work together to expand our path to the future and to do that we have to be mindful of our history. History at times can guide us and history at times is best not repeated. I believe that history will define these past four years as a time when the CPSC moved out of the darkness and into the light from being a reactionary agency to being proactive, from protecting the status quo to redefining consumer protection. My approach over the last four years and the approach that will guide the CPSC going forward is based on what I call the next generation philosophy. To CPSC the next generation philosophy means that we will never be satisfied with the status quo and we will always push to improve the state of consumer safety for the generation to come. This philosophy is rooted in a system of safety built to protect today's children and tomorrow's children and the next generation and to avoid repeating the mistakes of the past. The system is driving the CPSC's work in the direction of injury prevention. The system has established protections of acute and chronic hazards and the system reaches from the source of manufacture to import to the marketplace and it is a system that is built to last. Today's children deserve a product safety system built to reduce their vulnerabilities and not expose them to it. The great poet Maya Angelo once said, children's talent to endure stems from their ignorance of alternatives. It is our responsibility to establish the advances in product safety so that a child's talent can endure, endure without harm. Our children deserve a safe and a healthy upbringing and fewer unintentional injuries than the generation before. Now I'm not talking about an environment free of risk, life is risky and we have made, we are made stronger by our ability to persevere. But I reject the notion as some espouse that my generation survived just fine riding in cars without child seats, riding bicycles without helmets and playing on metal playground equipment without safe surfacing. Even with all of the progress we have made we still have so much work to be done. Unintentional injuries are the still, the leading cause of death for children over the age of one. And unintentional injuries are one of the leading causes of injury among children younger than 15 according to a Princeton University researcher. Yet there are fringe thinkers who want to roll back our progress in injury prevention and recklessly expose children to preventable risk. We have come so far and we've come too far and safety is advancing too fast for us to turn back now. My belief in the next generation philosophy stems from my past work in education and it has continued during my tenure at the CPSC. From preparing young children to be proficient in basic math to teaching young athletes how to protect their brains on the playing field. From preparing teenagers to be first in their family to go to college to making sure that a ride on an ATV or a skateboard does not end their dreams to walk across a college campus. My life's work has always been about achieving healthy upbringings and bright futures for our children. And the system of safety that the CPSC has established is all about healthy upbringings and bright futures. Here are the pillars of our system. Through a combination of federal rules and strong consensus standards we are doing our part to block children's exposure to lead, cadmium, chromium, arsenic and other toxic metals. And these metals that can severely limit, these are metals that can severely limit the development of children. Our system to prevent children's exposure to toxins is more comprehensive than the system of the past. It has addressed surface coatings and content. It has brought together the power of congressional mandates and the scientific research by the CPSC. Our system has other protections. Certain phthalates, a chemical of concern to many parents, have been banned in accessible parts of toys and childcare articles. Durable infant products, products that our children sleep in, ride in, are fed in and are carried in, never have been safer. Cribs and bath seats, baby walkers, toddler beds and portable bed rails are all covered by strong mandatory standards. This is all thanks and key part to the CPSIA, the part called Danny's Law. Now I have kept a picture of Danny Kesar in my office for years.  At the age of 16 months he died in a play yard, a play yard that had been previously recalled. Danny was taken far too soon from his mom Linda and his dad Boaz, far too soon. Linda and Boaz became the founders of Kids in Danger and they worked tirelessly to turn Danny's tragedy into Danny's Law. The time I've spent with Linda and Boaz has been among the most meaningful moments as my tenure as chairman. This is why I'm so proud, I'm so proud to announce that a new federal standard for play yards goes into effect today. I look out at Nancy Cole's from Kids in Danger who is sitting here today. She too has dedicated years of her life to the memory of Danny and the pursuit of child safety. Nancy, it took 15 years, 15 long years but we did it. Again, all of the hard work we do at the CPSC is about healthy upbringings and bright futures and thus we press forward because we have safety rules that need to be established for bassinettes and cradles, bedside sleepers, handheld infant carriers, strollers, slings and so many other juvenile products and we are pressing forward with establishing protections for consumers of all ages. Strong compliance action and ongoing rulemaking have tamped down the terrible burn hazard posed by horrible gel fuel and gel pots. Open rulemaking and ongoing work with the underwriters laboratories has aimed at reducing the life altering finger and hand amputations that happens every day to wood workers using table saws. And in support of our aging population, the CPSC is working with the FDA to warn older consumers, their families and healthcare providers about the entrapment hazard posed by adult bedrails. This is what our system of safety is all about. Strong performance standards, better manufacturing, independent testing, enforcement, education and accountability. The results of this system are live saves and injuries prevented in healthy families. When I first arrived at the CPSC, some people questioned why I pushed so hard to complete the CPSI rulemaking. I did not make the staff work at such an exhaustive pace to complete the record number rulemaking simply because Congress told us to do so. We did it because Congress had handed us a roadmap, a roadmap to becoming a truly proactive agency. Ask a parent what kind of safety systems they want. Ask a grandparent what they want for their grandchildren. Ask a consumer what they want from the marketplace. The answer you consistently hear is that they want a system that works for them to represent their interest, to hold manufacturers and retailers accountable if their products put the safety of families at edge equity and to have their confidence in government restored. And this is what we have done. And I want the Iqviso community to join the CPSC in making our system even better. When I was a little girl growing up in rural Georgia on Friday afternoons when school let out I frequently went home with a friend to spend the night. The next day when my mother came to take me home my friend and I would be having such a great time that would ask if I could stay over another night. Most of the time my mother would not let me and she'd say you should not out stay or overstay your welcome. I still believe that one should not overstay one's welcome in any venue whether it's professionally or personally. So I wanted to announce to all of you today that I've asked President Obama not to re-nominate me when my term is over in October. I plan to stay on at the commission however until my successor is nominated by the president and confirmed by the Senate so I can be sure that the U.S. Consumer Product Safety Commission is in safe hands. I've been assured by the White House and that my successor will be someone who believes in and fully supports the mission of our great agency. That is to protect consumers. So many qualified and deserving people have wanted to serve in President Obama's administration and he chose me. For the rest of my life I will be grateful to President Obama for nominating me chairman of the CPSC and for giving me the opportunity to serve in his administration. It has been my great privilege to serve as chairman of the CPSC and the best part of my experience has been working with the many talented dedicated people at the agency. My term as chairman also has been greatly enhanced by working with all of you. Consumer advocates and corporations trade associations and members of Iqviso so I say with a very grateful heart thank you. But in the remaining time that I have at the CPSC we still have a lot of work to do. So during the rest of my time today I'd like to talk about with you the future agenda of the CPSC and agenda that will strengthen our layers of consumer product safety. Leading off is our import surveillance program. As the president has stated on many occasions manufacturer is making a comeback in the United States. That comeback should not be slowed by foreign manufacturers and domestic importers who seek a competitive advantage by sacrificing safety. Any company domestic or foreign is seeking to do business in our marketplace should adhere to the same performance standards. I believe that American manufacturers deserve a level playing field. Exporters who do not achieve safety at the source are on notice that they face the CPSC that is standing on guard in the front lines. Well trained port and field investigators are using state of the art technology to detect and detain violative products from folk toys to fireworks to lighters to mattresses. As was discussed throughout the morning our port investigators are standing arm in arm with inspectors from Customs and Border Protection CBP. CBP is one of the very best agencies in our government and we are proud to be co-located with them at the Commercial Targeting and Analysis Center in Washington and at ports from coast to coast. The CPSC and the CBP staff prevented more than four million units of violative and hazardous imports from ending up on store shelves during the last fiscal year. I will not restate the well presented points made this morning about our risk assessment methodology which we call our RAM pilot project. But I want to emphasize one key point. My administration has made it one of our top priorities to increase the funding of the RAM program. More staff will be will mean a stronger RAM and a stronger RAM will help the CPSC be an even more proactive regulator. As great a job as our imports investigators do, CPSC should not be limited to just 20 people working at a handful of ports. We cannot fight a fair fight with just 20 people to screen $700 billion worth of consumer product imports, $340 billion which are coming from China. The more hands we have on incoming shipments and the more hands we have on potentially violative samples, the safer American consumers will be and the more level the playing field will be for our compliant trade. I will be seeking more funding support for our RAM program and I need your support. Facilitating the flow of legitimate trade is one of the benefits of the RAM. Moving compliant products through the systems faster is good for industry and it helps our investigators focus on high-risk products and repeat offenders. This is a winning approach to ensure a level playing field for trade and I hope many of you will express your support. I would like to discuss now a series of products that have the potential to save hundreds of lives, prevent thousands of injuries and advance consumer product safety. I'm referring to one, the creation of an upholstered furniture flammability standard that promotes the use of barrier technology that does not require the use of flame retarded chemicals and that can severely slow down or prevent deadly fires. The next is an invisible killer, carbon monoxide. Exciting research has recently been completed by the CPSC staff, the University of Alabama, the National Institute for Standards and Technology on Gas Generators Engine that emits lower levels of CO and increases escape time. I want to see this research turn into real-world innovation that gets incorporated into generators for consumers. The potential to save lives is there and now we need to know how and the will of the industry to make it happen. Another project is window coverings. I will continue to speak out and encourage families with young children to go cordless with the blinds and the shades in their homes. When it comes to child safety, going cordless is the position of the commission. It is the position of consumer advocates and it is the position of the Ender Street Education Council. So consumers should know that they can walk into a major box retailer and specialty store today and find cordless options and blinds and shades with inaccessible cords. And I believe that the innovations, many of innovators, many of whom I've met last year, will chart the future of this industry. Two other products on which we're focusing are ATVs and ROVs. Staff is working on separate rulemaking projects, but both of these off-road vehicles are involved in far too many incidents each year that result in death and life-altering injuries. We will continue to work to make these products safer and educate writers and families about the risks that they pose. Safer play in youth sports and reducing brain injuries is also high on my list. I initiated a great program last year with the NFL and others in the football safety community to accelerate the much-needed change in the safety culture in this sport. It was inspiring to be with the NFL commissioner Roger Goodell and football players in Akron, Ohio during the Hall of Fame weekend to celebrate the kickoff of this program last year. The program provides helmet assistance to economically disadvantaged youth teams, but only if they agree to specific steps that support player brain safety. This has been a great example of the power of a public-private collaboration, and I am so looking forward to the program's growth in expanding the reach of this program this year and in the years to come. Safer play is smarter play. It is also the future of youth sports, I believe.  We will help affected companies to understand and comply with the continuous testing rule, which went into effect earlier this month. The periodic testing rule is intended to fulfill two promises, a promise that Congress made to parents and a promise that the CPSC made to children when under my leadership we adopted the third-party testing requirements. The need for the independent testing of children's products periodically during the manufacturing process to help ensure continued compliance is not only good manufacturing practices, it is absolutely a necessity for safety. And using the CPSC's enforcement powers wisely will continue to be a priority. Companies that report on time are responsive to letters of advice and agree to corrective action plans will be treated fairly. Companies that fail to report on time decline to agree to the terms of a corrective action plan or ignore repeatedly letters of advice will fill the effects of our enforcement team. Civil penalties, stop sales, administrative lawsuits, and health and safety warnings are authorities that the commission takes seriously and we use it judiciously. As many of you know, it is rare for CPSC not to reach an agreement with a company when a recall is negotiated. In a few pending matters where the staff filed administrative actions against a non-compliant manufacturer, the retailers were the ones who stepped up to provide a remedy to the consumers. So I want to express my appreciation for the proactive role that many retailers have played in recent months. Thank you. So as you can see, the CPSC has a robust agenda. It is an agenda aimed at making 2013 even more successful than 2012. I predict that the year 2013 will be another successful year, especially if everyone joins together to strengthen our product safety system. At the CPSC, we are up for the challenge. We are not slowing down. We are committed to employing our limited resources not just for short-term gains, but for the greater good of the next generation. I believe that each of you is up to the challenge too. I believe this because your corporations, your associations, organizations, and agencies already have missions that put the safety and the well-being of consumers first. Collectively, we can build a global product safety system that supports and empowers future generations to reach their potential. So in closing, I would like to commend Iqviso for reaching the milestone of its 20th anniversary. It is quite fitting that after hosting events on three different continents, across three decades, this conference has set a record for attendance. This is a testament to the thousands of hours that product safety consultants, attorneys, association leaders, consumer advocates, and the CPSC staff have volunteered. Volunteered because of their belief in the Iqviso way. Now many of the Iqviso founders are here. Ross Kozer, Dave Schmelzer, Michael Brown, and Joan Berge. And the 24 founders were a wonderful mix of CPSC staff, industry representatives, and state officials. They eventually turned over the reins to today's leaders, Carol Pollack Nelson, Mark Shone, Joan Mattson, Joan Lawrence, Mark Dwaran, others. Although Ross is still the heart and the soul of this great organization. So Iqviso has carved out a special role in creating constructive conversations among diverse sectors of the product safety community. These conferences bring to light new and emerging technologies. They provide training for new members and provide a forum for the leading practitioners of risk assessment and quality assurance. Many of the advancements in consumer safety that are now commonplace were first discussed at Iqviso. So in recognition of 20 great years, now I'm looking for this.  Thank you once again. Thank you once again for the opportunity to speak at CPSC Day. And please attend all the guest sessions this afternoon. And I hope to spend more time with you throughout the day. Thank you very much. It's real quick. Thank you. Let's say a couple of remarks. Very outstanding field.


Hello and welcome to another episode of Issues and Answers, a production of the Government Information Service. We are on NTN right now. We'd like to thank you so much for tuning in. My name is Jessie Léonce. In today's installment we are focusing on national health insurance, something that is surely on the way for St. Lucia, but of course so many things have to be put in place first. I would like to welcome my guests, the health planner and the corporate planning unit of the Ministry of Health and Wellness, Lauren James, as well as Chief Economist in the Department of Finance, Janaye Léonce, to speak to us about the progress that has been made so far and what is left to be done. Good day. Thank you so much for being here. Thank you for having us. We are definitely pleased to be here and to explain and sort of let the public know where we are with respect to national health insurance. Wonderful. I want to start with you, Ms. James. If you could just for the purposes, for the benefit of our viewers, give a definition of national health insurance and what it would mean for our population? Okay. I just, before I answer that question, I want to give a scenario. We have many cars on the road and we are required to insure our cars and we don't have insurance. We cannot be driving on the road and similarly for our houses. So why should our health be any different? National health insurance is really a prepaid mechanism for rich persons who can access health care without paying out of pocket for health care when they need to use it. So it's a system by which we are trying to encourage persons to take a more proactive approach to their health and to prevent them from going to health prices, which is eventually more costly for them. So it works almost like car insurance, house insurance is just for health insurance now, protecting you against any costly intervention that you may need in the future. Okay. From the administrative perspective, tell us the work that has been ongoing. But first of all, funding for this project, we know it's under the Health System Strengthening Project. Tell us a bit about what has been allocated for this venture. Well, currently we have under the Ministry of Health a $25 million World Bank project where we have approximately $5 million in place to put in place structures for health insurance. That doesn't mean, like I said in an earlier interview, that doesn't mean the $5 million is to, $5 million USD that is, is not to pay health insurance, but to put in the necessary structures to operationalize health insurance. That would mean things like legislation, you have your registration of the population and your health management information system and all the necessary structures in place. Okay. Speak to us about the initial phase of NHI in St. Lucia. What will it look like and what will it address in terms of coverage? Right now we are in discussion with private health insurance because they submitted proposals, but what we envisage is that it will encompass a range of services such as inpatient care, outpatient care, we would have surgical benefits, we envisage it to have air ambulance, but it's an ongoing discussion with the health insurance providers. It is not setting somebody, it is our vision for the health insurance to have those sort of coverage for the population. Okay. I want to now come to you Mr. Leonce, if you could just speak to us about, well we're venturing into welfare economics here. Speak to us about the, how it will augur well I should say for the population, for the countries, economics at this time for an injection of NHI. Thank you. Thank you for having me on the program. One of the things that we noticed was that St. Lucia actually has relatively high levels of out-of-pocket expenditures. So on average we spend almost four times the amount that is the World Health Organization and other institutions have indicated is the amount that a citizen should be paying out of pocket. Each dollar that you spend out-of-pocket, that is the money that could have been spent on other economic activity, education and what have you. And health care and paying for your health care has the potential to bankrupt many persons to the extent that they are not covered or they don't have health insurance coverage. When we dug a bit deeper we recognized that only 18% of the working age population has health insurance coverage and that made us look a bit deeper to see why is that the case and one of the issues that's contributing to that is the price of insurance policies, the design of insurance policies and also our attitudes and perceptions with respect to insurance. So one of the things the National Health Insurance Scheme is trying to do is to meet with the insurance providers and see to what extent we can design standardized products that can be at the price point that persons would be able to afford, but also design in a way that it may change the attitude and the perception with respect to insurance a bit. And to the extent that you could do that, a lot of the debilitating costs that persons need to incur should a health event happen to them, that would be spread given the fact that they have health insurance coverage and those monies can be spent on education, childcare and a whole host of other areas. So to Ms James's point, the pooling that insurance allows and facilitates has economic benefits as well. Okay, Ms James back to you, it would certainly also reduce inequity in our population as well. That's correct. Because you have persons over various classes not being able to afford insurance right now. What is the significance of that aspect? I always like to use the real life examples when we speak to those issues. We've seen many persons now, young persons getting cancer and we see and we have donations sheets, we have dances, we have barbecues. That is what the health insurance is looking to get people away from. You have persons that no matter your race, your sex, your economic status that you are able to access this basket of service and there's no barrier to accessing that health, that basket of services. So that is how it really intends to reduce the inequity in health. Okay, now I want to talk about, you wanted to add a point. Just to add to that point, one of the notions that the state is looking to do is where persons are poor and vulnerable and what not to ensure that those persons can be provided with insurance policies that would allow them to access an array of services and benefits that they otherwise would not have. So I think Carries has been placed in the design of this that whatever is to be designed, the poor, the vulnerable and what have you would be proxy means tested to ensure that they meet the requisite standards for poverty and vulnerability so we're not just using ad-lib terms but proxy means tested until the extent that persons do meet the definition. I think the design phase that we are in now, in phisages that those persons would be able to receive the coverage. Wonderful. We're speaking on the national health insurance and the work that is going into it right now to achieve that for St Lucia. We're talking to Health Planner in the Corporate Planning Unit of the Ministry of Health and Wellness, Ms Lauren James as well as Chief Economist in the Department of Finance, Mr. Jeunais Léonce. When we come back, we will get into coverage. Stay with us. Amela, I noticed that you built your retaining wall on my property. You will have to give me my land back or compensate me for that. My contractor isn't dumb. I trust that he will not build anything on your property. Where is your proof? Let's go to court. This situation does not require you to go to court. Just like we have to go through mediation here. Mediation is a way people resolve conflicts like this. Someone, a third party, comes to speak to both parties. This person is called the mediator. The mediator is impartial. He or she makes sure that communication between both parties is effective and efficient. So the mediator is a judge? No. The mediator is not a judge. Judges, unlike judges, do not decide cases or impose settlements. Let me get a mediator to handle this retaining wall and that kitchen. Kitchen? Yes. Your kitchen also falls on my land. Let me call the mediator. Thank you so much for staying with us. This is Issues and Answers and we're talking National Health Insurance with Ms. Lauren James out of the Ministry of Health and Wellness. She is the health planner in the corporate planning unit and we have chief economist over from the Department of Finance, Mr. Jean-Ailéance. Ms. James, I want to get into NHI coverage. At this time, the purpose really is to provide all St. Lucians ultimately with affordable rates of health insurance here on Ireland. Talk to us about the coverage. The coverage is for all eligible residents of St. Lucia. That would mean even if you're from St. Kitts and Libes and you're authorized to work and live in St. Lucia and you are contributing, you will be eligible for coverage. It is our hope that all individuals regardless of age is covered, but that would be an ongoing discussion with the insurance companies. But it is our vision that all eligible residents and that would mean persons who are allowed to live and work in St. Lucia. Okay, and as we mentioned earlier, there are certain vulnerable groups that will be assessed to determine their ability to pay for that insurance. Alongside individuals who will be purchasing on their behalf, the state will also be purchasing in bulk. So tell us about that. So one of the things that we have been working with the World Bank and our other stakeholders as we are in the design element is to address which modality is best. So would it be best for the state to purchase all of the policies and then have persons who are poor and vulnerable receive from the state and also persons who are not poor and vulnerable but would like to purchase insurance to do that for the state as well or whether it may be best to have the state simply focus on the poor and vulnerable and allow your non-poor to be able to access through the employer, through a provider of their choice and so forth. So we are doing the analysis to see what permutation works best for us. What are some of the factors that are being considered? Well, with respect to coverage, one of the key aims for the state is to improve access. So most persons or most insurance products right now, once you get to 60 or 65, these products end. So to the extent that you are over 60 or 65, you often don't have health insurance coverage. So we are actually working with insurance providers to see if we could design products for those persons who are after 60, 65 so that they too will be able to have coverage. I'll meet at a smaller scale relative to what's the norm for your working age but we want all demographics to be covered by health insurance. What's happening now where you look at your working age population is only a small percentage of insurance there and when you look at your non-working age of 65 and above, they cannot have insurance even if they wanted to or they have the financial means to. So the discussion with insurance providers is to explore how the entire demographic age-wise can be covered and that to Ms. James Point, both persons who are citizens and also persons who are domiciled here, resident here or simply working here, they will be able to purchase products as well. So coverage is really intended to have all age demographics covered and that to have the policies so designed to allow any demographic to access. Okay and in keeping with that we also have seeing the note self-employed and the informal sector workers will be required to join the NHI. Speak to us about the significance of that aspect tying into your statement. Yeah thank you. I think COVID-19 and the pandemic has actually showed the importance of pooling. We saw when COVID hit that many persons who were not contributors to the NIC now needed to get benefits because there was no safety net under them given that they were self-employed so many persons had to fall back on the state for income support or what have you whereas persons who were NIC contributors they were able to benefit from the NIC scheme and I think in the discussions we have had with stakeholders to date there's a heightened sense amongst your self-employed and what not who typically would not have thought it best to purchase any sort of group product or what have you. That attitude, that mindset is changing a bit so I think those self-employed and what not who typically would opt out of pension contributions or what we are now proposing health schemes there is a new attitude, a new sense and they will be able to purchase and we are encouraging them to purchase insurance. Our intent is to really have broad-based insurance coverage for the entire populace, all age demographics and to the extent that you have that coverage many more persons will be able to access care and all sectors of the society would benefit in that given you can now access care you will have less persons trying to access care later on in their chronic disease or what have what you have now is that persons are choosing to not go to the doctor early up in their condition and where things become really severe really acute they present themselves to the Owen King or to Zitsen Jew facility and what not where it is now way more expensive to treat and it's way more debilitated from their standpoint so to the extent that you could encourage persons to have insurance coverage up front and be able to to see the doctor and have visits two three visits a year and so forth we're hoping it will stimulate some of that lateness that we are seeing. Okay and of course we are a population we are well known for our pre-existing conditions our chronic non-communicables I want to get into eligibility on that note but before I come to that I want to talk about the life of the coverage is there a time is there a shelf life for NHI will there be? Well most insurance products in the market right now have lifetime caps so you can get a $500,000 policy or $200,000 policy that covers your entire lifetime sorry what one of the things we are working if insurance providers to do is to sort of step away from that a bit and to essentially have whether it be a two or three annual caps which can be adjusted so your annual cap or your major medical limit let's say is $100,000 or $200,000 and to sort of move away from the lifetime caps it is a negotiating of the insurance providers but that's one of the issues that we are thinking to do as well and on the issue of eligibility you did indicate that there are many pre-existing conditions when you look at the market right now what you see is that many persons cannot get insurance because of a pre-existing condition so it's actually one of one of the discussion points that we have and to explore how can we move away from that so that anyone regardless of they having a pre-existing condition or not can purchase a product that is affordable because then otherwise it will simply be denied and to the extent that you have large swaths of the population denied not due to financial ability but simply the market does not cater to them that means that those persons now in terms of the economic situation and what not they have no recourse to any sort of reimbursement and they bear the full cost of their conditions so to the extent that you could shift and design insurance products to remove the barrier of pre-existing conditions that I think would be down to this society well okay understood but just to add to what Shana said and if we have to exclude persons with pre-existing condition then we exclude a huge segment of our population and we we're not able to get to get to where we want to be where we have persons managing the condition from going to further crisis so if we have to look at excluding those persons that would exclude a large proportion of our population because we have huge huge amount of positive hypertension diabetes and now we have cancer under rise so it would that's a that would be discriminatory in that sense yeah that's the intention no that's the intent yes that's the intent in terms of the overseas care that's something that we see come up you mentioned miss james persons raising funds for travel abroad where healthcare access is better but it but it also comes at a cost speak to us about how the coverage NHI will deal with that if there we have proposed a component in the package for that but that would have to be something I guess we'd have to look it out of the insurance provider the way it has to be something that is not provided on island if it's provided on island then it has to be accessed here but if it's something that's absolutely necessary it would have to be accessed overseas but it's something that we are factored into the package and it's in the discussion of the companies insurance companies and just just just to that point the the health strengthening project program is looking at ways within which some of the very same issues where it's not offered here and whatnot what can be done to strengthen the health system here to sort of reduce the the need and in some cases it is the need to go to go overseas so to the extent that you could invest in the the capital stock and the human resource that solution needs to be able to offer some of those services not all but at least some of those services it would put us in a situation where you would not need that many persons flying to martini flying to columbia and whatnot okay going back to to the the qualifications for accessing any giants in st lusia you just have to be a resident you don't have to be a st lusia national yeah that would be correct so that's what it would obtain would the individual if the person is coming for less than a year what are the obligations in terms of paying or contributing toward the n h i yeah i think that's that's one of one of the issues we've we've been grappling with in terms of the length of period where it becomes that you were you're sort of required or or encouraged to do that i think a year is is good now we are we are looking towards a situation where persons can opt in if if they choose to and particularly if they are here more than the for tax purposes 183 days is usually considered where you were where you were sort of tax resident so i think we are looking at that that time period as sort of a a threshold and then once you are over that period then it's definitely available to you so that's that's one of the modalities that we are looking at okay what about st lusians in the diaspora who are considering getting insurance through st lusians n h i can they we we would have to we would have to discuss that i we are not settled on on that point as as yet but it is something that would be looked at with all stakeholders okay and what about persons who would have recently moved into st lusia how soon would they be able to capitalize on the part of n h i i think that was about the same because for example um i once lived and worked in um sinkets and i contributed contributed to the the um n i c and it was only after six months i could have claims to the n i c so it would have to be something to that effect with those conditions okay so we are due for another break do stay with us this is issues and answers we're going to be going into our final segment after this break continuing on with the stakeholders of n h i stay with us studio 758 acid creations and the royals and lusia police force good god thank you so much for staying with us this is issues and answers we're talking national health insurance and we are speaking to mr janai leon's chief economist in the department of finance as well as the health planner in the corporate planning unit of the ministry of health and wellness miss lauren james thank you so much guys for being here so far it has been insightful i want to get into stakeholders at this time um what impact will n h i have on the health care sector and we're talking from the administration the ministry all the way down to health care workers and nurses on the beat and so on that's a good question um as you know government spends approximately a hundred and that's the hundred and thirty hundred and forty million dollars a year to the health sector and right now we only recoup about five million the other five million that we receive is from n i c has a contribution to health it um would benefit the health care system in terms that we will be able to recoup monies to plow back into our health system to provide more services for the people um we would also have um in terms of our population they'll be able to access health care on a timely basis so that they would avoid going to those health crises um or avoid it altogether or delay it in terms of our health system we are i think that it would impact the health system in terms of quality that we would hold our health providers accountable for the outcomes um it would um probably encourage more persons to go to those health providers because we plan on roping in the private sector so they'll probably see a larger population in a larger influx of persons in their day practices we expect that persons would come out now because they have access now okay so less of a burden on the health care system in terms of finances because we and we intend to by roping in the private we intend to like spread out the the patients what it would be less of a burden on the public health system okay and by which time performance-based financing would have been in full swing the other services through the 8D project would be in uh as well and as um not to cut you short but as you know the world bank project also aims to strengthen primary care so yes the gaps we identify in the primary health care into the equipment infrastructure we will be um upgrading those to deal with the influx that we anticipate okay so now what what of the governing body for NHI the governing body um that is still being worked out but we um are looking at something more like a central health regulatory authority which would regulate the whole insurance company in terms of the benefits package the the providers of health services the insurance providers the patient registration and all that um kind of thing to do with NHI so we foresee something like that but it's still under consideration that would be more it's like the governance structure that would um oversee NHI okay and what sort of training is has there been any training or will there be any training for health care workers to prepare them for the introduction of NHI yes we do have a component under our health insurance project for training of um for capacity building for our health care workers so we will be tapping into that so whatever training that they may need that we will be doing that okay and what sort of engagement in terms of consultation that's also in the plans as well yes okay wonderful um we know the private sector they were the private insurance companies are definitely looking forward to seeing how this is fleshed out but what sort of um how will the the implementation of NHI affect the private insurance companies I think in the discussion with the insurance providers what we have indicated to them is that their market is going to is going to increase significantly right now each of the private sector insurance companies are really servicing a relatively small small market a few hundred to a few thousand um clients to the extent that you could broaden that out and service maybe double or even triple that it does allow them to receive some economies of scale to the extent that you as an insurance provider are now working with a larger pool of of persons those premiums that you're getting from a much larger pool also can read down to you to strengthen your your your product offerings and to also lower your costs over over the long the long term ideally that is that is the hope but essentially it allows them to be to be larger stronger by servicing a larger pool of of persons because what's happening right now due to the price points the attitudes and the current regulatory setup very few people are coming so they're only essentially reaching the choir to the extent that you could be structured in market where the entire audience has insurance coverage and is serviced by your different insurance providers it makes everyone better off not only the the state but your insurance companies are now stronger and larger refer a significantly enhanced pool of persons paying premiums and what have you okay but so i um to watch and i said it's not an intent to crowd out the current insurance market it's more less to augment it because if persons already have insurance like myself we just encourage persons to just if it covers the bare the bare bare minimum that we outline we encourage persons to just stick with their policy and they don't have necessarily have to purchase a new insurance policy with no intention to crowd out um what currently exists okay Mr. Layhouse I know we spoke a little bit about how the NHI will benefit the population our economy and so on but how does the government intend to make this project sustainable because an investment of this magnitude uh I can't think of a better word than recoup yes how are you able to recoup yes I think Ms. James spoke to it earlier what what do you see now both your San Jude Owen King and some of your other facilities while they provide services to the public due to the fact that the vast majority of the public does not have insurance and the price points are so low even when persons pay for the services that they receive from Owen King or what not what they are paying for is relatively relatively small given that it's a highly subsidized uh venture to the extent that you have the entire populace or a significant percentage having insurance coverage you can then now have some of that cost being borne by your insurance providers and that redounds to the to the benefit of the state by now being able to to build a provider more so than an individual so the the pooling of premiums across the entire populace allows it to be an injection of monies into the system that the providers of healthcare whether it be in the private sector the public sector can levy claims against that pool that's housed by your insurance providers and therefore recoup way more than what what is happening now that increase our monies that you are now able to recoup you can now plow that back into some level of sustainability and it becomes a positive cycle we we believe okay and so final question before we wrap up uh what do you do if you already have um private health insurance and for the individuals who may be saying how much is the premium i'm ready to pay let's get this thing signed off on okay the premium is still being worked out of the insurance companies we will be engaging them for over the next few weeks to work that out and if you have health insurance um already once it meets the bare minimum that we outline then you are encouraged to keep it or if you choose to buy the one another health insurance then you are free to do so okay that's really really really unsure what we are attempting to do is set a standardized flow for insurance coverage and insurance products in the in the marketplace and to encourage persons to at least have that flow as it were or better okay wonderful uh thank you very much mr genaille leance a chief economist within the department of finance and i need to reference the people because there's so many words for your your department um miss james lauren james a health planner in the corporate planning unit of the ministry of health and wellness i'd like to thank you both for being here just elucidating us letting us know where things are at right now in terms of the journey toward nhi here in st lucha uh we've come to the end of another installment of issues and answers my name is jessie leance signing off for now goodbye


Well, good afternoon everybody and thank you for your very good presentation Wendy and it's good to be part of the third Asian Pacific. I'm going to be talking about the city of Leeds, which started out as an industrial town in city like so many in the north of England. And it didn't actually move as far forward as it should be in terms of making itself a good place to be. Until that is, we had a report, and I will move on to hopefully the next. Yes. Leeds is the third largest city in the UK, and it lies in the fourth most populous area. The area has about two and a half 2.6 million people in it. It is one of the most diverse economies in all the UK employment areas and has, which is rather good. It's one of the most diverse, fastest growing private sector jobs. That said, the character of the city is diverse in appearance and density but the public realm to be perfectly honest did lack distinctiveness. As in most cities can enjoy the city most by walking around it on foot or possibly by bicycle, but Leeds was fundamentally designed round vehicles. And that is not very helpful. Leeds came in 2014, when a report by the public health England on air pollution in cities and supported by the World Health Organization found that over 320 people per year who lived or worked in the city centre in Leeds died from diseases caused by air pollution. And that triggered a lot of very quick rethinking thinking how on earth, can you have a city where you know that that number of folks are going to die. So things moved on. And yes, it's easy just to draw cartoons of situations. It doesn't make them really any better. That is the centre of Leeds. And the some of the areas I'll be talking about is is the head row, which is that road there. Cookridge Street, which goes up there and one or two other places bond court there. The sovereign square down there and the city square. As a result of the poor. The city produced an open spaces strategy, and the strategy embodied a vision of the creation of a vibrant inclusive. And much more pleasant world sort of centered city, as they call it. And it was really the whole object was to make the public realm worth being in trouble is you actually can't do that overnight. You can get a Harry pot a stick and wave it but it actually doesn't work that quickly. And the first scheme in order to get people convinced that things were going to happen was really getting rid of a car park and turning it into a city park. It was the first part that had been built in Leeds for decades. And the second was a scheme called bond court, which we will see in a moment. This was the our spaces strategy, and the reason it took a number of years to get going was really because of public engagement. It is so important, not just to say right now we're going to do this. And people are not involved. We have people from 170 different countries living in Leeds, and there are 140 languages spoken, not by everybody as you can imagine. So it is a very versatile city, and it takes time to engage with people. And you can engage rather consult because consulting communities tends to be top down. And when you've done it you sort of say oh well we've done that, and you carry on engagement is what it actually says you engage with people, and they have a say. So the first square that we built was sovereign square. It was fairly quick off the ground. We got a lot of money actually from private sector because they said wow, you're prepared to do a new square. And the car park that it replaced actually made a lot of money for the council, but I'm glad to say they sort of said no, no, the square is got to be done and we've got to do it as quickly as we can. But well, it had a large rain garden which you can see going off into the distance there. That little girl isn't about to do something terrible by leaping into that water. That water is actually only 50 millimeters deep. And it was put there so that children could upset their parents by actually jumping in it and getting wet. Because again, how you give pleasure, if you like, or potential pleasure for young children in the city. It isn't just about shops and trees, although that is critical. It's also about what you do if you're a little kid, but trees were very much part of the square. It was actually very successful. And the good thing about it was that people were very happy with the fact that the council actually did what it said it promised to do it, and it actually did it. And that helps a great deal. We then moved on and built bond court, which was quite easy to do because again, it was in a slightly commercial area. Art started coming in. Art is the tree of life, if you like. But again, a lot of trees were planted and we started started changing the species a lot because a lot of trees originally were pyrus caloriana. And Fraxness and Gustaf earlier Raywood, which of course was a problem because we have ash dieback disease. But we started expanding the species quite dramatically. Very humble little space, but it's amazing how it actually changed things that was a large London plane tree, which we put in the ground it's got 28 cubic meters of rootable area. It started growing the very day we put it in there. And what was originally just a gray little bit that people nipped through as quickly as possible. All of a sudden people were happy to sit there in this this this one, admittedly fairly large tree and it cost a lot of money to put it there. And then cafes started opening up and all sorts of things. It was amazing what just planting a large tree can actually do. The other thing that we had to start doing was controlling vehicles. And the principal city streets are the key points of arrival for so people entering the city by bus or train. They're deemed to be part of the highway infrastructure and therefore there were far too many vehicles high traffic volumes and noise and air pollution. Now, many of these streets are dominated by pedestrians together with an increase in the planting of trees. And we have an amazing park and ride system, which I'll show you in a moment, which is actually the only one in the UK to be totally so the power. And all the buses that take people from there into the town center are electrically powered. And so it can be done. This was a street which was pedestrianized it's not perhaps quite as designed as some people would like but it was important to keep people being able to move the building on the right hand side is a big hotel who were against it originally. And now they just say it has changed the whole way our hotel works, the number of people that come here. So just booting the cars out and bringing people in helped amazingly place called corn exchange which is that large building in the middle which is what it says really it's a very old market going back for very long time. But now it's full of very small, but but rather fine little shops, the rents are low. So if you or I wanted to start up a shop to sell whatever it is. That's probably the good place to start. Again, vehicles were pulled out public transport goes down that road there. All these areas which used to be for vehicles cars have been booted out. They've been modernized and more trees being added. The head row, which I mentioned previously has still got public transport down the middle bit. It had four lanes of traffic before it now only has two footpaths have been troubled in wits and tree planting. And that's what the city has gone on. Again, the retail side of things has just rocketed, because people have got the time to actually look. And as the trees grow, it will get even better. The park and ride I mentioned as a place called oddly, which is on the edge of Leeds. But you can see there's one wonderful proposed big one fact speed built now tree in the middle there. All around it and that the woodland all around it. It was an absolute gem. And again, it's absolutely full of cars and people now who think yeah, yeah, well I can drive in from any part of the Yorkshire North of England Park there, get in the town buses. There isn't actually a timetable because they run every few minutes or so. So again, the cost of it which initially people thought who do this is going to cost. They said no, it cost a fortune but look what the benefits have actually brought to the city. There's a lot more happening now, as I say it took several years to actually get going. But the program is moving fast. The greatest thing which I have to confess it surprised me a little bit but I was will go into it but slightly involved with this. This is the central square in the middle of the city. The station is down here people come out and move through here retail area is over here. That for anybody who lives in Leeds was the center of the city. It was terrible. It was traffic was all the way around here you really didn't you could just about get across the road and then you pollution. So all traffic has already been booted out we haven't actually built this yet. This is called the Glade. And this area of Yorkshire once upon a time was the forest of Lloyd ease which goes back to Celtic times. Now, the center of that forest is now going to be city square. We're going to be planting 170 trees in the square, and they go up the adjacent streets. As I say, the hotels and the cafes, as you can see it moving out. And it's going to be a wonderful space. I was very surprised that the, that, to be honest, the politicians sort of said, what, this is the central square and you're going to turn it into a, an urban forest and said, yeah, as you've got to approve it. And they did. So that was brilliant. We are going to do to double the canopy cover of the city to 19%. That's a lot lower than some cities in Europe. But at the moment, or when we started out, the tree cover was only about 6%. It's now well over 10% now, and obviously is going to go further. Wendy mentioned, I'm chair of the White Rose Forest Leeds as you can see is in the middle there, and we cover over 9000 square kilometers of the north. And things are going very well. We've got 3.5 million pounds from the government this year, we've got 254 sites which we're planting up covering 850 odd hectares. A lot of those are peri urban woodland round leads, but also a lot are street trees, and we have a green streets project as also going into the areas of dense terraced housing around the edge of Leeds and the old industrial areas, and basically retrofitting them, because if you live in those areas you just as entitled to the urban forest as anybody else. So there'll be certainly the old bits of brown to the land we're putting in mainly mini forests because a lot of the streets are too narrow to put street trees in. But it's on the go. The R Spaces project strategy is ambitious, but it does present a realistic picture of what Leeds will look like as Leeds says a world class city. It will be substantially greener. It will be better connected. And it will be a much cleaner city and more accessible to people and recognizable as a unique place to be. It does take time, but it's getting there and certainly by the time the program is finished, which is 2030 things are going to be much better indeed. And as you can see things are moving forward quite well. Biggest benefit. And I'm speaking personally I suppose here is get rid of that is that city design used to be like that. We're pulling in different directions highways planners developers urban designers architects, urban forest is all pulling in different directions and some poor souls just trying to pull glue into it and bring it together it has changed. And this this places and spaces strategy has changed it we're now all working together and pulling in the same direction. And as I tell to professions we've all got a benefit in success. None of us can just succeed on our own, just pursuing our own narrow way, we've actually have worked together. I'm glad to say this program has really helped that. Thank you for your time.