I want to welcome everybody to New America. I'm Mark Schmidt. I'm the director of the political reform program here. And before I introduce Secretary Burwell, who's here to make some remarks about the future of health care on a number of dimensions in the new Congress and the year ahead, I just want to make a few quick comments about New America and why we're so honored that we're able to host her here today for these remarks. Among the founding principles of New America, which is reflected in the book, The Radical Center by Ted Halstead and Michael Lind, who are among the founders of this organization 15 years ago, was a commitment to get beyond traditional partisan alignments and specifically to apply that idea to health care, to treat it as a matter of both rights and responsibilities, and is something that should be vested in individuals and people, not just in some jobs and not others, and to improve care and not just coverage. Over the following years, the middle of the last decade, New America's health program, which is led by Laurie Rubiner, Len Nichols and Shannon Brownlee, worked to put that vision into place, particularly in the period 2006, 2008. This organization and Len Nichols created a space for bipartisan and, most importantly, cross-ideological conversation that ultimately, and it was wonderful to see it happen, ultimately resulted in some legislation that by 2008 had 10 cosponsors from each party and a piece of legislation that, in some ways, went further than the Affordable Care Act, but not in others. In my work on political reform, one of the things that we've done is try to look at the kind of situations where government can get things done, even in a situation where people have deep disagreements about values. And in doing that, I still look at the work New America did eight and 10 years ago. As a fascinating example, because it reaffirmed for me a very basic truth, that when people share a commitment to getting something done, when they agree that the status quo isn't good enough, and they're willing to talk to each other, then even if they're very deep differences about what to do and how to do it, but if people are willing to talk to each other, anything's possible, and people can find solutions even without giving up their core beliefs. And I think as Secretary Burwell will tell us, we're on the verge of an era where we can begin to have that kind of conversation again. I'm also looking forward to hearing Secretary Burwell's thoughts about innovation and how government can do better. Last week, two longstanding board members of New America, Lenny Mendenka of McKinsey and Laura Tyson of Berkeley published a wonderful article highlighting some of the ways in which the Affordable Care Act was encouraging innovation, reducing costs while expanding and improving care. They concluded the article 25 years from now, we hope that historians look back on the Affordable Care Act as the start of a new era of public-private collaboration to develop innovative solutions to complex social problems, and thus, to restore trust in government itself. We share that confidence. Now I want to introduce Secretary Burwell, when I was first, our staff said, you need Secretary Burwell's biography, and I said, you know, I actually really know Secretary Burwell's biography because, you know, when I was in government, she was a hotshot in government. When I worked in philanthropy later, she was a hotshot in philanthropy, but I'll do the full bio anyway. Sylvia M. Burwell was sworn in in June as the 22nd Secretary of Health and Human Services. That's a smaller club than I would have thought of people who have been Secretary of HHS. Before that, she served as director of the Office of Management and Budget, where she worked closely with Congress to restore order to the budget and appropriations processes. Before coming back to government and rejoining this administration, she was president of the Walmart Foundation in Bentonville, Arkansas during a period when that foundation surpassed $1 billion in total giving. For 10 years before that, she was president of the Global Development Program at the Bill and Melinda Gates Foundation in Seattle, Washington, which is an extremely large foundation, and works on a huge range of issues from vaccinations, children's health, agricultural development, and she was the foundation's first chief operating officer. During the Clinton administration, Secretary Burwell served as deputy director of OMB, deputy chief of staff to the president, chief of staff to the secretary of the treasury, and staff director of the National Economic Council. She was born and raised in West Virginia, received her A.B. from Harvard, and a degree from Oxford. So we're pleased to have her here. Let me just do a quick logistical thing. After her remarks, we'll have questions and answers. You have cards for questions. Please put your question on it and your name. We'll go through it and I'll call on people and you'll say your question, but we want to do it efficiently with the cards first. So with all that, Secretary Burwell, we're pleased to have you. Thank you very much, Mark. Appreciate it. And it's great to be here at the New America Foundation. Mark Twain once said that you can't depend on your eyes when your imagination is out of focus. And I think the great thing about the New America Foundation is that you work to refocus our collective imagination on the things that we can do together to renew American prosperity. And that's a very important thing and why I think this is the ideal place for me to be, to reflect upon the values and interests and priorities that we have in common as Americans and in the broader sense as citizens of a shrinking planet. I've long believed that across the globe, regardless of your nationality or your financial status, that we all basically have the same desires for our children. And that is, we want them to live healthy and productive lives. And as the mother of a seven and five year old, I share that dream as well. I'm a believer in the notion that people who share common interests and common dreams ought to be able to find common ground. And that's what I wanna talk with you about today. I truly believe that there are a number of things where we have an opportunity and in fact, a responsibility to get done together in this new year, working across the aisle and working across different sectors. This is especially true in healthcare, where our system is on the threshold of both positive and I believe transformational change. There are also opportunities that flow from the innovations in science and medicine that are being advanced by American scientists, researchers, and entrepreneurs. Many of these innovations are redefining the boundaries of progress. At the same time, they're opening the promise of a new innovation economy. The opportunities before us are good for families, they're good for business, they're good for the economy, they're good for taxpayers. There are things we can get done if we work together. And I believe there's a shared interest on both sides of the aisle and with business and civil society communities in moving them forward. At the same time, the new year did bring in a new round of efforts to repeal the Affordable Care Act. These efforts are happening despite increasing evidence that the law is working. Millions more Americans have access to quality affordable care, some for the first time. What's more, millions of Americans who are already insured are benefiting from the law as well. As you can imagine, I will be vigorous in making the case that this law is working and that families, businesses, and taxpayers are better off as a result. I believe this firmly, and as I've traveled around the country, I've been told by people that I've met that they're not really concerned about the next headline. What they're concerned about is the next generation. They want us to stop the back and forth to move forward and to focus on the substance. And that's really what I wanna talk about today. I count myself among those who do not believe that disagreements in some areas, even significant disagreements, should prevent us from moving forward on others. Medicaid expansion is an example. Governors from 27 states plus DC, including those who disagree on elements of the Affordable Care Act, have reached the same conclusion. Expansion is good for the people and the economies of their states and some who have not yet expanded have expressed interest in moving forward. States like Wyoming, Indiana, and Utah. I wanna see all 50 states expand in ways that work for their states and we will work with governors from both parties to try and make that happen. There are other critical areas in healthcare where our common interests give us ample opportunities for common good. Improving the quality of care we receive while spending our dollars more wisely. Reducing substance use disorders and overdose deaths. Strengthening global health security. Reaffirming American leadership in research, innovation, and science, and building an innovation economy. Let's start with our healthcare system. For all the differences of opinion about how to move forward, there is one area which we have unanimous agreement and that's that the system that's been in place for 50 years has under delivered on access, affordability, and quality. You could almost sum it up with the prices we paid, far outweighed the progress that we made. Health costs grew significantly faster than things like GDP and middle class family incomes. We all felt the effects of a system that did not spend our healthcare dollars as wisely as we could have. However, over the last several years, we started making significant progress, thanks in large part to the Affordable Care Act. It's now within our common interest to build a healthcare delivery system that's better, smarter, and healthier. A system that delivers better care. A system that spends healthcare dollars more wisely. A system that keeps us healthy rather than waiting for care when we get sick. A system where medical information and medical bills are easy to understand. A system that puts information in the hands of patients and doctors and empowers them to make better choices. If we do this, we will leave a legacy for our children and our grandchildren. And as I've met with members of Congress from both parties, they've told me they want a better system too. They want to tackle healthcare-associated infections and patient harms. So we keep patients safer when they're in the hospital and healthier when they're out of it. We are already making progress as a country. We've achieved a 17% reduction in harms nationwide since 2010, and members of Congress from both parties also share our interest in payment innovation. We all want to find better ways to reward quality and high-value care in the system. There are opportunities to work together on putting better information in the hands of patients and their doctors and building a more transparent system. We've had fruitful discussions with Congress about supporting and encouraging the interoperability of information in our healthcare system. We also share members' interests in expanding access to Medicare claims and clinical data to support innovation and empower consumers with information. Medicare and Medicaid are two of the largest health insurance plans in the world. Together, they cover one in three Americans. So one of the things we're going to do is leverage the grant and rule-making opportunities to improve the quality of care that beneficiaries receive while spending those dollars more wisely. We understand that's our role and it's our responsibility to lead and we will. But what we won't do and can't do is go it alone. Patients, physicians, government, business, we all have a stake and I believe that this shared purpose calls out for deeper partnerships. Some of our most important results-driven partners are actually state governments, which are taking creative and innovative steps when it comes to improving the quality and achieving smarter spending of Medicaid dollars. I believe we have an opportunity to strengthen our relationship when it comes to things like modernizing Medicaid enrollment systems, improving models for care in payment, coordinating and improving the care that's delivered to beneficiaries in managed care. Part of building a healthcare system that keeps us healthy is actually reducing substance use disorders and overdose deaths. For millions of Americans who rely on prescription painkillers known as opioids that are prescribed to them by their doctors, these drugs can be the difference between constant chronic pain or welcome relief. However, these drugs can be deadly. In 2009, drug overdoses overtook every other cause of injury death in the United States, outnumbering fatalities from car crashes for the first time. Meanwhile, in 2012 alone, 259 million opioid prescriptions were written. That's enough for every American adult to have a bottle. rural America, including my home state of West Virginia, knows the tragedy of this issue all too well. Moving forward, we hope to work with members of Congress from both parties on the goals we share for driving down opioid dependency and overdose deaths. This is a critical and complex public health challenge and requires a multifaceted approach. We have an opportunity to work together on improving opioid prescribing practices by enhancing prescription monitoring, data sharing, and clinical decision making. We also want to incentivize the development of abuse deterrent opioids and expand the utilization of noloxone, a drug that used to reverse is used to reverse overdoses. And there's more we can do together in the realm of medication assisted treatment to help those who are addicted break that cycle. Last session, Congress introduced more than a dozen pieces of bipartisan legislation to try and address this problem. Many proposing ideas that would help fuel progress in some or even all three of these areas. And we think we should continue to work together. I want to turn for a moment to global health security. The tragic Ebola outbreak is a solemn reminder of our common humanitarian and security interests. The most effective way to protect Americans here at home from outbreaks and other public health threats abroad is to stop diseases and their threats of them at their source. Microbes and diseases are moving faster and further than ever before in human history. And they do not recognize national borders. I want to take this opportunity to thank the Congress for choosing to act and invest in this critically important common ground priority of global health security. Recently, in a bipartisan fashion, members of both parties made a $597 million investment with the CDC to advance the global health security agenda. And it's three pillars of prevention, detection, and response. We want to work with our global partners to enhance their prevention strategies and tools for both naturally occurring and man-made threats. With only about 30% of countries reporting that they actually adequately can detect, respond, or prevent the health threats proposed by emerging diseases, there is an urgent need for this sort of investment and commitment. And it's important to note that just as Congress has stepped up to the plate, so have governments from other countries who are choosing to invest as well because they recognize that all of us have a stake in stopping outbreaks before they become pandemics. In September, President Obama convened the 44 countries that have signed on to be a part of that agenda, covering 4.8 billion people across the world. These countries have the will and the desire to implement the global health security agenda, but many of them require assistance to achieve the full range of its goals. This is an important start from both a national security standpoint and a humanitarian one. Our goal must continue to be for every nation on earth to have the ability to prevent, detect, and respond to infectious disease threats. Our Ebola efforts overseas and our preparedness efforts here at home have also shown us where we can improve our abilities to add capacity and flexibility and wisely deploy resources in times of public health emergencies. We hope to work with the Congress in the spirit of the emergency funding we received, and that includes making sure that we share our approach for spending of this funding. I want to now turn to another area where we as Americans both have an opportunity and responsibility to lead innovation, in science, and medicine. The investments we've made through our federal government have reshaped our understanding of health and disease, advanced life-saving vaccines, and helped millions of our fellow citizens live longer, healthier lives. But there's more we can do and should do together. And while we can always do better, our goals are bolstered by the FDA's speedy regulatory review process. In the United States, our process is not only one of the most efficient in the world, but our drug review times are consistently faster than other advanced authorities around the world while maintaining the highest safety standards. In the last year alone, FDA approved the most new drugs in almost 20 years, including more drugs for rare diseases and more new therapeutic biological products than ever before. We want to work with the Congress to secure the investments in science, research, and innovation that will allow our nation's scientists and researchers to continue the progress they've been making on new and improved vaccines, cures, therapies, and rapid diagnostics. A few months back, when Republican Representative Fred Upton and Democratic Representative Diana DeGette invited me to attend a panel on 21st century cures, I said, where and when. Because I firmly believe that we have many common ground opportunities to work together. And I look forward to working with Chairman Upton, Ranking Member Palone, and Representative DeGette on this bipartisan effort. As we look to move forward, I've told members of Congress from both parties that we agree with them on the need to improve innovation, collaboration, and data sharing among scientists, to respond to patients' needs and give them a meaningful voice in their own care, to bridge scientific gaps and bring products to market, to attract the best experts to accelerate cures, to reduce the administrative burdens and duplication, and to do all of this while maintaining and protecting the public's health safety. I wanna give you an example of how, by moving innovation forward, we have the opportunity to deliver the sort of impact that can touch the lives of so many for the better. And that example is precision medicine. The science of harnessing our understanding of the human genome, to customize our medical care to our own personal genetic makeup. For most of history, medical practitioners have been forced to make recommendations about prevention and treatment based largely on the expected response of an average patient. The ability to assess and use information about important differences among individuals has been very limited. The promised precision medicine has is that it gives us the ability to develop medical treatments that are highly tailored to the individual characteristics of patients. I hope we can work with the Congress to scale up the initial successes we have seen in this promising avenue of scientific endeavor. It's in the interest of our health and our children's future to make these breakthroughs happen. It's in our economic interest to make sure that they happen here. I wanna close by the way I opened and that's by talking about the common dreams that we share for our children. If we take action to advance innovation and if we choose to work together on the other priorities I've outlined this morning, then I believe we will build a stronger, healthier future for the next generation. In doing so, we can create a 21st century innovation economy in which we lead the world in advancing the next generation of scientific and medical innovations. At the same time, we help American entrepreneurs capitalize these innovations into the market for economic growth. The 21st century has been called the century of biology. And in this bio century, our common interests in job creation and innovation are mutually reinforcing. Steve Jobs told his biographer Walter Isaacson that he saw parallels between the ways medical research was capturing his son's imagination and the ways in which computers and captured his own. Jobs said, I think the biggest innovations of the 21st century will be at the intersection of biology and technology. A new era is beginning, just like the digital one when I was his age. This intersection presents us with some of the most fertile ground for building an innovation economy. As President Obama said, what America does better than anyone else is spark the creativity and imagination of its people. We know that when we give American innovators the opportunity to innovate, they accomplish big things. This is especially true when it comes to innovations in medicine. I'm looking forward to working with leaders from both parties, from the private sector, from civil society, and from the scientific and medical communities to deliver impact and drive progress that is worthy of the possibilities of our time. As I mentioned up front, I hope that we can move beyond the back and forth of the Affordable Care Act and focus on the substance of access to affordability and quality. Working families have come to count on that financial security that comes with having quality, affordable health coverage. As Secretary, I am contractually obligated to mention that open enrollment goes until February 15th. Whether we're talking about affordable health coverage, a better, smarter health system, a healthier population, or a more secure world, I think it's fair to say that as a country and as a world, we are on the threshold of positive and transformational change. It's up to us to build the common ground necessary to reach our common dreams. The world is watching. The next generation is waiting. The work is up to us. Thank you very much. I think we will take some questions. We will take some questions. First question is David Morgan from Reuters. Is David here? Oh, go ahead and ask your question. Hi, I wanted to ask how confident you are given that two thirds of the open enrollment period has passed that enrollment will in fact meet or exceed your target of 9.1 million enrollees. I believe that we've made strong progress. You probably saw the numbers that we announced yesterday for the federal marketplace that we're almost at 6.8 million people who have either re-enrolled or have newly enrolled. And as I've said all along and said before we even started this open enrollment, it's my job to keep us focused every day. We have a ways to go. It's a short period of time to reach the 9.1 million and that's an infexuated number of the goal that we set out. So every day we are working hard against that. You probably know and saw that yesterday this is a week of Latino action firmly focused on that group and we're gonna continue to focus across the populations that we're trying to reach. I'm out there traveling quite a bit to different places and what we're trying to do most to try and get to that goal is meet the consumer where they are and that's both in terms of the speed and ease with which they can sign up and getting them the information they need to get there. Great, thank you. Mary Agnes Carey, Kaiser Health News. I know you meet with a lot of members of Congress. I'm wondering what you're hearing from Republicans, especially in the Senate, about possible common ground around the Affordable Care Act. So much of the conversation as is reflected in this speech is as I focus on the issues where I think there are places for common ground. And we know that the issues that I mentioned, the bipartisan bills, there have been bills on the issues of opioids that have been proposed by Senator Porter. Senator Ayotte has been an important co-sponsor of that legislation. Senator Wyden has been involved and engaged. On the House side, Mr. Rogers, who is from neighboring Kentucky, West Virginia, deeply interested in those issues. The issues, and that whole list of issues that I've mentioned, those are much about what the conversation's about. One of the things that I'm trying to do and this speech is a reflection is, focus on the places where we have common ground. And there are, as I outlined today, whether that's delivery system reform where people do want to improve the effectiveness and efficiency of the dollars at the same time we do the quality. So that's the place where I focus mainly. Around with Republicans on the HCA, I mean, that is a key law. They are fighting it, but are there members that maybe have a different message or a different agenda than their leadership has? We are hopeful and look forward to that opportunity. As we've said all along, we want to find the places where the act can be improved. And we did support the hero's piece of legislation that came before us, and as I've said, we think about it in terms of affordability, access quality, and how things affect the economy. That's how we think about it. We welcome the conversation. We look forward to it. At the same time, we want to work to make progress on issues where we know that there is clearly common ground that we've seen. Joe Minnard from CED. What do you see as the next steps, particularly in the direction of affordable care, either through legislation on a bipartisan basis or from non-legislative action? So I think as we think about the Affordable Care Act and continuing to move forward on the issues of affordability, quality, and access, I think making sure that we have a successful open enrollment and that we continue to serve the consumer, that's the thing that is most in front of us right now. That's both about quality and affordability. Second, and continuing to work on that in the marketplace and contributing to a marketplace that works for consumers. Second, in terms of continuing to work on that space, I touched upon it in these remarks, Medicaid expansion is an important place for focus, and that's a place that has more to do, perhaps with governors, but in a bipartisan fashion because of the states that are left and have communicated clearly. We wanna work to do plans that work with states. In my conversations, it's reflected that different governors have different priorities for their people and their states. We wanna work with them with flexibility. There are certain key elements of the expansion that were legislated and that we believe are important from a policy perspective, but we're open to the innovation of states. So that's area two. Area three, Joe, in terms of the areas of focus on those three things and moving that ball forward is to continue the work on delivery system reform. And that comes in a number of different ways, and that's one where it's going to take the government executive branch and the rulemaking and grantmaking that I mentioned as a place that's very important to drive how payment reforms can occur because we are such a large payer. It has to do with what the private sector is doing. And so that's the next one. And then the last one is focusing on how we make sure that this access translates to care for individuals. So whether it's in those that are newly insured or those of us who had employer-based coverage and that there are additional benefits and whether that's the preventative care that you can be doing or the flu shot that you could be getting without copays or the child wellness visit. And so that fourth area of focus, Joe, in terms of moving those balls forward is about focusing on making sure that it isn't just the access, it is the question of the actual use and the benefit that comes from it. I wanted to take the moderator's prerogative and just ask you a quick question. Yes. Crossing over your experience at OMB and NHS, do you foresee a future in which the kind of things you've proposed today, some of the things that are beginning to happen with the ACA begin to reduce the growth of healthcare costs in a way that begin to take some of the pressure, maybe change the complexion of the debate about the long-term federal fiscal situation and potentially create new opportunities for different coalitions and alignments around that set of issues? So I think we have seen since I arrived in town at OMB in terms of the deficit reduction, the most recent deficit numbers, overcut in half from the point in which I arrived. And so we continue to see downward pressure, I think always as an OMB director, it's important that we always keep our eye on the long term, which is one of the issues that people have their eye on and healthcare costs are an important part of that. What we have seen is the changes in terms of, when you start to see that 2011, 2012, 2013, those numbers in terms of the lowest per capita healthcare cost growth that we've seen on record, when you see that downward pressure on Medicare in terms of its per capita growth being nearly flat over an extended period of time, I think we're starting to see that. Now, the question of are those structural changes that will last for an extended period of time, how that incorporates with more people getting care, we need to keep our eye on. And that's why I was emphasizing so much delivery system reform. Because while that's an issue that's about quality, it is about changing the way we do things so we get some of that long-term cost savings that we're talking about. Ricardo Alonso is out alive. Hi, thank you for taking my question. And in your speech, you didn't mention SGR and CHIP. And could we get what your outlook is for those two programs and what has to happen on the Hill this year? And does the fact that you didn't mention these two programs mean that you think it's gonna be contentious? So glad you raised them. Probably the reason that I didn't mention is because if this speech lasted much longer, I'm not sure how long all of you would be here. The issue, I think those are both important issues and I actually think they do fit into the frame of the conversation and what this speech was about, which is general bipartisan support, both for SGR as well as the issue of CHIP. And so I think those fall into the category of things where I think there will be bipartisan support. I think those are very clearly legislative issues that the Congress will take the lead in terms of the timetable and focus that they will do, but not mentioned because I thought that they were very contentious. As a matter of fact, if I'm on the ledger of putting things in columns of more contentious or greater possibility for working together, I see both of those in that category of greater possibility for working together. I think the question will come back to a point that was just raised in terms of deficits and that sort of thing as one looks at costs. The administration has expressed support for both of them and so the question is a legislative approach to achieve them. Well, we want to thank you all for coming and we especially want to thank Secretary Burwell for joining us at New America and we hope you'll come to future events here. Not always as high profile as this one, but we're really glad we could host you all today. Thank you very much. Thank you. Thank you.


What's going on guys? It's your boy DPJ here today with another Destiny video and today I want to go through the latest weekly update just dropped by Bungie and if you guys want to read through the whole thing because they ain't covering the whole thing I'm just going to read it out to you guys and report the best things in my opinion but if you guys want to read out the whole thing I will link it in the video description but before we get into the video if you guys do enjoy it leaving a like is much much appreciated especially in these dry times of Destiny where content is always low people like me have to cover all sorts of shit like Zer news and absolutely everything but yes anyway getting straight into it now starting with the main thing now it's coming around at time of year where crimson bays normally comes back around crimson doubles you know that Valentine's crap well I say crappy events it's an event I didn't play last year weren't really fussed about it to be honest I know I missed out on quite a bit of decent loot but I just weren't feeling it I want a PV event and I think not guaranteed but I think that maybe what we might be getting because they start off this weekly update stating first things first crimson days will not be making a return this year we enjoyed adding some gunfire to your date night but we have other plans instead we're dedicating our efforts to delivering different things for you to play last week at bungee we tease that you haven't heard the last from the live team their next content update is taking shape we're super excited to tell you about it but we're not so excited that we'll jump the gun there will come a time when you'll take a seat and our streaming set to talk about how we'll spend the spring time together they go on to say it's really our policy to issue guarantees about things that are not certified for download given a work that is being done behind the scenes however we feel like we can start to call the shots so yes we won't be getting crimson days this time around or crimson levels whatever the fuck you want to call it hopefully hopefully they're working on some new fresh PvE content because in my opinion that is what this game is a lacking what that could be I don't even know hopefully it's something new but if it is an old raid remastered and brought back I'll be equally as happy just in my opinion PvE at the moment is where this game is seriously lacking some good content I mean it's fair enough with the dawn in event they brought out these remastered strikes or whatever strikes going and a few other things but it doesn't last that long when you grind the game as much as most of us do PvP is different there's always and weekly and monthly events iron banner and trials of Osiris and there's plenty to play therefore for PvP players PvE players though which I actually class myself as we are seriously bored of what we've got in the game so far so a remastered raid new quests new strikes even that is what in my opinion is needed for this game and hopefully hopefully when we do sit down on their streaming set we get some good news okay so getting back into the weekly update they go on to talk about a balancing act and this is what they state if all goes according to plan the next update to destiny will include some design work to refine weapon balance the exact release date is to be determined the full notes unfixes and changes are to be revealed with every content update there seems to be one category firearms that becomes the favorite option for winning a match against fellow guardians balance is like utopia it's unknown that doesn't mean we won't seek it upon the launch of the dawning our sandbox team said this under bungee.net forum as we wage wars in our play test labs we're taking a lot of things into account player data your feedback and our own gameplay experiences we've heard the conversation about and felt for ourselves shotgun dominance yes we see you matador 64 but we feel strongly that our goal shouldn't be to nerf them into the ground instead we're looking at solutions that could bring shotguns into a better state of balance with the rest of the guns in the game in doing this we would still want shotguns to be effective and fun to wield we could quickly and easily break shotguns and call it a day but it's important to us that we explore positive changes that can make destiny better for everyone now I don't know how to how they're gonna do that without nerfing them into the ground because in my opinion no matter what they do to shotguns unless they nerf them into the ground they will always rule PVP and to be honest it's more than just a certain weapon I mean yes shotguns are pretty bad but what about the high fire rate pulse rifles alike the clever dragon I've said it before and I'll say it again PVP weapon balance wise needs a complete overhaul of balancing it really does more than just nerfing and buffing a few weapons but that's just my opinion I ain't gonna go into all of that shit now because I'll just board a hell out of you all but yes like they said they are taking a lock at the weapons that are dominating PVP and are gonna make some changes whether that's nerfing shotguns even further or buffing other weapons I don't know as long as auto rifles get to both they deserve and shotguns whatever they do to them and as dominant as they are now I'd be happy they finish off talking about the weapon balance with this we'll have more to say as the exact details come into sharper focus please stay tuned as usual when we are ready to make promises there will be developer commentary there will be data and charts and stuff too they go on in the weekly update to talk about bungee bounty days they state bungee bounty days have been raging since we announced them last week every weekday until February 10th we'll have another target for you to chase through the worlds of matchmaking the exact time and platform will be up to those who lead the chase check out the full schedule so you can plan your attack now I'll put these on screen now I don't know all these motherfuckers names but yes there's quite a few of them there and both platforms exports and PlayStation 2 they then state we know what you're thinking what about this certain person or that certain person these balances will become a weekly ritual after the cooldown of the pilot calendar once a week we'll set you upon another Guardian who has volunteered to put on a good show there is no way we could deliver the full scope of diversity of this community in one month so we'll keep the party rolling for the foreseeable future and along enough timeline everyone on the planet will have a chance to hunt down a designated mark in their neck of the woods then we'll start looking for candidates on the moon it could happen now my name and on this list and I ain't really fussed about it I mean I ain't a PVP youtuber I don't stream or none of that shit so I don't expect my name to be on the list plus all the negative things I do say about bungee even though it's out of love I wouldn't expect my name to be on the list but yes I could name you a few other PVP streamers who do nothing but good for Destiny who are a little pissed off that their name is not on this list as it does in right promote their stream but yes that's their problem not mine so I ain't gonna go into it in a weekly update after this they're going to talk about bands and shit which to be honest ain't really worth mentioning but if you do want to read it like I said it is linked in the video description so you can check it all out but guys that is it for another weekly update cover let me know what you think about the next event now we know it isn't gonna be crimson days what do you think it could be what do you want it to be let me know down below in that comment section thanks always guys for stopping by and I'll catch you on that next one peace out next time peace


Welcome to the 2.30 p.m. to 3 p.m. session of the 2017 Open Simulator Community Conference. As a reminder to our in-world audience and you can view the full conference schedule at opensimulator.org and tweet your questions or comments to opensim.cc with the hashtag PoundOSCC17. For this session we're happy to introduce a terrific session called fueling innovation virtual worlds in research. Our speaker today is Lisa Laxton. Lisa is the R&D visionary and CEO of the Open Simulator Community-focused organization Infinite Metaverse Alliance, IMA. She is also president of Laxton Consulting, LLC with experience providing various virtual world technology solutions for education, research, business, and defense clients. You may have also seen her around the hypergrid building content engaged in testing but she's available via meetings to anyone in the Open Simulator Community. She's interested in collaborating to advance virtual worlds technology and improve accessibility. Welcome everyone. Let's begin the session. Lisa. Good afternoon. Thank you very much Barbara. I'm really excited to share our research and I know it's going to be a lot to get in so I'm going to go through it as quickly as I can so we'll try to have some time for answers. Now positive technology is a nascent research area that focuses on technology used to promote and support well-being. One of the main technologies identified for use is virtual worlds. Today I will highlight a case study using Open Simulator to support meditation which is a well-being activity. At the conclusion I'll share some thoughts about fueling innovation using virtual worlds in research. Sanctuary is a meditative virtual world that was developed as part of a doctoral research project to investigate the nature of engagement and the human experience. High-level requirements included a realistic natural environment, meditation support, and engaging but non-distracting design, development of new content, adjustment of the viewer user interface, and accessibility. I will present an overview of design considerations and solutions that were employed. Guidance will also be shared on how best to approach a research project using virtual worlds. While challenges were encountered, this project produced positive results. A blended evaluation approach included both quantitative and qualitative measures. Experience meditators with no virtual world experience and initial skepticism rated the experience as engaging and successful. The positive technology framework you see on this slide combines technology with three well-being constructs to create three levels of the framework, subjective, psychological, and social. Virtual worlds may be applied at all three levels because a primary principle in the framework is the concept of presence, real or virtual. A high sense of presence creates a more satisfying experience which positively contributes to change and transformation. Being present in the moment is also a fundamental concept in meditation. As such, Sanctuarium is a positive technology application at the eutomonic level. It combines virtual worlds and meditation aimed at self-actualization. The goal of this research was to gain a richer understanding of user engagement and the human experience of technology-supported meditation in a virtual world as an essential component of how best to leverage technology to encourage and support well-being activities. The study included three main research questions. Purpostal sampling was used to recruit adult participants with a strong interest in meditation to offer informed perspectives as the target phenomenon. Each participant virtually performed walking and seated meditation using a touchscreen tablet computer. The researcher viewed the participant's screen in another room on a laptop computer. This multi-dimensional approach allowed for triangulation of results and yielded a rich and comprehensive view of the Sanctuarium meditation experience. The summary results include engagement ratings and measures of meditation effectiveness, combined with analysis of interviews to answer the three research questions. Findings emerged from the overall final analysis. Sanctuarium was perceived as restorative and viewed as a unique approach to guided meditation. Participants also highlighted Sanctuarium as a tool to help those new to meditation. We don't have enough time today to go into details, but a full description of results, discussion, and findings are publicly available in Dr. Laura Downey's dissertation, linked at our presenters' booth. To support the research, Sanctuarium was designed as a tropical island scape with a bamboo forest, a natural restorative environment with water. It also included multiple meditation elements, such as a labyrinth to support walking meditation and a central point to support seated meditation. Limited messages appear at the beginning of Sanctuarium before and after seated meditation at the center of the labyrinth. Since meditation is a very concentration-based activity, the only interaction the participant had with Sanctuarium was an occasional screen touch to indicate a message had been read, and the participant was ready to continue. The choice to use a seven-circuit labyrinth in Sanctuarium was driven by its long-standing use over centuries, the ability to reproduce the design in a virtual world, and the positive effects of labyrinths. Each circuit may be associated with a specific chakra. The circuit displays subtle indicators of the chakra associations via colored flowers floating in a bowl at the beginning of each circuit. A soft tone associated with the chakras also sounds when the participant enters the circuit while butterflies provide the visual cue. Finally, because avatars play an important role in interacting with the virtual world, the avatar in Sanctuarium was designed to offer a general representation. Designing a highly customized and individualized avatar was beyond the scope of this research. However, to address diversity, gender, skin color, and hair color in 48 avatar variations were created. In order to experience the restorative effects of nature in a virtual world, it's critical that the elements are recognized and perceived as realistically as possible. Multiple design and review sessions were conducted to achieve the high fidelity results. New content to support the island scape with a labyrinth cut through a bamboo forest took time to create. Higher quality textures and sounds require greater bandwidth. More complex objects require powerful graphics. Physics computations in an interactive virtual world require greater CPU resources than a static visualization in a browser. A clear understanding of these considerations is necessary for researchers when considering design rationale, virtual world elements, levels, objectives, and a framework. The overall design objective was to provide a restorative natural environment that supported and or enhanced the meditation experience. Accessibility was also a consideration not often included in general research. Accessibility by design with subtle immersion required oral cues for every visual event and visual cues for every oral event. Butterflies were emitted from singing bowl sound events. Bird sounds provided oral cues when birds were seen. Wave animations were synchronized with wave sound events. It also meant programming a virtual world more for designer control rather than user control to support immersion. All of the design requirements had to be translated and implemented. To help other virtual world engineer research teams prepare for a similar undertaking, I published some guidance with four major topic areas, research goal and requirements, fidelity and realism, content and hardware and software for the participants. Each of these focus areas begins with the questions researchers using virtual worlds need to ask at the outset. Associated rationale and further guidance are provided for each major area. The ongoing collaboration between the researcher and the virtual world engineer contributed to the success of the project. Supporting virtual worlds in research can be more complex than supporting a service contract or hosting virtual worlds project. Every research project is unique, which leads to unique requirements and challenges. Early engagement between the virtual world design team and the research team is critical to large project success. We strongly recommend establishing a partnership beginning at research conception. Planning should be collaborative and design should be as agile as possible. Without a well defined design concept, the likelihood of unforeseen cost issues and delays is high. In fact, changes in the design process can cause persistent restarts and news software development needs can impact success. Even with successful research projects involving virtual world, technical challenges remain with the current state of virtual world technology that impede adoption by education. To support future research and to innovate virtual world technologies, issues need to be studied. New approaches need to be envisioned and championed. And the next generation of virtual world technologies need to be educated and empowered through research efforts to develop the next next generation of virtual world technology. This needs to be integrated with virtual augmented and mixed reality components. Parallel efforts need to merge for mutual success. This approach can create an evolving resource that can support future research globally with an embedded workforce that fund this new generation of virtual world technologies. While the revival in popularity of virtual reality augmented reality and mixed reality markets has them growing again, technical challenges in virtual world remain due to obsolete technology approaches that may not be able to continue evolving. Technology advancements related to the use of virtual world leave the community poised for another paradigm shift. The free and open source software or a fast community is driving innovation amid the rise and fall of commercial applications, not supported by research interest. However, interest from industry and the public sector has begun driving new standards initiatives aimed at decreasing the time to market and improving interoperability. There are many opportunities to standardize that will drive greater adoption in the use of virtual technologies across the board. Human centric virtual technology research is on the rise in the treatment of PTSD, dementia and various cognitive disabilities. Predictive modeling, historic preservation, education in all disciplines, STEM initiatives, experiential training opportunities, cultural awareness programs, first responder training, disaster preparedness and military research all benefit from the use of human centric virtual worlds. The use of virtual worlds for modeling simulation and analysis is also increasing in industry supporting municipal, state and federal clients as we learn to embrace technology to decrease costs, improve productivity and eliminate safety risk where identified with these emerging needs comes the necessity of a competent and skilled workforce involved in not only supporting these efforts but in thinking out of the box with a new approach to virtual technology software development. The majority of the current virtual world technology engineers, developers, programmers and content creators are aging and the American University system for the most part has not prepared the next generation to carry on the work. Very few universities offer classes to develop the unique skills needed to support the development of the next next generation of virtual worlds. There are a few but the focus of that education is based on soon to be obsolete methods for modeling simulation and analysis. Perhaps the lack of associated well funded research programs in America between academia industry and government is the reason. It is evident from multiple technology solutions that unfunded development can lead to stagnation and abandonment. Lack of research and development with new innovations intersecting science and technology can lead to lack of funding. So we are once again at a paradigm shift in virtual technologies. The goals of 100 concurrent users in a virtual region or even 1000 users across distributed regions are now obsolete and short-sighted in today's fast paced technology era. 10 years ago these were laudable goals and we reached them with the help of military research and open source community efforts. Bravo to all of you. Now we have to start thinking in terms of millions of concurrent users not thousands. We have to design for even greater numbers for the next next generation of virtual world technology I like to call the infinite metaverse where technology is platform independent and standards and specifications for intergrid interoperability or IGI exist for developers, engineers and programmers. A new approach creates a living resource for researchers to use and for industry to nurture. I propose we move forward with the support of new research that can fund application development and opportunities for employment in virtual world, integration of virtual augmented mixed and fused realities with virtual world, and development of new and updating of old standards and specifications to support virtual technology evolution. The support of FOS initiatives by industry government and academia is necessary to push the boundaries of the imagination and creativity that fuels the coming paradigm shift but it can't be sustained by traditional research alone. Markets need to be created or adapted. Best practices and use cases need to be examined. Future generations need to be prepared with knowledge and empowerment along a path to the future by the champions of virtual world technology as it exists today. You are all champions of virtual world technologies. Thank you for all you do or you may even be future technologists. This new ecosystem model for the next next generation of virtual world will change the way we work, communicate, and experience life with job creation, lower operating costs, and economic stimulus through design thinking combined with system thinking. This is the research and development mission of Infinite Metaverse Alliance aligned with community needs. Every advancement and open source virtual technologies made in support of funded research benefits the entire community. I hope you all will join us. Thank you for listening today. It's been a pleasure to share what we learned and I'm happy to answer any questions we have time for. Woo! Thank you Lisa. You really packed a lot into that presentation. Yes I did. It was a little challenging for your slides to come through. I hope everyone was able to see those slides with the data on it. Can you, you also recently had an article published, did you want to share a little bit about that article? Sure. For those who are interested in this and other innovative research and a global look at the future of virtual world technologies, you stopped by our presenters booth to get a link to the book where this topic is covered in more detail. Over to the right of Barbara on the stage, if you're looking from the audience you'll see a pushpin that you click that to get a little landmark to our booth to take you straight there. Well fantastic. Thank you Lisa for a terrific presentation. I think we have just a little bit of time for a couple of questions. Looking back in the chat I did not receive any items of any questions. Yeah the chat was scrolling pretty fast because I was transcribing for those who have hearing impaired. I always keep accessibility in mind. And I know you used multiple approaches today to be able to deliver this presentation live so thank you for doing that. Eudomonia is not something that people think about all the time and that's one of the really interesting findings from your study was that using virtual worlds gets on that level. And the qualitative methods you know to have both methods is really interesting. I did get one question regarding the sanatorium. The sanctuary. Sanctuary. I beg your pardon. Is that available as an OAR or can people visit it? There is an OAR but I will be bringing that up live. We're working on a mobile application that would give people the opportunity to experience this without having to log in to open sim. Okay terrific. Is there any future research planned for that activity? One of the things that Dr. Downey and I did discuss was some follow-on research so we'll be looking for funding for that. And you covered quite a few topics related to the different types of funding and I know that you have experience working in government and also for the military previously. I think with the Navy. Do you have a particular goal in mind in terms of an organization to approach? Yeah I think that you know one of the vehicles for getting research funding that a lot of people aren't really aware of is the Small Business Innovation Research or otherwise called CBER or SBIR. This is the primary reason why IMA was formed as a for-profit organization to give us access to those funds. Then you know we're certainly not prohibited from going after the traditional grants partnering with universities under NSF, the National Science Foundation, National Institutes of Health, Homeland Security, etc. Anything where a human-centric virtual world makes sense is certainly where we can put in some proposals. Terrific. Well thank you again Lisa and I want to remind our audience that you can see what's coming up on the schedule and do do refresh your browser for the schedule. There's been some changes you may not have been able to follow and go back and reference it later after the conference as well. The next session begins at 3 p.m. in here and it's titled Why I Don't Need a Physics Engine. So we encourage you to visit the poster expo in expo 3 to see Lisa's booth. There you've got the landmark and also explore the hypergrid tour resources as well. So again I want to thank you and we will see you at the next session. Thank you all and thank you for the compliment and thank you for listening. You know sorry that I had to really run through a lot of information but I didn't really know how to get it to you any other way.