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The Situation Room

Fighting Mad About Health Care; Swine Flu Risk For Children; Stadium Turns Into Free Clinic; Hidden Hospital Charges Revealed; Posters Mention Obama Girls; The Kennedy Family Tree

Aired August 11, 2009 - 18:00   ET

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


WOLF BLITZER, CNN ANCHOR: I'm Wolf Blitzer in CNN's command center for breaking news, politics and extraordinary reports from around the world. You are in THE SITUATION ROOM.

At one point today, it looked like 79-year-old Senator Arlen Specter was going to have to break up a fight or possibly get punched himself. That's how intense the debate over health care reform has become. Tensions are flaring in town hall meetings across the country.

But there are some calmer discussions going on as well. We are covering it all for you as part of our extensive coverage of this make or break month for health care reform.

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: That's what America is about, is we have a vigorous debate. That's why we have a democracy.

But I do hope that we will talk with each other and not over each other, because...

(CHEERING AND APPLAUSE)

(END VIDEO CLIP)

BLITZER: Our White House correspondent Suzanne Malveaux is standing by. Our national political correspondent, Jessica Yellin, is covering the Specter town hall meetings in Pennsylvania.

Jessica, listen to some of the fireworks that sort of came up earlier today.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I don't want this country turning into Russia, turning into a socialized country. My question for you is...

(CHEERING AND APPLAUSE)

UNIDENTIFIED FEMALE: ... what are you going to do to restore this country back to what our founders created according to the Constitution?

(CHEERING AND APPLAUSE)

UNIDENTIFIED MALE: Why don't you do this, please? If you guys think that we want health care reform so bad, do this. Let's have a referendum in 2010. We will tell you if we like your plan or not. How does that work?

SEN. ARLEN SPECTER (D), PENNSYLVANIA: Well, that's one of the ideas I am going to take back to Washington, a referendum.

(APPLAUSE)

UNIDENTIFIED FEMALE: ... on page 42 talking about the health commissioners, that the health commissioners will decide our benefit plans. Who in heaven's name are going to be the health commissioners? How do they get picked? On what basis will they be selected and how will they make these awesome decisions for all these very different people in this room?

UNIDENTIFIED MALE: I'm leaving.

SPECTER: OK, OK, OK. We have just had a demonstration of democracy. OK?

(CHEERING AND APPLAUSE)

(END VIDEO CLIP)

BLITZER: Jessica, who are these people showing up at these town hall meetings and what are their biggest concerns?

JESSICA YELLIN, CNN CONGRESSIONAL CORRESPONDENT: Wolf, on the side of the people who are critics of health care reform, a surprising number of young families, parents who say that they are worried about the future for their kids, whether they will be able to afford coverage under a new plan, whether their kids will be saddled with an enormous amount of debt, the quality of the medical care that will exist.

Among those people who are in support of health care reform, a lot of folks of all ages who have horror stories of friends and loved ones who suffered or died because insurance companies, they said, denied claims or denied them coverage, so real intense feelings on both sides, Wolf.

The one thing they share in common, no matter who you spoke with in these crowds today, they all said they felt they are not being heard, that their views are not being well represented. Interesting reality.

BLITZER: Yes, and a lot of anger pointed towards Senator Specter. Is there something else going on here besides health care?

YELLIN: Well, as you well know, Senator Specter changed parties from Republican to Democrat. And he was visiting two strongly Republican counties, and in these areas, a lot of frustration that he changed on them, that he unexpectedly left the party. So, there is some residual anger about the senator's party flipping and that fed some of the intensity of passion at these events -- Wolf.

BLITZER: And there was an intensity of passion.

Jessica, thank you.

Arlen Specter takes the issue of health care reform very personally. And here's why. The 79-year-old senator was treated for Hodgkin's disease back in 2005 and once again last year, when the cancer came back. He had two non-cancerous brain tumors removed, one in 1993, the other in 1996. And he had heart bypass surgery a decade ago. As a senator, Specter is eligible for very generous insurance benefits to cover those conditions.

Another Senate Democrat also got an earful from angry constituents today. Senator Claire McCaskill was shouted down more than once at a health care town meeting in Eastern Missouri. One woman in the audience was escorted out.

Compared to what Senators McCaskill and Specter went through today, President Obama had it pretty easy at his health care event. About 1,800 people were in the audience in Portsmouth, New Hampshire. Most showed up on a public Web site that randomly chose who got tickets.

Let's go to our White House correspondent, Suzanne Malveaux.

Suzanne, how is the president controlling these events? Because it was pretty well-organized and the questions largely supportive.

SUZANNE MALVEAUX, CNN WHITE HOUSE CORRESPONDENT: You're right. The president got it very easy today compared to the alternatives, those kind of shouting matches that we saw.

But the White House was prepared in case there were any raucous crowds. And quite frankly President Obama does relatively well in dealing with that, the kind of back and forth. It didn't happen. He had a free forum essentially to be able to answer some of the misinformation, what he calls these boogeymen, the criticisms against his health care plan, without challenges.

And, Wolf, it was very much like a campaign rally. In the beginning, the first thing someone said, we love you, Obama. And he shouted back, I love you, too. He didn't -- he wasn't really challenged on a lot of these points.

One woman who actually introduced him, Lori Hitchcock, she had hepatitis C. She used her example as an example of not being able to get insurance because of a preexisting condition. President Obama was able to use her as the example of his reform and change.

At one point, Wolf, he even said, look, anybody have criticism, some questions, I will take those, because I don't want people to think that these are just plants in the White House. And the White House went out of their way to explain that there were no pre-screened questions or plants and how these tickets were distributed -- Wolf.

BLITZER: It went very smoothly for the president today in New Hampshire. He has got some more coming up later in the week.

Thanks, Suzanne.

Let's turn now to a car that could change the future of General Motors, maybe even the entire auto industry. GM says it is developing an electric car that will get an estimated -- get this -- 230 miles per gallon. Yes, you heard it right, 230 miles per gallon.

The Chevrolet Volt is expected to go on sale late 2010. GM's chairman says this could be a game-changer for his company just one month out of bankruptcy.

Let's bring in Poppy Harlow of CNNMoney.com. She is watching this for us.

Poppy, 230 miles an hour, is that realistic?

POPPY HARLOW, CNN CORRESPONDENT: So, how did GM get to this number? Well, it's actually an EPA calculation. The Volt goes 40 miles with not a single drop of gasoline. But, after that, it uses gasoline. So, when you drive more than 40 miles at once, the miles per gallon falls. The further you drive, the farther that falls.

So, how does it stack up when you compare it to a hybrid? Take a look there. When you look at a Prius, for example, it gets 50 miles per gallon powered by gasoline, costs about $25,000.

Let's compare that now with the Chevy Volt, 40 miles without any gas. After that, though, the gas engine kicks in and that's where you get the 230 miles per gallon. But it costs about $40,000. That's the estimated cost by GM at this point. And you know what, Wolf? Today, GM executives came out and they said they are going to have to eat some of that cost.

They're going to turn little to no profit on the Volt at first. This is a company that is in $59 billion in the hole to taxpayers, Wolf, and they're not expecting a profit off the bat -- Wolf.

BLITZER: Two hundred and thirty miles a gallon, that would still be amazing.

Despite the fuel economy, there still is a recession under way. How much is GM really betting on this Volt?

HARLOW: It really seems like they are putting a lot of eggs in one basket on this car. You have got a lack of charging stations. Where do you charge this car if you don't have a garage, if you live in a big city? That's a problem.

Affordability. A lot of Americans, right now, $40,000, that's incredibly steep. And what we did was, we did some calculations. We compared it to the Prius. So, in a year, it takes about $720 to drive a Prius. That's based on 12,000 miles a year, 50 miles per gallon with gas at about $3.

Let's compare that to the Volt. Driving 12,000 miles per year, at 230 miles per gallon, with the cost to charge the battery at about 88 cents a day, you are looking at an annual cost of about $321, not a big difference there. But the up-front price tag is really very different.

The reason GM, Wolf, thinks this is a game-changer, they call it the halo effect. This changes the way the public looks at this company from building trucks and SUVs to building fuel-efficient cars. And they are betting a lot on the Volt -- Wolf.

BLITZER: Yes. When I spoke earlier with Fritz Henderson, the GM CEO, he reminded me, you get a $7,500 government tax credit if you wind up buying a Volt.

(CROSSTALK)

HARLOW: They remind you of that one.

BLITZER: Yes, so that's a good piece of cash right there. Thanks very much, Poppy Harlow.

For more on the new Chevy Volt, you can log on to CNNMoney.com, get some more information there.

This just coming in to THE SITUATION ROOM, a new plea deal today in connection with one of the biggest Wall Street frauds of all times, maybe the biggest. That would be the Bernard Madoff scandal.

Madoff's former chief financial officer has now decided to plead guilty to securities fraud, falsifying records and international money laundering. A federal judge ordered Frank DiPascali to jail without bail, which is unusual for someone who is cooperating with prosecutors.

DiPascali could face up to 125 years in prison if convicted of all charges. Madoff is serving 150 years in prison right now.

Let's go to Jack Cafferty for "The Cafferty File."

This guy cooperates, Jack, and names names and has got evidence, others could be going down pretty soon.

JACK CAFFERTY, CNN ANCHOR: You're reading my mind. I'm sitting here listening to what you were just saying. I'm thinking, I will bet he is not the last one that is ordered to jail.

And if he is -- like you say, if he's going to play ball, if they turn him, which is the phrase they use, and get him to -- to cooperate, he could take a lot of people down with him. You don't run an operation the size of that thing Madoff had going without some help. And there had to be some other people involved that knew what was going on.

President Obama says he has got a lot on his plate and that immigration reform is going to have to wait until next year. At a summit meeting with leaders of Mexico and Canada, the president repeated his commitment to providing a legal pathway to citizenship for those who are in the U.S. illegally.

This would be called amnesty. But, first, he wants Congress to finish work on health care, energy, financial regulation. The president says his administration is meeting with members of Congress. They are working on an immigration bill that would get bipartisan support but he doesn't expect anything to pass until 2010.

And even then, Mr. Obama acknowledges that he will face tough opposition, what he calls demagogues who say any pathway to legalization is unacceptable.

It is not just demagogues, Mr. President. The American public has repeatedly expressed broad-based opposition of granting amnesty to illegal aliens. Last week on "The Cafferty File," we reported a recent Gallup poll that showed that Americans are taking a much tougher stand on immigration than they have for several years. Not everybody is happy with the president's new timetable.

Immigration advocates say they don't think reform will be as tough as the White House imagines. And they wish he would act sooner. But with rising unemployment, dwindling tax revenues with which to provide services to our own citizens, let alone millions of illegal aliens, expect the debate to rival the intensity of the one we are currently having over health care.

Here is the question. Is it a good idea to put off immigration reform until next year?

Go to CNN.com/caffertyfile. You can post a comment on my blog.

That one is not going to be easy whenever they get around to it.

BLITZER: It never is, Jack. Thanks very much.

Jack will be back.

It's a disturbing, very disturbing fear, swine flu sickening, possibly killing large numbers of children. What's the U.S. doing to make sure it doesn't happen? I will speak about that with Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. He's standing by live.

And amid health care anger, some people claim to state facts. The president says he is battling rumors. So, we have asked our Dr. Sanjay Gupta to do a fact check for us.

And want health exams, dental work, even glasses for free? Some everyday Americans, they get that already today. What's going on? We will explain right here in THE SITUATION ROOM.

(COMMERCIAL BREAK)

BLITZER: Kids already are back to school, at least in some parts of the country. And that's giving health officials nightmares. They are scrambling to be ready for a second swine flu outbreak. The next wave could be a whole lot worse, especially for kids. Our homeland security correspondent, Jeanne Meserve, is here with a SITUATION ROOM investigation.

What have you found, Jeanne?

JEANNE MESERVE, CNN HOMELAND SECURITY CORRESPONDENT: Well, Wolf, federal officials say their worst fear is that H1N1 swine flu will sicken and even kill large numbers of children. Let me emphasize at this point there is no hard evidence that that will happen.

But if swine flu does continue to hit children disproportionately, is the country ready to cope?

(BEGIN VIDEOTAPE)

MESERVE (voice-over): The 1918 Spanish flu may have killed as many as 100 million people worldwide, many of them young. Survivors said it transformed their childhoods.

UNIDENTIFIED MALE: I was a pretty lonely kid at the time, because these were my friends that I played with all those years and went to school with, and when I lost them, why, my whole world changed.

MESERVE: There is no indication H1N1 swine flu will be as lethal. But officials are nonetheless focused on minimizing the impact on children. Trials of a children's swine flu vaccine are scheduled to begin shortly. But if swine flu hits before a vaccine is ready, some experts worry the health system is not ready for large numbers of very sick kids.

DR. IRWIN REDLENER, COLUMBIA UNIVERSITY'S NATIONAL CENTER FOR DISASTER PREPAREDNESS: They need people who are not only skilled, but actually trained to deal with sick children. We need special equipment. The ventilators that we use for adults may or may not be appropriate for children. And we don't have enough of those to begin with.

MESERVE: Experts also say in a severe outbreak, hospitals may not have enough capacity. Right now, there are only 2,640 pediatric intensive care beds in the entire country. Though hospitals have plans to increase capacity and staffing, some worry even those won't meet the need in a severe pandemic.

JANET NAPOLITANO, U.S. HOMELAND SECURITY SECRETARY: Ill students and staff should be separated.

MESERVE: Federal officials have issued practical advice for schools and kids too.

UNIDENTIFIED ACTOR: Washing your hands with Elmo. Wash, wash, wash, wash, wash.

MESERVE: But experts say teachers, parents, and caregivers also need instruction on how to talk to children about swine flu to prevent anxiety and fear. ROSEMARY SCHWARTZBARD, CLINICAL PSYCHOLOGIST: The children need to be told about taking precautions, but the message always needs to be stay calm. Be reassuring. Be loving but be realistic.

(END VIDEOTAPE)

MESERVE: And health officials are concerned that if and when a vaccine is available, some parents will resist giving it to their children. Federal officials are already holding focus groups to determine how big an issue that may be and how best to calm parental fears -- Wolf.

BLITZER: All right, Jeanne, thanks very much for that.

We are joined now by the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci.

Dr. Fauci, is the country ready? Because I did some work, some statistics. There are only 400 pediatric intensive care unit beds in all of New York City.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASE: Well, it depends on what you mean by ready, Wolf, because as you said just a few moments ago, as Jeanne said, there is no indication that we are going to have a worst-case scenario.

If you have a worst-case scenario like 1918, and there is no indication really to suggest we are going to have that, no one can ever be ready for that type of catastrophic health situation.

However, we are prepared and continue to be prepared. One of the most important things that we need to do is what we are doing right now, is to get a vaccine ready and being able to deliver and administer to children. And children six months and older are one of the major of five targets for the vaccination program that we are getting ready to implement.

BLITZER: Because this H1N1 apparently -- correct me if I'm wrong -- really is the most dangerous for children and pregnant women.

FAUCI: Right. That is correct. Pregnant women clearly are at very high risk of the complications of any kind of influenza, certainly this H1N1, as are children.

Unlike a seasonal flu, where it appears to be much more of a serious situation with elderly individuals, we are seeing now with the evidence that we have from what we have seen in the spring and what people are seeing in the Southern Hemisphere, that younger individuals and pregnant women appear to be much more vulnerable to serious disease.

BLITZER: Are we talking about one vaccine, two vaccines, three vaccines, one for the traditional flu and two new ones for the swine flu? What are we talking about now getting ready for the flu season?

FAUCI: Well, there are two major components, Wolf. One is the seasonal vaccine that we give every year on a seasonal basis in the fall and in the winter. That's one vaccine that we give.

The other is the vaccine against the H1N1 novel 2009 so-called pandemic flu. It is likely that many people will require two shots of that. We don't know for sure. But based on past experiences, when we have a new vaccine that we're giving, generally, people require two shots. But we're doing the clinical trials right now to determine whether or not we are going to have to give two shots to those individuals. So, there are two separate vaccines, one of which may require two shots.

BLITZER: The CDC says normally about 36,000 people a year die from flu, mostly the elderly. How many people beyond that 36,000, especially young people, pregnant women, how many people do you estimate potentially, God forbid, could die in this flu season?

FAUCI: It really depends on the degree of severity that we see, Wolf. There are several categories that we have mapped out. The worst-case scenario, you could have a lot of people. People talk about a million people. I think we shouldn't even mention that right now, because that is the worst of the worst-case scenario.

The way this is acting right now in our spring and now in the Southern Hemisphere, where they are going through their flu season, it is acting like a moderate, in fact, if not relatively moderate flu, which would mean that, with 36,000 deaths per year, we may get double that. But we may not, because it may displace the seasonal flu type of virus that circulates.

So it really is unpredictable. But I think when we start talking about these way-out worst-case scenarios, you put a number up there, and people start panicking. And that's really not helpful, because it is unlikely that that's going to happen. Even though we hope to be prepared for it, it is unlikely that it's going to happen.

BLITZER: Let's hope.

All right, Doctor, I know you and your team at NIH, you are working around the clock to protect all of us. Thanks so much.

FAUCI: You are quite welcome.

BLITZER: Super expensive planes for government officials, lawmakers wanted them. Now they don't. You're going to find out what prompted to do a 180 on the pricey purchase.

And a brazen jewel heist in Britain -- $65 million in merchandise taken. Now police are turning to the public for help.

(COMMERCIAL BREAK)

(NEWS BREAK)

BLITZER: Here is a dramatic example of the desperate need for health care. In Los Angeles today, hundreds of people lined up before the crack of dawn to get free medical tests, dental work, even glasses. Let's go to CNN's Ted Rowlands. He is there.

Ted, this is a huge undertaking. What happened?

TED ROWLANDS, CNN CORRESPONDENT: Well, Wolf, yes, you are talking about thousands of people that showed up today. And they came for this. Basically, they are getting free dental work. Everybody has got a different story.

This is Misty (ph) here. She is a truck driver, lost her job a while ago, hasn't been to the dentist in a while. She is not only going to get dental work but she's going to get some eye work done as well. This is Remote Area Medical. This is an organization that normally works in remote areas.

This is their first time coming to urban area. And the response has been overwhelming. Thousands showed up. They whittled it down to 1,500. Only about 700 got in.

Roger Fieldman has been -- he's a dentist working on people all day.

Give us a sense of how many people showed up and what kind of a need you found here in L.A.

ROGER FIELDMAN, DENTIST: Well, we don't know how many people showed up, because we had to start turning people away at 4:00 in the morning. There was so many people.

ROWLANDS: What have you been performing? And I know it's gone from cleanings to root canals.

FIELDMAN: Mainly extractions, some root canals, but that's difficult because it is time-consuming and there are so many people with so much need. Definitely a lot of cleanings. Our dental hygienists have stepped up and shown up in force. And cleaning teeth is one of the major things that's needed.

ROWLANDS: Who are these people?

FIELDMAN: Well, probably unemployed. We don't have a lot of time to really get into their background, but I would say obviously, they are people in need.

ROWLANDS: Yes. And we have talked to a bunch of people today and a lot of them are folks that either have lost jobs or they have limited coverage and they haven't paid the deductibles. And dental is really one of the things that is at the bottom of people's list.

And also eye doctors. Wolf, one of the real tragedies here is that they have extra spots here, stations, not only dental stations, but eye doctor stations for ophthalmologists that could come in here and help, but they ran short on volunteers on that side.

And there is a rule that doctors can't come from state to state, even when they are donating their time, because of bureaucracy. They have been trying to change this for the last 10 years. And that really is sort of a pathetic reality here, that...

FIELDMAN: If there's any volunteers out there that are licensed in California, they just need to come on down here license in pocket and there will be a place for them tomorrow.

ROWLANDS: Yes.

All right, Doctor, thanks.

Just a fantastic organization. And what a turnout here, Wolf. It really shows both sides of it, the bad and the good, the bad that this is needed, but in the good in the people that did volunteer and have come out.

And the sound of drills are horrifying to most people, but for these people that are living in pain, they are really a sound of potential relief. And you're seeing a lot of smiles.

BLITZER: Yes, a lot of -- a lot of thankful people out there. That sounds like a rule that they should reform right now. I hope they're considering it, because there are good doctors all over the country, no doubt, who would have loved to come to California to help these folks...

ROWLANDS: Yes.

BLITZER: Go ahead.

ROWLANDS: Tennessee -- Tennessee the only state that does allow that.

BLITZER: All right.

ROWLANDS: Yes.

BLITZER: Thanks very much. Ted Rowlands. Where -- we've shown you the fireworks over health care reform. Now, we want to dig a little bit deeper. Many Americans have very serious questions about the future of their medical coverage and they don't always believe that the politicians are giving them straight answers. So let's bring in our chief medical correspondent, Dr. Sanjay Gupta, to get some answers -- Sanjay, I want you to listen to a question about Medicare that came up today when President Obama held his town hall in New Hampshire.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: OK.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I am on -- presently on Medicare. And I do have a supplement. But if something happens to my husband, I lose the supplement, and what will happen? I have -- I take a lot of medications. I need a lot -- I've had a lot of procedures. And how will Medicare, under the new proposal, help people who are going to need things like this?

(END VIDEO CLIP)

BLITZER: All right. Well, the president answered that question, but I'm interesting to hear how you would answer that question -- Sanjay.

GUPTA: Well, let's -- taking a step back, first of all, when people have lots of conditions or are on lots of medications, concerns about being able to get health care insurance later on is a big one. And this whole idea of not discriminating on the basis of pre-existing conditions is something that we hear about a lot, Wolf. A couple of caveats. One is that discrimination on pre-existing conditions only works if most people have health insurance. You get healthier people buying into the system and they can help offset the costs of people with pre-existing conditions. But with regard to her question in particular, there's a lot of concern about medications and how those are going to be paid for. And Wolf, you've heard this analogy, this idea of a doughnut hole. If you imagine a doughnut, at the outer edge, as you're starting to bite through it, the first part is covered. Then you have this huge gap until you spend a lot of money and then you're sort at the other end of the doughnut. And it's that gap that has so many people concerned. There's about $80 billion that we've -- that we've been hearing about from Pharma, over the next 10 years, that could help shrink that doughnut hole, which would help someone like that. And that -- that's sort of what we're hearing. And again, none of this is written in stone. Some of the specific questions she had are not addressed, as far as I can tell, reading through the 1,000 bill -- 1,000 page House bill. But that's sort of the gist of it, as far I as I can tell -- Wolf.

BLITZER: Pharma being the pharmaceutical industry...

GUPTA: That is correct.

BLITZER: ...the drug makers. Listen to this question that Senator Claire McCaskill of Missouri -- she was asked this yesterday about pre-existing conditions, such a sensitive issue.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: If you're like a -- at my age, at 55, and with all these chronic health conditions that -- we're of no value when it comes to the health care system. They're just going to weed me out. SEN. CLAIRE MCCASKILL (D), MISSOURI: All right. Let's talk about that, OK? Let's talk about it. UNIDENTIFIED FEMALE: All right. MCCASKILL: Thank you, Dorothy. UNIDENTIFIED FEMALE: Thank you very much for coming.

(END VIDEO CLIP)

BLITZER: All right, what would you tell this woman that she could expect, assuming health care reform gets off the ground?

GUPTA: Well, she didn't get much of an answer there from the senator. That's clear. And part of this is a -- a bit confusing, no question. First of all, someone like her, age 55, pre-existing conditions, lots of medications, if she were just to go out to the market today, she would have a hard time getting insurance. That much I think people sort of agree on. So the question, could -- could a new plan sort of benefit her in some way? And it does get down to this idea, as you mentioned, Wolf, again, of pre-existing conditions -- this idea that if you have health reform, a lot of people buy into the system, you end up having healthier people being able to offset the costs of people who might have some of these pre-existing conditions. So she might have an easier time getting health care. That -- you know, we've asked specific questions of the American health insurance providers, trying to figure out, look, are the premiums just going to be so exorbitantly large that you can get insurance, but it's just almost cost prohibitive. And they say no. They say it's going to be sort of rated at the same level as people who have health care insurance and don't have pre-existing conditions. But, again, it really is all predicated on whether -- whether the health care reform -- whether people actually get a guaranteed access across the board. That -- that's how you pay for it.

BLITZER: Sanjay, I'm going to have you stand by, because we have more to talk about. This is such an -- an important issue. The president's critics are trying to use his daughters against him and the White House isn't necessarily pleased. Stand by for the best political team on television, as well.

(COMMERCIAL BREAK)

BLITZER: It's the last thing you want to think about if you're going into surgery, but the fact is every doctor, every scalpel, every pill comes with a price tag. Only on CNN, our chief medical correspondent, Dr. Sanjay Gupta, has been looking into the hidden costs in hospital bills -- Sanjay.

GUPTA: I don't know about you, Wolf, have you ever tried to take a look at one of these hospital bills and try and decipher it? What do all these various costs mean? I can tell you, even as a doctor, I'm not quite sure sometimes. So we decided to take a closer look.

(BEGIN VIDEOTAPE)

DEBBIE FRAZIER, PATIENT: And all the x-rays. There's a rotation tool for 119. There's a wrench kit.

GUPTA: On its face, it looks pretty straightforward. But your hospital bill is anything but -- something 56-year-old Debbie Frazier found out the hard way when she had surgery in March.

FRAZIER: I just had to have the battery replaced on my defibrillator. I was in there two days and it was $196,000.

GUPTA: $196,000. That's because once you strip away what you pay for your actual care, there are layers of charges that have nothing to do with your hospital stay. Take a look at Debbie's bill -- nearly $3,000 a day for room and board; $72,960 for the pacemaker; $44 for two Lipitor pills.

But the key is what you don't see on this bill. JAMES BENTLEY, AMERICAN HOSPITAL ASSOCIATION: And I think it would help consumers if they understood that that bill represents, really, four tiers of costs.

GUPTA: There's the direct cost of your care. Then there's the overhead costs -- the cost of running the hospital; things like administrative staff, the utilities. There's also the operating margin. That goes toward things like new medical technology, replacing worn equipment and, finally, subsidy costs or uncompensated care.

Insured patients help pay for the uninsured and underinsured who can't pay their bill.

RON POLLACK, FAMILIES USA: It's a significant part of the bill. You'll never see it written in the bill, but it's sure there. It's a hidden surcharge.

BENTLEY: If the costs weren't passed on to consumers, we wouldn't be able to care for people who have no insurance. We wouldn't be able to train physicians and doctors for the future. We wouldn't be in a position to maintain the facility.

GUPTA: The American Hospital Association's James Bentley admits it's a complicated system. And it's almost impossible to look at a bill line by line and pull out the direct cost of your care.

FRAZIER: Fored (ph), that's not the generic. Monopril is not the generic that I take anyway.

GUPTA: Frazier says it's time hospitals got creative. She's even got a suggestion. FRAZIER: They need to use generic medication. That would keep their costs down.

GUPTA: And, hopefully, those savings would be passed on to you.

(END VIDEOTAPE)

GUPTA: So, Wolf, there are a couple of things that really jumped out at me. For example, there's no standard fee schedule. So you may have one operation in Miami and pay a totally different price for it if you're in Minnesota. So even between locations or even within hospitals, you can have different -- different charges.

Also, if you look at those four different categories of costs, you get an idea of how you might be able to make that more efficient and to start to lower costs.

But, again, these are hard to decipher and you get an idea as to why that might be -- Wolf, back to you.

BLITZER: All right, Sanjay.

Thanks very much.

A confusing bill, there's no doubt about that. A face-off between the White House and advocates for healthy school lunches. The source of their dispute -- ads that mention President Obama's two daughters. The White House wants the campaign stopped. The group, though, says they're not going to stop it -- the brewing controversy, straight ahead.

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BLITZER: An advocacy group using President Obama's daughters.

Joining us now to talk about that and more, David Frum, the former speechwriter for President George W. Bush. He's a fellow at the American Enterprise Institute. Also, the White House correspondent for Politico, Nia-Malika Henderson; and our own Joe Johns.

We're going to talk about this, but I want to get some background first from CNN's Deborah Feyerick -- all right, Deb.

DEBORAH FEYERICK, CNN CORRESPONDENT: Well, Wolf, you know, there's a known rule in Washington -- the president's kids are off limits. But not everyone is playing along.

The White House is now ticked off at one group that refers to Sasha and Malia in new posters around the capital.

Take a look at this image of a young girl thinking: "Hmmm, President Obama's daughters get healthy school lunches, why don't I?"

Well, the non-profit organization claims the ads are simply advocating for vegetarian lunches at schools nationwide. But the White House wants those signs taken down, saying they don't want the president's daughters used as a publicity stunt.

The head of the group, Physicians Committee for Responsible Medicine, isn't budging. He says the ads will stay up until the end of the month.

So here's the question -- is it OK to mention President Obama's children in an advocacy campaign -- Wolf?

BLITZER: It's a good question.

David Frum, even for a good cause, should you put these two girls out there right now?

DAVID FRUM, FORMER BUSH SPEECHWRITER: I think the White House is completely out of line here, that they -- there is not an image of the girls, there's not a mention of their names, there's not a criticism of them. There's an invocation of them and a -- and a demand for an equal standard.

It's the same way that some people have said President Obama gets to choose which school he wants to send his children to at the same time as his administration is shutting down voucher programs in the District of Columbia. You're comparising -- comparing not actual people, but the concept of the president's children.

By the way, I looked it up. They do serve a nice lunch at Sidwell Friends.

BLITZER: That's where the girls go to school.

But just even using, you know, the name of the girls -- not specifically saying the Obama daughters, if you will, whatever that advocacy ad says. It does so -- sort of go against the grain for a lot of us who have covered the White House, and, you know what, you keep the kids private. They have enough difficulty, you know, getting older as it is, being the daughters of the president of the United States.

NIA-MALIKA HENDERSON, WHITE HOUSE CORRESPONDENT, POLITICO: Yes, it does go against that unwritten rule. But I think one of the things we've seen from this White House that we didn't see from the Bush White House or even the Clinton White House is that -- is that Michelle Obama and President Barack Obama mention their daughters quite frequently. I mean they give anecdotes about -- about their kids, about having chores around the White House, about setting their alarms in the morning.

And so I think there is kind of a blurring of the line that we see here that we didn't see in previous administrations. So in some ways, it kind of has invited this sort of thing. We saw it with J. Crew. They're using the girls to essentially sell coats and -- and all sorts of clothing.

So -- so there is a blurring of a line that we've seen, I think.

BLITZER: You went to law school.

Does the White House have a potential legal case here that they could challenge this in court?

JOE JOHNS, CNN CORRESPONDENT: Well, I was trying to think about that. You know, the -- the big question is what you can do about the children of public figures and whether the parents control the image and likeness of public -- of their children in a situation like that?

But there's also a question of slippery slope -- you know, at what point do you stop, if the parents can't say no?

You know, we'll talk about J. Crew. That's fine. But it seems like parents generally -- especially these parents -- have a right when they want their children's names or likeness used.

You're right, though, there was not a picture. But that's a -- that's a big point. That's a big selling point.

Nonetheless, when you start talking about the kids of the president and the first lady and they say no and then the people who are doing it say we're not going to stop, it seems to me that there's at least something to talk to (INAUDIBLE) about. BLITZER: If there would have been a similar advocacy ad involving the two Bush daughters, the twins -- you know, for whatever cause -- do you think the Bush White House would have acted differently than the Obama White House?

FRUM: Well, we don't have to ask that question, hypothetically. We'll remember that, in fact, somebody did an off-off-Broadway play ridiculing one of the Bush daughters and the president -- President Bush was pretty upset about it. But I do think there was a lot of -- he got a lot of sympathy.

Somebody wrote a pretty unpleasant novel in which Mrs. -- Mrs. Bush, Laura Bush, was the principal character. I think it won a prize.

And somebody wrote a novel proposing that President Bush be assassinated.

So my feeling would be that President Bush's attitude would be that this president needs to develop a somewhat thicker skin.

BLITZER: Does it make any difference that the Bush twins were older than the Obama girls?

HENDERSON: Yes. I mean I certainly think it makes a -- makes a little bit of a difference that -- that the kids were older. And they've made -- made, you know, a real point of saying that these girls need to have a private life and things like that.

I mean, one of the things about this, too, is that it really dove -- dovetails with issues that Michelle Obama is already talking about -- the issue of healthy lunches. Come the fall, she's really going to be pushing for that and telling you about childhood obesity. So this campaign is -- is really in sync with that, obviously.

BLITZER: We'll see what the next step in this saga is.

Guys, thanks very much.

The Kennedy family in mourning after the death of Eunice Kennedy Shriver, the sister of the late president. We're taking a closer look at Shriver's lasting legacy and the role she played within this very prominent political family.

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BLITZER: Let's check in with Lou to see what's coming up at the top of the hour -- Lou, what are you working on?

LOU DOBBS, HOST, "LOU DOBBS TONIGHT": Thank you, Wolf.

Well, among the things we're working on, complete coverage of the president's town hall meeting today, taking on his critics and protesters who oppose his health care plan. The president accusing opponents of what he called "scare tactics" to mislead the American people. We'll go through the roster of mistakes by both sides tonight.

However, those demonstrators continue to exercise their right to freedom of speech and they're demanding answers now from members of Congress. We'll examine the impact of these town hall protests in our Face-Off debate tonight and we'll assess the president's plunging poll numbers.

There are rising concerns that the Obama White House is now threatening the right to privacy. The ACLU is concerned -- the Obama administration considering plans to collect personal information on anyone who uses a federal government Web site.

That report, all the day's news and much more, at the top of the hour.

Please join us -- Wolf, back to you.

BLITZER: All right. Lou, thank you.

Let's check in with Jack Cafferty once again for The Cafferty File -- Jack? CAFFERTY: The question this hour -- is it a good idea to put off immigration reform until next year?

That's the earliest President Obama says they're going to get around to it.

Russ writes from Johnston, Iowa: "There will be no immigration reform as long as some kind of amnesty for people here illegally is continually offered up in Washington. The citizens shut down D.C. Three years ago for that wonderful Kennedy/McCain amnesty bill and we'll do it again. The mood of the country hasn't changed. Hell, our government hasn't even made a valid effort to close the U.S./Mexico border."

Carolyn in Maine says: "It depends upon the definition of immigration reform. Determining a pathway to citizenship must be addressed at some time. However, both northern and southern borders should have been of immediate concern to national security after 9/11." Duh. "Now, with the drug wars spreading across the border from Mexico into our country, attention is certainly needed ASAP. However, President Obama isn't listening any more than President Bush did."

John in Vermont writes: "Reform? Obama's reform sounds more like amnesty to me than reform -- bring in more illegal workers that our tax monies support, while they Western Union their pay back home. Our economy is in shambles and many good workers here can't begin to find a job. We don't have the jobs or the dollars to continue to support so many illegals flowing across our southern border." Michael in Phoenix writes: "No. Case in point -- my girlfriend, one of the directors at a major non-profit hospital here in the Phoenix area. The cost of treating illegals coming into the emergency room -- no insurance, no co-pays, no way to collect -- for even minor treatment is outlandish -- and they can't turn them away, either. One of the hospitals in the area absorbed $400,000 for the treatment of a young Hispanic woman who was in a car accident." And Mark writes: "Immigration reform is long overdue and Obama is going to delay the process even further. I guess he's hoping to win support from the illegals that will eventually be covered under his health care plan."

If you didn't see your e-mail here, you can go to my blog at CNN.com/caffertyfile and look for yours there, among hundreds of others.

And I'll look for you tomorrow, Mr. Blitzer.

BLITZER: See you tomorrow, Jack.

Thank you.

She was part of a family well-known as a political powerhouse -- Eunice Kennedy Shriver's death leaving behind only two remaining Kennedys from her generation.

(BEGIN VIDEO CLIP)

EUNICE KENNEDY SHRIVER: Together we answered yes.

(END VIDEO CLIP)

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BLITZER: Eunice Kennedy Shriver died today at the age of 88. She was the sister to President John F. Kennedy and Senator Ted Kennedy.

The Kennedys, as you know, regarded as a political dynasty here in the United States, by many as the closest thing the U.S. has to royalty.

Our Abbi Tatton is here with the Kennedy -- a Kennedy family tree.

And there are a lot of Kennedys out there -- Abbi.

ABBI TATTON, CNN INTERNET CORRESPONDENT: Wolf, Eunice Kennedy Shriver was one of nine and now just two surviving members of that generation. The two youngest, in fact -- Senator Edward Kennedy; his sister, Jean Kennedy Smith, perhaps best known as she was ambassador to Ireland.

But the next generation of Kennedys continued the family's dedication to public service.

Take a look at Eunice Kennedy Shriver's own five children. They include Maria Shriver, the first lady of California. Moving along there to her brother. That's Timothy Shriver there. He now leads the Special Olympics that his mother founded. Mark Shriver, a former Maryland state legislator -- he's now with the charity Save The Children.

BLITZER: And there are a lot of nieces and nephews, as well, many of them quite famous.

TATTON: Many notables, as well. We have Caroline Kennedy, lawyer and author, she was active in last year's election; Bobby Kennedy's children, Kathleen Kennedy Townsend, former lieutenant governor of Maryland; Joseph Kennedy, former Congressman; and Congressman Patrick Kennedy, as well. And we could go on -- Wolf.

BLITZER: We will, but we won't, because we've got to go to Lou Dobbs.

He's in New York -- Lou.

DOBBS: We missed an opportunity there for cousins, Wolf, didn't we?

BLITZER: Yes.

DOBBS: Thank you very much.