
Brian Klepper
is a health care analyst and commentator with wide-ranging health care interests and relationships, and a broad interest in other topics as well. He is a Principal and Chief Development Officer for WeCare TLC, LLC, an onsite primary care clinic and medical management firm based in Longwood, FL, and Managing Principal of Healthcare Performance Inc., a consulting practice based in Atlantic Beach, FL.
He is an active author and speaker, and has provided health care commentary to CBS Evening News, the Wall Street Journal, the New York Times, and the Washington Post. He has published articles on Kaiser Health News, Medscape, Healthleaders, The New England Journal of Medicine, Modern Healthcare, Business Insurance and newspapers nationally.
In December 2010, he founded and now edits Care & Cost, an online professional health care magazine. He is a regular contributor to the Health Affairs Blog and other expert health care blogs. With his wife, he maintains Elaine’s Journey, which details their struggle against Primary Peritoneal (Ovarian) Cancer.
He serves on the American Academy of Family Physicians’ Primary Care Services Valuation Task Force, and is a reviewer for Health Affairs and The Journal of Ambulatory Care Management. He serves on the Board of the Consortium for Southeast Hypertension Control (COSEHC), dedicated to translational medicine for vascular disease. He is an Advisor to the Lundberg Institute, the Patient-Centered Primary Care Collaborative, which advocates for medical homes, and the Center for Value Health Innovation, which helps business identify and implement approaches proven to improve quality while reducing cost.
In January 2011, with David C. Kibbe MD, he began a campaign, Replace the RUC!, that focuses on the most important driver of inappropriate health care cost. That effort has resulted in a lawsuit by six Augusta, GA primary care physicians against the US Centers for Medicare and Medicaid Services (CMS) over its longstanding inappropriate relationship with the AMA’s Relative Value Scale Update Committee (RUC).
In is spare time, Brian is an offshore sailor.
Contact him at 904.395.5530 (o), 904.343.2921 (c), bklepper@gmail.com.
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Plumpy’Nut
The NY Times ran an important op-ed yesterday by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders. The core of her message is that as the farm bill progresses through Congress, we should focus not only on the quantity of food that is produced and that we export for relief to underdeveloped nations, but on its quality as well.
Dr. Shepherd describes the difficulties in treating children who are victims of severe malnutrition, particularly in areas like Africa and South Asia where milk and clean water can be scarce.
The US and other international donors current supply fortified blended flours for moderately malnourished children. Much better and more accessible nutrition is available through a ready-to-use food called Plumpy’nut (or Plumpy). But Plumpy costs a little more, and current UN and US guidelines restrict its use to the 3% of children who have already decended to the most acute malnutrition.
Ten years ago, a French pediatric nutritionist affiliated with the World Health Organization, Andre Briend, developed Plumpy’net, a high protein and high energy food bar comprised of peanut paste, vegetable oil, milk powder, powdered sugar, vitamins and minerals, that can be prepared locally and that has a two year shelf life in an unopened package. Children can be treated at home rather than in hospital settings, a critical advance. They receive 2 packets a day. Delivered in combination with Unimix, a vitamin-enriched flour for making porridge, a 2-4 week treatment costs $20 and can allow 90 percent of severely malnourished children to recover.
One of the lessons of Jeffrey Sachs’ book, The End of Poverty, is that we now have the tools to stabilize the billion people who remain in extreme poverty, so that we can then help them onto the bottom rungs of the economic ladder, where they have a chance to prosper.
Despite its current economic gloom, America remains a center of prosperity in a volatile world. Think of the goodwill we could create if we resolved to couple our aid with the best we we’ve learned in food science and other disciplines. The creation of Plumpy is a shining example of what’s possible, and the work of Doctors Without Borders and other relief organizations an inspiration for how we can cultivate peace in the world.
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