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Sanjay Gupta MD

Swine Flu Vaccine Testing Underway; Hidden Hospital Fees Revealed; Shape-Up Shoes

Aired August 15, 2009 - 07:30   ET


DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL: the show that helps you live longer and stronger. I'm Dr. Sanjay Gupta. Thanks so much for watching.

First up, testing the safety of a new swine flu vaccine. It's already under way across the country. Here is a question: Would you have your kids get the shot? It could help kids across the country, maybe even across the world.

Then, he spent 20 years in the health insurance industry. Now he's talking with us. He's called a whistle-blower. He's going to give us a rare view inside their tactics.

And milk does a body good. I don't drink enough of it. And there are some better ones than others. We're going to give you the truth about milk.

You're watching HOUSE CALL.


GUPTA: Across the country this week, hundreds of people are becoming the first to get the swine flu vaccine through clinical trials. Next up is going to be trials for kids, children as young as six months are being signed up by their parents to become human guinea pigs.


GUPTA (voice-over): It's a typical summer day for Andrew and Nathan Stein. And what they plan to do for the rest of their school vacation is anything but typical. In a couple of weeks, both boys will enroll in a human trial of a vaccine to prevent the H1N1 or twine flu virus.

Although both admit they aren't looking forward to be poke with needles, their decision to join the trials is personal.

ANDREW STEIN, TRIAL PARTICIPANT: One boy that I knew at our school died from a type of the flu. So, I wanted to prevent that as much as I could.

GUPTA: The boys' mother, Christy Stein, supports their idea. She was involved in a trial of a pediatric vaccine to prevent swine flu back in 1976.

CHRISTY STEIN, MOTHER: I trust the people who are running the study. And I'm not concerned about it at all.

GUPTA: Why enroll children into an H1N1 vaccine trial? Well, it seems young people age six months to 24 years are more susceptible to the virus. And because young people are different, trials also need to be tested on youngsters.

DR. KAREN KOTLOFF, UNIV. OF MARYLAND SCHOOL OF MEDICINE: Particularly in the younger population, groups that may need a higher dose or two doses of the higher dose, et cetera. And these studies will answer those types of questions.

GUPTA: The Centers for Disease Control has also warned pregnant women are at high risk. But for now, adults, young people, and those over the age of 65 will be tested in different groups to determine dosage.

Scientists say it's extremely important. They complete their pediatric trials so they have a proven vaccine to protect kids if the swine flu begins to spread rapidly in the United States. Even the Steins' grandfather who happens to be a pediatrician believes his grandsons can make a difference.

DR. WAYNE CROWDER, GRANDFATHER AND PEDIATRICIAN: The H1 influenza has potential for causing a severe pandemic. I'm interested in doing anything I can to protect my family, my patients and the general public health.

GUPTA: Nathan Stein agrees.



GUPTA: You've been telling us you have a huge amount of interest in this.

So, joining me now, director at one of the sites where clinical trials for the vaccine are currently underway. Dr. Kathryn Edwards is leading the H1N1 vaccine trial at Vanderbilt Medical Center.

Thanks so much for being with us, taking a break from your busy schedule. Thank you.


GUPTA: Let me start off by asking, what are you seeing? How are the participants so far tolerating the vaccine?

EDWARDS: They're tolerating it really well. They are signing up in large numbers. Most of them that we've called in the last couple of days say that their arm might be a little sore, but most of them are saying that they actually have less discomfort or inconvenience than the usual flu vaccine that they get every year.

GUPTA: What's the -- is there something that's been the worst thing you've seen?

EDWARDS: We really haven't seen anything that's significant at all. So, it's really been very well tolerated.

GUPTA: How long before you can say this is safe?

EDWARDS: Well, I think that we certainly will look at the patients that we're enrolling. We're going to be enrolling about 140 in this study and then we'll go to the children. And every single day, all the data goes to the NIH. And so, every single day we know what all the participants are doing. And so, I think that the more people that we enroll, the more reassurance that we'll have.

But what we're seeing now is really actually less than what we usually see from the usual flu shot.

GUPTA: You're going to be -- you're going to be testing children as well at Vanderbilt.

EDWARDS: That's certainly. Yes.

GUPTA: Any specific concerns about that?

EDWARDS: No. I think that one of the good things about this vaccine is it's made in exactly the same way as the usual flu shots that children get. It's grown in eggs and purified. And we're simply going to be studying two different doses, one the dose you usually get and one with a little bit more.

GUPTA: We're looking at possibly three vaccinations from what I understand -- one for seasonal flu, two shots for H1N1. It's hard to get people to get their flu shots. I talk about this all the time. Which one is more important to get, if you had to pick -- seasonal or swine?

EDWARDS: Well, I think that one of the problems with influenza, it's very hard to predict what's happening -- although if we look at what's circulating in the southern hemisphere and what actually is still even circulating now, my bet would be that there will be more H1N1 swine flu than the other.

GUPTA: Really quick, pregnant women have been listed as well as particularly vulnerable.

EDWARDS: Exactly.

GUPTA: Is there going to be trials for them as well specifically?

EDWARDS: Yes. They're going to be starting very soon. Right after we get the children enrolled, we will be enrolling pregnant women in the H1N1 vaccine trial.

GUPTA: We've been hearing October potentially, Dr. Edwards, is when the vaccine be available, at least the first shot. Is that what you're hearing as well? EDWARDS: That's what we're hearing as well. And we're sending blood away every night so it can be tested immediately and working really hard to get all of the information as soon as possible. So, I think that timetable seems very reasonable.

GUPTA: Thank you so much for joining us.

EDWARDS: Thank you.

GUPTA: Now, if you interested in enrolling yourself or your kids even in the vaccine trials, you go to You get a lot more information over there.

Now, what the health insurance industry doesn't want you to know. I found this really interesting. I've been wanting to interview him for sometime, a little scary. We're talk about an industry insider just ahead.

Plus, check out this MRI. Can you spot the problem that brought this patient to the hospital? It's an operation pop quiz. I've got the answer in "Ask the Doctor."


GUPTA: We're back with HOUSE CALL.

You know, we talk about the high cost of health care and there's no better example that exists than looking at a hospital bill. Many patients open these bills and they see charges that not only are confusing but they can seem outrageous. I look at those all the time and I'm confused by them.

So, we decided to take a look at what other charges besides your direct care are rolled into your hospital visit.


DEBBIE FRAZIER, PATIENT: And all the X-rays, there's a rotation tool for 119. There's a wrench kit.

GUPTA (voice-over): On its face, it looks pretty straightforward. But your hospital bill is anything but. Something 56-year-old Debbie Frazier found out the hard way when she had surgery in March.

FRAZIER: I just had to have the battery replaced on my defibrillator. I was in there two days and it was $196,000.

GUPTA: A hundred and ninety-six thousand dollars. That's because once with you strip away what you pay for your actual care, there are layers of charges that have nothing to do with your hospital stay.

Take a look at Debbie's bill -- nearly $3,000 a day for room and board; $72,960 for the pacemaker; $44 for two Lipitor pills.

But the key is what you don't see on the bill.

JAMES BENTLELY, AMERICAN HOSPITAL ASSOCIATION: And I think it would help consumers if they understood that that bill represents really four tiers of cost.

GUPTA: There is the direct cost of your care, then there's the overhead cost, the cost of running the hospital -- things like administrative staff, the utilities. There's also the operating margin, that goes toward things like new medical technology, replacing worn equipment. And finally, subsidy cost for uncompensated care.

Insured patients help pay for the uninsured and underinsured who can't pay their bill.

RON POLLACK, FAMILIES USA: It's a significant part of the bill you'll never see it written in the bill, but it's sure there. It's a hidden surcharge.

BENTLEY: If the costs weren't passed on to consumers, we wouldn't be able to care for people who have no insurance. We wouldn't be able to train physicians and doctors for the future. We wouldn't be in a position to maintain the facility.

GUPTA: The American Hospital Association's James Bentley admits it's a complicated system and it's almost impossible to look at a bill line by line and pull out the direct cost of your care.

FRAZIER: Fored (ph), that's not the generic. Monopril is not the generic that I take anyway.

GUPTA: Frazier says it's time hospitals got creative. She's even got a suggestion.

FRAZIER: They need to use generic medication. That will keep their costs down.

GUPTA: And hopefully, those savings will be passed on to you.


GUPTA: Well, bringing down costs, obviously, is a core point in any discussion about health care reform. And the battle over health care is heating up. I mean, just look at the town halls this week.

Meanwhile, a health insurance insider has stepped forward to warn the public about the industry's plans during the entire health care debate. And Wendell Potter is a former insurance company executive. He's once the chief spokesman for the CIGNA Insurance Company. He's now a senior fellow at the Center for Media and Democracy. He joins us from New York.

Welcome to HOUSE CALL.

WENDELL POTTER, FMR. HEALTH INSURANCE CO. EXEC.: Thank you, Dr. Gupta. GUPTA: Now, in the name of transparency, I should point out that you are pro-health reform and pro a public insurance option as well. Is that fair?

POTTER: I have been saying that, absolutely. I think that's a vital part of health insurance reform.

GUPTA: You know, as I'm interviewing you right now, and you may know this, it is fair to say that public option is maybe gasping its last breath. Some of the blue dog Democrats are coming out and saying it just doesn't look this is going to happen.

What is your reaction to that?

POTTER: Well, I think that they need to take another look at it because I think it's vitally important. And I think that they're saying -- they may be saying that because they're just not realizing the importance of having a public option and what that will mean for people who would prefer to have a public option as opposed to a private insurance option.

If we don't have that and there is an individual mandate, which appears to be likely in the legislation, that means that all of us would have to be enrolled more than likely who are uninsured in a private plan and those of us who might not be able to afford all the premiums, tax dollars would have to go straight into the insurance companies. I don't think that's a good idea.

GUPTA: I'm a practicing neurosurgeon, as you know, and I deal with loads of paperwork and denials from the insurance company, some of which you've talked about.

POTTER: Right.

GUPTA: Was that part of a strategy? I mean, this idea of denying care. You know, for example, I would write this patient needs a cervical spine operation and I immediately get these calls where they would say, "Dr. Gupta, thank you for taking care of this patient. We see that he needs a cervical spine operation, terrific, except we're not going to pay for it."

Was that part of the strategy?

POTTER: Well, actually, yes. Because the insurance industry knows that doctors will often -- will just give up.

GUPTA: Was there a particular story that you remember? I mean -- and again, we all have these pivotal moments in our lives. But was there a particular case or something that really illustrates what you're talking about?

POTTER: You know, one of the things, though, that really was probably a deciding factor was -- what we call a high-profile case in the insurance industry -- involved the death of a 17-year-old girl in California whose doctors had recommended a liver transplant. CIGNA initially denied it and the family appealed, and ultimately, after a public protest, the company reversed itself and did provide coverage or said it would, but the girl died a couple of hours later.

GUPTA: You were part of CIGNA at that point when that particular case was denied or the claim was denied.

POTTER: I was.

GUPTA: How do you -- how do you dealt with that emotionally? I mean, because I -- you know, again, I'm a physician who takes care of patients. How did you deal with that? She died just a couple of hours after this was reversed.

POTTER: Yes. It was -- it was one of the most difficult things that I had to deal with in my career. It was -- it was just emotionally wrenching because, you know, I'm a father, and I have a daughter. And I could just imagine what the family was going through. And what I would have done myself had I been a parent. I would have done exactly the same thing that they had done to try to get the procedure covered.

GUPTA: I don't want to belabor this point, but -- you know, again, this idea that I have these patients at Grady who can't get their operations and I hear about these insurance executives like you used to be flying around in private jets and living in these towers that are huge and making millions and millions of dollars. It really -- I've got to tell you -- it breaks my heart. It really -- it really is hard to think about.

But what is the biggest secret that you think health insurance companies don't want us to know?

POTTER: That they are really behind the efforts to kill reform and to gut it. They are really behind the effort to make sure we don't have a public option.

GUPTA: There seems to be a large number of people who are very concerned about where our health care system is. Yet, as you mentioned, the outrage at these town hall meetings, I'm trying to decipher this, put this all together. And I hope you'll be someone who can help us again in the future.

POTTER: Thank you very much. Thank you.

GUPTA: We'll be hearing out more from Wendell Potter in the coming weeks on HOUSE CALL for sure.

And it's that time again, back to school, and a controversial vaccine is in the spotlight. We're going to have details.

Also, special athletic shoes that promise to tone your body. We'll tell you if they really work.

Stay with HOUSE CALL.


GUPTA: We're back with HOUSE CALL. You know, the HPV vaccine was approved just a few years ago by the FDA which says it it's safe and effective for preventing cervical cancer. Now, the CDC recommends vaccinations for females 9 to 26 years old and immunization schedule for 11 and 12 years old. But parents of many preteen girls are not convinced by this and senior medical correspondent Elizabeth Cohen is here.

You know, we both covered this when it came out and it was the first time you had a vaccine that could prevent cancer. And everyone was pretty excited about it at that time. But now, there's more debate. What's going on?

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Right, there is more debate. Some parents of preteens, as you said, are not necessarily so excited and some physicians also are having some reservations. There was a survey of doctors in Texas that showed that half of them are not recommending the HPV shots for girls ages 11 and 12. And as Sanjay is said, it's on the CDC schedule for girls that age. Part of the concern is that it's new, it's only been on the market for just over three years, and that you don't know long-term effects of something that's so new.

Also, there have been reports of so-called adverse events in laymen's terms, that sort of bad things happening to people after they get the Gardasil shot -- complaints of neurological disorders, blood clots, and death. Now, Sanjay, as you know, when people report problems after a vaccine, it's not necessarily the vaccine that caused it.

And Merck and CDC -- Merck makes the shot -- are quick to point that out. Just because something bad happens after a shot, it could be a coincidence.

But still, there are these concerns.

GUPTA: It's worth pointing out that between the two of us, seven daughters.

COHEN: That's right. Not together. We want to be clear. Not together.


COHEN: But, right. But seven daughters.

GUPTA: Seven daughters. This is a decision we're going to have to make at some point. But let's say you go to the pediatrician's office, the pediatrician is recommending this. What are pediatricians saying to patients or parents of patients who don't want this?

COHEN: Right. It was interesting, because I think most pediatricians -- if not all of them -- if you said, you know what, I don't want the meningitis shot, I don't want the measles shot...

GUPTA: Right. COHEN: The pediatrician would say, sorry, I really, really think you should get this. Many of the pediatricians that we talked to said that they weren't doing that. They were allowing parents to sort of put this shot off if that's what they wanted to do.

To see an interactive on, we have a great, great project that my colleague Sabrina Reich (ph) works on. This is three pediatricians responding to parents' concerns. You can see them right there. And so, we quoted from parents about the concerns they had and then we allowed the doctors to give their responses.

There's Dr. Jennifer Shu, who we all know is a doc.

GUPTA: I'm going to check it out myself. That's fascinating. I'd like to hear what they'd say. And I don't know what I'd do right now frankly.

COHEN: You got many years to think about it.


GUPTA: I got several years still to think about it.

Thanks so much.

COHEN: Thanks.

GUPTA: A lot more details on your column.

COHEN: That's right.

GUPTA: Elizabeth's column, she writes a column every week,


GUPTA: Just about every week on Twitter, I have been posting a picture, a kind of a neurosurgery pop quiz. I'm in the operating room every week and I post an unidentified image of some sort for folks to try and identify them. I decided to bring this to HOUSE CALL. It's been quite popular on Twitter, so I decided to bring this week's image right over here.

This one, this is a neck MRI scan. Right over here is the back of the brain. This is the cervical spine, the front of the spine.

But I want you to focus on an area right over here, this sort of white area in the middle of the spinal cord. This is the spinal cord coming down. This white area represents an area of injury.

I want you to focus on what happened here. This is a patient that fell that had a slight herniation of a disc. When the patient fell, they actually pushed that disc back against the spinal cord and caused that sort of injury.

So, if you've ever been curious what a spinal cord looks like, at least in the immediate term, it's right there. It's that white area right over there. Fascinating stuff.

We're going to try and bring this to you ever week on HOUSE CALL. We'll post those images every week. You can go there. You can e- mail. You can tweet your guesses, go to @SanjayGuptaCNN. And I'm going to try to give you a new neurosurgical mystery just about every weekend.

Now, fitness shoes that claim to give you a workout. We got the facts.

Also, what's in your milk? I'm fascinated by this. You're going to be surprised about all your options and what you might or might not get with your extra money.

Stay with HOUSE CALL.


GUPTA: We are back with HOUSE CALL.

You know, there's a new wave in athletic footwear promising toned muscles just simply by standing there. So, how can shoes get you toned without any exercise?

I was fascinated by this. We decided to separate fact from fiction.


GUPTA (voice-over): Every month, new fitness products are hitting the market that offer to help you get fit faster and easier. The latest craze: fitness shoes that claim to build your calves, hamstrings, and glute muscles. But do they work?

Sports medicine expert, Dr. Amadeus Mason, says -- probably not.

DR. R. AMADEUS MASON, SPORTS MEDICINE SPECIALIST, EMORY UNIV.: The main thing that makes one shoe better for another -- one person versus the other is the comfort of fit.

GUPTA: The EasyTone is just one example of these new rocker shoes. Reebok claims lab tests show a marked increase in muscle activation due to the mini-balance balls underneath the shoe.

MASON: The type of technology that they're using, people use that to rehabilitate ankles and work on your position's stance, not your fitness or your strength. And so, to think that that would then make you the more fit with your regular activity, I have a hard time kind of buying that.

GUPTA: Then, there's the Fit Flop, that claims added support for your feet leads to a fitter, more fabulous you.

Mason's verdict?

MASON: It does give good arch support. It does give cushion to the heel. And there is some support to the mid-foot, which you don't see in a lot of flip-flops. If you are buying it because you want a stylish pair of comfortable flip-flops, absolutely. I think that that would be a good purchase.

GUPTA: Both Reebok and the makers of Fit Flop say, while their footwear may not be the magic pill to get you fit, they can help release pressure on your feet and toned muscles that women and men care about.


GUPTA: We couldn't help but poke a little bit of fun at our own Rick Sanchez. He apparently wears these fitness shoes. He swears by them. He's used to tell everyone in the newsroom about them. I wonder who's going to have a heart to tell him that it may not be worth the dough. Karen, maybe you can do that?

Up next: We (INAUDIBLE) milk with a nutritionist. Her advice on some healthy alternatives to regular milk that could just save you some money.


GUPTA: And we are back with HOUSE CALL.

Have you poured yourself a glass of milk today? I'm not good about this. I should probably be drinking more milk. So we decided to take a look at the truth about milk.

A couple of instant facts, it turns out that organic milk has higher amounts of omega-3 fatty acids than regular milk. Those omega- 3s are good for your heart, may also provide some cancer protection as well.

Now, if you're not drinking that glass of milk every day or if you just need your milk to last longer, organic milk is ultra pasteurized. That process can kill off a lot of bacteria that cause spoilage. It could extend the life of the milk as well. It could be helpful if you are trying to save money.

You know, we decided to dig a little deeper, asked Atlanta nutritionist Cheryl Williams to take us inside the grocery store and show us some other healthy, even vegan alternatives.


CHERYL WILLIAMS, NUTRITIONIST: You also have vegetarian options like soy milk, which is really popular. It's a great source of protein. You also have rice and almond milk. These aren't such great sources of protein. But all three options are low in cholesterol, or rather, free in cholesterol. They're low in fat and they're also lactose-free.


GUPTA: Lactose, incidentally, of course, is a sugar in milk that some people have a hard time tolerating, can lead to a lot of discomfort. There are some other dairy options out there, you might be sensitive to lactose, such as lactaid and goats milks as well. Hope that helps you.

Unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast, Join us on Twitter, as I mentioned earlier, @SanjayGuptaCNN. Almost 600,000 followers. Thank you very much for following along.

Remember -- this is the place for the answers to all of your medical questions. I'm Dr. Sanjay Gupta. Thanks for watching.

More news on CNN starts right now.