Gary Mendell choked back the emotion as he stood before the crowd at the Clinton Health Matters Conference, held recently in La Quinta, California. He told the story of his 25-year-old son, Brian, who hung himself after years of battling ADD and drug addiction. “I wish I could tell you that the anguish dulls with time. But it doesn’t. Knowing that my son died of a disease that is preventable but we don’t prevent it. It’s treatable but we don’t treat.”
Mendell is now fighting in Brian’s honor – and announced the formation of a new national nonprofit to improve prevention and treatment of addiction. His commitment was one of 31 pledges made at the conference – aimed at getting individuals and communities to take action to improve health and bring down costs.
In his opening remarks, Former President Bill Clinton said his foundation has worked with dozens of companies and non-profits to make best-practices a reality. “Today there will be pledges that amount to 100 million dollars that will help more than 25 million people across America.”
Actress and singer Barbra Streisand announced a two million dollar donation to the Barbra Streisand Women’s Heart Center at Cedars-Sinai Medical Center. Walmart is rolling out a program to put a “healthier choice” icon on certain foods and they are working with suppliers to eliminate trans fats and cut excess sugar and sodium in packaged foods.
Health insurance giant Humana is launching a program called Humana Vitality that rewards people for losing weight, getting active and eating better.
General Electric is putting six million dollars into a “Healthymagination” private/public health program that gives people online tools to improve their health. GE has also pledged to take nationwide a program that they started in Cincinnati, Ohio. There, GE worked with hospitals, nonprofits and government to improve coordination in patient care and encourage hospitals to publish what they charge for various procedures. GE says the program has already saved the region 200 million in emergency room costs over the past two years.
Tenet Healthcare, which owns Desert Regional Medical Center in Palm Springs and JFK Hospital in Indio, is hiring more case workers to follow-up with patients after they are discharged, in an effort to keep them from being readmitted.
One overarching theme emerged again and again: regular people have the power to fix most of what ails the health-care system – and the economy – just by embracing a healthier lifestyle.
Former President Clinton opened the conference with a warning about obesity, heart disease and diabetes, “About 70 percent of adults have already developed a preventable chronic disease which contributes to rising health care costs and reduces workplace productivity and (leads to) premature death. He cited a Columbia University study that found the cost of treating preventable diseases will rise by $48-66 billion a year if current trends continue.
Dr. Donald Berwick, former Administrator for Medicare and Medicaid, said genetics determine 50 percent of a person’s overall health. Health care (or lack thereof) is only 10 percent, and a person’s lifestyle makes up the rest.
“Forty percent of our health depends on our choices: What we eat, how much we walk, the risks we take, the substance abuse, the unprotected sex, the guns and violence in our streets, the pollutants in our air, the seatbelts and and bike helmets that we use or don’t use,” Berwick said. “That is very good news. That means that we can do wrong and what we do well largely into our own hands.”
Renowned heart health expert Dr. Dean Ornish said three-quarters of U.S. health-care costs are related to chronic disease. Ornish said he’s pleased that Medicare now covers his nutrition program and emphasized the benefits of a better diet and more exercise. “These approaches can not only help combat most chronic diseases but it can actually reverse them,” Ornish said. “They can even turn on good genes that protect us, and turn off harmful genes.”
Ornish added, “We need to address the more fundamental causes of why people get sick. We will find that we can have better healthcare available for more people for lower costs.”
President Clinton said that we need to give people incentives to make healthier choices rather than continuing to pound home the message that overeating, a sedentary lifestyle, drugs and smoking can kill. “We have to create positive incentives,” Clinton said, “not just threats about death or injury.”
The discussion also centered on improving transparency in medical care while protecting privacy. President Clinton lauded a unique law in Pennsylvania that requires hospitals to make public the prices they charge for various procedures and their success rates. Dr. Berwick called for a similar, national database and said that the Affordable Care Act (ACA) gives the government the authority to set it up, but Congress needs to mandate that Medicaid participate.
The experts also lamented the massive shortage of primary care doctors. They suggested that the health care system be overhauled to make careers in family practice more attractive to medical students.
Dr. Ornish suggested a new approach, where multiple specialists treat patients as a team. “The managed care approach … is forcing doctors to see more patients, in less time for less income, driving the best doctors out of medicine. We can create a new paradigm which is based on the quality of care and not just more care.”
Dr. Berwick agreed that the current system encourages hospitals to over-treat patients. “They’ve been conditioned by decades by a broken volume-based healthcare payment system to maintain business plans that depend on doing more, not less.” He says the ACA is a step in the right direction. “There are new emphases on payment for chronic care, coordination and outcomes.”
Technology also figured in plans to improve health care outcomes.
Dr. Peter Tippett, chief medical officer and vice president of Verizon’s Innovation Incubator vowed to facilitate health care transformation with technology and mobile apps. For example, Verizon now makes a watch that works like On-Star – you push a button and it makes a call to a relative or to emergency services. The watch also has a GPS tracking device that helps find wandering Alzheimer’s patients. And it can measure an elderly person’s movements and send a message to family if he or she doesn’t move for an extended period of time and may have fallen.
ABC News Medical Director Dr. Nancy Snyderman challenged the group to help more seniors age in place – and be monitored in their homes so they spend less time in expensive hospitals and nursing homes. GE announced a joint venture with Intel to offer remote patient monitoring, so doctors can check on a patient without an office visit. GE is also working on a refrigerator that can dispense medicine in the correct amounts.
Many experts also called for hospitals, insurance companies and government agencies to make databases compatible. Tippett lamented, “Almost no sharing actually happens. If we could get health information technology in healthcare to be similar to what they use in banking, everybody would be dramatically healthier…700 billion dollars in savings are available if we could only leverage the kind of information that we already have in meaningful ways.”
Berwick noted that seniors in private Medicare programs get information every month on what drugs they take and what it costs. “When they know that, they are incredible buyers and seekers of value.
The broader we get that idea (of transparency) in the system the more powerful it’s going to be. “
The first Health Matters conference led to the creation of the Clinton Health Matters Initiative, which is a seven year effort to improve health in two regions: Little Rock, Arkansas and the Coachella Valley.
The Coachella Valley, which became a part of the Health Matters Initiative late last year, is already implementing plans to improve health.
Carolyn Caldwell, CEO of Desert Regional Medical Center in Palm Springs said the hospital is revamping their cafeteria food to offer more healthy choices. The medical center is also partnering with the city of Palm Springs on a $25,000 fundraiser for the Clinton Health Matters Initiative, Caldwell said.
The Desert Healthcare Foundation (DHF) has funded a new manager to work with all three local school districts to combat childhood obesity. DHF Vice President Kay Hazen said, “The realization that we were raising a generation of XL children and our kids were becoming the first generation who might not live as long as their parents spurred us into action.”
A panel of local leaders also discussed ways to optimize the environment to encourage people to exercise more and develop stronger social ties. That involves cleaning up graffiti, building more sidewalks and parks, and helping people form walking groups and neighborhood watch programs with social networks. The City of Coachella has incorporated health concerns into its general plan, so any future development will include more space for recreation.
In December the CHMI gathered local leaders to write a blueprint for further action in the Coachella Valley. The plan will be released in early February.
Note. This article was updated Feb. 8 to correct the identification of Dr. Peter Tippett.