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American Morning
Report: CIA Used Controversial Techniques; Taliban Improves at Insurgency in Afghanistan; Cash for Clunkers Ends; Health Care Reform Debate Continues; Cost of Medical Malpractice; Employers of Illegal Immigrants Targeted; Cancer On Its Way To Top Cause of Death; New Footage Of Fidel Castro Appears
Aired August 24, 2009 - 07:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KIRAN CHETRY, CNN ANCHOR: And welcome once again. We're coming up on the top of the hour on this Monday, August 24th. Welcome to AMERICAN MORNING. I'm Kiran Chetry.
JOHN ROBERTS, CNN ANCHOR: And good morning to you. I'm John Roberts.
Here's what on the agenda, the big stories that we'll be breaking down for you in the next 15 minutes.
A report on CIA interrogation techniques under wraps for five years about to be released to the public today. And the findings could mean the attorney general will appoint a special prosecutor to investigate.
Elaine Quijano on how CIA members allegedly used guns and a power drill on prisoners.
CHETRY: The chairman of the Joint Chiefs of Staff saying that the Taliban is getting better and the fight for Afghanistan is "serious and deteriorating." He could see more troops headed to the front lines.
But how many and when?
The breakdown from the Pentagon just ahead.
ROBERTS: Fidel Castro suddenly showing up on television and on the front page of newspapers this weekend. The footage and the photos said to be very recent. At 83 years old, is the former Cuban leader on the mend?
Our top story this morning -- guns and power drills, tools of the trade for CIA interrogators, according to a 2004 report by the Inspector General that has been kept under wraps until now. That report is going to be made public later on today. But some of the information is already leaking out.
Our Elaine Quijano live in Washington this morning.
And, Elaine, what do we know right now about all of this?
ELAINE QUIJANO, CNN CORRESPONDENT: Well, as you said, this CIA report is expected to be released today, but some new details already emerging.
(BEGIN VIDEOTAPE)
QUIJANO (voice-over): In separate incidents, CIA interrogators threatened Abd al-Rahim al-Nashiri. He's the man suspected of plotting the deadly bombing of the USS Cole, according to knowledgeable sources familiar with the 2004 CIA report.
Sources confirm one interrogation session involved a gun. Another an electric drill. Both meant to scare the al Qaeda prisoner into giving up information.
"Newsweek" reports mock executions were staged, including one where a gun was fired in a room next to a detainee to make him believe another prisoner had been killed.
The American Civil Liberties Union, which sued to get the CIA report released, called the tactics under the Bush administration, quote, "not only reprehensible but illegal" and said, "The American public has a right to know the full truth about the torture that was committed in its name."
Although the government had authorized such controversial techniques as waterboarding, the use of a gun and drill fell outside approved tactics. A CIA spokesman said, quote, "The CIA in no way endorsed behavior, no matter how infrequent, that went beyond formal guidance," and added that Justice Department officials reviewed any cases of alleged misconduct.
But the report could renew questions about whether the Bush administration went too far in the name of national security. Former Vice President Dick Cheney has maintained the interrogation program as a whole was needed to keep the country safe.
DICK CHENEY, FORMER VICE PRESIDENT OF THE UNITED STATES: The intelligence officers who questioned the terrorists can be proud of their work, proud of the results, because they prevented the violent deaths of thousands, perhaps hundreds of thousands.
QUIJANO: For the Obama administration, the reports released means a delicate balance.
ERIC HOLDER, ATTORNEY GENERAL: We would not be doing anything that would endanger the American people or in some ways lessen our national security.
QUIJANO: But some fear the release will have a chilling effect on intelligence officers trying to do their job.
GENERAL MICHAEL HAYDEN, FORMER CIA DIRECTOR: We will teach timidity to a workforce that we need to be vigorous and active.
(END VIDEOTAPE)
QUIJANO: Now Attorney General Eric Holder is expected to announce soon whether he'll appoint a special prosecutor to investigate the Bush administration's interrogation policies -- John?
ROBERTS: Elaine, what are CIA leaders saying about all this?
QUIJANO: It's interesting. A former CIA official, John, said that when CIA leadership found about, for instance, about the drill incident, they were, quote, "angry as hell." This official called it "nickel and dime foolishness that wasn't tolerated," and he said the individual who used this drill was pulled from the program and "sharply reprimanded" - John.
ROBERTS: Elaine Quijano for us from Washington this morning. Thanks, Elaine. We look forward to hearing more about this throughout the day. Appreciate it.
CHETRY: Also developing this morning, the highest ranking man in the military saying the Taliban is getting better and the situation on the ground in Afghanistan is getting worse. The chairman of the joint chief of staff, Admiral Mike Mullen, spoke with our John King's on CNN's "State of the Union" yesterday.
(BEGIN VIDEO CLIP)
ADM. MIKE MULLEN, JOINT CHIEF CHAIRMAN: I think it is serious and it is deteriorating, and I've said that over the last couple of years, that the Taliban insurgency has gotten better, more sophisticated, their tactics, just in my recent visits out there and talking with our troops, certainly indicates that.
(END VIDEO CLIP)
CHETRY: There's also talk that the top U.S. general in Afghanistan is expected to ask for more troops. Our Barbara Starr joins us live. She's working her sources at the Pentagon this morning.
When we talk about more troops, of course everyone wants to know what they mean in term of numbers. How many would be added to that theater?
BARBARA STARR, CNN PENTAGON CORRESPONDENT: Well, we don't know the answer to that yet, Kiran, but it is looking like more troops. Some of the indications coming from a Congressional delegation that just met with General McChrystal.
Senator Susan Collins of Maine wrote this on her blog, and it is very telling. She says on her blog after meeting with McChrystal, quote, "He shows us a color coded map that indicates areas of Taliban control. A great deal of the discussion focuses on whether or not more troops are need. The general says he has completed his analysis.
"It seems, however, pretty clear to me," says Senator Collins, "that he will be asking for more troops."
Why? CNN has learned that the latest military assessment is that the Taliban now exert influence, if not outright control, over one-third of Afghanistan.
We are just a few weeks away from the eight-year anniversary of the 9/11 attacks planned in Afghanistan, and the Taliban now have their hands on about one-third of the land mass in that country -- Kiran.
CHETRY: It's very interesting, we talk about the timing. When could an order for more troops come and how soon until they would head into Afghanistan if indeed they were ordered to go there?
STARR: Well, you know, General McChrystal is indicating it's getting worse, the timing is getting very sensitive, because Admiral Mike Mullen, who you saw talking to John King there, has his next confirmation hearing for reappointment in mid September.
And the question will be whether the Obama administration wants to have this on the table at the time.
How bad is it, Kiran? We're just 24 days into August, and already this is the second worst month for coalition deaths in the war -- 62 troops have lost their lives, and the month is not over - Kiran.
CHETRY: Certainly the situation getting worse there militarily. Coming up in a few minutes we're going to talk about politically how this is playing out as well, because support seems to be eroding as well for the mission in Afghanistan.
Barbara Starr for us this morning. Thank you.
ROBERTS: Other stories new this morning. Bill used to be a hurricane proofing deadly in the United States even though it was way offshore. The storm made landfall early this morning as a category one hurricane in New Finland, Canada.
It's now downgraded but is still packing 70-mile-an- hour winds. Officials says a seven yearly girl died after being swept away by the waves yesterday in Maine. And a swimmer died in Florida died on Saturday.
Well, Cuban TV is airing what it calls recent footage of former President Fidel Castro looking healthier and well rested. The video shows him talking to some students from Venezuela.
Castro has not been seen much since turning over power to his brother Raul back in February of 2008. The Cuban government said that he underwent abdominal surgery back in 2006, but has released few other details about his health.
ROBERTS: "Ingluorious Basterds" took the number one spot at the box office this weekend. Quentin Tarantino's Nazi killing movie starring Brad Pitt took in more than $37 million. That's more than double what the number one movie got this time last year. That was "Tropic of Thunder," by the way, just to refresh your memory. CHETRY: Well, still ahead, we're going to be talking politics. As we said, the war in Afghanistan and the words from Admiral Mullen about how the Taliban is doing better and the ground is deteriorating there, the fight is deteriorating.
So we'll be speaking with Jamal Simmons and David Frum about how the president needs to shape his argument and whether or not he has support even from his own party in putting more troops in Afghanistan, plus, of course, the looming health care debate as well.
It's seven minutes after the hour.
(COMMERCIAL BREAK)
ROBERTS: Welcome back to the Most News in the Morning.
More fallout over Scotland's decision to showing a mass killer mercy. The Scottish parliament is holding an emergency debate to question the government of first minister Alex Salmon after the Lockerbie bomber was sent home.
Abdelbaset Al-Megrahi was released because he is terminally ill with prostate cancer. The Libyan was the only man convicted in the bombing of Pan Am flight 103 in 1988 that killed 270 people, most of them Americans.
CHETRY: The number of teenagers using ADHD medication may be on the rise. According to the journal "Pediatrics," calls to poison control centers about these drugs for attention deficit or hyperactivity soared 76 percent over the year and prescriptions grew 86 percent.
And ADHD experts said the kids using these drugs typically crush and snort them to either get high or to stay focused. The cases covered by the study include four deaths.
ROBERTS: And a Malaysian model and mother of two spared six lashes at the cane, at least for now. Her crime, drinking beer in public, a violation of religious law in the Muslim country. The government says the woman be facing punishment and a week in prison after the holy month of Ramadan ends.
CHETRY: America's top military officer breaking some news right here on CNN, talking with our John King. Joint Chiefs Chairman Admiral Mullen says that after eight years in Afghanistan, the Taliban has only gotten stronger, better, and the situation on the ground is "deteriorating."
Meantime, on the domestic front, the president may be losing support from his own party on health care reform.
Here to talk about all this, former DNC communications adviser Jamal Simmons. He now works with the Raben Group where he advises a private health care in organization in California. We want to keep everyone in the know about other -- let's say other activities and interests of our guests. Also with us, editor of thenewmajority.com and former speechwriter for President George W. Bush, David Frum. Thanks to both of you for being with us this morning.
I want to start with Afghanistan. I want both of you to listen to what Admiral Mullen said.
(BEGIN VIDEO CLIP)
MULLEN: I think it is serious and it is deteriorating, and I have said that over the last couple of years, that the Taliban insurgency has gotten better, more sophisticated.
(END VIDEO CLIP)
CHETRY: And so David, let me start with you. The top commanders in Afghanistan are sounding almost like we're starting from scratch even though we've been fighting, as we know, for eight years. How does President Obama the mission, as he sees it, and also the endgame for Afghanistan?
DAVID FRUM, EDITOR, NEWMAJORITY.COM: In a way we are starting from scratch. The usual rule in an insurgency is you need about one troop for every 30 civilian population. In Iraq, we hit that number because we carried out a very successful buildup of the Iraqi forces. And so by the top of the surge we hit the magic one to 30 ratio.
In Afghanistan we've had no success building an Afghan army or police force. It's just now starting all over again in the last year. And the result is we are so far away from that number.
And the president, although he has verbally committed to Afghanistan, has not put in anything like the number of troops you need to succeed. He's put in just enough to make the failure very expensive. It's not a communications problem he's got, it's a strategic problem he's got.
CHETRY: Let me ask you about this, Jamal, because there's a recent poll that just came out. It was "Washington Post"/ABC News poll showing that seven in ten Democrats, 70 percent of Democrats that were asked in this poll don't believe this is a war worth fighting, meaning Afghanistan.
So has the president failed to articulate why he thinks this is a war of necessity, or does it not matter what he says, Democrats are just weary of this?
JAMAL SIMMONS, PRINCIPAL, THE RABEN GROUP: I think Americans are weary of war in general, and Democrats would certainly be included in that number.
But I've got to go back to something David just said, because what we can't do, and what Admiral Mullen said this weekend, he's been sounding this alarm for two years. Barack Obama has been president for eight months. You can't sort of lay all of this on Barack Obama's head.
In fact, had George Bush not taken us into Iraq, we could have been much further ahead in this fight in Afghanistan than we are today. And so it's hard to have the conversation without looking at the totality of the history. We didn't just show up here.
CHETRY: I don't think anybody denying that part of it, but moving forward, I mean, the reality is that while we are trying to unwind and pull back from Iraq, we're still there. We still have more than 100,000 troops there, and now we have Afghanistan.
And if the Democrats aren't onboard with President Obama putting more troops there, where do they go?
SIMMONS: A lot of Democrats are onboard. And I do think the president has more work to do in terms of explaining that.
The one thing we know about the Taliban is that left to their own devices, they will harbor and aid al Qaeda. And al Qaeda, we know, attacked us on 9/11, and they will do it again if they have the opportunity.
So we can't walk away from Afghanistan. But again we can't talk about Afghanistan without realizing we're in the position because of what happened in Iraq.
So we've got to now start to shift that focus back to Afghanistan and win that war so we can to protect Americans.
CHETRY: Indeed, but I want to ask you about the situation with Iraq as well. There was a couple of very interesting articles saying that if Iraq was the lesson, the primer in a counterinsurgency, than Afghanistan is going to be where we get our doctorate, meaning that just throwing a bunch of troops into Afghanistan is not going to make as big a difference as trying to figure out where they need to go.
Some troops, perhaps special forces, doing things that have to do with opium production, others trying to work with warlords and tribal elders.
This situation sounds like a very long and involved commitment. How do we make that case, that that's something our forces are even able to do right now when they have been stretched to the max?
FRUM: It's a huge problem. I had a privilege of being a guest in Afghanistan last October, a guest of NATO for some time. And what you can see in comparison to Iraq is that local facilities, ultimately local people win counterinsurgencies or lose insurgencies.
In Iraq, the Iraqi's have had a long history of sophisticated state structures. They had an army, they had a police force. In Afghanistan a lot of these things are built from zero. And it's not clear the United States is as yet very good at those things. Sending troops out to set fire to opium fields accomplishes nothing. You have to build local structures and institutions, local governance. You have to have an honest and effective government at the center, which we don't have.
President Obama made a big commitment, recommitment to the United States. The Bush administration had been anxious to draw back on that commitment. He's plunged in. I'm not sure he understood what he signed up for. I think he understands now.
CHETRY: Quickly, I want to get your takes quickly on two different possible ideas by Democrats in the Senate on how to get health care through. And Jamal, I want to start with you.
One is the Schumer camp, I guess you could say. What he said is that when it comes to health care, he's for Democrats possibly pushing through a bill with no support from the GOP. How do you think that would work?
SIMMONS: I'll tell you what Democrats are for. Democrats are for anything that will actually fix this problem and get health care reform passed.
So if Republicans are going to continue to be intransigent and not want to play ball with the administration, then the administration has to do what it has to do to get some sort of health care reform passed. It's going to be actually a real health care reform bill.
So, a lot of Democrats would support that if that's the only way to get it done.
But the real issue here is also going to be getting those six or seven or eight who live in moderate states where perhaps John McCain, getting them onboard with this as well, places like Arkansas, Louisiana, North Dakota. They have to work on those Democrats.
CHETRY: Quickly, David, I just want to tell you about the other possible plan. And this is Joe Lieberman. He's an independent, but he caucuses with the Democrats.
He says, look, I think we may have to off some of this health care stuff until we're out of a recession. He said there's no reason to do it all now, that perhaps where you start is with cost delivery reform and insurance reform.
Is that an option with Democrats? Would the GOP be willing to jump on board with something short of an overall?
FRUM: The Schumer plan is a total fantasy. Every Republican in the Senate could come down with the swine flu and the president would have exactly the same problem because his own caucus it's no disunited.
He went, unfortunately, he lent support, unfortunately, of a very radical House bill. It can't pass the Senate. And so they will end up having to do something like what Lieberman says. Start over, start in the Senate finance committee, and focus on cost.
The president sold the bill on solution to cost but it has no cost control in it. It only costs money.
CHETRY: We have to leave it there, but it's great talking to you this morning. Jamal Simmons as well as David Frum, thank you.
SIMMONS: Thank you.
FRUM: Thank you.
ROBERTS: The cash for clunkers program is winding down. It ends at 8:00 p.m. tonight.
There was a stampede of buying, and a lot of people wondering will the selection on dealer lots after they get so much trouble getting rid of those cars be a little thin now in the weeks to come.
We're minding your business this morning at 18 minutes after the hour.
(COMMERCIAL BREAK)
ROBERTS: Christine Romans here "Minding Your Business" this morning.
And we're down to the wire here for Cash for Clunkers.
CHRISTINE ROMANS, CNN BUSINESS CORRESPONDENT: We've got to put the song away after 5:00 on the West Coast and 8:00, right? This is the last day for Cash for Clunkers. It was wildly successful, so successful that the dealers are worried in some cases they are so behind on the paperwork they are not going to get paid.
Thirty percent of the applications have been reviewed, the dealers have been given about $140 million paid out. There are hundreds of millions of dollars more that they are waiting for.
In fact, the dealer's association is really stressing they would like to see the paperwork deadline pushed forward. They want more time. But the government says, no, paperwork has to be done tonight.
Again, let me reiterate, 8:00 p.m. Eastern, 5:00 p.m. on the West Coast. That's when Cash for Clunkers is officially over.
So, let's look forward. What does it mean now? What does it mean for the economy? It was meant to be temporary, it is temporary. Now you have got hundreds of people who have an extra car payment. So, will this hurt the economy going forward? Will it mean that people aren't going to be spending money elsewhere? About $400 on an average for a new car payment. So people have this new car payment.
Second, what does it mean if you want a car and you've been waiting, you didn't have a clunker to turn in? You might have a tighter used car market, you might have trouble finding -- all those cars out of circulation. They have been junked. So think of that. That's already a very tight used car market might be tighter.
And also, you might have trouble finding what you want on the lot in some cases. GM and Ford have raised production, but it takes about 45 days from the steel from those assembly lines to make it into your dealer lot as well. So you might have to wait as well. So you might see some changes if you're out there.
They want to really push the momentum here. The industry loved to see the momentum. But a lot of economists say that they think this was -- we won't go back to -- we won't keep this kind of momentum without cash for clunkers for sure.
CHETRY: All right, and you have a "Romans' Numeral" for us today, which is a number Christine gives us every day or every hour about a story driving your money today.
ROMANS: And this number is $600. And so, Cash for Clunkers is going away. But I wanted to really be clear here. There still is stimulus money available to you.
CHETRY: Is this how much money you're saving because gas prices are lower?
ROMANS: It's $600 -- there is a tax break for new car buyers that exists this year that continues even without the Cash for Clunkers. So don't forget, if you haven't bought a car yet this year, there still is this tax break, state, local, and excise taxes. You get a deduction.
Next year when you file your 2009 tax return, on average, that's about $600 for a $35,000 car, depending on where you live, folks.
I mean, across the country, the taxes are different. But there still is a stimulus incentive in there even though cash for clunkers is now going to be dead tonight.
ROBERTS: Christine Romans minding your business this morning.
CHETRY: Silver lining.
(LAUGHTER)
ROBERTS: So in the battle over health care reform, nobody is talking about malpractice costs and just how that of that is a factor of the high cost of health care. We're going to look into that coming up next.
There are some doctors who are paying upwards of $100,000 a year in premiums. How much of that get passed on to the patient? Could we save money if there were to be malpractice reform? There's arguments to be made on both sides, and we'll look at those.
It's 24 minutes now after the hour.
(COMMERCIAL BREAK)
CHETRY: There's a shot of the White House this morning, missing a president and a first family because they are on a little bit of a vacation at the end of August.
Right now it's mostly cloudy, 70 degrees, a little later isolated thunderstorms, 87. Hopefully it will be nicer where they are on the Vineyard.
ROBERTS: Wasn't so nice over the weekend.
CHETRY: Because of Hurricane Bill.
This morning President Obama is on Martha's Vineyard for a weeklong vacation, but there's still no rest in the health care debate over reform.
ROBERTS: Right now a growing list of lawmakers breaking with the White House over the so called public option. That's a government-run health plan that would compete with private plans and supposedly drive down costs.
Our Jim Acosta is live in Washington. And Jim, what are lawmakers saying about all that today?
JIM ACOSTA, CNN CORRESPONDENT: John and Kiran, you've heard a lot of ideas tossed around this past weekend. You've heard some talk about reconciliation, trying to ram this through the Senate with just 50 plus one votes. You've also heard about splitting this bill in two.
So they are playing the game of mouse trap right now, trying to build a better one. And the first family, as you just mentioned, may be taking a vacation on Martha's Vineyard, but with health care debate raging, the president might not get much of a holiday from Washington.
Some Democrats don't want the president to get rest as much as they want him to get tough.
(BEGIN VIDEO CLIP)
ACOSTA: With the president hitting the beach on Martha's Vineyard, the tide may be turning against the idea of government-run insurance program or public option in health care reform.
SEN. JOE LIEBERMAN, (I) CONNECTICUT: I'm afraid we've got to think about putting a lot of that off until the economy is out of recession. There's no reason we have to do it all now. ACOSTA: Add Connecticut's Independent Joe Lieberman to the list of Republicans who doubt the president will get everything he wants.
SEN. JOHN MCCAIN, (R) ARIZONA: I believe that one of the fundamentals for any agreement would be that the president abandon the government option.
ACOSTA: The president is also feeling the heat from liberals in the House threatening to vote no on the reform unless it has the option.
UNIDENTIFIED MALE: Is there a line in the sand saying I vote no.
REP. MAXINE WATERS, (D) CALIFORNIA: Absolutely.
(APPLAUSE)
ACOSTA: At her own boisterous town hall, California Congressman Maxine Waters urged the president to start twisting arms in the Senate.
WATERS: Not only are we going to do everything we can to organize and put pressure on the senators, some of whom are Neanderthals, we are going to say to the president to use every weapon in your...
ACOSTA: In his weekly address, the president was more interested in what he sees as twists of the truth.
BARACK OBAMA, PRESIDENT OF THE UNITED STATES: And we've all heard the charge that reform will somehow bring about a government takeover of health care. I know that sounds scary to many folks. It sounds scary to me, too. But here is the thing. It's not true.
ACOSTA: But before the president could say cowabunga, an ad from one reform opponent accused the White House of a government takeover.
UNIDENTIFIED FEMALE: Because his public option health plan could lead to government run health care.
DONNA BRAZILE, DEMOCRATIC STRATEGIST: We need message discipline on the Democratic side. I can't speak for Republicans, but I can tell you without message discipline this has been a very difficult uphill battle for the president.
(END VIDEOTAPE)
ACOSTA: This week the president's grassroots volunteer network known as Organizing for America is urging its members to show up at town halls and rally near local congressional offices. Sound familiar? The move is right out of the playbook of reform opponents who have raised their voices at town hall meetings for weeks. And Kiran, just looking at those pictures of Martha's Vineyard reminds me of the fact "Jaws" was filmed near those waters. And the president, as they said in that film, just might need a bigger boat to get health care done this fall - Kiran.
CHETRY: All right, Jim Acosta for us this morning. Thank you.
And meanwhile it's 30 minutes past the hour. We're checking top stories right now.
A reality TV contestant wanted for murder of his "Playboy" model ex-wife is now found dead. Police say Ryan Jenkins body was found hanging in a hotel east of Vancouver, Canada.
Jenkins was the prime suspect in the murder of Jasmine Fiore. Police say Fiore's body was found stuffed inside of a suitcase in Anaheim, California. Police say Fiore was eventually identified by serial numbers on a breast implant since her body was badly mutilated.
Bill proving to be deadly in the U.S. even though it was way offshore. The storm made landfall early this morning as a category one in Newfoundland, Canada. It's been downgraded but still packing 70-mile-an-hour winds. Officials say that a seven-year-old girl was killed after being swept away by the waves yesterday in Maine. A swimmer in Florida also died Saturday.
Well, firefighters in Greece are racing to contain at least 90 wildfires that broke out this weekend before they reached Athens. These fires have forced 20,000 people out of their homes. Officials say 10,000 more have chosen to stay behind, to try to protect their property. Several countries have sent water dropping helicopter aircraft to help. Fires destroyed hundreds of homes as well as thousands of acres of forest.
ROBERTS: Even though the first family is on vacation this week, you can bet that President Obama is keeping an ear on his make or break push for health care reform during this month of August. Some critics say his plan doesn't do enough to drive down malpractice costs for doctors. But maybe that's by design. Here he is talking to the American Medical Association back in June.
(BEGIN VIDEO CLIP)
OBAMA: I want to be honest with you. I'm not advocating caps on malpractice.
(END VIDEO CLIP)
ROBERTS: So how much does malpractice really add to our health care price tag and what, if anything, should be done about it?
Joining me now is Dr. Jamie Grifo. He is the program director at NYU's Fertility Center and a partner with the Covington and Burling Law firm, Philip Howard here to talk about malpractice reform. Dr. Grifo, medical malpractice often used as a catch all for anything that goes wrong with a patient. How much is malpractice and how much is bad outcomes?
DR. JAMIE GRIFO, PROGRAM DIRECTOR, NYU FERTILITY CENTER: Well, clearly there's malpractice that occurs. Doctors are human and they make mistakes. But a lot of what gets told as malpractice is really just bad outcome. We have a baby that's born with a problem. And the doctor did everything right but there's a bad outcome. And that's a problem. We need a way to compensate that victim but we need a system that actually compensates the victim instead of 60 percent of the dollar going to a system that doesn't really work very well.
ROBERTS: That's a topic I want to talk about just a second. But Philip, President Obama told the American Medical Association that he'd like to initiate some sort of medical malpractice reform but rejected a cap on malpractice awards. As long as you have those big malpractice awards, can you really have malpractice reform?
PHILIP HOWARD, PARTNER, COVINGTON & BURLING LLP: Well, most civilized countries have limit on non-economic damages. The most important reform is to make justice reliable. I mean it's only when doctors feel that justice is reliable that they can focus on curing the patient and not protecting themselves. And the big cost is - it's a big cost, all the insurance and the awards but 10 times bigger than that is the amount of defensive medicine. Doctors ordering too many tests in order to protect themselves.
ROBERTS: Well, let's talk about this - this idea of defensive medicine. The "Journal of the American Medical Association" back in 2005 did a survey, doctors in Pennsylvania and Massachusetts found 93 percent of high-risk specialists admitted to practicing defensive medicine, that would be ordering tests after tests after tests, you know, a little bit of CYA there.
In Massachusetts that number was 83 percent. We should ask the doctor, do you do extra testing just to make sure that if somebody ever comes to you for a malpractice suit, you can say, hey, we did all of this and we still have a bad outcome?
GRIFO: Oh, absolutely. That happens on a daily basis and some of it is well meaning. We want to avoid the one in 1,000 case. But at some point, you can't use your clinical judgment, you can't use it as a defense anymore. So you have to use a test and that's not just good medicine, it's expensive medicine and doesn't make us better as practitioners.
ROBERTS: The American Association for Justice which is the trial lawyers, Philip, said, "The notion that defensive medicine is leading to higher health costs is not supported by empirical data or academic literature." So they disagree with you
HOWARD: Well, it's very hard to measure precisely how much it is. Most estimates put it at $1 to $200 billion a year, which is by the way, more than enough to pay for all the uninsured. But it's very hard to measure exactly when the MRI is needed or not. That's why it's an estimate. But you cannot find anyone in the health care business, anyone, patient safety groups, legitimate consumer groups, who won't say that medicine today is dominated by defensive medicine. Doctors practice it all day long.
ROBERTS: OK. But what about the cost of malpractice insurance? You know, it depends on what specialty you're in, I guess. OB-GYNs and neurologists are very high. I mean, in a field like yours, what are your malpractice...
GRIFO: I don't deliver babies, so mine is just $70,000, but for obstetricians it's $200,000, neurosurgeons up to $400,000. And those are costs. Those costs are paid for by patients. And it's not a good system. That system eats up money that should go to victims, instead it goes to trial lawyers and administration and it doesn't protect patients. We need a better system. This isn't the system.
ROBERTS: The "New York Times" looked at this a while ago, did a calculation and found that OB-GYNs where premiums are $200,000 a year. If they deliver an average of 100 babies a year, which is about average, there's $2,000 in the costs of the delivery of that baby that goes purely to paying malpractice premium. Is that outrageously high?
HOWARD: It's outrageous. Many hospitals have stopped delivering babies. And many hospitals do it essentially as a public service, they lose money on it. But if looking at the macro picture here, overall, the name of the game is creating a reliable system of justice so that doctors can get back to practicing medicine. They are taking care of patients and not protecting themselves.
ROBERTS: The "Atlantic Monthly" magazine looked at all of this and said that medical malpractice premiums account for less than one percent of health care costs. Do you agree with that? Is that true?
GRIFO: I have no reason to disagree with that. But that's not the whole cost of this system. There are cases that are settled out of court that never make it to a court where you didn't have to - there was no malpractice but you settled because it's cheaper to settle than it is to defend. I had a bruise from surgery, settled for $75,000 because the hospital said, look, it's a business decision. We know you didn't do nothing wrong.
ROBERTS: Seventy-five thousand dollars for a bruise.
GRIFO: Yes. Well, it was a significant bruise, two weeks of pain but yes, it's outrageous. That's not a good system.
ROBERTS: Philip one of the things that you're advocating is disagreement over medical treatment would go through that as opposed to going into an open court. You mention add lot of money associated with malpractice awards goes to the trial lawyer as opposed to the patient. Do you know what the ratio is and how would special health care courts reduce that?
HOWARD: Well, upwards of 60 cents on the dollar goes to lawyers fees and administrative costs today.
ROBERTS: So the patient would only get 40 percent.
HOWARD: Yes. With an average of five years to settlement. That's now how any other country does it. And so what we proposed, a group called Common Good, that I chair, is a system special health courts which we devised for the partnership of the Harvard School of Public Health, where you have expert judges with neutral medical experts in each case, where cases would be resolved in a matter of months.
We think more people would be compensated. But the main point of this is it's reliable. So doctors can go through the day focusing on their best judgment not ordering extra tests. And defensive medicine is upwards of 10 percent of the cost. That's huge.
ROBERTS: And Dr. Grifo, what do you say to critics who say doctors just want to reduce liability and these insurance companies whose business it is to sell insurance just wants to make sure that they maximize their profits.
GRIFO: Well, the liability of premiums are passed on cost to patients. I don't pay my malpractice premiums, my patients pay it. We all pay it. We pay for it in every product in medicine. We pay for it in drugs. When you think the cost of class action suits on drugs is not passed on and the cost of medicine, is there a reason why our drugs are more expensive in the U.S. versus other parts of the world?
Yes, this system is the reason. And it needs to be fixed. Because we need to get more people health care. Without fixing the system that's not going to happen easily.
ROBERTS: Another part of the health care debate. Philip Howard, Dr. Jamie Grifo, good to talk to you this morning. Thanks for coming in. Really appreciate it.
We know that you got lots of questions about the health care reform proposals, we're trying to sort out fact and fiction and put it all together for you on-line, just head to CNN.com/healthcare. It's now 39 minutes after the hour.
New tactics to fight illegal immigration, go after the employers. We'll tell you what's happening. Coming up next. Stay with us.
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ROBERTS: The government is using a new tactic to fight illegal immigration. They are focusing less on raids surrounding thousands of undocumented workers that we saw during the previous administration.
CHETRY: And the immigration agents are targeting their bosses. Recently American apparel was the target of an investigation. Jason Carroll is here to fill us in. And you've heard this back and forth in the debate as well, go after the people that are employing the illegal immigrants, not the people trying to find work.
JASON CARROLL, CNN CORRESPONDENT: Right. That's exactly what's happening here. I mean, this new strategy is a little less confrontational. And what we actually did was we spoke to the new chief of the Immigration and Customs Enforcement Agency, spoke to them about this new strategy. What companies can expect are less raids and more audits of their employment records?
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CARROLL (voice-over): New Bedford, Massachusetts, suspected undocumented workers at the leather factory in tears after immigration and customs enforcement agents raided the workplace in March 2007. Illegal immigrants like Maria, who works at another new Bedford factory and conceals her identity constantly worried.
"MARIA," ILLEGAL IMMIGRANT (through translator): It's very frustrating to me. I came to work, to help out my family, just to struggle to get ahead.
CARROLL: Under the Bush administration's immigration policy, high profile raids focused on deporting people like Maria. Now under President Obama's watch, a push to punish those who hire people like Maria
JOHN MORTON, ASSISTANT SECRETARY OF HOMELAND SECURITY FOR ICE: We are focusing first and foremost on the employer.
CARROLL: John Morton is the new chief of U.S. Immigration and Customs Enforcement, I.C.E. for short.
MORTON: If we are going to make against sustained headway or real change, not the incremental change but the real change and for the way we address the question of illegal immigration in this country, we have to focus on the employer community.
CARROLL: Morton says they have increased audits of company's employment records issuing 655 notices to companies such as American Apparel.
(on camera): They're cheering for you.
CARROLL (voice-over): On a tour of the Los Angeles factory a few months ago, it was evident CEO Dov Charny is popular with his employees. He's outspoken on immigration reform, highly critical of those raids under the Bush administration. T-shirts he sells, legalize L.A.
DOV CHARNEY, CEO, AMERICAN APPAREL: There's a special connection that I have with employees and a special connection they have with me.
CARROLL: When we asked for comment regarding his company's audit notice, Charney declined. Conservative critics of the policy say it may not be enough.
JAMES CARAFANO, HERITAGE FOUNDATION: The notion that we're just going to focus on employers and we're going to ignore the unlawful employees, well to me that doesn't make any sense. CARROLL: To which John Morton says I.C.E. has not stopped going after illegal employees and the policy is affecting workers like Maria.
"MARIA" (through translator): There might not be the raids, immigration agency is attacking employers now and so it's really affecting us.
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CARROLL: Well, so far the new policy seems to be having its intended affect on a number of illegal immigrants like "Maria" who you just saw there. Take American Apparel, for example, about one-third of its workforce may not be in compliance. The company says it is working with the government to try to rectify the situation. What's going to happen, basically, they have 30 days to contest this audit. And if they find out they cannot meet the government's requirement, they will have to fire all these people.
But we're not seeing are the raids. We're not seeing this confrontational going in there and making the arrests. But the end result may actually end up being the same, illegal immigrants no longer working at these places.
ROBERTS: Jason Carroll, thanks so much for that. Great piece this morning.
So our Dr. Sanjay Gupta gets around. You know, sometimes he's in Atlanta, sometimes he's in New York. Well, today he's in Dublin, Ireland. He's attending a cancer conference that Lance Armstrong's LiveStrong Foundation is putting on. What health experts want to you know about cancer.
Our Dr. Sanjay Gupta ringing in on that coming up. They are trying to find a cure for this. Will we ever see one. It's 46 minutes after the hour.
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CHETRY: Good morning to you. It is a shot of New York City this morning where right now at 49 minutes past the hour, it's sunny, 71 degrees. A little bit later partly cloudy, 86 degrees for a high.
ROBERTS: Our Rob Marciano is in the weather center in Atlanta. He is tracking the extreme weather for us today. And Bill is gone, not before leaving a mark on the East Coast and a couple of deaths in his wake. What are we looking at now, Rob, in terms of Bill and what else is out there?
ROB MARCIANO, AMS METEOROLOGIST: Well, still rough seas being churned up by Bill even as it continues to race off across the North Atlantic. Here's Newfoundland, it's about 200 miles east of Cape Race. It is racing along at 43 miles an hour. And where it goes from here, it's going to be very interesting. Tropical storm right now with winds of 70 miles an hour and moving at 43 miles an hour across the North Atlantic. That means it will get to the British islands in a little over two days. So certainly impressive stuff there, look forward toward Ireland, and maybe Scotland. Later on this weekend.
All right. Speaking of international weather, how about Greece?
Athens, Greece, just outside there, and some of the suburbs getting closer now. This fire, 37,000 acres have burned. Hundreds of homes destroyed, 90 fires in total since Friday alone, 20,000 have been evacuated in the suburbs of Athens as this thing begins to burn closer to that area. They have seen a respite in the winds, but those are expected to kick up again today.
All right. Back to the U.S. we go, we are looking at some storms across the Delmarva. This is about all of the action we're seeing right now. Parts of Delaware south towards Maryland, these are racing offshore, and we'll probably not mean too much for the northeast.
A decent day for you in New York. It will be 85 degrees, 86 degrees in Atlanta, 84 in Memphis. You know, a little tinge of fall in the air this weekend, with that cool front, that push Bill out to sea, giving everybody from Chicago all the way down to New Orleans some refreshing September-like air. John and Kiran, back up to you.
ROBERTS: It looks pretty reasonable down where you are as well today, Rob.
MARCIANO: Not bad at all.
ROBERTS: All right. Thanks, Rob.
MARCIANO: You got it.
CHETRY: Still ahead, we're talking about Sanjay Gupta. He's in a big cancer conference round table taking place actually in Ireland. Health care experts say that in just a year cancer will be the leading cause of death. They want to get to the bottom of ways to prevent that from happening. It's 51 minutes past the hour.
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CHETRY: Fifty-four minutes past the hour. Lance Armstrong's cancer summit begins today in Dublin, Ireland. By next year, the disease is expected to be the number one killer across the globe. Right now, it's number two behind heart disease.
ROBERTS: It's hard to find someone who doesn't know someone who has been affected by the disease. My brother died of cancer, for instance. We're "Paging Dr. Gupta" this morning.
CNN's chief medical correspondent Dr. Sanjay Gupta is in Dublin, Ireland. He sat down with a group of leaders in the field to find out what you need to know to protect yourself.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Greetings from Dublin, Ireland. We've got a rare day of sunshine here. Pretty nice day, I'm here for the global cancer summit. Sixty-five countries represented here talking about the impact of cancer around the world. It is remarkable. Something that maybe you didn't know is that within the next year, cancer's expected to become the leading cause of death all throughout the world.
So what do health experts talk about? What are they thinking about to try and prevent that? I sat down with a group from India, from Norway, from Iraq and from the United States to try and figure that out. Take a listen.
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GUPTA (on camera): What piece of advice would you give to people at home interested in this?
DOUG ULMAN, CEO, LANCE-ARMSTRONG FOUNDATION: I think most importantly that cancer enters your body, but you cannot let it control your life. And to us that means knowledge is power. You have to educate yourself. Unity is strength. You have to have people around you to support you through this, and attitude is everything.
DR. ALA ALWAN, WORLD HEALTH ORGANIZATION: You should also exercise and be physically active, you should not engage in any activity that predisposes to sexually transmitted disease. These are the key risk factors.
GUPTA: And you can draw a line from reducing these activities and reducing cancer?
ALWAN: Oh, absolutely. I mean, as you said, one-third of all cancers is preventable. And this is the way to prevent cancers.
GUPTA: Is cancer a glimpse into the world of health care reform? Something that we've been talking so much about in the United States?
ULMAN: Yes, I think cancer is the best example or microcosm of this big debate, and obviously, in the United States, we have a very poor system and we need to make significant enhancements and improvements. And cancer gives us a great snapshot of what's happening each and every day when people are diagnosed, they're detected late.
And if they are detected, they don't have access. They're left with no hope. And if nothing else, an individual and their family diagnosed with cancer deserves to have hope.
DR. M.R. RAJAGOPAL, FOUNDER, CHAIRMAN PALLIUM INDIA: It is the duty of somebody who is healthy to lend an arm of support to somebody who is suffering. And that suffering can so easily be removed. Pain in cancer is so easily removed most of the time. Very little cost. It is just lack of the knowledge, information, and will.
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GUPTA: John and Kiran, as you hear all that, keep in mind there are 28 million people around the world that right now are battling cancer. So this is a huge interest, obviously, for lots of different people. There's a lot to be learned here in Ireland, as well. When it comes to discussions about health care reform, Europe is often used as a model. What exactly can we learn? That's what I'm talking about tomorrow.
John and Kiran, again, a beautiful day here in Dublin, Ireland. Back to you.
ROBERTS: Lovely. What a treat it would be to be there, too. Dr. Sanjay Gupta for us this morning.
Well, what about Fidel Castro? What's his health like. We haven't seen him for a long time, but there's a new video out there, same track suit, and apparently same Fidel. He's actually looking better than he did. We'll have that full story coming up for you in just a couple of minutes.
Fifty-six and a half minutes now after the hour.
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CHETRY: Welcome back to the Most News in the Morning.
Cuban TV is airing what it called recent footage of former President Fidel Castro. In it he looks fit and well rested. They say it's from over the weekend. The video shows him talking with some students from Venezuela. And as you know, there's been plenty of speculation about Castro's health since the Cuban government announced he was stepping down after needing emergency abdominal surgery in 2006.
Our Shasta Darlington is live in Havana. So tell us more about this video, why are we seeing it now? And it is the first video we've seen in a year. And you know, have they been able to authenticate that it was taken really this past weekend?
SHASTA DARLINGTON, CNN CORRESPONDENT: Well, that's a good question, Kiran. We haven't been able to authenticate it, but I can say I saw that same group of students wandering around Havana this weekend. So I feel fairly certain that it is from this weekend. But what's key here is how few videos we've seen of Fidel Castro since he fell ill.
And this is a way of not only to see him, but to hear him. And even though, we have had no rumors lately about his health, this will definitely keep any from cropping up in the near future. And what we hear is a strong voice. He seems lucid. We catch bits of conversation about global warming and other topics.
In previous videos, his voice has been weak or even covered over by music. So I think that's a very important point. Now, as to whether some people will probably speculate is Fidel Castro coming back to power, I definitely wouldn't go that far, but I think we can fairly say that the Cuban government wants to project an image of him as alive and well -- Kiran.
CHETRY: Shasta Darlington for us this morning. Thank you.
