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HOUSE CALL WITH DR. SANJAY GUPTA

Your Vote, Your Health

Aired November 4, 2006 - 08:00   ET

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


BETTY NGUYEN, CNN ANCHOR: Well, good morning, everybody. I'm Betty Nguyen at the CNN Center in Atlanta.
We do have a special WEEKEND HOUSE CALL, "Your Vote, Your Health". Well, that begins in just a moment. But first, here's a check of the headlines at this hour.

A prominent evangelical pastor admits buying meth from a gay male escort, but Reverend Ted Haggard denies having sex with the man and says he threw the drugs away. His accuser, Mike Jones, alleges he and Haggard had a sexual relationship, but he failed part of a polygraph test.

On the road and on message. President Bush is in Colorado today, continuing his campaign blitz before Tuesday's midterm elections. The president is stumping for GOP candidates in states that supported his re-election bid two years ago. And just about two hours from now he will deliver his weekly radio address on television. And we will carry that live, right here on CNN.

A fresh call to oust Donald Rumsfeld. An editorial to be published in Monday's "Army Times" publication says the defense secretary has lost the support and respect of the military leadership. "The Times" previously called for Rumsfeld to resign in 2004 when the Abu Ghraib prison scandal broke.

We have another check of the headlines. That is at the bottom of the hour. "Your Vote, Your Health" with Dr. Sanjay Gupta, that begins right now.

(BEGIN VIDEOTAPE)

KYRA PHILLIPS, CNN CORRESPONDENT (voice-over): HOUSE CALL goes to the races. It's midterm election time. Do you know how your vote could impact your health?

MAYOR EDWARD LAMBERT, FALL RIVER, MASSACHUSETTS: Our government has protected the prescription companies over consumers.

PHILLIPS: Meet one mayor whose prescription for lower drug prices means bringing them in from Canada.

Plus, the newest group of uninsured Americans. It's the middle class.

UNIDENTIFIED MALE: When it come down to it, we have to decide between gas and groceries, or insurance for the family. PHILLIPS: Also this hour, the showdown in the Show-Me State, home to a critical contest for stem cells. It could decide who makes a cut and which party controls the Senate.

(END VIDEOTAPE)

DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: Good morning, and welcome to a special edition of HOUSE CALL.

I'm Dr. Sanjay Gupta, coming to you from CNN's election headquarters in New York.

Now, as candidates vie for your vote this November, we're giving you a glimpse into the impact your vote could have on your health, from medical research, to legalized marijuana, and the price of your medication and your health insurance.

We start with the price of your medicine.

Now, Congress has adjourned until after the election without resolving the issue of prescription drugs from Canada. The House and Senate have been unable to agree on whether to allow Americans to import drugs from Canada, but some cities and states aren't waiting.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Every day breast cancer survivor Chris Tague takes the maintenance drug Tamoxifen to help keep herself cancer free. Tague gets the drug from Canada. That's something the FDA considers potentially unsafe, but Tague isn't worried.

CHRIS TAGUE, BREAST CANCER SURVIVOR: I don't really see any issues there. I think that's a lot of political mumbo-jumbo, to be honest with you.

GUPTA: Canadian drugs are cheaper. What's more, her employer in the city of Fall River, Massachusetts, waives her copay and gives Tague a $25 rebate when she orders drugs from Canada.

LAMBERT: Good morning. How are you?

UNIDENTIFIED FEMALE: What are you running for?

LAMBERT: My life.

GUPTA: Fall River mayor Edward Lambert started the program. He thinks Congress has let the American people down.

LAMBERT: Our government has protected the prescription companies over consumers. So, you know, I know that the FDA and others might want to say, well, you're breaking the law. Well, the fact of the matter is, I think we're changing the law.

GUPTA: Other cities and towns have similar programs without the rebate. And at least seven states have established procedures to help employees or residents buy drugs from Canada. UNIDENTIFIED FEMALE: And when was the last time that you ordered?

GUPTA: These programs use a Canadian company to serve as a clearinghouse, like CanaRX Services, offering 90-day supplies of maintenance drugs at well below U.S. prices. CanaRX gets drugs from Canada, the United Kingdom, Australia, and Israel, wherever they're cheapest. These are all countries that negotiate prices with pharmaceutical companies.

ANTHONY HOWARD, CANARX CEO: The United States is one of only a handful of countries that doesn't sit down and negotiate a standard price for medications. Our average savings now for the medications that we supply is over 50 percent. Over 50 percent.

GUPTA: The program with CanaRX saves Fall River more than $750,000 a year. That's a significant sum for a city with a $210 million budget.

LAMBERT: I would rather see that money going into public safety and education than going into the pockets of pharmaceutical companies.

GUPTA: Getting drugs from Canada has recently become easier. The U.S. Customs and Border Protection in October ended an almost year-long policy of seizing and destroying drugs imported by mail from Canada. That prompted the Ontario Pharmacist Association to worry about a flood of drugs leaving Canada and threatening to deplete Canada's drug supply.

The U.S. Food and Drug Administration has a warning of its own, saying drugs from Canada are not FDA-regulated, making them potentially outdated, contaminated, counterfeit, or containing too much or too little of the active ingredient. Not surprisingly, U.S. drug makers are also opposed to Americans importing drugs from Canada.

LORI REILLY, PHARMACEUTICAL RESEARCH & MFRS. OF AMERICA: I think it's important for people to know it's a safety risk when they buy drugs from outside the United States. The Internet is somewhat of a wild, wild west when it comes to purchasing prescription drugs.

GUPTA: That's a claim CanaRX CEO Anthony Howard dismisses.

HOWARD: We get our materials in sealed containers directly from the manufacturer.

GUPTA: In Fall River, cancer survivor Chris Tague says she knows savings when she sees them. After all, she is the city's chief financial officer and treasurer.

(END VIDEOTAPE)

GUPTA: And reducing drug costs is a hot-button issue in races along the northern border states, as well as Florida this fall. Candidates talk of everything, from subsidizing drugs from Canada, bussing seniors over the border, and making deals with drug companies to lower drug costs. Now, in Florida's gubernatorial race, the front-runner, Republican Charlie Crist, and his Democratic rival, Jim Davis, have made cheaper prescriptions an election year promise.

Our senior political analyst, Bill Schneider, has been traveling the areas such as Florida, where this is really big issue, it seems.

I mean, how big a deal is this?

WILLIAM SCHNEIDER, CNN SR. POLITICAL ANALYST: Oh, boy, it's a huge issue.

I went to Florida along the Gold Coast of south Florida, where there are a lot of seniors there, they have a lot of hot congressional races. One of them is the former district of Mark Foley. Another one is Clay Shaw's district. He's in a difficult race. And there are so many seniors there who are on the Medicare prescription drug plan.

It's a very big issue. Two reasons. Seniors vote, and more than any other constituency, they vote their interests.

GUPTA: You know, people talk a lot about this donut hole phenomenon, essentially running out of money. What happens then? You know, how do seniors sort of play into that?

SCHNEIDER: Well, what happens is, seniors get prescription drug coverage from Medicare insurance up to a limit. The limit this year is $2,250 in total drug costs. That's shared with the insurance company.

After they hit that limit, which 35 percent of seniors are hitting this year, they have to pay everything until they have spent $3,600 out of their own pockets. Once they have hit that second limit, then they get insurance coverage kicking in again at a catastrophic level, paying 95 percent of their costs. But that means you have to spend $3,600 before you get that kind of coverage.

GUPTA: And a lot of people are running out of money right as elections are coming up as well.

SCHNEIDER: About a third of seniors.

GUPTA: You know, it's interesting as well. Now, as you listen to lots of different plans, I mean, there are so many different plans -- 58 of them I think you told me. First of all, how do you -- how do you help decide which plan you're going to choose, and what's the solution you think for seniors?

SCHNEIDER: Oh my goodness. I went to a Florida Medicare services consulting company which is a private -- I'm sorry, it's not for private, it's not for profit. They work with seniors.

They say in Florida there are 58 choices. Seniors are bewildered. Anyone would be bewildered by that kind of choice.

And what do they want? Well, actually, here is the irony. People who are on a plan tend to be happy with it, but they have a lot of trouble with the complexity.

They're worried about the donut hole. And the third complaint they said they're getting all the time is they wonder, why can't you just control costs? Why are drugs so expensive? And they suspect and they're angry about the fact that they see this as a sellout to insurance companies and pharmaceutical manufacturers. They think it could be much simpler and there ought to be something done about the cost of drugs.

GUPTA: I'm sure you've got a lot of people that fell that way, instead of putting people first, putting those insurance companies and pharmaceutical companies first.

SCHNEIDER: Yes.

GUPTA: It will be an interesting race.

Bill Schneider, thank you so much.

Coming up on this special edition of HOUSE CALL, why are so many Americans uninsured? We talk about this all the time. How is that impacting your healthcare? We're taking a closer look.

Plus, cancer patients say use it, doctors say don't abuse it, and some states have it on the ballot. We're talking about marijuana, the pros, the cons, and this election. That's just ahead.

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

CAROL COSTELLO, CNN CORRESPONDENT (voice-over): It's been called nature's health club. People are kayaking more than ever for fitness and adventure. Expert kayaker Bubba Sloan (ph) says he enjoys the serenity of nature and muscle-toning at the same time.

UNIDENTIFIED MALE: You decide how fast you want to paddle and what type of aerobic exercise you want to get. And it works not only your arms, but your back muscles and your stomach muscles and your thighs.

COSTELLO: Kayakers can burn an average of 300 calories or more in an hour's worth of paddling.

UNIDENTIFIED MALE: Kayaking is actually a great workout. It combines an incredible upper body workout with cardiovascular exercise. If you keep moving, depending on your water conditions, you're going to burn a lot of calories.

UNIDENTIFIED MALE: The most comfortable stroke would be right in front of you.

COSTELLO: Whether you're a beginner or an expert paddler, those who do it say kayaking is great for a true mind and body workout.

Carol Costello, CNN New York. (END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Tens of millions of Americans don't have health insurance, and that puts a burden on people who do. Premiums have gone up an average of $900 this year to cover the cost of carrying those who are uninsured.

What if you were required to have health insurance, like car insurance? Well, if you live in Massachusetts, that's just what's happening. Listen to this.

A law signed this year requires residents 18 and old to have insurance by July 1st or suffer tax penalties. This law is just one of the actions some officials are taking to fight the rising number of uninsured in America. What might surprise you is the people actually making up those rising numbers.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Layla Barr and her husband Emmitt worked as chefs for more than 10 years. They paid for health insurance on their own until six years ago, when Emmitt had hernia surgery and their insurance company denied the claim, leaving the Barrs with a $24,000 debt.

LAYLA BARR, UNINSURED: And we just ended up putting it on a credit card, you know, which is not -- it's not a good answer.

GUPTA: They were healthy, so they decided that paying their debt was more important than continuing their health insurance. Four years later, she was pregnant.

BARR: And that was a total blessing for us. But we're then sort of thrust into, OK, well, what do we do now?

GUPTA: The Barrs tried to get insurance again, but were told they needed to have coverage a year before the pregnancy to qualify. They tried public assistance but had too many assets to qualify. Their only option was to pay out of pocket for the birth of their daughter, Isabella, and hope that nothing went wrong.

BARR: Financially, it could be totally devastating for us.

GUPTA: In fact, healthcare costs are the number one reason Americans file for bankruptcy. The Barrs negotiated directly with the hospital for delivery and doctors' fees and took a second mortgage on their home to pay the $20,000 cost.

BARR: To have a baby, you shouldn't have to have -- take out a second mortgage on your house.

GUPTA: They are not alone. Forty-six million Americans have no health insurance, and the Barrs belong to one of the fastest-growing demographics, the uninsured middle class. An independent study found 41 percent of middle-income Americans had no health insurance for part of 2005. That's up from 28 percent in just four years.

Why are so many Americans uninsured?

RON POLLACK, EXECUTIVE DIRECTOR, FAMILIES USA: Healthcare costs are skyrocketing at the same time that wages are very stagnant. And so, employers are having a tough time continuing to pay for healthcare coverage. Workers simply can't afford healthcare coverage. And as a result, more and more people are being priced out of the healthcare they used to take for granted.

GUPTA: Ron Pollack, who heads a consumer healthcare lobbying group, says the growing number of uninsured is a national healthcare crisis.

POLLACK: If we had some kind of a law that said you, member of Congress, you can't have better health insurance than your own constituents, this problem would get fixed really quickly.

GUPTA: The Barrs don't see any immediate way out of their healthcare crisis, but are looking into state child healthcare programs.

EMMITT BARR, UNINSURED: When it comes down too it, we have to decide between gas and groceries, or insurance for the family. It's tough. You know? I want to be the bread winner, and I want to be the provider, but in this system that we exist today, it's hard.

GUPTA: In the meantime, they just home that they and Isabella stay healthy.

E. BARR: Every day that I wake up, I'm an accident or an illness away from not being able to provide for my family. And that's the cold, hard facts.

(END VIDEOTAPE)

GUPTA: Now, in a nonscientific quick vote on CNN.com/health, the majority of readers voted health insurance costs as the number one health issue affecting their vote this November. Now, those costs and a lack of coverage for millions of Americans is causing havoc in hospitals across this country.

Joining us to talk about the problem of the uninsured and its impact on everyone in America is Dr. Arthur Kellerman. He's chairman of emergency medicine at Emory University School of Medicine.

First of all, welcome, Doctor. Good to have you.

DR. ARTHUR KELLERMAN, EMORY UNIV. SCHOOL OF MEDICINE: Thank you.

GUPTA: You know, it's interesting. The vast majority of people watching out there right now may say, you know what? I have health insurance. So why do I care about this issue?

What do you tell them? KELLERMAN: That's one of the big myths about this problem, are when Americans say, I've got coverage, I don't need to worry about it. They're dead wrong.

First of all, your coverage if you have a job is only as safe as your employment. And we known in this day and age that's not necessarily secure.

Number two, it's only dependant on your employer's willingness and ability to keep providing you with health insurance. And the day may come, if current trends continue, when your chance of getting insurance is about as good as your chance of earning a company car. It will be a very select group of employers.

Finally and most importantly, the fact that we have so many Americans without health insurance is actually creating enormous problems for the health system on which all of us depend. If your ER is swamped with critically ill and injured patients, if specialists are not taking call in your community for major trauma, or if your trauma center is closed, it doesn't matter whether you have coverage or not. You're out of luck.

GUPTA: You know, it's interesting, because we hear a lot about specialty coverage in hospitals. Another thing we hear a lot about is, you know, if someone is uninsured, they go to an emergency room like yours, and they get their healthcare. I mean, they get taken care of ultimately in the United States.

Is that not the case? And does that make it less of a problem?

KELLERMAN: It is and it isn't. There is a myth that the uninsured get the care they need. They don't. On average, uninsured Americans get about half the medical care that insured Americans do. And as a result, they tend to be sicker and they die sooner.

When they come to the emergency department, it's often much later in their clinical course when they're very expensive to treat and often have much worse outcomes. So it's really a cruel illusion that the uninsured get the care that they need.

But the big problem driving ER crowding are that hospitals, squeezed financially, including having to carry the burden of treating the uninsured, have reduced their capacity to the point that now there are often not enough in-patient beds to get admitted patients out of the ER and upstairs. That bottles up the ER and impairs everyone's access to emergency care, insured and uninsured alike.

GUPTA: Dr. Kellerman, are we talking about a financial problem here? I mean, can we -- right now as a country, if we decide either in this election or one of the ones upcoming that we want to create a healthcare plan for America, can we afford to do so? Or what's the rate (ph) limiting step here?

KELLERMAN: That's the third myth that's kept us from dealing with this problem. Our politicians say we can't afford to cover the uninsured. Well, the fact is, we can't afford not to. This is creating chaos in the healthcare system, it is hindering our competitiveness in international business, and it's creating enormous stress for millions and millions of American families. You know, countries around the world with economies that are less strong than ours cover everyone in their country. They have better life expectancy, lower infant mortality, and they do it for less money.

They are not smarter than we are. We can solve this problem with political will.

GUPTA: It's interesting. We've gotten to a certain point where we have a lot to work to do to get us out of the hole.

Dr. Arthur Kellerman, good luck to you. Thank you for all the work that you do as well.

KELLERMAN: Thank you.

GUPTA: From the underinsured to a controversial new drug on the ballot, high stakes and debates over legalizing marijuana. That's still to come on this special edition of HOUSE CALL.

And the only other way to light up legally may be to take it outside. The benefits of showing cigarette smokers the door.

Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Welcome back to a special election edition of HOUSE CALL.

On Tuesday, people will be voting on more citizen-sponsored referendums in a midterm year than has happened in nearly 100 years. Get this. Across 18 states, 76 ballot initiatives will take on a range of issues on the health front: smoking in public places, stem cells, and regulating marijuana.

Let's start with the controversial marijuana initiative.

Dan Simon has this report.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: So please make sure to get out and vote yes on question seven.

DAN SIMON, CNN CORRESPONDENT (voice-over): Pushing Nevada's true green party candidate, only here we mean green as in marijuana.

UNIDENTIFIED MALE: Question seven, the marijuana initiative.

SIMON: These campaign workers are doing some old-fashioned politicking, trying to convince people here to vote yes and legalize marijuana.

NEAL LEVINE, CAMPAIGN MANAGER: We're taking on the entire establishment.

SIMON: Neal Levine is managing the committee to regulate and control marijuana. His group gathered 86,000 signatures to force the issue on November's ballot.

LEVINE: What we're proposing is a pragmatic, sensible approach to a very bad and failed policy.

SIMON: What they're proposing is allowing people 21 and older to legally buy an ounce of pot. The drug would be grown and sold by state licensed businesses. Just so there's no confusion, we're not talking medical marijuana, which is now legal in 11 states, including Nevada.

LEVINE: Right now, our marijuana laws put money in the hands of some very bad people. And all we're proposing is to pull it out of the criminal market, where it's widely available, and put it into a tightly regulated and taxed market.

SIMON (on camera): In a town where pretty much everything goes, organizers of the initiative hope to take things a step further. Think of it. If the vote passes and proponents get their way, you can see stores here in Nevada selling marijuana.

(voice-over): The movement has some unusual allies -- nearly three dozen members of the clergy, including Sister Toni Woodson, a Roman Catholic nun.

SISTER TONI WOODSON, SUPPORTS LEGALIZATION: I don't think smoking marijuana is a sin any more than drinking alcohol is a sin or smoking a cigarette is a sin.

SIMON: A position certainly not endorsed by the Catholic Church.

A September poll conducted by the "Las Vegas Review Journal" shows the initiative trailing. Forty-two percent were in favor. Fifty-one percent in opposition. The rest, undecided.

Levine says internal polling shows a dead heat. Either way, opponents are taking nothing for granted.

SANDY HEVERLY, STOP DUI: If marijuana was legalized, more people are going to use it, more people are going to drive under the influence of it. And what is that going to lead to? Obviously more death, injury and destruction.

SIMON: Critics also point to marijuana's effects on the mind.

Dr. Garn Mabey is a member of the Nevada legislature.

DR. GARN MABEY, NEVADA ASSEMBLYMAN: It impairs your cognition. It impairs the way you function. But if you got in a car, it would be very dangerous. I think it's a bad example to set for our children.

SIMON: But supporters argue marijuana is no worse than alcohol and challenge the notion that it's a gateway to harder drugs like cocaine and meth.

LEVINE: If marijuana were a gateway to harder drug use, why don't we have a hundred million hard drug users in this country? We don't. It's not. It's a complete myth.

SIMON: If the initiative were to pass, Levine and his group would have to hope Uncle Sam would stay on the sidelines. Marijuana, of course, is illegal under federal law. And since federal law trumps state law, the feds could shut down the providers at will, which is what it's increasingly doing to medical marijuana providers in California.

Even so, if Nevada voters say yes, it would be a bold move by any measure in a state that has defined what bold truly is.

Dan Simon, CNN, Las Vegas.

(END VIDEOTAPE)

GUPTA: All right.

Dan Simon, thank you so much.

Now, the medical community has mixed views about marijuana. Here are the facts.

We know marijuana impairs your thought process, motor skills and memory. In fact, one small study found diminished blood flow in the brains of marijuana smokers which lasted up to a month.

Other dangers, marijuana increases a person's risk of heart attack. And like smoking anything, it can increase respiratory infections.

And there is some dispute about whether it may be a gateway drug, as you just heard, leading to more addictive illicit drugs.

Now, on the flip side, research has shown components of marijuana may help with a variety of conditions, like nausea caused by chemotherapy or AIDS medications. Marijuana also reduces pressure in the eyes, helping glaucoma patients. And studies have shown it helps with pain, possibly as much as codeine.

Lastly, there is some evidence that it may help with the muscle pains and spasms of Multiple Sclerosis.

You decide.

The best is yet to come on this special edition of HOUSE CALL.

The biggest health issue facing Americans this election -- you're not going to want to miss this -- it might surprise you. Former Health and Human Services head Tommy Thompson joins us.

That's coming up next.

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE (voice-over): Parkinson's and politics.

MICHAEL J. FOX, ACTOR: What you do in Missouri matters to millions of Americans, Americans like me.

UNIDENTIFIED FEMALE: A Hollywood star comes to the stem cell debate in the heartland.

Then...

UNIDENTIFIED FEMALE: It hurts my eyes, irritates my eyes.

UNIDENTIFIED FEMALE: Smoke gets in your eyes no more. Why voting to clear the air is giving more people a clean bill of health.

And what if your only option to get vegetables is the liquor store? We'll tell you which major American cities are home to food deserts.

UNIDENTIFIED FEMALE: You can't chose healthy food if you don't have access to it.

(END VIDEOTAPE)

GUPTA: We're talking politics and health this morning on a special edition of HOUSE CALL.

One of the hottest debates marries politics and science. I'm talking about stem cells. The issue has made for some unlikely alliances. Michael J. Fox, Nancy Reagan, Mary Tyler Moore have all campaigned vigorously for expanding stem cell science in the hopes of finding cures for diseases so close to their hearts.

So why if this research has such possibilities would anyone object? Well, the answer to that question is mired in controversies, both large and microscopic.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's hard to believe this little cell that can't even be seen with the naked eye can cause such a big controversy. But it does because it comes from an embryo. And harvesting it destroys the embryo. It's called an embryonic stem cell. Feelings about it run deep. Some, like John Gearhart, one of the top stem cell researchers in the country, believe these cells hold the power to cure many diseases.

DR. JOHN GEARHART, JOHNS HOPKINS MEDICAL INSTITUTE: They're the only ones we know about that can form all 220 some different cell types that constitute the human body. Now that's remarkable.

GUPTA: But others believe that an embryo in a Petri dish, no matter how small, is a life. And destroying it to use its cells for scientific purposes is tantamount to murder.

JASON JONES, HUMAN LIFE INTERNATIONAL: It's destroying a human person. Do human beings have intrinsic dignity and worth? And we need to answer that question before we go any further as a society with this type of research.

GUPTA: Let's take a closer look. The embryonic stem cell is a virtual blank slate, taken from human embryos, usually left over from fertility clinics. With a little coaxing, they can be turned into any cell in the human body.

Scientists hope one day they can be used to replace damaged cells that lead to diseases or injuries. But it's easier said than done. In 2001, President Bush allowed for the first time federal funding for stem cell research, but with strict limits. Researchers who get money from the government can only work with lines of embryonic stem cells that existed before 2001. Gearhart says they're not good enough.

GEARHART: They were derived under what we would call not the best conditions. They were grown in the presence of animal products, of other animal cells. And you're always concerned that they will - that they could then harbor viruses.

GUPTA: Proponents of embryonic stem cell research, like Nancy Reagan and Christopher Reeve, pushed the issue politically and drew moderate support. In fact in a "Newsweek" poll in August, found 48 percent of those surveyed were in favor of using taxpayer dollars to fund medical research using stem cells obtained from human embryos. That's compared to 40 percent who opposed it.

The House and the Senate passed legislation this year that would lift the funding restrictions on stem cell research, but the president vetoed it.

GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: I felt like crossing this line would be a mistake.

GUPTA: He and other opponents of embryonic stem cell research believe there are alternative cells which are just as promising. Many researchers disagree. What's unclear is how much the voters will weigh in. Will stem cells influence how they vote?

(END VIDEOTAPE)

GUPTA: Hmm. And according to our latest polling, the majority, 54 percent of those polled by the Opinion Research Corporation, favor using federal funds for stem cell research. 39 percent oppose. That funding of the stem cell debate is, of course, playing a major role in a hotly contested Senate race, one that could tip the balance of power in the Senate.

Now Democrats need to pick up six seats to regain control. And they're placing some of their highest hopes on Missouri.

Our senior political correspondent Candy Crowley has been following the race closely. Candy? CANDY CROWLEY, CNN SENIOR POLITICAL CORRESPONDENT: Sanjay, what's interesting is this is not only a closely watched race, but a close race. 49 percent to 49 percent, according to CNN's latest poll.

So what does this mean? It means anything in this race could make a difference. And the biggest thing in this race other than the U.S. Senate candidates has been a stem cell research ballot initiative, an effort to change the Missouri constitution to allow in Missouri anything that is federally approved having to do with embryonic research.

This, of course, has gotten the candidates out there talking about it. The Democrat, Claire McCaskill has embraced this. The Republican, Jim Talent, a sitting senator, has said, listen, I'm against anything that destroys an embryo. I am against anything that's cloning. But people should make up their own minds.

What does this mean to voters as they come to the voting booth? 51 percent of Missourians who have said they favor this constitutional amendment to the Missouri constitution.

But what happens here is that many of Jim Talent's, the Republicans' base voters are evangelicals and conservative Christians, who are against this. So the thought is that this ballot initiative actually drives out Republican voters, the more conservative voters who might otherwise sit home because they're upset about other things in the Republican party.

So this has been a fascinating race to watch because it is so intertwined with this Missouri ballot initiative. The ads are all over the place. They could use your primer, Sanjay, that you just did about what exactly is embryonic stem cell research because there's a lot of confusion. Each side accusing the other of sort of mushing up the issues.

So what we saw in the latest poll was that support here in Missouri has begun to drop. It used to be at 54-55 percent. So as we run into these last days of this race, no one is sure either who's going to win this election or where the embryonic research ballot initiative is going to end up. Sanjay?

GUPTA: Candy, you're so right. It's complicated science and it is politics certainly coming together. Thank you so much, Candy. Appreciate your time.

CROWLEY: Sure.

GUPTA: Candy Crowley and Bill Schneider are part of the best political team on television. And remember, for the latest campaign news at any time, check out the political ticker. That's at CNN.com/ticker.

Now still ahead, a look at the biggest health issue facing Americans. Former Governor Tommy Thompson, former Secretary of Health Tommy Thompson weighs in on what's next for your health. He's going to stop here. All that's coming up on HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. As the most recent secretary to leave the post of Health and Human Services, Tommy Thompson has a unique view of what's facing Americans today. Now since leaving that office, he's been busy. He's spoken out on bioterrorism, he's helped summits aimed at restructuring Medicaid, and touted the benefits of preventative care. And Secretary Thompson joins us now. Welcome, sir.

TOMMY THOMPSON, FMR. HHS SECRETARY: Sanjay, always a pleasure to be with you.

GUPTA: Thank you, sir. You've been very busy. I want to ask you something. You just heard our conversation about stem cells.

THOMPSON: Right.

GUPTA: Now you were the one who actually announced that the 60 stem cell lines and the fact that they were viable and that would be federally funded, you understand how all that's sort of transpired over the last few years. Do you stand by what you said at that time?

THOMPSON: Oh, absolutely, but I also support embryonic stem cell research. As you know, Jamie Thompson from Wisconsin was the first person to discover it. I came out for embryonic stem cells shortly thereafter.

It's science that needs to be developed. It's science that's going to help prove. I also believe in other stem cells, adult stem cells, as well as having the development of stem cells that really do not affect the killing of an embryo.

I think there are many ways in which we can do this. But stem cells itself, embryonic as well as adults, are -- got a great future I think in coming up with discoveries to solve some of the maladies affecting human people.

GUPTA: You know, a lot of the scientists say, Mr. Secretary, and you know this better than anybody, that without federal funding for lots of stem cell lines, without lots of support for laboratories all across the country, we're not going to see the progress nearly as quickly as we otherwise would. Now -- so what do you say to that and the people who are waiting for some of these treatments?

THOMPSON: Well, Sanjay, I say that first off, there is money available for embryonic stem cells. It's limited to the lines that were announced by the president.

But I also want you to know that there's money available, lines still available that have not been utilized yet for this kind of research. So research has not been set back as a lot of people have indicated and have postulated.

But the truth of the matter is we need to expand and allow for further research in embryonic stem cells, as well as adult stem cells. It shows great promise.

GUPTA: Lots of different issues facing Americans today. This is something you've been focused on since leaving the post of secretary.

THOMPSON: Yes.

GUPTA: As you survey the playing field now in the world of health, what do you think is the biggest health issue facing Americans right now in 2006?

THOMPSON: Well, the biggest one, there's no question about it, is the fact that 75 percent of the dollars go for chronic illnesses. And we have to do something about it. We can do that by changing human nature and human decision making.

Tobacco is still the biggest one. There's no question about it. 442,000 Americans died. We need to regulate tobacco in America. We haven't done it. We regulate baby aspirins, but we don't regulate nicotine.

We have to do something about diabetes. $1 out of $14 in the healthcare system of $2 trillion goes to treat diabetes. There are 18 million last year that Type 2 diabetes. This year it's 21 million. But what scares me is 41 million more Americans have -- are pre- diabetic.

And if we don't do something in five years, that means 62 million Americans will be Type 2 diabetic. And that will go from 1 out of 14 cents out of the healthcare dollar to one out of 10, to 1 out of 8, eventually down to 1 out of 6. So we have to do something with that.

And the third one, of course, is obesity. We're just too darn fat in America. And I know people say -- look at themselves in the mirror and say chunky's good. But slim is better. And we know that.

And we have to realize that these are human decisions that we're making, that we have to do. Companies have to be involved. Healthcare organizations have to be involved. We have to do something about holding down, curtailing, and redirecting the chronic dollars that go into chronic illnesses.

GUPTA: You know, Mr. Secretary, you've slimmed down as well. You talk a lot about your own weight loss. Let me ask you something. The old adage, don't fix it if it ain't broke. A lot of people apply that to their own bodies as well. People aren't focused on preventative care. They wait until they get it sick. And that seems like that's a psychological thing. That's just the way we think. How do you change that?

THOMPSON: Well, it's got to be changed because nobody would set up a healthcare system like we have today. We spend 92 percent of all the healthcare dollars after people get sick and less than 7 percent to keep people well in the first place. It just makes no sense.

You don't do that for your car, you don't do that for your house, you don't do it for anything else in your arena of life. You always are trying to maintain and prevent things from happening.

And we don't do that for our bodies. And this is - and our bodies are the most important thing we have. We have to become healthier. And we have to start going into wellness and prevention, rather than waiting for people to get sick. That's the big problem.

GUPTA: Well...

THOMPSON: And that's what we have to do, Sanjay.

GUPTA: Hopefully people will start paying attention to that message. Secretary Thompson, thank you for your time. The former secretary, very busy schedule. Appreciate that.

There's much more to come on this special edition of HOUSE CALL. Smoking is out or being voted out of restaurants in other public places. Now it's changing your health.

And why many people aren't getting the right things to eat where they live. But first, more of this week's medical headlines in "The Pulse."

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): British researchers say regular exercise can reduce the risk of developing an eye disease. That's the leading cause of blindness in elderly. A study finds those with active lifestyles were 70 percent less likely to be diagnosed with macular degeneration.

Researchers at Childrens Hospital in Boston have new clues in the mystery behind Sudden Infant Death Syndrome or SIDS. Autopsies on 30 infants revealed abnormalities in the part of the brain that regulates breathing, blood pressure, and body heat. Doctors are hoping to develop a test to identify those infants most at risk for SIDS.

Judy Fortin, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Around the world, countries are taking steps to ban smoking in public places. To date, 11 countries have done so. In the United States, 14 states have banned cigarette smoking in bars and in restaurants. And this Tuesday, three more states will be voting on smoking bans.

This is a real example of voting for your health. In fact, the new study provides more evidence that there are real benefits to these laws.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Myra Cardona is a bartender in a smoke-free arrest restaurant in Montgomery County, Maryland. She doesn't smoke. MYRA CARDONA, BARTENDER: It hurts my eyes, irritates my eyes. And so, you know, I'm kind of glad that I work in a non free restaurant with a bar that's not smoking.

GUPTA: Just seven miles away, Paul Hickey works in Washington, where a smoking ban will be imposed in January. He is a smoker.

PAUL HICKEY, BARTENDER: I just don't see how smoking in a bar really, you know -- second-hand smoke, I don't know if I'm really sold on that.

GUPTA: The debate over smoke-free environments rages on, even though the negative health effects of second-hand smoke have been documented. In June, the Surgeon General found a causal relationship between secondhand smoke and premature death.

PAUL BILLINGS, AMERICAN LUNG ASSOCIATION: Secondhand smoke causes lung cancer, premature death from heart attack, and a wide range of other respiratory health effects. Secondhand smoke is very harm to public health. And no one should have to be exposed to it in their workplace.

GUPTA: Now a new study in "The Journal of the American Medical Association" found bar workers in Scotland had significant improvements in respiratory symptoms and lung function only two months after a smoke-free policy was implemented.

The numbers seem to bear that out. Before the ban, nearly 80 percent of these workers reported some type of respiratory symptom like wheezing, shortness of breath, and things like irritated eyes, throat pain, and inflamed airways.

MATTHEW MYERS, CAMPAIGN FOR TOBACCO-FREE KIDS: Laws banning smoking in bars and restaurants result in an immediate improvement in the people who work there, and an improvement in the health of the patrons of those places.

GUPTA: Lung and blood tests were performed before and after the ban. And at the end of two months, only about 47 percent reported having any symptoms. Clean air advocates say smoking bans are becoming more accepted, even popular.

BILLINGS: The debate's over. The scientific consensus is clear that secondhand smoke kills. And we need to eliminate exposure. Ventilation, nonsmoking sections, these things do not work.

GUPTA: Some restaurant owners say smoking bans are bad for business.

DANNY COLEMAN, OWNER, THE DUBLINER: It's certainly not going to put me out of business, but we're going to lose a little business because of it.

GUPTA: But advocates of a smoke-free environment say bars, and restaurants, and places where smoking is now restricted have seen an increase in business, not a decrease. (END VIDEOTAPE)

GUPTA: Stay tuned to this special edition of HOUSE CALL. Searching for food in plain sight, why some Americans don't have access to good nutrition, even though they live in major metropolitan areas. Details, coming up.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSE CALL. A lack of access to healthy food in some urban areas has become an unlikely political issue. From coast to coast, lawmakers are introducing initiatives, trying to get supermarkets and fresh food retailers into disadvantaged areas.

Former President Bill Clinton argues that these food deserts are partly to blame for rising obesity rates.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): When Tesha Temple needs to feed her family, she spends $6 on the bus ride there, another $10 to take a cab back from her nearest grocery store, which is a 45 minute journey.

TESHA TEMPLE, RESIDENT: Where the car lot is right now, there was a grocery store called Wades. And that was the big grocery store out here for us until they closed down. Other than that, we have nothing.

GUPTA: Welcome to what experts call the food desert, where there is little help for residents who may want to buy healthy food, but can't.

UNIDENTIFIED MALE: Eight, nine, ten. Thank you, have a good day.

GUPTA: Here in Chicago's Roselawn neighborhood, vegetables come in cans sold at corner convenience stores. Meat is one of the fast food varieties. And the only fruit is what's in jars sold at liquor stories.

Roselawn residents aren't alone. In a study for LaSalle Bank, researcher Mari Gallagher measured the distance to every single grocery store and fast food store in Chicago. The results were shocking.

MARI GALLAGHER, RESEARCHER: What we found is that over 500,000 Chicagoans live in what we call a food desert, areas with no or distant grocery stores, but ironically, nearby fast food options.

GUPTA: Researchers speculate the reason supermarket chains aren't in these so-called deserts is they don't see these areas as money makers. Some residents even have to cross state lines just to get groceries. And the study found food deserts aren't just an inconvenience, they have dire health consequences.

GALLAGHER: Areas that have no or distant grocery stores, but nearby fast food have a much greater likelihood of their residents suffering from diet-related diseases, like cardiovascular disease, diabetes, stroke, things of that nature, and also chronic health conditions that are very serious, like obesity, hypertension and so on.

GUPTA: The study sparked city leaders' interest. The Chicago city council says it will try to find ways to encourage grocery stores to move in.

GALLAGHER: The bottom line is you can't choose healthy food if you don't have access to it.

(END VIDEOTAPE)

GUPTA: It's your health and it's your vote. What you need to know at the ballot box. There's much more to come on this special edition of HOUSE CALL.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I think this country should get more advanced as Europe has done in stem cell research. And I think it certainly will help people that are in need of that type of treatment.

UNIDENTIFIED MALE: We pay a lot of money in taxes. And this country should allow us to have some sort of medical insurance regardless of our age, race, ethnic background, religion, or any of that type of thing. And so we should be taken care of as we take care of the government.

UNIDENTIFIED MALE: Universal healthcare. You know, in a perfect world, that would be a beautiful thing. But the world is not perfect. You know, people are going to have to pay for it. You know, somebody is going to have to pay for it. That's a complete can of worms.

UNIDENTIFIED FEMALE: To find out where the tour is headed next, go to CNN.com/election.

(END VIDEO CLIP)

GUPTA: And those are just some of the opinions expressed by people who turned up at our Election Express trailer, which is touring around the country this fall.

Well, thanks for joining us for this special one-hour edition of HOUSE CALL. Be sure to vote this Tuesday. And afterwards, turn on CNN. Our own Wolf Blitzer, Anderson Cooper, Lou Dobbs and Paula Zahn, they're all part of the best political team on television. They'll be bringing you all the latest election night numbers and what those numbers mean to you.

Also, don't forget to tune in every weekend at this time as we look at the top medical stories and answer all of your questions

I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.voxant.com

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