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July 21st, 2009
01:08 PM ET

soundoff (195 Responses)
  1. Ruth Snyder

    Odd how we have no idea what the health care sytem is of our Congress!!! Why can't we have the health care system brought to light for those of the House and Senate so we can compare what they receive to what is anticipated for their consituents? Afterall...aren't they really supposed to be looking out for us in the very best way?

    Dr. Gupta had a segment on healthcare this am (Saturday, July 25) where a black minister spoke of his wife not receiving treatment for ovarian cancer soon enough that could have saved her life. Dr. Gupta, ovarian cancer is missed in so many cases because women of all color and nationalities may complain of symptoms and they are over looked by their doctors or the wrong tests are given. As an ovarian cancer survivor of over 10 years, I have seen way too many women in that same circumstance. Even President Obama's mother passed away from this deadly disease. Could she have been detected earlier in her disease?Definitely a time for change. However, it is not the government that needs to control us. We need a check and balance system to help the AMA get rid of the bad doctors that travel from state to state, slapped on the hand and given more chances to make their medical mistakes over and over. Also, women and the men who love them need to know the facts and symptoms of ovarian cancer. Knowledge is power. It is up to we, the people to be informed and take action when and where needed. Silence gets us nowhere. Thank God we live in America!!

    July 25, 2009 at 10:57 | Report abuse | Reply
  2. Deidra

    I would like to know what is being done about insurance companies who require spouses to maintain their own insurance if it's available through their employer, even if it cost (co-pay) the employee to maintain it when their spouse has full coverage for free.

    July 25, 2009 at 12:16 | Report abuse | Reply
  3. Ritchie Griffith

    Our country or no country can afford the type of medical care President Obama is promising. All countries that have universal coverage are about bankrupt and their care has gone way down. I have friends in Canada and they come to the US and pay for care. You can't get treatment for months in Canada. We have to stop this at all costs.

    July 25, 2009 at 12:33 | Report abuse | Reply
  4. janice bonnecaze

    The piece about the black man who sought treatment for the paper cut that would not heal at an emregency room and a emergency center and was bot tested for diabetes. Why had he not made an appoitment with a primay care physician when he had lost 80 pounds and had frequency urination? Emermency rooms and centers are just that. They are set set up for tests and return visits. This not because he is black.. And as for the minister's wife who dies from ovarian cance. again, not a black issue. As I recall Gild Radner, of Saturday Noght Live fame died from the same thing. She was white and had oodles of money. The race card is played when it is the case and we start ignoring it. And as the Cambridge Police office and the Harvard professo: the racial prifiling was on the the professor.

    July 25, 2009 at 13:35 | Report abuse | Reply
  5. Pam Hu

    I received an email from a relative that I find very hard to believe.
    This is rumor going around. How do I respond to this?;

    "This health care bill not only makes us want to shoot ourselves, but it even suggests we do – every 5 years.

    Page 425 of Health Care Bill – Listen to this interview Fred Thompson's Radio Show interviewing Betsy McCaughey (pronounced Mc Coy). Or look it up on http://www.fredthompsonshow.com, under interviews.

    On page 425 it says in black and white that EVERYONE on Social Security, (will include all Senior Citizens and SSI people) will go to MANDATORY counseling every 5 years to learn and to choose from ways to end your suffering (and your life). Health care will be denied based on age. 500 Billion will be cut from Seniors healthcare. The only way for that to happen is to drastically cut health care, the oldest and the sickest will be cut first. Paying for your own care will not be an option.

    Now, CALL YOUR PEOPLE IN WASHINGTON!!!!!!!!!!!!!!!!!! Tell them to read page 425 if they don't read anything else. Surely some of them have parents.

    "ON PAGE 425 OF OBAMA’S HEALTH CARE BILL, the Federal Government will require EVERYONE who is on Social Security to undergo a counseling session every 5 years with the objective being that they will explain to them just how to end their own life earlier. Yes...They are going to push SUICIDE to cut medicare spending!"

    Fred Thompson: Interviews"

    July 25, 2009 at 14:15 | Report abuse | Reply
  6. Dovie Desirey

    I support health care reform. When my daughter was a few months pregnant with her second child my son in law changed jobs and she was denied insurance for their second child becuase of a pre-existing condition...she was two months pregnant. My son in law was making $12 hour at his work. 90% of the biils they have in collections is due to medical bills. My son stepped on a nail the other day but because he does not have medical insurance did not go to the doctor and will only go in an emergency. Two days later his foot began to swell. I forced him to go to the ED and he had to have it lanced and then had to obtainmecication for the infection and pain pills. I work two jobs and just happened to get my check in the mail from one employer and paid for his medications which came to $70. He has had a tooth infection in the last three months but can not afford the dentist. He has had to go on antibiotics twice for the infection. He also missed two weeks of college last term because he was so ill he could not attend classes now he is on suspension. I was concerned with the swine flu but he would not go to the doctor. He will say, "I can't afford it." So much for the health care system. He is only 25. My family is only one example. These are only a few examples of many more I could give you just within my family.

    July 25, 2009 at 20:44 | Report abuse | Reply
  7. Pat Dixon

    My biggest concern for the U.S. is that the way you will "transform" the health care system WILL cost you more, for the simple reason that you're not eliminating the ridiculous doctor and insurance profits and other profiteering.
    Sometimes, for the benefit of the majority, you just have to take the bull by the horns and do the right thing, even if it causes a firestorm. When Canada switched over from private to public health care, a ton of detailed planning went into it, because the results otherwise would have been a chaotic disaster.
    It is astonishing how the 'right' to make a profit seems the most sacred American value - and even more astonishing to see how often it is the ostentatious christians who feel that way.

    July 26, 2009 at 07:30 | Report abuse | Reply
  8. Linda Smith

    I feel a need to clarify for Americans what the Canadian health care system consists of. First of all there is ONLY govt run health care. It covers ONLY doctor visits, hospital stays, medications while in the hospital, diagnostic tests. It does NOT cover out of hospital medication, vision care, dental, massage therapy, chiropractic, podiatry, physio, etc. These extra things are paid for out of pocket or by extended health care through an insurance company – sometimes paid for by your employer. The basic doctor/hospital care is for everyone equally – it is not possible to PAY for this. So the President would have the same care as a street person. The hospitals are all government run and all doctors are paid by the government – by the patient/visit/surgery, etc The rates are set by the government so their salaries are in essence capped. This is why we lose many doctors to the US as their potential for income is unlimited. So there is positive and negative things with our health care but we NEVER need to worry about paying to survive or be health. I guess the private insurance companies would be the big losers if your country went with this type of system as they are out of the picture here.

    July 26, 2009 at 07:58 | Report abuse | Reply
  9. Jane Boucher

    Janice Bonnecaze, I can ans. your question as to why the man who cut his finger did not go to the doctors when he lost 80 lbs, CAUSE HE HAD NO MONEY. and no way to pay for tests, my nephew in OH does without insulin half the time and reuses his needles, he has no ins. and cannot get medical cause he has a house. go figure,wellcome to medical care in AMERICA.
    These folks who advocate going to the Dr when you have no ins. is out of touch with reality, how can you visit A doctor who will then refer you to a specialist who then needs tests run. Bloodwork cost me abt 400 bucks here, thankfully I do have ins. myself, others are not so fortunate. Doctors around here do not do MRI'S for nothing. Folks are out the dying. Jane Boucher.

    July 26, 2009 at 08:43 | Report abuse | Reply
  10. Jane Boucher

    TO Dovie and all the folks on this site with their bad stories please tell these stories to your congressmen and senators, even if they never read them it will make you feel like you've done something, I go thru this with the uninsured in my family who have no access to medical care. I don't know of one single person who would not love to have access to medical care, who thinks if is fun to visit a ER room and sit for hours there. or knowing you can't pay. There are many good people out there suffering on a daily basis. THIS IS THE TRUTH. I don't care if its Gop plan or Obamas, just FIX IT. Jane

    July 26, 2009 at 08:49 | Report abuse | Reply
  11. Bette Garfield

    Health care reform the first time around cannot possibly be perfect. Under the current system, we have NO redress with the insurance companies-they refuse, deny, and will not even speak with you. if the new reform has flaws, at least with elected officials, we will have some one who will listen-because they want to be re-elected. There will be ongoing monitoring of the reform, and changes along the way. That is much better than the current system where the insured have no recourse.

    July 26, 2009 at 20:21 | Report abuse | Reply
  12. Gina W.

    I just want to ask, Who is right? Those on the left or the right?
    I feel like the republicans are frighting us because of cost and
    the democrats are not telling us everything. So, which is it?
    I have a cronic condition called fibromyalgia. I want to keep
    the healthcare & the doctor I have. I don't want to go back when
    I first learned I had it. To make a long story short, it was a
    nightmare, that I don't EVER want to live again.
    Any information you could provide would be greatly appreciated.

    July 26, 2009 at 20:52 | Report abuse | Reply
  13. Ann Stovall

    This is a very complicated issue with many angles for all people... rich and fortunate and those with less and not fortunate. However, until we all realize that we are going to have to give up something to get more, we all want better health care but no one group wants to give up. I do have good health insurance, however, my husband works very hard, usually 65+ hour work weeks for the same company for 24 years and every year we contribute more to our health insurance than the year before. The numbers are staggering, however, I do not agree with one of your viewers comments that l"doctors are as greedy as those on wall street." We have several friends that are doctors and they are not greedy and they happen to be some of the most generous people I know. I think most are under paid for how much education they have and how hard they work.

    I do agree with tying some portion of the insurance to the "choices people make about their health." ie smoking or being more than 20% over weight for their height, age, etc.

    Costs need to be posted like on a menu at a restaurant, for all medical procedures, annual visits, etc. etc. People need to become comfortable asking their doctors what the cost is for the procedure and/or visit. And Doctors need to know the "ballpark" of the costs.

    This is an enormous problem, however, I do not agree that the wealthy need to bear the brunt of the cost for this "proposal!" Let's find a solution that works together with the doctors, insurance companies, drug companies, patients, government, farmers and food suppliers. One of the large problems for low income families is that poor quality food is cheap, fresh good nutrition is more expensive and takes more time to prepare.

    So much to think about but we as Americans have the ability to overcome this issue and remain on top of the health care field.

    July 26, 2009 at 23:02 | Report abuse | Reply
  14. JS

    I know you love to interview people like Lance Armstrong, but did you do a program on the 2000 Americans this past week waiting in a field at daybreak in Wise, Virginia. They were begging for some small help. They had no healthcare at all, some in wheelchairs.

    July 27, 2009 at 08:53 | Report abuse | Reply
  15. OP

    For this health reform to work, what is essential is to have task force that will look at where costs can be diminished. For example, why are so many fraudlent clames being able to pass the Medicare system? I've been helping doctors and dentists cut costs by implementing an EMR system to create better staff productivity and cut unnecessary costs.

    http://paperfreeoffice.blogspot.com/

    July 27, 2009 at 08:59 | Report abuse | Reply
  16. jane boucher

    HEALTH CARE REFORM BILL.

    For all you people getting info from emails and other people abt whats in the bill, some is misleading and some is downright lies.

    go the the usgov.org and read the bill for yourself. I have found sayings out of context having the page and lines listed. I've checked abt 4 of these line item and pages numbers. some does not make sense what you get in email, one had page 126 with a line 26 and there was no line 26 on that page. so beware of misinfomation floating around READ THE BILL . Or check out what you are finding being sent to you. I HAVE A COPY of the bill in my files, its out there. Jane Boucher.

    July 27, 2009 at 14:31 | Report abuse | Reply
  17. Lynn

    The numbers do not seem accurate when you consider all the young people who feel infallible and could care less about insurance as well as the illegal aliens that we are not responsible for...we need reform...not total overhaul....each piece should be added after full consideration. Sure we need to make health care affordable to everyone but why must it be government run? Put some constraints on the insurance carriers and pharmaceutical companies...Having worked in healthcare I can tell you that there are already many rules in place to make sure only medically necessary tests and procedures are done.
    My biggest concern however concerns me....I am nearly 63 and have several serious health problems...does that mean I am headed to the guillotine?

    July 27, 2009 at 22:00 | Report abuse | Reply
  18. Medical Student

    It is very easy to place all the blame (or a large majority of the blame) on physicians. Many so-called experts have come out of the wood-works to weight in on health care without any formal training or prolonged exposure to the field. While they are all entitled to their opinions and to share their opinions, it is very dangerous to accept their opinions as fact. This problem goes all the way to the top – right up to President Obama.

    He places blame on everyone but patients because placing any blame/need for responsibility on patients would be a political disaster for him. In particular, he seems very ready to scape goat physicians. I am very frightened by numerous examples of his obvious lack of knowledge of how medicine works. At the last "town hall meeting" he said that reimbursement is done in such a way that if you bring your child to the doctor for a sore throat, rather than going ahead with conservative medical treatment or dealing with possible allergies, the physician (who in this case would be a pediatrician) would elect to take the child's tonsils because he/she is paid more for procedures. I ask you – when was the last time you heard of a pediatrician doing a tonsillectomy? Pediatricians are not surgeons and therefore they do not do surgeries. In fact, a referral to the ENT to have such a procedure done would not benefit the pediatrician financially whatsoever and would only be done in the patient's interest. This goes to show yet another example of the fact that Obama really has no idea how medicine works, yet he feels he knows enough to dictate how medical practice should work.

    He cherry picks his data and says that we spend more, but have no better medical outcomes. I would ask Mr. Obama to look at some confounders that may contribute to some of his claims. For example, obesity is a major problem that our nation faces. While many people believe that hypothyroidism is the cause of their weight problem (a “gland problem”), many studies suggests that this is not the case. Even if this was the case, one could have a simple blood test done and if they were found to be hypothyroid, they could take thyroid replacement therapy (levothyroxine) with the direction and guidance of their physician. The real problem with obesity in our nation probably has more to do with our lifestyle than hormonal imbalances. In fact, within the hospital that I train at, the one restaurant present (not including our cafeteria) is McDonalds. If one made the claim that they intend to eat at McDonalds and be healthy, they will be surprised to see how much more they will have to pay in order to eat healthy. The financial incentive at McDonalds and many other restaurants is to eat high fat, high sugar, high salt, high cholesterol meals, perhaps because it may be more expensive for McDonalds to maintain supplies of vegetables and fruits than frozen meat, french fries, etc. Now, let us look from a scientific perspective just why obesity is a problem:

    1. Among the leading killers of adults in the US include heart disease, stroke, colon cancer and breast cancer.
    a. Atherosclerosis: the deposition of fatty plaques into blood vessels. This deposition takes place in places like the abdominal aorta (which can lead to an abdominal aortic aneurysm that can rupture and rapidly lead to death), the coronary arteries which supply oxygen and nutrients to the heart (which can lead to a heart attack and/or heart failure), the carotid arteries (which can lead to a stroke), the mesenteric arteries (which can lead your intestines dying), medium and smaller sized vessels which supply other organs and your limbs (which can lead to peripheral vascular disease, a disease state where not enough oxygen and nutrients are delivered to areas such as the legs and feet that can ultimately result in ulcers, infections and the need for amputation). Among other causes, atherosclerosis is accelerated by high low-density lipoprotein, LDL, levels (the “bad” cholesterol), low high density lipoprotein, HDL levels (the “good” cholesterol because it can help remove some of the fatty plaques in the arterial walls), smoking and diabetes.

    b. Colon Cancer: this is the third most common cancer in males and females separately, but is the second most common cancer killer when both genders are combined. The risk of colon cancer is increased by low fiber, high fat and cholesterol diets.

    c. Breast Cancer: this is the second most common cancer among women and the second most common cancer killer among women. In a women who no longer has periods (post- menopausal), the amount of estrogen she has present in her body decreases. This is good because estrogen stimulates many tissues to multiply. Many studies have shown that increased exposure time to estrogen increases the risk of breast and gynecological cancers. For example, late menopause and early menarche (starting of having periods in adolescence) are risk factors for the development of cancer later in life due to the prolonged estrogen exposure. This includes breast tissue and other gynecological tissue. Fat has an enzyme present known as aromatase. This is the same enzyme present in the ovary that converts compounds into estrogen in the pre-menopausal woman. Therefore, the more obese a woman is, the more estrogen she makes and the more she exposes her estrogen responsive breast tissue. Therefore, obesity is considered a risk factor for the development of breast cancer.

    These are just samples of the health impact of obesity. They can lead to deadly disease and also can lead to disability. For example, obesity contributes to osteoarthritis. Additionally, obesity causes insulin resistance and can result in the development of Diabetes Mellitus type 2. The result of diabetes is widespread. It is a leading cause of blindness in the United States. Additionally, it is a leading cause of kidney failure necessitating long term dialysis (which is a tiring and terrible experience for the patient), a kidney transplant (which requires long term immune system suppression therapy that predisposes to life-threatening infections and cancer) or death. Additionally, diabetes will accelerate atherosclerosis leading to an increased risk of heart attacks and strokes. Another common problem with diabetes is a lack of sensation at the feet and poor function of the immune system. The combination of the two previously mentioned results in diabetics being unaware that they have injured their foot and an immune system that cannot fight the infection that sets in. This results in the need for amputation of the toe foot or leg if the infection cannot be controlled by antibiotics. The main point about obesity is that it is an epidemic in the U.S. and leads to significant health problems which plague the lives of our patients and run up massive costs in terms of health care dollars. The initiative should not to ostracize obese patients, but rather to find a more effective way to reduce this problem.

    1. I have personally seen many patients with chronic, treatable disease such as diabetes, high cholesterol, high blood pressure, etc who will not make life style modifications (exercise, better diet) and are not compliant with (or outright refuse to take) medication. These same patients come back time and time again with diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic non-ketotic syndrome, congestive heart failure, heart attacks or strokes. Many of these patients are on Medicare or Medicaid and so tax payers pay for their hospitalizations. These hospitalizations are largely reducible or even preventable with adherence to lifestyle modifications and medical therapy. In particular, during one month, I saw the same patient come in 2-3 times for DKA because he/she “could not figure out how to work his/her insulin.” Each time he/she came in, he/she spent at least one day in the intensive care unit which costs a considerable amount of money. Before he/she left, he/she had a meeting with a diabetic educator to teach about diet, monitoring blood sugar and using his/her insulin.

    2. I have seen patients who cannot fit into the MRI scanner (diameter too large) or they exceeded the weight limit. As I previously mentioned, this is not a laughing matter. This is a major health concern for the patients.

    3. I have seen uninsured, unemployed patients in the labor and delivery units having their 4th or 5th child. While we do not place limits on how many children a person can have (and should not), people need to take responsibility for their health and the health of their family.

    4. I have seen drug users come in for overdoses or drug related problems and get caught using drugs in the hospital. Often, they use the same IV lines the doctors are using to give medicine to give themselves drugs.

    5. I have seen alcoholics come in multiple times for their treatment only to return time and time again for more drinking related problems.

    6. Smoking. This is the leading cause of lung cancer which is the most common cancer in the U.S. and is the biggest cancer killer for both men and women. Additionally, smoking accelerates atherosclerosis and is a risk factor for many other forms of cancer. Also, it is a major risk factor for COPD, another major killer in the U.S. However, I have seen many patients, both young and old, who refuse to stop smoking – or even consider stopping of smoking. Some even stand outside, plugged into their IVs smoking right outside of the hospital.

    7. End of life care – this is the big topic that Obama dances around but never answers. Massive spending occurs for this part of one’s life. Many patients want everything possible to be done when it is them or their loved ones (which is understandable). In a setting where cost cutting taking place like being described, one place that will be certainly cut will be this area. If your outcome will be no better, you will not have the option to undergo such treatment. An example close to the heart of Dr. Gupta would be patients who suffer from glioblastoma multiforme. From what I have learned, the outcome is almost universally dismal and the radiation therapy, chemotherapy and surgery offer very minimal in terms of prognosis. However, they offer the patient and their family hope. Should we take that away hope and maybe a few more months of life from patients and their family to cut costs?

    What all this means is one of the ways we can reduce costs is by providing financial incentive to patients being compliant with medical recommendations and strategies. For example, the patient with diabetes who takes their medications and make lifestyle changes that brings their hemoglobin A1c down into the range shown to reduce morbidity and mortality should get more health care coverage than another diabetic who decided to not be compliant and would rather just wait for emergency care when the disease has progressed. Additionally, the patient who refused to even attempt to quit smoking probably should not be entitled to the workup, diagnostic imaging, surgery, chemotherapy and hospice for their lung cancer. If a smoker makes continuous and honest attempts to reduce smoking or stop smoking all together, they should receive financial incentive in the form of better health care coverage. This strategy can be employed for many other disease processes and translates to a financially sustainable health care system and an overall healthier population.

    This is not to say that some basic coverage should not be extended to everyone. Personally, I believe that non-self induced catastrophic medical treatment should be priority number 1 for the government. For example, a child with leukemia should be entitled to health care dollars before the 40 year smoker with lung cancer.

    Electronic medical record keeping: It would save money for sure, but by cutting the jobs of administrative people in the medical community. For example, the people who used to type up physician dictations are being largely replaced by software that types the records as the physician dictates. This is what the electronic medical record push will result in – a reduction of overall costs to the consumer by cutting the salaries of people who used to work as administrators in medicine. However, duplication and waste could still exist if there is not a single computer program for all providers to use. The patient would have to have a copy of their complete medical records (including test results, imaging and doctor notes) on a portable mass storage device (that could be backed up on a central server in the event of a lost mass storage device) which could be plugged in and updated at each provider encounter. This would be ultimate efficiency, but security and privacy would become the new issue.

    Lastly, to cut costs by paying physicians less, taxes need to pay for the medical student education. It is unrealistic to think that people would train for minimally 11 years after high school (to become a primary care physician) or an additional 5-7 years to be a specialist to work to pay off the massive education debt. To provide an idea, the cost of undergrad and medical school could be 20-40,000 USD/year. Assuming a 30,000 USD tuition cost, that is 240,000 USD for education not including living expenses or interest for the resident that, like his/her patients, wants to have a support their family. Also, to keep the good access to care, it would be wise to change medical care in all fields to shift work. This would dispel the use of the call system and could reduce hours to a more reasonable load which could reduce costs in paying physicians.

    In summary, the best way to cut costs:
    1. Have a system that financially rewards (though increased healthcare coverage) compliant patients and penalizes non-compliant patients.

    2. Offer universal catastrophic healthcare coverage for non-self imposed medical castastophies.

    3. EMR with a central database and a mass storage device the patient carries from provider to provider to reduce duplication of care

    4. Raise taxes to pay for medical education

    5. Change medical care schedules to shift work for all fields

    6. Cap malpractice suits and strong tort reform which penalize patients and attorneys for frivolous cases

    7. Strong campaigns in school (must start early) about the importance of maintaining a healthy lifestyle. This includes ensuring that all students are provided with a mandatory exercise time each day in school (PE has been cut in many schools).

    8. Pay for drug research and development with taxes so that generic drugs can be made for the patients. This way, drugs can be made and released to the public not for profit which allows for cheap, newer and better medicine for all patients

    9. Mandate that everyone contributes to the healthcare system

    July 28, 2009 at 12:10 | Report abuse | Reply
  19. Gerald Sparer

    I just saw your comparison of Medicare and Private insurance coverage for health prevention items. You should note that Medicare coverage is primarily geared to 65+ persons and the frequency of some screening usually diminishes with age and a prior clean history.
    Additional factors worth mentioning are the standards published by AHRQ Guidlines published by USPHS for these procedures.

    July 28, 2009 at 13:05 | Report abuse | Reply
  20. Christine

    I have been a medical writer for over 20 years for both pharmaceutrical companies and nonprofit research organizations. WEhen I listen to your reports and people's questions about national health care and "off-label" use of medications, I hear two different types of questions.

    1. Will national health insurance cover the cost of prescription even if I don't have the illness that it's approved to treat by the FDA. One example comes to mind when I started to get migraine headaches in college. The current drugs for migraines didn't exist. The neurologist prescribed inderal, a drug for high blood pressure. The actgivities of this drug not only decreased high blood pressure, but a result of that activity happened to be prevention of migraine headaches.

    Doctors can prescribe medications for problems different from what the FDA approved for the pharmaceutrical company, as long as they show "due diligence."

    Will drugs prescribed off-label be coveed by national health insurance?

    2. A second question concerns clinical studies. Of course, the study drug is provided at no cost by the pharmaceutical companies, but many related study costs are not. For example, patients may need blood tests, a chest x-ray, and an MRI as part of the study protocol. Will national health insurance cover these costs for those brave patients who take part in clinical studies?

    July 28, 2009 at 13:28 | Report abuse | Reply
  21. jane boucher

    Medical studen, a lot of good ideas, really, but what about the price we pay covering the uninsured and what to do with them. It cost 600 here to go to the ER, how abt more clinics to serve people and charge a reasonable price, Near here they have opened clinics and charge 45 for the visit. They can treat many problems, not all, but offer vaccinations and things like this for the uninsured. We pay much more in the US than other countries getting the same prescriptions, why?. Early prevention, like more screenings for cancer, colonoscopies, breast cancer etc. Needs to be done, people are dying. I have heard most of the free screenings for Breast cancer are for women over 40. I have a friend with 2 grand daughters both in their 20's with lumps in their breast, trying to find a place where get can get mammos at a reasonable price. this is insanity., they have tried the county and the american cancer society and other places., they are unisured. Jane Boucher.

    July 28, 2009 at 16:09 | Report abuse | Reply
  22. Shelton

    The issue that I have with the proposed system is that it will turn out like what is currently in place for Veterans. The VA hospital does not have the best record for health care and the waiting list for certain items can last extremely long, my father went to one for treatment but due to the way he was treated we ended up paying for his medical ourselves.

    I would like to know what type of guarantees are going to be in place to assure that this does not happen with this plan. Unfortunately, the VA Healthcare System is the only one that we can use as a judge for this type of care in the U.S. and shows what happens when politics are involved with a healthcare system.

    July 29, 2009 at 09:04 | Report abuse | Reply
  23. Diane

    I strongly support President Obama's plans to reform healthcare in our country, but have not heard enough about what will be done to hold insurance companies accountable for the rates they charge! Our healthy family of 3 currently pays nearly $14,000. a year in insurance preminums! We have never had a major illness or claim and this coverage is basically for major major illnesses with a $3500. deductible. We're fortunate to own a small consulting firm that pays for our insurance, if we had to purchase this policy on a personal plan it would be even higher! Something must be done to control insurance costs. My guess is that their profits would rival the oil companies, if they had to publish their financials.

    July 30, 2009 at 13:48 | Report abuse | Reply
  24. jane boucher

    You folks against health care reform, this could be you. My niece in her 40s just tried to overdose,WHY, cause she has a painful debilitating disease called Interstitial Cystitis, A bladder disease, She used to be a surgical assistant, and lost her job her ins. and Cobra and now losing her home, Her meds are up to 900 bucks and some medical professionals want money up front, she is constantly in the hospital due to bladder spasms that won't end , the disease has spread to her kidneys, the doctors accuse her of being hooked on Drugs, she has to Cath herself all the time. When you get this sick there is nowhere to go and no one to help. yes, she is in contact with others with this disease, most not as bad as her. As far as I'm concerned people who don't want the uninsured insured has no heart. This could be your daughter, mother or sister. Jane Boucher.

    July 30, 2009 at 14:35 | Report abuse | Reply
  25. MG

    I work in the healthcare field, specifically in the revenue section. I see the money side but I also hear and see the patients that are sick. I also see the doctors and the hospital goals and motivations. I believe that this field has been so focused on money, (ie insurance companies and rx companies). Hospital and doctors are caught in the loop because they provide the services. Some hospitals and doctors are subject to billing for higher prices because the insurance companies are so eager to deny claims. Rx companies are also responsible for this, they help drive the money up by redeveloping prescriptions and charging $30 per pill when it doesn't take as much money to manufacture it. The worst part about it is that that's just the money portion, that's not even considering what patients are going through to get care, and not just ordinary band aide care, but top notch healthcare.

    In respect to patients, I think the first thing is to have some restriction on rx companies and commercial insurances. They are the ones that are truly hijacking the prices. Once they get their reform then you can go after hospitals. Hospitals are subjected to government scrutiny more than people think. It's up to each hospital to work up to the guidelines set by the federal government, not only in basic health care and privacy but in funds as well, maybe those standards should be higher. Once those three aspects are put in place then doctors can be looked at. Doctor's do make a lot of money, but they also have school loans to pay off and long hours and high risk situations, they are supposed to be holding a person's life in their hands afterall. Doctor's should be completely patient focused, how they would get paid should be based on their patient care. This would lower prices for patients where they can afford healthcare without giving up their homes and filing for bankruptcies.

    I also think that there should be a way to get Americans insured, but as a human being I can not forget the immigrants either. I can't stand idly by and know that when a man is in front of me having a heart attack or stroke that I would ask for citizenship status. It's not right. I can not, under any circumstance let people forget the poor or the immigrants. I do know about EMTALA (the law the prohibits discrimination in the ER) but what happens when their lives are saved and they have a $30k bill, that's just going to increase their stress putting them at risk for another heart attack/stroke. Some things can not be denied, human rights. Citizen or not, we're all human and have the right to basic rights, I believe healthcare is one of those rights.

    that's my 2 cents.

    July 30, 2009 at 22:53 | Report abuse | Reply
  26. Mickey Smith

    I think that the health care premises are too simplified. I just saw housecall and am left wondering about why it is a given that a teenager's life is more worthy of saving than an 8o year old. The teen may be a crack head and the 80 year old may be a wonderful person, who may live another 20years,worked hard and paid into the system for years and years and doesn't want to die.

    August 1, 2009 at 08:12 | Report abuse | Reply
  27. Jim Kozlowski

    Dr. Sanjay Gupta:
    It would be very beneficial if you could give your viewers a line by line, which items that are directly health care items in the government health bill, & which ones have very little or nothing at all to do with health care. An example of this would be where the health bill gives aid to those that are not even citizens of this country. The only place citizens have to find this kind information out are from an unbiased look from people like you. Thanks in advance for your input to this very complex issue.

    August 2, 2009 at 16:16 | Report abuse | Reply
  28. gewisn

    Two things:

    1) A huge waste of funds is the separation of the Mental Health system from the rest of the Healthcare system. Medicaid separates them, insurance companies pay for them differently, states/counties separate them – and it all leads to reproducing ineffective bureaucracies and tiered systems of care (RATIONING). Even in public systems, permission to even see a physician is often determined by a masters or bachelors degreed social worker and once patients are stratified to one level of care or another, it takes an act of congress to change the response to changing conditions. Diversion from some forms of care, including inpatient care, is Absolutely DENIED on the basis of forms of payment – a system that is patently illegal for non-psychiatric care. Patients are, indeed, forced against their will (sometimes in restraints) to go to one hospital vs another based entirely on payor preference (regardless of open beds at the PATIENT'S preferred hospital).

    2) There is talk now about insufficient numbers of Primary Care Physicians (PCPs) to manage the new patients suddenly covered under any of the major healthcare reform bills working through congress. How should we respond to this? Force people to go to care providers with less training and experience (Nurse Practitioners and Physician Assistants?) NO. The answer is to stop allowing the federal government to keep paying for the training of every medical student who would prefer to go into a specialty field with a salary 2-10x that of a PCP! It is the federal gov't that pays most of the money for ALL U.S. medical training and it is the feds who determine how many specialist spots will be funded, and it is the feds who largely determine the baseline salary range (via reimbursement rates) for the graduates of specialty residency training programs (except for those few "cash" fields, like most cosmetic surgery). A lot more medical school graduates would become PCPs if the feds A) reduced the number of specialty training spots by 10% and subspecialty training spots by 20%, B) increased the pay for PCP residents in training, C) increased the reimbursements for PCPs and decreased the reimbursements for procedures by subspecialists. There is NO reason that a cardiovascular surgeon should be making more money on average than a cardiologist (an Internal Medicine specialty), esp since it is the work of the cardiologist that can keep the patient out of the cardiovascular surgeon's O.R. (though the patient's behavior has the MOST to do with it). The CV surgeon's decisions are no tougher, and the outcomes no more life-changing. In fact, I would argue that the cardiologists' decisions and difficulties are tougher than those of the CV surgeon.

    gewisn,
    county hospital psychiatrist

    August 3, 2009 at 12:28 | Report abuse | Reply
  29. joey martin

    Real health care reform can be found at http://www.millionmedmarch.com
    Check out the Mission statement – the physician's Mandate.
    Get the government out of healthcare. Tort reform. Pharmaceutical reform. Individual control and responsibility. Insurance reform. Not fascism and union payoffs. This is a positive reform package.

    August 5, 2009 at 23:59 | Report abuse | Reply
  30. Jenny

    Dr Gupta,

    Please read the bill. You can google it and get it online and See Section 1145, Pag 272, see Section 1162, Pg 335-339, and Section 203, Page 85, Line 7. . It just takes a minute to pull it up and go directly to these sections. See what you think.

    Also, for the sake of doctors you might be interested in Section 1501 Pg 659-670 and Section 2212, pg 875-891.

    You can then decide for yourself. You are in a role that can influence others. I hope you will do the right thing

    August 6, 2009 at 19:17 | Report abuse | Reply
  31. Maralee

    The answer to the Health Care Reform is right in front of Congress eyes. Put every one on the plan that the Congress, Senate, and all Staff has. Isn't that what we had heard during the campaign how great their health care plan was and that every one should be so lucky to have that type of coverage.

    August 7, 2009 at 15:27 | Report abuse | Reply
  32. Mary King

    Hi: My 45 minutes foot procedure cost me $ 11,000. This was just the hospital part which does not included doctor/anesthesiologist, etc. fees. my husband’s 30 minutes procedure when he fell was $ 43,000. Again this was just hospital bill and he was charged for a lot of things he never got. His room did not even have towels or soap, the food was iced cold, etc. Health providers are out of control with the cost. A five minutes doctor consultation is $ 303 to get a prescription. Doctors see 10 patient an hour and charge a full amount for each. We are in the wrong line of work, right? In other countries like England and south America doctors must see a patient for at least 20 minutes and do a complete exam. Nowdays, doctors are pill pushers and they experience is based on how many over a million dollars houses or assets they have. Healing is not longer their purpose but making money. It is sad. Seniors cannot afford to see a doctor because we have to buy food or pay our utilities. Healthcare providers are out of control with the cost.. I am not rich nor a politician.

    August 8, 2009 at 14:57 | Report abuse | Reply
  33. Sara

    I am floored at all the talk about healthcare reform and one of the biggest problems with our current healthcare system is almost never mentioned. I am one of thousands who as a very nice career decause of the flaw that has a dramatic impact on cost for everyone who see's a doctor and there by all players including the goverment and insurers. There is almost no way for doctors to tell you how much your visit, surgery, or other service will cost because the cost is determined by a set of codes which can only be applied after the service is completed because is it based on what is done once the door is shut. Top that off with having to follow policies that are out of this world crazy written by politicians and you now need staff to determine this. If you are going to hire staff in this area you have to hire specail staff because if you hire someone that does not know what they are doing you could ruin your practice to the goverment for fraud and abuse. Which I do not beleive is intentionally as rampant as the government says but happens more often than not because the policies are so out of hand. How many of you are aware Medicare has an 8 page policy on cutting toenails?? Eldery on blood thinners or certian conditions should not cut their own nails but if a docotor does it there are at least 9 things they must put in their notes they need to code it and add modifiers all in the proper order and if they do it all correctly they will be paid $17. Crazy! We have over 40 coders in the practice i work for of 500 doctors. Good coders pay for themselves in revenue and peace of mind in case of an audit but they cost big money making anywhere from $15 to $45 an hour, Cutting the red tape, and simplif billing. Moving to a time based system of payment would reduce costs for everyone!

    August 10, 2009 at 00:49 | Report abuse | Reply
  34. Karen Price

    I have no idea of what is in the plans. But as wife of a physician working in community mental health, my observation is that the present system is broken. However, I don't really trust the congress to fix it. I have not heard anyone address the fact that HCFA determined fees based on precedures years ago eventually resulting in excesses of precedures. Doctors don't get paid for time spent with a patient to teach, encourage, console or engage in the art of healing. The demands of complying with the rules and regulations and the difficultly of getting reimbursed from insurance companies all adds to the cost of care. Older doctors sometimes just give up.

    August 10, 2009 at 12:02 | Report abuse | Reply
  35. David Auerbach, MD

    Dr. Gupta,

    Preventive medicine is an important aspect of any healthcare reform. I'm an orthopedic surgeon and I started a FREE service that reminds people to take their medication with a text to their cell phone. 100 million people in the US are non-compliant with their meds, mostly because they forget. I'm trying to get the word out but as a full time surgeon with limited resources it is difficult. Do you have any ideas? The site is http://www.remindermed.com. Thanks.

    August 10, 2009 at 13:32 | Report abuse | Reply
  36. Margaret M. Dardis

    Funding is already there- remove the CAP (TOP-HAT?) on Social Security FICA contributions and dedicate the money to:
    1. A government-option plan for everybody without restrictions for (act of God?) pre-existing or genetic conditions;
    2. Covering all of everybody's body: feet, teeth, eyes, ears, and brain- including "mental" health;
    3. Annual comprehensive testing for every U.S. citizen at a one-stop diagnostic laboratory (with overnight motel-style accommodations) within 2 hours drive- catching H. pylori, urinary E. coli, systolic hypertension, alpha-1-antitrypsin deficiency, diabetes 2, etc. BEFORE running up costs for perforated ulcer, kidney failure, stroke, emphysema, blindness, etc.
    4. Non-profit Cleveland style salaries for physicians- with generous bonuses awarded by a committee of their peers+patients' groups for outstanding reseach/diagnosis/performance; 5. An economic stimulus plan to build this chain of clinics and accessible hospitals (preferably with environmentally friendly energy;
    6. "Body parts" above to include contraception before the whole world evolves into Homo insapiens, v. lemmus, devouring the last scraps of Soylent Green- at the present rate of growth scheduled for about 3010 of the Common Era.
    (One of Charlton Heston's great performances,
    Republicans please note.)

    Uncapping the FICA contribution would go a long way to funding such a program. What, Dr. Gupta, do you estimate it would do for our health and life fulfilment?

    August 10, 2009 at 16:23 | Report abuse | Reply
  37. Margaret M. Dardis

    Post-script to my previous comment (after reading more of previous postings):

    Thank you, friends and neighbours from Canada!! On the issue of "foreigners" "aliens" etc., some years ago when my son was taking a summer course in French in Montreal, he became very ill. A Canafian classmate sent him to the nearest hospital, where he received excellent care, It is the job of the medical profession to cure sick people, It is the job of immigration officials to stop undocumented people from crossing a border.

    August 10, 2009 at 17:32 | Report abuse | Reply
  38. Michael Freedland

    As I see it there are 4 distinct issues with Healthcare reform. While interrelated, each is complex and must be dealt with separately. Insurance company reform, healthcare costs, high premiums and uninsured Americans.

    The first issue is insurance company reform. A valid complaint, for instance, is that insurance companies drop patients once they are diagnosed with a disease. This cannot be allowed. Forcing the companies, though, to take all patients without preexisting clauses, would mean that no one would purchase healthcare until after they became sick.

    The second issue is healthcare costs. Contributors are insurance companies, hospitals, physicians, lawyers, unhealthy patient behavior and ever increasing technological advances (drug and equipment manufacturers). Understand that cutting salaries or budgets will undoubtedly result in decreased access, like in Europe. For instance, the word HMO has become synonymous with poor care in most states. One can tax poor behavior, but no one seems to want a sugar tax or even more cigarette taxes. Regardless, though, the number one cause of rising costs is the technological advances. Understand that the Canadians do not get the latest drugs and have substantially limited access to care.

    The third issue is high premiums for average Americans. Forcing small businesses to cover the entire cost of premiums will force them out of business as they will not be able to compete with the larger corporations. The larger corporations will not be able to compete with international corporations that rely on government supplied health insurance.

    The fourth issue is the uninsured population. Since these individuals are more likely to be unhealthy, the cost of giving them healthcare benefits is difficult to estimate. Using the Canadian system as a model is not accurate, because the Canadian government does not track the costs associated with their citizens crossing the border to get their care here in the states. A better estimate of cost would be to look at our own VA system, which by the way is no more efficient than any private insurance plan. In any case, the increase costs for insuring these individuals would far exceed any cost savings measure proposed so far.

    The bottom line is that there is no magic here. Physicians will not work for free; drug companies need profits to attract investors and patients will not change their behavior. So, perhaps President Obama should focus on a few small items here instead of trying to ‘fix’ everything at once. For instance, they could pass a few regulations for the insurance companies to make it fairer. They could allow for a few low cost plans, which would offer less care (with ever increasing technology everyone just cannot have all the care they feel that they deserve). Later, the government might look at expanding the VA system, which could include the low income Americans that cannot afford any premium regardless of the cost, but again, this will not be cheap.

    August 10, 2009 at 20:45 | Report abuse | Reply
  39. Lance from Oregon

    Dr. Gupta,

    I think one of the main issues of health care reform is to discuss and come to some conclusion of how we got to this place. I have been involved in health care and consult with medical clinics as a CPA.

    I believe most people will say they can recieve good health care, but it is costly and costs are rising too fast for people to pay for insurance in the private sector. Over the years it has become it very clear to me that the reason health care continues to rise at a 10% to 30% a year is very simple.

    Medicaid and Medicare is about 40% of the insured population. With the baby boomers coming on board and more and more people coming into Medicare and Medicad there is a significant cost shift to private insurance that has happened and will continue to happen. The reason is that on Medicaid and Medicare providers are paid from 30% to 60% of what the private insurers pay for the same procedure.

    Thus with the growing population of medicaid and medicare, providers and insurance companies have to cost shift to private insurers to just break even from year to year. Doctors have to continue to raise rates to insurance because of the shift of population to Medicare and Medicaid and they do not want to take this client base on.

    The reality is if medicaid and Medicare payments were comparable to private insurers payments to providers, health care cost would be significantly lower. Probably insurance would cost half as much in cost, but there has been a significant cost shift that the government has basically taxed the private market for many years by what they have done with Medicaid and Medicare.

    I think we need to understand that Medicaid and Medicare, which are good systems, have the greatest impact on private insurer's health care costs. In addition, Medicare system is going broke.

    So to blame insurance companies is probably not realistic. To blame medical providers is not the solution.

    I would just like the government to assess why health care costs are high for private insurers and I guess this cost shift because of medicaid and medicare is a big reason.

    The american people need to know how we got here and why and that would be good to understand before we go ahead with health care reform. IF continue to under fund Medicaid and Medicare the cost shift to a govt plan or private insurance will continue to happen.

    August 11, 2009 at 17:16 | Report abuse | Reply
  40. Donald Givehand

    Insurance Reform or Hospital Fee Fund
    Health care reform is really not the issue. It's all about insurance, who can afford it who cannot. Our health care system is great,needs help no doubt. Why are we paying high cost insurance rates to large companies instead of paying our fees directly to the hospitals, care facilites directly? What is so wrong about that? Do we actually need a middle man controlling our health as well as our services? I noticed the long lines at the Forum in Los Angeles. I cannot recall the exact number of people in the long lines and waiting in the bleachers. Many could afford some type of care if paid like insurance, but directly to the health care system. We first don't really need to worry about the Government in health care. They have been there forever. VA Hospitals, Medicaid/Medicare, heck even our folks in Washington DC have the best ever. So no need to wrry about that. Health care should never be taxed. If we pay directly, we should get all that we need. So the real issue is simple.
    This issue is to eliminate the position of middle men companies that require average citizens to pay fees for services with honesty and integrity, only never to receive such services when required. It is simple to go to a grocery store and pay for groceries you pick out individually and consume such products. To purchase a vehicle, drive it off a dealership lot and subsequently getting a use for the vehilce one has purchased. Many examples show of such purchasing power and we could go on forever. This issue is to quit paying insurance companies that deny one the right to obtain a service when needed. That is the whole purpose of insurance is to gather funds of many on a large scale basis for profit only to deny any services that in good faith are prepaid by many.
    Doctors and those who work directly such as nurses, and all the employess in health care and education understand how well we can and will do and understanding the needs of each and every patient. These are not the people who refuse services that are paid for over many years and not given to those who do. It's the insurance companies who dictate what, how when services should be rendered and at what cost.
    We all know that and agent sitting in a cubicle cannot diagnose any issue that a medical doctor can and should not be in a position of denial or authourity to do so. We don't pay for services NOT to be given. We are not getting what we pay for. It's that simple. We as consumers can change this very quickly and simply and get what we pay for. We do not need the government to intervene in doing so, but a simple regulation will help us all.
    For the amount of money we now pay insurance companies we should pay directly into the hospital feed fund. The fee fund will be available to everyone in any given community in the United States as long as you are a citizen of this country. This must be the first requirement. If you are a military veteran you automatically qualify. If you pay directly into the fund as a citizen you will qualify. We will continue to deal with indigent and poor people and our government can and will help in that area as they do now (more on that later).
    It should not matter where you live as long as you have paid into the fund you will get the services you need. It should not matter which part of the U.S. you live in you will get services. Imagine the billions of dollars pouring directly to hospitals. How quickly the researching methods, patient care,direct contact with paitients will improve because of the equipment, doctors etc., all go where the money flows best.
    Hospitals can still do what they do best. If a hospital specializes in a certain field of service and the paitient is recommended by a doctor from an existing hospital to go to another, as long as he/she has paid for such services, they should receive them. Specialty doctors will get back to hospitals if they want simply make a living as the money will be there. Hospitals will hire more and better primary care doctors and nurses. This could help by not overworking them as well.
    Many of us will not even need the services, but one should not be denied no matter what the situation is when we do. We should then be able tailor services as well and hospitals can add additional programs for wellness that can benefit us all.
    The relationships between local community schools will be enhanced. High schools and secondary educational programs can turn their attention to new local programs that will benefit both our citizens by educating them as well as providing meaningful employment. The schools can and will develop more heathly programs for its students to entice a healthy community.
    There are many issues that can be answered and here are a few as well.
    Q1.What happens to all the money insurance companies take in now?
    A1. Much of this money is being invested right now. Those investment dollars must be directed to the hospital fee fund directly. (We can certainly find out where the money goes now) This will stimulate jobs and services directly.
    Q2. What will happen to those employees who work for the insurance companies now?
    A2. Many of them can go to work making sure the services they used to deny in the past can be attainable. Since they know all of the steps to deny service, they can and will find steps to make sure a patient is not denied and qualifies for the patient.
    Q3. Will we still pay for the indigent to receive care?
    A3. Our tax dollars pay for some of it right now. It will not change. But we will have to introduce programs that can help those who can least afford to pay earn a way to pay for it as well. These are a few of the things that will have to be worked out.
    Q4. Who pays the taxes?
    A4. What taxes? We do not need to pay taxes on such services. If every one is paying into the fund, we do not need extra money out of ones pocket to pay taxes and the government does not need to step in and remove such funds for taxes. We are talking about the health and welfare of our people. We are overtaxed right now and look where our money is going.
    This is and should be one service we should not ever have to worry about and or money should not go to industries that don't repsect their position by not helping those who give it to them.
    Q5. Will this kill the insurance industry?
    A5. No way. We have insurance companies for our vehicles, our homes (which must be next in line for changes) and many other requirements. Remember we need the services in which we pay for. It's amazing we pay for co-payments for much of our services and still get denied in the end when we really need it. Some of these co-payments can be lowered to help with the cost of medicines and prescription drugs. Currently we should wonder what happens to our money when we are denied what we pay for. We should not have to hire a lawyer to figure this out.
    Q6. Lawsuits?
    A6. We only sue when we know what has been given to us is wrong. We will have to give up something and on the other hand many doctors who are not qualified and those who are not doing a good job can and will be weeded out by the industry itself. Hospitals will employ only those today who don't carry the extra baggage. Having been sued and continuing to practice what kind of insurance do they carry?
    Q7. If this does not work?
    A7. Our government has the perfect program in place right now in Washington DC, from the president on down to everyone in congress,all of our senators and legislators on every level that we as citizens pay for. If we cannot get the Hospital fee fund direct. Then we must demand from our government the same that they receive and again that we pay for right now.
    Q8. Wouldn't that be socialized medicine and or healthcare if we have the same programs as those who represent us?
    A8. We all want better health care.We can call it whatever we want...we want simply a program that works.
    These are a few of the questions and answers and we know now and that there are many more to come. The questions and answers can be simplifed by acknowledging the issues that exist and continue to move in a direction to abolish the wrong system in place right now that does not work. This is not a socialization or warehousing for care. We can have better health care if we can get it done correctly. We have to start somewhere.The rebuilding of our infrastructure actually begins with ourselves. If we can change this ourselves we can have a big change on the federal level to retool our economy. Just think if the government did not bail out the current industry (Like AIG) and gave the money directly to American citizens who would actually spend it and put it back into the economy, we would not have a few of these issues. We would instead be purchasing health care insurance ,automobiles (more insurance) and many other items we pay taxes for. We can develop more jobs if the money was given directly. Even if many americans save the money..it will be in banks credit unions as well. Right now our backs are against the wall and it does not matter what politcal party,your race or your sexual orientation. When it comes to health care and paying for it, we are all in the same old boat..... right now we are all sinking in this boat together.
    Again why should we pay for a service only to be denied what you are paying for? This in itself is a gamble and the insurance companies make us put our money on the table knowing in advance we will not win or have a chance to even the odds!

    August 11, 2009 at 23:26 | Report abuse | Reply
  41. Kathleen Koziol

    Dear Dr. Gupta,
    I would really like to see you re-visit that $200,000 hospital bill for the woman who had the pacemaker replaced. As anyone who has a hotel (I did) knows, room and board prices INCLUDE overhead, employees, administration costs, even empty unpaid rooms PLUS profit, or else you wouldn't make any money! Also, a pacemaker does not cost $72,000 dollars. Also, if they told you only $1000 was for the uninsured, that's BS.

    The only legitimate concern over the health care reform is cost. Everyone who has ever worked in a hospital (I have) knows the uninsured get pretty much the same services for free. Who does everyone think is paying for them? We do: in our insurance premiums, in our hospital bills and in the price of our new car! We are already paying for those 44M uninsured. The major question is, when they become insured, will all the insurance companies and hospitals lower their prices or just continue to charge the same and keep the difference? What's your best guess?

    I would REALLY love to see a whistle blower from: hospital administration, a medical insurance company and a pharmaceutical company tell how prices are determined. It will be as big a scandal as the bank bonuses when it all comes out. People are unaware and uncaring because their co-pay and their portion of their premium is affordable – just the same as the people who went into all these creative loans with banks were happy – until the foreclosure!

    All the things people are concerned about with health care reform are already happening. Insurance companies already make life and death decisions, and it is based on PROFIT right now. If I have to choose, I think I would rather have a panel of doctors deciding. people trust you. Please go back to that hospital bill. Make them explain every single item. It would open a lot of eyes.

    Kathleen Koziol

    August 12, 2009 at 08:01 | Report abuse | Reply
  42. WES BAYLESS

    Dr. Gupta: You want a challenge? I have one for you. I have a spinal cord injury from a 60 foot fall rock climbing. I also have a shattered pelvis and fractured legs and feet. There is considerable internal injuries and I also have a hole in my heart that is inoperable. I live alone with pain that never ceases and never drops below a tolerable level. With all of these serious health issues that have forced me into disability I have seen the changes that the health industry will face with considerable trepidation and paranoia over loosing the bottom line. We are on the cusp of a massive healthcare revolution: where many physicians and healthcare administrators who have advanced their own personal wealth at the expense of the sick, weak, and insecure will be faced with having to actually serve the greater good. I have spent my life working and living with doctors and scientists and found that the public has given over the notion of "God complex" to someone who is no more than a technician for the human body. There is so much waste and corruption in the system that it needs to be completely revamped and restructured. The recent protests have nothing to do with healthcare, only social unrest and the resentment over the loss of power in some obscure political dichotomy. There is no question that I am dying from my injuries and I cannot be repaired, but I am intelligent enough and motivated enough to move beyond my paralysis and pain to release the anchors of material attachments. Now all I desire is knowledgeable medical information without the added cost of needless maternal nursing or administrative overhead to cover the added employees that do no more than move a piece of paper or take an X-ray from one stack to another in order to stay employed. The doctor needs to do medicine: and if that is accomplished then many other factors will be resolved. I am a disabled architect and physics research associate and understand the science of medicine, the rest is just a social contract that demands marketing of my health to support a base of too many workers trying to grasp a brief glimpse of the brass ring. It is appalling to see doctors living in near opulence while their patience scratch to buy a box of macaroni and cheese. There is plenty of guilt to go around.

    August 12, 2009 at 10:48 | Report abuse | Reply
  43. Sandra Schneider

    I am afraid that we medicare beneficiaries will lose our ability to keep our current physicians under the proposed reform. Currently those of us who pay for good supplements can have our specific medical treatments cared for by excellent specialists. We have our cardiologists, ophthamologists, gastroenterologists and hemotologists who have been caring for us for years. With the proposed reform's change in the "method of distribution" we must have a primary doctor decide whether to give us a referral and who can send us to a specialist in his particular little group rather than to our current specialists. Why can't we do what some other countries do and have another option for those who want to pay for it where we keep our rightto choose and see our chosen doctors? Why should professionals and successful business people who have worked all of our lives to have a good quality of life be forced into an inferior system when we are willing to pay for quality care?

    August 17, 2009 at 20:44 | Report abuse | Reply
  44. SheldonPelly

    Hi Sanjay: Just a short note to comment on "Health Reform". As a Canadian I have the good fortune to have single payer care. Currently, my brother is at one of our hospitals with about 3 months left in his life. As part of his "end of life care", Canadian "death panels" have forced him to die in dignity in the palliative care unit of the hospital. He also has one on one nursing, end of life counselling and a social worker assigned to him and his family for couselling. He also has the most up to date medical care for his illness. This care has involves surgeries, medications, chemo, radiation and, so far, two months in the end of life care unit. The care is superlative in every way. And, there is NEVER a bill of any kind.....NEVER. Wake up Americans! What would happen to you if you had three months to live in your life living in America? What would happen to your savings? Your kids healthcare? You know the answer. THere is zero cost in Canada for dying care. Stop worrying about the cliched takeover of medicine. Thank God I live here, where my brother, along with all citizens will die in dignity without any worries about paying to die. Thank God we have "death panels" loaded with caring experienced palliative, end of life care. We are covered and protected by our healthcare system from in utero development until death.

    April 16, 2010 at 14:01 | Report abuse | Reply
  45. SheldonPelly

    Hi: I have been reading many Americans' healthcare/financial worries. I feel for all of you. In Canada, no one knows how much a medical visit or procedure costs because, we have never seen a bill! In fact because doctors bill the government directly, I never see the charge and I am NEVER responsible to pay for any healthcare....EVER.

    April 16, 2010 at 14:10 | Report abuse | Reply
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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.