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CNN Larry King Live

Bill Clinton on Health Care Reform

Aired March 11, 2009 - 21:00   ET


DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Tonight, Bill Clinton exclusive on the nightmare that keeps 45 million Americans from seeing a doctor -- the health care disaster.


BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: It's difficult to see how America can be a preeminent country in the 21st century without an affordable, high quality health care system.


GUPTA: He couldn't change the system.

Can President Obama?


CLINTON: I think he's doing it right.


GUPTA: If you can't afford to get sick, if you're going broke getting treatment, if you're desperate to help your suffering child, you need to watch this show.



BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Christopher did not get that chance, but maybe one day, others like Christopher Reeve might.


GUPTA: Christopher Reeve's daughter

Is it in time to save your life?


I'm Dr. Sanjay Gupta sitting in for Larry King.

The health care system itself is an ailing patient and it needs to be healed. That is the message from President Obama. And he kicked off the effort last week with a White House summit. But talking health care reform is one thing, achieving it quite another. Just ask Bill Clinton.

In the fall of 1993, polls showed 90 percent of the public wanted either a fundamental change in the public health care system or a complete rebuild. So I sat down for an exclusive interview with the former president to talk about this earlier today.

Now, in the interests of full disclosure, I was a White House fellow during his administration and served as an adviser to then first lady, Hillary Clinton.

Plus, until withdrawing my name, I was under consideration to become this administration's surgeon general.

I began my interview with Bill Clinton by asking him why, despite the public's appetite for change, he couldn't get health care reform done.


CLINTON: Well, I think, first, we had a couple of problems that don't exist today. At the time -- let's review the bidding. At the time, we had about 14 or 15 percent uninsured. Today it's more than 16 percent. We had a lot of people underinsured, but there are probably more than 30 million underinsured today -- a huge underinsured problem.

We were spending 14 percent or our income on health care. And nobody else -- none of our major competitors were more than 10. Now we're at 16.5 and none of our competitors are over 11, except for Switzerland, which has an unusually old population. They're at 12.

So all of the problems are worse.

Secondly, they really -- both -- in the presidential campaign good ideas came out. And both Senator Obama and Hillary came out with this idea that you could achieve universal or near universal coverage without an employer mandate if you subsidized individuals and small businesses and gave them the option of buying into the federal employee health insurance plan, which is a bunch of private plans, as you know -- assuming there was no other available option.

So when I did it, we had very -- we had budgetary constrictions. We couldn't raise taxes. We just raised taxes and cut spending to balance the budget. And therefore our only option was to have an employer mandate. That put the small business lobby in with the health insurance companies. And together that, plus the unified Republican opposition in the Senate, was enough to beat it.

Now, you've got the small business community wanting something new. The physicians were divided last time. They're united in believing we need reform. And a number of the health insurance companies have said they are willing to move toward universal coverage. So I think that the consensus is overwhelming. You don't have the problems in the Senate that you had last time, although there is still the theoretical possibility of a filibuster.

So I think the politics and the economics are much better now. And the policies are better. These -- the policies that came out of the Democratic primary process this time are, I think, refined. They've made advances over where we were. So I feel good about all of that.

I still think the big test now is going to be how do we do more to bring costs in line with our competitors and improve health care?

We've got to do more primary prevention. That's why I spent so much time on the obesity issue, because I think that if we don't change the delivery system, then we'll cover everybody for a while, but we'll be up to 18 or 19 percent of our income on health care and eventually we won't be able to afford it.

GUPTA: I want to talk about some of those cost-saving measures and what you've been doing since you were president, as well. Let's talk about the timing of this. You talked about the politics. The cost -- the economy is in the tank, by all measures. "It's the economy, stupid," that was the mantra of '93.

Should we be focusing on the economy for now?

Health care is an important, education is important, energy is important.

But how does that help the economy?

How do you sell that?

CLINTON: Well, first, I believe that health care and education and energy are all economic issues. It's difficult to see how America can be a preeminent country in the 21st century without an affordable, high quality health care system; without doing a better job in K through 12 education and doing a better job of getting more people into college and out of college; and without becoming more energy independent through clean energy and greater efficiency.

And if we do the right things, then education will give us more of the right kind of jobs, energy will generate millions of jobs and health care will both make us a healthier, stronger, more productive country and free up money that we would otherwise be wasting on health care to invest in our children's future.

So I think they should do all of these things. What they have to remember, though, is that there are, in essence, no budget constraints now on Washington because we're in a period of asset deflation. In other words, we're worrying about the economy contracting. So we need the government to spend money now.

When the economy comes back, I think in some place -- between one and two years is what I think will happen -- then the government will have to exercise more fiscal discipline.

They'll have to take money out of the system -- the Federal Reserve will. And the federal government will have to exercise more budgetary restraint.

And so it's important, if we're going to do health care reform and education reform and energy reform now, which I think the president is right to pursue, that particularly on health and education, we have to know what we're going to do as we come out of this to avoid high interest rates and inflation.

But they have no choice but to do this investment now. They're doing the right thing.

GUPTA: Is it that the public -- are they going to understand that some of the rewards from some of the programs you're talking about aren't going to felt for a decade, maybe two decades?

CLINTON: Well, I think people are pretty smart about that. I think that, first, insofar as we expand coverage and protect people in down economic times, they will receive rewards that are immediate.

And I noticed in the election season -- I always thought health care was an underreported issue, because people talked about the economy. But for many people, many working families in America, before the financial crisis, the economic problem they had was health care. Health care was driving the majority of the bankruptcies in this country. It was -- it was keeping parents up late at night. It was the economic problem.

And so I think that this is one of those moments when the president can make the case he made yesterday on education and the case he made a couple of days ago on health care.

We may not get everything we want right now, but I think it's important to realize that the system will accommodate more change now than it normally would. And he ought to drive through as much as he can. If we get the framework in place, then next year and the year after that and the year after that, we can build on it.

GUPTA: Fifty days now into his presidency, he's had -- he had this health care summit, as we know about.

If he were here right now, what's the one stumbling block that you might remind him of when it comes to health reform?

CLINTON: Well, I think he still has to worry a little bit about a filibuster. But I think -- I think he's doing it right. The plan they have that emerged from the primary process -- it started -- I don't know if you remember this. There was a big health care forum sponsored by the Center for the American Progress in Las Vegas.

GUPTA: Sure.

CLINTON: And Hillary spoke there. All the other candidates did. Senator -- then Senator Obama did. I thought she did very well there, but she had a bigger knowledge base. You know, she had years and years of working on this.

But it -- John Edwards had a very good health care plan.

So they all sort of upped their health care performance after that Las Vegas initiative because they realized what a very big deal it was to the American people.

By the time the primary was winnowed down to two candidates, there was some difference on how universal the coverage would be, but Hillary's plan and then Senator Obama's plan looked pretty close. The president then made it absolutely clear that he was going to pursue this.

And I will say again, we have a simpler, clearer path to the future than we did when I was there. You don't have to have an employer mandate. You don't have to have a tax increase now. And there -- and the risk of a filibuster is less. So I think the obstacles are less than they were.

Plus, the doctors want it now. The small business community needs it now. And the insurance community, even, is not unified against it now. So I think we've got a real shot here.

My worry is more on the back end.

GUPTA: Coming out of it?

CLINTON: I -- I don't want us to wind up getting universal coverage, which is morally imperative and necessary, and not do enough preventative and primary and cost control changes about the way the system is organized to bring our costs in line with our competitors. Because if we are 5 points of our GDP more on health care than any of our competitors and we're getting no better results, now we get worse results. But if we get no better results, then it will weaken our economy over the long run and we won't be able to afford the system.

So his problem -- the challenge is going to be not the coverage challenge, which is what all of us from Theodore Roosevelt through Bill Clinton faced. It's going to be the cost challenge.

GUPTA: Right. You brought up a lot of good points, including one about the role of the former first lady -- at that time, a pivotal role in health care.

We're going to ask you about that when we return with LARRY KING, just after this break.





OBAMA: This time, there is no debate about whether all Americans should have quality, affordable health care. The only question is how.


GUPTA: Obviously, Secretary Clinton -- now Secretary Clinton -- has a full plate. She has a lot of tasks in front of her. But she had a pivotal role in the early '90s and knows that, as you just stated, better than just about anybody.

Should she be used in some way when it comes to health care reform?

CLINTON: I don't know if she can be. She's pretty busy now. But, you know, she's interested in it. We both keep up with it. And I I'll bet you she and the president will have some personal conversations about it.

But the one thing -- the other thing that I didn't mention was she and I have been criticized for presenting a bill to the Congress. And President Obama is going to use the secretary of Health & Human Services, Governor Sebelius, to negotiate with Congress and let them do the bill. That is clearly the better way to do it.

But everybody has forgotten that we offered to let Congress write the bill and we offered Senator Dole the chance to do a bipartisan bill. The chairman of the House Ways and Means Committee at that time, Senator -- Congressman Rostenkowski, insisted that we present a bill, because he said that Congress was so unfamiliar with all the details, they could do better amending our bill than coming up with a bill on their own. So we did that because the Congress insisted on it, the leadership did.

I think now you have a much higher level of literacy in the Senate and the House and in both parties than you did when we tried before. Because people have been coming to grips with this and we've made a lot of progress. You know, we did the Children's Health Insurance Program and all that.

So, you know, if she -- she may have some insights on this. But the playing field they're on and the number of members of Congress who know enough about this to be really constructive players is much, much better. And she's pretty busy.

So if he asked her, I'm sure she'd love to talk about it. We talk about it a lot. We care about it. But they'll do fine.

GUPTA: You and Secretary Clinton?

CLINTON: Yes. We talk about it a lot. But I think they're going to do fine.

GUPTA: All right. Let's drill down specifically on something you said earlier. When it comes to sort of creating these silos of health care reform -- you have sort of single payers and more governmental involvement on one send -- one end, free market involvement solely on the other end. Single payer never has really caught traction politically. Is it politically unpalatable or is it a bad idea?

CLINTON: Well, I think it's more politically unpalatable than it is a bad idea, because single payer is not socialized medicine. Canada has a single payer system and a private health care provider system. Our single payer systems are Medicare and Medicaid.

GUPTA: Sure.

CLINTON: And Medicare is quite popular.

The good thing about single payer is the administrative costs are quite low. We probably waste $200 billion a year between the insurance administrative costs, the doctors and other health care providers' administrative costs and employers' administrative costs in health care that we would not waste if we had any other country's system.

On the other hand, if you look at the experience of Germany, France, Japan -- that don't have pure single payer systems, they have more mixed systems -- their costs are actually slightly lower overall than Canada's. So there's something to be said for having a mixed system if you can get the administrative costs down, because then the systems have enough competition in them to try to restrain costs and it's not all up to the political bodies.

In Canada, because it's all financed through the government, it's more difficult sometimes for the politicians to say no than for just the regular management of the health care system to cut the costs.

So I think you can have a mixed system. If you look at the French system, which scores very high on every international measure...


CLINTON:'s mostly publicly financed, but there's enough private in there that there's some tension that's creative and positive.

GUPTA: Do you think there is a degradation quality of care with a single payer system?

Is that a concern?

Should that be a concern?

CLINTON: Well there's no evidence of that in Canada that I'm aware of, except for excessive delays, which they always try to come to grips with. The British, you know, do have a completely government- run system, but they allow people who can afford it to get outside the system. And they've also started running hospitals almost like charter schools in America, that is, they have these trust hospitals that perform very well and therefore they're given more control over setting their priorities, specializing and cutting delays.

There are all kinds of different ways to do it. But first, you do have to cover everybody. And then you have to stop people from gaming the system. There's a lot of gaming going on now in the American system so that we spend more than anybody else and get loss for it.

I think that once you get the universal coverage, I think the health insurers then could play a more positive role than they do now, which is often involved in -- you know, they make a lot of money through saying no and sort of the inordinate paperwork burdens that are put on doctors and hospitals and other providers.

GUPTA: What is it about the insurance industry that you just brought up?

They tried to scuttle the health care reform plan of '93. Now they're saying we also believe in universal health care.

A politically tactile question, I guess, are you buying it?

Do you think they're being honest?

CLINTON: I think some of them really do want it. Yes. If you look at their new organization, the person who heads it came out of a progressive background and favored, as a philosophical matter, coverage.

Secondly, I think they now understand that, in terms of the health of America and the well-being of our economy, we can't go on basically giving them more and more dollars every year -- the insurance industry -- and getting people sicker and sicker and leaving more and more people behind.

I mean look at all the healthcare problems. The child obesity problem, which is my obsession, is the most glaring manifestation of a system that treats sick people and doesn't keep people well. And that's one where, I think, by the way, we can get broad bipartisan support on trying to -- to do more on wellness. And that will save money.

I think the insurance industry realizes that they -- a lot of the smarter ones realize that they could kill the goose that ate the golden egg here, that America can no longer go on spending more money and getting less for it and having all this money go to them and that they can make a lot of money and do well by making us healthier at a more affordable price.




GUPTA: Childhood obesity is something that you've spent a lot of time thinking about. These public-private partnerships have become very well known, your ability to target these at risk youth of obesity-related diseases, over a million this year, is the goal. It's amazing stuff.

You talk a lot about prevention. And one thing that sort of comes up and I find interesting as a doctor, that it makes perfect sense to keep people from getting sick in the first place. But the other side of prevention, this idea of should we be doing more screenings, might that find abnormalities that lead to biopsies, worry, concern and cost?

Can you take prevention too far?

Can it be a detriment as far as costs go?

CLINTON: Well, I think you have to look at it in the aggregate. And if you look at it in the aggregate, the answer is no. That is, if you do more screening and you find cancers earlier, you'll spend more money on treatment.

But if you add 10 or 20 or 30 years to someone's life and they're a productive employee over that lifetime and they contribute to the rest of our welfare, you've not only had an economic victory, but you've also fulfilled the moral imperative that we should all live as long and as well as we can.

Will that individual person cost more?


Will society pay more?

I don't think so.

And if you look at -- for example, what we've done is to try to first reduce the calories in school...


CLINTON: ...through better lunches and reducing the vending machine calorie content of drugs -- of, excuse me, of drinks and snack food. And we've had a lot of help from the industry in doing that. And that's good.

We try to increase the exercise programs in schools and communities.

But we recently announced a really interesting thing with Aetna Life Insurance Company and Blue Cross of North Carolina and Massachusetts -- and PepsiCo is our anchor employer -- to offer health insurance policies to the children of employees three through 18, either all of them or kids whose body mass index is 85 percent or more above the average. And they get four trips a year to a physician and four trips to a dietician to try to do this preventive work.

Now, there's no question that if you look over the lifetime of these children, we've got kids coming up with Type II Diabetes. Your profession told us two years ago that we could no longer refer to Type II Diabetes as Adult Onset Diabetes. Here in Harlem, where we are, we had a 9-year-old child three years ago diagnosed with Type II Diabetes.

So if you can just turn the tide on that, diabetes and its related conditions account for approximately 25 percent of all the Medicaid expenses. The savings to society will be enormous.

So, will some individuals cost more because we find their cancer and we have to treat it?

You bet. They'll live longer and good for them.

But the overall cost to the system will be much lower if we do this.

GUPTA: Let's talk about this thing on health internationally, AIDS -- another area which you've had a lot of focus. You've focused on this very carefully since being president.

Drug costs are something that come up all the time when it comes to overall healthcare costs. You've been able to lower these costs in so many countries, down to less than a dollar a day in some places.

How do we -- how do we do some of that same good stuff here domestically, in terms of bringing down some of these pharmaceutical costs?

They're so high, they're really hurting us.

CLINTON: Well, yes. The McKenzie Study done a couple of years ago said that we pay $66 billion a year more for medicine and that at least our older populations consume relatively less per capita than other wealthy countries.

There is a very simple answer to this, which is that we have made a bargain with our pharmaceutical companies. We've said to them for decades now, we love having you in America. We're proud of you. We know you have to spend a lot of money on research and then you market the drugs and all.

So we will eat your research and development costs in American prices so that you can sell exactly the same drugs you sell to us for less money in Canada and Europe.

Even our -- for example, our AIDS clinic down the street here in Harlem, the taxpayers pay $10,000 a year to treat people with the big pharmaceutical companies' AIDS medicine. That medicine costs about $3,500 a year in Canada and Europe -- countries with per capita incomes as high as America.

GUPTA: Right.

CLINTON: Now, if we're going to get out of that or move away from that to close some of that $66 billion window -- keep in mind, Europe has a lot of very successful drug companies and they don't do this.

GUPTA: Sure.

CLINTON: We need an honest, open, clear dialogue admitting that we're proud of these companies. They've got thousands of employees -- tens of thousands of employees. They've done a good job for America. They've saved countless lives. But we just can't go on subsidizing it as much as our other competitors can.

So how can we reach a different arrangement so that we keep the drug companies healthy enough and we keep them developing new medicine?

The system we've got is not working very well. They don't have a lot of new medicines in the pipeline, partly because we've lost the influence -- the emphasis on research and development.

A lot of -- so many new advances, particularly with the sequencing of the human genome, have led to patents on smaller and smaller and smaller components of what ultimately becomes a blockbuster drug. So a lot of new drugs are not coming because we haven't reexamined how the patent process and the research process are working together, or not working.

Meanwhile, we keep eating all these costs and countries just as wealthy as we are, are getting the same drugs made by the same people for less money, which is why there was so much opposition to allowing re-importation from Canada.

I -- what I recommend is let's don't pretend these drug companies are bad people. They've done a lot of good for us. But let's be honest that America is no longer so dominant over Canada and Europe and Japan that we can afford the whole subsidy. And let's -- the one good place to start is what President Obama has proposed, letting the federal government do what I do for AIDS drugs, letting them bargain...

GUPTA: Right.

CLINTON: ...for lower prices for well-established medicines bought in bulk for the benefit of our seniors. That's a good place to start. And we just need to work out a new deal with them so they can do well.

But, you know, for most of the 1990s and the early part of this decade, they earned 18 percent, which is a huge return. You know, Wal- Mart is, what, 5 or 6 percent. And it is fascinating to see that at the same time, because of a lot of these factors relating to patenting and scientific advances, the number of new drugs in the pipeline seems to be slowing down.

So we need to examine both how we can both get the benefits of genomic advances and how we can lower the cost to the consumers.

GUPTA: We're having a health summit of our own right now on LARRY KING LIVE, talking to former President Clinton.

There was an issue that came up with week that is one of the most controversial in medicine. It has to do with stem cells. Former President Clinton has been down this road. We'll ask him about it after the break.


(COMMERCIAL BREAK) GUPTA: I have to ask you, how are you feeling? I was there outside the hospital when you had your heart surgery. Are you back 100 percent?

CLINTON: I think so. It's interesting, in some ways, I'm stronger than I was before my surgery. And by conventional measures, I'm healthier. I've still got about ten pounds to lose that I gained in the campaign last year, working for Hillary. But otherwise I think I'm fine. The one thing I notice -- and my balance is better, when I'm doing balance drills. But the one thing I notice and what a friend of mine referred to as raw country strength, I don't know if I've recovered. Like, I can't hit a golf ball as far, even though I can lift more weight.

GUPTA: How far are you hitting a golf ball?

CLINTON: Not as far as I want to. I rarely hit 300 yards. I used to do it all the time. It could just be aging, but I think the surgery kind of discombobulated my internal coordination a bit. And I've just got to keep working on it. I've been working too hard for the last year and a half or so to do more than just maintain my weight and maintain my level of fitness. I think if I did a few different things, I could maybe get it back.

GUPTA: One thing I notice when I was talking to you -- we talked about this before -- when you point with your finger --

CLINTON: Sometimes it shakes. See it's a little shake, no shake here. I've been tested for it. I don't have Parkinson's.

GUPTA: Don't have it.

CLINTON: The doctor told me as people age, they become more vulnerable, for example, to having these muscles. Like if I write a lot.


CLINTON: Or play video games or, you know, just do anything like that, anything with a lot of my fingers, and these tighten up, or if I'm tired, if I'm working hard, it will cause your hands to shake. So see that's pretty calm today, a little bit of shake, none over here. And some days they both shake, some days none of them do. And I was quite concerned about it, because if I had Parkinson's, I wanted to know, so I could prepare.

I had it tested and the doctor says, no, it's just a normal aging phenomenon.

GUPTA: Let's talk about something you talked a lot about in the early part of your presidency, stem cells. There was an order today providing federal money for embryonic stem cell research. First of all, let me just ask you, as someone who studied this, is this going to always be as divisive an issue as it is now? Is this going to be the abortion of the next generation? Or are people going to come around? CLINTON: I think -- the answer is I think that we'll work it through. If -- particularly if it's done right. If it's obvious that we're not taking embryos that can -- that under any conceivable scenario would be used for a process that would allow them to be fertilized and become little babies, and I think if it's obvious that we're not talking about some science fiction cloning of human beings, then I think the American people will support this.

I think they'll support it because we want to solve Type-One diabetes. We want to solve -- we want to find out about whether Parkinson's and Alzheimer's can be reversed. We want a whole range of other things. I think at some point -- maybe it's decades down the way -- if somebody severs an arm and you try to sew it back on, and you're missing some component things, if you can figure out how to fill in the blanks, I think people would like that.

So I think we'll just have to debate it as we go along. I was anxious for the president to do this and get this research going again.

GUPTA: Any reservations?

CLINTON: I don't know that I have any reservations, but I was -- he has apparently decided to leave to the relevant professional committees the definition of which frozen embryos are basically going to be discarded, because they're not going to be fertilized. I believe the American people believe it's a pro-life decision to use an embryo that's frozen and never going to be fertilized for embryonic stem cell research, especially since now, not withstanding some promising developments, most of the scientists in this field and the doctors will tell you they don't know of any other source as good as embryonic stem cells for all the various things that need to be researched.

But those committees need to be really careful to make sure if they don't want a big storm to be stirred up here, that any of the embryos that are used clearly have been placed beyond the pale of being fertilized before their use. There are a large number of embryos that we know are never going to be fertilized, where the people who are in control of them have made that clear. The research ought to be confined to those.

And I think the committees will surely do that. But that I think is the only area of debate that I sort of saw. I appreciated the fact that the president wants to send a strong signal that scientific research on everything from climate change to the genome to the embryonic stem cells was too politicized in the previous eight years, and he wants to put it back to science. I agree with that.

But there are values involved that we all ought to feel free to discuss in all scientific research. And that is the one thing that I think these committees need to make it clear that they're not going to fool with any embryos where there's any possibility, even if it's somewhat remote, that they could be fertilized and become human beings.

GUPTA: Mr. President, thank you.

CLINTON: Thank you.

GUPTA: Some health seminar. I appreciate it.

CLINTON: Thanks.

GUPTA: Stem cell research and President Obama's recent decision. No one fought harder for this than Christopher Reeve. His daughter Alexandra is here to talk about it. We have her next on LARRY KING LIVE. Stay with us.


GUPTA: We're back with LARRY KING LIVE. Joining me on the set now, Alexandra Reeve-Givens. She's daughter of the late Christopher Reeve, also a member of the board of directors of the Christopher & Dana Reeve Foundation. And Peter Kiernan, as well, chairman of the board of the Christopher and Dana Reeve Foundation. Thank you both for joining us.

Stem cell is obviously a big topic this week. President Obama, as you know, paid tribute to Christopher Reeve earlier this week when he signed the executive order lifting the restrictions on federal funding of human embryonic cell research. Take a look.


OBAMA: One of Christopher's friends recalled that he hung a sign on the wall of the exercise room where he did his grueling regimen of physical therapy. It read, "for everyone who thought I couldn't do it, for everyone who thought I shouldn't do it, for everyone who said it's impossible, see you at the finish line."


GUPTA: That's amazing to hear him talk about your father that way. The accident was back in 1995. It's remarkable how much time has passed. What was it like for you to watch President Obama sign that -- talk about your father like that? Bittersweet or how did you feel?

ALEXANDRA REEVE GIVENS, DAUGHTER OF CHRISTOPHER REEVE: It was a tremendous honor. Our whole family was just moved to be mentioned in President Obama's speech. And this whole event, signing this executive order, it's a big moment for us, and for the spinal cord community and disabled community as well.

GUPTA: A lot of people so focused on stem cells, trying to learn more about it, understand it better than ever before. Peter, you read this legislation. Is it going far enough? What are we going to see?

PETER KIERNAN, CHAIRMAN, CHRISTOPHER AND DANA REEVE FOUNDATION: I think the most exciting part is we've begun the process. The event has passed. And now we've been given a privilege. Frankly, it's time for the NIH, the National Institute of Health, to take its rightful place at the head of the parade. We want them on that wall. We need them on that wall. I think the other exciting thing is there's been a lot of young scientists who have been sitting on the periphery, viewing stem cell research as a cul-de-sac, with bad Karma and not a lot of funding.

Well, as of that announcement, that cul-de-sac just became an on ramp to a super highway.

GUPTA: The culture is going to change, I think, too, as a result of this federal funding. How divisive an issue is this? When you talk to your friends about this, as part of the foundation, do you still sense that from people, just that this is such a divisive issue?

GIVENS: It's tough and I think that's one of the most important things about this executive order, is that we're moving away from a policy of fear, and instead focusing on the incredible benefits that can come, focusing on the help and the quality -- health and quality of life for millions of people living around the world.

GUPTA: It's a tough thing to grapple with a little bit, because, as of now, we don't know of a single human being that has benefited from stem cells that's been published in some way, reproduced in some way. How much process is there, based on what you're hearing from scientists? Is it all still just a promise or is there more than that?

GIVENS: I think there's tremendous potential here. We have a long way to go, and a lot of work to do. But as Peter said, the door has been opened. And to have the support of the federal government, to now be working in a centralized way, with a central source of regulation and oversight, it's tremendous difference.

GUPTA: Peter, how quickly are we going to see something? When will we be on the show again talking about something definitive?

KIERNAN: I think in terms of the regulation and the rules of the road, I think very quickly. In terms of achievements, I think we have to counsel patience. That it took -- one of the first stem cell initiatives ever was bone marrow transplant. It took ten years to get it right. This is something we're going to have to use that kind of calendar thinking.

Whenever there's an event as exciting as occurred this week, the urge is to grasp right away for cures. They're going to be a long time coming. But you have to get started and now the hard work really starts.

GUPTA: And Christopher Reeve was a guest on LARRY KING LIVE many times. In July of 2003, he appeared via satellite and talked about his belief in the promise of stem cell research, what we're talking about, and the obstacles to making it a reality.


KING: Do you still have that motto? Do you still think you will walk again? CHRISTOPHER REEVE, ACTOR: I certainly have the motto that nothing is impossible. I think the question of whether I will walk is going to depend on politics. It's going to depend on collaborations between scientists around the world. It will depend on economics. A lot of factors that I knew very little about when I was injured eight years ago.


GUPTA: Never enough time to talk about all of this. But we should note that Christopher Reeve was also posthumously honored with CNN's first ever Hero's Hero Award. It's a thing that we take very seriously. It was in December of 2007. Alexandra accepted the award at the first annual event, the all-star tribute. It was quite an evening for you, wasn't it?

GIVENS: It was a tremendous evening to be honoring all these people, just regular guys and gals on the street. It was really something.

GUPTA: Peter, you were there as well.

KIERNAN: I was and it was very moving. And you know what? It was more than a job well done. It was a reminder to both of us that we've got to get going. We've got a lot of work to do. We've got miles to go before we sleep.

GUPTA: I hope we can talk about this a lot more. We talk about embryonic stem cells, adult stem cells, all that's happening. There's a lot to talk about. We're going to keep on it. Thanks so much for joining us.

GIVENS: Thanks for having us.

GUPTA: Do you agree at home with the president's plan to use federal money for stem cell research? That's tonight's quick vote. Go to and cast your ballot. We'll have much more on the health care crisis. Also, we're going to focus on possible solutions that could affect you. You've got to watch this. Stay with us.



GUPTA: We are continuing with our own health care summit. We're going to drill down on some of these topics. Joining us from Washington, we have John Podesta. He's president of the Center for American Progress. He also served as chief of staff for former President Bill Clinton. His boss was just on. He also attended last week's health summit. Dr. Bill Frist is also joining us. He's former Senate majority leader. He's a heart and lung transplant surgeon as well. And here, my friend in New York, Dr. Mehmet Oz, a cardiac surgeon as well. You have so titles here, founder and director of the Complementary Medicine Program at New York. You're also, obviously, a best selling author and a friend. I appreciate you being here. DR. MEHMET OZ, NEW YORK UNIVERSITY: Thank you, Sanjay.

GUPTA: You've all watched what we were talking about here. Let me start with you, John, if you can. This is something you've been focused on for sometime. Health care reform; since Teddy Roosevelt they've been trying to get this done. Is it going to happen?

JOHN PODESTA, FMR. CHIEF OF STAFF TO PRESIDENT BILL CLINTON: I think it is going to happen. I think the president said we need to do it. We need to do it this year in his address to the joint session of Congress. I think that if you watched his health care summit last week, you saw a lot of agreement and a lot of parties that had been opposed to health care reform coming together to say OK, we're in the game.

GUPTA: Let me ask quickly, I asked the president as well, with regard to single payer systems, has that been something that has ever been on the table with this administration, or is that simply never going to happen here, John?

PODESTA: I think the president has been clear that he wants a system that if you like your insurance and you like your doctor, you can keep it. So I think he's building out on what currently exists, but he wants to give people more choices of insurance they can get. And, most importantly, I think he wants to bend the curve on the cost of health care that's just crushing family budgets and crushing business budgets around the country.

GUPTA: Senator Frist, Dr. Frist, which do you prefer?

BILL FRIST, FMR SENATE MAJORITY LEADER: I think doctor for tonight.

GUPTA: Dr. Frist. OK, we'll call you Dr. Frist. The economy is obviously a big issue right now. Is it an impediment to getting health care reform done or could it be a stimulation?

FRIST: Sanjay, I think a little bit of both. The more people link the cost of health care to the cost and the really travails of the economy, I think the more powerful push. I think what is important is really what President Clinton said, is that we can't go out and promise everybody coverage, universal coverage, without addressing the fundamental issue of cost.

But cost security, economic security, if they're linked hand in hand, I think it does increase the impetus for a more comprehensive health care reform, where we can have 100 percent coverage for all Americans.

GUPTA: How optimistic are you about this? I mean, you're a practicing physician.

OZ: I'm very optimistic actually. I'll tell you why. It came up in your interview with President Clinton. We're spending a lot more per person in America in health care than they are in Canada and Europe. Part of the reason is in many areas we're sicker. Since we know that 70 percent of these aging processes are driven by lifestyle changes, if we can change the culture of wellness in America and we can build systems -- we've had discussions with the Institute of Medicine. This month, we've had discussions with the Senate about how you can make, for example, health coaches, which could be a tier of health care providers that don't cost a lot to train, but could actually provide the infrastructure to people to make it easy to do the right thing.

If we can make that happen in America we'll cut our costs. Everything else falls into place.

GUPTA: Dr. Frist, the message, eat right, exercise, prevention, wellness is something you talk about. Dr. Oz talks about it. I talk about it all the time. People don't always listen to this. How do we get this message which everyone seems to think is important? How do we get it through?

FRIST: You know, I think the prevention and the management of chronic disease we need to come back to. It's going to take a strong surgeon general. It's going to take a changing culture of what we're used to. I do think we have to do more than just that, though. If we're going to have more affordable coverage for all Americans, we have to not only shift the cost curve down, things like administrative costs, which you talked about earlier in the show, but you have to bend the cost curve itself.

I would argue the way to do that is use market forces. Have more of a patient centered system, more provider friendly, more consumer driven, that uses 21st century information, and choice, with some element of control. I think that's the only way. So prevention is very important. The Obama administration put out IT, information technology. They put out prevention. They put out comparative effectiveness the other day. All very important.

But in terms of health service delivery, we're going to have to bend that cost curve over time. Otherwise, promising coverage for everybody simply cannot be sustained.

GUPTA: So this all raises the question, what is the health care system going to look like five, ten, 30 years from now? Find out when we return.



OBAMA: In this effort every voice has to be heard. Every idea must be considered. Every option must be on the table. There should be no sacred cows.


GUPTA: Welcome back to LARRY KING LIVE. We're doing our own health summit tonight. You're all familiar with health care in other nations. I myself am just back from India. One of the things I was looking at there was the health care system, Dr. Oz. They do world class surgery there. They do it at a fraction of the cost, not kidding, about a tenth of the cost. And it's very good care. How can they do it so much cheaper? You've been there as well.

OZ: I have. It's in China and many other countries as well. When they cut all the fat out, they have a health justice system. By that I mean they don't have a tort system that actually stimulates defensive medicine practices. So they get done what they need done in an efficient way.

But I got to say, trying to take that to America, we need one other important element. Tip O'Neill used to say all politics is local. All health care is personal. In India, your family is always with you. So they absorb a lot of the extra expense that in this country we might deal with by sending you off to one home after another. I think we have to do that in this country. I think we can do it through service.

It's a wonderful opportunity. Programs like Health Corps go out there and they actually make it easy to take those obese children that President Clinton spoke to you about and make them part of the solution, make them activists, teach them how to protect their own bodies, not just because they want to be healthy, but they want the mental resilience to take care of what's in here, so they can take care of what's out there, also.

GUPTA: John Podesta, President Clinton just talked about the fact, as much as he focused on access in the early par of his presidency, President Obama needs to focus on cost. How do you get more people signed up for health care and reduce costs at the same time? Won't the costs continue to increase? How do we pay for that?

PODESTA: In fact, what we have now is a lot of cost shifting. People pay about 900 dollars a year to pay for the uninsured. So we have to get everybody in the system. We've got to have the delivery for them that the doctor talked about, and that my friend Dr. Frist talked about. And I think what we've got to do is focus on wellness, focus on disease management. But we also need a lot more information about what works and what doesn't, and pay for the things that work and get rid of the things that don't.

We're just wasting a lot of money in the current delivery system.

GUPTA: Dr. Frist, what grade would you give so far this administration on dealing with health care reform? And are they going to get bipartisan support?

FRIST: You know, I'd give it a B plus. I think it's moving in the right direction. We do have to eliminate the inefficiencies and the terrible waste in our system today. The inefficiencies involving 45 million uninsured and the ways that is accompanied with the huge variations in the practice and charges for health care across the country. I believe they're systematically looking at it.

The good things they're doing, they're being very inclusive, listening to people on both sides of the aisle. As President Clinton said earlier, it is smart not to have the administration write the bill, but include Congress, Republicans and Democrats at the table, which is the intention. It's a tough problem. Republicans don't have the answer. Democrats don't. It's going to have to be an American problem that we address head on.

Cost, access, and that will have to be coupled with quality. I think -- I know that it can be done. It can be done.

GUPTA: All right. Dr. Frist, thank you very much. This is our own version of the health care summit. John Podesta as well, who has been focused on this for a long time. And, of course, Dr. Oz here in New York, thank you so much.

An interesting discussion. We'll keep on it. I assume we'll be talking about this for weeks and months to come. Thank you so much. You can go to and let us know what you think about health care, stem cells or anything else. is the address. Click on blog. Start typing.

While you're there, take the quick vote about stem cell funding. Hey Larry, thanks so much for letting me sit in the seat tonight. I got kind of comfortable here. Don't you think? Time now for Anderson Cooper and "AC 360."