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Sanjay Gupta MD

White House and Health Care Industry Promising Savings: What Does It Really Mean For You?; Interview With Lisa Jackson, New Head of the EPA; Tips to Spend Less on Prescription Drugs; Your Diet Could Improve Your Vision

Aired May 16, 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. This is the show that helps you live longer and stronger.

First up, the White House and the health care industry are promising $2 trillion in savings -- but what does that really mean for you?

Plus, prescription drugs are more expensive than ever. They don't have to be. We have some tips for you.

And what if I told you that your diet could improve your vision -- especially as you get older?

You're watching HOUSE CALL.

You know, it's a start. The first steps in healing our nation's health care system could be in place as the industry pledges to reduce cost by $2 trillion over the next 10 years. And if you think about it, slashing costs does seem to be the real medical emergency here.

The president put it this way.

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Half of all personal bankruptcies stem from medical expenses. And too many Americans are skipping that check-up they know they should get, or going without that prescription that would make them feel better or finding some other way to scrimp and save on their health care expenses.

(END VIDEO CLIP)

GUPTA: And industry leaders say they can reduce health care spending by about 1.5 percent a year. That's the plan. How exactly will it get done? They've only figured it out sort in broad brush strokes. So, what they want to do exactly is something that still remains to be determined.

Here's how I look at it. Changing incentives for hospitals and doctors so the focus is on keeping people healthy, and less on payments for specific procedures or repeated admissions. Right now, for example, if a patient is readmitted over and over again, the hospital gets paid each time. There's little or no incentive to keep the patient healthy and out of the hospital in the first place.

Along those lines, creating what I call a culture of prevention. Promoting health practices, providing real help towards controlling things like obesity, like diabetes.

And finally, an overhaul of health information technology. Electronic medical records, EMRs, as you may have heard, so it's easier for doctors to share information on the care of the patients receive in various places.

Now, keep in mind, this is not legislation. But it's a pledge of sorts from the industry, to work with government to try to make this reality. And we have been down this road before.

We'll have a much better idea of its feasibility in the weeks and months to come, and HOUSE CALL is a place you can count on, of course, to bring it to you.

Now, you've heard the industry's plan to reduce health care costs, but what if you have a pre-existing condition? Can you get affordable treatment today? Well, we'll ask Elizabeth Cohen to answer that question, CNN senior medical correspondent, of course.

That can be sort of a linchpin in all of this, right? If somebody has some sort of pre-existing condition?

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Oh, Sanjay, it is a huge problem. And people say it's one of the reasons why people like President Obama want to overhaul the health care system, because people with pre-existing conditions who don't get insurance through their employer -- because they're not employed or their employer doesn't give it or for whatever reason -- are really in a terrible, terrible situation.

As a matter of fact, one out of five people who apply for insurance on their own -- they have a hard time getting it because of the fact that they have a pre-existing condition.

GUPTA: So, if they're in one of these situations that you're describing, what are their options? Do they have any?

COHEN: You know what? I won't sugarcoat it. It is very, very difficult. But there are some options. And actually, it was very difficult for me to get this all together, because all the options of sorts are spread out in different places. I'd tried to put it all together in this column.

GUPTA: Yes.

COHEN: So, let's take a look at what some of those options are. You can become, in about a dozen states, what's called a group of one. And what that means, Sanjay, is that one person becomes basically kind of their own company and that makes it easier to get insurance. Because when you're a group -- even if it's a group of one -- insurance companies cannot discriminate against you because of pre- existing conditions, in the way that they can when you're an individual.

Now, in other states, you can become a group if you're just two. So, as someone said to me, hey, start landscaping company and hire your brother-in-law. Voila, you're a group of two. So, there's an idea.

Also, you can join what's called a state high risk pool. And a state high risk pool is specifically for people with pre-existing conditions. The insurance can be expensive but it is really worth checking it out. In my column, I have a link to what states have high risk pools.

GUPTA: That's interesting, the group of one. I hadn't heard that before. Are there people who can help if you're trying to get more information about this?

COHEN: There are, Sanjay. And I'll tell you, I get questions about this all the time. And most people don't realize that there is help out there. There are advocates who can work for you. So, there are two groups that you want to go to. You can either call them, they have 800 numbers or you can e-mail them.

And the first one is called Coverage For All. And the second one is called the Cover Me Foundation. So, you can get the URLs right there. You can get those on my column and you can also get the 800 numbers on my column.

GUPTA: All right. Elizabeth, thanks as always. I'll be reading the column for sure, as a lot of people will. Thanks so much.

And for tips on getting medical coverage despite pre-existing medical conditions, visit CNN.com/EmpoweredPatient.

Now, in this economy, people are sometimes skimping on their medications. I can tell you as a doctor, bad idea. So, we're going to tell you some affordable ways to get prescription drugs you need, and so, we'll tell you how.

Plus, keeping your eyes healthy as you age -- it can be as simple as what you had for dinner last night.

But first, my exclusive interview with the new head of the Environmental Protection Agency. She told me that climate change is the biggest global health threat of all. We'll explain why. HOUSE CALL is back in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

A new report out of University College London is calling climate change the biggest global health threat of the 21st century. Among the findings: climate change will result in more extreme weather, we already knew that -- but also, less certain food and water supplies, and changing an emerging patterns of disease. This week, I sat down for an exclusive interview with the new head of the Environmental Protection Agency, Lisa Jackson, to talk about climate change, and also, Mr. Obama's new mandate for the EPA.

(BEGIN VIDEOTAPE)

GUPTA: Greenhouse gases and climate change, are they a threat to human health?

LISA JACKSON, EPA ADMINISTER: EPA has said yes. EPA has a proposed finding. It's out for public comment. So, you have to -- we have to allow that process to run its course. But, about a month ago, in April, EPA said tentatively that six gases including CO2 are a threat to human health and welfare. It means there are serious problems for this generation, and more importantly, for future generations.

GUPTA: You know, when you hear something like that, it's pretty startling, because we are surrounded by these gases. We are surrounded -- we are confronted with climate change.

JACKSON: Well, I'm happy to hear you say we're confronted with climate change, because it is something that we have to confront as a nation and as a people and actually as a world. The endangerment finding that we refer to is really the first step.

It says, based on science, we know that these gases have the potential to change our climate, to make hot days hotter, to increase drought, to make major changes in the water cycle and flooding -- and all of those things exacerbated with air pollution that we already have means people who have lung problems, people who have respiratory problems will have more of them.

We owe that to the American people to tell them first what we know, whether there's a danger or not. The next step is actually up to Congress right now. Right now, in Congress, there's climate change in energy legislation being debated. We're very hopeful that this country will soon confront the issue head-on with new law.

GUPTA: They talk a lot about science, and how this particular administration, and particularly the EPA, will be founded on science. Is that to somehow suggest that the previous administration was not based on science?

JACKSON: I think that there is a feeling and I fear it, that the previous administration too often allowed the scientific process to be intermingled with the political/policy considerations too early. And one of the things I've said is that science is accomplished. It should be accomplished at such the direction for the decisions and for the communications from this agency.

GUPTA: Based on the fact that it sounds like science and ideology are sort of combined at least in some of the decisions made previously -- are there things that you walked into this office saying we absolutely have to reverse those right away because they're not based on science? JACKSON: What I walked in saying was that we have to review most of the decisions right away, to make sure that they follow science -- the best science we have and the law. And that came straight from the president. That came from the campaign. That came from commitments I made during the confirmation process.

(END VIDEOTAPE)

GUPTA: She certainly has a big job in front of her.

So, tightening your financial belt doesn't have to mean foregoing your prescriptions. There is some help out there. I'll ask personal finance editor, Gerri Willis, to give us a hand.

And take a look at this video. Does that blurriness look familiar? I'll tell you a simple step you can take to keep your eyes healthy as you age.

HOUSE CALL will be right back.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

Let's take a look at this week's medical headlines.

The ACLU, along with cancer patients, genetic specialists and medical associations are suing the government over the practice of granting patents on genes, specifically for granting private company Myriad Genetics a patent on two genes linked to breast and ovarian cancer. Now, the ACLU claims that patenting pure genes hinders research for a cancer cure and they went on to say -- they think it's unconstitutional.

The outcome of this lawsuit could significantly impact the future of genetic research because the plaintiffs are claiming the government should not be allowed on genes, and that includes genes for Alzheimer's disease, muscular dystrophy and asthma.

Cheerios, a popular breakfast cereal, is under fire from the Food and Drug Administration. Now, the claim on the box says the cereal can help lower cholesterol and treat heart disease. The FDA says only drugs can have those sorts of claims. General Mills said in a statement that the science is not in question. It says the clinical study supporting Cheerios' cholesterol-lowering benefit is very strong.

And hidden salt -- a new study says salt content in foods at 17 of America's most popular restaurants is much higher than it ought to be. Red Lobster and Chili's are getting singled out as the worst offenders -- each with meals containing three days worth of salt, a single meal. The report was issued by the consumer watchdog, the Center for Science in the Public Interest. Chili's and Red Lobster tell CNN don't dispute the findings, but they added that many options have significantly lower amounts of sodium.

HOUSE CALL is going to be right back with an easy step you can take right today to protect your eyesight.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

You know, paying for prescription drugs is getting harder. You all know that. New drugs are more expensive than ever, and consumers are shouldering a lot more of those out-of-pocket costs as well. So, we asked personal finance editor Gerri Willis to help us.

This is something that we've talked about in the past.

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: True.

GUPTA: And health care reform is squarely on the map again. How big a problem specifically are these prescription drug costs?

WILLIS: Huge. Huge, Sanjay. In a recent Kaiser Family Foundation poll, it was found that almost 30 percent of adults say they haven't filled a prescription because of the cost. And about a quarter of people polled had split pills in two or skipped doses to make the medicine last longer.

But there are ways you can cut prices. Some stores have discount pharmacies. For example, Kmart Pharmacy has a 90-day generics program for 15 bucks available anywhere in the country where there's a Kmart Pharmacy. Costco, Sam's Club, BJ's pharmacies often have competitive prices. Membership is not required to use the pharmacy services. Check Costco.com, SamsClub.com and BJs.com for pharmacy locations.

And don't forget that the Internet is a great tool for comparing prices. Check out the following: Drugstore.com, Homemed.com, Familymeds.com. You can also go to DestinationRX.com to compare drug prices.

You know, there is one word of caution here. Beware of fly-by- night sites where you risk getting counterfeit or tainted drugs. Look for sites that carry what they all a VIPPS seal. It stands for Verified Internet Pharmacy Practice Site. What a mouthful. And it's awarded by the National Association of Pharmacy Boards, so it's a good thing to look for.

GUPTA: Yes. It's such a bad idea for people to be skimping obviously or breaking those pills in half. It's just not doing what the medication is supposed to do.

Are there other ways to score discount out there?

WILLIS: Absolutely. Think about drug discount cards. They're available from state government membership associations, nonprofit organizations or for-profit businesses. You can save 15 percent to 50 percent. Yes, it's 50 percent on certain medicines. The cards may have annual fees that range from 30 bucks to 60 bucks per family or $9 a month.

And here are places to get those things. Check this out: Togetherrxaccess.com. Merck has a drug discount card program at MerckHelps.com. Pfizer also has one called Pfizer Friends. You have to call 866-776-3700 for more information.

Keep in mind, there may be income requirements.

GUPTA: You know, it's interesting, because there are people who are starting way deep in the hole, right? They have no health care insurance at all. What about those folks?

WILLIS: Yes, this is a big problem if you're uninsured or have no drug coverage. Tell your doc. You may be able to get a healthy dose of samples. I've done that myself. Think about pharmacy assistance programs. You may qualify for free or low cost medicines -- they're usually run by drug companies.

Keep in mind that you may -- that you may have stringent income cut-offs at around $20,000 per family. For more info, more Web sites for you out there, you need to have your pencil out for this -- RXAssist.com, Partnership for Prescription Assistance at PPARX.org, and NeedyMeds.com. People have to TiVo this show.

GUPTA: They have to TiVo. You know, we'll put some of these Web sites on some -- on our Web site as well at CNNHealth.com.

WILLIS: Great.

GUPTA: Thanks. You know, we've been talking about this a lot and I really appreciate you joining us again. Thank you.

WILLIS: My pleasure, Sanjay.

GUPTA: Thank you.

All right. We got another reason to eat healthy -- so that you can keep your vision as you age. Over the past decade, there had been several studies looking at the association between what you eat and what you see as you grow older.

A new study from Australia echoes some past research that omega-3 fatty acids may protect against a very common age-related vision problem, something known as macular degeneration. To help us understand, let's go over here to the magic wall. Let me show you. This is amazing stuff here.

Look at the eyeball and look at how light sort of comes in through the cornea over here and then back to an area of the eye called the lens. And it's this area over here called the macula that is so important. It focused on this area in the back of the eye and sometimes can deteriorate and break down the delicate macular tissue that surrounds it.

Take a look here at what happens. About 9 million people see things differently than other people as a result. You see the phone like this. But if you have macular degeneration, you get those black spots sort of in the middle. And you can see what a problem it is. It causes that blurriness. It makes sense because the macula is located in the center of the retina.

Now, healthy macula allows a person to see fine details, those fine facial features, to have that crisp vision. Theoretically, for a person suffering from macular degeneration, it's better to look up or to the side to see.

Not much is known about why it occurs or how to prevent it necessarily, but this study found some interesting things. First of all, with regards to what you eat. There are some foods that can prevent this sort of vision loss. Now, specifically, look at fish. You have one serving of fish per week, a 31 percent decreased risk of developing this problem of macular degeneration.

Now, also, if you look at nuts -- two servings of nuts, again, these omega-3 fatty acids, a 35 percent decreased risk. And just having one tablespoon of olive oil, can be a simple as that, a 50 percent decreased risk. People who ate these foods were less likely to develop macular degeneration than when they hadn't.

Also, if you flip that around to the people who are stocking up on diets high in trans fats, the results aren't so positive. People who consumed the highest amounts of trans fats were 1.76 times more likely to get macular degeneration.

So, how are these foods helping? Researchers believe high in omega-3 fatty acid foods reduce inflammation in the eye, keeping those arteries and blood vessels that target the macular area healthy. They may also counter the effects of destructive oxygen molecules. You know what? It's not just your eyes, I can tell you, but your whole health overall that's going to be benefited.

Up next: We're going to answer your questions. Ask the Doctor is my favorite segment -- that's after the break. And you want to have legs of steel and lose weight at the same time? A hot trend you don't want to miss.

Stay tuned to HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: It is time for my favorite segment of the show: "Ask the Doctor."

Let's jump right in. Here's a question from Theresa in Ohio, who asks this, "I'd like to know what is a bone cyst. What are the symptoms? How are they treated?"

Well, Theresa, there are many different kinds of bone cysts. But the most simple is something known as the unicameral bone cyst. That's a cavity found within the bone that is filled with fluid. Now, they're usually found in younger patients.

The good news -- they're non-cancerous. You can find them in the upper arm, the thigh bone, but you can also have them in the pelvis, ankle, heel, even the spine. Most bone cysts have no problems, but if a unicameral bone cyst is starting to thin the bone, there may be some pain especially when lifting heavy items.

A bone cyst without pain can be treated with X-rays alone. But you may need surgery if the cyst becomes painful, is growing larger or is in a location that may cause a fracture of the bone. It can also be treated by draining it and injecting it with a steroid medication. Remember, of course, talk to your doctor to get the best treatment for you.

Here is another question from a reader of my blog. Dick asked this, "Hand sanitizers have been recommended, but the bottles say effective against bacteria, no mention of viruses. What gives?"

Yes. Well, there's not a lot of data on this, and just not a lot of data on how effective those sanitizers are against viruses, specifically. Studies show that soap and water are better but hand sanitizers are a good idea when you have no other option. We carried them everywhere down in Mexico. While they may not kill a virus, sanitizers sort of make your hands very inhospitable to viruses clinging on them.

At the end of the day, basic principles still apply -- avoid touching your mouth, your eyes, your ears and your nose.

Now, they call themselves the Mason-Dixon Roller Vixens. Up next: Find out how these dangerous divas are burning up to more than 400 calories an hour, they're doing it on skates.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

So, you're tired of the same old treadmill? Pilates just not exciting enough? Why not take to the rink? The roller rink, that is.

Here's a look at the roller derby workouts.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): They are mothers and teachers, wives and workers, but put a pair of skates on them and they become the Mason- Dixon Roller Vixens. This group of dangerous divas is just one of many women's roller derby clubs popping up all over the country. It may look like a breeze, but racing around the rink trying to bump blockers and jostle jammers is no easy task. On the average, these women can burn up to 400 calories an hour.

Amber Mori, otherwise known as "Cykosis," has been skating for over a year.

AMBER MORI, "CYKOSIS": After probably eight or nine months, I just started dropping pounds like crazy. I think I've lost 16 since I started.

GUPTA: Competitions like this one against the Dutchland Derby Rollers are tough enough, but the workouts, even tougher. Each practice, their coach requires the gals to do sit-ups, push-ups, stretches to help them with their endurance. The team captain, Jocelyn Bassler, has always been athletic, but says this is the best workout she's ever had.

JOCELYN BASSLER, TEAM CAPTAIN: I don't go to gym anymore. I just have to roller derby.

GUPTA: Clubs like the Vixens are always looking for new members, but think before you skate. Most of these ladies know the pain of bumps and bruises, as well as the thrill of victory.

(END VIDEOTAPE)

GUPTA: I haven't roller-skated since I was a kid. It looks like a lot of fun -- a pretty good workout as well.

Well, before we wrap things up, I want to tell you about my Fit Nation tour that's kicking off this weekend. It's a chance for us to get off the television screens and talk to you directly. And, more importantly, hear from you as well. We're making pit stops at several places around the country, marathon races into the summer and into the fall. You can see there: Cleveland, Seattle, San Francisco, Minneapolis and Chicago -- so come out, visit us.

And if you missed any part of today's show, check out my podcast, CNN.com/podcasting. Also, join us at CNN.com/health, and on Twitter -- a lot of followers there, Sanjay Gupta CNN.

Remember, this 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.