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Sanjay Gupta MD

Health Care Legislation Challenges; Living a Healthy Life; Conquering Financial Troubles to Gain Dialysis; Examining the New School Lunch Program

Aired December 18, 2010 - 07:30   ET

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

DR. SANJAY GUPTA, HOST: Good morning. I'm Dr. Sanjay Gupta. Welcome to the program.

First up: a judge has ruled part of the Obama administration's landmark health care reform law unconstitutional. Big question for a lot of people: What does this mean for you?

And could this unlikely candidate also become the healthiest man alive? That's his goal. We'll let you in on his secret.

Plus, you know, as a dad of three, I was pretty happy about this one. It's taken 30 years, but school lunches are about to get a whole lot healthier for millions of American kids. I'll tell you how.

Let's get started.

(MUSIC)

GUPTA: A big blow to President Obama's health care reform plan, the Affordable Care Act. Late this week, a Florida federal judge heard arguments on the lawsuit filed on behalf of 20 states challenging the constitutionality of the new law.

Now, previously, two rulings found that the law was constitutional. But earlier this week, a Virginia judge struck down a key provision for one of the same reasons Florida is challenging it.

The court found it unconstitutional to require a person who doesn't already have health insurance to buy it. Now, more specifically, it ruled against the requirement that an individual must purchase health insurance or face up to $750 penalty or 2 percent of their income, whichever is greater.

Everything, as far as we can tell, stays in the law, at least for now. That includes two biggies that people always asked about. Anyone under the age of 26 will still be able to be on their parents insurance and there won't be discrimination against children with pre- existing conditions.

Big question, though, for a lot of people: How is this all going to play out? How will the new health care law affects you?

Joining me is the perfect person, I think, to talk about it, Nancy-Ann DeParle. You're director of the White House Office of Health Care Reform.

Thanks for joining us.

NANCY-ANN DEPARLE, DIRECTOR, WHITE HOUSE OFFICE OF HEALTH REFORM: Thank you. Good to be here.

GUPTA: You know, there's a lot of people, obviously, talking about this recent case in Virginia, talking specifically about the mandate. Let me ask you, I guess the question a lot of people are thinking about, if this plays out and the mandate is not part of the final plan, can the Affordable Care Act, the way it stands, can it -- can it actually be -- can it continue?

DEPARLE: We are proceeding with the limitation and we believe that in the end, the courts will uphold the validity of this law. In fact, there's one federal judge who ruled this week, but a few weeks ago, one of his colleagues in Virginia ruled the other way, and say it was constitutional.

GUPTA: Right.

DEPARLE: So, this is just working its way through the courts.

GUPTA: And no one knows how, I guess, it will all play out, obviously. But just give me an idea of just how important a part of the whole act this individual mandate is. The way it's been described by some people, you know, you think about the fact that more people will buy into insurance programs, and that it may help offset the costs for some of what the Affordable Care Act provides.

So, if the mandate isn't in place, does that threaten the rest of the act?

DEPARLE: Well, you know, if everybody has an individual responsibility to have insurance if they can afford it -- and as I said, if they can't, the government will help them afford it through tax credits. And everyone wants affordable insurance, but to get it that to work for the whole country, you have to have a big enough pull of people. That means getting all the younger healthier people into the pool as well as the people who are sick and really need insurance. So, it has to be broad and that's what this is about, it's a broad pool

GUPTA: The mandate has to be part of this.

DEPARLE: It's an important part of ensuring that we can ban this practice that insurance have had in the past by saying that if you have a pre-existing condition, you can't get insurance. That's something that you saw as a surgeon, I'm sure. You have patients coming in who might need surgery. They can't get insurance because they had a pre-existing condition.

GUPTA: Right.

DEPARLE: In order to do away with that, which most people want, this requirement that everyone who can afford it has insurance is an important piece of it.

GUPTA: You are confident that this is going to move forward. Why are you so confident thus far?

DEPARLE: I am.

GUPTA: And I mean, what is your sense of how the American people sort of feel about this?

DEPARLE: Well, you know, there's been -- we just come through a period where there's been a lot of money spent and ads run to try to convince people that they shouldn't be for this. And even with that, public opinion has remained about the same. In fact, it gets a little bit better the more people learn about the benefits in the law. So, you know, there was a lot of activity last summer. I know you reported on this where people were -- they were trying to scare seniors in saying that this hurt Medicare.

GUPTA: The polling data that we've been collecting at CNN, we've been researching this very extensively. Most recently, the question was asked: what should Congress do specifically with health reform? From November 11th through 14th -- 24 percent said leave it as is; 24 percent said change to increase government role; 49 percent repeal most major provisions and replace with completely different proposals, 4 percent had no opinion. These are numbers you are familiar with.

But let me ask you this, is -- in your office, right now, is there a plan B? If this plays out not the way you want it and the constitutionality continues to be challenged, is there a plan B?

DEPARLE: Well, we are spending full time working with the states on implementing these reforms. As you pointed out, we -- in the past few months, you know, change the landscape with rules that say no longer can insurance companies discriminate against a child who has a pre-existing condition. No longer can an insurance company rescind your policy because you made an inadvertent mistake. No longer will you have lifetime limits on your policy.

So, those things are what we are working on now. And we're turning to work with the states on setting up these exchanges so that they'll be affordable options for people who haven't been able to afford insurance before. The small business tax credits are out there; $40 billion worth of tax credits over the next two years to help small businesses afford it. That's our plan.

We feel confident the court, in the end, is going to say it's constitutional. That this law that helps provide all Americans with health insurance is the right way to go.

GUPTA: You believe this is going to go to the Supreme Court?

DEPARLE: Do I believe it's on the way to the Supreme Court?

GUPTA: Yes.

DEPARLE: Yes, I do believe that eventually the Supreme Court will have an opinion on this, yes.

GUPTA: All right. Ms. DeParle, Nancy-Ann, thanks so much for joining us. I know January is going to be a very busy month with what's happening in Florida as well. So, I hope you get some rest over the holidays. And, hopefully, we can talk to you again sometime as this conversation continues. Really appreciate it.

DEPARLE: Thank you.

GUPTA: Well, it's obviously an important decision. But as we said, two other federal judges have held the opposite ruling that the law is constitutional.

Well, CNN senior legal analyst Jeffry Toobin is here to help clear this up.

You just heard that interview with Nancy-Ann DeParle. Any reaction to that?

JEFFREY TOOBIN, CNN SENIOR LEGAL ANALYST: Well, I think the party line and the Obama administration is they expect to win. And they may win, and the courts may uphold the health care reform act as constitutional. But it is not a sure thing. The courts have changed over 20 years. Twenty years ago, I don't there's no doubt that a law like this would have been upheld.

But President Reagan and the two President Bushes have appointed a lot of judges who have conservative values. And like Judge Hudson who struck this law down, many of them regard expansion of federal power is as unconstitutional. And that attitude, sometimes, goes all the way up to the Supreme Court.

GUPTA: Correct me if I'm wrong. You mentioned party lines. So, along those lines, has this been ideological? If you look at the two judges so far that found this constitutional and the one that found it unconstitutional, what is the ideology here?

TOOBIN: You know, in the sad but true category, the partisanship that we see every day in Congress and in the fights for f the White House exist in the judiciary as well. As you point out, the two judges who upheld the law were Clinton appointees. The one judge, Judge Hudson, who struck it down this week, he was a George W. Bush appointee.

By and large, the politics of the president are reflected in the judicial appointments, and there are different views of this law depending on your political perspective. It's just a fact.

GUPTA: And, real quick, I mean, you wrote a whole book about this, but the Supreme Court, I'm curious what the Anthony Kennedy's holidays are going to be? Do you have any predictions? I say that because it seems like he's going to be such an important voice in this.

TOOBIN: You know, Sanjay, it is a very good time to be Anthony Kennedy because there are four very conservative votes on the court, four pretty liberal votes on the court. And Kennedy, who sometimes votes with the liberals, mostly with the conservatives, just wields enormous power. My guess today is that he will be the deciding vote in this as well.

What will he do? If I had to bet today, I would say he would uphold the law. But not -- that's not a bet made with a lot of confidence. And I think we also have to see how this appeal plays out in the lower courts before we make a prediction. And if I'm wrong, I'll deny having made it.

GUPTA: All right. Although we do have it on tape.

Jeffry Toobin, thanks so much. Really appreciate you being on the show, thanks.

TOOBIN: See you, Sanjay.

GUPTA: Of course, all of what we're just discussing right now is about real patients like a 16-year-old, for example, fighting an uphill battle right now since he was born. His mom losing 30 pounds to try and help save his life and now, an unlikely friend who got in on the fight as well. We'll tell you about it. That's next.

(COMMERCIAL BREAK)

GUPTA: Today, as we always do around this time, we want to introduce you to some ordinary people who are doing extraordinary things. A 16-year-old who's been living with a life-threatening illness, his mom and a friend he met while he was sick, who's now trying to help him.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's 5:30 in the morning, and Kiwane Clay is arriving at the hospital for his dialysis. The 16-year-old has been fighting an uphill battle with his kidneys since he was born.

(on camera): He needs a kidney transplant?

KEIONNE CLAY, KIWANE'S MOTHER: Yes, I lost 30 pounds so I could give him a kidney.

GUPTA (voice-over): Like most moms, she wants to do everything she can for her son. But just paying for treatment is a real struggle.

KEIONNE CLAY: Just doing what I have to do for my son. And I have been doing it for 16 years. So, I figure that I'm a good mom.

GUPTA (on camera): Financially, how hard has it been on your family?

KIWANE CLAY, 16-YEAR-OLD: Really hard.

GUPTA: This is the sort of physical, emotional and financial hardship that -- he's 16 years old. This is what he's had to overcome. But he was about to get help from a pretty unusual source, his friend Kyle over here.

Good morning, Kyle. Fourteen years old. Have a seat.

How do you guys know each other?

KYLE COBB, KIWANE'S FRIEND: I met Kiwane in dialysis clinic.

GUPTA: So, you're a regular as well?

COBB: Right. I was also on this machine as he was, for about three hours Monday, Wednesday and Friday.

GUPTA (voice-over): Kyle Cobb looks like any healthy teenager. But it wasn't always the case. In 2009, Kyle's kidney's failed and it took months of dialysis and a new kidney to save him. Kyle never forgot his friend Kiwane.

(on camera): What made you decide that after all that you've been through, that you wanted to give something back?

COBB: I just want to help him any way I can. It just gives me a sense of joy to make me think that I'm thinking outside of myself for once in life. And just to help someone else is a blessing to me, also.

GUPTA: So far, Kyle has raised $3,100 for Kiwane and his family with some help from the local motorcycle club.

KEIONNE CLAY: It helped with what Kiwane needs.

GUPTA (on camera): He didn't -- he didn't really get a Christmas last year?

KEIONNE CLAY: No.

GUPTA: He's going to get a Christmas this year?

KEIONNE CLAY: Yes.

GUPTA (voice-over): Kiwane continues his fight with Kyle by his side -- both agreeing that a kidney would be the best gift of all.

(END VIDEOTAPE)

GUPTA: They are just -- they're good kids. And, you know, I got to tell you, while reporting on these two teenagers fight with kidney failure, it's also reminded of the human bond forged by shared experiences. They hope every day together for Kiwane's transplant.

Now, he jokes about it a year ago. He was 300 pounds and his hair was falling out. So, how could he possibly become the healthiest human being alive? We're going to tell you, his secrets, his tips, and what he's doing to get there.

Stay with SGMD.

(COMMERCIAL BREAK)

GUPTA: Welcome back to SGMD.

Does Morgan Spurlock ring a bell? Remember he's the guy who wrote "Super Size Me." He ate every meal at McDonald's for a whole month to see what would happen, how unhealthy he could possibly become.

Well, A.J. Jacobs, who you're about to meet, for him, it's just the opposite. For his last book, he tried to follow literally every rule in the Bible. His new project: follow every piece of good health advice, big and small. His goal? To become the healthiest person in the world.

(BEGIN VIDEOTAPE)

A.J. JACOBS, AUTHOR, "THE YEAR OF LIVING BIBLICALLY": I was never super fat, but I was skinny fat. You know, that where you're skinny, but you have a potbelly, which is the least healthy kind of fat. I didn't pay attention to my body for the first 40 years of my life. I just thought it was a sort of a container to hold my brain. So, this is a radical change.

I subscribed to a movement called chewdism. The more chewing, the better, because it's healthier. You'll get more nutrients, but more important, it's slows down your eating so you don't overeat.

This guy said that you should chew 50 to 100 times per mouthful to get all of the nutrients. So, that's kind of insane because I tried that for a week and it takes like an hour and a half to eat an apple. So, that I don't recommend.

But I'm reformed chewdist. That's right, I'm a reformed chewdist. I chew maybe 15, 20 times.

Another thing I like to do, run errands. Literally, run errands.

I think in America, a lot of us, we compartmentalize it. So, we go to the gym for half hour and an hour, and then we sit on our butts for the 23 other hours. That is not healthy at all.

So, I've tried to incorporate moving into every single part of my life.

Why walk when you can run? I literally run errands. So, I run to the drug store, buy toothpaste and toothbrush and then run home.

This is my treadmill desk. I walk and work at the same time. Because studies show that you should not be sitting on your butt all day. It's terrible for your health. And people say: can you do that? How does that work?

I actually am more efficient when I do this because I'm not tempted to go straying, wandering around, getting a snack, bothering my wife. So, I basically just stacked a bunch of boxes up, and I put my laptop on top, and it works fantastically. I'm like a human guinea pig. I have tried every diet I can find, raw food, I've done Mediterranean diet. I met with guys who believe in calorie restriction, extreme calorie restriction.

If you are on the edge of starvation, you're going to live a lot of longer. Studies of monkeys and rats show this. So, I had dinner with them. Our dinner was the appetizer was a blueberry, and for the main course, we went crazy and had a walnut. So, that's the kind of thing I'm doing.

(END VIDEOTAPE)

GUPTA: Well, coming up, what's the one thing he misses most? What's the first thing he's going to do when this is all over?

Stay with SGMD.

(COMMERCIAL BREAK)

GUPTA: Welcome back. We've got more now from author A.J. Jacobs. Tongue only half in cheek. What he's doing in his quest to be the healthiest person in the world.

(BEGIN VIDEOTAPE)

JACOBS: When I go to a restaurant, I basically drive the wait staff crazy. Because -- can it be steamed, no sauce? Unlike when "Harry Met Sally," I'm basically like Sally.

(BEGIN VIDEO CLIP, CASTLE ROCK ENTERTAINMENT)

MEG RYAN, ACTRESS: But I'd like the pie heated. And I don't want the ice cream on top. I want them on the side. And I'd like strawberry instead of vanilla, if you have it. If not, then no ice cream, just whipped cream, but only if it's real; if it's out of a can, then nothing.

(END VIDEO CLIP)

JACOBS: Noise is a huge health hazard. We don't think about it. It's one of the most underrated health hazards. But it's terrible for you. It's bad for your stress levels and it's -- it's bad for your hearing, of course.

So, I actually -- I wear these all the time. So, I won't wear them for the interview, but I love them because it's healthier. I have a collection of ear plugs and I've got these beautiful noise- canceling earphones, I really recommend them.

I think people worry about the wrong things. I mean, we spend time worrying about things like shark attacks. That's insane. Ten times more people are killed by hot water attack in their home than by sharks.

I've read statistics that more people are killed by falling coconuts than by sharks. Sadly, I'm not sure that that is 100 percent accurate. But listen, don't sit under a palm tree. That's the takeaway.

Having dogs is actually really good for your health. Lowers the blood pressure, it cuts down on your stress hormones. So, I try to -- try to pet my dogs -- actually, it's not my dog.

I've been at this for about a year. It was supposed to be a year, but it's taken a little longer. I keep telling my publisher: stress is one of the worst things for your health. So, please don't bring up the deadline. I've still got a lot to do.

Actually, ideally, there are things to be totally healthy. I would like to win an Oscar because there are studies that show that Oscar winners live longer. I want to go -- move to Okinawa. That's going to cause some stress to the wife.

I have to become a woman. Women are actually healthier, longer live than men. So, there are some things that might present a challenge. But I'm going to try in the last five months.

What do you think of that? Interesting?

Some of it is about joy because you've got to be healthy. You've got to embrace these things with joy. So, it can't all be living like a monk.

But one thing that I am desperate to have again is pizza. It just kills me. So, I can't wait for that. I'm just going to -- I'm going to put it all over my face like my kids. I'm going to take a bath in pizza. I can't wait.

(END VIDEOTAPE)

GUPTA: All right, A.J., good luck with that. I wonder, A.J., how many times you chewed your food when you were back in school, school lunches, or even what you ate back then.

Well, school lunches are about to get a lot healthier for millions of American kids, A.J. This was the first major change in 30 years. Everyone should pay attention.

We'll give you the breakdown. That's next.

(COMMERCIAL BREAK)

GUPTA: Welcome back to SGMD.

You know, as a father, I was pretty happy to hear this next big of news. School lunches are about to get healthier for millions of American kids. It's really the first major change to school lunch standards in 30 years. Think about that.

President Obama signed a major child nutrition bill into law this week. And there is money attached to it if certain guidelines are met.

Breaking it down -- the bill's focus really is to improve nutrition and reduce childhood obesity in the United States. Something we talk about all the time.

Couple of broad points that we pulled out of this: you're going to provide healthier meals. You're going to start kids' nutrition programs and also buy more locally grown foods for school cafeterias. And also, sometimes, even get school gardens going. Also, provide meals for low-income children.

It's also going to look at these vending machine issues, going to provide healthier snack choices in those school vending machines.

Let me give you a little bit more of a breakdown. Among the new requirements specifically is looking at what the kids are eating. They want to have more of this, more fruits, more vegetables, more whole grains, more low-fat dairy. In broad terms, that's what they want. They have specific serving sizes they're going to include.

They want less of this: sodium, sugar, and fat. No surprise there.

We want to give you a better idea of what it would mean for the average kid, for example. Let me show you this -- a school lunch as things sort of stand now, pretty the typical. This comes right a menu. Cheese pizza, as you see, canned pineapple, Tater Tots with catsup, low fat chocolate milk.

If you have this menu as a result of the act, you're going to see this, school lunch afterwards: whole wheat cheese pizza, baked sweet potato fries, grape tomatoes, raw, apple sauce, low-fat milk, and also low-fat ranch dip.

So, that gives you a little bit of an idea of what might happen when this nutrition act is up and running. The USDA incidentally is going to plan on working with states locally as well as school districts and neighborhoods to implement all of these various provisions of the bill.

And if you miss any part of today's show, be sure to check out my podcast, CNN.com/podcasting.

As always, thanks for watching. I'm Dr. Sanjay Gupta.

More news on CNN starts right now.