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CNN Saturday Morning News

Reporter's Notebook: Health Care Legislation, Human Cloning

Aired June 30, 2001 - 09:36   ET

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

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
MILES O'BRIEN, CNN ANCHOR: Time now for our "Reporter's Notebook" segment. Your e-mail questions and comments, your phone calls too. Our focus, the patients' bill of rights, Vice President Dick Cheney's new heart procedure, and what we were just talking about, the crackdown on cloning.

Taking your questions today, CNN congressional correspondent Kate Snow, she's on Capitol Hill, CNN medical correspondent Rea Blakey, she's in Foggy Bottom outside George Washington University Hospital, and our medical correspondent, Elizabeth Cohen, sitting across the studio from where I stand right now.

Let's go to the e-mail right away without further ado.

This one comes from a gentleman with a handle I can't pronounce on AOL. The question is this, "With the patients' bill of rights, will I be able to select the hospital and physicians of my choice?"

Kate?

KATE SNOW, CNN CONGRESSIONAL CORRESPONDENT: Well, that's a really good question, and that gets to the heart of the bill. And in fact, this was an agreement among all the players, Republicans and Democrats. Everyone wanted certain provisions in this bill to protect patients in HMOs.

And indeed, you will be able to go to the emergency room if you have an emergency and you want to go to the hospital, without getting prior authorization from your managed care group, from your HMO, so that's a key difference in terms of hospitalization.

Also in terms of choosing a specialist, the access that you will have to specialists will be much greater. You won't necessarily have to always go through a primary care physician, as plans are currently set up. For example, if you're a woman and you want to go to an OB/GYN, you could go straight to that person. If you're a child, you could have a pediatrician as your primary care physician -- Miles.

O'BRIEN: All right. Let's move into cloning. Lots of questions about cloning today. Matter of fact, we got an equal balance of questions, it was interesting to see how people responded.

Elizabeth, this is for you. "Why is cloning looked at as immoral? Wouldn't many of us in our twilight years of life be glad to have a clone in which to transfer our psyche into to live another 100 years? I myself would weigh the issues, and in my last years of living might take into consideration of having a clone made of myself in some way, have all my knowledge and personality transferred," on and on and on. That's from Dave Aucoin in Norwood, Massachusetts.

Elizabeth?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, Dave, I have to say, I think you're in the minority. There was a survey that was done recently that showed that nine out of 10 Americans think that cloning is a bad idea.

One ethicist who I talked to said, You know what? It's just the yuck factor. It's just the thought that somehow scientists could just go and make another one of you or even worse -- I don't mean you personally, just another, another copy of a living person, or even worse, another copy of, let's say, a Hitler. I mean, that would be the worst-case scenario.

And people have in their heads this feeling that once we get cloning going, if it ever happens, that we could just create these huge armies of look-alike clones who look alike and think alike and could do terrible things if they were a clone of a terrible person.

Now, there are some people out there who say that this is just overblown and we should all just relax, that the technology isn't really there, at least not yet. And when it does happen, that it isn't necessarily going to be as bad as we all have in our heads.

O'BRIEN: And I noted just a few moments ago when we talked to the research director there at Clonaid, she was very coy when we asked her about how far along they are there.

COHEN: That's right, absolutely. She has -- she said earlier this year, "We could have a pregnancy as soon as April," April meaning two months ago. So they may have a woman out there pregnant with the world's first clone. We just don't know. She indeed was very coy. Or they may be nowhere near having a clone. They may be years away. We just don't know.

O'BRIEN: All right. Dale Friesen has this for Rea Blakey. "Please clarify the difference between a defibrillator and a pacemaker."

REA BLAKEY, CNN MEDICAL CORRESPONDENT: All right, Dale. A pacemaker generally was devised to speed up a slow heartbeat. A defibrillator could actually do two functions. It could slow down a fast heartbeat, which is what we understand Vice President Cheney is experiencing occasionally, or it could actually speed up a slow heartbeat.

So the difference lies in basically the technology. They're about the same size, they're both implanted in the chest, and both of them are regularly monitored by physicians who implant them just to make sure that there are no problems. But people can go for years and years with either a pacemaker or a defibrillator without the batteries, if you will, going out. So it could be five, 10 years before someone would have to go and have that machine rereplaced (sic).

O'BRIEN: All right, we have a natural segue from one of our e- mailers. This one is for Kate Snow. "If Mr. Cheney was not the vice president but rather an ordinary citizen, would his HMO have approved the expense of his 34-hour EKG monitor and the procedure that he has described as insurance against possible future problems?" That comes from Russ in Mississippi. Russ, good question.

SNOW: Well, you know, Miles, I can't answer that. Rea Blakey might be better to -- better able to answer in terms of the medical choices. But I can tell you that HMOs under the bill that was passed yesterday in the Senate are not necessarily going to have to change the way they make decisions.

What it really does is, it allows people rights to sue or to go after them legally if they don't agree with the decision. So let's say Dick Cheney was denied some care, or his HMO made a contract decision that he didn't agree with, well, then he could potentially pursue some legal action, either in state or federal court.

That's what the bill does.

O'BRIEN: All right. Dale Friesen has this for you, Elizabeth Cohen. "Which countries have no legislation on the books with regards to cloning? Or should I be asking in reverse, which countries have legislation with regards to cloning which might imply where this particular lab might be headed, or not headed?"

COHEN: You know what, Dale? I don't have a list. I'm sure which country -- countries have no legislation. I know that Brigitte Boisselier, who was just on our air, who's with the Raelians, was in France, and she said that she had to leave because she felt like she couldn't continue her cloning efforts there. And then they went to the Bahamas, and they said that the Bahamanian government made them leave there as well. So I know that you're not supposed to do it there.

In the United States, it's sort of a weird patchwork. There are four states where it is absolutely illegal to try to clone a human being. And then in the entire country, the FDA says they have jurisdiction. They don't say you can't clone. What the FDA says is that like any other scientific experiment, if you want to do an experiment that involves human beings, you have to go through us first, which the Raelians haven't done.

And that's why the FDA knocked on Brigitte Boisselier's door.

O'BRIEN: All right. This one goes to Rea. This comes from Alberta Ruelke. It's a very long one, so I'm going to paraphrase the last part of it. The basic question is, the patient, referring to the vice president in this case, "would he experience a loss of consciousness should the heart rate exceed set parameters, and the implant fire?" Such things as driving a car, would he be limited in any way in that respect?

BLAKEY: Well, I'm not exactly certain as to what her question refers to, but I can tell you that the physicians who worked with Mr. Cheney indicate that even if he does have this defibrillator implanted, there should be no restrictions whatsoever on his ability to complete his work as vice president. And therefore, I would assume that he could certainly drive a car if he chose to. I can't envision any issue that might preclude that.

But maybe she has more information than I do.

O'BRIEN: And he's got plenty of drivers, so don't worry about him a bit.

All right, let's go to the phone lines. On the line we have -- tell me again? Linda in Texas. Hello, Linda, good morning to you, welcome.

CALLER: Good morning. I would like to ask my question to Kate Snow on patients' bill of rights. And why is President Bush and all the Republicans against this when at one time they were trial lawyers and when a doctor or an HMO makes a mistake, we have a right to claim suit? And why do they want to cap it? Because our lives are valuable also.

SNOW: Well, let me tell you what their opposition is. First of all, the president and Republicans here on Capitol Hill are not completely opposed to a patients' bill of rights. In fact, the president has been very clear, last night after the vote in the Senate, he said, I like a lot of the things that this bill does. I like the protections, some of the things I mentioned earlier about emergency room access, access to specialists, that sort of thing.

They agree with those provisions. What is at issue is this issue of suing your HMO. How much right should you have? How far should that right go? Democrats and the bill that passed last night wanted it to be a pretty broad right. They're allowing, under the bill that passed in the Senate, for suits to go into state and federal court, and they put a pretty high cap on the amount of punitive damages, damages meant to punish the HMO, that you could get in federal court. That cap in this bill, about $5 million.

The president and Republicans wanted that to be much lower. In fact, they didn't even want punitive damages to be allowed. They wanted pain and suffering damages to be limited to about half a million dollars. They wanted the court cases to only be able to go to federal court.

What they fear is that by being able to go to state court and being able to sue for great amounts of money, they fear that it's going to cause rampant lawsuits, which would drive up, in their view, the cost of insurance, because HMOs would then have to protect themselves against that liability. They'd have to charge more for insurance. That might mean that some small businesses would have to drop insurance altogether because they couldn't afford it.

That's the Republican argument.

O'BRIEN: All right. Let's go back to Elizabeth Cohen and the issue of cloning for just a moment. Dale Friesen has this one. "Please explain the difference between a naturally occurring twin and a clone."

COHEN: Dale, the difference basically is age. Naturally occurring genetically identical twins are the same genetically. They have the same DNA. Obviously they're born at the same time, so they age together, they have a second birthday together, a third birthday together. A clone, however, would be years behind its parent, so to speak, or its twin, so to speak.

For example, the Raelians want to clone a baby that died at about 10 months of age. If that baby were still around, let's say, they would clone it, and then the clone would always be 10 months behind. Or let's say they cloned me, God forbid. My clone would always be 35 years behind me.

So at 35 years from now, the clone would look like what I look like now, and I'd be 70. So that's a very important distinction with cloning is that you don't clone a full-grown person into a full-grown person. You take a full-grown person, you take genetic material, you create an embryo, you implant it into a woman's womb, and you have a baby, so they're always behind their clone.

O'BRIEN: All right. Let's go back to the phone lines. Great questions on all these subjects. Charles is in Minnesota this morning. Good morning, Charles, welcome to the program.

CALLER: Morning. Yes, I was just wondering, how is this going to hold down on medical costs? I'll tell you, my wife passed away seven months ago with cancer.

O'BRIEN: Sorry.

CALLER: And she was 38. And we were too young for Medicare, and we weren't -- we had too much for Medicaid. And we had insurance and all that, but it still wasn't enough. And she was in the hospital for two weeks, and it just broke us. After she passed away, I had to sell everything I had, including a small aircraft and my boat and my home. And I can't see that even if they have a patients' bill of rights, that it's going to hold down on costs.

We had no choice in the matter. The doctors, when we found out that she would never survive, they said, no, they had to have these treatments, and it just brought -- jacked up the cost. Now, I'd like to know how it's going to hold down on costs.

SNOW: Well, Democrats would say to that that probably the answer you're looking for is really a different bill, Medicare reform and reforming the system that we now have. Of course, Democrats, many of them, favor going towards a more universal health care program, which might alleviate some of what you're talking about.

What the bill that passed here does is protect patients who already have insurance, who are already in managed care systems. And in fact, both of the versions of the patient bill of rights, if you will, both the Democrats' and the Republicans' version, both would lead, and both sides admit, they would lead to increased costs, just slightly, that this bill that passed the Senate last night will boost costs just in -- depending on whose view you believe, either a little bit, or, if you believe the Republicans, they fear it will boost costs quite a bit.

But the tradeoff is that they say that it provides more protections to patients.

O'BRIEN: All right. One final question for Rea Blakey. This comes from Lester Johnson, who is up in Michigan. "I wish V.P. Cheney the very best and a speedy recovery," and we all do that. "But if Cheney continues doing the same thing over and over in his job capacity, do you think he's pushing the envelope? Technology has limitations." Rea?

BLAKEY: Lester, that's a good point. What we've heard thus far, both from the White House, from the vice president himself, and from his physicians indicates that obviously there's stress in his job. He has changed his diet, after having had four heart attacks. He exercises at least 30 minutes every day, just about every day.

So the point being that he's doing everything he can. And this implantable device that may in fact be going into his chest this very morning would help to regulate his heartbeat such that it would be almost like having, according to an expert, an emergency room in his chest.

Therefore, if he did have an abnormal heartbeat, that this machine would kick in and keep him from having fatality, heart attack, stroke, other adverse reactions. So the idea being that it's really not so much the job, it's just that he's had heart disease for 25 years, and those kinds of things take a toll on the body.

O'BRIEN: All right. Rea Blakey, Kate Snow, Elizabeth Cohen, thank you so much for participating in our Reporter's Notebook. Great answers to some excellent questions. Thank you folks for sending in some good questions on three seemingly disparate and yet somewhat related subjects. We appreciate you participating in the program, as always.

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