|
The ideas and innovators shaping health care | | | | |  | | By Evan Peng, Carmen Paun, Erin Schumaker, Ruth Reader and Daniel Payne | | | | | 
Marshall sees the case for government promoting healthy eating. | Evan Peng/POLITICO | Sen. Roger Marshall (R-Kan.) wants Americans to eat healthier — and sees a role for government in promoting better diets. Doc Marshall, who practiced medicine as an OB/GYN before entering Congress, told a Milken Institute 2023 Future of Health Summit audience today that he was concerned about increases in diet-related health problems and an American menu rife with processed foods packed with salt and sugar. What’s his plan? It would largely come down to the private sector to embrace food as medicine and facilitate healthier eating, Marshall said, but he acknowledged that the federal government could play a role. The farm bill, up for reauthorization, and the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, could be focal points, he said. Marshall also pointed to several pieces of bipartisan food-policy legislation he’s introduced, from a pilot program for medically tailored home-delivered meals to a measure to require community health centers to offer nutritional and dietary services to low-income patients. Marshall hopes food policy can be an area for bipartisan collaboration. He pointed specifically to his relationship with Sen. Bernie Sanders (I-Vt.), whom he recently visited in Vermont to tour community health centers and discuss how to integrate food as medicine into those spaces. The two are collaborating on legislation to boost primary care. “We disagree on some things, but what we both agree upon is that people don’t have meaningful access to primary care in this country, that prescription drugs are too expensive,” Marshall said. “We don’t always agree on the solutions, but we agree that that’s the challenge.” Why it matters: Poor diets are the leading cause of death and disability in the U.S.
| | | | GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here. | | | | | | | | | 
| This is where we explore the ideas and innovators shaping health care. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ruth talks with POLITICO health care reporter Maya Kaufman, who talks through New York’s new legislation that makes it easier for state residents to find doulas to provide nonmedical support during pregnancy, labor and beyond.
| | | | | | | 
Collins and Wegrzyn celebrate the confirmation of NIH Director Monica Bertagnolli. | Erin Schumaker/POLITICO | Renee Wegrzyn's first year directing the Advanced Research Projects Agency for Health primarily meant standing up the new high-risk, high-reward agency. Now Wegrzyn is laying out her vision for year two, she said at the Future of Health Summit. The agency's initial investments ranged from a project to help joints heal themselves to one aimed at improving cancer surgery. Wegrzyn is now aiming to fill in gaps in ARPA-H's portfolio. What's next? "We think we can really advance the state of the art in women's health, in maternal health, mental health — especially adolescent mental health," she said. "We need to really proactively start to search in those areas." She also wants to build out the agency's international strategy next year. ARPA-H will look across the globe to fund innovation and bring back the best ideas. On that, Wegrzyn made a key hire this fall. Megan Frisk, a former senior advisor in the State Department, is ARPA-H's new director for international affairs. Dive deeper: As head of a new agency, Wegrzyn's learning to navigate her role in the government ecosystem. That means engaging with members of Congress, which Wegrzyn had never previously done, as well as figuring out how to work with the National Institutes of Health, she told Dr. Francis Collins, the former NIH director. "We can really lean on NIH for their incredible expertise. They helped incubate us and get us started," Wegrzyn said, noting that NIH can also learn from the new kid on the block. "We're teaching them about some of the ways you can hack bureaucracy."
| | | | 
Gawande hopes AI will help fight TB. | Carmen Paun/POLITICO | Artificial intelligence could speed diagnosis and treatment of tuberculosis, the global health boss at the Agency for International Development told attendees at the Future of Health Summit on Tuesday. How so? In the last few years, USAID has funded AI to read chest X-rays in seven countries, the agency’s assistant administrator for global health, Dr. Atul Gawande, said at the summit. That, combined with access to a primary care doctor and a portable molecular test that provides results within the same day, led to a 40 percent increase in detecting people who have tuberculosis, he said. “Combined with the ways the drug costs have been lowered, this is a vital part of the solution to being able to eliminate TB as a major public health threat by 2030,” Gawande said. Why it matters: Finding people infected with tuberculosis and treating them as soon as possible is key to fighting the disease, which has surpassed Covid-19 to again be the top killer among infectious diseases globally. But in many countries, not enough health care workers are available to speed the path from diagnosis to treatment. The latest World Health Organization report on tuberculosis, released Tuesday, shows that the world is off track in the effort to reach the 2030 target. The number of TB deaths in 2022 — estimated at 1.3 million — is only a fifth lower than in 2015, POLITICO’s Ashleigh Furlong reported.
| | | | 
Milken panelists said digital therapeutics makers need to rethink their business plans. | Erin Schumaker/POLITICO | | | “They believe that once you get an FDA approval, they’re going to be successful. That’s not the case.” Troy Tazbaz, the FDA’s director of digital health initiatives | | The shadow of Pear Therapeutics still looms over the digital therapeutics industry. How so? The company’s bankruptcy earlier this year was shocking because Pear had developed digital prescription therapies that were cleared by the Food and Drug Administration. But some digital companies misunderstand the regulatory pathway to success, said Troy Tazbaz, the FDA’s director of digital health initiatives, at the Future of Health Summit on Tuesday. “You have to ask the question, ‘How am I going to get paid for this?’” Tazbaz said. That means considering what type of clinical evidence insurance companies might require and whether they’ll see the product as useful to their customers. Even so: The pacing between companies, which can innovate rapidly, and regulators, not known for their speed, is mismatched. As a former executive at Oracle who grew up in Silicon Valley, Tazbaz is familiar with moving fast. Then, almost a year ago, he went into government. Going fast "doesn’t work when you’re dealing with 350 million people,” he said, adding, “The decisions that you do make have potential consequences that are at a scale that I never understood until I started working in the federal government.” “We’re not trying to be slow at this; we’re trying to be thoughtful about it.”
| | | | DOWNLOAD THE POLITICO APP: Stay in the know with the POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID. | | | | | | | | |  Ehrenfeld says government can help beat burnout. | AP | The state of the health care workforce is dire if nothing is done about burnout. The head of the U.S.’ top doctor lobby made that case at a Future of Health Summit panel discussion about the subject Tuesday, adding that policymakers could help. “If we don’t make investments in expanding the workforce, if we don’t reduce these administrative burdens, it’s only going to get worse,” Dr. Jesse Ehrenfeld of the American Medical Association said. Why it matters: Panelists underscored the precarious point the industry is in, given the pandemic’s toll on the health workforce. More and more providers feel burned out in recent years, according to the CDC, and several recent health care industry labor actions and strikes have specifically cited understaffing as a driving factor. Ehrenfeld said policymakers can help combat shortages and burnout by: — Eliminating prior authorization. Insurers’ process for approving prescriptions is overused and overly burdensome for doctors, he said, and eliminating it would free up clinicians’ time. — Protecting doctors who seek care. The AMA is working with state doctor groups to lobby for rules mandating that a caregiver’s decision to get mental health care remain confidential and not jeopardize their medical license. — Reforming the immigration system. Ehrenfeld lamented that J-1 visa waivers for work-exchange programs have gone unused when they could be alleviating staffing issues. — Funding residencies. Despite more medical schools opening in the last few years, residencies haven’t expanded, he said, arguing that expanded federal support would bolster the physician pipeline. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
