Today we're reliving the top 25 pulls from 2021. What's up guys, we're back with another video. Today we're gonna be reliving the top 25 moments from this year. It's not just pulls this time, we're doing moments. So if it's from one video, it's all gonna be in one moment. That means there's a lot of crazy pulls in this video. So hope you guys enjoy it. We are doing a giveaway. I'll be giving away this duelist pack blister.  Let me know your favorite moment out of all 25. You can just put the number in the comments and let's get into the video. Okay, let us see what we can do. Oh, there it is, infinite impermanence. I almost didn't even notice that it was ultimate at first. That is a very nice pull. I'm not sure if that's gonna last pack of Gold Series Haunted Mine. Will it be the blue-wise white dragon? Let's go, let us do this. We did not move anything, so we're gonna go like this. Okay, these corners are a little jacked, which is scary. We're gonna look at the commons, which there are many, 22 actually. Dark Scorpion, Spellbook, Red Ogre. We got the Lady in White, I think, is actually an okay card. Petition, Zombiemaster, Donzalook, and Dark Scorpion. The big cards of the pack. We've got a Grafa Dragon, Lord of Dark World, very cool. Call of the Haunted again, I mean, that's a cool one. It's got a chip on the edge already, which is not good. Hopefully that's on this card, not the ghost. And will this be the blue-wise white dragon? It is the blue-wise white dragon. Oh yeah, and it does have the Starfoil Bleed. Oh, that is so cool. Oh, this looks so good. I don't know how people don't like this card. Jenszo, no wait, Wing Dragon of Raw was with Slime, and then Jenszo, and then there was another one. I can't remember what the other archetype was. Oh! Crystal Clear Wing Seaco Dragon Ghost Rear. Oh, in the last five bags, you guys can win this too. This is a viewer ghost rare. Oh, no! We pulled the ghost rare out of two boxes? That's crazy. Ash is in the booster box, that's what you say, but people are saying they pulled him from Special Edition, so I'm pretty sure that you can pull it from here. Ash is in the booster boxes! Yes! Halfway, we will pull Ash two more times. I believe, I believe. Yes! I believe! We got another one! We only need one more for the play set. Supreme Dragons, is that the Ark guy? Yes, we pulled like six, I think. We pulled like six of that guy. Oh! Two in a box! Let's go! On ending, it's, yeah, I think our second. I think it's our second, yeah. Awesome, oh my goodness. Part of the cards. Come on, we need a third secret rare. Peace, last button! We finally got it! What a good opening, that was awesome. How much, well, don't ghost Ark Magician girl. It's gonna be a lot, man. It's gonna be a lot. There's a lot of good ones, though. Oh, is this it? Is this the moment? Or is this a Leviathan? Is this Leviathan or is this Dragoon? If it's Leviathan, we gotta keep going. If it's Dragoon, it's over. Here we go. Yeah, get it ready, here we go. Hype, hype, hype, hype, hype. Come on, red eyes, Dragoon. Yeah! Let's go! And the sintering is pretty bad, so it looks like this is gonna be going in the deck. Let's go on to the next one. I think Star of Strava Drive is a little bit better than Ancient Prophecy, so we'll leave that one for last. Ancient Prophecy it is. Fossil dig. The card got reprinted a lot. Flamengo counter. Cyborg doctor, it used to be a dollar. Oh! Oh! Oh, it's small talking! It's a ghost rare! Ancient Fairy Dragon! We're recording, right? We are recording. Oh! Yuki Boat is not gonna be happy, guys. Yuck, stating the obvious there. By the way, if you're wondering the ratios, oh, yes! As I was saying it, okay. Breaker the magical warrior, that's a super rare. Oh, that's minty. Sintering's good, too. This might have a PSA 10 chance, guys. And let's see what we can get. There are three very good ultimate rares in here. First of all, the Cyber Dragon. That's the one we want. There's also the Forbidden Droplet, which is a very big card as well. Are you kidding me? You gotta be kidding me! The first pack is a Cyber Dragon ultimate rare, and yes, if you guys haven't seen this open yet, the Ulti Stamp is insane. Like, you can see the entire artwork through the back. There's not too many printings of Cyber Stein. So pretty good, cause there's the Shonen Jump, obviously, you're not gonna get that one. Oh, wait. Forbidden Droplet, yes, a huge bull. This is a very strong card in the meta. This is originally from Rise of the Duelist. Our best live case opening of all times from Rise of the Duelist. Here we go. I guarantee there'll be some comments like, dude, you gotta slow down. I haven't been going kind of fast, sorry. Oh, Forbidden Droplet, ultimate rare. That's the second one, that's really nice. That tension is really nice, wow. Yeah, look at the back of that thing. You can see it through the back. I don't think I've ever seen that Cyber Auroboros card before. I know I've seen it because of the Cyber Dragon theme deck. Oh, okay. I don't know if it's a Stranger one. Yeah, I know what you're talking about, Ann. Spell Chronicle, okay, we don't have a Secret Rear yet. This is a little bit scary. Shield. Oh, a dark Grim Reaper! That's probably the second best one! I think that's the second best one. We are happy with that! I couldn't tell it was a Secret at first, and then I read what it was, and I was like, oh, that's a Secret Rear. Look at that. Here we go. Ooh. Oh, it's beautiful. All right, this is a successful box. I can't say successful there. The different types of summoning, I'm not your guy. I don't even know how to link summon, to be honest. I don't know how to link summon. Maybe we'll do a... I don't see any! You guys see any? Okay, here we go. Another Euro pack. Oh, this feels like a good one. Why does it feel... Okay, let's go like that, here we go. Dark Magician! Okay, it's got some red lines. Oh, wow, that thing looks kind of bad for this angle. But if you look like that, it looks nice. Yeah, we look like that. Oh, wow! Oh my goodness, can you guys see that? Really bad. Whoa! Okay, it's not quite raw level, but it's cool. Look at that color! What the... This is like a retro pack secret. Yeah, an Ultra or a Secret to save us, because we have now opened a lot of packs. Let's see what's in this one. Spiritual Energy Settle Machine. We've got the Super Robo Lady. Troop Dragon. Fanching Mirror. Tyrant Dragon! Let's go! The sinnering is terrible, and it has a little ding up there, but we finally got an Ultra Rare. We're taking it. We're next, Heavy Pack. Labyrinth of Nightmare. Been alright to us. I mean, we pulled some alright stuff. Definitely not bad cards, but we're looking for a little bit better. Let's see if we can improve right here. Dark Necro Fear. Lady of Salem Flames. We've got the Drugonic Attack. Spiritist Lady. Shining Abyss. And... It's the Dark Necro Fear! Okay! The sinnering from side to side is not bad, but top to bottom is pretty bad. This is what I always see the Dark Necro Fear is looking like. I already have a PS8 10 anyway, so I'm so really happy about this. Supposedly heavy. Retro pack, one pack, and salvage the opening, because so far it's been rough. I am 0 for 8 opening this set. This is an interesting way you can open these. 0 for 8. I've never pulled a hollow. We don't know how the weights really work, so it was weight heavy, but we don't know if it actually worked or not.  You can pull the Harpy's... I already forgot. The Harpy's Secret Rare. The Cyber Harpy's Lead. There we go. And some other awesome ones. And the back corners are usually messed up, so we'll check that if we do pull something. Harpy's Lead. There's also a scapegoat in here, which is a ton of money. Elegant Ego Test. Pretty much any hollow. We've got a Giant Soldier of Stone, and it's an effect monster. Could it be that Harpy's Cyber Harpy's Lady? There we go. Come on. Let's get something. Kyba Man's Secret Rare! It was a secret rare. Our first ever pull from RetroPak 1 as a hollow. It's Kyba Man's Secret. It does have a print dot up there, which is totally fine. Overall, it was a pretty rough video, but this Kyba Man really showed up for us and actually got us something at the end. Okay, okay, okay, okay, okay, okay. Like button for luck, guys. Destroy it. Here we go. This is our chance. Well, we have a few more chances, but I have a good feeling about this. Spell Reproduction. Gaggy Ego. Exodia Necross! We got it! Oh my goodness. Okay, we gotta put this in sleep. I'm getting a little sweaty because I got hyped. Wow, what a third ultra. The sintering is pretty good. That card is a solid candidate. Let's pull something good. I hope you guys are hyped about this video because I just decided, you know what? We got this box. Let's just open it up. Hida, the fire charmer.  There are the elemental heroes though, which is cool. Final Ritual of the Ancients. Here we go. An Ultimate Rare! I had to look twice. Oh my goodness! We got an Ultra Ulti! Finally! I didn't think it would be that fast! The finale, guys. The moment we've all been waiting for. Since the first pack. There should be two Ultimates in the box. Can we pull another Ultra Ulti? Thunder Giant. Obviously, Gear Golem is the absolute dream to pull. The absolute dream. So we're gonna try and go for that. All right, guys. Hit the like button for luck. The ultimate like button. Here we go. Hope you guys have enjoyed this video. It's been a lot of fun, obviously, for me. And we pulled the crazy card. Okay, burst into tricks. Final Ritual of the Ancients. We got an Ancient Gear Soldier. Gift of the Martyr. Okay, we got Ancient Gear Soldier. We just need the Daddy, the Golem. Here we go. The Martyr. Dun, dun, dun, dun, dun, dun, dun, dun, dun, dun. Yes, we got our Chef, the Dark Bean. Oh, why is the, why do the stars look like that? We got another Ultra Ulti, so we will take this all day. What a fantastic box. Okay, let's try another one. It impacts at the ultimate rare. Trap Tricks, Trap Hole, Nightmare. Finally, we got something. A Trap Tricks, Trap Hole, Nightmare. They were hidden below the TurboPak VI or TurboPak VIII. TurboPak V just seems like a weird one to reseal, but, you know, people will do anything. These are hard to open, though. I don't know if that's normal. I can't remember. I'd have to go back and watch my other video and see how hard or easy they were to open, because I had a sealed box, so. It's, nope, it's good. Colossal Fighter Ultimate Rare. I knew it. I called this Ultimate Rare. Okay, we're back, guys. All of that doubt for, like, probably 20 minutes of the video. We've got a Colossal Fighter that turns out to be a pretty great card back in the day. I mean, that's a pretty cool card. TurboPak II, and those ChampionPak III and IV, we only have one to start with, which is why we have no clue. Oh, that's a big one! Chaos Sorcerer! It's a big one that's like $360, I think. Last time I checked with my Goat Deck, which was just a couple weeks ago, it was $360 for one of these. This is the last one before the last of each. One more big hit would be great. I mean, we have not had great ratios for sure. The ratios have been rough. Maybe we can get A foil. Oh! Oh! Lumin' on a LightSword Summoner! Oh, speaking of big foils, that is B big foil. Oh, that's probably worth several hundred dollars. Oh my goodness. That one might be worth more than the Chaos Sorcerer. It's close. Wow! Five big foils! So here we go. What's up, Simbo? All right. What is this, Joe? All right, here we go. Amelot's Rescue Road. We got a Destiny Hero Fearmonger. The Paths of Destiny. Orbital Bombardment. Oh! Ultimate Rare, it's a little bit off-center. One of the best cards in the set, right on the cover, guys. The cover has given us some good luck. Elemental Hero Flair Nios. How much is it worth? Somebody... Somebody, check it out. Check out the price. Ultimate Rare, first edition. So already an Ultimate Rare. That's a good start. Can we get the Elemental Hero Dart? Right now I'm just getting this tactical evolution. Elemental Hero Nios, nice. Oh! Back to back Flair Nios! We got the Ultra Rare version this time. All right, yeah. We're just waiting for Prodigy to bring out the brownies, you know? We're just waiting for him. Okay, Flying Saucer. Oh, an Elemental Hero Flair Nios! A second Flair Nios, that's good. Let's try another Invasion of Chaos, please. Can we pull it? The Legendary. Grand Majidae Iza? No, Heart of the Underdog. Be gone, Nave, and... Ooh, a Dark Magician of Chaos! We cannot pull the BLS, but man can we pull the Dark Magician of Chaos. Time for a Dark Crysis. We've got Kel-Do. Drag down on the grave. Rot of Sounds Caste. Exodia Necross, I called it! I cinched the Dark Lord Exodia Necross. Here we go, very nice. Final five packs. Let's go with Invasion of Chaos because we do have three of these. It's been a good one so far. We've had some pretty good luck. We've cooled down a little bit. Well, let's just say it was something big. Salt Bird, Soul Tiger. Black Luster Soldier, we did it! Yes! I didn't think there was anything in there. It didn't look like suspicious or anything at all.  Oh my goodness, I had a good feeling about this video. We're just pulling so many good cards. Legend of Blue Eyes, two more packs. I can't believe we finally pulled Black Luster Soldier and it left it to the last five packs or was it the last four packs? I have a 39 pack opening. Root Water, and we're in number two. Oh! This is the best video ever! The Blue Eyes, I should have opened that last! What an unbelievable opening. You guys ready for the reveal? This could be the card that I've opened. 130-something boxes to get. Woo, here it is. Is it gonna be the Starlight? Please be the Stardust, come on. Will this be it? All right, let me pull it off right this. Really, because I get some good info out of it, I think they talked about it a lot. So maybe I'll go back and watch that at some point. But maybe if I'm considering it, there's a Starlight. Guys, hate to do this to you. We're gonna save this for later, all right? Let's put this Starlight down right here. We're gonna have this wait around a little bit to see what we get. We've already gotten a Starlight. Almost time for the reveal. What will the Starlight be? This is a Starlight card. I believe it's what? The next one? Is it the next one? So it's gonna be second to last? Let's just do this to be safe. We know it's not these. Starlight IP, baby. If it's IP, we lose it. If it's IP, if not, we have hope. We still have the rest of the case. E-Chat is correct. Starlight Rare $1,000 Yu-Gi-Oh card. This is like $800 more than every other Starlight. What a pull. Check this out. Oh my goodness. Starlight Rare IP Mascarena. One case? I mean, this seems like a lot, but it's one in eight cases basically. One in a hundred boxes. Starlight Mascarena. Can this case pot? If it has a double Starlight, this is like the craziest thing ever. A few moments later. It's got a nice pull. When did he get the Starlight? We got it a few minutes ago, I think. Fun! We're sending down. We got to calm down. Another Starlight. Double Starlight case. Double Mask. Double Mascarena. Is it gonna happen? What is this? Roscoe, thanks for the five. What is going on? We can get the what is this button. What is this? What is this? Let's go. Oh, what is happening? This is the best opening ever. What? There's three Starlight! This is why you open the whole case. This is why. Every time. I need more sleeves. Double Mascarena. And there's another Starlight right there. I was never expecting three. I've never seen three before. Now we have a chance to pull a third Starlight Rare Mascarena. It looks like it's the next card. So we're gonna go just to make sure we don't ruin it. We're gonna go like this. This is it. This is our final chance at a Starlight. This could be a play set of Mascarena out of a singular case. This could be the craziest opening I've ever done. Let's go. Clover's in the chat. Picanha mods. Oh, I thought it was it. It's the goddess Empress of the Evil Eye. It was a link. I was like, oh my goodness. I mean, there's a lot of links, but we will take it a third Starlight in one case. First pack. No one has pulled anything out of retail yet. No one has pulled anything out of retail. No Galvan Attack Force yet. Hopefully none are pulled. No offense, Galvan. I do like Galvan Attack Force, but not the one you're really looking for. We've got a Steel Ogre Grotto number two. We've got an Earth Shaker. Come on, let's get some. Mr. Volcano. We've got a Gradius and Order, so we did get a Secret Rare. So he's got a chance at a Secret Rare and he pulled the Secret Rare. He could get double Imperial Order, but there still could be like, that probably means we have nine more foils in there, which is really, really good. We have a Mystic Probe. Solomon's Law Book. Deep Sea Warrior. DNA Surgery, and yeah, these are Ed. That's restrict! What a pull! Oh my goodness! Unbelievable, check out that centering. Not great on the centering. Let's check the back. The, what am I trying to say? The surfaces are very clean on here. Next pack. Hobby Pack. Is Spike Butter Shortbread? I feel like I'd get that one every time. Insect Imitation. Attack and Receive. Isn't, wait, is Insect Imitation or Multiplication of Ants is like five bucks now. Island Turtle. We've got the World's Depression, and... Oh, a Legendary Fisherman! Nice, Ultrarare! It is pretty OC, but this is a crazy good opening. Double Foils have been pulled. First Edition Hobby Pack. Blue Eye 98. Let's get you something good. Let's get you something good. That was a shallow pull. Ah, these puns, you guys, you guys are killing me. All right, Dark Fire Soldier Number Two. We've got a Bite Shoes. Can we get the Ginzo in here? All Seeing White Tiger. We've got a Ground Collapse, and... Not a bad win right there. Very nice. Very nice, let's check the centering. Oh, it's not too good on the centering. Let's check the back. The back looks pretty good. Okay, the back looks good. Next up, Retail Pack. Or a Hobby Pack. This one we're hoping for a Super, unless there's a Third Ultra. It has happened on Simply Unlucky Stream. It happened on One of Mine once. So it's possible to get a Third Ultra. Could be a nice little steal to get in there. We've got a Dark Fire Soldier. Bite Shoes. All Seeing White Tiger. And... Left on it, and look what happened!  Legendary Fisherman! Buster Blader! Ginzo! Let's just open this one up to see what happens. It's just more excitement than anything else. Yeah. All right. Oh! It's just 20 years in the... This is open. Let's check out what's in here. Yeah, it just fell open. Yeah, that's weird. Okay, let's see. We might have to open to a hollow to make sure. Definitely not. Okay. All right, come here. Definitely real cards. Yeah, the cards are 100% real. They would be much redder on the back. And then the text would be off, too. Okay. Dark Gray. Okay. Crunch Creeped! It's a secret rare! Okay, you know, 100% real. Let's just... Wow! Look at that boy on the sun. Wow, that's crazy. Yeah, I was like, what is going on with this package? So they just have like one random printing. That's just kind of weird for tournament pack commons sometimes. And then they just have a ton of value because there's just no other cards of them. They're kind of unique. All right, third pack. Here we go. We got the statue of the Easter Island. If that doesn't remind you of 90th Museum, I don't know what will. The judgment hand. Here we go. Make sure you guys hit the like button for this video because this is pretty expensive, pretty epic old opening.  Look at it. Oh my goodness. Mechanical Chaser Ultra Rare Pulled from Tournament Pack One. Unbelievable. That is so epic. What's up guys? We're back with another epic video. We are here with the one and only Ruxen 34. Oh, we're here with myself. All right. And I'm sad. Okay, here we go. Yeah, by the way, these retro pack two are like a grand now. Yeah. So like the retro pack one are insane. But like even these are a grand, which is nuts. What kills me is the quality for the cards aren't really that good. So it's like retro pack one. Who's buying these? It's awful. It's awful. Masker strike. I'm mad because we just can't buy any more of them. Yeah. I'm pretty mad. I wish you'd get it for 200 again.  Why not to start it? You're starting it off. Okay. Okay. So so far out of this box, I've pulled Dark Magician. I've pulled the Curse of Dragon, Polymerization and Flame Swordsman. So I think Rygeki would be a six super. Obviously for Ultras, we want blue eyes. We want Exodia head. We really want blue eyes. I can't believe I'm doing this. Can you see how much these packs are? Have you ever opened this? No, this is my first time. I think if it for like a heavy pack, I would guess it's like at least two grand, probably over. Oh my God. And it's funny. I'm hoping for my packs are worth way more. For some reason, LLB First Edition is like opening First Edition Shadowless. It's hard to find. It's really hard to find. All right. Yorabi. I can't fail this. This is a heavy. Okay. It's glossy. So it may or may not be heavy. It's supposed to be heavy. So we'll see. It's the next one. Bum bum bum. Oh! This is such a good box. All the best super. That's probably the best super. Poly, Flame Swordsman and Rygeki in the same box. Oh my goodness. Let me sleep in this also. Let's finish the rest of the bag. That is, that is lit. Yeah. So there should be one more. That should be it. This should technically be it. I think this is the heaviest pack, right? I think so, yeah. I can't remember if we set it up like that or not. But we pulled Dark Magician with Leon. And now we are hopefully going to pull Blue Eyes with Rhyme. Here we go. We need his luck. I might scream. Come on. Spike Sieger, let's do this. I'm right next to this mic, so I gotta be careful. Mammoth Graveyard, come on. Fire Grassles. I had crazy luck this past week. That's why I use it all up on myself. Dark Magician is probably the second best pull. There's Exodia, the forbidden one. Red Eyes, you can pull a piece of Exodia. We don't really want that though. We just want the head. The head if we want. Okay. The head of Exodia? Yeah, that's valuable. The arms and stuff are, there's just so many of them. I don't know if you've seen recently they just announced the Union. I mean Union Pokemon. Yes, I have the Exodia. Everybody's like saying it's Exodia. I saw that, guys. Here we are, ladies and gentlemen, starting off with a forest, making some room over here. So forest. Skull Surveys. That's actually a good comment. Just because people think it's hilarious. I love that card, just memory purposes. Rain Phantom King. That's classic. Hitsumi Giant. Oh, this is it. And we have... Oh, it's been. Where's Joey? Where's Joey? It was heavy then. So that's weird. So maybe it didn't work. Right. They haven't gotten to that level yet for that set. That's why I was just really excited about potentially getting, not just the Toon Dragon, but a couple other ones which struck cores with me way back when. All right. This is the final magic ruler pack for myself. All right, Whiptail Crow. Performance of Sword. To the last team. Giant Turtle of Feet on Flames. I love that. Magical Labyrinth. And... Oh, you didn't know! Is this real? Legacy of Darkness. We're gonna start off with one pack. I don't know if we can possibly do that well, but we have not pulled the injection fairy literally, guys. I wanna see it. So if there's a way to win this not actual pack battle. Yeah, there we go. I'll go over here. I'm just gonna ride this. Room for our faces. Right, right.  All right, Spirit Ryu. We've got the Spiritual Energy Settle Machine. Super Robo Lady. And... Oh! First pack! First pack magic! Here we go. Well, hey, let's hope. What would, like obviously, Blue Eyes. Blue Eyes is the number one card. Dark Magician's my favorite. Dark Magician, Red Eyes, and Exodia Head are all very big. They're big. Well, I've pulled Red Eyes on my channel, so we'd prefer one of them. That's like, what if we pull any of those? I'm just gonna get really excited. Obviously, Blue Eyes. If we pull any of those, I might pass out, just saying. And of course... I'm getting sleep ready just to get it. Super airs are great. Any foil's good. And also it means that might actually scale the packs, which is kinda good. Maybe we can actually know what we're gonna pull. May or may not happen, we'll see. All right, Kumutoko. We've got some weird ones. Definitely glossy cards. Yeah, I noticed that one. You see that, that's the difference. Glossy looks like this, wavy looks a little different. All right, Kumutoko, this just looks really nice. Forest, very good. I like the magic cards in the originals. They're just the nice green, I'm a big green fan. We got some green in the background as well. Skull servant, that's pretty good. The centered comments too. These actually are worth a little bit if they're graded. Green Phantom King, okay. This is it, guys. I hit your camera, okay. Oh my gosh. I can't believe this. This is insane, man.


Welcome to Sheboygan County government working for you. My name's Adam Payne, Sheboygan County Administrative Coordinator and co-host of this program, though as you can see, my fearless leader, Chairman Bill Gehrings, not with us today. So I'm going to do my best to take the lead without his help. We're very fortunate today to have two special guests that are going to talk a little bit about UW-Sheboygan and all the exciting new developments out here, as well as some of the opportunities and challenges ahead. First Dean Ray Hernandez is with us, as well as I want to make sure I get this title correct, the Assistant Campus Dean for Administrative Services, Mr. Richard Barnhouse. Yes, the title is correct. Gentlemen, it's good to have you with us. Thank you. That's a pleasure. Ray, why don't we start with you? Please share a little bit about your role and responsibilities as Dean of UW-Sheboygan. Well, basically, you know, my title is Dean, but I'm the campus executive officer, which means that I'm in charge of the entire campus and all the operations and the programming and staffing and that sort of thing. And I also am responsible for interacting with the community, with the government and legislative leaders and business leaders and community groups and essentially be the contact with the community for the campus. And when did you start here as Dean? I started here in July of 2000. So this July, I would have completed six years. How quickly the time passed, I started as a county administrative coordinator in January of 1999. So you and I were both relatively new to our positions here and it's been certainly a pleasure working with you. Rich, turning to you, you're one of the newer kids on the block here at UW-Sheboygan. When did you start? And please share a little bit about your role and responsibilities. I came on board in August of 2004 from the University of South Carolina, which gave me some good experience in public administration and a large comprehensive university. In my role, my title, the Assistant Campus Dean for Administrative Services, I basically oversee everything outside of the classroom and everything outside of student affairs and I report directly to Ray, the dean and CEO. Some of my main responsibilities, for example, would be I'm the chief financial officer. I oversee human resources, facilities. I do some of the things with the county on behalf of the dean, information technology, food service, bookstore, the exhilaries. So really everything on campus that doesn't have anything to do with academics or directly related to student affairs. Very good. And it's been since August of 2004. It's August of 2004, so I'm coming up on entering my third year here on campus and it's been a great experience so far. A lot of exciting things going on on campus. Well, it's been great to have you. I know you two make a good team. And speaking of teamwork, I think a lot of people don't recognize that UW-Sheboygan, the buildings and grounds are owned by Sheboygan County, county government, and the state obviously is responsible for the staffing and the personnel and a lot of the administration here. So it's been a long-standing relationship and I think a very productive one. Ray, please share a little history with our viewers about this relationship, this partnership. Well, the partnership actually began in the 1930s with what was then called the Wisconsin Idea, where the University of Wisconsin was partnering up with the local units of government to provide programming to local residents. So the original UW Center, if you will, was located where Central High School is now and it was part of the center system. And then in 1963, then the current campus was built by the Townie. But the relationship has been fantastic. I mean, in terms of the University providing the programming and services for the local residents and the Townie providing the facility for the programming to happen. It's a wonderful partnership and really benefits the local citizens here. And with this relationship and obviously UW-Shaboygan here being here for, when did you say it was built in 1963? 1963, this campus would be done, yes. Clearly, there's been growth, there's been demand by the community and students to come here. And what have you seen just in the last few years from a standpoint of student enrollment? There's been a pretty steady influence over the past five years, although it's sort of leveling off right now. But we've seen a significant growth in what we call non-traditional-age students. You know, those are students that are 22 years old or older, more adult type of students to the point that we're 35% or more of our enrollment now are adult students.  So about how many students in total are enrolled here now? Between 750-800 students, something like that, we've been holding pretty steady now for a couple of years in that range. That should hold for another year or two. And about two years I anticipate another spike. Very good. And one of the things I know you two have been working real hard at is improving the program and just improving the standing of this facility period. And Rich, certainly you've had a key role in that. And one of the things I know you both have been working on is creating more of a relationship with the four-year campuses. Absolutely. How does that work? Well, what we try to do is provide a greater breadth of educational opportunities here on campus. And it's something that the Dean has really done an outstanding job in developing relationships with the four-years, which allow us to offer different opportunities, educationally speaking. So this allows us, through these collaborations with some of the four-years, to offer baccalaureate degrees right here on campus so that students don't have to transfer. You know, I'm sure there was a time on campus here, probably not too long before I came, when students would complete two years and then they would have to transfer if they wanted to complete a baccalaureate degree. That's no longer the case in a number of fields, including business and management, information technologies, as well as there are really a plethora of other areas that we have collaborative degree programs with the other four-year institutions. So basically what that means is our students can stay on campus and complete their bachelor's degree right here on campus, as well as one of our master's degree in education. And the Dean is continuing to really push this, which we think is a great initiative and really allowing our campus to grow and expand. And so we've got some other things that we're considering in engineering and education because obviously there's great need in Sheboygan County for those types of professionals. So that's really been beneficial to us. And really we need to thank the four years as well for being strong partners in bringing this programming to the community because there are many students that are place-bound and really if they wanted a baccalaureate education they wouldn't be able to leave Sheboygan County. And so now we're really beginning to bring these programs right to our neighborhood, so to speak, so that people can stay, you know, their families and jobs here and they can get their complete and comprehensive education right here in Sheboygan County. So we're excited about it and we're very excited about the, you know, increasing the programs at the baccalaureate level here on campus. More opportunity we can provide to people. Yeah, right. Yeah, maybe you could talk a little bit about that. Yeah, our most recent baccalaureate offering is in nursing, Bachelor of Science in Nursing.  And that just started a couple years ago or has it been less than that? Yeah, it's not about a year ago. What a year ago, yeah. Yeah, and that program is very strong, you know, lots of interest in good environments. Outstanding. This is really the new frontier for us, I think. Yeah. Bringing baccalaureate education right to Sheboygan. Now, to set the stage a little bit, because I imagine a number of our viewers aren't aware that, you know, just how fortunate we are to have a campus here. There's 72 counties across the state, and if memory serves and certainly correct me, there are 13 that are two-year campuses, and obviously they're scattered throughout, and then you have how many four-year campuses? 13. 13. So 13 four-year, 13 two-year, and now Sheboygan County, the people of this community have an opportunity to come here to a two-year campus, but literally get a four-year degree. Absolutely. Which has got to help the pocketbook as well for people. Oh, sure. Oh, tremendously, yeah. Outstanding. Well, speaking of the pocketbook, times aren't getting easier from a standpoint of resources. We've had a number of challenges at the county and state level, but with that said, as you know, we need to continue to invest in our infrastructure and we need to continue to provide a strong educational system. And there's been some really nice improvements made here of late under your leadership, Ray. Certainly the HVAC system, we had a real concern there with staff and the professionals working here and some students obviously, and we put about a $2 million upgrade there. We just completed the science edition, which is about a $5, $6 million improvement here, which I think people are really beginning to appreciate. And now we're looking at a new technology center, which is just wonderful news for the campus and for this community. We just broke ground. What was it? A couple of few weeks ago. That's right. Ray, please begin by sharing a little bit about what this new technology center means to UW-Shaboygan and the students that come here. Well, what it means is that we will now be able to offer up-to-date state-of-the-art instruction in technology and provide equipment and laboratories that will meet the needs of now and today but future students who are in technology. Everything is in view with technology now. And so we have to try to remain current in that area. And then we'll also be able to provide a brand-new state-of-the-art library. And that library will be much larger and much more modern technologically advanced library that will be of use not only to our students, but also to the community at large. This is a tiny facility. And then this library, this building, will be a prominent part of our campus, right at the entrance of our campus. So it will provide access to the general public, to this facility. And that's something that we want to provide as well. Now, as you know, it was no small feat to bring this vision to reality. And frankly, if it wasn't for a member of our business community really stepping up, it wouldn't have happened. You spoke earlier about the strong relationship, the partnership between the county and the state. But we've added a third party. Why don't you touch on that a little bit? Well, you know, today the taxpayers of the town and of the state have been very generous and support, you know, the town of our supervisors and supporting this facility. But the reality is that public dollars have become tighter and tighter, you know, by district firm and we have less and less to work with. So our only alternative then in terms of trying to expand the facility is to seek some private dollars. And so this is new territory for us. And fortunately, we have some benevolent private businesses in the area who believe in education, who believe in giving back to the community, providing services to the citizens of Suburban County. And so with respect to the new technology center, a charity company stepped forward with a very generous donation of $1.8 million towards construction of that building, which represents the largest private donation to any of the 13 two-year campuses today. So Mr. Ben Salzman, the CEO there and Acuity, as you said, really stepped up. And I'm certain the vast majority of our viewers have to have seen an article in the paper or heard something about this already. But clearly the partnership between the county, the state and the private sector and just a major contribution like that is helping bring this to reality. And it's wonderful. Now, as we talk about some of the good things that have happened out here and some of the improvements over the years, clearly there are some trends or challenges that we're being posed with and rich, obviously as the financial officer and overseeing that. What are some of those trends or upcoming concerns that you may see on the horizon when it comes to the relationships that we have with the county and the state and challenges that you have to contend with? Yeah, absolutely. Anybody that receives funding from the state certainly is going through the same things and I'm certain that the county is as well. And we're seeing reduced budgets, reduced funding from the state. But like I said, that's affecting everybody who has states supported. And so we need to be doing things better with less. And I think that we're doing that through our collaborative degree programs and really with our partnership with the county quite honestly to some degree, our bread and butter. So I think those relationships are very, very important. As the state support dwindles, it's going to be the outreaching to the community, to corporations like acuity and definitely our strength in our relationship with the county. But at the same time, we need to do things for the students and make sure that we don't forget our purpose here and that's providing an education. And so by serving the students through a more comprehensive education, we also serve ourselves as far as increasing the number of students on campus and funding in that manner. So those are some of the challenges that we're facing, really a reduced budget that's coming from the state. But we're not the only ones facing these problems. And you hear about many of the four years who are increasing their enrollments for obvious reasons. You know, they're struggling just like everybody else. So we have to be creative. We have to do more with less. And this is really the time to develop those relationships with people maybe the universities haven't in the past. And so that's really how we're addressing the situation. But we're also being a lot more careful with our expenditures on campus and we're being very, very specific as to what we are purchasing and really what type of longevity we're going to get out of those types of materials. Now with the county budget, we will have our kickoff here in late June and all the departments, including UW-Sheboygan because of the building and grounds maintenance are part of that equation. The county board will adopt our budget in November and clearly because of the state caps in place, as well as just trying to be fiscally conservative, there's going to be give and take as you're aware of that happens every year. Specifically with the state level and the state budget, which obviously you're most concerned with from a standpoint of personnel and covering administrative costs and everything else that goes on. Are there any specific areas that you've gotten some feel for? I know there are a two-year operating budget, but have you gotten any guidance thus far as to some areas that you know they're going to make some adjustments in? Well, I think that we can be certain that our operational accounts and our budgets will be far, far less. Now, when I say far less, it's not detrimental, but any time you're receiving less funding and your costs are increasing, it does become a little bit of a challenge and that's what it is at this point, a challenge and it's something that we can definitely overcome. At this point, it is operational in nature and we're not looking at faculty and staff at this point and I do sense that in the next few years things may turn around again from the state side of things. So right now we're just dealing with a limited operational budget. So it's a challenge. And Ray, as he mentions these limited operational funds that you have to contend with, clearly you both know that there are certain needs that the campus has, things that opportunities or needs in the future. How do you balance tightening your belt and making some of those operational adjustments yet addressing some of the areas you know need to be addressed to improve the campus? Well, unfortunately, depending on what the legislature does in West Biennium and how deep the cuts are going to be to use every system, and something that I'm concerned about is that I'm hoping that we don't have to resort to raising tuition in order to continue operating. But my fear is that it may go that way. But it just depends on how deep the cuts go. But that's the only way. I mean, just to maintain, just to keep the doors open, as Rich mentioned, the cost is going up. And if our revenue continues to go down, there's a bridge point there that it's out of time from somewhere. Right, right. And it would be the same, but I think that might be an area that would be impacted, would be the tuition. And that's a very, very important component.  At this point in time, as far as our institution is concerned, the 13 to year colleges, approximately 60% of our revenue comes from tuition and approximately the other 40% comes from the state. And it wasn't too long ago that that equation was flipped, that ratio was flipped. So we have seen some significant change in probably six to eight years, I would guess. And as Ray said, as the state support does dwindle, revenue has to continue coming in to keep the doors open and the revenue is the tuition. So we've talked about some of the really nice improvements that have occurred out here. And clearly the partnership that's been strengthened with now the business community stepping up for the science building, for the new technology center. And I anticipate, as you've both suggested, we're going to see more of that in the future. With that said, we continue to have these real pressing financial concerns in part borne by the state because when they have a budget crunch that tends to trickle down to the local level, the county is certainly going to be subject to that as well as all levels of government. And very recently, we had some referendums in this county, as you know, asking for more support for certain programs and services. And all of them, all of them were not successful. All of them failed to be successful from a standpoint of raising taxes. So in light of those trends, I'm sure some of viewers who are listening to this who have been following some of the developments out here are wondering, well, how is it? How is it with the trends being what they are with taxes and the concern as a whole? How is it that we're able to still make these investments at UW-Shaborgan? Or why are we making these investments to the extent we are at UW-Shaborgan? How would you respond to that? Well, I would say that tax revenue is generated from people who pay taxes. And so if you have the better educated workforce that you have, you know, the more interim the light that you make and the more taxes that they're able to pay. So we're actually investing in the future tax base for the county by providing this education in facilities, I mean, just simply put. Yeah, absolutely. I would agree with that. I look at it as money in the bank and a very solid investment. And there is a difference between an investment and an expense. They both look the same on paper, but they're not. And education is absolutely an investment. And I think that the county has been very wise. Obviously, I have some bias in this, but I think the county has been quite wise in investing in education in the local campus because it's going to ensure, to a great degree, that the residents, as they grow up here or educated here, stay here, create businesses, pay taxes, et cetera, et cetera. So I think that's very important. And it's obviously, Sheboygan County is one of only 13 counties that has this local opportunity. And so I think the county's been very wise in investing because you're setting aside funding that you could do other things with in order to invest in the county's future. And I think that ultimately that's the important thing is that you're investing in the future. And when you say county, obviously, that's in the broadest sense, meaning the county board, the county taxpayers. Yes. One of the things that I know I feel so strongly about living in this community and raising my family is we have so much going well for us, whether it's UW Sheboygan, our school system that just has received national recognition for being the top two or three in the country. When you look at our economy here, it's starting to diversify more. And clearly it's going to continue to diversify with the opportunity for people to come here and get a good education. So all of that is so important to our local economic development and quality of life. And I'm sure obviously you're here, Rich, because of the position, but clearly people, when they move to a new area to raise their family or settle down, they look at the quality of the schools and the quality of life. And I just think we're so fortunate to have a pretty nice package here. Well, we only have a couple of minutes remaining. And in those couple of minutes, are there any other areas that you just wanted to touch on briefly or any other positives that you wanted to share about UW Sheboygan, especially if someone's never come up here and checked this place out before? Yeah, I was certainly intrigued to do that, especially with the new building going on and all the excitement that's happening around that. And people need to familiarize. I think people probably are not as familiar as it perhaps should be about everything that we have to offer out here. And we have so many things going through our continued education program, through our pre-college program, summer programming. We already touched on our baccalaureate degree programming. It's a different place. I run into people all the time out in the community and said, oh yeah, I was out the center back in the 70s or 80s or whatever. I encourage them to come out because it's a much different place than it was even 10 years ago. And also, you mentioned off the air here, but I know that you're working on what, a new garden or some type of, maybe you want to mention that briefly. Yeah, the bookworm gardens, yeah. It's a group of people who would like to site a garden here on the campus that's specifically designed for early childhood, you know, children. It's immediately based on children's literature. So it'll be about two ways of interacting with gardens for children that we're hoping to have presented out here in the next couple of years. And that's a pretty, I mean, that's a multi-million dollar investment. A pretty large investment, yeah. And then our partnership with the UW Extension, I see that expanding. I see more programming opportunities and services through the UW Extension since we're now part of the same family under one chancellor. I anticipate much more collaboration between us and providing services to the county. Very good. Rich, anything final that you wanted to share? Yeah, I would say that although geographically we're the campus on the hill, philosophically we are not the campus on the hill. And we want members of the community to make use of our campus. We want people to be actively engaged in our campus whether it's for an academic reason or not. We have a lot to offer here, whether it's through our theater which is thriving and we have a lot of community members who come up here in our part of our theater and theater program, whether they're patrons or whether they're actually acting in some of our plays and musicals. As Ray touched on, we have an outstanding continuing education department and we do rent out space to the community. We are quite simply not the campus on the hill and we're a member of the community and we want the community on our campus. Very good. Well, Dean Ray Hernandez, Assistant Dean Richard Barnhouse, appreciate you being our guest today and for those of you who have the opportunity to view this program, don't hesitate to come on up to UW-Shaboygan and take a look around and these two are always so open and willing to meet with people and they have an outstanding staff and if you want to check out the new science edition or get a feel for what this campus has to offer, please don't hesitate because this is our campus throughout for all the people in Shaboygan County and please make use of it. So again, thank you for your time and thank you for all your hard work. Thank you for having us. Until next time, on behalf of Chairman Bill Gehring, myself, Adam Payne, County Administrative Coordinator and the full Shaboygan County Board. Thank you for joining us. Thank you.


Now, just in case you're confused, I'm a tool. He's Hovick. What a pleasure to get to talk to you. So, people don't realize, I didn't even realize, is a doctor. You went to MIT in molecular biology. He went to Yale for medical school. But then he bailed after medical treatment. My mom has never forgiven me for that. That's right. And ended up going to Wall Street as a biotech investor. But along the way, he became a policy blogger, went to the Manhattan Institute as part of that, has his blog to the stay at Forbes, but then was invited to become the advisor to Romney, and then Rick Perry, and then Marco Rubio on health care. He is now the head of a foundation he is founded in Austin, Texas, called the Foundation for Research on Equal Opportunity. And the chance to talk across lines, we have not actually gotten much of a chance to talk to each other. We have debated at a distance, but the chance to actually talk together is something. First time we've met in person, thanks to America. Yes, exactly. And I think this is part of the opportunity to get to dig into. So what I wanted to start with is part of what is interesting to me is you have been making the conservative case for universal coverage of health care. What is the case, from your point of view, for universal coverage of health care?  We modeled it in part after New America because we really want to be the kind of a think tank that focuses on what the future of America looks like and try to find the policies that address the problems that we're facing in a future-facing way. And of course, you're too young to be my boyhood hero with tools, but whatever expression I can come on with, it's an honor to be here with you. Those of us who are true believers in free markets believe that nothing has lifted more people out of poverty in the history of the world than free markets. Just in the last 25 years, the economic liberalizations in India and China have lifted a billion people out of poverty just in those two countries. Those of us again who believe in free markets believe that the competition, the creativity, the entrepreneurship is what leads there to be more abundance, more access to what was formerly scarce. It drives down prices, increases quality, increases access. So one thing I've always found puzzling about conservatives is that if this was a room full of conservatives, and I said, raise your hand, conservatives, if you believe that we need a bigger government to make sure that everyone has a smartphone, no one would raise their hand. They would actually count on innovative companies to deliver those products at a lower cost and expand access. So then why is it that we accept the narrative that the only way to achieve universal coverage is through more government? Certainly there's a role for government in providing assistance to those who need it. But I think the poverty of the imagination of conservatives has been to not apply their principles that free markets can expand access to all things, to healthcare. And so the argument of the pitch I make to conservatives is say, hey, you all say you believe that free markets can expand access to everything, particularly for poor people.  And instead of being against the outcome of more people having health insurance, show how our ideas can achieve that. So let me, I think this is a really fundamental question in our discussion right now. Is that outcome we're trying to achieve one that is a common cause across much of the political spectrum? Or is it fundamentally unconservative to believe that everybody should have a basic level of healthcare? And I think we see that divide in the debate around the American Health Care Act. You have the coverage caucus and the freedom caucus as if those two things are opposed and you're trying to say that coverage and freedom are not. Absolutely. And so what is the goal? What is the goal of sound healthcare policy? Sound healthcare policy in general? Well, I mean, obviously there are a lot of different people who have different points of view as to what the goal of the healthcare system should be. My personal view is, and then this just goes to the issue of whether healthcare is a right or not. One thing that I've written about and we've talked about this offline is conservatives actually, they don't talk about it this way but conservatives actually do believe healthcare is a right but in a very different way than progressives do. They think of the rights in healthcare are the rights of freedom of choice, the right to choose your own doctor, the right to choose your own health insurance plan, the way you get your healthcare. And that's what they focus on. And again, it seems to me that those things actually can serve the goals that we all share of a system where there's more access to low-cost affordable healthcare. And again, we don't have that debate in part because the conservative movement has not really thought about how to expand access to healthcare. There is this coverage caucus like you say in Congress and the Republican side but it tends to be more about what do we take the status quo to do and kind of tweak it as opposed to I think a lot of us who spend a lot of time in healthcare say we need this system to be a lot less expensive than it is. We need the quality of delivery to be higher and we need more people obviously to be able to have access. And by the way, it's not just about healthcare. I think one thing we lose when we just talk about healthcare as healthcare is that health insurance is really a financial instrument. Paul Grumman once said, well, we wouldn't expect fire insurance to protect us from having fires, right? And similarly, we forget that really the attribute of health insurance that's the most important is economic security. The idea that no one in this country will go bankrupt because of medical bills. And the irony is even though it's mostly Democrats who talk about healthcare in that way, it's an idea that conservatives feel at home with the idea of catastrophic insurance. That actually serves that purpose in the most cost effective way. So I think there's a lot to talk about. There's a lot of opportunity for common ground. And I think a lot of sometimes what we don't talk about because we argue so much about healthcare is what does it mean to have a right to healthcare? Does it mean you have a right to a $2 million treatment that extends your life by two months? Does it mean you have a right to Viagra? What does it mean?  And what is that basic standard of healthcare that we want everyone Americans to have? We don't have that debate often enough because we just debate the dollars and cents so on. So yeah, if I were to talk about the goals, I would say partly it's that, and I'm curious whether you agree or not, number one, that you don't go bankrupt because of medical needs. And the two biggest sources of financial insecurity now are your health and your housing, right? So those are really fundamental critical needs. It used to be food a century ago. That was 30 or 40% of people's bills. Now it's healthcare and it's housing. But the second part of it is that we have this access to a better, higher quality of life and longer life expectancy. And there are stunning and unacceptable, I think, immoral levels of difference that people are achieving varying from cities where it's a six year life expectancy difference between the top 10th percentile and the bottom 10th percentile to cities where it's 25 years and more difference in life expectancy between the top and the bottom. And some of that is about, a big part of that is about delivery of healthcare. So access to a regular source of care from someone who knows you over time, usually a primary care physician, is shown in multiple studies to be worth about 10 years of lifespan. And so getting access to not just the catastrophic event, but getting access to the benefits of having a regular source of care and being able to deal with chronic illness prevention and the reality of being frail creatures who get to live 85 years and have phases of your lifespan. Means having access to that as a system that can serve that and not just have that bankruptcy. Do you buy into that? Yeah, I would say I have two thoughts in response to that comment. The first is I do think that we underestimate, we talk about it to some degree, but we still underestimate the degree to which a lot of the challenges in terms of health outcomes are driven by things like education and economics. So there's such a correlation between say whether you went to college or whether you graduate from high school or not and your health status. And a lot of that is intractable to health policy and the traditional sense of health policy. So that's a challenge that's broader broader than healthcare. And I think another challenge that we have is that we have this fragmented system where we have Medicaid which for a lot of people means really poor access to providers. Then if they cross the poverty line or 1.38% at times the poverty line, they end up in what's now the ACA exchanges where they have a completely different modality of health insurance. And then as soon as they turn 65, they're on Medicare. And so a lot of the challenge with our particular healthcare system is this fragmentation. And one thing that I've talked about in my health reform writing is wouldn't it be great if we actually had something closer to a unified system where take something like the exchange where people are ideally shopping for the coverage and care that they want. But they can also do that when they're low income. They can also do that when they're over the age of 65. Why is it someone's on the exchanges at the age of 64 and then on a completely different system at 65? Why is it someone's on Medicaid when they're at 90% of the poverty level and then on the exchange when they're at 140% of the poverty level? Because people's incomes go up and down quite a bit in that income bracket. So that disruption, that discontinuity I think is a big challenge and a big part of what I've tried to do is say let's do what we can to have a more integrated system in that regard. Yeah, I think there's really strong case to say that employment-based healthcare is a disaster for the future, right? In a world where there is gonna be a dramatic change in the way we work having your house insurance housing insurance covered through your employer would make no sense, having your health do so simply as Matt Miller would put it, a dead idea that needs to die, right? But the problem is transitions. So we have 155 million out of 310 people, 10 million people in the country who are an employer-based insurance and it is often very good insurance, better insurance than we can provide through other means. But at the same time you have employers feeling completely saddled by that and trying to shift the cost so all of us in the room were probably experiencing higher and higher deductibles, higher and higher copays, higher and higher premiums. So when you imagine breaking out of that box but dealing with the fact that people are more afraid of the losses than the gains of a change in insurance the phenomenon we've seen is Obamacare was an example of let's do something about two groups that are missing from the system. The near poor and poor and near poor and give them all access to Medicaid and then people who have to buy insurance on their own.  But you have, and you had all of the fears about what you would lose. Now we're seven years in and now that it's been established there's fears about oh my God you're gonna break that system now. What are we aiming to rip? What will happen beyond that? How do you get through, what I hear is a common belief that we have to move beyond employer based. And naturally there are versions of single payer that take you in that direction from ones that are really based on private provision like Switzerland to the French based system and others which are much more a kind of public insurance a Medicare type of thing. Where is the goal to you? And most critically you can have a pie in the sky goal but how do you begin to imagine getting there? Yeah, so one of the things that was disappointing about the American health character of House Republican bills that actually the leaked draft that came out in I think mid February had a robust reform of the employer tax exclusion, the tax break that allows basically all the value of your employer based benefit to be free from not only income taxes but payroll taxes and local taxes. So it amounts to about $500 billion a year if you add it all up in annual subsidy. So it's really the second largest entitlement in the country if you think about it that way. It's a challenge. And spend a moment on that. I think that might have shot over people. So explain the value in terms of the lost revenue to federal state and local government entities because of the value of this exclusion. We think of for example the tax break for mortgage interest, right? That's about $130 billion a year plus or minus. The tax break, the value of the tax break for employer based insurance because it's paid for and then it's not counted as your wages.  But that all those taxes that you pay for anything, a dollar that comes into your paycheck, you're not paying any of those tax on employer based health insurance. So if you add up sort of the aggregate taxes that are involved in that, basically what that means is someone can give you a dollar in wages or they can give you $2 in health insurance. And so the incentive having had the system for 70 years is having more and more money routed to health insurance where it's more valuable because it's not taxed and what does that mean? That means insurance finds excuses to cover more things as insurance that normally in a conventional insurance market would be out of pocket. Like you have car insurance so that if your car gets totaled you don't have a bill for that. But you don't expect insurance to pay for your gas, your wiper fluid, your oil change. So similarly, the model of insurance that a lot of market-oriented people talk about is like, that's a great model for health insurance. Let's have a model where, again, we protect everyone from bankruptcy due to medical bills but those everyday costs that are affordable, actually they'll be even more affordable if everyone is controlling those health care dollars directly instead of routing that through insurance. But it's a big challenge to change the system because as you said, 155 million people are on it and the biggest challenge is, we talk about cancer as a silent killer, the employer-based insurance system is like the silent killer economically of our health care system because it's taken out of your paycheck before you see it. I mean, I could ask all of you, how many of you know how much money is taken out of your paycheck by your employer for your health insurance? Raise your hand. Okay, so a healthy like 8%, 10% of the audience, that's pretty good actually. Normally when I ask that question about five hands go up. So it's a real challenge and then people say, hey, you're taking something away from me that I'm not paying. People don't realize that wage stagnation is driven a lot by the fact that actually overall compensation is growing but all that overall compensation growth is going into health insurance. So the Republicans tried to reform this system in the original bill and then it was watered down and eliminated almost by backbenchers in Congress. So that was extremely disappointing and obviously the ACA tried to do something around this through the Cadillac tax and even the Cadillac tax is sort of pushed back and watered down by the ACA. So how health policy wants like us? We're very disappointed by that. We're just incredibly disappointed, right? This is this ready pool of waste and money that could dramatically decouple employment from, so the best way to put it is every dollar that your employer is spending is invisible to you. It could be yours but it's perceived politically as a tax to take that money because we don't trust that it's coming back to us, it's staying going to your employer. And so I think one of the interesting things is the idea that we still have ways if we learn how to figure out these transitions. It's a smart policy, it's one that's got wide agreement across the spectrum. It is a ready source of significant money and it could be in our personal control as individuals being able to decide how that money spent by your employer is actually deployed for healthcare and have more of our own community pool around that. I think there are many possible pathways forward. I'd like to make sure we open up to questions. And so maybe if hands can go up and the microphone's gonna go around and I'll ask one question then while you get the microphone to someone, which is, so what do you think of the Cassidy Collins bill? Which says what we need are 50 laboratories if and the Cassidy Collins bill is one that says keep the Obamacare taxes in there, give it to the states, maintain the minimum benefits, the expectation on pre-existing condition exclusions. And if you wanna keep Obamacare, you keep it. But if you wanna radically remake your state, if you're Vermont and wanna try a single payer solution, if you're Texas and wanna try a healthcare savings account solution, you can do that. A, what do you think about it? B, does it stand a chance in hell? I think, and by the way, let me just say that I think Bill Cassidy, for those of you who don't know him, he's new to the Senate, relatively speaking. He's a really terrific guy on a lot of these issues, very creative, trying to find areas of common ground and he's a guy to keep an eye on. I think that the concept has a lot of appeal, right? It appeals to, as you said, progressives who are dissatisfied with the current system and conservatives who might be dissatisfied with the current system. So I think there is, it has potential from both from a policy standpoint and politically. The challenge is, of course, Republicans campaign on repealing Obamacare and the Cassidy-Cons bill, by definition, doesn't really do that. And so I think it only gets traction with Republicans if they just fail to come up with 50 votes for something that they can market more resembling repeal. Of course, the AHA doesn't technically repeal Obamacare, it just takes some of the dollars on Obamacare and moves them to different places. So it's not actually repeal. But it's marketed and successfully, I think, to conservatives as being a repeal and replace bill. So I think that's plan A and B, and then plan C is the Cassidy-Cons approach if that fails. And it very well may, because they're having a tough time getting to 50 votes. Microphone. So I'd love to hear you, as a conservative, take on the issue of the problem is not so much the cost of healthcare, but the need for it. And why don't we invest in things that keep people healthy long-term? Starting with prenatal care, as Peter Orszag often remarks, early childhood education, better education for kids, maybe you tax sugar and you subsidize vegetables so that you get the externalities back into the food. That seems to me to be a really nice and conservative approach that might actually generate not just more care, but more health. Yeah, I think a lot of what you describe has a lot of appeal. I think the challenge is that our healthcare system is so incredibly expensive and out of whack with any norms of international standards that that dominates the debate. Both in terms of just, it's the absolute cost today, but also the future growth of healthcare spending. If you look at congressional budget office projections, which are an art more than a science, literally every percentage or decimal point of growth in federal spending as a share of GDP is healthcare, every single one, except for interest on the federal debt. So the challenge is, we have a system right now, and this is a remarkable thing, and this is sometimes when we talk about the conservative case for health reform, conservatives say they're for limited government, the amount of public spending on healthcare in the United States per capita is actually pre-ACA was higher than all but two other countries in the world. So there was more than enough money in the system to actually make sure that every American has not only access to healthcare, but a lot of money left over for a lot of the priorities that you talked about. But the challenge is that because the public spending on healthcare keeps growing at such an incredible pace relative to the rest of the economy and our ability to finance it, it starves the discussion about other policy priorities that we could fund. So it's really important to get Ben the cost curve, and it's, I think it's too bad that while progress isn't concerned, as it's both talked about Ben and the cost curve, they haven't found a way to talk about it together. Yeah, I think there's three basic ways that you can Ben the cost curve and tackle this. One is the consumer choice model, which says, let's have big high deductibles, have people have skin in the game, and they be the drivers of cost reduction. I have reasons why I don't think it's very powerful or very effective. Second is the regulatory model. Maryland has regulated prices of the hospitals and they're moving to a regulation for the total cost of care and trying to figure out how to do that. And then the third is what's called fee for value. And I think there's a fair amount of agreement across the political spectrum, and it's the camp that I'm in, which is that we pay organizations, Medicare Advantage Plans do this right now. A third of patients, people on Medicare, actually get private provision from essentially HMOs that give you prepaid or prepaid for the total budget of healthcare. And you have more and more institutions being able to deliver prepaid healthcare. And what they do once they discover that you're responsible for the whole budget, they stop investing so much in the hospital, start investing in primary care, begin investing in other forms of reaching patients, including group contact, nutrition, health coaching, and a variety of other versions of being able to lower costs while trying to constantly be attentive to the bottom line about cost effectiveness. And so I think there are actually approaches that don't get enough discussion and are very important. Microphone here. I wanted to ask about Alzheimer's and dementia, which in the top 10 diseases in America, that's the only one really going up. It already costs the nation $236 billion that'll break the back of Medicare and Medicaid by 2030. And there's no drug solution on the horizon, and long-term care insurance only covers 8% of Americans. We obviously cannot afford this. How do we address, the class act was not included in the ACA, how do we address this coming crisis of long-term care? Well, I'll say two things, and then you can jump in. Number one is, I think it's a little bit of a myth that dementia is increasing. It's actually decreasing substantially. Alzheimer's is less than 20% of the dementia that there is. The major cause is related to high blood pressure and smoking, and small strokes are the biggest cause. So we're having a dramatic improvement in how well and how cognitively intact people are as they reach 80 and 85 years old and so on. And so people are spending less and less time with need for that kind of long-term care for cognitive reasons. Second is, I actually think that we don't invest enough, and there's a major opportunity right now with a class of drugs that are in the pipeline for Alzheimer's that I think could have a really significant impact. And it's not being followed with the next generation of follow-ons, because the first round may not be the total cures. So I think we underestimate the importance of technology and implementation of new discoveries that really, really matter. That said, we are an aging society, and there will be periods of time, a couple of years, where we will likely need some serious support in our lives. And being able to offload them from institutions, people want to stay in their homes and want to have a kind of network of care that enables that capacity. And a lot of what Anne-Marie has talked about and founded in a group here around the caring economy, I think is really fundamental. There are ways to provide coverage for that caring economy, which I'm not sure the class act was able to completely solve, but it would have been a first shot at having long-term care as a provided benefit that takes a wider view of the lifespan. And so I would favor including acute and chronic care as part of what we try to cover in benefits, but I'd be curious what you think. Yeah, a lot to say about this. I mean, the first thing to mention is that it's only in rich countries where Alzheimer's disease is a problem. In poor countries, or even historically in the US, you never had Alzheimer's because you didn't die at an age where Alzheimer's was a problem. You died of a bacterial infection in your 30s, or you died in the womb. So it's actually, as we get better at caring for people at any age level, you're gonna have, hopefully, longer life expectancy.  So there will always be high healthcare spending at the end of life, and that's why when people talk about, say, prevention will lead to lower healthcare spending, it's not exactly true, because the fact is you might prevent one thing, but you're gonna die of something else. Maybe it's not diabetes, maybe it's lung cancer, or it's gonna be something. So we're always gonna have expenditures at that back end that are higher, and the longer we live, the more there's gonna be a need for long-term care and management of things like Alzheimer's if we aren't able to come up with a cure anytime soon. So I think that problem is only gonna get bigger over time, and we're gonna spend more on people who are what we can now consider elderly over time as life expectancy increases. And of course, I wanna note, of course, there's a dispersion in life expectancy and people who don't have a high school diploma in particular are not living as long as people who have a college degree. So I think there's a lot about this topic where we have to think about what's the world gonna look like in 20 years and 30 years, and not just the world today and the world 10 years ago. But having said that, is long-term care an important policy priority? Absolutely. It's unfortunate the class act, in my view, and not just my view, the view of Kathleen Sebelius, the view of the Obama administration, was that it was poorly designed, it was not financially sustainable, and it's in the way it was structured. So that was a missed opportunity to get this important topic right. And it's unfortunate, but I think it's gonna be a long time before we get to a point, a long time, meaning at least 48 years minimum, maybe longer than that, where we're able to think about a way to do long-term care the right way, because the cost is significant. If you're gonna do it in a way that really covers everybody, you're gonna have to have something like either a Medicare-style structure or an individual mandate, as Peter Orszag would say, for long-term care, and again, everyone when they're young. And both of those ideas are just heavy lifts in the world we live in. So I think it's gonna be a big challenge and I think it's a big one. I think it's tough to deal with. Just to say real quickly, Medicaid, people don't understand, a third of it is already spent on long-term care for the elderly once you've spent down into poverty. And then the creation of buying into long-term care insurance, so you're buying when you're young for insuring in the future, that is the direction that most of us advocate going, but it requires us spending now for something years down the road, and we're not great at that as Americans. Let's take one last one, and so who's got the microphone? There you go. Hi, Attu raised the issue of the moral question of healthcare. And I'd like to ask, Avik, I will confess having grown up in England, I grew up with a national health service, I came to America as an adult. Unfortunately, I have great healthcare, unfortunately I got cancer. That's gonna happen to a lot of people and I think what struck me about the conversation about the AHCA was a discussion about moral failure, that if you can't look after yourself, that you are somehow at fault. And I think that that to me is what is missing from the debate, the idea that there was no cancer in my family, I got cancer, you can walk down the street, be hit by a bus, and have long-term problems, whether you're 18, or whether you're 30, or whether you're 60. And the idea that one sixth of this economy cannot cover every American for basics. Let's put aside end of life care, which I told has talked about a lot and we can discuss that. Having a baby, having a baby who has a complication, your natural birth turns into a C-section.  And the idea that one would discuss health insurance the same way as flood insurance or house insurance, I think misses the point with regard to what is our collective responsibility. I think it's a great question. Can I embellish it a little further? When I talk to, I come from rural Ohio, one of the poorest counties in Ohio, and when I go back home, I was just there over Easter and talking with people. And they have no problem with the idea that Jimmy Kimmel's baby would be covered and that everybody who has a child with a congenital heart defect or someone has cancer might get it. But then we get in this discussion that says, but I don't wanna take care of those people who have mental health problems or I don't wanna take care of people who, why am I using my money to pay for people who, Craig Mulvaney recently said, who don't eat right, put on weight and get diabetes. Like why are we paying for those people? And what's your take on that discussion that there are the undeserving sick? Yeah, so I think there are two elements of that conversation that are actually opportunities for the conservative case for universal coverage. The first is that so much of healthcare is, again, about these things that happen to you where there is no fault involved. I mean, yes, maybe there's some narrow case where you might be able to attribute it, but broadly speaking, there is no fault involved in most misfortune we have in life when it comes to healthcare. And Friedrich Hayek, the Austrian economist who was the intellectual godfather of modern American conservatives in both of his seminal books, The Road to Serfdom and the Constitutional Liberty, advocated for universal coverage on just the spaces that in a wealthy country, he was actually referring to Britain in 1948, which was not nearly as wealthy as America of 2017, that there is an absolute positive case for a system of universal protection from what he described as the hazards of life. So I think that's something that an increasing number of, Mick Mulvaney is not one of them necessarily, but I think there's an increasing number of conservatives who are embracing that view. And the second point is a point I've made a couple of times already today, which is that we could spend less money in America on healthcare, both in terms of public spending and private spending, and cover everyone in this country. If we spent the OECD median of $500 per person on prescription drugs, instead of $1,350 per person on prescription drugs, we could save an enormous amount, hundreds of billions of dollars a year in healthcare spending. If the same thing was true of hospital spending and physician spending, we could save a lot of money and actually cover more people. So that's, to me, the limited government case for a better healthcare system that helps everybody. And again, it was a contrarian view when I started to articulate this five or six years ago, but I think more and more, as particularly now as conservatives and Republicans are really forced to think about what they're for. For all the years of the Obama administration, they could just define themselves by what they were against. But now they're forced to really think hard about what they're for. And a lot of the allies for a lot of the things I've been describing are people in the House Freedom Caucus, people who say, you know what, in my districts, there are a lot of people who are being priced out of the healthcare system and I wanna help them. And I wanna do so in a way that's consistent with my values. So the opportunity is there, and I think we just have to find those allies. OVIC's fantastic talk to you. Atul, an honor. Truly, thank you. Thank you both so much.


President Mohamed Bwari has condemned the recent attacks in Benway state. Over 50 persons were gone down by a suspected headman in Beji town in the Khome local government area of Benway state. The president said it is unacceptable for lives to be taken by headsmen and farmers alike. According to him, no one should attack anyone because of their way of life, neither should anyone take revenge on others for injustice done to them. Both should be held accountable for their actions and justice delivered.


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