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Sanjay Gupta MD

"How To Survive A Plague"; The Secrets Of Happy Families; How Kids Can Feel More Confident In Their Bodies; How Sequestration Could Affect Health

Aired February 23, 2013 - 16:30   ET

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

DR. SANJAY GUPTA, CNN HOST: Hello, and thanks for joining us.

A lot to discuss today, including the Oscar nominated film "How to Survive a Plague." It's a documentary about a controversial time in our country's history, the early days of the AIDS epidemic. The filmmaker is going to stop by.

Also, the secrets of happy families. How to improve your mornings, rethink family dinner. Even how to fight smarter.

Plus, how we can all raise our kids to feel more confident about their bodies.

But first, it's the biggest buzz in Washington, these forced spending cuts less than a week from taking effect now. And today, we're going to share what we have investigated, some potential real consequences for your health.

The CDC, first of all, they expect to face projected cuts of just over $300 million. What does that mean? Fewer people potentially working on the front lines of any epidemics. Fewer immunizations as we learned as well affecting 30,000 children, but also 20,000 adults. The infectious diseases, they may not be tracked as well around the world, and that could put the U.S. more at risk.

We also estimate the Food and Drug Administration, the FDA, they could lose around $200 million and $250 million. The White House says that means up to 2,100 fewer food inspections would occur every year. Remember those food outbreaks?

And one FDA official we spoke to says the loss could also mean delayed approvals of new medications and new medical devices. Things would move even slower.

Lastly, the NIH, National Institutes of Health, expects $1.5 billion in cuts. Now, keep in mind, the NIH, this is the place where chemotherapy was used for the first time, where blood was made safe to transfuse, where the genetic code was literally cracked.

In fact, take a listen to what Francis Collins, director of the NIH, had to say.

(BEGIN VIDEO CLIP) DR. FRANCIS COLLINS, DIRECTOR, NATIONAL INSTITUTES OF HEALTH: That translates into hundreds of grants that would have been funded in this fiscal year that simply will not get paid. The way in which the sequester hits NIH is that each one of our 27 institutes and centers has to take an equivalent cut of 5.1 percent.

So that means this will hit cancer, it will hit heart disease. It will hit diabetes. It will hit HIV/AIDS. It will hit Alzheimer's. It will hit all of those areas.

(END VIDEO CLIP)

GUPTA: That is just about all of medicine.

And joining me to talk more about this are two CNN experts, and all things Beltway and economics, Jake Tapper and Ali Velshi.

Thanks for -- thanks for joining us.

You know, you hear Francis Collin talk. Obviously, it's very concerning.

Ali, let me start with you. What happened to cause this?

ALI VELSHI, CNN CHIEF BUSINESS CORRESPONDENT: Yes, for once I'm going to use a colloquialism that actually fits. This is a poison pill. The sequester, forced budget cuts were something the government imposed upon itself to say if you don't take action to deal with the deficits and the debt, the consequence is going to be something so bitter that you're not going to want to swallow it.

And guess what? This is the bitter -- the idea that there are across the board cuts.

Now, there are many Americans who justifiably, Sanjay, think that we've got to get our spending under control. The problem with these forced budget cuts is that they are ham-fisted. They are -- they are using a sledgehammer where you need a stiletto.

Some of the things you described that are going to be cut are not the things that we should be cutting. There are probably other places we can cut.

And keep in mind, only a very small portion of the federal budget is what you call discretionary. The things you can cut. Everything else is mandatory, and most of that isn't going to get affected.

So, even though the cuts are -- don't seem that big, they're all out of a smaller portion of the budget. So everybody is going to feel this. There are going to be jobs lost --

GUPTA: Yes.

VELSHI: -- in addition to all of the things you've just described.

GUPTA: I want to talk about the job loss.

But, Jake, let me ask, obviously, I approach this from a health angle. Is this real money that we're talking about? Because those are big numbers, certainly, in the health world. If you think about $1.5 billion in the NIH, that hurts. Is that real money, or how much is of this is political posturing, do you think?

JAKE TAPPER, CNN WASHINGTON CORRESPONDENT: It is real money. And as Ali described, I mean, this was supposed to have forced Congress to have come up with smart budget cuts. The idea was to make something that was so unpalatable, liberals would not want these drastic cuts to the NIH budget or any social welfare programs. Conservatives would not want these drastic cuts to the national security budget. That was the idea to force them to actually do something smart.

But instead, we find ourselves in a situation where there is still not the will to act, and there are those on the left who look at these defense cuts and say, well, this is actually a good way to get some money out of the Pentagon budget and those on the right who are saying the same when it comes to general domestic spending. And, ultimately, it is easier to have inertia in Washington than to have courage.

GUPTA: You know, Ali, it seems like reasonable you've been trying to give some good news lately about where things were headed. And now we talk about a 2 percent cut --

VELSHI: Yes.

GUPTA: -- to Medicare specifically over the next eight years. You have talked a lot about this. But what is the impact on jobs? I heard 66,000 physicians, hundreds of thousands of other health care people.

VELSHI: Yes.

GUPTA: What are you hearing specifically?

VELSHI: A number of the associations, the lobby groups, the National Medical Association, the National Hospital Association, the National Nurses Association, have come up with some numbers.

And they're saying over the course of these forced budget cuts, it could end up being three quarters of 1 million jobs. And this is in an area, health care, which, as you know, has been growing. It's one of the bright spots, one of the things people train into in so many different levels. It's a ladder profession.

So it would be devastating to see that degree of cuts, not just in the services that we're not going to get that you so effectively described. But in the jobs that are not going to be there. Remember that every one of these jobs lost means somebody who may fall on to government assistance, thereby costing the economy more money.

So look, here's the important part, Sanjay. Cuts probably need to happen. These are not -- these are not the right cuts. These were not meant to be the thing that was supposed to solve the problem. This was supposed to be the thing that Congress avoided at all costs.

So if these cuts go through, it will eviscerate a good part of medical services and that 2 percent going to Medicare. There's not a lot that's been cut to entitlements, but Medicare is going to take that cut.

GUPTA: It is pretty remarkable to think about the impact.

And, Jake, I think this is a sentiment that, look, they're going to figure it out. This can't possibly really be happening. We've seen this before, even, as recently as last year. Jake, what do you say to people who say that to you?

TAPPER: Well, I never have a lot of confidence in Washington's ability to get its house in order. This was, remember, a solution to a problem in 2011, the Budget Control Act, when congress finally agreed to pay the debt on money that the government had already spent. And part of the solution was to set up the super committee, which I think Jimmy Kimmel once said, a super committee is a committee to what super cuts are to cuts.

The committee was supposed to come up with more than $1 trillion in budget cuts and they were not able to do it. The super committee failed, and that is why these forced budget cuts are now taking effect. It's not as if we woke up last week and were told these cuts were going to happen. We have known about this for more than a year.

GUPTA: Now, we just want to make sure people understand, at least from a health perspective, what some of that impact is going to be.

Jake Tapper, welcome. Thanks for joining us.

Ali Velshi, as always, appreciate it. Thank you.

VELSHI: Our pleasure.

GUPTA: And coming up on SGMD, the man behind the Oscar-nominated documentary about the early days of AIDS.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Plague, we are in the middle of a plague! Forty million infected people is a plague!

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Until we get our acts together, we are as good as dead.

(END VIDEO CLIP)

GUPTA: "How to Survive a Plague," it's an Oscar-nominated documentary about the early years of the AIDS epidemic at 85th Academy Award Sunday night. We decided to talk about it.

And, joining me from Los Angeles, David France, he's director- producer of "How to Survive a Plague."

And Peter Staley, a long-time AIDS and gay rights activist, one of the film's main characters. He has a much deeper story than that, which we want to talk about.

Thanks for joining us, both of you. Congratulations on the nomination.

UNIDENTIFIED MALE: Thanks.

GUPTA: David, let me just start with you. And ask why this project now, and was there a specific message for a particular audience?

DAVID FRANCE, DIRECTOR/PRODUCER, "HOW TO SURVIVE A PLAGUE": The reason I went back to look at the old days of AIDS, before 1996, when the effective medication came out and made it possible to survive an HIV infection, was because the history as we have reported it through plays and books and films have all focused on the early days of the epidemic, and ended before we had a chance to tell the story about how activism and this incredible grassroots movement took hold, and what that activism did to transform the epidemic, and -- and they did it by joining hand-in-hand with the researchers and the folks at the NIH and pharma to help find the drugs that made it possible.

GUPTA: Yes, and that locking of hands, as you portray in this did not come easily. Certainly.

Peter, again, thanks for joining us. I think you can see the monitor there. I want you to look at a couple pictures. These are pictures of you and obviously many years ago. One there, obviously you're being arrested. There's another one where you're actually, I think, on top of the FDA building, 560 building.

Peter, tell me about these images. Obviously -- I mean, you -- this was your life. You -- this conviction, just everything that was driving you.

Where did that come from for you? What was inspiring and driving you at that point?

PETER STALEY, FOUNDING MEMBER, ACT UP: Simple answer is community. It was a moment where the gay community had had enough. We were being left to die by a country that was indifferent to what we were going through. And we were watching all our friends die.

So, we had a choice of either lying down and rolling over or standing up and fighting back. GUPTA: There's a scene in the movie where you appeared on "Crossfire" and making a plea for the FDA to begin testing on some 140 drugs you thought could be useful.

I want to set this up. We're going watch this here, but I want to set this up by saying what Peter is saying is right. At the time, we didn't know for sure what the effectiveness of the drugs would be. But I want you to hear this exchange and keep in mind just how ahead of the curve he was. Listen.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: What I want to ask you is whether you know of anything that you think might be some kind of miraculous cure that you think they're sitting on at FDA?

STALEY: There are over 140 drugs out there that the FDA has identified as possibilities, and are in some stage of being looked at right now.

UNIDENTIFIED MALE: Why are they holding back?

STALEY: Among that 140, there's got to be one or a combination thereof that can -- that can slow down this virus or halt it in its tracks.

(END VIDEO CLIP)

GUPTA: You know, I mean -- and we now know, again, what you said was true. There were some very effective medications. And I don't know if the correct way of describing it is that they were being sat on.

But do you think -- Peter, let me ask you, ACT UP truly changed the trajectory of the drug approval process, because this is a cumbersome process in this country?

STALEY: Indeed. And, you know, up until that point, it usually took a pharmaceutical company upwards of 10 years to get a drug approved by the FDA. We pushed them and got that down to a matter of months.

But the real key was getting the federal government to actually spend some money on AID research, which they hadn't been doing much of prior to ACT UP. And once we started pushing AIDS into the national agenda and the national consciousness, the budgets got larger, the NIH started spending money on AIDS research, and that money ultimately found those compounds, got them off the shelf. Some of them had been on the shelves since the '60s, the nucleotide analogues.

So it was just a matter of getting everybody in high gear so that we could find those compounds and the combinations that would save our lives.

GUPTA: Well, I'm -- thanks so much for joining us. And, David, maybe more of a comment than a question. You know, you watch something like this, and you think, you know, does activism still really matter. Can it make a difference? And you watch something like this and you realize just what an impact it had on the entire trajectory of our society, obviously, and a particular population of people, but on medicine as a whole.

So I applaud you for that.

FRANCE: Thank you.

GPTA: I wish you guys both good luck at the Oscars. Thanks for joining us.

FRANCE: Terrific. Thank you so much.

STALEY: Thank you, Sanjay.

GUPTA: Thank you.

And still ahead on SGMD, the secrets of happy families.

(COMMERCIAL BREAK)

GUPTA: Welcome back to SGMD.

I first met Bruce Feiler three years ago when he was trying to rebound from a cancer diagnosis. He was grappling with the possibility of dying before his twin daughters Eden and Tybee grew up. He wrote a book about it.

Thankfully, Bruce and his family got through it. And today, Bruce has no evidence of cancer in his body, thankfully.

With all that behind him, Bruce resumed doing what he does best -- writing. In his new book, called "The Secrets of Happy Families." It has chockfull of tips on how to improve your family life.

(BEGIN VIDEOTAPE)

GUPTA: What inspired you to write this book? Was there a moment when you said I want to write about happy families?

BRUCE FEILER, AUTHOR, "THE SECRETS OF HAPPY FAMILIES": We were always on the defense. And that's what it's like to be a parent these days. Just when -- just when they stop teething, they start tantrums, and when they stop needing help taking a bath, they need help with online bullying.

It's a -- we are always reacting. I wanted to feel like I had some new tricks up my sleeve, some new ideas that I could sometimes play offense.

We made a list of all the things the kids have to do in the mornings. And then here's the key, they have to check off their own lists. And so a lot of what we are doing here is trying to kind of bring them into the process. Be less top-down. Be less parental controlling them all the time. Kind of enlist them wherever possible in their own upbringing.

GUPTA: You're their dad. But you want to give them the equal voice. How do you reconcile those two things?

FEILER: Scientists have found that children who set weekly goals, plan their own schedules, evaluate their own work, build up their prefrontal cortex and become better at taking control over their lives. So this isn't lax, this isn't the inmate to running the asylum. But we are bringing them into the process and letting them get the skills they're going to need to succeed later.

LINDA ROTTENBERG, BRUCE'S WIFE: This is where we have our family meetings.

GUPTA: The girls are into it? Do they look forward to these meetings?

ROTTENBERG: Shockingly, yes. Just to see them throughout the week look forward to family meeting was a surprise.

GUPTA: Are there ground rules? Are there things that cannot be said, for example?

ROTTENBERG: No. You are allowed to criticize the parents. We vote on what we're going to work on and anything can go on the table.

FEILER: Just the other week they were saying, you know, dad, you were yelling too much. In fact, we have this iPad, and we recorded you yelling.

Linda loved this, she was giving them a high five. And they said, yes, mom, but we got you cursing too.

Nothing came of it. But it was just a way for them to let out some pressure and to realize that, you know, they have voice in this family too. One option is whoever screams the most, gets --

UNIDENTIFIED GIRL: Less screen time.

FEILER: Less screen time.

In these family meetings, we ask three questions. What went wrong in our family this week, what didn't go well, and what will we work on in the coming week? And almost from the very beginning, the most amazing thing started coming out of their mouths.

Everybody knows that family dinner has a lot of benefits. But so few of us can make it work in our actual schedule. Because it turns out there's only 10 minutes of productive time in any meal. Ten minutes. The rest is taken up with take your elbows off the table and pass the ketchup.

Research shows you can take that 10 minutes and put it at any time of the day and still have the benefits. So can't have family dinner? Have family breakfast. Meet for a bedtime snack. Even having one meal on the weekend has the same benefits.

GUPTA: People feel guilty if they're not spending as much time with their families or feel guilty maybe about if they were too abrupt or cross with their families. How big a deal is just guilt?

FEILER: The research clearly shows, we should spend less time worrying about the bad things we do or the things that we do wrong, and spend more time focusing on the things we do right. Everybody has conflict. It's how you handle the conflict.

Everybody has chaos. But if you make time to play games, if you find the thing, whatever the thing is, that makes you happy, could be hiking, could be playing board games, could be swimming.

Should we play the game?

UNIDENTIFIED KID: Yes!

FEILER: OK.

GUPTA: Frog --

FEILER: I'm a ballerina!

If you make time to do that, you build up this bank of positive memories that can balance off kind of the natural rhythm of when all of the things go wrong.

(END VIDEOTAPE)

GUPTA: Bruce says if you implement just a few of the couple hundred suggestions in his book, you're going to have a happier family in a week. That's what he told me. It sounds good.

So good, in fact, we decided to post more of his advice online at CNN.com/health.

One thing that you're going to use to keep your kids happy for sure is make sure they have clear skin. In fact, there was a study out this week that reaffirmed something we kind of already knew. You are what you eat. We talk about this all the time on SGMD and some of the foods you put in your body can make your skin or even acne worse.

So I want to give you three factors to consider that contribute to breakouts: inflammation, hormones and bacteria. And your diet again has a profound impact on all three things.

Inflammation, for example, that's worsened by high fat and Trans fats, improved by richly colored fruits and vegetables and also omega 3 fatty acids, such as fish.

For bacteria, lower the sugar. And remember, it's not just chocolate or candy. Sugar is hidden everywhere.

Also, we hear this all the time. What about milk?

(BEGIN VIDEO CLIP)

DR. MELINA JAMPOLIS, PHYSICIAN NUTRIATION SPECIALIST: I think the one thing that I was concerned about in this study is the findings on dairy. And even though this showed an association, I think that warrants further investigation, because I'm very concerned about teenage girls in particular limiting their dairy consumption significantly. They already don't get enough, and this had could have a profound effect on bone density.

(END VIDEO CLIP)

GUPTA: So at least drink milk. It sounds like she is saying. Or at least try and get some dairy still.

Up next, a new solution for a problem 30 million men and women experience at some point in their lives.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: You know, as a journalist, a doctor, and I think most importantly, the father of three young daughters, I can't stress enough how important it is that our kids grow up with a positive body image. One young girl that I spoke with started a troubling pattern among her friends.

(BEGIN VIDEO CLIP)

JULIA BLUHM, "SPARK A MOVEMENT" BLOGGER: Girls get this idea that they need to be beautiful to be accepted and liked and to have a good life. And they think that to be beautiful, they have to be really thin, with light skin and light hair and no blemishes whatsoever. And that idea comes from the media.

(END VIDEO CLIP)

GUPTA: That's Julia Bluhm. And she is making this argument, the media's ideal body image was simply impossible to achieve without PhotoShop. And then she got "Seventeen" magazine to change their photo retouching policy.

Well, you know, this coming week is National Eating Disorders Awareness Week. I want to share a new Web site where you or your kids can take a free, anonymous self assessment to gauge the risk of an eating disorder. It's called mybodyscreening.org. It can even provide referrals, if needed, to local medical professionals who might be able to provide some treatment. I hope that helps.

That's going to wrap things up for SGMD. Let us know what you think. CNN.com/Sanjay and follow me on Twitter @DrSanjayGupta.

A check of your top stories are next in the "CNN NEWSROOM."