The National Academy Of Medicine’s Vital Directions For Health: Forging a Path for our Future (Forbes)

FORBES | Health is more than healthcare. Smart reform looks beyond the current conversation of repeal and replace. It must include an active and empowered consumer making choices that matter within a modern, connected, knowledge-driven system.

That is the powerful message of the National Academy of Medicine’s pivotal report released today. Drawing on the expertise of 150 health care policy experts, scientists, and researchers from across the country, the report was developed by a bipartisan steering committee that included former Governor and HHS Secretary Mike Leavitt, former FDA Commissioner and CMS Administrator Mark McClellan, former Senate Majority Leader Tom Daschle, and me, among others. Its core goals are better health and wellbeing; high-value healthcare; and strong science & technology. The report outlines actionable policy recommendations to further these goals.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2017/03/21/the-national-academy-of-medicines-vital-directions-for-health-forging-a-path-for-our-future/#6dd5bc373e49

No. 1 killer of Nashville women may surprise you (The Tennessean)

THE TENNESSEAN | If you were asked to name the No. 1 cause of death in women in Davidson County, what would you say?

Some might suggest cancer, or perhaps Alzheimer’s. But the truth is that our number one “lady killer” is a condition that many consider a man’s disease.  And what’s even more striking is that its early symptoms can go unnoticed for years.

Cardiovascular disease kills one out of every three women in the United States. In Davidson County, it is women’s number one killer. For every one woman who dies of breast cancer, more than eight die from heart disease and stroke.

And even more are at risk: 22 percent of adults smoke; nearly one-third are obese; one in four are physically inactive; and more than 33  percent report having high blood pressure.

Read more at The Tennessean: https://www.tennessean.com/story/opinion/2017/03/21/no-1-killer-nashville-women-may-surprise-you/99172294/

Reconsider severe international affairs budget cuts (The Tennessean)

TENNESSEAN | While music, faith, health care, and even hot chicken have made Nashville famous, we also have a robust hub of research, work, and advocacy for global health and development.

Thanks to the dozens of humanitarian organizations providing excellent services for vulnerable populations worldwide, Vanderbilt’s Institute for Global Health research and development, and the missions of hundreds of places of worship throughout the city, Nashville understands the critical health needs of mothers, children, and families around the world.

More than half of Americans believe that our foreign assistance constitutes 25 percent of our U.S. budget. But they are wrong. Global health advocates in Nashville know that our international affairs budget is actually less than 1 percent of the U.S. budget.

President Trump has recommended to cut this fraction — already less than a penny of each budget dollar — by 37 percent. And if the severity of this cut passes through Congress, what does that mean for women and children around the world?

Over the past 25 years, the U.S. has led an historic initiative in the history of humankind. Since 1990, we have halved the number of people living on less than $1.25 per day, even with an increase in population. We have halved the number of people who die from malaria and tuberculosis.

We have halved the number of children who die under the age of five from preventable, treatable diseases like pneumonia, malaria, and diarrhea. We have halved the number of women who die from complications in pregnancy and childbirth. And we have turned the tide of the HIV/AIDS crisis.

In 2000, less than 50,000 people in Sub-Saharan Africa had access to anti-retroviral medication. But today, thanks to the leadership of many faith, music, and academic leaders in Nashville who helped lead the nation’s advocacy to support those suffering from HIV/AIDS in Africa and around the world, over 21.5 million people have access to life-saving anti-retroviral medicines. Imagine if we cut these programs by 37 percent. How many people will die? How many more people will contract the virus because we weren’t at the forefront of prevention?

Leading the world in providing foreign assistance, albeit less than 1 percent of our budget, is not only the compassionate, moral thing to do. It’s also the smart thing to do. We know that development is a critical component to national security.

Over 120 retired generals and admirals agree. Now is not the time to back down. Failed, collapsed countries are the breeding grounds of terrorism. But if we can provide a modicum of assistance, these same states have the wherewithal to pull their communities out of poverty to empower, educate, and build employment for sustainable governments and economies.

We have revolutionized the way that we provide foreign assistance over the last 15 years. Our leading global development agency, USAID, and bipartisan Presidential initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR), the Millennium Challenge Corporation and the Feed the Future global agriculture program are using the newest and best interventions.

They are continuously conducting evaluations and learning agendas to ensure that our tax dollars are being spent effectively and responsibly. Because economic growth and country ownership are guiding principles for our development strategy, we ensure that our assistance is rooted in partnerships that empower developing countries to assume responsibility for their own future and to move beyond dependence on foreign aid.

We ask that the president reconsider these severe cuts to the international affairs budget — from moral, national security, and economic perspectives — to preserve the current level of funding that saves the lives of millions.

Bill Frist, M.D. is a nationally acclaimed heart and lung transplant surgeon, the  former U.S. Senate Majority Leader and the founder and Chairman of Hope Through Healing Hands. Pastor Mike Glenn is Senior Pastor of Brentwood Baptist Church in Brentwood. Colleen Conway-Welch, Ph.D., R.N., is Dean Emerita of the Vanderbilt University School of Nursing and has recently been named a Living Legend by the American Academy of Nursing.

Read more at The Tennessean.

Bill Frist: Foreign Aid Saves Lives—And Makes America Safer (Christianity Today)

CHRISTIANITY TODAY | For the past two decades, we have had a front-row seat in the bipartisan movement to end worldwide preventable, treatable diseases like AIDS, tuberculosis, and malaria, and to make poverty history.

Since 1990, the world has cut in half maternal and child deaths, infectious diseases, and poverty as well as turned the tide on HIV/AIDS. We have made unprecedented strides in human history.

This may be the legacy of our generation as historians analyze what we were able to accomplish worldwide during our lifetime. Central to this legacy, it is worth noting, is the progress led by the United States during the Bush Administration. Millions of mothers, babies, children, and families are alive today thanks to America’s great leadership in the world for health, food security, and education—all at a cost of less than 1 percent of our country’s spending. (Year after year, most Americans estimate that we spend far more than that.) As doctors say, an ounce of prevention is worth a pound of cure.

As President Donald Trump seeks to balance the US budget, it has been reported that the administration wants to dramatically cut foreign assistance by as much as 37 percent.

Read more at Christianity Today: https://www.christianitytoday.com/ct/2017/march-web-only/bill-frist-foreign-aid-saves-lives-and-makes-america-safer.html

Tackling Tobacco Use In The Volunteer State: Let’s Start With Tennessee Quit Week (FORBES)

Forbes | In the last six weeks, two critical reports have shined a spotlight on Tennessee’s high levels of tobacco use and inadequate prevention efforts.

In December, the Campaign for Tobacco-Free Kids and other public health organizations published a report that compared funding for tobacco cessation and prevention in each state, and Tennessee ranked a dismal 45th nationwide.  Tobacco-Free Kids noted that Tennessee provided only 1.5% of the CDC recommended $75 million in funding for tobacco cessation, despite receiving over $400 million in revenue from tobacco taxes and a long-standing settlement deal with tobacco companies (known as the Master Settlement Agreement).

In January, the American Lung Association (ALA) released its “State of Tobacco Control” report for 2016, and Tennessee received “F” grades nearly across the board.  The ALA pointed out that the Volunteer State “remains among the 22 states that have not passed comprehensive smoke-free laws and has one of the lowest tobacco taxes in the nation.”

Read more at Forbes: https://www.forbes.com/sites/billfrist/2017/02/14/tackling-tobacco-use-in-the-volunteer-state-lets-start-with-tennessee-quit-week/#5fee396e74b7

The Case for Keeping America’s AIDS Relief Plan (New York Times)

NEW YORK TIMES | Among global public health advocates, there is a growing concern that President Trump may cut back, or even eliminate, programs that have played a critical role in fighting diseases worldwide. While every administration should strongly review our nation’s overseas commitments, and there are undoubtedly programs that we should cut, I hope he recognizes the success and importance of one in particular: the President’s Emergency Plan for AIDS Relief.

I have been treating patients in Africa and Haiti for 20 years. When I was Senate majority leader in 2003, I led the Senate’s passage of the plan, called Pepfar, on an overwhelming voice vote. It has since been reauthorized twice. President Trump, like his predecessors, will have the chance to put his own stamp on this winning program.

Pepfar was created in a moment of crisis: In the late 1990s, H.I.V.-AIDS was the No. 4 killer worldwide, and No. 1 in Africa. The program aimed to bring reliable, proven measures like antiretroviral drugs, counseling and prevention services to underserved communities around the world — and it worked. Today, Pepfar reaches 11.5 million people with antiretroviral drugs, a 50 percent increase since just 2014. Two million babies with infected mothers have been born H.I.V.-free thanks to Pepfar interventions, and 6.2 million orphans and vulnerable children receive care from the program.

Read more at the New York Times.

Telemedicine can improve access to quality, affordable care in Texas (Texas Tribune)

TEXAS TRIBUNE | If you become ill and need a doctor tonight at 11, who will you call? What will you do?

Texans in Austin, Dallas, or Houston are probably surprised to learn that Texas ranks 47th in the nation in the number of active primary care physicians per capita. Among its 254 counties, 35 have no practicing physician, and 80 have five or fewer, according to research conducted in 2015 by Merritt Hawkins. And 185 counties — more than 70 percent — lack a psychiatrist. The doctor shortage is an issue that impacts most of the state.

In recent meetings with state legislators and other public officials, I have emphasized the importance of making telemedicine a priority in the current legislative session.

Read more at TribTalk.

Less salt in foods means longer lives — Trump’s administration can fix this (The Hill)

THE HILL | No state is an island when it comes to our food and its impact — good or bad — on our population’s health.

That’s why it’s critically important for the Food and Drug Administration (FDA) to continue its efforts to reduce sodium in our packaged and restaurant foods. In June, the FDA published a draft voluntary guidance to the food industry, establishing targets for sodium reduction in two years and in 10 years. It’s time to finalize that guidance.

Read more at The Hill.

Healthy Foods Are Good For Business And Deserve The Support Of President-Elect Trump

At the start of a new year, we often find ourselves making resolutions to eat healthier and get active (I know I’m one of those people!). But the good news is, America’s interest in healthier foods has become a year-round trend, not just a New Year’s fad.

More than 66% of shoppers say they want to make healthier choices while at the grocery store. Low-calorie options accounted for 82% of snack food sales growth in 2013. Restaurant chains that increased lower-calorie menu options reported increases in store sales, customer traffic, and servings sold.

With a new Congress and a new presidential Administration starting on Friday, we have an opportunity to continue to support business-driven successes in incorporating healthier choices into Americans’ diets.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2017/01/17/healthy-foods-are-good-for-business-and-deserve-the-support-of-president-elect-trump/#252f79fd7a6d

Supporting Betsy DeVos for Secretary of Education

Betsy DeVos has been nominated for the next U.S. Secretary of Education, and I believe she is the best person for the position. I’ve known Betsy for many years, and I’ve seen firsthand her passion for education and for our children. Here is the letter I’ve just sent Lamar Alexander, Chairman of the Committee on Health, Education, Labor and Pensions in support of her confirmation. 

 

Dear Chairman Alexander:

In advance of Mrs. DeVos’s  January 17th confirmation hearing in your committee, I share my strong support for her confirmation as our next U.S. Secretary of Education.

Young people in America today are entering a workforce that is the most competitive we have seen in our lifetime.  Our economy is truly global, and how well our students are learning is being measured on an international scale.

We also know that, in too many communities across our country, students are receiving an education that is leaving them unprepared for next steps after high school—a reality that has a deep impact on the success and future of our citizens.

I devoted much of my post-U.S. Senate career to improving public education in Tennessee in an effort to jumpstart long-term educational change in our state and ensure that every child graduates high school prepared for college or a career.  As a surgeon, I also know that education impacts all aspects of our life, including health.  Studies I led for the Robert Wood Johnson Foundation found that education is one of the best predictors of health outcomes from life expectancy to the infant mortality rate.

It is for these reasons that I am both excited and hopeful about the nomination of Betsy DeVos as the next U.S. secretary of education.  I have known Mrs. DeVos for many years, and I know firsthand that her passion for education comes from a deep desire to do what’s best for our nation’s children.

In Tennessee, we have shown what is possible in improving public education.  Tennessee has gone from 46th in the nation to 25th in 4th grade math in just four years. We now rank 19th in the country in 4th grade science.  More Tennessee students are enrolling in and completing education beyond high school—education that will help them secure a bright future for themselves and their children.

This progress has been made due to the reforms Tennessee has committed to—stronger teacher evaluations, higher expectations for students, teacher tenure reform, and expanding high-quality school choices for parents, among others—and those reforms must continue in order to ensure success for all students.  As the center of gravity in education moves away from the federal government and into locals’ hands, we need a secretary of education who can both safeguard the flexibility states need to advance these reforms and inspire innovation that will challenge the status quo.  I believe Betsy DeVos is that leader.

She has more than 28 years of experience advocating for policies that are good for students, policies like more choices for parents, ensuring high-quality teachers in the classroom, and protecting the right for every child to receive an excellent publicly-funded education.  With a devotion to transforming our K-12 education system that has received wide-ranging bipartisan support at the local and national levels, Mrs. DeVos fits the bill for the trailblazer needed at the helm of federal education policy.

Most importantly, she puts children at the forefront of her advocacy efforts. As a mother and grandmother who, together with her husband, helped start a high-performing public charter school in Michigan, Mrs. DeVos is intimately familiar with education policy from all angles. In fact, West Michigan Aviation Academy is the top-rated public charter high school in the state of Michigan.

Betsy DeVos will bring a renewed sense of urgency and focus to improving schools in neighborhoods across America.  As someone who has worked with Mrs. DeVos for years, I urge the U.S. Senate to confirm her nomination.  She is the public servant our country needs leading the U.S. Department of Education.

Sincerely,

William H. Frist, MD

New Model Can Advance Treatments, Cures For Rare Diseases (Forbes)

FORBES | If your child suffered from a rare and incurable disease, what would you do to find a cure?

My former colleague and good friend Dr. Chip Chambers faced just such a challenge, and took the bull by the horns. Last month, Dr. Chambers organized a unique medical conference that should serve as a model for advancing research and treatment for newly discovered rare diseases. On November 11, 136 physicians and scientists from 16 countries came together in Bethesda, Maryland for the Inaugural International Conference on Deficiency of ADA2. The medical experts were joined by nearly 70 patients and family members from six countries who are affected by DADA2 (Deficiency of Adenosine Deaminase 2), providing a unique opportunity for shared learnings and global connections.

As far as we know this is the shortest time between a disease being first described in the medical literature and the convening of an international meeting of this scale—less than three years. Nearly every physician and researcher who in some way has touched this disease was present.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2016/12/15/new-model-can-advance-treatments-cures-for-rare-diseases/#2c4033cf53ed

Groundbreaking 21st Century Cures Act

The US Senate just voted 94-5 to pass the 21st Century Cures Act. This is an historic moment for American medical innovation and the millions of patients who will benefit.

The Cures Act is groundbreaking. Over the 40 years I have been in medicine, there has never been a more exciting time for medical innovation than today. The Senate’s passage of this bill will impact millions of Americans and give a big voice to patients in improving their care. With an estimated 7,000–10,000 known molecular-based diseases without cures, we now have an opportunity to change that trajectory and find new cures and treatments for patients.

Chairman Lamar Alexander’s vision and steady leadership in spearheading the Senate version through the Health, Education, Labor and Pension Committee was vital to making today possible.  I worked with Senator Alexander and the Bipartisan Policy Center to bring in medical perspectives from across the county to develop key pieces of the final legislation, including language to advance regenerative cell therapies that hold promise for restoring vision, repairing hearts, and rebuilding damaged joints.

This legislation includes major investments in cancer research, precision medicine, opioid-abuse prevention, and neurological disorders, paired with the streamlining of regulations, that will advance treatments for the millions of Americans still suffering from untreatable illnesses.  No other legislation enacted this Congress will do as much good for so many.  Its passage today will pave the way for groundbreaking cures that will touch nearly every American family, and demonstrates that Washington can still work together to address the most pressing needs of the American public.

For more information, please see the press release from the Bipartisan Policy Center:

FOR IMMEDIATE RELEASE

December 7, 2016

Contact: Joann Donnellan
(703) 966-1990
jdonnellan@bipartisanpolicy.org

Congress Puts Patients First Passing Groundbreaking 21st Century Cures Act

Washington, D.C.– Today, Congress put patients first by passing the 21st Century Cures Act – groundbreaking medical innovation and research legislation that will help millions of Americans with life-threatening diseases and their families. The Bipartisan Policy Center applauds Congress for working together to achieve this rare bipartisan compromise. It signals an encouraging moment for the nation that their government can make progress on behalf of the American people.

“The Cures Act is groundbreaking. Over the 40 years I have been in medicine, there has never been a more exciting time for medical innovation than today,” said former Senate Majority Leader Bill Frist. “The Senate’s passage of this bill will impact millions of Americans and give a big voice to patients in improving their care. With an estimated 7,000–10,000 known molecular-based diseases without cures, we now have an opportunity to change that trajectory and find new cures and treatments for patients.”

“I congratulate my former colleagues on tackling this ambitious legislation and succeeding,” said former Rep. Bart Gordon. “It shows the American people that Congress can work together to create and pass meaningful legislation that will touch their lives. I am especially pleased to see the Senate honor Vice President Biden by renaming the cancer moonshot and NIH innovation projects in the bill for his son Beau, who lost his brave battle to cancer last year.”

BPC began its medical innovation initiative in 2014 under the leadership of former Senate Majority Leader Bill Frist, M.D., and former Rep. Bart Gordon. The Cures bill reflects many provisions outlined in its July 2015 report Advancing Medical Innovation for a Healthier America: bringing the voice of the patient into the drug development process, increasing the use of real-world evidence and drug development tools to improve the drug development process, advancing precision medicine to tailor treatments for patients, enhancing the FDA’s ability to hire and retain top scientific talent, improving interoperability and increasing regulatory clarity associated with health information technology, and improving the regulation of regenerative cell therapies.

“This legislation will accelerate the development of promising new treatments and cures for Alzheimer’s disease, Parkinson’s, heart disease, diabetes, and cancer,” said Janet Marchibroda, director of BPC Health Innovation. “Extending the existing FDA accelerated pathway to include regenerative cell therapy will preserve the gold standard for safety and efficacy. This is not only groundbreaking for patients, this is groundbreaking for their families and caretakers who can also be affected.”

“Ultimately, this legislation will accelerate the discovery, development and delivery of new drugs and devices in a safe and effective manner and modernize the Food and Drug Administration,” said former FDA Commissioner Andrew von Eschenbach, who serves on BPC’s medical innovation initiative advisory committee. “It will also empower the FDA to significantly enhance the scientific resources it requires to cope with the advances in the science and technologies of medical product development.”

The bill supports significant investment in innovation and research at the National Institutes of Health and the Food and Drug Administration, including President Obama’s precision medicine initiative so doctor’s can tailor treatments to patients; the Beau Biden Cancer Moonshot to fight cancer; the BRAIN initiative to find new cures and treatments for neurological disorders and brain diseases, and to address mental illness and opioid abuse.

How NashvilleHealth Is Maximizing Community Population Health (Health Affairs)

HEALTH AFFAIRS | How can Main Street, America, move the needle in a city’s population health and wellbeing? It begins with a solid, organizational structure built for the long term.

I fondly call my hometown, Nashville, the “Silicon Valley of Health Services.” With 18 publicly traded national health care companies headquartered here with annual global health care revenues of over $70 billion, our city takes health seriously. One in 10 workers in the Nashville metro area are health care providers, nurses, or health aides. Even more work in the broader health sector, such as health management, financial, and legal roles. We have two outstanding medical schools, six schools of nursing, a dental school, and two schools of pharmacy. Our city is in the business of providing multiple health services to every state in the country.

Here is the cruel irony. When you compare us to similar cities, the health of Nashvillians is poor. We smoke at rates higher than Charlotte. We have blood pressure rates that exceed those in Austin. Our obesity rate surpasses Cincinnati’s. Our infant mortality rates are not even competitive. Our babies are more likely to die in their first year of life than in countries like Croatia, Serbia, and Qatar.

How can that possibly be? One of the things they didn’t teach me in medical school is that health services delivered accounts for only 10 to 15 percent of a population’s health status. We can build the best hospitals, provide the richest health plans, and I can be the best heart surgeon possible, but behavior and how and where people live, eat, work, and play have a far greater impact on an individual’s health.

Read more at Health Affairs.

The time to act is now: Bipartisan action will accelerate cures for Americans (The Hill)

THE HILL | With the election over, speculation is rampant on what this means for politics and policy in 2017.  We need to take a step back however, and realize there is critical work to be completed by Congress in 2016, to set the stage for a new generation of medical innovation, and demonstrate to the American people that Washington is not broken.

Congress has four remaining work weeks in Washington to hash out the budget and hopefully finish work on the “21st Century Cures” legislation which will accelerate the discovery, development, and delivery of safe and effective medical therapies.  As medical doctors we have witnessed the potential of life-changing treatments, and as a former Senate Majority Leader and former Food and Drug Administration (FDA) Commissioner who have spent years in public service — we recognize this rare and exciting opportunity for Congress to pass legislation that will affect the health and well-being of millions of Americans suffering from diseases today with no cure.

The Cures legislation is the product of two years of negotiation, resulting in nearly unanimous support among members of the House of Representatives and the Senate Health, Education, Labor, and Pensions (HELP) Committee at a time when many believed Washington was incapable of compromise.  Indeed, in late September, Senate and House leadership, and bipartisan leaders in the Senate HELP Committee and House Energy and Commerce Committee committed to getting a bill passed this fall.

Read more at The Hill: http://thehill.com/blogs/congress-blog/healthcare/307116-the-time-to-act-is-now-bipartisan-action-will-accelerate-cures

TrumpCare: In The Beginning… (Forbes)

FORBES | The immediate question for those whose lives focus around lifting the health of individual Americans is, “What does Donald J. Trump’s presidency mean for health care in America?” At the heart of the answer is uncertainty. Trump is an “unknown unknown” when it comes to deep, thoughtful health policy. He has excelled in many fields, but at best he personally has only dabbled in the field of health care, which accounts for a fifth of our overall economy and affects literally every American. So, to begin to answer the question, we can only start with what he has said on the campaign trail and the bare-boned, seven-point “plan” on his website and conjecture from there.

Read more at Forbes.

It’s time for the U.S. to lead on combating global malnutrition (The Hill)

THE HILL | One single public health crisis accounts for nearly half (45%) of all child deaths under age five. Every 4 seconds, a person dies from this cause – approximately 21,000 every day. And shockingly, nearly one in nine people globally is affected.  What is this epidemic that has taken so many lives? That has wreaked havoc on so many families? It’s want of a most basic need: we still have 795 million people worldwide who suffer from various forms of malnutrition and undernourishment.

This is not a complex disease where we need to develop new treatments, build new clinics and health infrastructure, or educate patients on prevention and medication adherence. But it is a health challenge that requires bold leadership and the commitment of greater resources from developing and developed countries. The United States should lead the way, and our next President has a unique opportunity to mobilize the global community around this critical issue.

Read more at The Hill.

My Turn: Around the world, Ayotte is a force for good (Concord Monitor)

CONCORD MONITOR | Since entering the U.S. Senate in 2011, Sen. Kelly Ayotte has emerged as a leading voice on U.S. national security and foreign policy. Through her service on the Senate Armed Services Committee, Sen. Ayotte has established herself as a strong defense hawk, consistently leading efforts to protect national security spending and to call for strong U.S. global engagement.

What is less known is Sen. Ayotte’s equally strong record of support for increased investments in the tools of U.S. soft power. Sen. Ayotte has championed strategic investments in U.S. diplomacy and development programs, and she has been a particularly strong voice in Congress for women and girls around the world.

While many Americans assume that our foreign aid dollars make up a substantial percentage of the U.S. government’s budget and that those dollars are often wasted, this could not be further from the truth. U.S. foreign assistance programs represent less than 1 percent of the federal budget, yet these programs have achieved remarkable results with strong bipartisan backing over the last two decades.

Read more at Concord Monitor: https://www.concordmonitor.com/Ayotte-has-championed-investment-in-diplomacy-and-development-5754730

Tennessee Makes Huge Strides

In 2013, Tennessee’s progress on math and reading scores was considered a bright spot. Today, our students continue to excel and have made Tennessee the fastest improving state in science since 2009.

On behalf of our team at SCORE (State Collaborative on Reforming Education), I applaud our students and teachers for their tireless efforts to strive for better. Building on our record improvement in math and reading scores in 2013, there is no doubt in mind that the future of our Tennessee children is bright.

This morning, the 2015 National Assessment of Educational Progress (NAEP), known as the Nation’s Report Card, released its 2015 Science Assessment Results, and the Volunteer State has a reason to be proud.  Tennessee is the only state to grow faster than the nation in both fourth and eighth grades, with Tennessee students doubling the average national growth in science. Our state has moved into the top 25 in science — the highest ranking it has ever held — and is now 19th and 21st in the country for fourth and eighth grade. Data demonstrated that our gender gap was eliminated, and achievement gaps between white, African-American, and Latino students narrowed.

At SCORE, we have seen firsthand the long hours and hard work put in by our teachers, school and district leaders, parents, and especially our students to make today’s exciting achievement a reality.  SCORE’s focus on driving statewide collaboration on policy and practice to ensure student success is paying off.

“Since the state began raising expectations, strengthening teaching, and emphasizing post-secondary education and workforce readiness for all students, Tennessee academic growth has been fast and sustained in multiple subjects over multiple years,” SCORE CEO Jamie Woodson said. “Although proficiency levels are not yet as high as we know our students are capable of achieving, Tennessee’s trend is decidedly in the right direction.”

SCORE will continue to work hand-in-hand with our state’s education leaders, teachers, and students to sustain and build on this headline-worthy progress.

The Last Shall Be First: Haitian Women Taking Steps To End Poverty (Forbes)

FORBES | How is it possible that the people of the poorest country in the Western Hemisphere have to shoulder repeatedly the impact of one natural disaster after another?

And what can we do as one of its closest neighbors – and by far the wealthiest country in the hemisphere – to best empower the people of Haiti to respond and to rebuild and indeed eventually to prosper after disaster strikes?

These are the questions we ask today as we see a people struggling to recover from a devastating hurricane earlier this month and an ominous rise in cholera outbreaks.

These are also the questions that a delegation of faith-based influencers from Hope Through Healing Hands and CARE asked last month as we visited Haiti to see what’s working and what’s not in terms of social and economic progress since the destructive 7.0 magnitude earthquake in 2010.

Read more at Forbes.

Want a more resilient world? Give mothers access to the tools they deserve (The Hill)

THE HILL | In 2010, the world watched in horror as more than 200,000 people lost their lives to a devastating earthquake in Haiti. And we shuddered again earlier this month when Hurricane Matthew – the most powerful storm to hit Haiti in more than 60 years – killed hundreds of people and impacted more than 2.1 million.

As the country continues to respond and rebuild, and as the world mobilizes much needed relief and assistance, it’s instructive to understand how Haitians are making themselves more resilient to natural disasters. And it is important to believe that there are strategies for long-term answers for Haiti.

One way might surprise you: better family planning.

That might seem like a lower priority amid disasters such as Hurricane Matthew. But it is exactly in these situations that women and girls are often subjected to an increased risk of sexual violence, unwanted pregnancies due to a lack of access to contraceptives and an overall lack of control over their situation.

And the time for women and couples to really strengthen their family planning strategies is between disasters, something that was clear just a week prior to Hurricane Matthew’s landfall, when CARE and Hope Through Healing Hands hosted a Learning Tour to Haiti. During the visit, the group visited successful U.S. foreign assistance programs focused on supporting healthier mothers and families.

There, the group met a woman named Ermicile Joseph, a 49-year-old mother of twelve. Ermicile welcomed the group into her home and shared her life story. She explained how hard it was to feed and provide for her large family and her wish that she had been able to time and space her pregnancies.

Ermicile lives in rural Haiti in the Central Plateau region where access to quality health care and family planning services is practically non-existent. Haitian women are often marginalized and have unequal access to everything from education and land to health care. They often experience health challenges due to serious obstacles in accessing pre- and post-natal care and family planning services.

However, this all changed for Ermicile when a community health agent made a visit to her home as part of a new effort to give mothers the services they desperately need to live healthier lives. Until recently, her options were limited. But now, Ermicile has taken control over her life and has used this newfound knowledge to educate her 31-year-old daughter Raphael about her options to choose when to have a family. Given the struggles Raphael witnessed growing up, she has decided to delay her first pregnancy until she is more financially prepared.

The benefits of this decision will have a long-term ripple effect for Raphael, her family and her community. Family planning is a powerful tool to combat poverty, particularly for those women who are able to avoid adolescent pregnancy, finish their education and enter the labor force.

When another disaster strikes the poorest country in our hemisphere, Raphael and her husband will have more capacity to provide for themselves. She will be more resilient in the face of danger. And if she does become a mother, she will know how to space a future pregnancy to avoid falling further into poverty.

We know that if women had the means to time and space the births of their children, it could prevent one in three maternal and child deaths in the developing world. Family planning is literally a life-saving intervention.

Thanks to U.S. foreign assistance, maternal and child mortality rates have dropped drastically in the past decade, as more mothers time and space their pregnancies. At a time of budget constraints, we must ensure that all of our federal programs are effective and this is an investment that pays off in the short and long-term. We must continue to ensure mothers and their families have access to the tools they so desperately need and deserve. This is particularly important during times of crisis and disaster.

We applaud the Senate for passing international family planning at the level of $622.5 million in FY17, and we call on leaders in Congress to protect these funding levels when they finalize their appropriations work after the upcoming November election. We also urge the incoming presidential Administration and the next Congress to prioritize international family planning programs within their FY18 budget requests and appropriations bills next year.

The foreign assistance budget supports families around the globe through low-cost interventions – such as family planning – that generate high-impact results. Through investments in women and girls, these programs will help women fulfill their potential and build a more sustainable future for their families and communities. And in the face of danger, they will be able to better control their family’s destiny and face the future with strength and resiliency. As Haiti currently responds to Hurricane Matthew – including CARE’s efforts to provide clean meals, water and supplies to those in immediate need throughout the country – we must stand behind mothers like Ermicile and Josephine who are the promise of a more hopeful future for Haiti.

Our Abysmal Maternal Health Statistics And How To Improve Them (Forbes)

FORBES | This past year, the United States received the dubious distinction of being one of only 7 countries in the world, including Somalia and Afghanistan, which have seen an increase in maternal mortality.

While countries with far fewer resources such as India and Brazil have made great strides to decrease the number of women who die each year as a result of pregnancy, our nation has more than doubled its rate of maternal mortality in the last twenty-five years (28 maternal deaths per 100,000 births in 2013, up from 12 in 1990). Since 2005, it has increased more than 20%. According to the World Health Organization (WHO), as many as half of these maternal deaths are preventable. This begs the question: How can we lead the world in cutting-edge health innovation and medical discoveries, yet fall behind in this telling public health metric?

The reasons for the increase are complex.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2016/10/12/our-abysmal-maternal-health-statistics-and-how-to-improve-them/#7b12711033b5

Hurricane Matthew & Haiti A Week Later

Hurricane Matthew, a category 4 storm, made landfall at about 7am this morning on the southwestern tip of Haiti.  Tracy and I just left Haiti a week ago, where we traveled with Hope Through Healing Hands and CARE to assess progress made since the massive 7.0 magnitude earthquake that struck in January 2010, resulting in 300,000 deaths and 1.5 million displaced people.

The full impact of Hurricane Matthew is not yet known, as the storm continues to linger over the island nation.  However, reports indicate communities under water, buildings stripped of roofs, and homes damaged or destroyed.  At least one citizen is dead and others are missing, although no formal figures have been released yet on the toll taken on human lives.

Haiti is the poorest nation in the Western Hemisphere, and much of its population still lives in shanty towns and tents following the earthquake.  Some Haitians were hesitant to evacuate for fear of leaving their homes and having their only possessions stolen.

Rapid emergency response following a disaster of this magnitude is vital to saving human lives, preventing spread of disease, and mitigating damage to infrastructure.  Hope Through Healing Hands is taking action to provide emergency relief and support again for our Haitian friends in Port au Prince and surrounding areas. You can help by donating to the HTHH Hurricane Matthew emergency relief fund here.  The funding we raise will be distributed, as we did after the earthquake, with trusted beneficiaries whom we know allocating directly for various relief efforts.

Our thoughts and prayers are with the Haitian people today.

The Newborn Illness That Nobody Is Talking About – And It’s Not Zika (Forbes)

FORBES | Nothing can prepare a mother for seeing her newborn seize multiple times an hour, refuse to eat or sleep, and shake uncontrollably. That’s what Julia found herself facing after severe chronic back pain from a car accident left her dependent on opioids. Julia had been a college student from a middle class family with a bright future, and never imagined she would end up an addict with a newborn diagnosed with Neonatal Abstinence Syndrome (NAS).

Read more at Forbes.

Back to Haiti

NOTES FROM THE ROAD | It’s no secret that I believe investing in global health is absolutely essential, and investments in women and girls—particularly maternal and child health—does nothing less than change a country’s trajectory.

Next week, Tracy is joining me as I lead a delegation from all over the United States on a learning tour to Haiti to see firsthand the changes being made in the lives of women and how those changes are building communities.

This will be my fourth trip to the country. I first visited immediately after the earthquake in 2010. Two days after the 7.0 magnitude quake hit right outside Port au Prince, I joined Samaritan’s Purse on a medical mission. At the same time, Hope Through Healing Hands—our global health nonprofit led by Executive Director Jenny Eaton Dyer PhD—launched the Haiti Disaster Relief Fund to provide medical services, equipment, and support for those who needed immediate clinical attention. We raised over $160,000 which was donated in full to trusted beneficiaries already on the ground.

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In the six and a half years since the earthquake, Hope Through Healing Hands has stayed vitally connected to Haiti. I was part of the founding board of the Clinton-Bush Haiti fund that raised over $60 million to help facilitate the long-term rebuilding and healing in the country. Hope Through Healing Hands has been sending midwives and nurses to serve in the country through our Frist Global Health Leaders program. Just last year Laurent Lamothe, the former Prime Minister of Haiti, joined me in Nashville to share a bit about Haiti’s future.

But next week our traveling group will see firsthand some of the things Hope Through Healing Hands has been sharing for the past several years.

In Haiti, we’ll be meeting with non-governmental organizations (NGOs), faith leaders, and the U.S. Mission. We’ll visit groups with longstanding efforts on the ground in Haiti including World Relief. We will meet with women and girls and hear from them how healthcare can break the cycle of poverty, and how education builds communities. We’ll tour a rural health clinic, a maternity ward, and a regional hospital.

Haiti has the highest maternal and child mortality rates in the Western Hemisphere. Just imagine how addressing those problems will strengthen families, stabilize communities, and support the entire nation.

We are particularly excited to be partnering with CARE on this trip. CARE has been actively fighting poverty in Haiti for more than 50 years, investing in programs of economic and food security for women and youth, sexual and reproductive health, and education.

I’m looking forward to sharing what we learn. It promises to be an eye-opening week.

(If you want to check out some videos from my very first trip, it’ll be amazing to compare how far the country has come!)

Systems Strategies for Better Health Throughout the Life Course: A Vital Direction for Health and Health Care (National Academy of Medicine)

NATIONAL ACADEMY OF MEDICINE | Health and health care outcomes for Americans should be better for most, and much better for some. This should be possible with currently available knowledge and resources. Capturing the potential will require adapting our strategies and approaches to the reality that health is not immutably determined at birth, but shaped by different factors over time. Similarly, caring for health cannot be confined to singular interactions within the walls of the health care system, but must fully engage powerful determining influences residing in other systems—e.g., education, employment, justice, transportation—which are natural parts of our lives. Exploring the nature and strategic opportunities inherent in these intersecting influences is the focus of this paper, and the implications for societal attention and resources suggest the promise of shifting emphases across the life span, across systems, and within the health care system.

Our assessment begins with an overview of the prominent health and health care challenges for Americans, and they are many. U.S. life expectancy at birth ranks 43rd in the global community, and has even recently declined among some specific groups. Unacceptable disparities in health outcomes and access persist among certain populations, in particular African Americans and Native Americans (Pearcy and Keppel, 2002). The U.S. health system ranked in a World Health Organization assessment only 37th in performance among 191 member nations (WHO, 2001), and in a recent study of 11 highly industrialized Organisation for Economic Co-operation and Development nations, the United States ranked last (Davis et al., 2014). These deficiencies are all the more glaring in the face of health expenditures that are clearly the highest in the world, about 50% higher than the country next behind us, and requiring investment of nearly 18% of our total economic productivity (GDP) in 2015 (Squires and Anderson, 2015). Why are we performing so poorly relative to our potential? A major reason lies in the fact that the primary foci of our attention, our resources (Murray, 2013) and our incentives, are too narrow and too late: despite an increasingly strong and specific understanding of the preventable elements in the development of many of our health challenges— social, behavioral, environmental—our investments are primarily directed to their biomedical manifestations, well after the problems have taken root.

Read more at The National Academy of Medicine: https://nam.edu/wp-content/uploads/2016/09/Systems-Strategies-for-Better-Health-Throughout-the-Life-Course.pdf

Thank you and best wishes to Risa Lavizzo-Mourey

Earlier today Risa Lavizzo-Mourey, MD, MBA, the first woman and the first African American to lead the Robert Wood Johnson Foundation (RWJF), announced that she was stepping down from her role as President and CEO of the Robert Wood Johnson Foundation.

I have been honored to serve with Risa on the RWJF Board. Her leadership is unparalleled: visionary and strategic, but with compassion and strong conviction. Risa is the origin of the “Culture of Health” movement that is sweeping the country now and will continue for years to come. She has put a face on the public health needs of the most vulnerable in this country, and made clear the essential role the private sector plays in building healthier, more equitable communities.

As an outspoken advocate of looking at health not just as healthcare, but as the conditions in which people are born, grow, live, work and play, Risa and RWJF are transforming our nation’s approach to wellness. Her work as CEO of the Robert Wood Johnson Foundation has personally touched thousands and will impact millions. She will be sorely missed, but her legacy will live on in the countless life-changing initiatives she has cultivated at the Foundation.

I wish her all the best.

Risa’s inspiring good-bye letter and charge for the future.
Robert Wood Johnson Foundation press release

Congress Must Preserve Quitlines and The Tips Program (Forbes)

FORBES | Smoking is the number one killer and public health challenge today, causing more deaths each year than automobile accidents, firearm-related injuries, HIV, illegal drug use, and alcohol abuse—combined. As a surgeon, it was the primary cause of the heart and lung disease that I operated on every day for 15 years.

In my home town of Nashville, Tennessee, approximately 110,000 people smoke—21% of the adult population. Each is cutting on average seven to ten years from their lifespan. Their habit is costing them years lost from family, friends, and loved ones. I take this issue seriously, and we recently launched a broadly supported, collective impact initiative called NashvilleHealth, which is rallying the community to address smoking as the number one health challenge to the vitality of our county.

Read more at Forbes: http://www.forbes.com/sites/billfrist/2016/09/09/congress-must-preserve-program-that-has-helped-nearly-a-half-million-americans-quit-smoking/#72fd6c785841

The right prescription for biomedical innovation (The Hill)

THE HILL | If you were a patient suffering from a disease, and you read about a treatment option for your illness, you would probably be eager to learn more. Imagine that the drug, device or other intervention had been on the market for several years, and studies showed that it was especially effective in some patients – but in others, it was useless, or even harmful. You’d want to know which group you were in, to make a fully informed decision about whether to use the drug or device, or not.

Welcome to the world of real-world evidence in health care – information derived from the practical or actual experience of patients.  This world can look very different from the idealized settings of randomized, controlled clinical trials (RCTs) that help regulators determine whether a drug or device can be allowed onto the market.

RCTs are considered the “gold standard” of scientific evidence. By assigning patients randomly either to a “study arm” in which they get the new intervention, or a “control arm” in which they get a placebo or the standard treatment, researchers can isolate those results produced by the new drug.  But these trials are typically filled with relatively small groups of carefully preselected patients, and usually are not reflective of the far broader population of people who may eventually use the new drug, or device, or the practices of the far larger circle of physicians who will prescribe it.

Read more at The Hill: http://thehill.com/blogs/congress-blog/healthcare/294045-the-right-prescription-for-biomedical-innovation

The Food We Eat Daily That Leads To Poor Heart Health For Our Children (Forbes)

FORBES | Earlier this year, I called attention to the dangers added sugars pose to cardiovascular health and other health outcomes.  In the months since, many people have told me how surprised they’ve been to learn about the sugar hidden in their healthy morning yogurt or afternoon energy bar.  Frankly, I was too.  And this lack of food literacy is a driving factor behind our nation’s growing health crisis and obesity epidemic.

Some health-conscious organizations are trying to bridge that information gap.  This week, the American Heart Association (AHA) came out with its first ever scientific statement on added sugar for children.  A team of scientists conducted an extensive review of the available evidence published in peer-reviewed studies examining the cardiovascular health effects of added sugars on children, and came to a powerful conclusion.

The AHA-backed experts recommended that children and teens should consume less than 6 teaspoons (25 grams) of added sugar a day, and those under the age of two should not consume any added sugars.  Additionally, those 2 – 18 should limit their intake of sugar-sweetened drinks to no more than eight ounces weekly (none for those under age two).  That means less than one soda or sugary fruit drink per week.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2016/08/27/the-food-we-eat-daily-that-leads-to-poor-heart-health-for-our-children/#fe1f7e92075d

How Bundled Payments Can Change Healthcare (The Hill)

THE HILL | Rising health care costs are a top concern for Americans today, with 64% of voters in a January 2016 Kaiser Health tracking poll, citing a candidate’s position on the cost of health care, health insurance, and prescription drugs as “the single most important factor” or “a very important factor” in their vote for president.  With health care costs continuing to outstrip inflation, not surprisingly, many Americans are looking to curb their out-of-pocket health care spending. Tom Daschle and I believe that now is the time to find and implement innovative approaches to fundamentally transform our approach to health care. Bundled payments should play a critical role in that.

Read more at The Hill: http://thehill.com/blogs/congress-blog/healthcare/291918-moving-the-needle-on-health-care-transformation

FDA Draft Guidance on Real-World Data (Forbes)

FORBES | In a document issued this week, the Food & Drug Administration laid out for comment its draft guidance of how real-world evidence could support regulatory decision-making for medical devices. This is a positive step forward for improving the medical product development process. At the Bipartisan Policy Center, Representative Bart Gordon and I have been urging FDA to advance medical innovation with real-world evidence. FDA has limited this guidance to how real-world evidence may be used for regulatory review of medical devices. But the FDA is to be applauded for taking this step, and acknowledging the increasingly vital role real-world data (RWD) will have in healthcare.

Read more at Forbes.

Exploring the Social Determinants of Public Health with Robert Wood Johnson Foundation

NOTES FROM THE ROAD | Scotland—Survival of men and women in Scotland is the worst in Western Europe. So is their general health. Why is that? What is being done? How successful are the new, bold initiatives that were launched in 2010?

I am in Glasgow with the board of the Robert Wood Johnson Foundation (RWJF) to explore these fundamental questions to better inform us to shape what we can do in Nashville though our bold new, community wide initiative NashvilleHealth to improve our current poor population health at home.

Scotland’s ongoing commitment since 2010 to make Scotland the best place in the world to raise a child, with the long-term goal of improving the social and health outcomes over the course of a generation, is similar to our efforts at NashvilleHealth.

And Scotland shares many of the same political, economic, and demographic profiles as the US, and Nashville.

Glasgow is about the size of Nashville: home to 600,000 people, with another 600,000 in the surrounding metropolitan area. Nashville has worse health than similar cities like Charlotte, Austin, and Denver; Glasgow has worse health compared to other UK cities with similar characteristics, such as Liverpool and Manchester. Smoking rates are about 23% for both cities. And like Nashville, within the Glasgow metropolitan area, there are even greater disparities.

In both Nashville and Glasgow, explanations for these disparate health outcomes include inequities in income and educational attainment but also social isolation, excessive tobacco and other substance abuse, unhealthy diet, and high rates of adverse childhood experiences.

A starting point for my investigations in Glasgow is similar to what we as a community are doing through NashvilleHealth at home: examine how various sectors are working together to improve the outcomes of existing programs that are aimed at helping families and children in health need.

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When Regenerative Medicine Changes Everything (Forbes)

FORBES | Two weeks ago I led a panel discussion at the Bipartisan Policy Center (BPC) on medical innovation with my good friends Senator Lamar Alexander (R-TN), who chairs the Senate Health,Education, Labor and Pension (HELP) Committee, and former Congressman Bart Gordon (D-TN), who previously chaired the House Committee on Science and Technology.  We were joined by Nashville native Doug Oliver, who had a powerful story to share.

Senator Lamar Alexander (R-TN), Doug Oliver, former Congressman Bart Gordon (D-TN), and myself.

Senator Lamar Alexander (R-TN), Doug Oliver, former Congressman Bart Gordon (D-TN), and myself.

Doug inherited a rare condition called dry macular degeneration. His vision began rapidly deteriorating at age 32, and within a year he was legally blind–unable to recognize faces, read the paper, continue his IT job, or drive a car. His doctor told him told him there was no cure but encouraged him to monitor clinicaltrials.gov, the federal site we set up when I was in the Senate where NIH-approved clinical trials are listed, for any new experimental studies that specialized in his illness.  Doug was diligent and in time found a physician in Florida who was treating his condition with patients’ own stem cells.

Doug’s decision to participate in this clinical trial was life-changing. His own stem cells were isolated in a centrifuge from bone marrow drawn from his hip bone, and then injected into his retinas. Doug saw improvement overnight, and within months—after a decade of blindness—he passed the Tennessee driver’s test and got his license back.

Read more at Forbes.

How Real-World Data Could Change Medicine (US News & World Report)

US NEWS & WORLD REPORT | With continuing advances in science and technology, the pace of medical breakthroughs is accelerating. Today, we can treat or even cure conditions that significantly shortened life just a generation ago. The exciting promises of personalized medicine are now becoming reality.

Congressman Bart Gordon and I co-chair the Bipartisan Policy Center’s initiative on Advancing Medical Innovation, and we believe that real-world data – data already amassed in electronic health records and other clinical software, claims systems and even in patients’ personal health tracking devices – is a rich source of information that can play a key role in accelerating the Food and Drug Administration’s approval process for promising drugs and devices to patients in need.

Read more at US News & World Report.

From Volume To Value: Achieving Bold Change In Our Healthcare Payment Systems (Forbes)

FORBES | One question I hear repeatedly as I travel the country discussing healthcare is whether the transition from fee-for-service to value-based care can really be done in a way that lowers cost and improves patient care. The answer is: it can.

While there isn’t a one-size-fits-all solution, successful systems change requires the collaboration and coordination of payers, providers, physicians, regulators, and patient-consumers, taking them outside their comfort zone by flipping the current incentive structure on its head.

It’s useful to review why we should change the way we pay for our healthcare in the first place. The current, dominant fee-for-service (FFS) model incentivizes over-provision of services, which contributes nothing to improving health. Physicians are paid for each medical test they run, but they aren’t compensated for coordinating patient care among different providers, or spending time on patient education. There isn’t a billing code for that. As a result, care is fragmented and disjointed, leading to inefficient delivery and wasteful duplication of services. A patient feels overwhelmed by the care labyrinth he or she must navigate. One estimate put the overtreatment cost alone at $192 billion in 2011.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2016/06/30/from-volume-to-value-achieving-bold-change-in-our-healthcare-payment-systems/#1a51fa989c82 

Better Healthcare at Lower Costs (AHIP 2016)

NOTES FROM THE ROAD | I had the privilege of speaking yesterday at America’s Health Insurance Plans Institute and Expo. Along with Bernard Tyson (Kaiser Permanente) and David Bernd (Sentara Healthcare), I discussed “Better Health Care at Lower Cost: Is It Possible?”

You know my answer: It is absolutely possible with technology. In case you weren’t able to join us, here’s my view of where we are, and where we can go.

 

I am a surgeon. I like to cut, and sew, and fix. I like to keep things simple. So my central organizing thesis is this: Health care delivery today fails because of a massive mis-allocation of resources toward the goal of a patient’s health. We overuse, underuse, and misuse existing resources.

We overuse health services, driven in part by a fee-for-service payment model.

We underuse prevention services and techniques.

We misuse our existing resources—doctors, facilities, medicines— by neglecting evidence-based medicine.

This can be fixed. These are exciting times; we will see more innovation in health service delivery in the next three years than we have in all the history of modern health care delivery.

Let me give two examples, and then toss out a challenge.

Aspire & A Better Way to Die

First, in America people don’t die the way they want to. They too often die chaotically and uncomfortably, with huge costs to the patient and the system. There are too many hospitalizations, too many trips at 2 AM to the emergency room, too many painful side effects from medicines, too much discomfort.

But it doesn’t have to be that way.

A company named Aspire Health is showing us the way.

Two years ago, a group of us founded the palliative care company Aspire Health to strike right at the heart of this end-of-life chaos and waste.

Aspire took the successful, decade-old model of inpatient, brick-and-mortar palliative care and modernized and transformed it using IT and specialized teams, moving it exclusively to the outpatient and post-acute space.

Aspire is pioneering the way, taking this new model to national scale, now in 13 states and 36 cities working with 14 insurers, including many of you in the room.

It has definitively given better results for much less cost. How?

  1. It focuses on not just physical care, but on emotional, on spiritual, and on mental health as well.
  2. It focuses on not just the patient, but the family and caregivers.
  3. It delivers care not just with any doctor, but a specially-trained, palliative care doctor and a tightly-knit team of a palliative-trained nurse practitioner, social worker, registered nurse and chaplain.

It’s highly specialized care—highly individualized for the patient at the end of life—and delivered in the home with intense attention to social determinants and environment.

What’s the secret sauce?

Analytics: Early, up-front and highly accurate identification of those specific patients who definitely will benefit. Everyone claims to have these algorithms and analytics, but they don’t. Aspire’s model is proven to work.

Specialists: Aspire’s care team features specially-trained palliative physicians and nurses. These are experts on end-of-life medicine. They know how to talk and treat, understand and empathize, with these specific patients and families.

Access: Aspire patients have 24/7 access to a physician or nurse practitioner. Patients and their families always have someone to call in a crisis. They don’t have to go to the emergency room.

Technology: The system is built on powerful IT-managed caregiver workflows, which ensure that the patient always has the right person, at the right place, at the right time.

The outcomes speak for themselves. For 12,000 end-of-life patients we found:

  • Higher satisfaction for both patient and family
  • Fewer hospitalizations (60% reduction), but more patient contacts in smarter settings (home)
  • Earlier referral to hospice (31 days vs 13 days) with continuity and communication ensured
  • Savings of $13,000 per patient served (from a study with two years data across five states with matched cohort comparison)

Better health at lower cost is possible as long as we use existing resources smartly.

Teladoc & Telemedicine

Today, narrow networks rule the day. Wait times for primary doctors continue to rise.

Emergency visits are going up with expanded coverage. And rural hospitals are closing.

But today’s technology can radically improve convenient and timely access to expert physicians. Telehealth is one of the few solutions that increases the capacity of the system by improving access to care while driving down costs.

There are a small handful of companies emerging in this space. Teladoc is by far the largest telemedicine company in the country.

It will approach one million doctor-patient visits over the next 12 months. A million individuals all of whom who would otherwise have had diagnosis and care delayed, and may have ended up in emergency rooms without a telemedicine option.

Imagine for a moment, it’s 10:30 at night and your child is suffering from a high fever or some other nonemergency illness. You either anxiously wait until the next morning to try to track down a doctor (good luck), or more likely you get in a car, drive 45 minutes to the emergency room, wait an hour, see a nurse or doctor in or out of network, and drive back home 5 hours later ending up with a $1400 bill from the hospital!

Or… within 10 minutes you reach a board certified doctor by phone or video, licensed in your state, who has an average of 8 years of clinical experience. At a cost of $45 out of pocket.

Yes, a full 50% of the more than 1.5 million doctor visits Teladoc has had to date occur on nights, weekends, and holidays, when doctors’ offices are closed, and the ER or Urgent Care Center is the only alternative.

Technology-enabled, remotely-delivered care provides equal outcomes delivered much more quickly and conveniently, yet at much much lower price. The purpose is not to replace the primary care doctor but to fill the gaping holes—to improve access and deliver quality care when and where it is needed for a fraction of the cost.

Every payer and system in this room will grow its reliance on telemedicine. Willis Towers Watson says that within a year and a half, over 80% of large employers will offer a telemedicine benefit.

How do you decide whom to partner with?

First, you must insist upon quality measures. Telemedicine has a low barrier of entry—it can get dumbed down quickly by inferior doctors—but a high barrier to scale.

Second, look for high patient engagement. Telehealth is an empty promise without active patient engagement. Without engagement and use by the patient, the value, and cost savings, will never be realized.

With the value of telemedicine so obvious, what has been the biggest barrier to more widespread adoption? To date it has been the resistance of some state medical societies who hold on to antiquated models of practice delivery. This is rapidly changing as quality and cost data so powerfully demonstrate the effectiveness and safety of remotely delivered, evidence-based medicine.

The Challenge

Imagine yourself in my 12th floor conference room in Nashville across from the park three days ago. 15 people are gathered around the table including the CEOs of the five largest employers in Nashville, the four largest health care companies—big public companies like HCA, Emdeon, Change—and representatives from the more than 120 nonprofits and churches in Nashville who have some interest in improving health.

It was the inaugural board meeting of NashvilleHealth, a new, county-wide collaborative that has come together to do a simple thing: Take the aggregate population health measures of Nashville, as reported by the Robert Wood Johnson Foundation—which are poor—and make them the best in the state. And then outperform our peer cities of Charlotte, Austin, Raleigh-Durham, and Cincinnati, all of whom are beating us badly now.

Our goal is to create a culture of health, to make the healthy choice the easy choice, and to focus on the social determinants of where and how we learn, live, work, play and pray.

Our discussion centered on a real example of how we REALLY improve health. Smoking rates in Tennessee are 23%, which means we have 110,000 smokers in Nashville. If we take that down to the national average of 15% or 70,000, that means we have 40,000 fewer smokers within 5 years. We have the knowledge and the proven tools today to do that. We didn’t five years ago.

40,000 fewer smokers translates conservatively into 200,000 years of life saved. Not across the country, or across the state, but within a 3 mile radius of where we were sitting in my conference room.

That reduces the burden of disease.

That conserves the health care dollar.

That improves wellbeing and productivity.

That saves lives.

So I close with a call to action. To maximally reduce cost and improve well-being, you lead the way in your home town of formalizing your own NashvilleHealth. It’s where the real cost savings and health determinants can be achieved.

Salty Stuff (The Hill)

THE HILL | When more than 75% of the sodium you eat comes from processed foods and restaurant meals, it can seem like the problem is out of your hands. How can you cut back on salt effectively when you can’t control those foods? The Food & Drug Administration feels the same way. In a draft guidance issued yesterday morning, FDA called for the processed food, restaurant and food service industries to reduce sodium in their products. It was a wise recommendation, and not a moment too soon.

Read the rest at The Hill.

The Most Helpful Illegal Medical Procedure (Fox News)

FOX NEWS | Last year 47,000 Americans had their blindness reversed through the transplantation of cells from a corneal donor’s final selfless act. It is safe, it is effective, and because it is curative, it is a relatively cost effective procedure. It is medicine at its most beautiful.

And according to FDA regulations, the distribution of this cell therapy is in violation of federal law.

That’s right. The regulation says that no matter how competent the surgeon, the FDA must first approve cells from donated corneas as if they were a drug—a process that takes over a decade and can costs billions of dollars — all for a practice that has been successfully restoring sight for more than 50 years.

The good news: the FDA doesn’t always adhere to its regulations and has not in this case.

The bad news: inconsistent enforcement creates uncertainty, deterring innovation for other unmet medical needs such as arthritis, back pain, and diabetic ulcers.

Read more at Fox News.

The Senate Must Streamline the Drug Regulatory Process (Wall Street Journal)

WALL STREET JOURNAL | Before the Senate is a powerful medical-innovation package of 19 bills—a companion to the House-approved 21st Century Cures Act—that will streamline the nation’s regulatory process for the discovery, development and delivery of safe and effective drugs and devices, bringing the process into the new century. This legislation, crafted by the Senate’s Health, Education, Labor and Pensions Committee, touches every American. Each of us has personal health battles or knows family members and friends who are fighting against devastating diseases. Passing this package will help ensure that patients’ perspectives are integrated into the drug-development and approval process and speed up the development of new antibiotics and treatments for those who need them most.

Read more at the Wall Street Journal (sub required)

Four Strategies to Save Lives, Curb Smoking (Forbes)

FORBES | This  month, FDA passed The Tobacco Control Act, which grants the Agency the authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, smokeless tobacco, and any other tobacco products including e-cigarettes and hookah pipes. The truth is, smoking and tobacco take 500,000 lives in the US each year, and healthcare for a smoker costs the system $18,000 more than for nonsmokers.

This is an all-hands-on-deck issue and we need a combination of efforts and approaches to make lasting change. I present four effective approaches at Forbes.

Read more at Forbes.

Congress Must Act Now to Improve School Nutrition (The Hill)

THE HILL | While headlines harp that the U.S. is a nation “hopelessly divided,” there is something lawmakers can band together on: forging a solution to our obesity epidemic.  In addition to being one of the greatest health threats our nation has ever faced, it is a terrible burden for employers, who are forced to spend more than $73 billion in costs associated with overweight-related medical and lost productivity costs every year. Obesity also threatens national security, as the leading medical reason why 71 percent of young adults between the ages of 17 and 24 cannot qualify for military service.

Read more at The Hill.

Let’s stand with retired military leaders to get healthy school meals over the finish line (The Hill)

THE HILL | While headlines harp that the U.S. is a nation “hopelessly divided,” there is something lawmakers can band together on: forging a solution to our obesity epidemic.  In addition to being one of the greatest health threats our nation has ever faced, it is a terrible burden for employers, who are forced to spend more than $73 billion in costs associated with overweight-related medical and lost productivity costs every year. Obesity also threatens national security, as the leading medical reason why 71 percent of young adults between the ages of 17 and 24 cannot qualify for military service.

The good news is that Congress has the opportunity to sustain recent improvements to school nutrition programs—a major step forward since many young people consume up to half of their daily calories during the school day.

That’s the headline from Capitol Hill, thanks to the Senate Agriculture Committee unanimously passing the bipartisan Improve Child Nutrition Integrity and Access Act in January.

Last week, a House version of the child nutrition reauthorization was introduced, but without the strong bipartisan support the Senate garnered.  It is now up to the House Education and Workforce Committee to find common ground with the Senate to move this issue forward.

Read more at The Hill: http://thehill.com/blogs/congress-blog/healthcare/278659-lets-stand-with-retired-military-leaders-to-get-healthy-school

 

Spring Update (Newsletter)

So much of my work is a balance of progress and conservation. Now, more than ever, that’s playing out at home. Tracy and I are working to turn Old Town, our Williamson County home on the Old Natchez Trace, into a thriving farm while preserving and honoring the property’s centuries-old history. We welcomed new members to our family this month. Pryor Lillie the calf is named after Old Town’s 1846 builder. Two new colts, Risa and Ray, will join us at Old Town next month. And Nickle, our little Australian Shepherd, keeps us all in line. At the same time, we’re working closely with Kevin Smith, a local archaeologist and anthropologist to preserve the 800-year-old Mississippian temple mounds that serve as the foundation for Old Town.

As always, we love welcoming friends from all over the country to Nashville. With Kix and Barbara Brooks we hosted a delegation from California a few weeks ago, touring some of the best of Nashville: the Bluebird Café, Vanderbilt, and the Frist Visual Arts Center. And I never miss the Mule Day Parade: an annual event in Columbia, Tennessee, dating back to 1840.

Today we begin two weeks of travel that will encapsulate that same push and pull. Before we go, I wanted to share with you some of what we’ve been up to and some of the important work ahead of us. We will be sharing details of the trips and what we learn on social media. Follow along on Twitter (@bfrist) or Facebook (SenatorBillFrist).

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Cellular Horizons Conference, the Vatican

We will be representing Hope Through Healing Hands and the Bipartisan Policy Center at the Vatican this week at the Cellular Horizons conference (#UniteToCure) to discuss the latest in regenerative medicine. I’ll be speaking on the Speeding Cures panel—an issue that weighs heavily on me. Late last year BPC recently released a report that I co-chaired with Representative Bart Gordon on cellular therapeutics. In the report, we encourage Congress and others to work to advance medical innovation legislation. This will require changes at FDA and in how research is structured. There’s an act pending in Congress now to apply some of these needed changes. The REGROW Act is bipartisan, bicameral legislation based on the BPC’s December report and would create an expedited approval category for adult stem cell therapy that would allow for conditional approval after Phase I and Phase II trials are complete, and evidence of safety and effectiveness is demonstrated. This could make a huge difference for how quickly we can develop life-saving drugs.

The Nature Conservancy Global Board of Directors, China

For the first time ever, the Board of Directors will visit TNC’s projects in China, and we are thrilled to be able to see some of the conservation projects underway in Sichuan, Beijing, and at 3 Gorges Dam. TNC’s goals in China include establishing land trusts, reforestation efforts, and working with the 3 Gorges Company to ensure the survival of the fisheries and communities downstream from the dam. All of this is important work, and we are anxious to be on the ground and see the progress being made.

NashvilleHealth & Domestic Health Reform

Hope Through Healing Hands & Global Health

State Collaborative on Reforming Education (SCORE)

  • All children should be educated and equipped for their futures. But how to best do that? SCORE launched a SCORE Institute in partnership with Project Renaissance to look at how students move from poverty into the middle class.
  • Community partnerships are working for education in Tennessee. SCORE highlights four that can be models of success.
  • SCORE’s Executive Chairman and Chief Executive Officer, Jamie Woodson, explains the new statewide report Equitable Access to Highly Effective Teachers for Tennessee Students and lays out the first steps toward addressing Tennessee’s “effective teaching gap”.

Tomorrow Might Be The Most Important Day This Year (Forbes)

It’s true that we are all living longer: the percentage of American adults over 65 years old has doubled since 1940, now reaching 13%. By 2050 that number is expected to double again to 25%. In actual numbers this translates to an estimated 89 million “senior citizens” by 2050.

Advances in sanitation and the advent of antibiotics has been responsible for much of this shift, and researchers continue to probe how changes in diet, medications, and genetics can slow or stop the process of aging. Artificial life preserving technology, transplantation, and advanced chemotherapies have transformed once fatal diseases into chronic illnesses. But living longer does not necessarily mean living better. Our ability to maintain the basic presence of life with medicines or machines does not mean we can continue to preserve the essence of the person that came before. We are still mortal, and we do eventually die.

Therefore, it is vitally important that you think about the type of health care you desire to receive as you approach the end of life. Saturday is National Health Care Decisions Day—April 16, 2016. Plan a time now to write out or update your personal wishes for your end of life care.

Read more at Forbes.

Improving Access and Adding Value for Mental Health Care (Forbes)

“When you break a leg, you get a cast and people sign it and put smiley faces on it. When you’re given a mental illness diagnosis, you’re cast out,” 24-year old Amanda explained to Kaiser Health News. Amanda was diagnosed with bipolar disorder in college, after several years of manic-depressive behavior. The family struggled financially and emotionally to get Amanda the best possible care, fighting against an outdated health system that is failing those with behavioral health needs.

It shouldn’t have to be that hard. We must change how we offer mental health care.

Read more at Forbes.

Charleston Helps Mothers and Children Globally (The Post and Courier)

This week, global health non-profit Hope Through Healing Hands (HTHH) seeks to galvanize the work already being done in Charleston and South Carolina around an important health initiative. HTHH will co-host a luncheon with faith leaders, nonprofit leaders, university leaders, and others in Charleston to discuss how we can better unite on behalf of child and maternal health globally.

Read more at The Post and Courier

Global Health: The Most Effective Policy

As the 2016 primaries unfold, it’s time for candidates of both parties to focus on expanding the big-hearted policies that have made this nation so exceptional. In recent years, the most effective of those policies has been global health — that is, putting U.S. resources to work saving lives in developing nations by spreading health treatments that work here at home.

Read more at The Hill.

Cutting Sugar for Better Health

On a trip this month to the U.K., I noticed many of their food and beverage products labeled “No Added Sugar,” and the message floods the airwaves. Britain has already caught on to the evils of hidden sugars, and has been loudly making it known to consumers. America should follow suit.

Reducing sugar intake isn’t just about losing weight or preventing cavities. Americans’ excessive sugar consumption poses tangible health risks. An April 2014 study published in JAMA Internal Medicine found “a significant relationship” between added sugar consumption and increased risk for cardiovascular disease mortality. Those who consumed a quarter or more of their daily calories from sugar were twice as likely to die from heart disease than those with daily sugar intake of 7% or less! As a heart surgeon, these are numbers I notice.

Read more at Forbes.

Tennessee Quit Week a first step to healthier Nashville (The Tennessean)

THE TENNESSEAN | Of the thousands of heart and lung operations I have performed, the most common cause of the underlying disease in these patients was a single voluntary behavior: smoking.

That tragedy is what Tennessee Quit Week (Feb. 22-28) is all about.

Smoking absolutely leads to a shorter, poorer-quality life. It more than doubles a person’s risk of stroke or heart disease, and increases the risk of lung cancer by 25 times!

Read more at the The Tennessean: https://www.tennessean.com/story/opinion/contributors/2016/02/22/tennessee-quit-week-first-step-healthier-nashville/80705838/

Flint’s Water Crisis and Public Health 3.0

When looking at the ongoing crisis over safe drinking water in Flint one thing is abundantly clear, the decisions made–at multiple levels–were made without a comprehensive evaluation of the impact on public health.

Karen DeSalvo, Acting Assistant Secretary for Health and National Coordinator for Health Information Technology, and I take a look at the public health approaches  being used to help the residents of Flint react to, and recover from, the consequences of the elevated levels of lead in their drinking water. In our own practices as physicians, we know that a well-rounded care team is crucial. But in public health we tend to deploy this multi-sectorial approach only in response to public health failures rather than using their full potential to improve health outcomes and prevent public health emergencies like we see today in Flint.

We believe now is the time for public health professionals to take on larger, more engaged roles as civic leaders, and for business leaders to invest fully in the health of their communities.

Read more at Forbes: What the Flint Water Crisis Reveals About Public Health

Health Diplomacy in Latin America

Strategic Health Diplomacy (SHD) recognizes that targeted global health initiatives can be an important foreign policy tool for the United States.  Healthier populations are productive, safe, and less vulnerable to instability. By addressing global health in Latin America and the Caribbean (LAC), the United States can save lives and improve its national strategic interests.

Read more at Kennedy School Review: An Application of Strategic Health Diplomacy in Latin America and the Caribbean: The U.S. Southern Command

A Cancer Moonshot With A Clear Plan

The Obama administration announced on Monday that it hopes to spend a total of a $1 billion to fund a cancer “moonshot” in search of cures. That amount is likely not sufficient, but it can establish the framework by which the goal can eventually be met.  It is critical that under this rallying cry we articulate a clear, cogent plan to achieve the goals articulated by our government leaders.

Read more at Forbes: Cancer ‘Moonshot’ For Our Generation

Congressional Challenges for 2016

2015 was Congress’s year. For the first time since 2011, both chambers of Congress were led by the same party. Leaders of both the House and Senate worked together on legislation instead of against each other. It was an about face. Unfortunately, election years are notoriously less-productive. But with bipartisan commitment, we can continue to reap the benefits of a Congress that has gotten back to doing the people’s work.

Read more at Forbes: Can Congress Be Productive–Again?

What’s Needed to Remain Competitive in Medical Innovation

Less than a week ago, Congress voted to increase the NIH budget by $2 billion. That’s a lot of money, but it only just reverses the erosion of federal funding for critical biomedical research. This funding increase is much-needed. But there’s more than can be done on Capitol Hill to re-prioritize lifesaving biomedical research.

Read more at Forbes.

Season’s Greetings

Merry Christmas all! Tracy and I hope this holiday season brings peace and joy and 2015 was a rewarding year.

It’s been a fall of new beginnings for us in many ways. After three sons, and two grandsons, our family welcomed our first granddaughter, Amelia Fearn Frist, just over a month ago. We launched a pioneering new health initiative for Nashville that we believe will serve as a model nationwide. And most importantly, Tracy and I were married this summer in Sinking Creek, Virginia, where we have a farm where Tracy runs her grass-fed beef business. We’ve since opened a satellite branch in Williamson County. We are now in the cutting horse business in Franklin, Tennessee, expecting two new babies in April at our farm, Old Town. Tracy has had her hands full training a surgeon to be a cowboy.

Nov15Pics

Domestic Health Reform

But it’s not been all grass-fed beef and cutting horses this fall. Much of our work has been focused on launching NashvilleHealth, an endeavor meant to change Nashville’s health outlook. Although we are a national hub for healthcare, our citizens are not all benefitting from the talent, expertise, and resources we have here. NashvilleHealth will be a county-wide convener to open dialogue, align resources and build smart strategic partnerships to create a plan for health unique to Nashville’s needs, leveraging the rich resources of our city and region.

NashvilleHealth has been a big undertaking, but it hasn’t been the only thing we’ve been working on. The Nashville Health Care Council has announced its 2016 Fellows Class, a one-of-a-kind executive program on which Larry Van Horn from Vandy’s Owen School and I work. We’ve also been writing on antibiotic resistance, a growing and extremely serious problem, and health care technologies, especially telemedicine. We are closely watching the health delivery on a national scale, encouraging AHRQ and calling for reform at the VA, bringing attention to health issues for children and the elderly, and continuing to argue for needed refinements to the Affordable Care Act. We continue to use writing and social media as the primary means of changing the culture around many of these issues.

Hope Through Healing Hands & Global Health

Tracy and I visited Cuba again this year, this time searching for a family doctor. On previous trips we’ve seen hospitals and clinics, but the patient’s first contact has been the missing link. This fall, we made a surprise visit to a Cuban family doctor, and got to see what medicine there really looks like.

We’ve been forever impacted by our visits to Cuba, and late this summer Tracy and I launched Mountain AIR, an artist-in-residence program at our Virginia farm. Hector Frank, an incredibly talented Cuban artist, is our first resident. We’ll be headed back to Cuba next month.

We’ve also worked this year to spread understanding of global health’s role in our national security. PEPFAR stands as a shining example of what a concerted effort for global health can mean for our country’s health and safety at home, but now more than ever we must be active and visible.

SCORE & Education

SCORE continues to soar. The State Collaborative on Reforming Education once again celebrated the hard work of Tennessee students, teachers and administrators at the SCORE Prize event. ABC’s Nashville star Charles Esten—Deacon Claybourne—was on hand to perform as we named twelve schools and districts as finalists for the coveted SCORE prizes.

I’m even more excited than usual for SCORE’s next year. Last week SCORE announced a new strategic plan, refined the leadership structure, and launched a strategy to 2020 with goals including closing achievement gaps by income, race, and geographic location; preparing all graduating seniors for post-secondary education; and continuing our impressive state-wide improvement.

More bits:

  • If you’re in Nashville and you have a car, you must check out Yoshi. I’m not unbiased, but I am genuinely thrilled with the time it saves. You will never have to fill your own gas tank again!
  • If you’d like newsletters like this by email, sign up here. Or, you can subscribe directly to the articles posted on our site.
  • A patient of mine is thriving 25 years after a lung transplant. It’s an amazing story. She’s a fighter—the longest living lung transplant in America.
  • Again, happy holidays, and here’s to a wonderful 2016.

 

 

 

The Childhood Experiences That Can Cut 20 Years Off Your Life

I recently heard a startling statistic. According to a CDC study, children who endure six or more adverse childhood experiences (ACEs) by the age of 18—incidents of abuse or neglect that make a child feel unsafe or unwanted in their home—live on average 20 years less than their peers who are not exposed to these ACEs growing up. Furthermore, those with four or more ACEs are seven times more likely to be alcoholics in adulthood, twice as likely to develop cancer, and sadly, twelve times more likely to commit suicide. They lead sicker, shorter lives. And they often pass those disadvantages on to their own children by recreating the traumatic environments that they grew up in, perpetuating a toxic cycle.

What does a childhood with multiple adverse experiences look like? It could be a girl of divorced parents, whose mother is abusive and suffers from mental illness. It could be a young boy who is being raised by his grandparents because both his parents are addicts and incarcerated. It could be a child whose father committed suicide after years of struggling to make ends meet to feed and clothe his children. These are some of the more troubling cases. But nearly two-thirds of Americans report having one or more ACE, and more than one in five report three or more ACEs. Childhood stressors are increasing the likelihood of illness and addiction for a meaningful portion of the U.S. population–and our healthcare system fails to address this key driver of health.

Read more (and take the ACE quiz) at Forbes.

Approve Limited-Population Antibacterial Drug Pathway (The Tennessean)

THE TENNESSEAN | A recent study about antibiotic resistance hit close to home for me. It projected that drug-resistant bacteria are developing at a pace that could soon threaten the lives of thousands more surgery patients each year.

This study also revealed that as many as half of infections after surgery are already being caused by pathogens that don’t respond to standard antibiotics.

While the threat of antibiotic resistance may sometimes seem amorphous and removed from our daily lives, research like this helps to crystallize why there is growing urgency to address this issue.

I know all too well the inherent risks involved in any surgical procedure. To think about patients surviving complicated heart bypass or organ transplant surgery only to lose their lives to a subsequent untreatable infection is infuriating and tragic.

Yet, this is the reality today, and it’s only going to get worse until we take collective action as a country and as a global community.

Read more at The Tennessean: https://www.tennessean.com/story/opinion/contributors/2015/11/23/approve-limited-population-antibacterial-drug-pathway/76145622/

The Numbers are In: The Case for NashvilleHealth

I like to keep an eye on my hometown’s statistics. I love seeing Nashville listed among the nation’s best cities to launch a startup, raise a family and visit for a weekend away. According to some estimates, we gain 80 new Nashvillians each day, transplants from all over, drawn to our welcoming atmosphere and our healthy business environment.

But for many of Nashville’s residents, “healthy” is not an apt descriptor. I’ve been closely watching these numbers, too. Nashville’s citizens have some of the worst health outcomes on a national and global level. Tennessee is one of the unhealthiest states in the country: 45th out of 50. And Davidson County ranks 22nd out of Tennessee’s 95 counties for health factors, according to the Robert Wood Johnson Foundation County Health Rankings.

To address these challenges, I am launching NashvilleHealth to create a comprehensive and bold, community-supported culture of health equity in Nashville. NashvilleHealth will serve as a county-wide convener to open dialogue, align resources and build smart strategic partnerships to create a plan for health unique to Nashville’s needs, leveraging the rich resources of our city and region.

Read more at the Nashville Post.

Our Opportunity Where Health and National Security Converge (Forbes)

FORBES | This week, former Senate Majority Leader Tom Daschle and I released a report recommending a policy of strategic health diplomacy, inspired and informed by the success of the President’s Emergency Plan for AIDS Relief (PEPFAR).  The report’s publication was announced at a conference in Washington, DC, where many of the architects of PEPFAR came together to advocate for a foreign policy approach that incorporates health care and humanitarian aid.  The PEPFAR program has provided access to anti-retroviral treatments to more than 7.7 million men, women, and children worldwide.  It has prevented transmission of the virus to 95% of infants with infected mothers, offered care and support to millions of orphans, and trained over 140,000 new health care workers.  It is by all accounts a major success.  Yet it took many years for us to get to this point.

When I first became acquainted with the AIDS virus, I was a surgical resident in Boston in 1981.  At that time it was still an unexplained illness with only a few documented cases.  I never would have predicted the scourge that HIV/AIDS would become.  Back then, we thought we would have a cure within a few short years.

Instead, AIDS was responsible for the deaths of 3 million people in 2003 alone, and 40 million people lived with AIDS or HIV at that time.  As a surgeon, the emergence of AIDS spurred radical changes in surgical practices.  In the early years, when I operated on a patient with HIV or AIDS, I wouldn’t require my assistants to scrub in due to the risks.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2015/11/13/our-opportunity-where-health-and-national-security-converge/#99dc1a4cdb73

Retreating From Global Leadership Puts America at Risk

The 2016 presidential campaign is well under way, and the candidates are already jousting over who is best suited to respond to an increasing number of obstacles abroad, ranging from the refugees crisis in Europe and the Middle East, to the threat of ISIS, to Russian aggression under President Vladimir Putin. As Democrats and Republicans, the four of us will almost certainly support different candidates in November 2016. But we all agree on this: Our security and prosperity are at risk if America retreats from our leadership responsibilities around the world.

There could not be a riskier time for America to pull back.

Madeleine Albright, Tom Daschle, and I explore why today in Time.

What PEPFAR’s Numbers Mean for National Security

As of last year, PEPFAR supported anti-retroviral treatment for 7.7 million people, mainly in Sub-Saharan Africa, and an astounding 95 percent of at-risk babies were born HIV-free. In 2013, Secretary of State John Kerry announced that the one-millionth baby had been born HIV-free because of PEPFAR-supported prevention of mother-to-child transmission. No nation in history has been responsible for a larger or more successful global health program. Yet it appears PEPFAR has accomplished much more than saving lives.

Tom Daschle and I look at the PEPFAR numbers at US News & World Report.

The Superbug Fight at your Grocery Store

You may have heard statistics about the over-use of prescription drugs, with reports indicating that up to half of all antibiotics prescribed today are used improperly. It’s a huge problem contributing to the rising threat of antibiotic-resistant bacteria. What you may not have heard, however, is that the majority of drugs used in the U.S. aren’t even taken by humans. Approximately 70% of medically important antibiotics are sold for use in livestock.

This is a trend that started in the middle of the 20th century when farmers began putting small doses of antibiotics in the food, water and minerals of animals for growth promotion, disease prevention, and disease control. It became standard practice and seemed to make sense – keep the animals healthy, increase growth, produce more food, increase farm profits, and lower food costs for consumers. It is even attributed with tripling American meat production over the last 50 years. But the reality hasn’t been that simple. A side effect we hadn’t anticipated was antibiotic resistance, and in turn, higher health care costs.

Read more at Forbes.

In Memory of Fred Thompson

Today Tennessee lost a talented and admired statesman and many of us lost a beloved friend. Working at his side in the Senate for 8 years, Fred embodied what has always been the best of Tennessee politics—he listened carefully and was happy to work across the aisle for causes that he believed were right. My thoughts are with Jeri and their children at this time; he will be missed.

Congratulations to the 2015 SCORE Prize Winners

All year long the State Collaborative on Reforming Education—SCORE—works with and for students, parents, and teachers in Tennessee and each October we have the privilege of dedicating an evening to recognizing the amazing progress they have made. I love that our annual SCORE Prize awards ceremony doesn’t just bring together administrators and policy makers in education, but also teachers and students from across the state. It’s a lively crowd and one of my favorite nights of the year.

This year I was particularly thankful to have Tennessee Governor Bill Haslam and our Education Commissioner, Dr. Candice McQueen, join me in recognizing the hard work of our schools across the state, and I think the whole crowd was thrilled that ABC’s Nashville star Charles Esten—or Deacon Claybourne—was on hand to perform for us.

The SCORE Prize is an opportunity to lift up successful schools and districts across Tennessee and share best practices with each other. These awards are earned based on data collected by our SCORE Prize Selection Committee. They spend weeks examining data and visiting schools and districts across the state to determine the best of the best. Watch the video to see how the SCORE Prize winners are chosen. I offer them my sincere thanks.

This year’s winners again raised the bar on excellence in education. Together they are pushing Tennessee forward for the sake of our children and future.

Elementary School Finalists:

  • Delano Elementary School in Shelby County (2015 winner)
  • Andersonville Elementary School in Anderson County
  • Dresden Elementary School in Weakley County

Middle School Finalists:

  • New Vision Academy in Metropolitan Nashville Public Schools (2015 winner)
  • Grassy Fork Elementary School in Cocke County Schools
  • KIPP Academy Nashville in Metropolitan Nashville Public Schools

High School Finalists:

  • The Soulsville Charter School, Shelby County Schools (2015 winner)
  • Covington High School, Tipton County Schools
  • Martin Luther King Jr. Magnet School, Metropolitan Nashville Public Schools

School District Finalists:

  • Trousdale County Schools (2015 winner)
  • Dyersburg City Schools
  • Johnson City Schools

You can learn more about the winning schools here.

I was also particularly impressed with the individual students who were honored for their work. The Students Rise to the Challenge (SRTTC) scholarships award $1,000 to a student in each age category for an essay or video describing how one of their teachers helped them overcome an academics challenge.

Weston Downing, a 12th-grade student at Covington High School in Tipton County Schools; Yeleeya Li, a sixth-grade student at Indian Trail Intermediate School in Johnson City Schools; and Nicholas Reynolds, a fifth-grade student at Andersonville Elementary in Anderson County Schools, all did outstanding and creative work and paid worthy tribute to the teachers in their lives. You can read and watch Weston’s, Yeleeya’s, and Nicholas’s prize-winning entries here.

Congratulations to all of the SCORE Prize finalists and winners, and thanks to the SCORE Prize Selection Committee, Jaime Woodson and the outstanding SCORE team, and all of the students in Tennessee who keep pushing us forward.

Making Health Convenient

I believe one of the secrets of achieving good population health is to make the healthy choice the easy choice, and I’m so pleased to learn of businesses in Tennessee who are working to make that a reality. Tri-Star Services’ Twice Daily convenience stores are making a strong committment to offering  healthy food and drink options in their Tennessee locations. I believe it will be a great model for others to emulate.

Read more in The Tennessean.

In Search of the Family Doctor

Over the course of three visits to Cuba in the past year I have learned much about this nation, its people, its art, and its healthcare system.  We’ve toured polyclinics, hospitals, and medical schools. I’ve met with professors and medical students.  We’ve gotten the government’s healthcare statistics and double checked those with providers on the ground. I’ve seen facility standards that are disappointing and observed shortages of the most basic medical supplies and pharmaceuticals. But everyone I have met on the street knows and respects their local doctor, assigned to them by the state. They have all described their doctors as accessible, empathetic, and caring. So my goal for of this trip was to make an unplanned and unannounced visit to this front line: to visit a family practice doctor who is the fundamental link connecting every person to healthcare delivery.

Read more at Forbes.

Doing the Hard Work for a VA Transformation

It was over a year ago that the public learned of unacceptably long wait times and false record keeping at the Department of Veterans Affairs, resulting in shoddy care for our service men and women. Since then, instead of progress, we have been met with ongoing reports of delayed care, wasteful spending, and poor management.

Last February some colleagues and I presented an array of concrete and actionable proposals for VA health care reform in a report, “Fixing Veterans Health Care.” The report was the product of a six-month process of careful study and deliberation through which our bipartisan task force identified key challenges in the VA health care system and developed workable solutions.

Now we need everyone’s voices to make lasting change.

Read more in the Military Times: http://www.militarytimes.com/story/military/benefits/veterans/2015/10/04/commentary-making-case-va-transformation/73213092/

Consumer Still Feeling The Pinch: The Next Big Health Care Debate (Forbes)

FORBES | News headlines have touted a moderation in the rise of health care costs since the economic slowdown and passage of the Affordable Care Act (ACA). But as I have traveled the country and met with health care professionals and consumers, those receiving the care have not felt any reduction in cost. In fact, many have experienced the opposite. Why are those most in need of a price break not receiving it?

While the ACA has reduced our uninsured population (latest estimates put the uninsured rate at 9.2%), it has facilitated the growth of the under-insured. An employer benefits survey released last week by the Kaiser Family Foundation (KFF) and the Health Research and Educational Trust (HRET) confirmed that employers are increasingly shifting health insurance costs to employees in the form of higher premiums and deductibles. This shift has occurred for two key reasons.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2015/09/30/consumer-still-feeling-the-pinch-the-next-big-health-care-debate/#59c9db702a20

The Future for The Agency for Healthcare Research and Quality

Research matters. An agency that I fought to save many years ago is at risk again, and Congress must make a move to save it.

I had just been sworn into the U.S. Senate in 1995, when I first found out that the The Agency for Healthcare Research and Quality (AHRQ) – then known as the Agency for HealthCare Policy and Research (AHCPR) – was on the chopping block. I was still unpacking boxes and learning my way around the Senate halls when my good friend and teacher Uwe Reinhardt of Princeton came to me with an urgent request. He reported the federal agency responsible for funding and conducting health services research was in danger of being eliminated in the 1996 Congressional budget. The AHCPR, which had been renamed and reorganized just six years prior with strong bipartisan support and a revised mission, had fallen out of favor with several influential members of the House Budget Committee.

More at Forbes.

Call for a Conversation: Alzheimer’s in Tonight’s Debate

Tonight, when Republican candidates, vying for the White House, debate one another at the presidential library and final resting place of President Ronald Reagan, they should honor his memory and address the illness that claimed his life and the lives of 700,000 Americans annually: Alzheimer’s disease, the sixth-leading cause of death in our nation.

Reagan was a true patriot. He led this country with boldness and tremendous strength. His optimism helped fuel our country’s continued ascent to greatness, even during difficult times. Just five years after leaving the White House, on Nov. 5, 1994, Reagan issued a letter to the American public announcing, “I have recently been told that I am one of the millions of Americans who will be afflicted with Alzheimer’s disease.”

That was more than 20 years ago, and this frightening disease is only becoming more prevalent. As baby boomers (now 51 to 69 years old) age, more Americans are at risk of developing the disease than ever before. None of us will be untouched.

Read more at US News and World Report.

Nashville’s Role in the Healthcare Landscape

I love Nashville and I’m so proud of the work being done  here. Healthcare is the heart of this town and the solutions being developed here are helping patients all over the world. I’m particularly proud of the Nashville Healthcare Council’s Fellows program, and was thrilled to introduce it to a broader audience.

I am constantly inspired by the sheer volume of creativity in Nashville, much of which is channeled toward shaping a smarter, more efficient health care system for our nation.

I was only 16 when my father and brother co-founded HCA in 1968, an innovative venture that grew into the largest hospital management company in the world and reshaped the delivery of care throughout the country. HCA’s founding helped set the stage for Nashville to become the epicenter of the American health care industry, today home to 400 health care companies.

I advise a number of cutting-edge organizations, and I consistently see tomorrow’s successful, shareable care-delivery models being built in Nashville. Future generations of patients across the world stand to benefit.

Read more at Modern Healthcare.

The Virus Wars: Vaccines that Work and Why We Aren’t Using Them

Researchers around the world are scrambling to find an Ebola virus vaccine. Rightfully so. The virus infected nearly 28,000 people and killed over 10,000 in Africa since last year’s outbreak began. But there are other viruses with even more staggering numbers: HPV–human papillomavirus–killed 230,000 women last year. 170,000 more were diagnosed with cancer, but survived.

And yet, we have a vaccine for HPV. Current versions can kill 70% of HPV strains. But in the United States our vaccine rate for HPV is abysmal. A proven-safe vaccine can snuff out a virus that we know causes deadly cancer. Yet only 35% of the recommended population gets the vaccine.

The time for excuses is over.

More at Forbes

Hector Frank and a New Opportunity for Cultural Unity

Last October, Tracy and I visited Cuba and got an up close view of the country, the people, and their challenges. I’ve written about my impressions of their healthcare structure–in many ways woefully lacking, but with some surprising lessons for us in America. What I didn’t write quite as much about was the art. We found the art and the artists in Cuba inspiring, bold, and visionary. I loved what they were doing and how their work was crossing borders and boundaries, even against great odds.

I’m sure you know that I believe health is a powerful tool for diplomacy. But art can be just as unifying–recognizing and communicating our common hopes and struggles like little else can. The creation and sharing of art among peoples around the world evokes cultural understanding and shared unifying dreams.

For that reason, Tracy and I are thrilled to launch today the Mountain Artist in Residence (Mountain AIR) initiative, and introduce the first artist in residence–the man whose work inspired this project–Hector Frank from Havana, Cuba. We will welcome Frank with an exhibit today–Cuban Summer 2015, benefitting Hope Through Healing Hands and SCORE. In the fall, Frank and his wife Teresa take up their residency. We are excited to see what happens next!

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About Hector Frank

Hector Frank was born in Havana, Cuba in 1961. Hector continues to be influenced by Cuban and the Caribbean artists working with strong forms and lines.  He incorporates impasto techniques along with various mixed media and collage to build his images up off of the surface and bring them to life.

From the start of Frank’s art career, he preferred to paint abstractly, and continues to be influenced by Cuban and Caribbean artists working with strong forms, and lines. Through drawing, he began expressing figurative forms in a variety of media including wood, handmade paper, and assemblage.  He incorporates impasto techniques along with various mixed media and collage to build his images up off the surface and bring them to life.  He works with mixed media and creates highly sought works on re-claimed wood with found objects. By changing his style often, he keeps in the forefront of the ever changing Cuban art scene.

Frank’s work has been shown in France, Mexico, Panama and the United States,and is featured in prominent private and public collections worldwide.

During his Mountain AIR residency, Frank will draw upon the natural environment and Appalachian setting to create a series of pieces in paint and in a materiel medium.  Abundantly available to him are natural materials, including reclaimed wood, wire, wood, copper, leather and glass that have accumulated on the property for the past hundred years.  His objective is to marry his traditional Cuban culture with the American Appalachian life in an interpretive fashion.

About Mountain AIR

Twice each year, an artist will be selected to spend two weeks living on a beautiful and inspiring 480-acre cattle and horse farm in Sinking Creek, Virginia, deep in the Appalachian Mountains with complete creative freedom. Our hope is to provide an environment encouraging to the individual’s creative and artistic sensibilities.  This majestic rural mountain setting amidst a working farm that includes grassfed cattle, sheep, horses, goats, and chickens provides an inspiring sense of time and place.

The artists will work out of a naturally lit, second floor loft above a working livestock barn with breathtaking, panoramic views of the flowing valleys and stream below and the mountains around. Artists have complete access to the farm including all the land, beaver streams, livestock, farmhands, and materials that have accumulated on the land over the years, as well as the Appalachian Trail and Jefferson National Forest. Artists are encouraged as they wish to actively engage in the farm life that so genuinely defines who we are as Americans.  They will have opportunities to interact with and introduce their art form to local K-12 children as well as writers-in-residence from regional higher educational institutions over two to three days.

Making Dementia Friendly Communities The New Normal (Forbes)

FORBES | Alzheimer’s may be one of the most frightening health challenges today. Over five million Americans—one in eight age 65 and older and one in three age 85 and older—are living with dementia and we don’t yet have a treatment that can prevent or cure the disease. But these men and women are not alone. They are supported by 15.5 million family members and friends, and there are things we can all do to ease their burden.

In 2015, Alzheimer’s and other dementias will cost the nation $226 billion, with half of the costs borne by Medicare. Last year caregivers provided 17.9 billion hours of unpaid care, averaging 22 hours per week and valued at $217.7 billion annually; $34 billion annually is lost in revenue/productivity due to caregiving responsibilities. Unless something is done, in 2050, Alzheimer’s is projected to cost up to $1.1 trillion (in 2015 dollars). This is both financially and socially unsustainable.

In May, I challenged the new Presidential candidates to make a War on Alzheimer’s a top health care priority, and I know that researchers are hard at work developing new drugs to treat, prevent, and slow the disease. We need increased federal and private sector funding to enable innovation in the field of cognitive disorders, and new initiatives in Washington are moving forward.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2015/07/31/making-dementia-friendly-communities-the-new-normal/#1809bf1316b0

Podcast: Medicare and Medicaid at 50

Fifty years after Medicare and Medicaid were created, healthcare in America is still rapidly evolving. Carefully observing where we’ve been will help inform where we are going, so in today’s special issue of the Journal of the American Medical Association (JAMA) Kaiser Family Foundation President and CEO Drew Altman and I look at the Perspectives of Beneficiaries, Health Care Professionals and Institutions, and Policy Makers over the past half decade. The full text of the JAMA article is available by subscription only, but Drew and I also discussed the piece and our findings with Dr. Preeti Malani, Associate Editor, The JAMA Network in a freely available podcast.

 

Telemedicine and the Tools of Care

At the Spotlight Health event at the Aspen Ideas Festival last month I had the privledge of speaking on a panel moderated by Steve Clemons. We focused on the Supreme Court’s decision on the Affordable Care Act and costs of healthcare in America. It prompted some thoughts about my dad’s medical practice many  years ago. Dad had a DeSoto, and that car took him to many house calls over the years. Of course a DeSoto isn’t the practice of medicine. It was simply a tool Dad used to meet his patients where they were. I think telemedicine is the same kind of tool, one that makes care infinitely better for patients.

More at the Health Affairs Blog

Three Challenges Impacting The Future Of Obamacare (Forbes)

FORBES | Last week’s Supreme Court decision puts the Affordable Care Act firmly and securely into institutional and cultural permanence.  It still bears flaws due to its imperfect construction and divisive passage, but after five years, the new certainty for insurance markets will permit a maturity of risk pools, and the more direct and predictable provider reimbursement moves toward eliminating much of the inefficient cost shifting that obscures pricing and value transparency.

The ACA will need to clear a number of hurdles before it can achieve long-term success.  Legislative action will likely be needed to fix some of these shortcomings.  The reality is that the new President, Republican or Democrat, will be charged to do what President Obama has failed to do: actively bring the parties to the same table to fix what is broken in the law in order to bring affordable care to those in need.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2015/07/03/three-challenges-impacting-the-future-of-obamacare/#d99897c7b09f

Compensating for End of Life Conversations Is Important First Step

The Obama Administration is soon scheduled to release the proposed 2016 Medicare Physician Fee Schedule, which determines what and how much providers can bill for health care services. The administration can choose to compensate providers for offering voluntary counseling services to patients and families about end-of-life care options, and I strongly urge it to do so. It is an important first step.

As a heart surgeon, I have seen countless instances where patients near the end of life undergo aggressive medical interventions in order to prolong the inevitable. Yet most people, when asked, say they would want to spend their final days at home, without pain, comfortable with family and friends, and not hooked up to multiple machines in the hospital. We simply must do better and help ensure that a patient receives the health care that they want near the end of their life.

Americans are living longer than ever, and children are increasingly helping aging parents and grandparents manage multiple chronic conditions. This new reality has more and more people thinking about new models of end of life care, and has sparked a national conversation about how we can all live well, until the very end.

I’m encouraged to see that this important issue has reached the halls of Congress, where legislators in both the House and Senate are pursuing bipartisan ways to improve the care patients receive near the end of life. One policy option being considered is reimbursing providers for discussing treatment options and care preferences with patients and their families. I wholeheartedly support this idea, and there is an immediate opportunity to make it happen.

Read more at Forbes.

 

Advancing transparency in healthcare: A call to action (The Hill)

THE HILL | “How much does health care cost?” It isn’t an easy question to answer. Your yearly check-up, a colonoscopy, or trip to the emergency room doesn’t typically come with an obvious price tag. And it isn’t just finding out the price of a service or product that’s difficult; it’s also difficult to determine the quality of the care provided. In fact, Princeton Economics professor Uwe Reinhardt has likened “shopping” for healthcare to trying to find a purple sweater in a department store while blindfolded.

Greater transparency and access to information about the prices and quality of health care would be beneficial to consumers, providers, policymakers, and stakeholders alike. To achieve the Triple Aim of better population health, an improved health care system, and a lower rate of cost and spending growth, we must take the blindfold off.

Read more in The Hill: http://thehill.com/opinion/op-ed/244714-advancing-transparency-in-healthcare-a-call-to-action

Cuba’s Most Valuable Export

If you had to guess, would you guess sugar? Cigars? What about doctors and nurses?

The Cuban government reportedly earns $8 billion a year in revenues from professional services carried out by its doctors and nurses, with some 37,000 Cuban nationals currently working in 77 countries. The socialist regime allows the government to collect a portion of the incomes earned by Cuban workers abroad.

For example, in 2013 Cuba inked a deal with the Brazilian Health Ministry to send 4,000 Cuban doctors to underserved regions of Brazil by the end of the year – worth as much as $270 million a year to the Castro government. By the end of 2014, Brazil’s Mais Medicos program, meaning “More Doctors,” had brought in 14,462 health professionals – 11,429 of which came from Cuba.

Over the past 50 years, Cuba consistently used the export of its doctors as a powerful and far-reaching tool of health diplomacy. The island nation has built good will and improved its global standing with emerging countries around the world during its years of isolation. It sent its first doctors overseas as far back as 1963, and to date has sent physicians to over 100 countries.

More today at Forbes.

 

The Worst Kept Secret in Healthcare

For many of our health problems, the solutions are not a secret: eat well, move, make healthy choices. Of course sometimes that is easier said than done. Our physical and social environments–where we live, what kind of emotional support we have, our access to fresh food and healthcare–determine more of our healthcare than what our doctors prescribe. If we want to be serious about improving wellness, we must get serious about preventing health problems before they start.

The Bipartisan Policy Center launched a report last week looking at the best ways to incorporate prevention into our lives. Alice Rivlin and I announced the study:

In order to refocus on wellness, over the past year, the Bipartisan Policy Center convened a Prevention Task Force to determine how to change our nation’s health conversation so we are taking actions to promote wellness rather than focusing solely on providing reactive medical treatment after a person gets sick.

Today, the task force is releasing recommendations for achieving this goal, which include better connecting clinical providers and community organizations, and creating incentives to make preventive care a priority. As senior advisers to the task force, we strongly endorse the two-part framework today’s report outlines to more fully integrate prevention into the nation’s approach to health and health care.

Read more at US News and World Report.

A Charge to Press Forward on Alzheimer’s Research

Heart transplantation revolutionized healthcare in a way that’s hard to comprehend. What was once a death sentence–sometimes without warning–became surmountable. People got their lives back. We need the same revolution in Alzheimer’s research. The answer will be different; transplant can’t solve this problem. But just because the way forward is unclear, we can’t stop pushing forward. I challenge the 2016 Presidential hopefuls to keep Alzheimer’s disease at the forefront of research. We have so much to lose.

One in five Americans are obese. One in four has a risk of dying from cancer in their lifetime. But one in three that live beyond 65 will die with Alzheimer’s or another type of dementia. All these ailments have significant health impacts. The difference? We have solutions to treat obesity and can cure some cancers.

Alzheimer’s is the only disease among the top 10 causes of death in America that cannot be prevented, cured, or even slowed.

Read more at Forbes.

Why Texas is missing out on the future of medicine

If you’ve read much of anything here, you know that I am a big fan of health technologies to improve care and create a sustainable healthcare system. I think it’s essential that we choose the right technologies that will serve patients, and I firmly believe telemedicine is one of those solutions (so much so that I joined the board of advisors for Teledoc, a telemedicine company).

But across the country, thousands of people are desperate for accessible and affordable healthcare. For far too many of them, their only option—even for non-emergency care—is a $1,500 visit to the emergency room.

For example, 200 counties in Texas are considered medically underserved with 16 counties having just one primary care doctor and 27 counties having none. These citizens have nowhere to turn.

The good news is that a solution exists. It is called telehealth and has been increasing in use across the country over the last decade. However, a decision last month by the Texas State Medical Board will sharply restrict access for Texans by requiring in-person visits before you are allowed to use telemedicine. Previously, the board required doctors to establish a relationship with patients before giving a diagnosis or prescribing drugs, but its April 10 decision narrowed rules to state that “questions and answers exchanged through email, electronic text, or chat or telephonic evaluation or consultation with a patient” are not enough to establish a doctor-patient relationship.

Read more at Fortune Magazine.

Killing the superbug: A call for Congressional action

When Alexander Flemming accepted his Nobel Prize for the discovery of penicillin, he issued a warning to future generations: his miracle drug—responsible for saving millions of lives—could one day be useless.

“It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them,” Flemming said. “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”

Seventy years later, Flemming’s nightmare scenario is coming true.

The U.S. Centers for Disease Control and Prevention (CDC) reports drug-resistant bacteria infect more than 2 million people nationwide, killing 23,000 annually. In addition to lives lost, infections cost $20 billion in additional direct healthcare costs, up to $35 billion in lost worker productivity, and $8 billion in extra hospital days. Given the knowledge and resources available to us, this is unacceptable. ​

We need a multi-pronged strategy to attack antibiotic resistance.

Read more at The Hill.

 

The Promises and Challenges of Precision Medicine

Only 15% of our health is determined by the healthcare we receive, the rest are the social determinants of health: environment, economic stability, access to care, education and community resources. Paying attention to that 85% is imperative, and precision medicine aims to take targeted genetic and molecular information and consider it in tandem with data about our environmental exposures and lifestyle choices. Integration of the smallest building blocks with the macro environment is exactly the direction in which medicine should be moving, and President Obama’s Precision Medicine Initiative is a needed step forward. But getting there will take some new habits, a new funding model and new technologies.

Read more at Morning Consult.

MCC: Foreign aid in action

Most people are surprised when they learn how little we actually spend on foreign aid. But as we know, global health issues know no boundaries. That’s why it is so very important that spend our foreign aid  money wisely. I’m at The Hill today discussing a model that I think does a great job.

Most Americans agree foreign aid helps improve our nation’s image globally and protects Americans’ health by preventing the spread of diseases.

In fact, it does more than that. Our comparatively small investment in foreign aid enhances national security by stabilizing weak states and helping to fight the causes of terrorism. It encourages economic development, opening new global markets for American business. And it supports our humanitarian goals and values, advancing peace and democracy.

Considering the benefits, the surprising truth is that the U.S. spends less than 1 percent of our budget on foreign aid, and that amount has been dwindling due to sequestration. At a time when we are faced with global unrest and budget cuts, we must make strategic investments in foreign aid programs that have a record of success.

The Millennium Challenge Corporation (MCC) is a prime example.

Read more at The Hillhttp://thehill.com/opinion/op-ed/240550-mcc-foreign-aid-in-action

A Conversation on Haiti

Last week, Hope Through Healing Hands and I had the honor of welcoming the former Prime Minister of Haiti, Laurent Lamothe, to Nashville. I’ve been to Haiti many times, and was thrilled to hear the latest updates on the quantifiable successes in Haiti over the last few years, namely in providing housing for those displaced by the earthquake and putting children back in school.

Jenny Eaton Dyer, Hope Through Healings Hands’ Executive Director, has all the details about the event on the HTHH blog.

 

It’s National Health Care Decisions Day: Who will you designate?

End-of-life planning is an important part of healthcare. It’s a refrain I’ve been repeating. I’ve called for changes in care models, payment schemes, and physician education. But all of the needed changes aren’t at the system level. There are steps that every individual must take as well.

Along with Gary Dodd, a palliative care nurse with years of experience, I’m at Fox News this morning talking about a conversation you can have to take to take control of your end-of-life care.

We know that at least 90% percent of Americans have heard of a living will, but still only about one third have one. Even among nursing home residents, only 65% have some type of Advanced Care planning documentation. This is not news in the health care community, but if we want to change these numbers we have to ask “why?”

Read more at Fox News.

 

 

Where Health And Environment Converge

An area of healthcare that has recently become very important to me is community transformation projects focusing on the social determinants of health: environment, economic stability, access to care, education, and community resources. Only 15% of our health is determined by the healthcare we receive, so looking at the other 85% is not only imperative, it is just good math.

At Forbes, I look at where health and environment converge, not just in our own backyards, but globally as well.

This past March, I met Luis Giuria at the Building a Healthier Future for America Summit.  He was smiling ear to ear when he and his beautiful family took the stage to talk about what an impact his environment has had on his life.

Luis was born in the South Bronx, and grew up eating inexpensive junk food because it was the easy, affordable option.  His hometown lacked safe playgrounds and he never learned the importance of exercise.  By age 27, he weighed nearly 400 pounds, had trouble sleeping, finding clothes that fit, and was prone to injury.  To be a good father and husband, and good to himself, he knew he needed a major life change.  That’s when he discovered Arbor House, an innovative low-income housing project in the Bronx that was designed to encourage physical activity.  Arbor House boasts indoor-outdoor gyms, play areas for children, a rooftop farm that provides fresh produce and clean air, and abnormally slow elevators that encourage residents to take the stairs.  Luis and his family moved into Arbor House, and it’s helped the whole family embrace healthy living. Luis has lost 200 pounds thanks to his new environment and other healthy lifestyle choices.

His experience shows where health and environment converge. Most people would still list exercise, diet, or access to affordable healthcare as the key determinant of health—and those are all important. But the most important factor is one that influences everything else: your zip code.

Read more at Forbes: http://www.forbes.com/sites/billfrist/2015/04/15/where-health-and-environment-converge/