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HOUSE CALL WITH DR. SANJAY GUPTA

How Your Vote Can Impact Your Health; Will SCHIP Move Forward?; Should Cancer Be a Priority?; Paying the Price for Your Health

Aired November 17, 2007 - 08:30   ET

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


(BEGIN VIDEO CLIP)
RUDY GIULIANI: It's your health.

UNIDENTIFIED MALE: Universal.

SEN. HILLARY CLINTON (D), NEW YORK: Affordable.

UNIDENTIFIED MALE: Health care.

MITT ROMNEY: The premiums are getting higher and higher and higher.

BARACK OBAMA: Most families want health care, but they can't afford it.

CLINTON: Universal health care is an American value.

UNIDENTIFIED MALE: We're going to bring down the cost of health insurance in this country.

UNIDENTIFIED MALE: Health care.

UNIDENTIFIED MALE: Health care.

UNIDENTIFIED MALE: Health care.

UNIDENTIFIED MALE: Health care.

(END VIDEO CLIP)

SANJAY GUPTA, HOST: It's on the candidates' mind and it's on yours as well. Your vote can impact your health. We're making the rounds this morning of the things you need to know this election season.

First up, will SCHIP ever move forward? What is it? And how did health care for kids become such a hot button issue? We'll look at the face of this controversy.

Then, the politics of the cure. Should cancer treatment be a priority in your candidate's platform?

And paying the price for your health. How to find affordable prescription drugs. We're going to have all of that. Let's get it started, though, with the battle to pass an expanded SCHIP bill, which would provide health care for millions of American children. And we talked a lot about the price tag and the battle between Congress and the White House. But behind all the political posturing and all the people are children with no health insurance.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Thank you.

GUPTA (voice-over): When 16-year-old Heather lived in New Jersey with her dad, she had health insurance. But when she moved down to Maryland to live with her mom, Cindy Marrocco, she was no longer covered.

CYNDEE MARROCCO, CHILDREN NEED SCHIP: I couldn't get her on my insurance. I had to take her to the doctor. It was really, really imperative that I took her right away.

GUPTA: So the doctor told Cindy about getting health insurance for her daughter through Maryland Children's Health Insurance Program. It's Maryland's version of SCHIP.

MARROCCO: It's been a blessing because Heather had to see a doctor, a therapist, and get prescriptions. And I would have been in financial trouble having to pay those bills.

GUPTA: Cindy now wants to move her two younger children to SCHIP as well. They're now covered by her health insurance policy, but she can't afford it.

MARROCCO: I only make $30,000 a year. It costs me $70 a week to keep those kids covered.

GUPTA: The children won't qualify for SCHIP for six months. And by then, Cindy might be working a better shift, more overtime. She might be making too much money to qualify for SCHIP, but still not enough to afford insurance.

Currently, to be eligible for SCHIP, the family income has to be no more than $41,300. That's twice the federal poverty level. The latest version by Congress would up that to nearly $62,000, which is three times the poverty level. That would cost an additional $35 billion. Currently over 600,000 adults in 13 states are covered by SCHIP. This and funding the higher cost with a 61-cent tobacco tax are two reasons why some oppose the SCHIP bill.

GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: And I made it perfectly clear that if you keep passing this piece of legislation, I'm going to keep vetoing it.

GUPTA: And that's something Cindy finds hard to accept.

MARROCCO: We have little kids all over the place that have no health insurance. It's insane that he would say oh, no, that's too much money.

GUPTA: Soon, only one of her three children will be insured. And she waits for a final SCHIP decision.

(END VIDEOTAPE)

GUPTA: And to be clear, the SCHIP bill is still in limbo, but a continued resolution has been signed, which will keep it funded until mid-December. We're going to, of course, keep you up dated on the battle and of course about the children in the middle as well.

Health insurance, along with other health issues, are critical to the majority of voters. We know that. The numbers say it all. In the latest CNN poll, 76 percent of Americans say health care is very or extremely important to their vote for president. Our CNN senior political analyst Bill Schneider is digging down on this issue.

Bill, CNN held a Democratic debate on Thursday. What are the candidates saying about health care?

BILL SCHNEIDER, CNN SENIOR POLITICAL CORRESPONDENT: Health care was the very first issue out of the box, when Hillary Clinton made accusations that her opponents really didn't support universal health care. She said John Edwards did not support it when he ran for president in 2004. He eventually went on the ticket, of course, as the vice-presidential nominee. And she said that Barack Obama's plan really didn't support the idea of universal health care because it didn't have a mandate requiring everyone to have health insurance.

She said her plan does that. Barack Obama defended himself and said what's more important is not a mandate, but that people should be able to afford to buy health insurance. And he had a plan that would help people afford it. And eventually, of course, then everyone would be able to have health insurance. So there was a lot of sparring back and forth about who had the best plan and how to achieve universal health insurance.

GUPTA: Bill, it seems that when it comes to health care, people are very clear on what their number one issue is.

SCHNEIDER: Their number one issue is health insurance. Lacking health insurance, being able to afford health insurance. That is by far the number one thing people worry about. And that was of course the issue that came up in the Democrats debate.

Health insurance costs have escalated. A lot of Americans find they no longer can afford not just health care, but the premiums for health insurance because they've skyrocketed. The cost has skyrocketed so much. That has now surpassed the cost of prescription drugs as the number one issue. The majority of Americans cite the availability and cost of health insurance, prescription drugs is a good deal lower in people's priorities when it comes to health care.

GUPTA: All right. Bill Schneider, thanks. And for complete coverage of the candidates issue by issue, check out our Web site, CNN.com/elections to discover where candidates stand on the health issues that are most important to you.

Plus, are you frustrated by the high cost of medical care or happy with your coverage? Send in your own i-report. That's on CNN.com/health.

Even if you have health insurance, it's not always enough. Coming up on HOUSE CALL, we have some ways to get the insurance companies to pay. And billions of dollars are spent on cancer research, but are we really any closer to a cure? We'll have a reality check in one minute.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: You have to think of this more against cancer for what it is. And what it is is a war of attrition. You know, the enemy is not going away.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. Federal funding for cancer research has dropped significantly in the past two years. But according to a CNN health poll, finding a cure for cancer remains one of the top five health care issues this election year. Let's talk more about the politics of a cure is Clifton Leaf. He's a former editor at "Fortune" magazine. He's currently writing a book about cancer. He's also a cancer survivor himself.

Great to see you again.

CLIFTON LEAF, CANCER ADVOCATE: Great to talk with you.

GUPTA: Well, we got an important year coming up, obviously. Are the candidates talking about cancer?

LEAF: You know, they're talking about it, but not nearly enough. You know, considering how prime this issue is right now for so many American families, it should be number one priority. And it's not.

GUPTA: But where are we in this fight against cancer? I mean, because people obviously care about it, as we've seen from our own polling. And you're a cancer survivor so you've lived it, but where are we really in the fight?

LEAF: Well, I'm an optimist, as you know, although I think I'm also a realist. And I think we've made some progress. You know, the rates are coming down, but not nearly enough. And where we're making progress tells us a little bit about how misplaced the strategy is.

GUPTA: Now let's talk about that specifically, drill down on it. You talk about the moneys that are spent towards cancer. And your premise is not so much how much we spend as the way that we spend it. What do you mean by that?

LEAF: Well, we spend a lot focusing on two areas. One in the basic science, what's driving the biology of cancer. And the second in terms of developing the drugs for end-stage disease and really trying to treat it after it's already started.

And where I see our greatest opportunity is to start earlier in the process of cancer. So cancer is a process that takes a long time to develop. And we need to start intervening earlier.

GUPTA: Is this an issue, Clifton, do you think of spending more money, not to make this too simplistic, but spending more money on prevention, screening-type programs? Or do we still need to be putting money into the therapeutic end of things?

LEAF: Well, we're never going to stop trying to cure patients with cancer. It's a horrible disease. And it exacts a terrible toll on American families.

But we have to start dealing with the growing burden of cancer. And it's not going away. And we have to start, you know, trying to intervene earlier in that process. Part of that is with better screening techniques, but earlier diagnostics. You know, buzzword of the day is biomarkers. And that's something we really have to focus on.

GUPTA: How are you doing? What sort of cancer did you have? And how are you doing nowadays?

LEAF: Well, I'm doing quite well. I'm a little tired from travel, but I had Hodgkin's disease in the late 1970s. And it's a great example of how, you know, the culture of cancer had changed. There was this real sense of let's throw everything against the wall, try to see what sticks with the treatment I had. And there was a real camaraderie. There was a lot of sharing of data, you know, a seat of the pants approach that we've lost in some regard. But I'm very grateful for that. So...

GUPTA: Well, you look well. And I wish you well in the writing of the book as well. Clifton Leaf, he's a former editor of "Fortune" magazine. Thanks so much for joining us today.

LEAF: Thanks again, Sanjay.

GUPTA: Appreciate it. Really important stuff.

And also along those lines, I'm going to be hosting a very special "LARRY KING LIVE" this coming Tuesday, looking at an issue that I've been examining for some time now, the issue of cell phones and brain tumors. There's now evidence that using a cell phone more than than hour a day for 10 years increases your chance of getting a brain tumor by 250 percent. Think about that for a second. We're going to be talking about that this upcoming Tuesday. Know the odds, know the truth. All that's coming up on "Larry King". That's at 9:00 p.m. Eastern on Tuesday.

Also, you have health insurance, but you also have big medical bills. Coming up on HOUSE CALL, getting your insurance company to pay more. And also, pay less for your prescription drugs. Ali Velshi breaks it down for us as he minds our business.

And our medicine cabinet. Stay tuned to HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Now even if you have health insurance, many of your medical bills may be going unpaid. Elizabeth Cohen has some tips on how you can get your insurance company to pay up in today's "Empowered Patient."

Hey there, Elizabeth.

ELIZABETH COHEN, CNN CORRESPONDENT: Hey there, Sanjay. Sanjay, we decided to go out and look for folks who had their claims denied by their insurance company. And I'll tell you, we did not have to look for long before we found plenty of people.

For example, we found the parents of Bailey Hutchinson. Bailey had the disease that was in the movie "Lorenzo's Oil." It's a terrible genetic disorder that affects the brain. And his parents said that they had $200,000 worth of medical claims denied by their insurance. They said that they kept arguing and arguing. And still, they would deny these claims up until the day that Bailey died of his disease in 2005.

But the Robinsons said they did eventually have success. They managed to get most of those denials reversed. And so they wanted to share their words of wisdom with other people who are fighting these same problems.

First of all, they said, it's very important that people know don't go it alone. Get help. For example, your employer, if it's an employer-based health care plan, ask someone from your employer's office to help you out.

Another thing that you can do is if you're in the hospital or your child's in the hospital, there are people in the hospital who are there to help you with these issues.

Second of all, be persistent. Don't give up. Appeal and appeal, a second, third, fourth time. Sometimes that's what it takes. If all else fails, Sanjay, well we're told is get a lawyer. Sometimes having a lawyer's signature at the bottom of a complaint can do wonders. Sanjay?

GUPTA: Now Elizabeth, this is such a big problem that some people now specialize in helping those who have been turned down by insurance companies. What other steps do they suggest?

COHEN: Sanjay, another piece of advice from the experts is to ask your doctor to file again if the first filing doesn't work and to change something. For example, the Hutchinsons had the experience that when the insurance company refused to pay for a drug that helped make his chemo more effective, but the drug also helped his anemia. So the second time they filed, they put the anemia reason instead. And that made them happy. That made them pay for it. So that's another piece of advice is to ask your doctor to file it and see if they can file it in a slightly different way.

GUPTA: All right, so what do insurance companies have to say about all this?

COHEN: We talked to a spokesman for the health insurance industry. And he says the denials are very, very infrequent. He says it's in the industry's own interests to pay for the claims.

GUPTA: All right. Thanks, Elizabeth. And make sure to check out Elizabeth's column on this very topic at CNN.com/empoweredpatient. Every week, she writes there about ways you can empower yourself to get the most out of your health care. Very good stuff.

Cheaper prescription drugs. They're out there. We're going to help you find them. That's ahead on HOUSE CALL.

Also ahead, we know about the obesity problem. Let's talk about the solution. Some new ideas to stop America's expanding waistline.

(COMMERCIAL BREAK)

GUPTA: The high cost of prescription drugs is pricing many people out of the opportunity to get or stay healthy. And business correspondent Ali Velshi joins us now for more on that pinch that so many are feeling. Ali, I mean, you've been reporting on this for some time now. You've talked to pharmaceutical CEOs. You've done personal stories on this. What are you hearing?

ALI VELSHI, CNN CORRESPONDENT: Well, here's the thing, Sanjay. You guys write those prescriptions. This is the only part of the medical profession where we know more than the doctor because we got to pay for these prescriptions.

The cost of prescriptions up about 8 percent year over year. You know, when you talk about inflation being 3 percent, if you have to buy medical prescriptions, and you are not properly insured, this is going to hit you hard.

And it's not just about people, almost 50 million people who aren't insured. It's people who are insured but have very strict limits on their insurance, or people with high co-pays, or even seniors on Medicare Part B, who are insured to a certain point and then that insurance falls off. So you have to get a lot of medication.

There are well over 50 million people in America who are really feeling the pinch of the increase in the price of prescription medication.

GUPTA: And it's interesting because prescription drugs alone sort of pushes people who are in that underinsured sort of pushes people who are in that underinsured sort of category as you're describing to the point where they may even become bankrupt or something as a result of those costs. And so what can the average person do to try and reduce some of the costs on prescription drugs?

VELSHI: You know, it's kind of like -- I follow finance a lot. It's always hard for people to make the right decisions because there's a lot of work involved. This is one of those cases where is a little bit of research on your part, a little bit of digging can really help.

First of all, generics are your friend. If you can, ask your doctor if there's a generic equivalent of the prescription that they're writing for you. Some doctors tend to do that automatically. Others don't. If there is a generic, it can save you a lot of money. It can also give you greater insurance eligibility if you're insured.

You also want to use the web to see whether you can buy drugs in wholesale, a 90-day prescription rather than a 30-day prescription, and use those wholesale clubs like Costco or even a Target or a Wal- mart, where the cost of filling a prescription is much lower.

Here in New York, I tried something out, Sanjay. There's a Web site where you can enter your zip code. And the medication that you're looking for, and it will actually show you price comparisons on one drug, the price of the retail drug. If you were just buying it without insurance within a one-mile radius, $25 difference.

GUPTA: Well, you know, the pharmaceutical companies have a pretty bad rep right now, right, Ali? I mean...

VELSHI: Yes, absolutely.

GUPTA: ...people think they're trying to - they're money mongers, they're sort of pillaging at the cost of people's health. You know, you cover this. Is that what's happening here?

VELSHI: The pharmaceutical companies say that it cost them so much money, an average of a billion dollars, for one of these very successful drugs. They would like to have a certain amount of time where they can reap the reward for that, and then the drugs can become generic. Someone else can make it for a lot less money. That's what they're trying to argue that they want to do.

But you know, when you need that prescription filled, the economics of the whole situation doesn't matter nearly as much to you. Most Americans would like to have those cheaper drugs available to them or have them covered as fully as possible.

So slowly, it's creeping onto the plates of Americans who are already suffering because of higher costs of everything else. So you know, it's a double-edged sword. We get the medications that make us live longer and cure diseases, but they're not cheap.

GUPTA: Ali Velshi, one of the smartest guys I know on this topic. And it's an important year, as you know, for health.

VELSHI: Yes.

GUPTA: So we hope you have you back on the show often.

VELSHI: Always my pleasure.

GUPTA: Thank you very much, Ali.

And be sure to join Ali as well every weekend afternoon as he minds your business news of the week on a show called "Your Money." It's 1:00 Eastern on Saturdays and Sundays and 3:00 Eastern on Sundays right here on CNN.

Now former President Clinton used to run to a McDonald's on occasion. He talked about that. Now that he set down the Big Mac and picked up a cause for good health. It's the politics of a fit nation.

(BEGIN VIDEO CLIP)

BILL CLINTON, FORMER PRESIDENT OF THE U.S.: This is perhaps the number one health challenge facing the United States.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Every week, we look at ways to battle the bulge in America. And we're quick to point out the problems, but also the solutions.

This week, we devoted a whole night to our "Fit Nation." I hosted a first-ever solution summit in New York City and was joined by advocates in the health community and former President Bill Clinton as well. President Clinton has been working on the obesity issue over the past two years with his alliance for a healthier generation.

(BEGIN VIDEO CLIP)

CLINTON: This is perhaps the number one health challenge facing the United States. And of course, there's a lot of discussion in both political parties this year, being an election year, about how we can finally join all the other advanced countries in the world and provide health care to everyone.

But if we do it under any circumstances, unless we deal with the rising tide of childhood obesity and the alarming rate of what we used to call adult onset diabetes among children, the American health care system will collapse on itself within a decade anyway. And more to the point, our children could live shorter lives than we do.

(END VIDEO CLIP)

GUPTA: It's always a startling stastic when he mentions that. As the former president said, it's not just about your health, it's about our future as well. In fact, get this. The CDC says overweight and obesity issues cost our health care system nearly $100 billion a year. We're going to continue to follow this fight against obesity right here on HOUSE CALL.

What's on your mind as we close in on Election Day 2008? We asked, you answered. That's ahead.

(COMMERCIAL BREAK)

GUPTA: This is usually the time for our "ask the doctor" segment, but since we've been looking at how your vote could affect your health, we decided to hit the streets this week to find out what issues are on your mind and what you want from your elected officials.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: There are many Americans who cannot afford health care for themselves or their entire family.

UNIDENTIFIED FEMALE: Why insurance companies only cover certain prescription drugs and not others.

UNIDENTIFIED FEMALE: I think that the government should come up with a formulated method to getting the health care together through the government directly.

UNIDENTIFIED FEMALE: Is there any way we can alleviate the cost of prescription drugs?

UNIDENTIFIED MALE: You say free health care, but it's never really free. You have to call out more debt. You're going to have to do something to pay for this.

(END VIDEO CLIP)

GUPTA: This is a really important topic for us. And we're going to try to answer those questions, a lot of them on HOUSE CALL. Stay with us as we count down to election 2008. Thanks for watching for today. I'm Dr. Sanjay Gupta. More news on CNN starting right now.

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