Lowell Weicker, former U.S. senator and governor of Connecticut and current president of the Trust for America’s Heath

Mark Masselli: This is Conversations on Healthcare. I am Mark Masselli.

Margaret Flinter: I am Margaret Flinter.

Mark Masselli: Margaret, we are four months out from Healthcare Reform
passage. The polls are drifting up but you know it feels a little like a high level
chess match with both sides positioning their pieces. We saw the Republican
Senators on the judiciary committee try to box in Supreme Court Nominee Elena
Kagan asking her to recuse herself on all future healthcare related matters. She
demurred and she said she didn’t work on any health reform matters as solicitor
general and the President moved to protect the Health Reform Bill by putting his
field general in place Don Berwick bypassing this senate procedures. There are
hundreds of decisions that need to be made to implement the bill if they are
going to be successful.

Margaret Flinter: And do you know I was thinking this morning it's just about the
one-year anniversary since the house first released its version of the bill last July
so certainly a very eventful year. And to that two-dimensional chess game they
talked about I think they actually be a three-dimensional one because the states
are playing such a huge role here and what a difference we say state to state.
We have 21 states that are getting ready, preparing for health exchanges and
setting up commissions to oversee the whole health reform implementation
process. Now on the other hand, we have about 20 states that are filing suits
saying the Health Reform Bill is unconstitutional and can't go forward as it is. So
we are going to have a very interesting time getting back to the Supreme Court
discussion seeing what happens on response to those states.

Mark Masselli: And you know the benefits are still rolling out for the Health
Reform Bill. 4 million small businesses were notified that they might be eligible
for a tax credit to defray the cost of health insurance and a few 100,000 Medicare
Beneficiaries who have reached that Doughnut Hole in Medicare coverage will be
getting a check for $250 quite soon.

Margaret Flinter: Well, that will certainly make some people happy. And now we
are going to turn to some of who I consider a consummate chess player on the
American Political Landscape and that’s an American Leader of many decades
Lowell Weicker, Former Connecticut Governor, US Senator and currently the
President of the Trust for America’s Health. The trust has been working to
modernize the public health system in America and bring prevention solidly back
to the Center of Health and Healthcare. The trust addresses a range of issues
and scores how well states do in investing an effective public health measures.
They are known for those public health report cards and also their aptly named F
as in Fat report the tracks obesity trends and policies.

Mark Masselli: No matter what the story, you call hear all of our shows on our
website chcradio.com. You can subscribe to iTunes to get the show regularly
downloaded or if you would like to hang onto our every word and read a
transcript of one of our shows, come visit us at chcradio.com.

Mark Masselli: And as always if you have got feedback, e-mail us at
chcradio.com, we would love to hear from you. Now, before we speak with
Governor Weicker, let's check in with our producer Loren Bonner for the headline
news.

Loren Bonner: I am Loren Bonner with this week’s headline news. The
administration announced new regulations under healthcare reform that will
require health plans to cover recommended prevention services with no co-pays
deductibles or other out of pocket fees. The rules would extend this prevention
benefit to 31 million people in new employer sponsored plans and to 10 million
people in new individual plans next year. Department of Health and Human
Services Secretary Kathleen Sebelius says the administration is laying the
foundation to help transform America’s healthcare system into one that focuses
on every American healthy.

Kathleen Sebelius: It's in our best interest as a country to make recommended
preventive care widely available to make it affordable and to make it convenient
for American consumers and that’s what we are trying to do.

Loren Bonner: The rules will eliminate co-payments deductibles and other
charges for blood pressure, diabetes and cholesterol tests, many cancer
screenings, routine vaccinations, prenatal care and regular wellness visits for
infants and children. Other services offered at no cost also include counseling to
help people stop smoking, screening and counseling for obesity and HIV testing.
And the President is committed to combating AIDS with his own domestic HIV
AIDS plan. He announced a new national strategy last week that Calls for AIDS
Relief in three major ways.

President Barack Obama: Reducing the HIV infections, improving care for
people living with HIV AIDS narrowing healthy spirits. These are the central
goals of our national strategy.

Loren Bonner: The CDC estimated that 1.1 million Americans were living with
HIV AIDS in 2006. Although annual AIDS deaths have declined the number of
the people living with HIV is growing. HIV AIDS advocate say the healthcare
reform legislation is an important step for people living with HIV but more
resources need to be dedicated to fighting the disease especially in communities
of color. The national action plan will redirect money to population groups at the
greatest risk including gay and bisexual men and minorities. The announcement
comes as state programs that provide AIDS drugs to patients with HIV grapple
with growing weighting lists for the critical medication that decreases the spread

of HIV and prevents the progression to HIV. Secretary Sebelius announced last
week that she will provide $25 million to states to help pay for the drug
treatments which average more than $12,000 a year. This week on
Conversations on Healthcare we are exploring public health and what efforts are
being made to improve this system. The Trust for America’s Health is a National
Leader on this front and the organization has recognized the need for stronger
prevention and public health preparedness policies in order to improve the health
of all Americans as we transition our health care system into one that provides
better healthcare to all. The Patient Protection and Affordable Care Act of
legislation is aligned with the trust goal to expand investments in prevention and
public health programs. Included in the legislation is the prevention and public
health fund $50 billion over the next 10 years to support prevention and public
health programs. According to Jeff Levi, the trust’s Executive Director, this could
translate into anything from a national campaigned to promote immunizations
and a better understanding of the safety of vaccines to a narrower neighborhood
approach that puts lights in a playground or negotiates a mixed use agreement
with a school so the playground can be open after hours. The goal is to build
healthier communities with a particular emphasize on eliminating barriers to good
health for low income residents. However, the administration recently announced
that a significant portion of this year’s prevention funds will go toward healthcare
workforce issues instead of the original intent to allocate the money toward
community prevention and public health. Only half the money $250 million will
go toward community and clinical prevention public health infrastructure,
research and public health training, the other $250 million will go toward
workforce development. The trust’s CEO Jeff Levi said that they will work with
the administration to make sure that next year’s funds will be strictly allocated to
investing and specific community prevention programs like the newly authorized
community transformation grants, also expanding state and local health
departments as they move toward accreditation and creating a new program of
public health services and systems research. Let’s turn now to our interview with
today’s guest the President of Trust for America’s Health Governor Lowell
Weicker to learn more about America’s future public health system.

Mark Masselli: This is Conversations on Healthcare. Today we are speaking
with Lowell Weicker former US Senator and Governor of Connecticut and current
President of Trust for America’s health a non-profit non-partisan public health
policy organization. Welcome Governor Weicker. You left an impressive legacy
during your years in the United States senate. You help shaped the Americans
with Disability Act and played a major role in strengthening the National Institute
of Health. After leaving office you took on a new cause public health. You are
now president of the Trust for America’s Health which is working to modernize the
public health system in America. With national health reform now underway
what's the major focus of the trust for America’s health and how does public
health fit into the federal health reform legislation?

Lowell Weicker: Well, it has a large place in the legislation that was passed in
the sense that big chunk of it goes to what is known as community transformation
grants in the sense of being able to go ahead and shape the community to keep
people healthy bicycle pass, playgrounds, the types of facilities which encourage
physical activity. It's also true that the public health piece in the legislation
addresses prevention rather than cure. And obviously prevention is much, much
cheaper than the cure process. You know I am going to use this occasion to site
something that was said to be within the last 24 hours. So I can make a point to
all your listeners as to the healthcare legislation. This person was opposed to
the legislation and didn’t want any healthcare legislation. And I said well, I said I
am not there. I said I certainly agree that there are many parts of the healthcare
legislation that could be improved. Maybe there should be some additions but to
go ahead and say no to the entire concept just suffice reality in the United States
of America. And this person turned to me and said well I would rather go ahead
and tear the whole build down and then start building a new bill. If this individual
realized the years that has taken us to get to this point where healthcare
becomes a priority for all Americans, you just wouldn’t make a comment like that.
You know I think that’s a prevailing attitude among many people especially in the
political sense. So, I want to make clear that nobody is stating that what’s out
there now is perfect. But it’s a hell of an important step forward and that’s to me
the main thing. The train is on the track and that’s the first time that’s happened.

Mark Masselli: That’s a great observation.

Margaret Flinter: Yes, thank you. And governor, this past decade, even the past
couple of years, certainly a real wakeup call about the need to bring the public
st
health system into the 21 century I think of bioterrorism and H1N1, the natural
disasters as well as all of the chronic diseases that call for a strong public health
response. Well, really interested to know about the Healthier America Project of
the Trust for America’s Health. It includes a blueprint for Healthier America really
modernizing the federal public health system. What progress have you seen with
that modernization in the last few years and what do you think we can look
forward to in the coming couple of years?

Lowell Weicker: Well as you know we have issued several reports on the
component parts of a total plan, obesity, smoking these types of matters which
are prevention. Do I see well let's take for example let's just take the public
health grading of the systems in the 50 states. We issue a report card for every
state. And quite frankly the results are varied from year to year. The report card
is based on what money is devoted to public health in a particular state. How
many public health experts are there in the state? What do they do to get people
to come into the public health system and so on and so on. So that had an
impact on what the states are doing here and it has somebody looking over their
shoulder trying to protect the public interest and sometimes the states have done
very well and the next year they just fall off the map because they figure they cut
all the funding for public health. One thing that bothers me for example, in the

current economic climate, is the public health is going to be one of the first things
to be tossed out of the window. And that will be disastrous in terms of where we
go health wise. It's important to know for example on one aspect of public health,
the obesity which we have touched upon that this generation of young Americans
born now has a lower life expectancy than those before. Well that will give you
an idea to the importance of addressing obesity.

Mark Masselli: Governor, as you noted one of the big focuses of the Trust for
American Health is prevention policies. You have worked with the Robert Wood
Johnson Foundation, you released a new public opinion survey which finds that
Americans rank prevention as the most important healthcare reform priority and
overwhelmingly in support increasing funding. But the same time I know you are
very concerned as a former governor. And you just mentioned that now about
the fiscal realities that the state governments will face many of whom are going to
be forced to cut spending. What advice do you have to your fellow college, your
fellow governors about what they should do in terms of how to prioritize
prevention in public health activities in the CEF rating that they have.

Lowell Weicker: Well the same advice I go on describing the National Health
Plan and now we hear lots of talk from the opponents of the National Healthcare
Bill as to how much money it's going to cost. With nobody saying okay there is a
big health piece and which actually saves you billions of dollars. Look we all
agree the health scenario in the United States right now is disorganized. It's very
expensive. It’s leaving people totally out of the circle of care. I mean it's a mess
it's the best way to describe it. And to go ahead and straighten that mess out is
not going to be an easy task. But public health is one area I think that even in
putting the bill together republicans and democrats had no argument over the
public health section. And what really made me mad as a matter of fact down in
Washington was in the old days you could agree or disagree on different aspects
of legislation. But nobody said “no” to the entire concept and that in effect is
what happened in this past year.

Margaret Flinter: Governor, I am glad you raised the public health component of
the Health Reform Bill. We were of course very happy to see the prevention in
public health fund included with the intention to provide financial support for
prevention in public health programs, I think $15 billion over the next 10 years. I
have been interested to see that a significant portion of the fund right now is
being allocated to healthcare workforce issues especially primary care workforce
development we all recognize how important that is but are you concerned that
this will take money away that was intended for the public health programs?

Lowell Weicker: No, you know there is obviously going to be a jocking back and
forth as we as the whole country operates within very narrow financial
parameters but if I can only get the public to see that what's being done in the
overall is going to benefit each of us then I am happy with the situation now look,
what bothers me and I got a specific example I can say to illustrate my point. If

you ask the 50 states what are you doing with the tobacco settlement money, I
bet you, you are going to get a variety of answers none of which have to do with
tobacco cessation of smoking. I use that money to fund about everything else in
the budget including right here in Connecticut.

Margaret Flinter: Right.

Lowell Weicker: And that’s outrageous, that money was specifically met to go
ahead and bring it in to smoking in this country which is one of the major causes
of death and certainly there is no excuse for not following the mandate that was
imposed. Well that’s the only thing that bothers me in terms of the various
component part of the health bill, people are going to start to use the money for
their own purposes rather than the purpose rather than the purpose of the design
in Washington.

Mark Masselli: Today we are speaking with Lowell Weicker – President of Trust
for America’s Health. Governor last year swine flu epidemic gave us all our front
row seated scene what a major epidemic would do and the strains on resources
that it could create and although it turned out to be less devastating that the initial
predictions were, it was certainly a wakeup call to look at our public health
preparedness. Do you think that country is ready for another threat like this one
and how is the Trust involved in helping states prepare?

Lowell Weicker: Of course our spirit, it worries me. The only reason I am
chucking is my number one aid that’s Trust for America’s Health who now has
moved on to the FDA a lady by the name Kim Elliot. Kim was assigned the duty
of the swine flu epidemic, and she threw her heart and soul into that. And like
many people we tried to make it so that we were truly prepared for what
everyone believed what's going to be a pandemic. Well as it turned out, that
didn’t happen and what worries me now as the next time we say there is going to
be even nobody is going to believe us. Believe me these things happen and you
know the things that belong to nature and to God are not things that we can go
ahead and dictate within our human population, so yes I think the states by virtue
of the preparedness lessons of the swine flu are better prepared today and will
be for a few years but if nothing happens I think that will probably fade from their
memory whereas it is a very real possibility. And you have to point out that we
live in a global society more so than ever so that what happens in the middle of
Africa can all of a sudden no matter in 48 hours happen in the middle of United
States. The interaction, you know, being as rapid and as numerous as they are,
so hopefully the country learned something even though the epidemic was not as
severe but hopefully those lessons will last for a while before that fade from the
memory.

Margaret Flinter: Governor Weicker, we do live in a global world and culture and
when you look around this country and the world, what do you see in terms of
innovation and who should our listeners at Conversations be keeping an eye on?

Lowell Weicker: I think the United States, let me say on thing of my chest. I think
the United States can play a far greater role in the world than it does in terms of
disease prevention and healthcare etc. You know we have always excelled at
the business or life that’s been the United States. Up until very recently when all
of a sudden we were very much involved in the business of death 20:25 vis-à-
vis the various wars that were waging. I mean an example and I don’t know the
exact statistics but I heard just myself on I think public radio the other day, we
have no vaccine for malaria we all agree, fair.

Margaret Flinter: Yeah.

Lowell Weicker: And yet it only costs a few million dollars to supply the main
ingredient against malaria which is mosquito netting and we ought to be able to
distribute that to every men, women and child in the world and we are talking
millions, we are not talking billions, it's very inexpensive but it is the only thing we
have at hand. You know I remember when I got into a huge debate here in
United States with the far right over the matter of AIDS and specific to that expect
of it which called for sex education and this was before we had the various
cocktails but we still don’t have the vaccine. The various matters that could go
ahead and ameliorate the disease and Jesse Helms and others refuse to listen to
the matter of sex education. I said listen I said if you don’t do this it’s the only
tool we have at hand to prevent AIDS because once you got it you are dead.
Now, that’s not the case today which sure it was in the 80s and what I am trying
to say you is that we can play a significant role with not so much money in terms
of saving life around the world if we apply ourselves to that instead of we have
chosen to spend trillions on war and we are not very admired for it at the same
time many of our philosophical opponents in the world are sending medical
teams and medical assistants around the world. We do it better than anybody
else but we are not doing it to the extent that we should.

Mark Masselli: Today we have been speaking with Lowell Weicker, former US
Senator and Governor of Connecticut and current President of Trust for
America’s Health. Governor, thank you so much for joining us today.

Lowell Weicker: Yes, great to be with both of you.

Mark Masselli: Each week, Conversations highlights a bright idea about how to
make wellness a part of our communities into everyday lives. This week’s bright
idea focuses on a program specifically targeting kids and teens in California
called Rethink Your Drink. Many people don’t realize just how many calories
beverages can contribute to their daily intake especially when it comes to excess
sugar. The single biggest dietary source of added sugar is sugar re-drinks in one
regular 20 ounce can of soda there are nearly 17 tea spoons of sugar. Daily
consumption of these sweet and beverages dramatically increases a child’s risk
for being overweight or obese later in life, which can lead to Type-2 Diabetes and

Heart Disease. At this summer all YMCA summer programs in the Gold Coast
California region will be learning about that Rethink Your Drink Program and both
parents and kids will be invited to participate in an eight-week summer challenge.
In addition to the final prices, everyone will receive a poster and a water bottle to
help them make healthy or beverage choices such as water or a 100% fruit
juices. It’s part a campaign by the San Luis Obispo Public Health Department
aimed to bring attention to the sugary content of soda and other popular sugar
sweetened drinks, teach proper nutrition labeling and offer insights into healthier
drink substitutes. In order to reach as many people as possible the campaign
offers free training, presentations and educational material to local organizations,
schools and programs. Different counties in the region are conducting their own
Rethink Your Drink launches this summer and hopefully other public health
departments around the country will eventually follow through teaching kids to
reach for a cold glass of water this summer instead of a sugary beverage and to
keep that habit up in definitely now that’s a bright idea.

Margaret Flinter: This is Conversations on Healthcare. I am Margaret Flinter.

Mark Masselli: And I am Mark Masselli, peace and health.

Margaret Flinter: Conversations on Healthcare, broadcast from the Campus of
Wesleyan University at WESU streaming live at Wesufm.org and brought to you
by the Community Health Center.