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Sanjay Gupta MD

Could Healthcare Reform Boost the Economy?; Late-Term Abortion Debate; Congress Working to Give FDA More Power; Inside the Operating Room

Aired June 06, 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, HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger. I'm Dr. Sanjay Gupta. Thanks so much for watching.

Like I told you, we're going to be your source for discussions about health care reform. There's another chapter. Could reform boost the economy?

Also, wrinkles. We're all going to get them some day. Maybe, you don't want them. What you had for dinner last night could help. I'll tell you what I mean.

And did you know this? I still practice neurosurgery. It's a question I get more than any other. So, for first time ever, I'm going to take you into the operating room -- a collision of my worlds.

You're watching HOUSE CALL.

(MUSIC)

GUPTA: Health care reform -- this time, the White House is making an economic case. An administration report released this week says by spending an estimated $1 trillion, the government can actually help save money down the road.

That's important, because according to a CNN/Opinion Research Poll, 69 percent of Americans are in favor of the government stepping in if it lowers health care costs and increases coverage. That's a big "if," as you know.

So, we invited personal finance editor, Gerri Willis, to join us to talk about this again.

Welcome back, Gerri.

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: Hey, good to see you, Sanjay.

GUPTA: You know, we have been talking about health care reform a lot.

WILLIS: Right.

GUPTA: Well, what kind of health care measures are we talking about and could they impact your world, the economy? WILLIS: Well, OK, first of all, we're talking about Americans have -- all Americans having health insurance, including the 45 million people who are uninsured. To pay for this new system, new taxes would have to be imposed, and the government would finance its own insurance plan for people who can't get coverage anywhere else.

If these reforms passed, here are the promises: The annual growth rate of health care costs would slow by 1.5 percentage points. Right now, health care increases three times faster than inflation, which runs about 3 percent to 4 percent a year. Reining in those costs would put the economy in overdrive. GDP, which is a measure of the country's growth, would increase over 2 percent in 2020 and 8 percent in 2030 -- down the road, obviously.

So, breaking down this to real numbers, let's look at this example from the president's Council of Economic Advisers. Health care reform for a family of four would be $2,600 higher in 2020. That figure goes to $10,000 higher by 2030.

Plus, the government says these reforms would be -- would lower the unemployment rate, increase the amount of people in the workforce by cutting absenteeism, disability. The group also says these reforms could also help slow the growth in the U.S. deficit.

Very high expectations for economic growth and big payoffs, they say, to this plan -- Sanjay?

GUPTA: Lots to digest there. But, you know, one thing, it seems to be, at the heart of all this is the cost savings promised by the health care industry. And we didn't see that back in '94. How do they plan to cut these costs and how many are we potentially talking about here?

WILLIS: We're talking about $2 trillion over 10 years. That's a lot of money. And to do this, the health care industry promised to do several things, including streamlining claims processing and bundling payments so that hospitals, doctors and insurers work together to build one fee for one treatment. There also the emphasis on prevention, like screening for diabetes, heart disease, cancer, depression -- Sanjay?

GUPTA: What -- you know, you live in this world. I mean, are you optimistic that this is going to happen? I mean, what are the critics saying?

WILLIS: It's tough. I got to tell you, a lot of criticism of this plan. And you can understand why. Can the health care plan achieve that $2 trillion in savings? Some are skeptical and won't employers simply be incented to just drop their health care coverage and expect the government to pick up the cost of providing health care?

Some feel the health care system should be built on competition, and the government shouldn't take that away. Lots of questions, though, about whether this can really happen. I guess, Sanjay, we're just going to have to wait and see if it can get passed and become law, and if the expectations can become reality.

GUPTA: Well, Gerri, with your help, we're going continue to be the source on health care reform. A lot of people interested. Thanks so much for joining us.

WILLIS: My pleasure.

GUPTA: All right. Quick check of the headlines now.

Remember swine flu? We were talking a lot about that. Well, the World Health Organization is considering raising the swine flu alert to phase six. That is the highest level. Phase five, where we are now, means the disease has spread to at least two countries, but most countries are not yet affected. Moving to phase six means a global pandemic, or worldwide spread of the disease is under way.

Now, this does not mean, however, that the virus itself is more severe. So far the numbers, more than 19,000 cases of swine flu have been reported in 64 countries with more than 100 deaths.

Also, some other news, before you make another call on your cell phone -- listen to this, holding the phone to your ear for too long can lead to something known as cell phone elbow. That's right. It's a common condition where constant bending of your elbow sort of chokes the blood supply off to the nerves in your arm. That can be painful.

Americans spend about 6 billion -- with the B -- minutes on cell phones every day. And orthopedic specialists are reporting more and more cases of cell phone elbow.

So, if your fingers start to feel numb or tingle while on the phone, experts say to change hands, switch too a hands-free headset or end the call. Yes, you could actually get off the phone. I try that every now and then myself.

But don't switch the channel. In 60 seconds, a controversial story in the headlines this week. It's one of most controversial in medicine. We got both sides of the story. You decide.

Plus, Congress is pushing for stronger regulation to protect the food supply. And we found that it had some support for one surprising group.

Stay with HOUSE CALL.

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GUPTA: We're back with HOUSE CALL.

You know, a man who was a lightning rod in the abortion debate in this country was killed last week. Kansas doctor George Tiller's willingness to perform so-called late-term abortions had made him a target in the past as well. Late-term abortion is one of the most charged issues in medicine. I'll tell you, even the term "late-term abortion" causes some controversy. And here's the debate. It really comes down to what is known as the viability of the fetus. Now, consider this -- a normal pregnancy typically lasts about 40 weeks. Most experts agree, prior to 22 weeks, that's more than halfway through the pregnancy, the fetus is not viable. Now, around 27 weeks, if a fetus were to be born, it would be viable. It's that gray area, that space between 22 and 27 weeks, that is so controversial.

I can tell you, having spoken with lots of doctors on this issue, there is simply hardly any agreement in the medical community on whether it's ethical to perform an abortion during that particular time frame -- again, between 22 and 27 weeks. Here's how one abortion provider explains his reasons for doing the procedure.

(BEGIN VIDEO CLIP, CNN'S AC360)

DR. WARREN HERN, AUTHOR, "ABORTION PRACTICE": The men and women who come for late abortions, in fact, have desperate circumstances with a desired pregnancy. They want to have a baby, not an abortion. But they -- the pregnancy is fatally or catastrophically complicated by medical problems, and it is the best thing for the woman to end the pregnancy. It's a matter of saving her life.

(END VIDEO CLIP)

GUPTA: Now, I'll tell you, the American Association of Pro-Life Obstetricians and Gynecologists disagree with that. They say that "when extreme medical emergencies that threatened the life of a mother arise, AAPLOG believes in treatment to save the mother's life, including premature delivery." They say, "This is not abortion to save the mother's life. And we are treating two patients, a mother and a baby, and every reasonable attempt to save the baby's life would also be a part of our medical intervention."

Also, I want to provide a little bit of context here -- I think this is important. About 1.3 percent of all abortions happen after about 21 weeks; 88 percent of abortions happen before 13 weeks.

Right now, laws do vary from state to state. In 24 states in the United States -- you can see them here in red -- the courts have said the states can restrict abortions once the fetus becomes viable. Eight other states prohibit abortions after a certain number of weeks, generally 24 weeks -- those are the states in yellow. And in five states, in green, the cutoff for abortion is the third trimester.

One thing is certain about all of this -- this issue is going to be debated for some time to come.

And HOUSE CALL will be back in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, it seems we're hearing about food outbreaks all the time and there was another recent salmonella outbreak. So, what is your confidence level in the safety of the food that you eat?

Well, Congress is working on giving the FDA more power over this industry. One thing that surprised us: some rather unexpected supporters.

CNN's Dana Bash explains.

(BEGIN VIDEOTAPE)

DANA BASH, CNN SR. CONGRESSIONAL CORRESPONDENT (voice-over): At first, Christopher Meunier's mother could not figure out what made him so sick, hospitalized for a week.

GABRIELLE MEUNIER, MOTHER: All of a sudden, the symptoms got very, very bad, very fast. We had absolutely in idea what was going on, never considered salmonella.

BASH: It was salmonella, from tainted peanuts -- an outbreak that sickened tens of thousands of people and caused nine deaths. The contaminated peanuts were traced to just one processing company with two plants in Georgia and Texas.

But the economic repercussions are widespread. Just ask Virginia peanut farmers Dee Dee and Tommy Darden.

DEE DEE DARDEN, PEANUT FARMER: When the salmonella scare hit, that just put the brakes on everything. It's really going to hurt us, at least 20 percent to maybe 30 percent less income on the farm.

BASH: That's why the Dardens are joining peanut farmers across the country in a move that may seem surprising. They want more government regulation over their industry.

DARDEN: The consumer wants confidence in buying a product. And I think a good food safety law would do that.

BASH: Jimbo Grissom came to lobby Congress on behalf of nearly 1,000 peanut farmers.

JIMBO GRISSOM, WESTERN PEANUT GROWERS ASSOCIATION: A stricter food safety would be -- would be good for the industry. And it would be for most industries.

BASH: Lawmakers appear to be listening.

REP. ROSA DELAURO, (D) CONNECTICUT: It is hard not to see a food safety system in crisis.

BASH: Several bills are moving through Congress to give the FDA more power over peanuts and other foods. Now, federal inspectors visit some food plants only once every 10 years. That could be stepped up to every 18 months for high risk facilities.

Lawmakers are also pressing to give the FDA something they don't have now: clear authority to recall tainted food products. And they want to toughen requirements on food handlers and growers to identify and report contamination.

Tommy Darden says it's worth it.

TOMMY DARDEN, PEANUT FARMER: This is what it's all about.

BASH: To save his peanut farm and his way of life.

Dana Bash, CNN, Washington.

(END VIDEOTAPE)

GUPTA: All right. Dana, thanks.

Now, let's face it, few people want to look their age, especially as you get older. I want to show you something. Take a look at this.

When you're talking about your skin and talking specifically about wrinkles -- if you zoom way in to the skin specifically, and flip that over and start to look at the outer layer of the skin -- that's the epidermis, that's what the wrinkling process is going to start to look like, the collagen starts a little squishy and you lose your elasticity. The top layer of the skin -- as you have less and less oil in your skin as you get older -- starts to actually develop these wrinkles that you can see there. First, it dries; as the drying occurs, you get wrinkles as well.

A lot of things happening. You start to lose a number of blood vessels in your face and throughout your entire body. Because blood brings nutrients to your skin, fewer skin cells can repair or replace themselves as you get older.

So, you ask yourself what specifically can you to about this. Some of the answers are pretty simple. Eat properly. And your diet can affect the amount of hydration and elasticity. Lots of fruits and vegetables can help prevent wrinkles.

Also, minimize alcohol intake. That's good advice for lots of different things. But alcohol can lead to spider veins, broken capillaries.

Also, a big culprit that might surprise you: sugar. Sugars in your blood stream latch on to proteins and form these things known as corrupting molecules which can damage the proteins in the skin.

And, finally, an obvious one: stop smoking. It can accelerate the aging process.

You know, they say sometimes a picture is worth a thousand words. Take a look at these pictures. This is what happens to the skin of smokers. Look at those wrinkles around the face. It's narrowing the blood vessels in the outer most layers of the skin.

And take a look as you get even older. Look at the side profile of the face. That is someone who is also a smoker. You can see the damage that it does.

OK. Listen, forget the wrinkles. Smoking shortens your life span by an average of more than 10 years.

Up next: We got to Ask the Doctor. This week, I'm going to answer one of the most popular questions that I get from viewers just like you: What's my life like as a neurosurgeon? Well, for the first time, I'm taking you inside the operating room.

This is HOUSE CALL.

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GUPTA: It is time for my favorite segment of the show: Ask the Doctor. Let's jump right in.

Here is a question from Dan in New York who writes this, "I'm curious to know the differences between generic and name brand drug. What makes the prices so different? Is there a difference in quality?"

Well, Dan, as you pointed out accurately, the big difference is price, no question. A brand name drug-maker spends a lot of money researching and producing new medications which are then patented to protect that company's investment. Once that patent expires, other manufacturers can apply to the FDA to make generic equivalents, without having to pay for all that research or all that branding, frankly.

In reality, generic and name brand drugs have the same active ingredients. What might be different are the inactive ingredients and the size and the shape of the pill as well. Both undergo strict FDA regulations, so, you know, talk to your doctor if you're trying to switch drugs.

Here's another question from Lynn in Georgia. "Can an insurance company deny you coverage for a pre-existing condition? What are my options?"

We get this question all the time. Lynn, first of all, the short answer is yes. One in five Americans who apply for insurance on their own do have a hard time getting it because of pre-existing conditions.

Now, there are some options which we have researched in about a dozen states. You can actually become something known as a "group of one," in other words, one person becomes their own company, making it easier to get and negotiate with insurance companies. You can also join the state high risk pool -- and this can be expensive, but it might be worth checking out for you.

Finally, there are advocates that can help you. We looked into this. Two good Web sites: CoverageForAll.org and the CoverMeFoundation.org. Both have people to answer your questions 24/7. Lynn, good luck with that.

There's another popular question I get from viewers: what is life like in my other job, as a neurosurgeon. Well, to help answer this -- for first time, we took a camera inside the operating room as I performed brain surgery. Take a look. (BEGIN VIDEOTAPE)

GUPTA: Pretty early morning, two big cases today. Two of the biggest cases we do in neurosurgery for the most part, ruptured aneurysm, and a sad story of a high school student who dove into a pool and broke his neck. He was supposed to graduate this weekend. So, we'll see what we can do for him.

I just got find out where everybody is. Are you still on three or where are you guys? OK. I'm -- see you in a few minutes.

Dr. Chara (ph) is my resident. He's going to be doing cases with me today.

UNIDENTIFIED MALE: She's got some old stroke there.

GUPTA: OK. Let me see that.

This is, I think, is probably the biggest trauma centers out there. We see more trauma here on any given day, I think, than just about anywhere else. They were doing cases here last night. Another team, obviously, 6:00 a.m. now, we're getting started with a new case and we'll be operating until late into the evening tonight.

The six-minute scrub, roughly.

(INAUDIBLE)

GUPTA: Can I have some irrigation, please? Everything now is three-dimensional at the base of the skull and you're dealing with a sort of time bomb here because the aneurysm itself could rupture.

UNIDENTIFIED FEMALE: OK.

(INAUDIBLE)

GUPTA: Come on, come on, come on. I would have blood ready. We lost a fair amount there.

OK, hang on. This will take a second, OK? And look around, and see what we've got.

Thanks, guys. I appreciate it.

Ninety-nine percent of the operation goes exactly as you expect, and then 1 percent can be a bit of an extravaganza. But, you know, the patient is going to do great. All the blood's out of her brain. Aneurysm's clipped; she's never going to have this problem again. So --

(END VIDEOTAPE)

GUPTA: Hey, it's wild for me to watch that. That's a -- to give you a little glimpse of my first love, medicine and neurosurgery. And I still practice it. I think it makes me a more informed reporter when I'm bringing stories to you. Now, buying your own health insurance -- as you may have realized -- is not exactly cheap. Tips on how to do it and what should you avoid.

Stay with HOUSE CALL.

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GUPTA: Unemployed and uninsured. That's a reality millions of Americans are facing. Experts say trying to purchase insurance on your own can be an absolute nightmare.

Elizabeth Cohen is going to joins. She has some five crucial questions to ask if you're considering buying 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. 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 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 you 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 co-pays. 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 co-pay. That's like, let's say, $25 every time you see the doctor. Find out exactly what the numbers are for your deductibles and co-pays.

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

GUPTA: All right. Elizabeth, thanks.

And we're going to keep giving you help at home if you find yourself in the situation. If you're shopping for coverage, there's also some more great information about how to avoid getting scammed. Look for Elizabeth's advice on CNN.com/EmpoweredPatient.

Now, guys, listen up - new list out there of the world's 25 fittest men. Plus, some tips on how you can get in better shape as well. We're all trying to do that.

You're watching HOUSE CALL. We're getting you stronger. Stay with us.

(COMMERCIAL BREAK)

GUPTA: All right. We're back with HOUSE CALL.

Now, here's a challenge for all you health buffs out there. Can you become the fittest man in the world? Well, "Men's Health" magazine recently identified 25 men whose physical capabilities seem limitless. Some of the winners might surprise you.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Topping the list of "Men's Fitness" magazine's 25 fittest guys in the world: Spanish tennis great Rafael Nadal. Now he may spend several hours a day on the tennis court, but Nadal says he also hits the gym heavily in the off-season.

Also, LeBron James. He's called one of the best NBA players today. This may surprise you, he does yoga and Pilates several times a week to help stay in shape.

Now, if you're thinking, those are professional athletes, of course they're fit, well, there are some non-athletes on the list as well. Singer Akon, for example, he says he does more than 500 push- ups, pull-ups and dips before each concert. And 42-year-old entertainment lawyer, Richard Roll competed in the ultra man race last November, that's a six-mile swim followed by a 171-mile bike ride and 52-mile run -- all of it on a plant-based vegan diet.

The good thing is, you don't have to go to extremes to get fit. CNN's "Fit Nation" is here to help you reach your full potential. Just staying active can really go a long way. For example, bicycling can burn 590 calories an hour. An intense one-hour game of basketball burns 440 calories; and even doing an hour's worth of heavy yard work can burn about 440 calories.

(END VIDEOTAPE)

GUPTA: So, get up and move around. Who knows, you get started now, maybe next year you'll make the list. I think I'm going to try that as well.

That's all the time we have for today unfortunately. If you missed any part of today's show, be sure to check out my podcast, CNN.com/podcasting. And also, join us at CNNHealth.com and on Twitter at SanjayGuptaCNN. More than 137,000 followers now. Join us there for a lot more.

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.