David Cade, CEO, American Health Law Association, speaks with Eric Zimmerman, Partner, McDermott Will & Emery, and principal of McDermott+Consulting LLC, about what effect a new Biden administration might have on health policy and how the health industry can prepare. The podcast discusses what to look for in the first 100 days of Biden’s presidency regarding COVID-19, health care reform, and other initiatives.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
David Cade, CEO, American Health Law Association, speaks with Eric Zimmerman, Partner, McDermott Will & Emery, and principal of McDermott+Consulting LLC, about what effect a new Biden administration might have on health policy and how the health industry can prepare. The podcast discusses what to look for in the first 100 days of Biden’s presidency regarding COVID-19, health care reform, and other initiatives.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
Today, Eric Zimmerman, the Global Head of McDermott's Health Practice, and principal of McDermott Plus Consulting, has joined us. Welcome Eric, and thank you for joining us today.
Speaker 2:David, it's great to be with you. Thank you for having me.
Speaker 1:It's, it's definitely our pleasure. Last week you penned an article titled A New President Signals a New Focus for Federal Health Policy that ran in our health law weekly publication. You outline what you think are some policy areas to watch today. I'd like to talk a bit more about what you see on the horizon and how practitioners can get ready for the change. We know transitions can be disruptive and full of opportunities. So just to set the stage and context and before we get into what's coming with the new administration, can you tell us about some past transitions and what you saw that was impactful in the healthcare arena?
Speaker 2:There are plenty examples, plenty of examples of that, David. And I'm really happy to have this opportunity to provide a little, uh, foresight and insight to help a H l A members think about, uh, what the policy landscape is gonna look like ahead. This is more than just, uh, for academic interest. It's really important for planning purposes. Uh, for any council that's working with, uh, a healthcare interest or any business leader, trying to understand how the environment is likely to transform and shift around them is really important to pressure test your business objectives against and your strategies for achieving those objectives. So I'm happy to provide a, a little bit of prediction and look, it's hard to look into the crystal ball and, uh, be accurate every time, but there are some sound predictions that we can make. Um, and so, uh, happy to have the, the opportunity to endeavor to do that. And look, transitions are always a time. Presidential transitions are always a time of, uh, great change and, and, um, uh, great opportunity. Sometimes we're making very significant, uh, turns to the left or to the right and really, uh, facing the prospect of very different policy objectives. This, in many respects, may be one of those times. I can give you a couple of historic examples. Uh, just to put into context for our listeners, um, probably the most recent and most profound, profound, of course, would be Barack Obama and the Affordable Care Act. When, um, uh, Barack Obama ran for president, he ran on addressing both, uh, the problem of the uninsured in this country and the rising cost of healthcare. And he made good on that very early in his, uh, first term. It was really his first major, uh, domestic policy priority coming, um, I would say on the heals level, but very much wrapped up in economic recovery. Remember, and we're hearing a lot about this right now cuz it's reminiscent of the moment we're in at the, at this time. Um, we were in a, a very deep recession. And so, uh, passing recovery legislation was really the first priority. But the Affordable Care Act came very quickly on the heels of that. And then very quickly before that, um, probably the major, the the previous, um, uh, most recent previous example that was equally significant was George W. Bush expanding Medicare to include prescription drug coverage through the Medicare Part D program in 2003, which was not quite on the order of the Affordable Care Act, but hugely significant and transformative in its own right.
Speaker 1:Yeah, I, I think you're right. These are, you know, they're pivotal times that, um, where we get a chance to see major change. And it usually comes with presidential transitions. And, and you're right with what's, what's in the queue and what's being discussed now is monumental. So what do you expect to see, uh, as the new administration is getting ready to come in?
Speaker 2:Well, I will start by saying I don't expect to, um, for this president to try to advance anything quite as transformative as the Affordable Care Act. And, and part of that is because of the cards he was dealt. And we'll talk a little bit more about that in a minute. But when I think about what, uh, president-elect Biden's number one priority is gonna be it's covid covid Covid, uh, if he campaigned on anything, it was about being a more effective, um, stored for the country, a more effective manager, uh, better capable of getting on top of the virus and, and changing the direction of the pandemic, uh, as well as stimulating the economy. And so both of those are really gonna be his first priority. Uh, I expect on January 20th, uh, the day of his inauguration, that you're gonna see a number of executive orders being signed, uh, as well as legislative proposals and, um, regulations being readied. And then in the first 100 days, the, um, the very common benchmark, you're gonna see a slew of, uh, new regulations, uh, many of which are related to covid, some of which are tangentially related. We'll talk a little bit about that. But just about everything they do is gonna be viewed through the lens of how do we arrest the spread of the disease and how do we, uh, restore the economy.
Speaker 1:Right. And, and I don't think any of us have, you know, as practitioners for some years, some decades and beyond, have any real world experience with what we're dealing with now and how to get out of this pandemic. Um, and so as you say, you know, that first a hundred days is a good benchmark. You're looking at, you know, there'll be a lot of executive orders on that, on that January 20th. Do you suspect that it is the executive orders that will drive the change less so regulations and maybe less so legislation? Or do you think that all are likely to help advance his agenda as it relates to COVID and other initiatives?
Speaker 2:Yeah, very good question. I mean, to be sure the president, uh, is going to pull out all of the tools in his toolbox and use them as he can. Uh, I think just like President Trump, you're gonna see a heavier reliance on administrative action and administrative action, uh, generally takes three forms. It can be executive orders, it can be new regulations, and it can be subregulatory guidance. And he's going to do that because he's going to, um, have greater challenge in Congress right now as we sit here today. Uh, you know, I think it's important to, um, put in context some of the assumptions we're dealing with, of course, the first being that we are gonna have a new president that Joe Biden is gonna be the 46th President of the United States. I know that's not a fully settled issue at this point, but let's, let's assume that to be the case. Let's likewise, um, we know that Democrats are gonna continue to control the house, the control of the Senate is up in the air. I'm gonna mostly assume that Republicans will retain control of the Senate for purposes of this discussion. But I think even if Democrats do win both Georgia special elections and they do get nominal control of the Senate, the challenges and headwinds facing the new president are gonna be the same because it is, um, the benefit of controlling the Senate is you get to control the agenda. But with a 50 50 split, just about anything that is gonna get through is gonna have to be bipartisan by definition. And there are, uh, I could certainly get into this in more detail if it interested you or the listeners, but, um, there are at least, um, three or four senators who, Democrats, democratic senators who are gonna be, um, in the middle and they're gonna be the pivotal swing votes. And so the President-elect could not count on a reliable 50 or 51 Democratic votes, even if they do retain control of the Senate. So everything, um, is gonna have to be bipartisan, which is gonna be inherently difficult. And that is not to say impossible, but I think because of that, um, of course they're gonna rely on regulations and other administrative action as they can.
Speaker 1:No, I I, I definitely understand that, you know, as you, as you're, as you're giving advice to us and, and the listening audience, it's not gonna be easy, is, is one of the takeaways, right? Is, you know, the, the incoming administration will come with an agenda and it has to be navigated through the process and it, and it won't be easy. And, and yet you started saying Covid Covid Covid is, this is an unprecedented situation that we have. I'm, I'm, I'm speculating that there may be greater opportunity for folks to walk a to walk across the aisle, given that we're spiking and many communities are still, you know, pulling back to their early phases.
Speaker 2:Well, I think that is right, and if you, you don't have to look back very far. It's really just this spring where you saw, uh, Republicans and Democrats in Congress come together like they have in very few, in instances in recent history to address a national crisis. All of the, uh, covid response bills, uh, capped by the very large Cares Act were overwhelmingly bipartisan responses to the urgency of the situation at hand. And all of course, signed by the president. There was great unanimity of opinion that we needed to, uh, come together, be very quick and efficient in negotiating compromise, and just get a lot of resources into the field, so to speak. Of course, in the seven months since Congress has been unable to, uh, brook compromise in on a, a next relief bill, they got close in a couple of instances in the lead up to the election, but politics ultimately got in the way of that. Uh, not surprisingly, but I think particularly as we're heading into, uh, a trajectory as we are at the moment, and the situation has only gotten worse, uh, and the economy is going to continue to feel the effects of that, I expect more bipartisanship, uh, to prevail and for our next, um, relief package to come together, if not in a lame duck session, uh, in December of this year, then almost certainly in, um, late January, early February of 2021.
Speaker 1:Now, as you pointed out that first a hundred days, COVID, COVID covid, good benchmarks that will be set for success. Is there room for the new administration to do anything else?
Speaker 2:I would not expect them to try to do a lot else, uh, at least not in the healthcare arena. That's not to say that they might not have other priorities like, uh, around infrastructure or other priorities that might be, um, credibly related to economic stimulus, which, you know, as I said, everything's gonna be viewed, I believe, through the lens of getting on top of the pandemic and stimulating the economy. And there's many things that, uh, very credibly could be related to that, like, uh, tax reforms. Now, I'm not, I'm not a tax guy, so I'm not suggesting that is gonna be a high priority, but, but many things that were priorities, uh, for Democrats generally in this, uh, president-elect in particular, very much could be, um, uh, cloaked in the, in the, uh, cloak of, uh, coronavirus response. So I think there's other things that are gonna come forward, maybe not necessarily on healthcare. I will say that, um, president like Biden certainly campaigned on further addressing the uninsured problem, further responding to the rising cost of healthcare and reversing the remaking of the Affordable Care Act. Uh, over the last four years in the Trump administration, um, very specifically, he campaigned on a public option. I don't expect, um, a public option to have any real prospect in, at least in the next two years. Again, even if Democrats control the Senate, it's, um, without getting into a very detailed political analysis, suffice it to say that it is, um, not a topic that is ripe for bipartisan compromise. And if bipartisan compromise is king, that is gonna probably fall by the wayside. Now, that doesn't mean that Democrats won't try, they're gonna, I think for political reasons and satisfying the base, they're going to have to make a, an earnest effort to put forward a public option, maybe even Medicare for all. But I don't expect either of those to emerge, uh, at the end of the day, and I don't expect there to be a lot of legislative, um, intervention on the Affordable Care Act specifically. Um, there was, in 2018, a bipartisan bill, uh, supported in the Senate primarily that would have shored up a few weak spots in the Affordable Care Act. So things like that are in the realm of possibility. And then beyond that, I, I would look to the administration to put a lot of emphasis on administrative action, including regulations to reverse course on a number of steps that the Trump administration took to, uh, reshape the Affordable Care Act in their image.
Speaker 1:So that would be a situation where I guess we would see a lot more, as you say, sort of the Biden administration, tit fortet to go encounter through the regulatory process or the executive order process, um, to kind of counter and undo is what you're saying, what has happened over the past four years. But would you see the possibility for greater legislative action if the Supreme Court takes a boulder step and strikes down or severely weakens the law? And does that, so right now you didn't open the legislative possibility. Does that Supreme Court action suggest to you that maybe the legislative process would be the avenue? Well,
Speaker 2:I'm glad you brought that up, because of course, the California v Texas case is the great wild card in all of this, and sometimes it's those, uh, shots from out of left field that you're not expecting, uh, that can, uh, disrupt otherwise sound analysis. And I think that very well could be won. I mean, let me start with what seems to be conventional wisdom at this juncture where we sit here now, and that is that I am not a Supreme Court authority, but most, um, Supreme Court authorities that I've consulted, listen to the oral arguments and don't expect, uh, based on the questions as well as their own legal analysis, that, um, the court is going to invalidate the entirety of law that the question of severability is, is one that is not, um, likely to get a majority of support to that, that, um, the defect in the individual mandate is sufficient to bring down the entirety of the law. So that then begs the question, does Congress have a, a crisis moment where they need to intervene, but for the sake of sport? We'll, we'll, we'll say that maybe that does come along and they do need to intervene. And the, the good news there, I think, is that there are some very real practical ways that Congress can step in and more or less moot the issue. Um, I, I know this has, uh, been talked about a lot, but just by putting a small penalty on the individual mandate or extracting the individual mandate altogether from the rest of the law, uh, which doesn't seem to be having any practical benefit now anyway, they can, they can cure the situation. So I don't think, given the simplicity of stepping into patch a big hole that the court might blow in the Affordable Care Act, I don't know that that creates a moment where all of a sudden Congress has to step in and do really, uh, substantial things to expand the Affordable Care Act.
Speaker 1:Mm-hmm.<affirmative>. So it may be that in the first order of business, once there's an opportunity to breathe after Covid, COVID, COVID then, and watching what may happen, uh, with the Supreme Court, there could be some more aggressive or perhaps less aggressive actions on the administration to deal with, with coverage.
Speaker 2:Completely. I, I expect this administration to absolutely, when it comes to health policy priorities as a second tier issue, absolutely be focused on, um, shoring up the Affordable Care Act, making it more stable, making it more available to individuals, enticing more people to come into the exchange marketplaces. And there are many tools at their disposal to do that. Um, but I don't expect, at least in the next two years, really, um, wholesale expansion through legislation. I think rather what you're gonna see is, uh, Democrats, well, let me put it this way. Um, the, the needs are going to be pretty apparent. I, I think, um, most people would look at the consequences of the economic downturn and see that the number of uninsured in this country is gonna, uh, rise up to rather depressing levels. And so the need is gonna be there. And I think rather what you're gonna see is, is, um, Democrats campaigning on the issue much like they did in 2018 and saying that they are blocked from really doing what the president, uh, committed to do with a public option, or even more broadly with Medicare for all because Republicans control the Senate.
Speaker 1:No. Do you see any other significant issues that, you know might be advanced through the new administration?
Speaker 2:Oh, yes. A a, absolutely. Um, listen, I, as I've said, uh, a couple of times so far, I think the administration's first, second, and third priorities are gonna be, uh, covid. Um, and beyond that, doing what they can to shore up the Affordable Care Act. But there's a raft of other really important, really impactful health policy issues that neither of the presidential candidates talked about much on the stump. Um, there, there may be more esoteric issues, um, that don't, um, tend to move electorate, but they're nonetheless really important topics and, and priorities for, uh, if not congress in, its in, in the whole then certainly certain members of Congress. And, um, I mean, prescription drug pricing kind of falls, uh, somewhere between those two. Clearly the, the presidential candidates, and particularly President Trump, talked a lot about prescription drug pricing, so that, that has, that might see its day in the sun. Um, surprise billing as a topic also, uh, got a little bit of, uh, play on the campaign trail, but not very much. Um, but other things like, um, value-based care, which is a, has been a big priority for both, was a big party for both. The Obama administration, also for the Trump administration will be, again, for the Biden administration, um, are gonna be friends to watch what happens to some of the flexibilities that were created, uh, as part of the public health emergency. Like the telehealth flexibilities is also something to watch. I do expect, um, both the Biden administration as well as Congress to look for ways to advanced policy solutions on all of these things, telehealth flexibilities, um, um, surprise billing, uh, possibly on prescription drug pricing. And these are the things that aren't necessarily, um, they're not making the headlines, but these are the things that can be really impactful to the healthcare community and that it's important to keep an eye on too,
Speaker 1:To the healthcare community for sure. And one of the things that, the theme that I'm hearing in this, um, is the patient, I mean, all of these impact payers and providers and our institutions as we come to know them. And yet, as you go through this list, prescription drug pricing, surprise, billing, value-based care, and the telehealth flexibilities, I see the patient and, and I'm, I'm wondering, you know, as these may be that secondary issue, do you see that the voice of the patient and what the patient wants may also become a driver in the health policy debate?
Speaker 2:100%. I do. Absolutely. And lemme give you another example of that, David. Um, I didn't talk about this in, in the article, but it's, um, that's cause I was limited on space. I could go on and on and on with, uh, probably a half dozen other really, uh, important topics. And the one I'm gonna highlight here is the movement towards transparency. And, uh, just by way of background, um, I'm sure many of our listeners will know that the Trump administration put forward two regulations, uh, one requiring healthcare providers to disclose, um, uh, actionable, uh, pricing information. Um, and then very recently before the election, a similar, uh, mandate on payers. Both of those were hugely controversial. The, um, one that applied to providers, uh, was and still is to some extent, uh, the subject of litigation. I think many people fall into the trap of assuming that, well, those were Trump priorities, therefore they won't be Biden priorities. And I think that's a false assumption. I think that these, they're, they're, these were bipartisan issues for decades, and they continue to be, have bipartisan appeal. Now, of course, the parties may choose to go about them in different ways, but the objectives are shared. And I believe that the Biden administration will continue to try to advance, um, more transparency that enables consumers to engage more thoughtfully in healthcare decision making. So those are, I, I, um, think that there could be some temporary suspension of those pending regulations. Uh, when the new administration comes in, the, the one applicable, the providers, for example, becomes effective January one, just given the, the state of change in the administration. And the fact that, um, healthcare providers across the country are, are struggling at the moment. I could see some sensitivity there and a desire to suspend implementation for a period of time, like maybe a year. But I don't think the issue's gonna go away. And I don't, I don't expect this administration to take a profound left turn on either of those issues.
Speaker 1:And all of these can be like little pillars or linkages to covid. And, and here's the point that I wanted you to react to, when you'd mentioned the telehealth flexibilities coming out of the pandemic crisis, and, and also within the covid, we realized that health disparities are exacerbated as a result of this. And so telehealth one could argue, has been a, a way to plug some of the holes and, and to address some of the access issues, but that flexibility doesn't last forever. It's temporary. And I know the providers and the payers are watching that space, and the states are watching that space. Not sure the patients are who will be most immediately impacted. Maybe everybody's gonna be impacted. So what is your prediction? And I know you said you, you, you don't have the crystal ball, but you read tea leaves very well. So what do you think is gonna happen with these kind of other issues, these second tier issues, telehealth being one of them as it, that one is a, is is on a time clock?
Speaker 2:Yes. There were so many, absolutely. And there were so many flexibilities afforded to healthcare providers, primarily by cms, but many regulatory agencies, um, to enable them to scale up, to meet demands of the moment. And I, I ha I give just so much credit to, again, cms, but, but many other agencies for being flexible and being responsive and having a plan and listening to the regulated community. I can tell you from firsthand experience, you know, they, they have emergency response plans that they execute on, and many of them do allow for. Um, they, they have lists of flexibilities that they're gonna automatically provide in order to enable providers to scale up. Typically, those are done in isolated geographic instances, like when there's a hurricane or something to that effect. I don't, I can't think of a single instance where it's been done on a national basis, but they have their, they have their play, uh, their, their roadmap or, um, their playlist. But I, I personally was involved in instances where I brought forward, um, flexibility requests that were shared with me by clients who said, we need to be able to do X and we need to be able to do Y in order to meet the demands. And these were instances that c m s had not conceived of before, but they considered them. And in many instances, they made, in most instances, they made the changes. So they deserve tremendous credit for, um, giving healthcare providers broad flexibility to do whatever the heck they needed to do within reason, of course, um, to meet the moment. Um, and yes, you're right. Those, most of those are time limited. They're tied to the declaration of a public health emergency. And when the public health emergency expires, um, to varying degrees, they go away. The current public health emergency we are in is, um, set to expire, I wanna say January 18th or somewhere thereabouts. It's, it's very close to the, um, inauguration by coincidence. Um, again, given just the way the state of the world looks right now, I fully expect that to be extended and every time it gets extended, typically for 90 day periods. So too to the flexibility. So I think the flexibilities will be around with us for a while, but, um, eventually, hopefully we will be beyond this moment. And the public health emergency will no longer serve a purpose, and an administration is gonna have to, um, both end that and then confront the consequences of ending it. And telehealth, I think is one of those instances where, you know, David, you've been around Washington a long time, you know, the, the old adage, it's very hard to take away a benefit once you've given it to people. Yes, indeed. And there's no greater example than the flexibility that has been given, not just to healthcare providers, but to your point, to patients. Yeah. I myself have had telehealth visits. I love it. I can sit here and do email, uh, until the doctor comes into, you know, whatever room. I'm not sitting there naked on a paper sheet, um, you know, waiting for the doctor to, to arrive and wasting time. And I think that is, um, some, it's a convenience people like, but more importantly, to your point, it's critically important for access. So I think the, the genie's outta the bottle on that one. But, but, um, that is not to say it's a foregone conclusion. And Congress is, um, very worried about, um, what happens, how to, how to contain potential abuse of that, uh, how to contain potential fraud and what it might do to the cost of healthcare. If all of a sudden accessing your doctor, as I said, is as easy as just, um, sitting in front of my computer making and doing emails while I'm waiting for the doctor to arrive. Believe me, there's plenty of times where I probably should have seen a doctor, but decided I couldn't take two hours out of my day. So
Speaker 1:Yes, yes. And then, and in fact, we won't, we, we won't label this necessarily the, the, the Zimmerman Health Plan<laugh>, but I understand your point, and, and I, I think that that ease, um, may be ignored by policy officials, but the health outcome benefits can't be. So this is, um, one where I, I know folks are studying the health outcomes, I know independent organizations are, and I suspect the, as the information comes to the table about better health outcomes, better access, some of those challenges we've always had in our healthcare delivery system, coupled with, as you pointed out, fraud and abuse. There'll be some marriage in the middle as they look at it. Um, and I, and I do wanna also say thank you for, for at least giving a ni a good shout out for the attention that c m s has provided and the flexibility that they afforded as a, as a former Fed and, you know, some time with, uh, C M S and its predecessor hva. I, I do, I join you in, in giving them a, a big shout out cuz this, this has been an, an amazing, amazingly challenging period in our, in our history and providing flexibility to allow folks states and, and, and other locales to be able to respond is key. So, um, thank you for, for recognizing that. What do you, what advice would you, would you give to our listeners about how to prepare for these changes?
Speaker 2:Well, I, that I am happy to, uh, provide that recommendation. It's, listen to what we're talking about here, then seek out your own set of information that helps you look ahead. I think, um, very often, uh, business leaders will sit around and they will try to make all kinds of projections and forecasts that affect their business and, um, too often overlook how the policy landscape might evolve around them and what kind of impacts that is gonna have on their business objectives. And again, their strategies to achieve on those objectives. And it is often, um, I don't wanna say it's easy to predict the future of health policy cuz that would make, uh, what I do<laugh> look, uh, pedestrian. But there are signals out there. You can look at what is, um, what is happening in committee hearings. You can look at what MedPAC is studying, you can look at what, um, different stakeholders are advocating and you can tie those signals together and, and make some reasonable predictions about how policies are gonna evolve. And surprise billing, you know, as a is a perfect example of that. Um, those are, those are signals that we saw coming for a while. Um, I think we were headed headlong into a resolution of that in early 2020. And, and of course, um, events overtook it, but I think, uh, we have not seen the last of consideration around surprise billing and anybody, and this is again, a good example, anybody who's out there thinking, oh, I haven't heard about surprise billing in a long time. I guess that issue went away not. Um, and so really taking some time to think about how might, um, policies, particularly around federal payment and regulation evolve and what might those impacts be on me is a really prudent step for all business leaders to take. So that's the advice that I would have. Just try to look ahead a little bit.
Speaker 1:So it sounds like, look ahead, get informed, stay informed, stay engaged. Um, because I think one of the other takeaways I have, as you talked about the limited possibility for legislative action, but the greater opportunity for regulatory and subregulatory in addition to executive order engagement. Active engagement is a way to help address, have your voice heard and influence policy outcomes. You would agree?
Speaker 2:Uh, uh, totally. Yes. I, I would say, um, the very least you can and should do is try to understand, uh, what the world around you looks like or how it might change a step better than that is getting in and trying to shape that world.
Speaker 1:And, and, and, and I would offer for the listening audience, you know, stay connected with A H L A, we will do all we can to help them stay connected, stay informed as we evolve through the transition. And the first a hundred days and even the last a hundred days, you know, we wanna make sure that folks know that we're here to serve, um, the, you know, the listening audience because it's complicated. Uh, all of what of what you've outlined is complicated and, uh, you know, and in that complexity are great opportunities. And so I, I suspect you are not bored. You're working from home, but you're not bored,
Speaker 2:Uh, anything but bored. And if I can, uh, just riff off of your, um, your comment about the complexities. All we were really able to do in the course of this conversation, David, as I'm sure you know, is skate on the surface and identify the major issues. Yeah, we didn't bother, we couldn't in the light at the time to get down deep into, okay, I'm sitting here saying, surprise billing is coming back, but what does that mean and what's a likely outcome and how is that going to affect me? And I, those are certainly questions I ponder. Um, and I think, again, there are some reasonable predictions that can be made. So, um, you know, identifying the issues is really important, but, but, uh, really drilling down a level or two and understanding, uh, where the winds are blowing and how that's likely to affect the outcome is really where the value is gonna come in.
Speaker 1:And as you said, how does it affect me? And, and, and that phrase means me as a counselor and advisor to my client, whether it's, you know, a, a payer provider, an insurer, you know, whatever, whatever. And me also means me as a patient, because one of the things I also take away is we are having this conversation, and you're right, we could spent, we could spend hours on any one of these topics. We are all patients on any given day, and we are in the company of loved ones who are patients any given day. And boy, that phrase me does resonate with me. Um, and that may help us come together to understand how we make change, how we influence change because it affects me.
Speaker 2:Well, that's, uh, a good aspiration and a good note to, uh, to end on. I think
Speaker 1:I, I, I will, I'll, I'll, I'll, I'll take that, that little joyous moment in my heart. Until the next time we get to talk to you, Eric, I do appreciate your time. A H l a thanks you for joining us today. Um, and as they say, watch this space.
Speaker 2:Thank you, David. It's always a pleasure to talk to you and always a pleasure to talk to a H l a members and others. Thank you for the opportunity.