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News Wrap: New York City declares public health emergency over measles outbreak

JUDY WOODRUFF: Attorney General William Barr says he will be able to release some of special counsel Robert Mueller’s Russia report within a week. He made clear that part of it, maybe a large part, will be blanked out. Democrats at a congressional hearing questioned Barr about the conclusions he reached last month from Mueller’s nearly 400-page report.
Looking ahead, Barr said he would again rely on his own discretion to make as much of the report public as he is able. We will have highlights of Barr’s testimony right after the news summary. Treasury Secretary Steve Mnuchin acknowledged today that White House lawyers had been in touch with his department following House Democrats’ request for six years of President Trump’s tax returns.
Mnuchin told a House panel he has not personally spoken with the president about the matter, and plans to — quote — “follow the law” with respect to the Democrats’ request. Mr. Trump has repeatedly said that he is under audit, and is unable to release his returns. New York City has declared a public health emergency, in an effort to combat a growing measles outbreak.
City health officials say there have been 285 confirmed measles cases in Brooklyn and Queens since September. Most were members of the Orthodox Jewish community. Mayor Bill de Blasio said that they have also ordered mandatory measles vaccinations for unvaccinated residents in the affected areas who may have been exposed to the virus. BILL DE BLASIO (D), Mayor of New York: The only way to stop this outbreak is to ensure that those who have not been vaccinated get the vaccine.
It’s crucial for people to understand that the measles vaccine works. It is safe. It is effective. It is time-tested. JUDY WOODRUFF: Residents who defy the new vaccination order could be fined $1,000. President Trump insisted today that he is not looking to reinstate the policy of child separation at the U.S. southern border. Mr. Trump said his predecessor is to blame for separating migrant children from their families. He spoke during a meeting with the visiting Egyptian president.
DONALD TRUMP, President of the United States: President Obama had child separation. Take a look. The press knows it. You know it. We all know it. I didn’t have — I’m the one that stopped it. President Obama had child separation. Now, I will tell you something.
Once you don’t have it, that’s why you see many more people coming. JUDY WOODRUFF: More than 2,700 children were separated from their parents at the Mexican border under the Trump administration’s zero tolerance policy, before it was reversed last year. Child separations did occur under the Obama administration, but on a much less frequent basis, and primarily in cases of child endangerment.
President Trump also dismissed claims that he is cleaning house at the Department of Homeland Security, after its secretary, Kirstjen Nielsen, announced her resignation on Sunday. The U.S. State Department has barred 16 Saudis from entering the U.S. because of their role in the murder of journalist Jamal Khashoggi. The list includes a former close adviser to the Saudi crown prince believed to have led the hit squad that killed Khashoggi in the Saudi Consulate in Turkey in October.
But it doesn’t name Saudi Crown Prince Mohammed bin Salman himself. The individuals’ families are also now banned from U.S. entry. In Israel, the national election that has been under way all this day is still too close to call, with both sides claiming victory tonight. Prime Minister Benjamin Netanyahu’s right-wing Likud Party is neck and neck with former military chief Benny Gantz’s centrist opposition Blue and White Party. We will have an on-the-ground report from Tel Aviv later in the program.
Britain’s Prime Minister Theresa May is trying to persuade European Union leaders to delay Brexit once again, on the eve of their emergency summit in Brussels. May met with Germany’s Chancellor Angela Merkel in Berlin, and then she traveled on to Paris for talks with French President Emmanuel Macron.
Meanwhile, in Luxembourg, the E.U.’s chief Brexit negotiator insisted that progress must be made in the British Parliament if Brexit is delayed once more. MICHEL BARNIER, European Union Chief Brexit Negotiator (through translator): This extension needs to be useful.
It needs to be useful to give more time, if needed, to make a success of the political process that I have talked about, to succeed in building this majority. JUDY WOODRUFF: The 27 E.U. member states will decide tomorrow whether or not to approve another extension to delay Brexit. If it is not approved, Britain will leave the E.U. without a deal on Friday.
We will take a look at what’s at stake a little later in the program. Back in this country, 16 parents in the college admissions bribery scandal are now facing a new money laundering charge. They include actress Lori Loughlin, who federal prosecutors had already indicted last month on mail fraud.
She is accused of paying $500,000 to get her two daughters into the University of Southern California as members of the crew team. California Congressman Eric Swalwell has become the latest Democrat to enter the 20 presidential race.
The 38-year-old four-term representative has been an outspoken critic of President Trump during the Russia probe. Swalwell says that his campaign will focus on gun control in the wake of last year’s mass shooting at a high school in Parkland, Florida.
Stocks fell on Wall Street today, led by losses in the industrial sector. The Dow Jones industrial average shed 190 points to close at 26150. The Nasdaq fell 44 points, and the S&P 500 slipped 17. And the Virginia Cavaliers are basking in their first NCAA men’s college basketball championship title.
The streets of Charlottesville erupted last night after the University of Virginia beat out Texas Tech 85-77 in overtime. It was an epic comeback in a year after Virginia became the first number one seed to ever lose to a number 16 team in the first round.
We will have more on their championship win at the end of our program. Still to come on the “NewsHour”: the attorney general faces tough questions from Congress about the Mueller report; Israelis decide their future, as they head to the polls to choose their next prime minister; civil rights advocates and tech representatives testify on the dramatic rise of hate speech through social media; and much more.

News in Review: August 2019

Thanks for joining us today, I’m Shantel Booth, here’s your Lakeland News in Review. On the journey to bring Lakeland and Spectrum Health together through integration, team members in certain areas have started collaboration, including finance, supply chain, implementation strategy, and human resources. Recently, a Workday team kicked off their collaboration, as Spectrum Health works to implement the program for everyone and build on our experience previously implementing Workday.
As progress is made on the integration, more updates will be shared. Remember to send us your success stories, pictures from meetings with Spectrum Health colleagues, or examples of partnership at corporatecommunications@lakelandhealth.org Progress continues on the Lakeland Medical Center Pavilion, with the completion of some clinical areas scheduled for late fall.
The Atrium, formerly The Atrium Café, is slated to reopen in early fall, featuring all new food stations and a viewing window overlooking Pavilion construction. Recent progress also includes the delivery of an MRI machine and the addition of 32 parking spots in the new emergency department lot.
Three operating rooms located at the Center for Outpatient Services will move to the Lakeland Medical Center Pavilion this fall. All other services currently offered at the Center for Outpatient Services will remain in operation.
Stay up to date with all of the latest Pavilion news at Pulse NewsLink. Spectrum Health Lakeland has added a new technology for men undergoing radiation therapy for prostate cancer. SpaceOAR hydrogel is a protective spacer clinically proven to reduce the risk of side effects during and after radiation treatment.
Radiation oncologist, Dr. Peter Paximadis, said, “Radiation therapy is extremely effective in targeting and treating prostate cancer, but with any procedure there are potential side effects which can greatly impact a patient’s quality of life.
SpaceOAR hydrogel allows us to better target the cancerous cells while preserving healthy tissue to help maintain quality og life” To learn more, call 269.983.8888 or visit spectrumhealthlakeland.org/spaceOAR On Thursday, October 3, join racial justice educator and award-winning author Debby Irving for a powerful conversation unpacking systemic racism and the pitfalls of white privilege.
The event is as part of the Community Grand Rounds speaker series, a collaborative effort between Spectrum Health Lakeland and the Todman Family Foundation. Community Grand Rounds will also host a second event in the month of October.
On Tuesday, October 22, join Dr. Arline Geronimus for an afternoon to stimulate thought and raise awareness about how biological and social sciences can influence and promote health equity. For more information or to register, visit spectrumhealthlakeland.org/cgrevents A selection of Spectrum Health Lakeland logowear is now available at a new online store.
Shop the collection of jackets and polo shirts anytime it’s convenient for you at lakeland.companyestore.biz Ever wish you could go on a real treasure hunt? At Lakeland, we want to help inspire our community to live a healthier lifestyle through our Get Fit in the Mitt series and share about local, affordable, and unique exercise activities.
In the latest episode, watch as the Get Fit in the Mitt team goes geocaching and learn how you can get involved and find some hidden treasures, and healthy habits, along the way.
Inside the caches, you find a logbook that somebody put in there, so that you can sign your name in there or your username, and then sometimes also you’ll find treasures in there for kids, like little toys, and what you do is exchange those toys out.
Watch the full video at getfitinthemitt.org I’m Shantel Booth, and that’s your Lakeland News in Review.

The coronavirus shows how badly China handles public health crises

This hospital was built in only 10 days in Wuhan, China, the epicenter of a new coronavirus that has become a global emergency. This is a livestream broadcast by the government for the whole world to see. Within the first few weeks, there were more confirmed cases of the coronavirus than the total number of SARS cases in 2003.
China put over 50 million people under an effective quarantine, the largest in human history. This type of drastic, almost draconian measure is typical of China’s strong government. But for about a month after the first confirmed case, authorities kept the public in the dark, in particular, about how contagious the virus is. The mayor of Wuhan even apologized.
Critical information isn’t communicated in time between the local and the central government or from governments to the people. It’s a mistake China has made over and over again. With SARS in 2003 and, most recently, the African swine fever in 2019.
So why do they keep making it? China is getting a lot of praise for reacting faster this time than it did during the SARS epidemic. In many ways, that is true. For example, Chinese scientists swiftly deconstructed the genetic sequence of the virus and developed test kits two weeks after. China also got the World Health Organization involved a lot quicker.
– We were very impressed with the level of engagement of the Chinese government at all levels. – The mobilization of the entire state to deal with a single problem is pretty remarkable. That’s John Yasuda. He studies China’s governance. He says the state has always been good at reacting to a crisis once they recognize it.
– But the same state, they’re not very good at dealing with emerging problems. This is apparent in almost every public health crisis in China in recent memory. During the first three months of SARS, China was a black box.
The government gagged reporters, detained whistleblowers, and refused to share information with the public or international authorities. By the time SARS was reported to the World Health Organization, it had already been spreading for at least three months, and likely reached thousands of people.
– The more people know during a crisis, the better prepared they will be. You need to build trust at this point. This exact dynamic happened again in 2018, when a deadly pig virus called African swine fever began wiping out hogs all over the country. Local governments minimized its severity, refused to confirm cases, and failed to update the public.
– Once SARS got dealt with and it kind of faded from memory, you had other major policy issues, like ASF, not realizing that, of course, that this is part and parcel of the same fundamental problem. And that problem played out again in Wuhan.
The government documented the first case of a “new, mysterious pneumonia” on December 8. A month later, the local government briefly detained eight people, including multiple doctors, for spreading rumors about a SARS-like virus.
While rumors continued to circulate, the city organized a Lunar New Year feast for 40,000 families. This whole time, the city repeatedly ensured that the virus was “preventable, controllable,” and there was no evidence of human-to-human transmission. We spoke with a Chinese journalist who’s been reporting on how underprepared the city was. He asked not to be named.
– By early January, many doctors already knew the virus could be transmitted human to human, but there was no official announcement. The public didn’t know for nearly a month the epidemic had been spreading. After the virus spread to other countries, international pressure began to mount, but the official number of confirmed cases in China stalled for days.
Then the central government stepped in. In the next few days, the official number of cases exploded. Once the central government intervened, Wuhan went from this… to this… within five days. Hospitals went up, resources were mobilized, and information started to flow more freely. But the virus had already spread to the rest of China.
– The question is why did we get to the same point again? The answer lies in how the Chinese government bureaucracy is set up. – Look at the central health authorities. I do believe they have strong incentives to be transparent. But the local governments, they are also concerned by social political stability.
That’s Huang Yanzhong, an expert on China’s public health policy. He says, ultimately, local governments are the ones implementing policies, and they operate under a mandate of putting social stability above everything else. There’s actually a term for it: weiwen.
This creates a strong incentive for local officials to minimize bad news and try to solve emerging problems locally. That means doing whatever it takes, silencing whistleblowers, scrubbing social media to downplay problems for their superiors. This plays out until the issue becomes clearly uncontainable. Then a different dynamic kicks in.
– Discretion moves away from the local level and moves up the hierarchy, which is generally more problematic because, especially in fast-moving crises situations like this, you want people on the ground with the knowledge to be able to make those decisions.
At this point, only high-level officials have the authorization to disclose politically sensitive information, creating more barriers for people on the ground. This type of inflexible communication is partly why China keeps struggling to contain public health crises.
– Unless there is a significant and fundamental change in the incentive structure of the bureaucrats, we are likely going to see this pattern of cover- up and inaction being repeated again and again. In the case of Wuhan, information vacuum ended up causing large-scale instability… in hospitals… on the streets… in China… and around the world.

State of the Department Address 2020

Ladies and gentlemen the Deputy Secretary of the U.S. Department of Health and Human Services, Eric Hargan. Good afternoon, everyone, and thank you all or joining us here today. Today is a great day to celebrate the accomplishments of our department of the past year, and I hope you all look forward to hearing Secretary Azar run through some of our high notes, of which there are many.
Before he does so, I wanted to lay out some of the many external recognitions that our Department has received for our work over the past year. Which as I said there are indeed many.
First, as many of you know, HHS was ranked the best cabinet department at which to work in 2019, for the third year in a row that we have received this award. (Applause) Our employee engagement score ticked up slightly, while overall participation used to determine in the survey used to determine this, the Federal Employee Viewpoint Survey, rose dramatically, from 57 percent to 72 percent.
Thank you to those of you who responded to my many all staff emails encouraging you to take the survey. We’ve distributed that data throughout the department for use to improve HHS as a workplace even more.
Notably, one tool that NIH developed to analyze FEVS results much more rapidly is now in use across HHS and has now been recommended across the government by OPM, as part of the President’s Management Agenda, to improve use of employee feedback.
Not only are we helping ourselves, we are helping the entire government. Also on our human resources front, I am happy to say that over the last year there has been a 73 day reduction in the average hiring time. Now as to the fact that we could bring down the average hiring process by 73 days shows we had a lot of room for improvement, and we are still working on this.
Keep tuned in on this. Large numbers of HHS employees also received individual awards to recognize their accomplishments in various fields. This included 25 winners of OMB’s Gears of Government Awards, which recognize individuals and teams that have delivered key outcomes in terms of mission results, customer service, and accountable stewardship.
And of those 25, 3 were awarded at the highest level possible, the Presidential Level. We are a very big department, but having a $1.3 trillion budget doesn’t make it any easier to win management awards, but these award winners were and I wanted to let you know it took place in a ceremony at OMB which isn’t necessarily the largest ability to get the message out.
For those of us at HHS I wanted to recognize them.
1. Dr. Kathleen Uhl from FDA who pioneered the transformation of generic drug regulation, improving availability and acceptance of generics that have the same high quality as brand-name counterparts. In fiscal year 2017, FDA approved 971 generic drug applications of which 19 percent were for first generics, paving the way to make these products more affordable for patients and we have that result already.
2. Comprised of Kenneth Kraft, Dustin Litwiler, Jess Weisz, Cassandra Newsome, and Roman Kulbashnya, Team Inspector General led an interdisciplinary and interagency effort, leveraging existing IT resources and combining disparate agency data, to identify and exclude healthcare providers convicted of opioid abuse, sexual assault, rape, and manslaughter from participating in federal healthcare programs.
This initiative yielded hundreds of measurable exclusion referrals that directly advanced the HHS Office of Inspector General’s mission to protect taxpayer-funded healthcare programs like Medicare and vulnerable beneficiaries from abuse.
3. Last but not least, Dr. Emily Haas was recognized for her research work on mine safety. As you may know the mission of the Mining Program at the National Institute for Occupational Safety and Health, or NIOSH, which is part of the CDC, is to create these outcomes through relevant research and impactful solutions. Dr. Emily Haas of NIOSH made major advancements in its mission by improving how to measure safety culture in the mining industry and how to develop and implement industry-wide strategies to improve workers’ safety.
We also had a winner of a Sammie, a Service to America Medal, which are known as the Oscars of Government Service. Secretary Azar personally presented the award, for accomplishment in Science and Environment, to Dr. Daniel Jernigan of the CDC. It’s also worth noting that we had a finalist for the Sammies, Dr. W. Marston Linehan, from the National Cancer Institute he was a finalist in the same category as Dr. Jernigan.
There’s nothing like a little friendly competition from your coworkers! Congratulations to both of them. Finally, in recognition of all the hard work that staff from across HHS put into the launch of President Trump’s historic kidney health initiative this past year, the American Society of Nephrology awarded their President’s Medal to eleven HHS staff, including from the CTO’s office, CMS, OASH, and FDA and even the immediate Office of the Secretary.
In other news we are also the #1 Department for regulatory reform for now two years in a row, leading to relief for health providers and a greater ability to dedicate resources to care rather than paperwork, where it is not necessary. Thank you to everyone who has been a part of this effort. Also I am happy to announce that we have graduated five out of the ten ReImagine initiatives into permanent homes at HHS, they are:
1. Bringing common sense to food safety at FDA.
2. Aim for independence in Human Services.
3. Maximize talent for HR.
4. Accelerating Clinical Innovation.
5. Optimizing Regional Performance.
That has been a lot of work. Now, without further ado, I want to introduce Secretary Azar. But, first, to set things up for his speech, we’re going to show you a new video we’ve developed that you’ll see being used across the department in the near future which shows the important contributions all of you make to fulfilling our mission to improve the health and well-being of all Americans. Thank you again for your hard work over the last year which is increasingly being recognized across the government and enjoy the video and the speech.
Thank you. The Department of Health and Human Services is many things: We are more than 80,000 employees, in more than 2,000 locations across the country and around the world. We are some of the world’s finest scientists, physicians, researchers, and public servants.
We are a big, busy, dedicated team. Yet all of us share one thing in common: our mission, to protect and enhance the health and well-being of every American. Our mission means reforming, strengthening, and modernizing America’s healthcare system, by keeping the patient at the center.
Our mission means protecting the health of Americans where they live, work, and play, from infectious disease, from addiction, and so many other threats. Our mission means strengthening the economic and social-well-being of all Americans, of every age.
Our mission means fostering sound, sustained advances in the sciences to help Americans live longer, healthier lives. With energy, dedication and focus, we, the men and women of HHS are committed to fulfilling our mission of serving the American people.
Ladies and gentlemen the Secretary of the U.S. Department of Health and Human Services, Alex Azar. Hey everyone. Hello and thank you very much. Thank you. Please please. Yes, it is still me. Although I am waiting the results for the Med page Twitter survey to see if I am allowed to keep it or not. We’ll see how that shakes out. I haven’t gotten the results yet.
But thank you all for joining us here today in the Great Hall and thank you for those that are joining us virtually. I hope everybody enjoyed that new video. I’m glad to have members of our HHS family watching via livestream today not only from across America, but really from around the world.
That’s especially the case because our department’s global work has been in the news quite recently, as all of you are well aware. Since December, when the novel coronavirus outbreak in China began to threaten to spread to American soil, there have been men and women at CDC, NIH, and elsewhere hard at work to respond to the outbreak and protect Americans.
The commitment to keeping Americans safe runs straight to the top. I have been speaking with the President regularly on the issue, and through the novel coronavirus task force, we’ve been working closely with other departments and the National Security Council.
There are still many unanswered questions about the virus, which your colleagues are working hard to resolve. But everyone here should be proud to be part of a department, and a healthcare system, that is capable of mounting the rapid and science-driven response that we’ve seen.
Within just weeks of the outbreak’s beginning, CDC scientists were able to develop a test that is now being distributed to state and local health departments so they can confirm cases of the virus here in the United States. NIH, ASPR, FDA, and others are hard at work on possible therapeutics and vaccines.
There is much work ahead of us, but for now, I want to give a round of applause to all the members of our HHS team, and our partners across other federal government and at the state and local level. Let’s thank them for their hard work so far.
[applause] Today is a chance for us to celebrate the results that you, as public servants, have delivered over the past year and to talk briefly about what we can accomplish together this year and over the next five years. The accomplishments I’m going to run through today can’t be comprehensive we’d be here all day if I tried to go through every major achievement of the department over the past year.
We have a little more room to be comprehensive in the annual report that the department published today, so I encourage you to check out that report and learn more about the amazing work your colleagues have done over the past year. Like last year, the annual report is organized into our five strategic goals as a department, which are important guides for our long-term planning.
I’ve also talked however about our work as falling under three key themes: facilitating patient-centered markets in healthcare, the second is protecting life and lives, and the third is promoting independence. All of our policy work from each and every payment rule out of CMS; to the work that the CDC does around the world; to the partnerships ACF builds with state and local governments all of it falls within one of those three themes.
I’ll start with what it looks like to use markets to put patients at the center and deliver more affordable healthcare and better health for every American. President Trump has an exciting vision for healthcare, which we’ve articulated and worked toward this past year and for frankly the last three years: a system with affordable, personalized care, a system that puts you in control, provides peace of mind, and treats you like a human being, and not like a number.
Undergirding this vision is a promise from the President: He’ll protect what works in our system and make it better. Some steps we took to deliver on that vision over the past year are going to be truly dramatic improvements to the patient experience.
We finalized a requirement that hospitals have to disclose to patients, in an easily accessible way, the prices that they want to charge. We proposed to require that insurers provide their pricing information, too, so patients know what they’ll owe for a procedure before they have to get the procedure and long before they get the bill in the mail. Imagine that, how can you do that.
We put out our draft rule on interoperability, which will require that patients finally be given access to their own healthcare data at no cost to them. Fixing these problems will be a fundamental shift toward putting the patient at the center of our healthcare system.
Every little step counts, and we’ve already seen many changes have an effect on the provider and patient experience. I’ll give you one example from CMS’s Patients over Paperwork initiative, which is projected to save 42 million hours of providers’ time through 2021.
Last year, we heard from an organ transplant surgeon at Johns Hopkins in Baltimore that he liked to set up his patients with their meds, in an organized pillbox, and talk them through the medications, before they were discharged from the hospital following a transplant.
But, due to a Medicare policy, he couldn’t set them up with their immunosuppressant medications. Those had to be shipped to the patient’s home address or home pharmacy. So we looked into this, and made a change so that the patient can receive his or her meds before heading home from the hospital.
Here’s what one of the surgeon’s patients said about the change: I don’t know how I could have handled going to a pharmacy and filling all of these medications that I need to take this evening after all I’ve been through. Thank you so much for making sure I have my medications this is one less thing to worry about.
(Applause) That is the kind of result you can produce through hard work to put the patient at the center. And it’s just the beginning of building a more patient-centered system including our sweeping efforts, through HRSA and CMS, to increase the number of lifesaving organ transplants.
I’d be remiss if I didn’t note that, next year, when we’ve finalized our proposed changes to the Stark Law and the Anti-Kickback statute, that Hopkins’ doctor may be able to make that pillbox a smart pillbox, and provide a home health aide to go home with the patient, talking them through their medicines as needed.
Providing these convenient, tailored benefits to promote health is also what we’re trying to do with new flexibilities in Medicare Advantage, which now allows plans to provide more supplemental benefits, such as home-delivered meals, transportation, and home modifications.
You may or may not be aware of that change, but if you watch a lot of cable news which none of us should do of course, unless it’s to see Dr. Fauci talk about coronavirus you may have seen frequent commercials talking about how Medicare beneficiaries can call a 1-800 number to inquire about whether they’re eligible for these new benefits.
I should note, these ads aren’t just on cable news they also drive me a bit crazy when I just want to get back to binge-watching the latest Bravo show. One particular ad looks a bit like something out of the 1990s, with red, white, and blue graphics, and, to complete the picture, there’s an NFL star from the 1960s involved.
On its surface, this doesn’t look or sound like the future of healthcare but it represents important work done here at the department, placing patients at the center and providing them with a tailored set of benefits that will keep them healthy and keep their costs affordable.
We’ve delivered significant results on affordability over the past year: Average Medicare Advantage premiums are now the lowest in 13 years, while Part D premiums are the lowest in seven years. We saw 1,200 MA plan options added from 2018 to 2019.
These are real savings real options for our seniors let’s thank everyone at CMS who worked hard to make that happen. Thank you. [applause] And, according to the National Health Expenditure data, in 2018, retail prescription drug prices dropped for the first time in over four decades.
What’s driving that historic trend? In part, it’s the amazing success we have seen at FDA for several years now: Fiscal Year 2019 saw a third straight year of record generic drug approvals, a historically high number of novel drug approvals, and a record number of biosimilars approved.
FDA also laid out the first-ever pathway for the safe importation of prescription drugs to lower drug costs, which we look forward to implementing this year. Let’s offer a special thank you to the men and women of the FDA for the results they’ve delivered over the past several years.
[applause] As all of you know, HHS is also proud to deliver patient-centered care directly, through the Indian Health Service. I’ve been immensely proud to see IHS’s commitment over the past year to establishing a new culture of quality, including through the formal establishment of the first-ever IHS Office of Quality.
Any major hospital system has a quality office like that, and the patients we serve in Indian Country deserve the same. We’ve seen some results already, from the award of a new contract for an adverse events reporting and tracking system to steps forward on CMS certification.
As of the end of 2019, 96 percent of all IHS hospitals and 97 percent of all eligible ambulatory care facilities have CMS certification. This work has been supported by the significant boosts in funding for IHS that the leadership of this department helped secure over the past year.
Tribal healthcare is also a key piece of our initiative to end the HIV epidemic in America, which is a part of the second theme I want to touch on: protecting life and lives. President Trump announced our HIV initiative just around this time last year, in his 2019 State of the Union address.
Since then, Congress fully funded the President’s budget request for the initiative; we’ve secured a donation of prevention medication for 200,000 uninsured Americans; we’ve made planning grants to the 57 jurisdictions that account for half of the new HIV infections in America; and we’ve already started implementation in four jurisdictions.
That is an incredible set of results in one year, so I’d like to applaud everyone, across the department, who has played a role in launching that initiative with such speed. [applause] That initiative will also build on the successful programs we already run for HIV, such as HRSA’s Ryan White HIV/AIDS Program, which hit another record this past year, get this reaching an amazing 87 percent of patients on viral suppression.
HRSA has also played a role in the success we’ve begun to see in combating our country’s crisis of opioid addiction and overdose. At long last, in 2018, we began to see results on the most important number of all.
For the first time in more than two decades, the number of drug overdose deaths declined by 4 percent, helping American life expectancy overall rise for the first time in four years.
We’re winning because our strategy is working. The number of Americans receiving medication assisted treatment has increased by 41 percent from 2016 until now. Since January 2017, the estimated total amount of opioids prescribed in America declined by 32 percent.
These are real victories but we’re not going to let up in our focus on substance abuse and mental health. We know there are concerning trends, such as a rising number of deaths from methamphetamine overdoses. This past year, we’ve already taken action to respond, securing flexibility for states to use SAMHSA’s State Opioid Response program to deal with addiction to stimulants like meth, too.
We’re also continuing to ensure that Americans have access to appropriate pain treatment. Toward that end, today, our Agency for Healthcare Research and Quality released a new evidence-based tool to help primary care providers better manage patients who need long-term opioid therapy.
I should note, not every division gets to announce something in the State of the Department address but 2019 was AHRQ’s 20th anniversary, so, happy birthday, AHRQ! [applause] We’ve been vigilant against addiction on all fronts.
In 2019, NIH, FDA, and CDC data showed that the number of American youth using e-cigarettes rose dramatically again. We laid out a path for action, effective this week, that prioritizes enforcement against the products most popular with our kids.
This is just part of the Trump Administration’s overall commitment to protecting a new generation from nicotine addiction and to continuing reductions in smoking rates. You saw that commitment reinforced recently with the release of the first report the Surgeon General has issued in almost 30 years that focuses specifically on how to quit smoking, and the benefits it delivers at any age.
Another vital way to protect the health of our kids is ensuring that parents are working with their doctors to get kids their recommended vaccinations. Sadly, this past year saw our country’s largest measles outbreak since 1992, threatening our country’s measles elimination status. CDC led an aggressive response, in cooperation with state and local health departments.
We took this troubling development as an opportunity to go on the offense, launching an unprecedented media campaign of HHS leaders promoting the importance of vaccination. Our work to protect life and lives goes beyond healthcare, too.
In 2019, FDA took major new strides to keep America’s food supply safe. As part of implementing the Food Safety Modernization Act, the agency began the first-ever routine inspections of large farms for produce safety, working under cooperative agreements with state partners to conduct more than a thousand large farm inspections. We’ve protected Americans in times of emergency, too.
Last year, ASPR led the federal government’s public health and medical response to seven hurricanes, two earthquakes, and the California wildfires. More than 2,120 federal disaster responders were deployed by ASPR to help lead the response, along with 214 tons of medical equipment and supplies.
That included more than 1,400 officers from the U S. Public Health Service Commissioned Corps, who deployed for nearly 32 disaster events, planned events, and community health missions. I’m proud to say that the Commissioned Corps is increasingly ready to respond to 21st century health challenges, and is in fantastic shape today.
That is literally the case the Commissioned Corps is now the second most physically fit service as measured by body mass index. Second only to the Marines! [applause] I’d like to personally thank all HHS personnel who contributed to this emergency work over the past year.
Let’s give them a round of applause. [applause] Our work to protect life and lives extends well beyond our shores, and I had a chance to see that in person this past year. Combating the ongoing Ebola outbreak in the eastern Democratic Republic of the Congo has been one of the Trump Administration’s top global health priorities since the outbreak began in 2018.
This past fall, I underscored that commitment when we traveled to the DRC, Uganda, and Rwanda with our head of global affairs, Garrett Grigsby; Director Redfield of the CDC, Dr. Fauci of NIH, Admiral Ziemer of USAID, and officials from the National Security Council. I cannot overstate what a challenging situation we face in the Congo.
We have a large-scale outbreak of Ebola in a warzone one of the most remote and least developed places on the face of the planet. One key reason that the outbreak hasn’t spun out of control is that we have tools today that we did not have during the 2014 West Africa outbreak, and a key reason we have those tools is the dedication of men and women across HHS at NIH, FDA, CDC, the Commissioned Corps, BARDA, and elsewhere.
It was incredibly moving to see firsthand how these tools have helped. We had one young boy, about 8 or 9 years old, proudly show us the certificate he would bring back to his family, certifying him as Ebola-free, after he received one of the drugs that’s part of the clinical trial that NIH is running, a four arm clinical trial being run, right in the middle of one of the most active war zones in the world.
Many of the healthcare workers we’d met had received what was then the investigational vaccine to protect themselves from infection. As of December, that vaccine is now an FDA-approved product. That isn’t the only international humanitarian crisis that HHS had to handle this year.
I also had the chance to see officers of the U.S. Public Health Service Commissioned Corps at work on the USNS Comfort, the American hospital ship that was deployed this past year to respond to the humanitarian crisis in Latin America, which was caused by the failed Maduro dictatorship in Venezuela.
The Commissioned Corps also played a key role in responding to the humanitarian crisis we saw at our own southern border, which resulted in an unprecedented number of unaccompanied alien children entering ACF care nearly 70,000 in FY 2019.
ACF’s Office of Refugee Resettlement worked to maintain consistent, high-quality care and safely unify children with sponsors, while we secured emergency funding from Congress and found other flexibilities to help care for these children.
ACF was able to expand our capacity to care for this record number of children while laying a foundation for a more flexible, sustainable system to handle such influxes in the future. Much of this work at ACF relies on our faith-based and community partners, and we took significant steps this past year to remove unfair burdens that had been imposed on faith-based partners.
That’s part of a much broader effort to protect life and conscience in our programs. This past year, we finalized new Title X regulations to ensure we’re following the law that Congress passed. Meanwhile, our Office for Civil Rights has been relentless on so many levels. We are enforcing, like never before, the rights of people of faith and conscience who do not wish to perform, cover, or refer for abortions.
We are protecting the rights of Americans with HIV to get equal access to care, and took historic actions to guarantee that Americans with disabilities are not excluded from organ transplant lists based on bias or stereotypes.
The third theme I mentioned is the work we’ve been doing to help Americans reach independence. This past year, to help break down barriers to finding work and economic independence, ACF started a public-private partnership across six New England states, which engaged state legislatures, parents, philanthropists, and the Federal Reserve Banks of Boston and Atlanta.
The partnership’s work resulted in the introduction of 17 different new policies or pieces of state legislation, as well as the National Conference of State Legislatures’ adoption of a national resolution to address benefit cliffs and other work disincentives.
We’ve also looked at how to promote independence for Americans with serious mental illness and Americans with disabilities. In 2019, we approved the first-ever demonstrations for states to use the Medicaid program to cover inpatient treatment for serious mental illness.
That was the first time we’ve taken steps to address serious mental illness in this way in the nearly half-century history of the Medicaid program. Thanks to the roaring economy we have under President Trump, the number of Americans with disabilities who are working has been rising steadily.
But there’s more we can do. That’s why, this past year, the Administration for Community Living issued a challenge to businesses to develop programs that better include workers with disabilities particularly people with intellectual and developmental disabilities.
Promoting independence also means helping American kids in our foster care system find their forever home and preventing kids from having to enter the foster system in the first place. ACF’s latest data show that the number of children entering foster care decreased at the end of FY 2018, for the first time since 2011.
The number of adoptions with child welfare agency involvement increased to over 63,000 in FY 2018, the largest number of adoptions reported since we started collecting data in 1995.
(Applause) Each child exiting foster care for their forever home, each child who never has to enter foster care, is a tribute to the work of ACF, our state, local, and community partners, and most of all, to the families who generously welcome and love them.
We were honored to have some of these families join us here in the Great Hall, alongside Vice President Pence, to celebrate National Adoption Month in November. That included a family from Minnesota, the Arntsons, who adopted their son Isaiah as a teenager and, together, they’ve now become leading advocates for adoption, and adoption of teenagers in particular, throughout the country.
Finally, I want to recognize the work that so many members of our HHS family have done this past year to make HHS as healthy an organization as we can be. That means a department that’s a responsible steward of our resources, that’s well-managed, and that’s the best possible place to work.
In 2019, we continued delivering results on regulatory reform, reducing the burden of our regulations in present-value terms by $11.4 billion, leading all cabinet departments for the second year in a row. (Applause) Our Office of Inspector General continued to excel at safeguarding taxpayer dollars, returning some $5.9 billion in taxpayer funds and barring 2,640 bad actors from billing HHS programs.
That included the largest healthcare fraud prosecution in American history, taking down a scheme where doctors were being bribed to admit patients into a care facility, to the tune of $1.3 billion in billings. We’ve continued to improve how we serve our customers through the Medicare appeals process.
The Departmental Appeals Board has been modernizing its technology so that it can now upload CMS claim files directly to its processing system, and the Office of Medicare Hearings and Appeals cut the appeals backlog by around 30 percent in FY 2019, surpassing the 19 percent target that had been set by court order.
You don’t need to be a lawyer like me, or an administrative law judge, to know that it’s always very good to beat a target that’s been set by federal court order. The Office of the Chief Information Officer has also been using the latest technology to produce cost savings and keep our IT infrastructure safe.
Using data collected and analyzed through the Department’s artificial intelligence platform, and using principles from the ReImagine HHS Buy Smarter initiative, O-C-I-O and the Program Support Center evaluated software spending across all of HHS’s 29 agencies and offices to leverage the Departments collective buying power.
Last Friday, the department finalized a deal that will save in excess of $33 million over 5 years, for the same or greater functionality and IT capabilities. Now my laptop might work. Continuing to use this data- and AI-driven approach, we believe we can conservatively generate an additional $250 million in savings over the next 5 years.
We’ve also continued to look at how the department can be structured to best accomplish our mission. As part of ReImagine HHS, this past year saw the development of the first-ever deep rethinking of how we organize our regional offices.
The goal here is both to reduce the overhead costs we have in running the regional offices, while also bringing new authority to the regional staff, including our regional directors, to make them the most effective departmental representatives they can be.
Lastly, we know that our organization is healthy because that’s what the data tells us. As the Deputy Secretary mentioned, according to the Federal Employee Viewpoint Survey, HHS was once again the best Cabinet agency at which to work in 2019, a distinction we’ve now held for three years in a row.
(Applause) I want to thank everyone who helps contribute to employee engagement across HHS, every line leader, every manager, every supervisor, through promotion of the F-E-V-S. The data that we get are highly valuable, and we take feedback seriously.
I want to encourage everyone to pay close attention to the survey and what your leadership has to say about it when the 2020 survey comes out this May. Give us your feedback. We want to remain the best cabinet department, the best agency in the federal government where anybody can work.
(Applause) I want to close by emphasizing just how important the work of this department is, and I have a data point for that, too: which is how often the President of the United States calls my cell phone to talk about the latest healthcare or public health topic.
He has been closely engaged on issues like responding to the novel coronavirus outbreak, and he cares deeply about the work that you do to improve the health and well-being of all Americans. For those of you who tuned in for the State of the Union Address on Tuesday night, you may have noticed just how much of it was spent on healthcare, public health, and promoting independence about a fifth of that speech, in fact.
So, the President is grateful for all your hard work and for the results you’ve produced. But I also want to remind everyone that there is a great deal of work still to be done, and I have the utmost confidence we can get that job done.
The CDC numbers I mentioned earlier, which show decreasing rates of death from drug overdose and rising life expectancy, also show a number of troubling trends that we need to confront: rising rates of suicide, high rates of maternal mortality, and stubborn health disparities between rural and metropolitan America. In the year to come, and the five years I hope I have ahead, we have our work cut out for us.
That means the looming issues I just mentioned, and it means continuing to respond to and prevent infectious diseases; ending the HIV epidemic; tackling serious mental illness and addiction; working with Congress to achieve lasting reforms on drug pricing; restoring a focus to promoting work and family in our human services programs; delivering even more results on transparency and consumer empowerment;
continuing the drive to pay for value rather than procedures; and advancing research in critical areas the President mentioned on Tuesday, like pediatric cancer, Alzheimer’s and neonatal survival. In other words, we have lots to do but the entire HHS family should be very proud of what we’ve accomplished so far.
Thank you for the dedication you have shown to HHS’ mission over the past year, congratulations on all you have to show for it, and I can’t wait to get to work with all of you on our important goals for the coming year. Thank you again for joining us here today.
Thank you.

What healthcare will look like in 2020 | Stephen Klasko | TEDxPhiladelphia

Translator: TED Translators admin Reviewer: Queenie Lee Well, I want to thank you all for coming, and especially the people that came from outside of Philadelphia that hovered over here; especially those of you that time-traveled from other decades and times.
I’m Steve Klasko. I’m the CEO of Stevie’s Vinyl Emporium and Implantable Health Chips in South Street in Philadelphia. (Laughter) That’s what I am today.
But for the past ten years, I’ve been the presidency of Thomas Jefferson University in Jefferson University Hospital System that literally was one of the pioneers along with several others for what is now called the leaders of the optimistic future in Healthcare Revolution from 2015 to 2024.
So for those of you who are coming from another decade, or for those of you who are here in the 2020s, I’d like to talk a little bit about how that journey happened and maybe give you a little bit of the personal story about how it happened for me.
So first one of the things that we did, is we got tired of whining, and we decided let’s just travel to the future, think about what we want and then create it. For me, that started in 1977. Very important time for me, I was a senior medical student.
It was important because I got asked to give a talk for TED. Now not the TED you’re thinking of because TED didn’t exist in 1977. It was called tomorrow’s education of doctors. It was everything different than the technology that exists today.
It was a little slideshow with a screen, but they asked me to talk about what the future of medicine looks like from a medical student’s point of view. I remember it for it was the first time I saw the Rolling Stones – this is what they looked like back then; I was a huge fan.
But what I talked about because I was a little nervous about the first talk, I talked about: Can you do anything about spiraling costs? Can you change the fee-for-service system, so we’re really rewarding value and not volume? And can you measure outcomes?
And I said my generation of docs is going to solve this over the next four years. We are not going to be dealing with this even 20 years from now. Well, amazingly the docs said, “No.” And that didn’t happen. Now I was also a very different person back in 1977.
This is what I look like. (Applause) (Cheering) Thank you. That’s called a leisure suit. (Laughter) But for a brief interlude where they tried to bring it back in 2019, I think it’s safe to say it’s out of the fashion lexicon forever, but the car was in 1968 GTO which was and is a very cool car.
Thank you. So then we went through really what some people called the middle or dark ages, the Managed Care Revolution, which did not really manage anything. It didn’t really provide care; it just promoted underutilization – the balanced budget amendment, which didn’t balance the budget, and didn’t really amend anything.
And then the first iteration of what has now been 17 iterations of what was then called Obamacare. So that brings us to 2014, and why was 2014 important to me? Well, I was very proud and honored to be inaugurated and selected as the first president and CEO of Thomas Jefferson University and Health System combined.
It was also a big moment for me because it was the second time I saw them. This is what the Rolling Stones looked like back in 2014. (Laughter) And in my inauguration I was given a script, and what I talked about my inauguration in 2014 is: “Hey, can we do anything about spiraling costs?”
Can we change the fee-for-service? Do you think we can measure outcomes? That was a bit of an a-ha moment for me, I said, “Well, 37 years, that’s a lot for not to have much change.” This time though, the insurers and government said: “We’re really going to do it.”
And really what people were actually predicting is – because believe it or not, even at 2014 the docs said: “I really don’t want to take any risks. I think things are fine the way they were.” And you couldn’t go a week without people threatening the extinction of academic health centers.
So I’m proud to say here in Philadelphia and at Jefferson we said yes, and I’d love to talk to you a little bit about what happened between 2014 and 2024. So here we are in 2024, and by the way, I don’t know if any of you saw it on your Facebook implantable glasses, the Zombie Rock Tour, it was awesome.
It was awesome. By the way, those Facebook implantable glasses can be bought at Stevie’s Vinyl Records and Implantable Devices. (Laughter) I thought the Rolling Stones, the Rolling Stones rocked, (Laughter) (Cheers) they rocked the undead tour, right?
Who agrees with me? They rocked the undead tour. Seven decades of great Rolling Stones. You talk about not getting any satisfaction, look at these guys. (Laughter) But more importantly, more importantly, what happened in Philadelphia, what happened at Jefferson was, that we took that mode of saying – people said that it’s impossible to change healthcare.
And really the personal piece, for me believe it or not, didn’t come from Maimonides or Aristotle, or even somebody from the University of Pennsylvania or Jefferson. It came from a sneaker commercial. It was an Adidas marketing campaign back in 2014 called the Impossible.
It said “impossible” is just a big word thrown around by small men and women who find it easier to live the world they’ve been given rather than explore the power they have to change it. Impossible is not a fact; it’s an opinion. Impossible is temporary; impossible is nothing.
So we decided, “What the heck, let’s do the impossible.” Because everybody knew things were changing, we weren’t going to wait for a miracle. And we said, “Let’s do it.” OK, so here it is, it’s March 28th, 2024. Now I apologize for those of you who come from this decade, but I know some of you probably have time travel lag, and I just want you to know where we’re at today.
So it’s March 28th, 2024, President Jenna Bush will be debating Democratic nominee Chelsea Clinton, in what a lot of people think will be a very tight race. Harrison Ford has signed up for one last Indiana Jones sequel, (Laughter) tentatively titled Indiana Jones: the Legend of Bingo Night, we’re all excited about that one.
And the Eagles are 2-0 and trying to win their first Super Bowl since the unprecedented fourth straight they won from 2015 to 2018, the so-called Chip Championship Years. (Applause) (Cheering) Of course, Governor Chip now has a very different job than he had back then.
But more importantly or as importantly, Jefferson is celebrating its 200th anniversary as an international hub of innovation, with headquarters in Philadelphia, instead of just the Philadelphia academic medical center.
We’ve become a destination site for innovative entrepreneurial health with unprecedented economic development, and our creative partnerships have allowed us to become what The Wall Street Journal called a thriving cluster on the verge of a chain reaction, which has helped make Philadelphia the epicenter of the new healthcare.
By the way, I’m getting out of my DeLorean to accept an award from the US News and Interplanetary Report. As most of you know in 2019, we found two other planets with slightly dysfunctional health systems, so they are now part of the ranking system that the former USNWR used.
So how did we get there? I’d like to … TEDx has asked me to talk about three things that we did that were very different. First of all, we decided that we’re going to start to create docs of the future, that it’s ridiculous to have the same way that we selected and educated physicians that became autonomous, competitive, and hierarchical, and that we actually were going to change the DNA of healthcare literally one physician at a time.
You may not believe this, but back in 2014, we still chose doctors based on science GPAs, MedCaTs, which were a multiple-choice test, and organic chemistry performance. And somehow we were amazed that doctors weren’t more empathetic, communicative, and creative. As my kids would say, “Duh.” (Laughter) (Applause) So we changed all that.
What we recognized is that it used to be for those of you who came from the ’70s – and I think there are actually some, I see some people from 2014, I see some people from the ’80s. Go Journey, yeah. (Laughter) I see some tie-dye out there, some ’60s and ’70s. Peace!
But we decided to transform admissions. What we realized is that all the scientific data is on what in 2014 we called iPhones and Androids, but really what we needed were emotionally intelligent physicians. So we now really select physicians based on self-awareness, self-management, and the ability to adapt, social awareness and empathy, relationship management, teamwork, and the ability to really embrace change instead of fighting it.
But not only that, we totally changed the way that we teach the physicians that we do accept. Believe it or not back in 2014, we used to spend two years really teaching them scientific principles in large auditoriums, classes that a lot of them didn’t come to, when we recognized that we could do all that, have them learn that at two o’clock in the morning.
Now we spend most of our time in what we call the Art of Attending. Teaching them to really observe, we started back in 2014, workshops designed to sharpen observation skills of health students by looking at art. Very unusual partnership, it was Thomas Jefferson University, Contemporary Art Museum, an institute for an optimistic future in healthcare.
We took students and had them understand art. So if you take this piece of art over here, medical students originally said, “Well, that’s a woman; that’s a snake; that’s a family.” But when you started to look and say, “What is the story?”, it started to totally change the way that they cared for patients.
And at the end of the day, we went from silos of full-time individuals to folks who could deliver team-enabled and team-based care. Doctors went from being captains of the ship to being part of a team, and they, believe it or not, work closely with multidisciplinary care-delivery teams, including doctors of nursing practice, nurse practitioners, clinical pharmacists, physician’s assistants.
and at the Thomas Jefferson Institute of Emerging Health Professions, professions that didn’t even exist in 2014, things like probability experts, electronic health care ambassadors, and telehealth professionals. So we recognized that we needed to evolve doctoring.
We also recognized that the patient experience was really pretty lousy. Back in 2014, you could actually do anything you needed to do in travel, anything you needed to do in shopping on a device, but could you get an appointment with a physician?
No. Could you interact with a doctor or nurse? No. So we decided that healthcare needed in 2014 to get into the E&I mode. If you even look at how people viewed us from TV shows – how many of you are here from the ’70s? There you go, okay.
So the big tip television show in the ’70s was Marcus Welby. Now here’s what Marcus Welby was. He was a family physician. He would get up in the morning, he would go to the homeless shelter, take care of people for free. On the way home to lunch, a cow would be having trouble delivering a calf, he’d deliver it. He’d then go to his family medicine office in the afternoon, and then at night he’d do left ventricular neurosurgery. We were Gods, we could do everything, that’s how people viewed us. In the 2010s this is what we had. Anybody remember this guy?
(Laughter) He was a drug-addicted, sex-addicted, really smart guy that couldn’t communicate or see patients. That’s what people viewed us. The number one TV show of 2023? Was Doctor WHO, which stands for Watson Hybrid Organo Doc, who basically fell in love with his robotic-bionic counterpart who does all the scientific stuff while he does the emotional stuff.
And as you can imagine, hilarity ensues. By the way … (Laughter) By the way the first season of Doctor WHO is available on Google Glass implantable chips, available at Stevie’s Vinyl Records and Implantable Chips on South Street. (Laughter)
So the other thing we embraced was entrepreneurship. We recognized that being academic and entrepreneurial just were not mutually exclusive, and we also recognized that we had to enhance the consumer experience. It really was lousy going to a physician.
This is what it looked like back in 2014. Female: What’s wrong? Stevenson: I don’t feel so good. F: Then you need to go to a doctor. Female nurse: Mr. Stephenson? S: Stevenson. FN: Do you have any allergies? How would you describe your symptoms?
What is the general area of pain? Does your family have a history of heart disease or diabetes? Doctor: And what seems to be the problem today, Mr. Stevenson? S: I’m feeling a little stuffed up. I’m experiencing some … FN: Doctor, your 3 o’clock is early, your 2:45 is late from 6 and 7. D: Follow these instructions; if it doesn’t clear up in a week or two, come back; we’ll do this all over again.
(Moaning) S: I don’t like going to a doctor. SK: So in July of 2014, we partnered with some great companies, created an innovation-driven ecosystem for healthcare. Starting in 2015, patients in 48 states could access Jefferson doctors via telemedicine. S:
Well, now you can see a doctor without going to a doctor’s office with the help of your smartphone, or computer, and American Well. Signing up and setting up your health profile is easy; it only takes a minute, and once you’ve done it, it’s stored safely and securely.
Then you can log in or use the App to see doctors who’re available, and connect by video phone or chat. D: Hi Allen. I see you’ve been experiencing some congestion and some nasal blockage. How long has this been going on? S: During the visit, the doctor can see your health information, afterward, you get a complete write-up of everything the doctor says.
D: It looks like acute sinusitis, a sinus infection. Now I wrote you a prescription to help with congestion. If things don’t clear up in, say, a week or so, just send me a message, I’ll be right here. S: A few mins later, I’ve got my diagnosis and my instructions for treatment and my prescription is already waiting for me at the pharmacy. SK:
Of course, all that now happens in your Google Glasses which are available by the way at Stevie’s Vinyl Records and Implantable Health Chips. We also recognized that information was everything. As Yogi Berra would say, it comes down to one word, big data. And believe it or not, believe it or not, we used to do everything based on experience and anecdote.
Evidence-based medicine in 2014 was actually a novel idea. And now we recognize that we can take things from other industries. So at Jefferson, for example, in 2014, we started the Center for Healthcare, Entrepreneurship and Scientific Solutions.
We said, “It really doesn’t make any sense that Nick Foles has a better idea of whether or not a screen pass will work in the third quarter than I do of whether or not a cancer drug will work.” So we took some of the best people doing mathematical modeling and created a predictive analytics and mathematical modeling to reduce uncertainty in medicine.
Believe it or not, in 2014, 28% of people that went to the hospital in this country got readmitted within 90 days. Now, through our mathematical modeling we’re able to see exactly what intervention will keep people from coming back. Not only that, we’ve changed the way we do things. In 2014, family medicine physicians would actually be out of the hospital.
Hospitalists would never leave the hospital, and then there was no real communication. Now we have what’s called extensiveness, hospitalists that actually follow those patients for 90 days so they don’t get readmitted. We actually pay for performance now because we can actually measure performance.
And we can actually give you predictable answers as to what you’re paying for and what you’re getting back. Accountable care organizations for the first time really are accountable because we have math to back it up. One of the great things that happened in Philadelphia, believe it or not, again in 2014, with decreasing NIH funding, Penn, Jefferson, Temple, Drexel, would all fight for NIH funds.
What we did, and one of the greatest things we did, we created the Philadelphia Clinical Research Super Site where we said really what’s important is to take all of our resources, both in education and research, and make Philadelphia an epicenter.
What did that do for us over the last ten years? We were able to take the Nanotechnology University of Pennsylvania and Molecular Genomics at Jefferson and create the DNA vending machine. For those of you from the 2010s, it’s sort of like a red box for your DNA.
We can now pick a drug for you, and instead of saying it’s for 200 people that look like you, we can take exactly the drug that fits your genome and have it available for you. We can also put your genome on a chip, so that God forbid, if you need a new organ, we can make that for you based on work that’s been done in Philadelphia.
And we finally decided to work with patients to really make them shareholders in their health, and this is what it means. It means that in a community like Philadelphia, if we’re able to make you healthier, we do better as physicians; you do better.
And we actually partnered with great companies from again outside Philadelphia to look at a different way of making sure that everyone matters, that we can look at not only drugs, but holistic remedies to look at personalized performance-gain plans integrating a proven system to drive health outcomes.
Whether it’s mindset, or nutrition, or movement, or recovery, we were able to do many more things that didn’t require pharmaceuticals. So that brings us to 2024, and as I said, I’m here to accept our number one ranking from the US News and Interplanetary Report and what’s really cool is that some of the ranking parameters didn’t even exist in 2014, and I’ll give you an example of a few of them on the academic side and also on the clinical side.
On the academic side, we actually, imagine this, get ranked based on how our students do at one year, three year, or five year. We measure individuals’ professional and personal happiness at varying intervals after graduation. Because after all, that’s why they came to our university. And if we don’t do really well, then they actually get some of their money back.
We have a collaborative quotient. Academic entities are incentivized to actually get over themselves and work well with others, (Laughter) (Applause) which would have been unheard of in 2014 when they were all cannibalizing each other.
And we have an entrepreneurial quotient where institutions are rewarded that invent and envision new ways of doing things that generate alternate revenue and develop new student opportunities. But probably nothing’s changed the most than health quotients.
I mean, it used to be back in 2014 and before that parameters were based on the reputational score in the past. Now it’s based on what patients think. The one I’m really proud of that we got a very high score on is called the BUB Quotient.
It stands for the Believable Understandable Bill, that we actually have enough respect for patients that we provide understandable bills, so they can understand what they got and what they’re paying for. We have the say-what-you-mean and mean-what-you-say quality parameter.
We actually take marketing professionals to read all the billboards in the marketing we do, and see if they have any semblance to reality of what really happens in the hospital, and you get points if there is some semblance to reality. And then finally we have the through-the-patient-eyes factor.
And this is really exciting because what it is, is every patient now, in 2024, basically when they get in the hospital is given a Google Glasses, and they basically can record what’s happening through their eyes, how the doctors and nurses are treating them, and then we have CEOs of other hospitals look at that video for a day and grade on 1 to 10 whether they’d like to spend a day in that hospital.
And again that’s a great parameter for us. So a lot has happened since 2024, and I’m really excited to be here. We’re about to accept an award in the new Convention Center & Casino on the Schuylkill River. (Laughter) And some things from the past really are good.
I’m going through my third midlife crisis because I’m 70 and what happens is people live to 120, so midlife crises have changed. And I’m proud to say this is what I got myself, I was able to retrofit a GTO to hit the standards for a hovercraft. Excuse me for a second, Google Glass out, could you get the GTO to get ready to go to the Convention Center? Great.
Thank you. Listen, I want to really thank you for being here, I want to thank you for traveling in time and space, and most importantly, stay healthy in Philadelphia. Thank you very much. (Applause) (Cheering)

TCNY 2020 | Smoke-Free Housing Promotes Healthy Living

All across the city, collaborations among community organizations, local businesses, health care providers, and most importantly everyday New Yorkers who want to have healthier communities have been doing amazing work to make our city a healthier place for everyone.
With that in mind, we are featuring some of the exciting work that community leaders are doing to promote health. We hope that the following video inspires you to adopt similar work in your own communities or to find other ways that you can make New York City healthier and more equitable for everyone. We had many problems with the smoke seeping into the apartments.
Secondhand smoke is dangerous, it’s bad for us. They thought they were going to get sick from secondhand smoke and it motivated most of us. And the board decided to take an initiative to see if we could get a no smoking policy here in North Shore Towers.
We had to gear up because we had to amend the proprietary lease by getting two thirds of the outstanding shares to vote for it. I chaired the committee. I had 50 people working with me. I said, “Do you ever smell the food cooking in another apartment?”
They said, “Yes, all the time. Frequently.” I said, “Well when there’s smoke, someone’s smoking, do you tend to smell that too?” They said, “Yes.” And that brought that up as secondhand smoke, which is extremely dangerous. Educate the people where they live.
We had a wonderful team come in and talk to anyone that wanted to come and we filled this room with people. And I think that had a big impact. And people then came to a recognition that it’s important to be considerate of others’ health and their own health. Every shareholder had a vote. We voted and the initiative passed. This affects 3,000 people who live here.
And these people that worked with me were able to engage their neighbors and talk to them on a one-to-one basis to tell them the necessity of doing this. When we moved in here, the fact that there was a non-smoking initiative was important to us. It was very comforting for us to know that we wouldn’t be exposed to secondhand smoke.
That people have picked up on what we’ve done has been a tremendous motivation for a lot of boards throughout the county and the city. So I think we were trend makers really. North Shore Towers is a premier community in New York City, New York State, and possibly the country for having done this.
So I, as a member of the board, I, as a member of the community, I’m so proud of our neighbors. Thank you for your interest in Take Care New York 2020. The city’s blueprint for improving the health of all New Yorkers and advancing health equity across the city.

94-Year-Old Embraces CrossFit, Healthy Living

So many people locally have said to me, “Do you know, George, you are the oldest man in this street?” Well, I was born in Bridgewater, living with my father in two rooms. My father died when I was 12 years of age, and then I had to go into a home. I was fostered by a lady by the name of Mrs. Bellington, and she looked after me until I got married.
I went to work on the railway, and I was there during the war. I was a local boarded fireman. I didn’t mind firing. Sometimes, you know, it was quite hard if the fires weren’t behaving themselves. One night when I was working, alarm was raised. It happened suddenly.
The Blitz started on Swansea. All the firemen got together, and they drove their vehicle to Swansea to fight the fire. There was a lot of shooting and bombs dropping. About two days after, I visited Swansea, and I couldn’t realize where anything was. It was such a mess. The local council helped by building a shelter where people could go if there was any bombing.
But in most cases, we went under the stairs. We didn’t go to the shelter. I had a friend that was living close to where I was living . He got killed, and, you know, I lost him, and then another person that I was quite friendly with, he was in the navy, and he lost his life as well.
Rationing restricted you to certain amounts of food, you know? Butter, cheese, little bit of meat. But if you could grow your vegetables, at least they were good nutriments , and you could fill yourself up with some vegetables. It was quite hard, and of course, the children at the time, they’d never seen a banana. I’ve always kept active.
I used to go to the swimming bars most nights, and then once I did an hour there of swimming, I’d go straight down to Harbour Island Beach and swim in the sea. I remember seeing Johnny Weissmuller in Tarzan, and I thought, “Well, he’s a good swimmer.”
So I thought, “I wonder if I can practice and perhaps I’ll be able to swim like him.” When I was 14, I thought to myself, “Why don’t I learn to dance?” It’s good exercise for the legs and for the stature, keeping yourself upright, and that’s where I did meet my future wife.
I’ve been dancing for 70-odd years. My wife has died, now three years ago. I haven’t been obviously dancing with her. I still do a little jig on my own sometimes in the house. I still drive. I do all my own cooking. I look after myself. I do all my cleaning in the house.
I do the gardening. And there’s nothing really that I really can’t do physically. I count my calories. I try not to reach the 2000. I don’t eat butter, and from 1964, I have never used sugar since, and I don’t eat salt, and of course I’ve never smoked. I’m a short person.
I’m 5-foot-2, so I’m trying not to put on any weight. Otherwise I’d be like a round football. I was 92, and the lady next door but one, she said to me, “I know you’re active, George,” she said, “but why don’t you come to CrossFit?” I can remember when he first came.
It was already open and he was just standing over there talking, and I didn’t know he was going to come, and he came in and he said, “My neighbor said I should come up and join.” I went over to CrossFit, and I saw Sophie. Sophie: And he said, “I’m 92.” And I was like, “Well, OK.”
But he’d—he was up and about and chatting and talking to people, and he showed me he could touch his toes, and he said he’d driven here, so clearly he wasn’t an average 92-year-old. Sophie’s been great. And she likes to laugh. She’s been a great instructor.
We do have a great relationship. I don’t see him as a member. I do see him as more like a friend. We have fun. We talk. He tells me about his life. He shows me photos. He brings me chocolate. She couldn’t believe my limbs weren’t creaking, as they say, you know.
She was—she couldn’t get over it, and she thought, “Good god, this man’s 92.” We went through just some basic squatting drills, just onto a box, him holding my hands and just sitting down, and he was looking at me like I was stupid because he didn’t know why he had to hold on to me.
Until you see him in action, when I came here and met him for the first time, it only then resonates what this guy is capable of at that age. I always start off—every time I go over there is with the rowing. I do 300 there on the rowing, and then I do some weightlifting, whatever Sophie says I should do.
Sophie: He surprises me every time he comes in here with what he can do. I put him on the rower and he had a go at that, and he was just fine. He enjoyed the heavy breathing. He enjoyed that feeling. His character is bigger than all our, sort of, doubts and fears.
He just took over. When he’s in here, it’s the George show. George: It’s essential that as men get older, that they do certain exercises, simple exercises. They don’t have to be strong, heavy. You can do small exercises, but at least it helps you throughout.
Sophie: When we were chatting about stuff that he’s done in the past like, has he ever been to a gym, or what’s he done that’s made him sort of healthy at this age, and he says he’s danced all his life. And I said, “I have no idea. I wouldn’t have a clue where to start.” So he said he’d teach me, so I was like, “OK,” but just taking it with a pinch of salt, and then he came up here with this record player and vinyls and said, “Come on then. I’ll teach you.”
So we had a go, and I am just the worst dancer ever. Obviously his dancing background, as well as all the physical labor he’s probably done over the years, has helped with his coordination. He’s full of personality. My next-door neighbor—I was talking to him and I said,
“Why don’t you come along with me and do some exercises?” “Oh,” he says, “I can’t. I’m too old.” And I said, “No, you’re not too old. Why don’t you come along and witness myself if you like? You’ll be looked after. You’ll only have exercises that suit you.” I think when people get over a certain age, they think, “Oh, I shouldn’t really do that because I’m too old.”
But you’re never too old, and it’s never too late to start. I feel that if I only spare a couple hours a week, it’s something, and I think it’s bound to do good. Sophie: He comes Monday, Wednesday, Friday. He’s outside 45 minutes early for the class because he likes to come up and read the paper. But I’m immensely proud, and he should be extremely proud of himself as well.
There’s nothing that’s too much for him. He’s a physical specimen at 94 years of age. I don’t know if it’s the way I’m living, the food I’m eating or what, but I like the exercise. After I’ve done the exercise, I don’t complain of any pains, you know?
It just goes to show what is possible if you do the right things. The way that he’s lived his life shows that. George is the real thing, and he’s a true story. If you sit here whinging about your day it doesn’t have to be butchering.
If you come in and bring some luggage in and say, “The day’s not been great, and I’ve done this,” you take one look at him and just feel weak for everything you say. So he’s great in bolstering everything. George: Because at the age of 12 I was left an orphan, I feel, and I said to myself, “I must look after myself.”
Because there was no one else, really, that could do that for me. I hope that though I’m 94, I hope I can continue now until I’m perhaps 100. Who knows? We never know.

What Do Bearded Dragons Eat To Live A Healthy Life

As a new beardie owner, one of my first questions was: “What do I need to feed my dragon in order to keep it healthy?” Hey I’m Abigail Kessler, Co-Founder of Raising Reptiles, so what do bearded dragons eat? Today we have a marvelous array of food to discuss. We’ll talk about how to make a healthy salad, the feeder insects available, and proper supplementation.
This is a healthy bearded dragon salad. Within it I have combined three different types of dark leafy greens; mustard greens, dandelions, and collard greens. Also there is shredded butternut squash, chopped up green beans, and a little bit of red bell pepper just to add some color enhancement. Finally sprinkled on top is some Repashy Super Veggie.
This supplement adds nutritional value as well as balancing everything out. In Raising Bearded Dragons, we show you how to get your picky bearded dragons to eat their greens and veggies. Over here we have a large variety of feeder insects, mostly worms, we’ve got dubia, roaches, and crickets. I’m going to go over the pros and cons of each of them.
Wax worms are essentially bearded dragon candy. They are very high in fat and should only be fed as a treat. They are slightly addictive to so don’t give them to the bearded dragon too often. Here we’ve got butterworms. Bearded dragons love these because of their high colors you know you see their yellows and reds. They’re really high in calcium and also pretty high in fat so don’t feed them all the time, only a couple times a week if that.
Over here are dubia roaches which is one of the best feeder insects you can give to your bearded dragon. Each of them has the nutritional equivalent of about 5 crickets. You will dust calcium over them. These are staple insects. You will feed them to young dragons daily and regularly to the adult ones. Over here are super worms.
Now larger dragons love these. They are fairly high in protein and also pretty fatty so you don’t want to give them a truckload of them. I don’t recommend them for young dragons as they are very hard shell and have the potential to block out their system. Both dubia roaches and super worms are incredibly easy to breed so if you have multiple dragons that you are feeding or even just one and you don’t want to constantly be going to the store, I highly recommend trying that out. Now here, these delightful great green worms are called Hornworms.
They are the most nutritious worm on the market. Very fatty. You can give them to your dragon as a treat. As you can see, they absolutely love them. Although this little kid is distracted. He’s been outside for quite a bit. We’ll see if he eats them later on.
I definitely recommend those only as a treat because they are so full of nutrition, they are also really high in fat and moisture, so don’t give them to your dragon super regularly. Once or twice a week at max. Yeah you see the one in the dish. I see how it is. See dragons are picky. Weird little creatures. Over here, we’ve got Phoenix worms. Now there are some small ones and some large ones. They come in both sizes.
This is also a staple worm for your dragons. They are high in calcium and low in fat. You can free feed these to babies and give 10-15 a day to adults or however much they’ll eat. Now over here, we have crickets. Pretty much everybody knows what these are. They’re not the best feeders for Bearded dragons, but they’re easy to find and manage.
I don’t like them, especially compared to the dubia roaches as they smell, they make noise, and if you leave them in the tank, a lot of people will just pour them into their tank, they have the potential to actually eat the dragon, so not the best feeder. They do work as a source of protein if you have no other options, but we definitely recommend dubia or discoid roaches.
Over here, we have our supplements. This one is SuperCalHighD. You will notice before I get into that that I use Repashy products. Repashy is really high quality. They’re actually probably the highest quality supplement on the market.
All of the powders are micro fined. Each one of these, I only have the 1 dragon plus other lizards in the house, but each one of these containers will last me a really long time because when you have your feeder such as crickets, you only are going to be dusting them with calcium.
That’s a daily thing, but making the investment for these, they cost a bit more than say ZooMed or Repcal products, but it is really really worth it. Alright so SuperCalHighD, this is a calcium supplement that is high in added D3. It is one of the best for bearded dragons.
You’ll just dust it on your crickets or roaches on a regular basis and every single day for babies and just a couple times a week for the adults. SuperVit is Repashy’s multivitamin and this is something that you’ll give to your dragon at least 2-3 times a week and more with your young dragons.
In Raising Bearded Dragons: The Ultimate Care Guide, we have a super extensive food list that goes over the supplements you need to schedule as well as more of the different types of vegetables as well as insects that you can give to your bearded dragon.
We have just gone over some of the basics of what bearded dragons eat. Click on the link below to check out Raising Bearded Dragons: The Ultimate Care Guide. Purchase the guide today and we will include a bonus food list. This is the most complete list I’ve ever seen, so don’t pass this up. Click on the link below today.

How healthy living nearly killed me | A.J. Jacobs

I’ve spent the last decade subjecting myself to pain and humiliation, hopefully for a good cause, which is self-improvement. And I’ve done this in three parts. So first I started with the mind. And I decided to try to get smarter by reading the entire Encyclopedia Britannica from A to Z — or, more precisely, from “a-ak” to “Zywiec.” And here’s a little image of that.
And this was an amazing year. It was really a fascinating journey. It was painful at times, especially for those around me. My wife started to fine me one dollar for every irrelevant fact I inserted into conversation. So it had its downsides. But after that, I decided to work on the spirit.
As I mentioned last year, I grew up with no religion at all. I’m Jewish, but I’m Jewish in the same way the Olive Garden is Italian. (Laughter) Not really.
But I decided to learn about the Bible and my heritage by actually diving in and trying to live it and immerse myself in it. So I decided to follow all the rules of the Bible. And from the Ten Commandments to growing my beard — because Leviticus says you cannot shave.
So this is what I looked like by the end. Thank you for that reaction. (Laughter) I look a little like Moses, or Ted Kaczynski. I got both of them. So there was the topiary there. And there’s the sheep. Now the final part of the trilogy was I wanted to focus on the body and try to be the healthiest person I could be, the healthiest person alive.
So that’s what I’ve been doing the last couple of years. And I just finished a couple of months ago. And I have to say, thank God. Because living so healthily was killing me. (Laughter) It was so overwhelming, because the amount of things you have to do, it’s just mind-boggling. I was listening to all the experts and talking to sort of a board of medical advisers.
And they were telling me all the things I had to do. I had to eat right, exercise, meditate, pet dogs, because that lowers the blood pressure. I wrote the book on a treadmill, and it took me about a thousand miles to write the book. I had to put on sunscreen. This was no small feat, because if you listen to dermatologists, they say that you should have a shot glass full of sunscreen.
And you have to reapply it every two to four hours. So I think half of my book advance went into sunscreen. I was like a glazed doughnut for most of the year. There was the washing of hands. I had to do that properly. And my immunologist told me that I should also wipe down all of the remote controls and iPhones in my house, because those are just orgies of germs.
So that took a lot of time. I also tried to be the safest person I could be, because that’s a part of health. I was inspired by the Danish Safety Council. They started a public campaign that says, “A walking helmet is a good helmet.” So they believe you should not just wear helmets for biking, but also for walking around. And you can see there they’re shopping with their helmets. (Laughter) Well yeah, I tried that.
Now it’s a little extreme, I admit. But if you think about this, this is actually — the “Freakonomics” authors wrote about this — that more people die on a per mile basis from drunk walking than from drunk driving. So something to think about tonight if you’ve had a couple. So I finished, and it was a success in a sense. All of the markers went in the right direction. My cholesterol went down, I lost weight, my wife stopped telling me that I looked pregnant. So that was nice.
And it was successful overall. But I also learned that I was too healthy, and that was unhealthy. I was so focused on doing all these things that I was neglecting my friends and family. And as Dan Buettner can tell you, having a strong social network is so crucial to our health. So I finished. And I kind of went overboard on the week after the project was over. I went to the dark side, and I just indulged myself. It was like something out of Caligula. (Laughter) Without the sex part.
Because I have three young kids, so that wasn’t happening. But the over-eating and over-drinking, definitely. And I finally have stabilized. So now I’m back to adopting many — not all; I don’t wear a helmet anymore — but dozens of healthy behaviors that I adopted during my year. It was really a life-changing project. And I, of course, don’t have time to go into all of them.
Let me just tell you two really quickly. The first is — and this was surprising to me; I didn’t expect this to come out — but I live a much quieter life now. Because we live in such a noisy world. There’s trains and planes and cars and Bill O’Reilly, he’s very noisy. (Laughter) And this is a real underestimated, under-appreciated health hazard — not just because it harms our hearing, which it obviously does, but it actually initiates the fight-or-flight response.
A loud noise will get your fight-or-flight response going. And this, over the years, can cause real damage, cardiovascular damage. The World Health Organization just did a big study that they published this year. And it was done in Europe. And they estimated that 1.6 million years of healthy living are lost every year in Europe because of noise pollution.
So they think it’s actually very deadly. And by the way, it’s also terrible for your brain. It really impairs cognition. And our Founding Fathers knew about this. When they wrote the Constitution, they put dirt all over the cobblestones outside the hall so that they could concentrate. So without noise reduction technology, our country would not exist.
So as a patriot, I felt it was important to — I wear all the earplugs and the earphones, and it’s really improved my life in a surprising and unexpected way. And the second point I want to make, the final point, is that — and it’s actually been a theme of TEDMED — that joy is so important to your health, that very few of these behaviors will stick with me unless there’s some sense of pleasure and joy in them.
And just to give you one instance of this: food. The junk food industry is really great at pressing our pleasure buttons and figuring out what’s the most pleasurable. But I think we can use their techniques and apply them to healthy food.
To give just one example, we love crunchiness, mouthfeel. So I basically have tried to incorporate crunchiness into a lot of my recipes — throw in some sunflower seeds. And you can almost trick yourself into thinking you’re eating Doritos.
(Laughter) And it has made me a healthier person. So that is it. The book about it comes out in April. It’s called “Drop Dead Healthy.” And I hope that I don’t get sick during the book tour. That’s my greatest hope. So thank you very much. (Applause)

Plant-strong

Translator: TED Translators admin Reviewer: Luis Tsai Hsu So, I’m wearing my shirt inside out, and a lot of you pointed that out to me. (Laughter) I do this from time to time. And when somebody says it, I say, “I know… I’m wearing my shirt inside out.” I’m doing it on purpose. And I’m doing it to help people turn their health around.
And they say, “Well, how do you do that?” And here’s the story. So, I became a firefighter to help people, to save lives, and to slay dragons. Now, obviously, we are not slaying real dragons, but that’s our term for slaying fires.
And a fire is really a living, breathing entity, It’s hellbent on creating all the destruction and devastation that it can. So, as firefighters, we have to use all of our wit, and we have to outwit, outsmart it and outlast it, and whether it’s an offensive fire or a defensive fire, there’re certain tactics.
but the essence of basically killing a fire is, “You gotta put the wet stuff, on the red stuff” It doesn’t matter if it is a house fire, an apartment fire or high-rise fire, or it’s a wild land fire We gotta put the wet stuff, on the red stuff Now, I retired from firefighting a little over 3 years ago
So, I’m no longer fighting fires, but I’m now still helping people, I’m saving lives, and I’m slaying a different type of dragon. The dragon that I’m slaying today, is what I call “The 5-headed-chronic -western-disease dragon”
And this, over the last 100 years, has gained more strength and power and momentum and it is flying around, and it’s creating more death and destruction on different individuals, families, cities and states in this country, It’s just absolutely amazing.
And, let me introduce you to this 5-headed dragon So, right here we have the leader of the pack, we have heart disease 100 years ago, heart disease wasn’t even on the map as 1 of the top 10 killers of Americans Today, it’s first and foremost.
1 out of 2 of us will die from heart disease here we have breast cancer and prostate cancer. Cancer will overtake heart disease as the number one killer of Americans if the trends continue. In the back row, we have diabetes, and we have obesity Close to 50% of Americans by 2030 will be either pre-diabetic or diabetic. And over 70% of America is now overweight or obese.
This dragon is playing [unclear] , ok? It’s playing hardball. And the current paradigm that we are using to try and slay this dragon, is having absolutely no effect whatsoever. There is a saying, “You can’t break a glass bottle from the inside.”
And what we are currently doing, with pills and procedures and more legislation and more doctors, we’re not gonna break that glass bottle, we have to think outside the box. And the answer is “Plant-Based Nutrition”
Something so simple, yet so profound, and so inexpensive, that we can absolutely lay waste to this dragon that now comprises 75% of this country’s healthcare cost, right? 5 diseases, 75% of our healthcare cost and we know beyond a shadow of a doubt, every one of these diseases is either preventable, or reversible with Plant-Based Nutrition.
Now, let me tell you why I have so many ripples of hope about what we can do as a country going forward. We did something really remarkable at a little fire house in Austin Texas. We had an event that led to the discovery that one of our own was basically a dead man walking And so I challenged these guys, for 28 days, let’s eat All Plant Strong.
Fruits, vegetables, whole grains, and beans, some nuts and seeds. And these guys, in 28 days, morphed themselves from medical time bombs, into healthy superheroes. It was absolutely amazing and it was the spark that we needed and the confidence that these guys needed to start a wellness revolution at a firehouse in Austin Texas, the land of beef.
(Laughter) And so we just fed on this. And the reason we were so successful is because We made health a habit at the fire station. And some of the things that made it easy is: The guys at the fire station, they’re my second family, so we had tons of support. We had an amazing amount of love between us, compassion, respect and admiration.
So we had the support that you need. We developed routines. Every day, we would come in, and we’d have a plant-strong lunch that we share together. Then we’d have a crossfit workout in the afternoon then we’d have a dinner, a plant-strong dinner
We would alternate who would buy and shop for the food and then together we would cook it and eat it and then clean up afterwards. And then the next morning, we’d have a plant-strong breakfast, and then before we left at noon the next day, we’d have a plant-strong lunch.
So these are routines that became consistent for months and years. And then, I had to educate these guys. These guys had the same questions that everybody has, “Well, where am I going to get my protein from plants?
What about calcium?” And I said, “Listen, as far as protein’s concerned, It’s a boogie man Don’t worry about it. The scientific term, the medical term for protein deficiency is “kwashiorkor” You don’t know it, and you don’t even have to mess with it.
And then for calcium. Calcium comes from the ground. It’s a mineral. If you want to get a first-class, highly absorbable form, you want to get it from plants, not from “Cowcium”. It’s not “cowcium”. Its calcium. (Laughter)
And then these guys, They had a huge disconnect between what they thought was healthy and what in reality was healthy. So let’s slay some of those dragons here together. So first, they thought red-meat put hair on their chest and made them more manly.
And I said, “Guys. No, it doesn’t. What it does is it puts plaque in your arteries and it makes you less of a man.” The canary in a coal mine when it comes to heart disease, the first sign is an under-performing penis.
And I said you take a look at the size of the arteries, they go up to the brain, to the heart, down in the legs. They’re all about 5 milimeters in diameter, about the size the straw here You take a look at the size of the artery that goes to the male penis. It’s one millimeter. It’s about the size of this coffee stirring straw right here.
And what happens after you eat all that meat, right? It gets clogged up with all the fat, the cholesterol and the animal protein. And that’s problematic. So if you want to slay that erectile dysfunction dragon and allow your Puff-the-Magic Dragon to roar, (Laughter) then you want to ditch the meat, and reach for the plants
These guys were absolutely convinced that chicken was like the cat’s meow when it came to health food I said, “Listen guys. Never mind that cat. This doesn’t even belong in your dog’s breakfast bowl” It’s got the exact same amount of cholesterol as red meat It’s got the same amount of problematic animal protein and the leanest piece a chicken is still 20 percent saturated fat You’re not gonna be slaying any dragons with this guy here.
“Okay, Rip. Fine. But fish, fish is the gold standard when it comes to a healthy meat, right?” And I said, No. It’s the 10th standard, okay? Most fish has more cholesterol than red meat or chicken; salmon, which is considered the healthiest, is 50 mg of cholesterol, You still have the problematic animal protein and varying amounts of the bad fats.
Don’t go there guys. “Okay. Fine, Rip. But the egg! The egg is the perfect food, right? We know it’s the perfect food.” Yes, the perfect food, if you want to continue to feed the dragon. If you want to slay the dragon, you have to get rid of the egg. One egg yolk, almost 200mg of dietary cholesterol. It’s the same amount as 2 Burger King whoppers.
And the egg white is a concentrated source of animal protein. Now these guys knew the processed and refined foods were not healthy. They knew about the sugar, and the pop, and the fried chips and the candy bars. But they had no idea that extracted plant oils weren’t heart-healthy and weren’t beneficial. So I said, “Listen, this epitomizes the triumph of marketing over science.
” Let’s pick on olive oil for a second. It takes 1,375 olives that you have to squeeze to death to get enough olive oil for one 32-ounce bottle. And you get rid of all the fiber, the water, and the phytonutrients and the anti-oxidants in the water. And you’re left with a hundred percent fat, the most concentrated source of calories on the planet and it’s 15 percent saturated fat. and all it’s doing, is contributing to America’s heart disease and obesity epidemic.
“Okay. But MILK! Milk does the body good, right?” (Giggles) And I said, “Guys. Milk does nobody any good. You’ve been marketed to death. Don’t buy the hype.” As a matter fact, this milk is just liquid meat Is what it is. It’s got a very similar nutritional composition and as a matter of fact, one eight-ounce glass of whole milk has the same amount of saturated fat as four slices of bacon
“Okay. Fine! But cheese!! Don’t take away our cheese, whatever you do, because we love our cheese!” and I said, “I know you love your cheese, and that’s exactly why I need to take it from you” Because when I think of a loving relationship I think is something that also loves you right back, and that cheese does not love you back.
Not one iota. And so I hereby declare that you are all in an abusive relationship (Laughter) with cheese and you need to kick it out of your life. “Okay, fine! But don’t take away our yogurt! (Laughter) I mean, this is the Mediterranean super food People can live to be 100 on this stuff, right?”
And I said, “Again guys, it’s the magic of marketing, alright? For example, this newfangled Greek yogurt that’s zero fat and twice the amount of protein, It’s twice the amount of problematic animal protein that’s promoting tumors and cancers, that’s leaching calcium from your bones, that’s harsh on the kidneys and the liver, You don’t need to go there, you can get everything you need from plants
And to put the nail into the coffin (Laughter) I said, “Guys, we’re the only mammals that drink another mammal secretions, okay?” You don’t need to go there, not one bit There’s 51,000 mammals on the planet. We’re the only ones that have the unmitigated audacity to go there, Alright?
Don’t need to do it. So, the other thing we did at the fire station after I educated them, we surrounded ourselves with these fantastic “Mantastic” foods.
(Laughter) So it filled them up, without filling them out. It tasted great and it made them feel fantastic. So we did these great breakfast bowls with plant-based milks Spelt-blueberry pancakes as big as manhole covers. (Laughter) Quinoa and fruit, the magic grain, almost 20 percent protein.
Oatmeal Waffles with nice Apple Sauce on top and then, for lunches and dinners We would do all time, all-american favorites We do Plant-Strong Pizzas, Portobello Mushroom Fajitas with all the fixings. Lentil Oatloaf.
It’s kinda glazed with barbecue sauce on the bottom and the top. Macaroni and NOT Cheese. (Laughter) Red Lentil Sloppy Joe’s. They were a lunchtime favorite. Bean and Grain Burgers, Red Curry Tofu Stir-fry, Three-Bean Chili Kale Ceviche Salad.
Kale, It’s angry lettuce. (Laughter) It needs to be tamed. So we would take a little bit of lemon juice avocado, some spices and drive it in there. Sweet Potato Lasagna, an all-time dinner favorite. Makes fantastic leftovers. Black Beans and Rice Extravaganza.
This is the ultimate peasant food, We could feed 5 hungry firefighters for less than 15 dollars. Dark Chocolate Oatmeal Cookies for dessert, Chocolate Mousses, Date Nut Crust Fruit Pies, and then a variety of fruits. But what happened is over the course of 28 days and then beyond, these guys developed a much more sophisticated and mature palate that appreciated all the little nuances and subtleties that are in these plant-based foods. and when you’re eating the standard american diet, all you’re really tasting is the salt, the sugar and the fat that it’s all laced with.
So I challenge you all. If you really want to develop a sophisticated palate, And also what happened with these guys over the 28 days They started pooping Perfectly, Regularly (Laughter) Most Americans are consuming 5 to 15 grams of fiber a day.
You start eating plant-based, and suddenly it goes up to 30 to 70 grams of fiber, and now you’re regular as a Swiss commuter train, ok? (Laughter) and you’re light and unencumbered and the quality your life goes through the roof.
So you gotta kick the habit! And I’m not talking about smoking cigarettes right now, but i wanna talk about cigarettes for a second 50 years ago, close to 50% of America was smoking cigarettes Now, it’s less than 20 percent. and what happened is America basically got educated, and understood that smoking cigarettes was not good for your health.
We need to do the same thing around the standard American diet. And this is more insidious and more destructive than smoking cigarettes. 94 percent of our calories are calories that don’t count They’re destructive instead of constructive only a mere 6 percent are coming from fruits, vegetables, whole grains and beans, that are really constructive, healthy calories.
So we need a complete paradigm shift that goes on in this country. And so this is what I want you to do. I want you to make health a habit. take the 28 day challenge. Okay? And change your health destiny, change your relationship with food.
You will forever have a different relationship Find Support. This culture, this society does not support healthy living or healthy eating right now. So you need to find support at family at work, online. There’re all kinds of communities where you can get support Develop Routines that make this sustainable Whether it’s breakfast, every morning, the same thing.
Monday through friday Whether it’s finding a couple restaurants that you can go to but Find Routines! Educate Yourself! Read the litany of fantastic books that are out there on this subject, Because once you have the knowledge, it’s a different ballgame.
And then surround yourself with healthy foods We do not want this to be about willpower, okay? So have a nice, sterile environment at home. And then make food you enjoy. You saw all the fantastic pictures that we’re eating at the firehouse
This is not about deprivation, this is about empowerment. If you’re a true foodie, you want to go towards eating plant-based. 99 percent of the food on the planet comes from plants, a mere 1 percent comes from animals and animal byproducts
So, I have so many ripples of hope going forward that this country can turn it around. I know that if a little fire house in Austin Texas can do it, any house in America can do this, And I know that the trends are changing. I’ve seen it with my own eyes over the last six years.
I’ve seen “Forks Over Knives” become the number 1 viewed and selling documentary in America for the last two years. I’ve seen the fast-food president go plant-based. I’ve seen media moguls like Oprah and Ellen that are now pushing plants. I’ve seen CEO’s like John Mackey and Biz Stone of Twitter, and Bill Ford, of the Ford Motor Corp., that are going plant-based.
I’ve seen professional athletes like Serena and Venus Williams and the #1 running back in the NFL, Arian Foster, are now plant-based. The time is here! The time is now! Go Plant Strong!
Slay! Slay the five headed dragon in your life. And it all starts with what’s at the end of your fork, your spoon and your knife. Awesome!!! (Laughter) (Applause)