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CNN Tonight
Drug Costs Soar; Cancer Controversy; Obama in China; Obama's China Syndrome; Refusing Deployment
Aired November 17, 2009 - 19:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(BEGIN VIDEOTAPE)
UNIDENTIFIED MALE: Tonight -- drug companies breaking a promise to the American people -- already raising prices instead of slashing them.
UNIDENTIFIED MALE: This is what makes people cynical about the issue of health care reform.
UNIDENTIFIED MALE: Also, wars raging in Afghanistan and Iraq, now the military says soldiers are committing suicide at a record rate. What can be done to help? And refusing deployment, a single mom tells the Army she won't go to war in Afghanistan. Why? There is no one to care for her infant son.
UNIDENTIFIED MALE: Does Specialist Hutchinson have a legal or regulatory leg to stand on in this case?
UNIDENTIFIED FEMALE: Most likely not.
UNIDENTIFIED MALE: What should the Army do? Also, Los Angeles -- the epicenter for medical marijuana, there are more pot stores than Starbucks there. Now some say "enough is enough". Should you be able to get high with a prescription?
(END VIDEOTAPE)
ANNOUNCER: This is CNN TONIGHT live from New York. Here now, John Roberts.
JOHN ROBERTS, CNN ANCHOR: Good evening and thanks so much for joining us. Consumers are taking it on the chin again. The Obama administration's deal with the drug industry to support a health care overhaul was supposed to keep drug prices down. Big pharma promised to cut drug costs by $8 billion a year after the legislation takes effect. But in fact before the legislation is even passed the industry is actually raising prices and raising them at an alarming rate. Louise Schiavone begins our coverage.
(BEGIN VIDEOTAPE)
LOUISE SCHIAVONE, CNN CORRESPONDENT (voice-over): It's probably no bulletin to the patients who use them over the past 12 months the cost of brand name drugs has risen an average nine percent, this according to a study commissioned by the AARP. JOHN ROTHER, AARP: The most frequently consumed drugs the ones that most people end up taking and they are for hypertensive, they're cholesterol drugs, drugs that you know are pretty well recognized and those are the ones that really led the way in terms of price increases.
SCHIAVONE: Among the higher priced brand name drugs the study included these well known products from Merck, Fosamax for osteoporosis, up 6.9 percent, Singulair for respiratory ailments, up 12.5 percent, anti-cholesterol agent Zocor up 6.9 percent. Merck declined to respond to CNN's request for comment, referring us to a statement from pharmaceutical industry association Pharma, saying quote, "All companies make their own independent pricing decisions based on many factors including patent expirations, the economy and huge research and development costs", end quote.
On Capitol Hill there could be repercussions. Top Senate Finance Committee Republican, Charles Grassley says the past year price escalations are an outrage.
SEN. CHARLES GRASSLEY (R), IOWA: It is outrageous because it comes on the heels at a time that the pharmaceutical industry was bragging because they were contributing $80 billion to health care reform. This is what makes people cynical about the issue of health care reform.
SCHIAVONE: Harvard University health economist, Joseph Newhouse (ph) says he saw drug prices climb in 2006 after Congress made pharmaceuticals part of Medicare.
JOSEPH NEWHOUSE, HARVARD UNIVERSITY: I did look at drugs that were heavily used by the elderly and drugs that weren't. And what we found was that the drugs that were heavily used by the elderly went up, noticeably more than drugs that weren't.
SCHIAVONE: Bayer Health Care which the study says raised the price of its multiple sclerosis drug Betaseron (ph) by 28 percent says that it's eliminated the co-pay for qualified patients in economic distress.
(END VIDEOTAPE)
SCHIAVONE: John, this report promises to make the health care reform debate all the more intense. Senator Grassley is forecasting that when all negotiations are over the drug industry may wind up giving back even more than $80 billion over 10 years -- John.
ROBERTS: Louise, what are Democrats saying about this and what about the White House, the administration which cut this deal with Pharma in the first place.
SCHIAVONE: The White House is taking this all in and Democrats are just concerned about this. They haven't come anywhere near to finishing up this health care debate in the Senate or going to conference. And all of this has to be reviewed in conference. ROBERTS: Louise Schiavone for us tonight -- Louise, thanks so much. Senate lawmakers are eagerly waiting to find out how much their health care bill will end up costing. And a Republican filibuster could be waiting in the wings. Meanwhile the historic $1 trillion health care bill that barely passed the House has Americans divided. According to a CNN/Opinion Research Corporation poll, 49 percent of those asked are against the measure while 46 percent support it.
Americans are also split on how soon the health care bill will actually become law. Forty-nine percent believe it will pass before the end of this year as President Obama hopes, while 50 percent do not. The annual rankings of the nation's healthiest states is out -- according to the survey by the American Public Health Association if you want to live a long, long time, live in Vermont. Vermont tops the list of states with the healthiest people followed by Utah, Massachusetts, Hawaii, and New Hampshire.
The five least healthiest places to live in the United States are Nevada, South Carolina, Louisiana, and Alabama. The report found that people in these states are most likely to be smokers or obese -- both dramatic health risks.
For the ninth year running Mississippi is the state with the single worst health care according to this report. Four areas to measure overall health were used in this report -- behavior, community, and environment, public and health policies and also clinical care.
An alarming new report finds the recession is having a deep impact on hunger in this country. According to the USDA, the number of Americans going hungry is at its highest level in 14 years. Nearly 50 million people including 17 million children struggled to get enough to eat in 2008. The number of kids who were sometimes outright hungry soared from 700,000 to more than a million last year. President Obama who has pledged to end childhood hunger by 2015 calls the report quote, "unsettling."
And now more on a story that we first reported last night -- those controversial new mammography guidelines -- a government task force says women in their 40s should not get routine mammograms to screen for breast cancer. And for women 50 and older the task force is now recommending screenings every two years instead of annually. But not all cancer experts agree with these new guidelines. Here is our senior medical correspondent Elizabeth Cohen.
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ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): The government might say routine mammograms are unnecessary for women in their 40s. But Sarah Fought (ph) would beg to differ. A routine mammogram caught her breast cancer when she was 42.
UNIDENTIFIED FEMALE: I think it saved my life because my cancer was detected earlier.
COHEN: She says she is horrified by the new recommendations. SARAH FOUGHT, BREAST CANCER SURVIVOR: It's fool hearty and I think you are playing with people's lives.
COHEN: Many experts agree with her. The American Cancer Society, the American Society for Clinical Oncology, Susan G. Komen for the Cure and the Patient Advocate Foundation all disagree with the government and say women in their 40s should get mammograms. The government task force agrees that mammograms do catch cancer in women in their 40s.
In fact, that 15 percent of cancers in women that age are detected thanks to mammograms. But they also say there are downsides to mammograms. Women get exposed to small amounts of radiation year after year. Plus there are lots of false positives that make women worry unnecessarily and prompt biopsies that aren't needed.
(on camera): But what do you say to a woman who says a mammogram saved my life in my 40s?
LUCY MARION, U.S. PREVENTIVE SERVICES TASK FORCE: Well, what do I say to the woman who called me today and said thank goodness for the new guidelines because I have had so many unnecessary biopsies and they have been painful and they've been costly. I have had to pay for some of them out of pocket. And every time it was benign.
COHEN: So for years we have been telling women get your mammograms starting at age 40. So you think we were wrong all those years?
MARION: I think that we probably were overzealous. But we weren't wrong based on what we had at that time. It was -- it was not wrong at the time.
(END VIDEOTAPE)
COHEN: Now here are some statistics that are really at the heart of this new report. You have got to take a look at these. For every 1,000 women who are screened in their 40s, 1,000 women screened they're going to find two cancers, they're also going to have 98 false positives. And when you get a false positive what that means is they think they see a cancer in the mammogram but they don't. And that woman then needs to have all sorts of follow-up testing which can be anxiety provoking not to mention expensive -- John.
ROBERTS: So if you look at the numbers you can see that this task force would say that it makes sense. Now this task force is considered to be the gold standard when it comes to guidelines for mammography. So will insurance companies look at this new information and say well if you are a woman in your 40s we're not going to pay for you to get a mammogram?
COHEN: You know there is some concern because insurance companies do look to this government task force (INAUDIBLE) wait a minute why should we pay for mammograms for women in their 40s if this group says that they're not necessary. But I have spoken with various experts on this including people in the insurance industry. Politically speaking it would be extremely unpopular to tell women in their 40s they can't get their -- that the insurance won't pay for their mammograms. A lot of people say it is just not going to happen -- it's just too unpopular.
ROBERTS: So what -- you know there is obviously a tremendous amount of confusion out there now, women in their 40s are thinking should I get a mammogram, should I not get one. What should a woman in her 40s do?
COHEN: Well as a woman in her 40s who has gotten a mammogram every year, of course now I am questioning well do I get it this year? I think the bottom line is, is that you have to talk to your doctor and think about the pros and the cons. The pros are you might catch a cancer.
The cons are you're exposed to a bit of radiation and you will be exposed to it every year and they might find something that is really not cancer and you freak out and you have to have further testing. I think a lot of women are going to choose the chance that they will catch a cancer. And that they're willing to deal with those cons, but we'll have to see what happens.
ROBERTS: Elizabeth Cohen for us tonight with the very latest -- Elizabeth, thanks so much. These controversial new breast cancer guidelines as we just said have got women and their doctors confused over what to do. So what should they do? We'll ask a couple of experts tonight a little later on.
Also was President Obama's trip to China a missed opportunity. Should China's poor record on censorship and human rights have been called out?
And a single mom takes on the Army, refuses to go to war in Afghanistan. Why? She says there is no one to care for her infant son. What should the Army do?
(COMMERCIAL BREAK)
ROBERTS: President Obama wrapped up his four-day trip to China with a pair of meetings with Chinese President Hu Jintao in Beijing today. The summit resulted in no dramatic breakthroughs. But the two countries are more partnered than ever. President Obama conceded it was Chinese money and markets that helped the United States pull out of the recession.
China remains America's biggest foreign lender. While there is much talk of greater economic cooperation, areas of disagreement remain. Ed Henry is live in Beijing for us tonight and Ed, it sounds like the president is really emphasizing a partnership with China unlike the previous administration which said that China was a strategic competitor. Is that a strategy?
ED HENRY, CNN WHITE HOUSE CORRESPONDENT: It certainly is, John, because when you talk to top White House officials what they say is, obviously don't like China's human rights record, they're not happy that China is still the biggest lender, but they don't really have much of a choice right now. We're $12 trillion in debt, the highest in U.S. history, trying to dig out of it obviously.
And they realize, look, on all of these major issues back in the United States and around the world, China could be the U.S.'s most important ally. For example, on the economy, obviously in terms of trying to pull out of the global recession they're key. Secondly on climate change -- next month in Copenhagen at a big summit it's going to come down to whether the U.S. and China are going to take the lead.
They're the two biggest emitters of green house gasses. If they don't take action together the rest of the word is not going to follow. And finally on both Iran and North Korea -- when it comes to stopping their nuclear programs without the support and cooperation of China the U.S. is going to get nowhere before the U.N. in terms of tough new sanctions against Iran and they're not going to get the six- party talks restarted in terms of dealing with North Korea unless they have China on board. The bad news for the White House is that on this trip China is still not on board with sanctions against Iran but they're showing signs that they're welling to get these six-party talks going again -- John.
ROBERTS: And the president was the target of some criticism last month when the Dali Llama was in Washington and for the very first time an American president did not meet with the Dali Llama while he was in Washington. The president preferred to wait until after his meeting with Chinese leaders. So how did the president address the tensions between China and Tibet?
HENRY: Well John, as you noted, he took a lot of heat for human rights groups for skipping a meeting with the Dali Llama just a few weeks ago. Their strategy basically behind the scenes has been you know why upstage and sort of snub the Chinese government on the eve of this high profile visit.
Why mess with that? Instead, what the president did was standing beside President Hu Jintao here in Beijing, just, just hours ago, he publicly, Mr. Obama did, said, look, he hopes that the Chinese government will start talking to representatives of the Tibetan spiritual leader, get a dialogue, get a conversation going.
They feel it's better to do it face to face like that. Try to build more trust with the Chinese. But these human rights groups obviously are going to be watching very closely to see about the action after the talk here in Beijing when President Obama meet with the Dali Llama in the days ahead and what's he going to do in terms of really putting pressure on China -- John.
ROBERTS: Ed, we just point out in just a few minutes' time you're going to go interview President Obama. They're allowing you 10 minutes with him, and not to give anything away but what's top of mind for you in terms of the conversation?
HENRY: Well you mention that China is now our biggest lender, for the first time, the U.S., this last 24 hours, has reached $12 trillion in debt. What is the president going to do to dig us out of that? That's obviously a big question. He's about to make a monumental decision on whether to send up to 40,000 more U.S. troops to Afghanistan.
And then of course while all this has been going on here, let's not forget that big health care debate still playing out. So there's a lot on the plate. We're going to have a limited amount of time. We're going to have to get as much in as possible and we'll have first thing on "AMERICAN MORNING" tomorrow -- John.
ROBERTS: You'll both have to talk quickly tonight. Ed Henry, thanks so much. We'll let you get to it.
Human rights advocates are questioning whether President Obama is going too easy on China. The president has praised the Chinese economy and culture but has avoided calling out China about its dicey record on press censorship and political freedoms. Kitty Pilgrim reports on what some are calling a missed opportunity for the president.
(BEGIN VIDEOTAPE)
KITTY PILGRIM, CNN CORRESPONDENT (voice-over): In a town hall- style meeting in China, the question to President Obama was -- should the Chinese be allowed to use Twitter freely? At first, Obama's answer sidestepped the issue.
BARACK OBAMA (D-IL), PRESIDENT OF THE UNITED STATES: First of all let me say that I have never used Twitter, my thumbs are too clumsy to type in things on the phone.
PILGRIM: And then the president talked about the Internet in the United States rather than address the repression of freedom of speech in China.
OBAMA: I recognize that different countries have different traditions. I can tell you that in the United States the fact that we have free Internet -- or unrestricted Internet access is a source of strength.
PILGRIM: Some China watchers like the conservative Heritage Foundation were intensely disappointed at a lost opportunity.
MIKE GONZALES, HERITAGE FOUNDATION: I just don't understand why the president is so deferential. He was given a question about censorship and he basically flubbed it. He punted (ph) it.
PILGRIM: During the meeting Chinese government censorship was on full display, the nationwide broadcast of the meeting was only in limited distribution, Web transcripts were censored and the hall packed with communist supporters. Tom Malinowski (ph) of Human Rights Watch says Obama did not call on China to tear down that firewall but he thinks the discussion was good despite China's attempt to control it.
TOM MALINOWSKI, HUMAN RIGHTS WATCH: They packed the audience in his town hall meeting with carefully chosen members of the communist party youth league. The White House tried to invite some Internet bloggers and other critics of the Chinese government to that event and the Chinese blocked that.
PILGRIM: The issue is particularly sensitive because of U.S. Internet companies that do business in China. In recent years, Congress has been intensely critical of U.S. companies such as Google and Yahoo! for their voluntary compliance with some of China's censorship laws. Google and Yahoo! have defended their policies saying it is better for the Chinese user than if they weren't there.
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PILGRIM: And human rights' officials say U.S. officials often sidestep difficult issues because China has the economic upper hand in its dealings with the United States. Some $800 billion in U.S. debt the Chinese have a powerful financial hold over U.S. and Western companies trying to do business in that country -- John.
ROBERTS: Kitty, at the same time though, China needs the U.S. as much as -- if not more than we need them because American consumers are buying everything that they make. So did the president have the latitude there to be tougher on the Chinese and these press freedoms and human rights and not upset the apple cart?
PILGRIM: Many people say yes that this was a missed opportunity, it was an anticipated opportunity. They set up the meeting to actually talk about such issues. And then when the question was asked the response was just not strong enough.
ROBERTS: Kitty Pilgrim tonight -- Kitty, thanks so much.
Coming up, outrage and confusion over those controversial mammography guidelines -- why some doctors say they put more women at risk.
And a single mom against the Pentagon -- she refuses to deploy to Afghanistan, to care for her son, what happens next? We'll have a special report.
(COMMERCIAL BREAK)
ROBERTS: A military mom is restricted to her base in Georgia tonight after refusing her deployment to Afghanistan. Army Specialist Alexis Hutchinson (ph), a single mother said she had no one to take care of her infant son if she shipped out. Brian Todd is looking into this for us tonight.
(BEGIN VIDEOTAPE)
UNIDENTIFIED FEMALE: Say hi.
BRIAN TODD, CNN CORRESPONDENT (voice-over): Kamani Hutchinson less than a year old and caught up in the middle of a high profile dispute between his mother and the U.S. Army. Kamani's mom, Specialist Alexis Hutchinson (ph), is restricted to her post at Fort Stewart, Georgia, a single mother she is under investigation by the Army after missing her deployment to Afghanistan earlier this month.
An official at Fort Stewart tells CNN Specialist Hutchinson showed up practically on the eve of her deployment and said her family care plan had fallen through that she couldn't find any one to care for Kamani. The official wouldn't discuss possible charges she could face but her civilian lawyer did with CNN affiliate, KGO.
RAI SUE SUSSMAN, SPEC. HUTCHINSON'S ATTORNEY: AWOL, missing movement, desertion, failure to have a family care plan, and disobeying an officer.
TODD: The attorney told CNN the Army threatened to court martial Hutchinson if she didn't deploy after reneging on a promise to give her more time to find care for her son. A spokesman at Fort Stewart emphatically denies both claims.
KEVIN LARSON, FORT STEWART SPOKESMAN: The Army did give her a 30-day extension and like all soldiers was given plenty of time to work out another care plan.
TODD: Kevin Larson says Hutchinson's Army unit has known for months that it would deploy to Afghanistan, that she was given an extension back in August and September. And that it wasn't until the last moment that she told them she had no one to care for her son.
Hutchinson had tried to place him with her mother Angelique Hughes. Hughes initially tried but said she couldn't handle it because she had other relatives in her care, plus a home day care operation. Still with his mother under restriction Kamani is now back with his grandmother.
ANGELIQUE HUGHES, KAMANI HUTCHINSON'S GRANDMOTHER: I am spreading myself thin and then I deal with kids all day long so I have not a break in between anywhere.
TODD: I asked former Air Force JAG Officer Michelle McCluer about this case.
(on camera): Does Specialist Hutchinson have a legal or regulatory leg to stand on in this case?
MICHELLE MCCLUER, FORMER AIR FORCE JAG: Most likely not. I mean when soldiers are ordered to deploy, and single soldiers included, they have to have a family care plan in place if they are single or military married to military. And they need to implement that.
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TODD: And it says so right here in black and white, this is military form DA-5305 (ph), the family care plan each soldier has to agree to when they sign up. It says if they don't have a plan to care for their family when they're deployed they could face disciplinary action. Then in a check-off space for soldiers it says, quote, "if arrangements for the care of my family members fail to work, I am not automatically excused from prescribed duties, unit deployment or reassignment." John, at some point, this soldier had to have seen some of these forms.
ROBERTS: So not a leg to stand on legally, so what legal strategy is her attorney pursuing?
TODD: I spoke with her attorney about that. She says they want to get an administrative discharge for her under one military statute called Chapter 5-8 (ph). That code states that you cannot perform your duties because of parenting responsibilities. That former JAG officer we spoke to, Michelle McCluer, says that is the most likely resolution to this case.
ROBERTS: Keep watching this. Brian Todd for us tonight -- Brian, thanks so much.
TODD: Thank you.
ROBERTS: And later tonight on CNN, an "AC 360" investigation, was it murder or battlefield justice? See what CNN uncovered then decide for yourself -- "Killings at the Canal: The Army Tapes", an "AC 306" investigation, CNN tonight at 10:00 Eastern.
Coming up, Los Angeles is earning a new distinction as the nation's medical marijuana capital, also a change in the way that women screen for breast cancer, why the new rules are creating controversy.
And a disturbing report from the Pentagon, the suicide rate among soldiers is at a record high -- what is the Army doing to turn it around? That story is next.
(COMMERCIAL BREAK)
ANNOUNCER: This is CNN tonight live from New York.
JOHN ROBERTS, CNN ANCHOR: The pentagon tonight is promising a thorough review of procedures to stop incidents like the massacre at Fort Hood from happening again. The new investigation will focus on Nidal Malik Hasan who allegedly killed 13 people in that Fort Hood attack. Investigators will try to determine if the army missed any warning signs about Hasan. Procedures in the other branches of the service will be reviewed. Tonight Republican members in the House Intelligence Committee are calling for an immediate congressional investigation into the circumstances surrounding the shooting.
The military today acknowledged that a record number of soldiers have taken their own lives. 211 troops have died by suicide so far this year compared to 197 for all of 2008. The high numbers come even as the army is making unprecedented efforts to provide counseling to troubled soldiers. Pentagon correspondent Barbara Starr, looks deeper into this disturbing trend.
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BARBARA STARR, CNN PENTAGON CORRESPONDENT: While Army suicides are at an all time in 2009, the rate is slowing providing a glimmer of hope. General Peter Chiarelli oversees the army's suicide prevention efforts. He personally reviews each case.
GEN. PETER CHIARELLI, ARMY VICE CHIEF OF STAFF: The reality is there is no simple answer. Each suicide case is as unique as the individuals themselves.
STARR: The army has long said financial and relationship problems, as well alcohol and prescription drug abuse may be major factors in soldiers deciding to commit suicide. In an effort to help soldiers better cope, the army has several initiatives. Troops entering the army will be given a new questionnaire when they enlist to better determine if mental health problems warrant treatment or could disqualify them from military service. Mental resiliency training is being offered to teach troops on duty to work their way through emotional adversity. Everyone is taught more awareness of post-traumatic stress and the potential impact of brain injuries.
One of the biggest problems is simply getting more mental health counselors. The army is trying on-line counseling and is seeing some success especially with younger troops. But it still needs more than 1,000 substance abuse and mental health professionals but it is not the total answer.
UNIDENTIFIED MALE: I will tell you 40 percent, over 40 percent of the suicides we had this year are individuals who have seen a behavioral health care specialist.
STARR: The generals didn't want to talk about the attack at Fort Hood, but this brigadier general, who heads the new mental health training, says the army is committed to relieving stress and she recalls a 1995 incident.
BRIG. GEN. RHONDA CURNUM, DIR. ARMY COMPREHENSIVE SOLDIER FITNESS PROG.: I was at Fort Bragg when there was the person who decided to started sniping at people who were doing P.T. and I don't think studying that guy would predict the second guy. Tragedies some times happen.
STARR: If you think serving in the war zone may be driving troops to commit suicide, think again. The army says about 1/of 3 those who take their own lives have never deployed.
Barbara Starr, CNN, the pentagon.
(END VIDEOTAPE)
ROBERTS: Joining me with more on the critical problem of suicide in the military is Kim Ruocco. She is director of suicide education and support for T.A.P.S., Tragedy Assistance Program for Survivors. Dr. Jeffrey Lieberman, chair of psychiatry at Columbia Medical Center is with me in the studio. Dr. Lieberman was a defense department consultant on psychiatric issues within the military. Veterans advocate, Steve Robinson, he's former airborne ranger who served 20 years in the army.
Kim, we should point out that you have personal experience with suicide in the military. Your husband Major John Ruocco died by suicide. What do you make of the numbers?
KIM RUOCCO, TRAGEDY ASSISTANCE PROGRAM FOR SURVIVORS: Well I do know that the numbers have decreased a little bit over the last couple months. That a lot of the numbers are from earlier on in the year. But I do know we are still struggling with stigma and people reaching out to get mental health and behavioral health care because of the stigma associated with having mental health issues.
ROBERTS: Steve, as we pointed out. You served two decades in the military. From your experience, where do the problems lie here?
STEVE ROBINSON, VETERANS ADVOCATE: I think the biggest problem that we really need to identify is that the military fundamentally does not understand how repeated deployments and the occupational exposure of war can play a role in some of the issues that suicide, when suicide occurs. So it is a leadership issue. And it is an individual educational issue that we have to train our military to understand war and its consequences. That will help us prevent suicides.
ROBERTS: Dr. Lieberman, help us out with the medical side of things here. Because as was pointed out by Barbara Starr one third of suicides occur among people who have never been deployed to a combat zone. When asked about it the army vice chief of staff Peter Chiarelli said he didn't know if the raise reflected unprecedented high stress because of long, repeated deployments. Columbia University we should point out is recipient of part of a $50 million grant to study all of this. What is your thinking?
DR. JEFFREY LIEBERMAN, CHMN. OF PSYCHIATRY, COLUMBIA UNIV. MED. CTR.: Stress induced mental disorders are known to occur and particularly occur in military theaters of war. We have seen this historically. There's things like combat neurosis, battle fatigue, shell shock, the current term which describes this as post-traumatic stress disorder. Suicide is one of the most unfortunate and dramatic complications of these disorders. So these occur in society and occur particularly in the military in war times. The problem now is that the numbers are rising. They have gone up each year and there are unprecedented numbers. There is something about this particular type of warfare which is uniquely stressful and causing these. I agree with Steve's comments that it could be the repeated deployments, it could be the fact that this is part of really unconventional war, an asymmetric war where you don't have the defined enemy or don't have defined combat lines. And this is producing this effect just now with the, advent really of the all-out effort for mental health emergency. There's been enough for the military to analyze and get on top of this problem.
ROBERTS: Steve, if that is the case, what then is the problem? Is the military not adequately screening recruits or are people not being prepared thoroughly enough for deployment?
ROBINSON: I think it is two things -- I think, I certainly believe that we, in the previous year, lowered some of our recruiting standards. So going back to screening troops before they come in, making sure that they're not having pre-existing conditions is important. But I also believe that educating the force that this injury, a mental health care injury like PTSD or combat operational stress is not a lack of intestinal fortitude, it's not a lack of character, it is an injury and it needs to be treated as such. We have to change the culture in our military. There is no reason why anyone in the military should feel that they don't have somebody to turn to, to help them. And that's part of the training and education.
ROBERTS: For so long the attitude in the military was, okay it is war. Suck it up. Kim, help us out here. Your husband, John Ruocco, major in the military, were there any signs that he was so troubled? And in the military, if there were signs, is the military adept at identifying those signs before it becomes too late?
RUOCCO: Well one of the things we are seeing that is a problem that I'm hearing from our family members that are survivors is that often these guys will not get help because of the stigma for behavioral health or mental health issues. But they are going to primary care clinics with a host of physical ailments that could also be identified as a behavioral health issue. They're not catching them at the primary care clinics. That's one of the things that the families are saying needs to be looked at is coordinating behavioral health with our physical health so that you are looking at whole soldier or marine. My husband's case, he was suffering from headaches and stomach aches and sleep disorders and concentration issues which all were seen at a primary care clinic but not identified as something that was a mental health issue. So and we're seeing that in the numbers that about 44 percent of soldiers have been to the clinic or to a behavioral health, but not -- not identified as somebody who needs behavioral health.
ROBERTS: So Dr. Lieberman, if the signs are out there, and the army, military has now got quite a -- a comprehensive program trying to identify post-traumatic stress, traumatic brain injury, trying to identify some of the early signs that someone may be contemplating suicide, do they have the knowledge at this point to put that altogether and identify it? And stop some of these people from dying by suicide?
LIEBERMAN: Well I think they do. They're taking it seriously. There is an intensive effort, ongoing to try to analyze and understand the causal factors and to put in place measures that will, as Steve was saying, screen better for people who may be vulnerable upon entering the military, secondly, provide support for the people who are in the field or about to be deployed give them the necessary support to mitigate the stresses that could impel them to mental disturbances and suicide. And third, there is a need for when people return to the United States to help them reintegrate because they're coming back to an environment that has not experienced the war in the way that they have and they have to re-acclimate to society.
ROBERTS: Bottom line, Steve, as we finish things off here, this is war. Terrible things happen in war. And even with all of the programs to try to identify the stressors, to give people help, can you eliminate this problem in the military?
ROBINSON: No, we can't eliminate it. And there will be people that, that will commit suicide. But we shouldn't be able to go to sleep at night until we have a coordinated effort and a cultural sea change in the military so that every single person that comes in knows what the dangers and risks of repeated combat deployment are and knows signs and symptoms of suicide and we also educate the family. Once we have done that and we have good programs in place, then we can go to bed at night and say we have done the best we could. Right now we are not there. These programs that are out right now are new. They have not reached the entire force.
ROBERTS: All right, Steve Robinson, thank you so much. As well as Dr. Jeffrey Lieberman, and Kim Ruocco from T.A.P.S., it's a terrific organization, really helps out the families of service members who have either died in battle or in the line of duty or died by suicide. Www.taps.org, if you're a member of the military and you need help.
Coming up next, medical marijuana stories exploded in California. But now a new law may make it legal to get high without a prescription.
Also ahead, both women and doctors are confused about the new controversial breast cancer guidelines. We'll discuss what should be done with a panel of experts just ahead.
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ROBERTS: More now on those important new mammography guidelines from the preventative services government task force, a government task force that is sparking controversy and confusion. Joining me is Christine Brunswick, she is vice president of the National Breast Cancer Coalition, Christine is a breast cancer survivor and Dr. Daniel Kopans, Dr. Kopans is a senior radiologist at the breast imaging division at Mass General Hospital and a leading expert on mammograms. Dr. Kopans is also a professor of radiology at the Harvard Medical School.
We have new guidelines from this task force that say women in their 40s, most women in their 40s, ones that are not at high risk should not get screening from mammography until they're age 50. At age 50 they should get it every two years as opposed to annually. Dr. Kopans, what do you think of the new guidelines?
DR. DANIEL KOPANS, HARVARD MEDICAL SCHOOL: John, I will not mince words. I think the guidelines are outrageous. The U.S. preventative task force agrees and states that the death rate from breast cancer has been decreased in the United States and this benefit accrued for women. They point out that it's highest among women in their 40s. And then they come back and say we're not going to allow women in their 40s to be screened. It makes no sense and it's not scientifically based.
ROBERTS: The American Cancer Society agrees with you though. I don't think their language is quite as sharp as yours is. Earlier on CNN Otis Brawley from the American Cancer Society said the methodology in compiling these new recommendations was not as sound as he would have liked it. Let's listen to what he said. (BEGIN VIDEO CLIP)
OTIS BRAWLEY, CHIEF MEDICAL OFFICER, AMERICAN CANCER SOCIETY: I have tremendous respect for the task force but I do have difficulty without getting into the scientific weeds, I have difficulty with the methodology that they use. I actually think that women deserve far better than what we are giving them with this back and forth about what various organizations recommend.
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ROBERTS: Christine Romans, what do you think of what Otis Brawley said and what do you think of the recommendations?
CHRISTINE BRUNSWICK, VICE PRESIDENT, NATL. BREAST CANCER COALITION: The National Breast Cancer Coalition agrees with the task force, an esteemed group of leading experts who of public health officials and doctors in the field. And the scientific evidence is there that for women ages 40 to 49, mammography does not make a difference with mortality rates. And the National Breast Cancer Coalition believes that women deserve the truth. We deserve to have the truth about mammography, and we deserve to make decisions.
ROBERTS: Christine, I apologize. You are not Christine Romans. She works for CNN. You are Christine Brunswick.
Dr. Kopans, you heard what Christine Brunswick had to say and what about the issue of too many false positives, too many unnecessary biopsies that most women do not need to be screened?
KOPANS: John, if I can interrupt for a second. We are talking about telling the truth. We just heard the not truth. The U.S. preventative task force has stated there is a statistically significant decrease in breast cancer deaths for women who begin screening at 40 and applies to women in their 40s when screening is introduced into the general population the death rate goes down. For women in their 40s, the U.S. preventative task force said that in the United States, the decrease in deaths from breast cancer that we have seen since 1990 for the first time in 50 years is highest among women in their 40s. So, the coalition can't say that there is no evidence of benefit. There is clear evidence of benefit. The task force admits it. It's in their paper. The problem is they then go ahead and use computer modeling instead of direct data and say that women in their 40s shouldn't participate.
John, you are familiar with computer modeling. It said hurricane Katrina wasn't going to hit New Orleans. So I guess if you use computer models we can say the destruction in New Orleans didn't take place.
We have direct data from the United States from Sweden and the Netherlands that shows that when you screen women in their 40s the death rate goes down by as much as 40 percent. That's huge. And the task force wants to deny women that benefit.
ROBERTS: Christine Brunswick, you were shaking your head there during what the doctor was saying. You know what about this idea there are these reductions in mortality? And if you can save even a few lives by screening does that not make it worth it?
BRUNSWICK: I think, I will just go back and say I think women deserve the truth. The task force looked at prospective randomized clinical trials which are the gold standard. There were two studies. There were 160,000 women ages 40 to 49. They were followed for ten years and there was no difference in mortality. There is no evidence that mammography saves lives. There is no scientific evidence that mammography.
KOPANS: There were eight studies, not two studies.
BRUNSWICK: The two were for.
KOPANS: And they showed a statistically significant benefit for screening women in their 40s. The task force admitted that. They're just telling women in their 40s no screening.
ROBERTS: We have a disagreement over the statistics, the methodology. All of this. Let me ask you a question that a lot of people at home are probably thinking right now. This task force is, a government task force. It's considered to be the gold standard here when handing down guidelines do you expect, Christine, this is going to have an effect on the coverage that health plans will give their subscribers in the future? Right now they're saying we are not going to change anything. Down the road, do you think this will affect that?
BRUNSWICK: I can't predict the future. Everything we hear now is indicating that they won't change coverage. And the recommendation is for healthy women, 40 to 49, and it says women who are at high risk should make an individual decision and consult their physician. So I am sure insurance companies will continue to cover those women.
ROBERTS: Dr. Kopans, are you as confident?
KOPANS: I am very concerned. With regard to suggesting women in their 40s should be screened based on being at high risk that is not supported by science. The data shows.
BRUNSWICK: It is supported by science.
KOPANS: It is in their 40s based on risk will save lives. None of the randomized control trials looked at that. If you only screen women at high risk, you'll miss the 75 percent to 90 percent of breast cancers that occur in women who are not at high risk. Most breast cancers occur in women without a family history or genetic abnormality. Those women will not benefit.
ROBERTS: We have heard both sides of this debate for people at home to assess. I think we should probably say the best thing that a woman can do if she is in her 40s is talk to her doctor about this. Christine Brunswick, Dr. Daniel Kopans, thanks for joining us. Really appreciate it.
BRUNSWICK: Thank you for having me.
KOPANS: Thank you.
ROBERTS: Just ahead, a case of unsportsmanlike conduct that happened above the field. We'll tell you what the 86-year-old owner of the Tennessee Titans did that got him in big trouble with the NFL.
The controversy over medical marijuana. Los Angeles moves one step closer to make it an easy legal purchase. We'll have the very latest.
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ROBERTS: The controversy over medical marijuana is raging in Los Angeles. There are more medical marijuana dispensaries than Starbucks locations in L.A. There's a debate under way about outlawing many of those cannabis retailers, but those retailers may soon have a new law on their side. Our Casey Wian has more.
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CASEY WIAN, CNN CORRESPONDENT: Los Angeles has quickly become the nation's medical marijuana capital. The city attorney estimates about 1,000 pot dispensaries are operating here, most illegally. Although California law allows medical marijuana use and even cultivation in limited amounts, some officials are trying to ban medical marijuana sales in Los Angeles.
DAVID BERGER, ASSISTANT L.A. CITY ATTORNEY: The city attorney's analysis of the state law suggests that sales are not allowed, whether they're for-profit or not for profit.
WIAN: The proposal drew hundreds of medical marijuana supporters to a rowdy, packed city council meeting Monday.
RICHARD EASTMAN, MEDICAL MARIJUANA SUPPORTER: The dispensaries that provide the medicine that have saved my life and all the people with cancer and glaucoma and multiple sclerosis and whatever illnesses should be allowed to receive medicine.
WIAN: Two cities voted to allow marijuana sales, just not for profit.
BILL ROSENDAHL, L.A. CITY COUNCIL: I know people today who have various illnesses, especially those with cancer, that it is the only relief that they get, because a lot of these prescription drugs that people get addicted to that end up killing them, okay, is not what medical marijuana is.
WIAN: The idea that the debate over medical marijuana is all about medical necessity is contradicted by the industry's own advertising. Here is the nearly 200-page Los Angeles journal for education on medical marijuana. Inside, ads feature longtime recreational pot advocate Snoop Dogg, offers of free joints for first- time patients, suggestive photos of nearly naked women and an attorney that boasts for winning light or dismissed sentences for accused marijuana traffickers. 14 states now have law permitting medical marijuana use. Colorado Governor Bill Ritter this week received legal clearance to accept sales taxes from pot dispensaries. In Portland, Oregon, last week, the nation's first marijuana cafe opened at a former adult club called Rumpspankers. Smokers must remain behind closed doors.
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WIAN: Back here in Los Angeles, the full had city council is scheduled to vote Wednesday on the new medical marijuana law. Even if it passes, the local district attorney says his office will continue to prosecute dispensaries who sell medical marijuana because he says that violates state law. All this while the California state legislature is considering a proposal that would legalize and tax marijuana statewide. John?
ROBERTS: Something that they're considering in Colorado as well. Amazing where this is going. Casey Wian tonight. Casey, thanks so much.
Coming up at the top of the hour, Campbell Brown. She's with us now. Hi, Campbell.
CAMPBELL BROWN, CNN ANCHOR: Hey there John. Tonight, as you may have heard, Sarah Palin taking a lot of people to task in her best- selling memoir "Going Rogue." How many of the claims are fact, how many fiction? Our own fact check is just ahead.
Plus tonight, the army mom defying orders to ship off to Afghanistan because she can't find anybody to take care of her little boy. Should she be forced to deploy? Her lawyer is going to join us in just a few minutes.
We're continuing our special series "The End of Privacy," tonight using the web to whip up a brand new identity. Just how easy is it to disappear and start all over? We're going to show you at the top of the hour. John?
ROBERTS: See you then. Looking forward to it. Thanks Campbell.
Still ahead, the owner of the Tennessee Titans declares, we're number one. But the way he did it got him in an awful lot of hot water. Stay with us.
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ROBERTS: In a case of older is not always wiser, the NFL has fined the 86-year-old owner of the Tennessee Titans $250,000 for his antics during Sunday's game. Titan's owner Bud Adams was caught on tape repeatedly flipping off the Buffalo Bills and their fans from his luxury box in the stadium. The Titans went on to beat the Bills, 41- 17. Adams has apologized for his actions saying, quote, he was caught up in the moment.
Thanks for being with us. See you tomorrow. We'd love it if you'd come back and join us. Up next, Campbell Brown.
