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July 31st, 2009
11:54 AM ET

Would health care costs under the public plan be too steep?

By Stephanie Smith
CNN Medical Producer

Three words - health care reform - have transformed the national conversation. And with the vigorous debate elicited by those three words - in Congress, on newscasts, on blogs, in opinion pieces, average Americans are coming out of the woodwork to tell their health-care horror stories.

One of those stories came to our health blog from P.J. May of Ohio, who is the primary caregiver to her 87-year-old mother, who suffers from Alzheimer's disease. A few years ago, before taking on that role, May was working full time, and had what could be considered a decent health-care plan through her employer. However, as her mother's health deteriorated, May made the tough decision to cut her hours to part time to help care for her, and with that she lost her health benefits.

Next, May. did what many in her position would do - she shopped around for private health insurance. She found a plan, but for her budget, the payment was going to be steep. You see, working fewer hours, May brings in only $700 a month, and $213 of that goes toward private health insurance.

May’s situation probably sounds familiar to many Americans who purchase private plans. She's paying an exorbitant amount on premiums, and on top of that, out-of-pocket expenses. In her case, premiums alone constitute about one-third of her income.

She, and many other bloggers, viewers and tweeters writing to us want to know: Will a new public health care plan be affordable for me?

"I don't know if Obama's decisions are going to help me or make it worse," May wrote in an e-mail to CNN.

To find out more about the cost of health care under a public plan, we pored over the 1,000-plus-page health care bill currently in the House with policy expert Kenneth Thorpe of the Rollins School of Public Health at Emory University in Atlanta, Georgia.

Thorpe crunched the numbers, and what he found may not match most people’s idea of “cheap.”

The uninsured, along with small business owners, would get first crack at purchasing a public plan, with the government providing subsidies to reduce costs.

Under the House plan, as it is drafted today, May's entire health care bill would be subsidized by the government. She would not pay a dime out of pocket for health insurance. So, for her, the news is good.

As income creeps above the poverty line, the cost of health care would also creep up, on a sliding scale. So an individual making $21,660 a year, according to Thorpe, would pay $1,083 under the House plan, while an individual making $43,320 would spend $4,704 a year, which is $392 a month.

The same goes for a family of four. At the lower end of the spectrum, a family of four with an income just above the poverty line - $44,100 - pays $2,205 under the current House bill, while a middle class family, making $77,175 a year would pay around $77,15, which is about $650 a month.

Ouch.

A caveat, however, is that those figures include co-pays and out-of-pocket costs.

Still, even considering subsidies, the cost of the public plan is concerning to some legislators. They say that the cost burden on the middle class is too high.

But Thorpe says to keep in mind that on average a family of four today pays around $12,700 a year for health care - more than $1,000 a month.

"[The public plan] sounds expensive, but it's thousands less than what the average family of four pays right now," said Thorpe.

What do you think? Does the public option sound too steep for your budget, or is this alternative better than what you're paying now?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


July 30th, 2009
12:00 PM ET

Will health care be rationed?

As a regular feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From iReporter Jason in San Antonio:
"Four years ago my father was diagnosed with terminal brain cancer.  [For] 18 months we fought that disease with everything we had because we felt like every day was precious, every day we kept him alive we were one day closer to a cure for that disease. I guess my question is, under a public option or government run health care system, would that type of care be possible? Is it something that 10 years from now we're going to have to sacrifice or come up with a tremendous amount of cash to pay for it because it would be rationed under our government run health care system?"

Answer:
First, Jason thanks for sharing that personal story. Our best wishes are with you and your family. The idea of rationing really strikes at the core of all that we are talking about with regard to health care - this idea of lowering costs, trying to increase access. The question is, will we have to ration health care as a result?

There was a New York Times editorial a couple of weeks ago by Peter Singer, a bioethicist at Princeton University, where it was put like this: "The death of a teenager is a greater tragedy than the death of an 85-year-old and this should be reflected in our priorities."  Think about that for a second. He's saying we should assign value of life differently in certain situations.

Jason, we took your story specifically to the White House and asked them to respond. They said, "Our heart goes out to Jason and his family. We know families across America are dealing with issues like this every day. There are a number of different bills making their way through Congress right now but we do know this: The reform bill that the President signs will not lead to rationing. It will be fully paid for and bring down costs over the long term." They went on to say, that the President won't sign a bill that doesn't guarantee coverage to all people of all ages regardless of  specific health conditions.

But as you're saying, Jason,  it may come down to numbers and whether estimates of the cost of  health care reform are accurate. When Medicare hospital insurance was conceived in 1965, the House Ways and Means Committee projected that in 25 years it would cost 6 billion dollars. The actual cost? 67 billion, according to the Centers for Medicare and Medicaid Services. You can see how far off costs for Medicare were, based on initial projections –much, much higher. Now the president says they'll add prevention programs and wellness programs, creating a healthier population and that will be a cheaper population with regard to health care costs. But who knows? You've got more people that you're trying to cover; more people, more tests, more screening. How that all adds up, we're just not sure.


July 27th, 2009
04:19 PM ET

Ask Dr. Sanjay Gupta your health care reform questions

Do the health care reform headlines leave you with more questions than answers? Dr. Gupta is your health care reform insider – and he wants to hear from you!

Post your questions for Dr. Gupta in the comments below or tweet him @SanjayGuptaCNN.


July 24th, 2009
10:00 AM ET

Making goals happen, on and off the court

By Caitlin Hagan
CNN Medical Associate Producer

On a hot sunny day, eight men play street soccer on the hard top of a local basketball court. They high-five and laugh while running drills and scrimmaging. Their dynamic is unique because despite their competition, they are also extremely supportive of one another. Friendly trash talk is intermixed with calls of praise that continue when it's time for a break and the men move off the court, into the shade. To an outsider, this group of friends is happy and healthy, enjoying an afternoon in the sunshine.

soccer

Street Soccer USA tries to give hope and restore self-worth to homeless men around the country.

No one would ever suspect these men are homeless. In fact, being homeless is what brings them together.
Welcome to the Atlanta Street Soccer team. One of 16 in the country, the team is part of the national program, Street Soccer USA. The program, open to men who are homeless, addicts in a rehabilitation program, or refugees, seeks to use sports, specifically street soccer, to help the players turn their lives around.

When someone is homeless, “you stop thinking about your health and things that make you happy, things that make you want to live, that make you want to be a productive member of society, that make you want to get up and go to work.” Participating in soccer and sports “makes you want to take that next step. It motivates you to want to do better,” says Jeremy Wisham, an AmeriCorps volunteer who coaches the Atlanta team.

Calvin Riley had a job and an apartment before his company went bankrupt and he was laid off. Eventually he lost everything and became one of the more than 2 million Americans who are homeless. “I was depressed…I never thought I’d be homeless. I never thought I’d be down in the homeless shelter.”

A chance encounter with Wisham brought Riley out on the court. Since then, he says, everything has changed. “Playing soccer got me back focused. Being around positive people…helped me to go out and do something.” Riley is now enrolled in college classes with a job lined up for when he graduates in a few months. He has lost weight and he quit smoking. “You know, there’s a lot of running in soccer. When I first came…I was running constantly. I didn’t like the way it made me feel…so after three practices I said, I’m giving it up, man. I am giving it up.”

“Street Soccer is about redefining yourself and setting goals,” says Lawrence Cann, founder and CEO of Street Soccer USA. “The homeless are usually locked out of normal life so a chance to get in and play and be a part of the team…it’s something they can be proud of at the end of the day.”

The 16 teams will meet at the end of July in Washington, D.C., for the U.S. Homeless Cup. From there, about a dozen players will travel to Milan to compete in this year’s World Homeless Cup. “Soccer is the world’s game. It’s the people’s game, and when you’re homeless, you’re so alone…but you become part of a community, the soccer community, probably the biggest community in the world,” says Cann.

Riley believes that support has been key to his success. “When you join this team, it’s like a family. If you need anything, we’ll be there for you.”

Do you think sports could be a solution to homelessness? Has sports ever helped you overcome an obstacle?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


July 24th, 2009
09:29 AM ET

What are phytonutrients and why do we need them?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From @richroll via Twitter.com:

“What are phytonutrients and why do we need them?”

Answer:

Thanks Rich. You can think of phytonutrients as health boosters. Plants produce these substances to protect themselves from bacteria and viruses, but they help the human body as well. They are highly nutritious active compounds within plants which promote good health.

Phytonutrients come in many classes. That list is long, but the ones you’ve probably heard of are carotenoids, flavonoids and sulfides.

We probably know the most about carotenoids, according to the USDA, they basically give fruit and vegetables their red, orange and yellow color. These compounds are believed to protect against certain cancers, heart disease and even vision loss due to macular degeneration. Think of carrots, green leafy vegetables, oranges and sweet potatoes, to name a few. In fact just one orange contains more than 170 phytonutrients!

One rule of thumb I like to follow – try to eat at least seven different colored foods every day. The brighter the color, the better, this will help fuel your body with the essential nutrients your body needs.

Evidence that these compounds help our bodies is compelling. In just one study in the Journal of the American Medical Association, consuming just three servings of fruits and vegetables, was linked to a 22% decreased risk of stroke. But overall, phytonutrients are said to help slow down the aging process and may protect against a host of illnesses and diseases like some cancers, heart disease, high blood pressure and other chronic health conditions. In addition, they could work to enhance immunity and serve as antioxidants.

By the way Rich Roll is quite an inspiration himself, read his story here.


July 21st, 2009
01:08 PM ET

July 20th, 2009
01:27 PM ET

A researcher's remix: A poetic take on medicine

By Akash Goel
CNN Medical News Intern

After my first year of medical school, I held an idyllic optimism about communication and the doctor-patient relationship. We learn about these interactions from videos that are perfectly staged with cued actors in camera make-up. After five minutes of talking with Jessica Ridpath, I confidently threw these false pretenses out the window.

She told me tragically unimaginable stories of an immigrant mother and a barely literate filmmaker. The mother helplessly killed her sick infant after being told to "force fluids." The filmmaker couldn't read the consent form for the "quick fix" proposed to solve her "female problem." She did not realize she had had a hysterectomy until her six-week follow-up visit.

Ridpath desperately recites these examples with a looming sense of urgency. Both a slam poet and research coordinator at Group Health Research Institute (GHRI), Ridpath is on a verbal tirade to improve communication and poor language in health care.

“Poetry is about making something meaningful," she explained. "Communication in health care is the same way - if the meaning doesn't land, then you haven't communicated."

She believes a human rights issue is at stake. In 2004, the Institute of Medicine reported that complex language prevents 93 million Americans - half of the adult population - from finding, understanding and acting on essential health information. While health illiteracy clearly has harmful consequences in clinical situations, Ridpath also believes it disenfranchises human research subjects because they are unable to understand consent forms. This is perhaps a striking paradox as the very purpose of consent forms is to ensure one's compliance and understanding of the research.

She champions the cause of human research subjects because they are acutely vulnerable and are many times participating in research as a last resort or as a personal sacrifice to advance clinical knowledge.

"People have a right to clear information when they're spending time–and perhaps risking their health and/or confidentiality–for the greater good," she said.

Most informed consent forms for research studies are written well above the national adult average of an eighth-grade reading level. Given this, Ridpath argues that the scientific community is not abiding by federal regulations that require research studies to be "understandable to the subject." This mandate traditionally meant that consent forms were to be written in research subject's native language. However, if the forms aren't comphrensible, the language might as well be foreign.

Four years ago Ridpath launched PRISM, the Project to Review and Improve Study Materials. Using the Flesch-Kincaid readability algorithm, she reviewed several years worth of consent forms and cataloged language that communicated rather than mystified. Sampling language that worked, Ridpath essentially created a remix of research study language in the form of a toolkit that offers communication strategies and proper plain language templates for researchers.

Ridpath calls the toolkit "a rallying cry to the research community."

"It reminds them of their ethical obligation to protect the rights and interests of research participants," she said. "And it gives them tools to help them do a better job of that."

While the toolkit has already had thousands of downloads, Ridpath's goal is to proactively put the kit in the hands of more researchers across the country and begin providing training and editing services to institutions that lack these resources in-house.

"In my opinion," she argued, "the effectiveness and integrity of the entire research enterprise are severely limited when research isn't disseminated in a meaningful way to the public."

Next Ridpath wants to tackle issues of numeracy - literacy about numbers - to help people understand the cost-benefit analysis of treatment options for patients. She believes we have a societal knee-jerk reaction to medicate via pills rather than to modify lifestyle.

"If you speak more like a poet and think about expressing meaning," she said, "you can convey that message in a way that will inspire action."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


July 17th, 2009
12:29 PM ET

African American churches fighting mental health ‘demons’

By John Bonifield
CNN Medical News Producer

Rev. Leland Jones resigned from his church to fight in Iraq. When he returned home in November 2007, he was injured and using a walker. Ten days later his wife told him that she wanted a divorce.

Jones, the pastor of Greater New Light Missionary Baptist Church in Atlanta, was in a dark place.

Reverend Leland Jones, Greater New Light Missionary Baptist Church, Atlanta, GA.

Reverend Leland Jones, Greater New Light Missionary Baptist Church, Atlanta, GA.

"I felt the walls of my soul beginning to close in," Jones told an audience of health care providers, local clergy and residents during a recent forum on mental well-being hosted by the National Alliance on Mental Illness.

A therapist diagnosed the reverend with depression.

"Even though I was getting back to an integrated mindset as to how to operate in this world, everything that was important to me was no longer there for me," Rev. Jones said.

In any two-week period more than 1 in 20 Americans experience depression, according to a survey by the Centers for Disease Control and Prevention. Rates are higher among blacks than whites, and yet a report by the surgeon general found that the percentage of blacks who actually get mental health care is only half that of whites.

Instead, it's the black church that's become the place for emotional triage. Rev. Jones, who is black, says too frequently African-American churches contribute to the access problem.

"Biblically we have looked at mental health as being infused with demons," Jones said. "Don't get me wrong. There are demons. But is that the diagnosis for everyone who is exhibiting behavior outside the norm? No, it is not."

Allen Carter, an African-American psychologist who has worked extensively with Atlanta's black community, agrees.

"Church is still the most powerful instrument in the black community," Carter said. "For very minor depression, talking to a pastor could be sufficient, but not for very major depression."

Rev. Jones and members of the Concerned Black Clergy of Atlanta have teamed up with National Alliance on Mental Illness to educate African-American congregations about the signs and symptoms of mental illness.

Efforts to change attitudes are underway elsewhere as well.

Dianne Young, a Memphis pastor at the Healing Center Full Gospel Baptist Church, leads a coalition of ten local congregations that are placing the black church on the front line in addressing mental health concerns.

Working with the Tennessee Department of Mental Health and Magellan Health Services, the churches have created "emotional fitness centers" to help faith leaders screen for signs of mental illness when parishioners come to them for support. A licensed professional counselor refers struggling church-goers to mental health care centers when appropriate. In a four month period, the program screened 477 people and referred 315 people to professional providers.

"You can have faith and get help," Young said. "We are the only one like this, but we want to see them all over the country."

The depression that Rev. Jones experienced has spurred him to speak up.

"The first thing we need to do is literally just listen. Find out what's going on. But at the same time, prayerfully–and praying with them–find out if they will allow us to then take it to the next step if possible," Jones said. "If someone is not rational, we need to find someone who is a caretaker or a caregiver for that person. But we need to seek the help that's necessary."

You can watch Rev. Jones on House Call with Dr. Sanjay Gupta this Saturday and Sunday at 7:30A ET on CNN.

And tell us what you think. Would you go to a leader within your faith if you were experiencing a mental health issue? What would your expectations be?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


July 16th, 2009
12:58 PM ET

How is Dr. Gupta doing in his quest to get fit?

As a regular feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Barbara, Chicago:

"I’ve lost 5 pounds since jumping on board with your fitness forum. How are you doing so far? Have you noticed changes in the last month?”

Answer:

Barbara, thanks for joining the forum and congratulations on losing 5 pounds! Keep up the great work.

It’s been three weeks since we started the #1023 trending topic group on Twitter. (Read the tips, join the conversation, by typing in #1023 Twitter's search browser) People are already starting to write in about their own progress. I really encourage you to read all the comments coming in – witty, inspiring, proactive and most of all, helpful.

@melmcd99: started morning with a yummy smoothie-2cup-stawberries, 1-banana,1cup-soymilk, 1scoop protein powder and tsp-almond butter! #1023

@JackRyan53: Rotated 10 min walks with 10 minutes of hard labor on the Elliptical. Not a bad routine. Feeling the effects!! #1023

@nhPNP: got up to 4.5 mph on the treadmill- could only sustain it for about 3 min, but it's a start. Love the interval training prgrm. #1023

@claudiasiegel: Friends gave me consequences for skipping exercise. So far it is working. Haven't missed a day since challenge started. #1023

@melmcd99: Walk to your next meeting instead of driving or riding the bus! #1023

As I mentioned in my initial blog, this isn’t about losing weight or inches, but about health and fitness. For my part, I am finally on a strict routine. Since I started three weeks ago, I have been able to work out 15 times (five times per week). I have not missed breakfast once and I have started to meditate almost every afternoon for about 10 minutes.

Without question, it hasn’t always been easy. For example, I had a day when I started work at 6 a.m., finished at 7 p.m., and then jumped on a plane that landed around midnight. As hard as it was, I woke up an hour early on that day – and got in a 4-mile run, followed by push-ups and sit-ups. I immediately look for a hotel gym or any other place to exercise when I am on the road.

In Haiti, I asked our cameraman if I could carry the tripod during our long hikes up hills, and I did curls with the tripod on the way. One of the best pieces of advice about diet that I received:  “don’t eat anything that is not worth eating…”

My biggest concern now is that I am becoming too lean. My producer Danielle pointed out that I was looking skinny after a recent shoot down in Texas. There is no doubt that I am losing weight, but I have to be careful to maintain muscle mass. After all, it is the muscle that is the metabolic engine for your body.

So, I plan on sticking with the program but adding on more strength training with some free weights. Look for more updates soon!


July 13th, 2009
05:09 PM ET

A capacity for cruelty is never justified

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

Read my blog on the AC 360 site about the child slavery trade in Haiti.


Filed under: Children's Health

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About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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