Early each year, a group called the Lake Nona Institute convokes a three-day conference, the Lake Nona Impact Forum, which brings together, right here in our humble neighborhood, the nation’s top leaders in the fields of wellness and health. The Forum is a highly exclusive, invitation-only assembly of the best and brightest brains – and celebrity advocates – who are engaged in bettering our nation’s health. In other words, the Forum is a really big deal, not just for Lake Nona but for the entire nation. This year’s celebrities featured familiar names such as Brooke Shields, Chris Evert, Andrew Young, Renée Fleming, Mariel Hemingway, and Talking Heads keyboardist Jerry Harrison. Luckily, Nonahood News secured a ringside seat at the Forum, where we took copious notes to help unlock for you the wisdom dispensed during the conference’s fast-moving discussions. Below is our summary of Day One of the Forum. In the coming months, we will publish similar summaries for Days Two and Three. 

One could hardly imagine a more sparkling host for the Lake Nona Impact Forum than Gloria Caulfield of Tavistock Corporation. “Eight, I am told, is a lucky number,” Caulfield announced cheerfully as she opened the 2020 Forum, the eighth in a series launched in 2012. Welcoming the crowd, Caulfield rattled off selected names of the 75 experts, innovators, policy makers, and celebrity advocates who were to share their expertise and experience with the 375 assembled guests tucked into the state-of-the-art auditorium at the University of Florida’s Research and Academic Center. Participants and speakers would “bring magic” to the discussions through “transformational conversations,” proffered Caulfield, and many of the presenters appeared to be her personal friends. Eight, of course, is a lucky number for the Chinese, and as the Forum opened, the Chinese – and all humanity – would need all the luck available to battle the global coronavirus pandemic.

For the first panel discussion, Toby Cosgrove of the Cleveland Clinic interviewed Seema Verma, administrator for the Centers for Medicaid and Medicare Services, the federal agency that manages our $1 trillion national healthcare budget. The Forum had opened in the wake of the first presidential primary elections, where a debate about Medicare For All had emerged front and center. In Verma’s view, the American public continues to regard a larger government role in managing healthcare with skepticism, and, presaging an opinion expressed frequently at the Forum, Medicare For All would be a non-starter in Congress. In contrast, Verma advocates a more competitive environment for healthcare. Oddly, at this panel, Verma also argued that federal health policies – the same policies her agency administers – are failing the American people. Much of her time, she says, is spent “unraveling bad government policy,” while “regulations stand in the way” to achieving greater competition in our national healthcare system.

In their conversation, Cosgrove and Verma raised two important issues, interoperability and price transparency, that found an echo in later panels. Interoperability means deploying appropriate and compatible technology to give both patients and healthcare providers better access to individual health data, while price transparency seeks to pin down the real underlying costs for the delivery of health services. Verma conceded that privacy and security concerns could impede the wider application of interoperability. To achieve greater price transparency, hospitals and insurance companies, said Verma, should post their costs so that apps could be developed to provide detailed costs for each individual patient, combining the two threads of interoperability and cost transparency. Challenges await healthcare policy makers in the near future as individualized genetic therapies “just around the corner” may carry price tags in the millions of dollars. Affordability in healthcare and prescription medications will therefore remain of crucial concern. In a comment that seemed to garner acceptance throughout the Forum, Verma asserted that the United States must move beyond fee-for-service healthcare; if not, we will not be able to contain or reduce costs and will be stuck with an unworkable “sickcare” system. 

In one of the day’s liveliest panels, Michael Dobbs, a member of the House of Lords and creator of the House of Cards television series, traded amusing stories about past world leaders with former Surgeon General Richard Carmona, a loyal Impact Forum attendee. Dobbs had served in the 1980s as chief of staff for Prime Minister Margaret Thatcher, whose behavior during her 1987 reelection campaign showed how the health of major world leaders can impact political events. During that campaign, Thatcher suffered from a nagging toothache but refused to see either a private dentist or National Health Service dentist for political reasons. Treatment by either, she feared, would be viewed as a political pronouncement. So, Thatcher suffered quietly as her poor dental health nearly lost her the election. Dobbs challenged our gullibility with other examples where a lapse in health may have caused a turn in historical conflicts. Napoleon, Dobbs alleged, lost the 1815 Battle of Waterloo due to an sudden irruption of hemorrhoids that prevented the general from mounting a horse on the day of battle, while John F. Kennedy’s Addison’s disease, which induces terrific back pain, caused his judgment to fail as he approved the disastrous decision to go ahead with the 1961 doomed Bay of Pigs invasion.

Should the United States adopt a national healthcare system similar to Britain’s NHS, Carmona asked. Dobbs offered no definitive answer but noted that Britain’s spending per capita on healthcare is half that of the United States – even though Britain’s NHS is the world’s fifth-largest employer after the U.S. Department of Defense, China’s People’s Liberation Army, Wal-Mart, and McDonald’s. Carmona lamented widespread unhealthy lifestyles in our country, including the persistence of smoking, behavior that drives up the cost of healthcare for all Americans. The Internet confers us with rights, said Carmona, but does not require responsibilities. The panel left unanswered one vital question: Can we keep providing healthcare to all, no matter what the cost?

Next up was “Crazy to Breakthrough: Learning from the Thomas Edisons of our Time,” where the amazingly prolific inventor and president of DEKA, Dean Kamen, shared the stage with Alan Lotvin, the CEO of CVS Caremark. Slides shown as the panel opened likened Kamen to Thomas Edison, a comparison hardly far-fetched. Kamen’s eye-popping inventory of inventions includes the Segway, a drug infusion pump for diabetics, a home dialysis device, the Slingshot water purification system, prosthetic limbs providing amputees with fine motor control, and the Stirling heat engine. During the panel, Kamen appeared to be sitting on an iBot, an all-terrain wheelchair he originally designed in the 1990s. 

Inventors are good at inventing, stressed Kamen, but not so adept at making their inventions gain wide acceptance. Inventors, therefore, need large organizations, such as CVS Caremark, that are willing to take a financial risk to deploy innovative inventions on a broad scale. In Kamen’s experience, new inventions have succeeded when the CEO of a large organization had taken such a gamble. A case in point is the symbiotic partnership between CVS Caremark and DEKA to test and deploy home dialysis machines, a partnership considered unique in the healthcare arena. According to Kamen, initial findings show that home dialysis, compared to treatment at healthcare facilities, returns lifespans of patients to normal levels, that is, to those of the general population. The success of home dialysis now offers the prospect of creating a national healthcare environment based around homes and communities, a trend in which large companies such as CVS Caremark are likely to play a major role. One jaw-dropping innovation this healthcare future may bring is the invention of wearable artificial organs, such as kidneys, infused with individual patients’ stem cells. Kamen’s team at DEKA is already working on these artificial organs. While policymakers in Washington remain mired in gloom and doom regarding healthcare, says Kamen, the slogan of innovators is “let’s fix this” as they watch technology move more quickly than policy.

In a “fireside chat” on breakthrough insights into drug development, George Yancopoulus, the chief scientific officer of Regeneron Pharmaceuticals, updated the assembly on his company’s accelerating efforts to develop drugs, including vaccines, to counter the novel coronavirus. Drug development is hard work, and the FDA approves very few new drugs each year. “We’ve got to convince the best and brightest minds in America that there is nothing more important than saving humanity,” advised Yancopoulus.

In my diplomatic career, I had attended countless conferences, private and governmental, but never had I taken part in such a fast-paced, information-packed event as the Lake Nona Impact Forum. International forums in particular unfold at a leisurely crawl, and attendees often watch the clock, waiting impatiently for the moderator to announce a break for coffee. But not at this Forum. Here, even the breaks are both fast-paced and invigorating. Deepak Chopra, whom you might regard as Lake Nona’s kindly godfather, took the stage in the early evening with Michelle Williams, dean of faculty of Harvard University’s School of Public Health, to introduce the Urban Yogis of Queens, New York, who led Forum participants in a series of moves and stretches to get our blood flowing. More fun and more effective than caffeine! The good works performed by the Urban Yogis, Williams announced, have demonstrably reduced community violence and shown that yoga and meditation can effect positive change even in the most troubled neighborhoods.

Suitably refreshed, we attendees regained our seats to pay homage to 87-year-old civil rights icon and former Atlanta mayor Andrew Young, the holder of an astonishing 130 honorary degrees. The moderator for the panel, Operation Hope CEO John Hope Bryant, reminded us that when Martin Luther King, Jr. was felled by an assassin’s bullet on the balcony of that Memphis motel in April 1968, Andrew Young stood behind King, pointing toward the origin of the deadly gunfire. Bryant then reviewed Young’s career, focusing in particular on his tenure as U.S. Ambassador to the United Nations under President Jimmy Carter and his two terms as mayor of Atlanta. “I have been blessed in life,” remarked Young in response to a standing ovation, “and the best thing that you can do for me is to pass on those blessings.” As UN ambassador, Young forged bonds with national leaders around the globe and gave special attention to building ties between the United States and Africa. Years later, the close relationships that Young had cemented worldwide enabled him to gain the 100 votes needed to bring the 1996 Olympics to Atlanta, a city transformed under Young’s leadership under the slogan “the city too busy to hate.” 

Young and Bryant addressed the question about how the ZIP Code where you grew up or now live impacts your overall health. Young wistfully recalled his childhood in New Orleans where, despite the well-demarcated ethnic sections of the city, if you “lose your temper, you could lose your head,” there was nevertheless “humility and humanity in the midst of poverty.” Now, says Young, although society has markedly evolved, this question remains: “How can we save our country spiritually and morally?” Before mounting his wheelchair scooter in a rush to catch a flight, Young expressed his admiration for the Urban Yogis and vowed to bring the program to Atlanta.

Science, as well as the music industry, grows rock stars, and the next panel brought to the stage was one of those most luminous stars, Harvard University Professor of Neurology, Director of Genetics & Aging for Massachusetts General Hospital, and part-time organist for the rock group Aerosmith Rudy Tanzi. Though playing keyboards for the 1980s supergroup offers moments of deserved relaxation for Tanzi, who is viewed as one of the world’s foremost experts in Alzheimer’s disease research, he laments that “science is tough.” Coming up with fruitful avenues for medical research is exceptionally challenging, and pursuing one’s intuition can sometimes prove more productive than applying logic. If a small opportunity emerges in research, urges Tanzi, then “run with it.” 

To study Alzheimer’s tangles and plaques at his laboratory at Boston’s Mass General, Tanzi and his colleagues have grown the equivalent of 3D human brains using stem cells. Why human stem cells? Normally, laboratory mice are the media of choice for biological research, and in the 1980s, selected genes were injected into mice to study the effects of Alzheimer’s. But in Tanzi’s view, “what happens in mice stays in mice,” for these small mammals do not always respond to diseases in the same manner as humans. 

“How can older adults supercharge their brains and reduce the chance of contracting Alzheimer’s?” asked Tavistock Senior Managing Director Rasesh Thakkar, the interviewer for the session. The four pillars of prevention, according to Tanzi, are diet, sleep, exercise, and stress reduction. The brain should be seen as another organ of the body, like the heart or liver, that requires tender care and proper feeding. Diets should include probiotic foods, such as yogurt or kefir, to foster bacteria in the gut, since these bacteria play an interactive role in maintaining the physical health of the brain. Adults should get seven or eight hours of sleep every night because plaques are systemically “washed” out of the brain during sleep cycles. Without a proper amount of sleep, the human body reacts to the development of plaques with neuroinflammation, which exacerbates damage to the brain. To reduce stress, meditation is highly effective. But in addition to these four pillars of prevention, learning new skills as we age is also of critical importance in minimizing the risk of acquiring Alzheimer’s.  

Day One of the Forum closed with a panel on understanding medical cannabis, a discussion that seemed to raise more questions than answers. Sanjay Gupta, the chief medical correspondent for CNN, had been billed to moderate this session but had to bow out as he was called that evening to a White House briefing on the Trump administration’s strategies for countering the novel coronavirus pandemic. (At that press conference, Gupta publicly corrected President Trump’s faulty assertion that the incidence of death caused by the regular winter flu is higher than that of the novel coronavirus; in fact, the coronavirus is 20 times more deadly than the flu.) Former Surgeon General Richard Carmona stepped in to act as moderator for this panel, which featured Nora Volkow, director of the National Institute on Drug Abuse, and Staci Gruber, director of Marijuana Investigations for Neuroscientific Discovery (MIND) at Harvard University’s McLean Hospital. 

A casual observer’s head could easily fog up listening to this discussion – not for any lack of expertise on the part of the panelists, who are nationally recognized experts and deeply knowledgeable about this difficult subject – but rather due to the overwhelming complexities of cannabis. A clear distinction must be drawn, stressed both Volkow and Gruber, between recreational users of marijuana and those who use CBD (Cannabidiol). The former want to get high; the latter seek medical treatment. The challenges for policymakers are many: Little is known about the long-term medical effects of CBD; research is difficult since cannabis remains widely illegal; much of the cannabis researchers manage to obtain is either impure or even fake; and CBD is just one of many possible chemical derivatives of cannabis. In short, regulating the use of CBD and marijuana will pose significant trials for policymakers.

So ended Day One of the 2020 Lake Nona Impact Forum, a day that offered an abundance of information, right in our own backyard, on current trends in the fields of wellness and healthcare.

In next month’s issue: Day Two of the 2020 Lake Nona Impact Forum (featuring Nutrition, Health Care of the Future, and Healing Through Music).

Photos Courtesy of the 2020 Lake Nona Impact Forum