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Judicial Watch • JW v. State Huma production 7 00684 pg 100-232

JW v. State Huma production 7 00684 pg 100-232

JW v. State Huma production 7 00684 pg 100-232

Page 1: JW v. State Huma production 7 00684 pg 100-232

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Number of Pages:133

Date Created:May 11, 2016

Date Uploaded to the Library:May 11, 2016

Tags:Model, clinical, Functional, Hyman, disease, Huma email, MEDICINE, Chapter, patient, senate, health, release, Mills, Huma, unclassified, Hillary Clinton, 00684, production, Obama, State Department, White House, department, FOIA, EPA, IRS


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UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939735 Date: 04/29/2016
From:
Sent:
To:
Subject:
Hume Abedut ~------------
Swiday, February 22, 2009 12:16
humamabedi~
PrFw:
RELEASE
PART
OrigiRBI Message--:
From 
To. Huma Abedin
Sent. S11t Feb 23:48:07 2009
SubJCCf: Fw:
Pis print
Original Message
lrom Bill Owens hdr22@olinlonemail.com
Sent Feb 21, 2009
Subject:
Deft! Hillary, ll11nk your listening lour has in.!ipiring ull who lmw 11uml abo our ralutionslup~ with A~m. o.l imm last nigh! B~iJing with aboul dolen very
well placod senior gc11crols nnd politiclons You would hnvc liked thoir comments abo11 your visit, proud ofwhnl youre doing mid nlwnys here help wll.:n cnn was very see you 11t the Embll.isy. After such arduous trip, thought .you wcro gr~~t the stafl! Mnrincslleacc r. from lhc~cttlc removed from the soldiers ond government otliclJll who removed
them Finally. our major funder for tlti work (Tom Harkin had helped ob1ain aomc seed money from the CDC) Chuck Feeney who helped with tl1e Irish peace process ond,.
polenlially interested economic development Gau well our humonil mental heallh work fool can help Hillary scxize this momont ofcrm1 and tum into o,tl1lord1nary opportunity Thero is, underneath the understandable fear ond anger and llte posturing much
yeam111g for peace, and perhaps CDn help her f111d woys uso creot ivoly and offectivcly.
Thanks much for being willing conblcl her
Jim
James Gordon, M.D.
www Jamcsgnrdonmd,cnm 
Founder and Director
Tho Center for Mind Body Mcdic111c
--,225 conmn:ticut A.vcnuc;-NW;-Su1te 4J4
Washin tan, 20015
www m.org
tlp //www cmbm .org> llnd Forwarded Message 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939765 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939766 Date: 04/29/2016
From:
Sent:
To:
Subject:
Attach:
Abcdin, Huma 
Monday, February 23, 2009 7:02
hum.amabedirj
RELEASE
PART
Marina print
022309 Press Briefing.doc; 022309 Press Clips.doc
,.,,. ,...w ...... _.,. .,..,.,. ... .,..,_.,.,,.. ... .,..,,..., .,..._._, ... ....,_. .,.......,_.,.,. .,. _._...,
.... ,,. ........, .,_. .,. .,.....o
.,..,
,..,_ .,. .,,..
.,_ ...... ,,. ,...,....,,. _.. .,....,,,...,.,...,,
From: BlShop, Christopher
To: Abedin, Huma
Cc: S_SpecialAsslstants; Macmanus, Joseph Sulllvan, Jacob
Sent: Mon Feb 07:01:36 2009
SUbject: Morning Press
Good Morning Huma,
Let know you need anything else.
Christopher
Christopher Bishop
Special Assistant the Secretary State
202-647-9573 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939766 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939768 Date: 04/29/2016
Obta ined via Judicial Watch Inc.
From:
Sent:
To:
Subject:
Rattner, Steven
Monday, Febru~ry 23, 2009 1:48
hrl S@att.blackberry.net news
L__~~~~~~~~~~~~~
!RELEASE PART B6i
Hillary:
Just let you know that its now official For whatever its worth, here the official description
responsibilities:
Steven Rattner joining the Treasury Department Counselor the Secretary. that capacity, will advise
Secretary Timothy Geithner regarding variety economic and financial matters and will lead the team
advising Secretary Geithner and National Economic Council Director Lawrence Summers the automobile
sector.
Thanks for all your support and offers help while was working through this.
Steve
Steven Rattner
Managing Principal
Quadrangle Group LLC
375 Park Avenue
New York 10152
W.W.W.19.ll!!.~r.~. rl.ll{!lll.r9.!R., !;!!.r:ll
n~1011n1
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939768 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939773 Date: 04/29/2016
From:
Sent:
To:
Subject:
Eric Bederman
Monday, February 23, 2009 5:21
Lauren Jiloty ; Abedin
RE: Mort Zuckerman
.____ _____,
[RELEASE PART 86) Will do.
Subject: RE: Mort Zuckerman
Date: Mon, Feb 2009 17: 17: -0500
From: Jilo state.
humamabedi1 __.
To: eri
Mine fine.
Thanks eric.
From: Eric Bederma
Sent: Monday, Febru..-.-Y-r,--.n-nm~r-n,,_--~.
ary
To: Jiloty, Lauren Abed
Subject: Mort Zuckerman.
Got message from Amy Mort Zuckermans office asking what the best email address would for
Mort send message HRC? Assume should one you gals? Eric
Windows Live Hotmail@ ... more than just e-mail. S.~~ b9.w...!tw.9.r.~.~
Windows Live Hotmail ... more than just e-mail. Check out. mun1,,n16
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939773 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939774 Date: 04/29/2016
From:
Sent:
To:
Subject:
Huma Abcdin.___
Monday, February 2009 730
bumamabedi
PrintFw: One your peop State. Fw: Global Partnership Center Website
RELEASE
PART
-----Original Message----From:  Hurna Abedm
Sent: Mon Feb 17: 14:39 2009
Subject: Fw. One your people State. Fw: Global Partnerslup Center Website
Plspnnt.
--- -Original Message,_- ---------~ From. Bums Strider
Dote Mon, Feb 2009 02:59 
Sub1ect. One your people State. Global Partnerslup Center Website
See comments below from Robert Hes been active volwiteer, do111g
online 1th blogging for for couple years ----J
--~~-~_ and your Globol Pannership
office lncreclible yowig man
._!
----Original Message---
from Lalka. Robert 
To. bstride~
Sent: Mon Feo2T17i:4T:202UU9
Subject FW: Global Partnership Center Website
Bums, JUSI realized that tonights when the Delta State reception
happemng and lrrt hoping make it. Just case, TWWlled wnte
let you know lhal had the chance meet lhe Secretary for the first
time today She was v1Siti.ng the East Asia and Pacific Affairs Office !honk them for the11 work her first trip obrood~ nnd, man. the
folks here seem love her ... also havent sent you link the Global Partnership Centers
website promised, have enclosed the link wilh the;: quotes are
using the read more boxes you see the right side the page,
Hope see you again torught,
Best,
Rob
httD://www state,aov/s/d/rm/partnerships/
Diplomacy primarily government mission. But !here are lots ways
that nongovenunent actors, like corporal1ons, like religious
orgaruzations, like charities and foundations, nrc actually building
relationshlps witll foreign governments and foreign people all the lime,
which, done the right woy, nre really lue added who ore nahnn 1111Crienced professionals and ~n1-;
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939777 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939780 Date: 04/29/2016
From:
Sent:
To:
Subject:
hdr22@clintonemai.com
RELEASE
PART
HRC: The Chinese see new era cooperation. throwing away the old talking points, you have changed the landscape: Sensational ~np
Sandy 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939780 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
From:
Sent:
To:
Subject:
Attach:
Burns Strider
Tuesday, February 24, 2009 6:34
hrl S@att.blackberry.net
What the Bible Says about Federal Budgets
Scripture the Budget- Part 1.doc
~~~~~~~~~~~
(RELEASE PART 86]
Three eight posts are www.faithful democrats.com from the updated Primer Scripture and the Budget
for 2009.
The second posting also attached: The Responsibility the Nation and Its Government the Least These
Over the next week Faithfuldemocrats.com, are going publish each section the updated Primer
Scripture and the Budget for 2009, which organized theme Our hope that you will use this resource,
share with friends, and discuss the comment section ... and that together can make positive
contribution the upcoming budget debates that will shape our countrys priorities and demonstrate where its
heart truly lies.
The sections and future posts are titled:
The Responsibility the Nation and Its Government the Least These
The Policy Implications Praying, Thy Kingdom Come ... Corruption and the Exploitation Workers
The Sin Helping the Rich the Expense the Poor
The Blessedness the Poor and Our Christian Responsibility Them
Wealth, Materialism, and the Bibles View Ownership Society
Countering the Rights Pharisaical Approach Moral Legalism
Concluding Thoughts: Applying Scripture Pluralistic Society
Back 2006, the budget debate followed immediately the heels Congressional consideration the
Marriage Amendment. result, there was desire number Democratic leaders for reference guide
that would more easily allow Democrats authentically speak out against the extreme and selective use
scripture the Republicans and their allies the Right. The first Guide Scripture and the Budget that
included scriptural references and simple talking points help equip Christian Democrats their response
Republican budget arguments was distributed shortly before the 2006 budget debate. underlying assumption writing and continuing update this document that Democrats should not cede
the prophetic language scripture and its ability inspire and frame issues moral context the other side.
Many traditional Democratic positions are rooted the teachings scripture, and time Democrats stopped
losing the Bible.
The language scripture language that calls people tum their attention away from selfish desire and
personal gain and focus instead serving God and their neighbors. Furthermore, language that speaks
with moral clarity and purpose. Therefore speaks with authority the policy debates currently underway
our country. short, language Democrats cannot afford ignore.
One aspect the Democratic response the upcoming Republican budget attacks must willingness
faithful Democrats discuss budget and tax policies from moral perspective and challenge Republicans
---apply the-same moral-codes-to -kitchen -able i8sues-that-they-So-eagerly- embrace-on-bedroom-issues .because we_
all know that soon start talking about budget and taxes, the Republicans will put away their Bibles
and turn Darwinian social and economic theories support their policy positions. 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
Obta ined via FOIA Judicial Watch Inc.
The first chapter the Book oflsaiah begins with the prophet cataloguing the decline the city Jerusalem into injustice, where its former greatness besmirched its obsession with
materialism and wealth. important remember that the prophets are speaking against the
government rulers and the nation whole. The prophets scripture are not calling for
individual piety and charity but for systemic societal/governmental reform. And they
specifically challenge government leaders remember that the nations leaders are called
help the powerless and those greatest need, not those with the most power and money.
Isaiah clearly states what God expects leaders: Wash yourselves; make yourselves clean;
remove the evil your doings from before eyes; cease evil, learn good, seek
justice, rescue the oppressed, defend the orphan, plead for the widow (Isaiah 16-17). [note:
does not say, cut federal funding for state child services]
Here what true Justice Sunday should (ocus from Jeremiahs exhortation the king
about his responsibility head government: Did not your father eat and drink and justice
and righteousness? Then was well with him. 16He defended the cause the poor and needy,
and all went well. that not what means know me? declares the Lord. 7But your
eyes and your heart are set only dishonest gain, shedding innocent blood and
oppression and extortion (Jeremiah 22: 15-17).
Taken together with Micah 6:8, this forms the core the prophetic message: know God
nation means take care the poor and ensure that justice done behalf the needy:
has showed you, man, what good. And what does the Lord require you? act justly,
love mercy, and walk humbly with your God (Micah 6:8).
There are obvious parallels between ancient Jerusalem and the role that big donors and lobbyist
played setting government priorities Washington that contributed the ouster the GOP
from Congress and the White House the 2006 2008 elections respectively Everyone loves bribe and runs after gifts. They not defend the cause the fatherless. The widows cause
does not come before them.(Isaiah 1:23)
The Lord takes his place court and rises judge his people. enters into judgment against
the elders and leaders his people saying, you who have ruined vineyard; the plunder
from the poor your houses (Isaiah 3:14).
You seem eager for God come near you Yet the day your fasting, you you
please and exploit all your workers. Yet not this the kind fasting your Lord, have chosen. loose the chains injustice ... share your food with the hungry and provide the poor
wanderer with shelter-when you see the naked, clothe them? (Isaiah 58: 2-7). who oppresses the poor shows contempt for their Maker, but whoever kind the needy
honors God (Proverbs 14:31). you away with the yoke oppression, with the pointing finger and malicious talk, lOand you spend yourselves behalf the hungry and satisfy the needs the oppressed, then your
-liglirwiU-r1se-1n the aatkness, and-your nighrwm become liRe fife nooriday.-- TneLorn4
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
guide you always; will satisfy your needs (Isaiah 9-11).
Nehemiah (who rebuilt Jerusalem after the Babylonian exile) enforces social justice through the
power the state and addresses insidious problem that sadly still plagues this day
(predatory lending): Still others were saying, have had borrow money pay the kings
tax our fields and vineyards. Although are the same flesh and blood our
countrymen and though our sons are good theirs, yet have subject our sons and
daughters slavery are powerless, because our fields and our vineyards belong others. When heard tht:ir outcry and these charges, was very angry. told the [nobles and
government officials], You are exacting usury from your own countrymen! called together large meeting deal with them and said ... What you are doing not right. ..let the exacting usury stop! Give back them immediately their fields, vineyards, olive groves and houses,
and also the usury you are charging them-the hundredth part the money, grain, new wine and
oil. will ... you say, they replied. Then summoned the priests and made the
nobles and officials take oath what they had promised. (Nehemiah 1-13)
From the New Testament: Mercy triumphs over judgment! What good it, brothers,
man claims have faith but has deeds? Can such faith save him? 5Suppose brother
sister without clothes and daily food. 16If one you says him, Go, wish you well; keep
warm and well fed, but does nothing about his physical needs, what good it? 171n the same
way, faith itself, not accompanied action, dead(James 14-17).
Scripture sets very high bar for public morality well for private behavior. Although
can easily rationalize why alternatives the commands Scripture might more sensible
and realistic, people are going insist applying scripture the bedroom, they must
willing apply the boardroom well. The Bible leaves room for trickle-down
economics. Jesus and the Prophets not say, Help the widow and orphan supporting
businesses effort prop the stagnant economy! the contrary, when rich young
man asks Jesus what must inherit the Kingdom God (go heaven todays
terminology), Jesus answered, you want perfect, go, sell your possessions and give
the poor, and you will have treasure heaven. Then come, follow (Matthew 19:21-note
Jesus says this what the man must before can follow Christ). The Bibles call repeated
throughout the Old and New Testament for direct action government leaders behalf
the least these nothing less.
nQtn11?n1~
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939781 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939784 Date: 04/29/2016
From:
Sent:
Cheryl Mills~-----~
To:
hrl S@att.blackberry net; hdr22@clintonema11.coni
JUSt called your house twice but keep getting hang was calling check onl~_ __,
Subject:
Tuesday, February 24, 2009 10:05
RELEASE PART 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939784 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939785 Date: 04/29/2016
From:
Sent:
To:
Subject:
MarkJ Peim.___
Tuesday, Febru111y 24, 2009 S@att.blackberry.net
__J
pretty good speech
Basically copy all the techniques used -well done and certainly what needed. Serious, patriotic and always
appearing bring people together. Very much the kind stuff that works.
You have been getting good reviews your tours always liked having leadership track and human track and you
have been doing both, but would careful about seeming too silly could make you 16ok irrelevant. Obama has
serious, direct, and powerful leadership style. biggest worry would that the policies may not work. n~/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939785 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939787 Date: 04/29/2016
From:
Sent:
To:
Subject: 
Wednesday, February 25, 2009 8:23
Tamera Luzzatto
How are you?
RELEASE PART tried calling you all your nwnbers Let know when can talk and whot c111l? 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939787 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939788 Date: 04/29/2016
Fi:om:
jkcancj~----~
Sent:
To:
Subject:
Wednesday, February 25, 2009 9:04
Hillary Clinton 
Welcome Back
RELEASE PART
Hllhuy,
Sent you message your old address mistake Lauren Will provide you hard cy. Welcome back, all the best, Jack
Sent via BlackBelT) ATT 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939788 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939801 Date: 04/29/2016
From:
Sent:
To:
Subject:
Huma /booill
~~~~~~~~~~
Thursday, February 26, 2009 626
hdr22@clintonemail.com
Re. Calls
RELEASE PART
[B6
China call confirmed for
Lavrov will later this morning.
Originol MesROge
From:  Huma Abedin
Sent Wod Fch 23-52:18 2009
Subjel. Culls
Origu1al Message--
From: Huma Abedin hdrl2@chntoncmi1il com
Sent leb .25, 2009 SO
SubjeI: Calls
Call with foreign minister yang has been confinned for tomorrow morning 7:30am wlule with 1snbelle. Lavrov will right after probably. 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939801 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016
To:
Gruy Gensler ~!----~
Thursdny, February 26, 2009 1137
hrl S@att.blackberry .net
Subject:
Harkin plans suppport
From:
Sent:
!RELEASE PART 86)
Hillary, Senate confirmation hearing today went well. Senator Harkin said afterward that planned poll the
committee shortly but saw opposition this time and would try schedule committee vote next week.
The newswire story below suggest his support now.
Senators Mikulski Cardin along with former Senator Sarbanes introduced today.
Off the Committee, both Senators Feinstein and Senator Levin have signaled their support well.
Your call Senator Harkin and following your specific advice how address !TIY past the Clinton Administration
was the greatest help.
Thank you once again for all your support.
Gary
Sen. Harkin Plans
Support CFTC
Nominee Gensler
Source. Dow Jones News Service
Date: 02/2512009 Sarah Lynch DOW JONES NEWSWIRES
(c) 2009 Dow Jones Company, Inc
WASHINGTON (Dow Jones)-Senate Agriculture
Chairman Tom Harkin signaled Wednesday that
intends support the nomination Gary Gensler
chair the Commodity Futures Trading Commission
despite some lingering concerns
Harkins support came after Gens/er, hearing
Wednesday, sought reassure the Iowa Democrat and
other senators the panel that his views swaps
regulation have evolved since his tenure the Treasury
Department during the Clinton administration. think that Mr. Gensler was very forthright saying his
views have changed over the years, Harkin said will polling t,he committee, but dont expect any
opposition. assume that will moving his name
forward the committee approves Gensler
nom1nation,Gens/erw1ll fac~ oonf1rmat1on vote from
na1n11?n15
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016
the full Senate.
Harkin had previously raised concerns about Gensfers
involvement talks over the Commodity Futures
Modernization Act, passed 2000, which deregulated
swaps the time, Gens/er was senior Treasury
official.
Harkin hit Gensler with tough first question Gens/ers confirmation hearing Wednesday, recalhng
testimony Gensler gave 1999 Quoting Gens/er
saying positively, unambiguously agreed with former
Treasury Secretary Lawrence Summers opposing
add1t1onal regulations for over-the-counter derivatives,
Harkin pressed Gensler whether not his beliefs
have changed.
Gensler responded: Looking back now, .it clear
that all that were involved the time, and certainly
myself, should have done more protect the American
public through aggressive regulation should have fought harder for some the things
raised with Congress the time, added
Since President Barack Obama first
nominated Gens/erto the CFTC late last
year, Gens/eltlas worked hard behind the scenes
convince Harkin and other lawmakers that would
tough regul!tor confirmed the agencys
chairman. Gensler has said didnt participate
discussions the Commodity Futures Modernization
Act certain times 1998, when was recused, but did get involved after that recusal period expired.
His efforts have paid off winning over key lawmakers
like Sen. Dianne Feinstein, 0-Callf, who has been
critical the CFTCs oversight the past Feinstein
indicated late Tuesday that she plans support the
nomination.
Sens. Benjamin Cardin and Barbara Mikulski, both
Democrats from Gensler home state Maryland, also
urged the Senate Agriculture Committee
support Gensler Wednesday.
Responding questions from the
committee, Gensler said that wished had fought
harder for uniform regulation for all physical commodities
when served Treasury. the time, said, those favor uniform regulations were unable get into
the legislation. confirmed, Gens/er pledged take the
issue again also said would support regulatory regime for
derivatives dealers. example why such reforms
are needed, cited the unit American International
Group (AIG) which issued credit-default swaps without
having the collateral back the provisions those
contracts.
Serr.-Kent-co-rmJd;-D;N-o:-;-a-memberofine-c-ommitte-e;--- said Wednesday deeply regrets supporting the
deregulation swaps 2000, adding that Gensler also
shares some the blame for it. 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016 leastfor some that. you gave bum advice,
Conrad said.
Gensler said believes its clear the regulatory system
failed, and pledged push for tough new reforms
confirmed, said, will support mandating clearing for
standardized over-the-counter products well
putting some those derivatives regulated
exchanges For customized products that dont lend
themselves cleanng,Gens/er said would push
enact strict reporting and record-keeping requirements. al~o reiterated Wednesday believes speculation
and Index Investing did contribute part the run-up
agricultural and energy commodities last summer and
would more prevent excessive speculation if.
confirmed That would entail re-examining the rules
governing hedge exemptions, which allow traders get
around pos1t1on limits 1fthey are hedging business risk proud believer financial reform, tough
regulation and enforcement, Gens/er said.
-By Sarah Lynch Dow Jones Newswires: 202-8626634; sarah lynch@~owjones com 02-25-091743ET
,.. 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939805 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939820 Date: 04/29/2016
From:
Sent:
To:
Subject:
Attach:
Abedi11, Hume 
Friday, February 27, 2009
humama~ini
Marina print
022709 State Briefing docx, 022709 State Chps docx
RELEASE
PART
Prom: Bishop, Christopher
To: Abedin, Huma
Cc: S_SpeclalAsslstants; Macmanus, Joseph Sullivan, Jacob
Sent: Fri Feb 07:02: 2009
Subject: Morning News Clips
Good Morning Huma,
Please let know you need anything else.
Christopher Bishop
Special Assistant the Secretary State
202-647-9573 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939820 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Obta.ined via FOIA Judicial Watch Inc.
Testimony Mark Hyman, M.D.
Founder and Medical Director The UltraWellness Center
Vice-Chairman, Institute for Functional Medicine
RELEASE
FULL
SENATE HEALTH REFORM TESTIMONY
INTEGRATIVE ~ARE: PATHWAY HEALTHIER NATION
Senate Committee Health, Education, Labor and Pensions
Chairman: S~nator Edward Kennedy
Ranking Member: S~nator MiChael Enzi
Senator Tom Harkin Senator Barbara Mikulski
United States Senate
Senate Dirksen Building
Washington,
February 26, 2009
Mark Hyman,
Senate Testimony 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Reforming the United States Health Care System:
Mastering the Challenge Chronic Disease
Executive Summary: Testimony Mark Hyman,
Effective Health Care Reform: Addressing the Drivers Costs and Chronic Disease
The current medical and scientific paradigm acute care medicine has been unable
effectively address the epidemic chronic disease and its associated costs.
There new paradigm which addresses the fundamental underlying causes chronic
disease, and can form the basis for more effective model medical education, practice, and
research that over time will generate dramatic cost savings.
There are specific initiatives and strategies based this new paradigm that can help
transform our sic~ care system into health care system.
The Right Solution for the Problem Chronic Disease
This new paradigm personalized, preventive, participatory, predictive, and patient centered. proactive rather than reactive. based addressing the causes disease and
optimizing biologic function the bodys core physiologic systems, not only treating the
symptoms. based systems biology medicine That model exists today, and called Functional
Medicine.
Functional medicine system personalized care; new operating system that directly
addresses how environment and lifestyle influence our genes create imbalances our
core biologic systems that, over time, manifest disease. th.is kind medicine that
needed create real successes century medicine.
Even get everything else right health care refonn, wont matter unless address
the underlying causes illness that drive both costs and the development chrome disease.
Clinical Examples: Systems Medicine the Clinic
Case examples Functional medicine chronic disease autoimmune, digestive,
behavioral, and hormonal disorders illustrating the power and imphcations for transforming
the quality our health care and reducing the economic burden chronic disease.
Report pilot program for children using functional medicine showing 16-fold reduction
costs from dramatically better health outcomes with integrated health care teams based
Functional medicine.
Key Avenues for Change: Recommendations Re-tooling medical education and research match the science systems medicine. This
would involve funding the development oftraimng programs medical schools and
residencies, and supporting initiatives for certification and traming functional medicine for
existing practitioners through establishing fully funded university affiliated Institute for
Lifestyle and Systems Medicine Creation Functional medicine demonstration projects feder11-lly funded community health
centers, with integrated health care teams focusing treating chronic disease and providing
Mark Hyman, !.ID
Senate Testimony 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
education about lifestyle and wellness. These would form the foundation for the development clinical practice networks Functional medicine for education and research.
Reforming the United States Health Care System:
Mastering the Challenge Chronic Disease
Testimony Mark Hyman,
Before the Senate Committee Health, Education, Labor and Pensions
February 26, 2009
Chairman Kennedy, Ranking Member Enzi and distinguished members the Committee:
Thank you for this opportunity share the dramatic changes medical thinking and practice
that must the central focus health care reform. name Dr. Mark Hyman.
practicing physician and vice chair the Board Directors the Institute for Functional
Medicine. practicing functional medicine physician, the front lines scientific
medical revolution.
Effective Health Care Reform: Addressing the Drivers Costs and Chronic Disease testimony will show that:
The current medical and scientific paradigm acute care medicine has been unable
effectively address the epidemic chronic disease and its associated costs.
There new paradigm which addresses the fundamental underlying causes
chronic disease, and can form the basis for more ~ffective model medical
education, practice, and research ~hat over time will generate dramatic cost savings
and improved health outcomes.
There are specific initiatives and strategies based this new paradigm that can help
quickly transform our sick care system into health care system.
Even get everything else right health care reform, won.t matter unless address
the underlying causes illness that drive both costs and the development chronic disease.
This innovative approach chronic disease cannot only prevent but also more effectively
TRE~TS chronic disease. must change not only the WAY medicine, but also the medicine DO.
must improve not only financing and delivery health care, but also our fundamental
scientific approach chronic disease-an epidemic that now affects 133 million Americans
and accounts for 78% health care costs.
This way doing medicine, Functional medicine, system personalized, patient
centered care based how our environment and lifestyle choices act our genes
create imbalances our core biologic systems. Those imbalances show the signs
and symptoms call disease.
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016 best solution for our health care crisis. The solution not our current acute care
model, which though extremely effective for acute disease, leads worse outcomes and
higher costs when applied chronic disease because doesnt address WHY people are
sick.
This new paradigm personalized, preventive, participatory, predictive, prospective, and
patient centered proactive rather than reactive. based addressing the causes
disease and optimizing biologic function the bodys core physiologic systems, not only
treating the symptoms. based systems biology medicine. That model exists today, and called Functional Medicine.
The Right Solution for the Problem Chronic Disease
Our current model medicine unsustainable because cannot stem the rising tide
chronic disease. Relying only reforms access, financing, electronic records, malpractice,
reduction medical errors, coordination care, and research new drug therapies while
retaining the acute-care model will untenable. These reforms are necessary but not
sufficient avoid the collapse our health care system that may soon mirror our current
financial crisis. These reforms not alter the fundamental approach prevention and
treatment. focus improving the way practice the medicine the past, will still
have the medicine the past. improve the wrong type care, then will simply
doing the wrong things better.
Acute-care medicine designed for acute illness, trauma, and end-stage disease for which the best the world. disease-, drug- and procedure-based. Our current medical
education focuses sickness rather than health; journals publish about disease management
not causality. Disease based acute care medicine the WRONG model address chronic
illness, because doesnt address WHY people are sick, the underlying mechanisms and
biologic causes. That why spend more than any other industrialized nation and are near
the bottom the list for all major health outcomes, and are witnessing decline life
expectancy for the first time history.
Functional medicine not new treatment, test, procedure but new operating system method for problem solving and processing complex clinical information.
fundamentally different WAY THINKING about the origins and mechanisms illness.
encompasses all the TOOLS healing and medicine, both conventional and integrative. And provides common language, map GPS system for navigating through the puzzle
chronic illness. A.growing coalition practitioners, educators, and scientists dedicated
advancing this model. have introduced 20,000 physicians and health care providers
functional medicine since 1991, and wrote the Textbook Funct1011al Medicine 2005
describe both the underlying science and the practical clinical strategies and tools that
comprise this new model. have begun certification program functional medicine and are building key
educational programs for residencies throughout the country. are partnering with Harvard
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016 strategic research document the extent and scope practice well the efficacy
this model better roadmap for chronic disease.
Through scholarship program funded one patients, have trained over
academic faculty and fellows from major institutions who are part the Consortium
Academic Health Centers for Integrative Medicine (funded the Bravewell Collaborative)
including Harvard, Yale, Duke, Johns Hopkins, USCF, and the University Arizona.
are also collaborating with the American Academy Family Practice and the American
Dietetic Association. collaborate and advance the foundational work James Gordon,
.MD the Center for Mind Body Medicine and Dean Ornish, .MD the Preventive Medicine
Research Institute
Clinical Examples: Systems/Functional Medicine the Clinic
Let illustrate how this works with real people. Pilot Prog1 For Functional Medicine: Reducing Costs Fold Sick Children the University Minnesota, Dr. Anne Kelly developed model care based
Functional medicine called the l!Special Kids program was for the the sickest
children who generated 60% the total costs, mostly from unplanned hospitalizations. one
year, the costs incurred that population dropped from million $250,000, more than
$50,000 per enrollee, 16-fold decrease costs. Yet the program was cancelled
November 2008 after one year because less than 10% the high science, low tech, and high
touch approach was reimbursable. cannot control costs reducing access effective programs. must increase access
integrated health care teams that include variety health professionals, all whom are
trained the appropriate chronic disease model. Both the science and methodology exist
utilize functional medicine for such teams wide scale.
Reform must also encompass re-structuring financing and financial incentives prioritize
health care, not just sick care. cannot afford incremental change. The health our nation,
our future generations, and the health our economy depend addressing the explosion
chronic disease and associated health care costs. Woman with Treatment Resistant Autoimmune Disease
Cris Scoufos, 40-year-old woman came see after years uncontrolled ulcerative
colitis with bloody diarrhea, joint pain and cystic acne, which started after rounds
antibiotics for respiratory infections. She was treated unsuccessfully the Mayo Clinic with
the most advanced, dangerous and expensive immunosuppressive therapies. Just before
returning Mayo start new investigational drug, she saw me. simply eliminated
common food sensitivities, treated yeast infections, and normalized the function her
digestive tract with probiotics, digestive enzymes, fish oil, and vitamin After just weeks treatment she went back Mayo and was found have completely normal bowel, and
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
her joint pain, fatigue, and cystic acne resolved treating the upstream triggers instead the
downstream symptoms. cannot get the solution for chronic disease with our current
methods diagnosis and treatment.
Here her email shortly after her visit Mayo Clinic. Her before and after photos are
attached.
Dear Dr. Hyman, thankful for all that you are helping with. prayedfor God
someone who could show how properly care for body that could heal and that
the honor and glory would belong Him. instead asking/or God just heal me, like had
for four and halfyears, askedfur guidance what needed du.
After failing all conventional drug treatments was told would have into
investigational drug study next. trip Mayo Clime had been planned and was nervous
about the choices was going have make. colonoscopy April 2008 showed 45cm
ulceration.
The trip see you the last week August was planned one week and everything.fell
together eas;/y. seems like was meant be. startedfollowmg your recommendations
nght away, even though havent mcorporated all the supplements yet, the change has
been amazing. colonoscopy the Mayo Clinic Rochester, Minnesota was last Monday, October J3th. physician Dr. Sandborn, who highly regarded the gastroenterology field one
the best the country, told that there ulceration le.ft ;,, large intestine and there
was onlx some scarring. have completely healed! amazing! was still bleedingjust two
months ago and now completely healed. has been ve1y long.five years and thought
you would want know just how much your help has made life. Thank you very much.
You have been the instrument that God has sent into life for healing.
Unending blessings you and your loved ones,
Cris Scoufos Doctor with Autoimmune Arthritis 57-year-old vascular surgeon was seen with debilitating autoimmune psoriatic arthritis that
had been unsuccessfully treated with Humira, methotrexate, and NSAlDs; also had
migraines, reflux, constipation, and fatigue. was symptom free and off all medications
only weeks after changing his diet, fixing nutritional deficiencies, and addressing
imbalances his digestive system, which home more than 70% the immune system. Woman with Multiple Chronic Diseases
Mark Hyman, fID
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016 46-year-old woman, having seen dozen doctors over dozen years, came with
different diagnoses, including depression, hypertension, obesity, polycystic ovarian syndrome,
migraines, heavy uterine bleeding, asthma, sinusitis, irritable bowel syndrome, fibromyalgia,
osteoarthritis and psoriasis. Each disease was treated with the best available conventional
treatment. But she was still sick, despite medications course, she didnt have separate diseases. She had imbalances few core networks
physiologic function digestive, immunologic, and hormonal that gave rise all her
symptoms. The underlying cause all her diseases was autoimmune response gluten,
leading autoimmune thyroid disease and severe vitamin deficiency because
malabsorption. Six weeks after eliminating gluten, improving her diet, replacing thyroid
hormone and vitamin her diseases were completely gone, along with pounds. Boy with Attention Deficit Disorder and Asthma and Allergies
Clayton Lampert was 12-year-old boy with severe attention deficit hyperactivity disorder,
behavior problems, and poor school performance Ritalin for years. also had illegible
handwriting dysgraphia. also had apparently unrelated problems asthma, allergies,
hives, stomachaches, headaches, insomnia, muscle cramps, and anxiety. had history
frequent infections and antibiotics. had seen specialists (lung, GI, allergist, psychiatrist
and neurologist) and was medications for allergies, asthma, pain, and ADHD. one
asked how everything was connected, how his diet junk food and sugar made him sick.
His immune system was activated, his digestion not working and was nutritionally
deficient zinc, omega fats, magnesium and vitamin B6. simply normalized his
function removing impediments health (junk food diet, food sensitivities, overgrowth
yeast, and lead) and providing the ingredients necessary for optimal biologic function whole
foods diet, additional nutrients including B6, magnesium, zinc, omega fats and probiotics. two months returned without any physical psychiatric symptoms and was off all his
medication. How many children suffer needlessly when have the solutions these
problems? Here his mothers email about his progress. And below his
handwriting sample before and two months after treatment.
Dear Dr. Hyman, had 504 meeting Claytons school this moming (where lhe teachers, school
counselor, parents, and principal all get toge th.er review the plan for kids with special
educational needs-in Claytons case prompted the ADHD diagnosis). This was the first
time his entire schooling history that everything seems going well. The mputfrom his
teachers was that different kid than they saw the first half the year and that
they amazed the difference. The school nurse hasnt seen him since March (and used her office several times week). The school psychologist said his social skills are
very good, age appropriate, and that she sees problem~ all. She also noted that Clayton
seems very proud himselfand his new health and that hes laking good ownership all the
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
changes his diet. even seems shrugging qff when the other kid school tell him alien because doesn drmk soda.
This was just such fantastic meeting and wanted pass along the good news and say
Thank You!
Recovery from Dementfa
The power this ~pproach that can often applied without the intervention trained
professional. Below the story womans whose husband recovered from dementia
following the principles Functional medicine. This recovery was likely due reversible
nutritional cause. Other causes dementia, which not homogenous disease, may respond
differently, however the social and economic impact this method can longer ignored.
Eight years ago, the age 42, me/ and married the love life; Robert Foster. both have felt that were absolutely meant together Two years ago began
worrying whether not the moments offorgetfulness meant the beginning dreaded
Alzheimers disease. began educate myself obsessively, and came the conclusion that
the traditional route ofpharmaceutical drugs was the wrong approach combat this beast.
would not accept that the only outcome was horrible death sentence. beloved
husbands cognitive function took sudden and alarming sp1ral downward this past fall. The
formal diagnosis Alzheimers was less heartbreakmg, but felt lucky have had
those two years the precious research and reading, where was given the exlraordinaJy
gift awareness and respect for Functional Medicine.
Knowing instinctively that this was the only amwer the war needed to.fight was
here that sought help. was made aware Dr. Hyman another Functional Medicine
doctor couple ofyears ago, and have followed his work and have read several his books.
Having program follow, was the answer prayer ... literally. The actual
turnaround has been dramatic that have been hesitant share the results, not wanting offer unwarranted hope others, sounds too good /111e not wan/ this sound like hype the magic pill that cured Alzheimers, but think would irresponsible not share our astounding results.
The bottom line--five days after starting the program, husband had gone from not being
able hold thought, constantly misplacing any number objects, repeating quest10ns and
thoughts, and not being able drive (as would get lost), the normal functioning man
married The comeback NO/ /OOIYrr- over 90%. ah/e hold his concentration prqjectfor hours time. able get into the car and run errands.flawlessly.
carries oui conversation and relates hours days later. able recall telephone
numbers and addresses. have husband back. have 110 doubt the change diet, addition specific supplements, the detox program, and the addition regular exercise, are
responsible for these results. pray that the miraculous results are multiplied million times
over, and others feel the joy and rehef that have had. Dr. Hyman our etemal thanks and
gratitude.
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Key Avenues for Change: Recommendations
While there are many questions still answered, and research done, time act.
Based the aforementioned considerations, submit that public and private sector
investment must made the following areas: Re-tooling medical education and research match the science systems medicine.
recommend the establishment sustainably funded university affiliated institute/or
Lifestyle and Sy.items Medicine/Functional Medicine. This would the national
center and prototype for the development training programs medical schools,
residencies, and postgraduate certification and training Functional medicine for
existing practit ioners and ancillary health professionals. Sixty seven percent the
250,000 primary care doctors are currently dissatisfied with medicine and 80% are
seeking new ways practice based this emerging model medicine: The goal
should 20,000 fully trained practitioners five years. Creation Functional medicine demonstration projects federally fundell
community hea!th centers, with integrated health care teams focusing treating
chronic disease and providing education about lifestyle and wellness. These would
form the foundation for the development clinical practice networks Functional
medicine for education and research. The establishment White House and/or Congressional Office for Health nml
Wellness coordinate all efforts this area detailed the WIN proposal
submitted Dr. Wayne Jonas.
Conclusion
Most chronic disease today not necessary. While conventional medicine has been great for
acute disease, Functional medicine the model for easing the heavy burden chronic
disease from which our society-indeed, the whole world-suffers today.
Thank you.
Mark Hyman,
Institute for Functional Medicine Walker Street
Lenox, 01240
(413) 637-9991
mark@drhyman.com
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Obta ined via FOIA Judicial Watch Inc.
Mark Hyman,
Senate Testimony UNCLASSIFIED
U.S. Department State Case No.
F-2~1 5-06322
Doc No. C05939857 Date: 04f2s120Y612015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
FOi~ Judicial Watch Inc.
::, :ye
Mark Hyman,
Senate Testimony 09/01 /2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Obta ined via Judicial Watch Irie
Mark Hyman,
Senate Testimony 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
Mark Hyman,
Senate Testimony
I.IA
ncun t1.,n.u:
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939857 Date: 04/29/2016
UNCLASSIFIED U.S. artment State Case .F-2015-06~22
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date:
04i291:2ols ~_2Q.1
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016 tained via FOIA Judicial Watch Inc.
2009 The Institute for Functional Medicine
441 Fosdick NW, Ste 305
Gig Harbor, 98335 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016
...
~..
CENTU~Y MEDICINE:
.2IST New Model far Medical Education and Practice
Table Contents
Preface .... ......................... ..... ...... ...... .... .............. ....... ...... ... .... iii
Chapter Introduction ..............................................................
Chaptez: The Changing Medical Environment ........... :........ ...
Chapter Emerging Models ....... ... ...................... ....:.. .......
Chapter The Clinicians Dilemma. ......................................
Chapter Functional Medicine: 21st Century Model Patient Care and Medical Education ........... .:.
References ..... ............. .... ..... .............................. ..... ... ...........
Appendix Table Contents ........... ............................................
...
L.. ... ..... ......: ............ 09/0112015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016
Obta ined via FOIA Judicial Watch Inc
....
..... ................ ..... .....
2IST CENTURY MEDICINE: .New Mndelfar Medical Education and Prac#ce
Preface
Beginning journey Discovery
The document you are about read emergedfrom systematic process inquiry .and intentionality
about some the most critical issues health care today. .Vhilc there arc many vital structural factors addressed elsewhere (reimbursement practices, imurance coverage, electronic medical records, and the
medical home concept), our attention and expertise are here focused the content and proces5 care.
The paLh followed conceive of, research, and write lhis while paper c:emuf) medicine can
traced back 2006, when the Fountainhead Foundation approved grant The Institute for Functional
Medicine (IFM) establish and manage scholarship program for medical schools and re5id~ncy
programs send selected faculty, students, and residents learn about fonctional medicine. Over twoycar period, scholarships were awarded, reprc5cnting medical schools and six residency programs. ..: in:}... h:t. :tn-:l opp(,r:i.trtHit :oi 1r::i: 11.
disease; the evolution evidence-based medicine; the poor performance the acute-care model
chronic-care environment; the emergence new paradigms such ;is syslems biology, integrative medicine,
and personalized care; and the lack consensus how address these issues ~ystematic way.
This journey took deep into the literature cost~ vs. performance, science v~. art, research vs. clinical
practice, and the many ideas about how consolidate the gains the 20th century without losing
lllX1b1hty 1..~:..L ~>.lrn,~ff cl., ~:;ad S)i:~h1;~:i1= inform comprehensive new model that will compatible with both established and emerging
approaches health education and practice. addition, there are important p1inciples and practices that
can provide solid foundalion for synthesizing these congruent element~ workable new model.
Visualizing and implementing fresh approach health and di~ease will require collaborative effort~
.1r1rl ~Y~L~lllS lh.tt v.ork ntlil ..,, p,1litnls a.rni r.1ra1!1litmtr:; :dil.t. !h1 p.1 tr, Will Ut:i:nl
how cert~in key forces and concept5 are critical component.5 dedicated effort achieve productive
and lasting improvement5 our healthcare system. will demonstrate how the common themes
these overlapping paradigms represent fertile terrain for synthesizing comprehensive new model.
will ide11tify elements that must added the common themes create ,t.:
?,:_; ..... .:,
into overarching approach. These will discussed much greater detail Chapter
but here introduce the key concepts each model. (There are other models note, course,
including the Future Family Medicine project and the Medical Home project; information both
these provided the Appendix. the body this paper, however, have narrowed our discu5sion
the models that appear have the greatest potential impact the actual content care, rather than the
strllcture care.) graphic representation some the common themes and key concepts these six models can
seen Figure Applies knowledge genetic
.individuallv improve diagnostics and therapeutics; phamiacc;igenomics
Personalized Medicine
i,J
:l~
..:~
Genetic vulner11bili1ies
.lb
Enviromnonlal influences
];,,~
Reduce adverse
drug effects amd interactions
 :~-
f:! 21st Century Me.dicine
!-rP 1al!y pn~),.: nlr:ll in;~ .:t 111
Since that time, ha5 undergone serious study, implementation,
:hri1l:!C C.H(~ ... (t;(~J:l frr~l
co: nJ ~i(t l:ri( :L:ttt t;:-O; P~: ric .:. I!} c:1uJ e:J :.rtf.:J :(~~ ::1H :ind:: t::~5 f.HTl rr:~a :.:1r1~h.
Emerging evidence has shown fairly conclusively that patient outcomes variety chronic
conditions can improved whene11er substantive progress made integrating !he elernent11 thi~ model into clinical practice, Core elements include: Productive interactions betwee1~ informed, activated patient5 and prep~red practice teams
Effective patient self-management strategics
.:1
Delivery system redesign (tt:am approach; multidisdpfouu), planned interve11tio11s iustead
acute, reactive intervt:ntious; use case mauagers; regular follow-up)
.:f cvi.:l( nct h~li ~tri-:l~:1 l:l(r ln: fl4. l:1:lct.d
that information support clinical decision making readily available)
Clinical information system (the use database and other resources that bring timely,
relevant information both physicians and patients).
Community resources and policies
f). ~c:$lor: :~l.tri :i! l:. IJecome apparem. The> are
absolutely vital co.mponent~ transformed approach health care. :IYnrJ ;l]
Summary this white paper, will establish the need for new model education and care; will address
forces that may represent ohstacles change; and will explore the key concepts and elem.ents already
present science and medicine that are ripe for synthesis into new, more comprehensive model.
Our goal make improvement medical education programs and clinical practice.foasib!e not abstract ideal sense, but the real world with all it~ resistance change and discomfort with
emerging concepts. that end, funding has already been secured for the development pilot project i.i.ptnl~ th~ p,r,. !n;d1, ,.r]qr,.1!1mi. Bel(11 i11~. fi1 ::ii/. :1l. ctr.Ii 1:;.~i: 1]11 (!jr will ht;
reviewed small group leaders within academic medicine who are interested achieving major
~hitl nv.:d.i r:dncnli.on, lh..ir WI.. aibr 1lir t~Ollll1V:11d.Jri .n1: i.J !.11r: n11cii .1h w;U1J.11il~ fir 1>:
possible. Our aim nothing short inspiring system-wide change--the ansformation medicine
imminent, urgently needed, and entirely possible. 09/01/2015
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016
UNCLASSIFIED U.S. Department State Case No. F-2015-06322 Doc No. C05939860 Date: 04/29/2016 ....
2IST CENTURY. MEDICINE:. New Modelfar Medi.cal Education and Practice
Chapter
THE CHANGING MEDICAL ENVIRONMENT
,.,
Background
There are, literally, innumerable facts and statistics available with which describe and analyze health
ar;d health care. Any discussion must necessity based selected ~ubset the data and, thus,
the authors. have, for example, omitted such critical i~sues the reimbursement
subject