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Sanjay Gupta MD

The Uninsured and Underinsured; How To Prevent Medical Bills from Leading to Bankruptcy; Firsthand Look in the Operating Room with Dara Torres

Aired August 30, 2008 - 08:30   ET

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

SANJAY GUPTA, CNN HOST: Good morning and welcome to HOUSE CALL. Today, we're going to help you live longer, stronger, and hopefully with some more money in your wallet. We'll tell you what we're talking about.
First up, the uninsured, underinsured, many people feeling tied to their jobs. You know what we're talking about, your health coverage. But more importantly, the lack of it.

Then, medical bills are the number one factor in most bankruptcies. We've got some tips to help keep you in the black.

And someone I really admire, Olympic swimmer Dara Torres like you've never seen her. I got an exclusive look in the operating room, the firsthand look.

But first, some new figures out from the U.S. Census Bureau, showing the number of uninsured people in this country has dropped by more than a million. Much of the decline is due to increased enrollment in government programs such as Medicaid. But that still leaves 45.7 million Americans without health insurance in 2008.

And the new numbers show a continued drop in private and company- based health insurance. All of that can mean many Americans are just one bad illness away from disaster.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): As an optometrist in South Carolina, Jim Matthews was making about $100,000 a year. But he got sick. A serious heart condition forced him to sell his practice.

DR. JIM MATTHEWS, OPTOMETRIST: It was a chronic condition. And I had open heart surgery, which cured it.

GUPTA: Then doctors found an aneurysm in a major artery. He may need major surgery again.

MATTHEWS: And you'd like to try some contacts?

GUPTA: At age 55, Matthews would like to slow down, but no job means no health insurance. So that's just not an option.

MATTHEWS: If you have health problems, you're not poor enough for Medicaid, you're not old enough for Medicare, and you don't have health insurance through your work, you're really out of luck unless you have wealth.

GUPTA: According to the Kaiser Family Foundation, today, more than 158 million Americans rely on their jobs for health coverage. But in the past eight years, thousands of companies have stopped offering health insurance. Those who still do are asking workers to pay a whopping 55 percent more. Some health analysts say getting it from your employer is not the answer.

REGINA HERZLINGER, HARVARD UNIVERSITY: We wouldn't want them to buy our cars, our houses, our clothes, but we trust them to buy something that's so important to us, which is our health insurance.

GUPTA: But it can be a big gamble, especially for anyone with a preexisting condition. When Jim Matthews went looking for individual health coverage, it wasn't just expensive, it was nonexistent.

MATTHEWS: They basically laughed at me. They said, you know, you don't have a hope with open heart surgery of having any broker write you a policy in the state of South Carolina. You are uninsurable.

GUPTA: Today, Matthews leases a small office at a Wal-mart. It makes him eligible for a small business policy. Even for that, he's paying through the nose.

MATTHEWS: It's a little under $18,000 this year for a policy that if you add up co-pays and co-insurance, deductibles and medicine, it will be about $23,000 this year.

GUPTA: So Matthews has to keep working.

MATTHEWS: I have no hope of retiring until I'm 65. I mean, I'm just crawling for the ropes to reach Medicare.

(END VIDEOTAPE)

GUPTA: Now, it seems that just about everyone is feeling the health care pinch. In fact, a startling statistic we found, every 30 seconds, someone files for bankruptcy after suffering a serious health problem.

And CNN's Elizabeth Cohen is here with ways you can avoid that bankruptcy and get out of medical debt. Elizabeth?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Sanjay, in preparing this column, I spoke to a family who went $15,000 into medical debt in three hours. In other words, three hours in the emergency room cost them $15,000.

Millions of Americans are in medical debt. And a lot of people don't realize two-thirds of the people in medical debt in this country, they have health insurance, but it just doesn't cover everything.

So, here are a few tips for what to do if you're one of those people who has found themselves owing hospitals and ambulance companies and doctors a lot of money.

First of all, look for billing errors. I talked to one advocate who says that she found that one of her clients had been charged $5,000 for disposable gloves. Another client got charged for a surgery that she never even had. Also, negotiate, negotiate, negotiate. I spoke to another advocate who said that her client owed $14,000 to a hospital. She walked in with a certified check for $4,000 and said this is all I've got. And they took it.

Also, get financial assistance. There are charities and foundations that are set up just to help people who are in medical debt. If you read my column online, I help you find where those charities are.

Now, another thing to remember is that if you want to prevent yourself from going into medical debt in the first place, if you're having an elective procedure, shop around beforehand. Sometimes hospitals will charge wildly different amounts for the same procedure. So you want to go online to CNN.com/empoweredpatient to see all these tips -- Sanjay?

GUPTA: All right, thanks, Elizabeth.

You know, health care is a top concern for voters. So, we're taking a closer look at the presidential candidates and how this election might shape a solution. That's going to be later.

But first, Olympic swimmer and 41-year-old mom, Dara Torres. We're inside the operating room as doctors try to fix her injured shoulder. That's right. Her shoulder has been bothering her for months. Did it hold her back in Beijing? That's just ahead.

(COMMERCIAL BREAK)

GUPTA: And we're back with HOUSE CALL.

You know, it turns out that a usually non-threatening skin cancer could be a red flag for your health. New research finds that if you're diagnosed with a non-melanoma skin cancer, you're twice as likely to develop other more serious cancers. I get asked about this all the time. Basal cell, squamous cell cancers, they affect about a million people every year in the United States. Now, if you've had one, make sure to tell your doctor about it and don't forget to examine your skin often.

Olympic swimmer Dara Torres smashed the record books this year by becoming the oldest swimmer to win an Olympic medal. She's 41. Like so many athletes who continue to work intensely in their 40s and beyond, the body can't always sustain that grind. We found out Dara won her medals while swimming with a shoulder injury.

She let us inside the operating room to fix that all-important joint. Take a look.

(BEGIN VIDEOTAPE) GUPTA: We got a chance, an exclusive opportunity, to spend time with Dara in the operating room while she was having this operation. You are looking at Dara Torres right shoulder. Well, we know a lot of things about her. We know she's an Olympic medalist. We know she's 41-years-old, the mother of two, she's an inspiration to millions.

But this you may not have known about her. All of that swimming at that age, wear and tear from the swimming and from weight lifting as well, which is part of her routine, that leads to the sort of problems that she was having even during the Olympics.

Dr. Schmall (ph) calls this another sort of tuning up maybe for another four years from now, who knows if that will happen or not. But a successful operation.

Let me just show you real quick. I'm just going to pull my shirt down a little bit here, the collarbone, which is this area right here, sometimes it impinges on your shoulder. That can happen with a lot of repetitive moment, difficult sports injury, just from moving part of that collarbone can take care of the problem. That's what was done.

She is awake, but she is sedated. She was talking about it's anxious to have this done. Looks like it was successful.

I spent a lot of time with Dara today and I can tell you there's no way you're going to keep this woman out of the swimming pool. Within seven to ten days after this operation that she's had, she's probably going to be back in the pool. And who knows, the doctors say she was fine tuned. Fine tuned for what exactly, perhaps the Olympics in 2012.

(END VIDEOTAPE)

GUPTA: We'll have much more on that. HOUSE CALL returns in a moment.

(COMMERCIAL BREAK)

GUPTA: Now, we're back with HOUSE CALL. You know, health care is a critical election in this election, ranking just behind the economy, and the war in Iraq as a top issue in people's minds. There's no doubt that health care costs are rising. And more than 45 million people in this country are uninsured.

Now, there are big differences between the Republicans and the Democrats on this issue. So, we're going to bring you their plans in their own words.

(BEGIN VIDEO CLIP)

SEN. BARACK OBAMA (D), PRESIDENTIAL CANDIDATE: Now, now is the time to finally keep the promise of affordable, accessible health care for every single American. If you have health care, if you have health care, my plan will lower your premiums. If you don't, you'll be able to get the same kind of coverage that members of Congress give themselves.

And as someone who watched my mother argue with insurance companies while she lay in bed dying of cancer, I will make certain those companies stop discriminating against those who are sick and need care the most.

John McCain doesn't have a health care plan other than to eliminate the tax deduction for employers for paying health care premiums and in return, giving $5,000 tax credits to each individual family.

Now, that sounds pretty good, getting a $5,000 tax credit to buy some health insurance. Here's the only catch. Health insurance for the average family is going to cost $12,000, $14,000. You're going to be $7,000 short. Meanwhile, your employer now has the incentive to get rid of their health care plan.

(END VIDEO CLIP)

(BEGIN VIDEO CLIP)

SEN. JOHN MCCAIN (R), PRESIDENTIAL CANDIDATE: There is a health care crisis in America. We would be, if it were not for the energy crisis, we'd be talking a lot more about health care issues. And we have to reform health care in America and we have to make insurance available and affordable for all Americans.

I do not believe that that means a government run health care system is the most efficient or what we need. And we need to have policies that encourage home health care as opposed to institutionalized care. And we need to treat people on an outcome basis that don't pay for every test or every procedure, every visit to the doctor, but treat them for a period of time and then pay that provider.

Give -- there's a -- there's a program now for senior citizens that is -- that is not as wide as I'd like to see, where it's called cash and counseling. And seniors are given money every month. And then they're able to decide how they want to pay for their own health care. It's remarkable the savings that have been realized.

We have what we call government approved plans so that we pool federal and state money together and establish wide risk pools so that there is affordable and available health insurance.

We cannot leave the "uninsurable" who are chronic disease victims without the access to care. And so it's going to have to be a federal and state combination.

(END VIDEO CLIP)

GUPTA: Now, whoever becomes president, they might just have the toughest job in the world. So have you ever wondered what it takes for a president to stay healthy when he sleeps, eats? How does he find time to exercise? Well, my next special called "Fit to Lead", I'm going to examine everything from minor illness to assassination attempts. What happens when the president becomes the patient?

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: When we think of the presidency, we think of a vigorous office.

UNIDENTIFIED FEMALE: And they need their help, otherwise it's all for naught.

GUPTA: You've been mountain biking with President Bush.

UNIDENTIFIED MALE: Right.

GUPTA: What was that like?

UNIDENTIFIED MALE: Crazy.

UNIDENTIFIED FEMALE: Health issues can come through as vulnerability. And if we see that in our country, the global community sees it as well.

UNIDENTIFIED MALE: The image of being healthy is something that ties into the image of him being a vigorous president.

(END VIDEO CLIP)

GUPTA: Look for my next special called "Fit to Lead" coming this October.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

The cost of some foods has more than doubled in the past a year. Consumers are experiencing sticker shock from the rocketing prices for sure. And CNN's personal finance editor Gerri Willis has been watching the trend and has some of the details. Gerri?

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: Hi there, Sanjay.

Dinner is getting more expensive and so is breakfast and lunch. According to the USDA, food prices will rise 5 percent to 6 percent next year, marking the biggest one year increase in food prices in 18 years

Breaking down those numbers, the steepest price hikes will likely come in the category of meat, poultry and fish, where prices will rise 5 percent to 6 percent. Fruit and vegetable prices will rise 3.5 percent to 4.5 percent. And the trend isn't new. These price gains come on top of healthy gains already recorded this year.

In terms of those items you pick up most frequently at the grocery store, a gallon of milk jumped to $3.96 a gallon in July from $3.74 a gallon in July of last year. A dozen eggs cost you 51 cents more in July than they did at the same time a year ago. And a pound of beef, well, is just up 14 cents year over year.

How can you beat these price hikes? Well, first off, shop at the periphery of the grocery store instead of the center. That's because fresh produce and meats are generally located in the aisles at the edges of the store, rather than in the middle. Buying and cooking your own meals rather than buying prepackaged foods is cheaper and healthier.

For example, cereal prices rose a whopping 12 percent in the USDA report. Also, try to eat before you go shopping. Hungry, being hungry when you shop is a surefire recipe for overspending.

Sanjay, back to you.

GUPTA: All right. Gerri, thanks. Some great information as always. And be sure to watch Gerri's own show called "OPEN HOUSE" every Saturday at 9:30 a.m. Eastern on CNN and both Saturday and Sunday on "Headline News" at 3:30 Eastern.

Now it's issue number one, the economy. Home prices are plunging. And now some officials are concerned the foreclosure crisis could lead to a public health threat. CNN medical correspondent Elizabeth Cohen is back with that story. Elizabeth?

COHEN: Sanjay, you have got to take a look at this pool. This is a pool in the backyard of a home in southern California. This home is under foreclosure. And the pool, obviously, has not been taken care of. It is green as you can see. And officials are treating it to get rid of the mosquitoes who may be carrying West Nile.

Now if this were just one pool, it probably wouldn't be such a big deal, but there are 1300 pools like this in Orange County alone. And officials are seriously concerned that this is going to mean a bigger West Nile problem this year and in years to come.

This problem is particularly bad in southern California, where they have the unfortunate combination of a bad West Nile situation, a lot of foreclosures, and a lot of homes with pools. But we're hearing about other parts of the country that are also having this problem.

And listen to this. Who do you think pays to clean this up? Not the homeowners. They're under foreclosure. We do. Taxpayers pay. And it costs a lot of money to chemically treat these pools to try to keep the mosquitoes away.

Now we don't hear about West Nile quite as often as we used to. So let's go over what happens to people when they're infected with West Nile. Many times people don't have any problems whatsoever, but some people do develop fever, headaches, convulsions, and sometimes paralysis.

And Sanjay, officials in California tell us that this year they are seeing an unusual number of severe cases -- Sanjay?

GUPTA: All right, thanks, Elizabeth.

And coming up next, dangerous food allergies. Could be more serious than you might ever think. What every parent needs to know before sending your child to the school cafeteria.

And the emotional amusement park experience that made this woman change her life forever. That amazing story, it's later in the show. Stay tuned to HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. It's time for our "Ask the Doctor" segment, my favorite segment. We get to answer the medical questions on your minds. Keep those questions coming.

Our first one comes from Indira in Maryland. She says this, "My daughter is allergic to dairy, nuts, fish, wheat, and eggs. Can she overcome any of these allergies? And what's the best way to prevent a severe allergic reaction?"

Well, Indira, about 8 percent of children do have food allergies. So, your daughter is not alone. As the digestive system matures, children typically outgrow reactions to food, such as milk, soy, wheat and eggs. But severe allergies, especially the nuts and shellfish, can be lifelong.

Now, the best way to prevent a reaction is to avoid the foods that trigger them. You already knew that. If you know your child is prone to severe reactions, be sure to read the food labels carefully. Have your child carry emergency epinephrine, or wear a medical alert bracelet, and notify key people about your child's condition. Good luck to you and your daughter, Indira.

Here's another question from Tiffany in Arizona. She writes this, "How long does it take for bacteria to grow in food that's unrefrigerated?" Well, Tiffany, that question comes just in time for all those Labor Day cookouts. The answer is quickly.

Bacteria breeds on food in warm temperatures. So, it's extremely important to keep it refrigerated when possible. And never leave it at room temperature for more than about two hours. That's a general guideline. And outdoor events or in very hot temperatures, reduce that time to about an hour.

Also, some cookout tips. Bring food out right before you plan to serve it. Keep containers with cold food on ice. And keep your coolers stocked with ice. A full cooler stays cold longer than a partially filled one.

Now just ahead, from 300 pounds and depressed, to a 120 pound personal trainer. That's transformation. You've got to see it. It's our weight loss success story. Don't go anywhere.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. Jennifer Marnel went through what she calls a mind change. From a severely overweight mom, to a proactive weight loss inspiration. We hope her story shows you no matter how much weight you have to lose, you can do it.

(BEGIN VIDEOTAPE)

JENNIFER MARNEL: In most of the pictures I didn't have a smile on my face.

GUPTA (voice-over): Jen Marnel was 27-years-old, 300 pounds, and very unhappy.

MARNEL: I didn't realize how depressed I was because my family loved me regardless, no matter what. It was a struggle with being overweight all my life. I was overweight from the time I was about 8- years-old.

GUPTA: One day at an amusement park, Jen was kicked off a roller coaster ride because of her size. In that moment, she began undoing 27 years worth of bad habits.

MARNEL: I just broke down in tears. And that was really the final straw.

GUPTA: Jen started her weight loss journey exercising on her own at the gym. And quickly moved up to group classes. When she reached her goal weight, of 120 pounds, almost a 200 pound weight loss, she started a new career as a personal trainer.

MARNEL: Good job. It's just made life a whole lot more exciting, more adventurous. I'm able to take more risks, to do, you know, do more things. It's really taken a weight off my shoulders literally.

GUPTA: Jen says her experience adds authenticity to her can-do message. After all, she's been there.

MARNEL: It can be done, you know, through hard work and dedication. It's not going to be easy, you know. I won't lie to you. But it can be done.

My name is Jennifer Marnel and I lost 180 pounds.

(END VIDEOTAPE)

GUPTA: Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, check out my podcast on CNN.com/podcast. Remember, HOUSE CALL is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.