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Sanjay Gupta MD

"Romneycare" Checkup; Interview with Massachusetts Governor Deval Patrick; New Age Baby Making

Aired March 03, 2012 - 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.

With Super Tuesday coming up, Mitt Romney obviously would like to secure his lead in the Republican presidential race. But there's a flash point that we're going to be looking at throughout this year on this show -- and that's his record as Massachusetts governor, especially with regard to the signing of the law that's brought health care to nearly everyone in his state of Massachusetts.

We know that it expanded the government's safety net and put new requirements on businesses and individuals. If that sounds familiar, it's because many call it the model for Obamacare. Although Romney himself says he'd repeal the federal law and let each state find its own solution.

Now, the Supreme Court is going to hear a case this month on whether the federal law is, in fact, constitutional. But if it takes full effect as scheduled in 2014, you might get a sense of how the law might change things if you look at Massachusetts, and you could do a lot worse, and to see how things have gone there.

Take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): In her mid-20s, Jaclyn Michalos was working in her parents' restaurant. Like a lot of people her age, she didn't think she really needed health insurance. It was too expensive anyway.

JACLYN MICHALOS, BREAST CANCER SURVIVOR: It was almost $700 a month and I couldn't afford that. So then I said, you know, I'm going to have to go without it.

GUPTA: But in 2006, Governor Mitt Romney put his name on a health care law. And faced with a state requirement to carry insurance or face a fine, Jaclyn signed up.

(on camera): How much did it cost you?

MICHALOS: No money.

GUPTA: So you didn't have to pay anything?

MICHALOS: No. GUPTA (voice-over): She was worried about a lump in her breast. And now, she could afford the doctor. She could afford testing. So, she went.

And they found something pretty frightening: invasive breast cancer.

MICHALOS: I was really devastated to know, because at 27 years old, it doesn't run in your family or anything. And, you know, you just -- your whole life feels like it's crumbling on you.

GUPTA (on camera): You cry?

MICHALOS: You cry, yes. You say, why me, then get over it and then you try to move forward in a positive outlook.

GUPTA (voice-over): She was fortunate. And with her new insurance, she could afford treatment. She believes it saved her life.

UNIDENTIFIED MALE: Hey. How are you?

GUPTA: Since the law passed, the state says Massachusetts went from 90 percent of the population covered by insurance to around 98 percent. A big success.

But it also brought some big headaches.

(on camera): All told, the new law meant insurance coverage for more than 400,000 people - people like Jaclyn. But in order to do that, the money had to come from somewhere. And that somewhere was big hospitals that for years and years, they had been taking care of the poorest patients with some of the biggest problems.

Nobody is turned away?

KATE WALSH, PRESIDENT & CEO, BOSTON MEDICAL CENTER: Nobody is turned away.

GUPTA (voice-over): In 2009, Boston Medical Center sued the state, saying the cuts in direct states funding could push them out of business. But the state has since restored some of that money. And for now, there's a truce.

WALSH: The state made a compact five years ago to provide access for all. We figured out how to provide the services. And now, we're working on ways to pay for them and to reform the system and transform it in a way so that we can continue to honor that deal.

GUPTA: And that hasn't been the only bump in the road.

(on camera): By getting almost everyone covered sounds great, but believe it or not, there is a downside. When you get insurance, you want to go see a doctor. The problem here is in Massachusetts, as with many states, simply not enough doctors to go around.

(voice-over): Dr. Somova Stout works with a network of 15 clinics and three hospitals. With a flood of new patients, she says they had to get creative.

DR. SOMOVA STOUT, CAMBRIDGE HEALTH ALLIANCE: So it's not a doctor alone trying to take care of patients. There's a medical assistant, a nurse, a care manager, sometimes a patient navigator, a pharmacist, other people, a receptionist, all of whom see themselves not as staff people but as caregivers to patients.

GUPTA: But for all the growing pains, nearly two-thirds of the people in Massachusetts support the law. As for the cost of medical care, it's gone up, but no faster than the rest of the country.

MIT economist Jonathan Gruber helped design the plan and he went on to help design the national health care law as well.

JONATHAN GRUBER, ECONOMICS PROFESSOR, MIT: I think that people wish health insurance was cheaper. And I think a misunderstanding of our reform is that it wasn't about lowering the cost of health insurance, that wasn't really the goal.

For people with employer insurance, which is most people, it was about fixing the insurance market for people without employer insurance. For those people, prices have fallen by about 50 percent.

GUPTA: Of course, it's hard to put a price on some things.

MICHALOS: It will be five years this July.

GUPTA: Jaclyn beat cancer and she's healthy now, back at work. And, she's in love with this guy, Craig. They are getting married next month.

(END VIDEOTAPE)

GUPTA: And joining me now from Boston, Massachusetts, is Governor Deval Patrick. Now, he came into office when Mitt Romney left, as you know, and he's overseen this whole process for the past five years.

Thanks for joining us, Governor. I really appreciate your time.

There's a lot of questions about this --

GOV. DEVAL PATRICK (D), MASSACHUSETTS: It's great to be with you. Thank you.

GUPTA: Thank you.

So many questions about this and people from around the country are now sort of digging in.

Let me start off by asking this. You know Jaclyn Michalos, who people just met in that piece there.

PATRICK: I do.

GUPTA: How many people got covered like her because of the individual mandate? Are you able to put a number on that? PATRICK: Well, we have a 43 percent increase in the number of people with insurance today, Sanjay, because of the health reform in Massachusetts. We're up to over 98 percent of our residents with health insurance, 99.8 percent of children. I don't think any other state can touch that.

And I love that you bring up Jaclyn's story because, really, policy only matters at the point where it touches people. And you can see that it's had a very profound touch in her life and in the lives of so many other of our residents. It's one of the reasons why I think it's so popular here.

GUPTA: Four out of five newly insured, roughly, are getting government health coverage. They are either subsidized or paid in entirety. You made the safety net bigger, or plan made the safety bigger -- which is great, but expensive.

Are you able to continue down that path in Massachusetts without, you know, breaking the bank?

PATRICK: Sure. In fact, you know, our system here, like the system at the national level under the Affordable Care Act is a hybrid system. It almost emphasizes private insurance purchased in the private sector. The expansion has added 1 percent to state spending.

The biggest challenge for us is a challenge that is national, and that is the fact that premiums go up as fast they do year after year. And that's the next big chapter. And we're going to crack that code. And, in fact, it made a lot of progress.

We had premium increases averaging nearly 17 percent or 18 percent two years ago. They are less than 2 percent today. And they are going down. So, we are making great progress there as well.

GUPTA: Yes, a lot of people paying attention to the increase in premiums. I mean, they hear you talk and look at their bills and see how their premiums have gone up, even over the last year. You made the point earlier and we checked into this about how popular this plan is in Massachusetts.

And it does appear to be very popular, but you also know that it's controversial in many other places around the country. I mean, "USA Today" had a story this week which said that the Affordable Care Act is, in fact, hurting the president politically in key states. If that is true, why is there a disconnect? How can it be so popular in Massachusetts and sort of a national version of it so unpopular?

PATRICK: Well, I think -- I think there's been -- you know, a concerted effort by one side to distort where the Affordable Care Act is about, and, frankly, a weak effort on our side to talk about the many, many benefits. I mean, there are millions of young people who are younger than 26 who get to stay on their parent's health insurance today and have that security. You can't be thrown of your insurance when you need it most when you become very sick. People aren't going to go bankrupt anymore if they have a serious illness, which was a serious issue here in the country before the Affordable Care Act. And, in fact, the expense of expanding health care for those who need the subsidy is picked up by the federal government for most of the early years. So --

GUPTA: You've heard former Governor Romney speak quite a bit on the campaign trail. And politics is politics. No one knows this better than you.

But one of the common refrains is: repeal Obamacare. That's what you keep hearing from him.

Massachusetts and the Affordable Care Act have pretty similar laws. What do you think of what former Governor Romney is saying?

PATRICK: Well, it amazing me that the governor who has always been a gentleman to me, by the way, would run away from something that's done so much good for so many people. What has happened here in Massachusetts is now happening across the country and in a very, very positive way.

GUPTA: Governor, thanks so much for speaking with us. I have a feeling this is going to come up again this year. You probably feel the same way. Hopefully, we can talk again.

PATRICK: That would be great. Thank you, Sanjay. Take care.

GUPTA: And up next, under the microscope, baby quest. We got some help out there for couples who may have trouble conceiving.

(COMMERCIAL BREAK)

GUPTA: Under the microscope this morning, infertility. It can be an emotional and exhausting experience for women and men alike. Now, while sperm donation has been around since the 1960s, surrogacy and egg donation are relatively new.

So, this morning, I want to share with you one couple story as they struggle with something known as secondary infertility. That means the inability to carry a pregnancy to term even though they've had one or more children.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Michelle and Mike Herring now have the family they always wanted. But it wasn't easy.

At 30, she had to use hormone therapy to get pregnant. The result was their son Levi who's now seven years old.

Two years later, they again had a hard time conceiving a second child so they tried hormone therapy and IVF, in vitro fertilization.

MICHELLE HERRING, FERTILITY PATIENT: By the third time, I sort of knew, OK, yes it was becoming -- it was stressful.

GUPTA: But after rounds of unsuccessful treatments, she learned she had premature ovarian failure. She couldn't produce any viable eggs, so she chose to use an egg donor. And May was born.

MICHELLE HERRING: It was just an emotionally taxing journey. I knew that one day I would look back and forget the struggle and -- and I did. I mean, it's hard for me to think about it now, but -- you know, I mean, we have a wonderful family. And I can't imagine it being any other way.

GUPTA: The decision to use sperm or egg donation is a personal one. Embryologist Dr. Peter Nagy says it's often the best solution since donor egg and sperm can offer higher success rates.

DR. PETER NAGY, EMBRYOLOGIST: The donor actually are coming from women who are donating and those women are typically somewhere around 21 to 28, 29.

GUPTA (on camera): So, a 40-year-old woman says I'm not making eggs, good quality eggs anymore, so I'll take a donor egg from a 25- year- old woman. Have that 25-year-old woman's genetic material --

NAGY: Correct.

GUPTA: -- and you combine it with sperm from --

NAGY: From her husband --

GUPTA: -- from her husband or that person's partner.

Is this something that happens a lot?

NAGY: Sure, oh, yes. Absolutely. Here in the United States, about 10 percent to 15 percent of all IVF cycles, is cycles involving egg donation. Yes.

GUPTA: Reproductive Specialist Dr. Mitchell-Leef says more and more families are choosing this route to have a family.

DR. DOROTHY MITCHELL-LEEF, REPRODUCTIVE SPECIALIST: They have a baby picture they can choose from and they also know most of their background history, whether -- what their genetic makeup is, their interests, maybe their education.

GUPTA: They get to chose their eggs?

MITCHELL-LEEF: And they get to chose them, yes.

GUPTA: How much does that process cost?

MITCHELL-LEEF: It is $16,500 and that includes everything.

GUPTA: If a woman in her mid-40s is pregnant, has a baby, is it -- is it almost assumed that that woman had an egg donor?

MITCHELL-LEEF: I think I had five women overall in 30 years that got a pregnancy at 45 with their own eggs. That's not a lot.

GUPTA: Michelle and Mike say they plan to share their conception stories with both of their children.

MICHELLE HERRING: It needs to be OK to -- and not be looked at as some weird thing, to use alternate method, non-traditional ways to have a family.

MIKE HERRING, HUSBAND OF FERTILITY PATIENT: If we're describing it in 10 years, hopefully it's like describing, you know, a visit to the doctor, that it's become so prevalent that the stigma is gone so that'll help too. It's just -- it's nothing we've worried about.

(END VIDEOTAPE)

GUPTA: I tell you, doctors we met with say they have been able to achieve a 66 percent pregnancy rate with eggs. It's about the same as fresh cycles they were doing before.

Something else I want to point out as well, with fertility issues, we seem to hear mostly about women. But consider this reality. And half of all couples having trouble conceiving, the man is, in fact, traced to the man.

I want to share with you the story of one man was told he would never father a child but he simply refused to take no for an answer.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Steven and Lindsay Averett always dreamed of becoming parents.

STEVE AVERETT, DIAGNOSED AS INFERTILE: We both knew we wanted to have kids right from the get-go. That was important to both of us.

GUPTA: They got married, bought a house in a good school district and eventually started trying for a family. Lindsay was in her 20s and totally healthy. Yet, after nearly a year, they hadn't gotten pregnant.

LINDSAY AVERETT, HUSBAND DIAGNOSED AS INFERTILE: It honestly never crossed my mind for 11 of those 12 months that it would be a male issue. But finally, you know, I said, well, maybe you should go to the doctor.

GUPTA: Urologist and reproductive specialist, Dr. Michael Witt, says male infertility is a more common problem than couples may realize.

(on camera): One of the first things is figuring out how big a problem male infertility problem is? How big is it?

DR. MICHAEL WITT, UROLOGIST & REPRODUCTIVE SPECIALIST: It probably affects 12 percent of the men in general. Though all couples who struggle with infertility, probably in half of those, there's probably a male contribution.

GUPTA (voice-over): It could be caused by a myriad of factors -- genetics, irregular chromosomes, obesity, drug abuse, even smoking. For some men, infertility is the result of something as simple as an undetected cluster of veins.

(on camera): When someone has a varicose seal, a cluster of veins, how is that making a man infertile?

WITT: Yes, it's just like a varicose vein in your leg, except it's around your testicle. You can fix it. It's a simple occlusion technique. In about 80 percent of cases, you get improved production and essentially enhanced fertility rates of about 60 percent, 70 percent.

GUPTA: A lot of people probably don't know that. But if that's the problem, it's a pretty high likelihood it can be treated and restore fertility.

GUPTA (voice-over): Like a varicose seal, infertility caused by obesity, drug use and smoking can also be reversed in many men. In even more complicated cases, like Steven Averett's, a diagnosis of male infertility is not necessarily the final word.

When he went to see his doctor, Steven was given devastating news.

STEVEN AVERETT: I walked in the office. He said, you have cancer in the left testicle. You probably -- you may have it in the right testicle, you'll almost certainly never father children.

GUPTA: For five years, Steven fought to save his life and his fertility. He froze sperm, had surgery to remove a testicle, underwent chemotherapy and went through an additional sperm extraction, all in the hopes of someday becoming a dad.

STEVEN AVERETT: You try to visualize it and you try to, you know, you try to will to happen. And it's, you know, at some point it feels out of your control.

GUPTA: Using Steven's extracted sperm and Lindsey's eggs, embryologists were able to create embryo that the couple used during an IVF cycle. Today, Steven is cancer free and he and his wife are 33 weeks pregnant with twin boys.

STEVE AVERETT: Just to see her belly growing and, you know, it's cliche of it seeing those heart beats in the ultrasound is just, it blows your mind. You're just like, I can't believe they are in there.

(END VIDEOTAPE)

GUPTA: Part of the reason they told us that story is because Steve, in particular, hopes other men will hear it and realize for male infertility patients like him, there's some hope out there. Good luck with the baby.

Up next, a tough, but interesting question. Do you, in fact, own your own DNA? At least one court has ruled that you actually don't. Well, now, that case is going to go to the Supreme Court. I'm going to tell you what it all means.

Stay with us. (COMMERCIAL BREAK)

GUPTA: You know, you may not realize this and it's a pretty stunning thing to think about, but of the nearly 28,000 genes in the human genome, as things stand now, more than a third are patented by universities and pharmaceutical companies, including genes that might tell you if you have an increase risk of cancer.

It's controversial, to be sure. And many people believe that the Supreme Court is going to weigh in on this. But here is to discussion just what it means for all of us, you, as well, is Dr. Valerie Montgomery Rice. She's dean of the Morehouse School of Medicine.

Good to see you back.

DR. VALERIE MONTGOMERY-RICE, MOREHOUSE SCHOOL OF MEDICINE: Nice to see you.

GUPTA: Thank you for coming.

MONTGOMERY-RICE: Yes.

GUPTA: You know, it is interesting. We talked about the BRCA, breast cancer 1 and 2 genes the last time you were on the program. These genes can tell if you've an increased risk of breast cancer, but they are patented by a pharmaceutical company known as Myriad.

First of all, I mean, how does some like that happen? And what does that mean that it's patented?

MONTGOMERY-RICE: Well, what it means that it's patented is that they have actually isolated what we call the DNA sequence of that gene and they have patented that because it was unique, based on the laws of the patent at that time.

GUPTA: So it's genetic material, but it's essentially owned by this company now?

MONTGOMERY-RICE: Well, it's not that they own our genes. What it is, is that they own the sequence, the knowledge that goes with the sequence of what we described as the DNA base pairs. So they own the order of those sequences, the knowledge that goes with that.

They don't actually own the genes.

GUPTA: They own the sequence.

MONTGOMERY-RICE: Right.

GUPTA: And the knowledge that went into creating that sequence.

MONTGOMERY-RICE: Correct.

GUPTA: So what does that mean? A lot of women out there say, wait a second, I want to get that genetic testing. What does this patent mean for them? MONTGOMERY-RICE: What this patent means for them, that company, that pharmaceutical company is the one who has the exclusive rights to do the testing and sometimes they also have the exclusive rights for the methodology that goes with the testing. And so, we really, in many cases, limit the ability of some women, if they can't afford to pay for that test, the ability to acquire that testing.

GUPTA: If somebody has a patent, it probably means it will be more expensive for an individual woman. But what do you think of this? I mean, this is an area of expertise for you. Is this a good idea?

MONTGOMERY-RICE: Well, I think that patent technology is a good idea, because I know that that investment that went into patent, that was what fueled that innovation. As a scientist, I know that, you know, research costs. And I -- when I'm doing my research, I look for investors, whether that's the NIH, the National Institutes of Health, or a pharmaceutical company.

And I know they also expect a return on investment. But I also know when I'm sitting across the from that patient and I'm getting her history, and I understand her risk profile for a certain disease, I want her to be able to have access to that test the it's available. And I don't want anything standing in the way of that.

What I think we got to do, Sanjay, is have a balance between the innovation of discovery and then also a balance between making these tests available to people, at an affordable cost.

GUPTA: And we're talking about this with respect to this particular issue, but what you just said, I think, could apply to science overall. Fascinating stuff. Thanks for being back. I always learn something when you're on the show.

MONTGOMERY-RICE: Thanks for having me. I appreciate it.

GUPTA: All right. Thanks so much, Dr. Rice.

Still ahead, chasing life through 100. I got a tip for you that I follow myself. It's called Hara Hachi bu. I'll explain.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: And we are back with SGMD. Something I want you to remember, Hara Hachi Bu. It's part of how you chase life to 100. And it's something that I learned from the people on the Japanese island of Okinawa back in 2008.

What it means basically is don't overstuff yourself. You know, they push their plates away when they're only 80 percent full. It makes a lot of sense. I've been doing this for years now especially when it comes to my own personal vice, ice cream. Push that plate away, everything in moderation.

That's got to wrap things up for SGMD this morning. You can follow me at CNN.com/Sanjay or on Twitter @SanjayGuptaCNN. You can get a sneak peek at next week's show. We're going to have a closer look at Alzheimer's. It's the sixth leading cause of death in the United States and it's the only cause of death among the top 10 that can't be prevented, cured or hardly even slowed down.

Make an appointment, come back and see us next Saturday and Sunday, 7:30 a.m. Eastern.

Time now, though, to get you a check off your top stories in the "CNN NEWSROOM."