What's up everybody?  Happy new release day two guys I just so many new releases besides prism you have Alan and get your chrome you have flawless baseball You have draft picks prism baseball I mean it's crazy day today guys, but we're starting off with a lot of prisms early on so let's go guys Let's roll the dice We got a two and a four for six times. So good luck six times And we're all the six again. Yeah, I guess it is a timestamp. All right, so here's the names. Here's the teams Make sure that I did roll the six again I have you do wow that's crazy. All right six times. I was just rewatching the replay of my video really quick one two three four five six Brian Croft Down to amber six times one two three four five six Titans down to the Carolina Falk Carolina Panthers are It's a bright crowd the other Titans Adam cover with the Buccaneers max of the Texans Adam with the Seahawks Greg with the Browns Amber with the Raiders Christopher with the Washington football team Max with the Cowboys Joe with the Jaguars Romeo with the Bears as well as the Steelers Matt with the Giants Derek with the Ravens Chad with the Bills Amber with the Saints Adam with the Vikings Eagles Brian with the Jets Joe with the 49ers Gary with the Packers Shackleton you have the Dolphins Amber with the Broncos as well as the Bengals Ryan you have the Rams Chad with the Lions Greg with the Colts Matt with the Patriots Amber last ball module Chargers Christopher the chiefs Gary with the Falcons and amber with the Carolina Panthers All right, if anybody wants to trade guys, I'll give you guys a quick minute All right, we're just Ravens Derek says no Rams up. It's not guys. I'm closing it guys Um Jay, let me pin the break schedule for you so that way you guys can see it But there it is right there and we have hobby Pikachu number one Pikachu number two is not sold out yet. We have two left. It is right there at the bottom for some reason I think it's showing up at the bottom of the football collection page It's down here, but two left there and then of course three and Four left the number four so I think I'll be able to get all four in before Joe gets here and then Hopefully we get someone gets that last team and flawless gets the Cardinals We can break some flawless as well But yes, number one is after this. All right guys trade winner closed You know if it's early. It's a new release day Um, probably we did a filler for what number nine, right? So I assume at some point today We will have a filler for number 10 But you know, like I said, so many people are going to be coming in and buying prism Maybe the maybe we'll have some people just buy these teams straight up But I'm sure at some point we will post a filler But um, like I said with hobby coming out today Um, it's just people are going to be buying hobby. So even if we post a filler Obviously can't guarantee that it's going to sell as quick So All righty guys, so let's choose a box really quick. I think we did box one and 11 earlier So let's actually sorry before I do that. Let's generate a box number. So we did number one and 11. So let's generate two more numbers So Click generate and it's five. So we have box five right here Yeah, I think someone was asking earlier if we're going to post up more hockey and I'm sure we will post up more. Um Chronology is just like I said, I think today's such a very packed release day Some of those other breaks may sit like hockey and stuff. So we're probably posted up maybe tomorrow Tomorrow and sunday All right, one more box guys Eight Like I said, there's four actually big new releases today You know what I mean? Oh, I thought you said hockey breaks. Uh, probably. I mean at some point. Well as we sell them out I read hockey for some reason, but yeah, I'm sure we will at some point So there's number eight and number Uh, three right there. Or sorry, not three. Number five. I was supposed to get number five All right, what was it five? Yeah, it was five There's five. I know it's kind of hard to see it, but that's a five Yeah, it's guys. I'm sure we will have more hobby But uh, as we continue to sell out All of these figure teams we probably won't post more The only thing we might continue to post more is hobby random teams, of course So let's uh sell out The first four picker teams guys and then that'll Give nick uh Some time to post up the next couple Again, I don't know how much hobby we have today We could only have so many cases today and then we get more cases tomorrow. Who knows And I'll tell this I'll tell people there's no guys Prism hobby's gonna come in waves, you know, not not everybody gets the price The same the first wave so If we have to pay up guys Tomorrow if we get more because it's from a different place Prices are gonna change So just remember that we always like to try to keep them as close as possible. But um I know that's not always the case though, especially with prism hobby. So Just be aware of that You might see a price for a team posted right now at this price. You might see it a little bit higher the next time And that's not because we're just like oh, let's just raise the prices because we want to You know, it's just more like hey, man We have to make a little bit off of this, right? Especially when we buy secondary market, we're buying it just like you guys But yeah, no, I'm at the same time. Some places have better connects some places Got x amount of cases at a better price at the end of the day I honestly think we're always very competitive though If you go look at our personal box prices, I think they're always the best they're out there Um, I can't say that we're number one, but we're always competitive. So whenever we sell out of stuff Whenever we sell out of stuff And we have to post more because we bought it at a second place. It's gonna go out But um picker teams is always tricky Some people like to capitalize on the chargers and price them the super highest And then the rest of the teams are really really cheap and then some teams like to keep it even Price up some of the cheaper teams have the chargers a little bit less Everybody has their own method But if you ever get to do the math, it's almost all the same Also, I think we have a patch auto coming up too, which is a case that I want to say So far this is the second round on team EA picker team number one starting after this Remember guys, I pinned the break schedule right there if you guys want to click that You guys can see the schedule but so far Uh first two rts sold out then picker team number one sold out right after Oh, of course man. Yeah I mean someone really wants to do all the work and look up everybody's prices for sure You'll see the difference with it. It's really never that much difference. Like you said if it's about five percent That's not that's nothing It's just depending on how you want to price your picker teams You kind of you kind of also have your breaker. You kind of go with your customer base, right? in a way I was on jeffrey So like I said, if you're a person that it's all about the prices for you The good thing is that we're not the only place to shop at there's many places I always tell people I don't blame you guys if you guys find better prices somewhere else for your team or your specific box break Because I don't shop at one place I shop at multiple places Some people like certain breakers. So they're willing to pay the extra percentage or extras Extra money for a specific team because they like breaking in some places. They won't So I always just tell customers that if they get fresher, they wire our prices are a little bit higher And then some people would be like man, your guys's prices are great. It's just it's going to be up and down everywhere Chase young Prism Joe P freaking prism garbage Chan Bailey out of 249 Dexter Lawrence I From I'm pretty sure we will I think obviously that we notice that picker teams sell much quicker So we pre-order picker teams random teams as much easier to sell once you post it But I'm sure we will man We always have to have at least one random team Just like this prism, you know, we realize random teams we're gonna sell so We can always just post it up a couple days before the release But um, I'm sure we will have random teams though For a ballman draft, let's just pick your teams always are the ones to To to move quicker because everybody likes to rather pay their fixed price for their team Eric Hendricks Grady Jarrett Chase Claypool Are we got Alan Lazar? We got a patch out or something crazy here Which I've only ever pulled like two patch autographs in my whole prism career of breaking CD lamb out of 49 patch autograph for the cowboys Very nice Oh, we got a two in this box In prism, no huddle if you've seen two of most likely Herbert was popping out So there you go. There's a twoa Dolphins And there's your Herbert Chris Jones and Herbie Very nice And for the bills Hobby's the same. Yeah, I think once you get one sequence down in one product like a variation product, it's going to be the same throughout Right away early on you catch on to like Zion and and Matisse Daibel and etc. etc. Which is kind of funny that They actually do it that way This is obviously machine packed, but it's funny that you can kind of catch on to that Also guys, I know you guys seen your teams, but just show you guys again Y'all enjoy Swift and the jimmick man All right next box and 12 winfield junior silver for the bucks I love that the silvers this year popped so well Kind of just reminds me of the old school like 2013 CJ Henderson out of 175 U-torque rosmatos, you know, Benjamin also they say is a Is a third when it comes to Herbert and twoa Sean Alexander to 125 Leviska Chinaltz Joe Burrow Alberto to 249 Zach Moss cd lamb Adam Theland And there you go. There's a tool to it's no go by law Based there for the dolphins are going to Ryan and there's Herbert Grady Jarrett Laramie Tunsel And we got Landon Collins Isaiah Simmons Devon Duvernay Minka Fitzpatrick Joey B. Well, this has been a great box.  Wow Jesus man.  Do you guys know me? I'm a big Eagles fan, but cd lamb is legit Which is scary. Wow.  I pull this as well So there you go guys appreciate it jazby's case breaks.com


So this lesson is going to be on mass concentration and molar concentration. So as we talk about in the lesson on solutions and number of concentration, concentration is defined as the amount of constituent per an amount of volume, and number of concentration is defined as the number of entities per an amount of volume, but that's only applicable for a system with a very small number of constituents. In practice in chemistry, that is usually not the case because you usually will be dealing with a very large number of entities, so you will be more often using mass and molar concentrations. So mass concentration is defined as the mass of a constituent mi, divided by the volume of the mixture, v, and molar concentration is defined. It's similar to the number of concentration, but the amount of constituent is represented in moles instead of number because there are just too many of them. So let's do a question. Say you put 2.1 grams of sucrose in a cup and filled a cup with water onto the 1.5 liter mark. Let's calculate the mass concentration and the molar concentration of this solution. So the mass concentration of sucrose in this solution is equal to the mass of constituent, which is 2.1 grams, divided by the amount of volume, which is 1.5 liters, which is equal to 1.4 grams per liter. So this is the mass concentration of sucrose. It tells you that for every liter of this solution, you get 1.4 grams of sucrose. Now let's calculate the molar concentration of sucrose. So the molar concentration of sucrose in this solution is equal to the number of moles of constituents, divided by the corresponding amount of volume. We know that the volume is 1.5 liters, so we don't know the number of moles of sucrose. So we do need to calculate that first. All right. So how do we do that? First, you would need the molar mass of sucrose, which is 342.3 grams per moles. Now the number of moles of sugar in 2.1 grams of sucrose is 6.1 times 10 to the minus 3 mole. So we got our number of moles of sucrose. Now we have all the ingredients that we need to calculate the molar concentration of the sucrose solution that we made. C equal n divided by V, so that's equal to 4.1 times 10 to the negative 3. And the unit, as you can see from the calculation, it is more divided by liters, so the unit is more per liter. There's also another unit for this, which is practically mean the same thing, and it's molar. So I would say that this is equal to 4.1 times 10 to the negative 3 molar. The symbol is Big M, so you will quite often see people use this unit to represent the molar concentration, but you should know that it translates to more per liter.


Still outside Africa, at least 46 people have been killed and dozens more seriously injured in a fire at a 13-storey tower block in southern Taiwan, officials say. A residential and commercial building in the city of Kaishong caught fire in the early hours of Thursday. It took firefighters more than four hours to extinguish the blaze. At least 46 people were killed in a fire in a residential building in the southern Taiwanese city of Kaishong on Thursday, according to authorities. The fire broke out in a 40-year-old building in the early hours of the morning when it was extinguished around dawn. Footage from local television showed firefighters dousing the burning building with water as rescue personnel carried injured residents away. This is one of the residents of the building. There was a boom noise and then there was a fire. The power lines may have been outside. These last few days there have been boom sounds in the power lines. The Kaishong Fire Department said in a statement that after completing a search of the building, they were able to confirm 46 deaths. Mayor Chen Chi Mai said the building was partly abandoned, having previously been host to restaurants, karaoke lounges and a cinema. The government is investigating the cause, including where the arson was to blame.


Good afternoon, ladies and gentlemen. It's for me a particular great pleasure to Continue what we did already in the past to have a dialogue with Satya Nadella Who I don't have to introduce him Probably is a highly as a most regarded and respected leader in industry and chairman and CEO of Microsoft so I'm Just when should you have a question or a comment, please stand up and mention your name but let me let me start with a discussion with Usatya and it seems when we look at the force industry revolution So now in technological development when you look at the S-curve We are really at the point where we have the exponential development. We see it Just look at the announcements over the last weeks Artificial intelligence quantum computing and I could go on and on now Satya you you are at the forefront of those technological developments in many ways and What do you see what major shifts will come out of this of those developments? and I mean, what would be the final result of all those dynamics? No, first for class. It's fantastic to be back here and have this conversation and I think you described it well, which is Where are we on the S-curve? and Interestingly enough I sort of think about it as there's one S-curve where we are at the tip Where it's now about? deployment confusion Mainstream in fact one of the things I think a lot about is in a time like this where let's just say with all of the macroeconomic Challenges or take even inflation. I think it's short time for us even in the tech industry To really say okay How can software for example be a deflationary force so that every business can do more with less? So there's one side of it, which is real deployment of technology so that we can use the most Reasonable resource we have in order to tame some of the inflationary forces a good example to just give you one is you know, there's a You know take what unilever is done with their lights out manufacturing with digital twins It was great during the pandemic as a way to do Manufacturing well remotely, but more importantly in Silico they're able to simulate and reduce energy cost water wastage and other wastage So therefore that's a good example of doing more with less. So that's one side. The other side is Something like artificial intelligence. If you look at it, it's at the beginning of her new S-curve And that's the fun fun part of being in the tech industry where there are certain technologies that are reaching maturity that need to get deployed and show real results and then we now have essentially Emergence of a completely new set of technology, which I think is going to be a revolutionary You say it will be a revolution I think we all feel it will be a revolution, but there is a certain fear particularly about artificial intelligence People feel it this humanizes us and so on now What what steps do we need actually to make sure that so is Technologies particularly artificial intelligence remains society oriented and human centered. Yeah I mean, I think it's a great point and I think a very important consideration and quite frankly a design consideration. In fact, one of the Things we think a lot about is how to deploy this technology To empower human beings to do more. So for example, like on New Year's Day I saw this tweet by Andrij Karpati who was an ex founder of the autopilot group at Tesla who's in you know an AI developer and So he sort of referenced perhaps the biggest product that made a difference in his life in the last 12 months Was the GitHub co-pilot we had launched last year. So so here's a software developer Using tools and saying now GitHub co-pilot is generating 80% of his code So it's that doesn't mean Andrij is not writing New code and being at his creative best It just so happens that now he has 80% leverage in doing what he's doing. He's still the pilot He does have a co-pilot. So that's why I even like the branding of what we did there Because I think it helps put the pilot in charge and the co-pilot helping the pilot But that's one example. I'll give you another anecdote, which for me perhaps was the most Revealing of what the can happen. I was in India at the beginning of January And I saw this demo class in India one of the things that's very exceptional That's happening is digital public goods that are getting built for identity payment many systems and one of the digital public goods That's getting built is for language translation So the basic they have an open-source project so that anybody building any application in India can translate between any language in Indian Any Indian language. So a demo I saw was a rural Indian farmer Trying to access some government program, right? So he just expressed a complex thought In speech in one of the local languages that got translated and interpreted by a bot and a Response came back saying go to a portal and here is how you lax as the program He said look, I'm not going to go to the portal I want you to do this for me and it completed it and the reason why it was able to complete it was because it they had that a developer building it had taken GPT and Trained it over all of the government of India documents and then scaffolded it with this speech recognition software So think about what that meant right that basically meant that a large model a Foundational model that was developed in the west coast to the United States a few months before had made its way to a developer in India who then Sort of added value to it to make a difference in a remote villagers life And I've never seen that type of diffusion to your point about the industrial revolution clouds You know, I would say you know, we're still waiting for the industrial revolution to reach some large parts of the world 250 years after The internet maybe took 30 years Maybe the cloud and mobile took 15 years and now I think we're talking months which to me I Think is perhaps the benefit doesn't mean to your core question We shouldn't take something like AI safety. Yeah as a core Consideration right, you know at the design time and so therefore even when we launched these APIs which we did this week One of the key things is the APIs have safety built into it for harmful content or the context in which they use So a lot of work needs to go into it still but we think of both the unintended Consequences and the benefits both being something that we harness. So you feel that GPT and similar technology Will become very fast Penetrating our lives business lives, but also personal lives. Yeah, I I I think about You know, we all remember in 2007 2008 the birth sort of that was the last time I would say we had major platforms being born by the mobile platform And the cloud platform and you know in the last 15 years. They've gone mainstream You know, we're still out say, you know still in the throws of its penetration, but it's Significantly understood that this technology is making a real difference I think that the AI piece in this particular generation of AI Is showing that type of I would say platform shift and just to kind of give you an intuition clouds the As to what exactly happened like why are we talking about AI in January of 23 after all we were talking about it last year But there seems to be even I had not expected if you had asked me last month coming to F Would I be talking about AI this much? But it turns out that you know, even the chat GPT moment as I think captured people's imagination But we started the work with open AI. I would say three and a half years ago When we started building the AI supercomputer in Azure to train these large models So in fact that the workload of this particular form of AI requires a complete rethink even in the system architecture of the Computing infrastructure and we did that hard work and train these models And when you look at GPT 3 to 3 5 to what's coming these are non-linear developments So they're showing emergent capability and I'm not saying this is the last model architecture Innovation there'll be more to come but the fact is that these things by themselves are becoming Platforms that I think truly can make a difference. Let's see. Yeah, we say we see audience. I raise a question Who of you has Made already his own personal experience with GPT Yeah It shows the sophistication Of the audience now there's another technology which we demonstrate here and we actually do it in Corporation in partnership with Microsoft and with Accenture But we have 70 80 companies in a consortium Behind it or behind us. It's a global collaboration village Which is the first probably the first metaverse application for public good What are your thoughts about it? Satya first of all, I think the vision you've had clouds around You're using this new technology of Metaverse and these immersive experiences to bring the world together To both have that sense of community presence And collaboration. I think it's just absolutely needed, right? I mean if I think about what is special about Davos It's about the ability for multiple stakeholders to come convene Learn debate come out of it with energy on what they can do to change the world And so to some degree to say that if there's some new technology that can for example Really bring this global collaboration village to life where not only can people collaborate when they're here But it can be an ongoing thing. I think it's fantastic. So I think if I would encourage everyone to go see the exhibits Because I feel the thing that is most for me Game changing about this particular technology is that sense of presence one has right which is When you're even virtually Interacting I think during the pandemic all of us obviously did a lot of video meetings And I think it is definitely got us through the pandemic And I think they're going to be very much part of our lives And I think of this as a very natural extension of it because beyond video meetings If you can have more immersive experiences where that presence the co-presence can be felt you can understand the impact of Any of these the hard topics that we're talking about I think that can be pretty game-changing So I think it's a brilliant idea. I'm glad to be partnered with you on it And I would really encourage everyone to participate. Let me let me just see who has participated at the demonstration So who haven't I think have still an opportunity To do so but um, let me come back Satya to an issue which we discussed also last time It's uh cyber security we discussed it every year and it seems that it gets every year worse And um, it's undermining actually is a trust into the digital system Um, so what can we do? We have any chance to enhance Trust into our digital infrastructure. Yeah, it's uh I think you said it well because in some sense as digital technology gets um much more You know pervasive in our sort of economy and in our life The unfortunate consequence of it is also cyber crime and And cyber security issues are on the rise. In fact, I think there was a great panel Today from what I understand on some critical infrastructure And in fact if you look at what microsoft has done in the case of ukraine or albania, these are all well recorded At this point in terms of the work we had to do to protect essentially critical infrastructure And even nation states that are under threat But to your point interesting enough you phrased it right, which is in order For us to have trust And security You have to have an approach which is zero trust Which is kind of the paradox in fact the the way The the security community talks about the best way for you to have Security is to assume breach And then think about your defense If you will and so therefore we have had microsoft developed an end-to-end infrastructure Whether it's from identity to the endpoint security to application security to uh the Infrastructure security with the zero trust architecture But not only that we are you know, we see trillions of signals right because at the end of the day It's an intelligence game. And so we are taking the Intelligence slash signals we have and using it actively right the only reason why we were able to intervene in the ukrainian situation Was because we saw the signals Long before even the attacks and therefore we were able to then help evacuate essentially the ukrainian Government into the cloud and so those are the kinds of proactive action that we have to take I think in order to protect so the operational security posture of every organization every nation every public You know critical infrastructure institution is going to be very very important But how do you explain that most of the companies are not yet on the level? They should be and what can be done in order to increase to make it Let's say a general rule like everybody today probably closes The door In the evening. What can we do? Yeah, I mean one of the things Which we always advise is you know you use the cloud So for example the place one of the ways to be secure is not to be fighting this alone Because at some level you want to be able to get leverage if if you go back to what I said This is a signals game. You want to have the signal strength on your side versus being isolated So that's one of the reasons why I think it's going to be very important for us, especially around local government public infrastructure To be able to modernize the infrastructure and have it run in what is environments that are really well suited to fight the cyber criminal activity I may change to a certain extent the nature of our discussion come back to an issue which of course is very much In our minds this week here in in Davos. It's the energy Sustainability and energy transformation And you are one of the pioneering companies because you want to be by 20 certain not only carbon neutral But carbon negative by 2050 to yeah, which means to to Take up the sins in the past and to correct some now Um What what would be your advice to us the companies and what can microsoft? What can what can the technology like your technology do in order to help other companies to achieve? To go faster in energy transfer in energy security and energy. Yeah So I mean first I would say you know, we're doing a lot first to make sure our house in order because um Given the commitments we have made Each year we audit them and we making sure that we are making progress on it and quite frankly In the last year for example, I think on scope one and scope two We did a good job reduced our emissions by 17 percent Where a scope three increased because of the increased usage of the cloud and our gaming consoles and a lot of those Uh, they increased by close to 20 percent. So we have our work cut out. In fact, I was very very pleased even this year Early on to see the work that we put into xbox in order to reduce its energy footprint When at rest. So therefore, I think there's a lot of work. We're doing ourselves quite frankly Like after all, you know, all those ai supercomputers consume a lot of energy And so one of the key things is that everything from the data center design to the power draw Of the chassis in which these gpus are act. Uh, I think the cooling systems This is sort of innovation agenda. That's front and center for us um The second thing though to your point clouds, which is one of the places where I think we can make a real difference And we're working hard and we have you know launched something called The cloud for sustainability Uh, is around carbon accounting, right? So one of the it's somebody described it to me It's like we're trying to deploy an erp system at the same time as the gap rules are being created And so you need an approach even, uh to how one does carbon accounting That is more flexible and keeps up with all the data that's coming in. And so we produce we have a software system with many partners We now want every small business. For example, I'm here like in europe I think every bank now is going to look at even the carbon footprint of companies before giving credit And so in order to enable that and enable the fluency of that I think we want I can do a lot of work and one other thing I'd also mentioned going back to some of the ai pieces and even sort of you mentioned quantum I think the core at least my layman's Understanding of even the energy transition challenges We want to take 250 years of chemistry And compress it into 25 years And if that is going to be possible or one of the ways that is going to be possible is with computing power and especially Computational chemistry and so we're doing a lot of work in Whether it's ai techniques or even quantum inspired algorithms even being run on classical To help with I would say computational chemistry and the discovery of new molecules that can perhaps accelerate This energy transition. I want to take you up on the world quantum. I come back to the Forced us revolution for some people quantum is still something in the future for some it's already reality Where do you stand in terms of you know, we we've had a research program in quantum In fact in the last year There have been some real breakthroughs because we've had a an approach to quantum where we are trying to not just achieve quantum supremacy But you know to be able to build a general purpose quantum computer You need to have sufficient number of Stable qubits and so the approach we have taken is that approach where can we build a general purpose quantum computer? And you know, we have sort of published results on some of the breakthroughs in the last year So I do think it's still, you know Ways away. It's not here today, but I think the interesting thing is the software stack That needs to be built for quantum is getting built actively. In fact, if anything the entire The fact that you can simulate Quantum algorithms on classical is one place where we can in fact already start benefiting But let's face it. I mean, there's you know, lots of things that are happening that are rapidly moving whether it's about On the encryption side or how do you in the post quantum world protect yourself? And so these are all fields that are actively both being researched as well as being deployed If we look at economic growth in the last 10 years or so it has been very much driven by companies like yours and There was a kind of tech boom and now lately we have seen the news about layoffs and Does it mean that the existing business model on which tech industry was based is coming to an end And has to be replaced by a new model. Yeah, I mean, I would say there are two things right one is I look at it in two ways. One is the overall economic growth in the world Because at the end of the day all of us are governed by What is happening in the world inflation adjusted in terms of economic growth? So because no one can sort of defy gravity And the gravity here is inflation adjusted economic growth And I would say all up in the world the inflation adjusted economic growth has been pretty weak And one of the things that I'm optimistic is digital technology Can help boost it things like artificial intelligence can help boost it That said in the tech industry we grow multiple times gdp And so the question is during the pandemic there was rapid acceleration I think we are going to go through a phase today where there is going to be some amount of normalization of that demand Quite frankly we in the tech industry will also have to get efficient right It's not about everyone else doing more with less. We will have to do more with less So we will have to show our own productivity gains with our own sort of technology And then coming out of this cycle though class I do believe that as a percentage of gdp tech spend by definition will increase And not because it should just increase it will increase by because of its contribution to the all up gdp growth So that's sort of how I view. I think what's happening in our industry our business model challenges But more importantly what I think are the economic challenges in the world But Satya I would go maybe even one step further and would say The next phase must comprise much more the application of Social technologies in areas where it is not yet applied and I'm not thinking only of Developing countries. I'm thinking of Education I'm thinking of agriculture if you look Just all at those two areas. They are very old-fashioned. So this is a large, let's say Opportunity for those technologies to penetrate much better. It's the overall economy. Would you? Absolutely. It's a very important observation because in some sense what you're pointing out is also economic growth is not just economic growth It's got to be equitable economic growth that is spread by geography by sector By segment. It's not about just large businesses But it's about large and small businesses is about public sector Institutions and that I think is the crux of it right. I think in this next phase of globalization even I think when we talk about economic growth, we'll have to think about it At the core like what's the equity of that economic growth and how is it being spread? Just to go even one step further if you if you go into this direction I mean the talent question becomes key. Now you have attracted So talents the best talents and silicon valley in seattle Um, isn't there a lack of talents? Let's take agriculture to translate the potential into reality.  I mean there is There's a real issue around skills re-skilling And talent I I'm very hopeful that some of these new technologies are going to be helpful in that process What I mean by that is You know, I give you already that example of andridge karpathi and him using github co-pilot and as an elite ai developer getting assistance from a co-pilot But the same thing is true for a first line worker using say one of our tools like power platform To be able to use a natural language prompt to do some workflow automation So think about this. This is someone who is in the front line who has domain expertise But doesn't have it skills Is able to now do it tasks That's one way for us to in some sense bridge the talent cap So I think that you're pointing in fact even the rebalancing of even software engineering talent In fact, if you think about it, then it was actually two years ago that the number of software engineers that are being hired Outside of what is considered the tech industry is higher than in the tech industry So that means going forward we will have more of the digital skills spread Much more evenly across the economy and that's a good thing right because we need that we need them in agriculture We need them in banking. We need them in health care. We need them in education We we spoke about the global collaboration village and um I mentioned we have 80 companies behind and we have a permanent exchange of ideas and one one, let's say Conviction came out That the metaverse will be a tremendous We can provide us with new capabilities, particularly in education Would you agree 100% because in some sense if you look at There too. In fact, if you sort of combine the two technologies that I think people are talking about take metaverse and take AI If you put these two things together, what does that mean? Like it means that you can now help People learn with other people together collaborate across space and time and most importantly Something like a co-pilot being there to help even diagnose the conceptual mistakes a student is making right when they make it Uh and then help them Overcome that I think so I think I think this notion of collaboration And learning together is where I think we can make a real leap forward I I think uh one of the reasons why Let's say this is animal meeting as a success Is not only working together, but it's the serendipity effect But if you do it in the virtual world in in let's say again in the global collaboration village You can build in the serendipity with artificial intelligence into the system So you know exactly who is the best in order to help you to solve your own problem? That's right. That's right. In fact one of the my favorite features even in One of the in the products we've recently built is whenever you want to research a topic It doesn't just tell you the answer to the topic, but it tells you the people That you should connect to it then that ability to know Whom to talk to to learn more As something that is I think as as important as learning more And you can build it in that's right Now I really running out of time that I would like to come back to one question which we also touched upon last time It is the future of work And there's a lot of discussion about remote work and I think you and your company has been very Let's say engaged into discussions about this issue. What is your learning from those discussions and What are your recommendations? I think that the the key observation that make is we're still learning because You know, there's been real structural change I don't think we can just say we'll go back to 2019 nor can we say we're going to live like is as if it is 2020 Uh, if you will so therefore there is real New patterns of work emerging there are three trends that we are observing class Which I think are in you know to me at least are guiding even our own set of decisions So the first is there is what I'll characterize as this productivity paranoia, right? Which is every leader thinks that somehow they're not being productive But there is everybody who's working in the organization feels burnt out So there is that debate As to who is true and what is the truth? And so therefore I would say less more data less dogma will be a good way to sort of End that debate and in other words at the end of the day organizations have to be productive There's no question the outcomes matter and the question is instead of being dogmatic about the way to achieve the outcome We should sort of focus on the outcome and then rediscover Perhaps new patterns of successful work. So that's one the second thing I would say Is we're also learning that people come for other people not because somebody set policies Uh, so people don't come for policy, but people will come for people And if you buy that then I think we all have to even learn many new soft skills, right? Convening, you know calling a meeting versus convening an event two different things Um, you know because you set like when you convene an event you set so much more context you You market it you help people have a successful event Whereas meetings sometimes you go in unprepared you don't worry about what the consequences of that are and what have you So I think we all have to learn be much more deliberate learn a lot of soft skills So that people to people connections are really forming because that's I think very important for social capital the last thing I'd even say Is it will be very important for us not to take for granted that the people who work in our organization Are all connected to the company's mission or the organization's mission and so re recruiting training In fact one data point we observed Is unless and until people feel fulfilled in their jobs in terms of new skills that they're acquired They're not going to have loyalty to the organization So us really investing in their progress inside of the job in the sense of accomplishment I think are going to be important so tools and technologies are there But I would say new management practice and sensibility is perhaps what we will all have to develop In this context you're just used to about Loyalty, how would you describe loyalty of an employee towards my cousin? No, look, I think at the end of the day. I always say The most important thing is for people to sort of think of who are working at Microsoft is the one Is they should think of Microsoft as a platform To be able to connect with our mission to achieve what's core to them Uh, I think that's the social equation. Uh, I think the loyalties only exist if Microsoft as a platform is helping them achieve what they want to achieve It's not a it's it's it's sort of not a Something that we take for granted. It's something that we have to earn as an organization by giving people a platform So you have to build an attractor Absolutely, and also give them a reason why they think of Microsoft Thank you so much. I may I may uh, just Close I think we are already over time, but one short Question I I met so many leaders and you may have seen in the agenda I wrote a small article what how I defined leadership and I said leadership is a combination of Soul brain heart muscles and nerves So soul standing for purpose So brain standing for professionalism So heart standing for passion And the muscles for Implementation capability And good nerves you need today, and I think we just have seen a leader who combines all those five dimensions So, thank you very much


Hi, my name is Carlos Afonso, I'm director for the Institute for Technology and Society of Rio de Janeiro. We are discussing in this conference the issues regarding AI and inclusion. And the main challenge here is to understand the whole that AI might play out in defining our lives in the future. Since AI is impacting and will definitely create even more impacts on issues as different as health, education, labor, industry. So it's important to understand how those impacts will end up playing out and make sure that those impacts are not on the negative side and that we can take the best of the opportunities that the AI deliver and at the same time we might overcome the challenges that the AI will pose us. And this is important to mention because when we think about developing countries we see that most of the time the big discussion around AI is framed around values, demands and needs from the North hemisphere, from developed countries. And in this particular issue it's important to keep an eye on how the global south and how developing countries might react differently to the demands and to the needs concerning the debates around AI. I believe the key factor here is to make sure that developing countries are protagonists and not only consumers of ideas, products and services that had been created elsewhere. So in the next couple of years the activities that are needed to be taken in order to take this discourse, to take this narrative is to make sure that those demands coming from the global south they are clear and in order for that to happen we need evidence-based research and that's where a global network of internet and society research centers might play a role in providing evidence-based research events in order to create this narrative that will be useful for policymakers to take a decision on issues concerning AI for the general public to understand a little bit better what this whole debate means and that's the point in which universities might play an important role in translating this debate to the general public and to the media and at the same time make sure that academic debate is not conceived among their specific elements and the usual conversation and reach out to the outside of the academic bubble and to find a larger public and to make sure that this narrative comes across.


Are you afraid to be alone? Or to start over? We understand that detaching from people and situations can be an incredibly tough process. And it's important to approach it with empathy and compassion for yourself. It's okay to feel overwhelmed by toxic relationships or challenging situations. In fact, it's completely normal to need to create space for yourself in order to gain perspective and move forward. According to psychologist Dr. Guy Wynch, detaching from negative emotions and attachments can have a profound impact on your mental health and wellbeing. He explains that when you experience emotional pain, your brain processes it in a similar way to physical pain, activating the same neural pathways. This can lead to a range of negative emotions that can be difficult to manage. However, Dr. Wynch believes that by practicing detachment, you can break free from these negative emotions and attachments and promote healing. With that said, here are some ways to detach from people and situations. Mindfulness meditation. Did you know that mindfulness meditation has been shown to have positive effects on your mental wellbeing? According to Dr. Davis Cresswell, an expert in mindfulness research, practicing mindfulness meditation can help you detach from negative emotions and attachments by teaching you to observe your thoughts and emotions without reacting to them. By focusing on your breath and physical sensations, we can learn to release negative emotions that may be keeping you attached to a person or situation. Additionally, research has shown that regular practice of mindfulness meditation can lead to changes in the brain associated with improved emotional regulation and reduced stress reactivity. So not only can mindfulness meditation help you detach from negative emotions and attachments, but it can also promote greater wellbeing. Have you ever tried mindfulness meditation as a way to detach from negative emotions and attachments? It might be worth giving it a try, especially since research has shown its potential benefits. Physical distance. How can taking a break from a relationship be beneficial? According to relationship expert, Dr. John Gottman, it can be a healthy way to detach and gain perspective. When couples are in conflict, taking a break from each other can help them calm down and reflect on the situation. By doing so, they can come back with a clearer mind to work on the issue together. In addition, physical distance can be helpful in dealing with a challenging situation that may be causing emotional pain or stress. By creating space for yourself, you can process your emotions and gain a new perspective on the situation. It's important to remember that physical distance should not be used to avoid or ignore problems. Instead, other methods of detachment such as mindfulness meditation, reframing your thoughts, and even physical exercise can be used if going on a break is not an option. And are effective ways to detach from negative emotions and promote wellbeing? Reframing your thoughts. How can you change your mindset to detach yourself from negative emotions in challenging situations? Positive psychology expert, Dr. Martin Seligman, suggests that reframing your thoughts can be a powerful tool to promote wellbeing and resilience. One technique to reframe your thoughts is cognitive restructuring, where you identify negative thoughts and replace them with positive or neutral ones and shift your focus from negative aspects of a situation to positive or neutral ones. Another way to reframe your thoughts is to practice gratitude, which can lead to increased happiness and improved relationships. Reframing your thoughts is a powerful way to detach yourself from negative emotions and cultivate a positive mindset, whether it's through cognitive restructuring or practicing gratitude. Changing your thoughts can promote wellbeing and increase your resilience. Remember that detachment doesn't mean you don't care or that you're giving up. It simply means you're creating space for yourself and allowing yourself to step back and gain perspective. Do you find these tips helpful? Share your thoughts in the comments. And if you found this video helpful, don't forget to like and share it with your friends and family. We appreciate your support and hope you continue to tune in for more insightful content.  Get your very own sai. The lovable plushie is here to brighten your days. It embodies the spirit of psych to go and it serves as a reminder to prioritize your mental wellbeing. Its green leaf symbolizes growth, renewal and the importance of self-care, whether it's for yourself or as a thoughtful gift for a loved one. Sai is ready to be your snugly friend through all of life's ups and downs. Buy your sai plushie today. Link is listed in the description box.


Good morning and welcome to the Center for Strategic and International Studies. I'm Steve Morrison. I'm a Senior Vice President here in Direct the Global Health Program, and we're delighted to be able to host this very timely and really fascinating gathering here today. I want to also welcome those who are coming online to join us today. This is being webcast live. The video from this will be posted subsequently on csis.org, as well as smartglobalhealth.org, our microsite for our program. Today's goal is to examine a vitally important and complex dimension of universal health coverage, and as we'll hear from all of our speakers over the course of the morning and into the afternoon, the core question really amounts to, as countries move to provide an expanded mix of health services to meet demands, to meet expectations that are evolving, how to make quality choices on the best mix of benefits. And this may sound simple, but it's not. It's not so simple on how to reach informed decisions amidst financial scarcity, competing demands, complex political realities, fluid market conditions, and multiple uncertainties that one has to make some estimation of what those represent and how to navigate those. So in an ideal world, folks aspire to, it seems to me, a common set of quality in this to reach informed decisions that are evidence-based, that are transparent, that are linked to clear public health outcomes, and that are sustainable, and that are defensible to multiple audiences, that are defensible to heightened scrutiny by civil groups, by voting publics, by ministers of finance, by interested private sector players who contribute very importantly to these outcomes in mixed systems that we have, very complex and variable mixed systems for public and private interests, bringing forward services. As we'll see today, we're in the midst of a very lively and important debate. On the approach, on the philosophy, on the methodology of proceeding here. And there's a growing body of very important evidence that we'll hear about. There's a growing body of analytic content and of country experiences, of global approaches that are evolving on this, and as we'll hear, there are no simple or magical answers and solutions to this question. But there's lots of people coming from different perspectives who are investing considerable expertise and talent in trying to arrive at better and better approaches. The approach that we're taking here today is to use our convening power to bring together a diversity of experts, folks from the World Health Organization, from the World Bank, from the U.K.'s NICE, from the private sector, national leaders, leaders of national programs, independent experts, representatives of other think tanks. And this builds very effectively, I believe, on the successful conference that we had on universal health coverage in January of 2014, a little over a year ago. And both today and what we did a little over a year ago were really the fruit of the effort of CSIS senior fellow Nellie Bristol. So I want to single her out for special thanks and appreciation for the intellectual leadership she brought to this, as well as the determination to find the best experts and get their guidance and input and bring them forward here today. I also want to offer special thanks to my colleague Sahil Angelo, who has made a very significant contribution to this. There are a number of other folks here at CSIS who have assisted us, colleague Catherine Peck, Katie Addis, and Travis Hopkins here, who is helping us with the program and the AEV, Jesse Swanson, on photography. I also want to offer a very special thanks to Pharma, its office here in Washington, for its expertise in financial support, particularly Kevin Henninger and Fumi Grejo, who have been longstanding partners in thinking about these issues in a very open way. What we're going to have happen here this morning, time is tight. We have a very ambitious program. In just a moment, I will introduce our opening keynote speaker, Jeanette Vega. She will open with a keynote, then we'll have a brief conversation afterwards, and then we will move to two successive panels, one on global approaches, one on country experiences, and then we will regroup for a luncheon discussion with Assistant Secretary Jimmy Coker from the Health and Human Services Department. And as we did in January of 2014, we've tried to bring this back since we are in Washington, since our orientation here, and our comparative advantage is trying to shape U.S. approaches. We wanted to bring the debate back at the close around what does this mean to U.S. global health approaches? What's the fit? What contributions does the U.S. make in this domain? How does it fit in the larger, in the larger, uh, uh, ambit of U.S., multiple U.S. investments and programmatic engagements in global health? Of course, we're all familiar with the continued debate that goes on domestically within the United States around the Affordable Care Act, which adds a further dimension, very profound dimension to the politics and the perceptions around something that we call universal health coverage in talking about this in global terms. So, uh, Jimmy kindly has agreed to come. I want to thank, there are many speakers who came considerable distance to be with us, uh, from Sydney, Australia, from Bangkok, Thailand, from London, Geneva, Mexico City, New York City, and elsewhere. And thank you all, those of you who came a considerable distance to be with us today. I know this is a big bite out of your schedules and, um, and it shows really the seriousness with which you're approaching all this, and we're very grateful to you. Our first speaker, our keynote is Jeanette Vega. She's the director of FONASA, the National Chilean Public Health Insurance Agency. She's been in that role since March of 2014. So she's at the one-year mark on that. She's an MD, PhD in public health, has had a remarkable career. She returned in 2000 to Chile, uh, to join the executive committee for health reform, which was a pivotal moment in, in executing and thinking through, uh, the reform of the Chilean system. She served in very senior position at a very critical moment at WHO as director of the Department of Equity, Poverty, and Social Determinants for four years until, until taking up her most recent post, was a managing director at the Rockefeller Foundation, which is, you all know, has really been, uh, the font of much of the intellectual leadership here in the United States around these issues of universal health coverage. So Jeanette, thank you so much for agreeing to do this. And I'd like to invite you to come forward and deliver your, uh, keynote address. So please join me in welcoming Jeanette Vega. Thank you. Good morning and thank you to all for being here. I first like to, uh, thanks the Center for Strategic and International Studies for inviting me to this very, very exciting, uh, morning. Uh, let me try to put my presentation. So my presentation today will have four parts. First, I will discuss the definition of universal health coverage and some key concepts. Then I will expand on some critical issues around implementing universal health coverage. Next, I will show you a country example in, in fact, I will show you my own country example. And then I will conclude with some, uh, final reflections. So let me begin with the exact definition of universal health coverage that comes from the 2010, uh, World Health, uh, World Report. Um, probably most of you know this definition by now and it is stated that all people should access the health services they need without incurring on financial hardship. There are two interrelated concepts coverage with needed quality services and financial risk protection. Both are intrinsic goals. All, and although are also instrumental in obtaining better health outcomes. And of course, and this is quite important when we talked about health services, we are talking about prevention, promotion, treatment and rehabilitation. The other important point I'd like to make is that we can measure access by using proxy indicators such as utilization rates for different conditions and events. We can also measure financial protection by using the most common indicators such as percentage of catastrophic payment and out of pocket expenditures. I, again, would like to emphasize that advancing towards universal health coverage is much more than focusing on health financing. In fact, it's about focusing on the whole architecture of the health system. So let me discuss now how do we in practice move to implementing UHC in countries? Well, one of the most helpful way to conceptualize the strategic choices facing governments as they undertake the journey is the policy box used by the WHO. This diagram proposes that governments plan their universal health coverage strategies, taking into account three key policy questions. The first one is who in the population should be covered? The second one is what services should be covered? And at what level of quality? And the third one, what should be the level of financial protection that citizens should have when accessing services? Who should be covered? In allocating financial resources, policy makers need to make choice on population and service coverage at the same time and make trade-offs between these two dimensions. Deciding how to start on the journey towards universal health coverage is critical. Countries usually push one of two broad strategies. The first one is to extend financial coverage for the whole population for a priority package of services. The second one is to prioritize financial coverage to specific population groups. People in formal employment or the poorest of society, for example, offering them a broader range of services. Now, there has been a lot of discussion about which strategy to follow. And I would say that in the last year there is a consensus emerging that at least in developing countries it's better to begin from the beginning universal. So it's better to begin covering the whole population from the beginning, even if it is with a small set of services, and then expand the set of services as countries developed. The experience of countries that have chosen to restrict financial coverage to selected population groups is that usually a polarization occurs. And we in Latin America have a lot of experience on that. Healthcare coverage is maximized for the world's groups in society who are covered by either private or publicly subsidized health insurance schemes. Meanwhile, some attempt is made to cover the poorest member of society with a publicly financed, usually public service. But most often this public service is less generous and with less quality than the rest that is offered to the other groups of population. This approach, and this is the important part, tends to create a missing middle, which in many countries represents the majority of the population, in particular in those countries where there are large percentage of informal workers that are not covered by health insurance. And for them that remain at this stage are therefore ineffective because there is a large proportion of the population uncovered inefficient because the fragmentation of health systems have a higher administration cost and inequitable because the richest households benefit disproportionately. The 2013 Lancet Commission on Investing in Health make a strong case in favor of compulsory, publicly governed health financing in its review of five different pathways to achieve universal health coverage. Unfortunately, it's not showing very well in the slides. Those are the five possibilities and then you see the effect on health and financial risk protection. We'll send this slide so you have a more detailed view, but basically it goes from progressive universalisms, which is basically paying for all towards public finance of only catastrophic coverage. To truly achieve universal health coverage of the whole population with the services you require to make a policy choice that is to use mandatory financing mechanisms. The WHO, the World Bank and the Lancet Commission have endorsed this statement. Furthermore, evidence points to the importance of publicly governed system and the importance of minimizing the fragmentation in funding pools. However, when you advance towards UIC, there is one key issue which is defined how to prioritize. Priority setting means basically deciding who is to get what at whose expense. In the context of health care, the what in that statement refers to different sorts of health care and the who to different sorts of people. The whose expense is not so straightforward. It appears to refer to who will pay the bill, but in the context of an economic rather than a financial analysis, the phrase at whose expense can be interpreted in a different way based in the notion of opportunity cost rather than in the notion of expenditure. Which is interesting because I understand that you were having this conversation last night. And the key concept here is opportunity cost is not expenditure. It means who is to go without a specific health interventions in order that others have it. Giving priority to one group of people means taking it away from another group. Giving priority to some interventions means deprioritizing others. Why priority setting? Well, because claims whether needs or demands on health care are always, always greater than the resources available. Because in the absence of a specific and a well-designed process of priority setting, what happens is ad hoc priority setting that can usually disproportionately affect those that are in most need. Because as we all know, health care cost growth is always greater than income growth. And because we need to increase efficiency and equity of health funding. So there are many applications for priority settings, achieving national objectives, allocating resources, defining the benefit package, and introducing and assessing new technologies including RACS, which is the very, very popular field of health technology assessment. Priority setting exists at all levels. At the broader level, the government makes decisions. And that is usually the case for decisions that involve the whole country. At the other end, we have the decisions that individual clinicians and people make all the time regarding their patients. And I just want to emphasize that sometimes these decisions, the ones that are made at the micro-level are the ones that create the bigger impact in terms of cost. The other thing that I'd like to emphasize is that the organizational level sets the context for the micro-clinical-level priority setting. Health practitioners, jointly with the patients, determine who will receive access to what intervention. And then, at this level, choices are made about specific treatment priorities, approaches, and the type of patients that will receive these treatments. The problem is that most of the time the decisions made at this level are not evidence-based. And in most of the countries are completely unregulated. So most of the cost of the system is out of the possibility of really controlling it. That's why it's so important to introduce clinical guidelines and to enforce the use of clinical guidelines in the countries. Another distinction that I like to make, and this is an important distinction, is that there are different approaches to priority setting. There is one approach that is called the vertical approach that basically deals with setting priority among patient groups in the same disease category, but with diverse needs. An example, for example, all the guidelines for different treatments, one example that I have here is the National Guidelines for Stroke Care that are usually published in Sweden almost every year. The other type of priority setting is what we call horizontal priority setting that refers to setting priorities among different areas or practice or among different disease groups. These choices in horizontal priority setting usually do not focus on individual users. And most of the time the definition of which population and the whole horizontal priority setting is our decision that are made by governments or regional authorities. One example is the state of Oregon's experience in prioritizing procedures across all disease groups to arrive at a set of procedures for which the state would pay using Medicare. In addition to this traditional division between vertical and horizontal, a third form has emerged. Priority setting mostly prioritizing specific groups that are defined not by common health problems, but by economic, social, or ethno-cultural characteristics that are determinants of health. Let's move on to the most common practical translation of priority setting. The design of benefit packages. The progress toward universal health coverage is faster by prioritizing universal entitlement to a defined benefit package. In Latin America we have a lot of experience on this and we have used different approaches to design and deliver these benefit plans. For example, in Uruguay. Uruguay provides integrated universal health care for health conditions through the life cycle independent of providers. This could be an example of comprehensive benefit package for all. Chiles au je-plan includes legally enforceable entitlements to a comprehensive set of services for a prioritized group of disease. While the rest is business as usual. This is an example of comprehensive for some. Peru, the plan esencial de aseguramiento en salud, prioritize health conditions but provides more limited essential health care services for specific groups. That could be an example of some scope for some. There are also differences of course in how broad or narrow is the scope in terms of technologies to be used in eligible populations. The Mexican benefit plan for example, prioritize catastrophic coverage for very complex benefits. Now, the most common use criteria to prioritize for defining a benefit packages are the ones that are there. The first one is the magnitude that is usually measured using burden of disease studies. And basically it is how severe is the problem and how many people are involved at each level of severity. The second one is the criteria of effectiveness and efficacy. Do we have effective interventions to address the problem? The third one is cost of course. How much will the interventions to address the specific problem cost? The fourth one and then that relates the connection between effectiveness and cost of course connect through cost effectiveness studies. The fourth one is feasibility and this is quite important because usually when you are really doing policy making this is probably the most important one. Is it feasible to put in place the interventions that exist or is there a potential to do that in a time that is reasonable? And then of course the last one, quite important is the risk harm criteria. Good intervention entail risk or harm at acceptable level. Many examples, the Oregon basic bundle of services, the New Zealand benefit package, the Israel basket of services covered by sick funds and the UK of course health technologies are praised through explicit cost effectiveness evaluation and clinical guidelines. Let's me move on then to show you one case study of definition of a specific benefit package and the case study is in Chile, my country. Let me give you some background. Chile basically relies on mandatory social health insurance to provide universal coverage for its population since 1952 but the population that is not covered by mandatory insurance which is basically 7% of the salary in the people working on the formal sector is covered through taxes. So we have a mix of the rich basically and benchmark. But during the Pinochet dictatorship that system was segregated and basically they created a different system, a different insurance system that is called they suppress where it's basically what you do is that you put your mandatory 7% to these private insurers and then the rest you pay out of pocket. What this created is an extremely segregated system because basically the most affluent part of the population went to suppress and the rest remain in the public insurer which is for NASA. And the second problem of this is that because of the logic that is very different the logic in the private insurers is a pure insurance logic while the logic of the public system is the social insurance logic. That means that you contract individually to the private insurer and when you cannot pay the premium you are basically thrown out of the system because you can't pay. And what happened then that happens usually when you are older and you are retired. And then because we have mandatory universal health coverage those people goes to the public system. So we are subsidizing the private system with the money that is basically public. So and just to show you this is the coverage by socioeconomic quintiles and you see that they suppress basically are in the upper quintile that those are their clients and the rest is mostly insured by the public system. Now we have when we when we began with restored democracy we had a big problem and the big problem is that Pinochet led some specific laws related to social benefits very very very difficult to be changed because he changed the constitution and in order to change some of these laws we required five out of seven by your majority vote in Congress. So it was basically impossible. So what we needed to do is that we needed to define a way to equalize the situation for people and the way that we did that is to use what we call a system wide benefit package that is the Alche package where what we specifically said is that we define a specific package of benefit that would be mandatory for both the private and the public insurance system and by doing that we basically pass a law to make sure that those guarantees were enforceable and by doing that then we make sure that those priorities in health would be equalized for both the private and the public system. So what we did is we say okay yes in theory we have a universal health coverage because everything is covered you cannot go in Chile without having medical care. However of course the system regulates using waiting lists. So what we say that is that on top of the traditional system with traditional guarantees we add four additional guarantees for 80 priority health events. 80 basically diseases that were the ones that created the biggest burden of disease. Those four were access for NASA and the SAPRES are legally bound to cover the explicit benefit package. Quality health interventions that are included in the complete treatment of the specific disease cover are basically have to be delivered by properly registered and certified providers but according to a standardized that can also be challenged legally clinical guidelines. Third opportunity health interventions must be delivered within explicit maximum time periods and for financial protection. They both for NASA and SAPRES must cover at least 80 percent of the guarantee package of health benefits. That is the least is 80 problems including the most frequent like hypertension diabetes and so on some catastrophic cancers and etc etc. So the question then becomes how do we prioritize what is included in our here and the way that we did is by using basically five criteria. The first one importance according to burden of disease which means having all the studies of burden of disease in the country. The second one high cost effectiveness of available treatments which basically meant that we needed to implement health technology assessment to make sure that we were able to do the cost effectiveness analysis. Third feasibility of supply to provide treatments which meant that we needed to have a very good understanding of the providers map them and understand exactly what type of services they could provide. For the importance of financial burden to households and we put a catastrophic level in the coverage and five social consensus on priority and in order to get that we basically did and we usually do a qualitative study to make sure that we are capturing the social preferences. And that is the way that we decided what is included in the benefit plan. For each one of the problems we basically calculated the cost and what you see there is for one specific problem. Problem out here number one end stage renal disease. For this end stage or problem number four eight breast cancer etc. For each one of them we need to make sure that we have the set of a specific interventions that are in fact defined and then costed. And what basically shows there is that from 56 problems that we originally include we came out with 446 major treatments and those major treatments included 1,320 different health interventions and we had to estimate that. To calculate what? To calculate the premium. The premium right now is estimated at one hundred forty dollars per beneficiary for the public sector. So the final benefit package is a mix of diseases with high burden for example schizophrenia, hypertension diseases with high financial burden for example end stage chronic renal failure, variety of cancers and heart disease, HIV and AIDS, diseases with existing high cost effective interventions for example cataracts and hip fracture and diseases with high social priority for example lower acute respiratory diseases and oral health. So I just want to finish by putting some conclusions for discussion. The first one is that I truly believe that in order to advance towards UHC we need to reflect in every country who should be covered how to pay for it and what services should be covered first. Second I just want to emphasize that priority setting is a complex political and muddy process because whatever the criteria to prioritize that you use at the end of the day the decision of what is in and what is out is political. There are no technical methods to define what is in and what is out. Third I'd like to emphasize that there are various tools for priority setting and when we evaluate success we need to consider not only the outcome of the process but also the process itself and the process need to be informed and participatory because if we do that then the decision is a societal decision and it's not a decision of a group of technical people. Four priority setting usually or should usually translate into the very practical thing of defining the benefit package. Five each benefit package of course must be should be constructed based in the local context with explicit prioritization criteria and enforceable guarantees. There is no point in building a benefit package if you cannot enforce that it is in fact delivered. Six that goal is that intentions really meet the reality and seven of course the need to monitor and measure to ensure that what you have planned and put in place is really happening and that there is impact in the final goal which is basically improving the health of the population. Many thanks. Jeanette we we have just a little bit of time here before we're going to need to move to the first panel but I'd like to first of all congratulate you and thank you that was a wonderful and rich and very very lucid presentation. Thank you we're off to a great start here. I was I was struck by your closing remark where you said it's just fundamentally political and this is fundamentally muddy which was a very good choice of term. Maybe you could offer a bit of I know you're in a you're in a senior position within the Chilean government maybe that constrains you a bit but maybe you could offer a little bit more illumination on this question of politics with reference to the Chilean case. How has over time the reform process you've now gotten a decade and a half of reforms underway. How has that political process unfolded with respect to the subject that you're treating here. How would you summarize what's the story in terms of political calculation at the national level and among the various constituencies that come into play. Yeah well let me just describe what has happened in the Chilean system. What has happened in the Chilean system over the next over the 10th year that we have been having out here in place is that this probably is the most successful policy in health that we have had. It has 80 percent approval right and people that are using are protected by out here basically think very highly of this policy. That let me give you first the pros and then I'll give you the cons. The second pro is that because of this process we had been able to open the door to truly change the system and right now we are in the process of discussing basically creating one pool as opposed to the 15 private pools and one pool for the public system. We are in the process and we are just going to get sending the law to the Congress to create one pool and at the beginning it will probably be with multiple insurers but with the idea and the goal to go towards one insurer for the full population and that discussion could be unthinkable 10 years ago. So that is the second one. Let me give you the cons now. The main con the main problem in our case is that when you prioritize you de-prioritize other things. So those things that are not included in out here what you see is that the waiting list for those particular things is increasing and the main issue now is how do you go and basically increase what is included in these guarantees because once before people would basically would wait whatever they needed to but now because they know that if you are in out here you have a specific times then everybody is basically pushing and all the interest groups and physicians and all of them are pushing to be included in out here that is updated every three years. So that is our experience that show what happens when you define benefit packages that the thing is not only to begin the problem is then once you have it how do you update it and what are the issues that come after. So when you look back I mean what I hear you saying is the arc of the politics over the over the 15 year period has been has been a positive one because you were building momentum politically around rewarding a broad segment of the population that raised its confidence that the system was working to their benefit but also delivering on the promises in a cost effective way. That was fundamental. Was somehow fundamental was getting the politics right and then proving the concept repeatedly and then in time that gave you the political space to continue to innovate. That political confidence that was broadly shared then permitted you to think in bigger strategic terms around further reform. Yes. Now let me just provide you with an example or give you share with you a bit of history when we embark on this it was extremely hard when you try to define benefit packages or advance increasing health insurance for example and putting it mandatory. It's extremely difficult because when you talk about this and you talk to one person the person basically the first reaction is to say I don't want to have restricted access. I don't care. I want to have the best care when I need it. So I'm not willing to go into putting my money is to basically to favor others. And that is an extremely charged discussion because basically you have the view your view as a policymaker that are thinking maximizing the everything for the population. But the person but if it is your mother you don't care about maximizing cost and benefit for everyone. You just care that your mother gets the best care whatever did cost that could save her. Now the way that I usually deal with this conversation is that when I in this discussion that we are having now which is basically going to one poor and then people say why should I contribute. I want to contribute only for myself. The way that people understand at least in my experience is that if you refer to them and you basically say fine you are OK now but think what is going to happen when you are older and when you are when you retire when you are older and you retire. If you continue to be in this system you basically want to be able to get the care that you need. So what you are basically doing is that you are saving for later. Even if you don't take into account the rest of the people it is sort of a saving for retirement type of approach. Two questions and then I think we will need to close. One is where is the private sector in this. I mean you are talking about a consolidation. You are talking about expanding the market. You are talking about expanding the public financing. In that sense it is a greater set of opportunities but you are also moving towards a more consolidated system. Where does the private sector fit in with it. Well of course we have had a lot of issues and discussion with the private sector in Chile in particular because the private sector was really taking advantage of these laws which is not necessarily the case in most of the countries or at least in some. Let me say that. But the thing is that for the private sector it is also it can also be an opportunity because basically there is a lot of waste of money and inefficiency in the way that the public the private sector is dealing with insurance. For the private and the public sector pulling is a good thing. For the private and the public sector using mechanisms to purchase services that are more efficient is a good thing. What it means though is that you need to improve your efficiency. And right now in Chile this year we are basically changing the way of purchasing services in the public sector. And what is happening is that the private insurers are also changing the way they purchase services. So there is an opportunity for the private sector assuming that the private sector in the country is willing to be efficient and to do business with a reasonable amount of gains of financial gains. If that is the case there is no contradiction on what I'm talking about. Just a closing question is what keeps you awake at night? No. Well I have several things that keep me awake. But regarding to this what keep me awake is that we are savvy enough to have this discussion in a way that most of the people of the country understand and agree in the changes that we need to do. We I had the experience I participated in the group that did the reform in 2005. And at that time we use a strategy that basically was to make sure that we were always in the middle. So the people that were opposed had another group that were not us that was basically confronting them. And keeping us in the middle, in the middle, in the middle was kind of the goal. I'm trying to do that now. I'm not always successful.  And that I would say is the most difficult part to maintain your credibility that you are really caring for everyone. Thank you so much. We have a problem here in the United States with a pragmatic center and preserving it as well. So I think that's a familiar problem we face. Please join me in thanking Dr. Vega. Thank you.


So, we went ahead for pilot production to the best manufacturers, then we ordered stainless steel from the market. You saw the stainless steel which we use for prototypes, they were like undulated, they did look like hand beaten, but in a pilot production I need to have very, very high quality surfaces. So, we went to Jindal's stainless steel and they gave us one of their best, you know, grades of stainless steel which is called scratch bright finish, so that the headlamps of the car when they hit on that stainless steel they do not reflect back. So, and then they also took us to their manufacturing unit which is called the Jindal architecture where we produced the components using CNC punching. What is the advantage of computer numerical punching of a sheet before you fold it? Accurate corners and folds. Accurate corners and folds, saving of material, nesting of parts, I do not lose any sheet, I just, you know, punch all along and I take all the parts out. Look at that, you know, sections which are coming at the end. Every small part I punch and use for some purpose and then nest my components so that I use all the sheet very effectively as well as the most important point is that it gives you very, very accurate parts and gives you very, very high quality and now comes the laser cutting. In CNC turret punch and cut the material. In laser you cut using lasers. What are the difference between the two? Why do you need to use laser sometimes and the punch sometimes in a prototype? I'm doing a pilot production and I've got very less quantity. So how many punches will I have? If I have a different diameter, if I want to cut a logo, I want to cut a post box logo on stainless steel. So when you have prototypes, generally what you do, you use laser cutting because your volume is less, you can use laser to cut the material and laser of course gives better edges.  And then what is this beautiful machine here? This is computer numerical control bending. Steel material is a very, very tough material. Here we have all the inputs coming from our mechanical engineering professors, our professors from manufacturing. So we have all the good features we built in, large envelopes can be posted. You have a posting rest. You can rest your hand to post the letters and then you have these, you know, design where you have no welding outside. Look at all the radiuses. Now are you able to see the radius? The edge, you can see those shines which are because of the multiple 22 strokes of the round radius. And then you fold inside and weld inside. When you bend and you weld on it, it makes lot of stress, undulation. So your sheet becomes very undulated. Then we have a tough composite top. What are composites? Mixer of two materials. Mixer of two materials in this case. Plastic. Plastic and? Glass. So glass fiber. Glass fiber reinforced plastic is very, very strong. And you can see they call the fiber reinforced plastics, FRP, you heard about FRP? They also using FRP, they make sculptures. Most FRP structures have that you can see the pattern of the fiber. You can see the pattern of the fiber, but you have more resin on the top.  This is painted. But otherwise it was resin. Otherwise it's up to your choice. You want to show the fiber on the top, you put rest resin, you have two layers of resin and then you put the fiber, you won't see the fiber. It totally depends upon how you process your fiber reinforced plastics. Why am I using fiber reinforced plastics over here? No, engineering plastics needs tooling, injection molding and the injection molding dies will cost me more than the order quantity. All the 20 boxes put together, the cost of that will, I won't get a die to injection mold a engineering plastic. What's the advantage? It's actually as strong as engineering plastics. So we're getting the advantage of the strength, but low volume production using this. But the component cost per cost of a component is costlier than the engineering plastic because engineering plastic large volumes, then amortization of cost whereas in this case you're making less number. So it's more expensive. Then we have this very interesting feature. So we put a sliding panel inside of the time. So it doesn't need to take it out. It quickly slides the time and you can go and you can see the very prominent pin number and the location address. So this is a feature built into the door and the door is very strong in stainless steel. And then we had this contemporary look because of the radius. It looked very contemporary and because of the smart top, it had a look which was very prominent. So it is very easily visible from everywhere. And we had this large surfaces where we could advertise. And then we have all the features built into this. The door is also locking very tight. So you have no insects going inside.  So all the bolts are like from inside. So nobody can uproot the box by using spanners.


vendor registration for the third annual country music highway tribute show is now open the show is looking for local musicians food vendors and handmade artisans from all around eastern Kentucky for one or all three stops of the tour we're in the third year of the country music highway tribute show and our vendor applications open so when we created this event we thought you know we'd set a stage up have a few hours of music and what we realized was is that the need was was much more and people wanted something more so what we did was is it morphed into a festival top atmosphere we joke around and say we can have festival organizer but we have arts and crafts food vendors so last year we were in Paintsville Wattsburg and Prestonsburg this year we're in Russell Louisa and Ashland and you know applications are open do you worry about having enough money to last throughout retirement give Reed Potter at Raymond James a call Reed has 26 years experience helping folks enjoy their best life in their retirement years registration is $25 for artisans and $50 for food vendors registration will close March 31st you know you go into something and you you really learn you know from the start and what we realized was is we needed some food vendors so we just you know we just reached out and then actually we just had a few people reach out and say hey you know are you are you allowing arts and crafts and we're like we are now and and it is that the floodgates opened and last year we had roughly 50 arts and craft vendors within our three locations and it was just a tremendous experience to walk around and just get to know some of the folks hear the story every product has a story behind it that is handed down by the family and and so we're just celebrating all forms of art and and really just celebrating this incredible place that we're fortunate enough to call home for more information and to register go to sore-ky.org reporting for mountaintop news I'm Brianna Robinson


If we take a look at the NDX chip stocks, they were on a tear, you had Micron Tech up 8.7%, Western Digital was up 6.6, Microchip Technology was up 6.7, and you had Trip.com, up 4.6. So big numbers out there, if we go take a look at the NDX100, the three Qs, you're going to see that it's high by two pennies. Bottom line, I expect that high is going to be tested, 216.16. We hit 216.14 today. S&P, different ball game. Bottom line is that if we take a look at this S&P, what you're going to see inside the spy is that we go back to Friday, our bottom line is that the spy didn't have the type of juice, the type of volume that the S&P did.  And in fact, if we take a look at the spy, the spy is saying that we're going to try to go back down and test the lows that were generated out here on Friday, which is 3206. So that'd be quite a move because we're at 3235 now. So that no doubt is a large number. Notes and bonds continue to want higher price. The bottom line, you had the note, as well as the bond market, pull back slightly out here today. Huge contraction and volume. What we had out here with volume out here today in the 10 years is at 1.2 million contracts. That's light volume. You're going into 1.8 million contracts. That's where the strength came in on Friday. We went from 12820 to 12914. Your 10-year out here is trading, I believe it's 1.825. Bottom line, this continues to want higher price, lower yield. Kingdala. Kingdala caught a bit out here today. Kingdala is up 347 ticks. And let's say the Kingdala is, you know, we're at the 97018. That's saying that good old Kingdala is going to try to get back inside its higher range once again. And right next to it right now, you only need approximately, we need about 100 and, well, you need 130 ticks. 97.141 will be the number. And I do expect it's going to try to get inside there. It's failed the last two times. It tried to get inside there. Have a great night, folks. Have a safe night. Come visit us again tomorrow morning, 9 o'clock. Larry Pesavento kicks us off. Great program. Have a great one.


So, our topics for today are, first of all, what is iridology? Some of you may have heard of it, some of you perhaps haven't, so we're going to be looking at what it is and how it came about, the major developers and researchers in the field and what we know from them, and of course, basic theory. Now, there's a lot of theory in iridology as we go through the six lectures, and we're only going to get very basic, but we're going to give you an overview of the iridology theory and a little bit of a preview of some of the things that we'll be looking at later on. We're going to introduce you to the iris reflex chart, as it's called, and some of you may already know that there is a map, if you like, of all the organs of the body that we can superimpose over the iris to guide us in our diagnosis, so we'll be taking a look at a very simple version of that in this introductory lecture. Then we're going to go into the whole area of consultation and how we actually use iridology in practice, and that will involve having a look at the consultation model, if you like, the order of procedure in an iridology consultation and an atropathy consultation, and also the use of simple iridology equipment so that by the end of the lecture we hope to get you actually practicing with some of this as well and getting used to using a torch and magnifier, for example, so that you can begin to do your own iridology examinations. Now, the most important thing that I've got to say about this course is that it is very practical. To be sure, there's theory and there's things that you need to understand, but as soon as you've got each piece of theory, you're going to go out and need to go out and test it. In order to do that, there are a couple of pieces of essential kit which we need you to have. One is the torch and loop, that word loop, as we'll find out later, it's a German word actually that means a magnifier.  It's a little bit like a reading glass but smaller and set up specifically to look at the iris of the eye. So in other words, when you bring the torch up to the eye, the light is in the right place to illuminate what you need to see, which is that coloured portion of the eye that we call the iris. Now, these are available, in fact, from CNM Head Office. So all you need to do is to email or phone in to the college and we can arrange for you to buy one direct. If you want to buy your own, they can be sourced online, for example. You'll need about a 10 times magnification, that's what we're looking for. That's about the right level of magnification for a manual iridology examination. And the other bit of kit that I suggest you furnish yourself with is a copy of my book, Practical Iridology. Lots of lovely colour pictures in there to supplement the material that we'll be showing you on the slides. Lots of therapeutic suggestions that go with each iris type. For example, some detoxification protocols at the end of the book in case you need to check those out as well. Now, in the UK and Europe, I am the sole distributor or seller of this book. If you're in America, you can also get them from Whitman Books. But right to me at the address that we see on the screen here, herbalmeddirectoratnaturopathy-uk.com.