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Sanjay Gupta MD

Interview With Former President Bill Clinton About Health of the Country; Will You Be Covered By Health Insurance When You Most Need It?; What You Can Do to Save Money This Summer and Get Healthier in the Process

Aired March 14, 2009 - 07:30   ET

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

DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger.

We've got a special show today that's aimed straight at your health and your wallet.

First up: former President Bill Clinton stops by to look at the health of the country. We've got an exclusive interview with him.

And we always think everything's OK until it's not. So, are you going to be covered when you most need it?

And digging in to save money -- learn what you can do to save money this summer and also get healthier in the process.

Just this year, 1.25 million Americans lost their jobs. An estimated half of them lost their health benefits as well. I had a chance to sit down and talk with former President Bill Clinton about where we need to go with our health care in this country.

(BEGIN VIDEOTAPE)

GUPTA: Should we be focusing on the economy for now? Health care is important, education is important, energy is important -- but how does that help the economy? How do you sell that?

BILL CLINTON, FORMER U.S. PRESIDENT: Well, first I believe that health care and education and energy are all economic issues. It's difficult to see how America can be a preeminent country in the 21st century without an affordable, high-quality health care system, without doing a better job in K through 12 education and doing a better job of getting more people into college and out of college, and without becoming more energy independent through clean energy and greater efficiency.

And if we do the right things, then education will give us more of the right kind of jobs, energy will generate millions of jobs, and health care will both make us a healthier, stronger, more productive country, and free up money that we would otherwise be wasting on the health care to invest in our children's futures.

GUPTA: When it comes to sort of creating these silos of health care reform, you have sort of single payers and more government involvement on one end, free market involvement solely on the other end. Single payer never has really caught traction politically. Do you think there is a degradation of quality of care with the single payer system? Is that a concern? Should that be a concern?

CLINTON: Well, there's no evidence of that in Canada that I'm aware of, except for excessive delays, which they always try to come to grips with. There are all kinds of different ways to do it, but first, you do have to cover everybody. And then, you have to stop people from gaming the system. There's a lot of gaming going on now in the American system so that we spend more than anybody else and get less for it.

GUPTA: Can you take prevention too far? Can it be a detriment as far as costs go?

CLINTON: Well, I think you have to look at it in the aggregate? And if you look at it in the aggregate, the answer is no. That is, if you do more screening and you find cancers earlier, you'll spend more money on treatment. But if you add 10 or 20 or 30 years to someone's life and they're a productive employee over that lifetime, they contribute to the rest of our welfare, you've not only had an economic victory, but you've also fulfilled the moral impairment that we should all live as long and as well as we can.

Will that -- will that individual person cost more? Yes. Will society pay more, I don't think so.

(END VIDEOTAPE)

GUPTA: So, we're talking about the country as a whole with the former president -- but what about you as an individual? You know, no one is immune from insurance issues. Whether you're looking for it, switching jobs, or signing up for a new policy, you may be virtually uninsurable and not even know it.

(BEGIN VIDEOTAPE)

JIM MATTHEWS, OPTOMETRIST: One or two?

GUPTA (voice-over): Jim Matthews was living the American Dream in South Carolina, but a serious heart condition forced the 56-year- old optometrist to sell his practice. To replace his group insurance policy, Matthews went looking for individual health insurance. He told us he was stunned by what he was told.

MATTHEWS: He basically laughed and he said, "You have no hope of getting insurance as an individual."

GUPTA: No hope because of something called a "pre-existing condition." Matthews had had open heart surgery and had also been diagnosed with an aneurysm -- that could require more surgery one day.

MATTHEWS: He said, "We wouldn't even write you a policy," he said, "it's a waste of time." He said, "You are uninsurable in the state of South Carolina."

GUPTA: A pre-existing condition is any illness or medical problem you have before buying or enrolling in a health plan. Even surgery a decade ago could count. And in 44 states and the District of Columbia, it's perfectly legal for insurers to deny coverage or in some cases charge higher prices to people with pre-existing conditions.

(END VIDEOTAPE)

GUPTA: Now, these pre-existing conditions could be anything from pregnancy to arthritis. So, joining us to talk more about it, Nancy Metcalf, senior program editor at "Consumer Reports" magazine, and Susan Pisano, the vice president of communications for America's Health Insurance Plans.

Fascinating stuff, the idea of pre-existing conditions. And first of all, thank you both for joining us.

Susan, let me start with you. "Pre-existing conditions," it's a term that a lot of people are becoming more familiar with. If President Obama's plans go through, insurance companies would not be able to exclude people on the basis of pre-existing conditions any longer. True? And how's that going to work?

SUSAN PISANO, AMERICA'S HEALTH INSURANCE PLANS: Well, we've actually proposed a series of reforms that would mean pre-existing conditions would no longer apply; but in order for that to work, everybody would have to be covered. As you know, in a group of people, a large group of people, say, a large employer group, you're naturally going to have some people who are sick and some people who are healthy. And when everybody's contributing, that helps to cover the costs for those who may not be as healthy.

But when you purchase ...

GUPTA: It's a little bit of a tough thing right now, right? Because people who have pre-existing conditions are often those who need insurance the most, because they may have some sort of medical malady.

PISANO: Well, it's a tough issue in terms of making sure that many people, as many people as possible, can afford to purchase individual coverage. If individuals choose to purchase only when they're sick ...

GUPTA: Right.

PISANO: ... and have higher costs, that makes the cost higher, and then, fewer people choose to buy it, and then the people who choose to buy it tend to be very, very sick.

GUPTA: OK.

PISANO: And that drives the cost up and makes it unaffordable for more people.

GUPTA: Let's get into some ...

PISANO: We want the system ...

GUPTA: Let's get into some specific questions, Susan and Nancy, both, because a lot of people had questions about this. This came from Wei-ling (ph) from Washington who writes this, "Why is lab testing not covered?" Now, she's talking about her specific example, so this doesn't apply to everyone necessarily, but she says, "A lot of blood work that we have to get must be sent out to other labs and insurance does not cover it. As of now, we owe hundreds of dollars to other companies."

Nancy, so, I don't know if you've heard of this sort of situation, but what does someone like Wei-ling, what her options?

NANCY METCALF, SENIOR EDITOR, CONSUMER REPORTS: Well, the first that she needs to do is get a copy of her policy and try to figure out whether lab tests are supposed to be covered. That's the piece of advice that really applies to anybody with insurance. Know what's in it.

We're actually doing an upcoming story on people who thought they knew but didn't know and lived to regret it. If it's covered, a couple things could be going on. First of all, she might just be in her deductible period ...

GUPTA: Right.

METCALF: And once she pays her deductible, it will be covered. Or, another thing that could be happening is, for some reason, it's being sent to a lab that's not in the insurance company's network. The solution to that is to get in the network.

If it's not covered, she really doesn't or he -- doesn't have really a choice. They have to pay for it on their own. And in that case, if they can't switch to a better policy, their only option is to call the lab and work out maybe a discount or a payment plan.

GUPTA: You know, that's important. Just the simple piece of advice that people have to read their policies for sure ...

METCALF: Yes.

GUPTA: ... and they might be able to save themselves a lot of heartache and a lot of money as well.

A lot more to come on this, for sure. Don't go away. We've got more with Nancy and Susan answering your questions -- just ahead.

And also, a garden bringing fresh food, food and hope, chemical- free, in this time of need. Recession gardening it's called. We'll show how it's done.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSE CALL. We've got two important reports on mental health this week: new evidence that depression can lead to heart disease in women. This is from Columbia University. Now, researchers found that depressed women were more than twice as likely to experience sudden cardiac death.

And also this week, a leading advocacy group gave the country a "D" after assessing how the nation cares for mentally ill patients. The National Alliance on Mental Illness says little progress has been made since it issued the same grade three years ago.

And get this -- body odor might do more than just offend. The Department of Homeland Security is doing a study, a study that's never been done before, to see if it also indicates if somebody is lying, sort of like a polygraph. How would you like to be the researchers working on that particular study? They're also working on whether or not your unique smell can identify you similar to how your fingerprints do.

We wonder if insurance covers body odor testing, Nancy. I'm not sure about that.

We're joined again, Nancy Metcalf and Susan Pisano, bringing them back. Susan is the vice president of communications for America's Health Insurance Programs. Nancy is senior program editor at "Consumer Reports" magazine.

As I mentioned, we just get tons of questions whenever we put stories like this out on the Web. Let's get right back to some. This is from Cherie (ph) in Georgia.

She writes this, "I'm self-employed and to my surprise I've learned I'm four months pregnant. My health insurance plan does not have maternity coverage. My income prevents me for qualifying for Medicaid. I don't know how I'll pay for a healthy delivery. What resources are available for people in my situation?"

I can tell you, this strikes particularly close to the heart because I'm -- we're due with our third child any moment now.

METCALF: Congratulations.

GUPTA: Thank you.

But is that -- I mean, first of all, does that even -- does that really happen, people aren't covered for maternity coverage?

METCALF: If she has individual insurance, which she probably does if she's self-employed, it's almost certain that she doesn't have maternity insurance. Very few individual policies have maternity coverage. You actually have to buy it as a rider, it costs a lot.

And even after you start paying for it, you'll have to wait for a year or two before you can use it. It's just going to add up to about the cost of having a baby.

GUPTA: So, what does she do?

METCALF: At this point, her pregnancy is a pre-existing condition. There is no way she can get coverage for it. She's going to have to pay for it herself. Her only recourse is to quickly get a job with group health benefits, because group health insurance has to cover maternity from day one, even if the day you start work, you're eight-and-a-half months pregnant.

GUPTA: I really didn't believe that there's a place that still considered pregnancy a pre-existing conditions. That was mentioned in Bobby Jindal's response after the State of the Union, I thought that was an antiquated belief.

METCALF: No, not at all.

GUPTA: I got another question, this comes from Linda in Oklahoma. "How can parents of teenagers with chronic medical conditions help their children stay insured through college?"

Susan, I'm going to throw this to you. "Is there any way to avoid an insurance gap between graduation and the day your child is eligible for coverage at their first full-time job?"

So, you know, we talk about these people who are uninsured. And they're comprised of several different groups of people. But a chronically ill teenager is sort of in that gap, Susan. What do you say to that family?

PISANO: Well, there are a lot of laws in states that have been amended lately to allow for children, teenagers and early 20s to stay on their parents' policy. And in many instances, a student will be required, you know, at college to have a policy. The main thing is to try to bridge the time between when the student leaves school and gets a job that has benefits.

And in some instances, a child will be able to stay on the parent's policy. There are short-term policies that are available and there certainly are some individual policies that our members, insurance companies, have been offering that are actually targeted towards those who are in, you know, the 20 to 30 range -- a segment of the population in which there are quite a large number of people who lack insurance.

GUPTA: Right.

PISANO: The main thing is to investigate before the insurance runs out, talk to the school, talk to the insurance carrier, talk to the employer, to determine what you need to do to bridge that time.

GUPTA: I think it's really good advice. I think we've heard from that both of you today, that you've got to make sure you're doing some of your own due diligence, I guess. Obviously, a lot of people sort of in a lurch right now. But maybe, that helps a little bit.

Susan, Nancy, this is a topic we're going to keep revisiting. We hope you guys will join us again. Thank you so much.

METCALF: Thank you.

(MUSIC) GUPTA: We're back with HOUSE CALL. You know, during the Great Depression, people would grow food for their families. Now, with hard economic times, that trend is coming back. But just how do you plant the seeds of inspiration? Check it out.

(BEGIN VIDEO CLIP)

TIM MOSS, GARDENER: The seed of potatoes. To start a garden, and, of course, one of the best things is to get a book that tells you about, you know, how to grow the plants. The key thing, we've got a beautiful day today, it's 75 degrees. But we're still going to have cold weather. So now's the time to prepare for it.

Another key point to starting a garden is the location where you're going to have your plants, because the amount of sunlight is important. Most plants need the sun. A few plants will grow in shade.

One of the things that Lori and I did, we actually wrote down a list of things, you know, what kind of vegetables do we like to eat, Italian green beans. One of the wonderful things about a seed catalog is it lists all the different varieties that you can plant, which is another reason to have a garden, because you can choose what specific vegetable you want.

I've seen some studies from years ago that said, you know, you can save several hundred dollars of your food budget by growing, you know, some vegetables yourself. It's better to start small and then let it grow.

LORI COMBS, FIRST-TIME GARDENER: Especially for a first-time gardener.

MOSS: Right.

COMBS: Because I've (ph) never gardening before, if I don't have success this year, I'm never going to do it again. I have to have success. So starting small, there will be success. And as time goes on, it will grow.

(END VIDEO CLIP)

GUPTA: Now, when you're shopping for health insurance, the legal lingo can seem a little daunting, even to me. Coming up: the top five questions you should ask when you're comparing health plans.

And here's a question we get all the time, alcohol and weight loss. See how that next drink could affect your metabolism. That's later in the show. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Unemployed and uninsured. Well, it's a reality millions of Americans are facing. We've heard these numbers. Experts say trying to purchase insurance on your own might simply be a nightmare. So, how can you ensure you get what you need? Elizabeth Cohen has five crucial questions to ask if you're shopping for a health plan.

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Sanjay, millions of people may now have to face the daunting task of buying private health insurance on their own. That's because so many people have lost their jobs recently.

Take a look at these shocking and very sad numbers. In January and February alone, 1.25 million jobs were lost, and it's estimated that half of those people who lost those jobs, they also lost their employer-sponsored health insurance. That leaves those people in a position of having to choose either COBRA, which could be very expensive, or just going out on their own and shopping for private health insurance. Now, there are many Web sites where you can do this, but even with those Web sites, it can be daunting to figure out all the legalese and to find the policy that's best for you.

So, let's take a look at three tips for helping you buy a private health insurance policy.

First of all, you need to ask: will my premiums go up? The insurance company may name your premiums and say this is what you're going to pay, but they may plan on increasing those premiums pretty quickly. So, you need to find that out.

Also, ask if the insurance company is licensed in your state. Sometimes insurance companies will sell policies in states where they're not licensed. That could be very problematic for you later on.

Also, ask, what are the deductibles and the copays? A deductible is where you have to spend a certain amount of money, your own money, out of pocket, before the insurance will kick in. And sometimes that's thousands of dollars.

And then, even once the insurance does kick in, oftentimes, you're required to pay a copay. That's like, let's say, $25 every time you see the doctor. Find out exactly what the numbers are for your deductibles and your copays.

These are all important things to know how to do when you go shopping for insurance -- Sanjay?

GUPTA: All right. Thanks, Elizabeth.

And be sure to read Elizabeth's full list of crucial questions you should ask when shopping for health insurance on her Web site: CNN.com/empoweredpatient.

Also, something we've never done before. We're going to take your iReports, if you're having trouble hanging on to your health insurance, put yourself on video, tell us your story. Logon to iReport.com; check out on our assignment desk. And we're really committed to this issue and we're going to try to help you out. Now, get your free weights and your machine. Cool acrobatic strength exercises are starting to draw some attention. And if you have many medical questions, we, of course, have the answers. My favorite segment of the show, Ask the Doctor is next.

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL. It's time to "Ask the Doctor." Let's get right to it.

Melanie in North Carolina asks this, "Does drinking alcohol really make it impossible to lose any body fat? And do I have to give up alcohol to lose weight?"

Well, Melanie, a great question -- a question we get quite a bit here on HOUSE CALL. The short answer is, no. You don't have to give up alcohol altogether.

You just got to keep in mind a couple of things. Alcohol does start to slow things down a bit. Alcohol is loaded with calories. More than protein and carbs, it metabolizes first before other nutrients. So, if you drink alcohol with a meal, it could impact your overall fat burning. A glass of wine is absolutely fine but you have to cut the calories from somewhere else during your meal.

In addition, here's a tip. Avoid those sugary mixers with alcohol, which can add literally hundreds of calories. Read those labels. So you can have a drink or two, but remember, as you've always heard, moderation is key.

Now, do remember counting chin-ups in gym class? Take a look at these guys. They almost got me beat.

Well, still ahead -- a workout that you can do just about anywhere. No gym required.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

Motivating kids to exercise by teaching them how to workout anytime, anywhere, they're called the "Bartendaz," a group of New York fitness instructors showing students all they need for a workout is their own weight.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): These fitness gurus aren't promoting underage drinking. Instead, they're named for the creative moves they perform on the floor and the pull-up bar. The Bartendaz, they're empowering high schoolers to calisthenics. Ditching free weights and weight machines in favor of using their own body weight, the Bartendaz acrobatic strength exercises have started to spark attention -- on YouTube and from celebrity clients like rapper Ludacris. The minimal equipment makes workouts affordable and accessible without the need of a gym and the use of body weight instead of free weights which is safe for young bodies.

Bartendaz founder, Hassan Yasin, owns his acrobatic skills on the pull-up bars at local parks in New York City.

HASSAN YASIN, FOUNDER, BARTENDAZ: I am.

UNIDENTIFIED CROWD: I am.

GUPTA: Yasin's program is a mix of motivational speaking and exercise. He says his proudest achievement is the program's impact on at-risk youth.

YASIN: You're going to see somebody comes to school every single day and fail. How do you do that? Like this. They go, success, I'm coming. And success is over here.

GUPTA: A number of New York City schools have adopted Bartendaz moves into their physical education programs. Yasin says the exercises resonate among students who have been difficult to reach.

(END VIDEOTAPE)

GUPTA: Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast on CNN.com/podcasting.

And tune in all this week for our special coverage of the issues affecting your wallet and your health, "Road to Rescue: A CNN Survival Guide." We'll cover issues from your health to your energy costs.

Remember, this is the place for the answers to all your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.