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Sanjay Gupta MD

Health Insurance; Corrective Vision Surgery; Breakfast Cereal May Be Getting Something New

Aired December 15, 2007 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SANJAY GUPTA, HOST: Thanks, guys. This is HOUSE CALL. We're making the rounds this morning of some of the most intriguing medical stories of the week.
First up, do you have health insurance? If you don't, you're not alone. And if you do, do you have enough? CNN personal finance editor Gerri Willis joins us to talk about ways to find affordable insurance now.

Then, we're going to be taking a closer look, so to speak, at corrective vision surgery. It's the topic that viewers voted for on CNN.com this week.

And your breakfast cereal may soon be getting something new. No, not toasted marshmallows. We'll explain.

Let's get to it, though, with a hot topic from Capitol Hill to Main Street. It's health insurance and it's a luxury many people can't afford. But what if you struggle to pay for insurance and then realize too late that that insurance wasn't enough?

(BEGIN VIDEOTAPE)

LISA CRISTIA, CANCER SURVIVOR: They didn't cover $3,669. And the next one, $525.11. And there's one here for $1,200. This is so old that I'm not even sure what it's for, but it's for $305.25, which is sometimes more than I make in a week.

GUPTA (voice-over): Lisa Cristia is a cancer survivor diagnosed with tongue and throat cancer four years ago. These are just some of the medical bills that are still piling up, even though she has health insurance.

CRISTIA: I did have insurance. And I thought that it was enough and that it would cover me, and that the only battle that I would have to fight was the battle against cancer.

GUPTA: After going through $5,000 in savings and $14,000 in her 401-K, Lisa was still $65,000 in debt because of what her insurance didn't cover. Eventually, she was forced to file for bankruptcy.

CRISTIA: I had fought the fight -- what I thought was the fight of my life, fighting cancer. And now I had to fight these creditors and people harassing me every single day.

GUPTA: Lisa still needs follow-up and medications. And that means more medical bills, bills she keeps in a box, because she doesn't know when or if she can pay them.

CRISTIA: That's a lost future, you know. I'm -- at 38-years old, I'm never going to be able to buy a house. I'm never going to be able to buy a brand new car, no matter how hard I work and how much money I make. My credit's completely ruined.

GUPTA: According to Ron Pollack, executive director of the consumer help advocacy group Families USA, Lisa's story is not unusual.

RON POLLACK, EXEC. DIR., FAMILIES USA: Health care cost is the number one cause for people declaring bankruptcy in the United States today.

GUPTA: A commonwealth fund study published two years ago, estimates that 16 million adults were underinsured in 2003.

POLLACK: The average cost of family health coverage purchased through a group is more than $12,000 a year. So even if you're making, say, $60,000 a year, that's one-fifth of your income devoted just to premiums.

GUPTA: Lisa pays as much as she can, whenever she can, and knows now that having health insurance isn't enough if you get seriously ill.

CRISTIA: I think most Americans don't understand that we're one cancer diagnosis away from complete bankruptcy.

(END VIDEOTAPE)

GUPTA: Studies show that Americans are more worried about their health care costs than about losing their jobs, paying their rent, or being the victim of a terrorist attack. In short, they're pretty worried about it. So what do you do if you have no insurance?

Well, personal finance editor Gerri Willis is here to break it all down for us. Thank you again for joining us, Gerri.

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: Great to see you.

GUPTA: As you know, this is a concern for a lot of people.

WILLIS: Right.

GUPTA: First of all, in all the reporting you've done on this, what do you tell people as to what they should do if they don't have insurance right now?

WILLIS: Well, there are many steps you want to take. Let me tell you first how many people aren't covered. 47 million. That's up 2 million from last year. The numbers are very big.

If you don't have coverage, though, you definitely want to start with your state insurance commissioner, who can tell you what kind of state programs are available to you. And I've got a lot of Web sites here. You should really get out a pencil if you're in this situation because there's some great Web sites to go to.

Covertheuninsured.com and healthinsuranceinfonet.com are two great Web sites to find state by state breakouts of programs that are available to people who don't have insurance, discount drug programs, Medicaid, who can be covered, who can't.

If you don't qualify for the state programs, there are other places to go. Ehealthinsurance.com will give you quotes from private insurers., where you can get private coverage. Obviously, you're going to have to pay for it yourself.

There are 33 states that have pools of coverage if you have a preexisting condition of some sort. And you know how that goes. It can be tough to find insurance if you already have a problem.

GUPTA: Right.

WILLIS: It goes to naschip.org. It's a great Web site that will hook you up if you happen to live in one of the 33 states with the program.

GUPTA: Now you got a T-shirt there. What's this T-shirt?

WILLIS: I do. You know, we were talking about how many people don't have coverage. And there are so many people out there right now that don't, it's becoming trendy to say, hey, I've got a problem here. Nobody's embarrassed anymore. This is "uninsured". And this is, you know, based on the Red campaign ...

GUPTA: Right.

WILLIS: ...for AIDS in Africa. And I've got to tell you, Sanjay, the woman who made these, she was a marketing person who worked part time, had no insurance coverage. She wanted to, you know, give a voice to these people. She put these out. Then she got in trouble with the people with the red campaign.

GUPTA: Is that right?

WILLIS: So she had to stop making them.

GUPTA: She sort of stole their little logo there?

WILLIS: That's right.

GUPTA: You know think about it -- it's interesting because people always are sort of divided into uninsured and insured. But based on everything that we're hearing, there's a lot of people sort of stuck in between.

WILLIS: Right.

GUPTA: They could afford it, but it is so expensive.

WILLIS: Right.

GUPTA: If people who can sort of afford it, do they not buy it and sort of skimp on their insurance coverage?

WILLIS: Right.

GUPTA: And what advice do you have for them?

WILLIS: Well, you just saw the story on somebody who didn't have enough coverage. Right? There are about 29 percent of people who actually have health insurance coverage through their employer, but the program isn't very good.

So let me give you some rules of thumb, things you should look for to find out whether you have adequate coverage or not. Lab tests, rehabilitation, medical equipment. If your insurance plan covers that stuff, you have a pretty decent plan. At the very least, though, it should have some kind of hospital coverage, you should have doctor visits, you should have some kind of drug reimbursement costs going on for a decent plan -- Sanjay?

GUPTA: These are things that you should -- I mean, you can look into yourself. And some of those booklets are so cumbersome.

WILLIS: Pick up the phone, call HR, find out what the program covers or call the plan directly itself. They always have somebody who answers a 1-800 number who could explain to you what is in the program. Because at the end of the day, it's you and your family that you have to take care of and make sure you have enough coverage for.

GUPTA: OK, Gerri. Like we said before, this is going to be such a hot topic for a long time to come. We hope to have you back on the show.

WILLIS: Love to help.

GUPTA: Good tips for a lot of people.

WILLIS: Thanks, Sanjay.

GUPTA: All right, Gerri Willis. Be sure to tune in to her show as well. It's called "Open House" right here on CNN every Saturday at 9:30 Eastern. And both Saturday and Sunday on "Headline News" at 3:30 p.m. Eastern as well.

Now you might be worried about your health insurance, but maybe you should also be concerned about getting the right diagnosis from your doctor in the first place. Empower yourself to avoid a dangerous situation. That's straight ahead.

And later, new labels will soon be showing up on your breakfast cereal. Might they ruin your appetite?

And a clear look at surgery to correct your vision. What you need to know and see. That's the subject of our quick quiz. That's coming up in 60 seconds.

(COMMERCIAL BREAK) GUPTA: We're talking vision today on HOUSE CALL. And sometimes we wonder whether our political leaders see the same things we do. That brings us to our quick quiz. Who was the first United States president to wear eyeglasses? Was it A, George Washington; B, Thomas Jefferson; C, Abraham Lincoln; or D, Teddy Roosevelt? Keep your eyes peeled. The answer in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Now before the break, we asked, who was the first president to wear eye glasses? Well, the answer is George Washington. And just about every president since then has had to use some sort of corrective lenses. Lyndon Johnson, incidentally, was the first president to wear contact lenses.

When you're sick, it can be difficult to question what you've been told by your doctors. So what should you do to avoid being misdiagnosed? Well, CNN medical correspondent Elizabeth Cohen joins us with some advice in this week's empowered patient.

ELIZABETH COHEN: Sanjay, no one wants to be misdiagnosed. And one way that someone can keep from being misdiagnosed is to know what diseases doctors frequently tend to get wrong.

In this week's "Empowered Patient," I list five diseases that doctors commonly misdiagnose, according to the experts who I talked to. Two of them, they're big diseases.

The first one is cancer. Experts tell me that doctors sometimes just don't go by the established guidelines of when to screen for cancer and how. And the second one might come as a surprise. Heart attacks. The experts that I talked to said doctors sometimes misdiagnose heart attacks -- Sanjay.

GUPTA: Now some people might wonder how in the world could a doctor misdiagnose a heart attack? I mean, that seems pretty big and obvious.

COHEN: I know, it seems so crazy. How could you miss a heart attack? But I spoke to the past president of the American Heart Association. And he says, yes, sometimes heart attacks are big and obvious. He calls them the Hollywood heart attack, someone clutches their chest, they fall to the floor.

But he says sometimes it's much more subtle than that. Someone has a sense of fullness in their chest or a sense of pain in their chest, or they feel nauseated, but it's not always obvious that it's a heart attack. And he said that's why when you have those symptoms, it's worth asking your doctor, you know, could -- is it possible that this could be a heart attack? Sanjay.

GUPTA: So what can you do to avoid being misdiagnosed?

COHEN: In my online column, I have several recommendations for what to do to avoid being misdiagnosed. And I'll share two of them with you right now. The first one is get your doctors to talk to each other. I think people who see a lot of different doctors for a certain problem know that sometimes they just don't communicate. That can be a huge problem. If they don't communicate test results with each other, you may not be getting the best possible care.

So what you want to do is look at your cell phone. You probably have a conference call function. Use it. Make phone appointments with two or three different doctors at the same time. Conference them all in together. You don't even have to tell them about it beforehand. But that way, you have them all right there, talking to one another.

Here's another hint. Be wary when doctors work in shifts. If you're in the hospital, or a loved one is in the hospital, and they finish a shift and they say OK, we're going to pass everything on to the next shift, you should be aware that sometimes that information does not get passed on. So maybe you had a test at noon that doesn't get passed on to the night shift. So always be wary when doctors are working in shifts.

GUPTA: Thanks, Elizabeth. And for the whole story, check out Elizabeth's column on CNN.com/health. You'll have to look for picture there. Every week, she writes about ways you can empower yourself to get the most out of your health care. Really good stuff, important stuff as well.

From empowered patients to empowered viewers, on CNN.com this week, we asked which topic you would most like us to tackle on HOUSE CALL. And the ayes have it, as it were. Vision surgery was picked as the topic of the week, thanks to all those who voted. We turn now to Judy Fortin with more.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): If you wear glasses, did you ever think you could go from this to this? Millions of Americans opt for correction vision surgery every year.

STEPHEN HAMILTON, DR., EYE SURGEON: The major benefit, of course, is becoming less dependent on glasses or contact lenses.

FORTIN: The three most common procedures are lasik, photorefractive keratectomy, known as PRK, and refractive lens exchange. With lasik surgery, the doctor cuts a flap in your cornea and uses a laser to reshape it and help your eye focus better. The procedure is able to correct most vision problems in about a 10 minute operation.

You'll experience some dryness and temporary night vision problems like halos around lights. And if you must, you can go back to work the next day.

PRK surgery uses only the laser to shape the cornea. Your recovery time is a week. And you'll have more discomfort than lasik, but it's considered safer. Another popular surgery is the refractive lens exchange. It takes the lens out of your eye and replaces it with an artificial one. This is more commonly done in older patients. All three surgeries can give a patient better than 20/20 vision. So how old do you have to be to get these surgeries?

HAMILTON: In most cases, it's about age 21. As far as how old you can do it, as long as you're alive, you know, we can do something to help your vision in most cases.

FORTIN: Fewer than 5 percent of patients will need slight touch ups or enhancements within one year after surgery. Fewer than 1 percent of patients experience serious problems.

HAMILTON: It's really a life-changing event. And it will last you from now until you're gone.

FORTIN: Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: You e-mailed us your questions about vision surgery. And we took them to an expert, Dr. Steve Hamilton, who you just saw in Judy's report.

The first question is about lasik surgery and comes from Dwight in Georgia, who asks this. "Price ranges for LASIK eye surgery vary greatly. Can the quality of care really be that different?"

(BEGIN VIDEO CLIP)

HAMILTON: There are lasik surgery centers. And then there are comprehensive refractive surgeons, who do every type of refractive procedure. So you have to, you know, go and do your homework and evaluate, are you going to meet your surgeon? How much time is he or she going to spend with you? Do they educate you about what's the best procedure for you? It may not be lasik. These are your eyes. So you have to make sure you're making the right decision.

(END VIDEO CLIP)

GUPTA: The next e-mail question is from Kirk in Virginia, who says this. "I had detached retina surgery three months ago and lost 50 percent of my vision in one eye. Is there any new technology that can fix this problem?"

(BEGIN VIDEO CLIP)

HAMILTON: Retinal surgery is far advanced than it was, you know, 30 years ago. And we can reattach a retina. As far as healing nerve tissue, there's really no new technology that's going to bring back that vision other than just, you know, time and healing.

(END VIDEO CLIP)

GUPTA: Now because you want it, we'll have much more on vision surgery in the next few weeks here on HOUSE CALL. Thanks again for voting and for sending us your e-mail questions as well. Be sure to visit CNN.com/health to vote on next week's topic.

Coming up on HOUSE CALL, what's in a label? Well, not enough apparently. There will soon be new information at the breakfast table. We're going to give you a preview.

And later, what you should know before you make a splash after lunch. You ask the doctor, I'll have the answer. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Let's get right to Judy Fortin. She joins us from Atlanta with some of this week's medical headlines. Judy?

FORTIN: Hi, Sanjay.

It's that time of year when we all tend to overeat. But a new study reveals skipping some meals just once a month may be good for your heart. Researchers in Utah surveyed more than 500 people, including Mormons, a group known to have less heart disease. Regardless of religious background, they found people who fasted once a month were 39 percent less likely to get clogged arteries. Researchers had attributed Mormons low rates of heart disease to other lifestyle aspects, like avoiding coffee, tobacco, and alcohol.

The new study finds fasting may also play a part by reducing the body's exposure to sugar and giving the cells a break. But here are some downsides, so make sure you consult a physician first.

Here's another good reason to keep your blood pressure down. A new study finds maintaining a healthy blood pressure not only reduces the risk of strokes and heart attacks, but also helps to prevent dementia later in life. High blood pressure can block blood vessels, limiting blood flow to the brain and causing strokes that impair brain function. Researchers found uncontrolled high blood pressure increased the risk of cognitive impairment by 70 percent.

Patients had trouble remembering words, managing finances, and performing simple tasks. Diet, exercise, and restricting salt are ways you can help to lower your blood pressure.

Chest pain may be the most common warning sign for a heart attack. But a new study finds women may be most likely to have the symptom. Researchers analyzing 69 studies published over the last 35 years found more than 30 percent of the women studied did not have chest discomfort before a heart attack, compared to just over 20 percent of men.

But despite the difference, chest pain remains the most common warning sign for both sexes. Authors of the study say being aware of symptoms helps people get treated early and avoid misdiagnosis. They also encourage public health campaigns to continue highlighting other symptoms, like shortness of breath, cold sweats, and nausea. Coronary heart disease is the leading cause of death for Americans. Sanjay, back to you.

GUPTA: And there's much more to come on HOUSE CALL. Could knowing at a glance how healthy your breakfast cereal is make you change your brand? That's next.

And sniffling, sneezing, coughing -- how to fight fall allergies in your home. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Knowledge is power when it comes to fighting obesity. But could knowing what's in your Lucky Charms or your Cocoa Puffs be helpful or scary? Maybe a little bit of both. Well, I checked out the new labels coming very soon to a breakfast table near you.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): The choices can make you dizzy. Healthy heart logos, zero trans fat stamps, low cholesterol, jam packed nutrition labels. Now manufacturers are introducing new packaging aimed at making the information clearer and consequently, decisions easier.

(on camera): Here's what you see on most of today's labels. The government actually requires that packages show you the bad stuff, such as total fat, cholesterol, sodium, trans fats. But also the good stuff, such as Vitamin A, Vitamin C, phosphorus, magnesium and zinc.

But now companies like Kelloggs and General Mills are taking that information and putting it right on the front of the box. Big, bold letters. They call it an effort to try and educate consumers.

(voice-over): But in countries like the United Kingdom and Sweden, the government is actually mandating label changes.

SUSAN ROBERTS, DRAKE UNIVERSITY: In Europe they're doing things with like a red light, green light, yellow light kind of thing. And it's very simple for people to see, is this a healthy food or not a healthy food?

GUPTA (on camera): These products here are from England. And they're actually color coded according to a traffic light system. So take a look. They're actually green if they're considered healthy. They're yellow or orange if they're considered sort of border line. And they're just plain red if they're considered unhealthy.

(voice-over): English food makers say since the label changes, sales of green and yellow foods have jumped. Back in the States, the FDA says it has no immediate plans to require new food labels. But with cereal makers out in front of the issue, other companies might follow suit.

(END VIDEOTAPE)

GUPTA: Well, we are in the midst of fall allergy season. So what's the best way to fight them? Without medicine. Ask the doctor, that's next.

(COMMERCIAL BREAK)

GUPTA: Welcome back. And it's time for our segment called "Ask the Doctor." We hit the streets to find the medical questions that are on your minds. Here's a question that a viewer had for me.

(BEGIN VIDEO CLP)

UNIDENTIFIED FEMALE: I was just wondering if there's any good home remedies that I can do for my kids that have allergies so they're not having to take medication.

(END VIDEO CLIP)

GUPTA: It's a good question. And many people have heard that alternative therapies like eating locally produced honey gets rid of your symptoms. Well, we looked into that. Truth is, there are no proven home remedies for treating allergies. But there are several things you can do to make your home a little bit more breathable.

For example, simple things like dusting, vacuuming, and cleaning will help to limit the amount of allergens you're exposed to. Also, try showering before you go to bed. This washes off allergens that have made their way into your hair or onto your skin during the day. Finally if you can afford it, use central air and keep those windows and doors shut. This stops pollen from getting into your home.

Here's another question that a viewer asked.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I've heard you can get a real bad stomach ache if you go swimming within an hour after eating. Is that true? How long should I wait?

(END VIDEO CLIP)

GUPTA: Well, determining when you should get in the water depends on how much you eat and how active you plan to be. Too much physical activity of any sort after a large meal diverts blood flow from your stomach muscles to other muscles. This slows digestion, that causes cramps in some people.

So generally, if you're going to be just swimming recreationally, it should be fine. But if you're planning on doing serious laps, you may want to play it safe and wait an hour at most.

That's all the time we have for today, unfortunately. Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN starting right now.

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