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HOUSE CALL WITH DR. SANJAY GUPTA

Obama's Health Care Push Continues; Lawyer Says Present Health Care System is Racist; Air Pollution Lowers Children's I.Q.; Could Your Weight Influence Your Quality of Care?

Aired July 25, 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. I'm Dr. Sanjay Gupta. Thanks so much for watching.

First up: Health care battles in the spotlight. We're the place for the latest news. We promise it. This week, President Obama, on the trail, talking to citizens and fighting for votes.

And imagine a paper cut. A simple paper cut turning into a life- threatening condition. The "why" of this whole story is even more shocking.

And what is the first thing your doctor thinks when you walk through the door? Well, the answer may have something to do with your weight.

You're watching HOUSE CALL.

(MUSIC)

GUPTA: All right. Welcome to the trenches of the health care battle. The president has been in high gear, as you know, visiting the Cleveland Clinic, holding a prime-time news conference. Meanwhile, the pressure is on for both the House and the Senate to hammer out legislation and -- as we've been stressing -- to figure out how to pay for all this.

CNN's White House correspondent Suzanne Malveaux joins us -- Suzanne?

SUZANNE MALVEAUX, CNN WHITE HOUSE CORRESPONDENT: Well, Sanjay, obviously, it's a disappointment to the president, to the administration not actually hitting that August deadline, the recess deadline. But the president will continue to push. He will continue to talk to members of Congress.

He met in the Oval Office with Senate Majority Leader Harry Reid, as well as Senator Max Baucus, the chair of the Senate Finance Committee -- obviously, two very important players in all of this, to get a sense of the timing, negotiations, where they go from here. He is not setting a new deadline but rather keeping this rather loose and open trying to figure out how to get through these impasses, but he does say that he wants something by the fall, by the end of the year, to get that legislation on his desk. They realize there's going to be a lot of tough work ahead in September. But as long as they continue to move forward, they do believe here at the White House that progress is being made and that that is really important. Also, the president's chief of staff, Rahm Emanuel, is meeting with blue dog Democrats -- those who are fiscally conservative.

When asked, Robert Gibbs, just how that meeting went whether or not it was much of cracking heads or begging for support, Robert Gibbs is saying that it was somewhere in between. Obviously, a lot of tough negotiations behind the scenes with those Democrats as well as the president reaching out to Republicans, members of the Senate Finance Committee, senators Grassley, Lindsey and Snow. The president will continue to talk with them.

And then, Sanjay, there is a whole public campaign. The president will continue to move forward, to push forward on health care reform, traveling to Raleigh and Roanoke and some other places in the weeks to come -- Sanjay?

GUPTA: All right. Thanks.

Lots to talk about there and we will continue to be your source on health care reform.

Got us thinking, you know, as President Obama pushes to overhaul the nation's health care system, some Americans say the problem isn't just getting the right care. They say it's something more -- they say it's racism.

The allegations of discrimination are disturbing, but are they true?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): The Reverend Gary Spears is the organist at this church in the southwest Bronx, Cosmopolitan, AME.

A few years ago, something happened to him -- something he couldn't explain. He was scared.

REV. GARY SPEARS, CHURCH ORGANIST: I see the paper cut and it became very badly infected.

GUPTA (on camera): So, over a period of months, lost over 80 pounds, became nauseated at the sight of food, lost your energy. You're urinating every 20 minutes. And you had a paper cut that turned into a it sounds like a full-fledged infection.

SPEARS: Yes.

GUPTA: And they said...

SPEARS: Change the gauze. Take the antibiotic. You'll be fine.

GUPTA: Spears went to an emergency room not once but twice, and both times, he was sent to an outpatient clinic run by the hospital. He never got a diagnosis. He never got a single test.

And as I will tell you in a moment, what happened to Gary Spears should never happen to anyone.

(voice-over): One thing about New York, it's famous for its hospitals. Sheiks, kings, the rich and famous come here in search of the best medical care. But many of the people in New York's poorest neighborhoods say their experience is different.

NISHA AGARWAL, N.Y. LAWYERS FOR THE PUBLIC INTEREST: You literally have two separate systems of health care operating within the same hospital. Patients with Medicaid are sent to what are called hospital clinics for their specialty care and privately insured patients are sent to what are called faculty practices.

GUPTA: Nisha Agarwal says the quality of care in the two settings is not equal.

Agarwal is a lead attorney for a grassroots group, Bronx Health Reach. In a legal complaint filed last year with the state of New York, they accuse three large New York hospitals -- Montefiore, New York Presbyterian, Mount Sinai -- of discrimination based on insurance status and race.

(on camera): The complaint targets clinics for diabetes and heart disease. Both of those are illnesses that have an outsize impact on African-Americans. It specifically says the hospital clinics for patients on Medicaid or with no insurance are overcrowded and second rate.

AGARWAL: When you look at the demographics of the Medicaid population in New York City and New York State, when you're doing the separation based on insurance, you are effectively segregating people based on race.

GUPTA (voice-over): Is that really fair? Is insurance a good indicator of race?

Here's a number that caught my eye. In the Bronx, there are 19 times as many African-Americans and Latinos on Medicaid as compared to whites.

The New York attorney general's office opened an investigation but won't tell us where it stands. The hospitals named in the complaint all referred us to the Greater New York Hospital Association. A spokesman there said it's unfair to blame hospitals for the black and white health gap. In a written statement he says the outpatient clinics offer care for the poor, quote, "where it otherwise not exist."

Dr. Neil Calman runs a large practice in the Bronx. He says health varies widely by race.

DR. NEIL CALMAN, INSTITUTE FOR FAMILY HEALTH: If you walked into the nursery of a hospital and there was a black baby and white baby who'd been born on the same day, that you could bet that the black baby was going to live eight years less long than the white baby.

GUPTA: The clinic system he says is not good enough.

CALMAN: What you end up with is people getting different types of care. You end up with one system with people with experienced doctors and another system where people are treated by rotating trainees. In one system, with good communication back to people's primary care doctors; and in another system, with no communication back to people's primary care doctors.

GUPTA: The church organist, Gary Spears, is not part of the complaint. But he was feeling lost with a terrible illness ravaging his hand and his whole body.

(on camera): So, for months, you have been searching for an answer. He finally gave it to you. What did you think?

SPEARS: I was amazed.

GUPTA: Were you angry?

SPEARS: I was just shocked.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

On the rundown this morning: Your weight and your doctor. There's a new study that shows if you're overweight, your doctor might have a problem treating you. We'll explain.

And the power of sports: How soccer is helping these men to survive.

Plus, racism and health care part two. Find out why some say Gary Spears' easily diagnosed disease was missed all because of the color of his skin. It is a stunning story and it's in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

Before the break you heard from Gary Spears. A raging infection had taken over his body. And some say the reason it had gotten so far was part of a larger problem, discrimination.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Gary Spears was confused and afraid. A festering infection in his hand, chills, sweats, massive weight loss, his hand simply wouldn't heal. To the doctors he'd been sent to in outpatient clinics, it was a mystery.

But not to Dr. Neil Calman. By pure chance, he ran into Gary Spears at the office where Spears worked. He says he knew the diagnosis instantly. Gary Spears had a severe case of untreated diabetes and a simple blood test confirmed it.

SPEARS: Immediately, he began to run tests and told me for the first time that I was a diabetic and that the reason why my body was not healing was because I was a diabetic and I had to get my glucose numbers under control.

GUPTA: Spears had medical insurance and thought he had good care. So, he wondered why his illness had gone untreated for so long.

SPEARS: I believe now after, you know, many years after, this happening that it had to be because of my color...

GUPTA (on camera): Because of your color?

SPEARS: The color of my skin.

GUPTA: Because your black, they think...

SPEARS: Yes.

GUPTA: They think...

SPEARS: They did not take that extra step to give me the medical care that I deserved and was entitled to as a human being.

CALMAN: Over many, many years...

GUPTA (voice-over): Dr. Neil Calman says it's part of a pattern and not just in New York.

CALMAN: It's been absolutely proven through studies that a black man and a white man going to the hospital with exactly the same complaint will be treated differently. That's been shown through study after study.

GUPTA: In one of those studies, cardiologists were shown tapes of people complaining about identical symptoms -- the same symptoms. And yet, the doctors were more likely to order additional tests for the white patients.

(on camera): No question, the differences between medical care and health is very different between blacks and whites. The real question is: why.

I think it's complicated. I mean, there are insurance issues. There are economic differences. There's even the physical environment. But if you scratch just below the surface, you'll find that race is on a lot of people's minds.

(voice-over): I sat down with Gary Spears and two others who wanted to tell me about their experience with outpatient hospital-run clinics. Long wait times, they said. No regular doctor. But there was something more -- something personal.

(on camera): How many of you believe that the health care system the way it is now is racist?

It's stunning to hear that. I mean, I think that maybe you think about people waiting longer in clinics or seeing different doctors each time but to say that it's racist is a pretty remarkable thing.

REV. TIMOTHY BIRKETT, CHURCH ALIVE DEVELOPMENT CTR.: I'm amazed when I ask at my congregation and groups that we have, "How many of you felt that you were not treated correctly" and hands go up.

GUPTA: Because of the color of their skin?

BIRKETT: Yes.

GUPTA (voice-over): The Reverend Robert Foley is the pastor here at Cosmopolitan Church. He's an outspoken voice on health issues.

(on camera): At first, he didn't want to talk about race. His goal: equal better care for everyone -- especially the poor and uninsured.

But you can't ignore race. It turns out he has a story, too.

REV. ROBERT FOLEY, COSMOPOLITAN AME CHURCH: I had an experience with regards to my late wife.

GUPTA: His wife had a pain in her side. Her doctors played it down -- until it was too late. Ovarian cancer and just 18 months to live.

FOLEY: That always bewildered me, you know? Why -- how could this happen and why did it happen? When you have this color skin and you run into situations that are inexplicable to you, that don't seem to be reasonable, it makes you wonder -- what's generating this. It does.

GUPTA: Gary Spears is now back at the church organ. He was in that similar situation. And we now know what he thinks about it. He suffered too much and for too long -- just because he is black.

(END VIDEOTAPE)

GUPTA: One of the more remarkable stories, I tell you, that I covered as a journalist. You can tune in tonight for much more, a look at solutions. Set your DVRs to CNN special report, "Black in America 2." That's tonight starting at 8:00 Eastern.

Straight ahead: Could your weight affect the way your doctor takes care of you? A new study out there says yes.

And later on the show: A game of soccer is helping this homeless man become more productive. Pregnancy and air pollution -- everybody is worried about this -- on the some concerns about the I.Q.s of children born in urban areas. That's next on HOUSE CALL.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

Developing now, labs across the country are preparing to begin human testing of a swine flu vaccine. Keeping you up-to-date here -- more than 700 people have died from swine flu this year around the world. Now, the World Health Organization says the H1N1 virus is spreading across the globe with unprecedented speed.

Here's what I mean. In the past, it typically takes flu viruses six months to spread as widely as the new swine flu has spread in less than six weeks. Think about that. It should be noted, the majority of cases have had mild symptoms and people usually recover within a week of getting sick even without any sort of treatment.

It's also news this week that air pollution could lower a child's I.Q. Now, it seems that a baby's intelligence may actually be affected by smog that gets into the womb. The pollution we're talking about here is something known as polycyclic aromatic hydrocarbons. That's not a name yet to remember, but you're looking at it right now. It's exhaust fumes basically, all that stuff you see in the air.

Experts we spoke to say the I.Q. differences are not major, but the concern is for an entire community. If everyone is being exposed to high levels of these pollutants, then you possibly talking about a whole group of kids in the future with some learning difficulties.

And experts say, if you live in a heavy pollution area, use common sense. Try and keep your windows closed during high traffic times and try taking less populated routes when walking.

You know, some recent estimates indicate that more than 30 percent of people in the United States are obese. You know that if you watch this show. The number is even higher for people who are overweight.

So, here's a question. Could your weight be influencing your quality of care? There's a new study out that says it just might. CNN medical correspondent Elizabeth Cohen has a report.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Sanjay, this is a fascinating survey of physicians. Let me show you what the results are.

What they found is that 45 percent of doctors surveyed said, "I have negative reactions towards the appearance of obese patients." Now, they also asked doctors another question and got this answer -- 66 percent of doctors surveyed said treating obese patients is very frustrating.

Sanjay, we asked the authors of this study, "Why would this be?" And they said, well, first of all, sometimes, people are bias against fat people and doctors are, after all, human beings. Maybe they have that bias as well.

But also, doctors, as you know, Sanjay, they are in it to help people. And so, it can get frustrating when a doctor tells an obese patient, you need to lose weight, or you're going to get high blood pressure, you need to lose wait or you're going to get diabetes; that it's frustrating to doctors that patients sometimes can't lose weight because then the patient sometimes doesn't get better.

And, Sanjay, I talk about this issue in my column this week and I also talk about other kinds of biases against patients that doctors sometimes have. You talked about this a bit in the piece that we saw earlier from New York. Are doctors biased against patients because they're minorities?

So, to read about these issues, you can go to CNN.com/EmpoweredPatient. My column is up there. It asks the question: Does your doctor have any biases against you?

Sanjay?

(END VIDEOTAPE)

GUPTA: All right. Thanks, Elizabeth.

A team of hope. It's a group of men struggling in their lives now aiming at success one kick at a time. Their story is ahead.

And I'm taking your questions in "Ask the Doctor." Here's the question for you, "Do you know what a phytonutrient is? I'm going to tell you.

Also, e-mail me your questions. We're hoping to use it in an upcoming show, housecall@CNN.com.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL.

We already know that being active is an important part of staying healthy and playing on a sports team is a great way to accomplish that. But you've never seen a soccer league quite like this one. Take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's a hot, humid day but Calvin Riley and the rest of his soccer team don't mind the heat. It's easy to see their dedication, but something else is not so obvious. All of these men are homeless. UNIDENTIFIED MALE: Absolutely beautiful.

GUPTA: Riley found himself on the streets after the company he worked for suddenly went bankrupt.

CALVIN RILEY, ATLANTA STREET SOCCER PLAYER: I never thought I'd be homeless. To be honest with you, I had a good job. But I never thought that I'd be in a homeless shelter.

GUPTA: Depressed, overwhelmed, he joined Atlanta Street Soccer USA Team. It's part of a national program designed to inspire hope and to restore self-worth. It's for men who are homeless, recovering drug addicts, or refugees.

JEREMY WISHAM, COACH, ATLANTA STREET SOCCER: You stop thinking about yourself and you stop thinking about your health and things that make you happy -- things that make you want to live, that make you want to be a productive member of society, that make you want to get up and go to work.

GUPTA: There are 16 teams around the country that will compete against each other in July. It's called the U.S. Homeless Cup, and about a dozen players deemed to have overcome the greatest obstacles will move on to Milan in this year's Homeless World Cup.

WISHAM: What we're trying to do is just provide case management, medical, transportation, employment, whatever it is we can do. Like I said, we don't -- this isn't a program that have you to force somebody into.

GUPTA (on camera): All starting with soccer.

WISHAM: All starting with soccer, yes.

GUPTA (voice-over): For Riley, soccer helped him turn his life around. With his team mates' support, he went back to school. He has a job lined up after graduation. He's lost weight, and he quit smoking.

RILEY: When you join this team, it's like a family. If you need anything, we'll be there for you. (INAUDIBLE) soccer team has helped me being around, you know, positive people, you know what I'm saying? Just want of trying to get out of this and not trying to make -- not trying to stay here but trying to get out and better themselves.

GUPTA: Against all odds, these men are making goals happen both on and off the court.

(END VIDEOTAPE)

GUPTA: I'll tell you what, it was really great spending some time with those guys. Good luck to them.

Now, keeping your own body fine tuned.

HOUSE CALL is here to help you get fit for life. That and more in "Ask the Doctor."

(COMMERCIAL BREAK)

GUPTA: All right. Welcome to my favorite segment of the show. Time for "Ask the Doctor."

Let's get right to it. A question from John in Illinois. The question is this, "What advice can you offer on the consumption of soy milk and soy-based burgers?"

Well, John, soy is an excellent source of protein, especially if you're a vegetarian. Now, plus as a non-animal protein, the FDA says it can help your heart, it can help with heart disease, specifically, say, if you eat 25 grams per day of soy protein and also supplement that with a diet low in saturated fats and cholesterol, this could reduce the risk of heart disease.

Now, there are many claims out there that soy might also prevent cancers and symptoms of menopause, but there are also some conflicting studies about soy's role in breast cancer and other hormone sensitive conditions in women. So, read your labels, consult with your doctor, of course. Thanks for the question.

Got a tweet here from Richroll. He asks what are phytonutrients and why do we need them? Well, phytonutrients --you can think of them as the highly nutritious components of plants that promote good health. You've heard them referred to as flavonoids, phenols, sulfides.

They help slow down the aging process to some extent and could protect against a host of illnesses and diseases, like cancers, hearth disease, high blood pressure, stroke -- other chronic health conditions. In addition, they could work to enhance immunity and also serve as antioxidants.

Now, you can find good sources of phytonutrients in fruits, vegetables, grains, legumes, nuts, and teas. Thanks for the question.

Well, by the way, Richroll, quite an inspirational story himself. In fact, we asked him to write about his own personal fitness initiative on CNNHealth.com.

This is how he put it -- I love the title -- "Self-Described Miserable Man to an Ultra-Marathoner." You know what an ultra- marathon is? This guy was 30 pounds overweight. He's an ultra- marathoner now. Check it out, CNNHealth.com.

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, CNN.com/podcasting.

You can also join us at CNN.com/health; and on Twitter, SanjayGuptaCNN. We have almost 500,000 followers now. Thank you very much for following along. Hope it's helping you.

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.

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