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Health Care Reform Politics; 14 Years Old and 400 Pounds; Creating Jobs by Going Green

Aired March 23, 2010 - 23:00   ET


ANDERSON COOPER, CNN HOST: Tonight, "Keeping them Honest" on health care reform. Who is putting cynical politics above what's good for America? New moves to kill the bill and new moves by the President and Democrats to sell it, the latest ahead.

Also tonight, with health in the headlines, a teen girl's struggle with weight, 14 years old, more than 400 pounds. Her fight to lose the weight and the radical surgery she has pleaded to get.

And "Crime and Punishment" tonight: Seven bodies in a single day, dozens a week, Americans also getting killed right across the border in Mexico.

He was warned not to go but 360's Gary Tuchman went anyway and brought back a front line look at the war next door.

First up tonight, "Keeping them Honest." We'll show you where the fight over health care now heads and the motivation behind the fight. Is it about what's best for Americans or about pure "Raw Politics"?

As you probably know President Obama signed the bill, its official name is the Patient Protection and Affordable Care Act. There is the signature up close. It's actually one of many. He used 22 different pens to sign the bill most of which were given away as mementos. That's the kind of thing they do at this bill signings. Two went to the National Archives.

Emotions ran high. They were chants of "fired up, ready to go, yes, we can, yes, we did." Vice President Biden forgot that microphones pick up all words including four letter ones. He dropped the "f" bomb right in front of the mike.

From the White House Mr. Obama went to the Interior Department where he began efforts to convince Americans that the bill is a good thing. He ran through some of the immediate benefits of the law. Listen.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: This year, we'll start offering tax credits to about four million small businesses to help them cover the cost of coverage. Parents whose children have a pre-existing condition will finally be able to purchase the coverage they need. This year, insurance companies will no longer be able to drop people's coverage when they get sick or place lifetime limits or restrictive annual limits on the amount of care they can receive.

This year, all new insurance plans will be required to offer free preventive care. And this year, young adults will be able to stay on their parents' policies until they're 26 years old. That all happens this year.

This year, seniors who fall in the coverage gap known as the "Doughnut Hole" will get some help to help pay for prescription drugs. And I want seniors to know, despite what some have said these reforms will not cut your guaranteed benefits. Let me repeat that. They will not cut your guaranteed benefits, period.

I would be wary of anybody who claimed otherwise.


COOPER: Well, the president is going on the road to sell that message. Democrats all across the country are going to be echoing those talking points as they try to hold on to their seats in November.

Let's just walk over to the wall here. I want to show you some of what is driving their decisions at least. Take a look at this poll. We're going to show you poll numbers over time. These are President Obama's approval numbers over time, from 2009 all the way to current time.

Now, the president came into office way up here in the 70s. 76 percent, dipped a bit there into the 60s. Then it starts to come down a few bumps as we crossed into 2010, 48 percent here. But then right before the bill was passed it dropped to its lowest ever, 46 percent. That was before the bill was passed.

Now, let's take a look at here. This is a new poll out from "Gallup" and "USA Today" taken after health care reform passed. It shows Americans now with a favorable view of the plan passing: 49 percent said it was a good thing, 40 percent said a bad thing, 11 percent had no opinion.

Now, the president and Democrats are hoping that once people get to know the details of the plan, they're going to like those details and that's going to improve the president's poll numbers and the Democrats' chances in the November election.

But now Republicans are vowing to fight it. They're going to slow it and stop it if they can. And they're doing it in a couple different strategies.

Let's take a look at this map. This is their state by state strategy. Fourteen states now, suing in federal court to block this law. Thirteen filed just today in a Florida federal court minutes after the bill became law, actually. Florida's attorney general called it a nonpartisan effort; though as you see every attorney general is Republican except for the one from Louisiana.

So that's one kind of challenge; the state by state challenge. But there are other challenges I want to tell you about. They still have vote in the Senate. Not in the main law but on that smaller package of fixes to it.

So Republicans may try to offer amendments to gum up the works or to get Democrats on record in ways that they're going to regret in November. Now, both sides are saying, look, that they are acting purely out of what they think is best for America. That's what both sides are saying.

But we wanted to note tonight, we want to take a look at how much cynical politics is really at play here.

Dana Bash tonight, is "Keeping them Honest", both parties. She joins us now. Dana, so what's going on?

DANA BASH, CNN SENIOR CONGRESSIONAL CORRESPONDENT: Well, Anderson, to put it simply, the debate that's going on right now on the Senate floor is all about the mid-term elections in November. Republicans know that Senate Democrats have closed ranks and they're planning to vote no on all of the amendments that are being offered as we speak.

So GOP sources tell me they've devised a strategy to use this health care debate, the remaining debate to make things politically difficult for Democrats. They want to force them to take tough votes. And a classic example just happened a short while ago. It's a doozy, Anderson.

Get this. Republican Tom Coburn introduced an amendment that prohibits erectile dysfunction drugs for sex offenders. That's right, you didn't hear me wrong. No Viagra and the like for sex offenders. So I'm sure you're wondering what this is all about.

Well, I talked to a Coburn aide tonight. He says there is nothing in the law right now that prevents sex offenders who get government subsidies from using that -- those taxpayer dollars to buy Viagra. And this was actually a problem, he said, for years with sex offenders on Medicare and Medicaid.

But Republican aides tell me they know full well any Democrat that vote against this can be painted as supporting ED drugs for sex offenders. That's politics.

COOPER: So -- so can Democrats vote -- vote for it? I mean, it's basically trying to paint them into a corner.

BASH: That's right. It's absolutely painting them into a corner. And that's exactly why Republicans are doing it. And they're doing other issues as well.

Right now, also on the Senate floor, Republicans know that one of the politically explosive issues for Democrats, very hard for them to vote against, those in tough races, is something, it something that we've heard a lot about. And those are special deals that have gone to some states. So John McCain just tonight offered an amendment to strip out the remaining special deals for states. And one of the senators who got special help for her State of Louisiana, she got angry.


SEN. JOHN MCCAIN (R), ARIZONA: They are provisions that were not allowed or provided to every other state in America. That's what makes them a special deal. That's what makes Americans think that the way we do business around here is not in their interests. It makes Americans believe that we are cutting these deals in order to secure votes.

SEN. MARY LANDRIEU (D), LOUISIANA: This amendment is a stunt that really doesn't deserve the time that I'm even going to give to explain the portion of it that refers to Louisiana. And the reason I say it's a stunt is because it's actually written for television or the Internet. It's not written for any serious debate here. And in my view, it's beneath the Senator from Arizona who at one time was a candidate for president of this country.


COOPER: So I mean, you mentioned in the beginning the Democrats are closing ranks voting no on all these amendments. But why? Why not take them on one by one?

BASH: The reason is because they don't want any amendments to pass that change this fixes bill. Because that would mean that it would have to go back to the House and cause problems for this bill, not to mention delay the end of the health care debate even further. And all Democrats want this to be done.

So I'm told Democratic leaders actually used their weekly meeting today, a lunch that they have every week, to implore rank and file Democrats to stick together. Have discipline and vote no on everything. Even amendments that they may actually agree with in substance or, Anderson, may get hammered for politically like the couple of amendments that we pointed out tonight.

COOPER: All right, Dana, stick around.

And let us know what you think. There's a live chat right now at We'll talk to viewers around the world who are watching right now.

Coming up next, what health care law means to three working families, three families: working class, middle class and the wealthy families. See what it might mean for you as well. And our panel, Dana included, weighs in on the political and medical implications of the law.

Later, how young is too young to have surgery to shrink your stomach and lose weight? Tonight, a girl facing that question, 14 years old, more than 400 pounds. Her life is on the line.

When 360 continues.


COOPER: "Up Close" tonight, health care reform and families, your family. Today at Arlington National Cemetery, Ted Kennedy's gravesite, a note from his son Patrick. It reads simply, "Dad the unfinished business is done."

Family business, the question is what kind of family legacy will this turn out to be?

Tom Foreman looks at how the new law affects three families "Up Close."

TOM FOREMAN, CNN CORRESPONDENT: Reform may be the cure for health care's problems but different people will get different doses; some taking effect almost immediately, others in four years. Let's start with a family making so little money that they cannot afford insurance.

When this program is fully running by 2014, the government will help buy coverage for pretty much anyone making around $30,000 to $90,000 a year. The more you make, the less help you get. And if you don't buy insurance under those circumstances, you will be fined.

But what about grandma? Well, seniors on Medicare, no matter what kind of income we're talking about, will see mixed results. They will get some breaks for certain tests and drugs. But those who have purchased extra protection, so-called Medicare Advantage Plans, will find some of the government subsidies for that being phased out and some may lose that coverage.

Let's look at a middle class family making, say, $100,000 to $150,000 a year. They have insurance through their jobs and the bill says keep it. But they'll still face changes which will affect everyone.

Look. One child has a heart problem which she inherited from her mother who has the same trouble. They won't have to worry about being denied coverage based on those pre-existing conditions. The insurance companies cannot limit how much it spends on their treatment and you can't be dropped for getting sick.

What's more, for all families, dependent children soon will be able to stay on mom and dad's policy until the age of 26 which will keep a lot of kids covered through college.

And finally, let's look at the family that is doing pretty well; more than $250,000 a year. They get the same protections as everybody else but they're also going to see additional Medicare taxes coming out of their paychecks rising from less than one per to almost two and a half.

There will also be new, almost four percent taxes on their investment income, and by 2018 anyone in any tax bracket who has a particularly generous health care plan through work will also be facing new taxes on that, too -- Anderson.

COOPER: All right, Tom, thanks.

Let's "Dig Deeper" now: the impact on families, political parties and the budget and a lot more. Joining us is 360 MD Sanjay Gupta; Dana Bash is back; also with us political contributor and Democratic strategist, Paul Begala, who's a veteran of the last battle to pass health care reform during the Clinton administration; and from the right, Reihan Salam, co-author of the "Grand New Party", contributor at "The Daily Beast" and a fellow at The New America Foundation.

Paul, so this package of senate fixes, anything but a done deal.


COOPER: I mean do you the Republicans are going to be successful in blocking it?

BEGALA: You know, all they have to do is let one through. And then, they will, they won't have blocked it. They'll have gummed up the works a little longer. If even one amendment sneaks through, then the House would have to take up the changed Reconciliation bill.

But right now the Democrats are very united. I think they'll be able to knock them off. I think they understand based on Dana's reporting and the wrong sense of the Senate that this is not on the level. I mean, if Senator Coburn really wanted to stop sex offenders from getting Viagra, he would have put that amendment up when the big bill was being negotiated.

So I think -- I think that some of those stunts are kind of backfiring on the Republicans.

COOPER: Reihan, if Republicans are concerned about reducing the effect of the deficit in this bill, why not now work to try to -- make the reform better rather than try to basically just kill it, put up roadblocks to it?

REIHAN SALAM, CONTRIBUTOR, THE DAILY BEAST: Well, I think that makes sense. And I think Republicans are going to be working on that. But for right now, the bill is actually pretty vulnerable in a lot of ways. A lot of the benefits are going to come online later down the road.

COOPER: Right, 2014 and 2013.

SALAM: Exactly, exactly. And also, a lot of the tax provisions come much further down the road as well. So really, it's in this awkward moment. And you've seen previous bills, for example, in 1988 Ronald Reagan passed a big comprehensive health package that was backed by Republicans and Democrats. One year later it was overturned by an overwhelming vote.

COOPER: So you think this could still be overturned?

SALAM: I think it's unlikely but it's at least possible. And I think that folks who believe that this is going to worsen our fiscal situation over time are now betting that we can raise the temperature and maybe get some kind of reversal rather than talk about compromising now.

Whether or not that's a good idea over the longer term is up for debate.

COOPER: Yes, I mean, Dana, what Reihan was essentially saying is that the focus is on -- what's best for mid-term elections rather than what may be best for the deficit down the road or for the country.

BASH: Shocking, shocking. In Washington politics -- right. At this point, especially, it is absolutely true. You mentioned the deficit. Mitch McConnell was -- was on earlier today and that -- that was the issue that he was asked.

Well, why not vote for this? You want to reduce the deficit. This particular change package adds to that. And you know the answer was, well, but there are lots of other things that I don't like.

So look, the bottom line is that as much as both sides say that they wanted to do this substantively, there is no question that at this point when you walk the halls of Congress, people are pretty candid about it.


BASH: There is no question at this point that they are making their arguments for political gains.

COOPER: Reihan, I see you shaking your head.

SALAM: Well, here's the thing. I mean, the bill happens in a bigger fiscal context, right? So Sanjay Gupta has earlier on, on CNN talked about the doc fix. This is a separate issue that's not in the bill but it's a big issue that shapes how much we're going to spend on health care over time.

Similarly, we've put a lot of revenue measures further down the line in 2018 and later in this bill that may or may not happen; that are going to happen after the president leaves office.

And so that's the tricky question. A lot of the pain in this is coming later. The spinach is coming later. But the good stuff, that's coming sooner. So whether or not this is -- this bill is really going to reduce the deficit is an open question.

COOPER: I want Paul to be able to respond but I also want to bring in Sanjay in just a moment to talk about fraud in this.

But we've got to take a quick break. The conversation continues right after the break.

We'll also talk about Vice President Biden and the "F" bomb heard around the world. Also, late word on a settlement in the lawsuit against Oprah Winfrey by the former headmistress at her school for girls in South Africa.

We'll be right back.


COOPER: Well, there's been plenty of cursing throughout this health care battle, much of it ugly and raw. As President Obama was signing the new legislation into law, today there was more cursing of a very different kind; the kind you get when Vice President Joe Biden gets too close to an open mike.

Take a look.


JOE BIDEN, VICE PRESIDENT OF THE UNITED STATES: Ladies and gentlemen, the President of the United States of America, Barack Obama.

This is a (EXPLETIVE DELETED) deal.

OBAMA: Thank you, everybody.


COOPER: Yes, well put sir. It's not the first time Vice President Biden has been caught cursing on an open mike, and at this rate it will not be the last.

Our panel is back to talk more about the health care bill. Joining me again: Dr. Sanjay Gupta, Dana Bash, Paul Begala, and Reihan Salam.

Sanjay, you've been looking into this ongoing problem of fraud in the health care system. How much does health care fraud cost us all?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, it's interesting. And no one knows the exact number. But if you look at Medicare overall, conservative estimates say that about three percent of all Medicare expenditures are actually fraudulent and that would put the number around $15 billion a year.

COOPER: And who's committing the fraud?

GUPTA: Well, you know, a lot of -- I mean, the criminals. Criminals are committing the fraud. But for the most part, it can be people who are not related to the health care profession at all. These are people -- there's one case in Florida, Anderson, where there were all these claims made for equipment; millions of dollars of equipment that were neither actually delivered to patients.

What was the real fraud here, the crime was that the doctors who were ostensibly ordering this equipment had been deceased for five to ten years. And criminals essentially gathered those doctors' names in creating those bills.

But the most common type of fraud is actually something known as up coding or up billing, where you bill for a service that's a higher level than what was actually performed. And that happens. It's intentional fraud and it happens quite a bit.

COOPER: So is there anything in this new health care reform bill that -- that pro-actively tries to root out fraud?

GUPTA: Well, part of the way that this bill is going to be paid for, as again, is possibly by rooting out fraud. And they want to add these investigation units all over the country through the Department of Justice, through HHS to -- to look at patterns of fraud and figure out if you can see things like what happened in Florida --

COOPER: Right.

GUPTA: -- and try and stop them.

Also, you mentioned Senator Coburn earlier. He proposed something about undercover patients, actually taking patients that aren't -- aren't really sick. Having them to go doctors' offices, have them be wired and see if doctors or any health care professionals are committing fraud there as well. So those are just couple of the ideas floating around.

COOPER: Paul, to Reihan's earlier point, of using example of the bill that Reagan had passed, then a year later it was dead, even though it originally had bipartisan support. I mean, is this health care bill still very vulnerable? Could a year from now, I mean, do you think any of the challenges that the Republican are raising, whether it's state by state or whether through the federal courts, is it vulnerable?

BEGALA: No, I was a brand new Hill aide in 1989 when that bill was repealed. It was a Reagan's -- it was catastrophic health insurance, mostly for elderly. And it was the elderly who wanted it repealed because it taxed the elderly for a benefit that went to the elderly and of course the elderly didn't like that.

No, I really don't see that happening at all.

I think the point that Reihan makes about this so-called doc fix, where doctors are going to be under-reimbursed under Medicare if they don't fix it, is absolutely right. It cost as fortune, $200 billion. It's not in this bill.

I do hope when Congress takes it up they pay for it. But that's a big debate. But if you care about the deficit, I know Reihan does and a lot of our viewers do -- it is simply a fact that this is the largest deficit reduction package in a decade. That's not from the Democrats or the Republicans; that's from a nonpartisan Congressional Budget Office.

COOPER: Right, but -- but the CBO as the Republicans will quickly point out, the CBO's numbers are very -- I mean, they're kind of estimates based on projections 20 years down the road, which is --

BEGALA: No, no. It's a ten-year number -- the ten year number first Anderson, which is much more reliable is that it will reduce the deficit by well, over -- by over $100 billion. The 20-year number is over $1 trillion. But you're right. That's very, very unreliable but it's all we've got. They are the agreed-upon arbiter here and they're totally nonpartisan.

COOPER: Reihan?

SALAMA: Well, here's one thing I'll say. During the Clinton administration, the president didn't get a lot of credit for being honest but he actually was a lot more honest. Clinton Care counted all of those insurance premiums as they were going on to the -- their version of the exchanges as federal revenues.

That was not counted this way this time around. So the sticker shock that happened during Clinton Care was a big reason why that bill failed. And this time you didn't have that. There are all kinds of ways in which the CBO projections are very different now because people learned from what happened that time around.

I personally think President Clinton was a lot more honest when he tried to pass the health care reform in 1993 and he really tried to take on the medical providers, the hospitals, the pharmaceutical companies, and that's why he had a much tougher time.

This time we have a deal that is really a sweetheart deal for a lot of powerful interests. That doesn't mean there is nothing good on the bill. There are a lot of good, decent ideas. But it also means that it wasn't as good as it should have been and now we're all going to have to deal with it. We're all going to have to fix it.

COOPER: Dana do you -- when you talk to people on Capitol Hill, do Republicans put a lot of faith in -- in this court effort by 13 states right now? By 13 attorneys general in the states challenge the constitutionality of this?

BASH: Do they put a lot of faith in it? Unclear yet. But is that really their biggest avenue for overturning this? Absolutely. I mean, this is -- that is really the place where they feel that they have some good arguments.

And I think that they believe that the best argument from their perspective is the whole idea of mandating health care coverage. I mean, they say that that is something that is relatively unprecedented. Yes, you have to get a driver's license. But you're not required to drive. This is something that is very different. So they think from that perspective, legally, they have the best argument.

COOPER: Sanjay, I want to show you something that Dr. Andrew Weil said on "Larry King Live" last night to Wolf Blitzer.

Let's listen.


DR. ANDREW WEIL, FOUNDER & DIRECTOR, ARIZONA CENTER FOR INTEGRATIVE MEDICINE: This is not health care reform. It's health insurance reform. And that is a good thing. It's a step in the right direction. We desperately need health care reform which means improving health outcomes, making us a healthier society and getting health care costs down. This bill will do none of that.


COOPER: Do you agree with that? That this is more about insurance reform and not really health care itself?

GUPTA: I agree with some of what -- what Andy Weil said. And I've talked to him about this in the past.

Two points really to make here. One is that -- is the delivery system for health care really being addressed in this bill.

So simply put, more people will have an insurance card that they can put in their wallets. But does that mean that they're going to be able to see doctors? There's a shortage of doctors, as we know. Does it mean they're going to get the high quality delivery that I think that they expect?

The other I think a little bit more obscure point that he's making is that simply having a health care insurance, can you draw a line between that and creating a healthier person? Or more importantly, a healthier society? And I think the -- that's a tough one to answer.


GUPTA: I mean, I know a lot of people who have health insurance, they have all the resources in the world and they still don't live healthy lives necessarily. So I don't know that it will necessarily lead to a healthier society; certainly not for sure.

COOPER: Yes, I appreciate your comments. Sanjay, thank you as always. Reihan Salam, I appreciate you being with us. Paul Begala as well and Dana Bash, thanks for reporting.

Still ahead, we're talking about -- off what Sanjay was saying, a major health care crisis facing kids right now, obesity. You're going to meet a teen whose doctors said she would die if she did not take extreme measures to lose weight, 14 years old, weighing 400 pounds. Her story tonight as we begin our special series, "Kids in Peril: Obesity in America."

Also ahead, new steps to keep Michael Jackson's former doctor, Conrad Murray away from patients.


COOPER: Coming up, a settlement in the lawsuit against Oprah Winfrey by the former head mistress at her school for girls in South Africa.

But first let's check some of tonight's other important stories. Christine Romans joins us with the "360 Bulletin" -- Christine.

CHRISTINE ROMANS, CNN BUISNESS CORRESPONDENT: Anderson, President Obama's pick to head the Transportation Security Administration says he supports the use of full body scanners. Robert Harding said so at his Senate confirmation hearing. If confirmed, the retired Army Major General says he also wants U.S. airport security to be more like Israel's where travelers are grilled extensively before being allowed to fly.

British authorities say they have compelling reasons to believe Israel was responsible for the use of forged British passports in the plot to kill a senior Hamas operative at this Dubai hotel in January. France is also looking into the use of forged passports in the plot.

Dubai police say this video shows some of the 27 suspects with fake passports at that hotel just before the assassination. They insist Israel's spy agency carried out this attack but Israeli officials deny any connection.

The California State Medical Board will ask a judge next month to revoke the medical license of Michael Jackson's doctor while he is being prosecuted in the singer's death. Dr. Conrad Murray has pleaded not guilty to involuntary manslaughter.

And in Forest Park, Georgia, a hit and run caught on a police officer's dash cam. The victim -- believe it or not, a 60-year-old woman -- she's bruised, badly shaken up but she is alive. Now the driver, Anderson, apologized and then fled the scene.

COOPER: Are you kidding?

ROMANS: Police are hoping someone knows the driver and turns her in. News flash. You can apologize but --

COOPER: Unbelievable.

ROMANS: -- you can't -- yes. You can't beat the law on something like that.

COOPER: I'm glad she's doing all right.

All right. It's time to take a look at our "Beat 360" winners. Our daily challenge to viewers; a chance to show up our staffers by coming up with a better caption for the photo that we put on the blog every day.

Tonight's picture, Speaker Nancy Pelosi has a laugh during a news conference yesterday after the House passed health care reform legislation. Our staff winner tonight, Ed Henry; his caption, "I just knew we could pass this bill without the Botax in it."

I kind of messed up with the delivery. I'm sorry.

Our viewer winner is Charlotte from Scurry, Texas. Her caption, "All for the health care bill say ahhh."

Very good. All right. Charlotte congratulations. Your "Beat 360 T-shirt is on the way.

ROMANS: There's something in there about she who laughs last laughs best, I think.


Still ahead, young, obese and facing the writing on the wall. You're going to meet a 14-year-old girl who was told she would not live to 18. Her extreme weight was killing her. She had surgery she hopes will save her life and help her feel normal, she says, for the first time in her life.

Part of our new series, "Kids in Peril: Obesity in America."

Plus, Gary Tuchman takes us to the streets of one of the world's most dangerous cities, Juarez, Mexico. Just over the border, three Americans recently were gunned down there; A horrible crime but also an all too familiar one.


COOPER: Welcome back. You heard Andrew Weil a moment ago. He and others criticizing the new health care bill for not focusing enough on making people healthier; they're concerned about the surging rate of obesity, for instance.

Take a look at this map from Centers for Disease Control from 1998. In all those blue states, less than 20 percent of adults are obese. In the beige states between 20 and 24 percent are obese.

Now look at a map from 2008. As you can see, ten years later, you see a lot of red and orange states; 32 in all. And in all of those a quarter or more of adults are obese. The epidemic is nationwide. And it is trending younger, interestingly enough.

According to a new Kaiser Permanente study, children may be facing shorter life spans than their parents; 10 to 20 years shorter. It's incredible.

And they say that is because obesity is putting them at risk for diseases that can kill.

Tonight we begin a week-long series, "Kids in Peril: Obesity in America" with one young girl's story.

Here's Randi Kaye.


RANDI KAYE, CNN CORRESPONDENT: Her name is Maria Caprigno and if you're staring at her, she won't be surprised. Because of her weight, people have been doing so since she was a little girl. Look at these family photos. They tell the story of Maria's ongoing battle with childhood obesity. At 4 she weighed 79 pounds, as much as a 7-year-old. By the time she was 7, 168 pounds -- off the charts her doctors said. By 9, she weighed 250. Last month, at 14, she topped out at 445 pounds.

(on camera): Does it hurt when people stare at you?

MARIA CAPRIGNO, UNDERWENT WEIGHT LOSS SURGERY: Yes. The first thing that goes through their mind is why is she so fat? Like oh, my God, why is she so fat? Why doesn't she just hop on a treadmill?

KAYE (voice-over): Maria's parents are overweight, too. And ad Military they don't eat healthy foods. Maria has always been a junk food junky. Dieting never worked.

So a few years back, Maria pleaded with her mother to find a doctor willing to do weight loss surgery on teenagers. Their search led them here to National Children's Hospital in Washington, D.C. and Dr. Evan Nadler.

DR. EVAN NADLER, CHILDREN'S NATIONAL MEDICAL CENTER: I had to help her. She was 440 pounds and going nowhere except for gaining more weight.

KAYE: Maria was 12 and already pre-diabetic.

NADLER: Her BMI, which is a measurement we use to determine how obese someone is, put her in the highest risk category. Not just morbidly obese but actually two categories higher than that.

KAYE (on camera): Dr. Nadler says 25 percent of all high school age children are either overweight or obese. And he believes that those most obese face health risks such as high blood pressure, diabetes and depression that far outweigh the risks of any weight loss surgery.

(voice-over) But some disagree. Like Dr. Edward Livingston who turns away most young patients.

DR. EDWARD LIVINGSTON, UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CITY: Kids don't really know what they're getting into. So I think you have to be really careful with children.

KAYE: Before surgery, Maria had to meet with a nutritionist, pediatric cardiologist and psychologist for approval.

CAPRIGNO: My name is Maria Caprigno.

KAYE: She also wrote this letter to her insurance company seeking coverage.

(on camera): You told the insurance company you need this surgery to make it to your 15th birthday.

CAPRIGNO: Doctors have told me for years if I keep gaining weight, I'm not going to see 18th and that has terrified me. I want to live. I want to do so many things. And I knew that this was my only option to do them.

KAYE: This was a life or death surgery for you, you felt.


KAYE (voice-over): Even so, some critics still argue, not enough is known about possible long term complications.

NADLER: I fully agree that we need to study this more. But I don't think it's fair to the Marias of the world to keep them from having this procedure based on their age alone.

KAYE (on camera): In his own study, Dr. Nadler followed 41 teenagers for two years after weight loss surgery. He said they lost half their excess body weight and their health had improved.

(voice-over): Last month, Maria had an experimental procedure known as a gastrectomy; 80 percent of her stomach was removed including the area that makes her appetite hormones.

CAPRIGNO: I wasn't hungry after surgery like normally I would have been starving.

KAYE: She has already lost 45 pounds and trimmed two inches off her waist. She is off junk food, getting regular exercise and eating a high-protein diet.

(on camera): What is your goal weight?

CAPRIGNO: It's not about the numbers. I want to be at a healthy size. I want to be able to run. I haven't been able to run since I was 5 years old.

I want to be able to wear a bathing suit without feeling embarrassed. I just want to be able to be normal.


COOPER: She just wants to be a kid. What is her diet like Randi?

KAYE: Right now, Anderson, she eats about 1,500 to 1,800 calories a day, mostly pureed food really and anything that you can put in a blender, but all protein. She's supposed to eat all the protein on her plate. And if she is still hungry, maybe move to carbohydrates.

But she is also expected to lose, she said, 100 pounds a year. This is only going to last for a couple years then she's going to flatten out and plateau for a while. But that's a lot of weight and she's blowing her way.


Sanjay, what is happening inside her body? I mean what kind of stress does -- this weight has got to put on huge stresses on her.

SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: On just about every part of her body, Anderson. You're absolutely right. A lot of people focus on the outside. But in kids now as young as Maria and even younger, things are happening inside the body.

Take a look. Some of these images here are from this exhibit where they actually look at the insides of thin bodies and bodies that are more overweight or obese. What they're really trying to show here is what's happening to organs such as the heart, for example.

You can take a look there. The heart inside, the muscle starts to grow around it. The arteries, even the arteries leading to the brain, the carotid arteries start to develop plaque. And some of the coronaries, which are the blood vessels on top of the heart, Anderson -- something you and I have talked about it quite a bit -- you can see significant disease inside these coronary vessels that would look like somebody in their 50s or 60s but you see it in someone in their teen years, sometimes in their -- even younger than that.

COOPER: So does, Sanjay, having the surgery, does that mean she is no longer, I guess, does it help reduce her risk for things like heart disease or diabetes?

GUPTA: Yes, you know, it does. But, you know, it is not quite that simple. I mean taking off weight is taking off weight. So it's going to help with things like your joints, knees and hips which can also be a significant problem at a young age. With regard to bariatric surgery in particular, losing the weight alone does have some positive impact on reducing some of those health problems, as Randi mentioned but it has to be accompanied by diet changes as well.

The person will eat less but the choice of foods have to change significantly as well if you're going to reduce your high cholesterol and address things like pre-diabetes or even diabetes.

COOPER: Well, also, especially for a teen, Randi, I mean diet is so important. If her parents are not eating well, then she is not going to, in all likelihood, eat well. Have they changed their diet as well?

KAYE: They have actually. Her mom said that she's now buying healthier foods. But her food bill has actually gone up, she said, about $60 a month --

COOPER: Right.

KAYE: -- because buying healthy foods is more expensive. Her mom had the lap band weigh loss surgery before Maria did so she could understand what her daughter might go through even though it was a different surgery. Her father has already lost 11 pounds. He is eating healthier and he is planning to have weight loss surgery this summer.

COOPER: We wish them all the best.

Randi, thanks very much.

COOPER: Next on 360, fanning the future. How wind energy is bringing hope and jobs to one former steel town. Our "Building up America" report coming up.


COOPER: Creating jobs by conserving energy. It's happening across the country. Tonight we want to show you, one company where going green has been good for business and pretty good for the environment as well.

Part of our "Building Up America" series; here's Joe Johns.


JOE JOHNS, CNN CORRESPONDENT (voice-over): This used to be steel country U.S.A. with its towering pollution machines. But now, new jobs and the clean energy sector, putting people back to work, going green all at the same time.

The U.S. subsidiary of a company based in Spain, Gamesa U.S.A., is manufacturing enormous windmill blades at this Pennsylvania plant, shipping them all over the U.S.

Ron Sanders is the plant manager.

(on camera): How many of these do you guys make a week?

RON SANDERS, PLANT MANAGER, GAMESA, USA: We're moving back up to produce more at 11 blades per week.

JOHNS: And at your lowest point during the recession, how many were you putting out?

SANDERS: Just five per week.

JOHNS (voice-over): Sanders got a break from the recession by coming here to work. He used to work for an automotive supply plant that fell on hard times.

SANDERS: I had been in automotive for almost 30 years. As the industry declined, I found myself having to leave the employer that I was working for at the time. So in December of '08, I left. And then in June 2009 I started here with Gamesa.

JOHNS (on camera): 230 people work at this plant, 24 hours a day, five days a week. And building just one of these blades is a huge job. They can weigh 15,000 pounds, 45 meters long. It takes almost 24 hours to build just one.

(voice-over): And there are other people here who might have been out of work but for the appearance of these green jobs.

Ed Burnat had jobs at three different steel plants before it all dried up. He's grateful to be working here. (on camera): So what's better? Steel working or this?


JOHNS: You go where the work is?

BURNAT: Sure, you have a family. You have to feed your family. You do what you have to do.

JOHNS (voice-over): It took about three months to figure out the new job and less time to see one of the upsides.

BURNAT: Most of the guys that work here like the idea of it being green. We like the idea of this, cleaning our environment up. A lot of people here are, you know, like that idea.

JOHNS: Creating green jobs is something the president talks a lot about, but to tell the truth, the U.S. lags behind Western Europe in windmill production and use. So in the end, the real job may be standing up the windmill industry in the U.S. so it can create more jobs, more energy, and compete in the global market.

Joe Johns, CNN, Evansburg, Pennsylvania.


COOPER: "Building up America." We'll be right back.


COOPER: Following a couple of other important stories. Let's check in with Christine Romans for a "360 News & Business Bulletin" -- Christine.

ROMANS: Anderson, we begin with that former university professor accused of killing three colleagues. Amy Bishop made her first court appearance today. The capital murder case against her was sent to a grand jury. Bishop allegedly opened fire last month at the University of Alabama in Huntsville. In a police interview, Bishop denied any involvement, saying, quote, "It wasn't me."

In Mississippi, a "360 Follow" on the high school that canceled its prom instead of letting a lesbian student bring her girlfriend as a date. Today a judge said it will not force the school to hold next week's prom. The ACLU accuses the school of violating the students' First Amendment rights.

Oprah Winfrey has settled a lawsuit brought by the former head mistress at her Leadership Academy for Girls in South Africa. A statement released today said Winfrey and the woman reached an agreement after meeting face to face. The woman accused the talk show host of defaming her in the wake of abuse allegations at the school.

And taking the pain out of gift cards: the Federal Reserve has announced new guidelines to better protect people who use these gift cards. The new measures include limiting fees on charges and inactivity. The rules take effect in August.

And according to several Hollywood trade reports, Sarah Palin, Anderson, is heading to reality TV. That's right, reality TV. They say she'll star in an Alaska-themed show for the Discovery Channel. And we hear Discovery is paying a million bucks for each episode.

COOPER: We don't know if a million -- I doubt that's $1 million for her. It's probably the price of the episodes.

ROMANS: I would suspect it's what they're paying for each episode of that. But this is -- this is Sarah Palin on her own turf on her own terms, right?

COOPER: You never know.

All right. Tonight's "Shot," this is great. Take a look. One way to stop a baby from crying. This is cute.





COOPER: A howling dog to soothe a little baby. That's adorable. I can't tell if it's working or if he's just drowning the baby out but I think it's working.

ROMANS: I think it's working. I want to make this a cell phone ring. It was nice.

COOPER: We found this at The site says the link was uploaded yesterday; no doubt going to go viral pretty quickly. Yes, there you go. And a pretty dog, too.

ROMANS: That's a dog who loves its baby.

COOPER: See, it works. It's amazing.

Christine thanks so much.

Hey, that's it for 360. Thanks for watching.

"Larry King" starts now.

I'll see you tomorrow night.