State Representative Bryan Terry

Rep. Bryan Terry: Clinical Cannabis-Research & Medicinal Developments

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As the world embraces the benefits and science surrounding cannabis based treatments, Tennessee patients look to our General Assembly with the hope that they, too, could utilize the medicinal properties in the chemicals in cannabis.  Chairman Bryan Terry, MD (R-Murfreesboro) has filed The Clinical Cannabis Authorization and Research Act which provides such a pathway for Tennesseans. The Act would allow Tennesseans, under medical direction, to participate in a statewide clinical cannabis program where the foundation is formed by medical research and patient safety. 

From its seeds, to the whole plant, to the chemicals extracted from the plant, cannabis has been utilized for medicinal purposes for centuries amongst various cultures.  The World Health Organization referenced the evidence based medical research available on cannabis to state that cannabis does, in fact, have medicinal value, and recommended removing the restrictive classification of cannabis in order to promote more research and development of cannabis based treatments.  Today, over two thirds of the states in America recognize the clinical value of cannabis and have exerted their 10th Amendment rights to help patients by providing them an alternative to the black market. Yet, Tennessee continues to languish in draconian policy by denying Tennesseans the ability to participate in research and development of cannabis based treatments, as well as prohibiting patients from their right to determine their own health care decisions.  The Clinical Cannabis Authorization and Research Act looks to change all that.

“The World Health Organization, Federal judges, and a multitude of scientists, researchers, and medical professionals, to name a few, have opined about the medicinal value of the chemicals in cannabis,” stated Terry.  “Unfortunately, outdated laws and unconstitutional treaties relying on erroneous information brought forth a prohibition of cannabis on all uses, including medical treatments and research. States are correcting this injustice across the nation and standing up for patients.  It’s time Tennessee does so, as well.”

Tennessee is currently ranked third in the nation in an illicit marijuana market behind California and Kentucky.  Much of the black market is generated by legitimate patients who, in looking for alternative treatments for things like chronic pain or other debilitating diseases, put their lives and livelihood at risk in search of relief.  Other Tennessee patients, who could benefit, but do not go to the black market, either continue to suffer or look for relief in another state. The bill, as it is drafted, decriminalizes patients by offering a clinical pathway whereby patients can enroll in a clinical cannabis program that includes research and use of non-smokable cannabis based modalities under medical supervision.  Once passed, having a safe alternative for patients should decrease the demand on the black market.

“Criminal justice reform is a big issue coming from the administration and on the national level.  It is my belief that most elected officials do not want to criminalize patients, and this bill is a positive step towards reforming an archaic and cruel system that harms patients,” explained Terry.  “If we, as a state, are going to be serious about criminal justice reform, we need to ensure that we are sending criminals to jail and not patients.” 

The Clinical Cannabis Authorization and Research Act authorizes medical treatments in the form of oils, pills, breathing treatments, patches, creams, and known medical modalities.  It explicitly prohibits recreational forms of cannabis including smoking, vaping, candies, or anything marketed towards children. Cannabis flower, which is the portion of the plant most known for being smokable, is only allowed for utilization in extracting the chemicals to make the medicines.  The bill does not allow for the raw flower to be sold.  

In addition to focusing on extract only medical modalities, the bill bases its safety and decriminalization regulations on current science and criminal statutes.  Dosage and possession monthly limits of non-flower THC containing medical modalities mirror those of known medical standards and Tennessee statutes. One half ounce of cannabis flower on the black market may contain up to 2800 mg of THC which correlates to some off-label uses of lab made THC medicines.  If purchased on the street, that amount of flower may last a patient a month, but it, also, carries the risk of a simple possession charge which is a Class A misdemeanor. In essence, the bill decriminalizes the possession of non-smokable, non-recreational cannabis based medicines for patients that enter the medical and research based program.   

“Having spoken with many legislators including legislators from other states that have reformed medical cannabis, patients, medical providers, and researching the science, I’m convinced that we have developed a program that is beneficial for Tennessee patients and can pass our General Assembly,” concluded Terry.

HB 2454 is scheduled to be presented on Tuesday, March 3 in the Facilities, Licensure, and Regulations Committee.

Rep. Bryan Terry: Why I Support The Medical Cannabis Only Act

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Rep. Bryan Terry: Why I'm Supporting The Medical Cannabis Only Act

MURFREESBORO- Perhaps the most controversial bill this session is the Medical Cannabis Only Act(MCOA).  For many, it is controversial because of fear, or of ignorance, or of the unknown.  For others, it is controversial because of what is known about cannabis and many of those facts become conflated when one focuses solely on the medical aspect.  Regardless, when I first ran for office beginning in 2013, I developed and campaigned on the three pillars of my platform: Principles, Process, and Passion.  I wanted to take a moment to explain my platform as it relates to the MCOA and explain how and why I support and signed on to the bill.

Principles:

There are three principles in my platform, and it is my goal to strike a perfect balance.  I refer to them as the three rights.

The first right is “What is our right?”  In other words, what is legal or what is Constitutional.  Just because something is legal or even constitutional doesn’t necessarily mean it is the right thing to do.  At one point, slavery was considered legal and constitutional.  Strict authoritarian thought often leads one to enforce or even follow immoral laws.  In addition, strict libertarian thought often leads one to focus strictly on their right, as opposed to, also, protecting the rights of others.

The second right is “What is right for the district(or state or country)?”  What benefits the majority of the constituency or what does the majority of the constituency want.  One would refer to this as populism or populist thought.  One must realize, though, that just because the majority wants something, it does not mean that it is constitutional or even the right thing to do.  We do not operate as a true democracy where there can be a tyranny of the masses, but we must protect individual liberty.

Last, but not least is “What is right?”  In other words, what is the right course of action in my world view based on my background, my family, my faith, and my world view.  Folks that only focus on this right would often be referred to as a theocrat or an ideologue.  Obviously, I am neither.

Process:

When looking at issues, I try to put them through a four step process that with the end decision ultimately lining up with the three rights.  Those steps are, premise, goals, options, and feasibility of those options.

One must first determine if the premise is true and if there is truly a problem that we are looking to address.  Secondly, what are your goals of any legislation?  Do you wish to completely fix the issue or only address part of the problem.  Do you plan to only bring awareness?  

The third step is to determine the possible options and the consequences of those options.  Doing nothing is always an option.  Lastly, what is the feasibility of those options?  In other words, are there votes for that option?  What is the fiscal impact of that option?  Is the option a workable solution and able to be implemented?

Passion:

If one is able to take an issue through a process and have it line up with their principles, then they should be able to defend their position with a passion.  I have taken the issue of medical use of cannabis or cannabis extracts through this process; hence, I am able to discuss the issue with a passion and have decided to support the Medical Cannabis Only Act.

The first option we always have is to do nothing.  Obviously, of all options, this is the most feasible.  However, this option, in my opinion, violates each of the three rights.  When asked either with my survey, other surveys, or with individual conversations, a vast majority of the district supports the use of cannabis extracts for medical or research purposes, though not for recreational nor pseudo-medicinal purposes.  MTSU grows and does research on all of the cannabis chemicals except THC.  MTSU could be a state or even world leader in pharmaceutical or nutraceutical uses of cannabis extracts.  Doing nothing goes against what is right for the district and retards progress for patients.

In addition, the Federal Government holds a hypocritical stance on cannabis that violates the 10th Amendment, the Commerce Clause, and the Due Process Clause of the Constitution.  Doing nothing is consent to allowing these violations of our rights; thus violating the second right in my principles.

Lastly, doing nothing will continue to suppress much needed research, as well as place undue burdens on Tennesseans with medical conditions that have been shown to benefit from medicinal uses of cannabis extracts.  Neuropathic pain, Crohn’s Disease, spasticity, and seizure’s are but a few conditions that have shown to benefit from cannabis extracts.  While cannabis extracts are not a panacea, they can benefit some patients.  Not acting on cannabis extracts violates my third principle of “what is right” as, in my opinion, providing options to patients and expanding research is the right thing to do.

The second and third options, respectively, are to either legalize the whole plant or have an expansive medical marijuana program like Colorado or other states.  Without going into specifics, these options don’t line up with the three rights to bring them into balance, and neither option has the votes to gain any momentum in the General Assembly.  While many folks may ruminate over these two options as a viable options to the Medical Cannabis Only Act, the bottom line is that neither option is one that is going to go very far in any committee.  

The final option is to have a program like the Medical Cannabis Only Act.  The act would allow cannabis extracts to be used in an oil based form for strictly defined medical purposes.  Raw plant and flower use would still be illegal.  The process for the patient would require receiving a specific diagnosis from a physician, a consultation with a pharmacist for medicine therapy management, and a card with dosing limits set by a commission.  One could obtain the medicine from a dispensary, but only in communities that would allow dispensaries.  The bill is permissive which means that counties would need to pass a referendum to allow and regulate participation in their communities.  

Obviously, the steps to possible treatment is a bit more onerous than receiving and filling a prescription, but with the draconian and hypocritical stances from the Federal Government, the method is probably the most feasible method that can pass and be implemented.

Understanding that this option is feasible which satisfies part of my process, one must understand how it, also, satisfies the three rights.  First, as previously pointed out, it is “right for the district”.  The majority support the use of cannabis extracts for medicinal or research purposes.  MTSU is currently doing research on cannabis as hemp with promising results.  Most recently, I saw polls from a cross section of Senate districts that confirmed that Tennessee favored the use of cannabis extracts by a wide margin.  

Secondly, the current posture of the Federal Government is that cannabis and all its chemicals are Schedule 1 drugs.  Yet, every chemical is legal in Tennessee, as long as it isn’t grown from marijuana.  Marijuana and hemp are the same plant except marijuana has greater than 0.3% THC.  Synthetic THC is legal as a prescribed medication called Marinol.  

In 1974, the Nixon Administration, with the Controlled Substance Act, placed cannabis into the Schedule 1 category which basically means that they believed it had no medical benefit and that it was too dangerous to study.  Yet, the federal government has its own strain of cannabis that they market overseas and they allow research at Ole Miss.  In addition, there are a multitude of patients that have had improved symptoms with cannabis based treatments.  The Federal Government stance is hypocritical at best and unconstitutional at worst.  We, as a state, can and should exert our 10th Amendment rights for patients in Tennessee.  It is our right to do so and satisfies the second right.

Lastly, it is the right thing to do.  Patients with cancer, Crohn’s Disease, neuropathic pain, seizures, and other disorders can benefit from cannabis extracts.  I can give various examples of patients and constituents that I know that have their own personal stories.  Some continue to suffer without our help.  Some live in the shadows addressing their symptoms and play Russian Roulette with cannabis not knowing if they would get arrested or obtain some spiked with fentanyl.  

One such patient whose life changed with cannabis based treatment is Alexis Bortell, the twelve year old from Texas who is suing the Federal government so that she can continue treating with her medications.  She developed intractable epilepsy at the age of seven and, by age nine, had tried over 30 medical regimens.  None worked.  And she was suffering life-threatening seizures every day – often multiple times per day.  Faced with a high-risk medication or experimental brain surgery, her family, with the guidance of physicians, opted to move to Colorado and try cannabis based therapy.  By day 33, after she started a new regimen of cannabis with THC, Alexis’s seizures stopped completely, and she has been seizure free for nearly three years.  Alexis went from suffering through multiple seizures a day to never having any seizures at all – and all after she started treating with cannabis.  Though willing, due to Federal and Tennessee laws, she is unable to testify on behalf of the Medical Cannabis Only Act this week unless subpoenaed by Tennessee.

“My Dad and I spoke with Dr. Terry about my situation.  I am living proof that treating with medical cannabis can change and save peoples’ lives.  Except for the risks of not having my medicine and the federal and state restrictions, I live a normal and productive life.  No more seizures.  No more hospital visits.  No more talk of experimental brain surgery.  I’ve been told that there are around 70,000 Tennesseans with seizure disorders and about 5,000 of those are kids like me,” stated Alexis.  “It takes courageous leaders like those supporting the Medical Cannabis Only Act to speak out on medical cannabis.  I’m hoping that the other legislators have the courage to join them so I can come to Tennessee.  I hear it is a beautiful state.”  

Our daughter is nine, the same age as Alexis when the Bortell’s were faced with a difficult medical situation.  I don’t know how anyone could look at their child and tell them that they either had to take a high risk medication that could kill them or have brain surgery knowing that there is potentially another option.  The Bortell’s made the right decision.  Tennesseans shouldn’t have to make that choice.

Folks, it’s the right thing to do to pass the Medical Cannabis Only Act.  It’s the right time to do it, and the right bill to move forward.

Representative Bryan Terry represents District 48 which is the eastern half of Rutherford County and can be reached at 615-741-2180 or vie email at Rep.Bryan.Terry@Capitol.TN.Gov.

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Rep. Bryan Terry 2018 Legislative Preview: MTSU, Medical Marijuana, Healthcare, Education

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Rep. Bryan Terry Hosts Speaker Beth Harwell For Saint Thomas Rutherford Hospital Tour

MURFREESBORO, January 7, 2018– I have been busy getting ready for the upcoming session.  I hope you enjoy and become more informed with my updates.  As we begin the 2018 session on January 9, here is my pre-session update.

The opioid crisis will be the biggest issue coming to the Health Subcommittee which I chair.  I was able to have a couple of opioid related bills jacketed this past week and I have some others waiting to get jacketed depending on a few more discussions.  I look forward to hearing the discussions and taking the lead on several aspects of this issue.  I am expecting a multitude of opioid related bills to come through my committee and may organize a special meeting to listen to all the potential bills.

Aside from the opioid issue, last week, I was corresponding with legislators, an attorney, and physicians from other states to on how they are tackling a particular bipartisan medical issue.  This issue has been going on for some time, and I have been working on a solution for a while.  Of all things, on New Years Eve, I was speaking to a democrat physician legislator about how his state was addressing the issue.  I’m working on drafting legislation on this issue, but can’t give specifics as it is too early and I may not be the one to carry the bill.

I, will, also, be carrying a bill with Dr. Briggs that should streamline a medical service to help decrease the morbidity and mortality of patients……more details to come later when we file the bill.

I will, also, be carrying at least one, if not more, bills related to education.  When they get filed, I will be able to go into more detail, but there are at least three bills that I will either carry or be a prime co-sponsor.  These issues directly impact Rutherford and Murfreesboro City Schools, and at least two of the bills were spurred on by problems related to testing that occurred in our county.  These bills, also, help address some of the concerns brought forth by our school boards during the education round table that I hosted.

I have, also, agreed to carry a bill with Senator Ketron that will directly impact MTSU.  When we file it, we will provide more information and details.  It will bring some jobs and an educational opportunity to the area.

Over the last several months, college students across the state have been bringing awareness to an injustice on their campus.  Working with these students, we hope to change the code to correct this injustice.  Yesterday, I was able to sit down with the student leader on this issue and we have the rough draft of the legislation in hand. I will be meeting with legal services this week to have it drafted.  Students are the largest constituency in many districts.  Students across the state know that I stand up for them every chance I get, and I look forward to being the voice of students on this issue.

As most people are probably aware, medical marijuana or cannabis based treatments will be discussed this session.  Senator Dickerson and Representative Faison held a task force this fall to discuss the issue and draft possible legislation.  Most recently in the news, Attorney General Jeff Sessions revoked the Obama era Cole Memorandum which, essentially, instructed federal prosecutors to not prosecute individuals in states who legalize forms of cannabis.  Congress has some bills to decriminalize or reschedule cannabis, but it is uncertain if they will act.  So, the impact of the revocation of the Cole memo on possible medical cannabis treatment legislation is yet to be determined.

Of note, however, is a federal lawsuit by a 12 year old girl by the name of Alexis Bortell against AG Sessions that is pending.  The lawsuit would essentially either reschedule or de-schedule cannabis as her civil rights are being violated due to her medical treatment.

As chairman of the health subcommittee and to further educate myself and, hopefully, other legislators and the public, I was able to conduct an exclusive one hour interview and follow up questionnaire with Alexis and her father, Dean.  I am awaiting permission from her legal team to release the questionnaire and more details from the interview.  In addition, Mr. Bortell has offered to testify before our General Assembly depending on the timing and the lawsuit.

What I can impart is the history of Alexis and her treatment with her seizure disorder.  

She lived in Texas, and began having seizures at the age of 7.  By age 9, she had been on multiple anti-seizure medications and had suffered many side effects from those medications.  Yet, she still had intractable seizures.

Faced with a lifetime of major medication side effects, intractable seizures, and a limited quality of life,  her parents were given two potential medical options.  Alexis could have a craniotomy which would involve surgery on her brain.  The part of the brain that would have involved surgery would impact her personality, ability to think or reason, and her memory.  Her other option was to move to another state and try cannabis based treatments.  If cannabis based treatment failed, she could then have surgery, but if she tried surgery first and it failed, she would be forever changed.  The family chose to move to Colorado and seek treatment there.

Alexis has been under a physician’s care and has participated in research projects while in Colorado.  She is perhaps the most researched and tested patient in America.  Of note, she currently takes two medications.  One is an oil that contains a high CBD to THC ratio that is her maintenance medication which she takes twice a day.  This oil is called Haleigh’s Hope.  The other is a higher THC cannabis based oral spray called Cannatol RX to treat auras which signal an impending seizure.  These auras present themselves to Alexis as a tingling sensation on her scalp or visual spots in her field of view.  She self administers the THC when the symptoms present and has access to the THC spray on school grounds at her school in Colorado.  

Since becoming stable on her medication on Day 33 of her treatment, she has been seizure free for nearly three years.  She has had to use the oral THC spray less than 20 times to prevent seizures. She is growing like an otherwise healthy girl with minimal if any side effects.  Aside from the limitations placed on her due to cannabis laws, she is able to lead a normal life.  One that she would not be able to lead if she still lived in Texas or even Tennessee.

Of note, there are around 70,000 Tennesseans with a seizure disorder.  Roughly, 5000 are minors like Alexis.  That translates to over 700 patients and 50 children in each legislative district who could potentially see the same medical benefits as Alexis without the major side effects of anti-seizure medications.  

In addition, I have heard candidates for legislative and gubernatorial office opine that big Pharma already has drugs to treat seizures or that we already have “medical marijuana” in a drug called Marinol.  In the case of Alexis and countless others like her, those medications either don’t control the seizures or they have severe side effects.  Marinol, the synthetic THC that is legal in Tennessee and every state, takes 30-45 minutes to take effect which isn’t fast enough to treat an impending seizure; whereas, the nasal and oral THC sprays works almost instantly.  

Sativex and Epidiolex are potential cannabis based FDA approved medications coming down the pipeline, yet neither medication would provide the ratios of THC to CBD necessary to treat patients like Alexis.  And neither would provide the flexibility to treat these patients as their metabolism changes during puberty.  

Ultimately, the action that our Tennessee General Assembly takes may very well depend on the action taken at the federal level, the result of the lawsuit, or the kind of legislation put forth by Senator Dickerson and Representative Faison.  Regardless, after speaking with the Bortell’s, it is clear that the current system is failing many patients.  Telling Tennesseans who are in the same position as Alexis to just keep suffering from medication side effects, move to another state, or have a partial lobotomy isn’t the answer.  

As always, it is an honor and a privilege to serve District 48 as your state representative.  Please, follow my updates on BryanTerry4TN.com, on Facebook at Dr. Bryan Terry, or on Twitter at @BryanTerry4TN.

With Liberty,

Rep. Bryan Terry, MD

 Follow Dr. Terry on Facebook and Twitter.

Rep. Bryan Terry Discusses Medical Marijuana Legalization With MTSU Students

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MURFREESBORO, March 7, 2017– With the Tennessee General Assembly in full swing, the issue of medical marijuana will be coming to the forefront.  Whether one is on the hill, in the community, or on the campus of MTSU, opinions and emotions on the topic range from a definitive “no” on any marijuana use to legalizing any and all forms and uses of cannabis.  Regardless of where one stands on the issue, the opinions and arguments for and against make for some interesting conversations.  Our Campus Connection provides a look into the issue and the opinions of the community.

All too often, when the topic of medical marijuana arises, many people conflate the liberty issue of recreational use with the medical issue involving the chemical cannabinoids found in cannabis.  A survey of District 48 which looked to separate the two issues produced an interesting result amongst respondents.  While comments ranged from not legalizing cannabis in any form to legalizing all forms and taxing it, of note , the majority of respondents were opposed to any legalization of recreational use and were opposed to smoking of cannabis for medicinal purposes.  However, when asked about cannabinoids, the chemicals in cannabis, such as THC or CBD being used for research or medicinal purposes, an overwhelming majority of respondents supported those measures.  Based on the survey of District 48, while not scientific, one could conclude that many see potential medicinal value in the cannabinoids, but reject any smoking or recreational use of marijuana.

According to an analysis done by the Pew Research Center, support for the legalization of marijuana has sharply increased in the past several years, particularly in the millennial generation.   On MTSU’s campus, sentiments by many students seem to follow the same trend. While college culture is known to be more excepting of recreational smoking, many students have considered the issue of its assumed medicinal properties.

Quinlan Odom, a senior at MTSU, considered the following stance for her view on the drug: “For me, personally, I do believe in the legalization of medical and recreational marijuana. I suffer from diagnosed anxiety which tends to result in severe panic attacks. I had been prescribed Lexapro and was a diligent user of that medication. I found, however, that it didn’t soothe the anxiety. Rather, it attempted to mask it.” She believes that the calming affects associated with cannabis use could provide a solution for a problem otherwise incredibly detrimental to her academic pursuits.

One adult student advocated medicinal uses explaining that, “My nephew has been suffering from epilepsy since he was about 8 years old. He has been on several different medications and, now, he is even on a special diet. All of this is an attempt to get his epilepsy under control. Yet, sadly, his seizures have become worse and more frequent. Many studies have shown that marijuana has positive affects when it comes to dealing with epilepsy. As it stands, due to the legality of marijuana, my nephew does not have access to that potential life changing medicine. Instead, he has to continue trying ineffective methods.  Legalizing marijuana, at least medical marijuana, would mean he has a chance at taking his life back.”

There is consideration to be made for the legalization of the use of the chemicals found in marijuana for medical treatment. Marijuana and all the cannabinoids and chemicals found in marijuana are currently classified as Schedule 1 drugs.  The Drug Enforcement Agency defines Schedule 1 as “A drug or other substance that has a high potential for abuse. The drug or other substance has no currently accepted medical treatment use in the U.S.”  While cannabis and all the chemicals in the plant are illegal, cocaine, a much more dangerous drug, is a Schedule 2 drug and is legal for defined medical purposes in all states as it has local anesthetic and vasoconstrictive properties.

Cannabis, and all the cannabinoids in it, are in a catch 22 due to being labeled Schedule 1.  Being illegal makes it near impossible to do medical studies which, in turn, makes it difficult to prove medicinal benefits and disprove the rationale for classifying cannabis as a Schedule 1 drug.  At the Federal level, a bipartisan Congressional Cannabis Caucus has been formed and Congressman Thomas Garrett (R-Virginia) sponsored a bill to remove cannabis from the Federal Controlled Substance Act.  Even nationwide advocacy groups like the Epilepsy Foundation support ending the Schedule 1 restrictions to increase access to research and treatment options.

“Marinol which is a drug with synthetic THC and medical cocaine are legal in all 50 states,” stated Representative Bryan Terry, MD.  “One would think that relaxing the restrictions on research or even placing cannabinoids in the Schedule 2 category would make sense.  Israel is leading the world in cannabinoid research.  We have universities, hospitals, scientists, and patients in the U.S. willing to research the use of cannabinoids in PTSD, Crohn’s Disease, neuropathy, amongst other diseases states.  Potential effects of cannabis on youth brain development, as well as other potential side effects are always a concern.  But given observed benefits to some individuals, it’s time we, at least, advocate for research and rescheduling the cannabinoids.”

The reprieve on the illegality on at least the cannabinoids that have been linked to medical benefits could form a temporary compromise. It would, in the minds of some students, provide for those who have found the drug beneficial without completely legalizing what many still consider an illicit drug.  Several students in favor of legalizing the drug acknowledged that this would be a welcomed step for those combating issues they feel are not well treated through other medications.

Overall, it seems that MTSU campus life echoes the national trends in regards to marijuana usage. A vast majority of those interviewed did not initially differentiate between the legalization of marijuana itself and the legalization of the chemicals in the drug. When questioned, most expressed that legalizing the associated chemicals was a start. However, those students who were pressed ultimately sided in favor of the drugs legalization, at least medically, so long as it could be made to benefit both health and revenue.