| | | | |  | | By Daniel Payne, Erin Schumaker and Carmen Paun | | | | | 
Azar and Becerra debated Medicare drug price negotiations at the Milken Future of Health Summit. | Daniel Payne/POLITICO | When it comes to the future of health care in the U.S., two of the secretaries of Health and Human Services from the Biden and Trump administrations agree on the generalities but not the specifics. How so? Speaking together at the 2023 Milken Institute Future of Health Summit in Washington today, HHS Sec. Xavier Becerra and his predecessor, Alex Azar, compared the current health system to Benjamin Franklin’s famous “Join or Die” cartoon depicting a snake cut in pieces. The point was that the myriad players in health care, from insurers to providers, need to better coordinate their efforts around the patient — from cost to outcomes. “Calling it a system is an overstatement,” Azar said, explaining that the HHS secretary’s role is to “serve as a convener” attempting to form the various parts into a better functioning whole. Bringing the providers, payers and drugmakers together to focus on patient outcomes is critical to the future success of the nation’s health system, both health leaders suggested. That’s apparent, they said, in considering the coordination of mental health care. Even so: They can’t agree on how to do it. Despite Azar and Becerra agreeing that the health system needs more agreement among different stakeholders, they were split on the government’s role in the marketplace, particularly concerning the Medicare drug price negotiations that Democrats ordered in last year’s Inflation Reduction Act. Becerra touted the new policy as a way to keep drug costs — and the burden across the health system — down. Azar said, “It’s just price fixing.” And with nations now negotiating a convention to guide the world’s response to a future pandemic under the auspices of the World Health Organization, Becerra said he didn’t see sufficient unity in Congress to sign on to new, legally binding international health agreements. Instead, he suggested the world’s public health leaders should work on another approach. “We may never get to the point of getting 67 votes to pass that out of the Senate,” he said.
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| 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, host Katherine Ellen Foley talks with POLITICO health care reporter Maya Kaufman, who explains what's behind New York Gov. Kathy Hochul's shift to opposing the funding of new overdose-prevention centers using opioid settlement monies, despite an advisory board's recommendations.
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Panelists at the Milken Institute Future of Health Summit discuss solutions for loneliness. | Shawn Zeller | Loneliness affects 1 in 2 Americans, and policymakers see it as a major public health challenge likely exacerbated by the pandemic. A growing body of evidence links loneliness and isolation to a greater risk of cardiovascular disease, dementia, stroke, depression and anxiety. Milken panelists offered concrete solutions ranging from involvement in the arts to community building to technology: — Jean Accius, president and CEO of the nonprofit Creating Healthier Communities, advocated for community-led solutions. A promising example: Age-friendly communities, such as a retirement community in Seattle that also houses a childcare center, promote interaction among generations. — Targeted social connection via technology can help, according to Ron Goldman, chief strategy and growth officer at Wisdo Health. Unlike social media, the company’s peer-support app connects members based on shared lived experiences, and they can volunteer to become helpers or coaches themselves. — Prescriptions for taking walks in nature and engaging in the arts, even for people who aren’t artistically skilled, can protect against loneliness, said Dr. Jeremy Nobel, a doctor on the faculty at Harvard Medical School who founded the Foundation for Art and Healing and its signature initiative, Project UnLonely. — Julianne Holt-Lunstad, a researcher on loneliness and professor of psychology and neuroscience at Brigham Young University, pointed to the six-pillar strategy in the surgeon general’s recent advisory on loneliness and social isolation, on which she was the lead scientist. To push that work forward, Holt-Lunstad would like to see national health guidelines on social connection. When to be concerned: There are different tiers of loneliness, Nobel explained. Most people are familiar with having bouts of loneliness from time to time — the bottom tier. A difficult or traumatic life event, like a serious illness or the death of a loved one, could catapult a person to the middle tier. “Loneliness is a signal. There’s something you need; it's a negative state,” Nobel said. Not taking action to address that signal risks transcending to the top tier, where health risks lie. That’s when loneliness starts to disrupt behavior and physiology. “It won’t just make you miserable; it can kill you,” Nobel said.
| | | | 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. | | | | | | | | |  Siri is there to help. | Getty Images | Technology is often blamed for young people’s mental health struggles. It can also be a solution, panelists at the Future of Health Summit said. How so? “Siri, I’m feeling depressed.” Encouraging a young person to start a conversation about their mental health care, even with Apple’s assistant, Siri, can make a difference, said Daniel Gillison, the CEO of the National Alliance on Mental Illness, a grassroots organization that provides support for people affected by mental illness. In response, Siri says it’s sorry to hear that and offers to connect the person to a family or friend or refer them to the alliance’s website, Gillison said at a session on America’s youth mental health crisis. Why it matters: While devices and social media are often seen as contributors to teens’ anxiety, depression and suicidal thoughts, they can also help youth get support with their mental health struggles, Gillison and other speakers said. Social media can provide community to young LGBTQ people in rural areas who feel isolated and don’t think they have anyone to talk with, said Amanda Grigg, the staff director for the Forum for Children’s Well-Being at the National Academies of Sciences, Engineering, and Medicine. Combining peer-to-peer support with validated mental health apps that provide the support they promise “is a powerful combination that we have not used enough,” said Obi Felten, the founder and CEO of Flourish Labs, which has created Peers.net, a telehealth platform where youth can connect with peer-support specialists for online mental-health support sessions. | | | | Follow us on Twitter | | | | Follow us | | | | |
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