almost no national recognition because i think it was on the front page. but it was presented as a public health story and not a political social story. america's lifet expectancy continues to rise for all groups except one -- non- college-educated white americans. school- non-high- educated. people who drop out of high school. hispanic high-school dropouts have a higher life expectancy than americans of european descent who dropped out of high school. african-american high school dropouts for the first time have a life expectancy equal to high school dropouts of european descent. unfortunately, it is because the latter have been dropping, not because the former have been rising. , it wasead the story

unbelievable. it said that from 1990 through 2008, life expectancy among high-school dropouts who were white women had dropped five years. to give you some measure of whereison, the only place anything like that has happened in the world is after the soviet union collapsed and the health care system went down with it when they went through total economic distress. there was a seven-year job in life expectancy there for men and slightly higher for women. the man's life expectancy had dropped three years, and they said there were several reasons .or this -- the rise in smoking rise in obesity race and the attending consequences.

the rise in drug abuse deaths -- mostly prescription drug abuses. and the lack of health insurance. and, they said, that the reason the women's life expectancy had dropped more than the men is that women's smoking rates went up way higher than the men's did. i believe that is another way of saying that a lot of these people were dying young of a broken heart because of the devastating effects of the economic trends of the last , but years or so on them we have to face the fact that this is happening and that this is part of what we need to do. these people are part of our country. they could be making massive contributions to our economy. they are parents. their children need them to live

long and healthy lives. whether wee can do, are doctors or nurses or medical researchers or health care .roviders or just people it is very, very important. most of the other news is good. there's a lot of evidence that the childhood obesity rates have leveled off and are dropping in many places. we've got a new report since we were here last year that the agreement we made with soft drink manufacturers to reduce the caloric content in schools of drinks served in the cafeterias and in the school vending machines -- that those calories have dropped by 90% in more than 90% of the schools in america purely by agreement. there are more than 30 million more children eating healthier meals, more nutritious meals at more affordable prices in rural areas where they used to have to

pay more for these things. these practices were instituted before the new usda guidelines came in, and i say that to encourage all of you to believe that we do not need a government solution to all these things. it is good to have the right government policies, but there are things we can do together that will make a difference, so i am encouraged by that. i wanted to also just mentioned a couple of other things -- last year, i asked everybody in this audience to get involved in some way and actually make commitments to do what we do every year at the climate global initiative. today, there will be pledges that amount in value to $100 million to improve health and wellness that will help more than 25 million people all across america. i am grateful to our sponsors

for stepping up. i am grateful to many of you in this audience, including my longtime friend, for the commitments that you will make, but i want to take special note of one. i would like to ask carter kessler to stand at. carter, where are you? stand up. there he is. see him? .e is 14 years old he will be able to support us all in our old age. he saw a problem and solve it. the problem was that he and his mom wanted to stay more hydrated and found they drink more water if they and use it with fruit.

as they travelled around town, they could not carry the pitcher with a strainer around, so he figured out a design for a carry-around few-and used water bottle, and he manufactured it -- fruit-and used water bottle -- carry-around fruit-infused water bottle, and he manufactured it. you will all receive his invention in your kit bags to date. i urge you to use it, and thank goodness there are 14 year olds who can think like this and doing something to give us a better future. thank you. [applause] today, you will hear more stories from speakers about how they, like carter, are planning to make a difference. i hope you will get involved because we have to turn the tide in america. as a result of what so many of oursaid to me last year,

foundation has now started a new year-round initiative called the health matters initiative, which will bring together individuals, communities, companies, and ngo 's and philanthropists to make health and wellness a priority to improve the quality of health for people across america who are not covered by our childhood obesity initiative. we want people to make healthy changes and to try to reform systems that affect people's health. we need your help to make this a success. it will take everyone in the room and then some to really turn the tide, but we can do it. you will hear today from people in all sorts of interesting ways have used their ingenuity and resources, large and small, to be part of the solution, so thanks for being with us today, and i look forward to having a great day. thank you very much. [applause]

>> ladies and gentlemen, please welcome don berwick. [applause] >> thank you all. it is an honor and pleasure to be with you, and i am grateful to the clinton foundation for their leadership here. in 1971, i was a medical student. jeff was 8 years old. he was my patient. he did not make it to nine. he had acute leukemia. he was the first child that i ever sat with as he died, and i think of him very often. .oday, he would live of full, gleaming majesty

medical technology would come to his side. chemotherapy, radiation, bone marrow transplant. he would someday see his grandchildren. it would be a miracle. when i was a young doctor in training, every kid i saw with leukemia died. now they almost all live. we can transplant livers and lungs. we can control aids. we can fix congenital heart defects that would have killed their victims just a few decades ago. bravo. we need these miracles and we should never, ever stop pursuing them, but let's look at some numbers. this year, 2000 kids will have leukemia. every single one of them deserves a miracle, no doubt. 215,000 kids will have diabetes. 7.1 million kids will have as much. 12.5 million kids -- 15% of all kids in our country -- will be obese. where are their miracles? for every person, a kid or

adult, who can benefit today from a heart transplant or miraculous drugs and surgery and should, there are hundreds -- there are actually thousands who live every day with their chronic illnesses. they need help that is less charismatic, less gleaming in order to lead their full lives to see their grandkids graduate, to do their woodworking, to cheer their football team. even though they will have and will always have chronic heart failure and chronic lung disease and diabetes and bipolar disorder and arthritis, they need teams -- teams of doctors and nurses to coordinate the test and medicines, communities to support and help them get around and stay safe. they need education so that they and their families can take better and better care of themselves. hospitals actually cannot help them thrive. communities can. when that goes well, what can happen is absolutely amazing.

one of my favorite examples is system, aled nuka primary care system for alaskan natives. it is team-based community focussed prevention-focused, education-up with health care. it uses every resource patients and families can bring to their care. it thinks the best hospital bed is an empty one. many alaskan natives have very high levels of chronic illness and social stress, but in six years, nuka cut hospital days by 53%, emergency room visits but it to%, specialty consultations by 60%. they even cut primary care provisions by 60%, and they have the best health care quality scores you can find and the best patient satisfaction you can find. it builds bridges to where the need is. chronic illness care,

prevention, spiritual help, family health, behavioral health. it offers love and respect to people who thought they were unlovable and invisible. i can give you dozens of examples like nuka. in pockets all over the world, and they hold the best possible solution to the immense problem of health care costs in america that president clinton referred to. the best possible solution is improve the care. improve the health. just do the math. if nuka can cut hospital use by 53% while getting better outcomes, what can we do if we could get even a fraction of that success in every community in our nation just by focusing on communities and on health? we would have all the money left over that we would ever need for the miracles of technology

to save kids like jeff, but that is not the whole story. we got two big problems, and i want to describe them to you. here is the first -- remember the nuka results? 53% fewer hospital days. 65% less use of specialists. not because these are rationed but because people do not need them. imagine a bright young innovator in a hospital runs breathless into the board room and she says, "guess what? i know how to cut our admissions by a 53% and our referrals by 65%." that will not be a long conversation. it is not that the executives or the board do not want people to be healthy -- of course they do -- but they have been conditioned over decades by a broken, volume-based health-care payments system to maintain business plans that depend on doing more, not less. for them, even though they know in their hearts that it is not

so, a full bid is better than an empty bed, and a busy machine is better than an idle one. these are not bad people. they are just hitting the pitch that we throw them. if it says do more, they will do more. if the pitch changes and says, "keep us healthy. help us drive." they will hit that, too. we are changing it slowly with new emphases on payment for chronic care, coordination outcomes, but do not make any mistake -- it took a century to build the edifice of technical miracles, and a lot of the $2.60 trillion we are spending on health care today is invested there. this is hard to change, and it will take guts. the second problem is about the causes of health itself. why do we get sick in the first place? heart attacks, depression,

stress? you have to remember only one number -- four. here is that math. if you assign 10 points to variation in health, the reasons we get sick, science says that our genes get five points. someday we will learn how to change those risks, but right now, they are just the cards we are dealt. what about the other 50%, the other half, the risks we can control? health care gets some credit for making us in keeping us healthy. of 10 points, health care is one. 10% of our help today is related to the care we get or do not get. 40% of our health depends on choices -- what we eat, how much we walk, the risks we take, the substance abuse or unprotected sex, the guns and violence on our streets, the pollutants in our air, the seat belts and bike helmets we use or do not use. four points for fresh air and

bicycle lanes and good parts and help to young mothers. four points for love in our lives and remembering that we are all in this together. four points for the quality of our neighborhoods and the knowledge we have and the knowledge we used to take care of our health and to respect the health of our neighbors. four times more held in our own hands than in all the awesome hospitals and surgery suites and blue pills and read sirens. that is very good news because that means that we can if we choose take living long and living well largely into our own hands, but it is tough news because it means we cannot make an appointment with a healer. we cannot buy the miracle. we are the healer. we are the miracle. that responsibility is one that we may not welcome. i applaud the clinton foundation for taking on the mission of healthy communities. it is the best path by far to

thriving, but make no mistake -- this is a mission of change, of profound change. i believe, in economics, in business plans, in the labor force, in our use of capital, in our deeply held myths about how to get and stay healthy. there are two new bridges to build. one to care for chronic illness. beyond that, another new bridge to new communities where health is the point. what we get for the trouble is this -- we will get better care. we will get better health. we will get lower costs to improvement. we will strive -- thrive. that, as far as i'm concerned, is what we wanted in the first place. thank you very much. [applause] >> ladies and gentlemen, please welcome president bill clinton and dr. nancy snyderman. [applause]

>> welcome, everyone, to the clinton foundation health matters, and welcome, mr. president, to your own forum. we've got to stop meeting like this. >> we should have full disclosure here. >> no, we should not. ok. >> we've been friends for 30 years. >> we go way, way, way back to win he was making $32,000 a year as a governor. right? or am i overestimating your income? >> i think it was $30,000. >> we go way back. not only are we old friends, but the secretary of state which used to practice law helped me about my now 26-year-old -- my now 26 year old.

rumor has it that hillary clinton's husband was spotted at the golden globes. laughing >> yes, it is not my forum, is it? >> i thought you did really well. i must say, standing ovation. >> steven spielberg let me write my own scrip, which i could not believe. here is what happened -- this is important for what is going on -- he and i have been friends for 20 years. on a couple of occasions, he has been nice enough to send me a script of a movie with some relevance to things i know and asked me to read it. he called me and said he wanted to make this movie about lincoln's last week and the passage of the 13th amendment, which is a story nearly no american knows, and he asked me to read the script. i did and made some suggestions for how he should change it, and

i called him, and he sent me a second copy and then a third copy. so he said, "you had something to do with making this movie because i really just wanted to tell the story about how this man had no death wish and how link and the man was way more interesting than link in the legend and how he practiced really tough, gritty politics, trying to achieve compromises on small things so he could do one big thing -- and slavery -- end slavery -- and why he was determined to do it with the congress he had instead of a better one coming back." this move explains all that, so he asked me to introduce it and explain the historic importance. >> you did a great job and did it with jocularity. when you read the script, were there things you thought did not read true to lincoln the man? >> no. >> you like it? >> i like it. i thought the movie should be a movie for general audiences, and

it was carefully done based on diaries, like, of these members of congress that made all these deals and the letters they and the letters fabulouscoln's secretaries left. i thought the language was a little too earthy if you wanted nine year olds to go to the movie. i recommended that they ended the way they did. it is hard to figure out how to end a story like that because you want to end it up not down, but it ends with linkedin being being killed,oln so they did it with his second inaugural address, which is by a long stretch the finest ever given by any president and the second shortest. george washington opposes second inaugural was the shortest. he basically said, "thanks for the job. let's go back to work." it was 90 seconds. my first was the third shortest.

>> you and i spoke about what you learn in your own life with your cardiac disease, how you have changed how you eat and you exercise. you have now led, through the foundation, by example. you have really changed totally how you approach sleep, to some extent. ating, exercise, etc. i have a question to ask of you -- when you have moments with the secretary of state and palo osmosis can happen, do you ever tell her to slow down? >> no, but she will when she gets out. >> because you know, we all worry. >> what you need to know is when she was in washington, the morning she was in washington, she worked out every morning a .:30 with a trainer she swam five days a week when it was possible. in is much more disciplined

sleeping than i am. she can sleep on an airplane all the time. every time she got on an airplane, she slept, so that is how she kept up this incredibly grueling schedule. what happened to her had nothing to do with exhaustion. she got a terrible virus, and one of the manifestations of it was prolonged retching, even when there was no biological reason to do it. she fainted and had her head and got a concussion, but she is going to take a long rest because she has been hitting it for 20 years. i want her to take a few months before she does anything. >> do had a bumpy and to 2012, and we look forward to 2013 being a little more mundane. >> i could be a private duty nurse, if you need anything. i am virtually certified. >> you have been a big believer in public-private partnerships since i knew you in arkansas. he maintained that through your presidency and living it now. where do you think we as

americans go wrong in expecting government to fix things? _ for me how you think the future of health care with me will change with these partnerships -- underscore for me how you think the future of health care will change with these partnerships. >> if you look at this precipitous drop in life expectancy among white high- school dropouts, there are clear medical reasons for it, but there are also psychological and social reasons that reinforce it. if you look at what is working, the places that are growing economically in america, the places that are doing best around the world, you have these creative networks of cooperation. there are some things the government is really good at, and they have to do that. there are some places private sectors and ngo's are better, and they have to do that, and

they have to figure out how to keep changing. we are moving into an era where the only way you can create enough jobs for people and generate enough wealth to have decently rising wages is if you use creative networks of cooperation. i think the same is true with this health challenge. that is the only way it works. by the way, there's a lot of research on groupthink, which proves that. i saw another study last week that said if you put a group of people with average iq's together and ask them to work on a problem for a year and you give the same problem to a genius, over the long run, the group of average intelligence with greater numbers working together will do better than one genius acting alone. >> do and i last year spent time in a school that has totally revamped its cafeteria and put exercise back in schools.

i have told you several times that nothing makes me bluer and more of a pessimist there in our at obesity rates kids. give me one reason why i should be more optimistic. >> the rates have leveled off and in some places dropped. in a few places where they measure body mass index, the bottom as indexes -- body mass have gone down. a lot of these kids are attuned to different foods, and they did not like it. i went to one of our highest and i was there one day, and people were exercising in the gym. they had it open at lunch hour, an ordinary kids weather exercising, not just athletes,

but a lot of them were walking past the vegetables. we just had to be patient with that. it has to become a positive thing. about the things we know human psychology is you cannot get group change very much with strategies -- with negative strategies. it has to be a positive thing, and there have to be a lot of peer changes. you should be optimistic because the overall numbers are getting better in an area where there has been a concentrated effort for about six years now. >> as we increasingly look in a global way, so many corporations have a global stake in not only staving off starvation, but the obesity issues in china and india and places where we are turning increasingly for technology. what is the responsibility of us in this country to have more of a global reach? our companies are

involved globally, and more of our citizens are involved, even if it is just internet giving just a modest amount of money. aret of these companies leading the way. if you want to be optimistic about the future, there is a book called "future of perfect." in his first two books, one was about how the cholera epidemic was stopped in london in the 1700's and one is about the discovery of oxygen, but he turned his attention to the modern world. this book points out that companies that branded themselves as being good for their employees and their health and wellness and children's aspirations, good for their customers and good for their communities over the last i up and down crazy, 12 years we've

been through had a rate of return that was almost 10 times as much as companies that had only a quarterly focus on quarterly returns and cared about their shareholders here and their employees and their families and their communities and their customers. more companies will adopt this model within the united states and beyond our borders, but there are huge global health problems that american companies and american citizens should help to address. people who get involved in trying to do that just in a little way also tend to be healthier at home and to influence their peers. spoke for aick second about the human genome. would you ever have yours mapped out and made available to the public? i would love to,

do that. out i'm related to attila the hun or something like that. everybody in asia is related to get this kind. he had so many kids. -- everybody in asia is related to genghis khan. >> what are you reading out? >> i'm reading a new book by this guy stephen johnson on the history of innovation and what really makes it work. getting,ing forward to you know, through that. i am reading nate silver's wonderful book -- he is the guy who did all the political predictions, but he started out trying to predict which college and minor league baseball players could make it in the big leagues. it is fascinating about the challenges of prediction and how much is statistics and how much

is instinct and what do you look for? those are the two things i'm reading now. >> do you read more than one book at a time? >> sometimes. i started at the year -- when hillary was convalescing, i read nothing but cheap thrills mysteries. newad janet evanovich's book, which is just hilarious. i read one funny book that came out several years ago -- 2005 or 2006 -- by jonas johnson, a swedish writer, called "the hundred year old man who jumped out of a widow and disappeared." it is one of the most interesting books i have ever seen. i cannot figure out how you could afford to make a movie out of it, but it is hilarious. i recommend it to you if you need something to get your spirits up. >> as the secretary of state takes time to get better and

looks at the transition to the new secretary of state and you guys get ready for normal whatever that is in the clinton family, and as 2016 is blooming and people keep nudging you guys, what would you advise hillary as the reason to run and what would you say to her she should be cautious about if she were to decide? all, i do not think her health is an issue, but when she had to go back to the hospital, as has been described, to take her blood thinners so we could monitor that because the ,oncussion was not totally gone it was the second time in her adult life -- in her childhood life, in her whole life -- that she had ever spent the night in the hospital. the first night she is -- the first time she spent the night in a hospital, chelsea was born, and chelsea was born nearly at midnight. i'm convinced that has even born in the morning, hillary would

have insisted on going home. she has always been very, very healthy. she has very low bread fletcher -- very low blood pressure, very low standing heartbeat. i teller she still has time to have three more husbands after me. she will live to be 120. i know she is thinking about that whenever i'm stumbling about something in her constant quest for myself improvement. she refers to me as her first husband. because i told her she was going to live to be 120 and have time for plenty more. my advice is that she should rest up and decide what she should do with the rest of her thinks this is the right thing for her and america and the world. if she does, she should do it. if she does not, she should not. we have had a great life. you reach a certain point in life when every day is a gift.

so your calculations are not the same as they were 20 years ago. i am much more tolerant of a lot of things that drives people nuts about washington because i remember when it was like to be 35 or 40 years old and still in the grip of your ambition. it is different when you reach this. she is the most gifted public servant i have ever known, and whatever she decides to do is fine with me. >> are you or she concerned with the third third of your lives? >> yes, it is the only one we got. you bet we are. to livealways try not in the past. i am a southerner who grew up on william faulkner. it is hard for me not to be obsessed with the past, but i try to do it in a positive way. i am grateful for the life and friends i had, and i learned a

long time ago that you some day subconsciously measure your life by the people you really cared about who are not around anymore. the older you get, the more that is true. but almost everybody who works in our foundation is way younger than i am, and i tried to spend time with younger people and keep my ideas fresh and my mind going. we are both like that. yes, we are obsessed with it, but i think it is a positive obsession. we just want to make the most out of every day. >> thank you for this conference. thanks for with the clinton foundation is doing. it is always a treat to see you. >> on the next "washington journal," will talk about the prospects of the house and senate coming up with a 2013 budget agreement.

and a group of bipartisan senators toward the arizona- mexico border last week as they work on an immigration bill. we will discuss what should be in the immigration bill and what challenges any immigration legislation may face with a former chief of staff to arizona senator john mccain and the bipartisan policy center's immigration director. "washington journal" live at 7:00 a.m. eastern on c-span. and thefotainment coverage of political news, with the executive director of tmx, a former network news anchor, and .n "l.a. times" writer this is an hour and 15 minutes. [applause] >> thanks so much for being here.

thank you to my colleagues. this is a terrific panel of three incredible journalists with incredibly different backgrounds. let's get into it. i must confess this is the first time i was told i would be moderating this panel. i felt great physical pain. it was a flashback, a moment of real physical pain back in 2003 outside buildings in norwalk. the recall election was scheduled and people were going to run for governor. i was staking it out and covering it when arnold schwarzenegger walked up the stairs to file his papers. i was sitting at a respectful distance and trying to get in a

question. arnold was ignoring me. next thing i knew, my head had hit the ground. i had been mowed over by teams of reporters and crews. i stayed at a respectful distance while they went right up to arnold and got answers to their questions. they were undeterred by security and various rope lines and things. i did not need medical attention, but i had a question in my mind -- should i be angry at these people who had managed to follow journalistic decorum? or should i learn something from them? figure out maybe a kind of martial arts training they got. that is kind of the question of tonight.

the entertainment culture is what it is. it is here, even if you are just standing there, it can knock you over. if you are a journalist, the question becomes, how do we get the journalism we need? how do we get that in that culture? in do journalists negotiate the culture? fight it? i will introduce the panelists. charlestart with latibeaudiere, tmz executive producer. before that, he worked at "extra."