Millions worldwide die each year because they can’t afford a pacemaker. Meanwhile, heart patients in the United States say they’d be willing to donate theirs after death to someone in need.

In this week’s issue of Circulation, experts at the University of Michigan Cardiovascular Center described the legality and logistics of collecting pacemakers, for reuse across the globe, and unveiled a new program to do just that.

They assert that humanitarian efforts so far have shown reuse of pacemakers to be safe and effective with little risk of infection. In fact, patients live as long with a recycled pacemaker as those who get new ones, authors say.

After lagging behind the rest of the country for years, Tennessee is catching up fast when it comes to improvements in its health care system aimed at elderly and disabled residents. More of them are getting the assistance they need in their homes — at a much lower cost than at a nursing home. A lot of this change is the direct result of efforts by Governor Phil Bredesen.

Nearing the end of his eight years in office (he is required to leave due to term limits this year), Bredesen decided to focus on getting Tennessee off the bottom rung in rankings of states that offer consumers choices in long-term care. Just a few years earlier, only a few hundred Tennesseans were able to get Medicaid funding for anything but a nursing home. Now, it is one of a handful of bellwether states that offer a broad range of alternatives to nursing home care.