The people's agenda  pg. 3

There is (also) concern… that great research opportunities will be lost during these times. If you have to cut back or stop funding an important long-term study, there’s no way to go back and reproduce that…

The AHA can’t compensate for flat congressional funding of the NIH… On the other hand… we can act as a catalyst for change. We can be a place where new models are tested. And we can partner with the NIH as we did recently in resuscitation studies.

Does our health care system make it difficult to apply the latest findings to the care of patients?

Robertson: I think there are several ways in which… the system makes it difficult to translate results… There’s insufficient time in an office visit these days, for example, for physicians to do the really substantial work you need to do to learn about patients’ lifestyles, to educate them and then to motivate them about ways to live healthier lives.

I think we would do better if we spent some dollars on the time to do prevention well, following evidence-based guidelines. Perhaps that would save us funds at the other end—certainly it would save lives.

Nabel: Absolutely, our health care system does not have good incentives for doing the right thing. Prevention is a good example. We desperately need health care reform in this country.

What can the institute do about this?

Nabel: We’re not CMS (the Centers for Medicare and Medicaid Services). We don’t set the policies and do the reimbursing. We’re not the FDA (Food and Drug Administration), so we don’t do the regulating.

We fund the research that generates the knowledge that goes into the evidence-based guidelines. If we do research that shows preventive measures are effective, then it’s really up to the policy organizations to take those on and make sure that those activities are reimbursed.

How can people be better motivated to reduce their risk factors for heart disease?

Robertson: It’s hard for the public to be responsible for things that it isn’t educated about. I don’t think we in this country educate our citizens very well about science and its importance in their lives…

(In addition), people do need to have their basic needs cared for… if you’re worried about keeping your kids off drugs and having them not shot on the street, you may not focus on preventing long-term health risks…

But we also need to build an environment in which the default is healthier. And some of that direct translation is actually done best by private organizations. So the American Heart Association with 20-plus million volunteers and supporters across the country, an extraordinary grassroots network and an ability to engage communities can do a lot to take research directly into action.

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