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Medications Made in China; Do You Know Your Health Insurance Plan?; Ways to Beat On-the Job Stress

Aired October 13, 2007 - 08:30   ET


DR. SANJAY GUPTA, CNN HOST: Thanks guys, this is "HOUSE CALL." We'll making a round to some of the most intriguing medical stories of the week.
First up, your medications may be made in China, but are there hidden dangers in your drugs than HMO or PPO or POS, what's about -- that's health insurance for you? If you can't quit, we'll tell you great ways to beat on-the-job stress.

Let's get started though with that made in China label. This time it's on drugs. You may not know it, but the Communist state has been exporting huge amounts of pharmaceuticals into the United States.

Kitty Pilgrim has details.


KITTY PILGRIM, CNN CORRESPONDENT (voice over): Compliments of China, poisoned pet food, hazardous toys, toxic toothpaste and now medications. Thousands of manufacturers in China supply about 50 percent of the ingredients for prescription and over-the-counter drugs made by pharmaceutical companies in the United States.

DARRELL ABERNETHY, U.S. PHARMACOPIA: They simply assemble the end of the final drug product and that's what goes into the market. The drug manufacturer oftentimes really doesn't know either where many of those materials have come from.

PILGRIM: U.S. lawmakers are worried there is virtually no oversight of drugs used by Americans every day.

REP. BART STUPAK, (D) HOUSE ENERGY & COMMERCE CMTE.: Like our penicillin, real basic staple in the medical field. That's all produced in China. Where is the oversight of the penicillin being produced? Is it the right potency? Is the active ingredient still good? These are really unanswered questions.

PILGRIM: The Chinese government admits its own oversight of the industry is full of loopholes. Last July, a former chief of China's state Food and Drug Administration was executed for taking bribes to approve the applications of hundreds of untested drugs, some absolutely fake. FDA inspections at U.S. factories are unannounced and happened every two years. In China, the FDA's power is limited.

LYNNE JONES BATSHON, BULK PHARMACEUTICALS TASK FORCE: If an FDA inspector were to go to inspect at a Chinese facility, they have to be invited by the Chinese government. The Chinese government, in turn, gives notice to the local manufacturer, who has anywhere between 30 and 60 days notice.

PILGRIM: Fake Chinese products have made it to U.S. store shelves. Last month, the FDA issued an alert to consumers about counterfeit Chinese diabetic test strips used by millions of Americans to measure blood sugar levels.

(on camera): Industry experts say there is virtually no U.S. government oversight of how these products are being manufactured in China. Supervision of the quality of the manufacturing process is mostly left up to the Chinese supplier.

Kitty Pilgrim, CNN, New York.


GUPTA: Alright. Thanks, Kitty. And this story is still developing. We talked with the FDA, who told us this ...

"Before we approve any new drug application, including for products or active pharmaceutical ingredients (ph) manufactured outside of the U.S., we inspect any associated manufacturing sites to make sure the product and its active ingredients are manufactured according to FDA regulations. We believe that American consumers should have confidence that our regulatory system is very effective in ensuring the safety and quality of finished drug products without regard to where the active ingredients are produced."

Of course, we'll keep you informed as Chinese goods remain under critical review.

Now, your job may be hard on your heart, especially if you've already had a heart attack. In fact, a new study in the "Journal of the American Medical Association" finds people who return to stressful jobs after having had a heart attack are twice as likely to have another one or experience another type of heart problem. You've got to work. So, what do you do?

Elizabeth Cohen joins us with ways to fight workplace stress for your heart's sake.

ELIZABETH COHEN, MEDICAL CORRESPONDENT: That's right. Absolutely. I mean, when I was talking to the experts, Sanjay, they were very clear. They said if all the evidence is in, you've got to reduce workplace stress if you don't want to have a heart attack. That's clear.

Now, what's interesting here is that they said it's not really the workload so much or what you do or how many hours it's how you perceived the stress. It's what you do about stressful situations. So, Sanjay, I'm going the give you a little bit of a quiz here and see if you can help figure out what to do in certain job stress situations that all of us have been in at one time or another.

Let's say, for example, that you have a backstabbing co-worker. Let's say I'm sweet to your face but behind your back, I'm saying terrible things about you. What do you think you should do? Should you confront me, do you think?

GUPTA: I think I probably would if I talked to you directly about it, I think.

COHEN: But you know what's interesting these experts that I talked to who wrote a book called -- "Working With you is Killing Me," but that's a great title, they actually don't confront the backstabber. They said that backstabber is not a nice person, they're not going to own up to what you do so they you're not really going to get anywhere. They said what you have to do is you have to launch a PR campaign of your own. The backstabber's saying terrible things about you. You have to launch a campaign to correct that and that many will make you feel less stressed out.

GUPTA: Wow, I say, we wouldn't have guessed that.

COHEN: Right, we never had guessed that either.

GUPTA: Most people obviously need their jobs. They got to stay employed. So, if it's getting really stressful, what else can they do?

COHEN: Well, what they can also do is they can think about their bosses because the expert I talked to -- you and I have the same boss, we have a great boss, we have a wonderful boss.

GUPTA: We're saying it on air.

COHEN: Yes, we're saying it on air. But a lot of people really apparently have bosses that are terrible. These consultants tell me that most of the time when people come to them stressed out about work, it's about their boss. So, the explosive boss. Sanjay, what do you think you would do if you had a boss who was a screamer and a yeller? What would you do?

GUPTA: Start a PR campaign?

COHEN: No. That was the other answer.

GUPTA: Talk to them? I don't know.

COHEN: No. What they said to do, the authors of this book said to do, and I thought this was brilliant, they said, just be quiet, watch them scream, and look a little bored, maybe go like this and look around. And they said eventually, they'll just kind of burn themselves out possibly you know. They said just look bored, don't react, detached yourself. And then they said if you've got this kind of a boss, that means after work you need to go running, you need to do some yoga, you need to meditate, you need to physically detached yourself from this toxic boss.

GUPTA: Wipe them out.

COHEN: Exactly. There you go. GUPTA: I always learn something from these segments.

COHEN: Oh, I'm so glad.

GUPTA: Thanks so much. And you can check out Elizabeth's column as well on this very topic at Every week, she writes about ways you can empower yourself to get the most out of your healthcare, really good stuff, important stuff as well.

Many viewers seem to be concerned about stress, so coming up on "HOUSE CALL," we'll have more about it in our "Ask the Doctor" segment. Plus: Do you know your HMO, your PPO, our POS?



UNIDENTIFIED FEMALE: I don't know the initials.


GUPTA: Kind of humorous but knowing the difference can be good for your health and for your wallet. We'll sort it all out. Viewers voted, we listened. A lowdown on the "No period" pill. Birth control is the subject of our quick quiz. That's coming up in one minute.


GUPTA: Before the break, we asked -- the answer is D, all of the above. That may sound far-fetched, but they were all used at some point in history.

Of course, there are much more effective methods of contraception nowadays. On this week, we asked which topic you would like us to tackle on "HOUSE CALL," and you voted for the latest generation of birth-control pills, the no-period pill. Thanks to all that voted as well.

And here to answer to some of question is Dr. Hilda Hutcherson in New York, she's the director for Centers for Women's Sexual Health at Columbia University Medical Center, she's also a professor at Columbia University Medical School.

Thanks for joining us.


GUPTA: Thank you. You know, we're talking about obviously oral contraception today. And the -- people may not realize all the various options out there. So, what are some of those?

HUTCHERSON: Well, we have a number of options today from the traditional birth-control pills in which you take one pill every day for 21 days and then seven days off and you get your period once a month to pills that give you your period four times a year to the newest one that gives you no period at all. So, we have options. GUPTA: Let's talk a little bit about that we've heard a lot about this no-period pill, I think it's called Lybrel.


GUPTA: How exactly does that work?

HUTCHERSON: Well, it has the same two hormones that the traditional birth-control pill has -- estrogen and progestin, and you take one pill every single day throughout the year, so theoretically you should have no period when you're taking this pill.

GUPTA: I have two questions about possible concerns or dangers. What are the dangers of these no- or less-period pills? There's rumors about blood clots -- one question. And the other is -- is there just a problem for a woman in not having periods?

HUTCHERSON: Well, no, we don't think so. We think that the real risks of taking this pill are the same as taking the traditional pill. The blood clots that you've mentioned if you're 35 or older and increased in the risk of stroke or heart attack. But we don't have long-term data, so we don't know for instance, if you take this pill every single day for the next ten years whether there will be a new risk or problem down the road.

GUPTA: OK. Well, we've sent our roving cameras out, Dr. Hutcherson to try and get some people's thoughts on this. Speaking of danger, specifically our roving camera captured a question from one concerned woman.


UNIDENTIFIED FEMALE: I want to know what are the statistics of women becoming unfertile after taking birth control.


GUPTA: I don't know if you heard that, but the question about infertility ...


GUPTA: ...when taking long-term birth control.

HUTCHERSON: That's a common fallacy about birth-control pills. There is no risk of infertility from taking birth-control pills, and it doesn't matter how long you take the pill. When you stop taking the pill, your fertility should be the same as it was before you start taking the birth-control.

GUPTA: What about another big concern for women -- weight gain? More weight gain with this?

HUTCHERSON: Yes, very, very common. The truth is that most women do not gain weight on birth-control pills. Now, some women will gain a little bit of weight because of water retention or it increases their appetite, and of course, if you eat more, you're going to gain weight. But an equal number of women actually lose weight on birth- control pills.

GUPTA: So, you don't have any concerns about this particular new product, Lybrel ?

HUTCHERSON: Well, my only concern is that the studies that have been done have only been done for one to two years. And we just don't know whether something else is going to come along down the pike. But as far as not having your period while you're on the pill, I don't see that has a risk, as a medical risk.

GUPTA: Dr. Hilda Hutcherson, we'll be checking back with you because this is really interesting stuff. Thanks for so much information today.

HUTCHERSON: Thank you.

GUPTA: Alright, now, let's check in with Judy Fortin. She's here with this week's Medical Headline, Judy?

JUDY FORTIN: Hi, Sanjay.

I'm starting with the warning for parents. Drug companies are voluntarily recalling cold medicines for infants. Drug makers plan to stop selling brands such as Dimetapp children's Decongestant and Pediacare's infant drops because of overdose dangers. Now the recall is for children two and under and it does not affect cold medicines for kids over two or adults.

A drug traditionally used for migraines may also curve cravings in alcoholics. A new study finds that after 14 weeks on a drug Taupemax, alcoholics had fewer heavy drinking days, fewer drinks per day and more continuous days of abstinence than nose who received a placebo. By the way, the study was funded by the manufacturer of Taupemax.

Experts say little is done to protect consumers from medical identity theft. The world privacy forum says in 15 years it's received 20,000 reports from people who have someone used their identity to obtain drugs or medical services. Falsified medical records can financially burden victims for years. Sanjay, this is something we haven't heard a lot about. I'm wondering what steps you and your hospital have take on the keep patients' medical information safe over the years.

GUPTA: Well, you know, it's interesting because as there is so much concern with electronic medical records, they actually passed an act, HIPPA, the Health Insurance Affordability and Accountability Act for that very reason. And there's lots of steps that our hospital takes, for example, no one who is not directly involved with the patient care can actually open a patient's record. And there are huge fines now, there Judy, $250,000, even ten years in prison if you use anybody's medical information for any kind of financial gain. So, really interesting stuff out there and Judy, thanks for all of that. Other stuff as well. It's open enrollment time for many with company-sponsored health insurance. Probably got that pack net the mail. How do you choose the right plan for your family and your budget as well? Gerri Willis is going to join us for some tips. And the best way to lose weight maybe dog gone easy. We'll explain.




UNIDENTIFIED MALE: It's prepaid's plan something?




UNIDENTIFIED MALE: Point of service? Something like that. I don't know.


GUPTA: Well, it's that time again, and many companies are now holding open enrollment, allowing employees to change their health insurance. But the plans can be an alphabet soup of confusing options such as HMO, such as PPO or more than that.

CNN personal finance editor Gerri Willis joins us with top tips for picking the right insurance for you and your family. I'm a doctor and sometimes I get confused by this as well.

GERRI WILLIS, PERSONAL FINANCE EDITOR: Well, there's a lot out there. I mean the reality though is -- is that the choices are consolidating. There actually are fewer and fewer out there. The two main choices you mentioned already -- HMOs -- Health Maintance Organizations, and preferred provider organization. Very different. The HMO is like the "she vet plan" that's less expensive, you pay less out of pocket, your choices are fewer,

Now, if you really want to get the doctor of your dreams, you may have to go with a PPO because there you have lots of choice with the physicians but you're going to pay more for it. There's one other plan that merits consideration or certainly discussion. It's a high- deductible plan that's relatively new, that's being offered by some employers out there. It can be very, very expensive, up to $1,100 to $10,000 in deductibles alone, this is only for people who don't have other options or if you're really, really young and you don't expect that you'll ever going to get sick.

GUPTA: I like that analogy. HMO kind a like a she vet, PPO if you want Dr. McDreamy, is that alright?

WILLIS: Yes, absolutely. GUPTA: Now, you're in good health. I translate (ph) is pretty good as well. Is that a benefit in terms of our overall premiums and deductibles?

WILLIS: You bet. Some employers are offering financial incentives to people who do healthy things, if they're in a Disease Management Program, for example. But I got to tell you there's a flipside to this, Sanjay. If you have unhealthy habits, let's say you smoke, you could get charged $50 to $100 a month in extra deductibles just to cover those costs.

GUPTA: That's interesting. I mean, both sides are get penalized for bad behaviors and popular rewards for good behaviors. So, this is the time -- open enrollment. What's the biggest mistake you think people make?

WILLIS: People just pick the plan they had last year, they don't think about it, you just make the automatic check and you don't look at what's going on. But here's what you need to know -- costs are going up as much as 10 percent, that means as much as $330 extra out of your pocket each and every year.

You really want to look at these plans because they change over time, and employers are trying to unload more costs onto you. You know, I must mention a Web site that could be very helpful for you as you look at these plans. You can get a report card on your plan. There's a Web site called the National Committee for Quality Assurance -- it's -- Great reference source for people out there who were struggling. You can also call your HR department and say, "Walk me through this I don't understand the literature ".

GUPTA: Probably worth the extra time.

WILLIS: You bet.

GUPTA: Alright, Gerri. This is a good stuff, let me talk about a lot this season, Gerri Willis, thank you so much for joining. For more information, healthy consumer advice as well, be sure to tune in to Gerri's own show called "OPEN HOUSE" right here on CNN every Saturday at 9:30 eastern and both Saturday and Sunday at Headline News at 3:30 eastern.

More of this week medical news you need to know is coming up, including why taking your dog for a walk may bring you one step closer to a smaller size in our "Ask the Doctor" segment, stay tuned.


GUPTA: We're back with "HOUSE CALL." Everybody has a theory about the best way to stay fit. But this next story caught our eye. It's all about letting your exercise routine go to the dogs, literally.


GUPTA (voice over): Since January, Tom Gayeski has lost 14 pounds, not at the gym or using any fancy equipment or diet. He's done it just by walking his dog, Max.

TOM GAYESKI, STUDY VOLUNTEER: I was coming off of hip surgery, so I need to exercise, needed motivation.

GUPTA: Both Gayeski and Max were part of a study conducted by a Bassett Healthcare in Cooperstown, New York, to see if people who walked their dogs had a better chance of losing weight than those didn't have four-legged friends.

ALLAN GREEN, BASSETT RESEARCH INSTITUTE: People who are overweight since have overweight dogs, but maybe people could partner with their dogs much as you partner with a gym buddy to lose weight.

GUPTA: And in Tom's case, it worked. Not only has he lost weight, Max the dog shed some pounds as well. Researchers found that anyone with or without a dog lost weight by walking, but they found that those participants with dogs have an edge. They're more likely to keep the weight off because they keep walking. It seems the pet, not weight loss, is the prime mode of the exercise.

GREEN: I think the bottom line is that if you stick with the program, whether it's walking your dog, riding a bike, or going to the gym, it will work for you. And I think one of the secrets is that each individual needs to find out -- find something that they enjoy doing and stick with it.

GUPTA: Green also believes that people need reasons to get out and get moving. Animals require exercise. He says put the man and the beast together and that's better than an underused treadmill sitting in the basement.


GUPTA: Good-looking dog as well. There's more to come on "HOUSE CALL" on our "Ask The Doctor" segment. Very important stuff, simple ways to de-stress right now. That story is right ahead.


GUPTA: It' time for my favorite segment of the show -- it's called "Ask the Doctor" and we hit the streets to find out the medical questions that are on your minds. So, here's a question that a viewer had for me.


UNIDENTIFIED FEMALE: The stress that is related to my job, I would like to know would that contribute to my migraines?


GUPTA: That's a great question. You know, our bodies react to stress in all sorts of different ways, some of them surprising. Through our digestive system, our nervous system, and stress can absolutely be the culprit to your migraine headaches. Experts say migraines not only occurred during stress but can be triggered by hard work followed by relaxation, so it might hurt more when you start to relax. It would always good to try to alleviate your stress before it gets to that point. Take a walk, do some deep breathing, take a hot bath, even. Another question now.


UNIDENTIFIED MALE: Could stress make me more tired than I should be on a daily basis?


GUPTA: You know, stress and anxiety can make your body fatigued. That's a fact. We know that. During our ancestors time, stress is an alarm system, used to survive. You've heard fighter flight (ph). But in today's society, you may feel stress for hours, everyday and that's something that our bodies simply weren't designed for. When you're exhausted, this is one symptom that your body stress response is in overdrive. You need to take a break. So, pay attention to what your body is telling you and take action and manage that stress a little bit better, a bit earlier as well. Try to slow down a bit and get some rest.

Well, unfortunately, that's all the time we have for today. Remember, this is the place of the answers to all your medical questions. Thanks for watching. I'm Doctor Sanjay Gupta. Stay tune now for more news on CNN, starting right now.