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July 21st, 2009
01:08 PM ET

soundoff (200 Responses)
  1. Queenie

    I'm Canadian and do feel that we have a really good health care system. The commercial there are playing on CNN is fear based and NOT true. I've never waited very long to be tested. Yes, our taxes are higher than in the USA but it's worth it. EVERYONE have health care here no matter what. There is no such thing is you can't afford it.

    July 22, 2009 at 10:26 | Report abuse | Reply
  2. Geneva Greenwell

    Dr. Gupta, always enjoy and learn so much from your segments. But I beg to differ on todays segment. The man that claimed it was racism that caused him not to be diagnosed as a diabetic. Why didn't a grown man know that weight loss, frequent urination, trouble healing, are signs of diabetes? A very common disease in blacks. He was not a child. He goes to the emergency room with a PAPER CUT. No wonder they didn't jump to his emergency. That is what is wrong with our medical care. So called emergencies.

    July 22, 2009 at 10:27 | Report abuse | Reply
  3. Walter Grant

    Dear Dr. Gupta:

    As a former California resident, NOW living in Canada, it is appalling to hear Representatives in the U.S. Congress
    trashing Canada's National Health Care System using the negative stories of a very few Canadians to support their case.

    Please use your considerable knowledge and common sense to tell the World that Canadians are Proud of THEIR (OUR) SYSTEM- and Americans will be well advised to emulate it!

    In November, 2008 my Gallbladder was removed within 24 hours of my 2nd attack. At NO COST to me!

    Sincerely,
    Walter Grant
    Burlington, Ontario
    CANADA

    July 22, 2009 at 10:38 | Report abuse | Reply
  4. Jack Richardson LCSW

    As a Social Worker healthcare has always been my soap box. Since my personal cancer diagnosis it has been even more important.

    A. We already have a Universal Health Care Plan that doesn't work.
    B. When I had insurance it helped underwrite the costs of ER care for the uninsured who can't or won't pay and need high cost acute care.
    C. Since the era of Managed Care no one has had the luxury of selecting their own doctor, specialists, ancillary services or hospitals.
    D. My cancer was over 10 years ago and still can't buy affordable, good insurance, limiting who I work for and jobs available.
    E. Last company I worked for went bankrupt so I "can't" get COBRA. Haven't heard anyone mention this fact in discussions of healthcare and I also understand that there have been a few Bankruptcies lately.

    July 22, 2009 at 11:04 | Report abuse | Reply
  5. Gail

    I was just hearing that they are pushing for mandatory insurance or pay a penalty. I would not pay the penalty and let them put me in jail, that way I would finally get the medical attention I can't afford since our ins was so high after my husband turned 65. With pre-existing problems ins is unbelieveablly high. So jail me.

    July 22, 2009 at 11:10 | Report abuse | Reply
  6. Andrea Schaal

    I've been watching your country's reaction to the possibility of healthcare reform with interest. There has been alot of critizing Canada's healthcare system without actually researching it. I am an average citizen with a husband and two kids. Our family pays $108.00 per month for our BC Medical. We also have extended health through my husband's employer. I know that if a medical issue arises we will not loose our home or be left with an unpayable debt. If President Obama can come up with a public/private partnership that would be ideal. Good luck President Obama!

    July 22, 2009 at 11:22 | Report abuse | Reply
  7. gwen

    people opposed to a national health care system point to the few people who have to wait for medical care as a reason for rejecting the plan . What about the many many pople under the current plan that have no medical care and die from health problems that could be easly ttreated if health care was available? Also it seem to me that if we want to control medical costs we need to keep the drug companys from over charging the people!

    July 22, 2009 at 11:35 | Report abuse | Reply
  8. thommyd (Thom Dalzell)

    Do the citizens of America realize that the only people not willing to move to universal health care are the big pharms, big business, the wealthy, doctors and politicians? The other 90% or so of the populace would benefit greatly with health care that would encourage them to stay healthy because they could afford to visit a doctor or clinic when they needed to do so. The plans in operation in Canada, Britain and France work well for the citizenry, and their plans have been working for years. It is frustrating listening to the reports of any negative examples when the millions of people in other countries are well-served by their health plans. This has turned into a war of the rich and powerful to maintain their status, damn the middle class and poor.

    July 22, 2009 at 11:38 | Report abuse | Reply
  9. Katie Katz

    Dr. Gupta... They keep asking on Tony Harris live programming today "what are you willing to give up?" Why are they not asking what doctors are willing to give up on the prices they charge???? When my local cardiologist said a heart test would be $1,500 and I got a bill for the $5,000 my insurance would not pay for the $8,000 test... where is the problem? Let's be fair...we all need to give up something, including these exorbitant prices!! Not a popular issue for you to address, and uncomfortable....but I cannot afford these prices. I am a 60 year old single teacher.... I am not rich...so do I give up health care? Thank you for listening. Katie Katz, Wichita Falls, TX

    July 22, 2009 at 11:44 | Report abuse | Reply
  10. Dean Cestari, MD

    Sanjay,

    THe claim that the difference in healthcare is rasicst is absolutely absurd. The majority of medicaid patients in New York are minorities and they are too poor to purchase private insurance. Medicaid does re-imburses on average $7-10 to a physician and around $100 or so the the hospital ofr a clinic visit. For this reason, most attendings do not accept medicaid and these patients are seen by resident physicians in clinics. Resident physicians are ALL supervised and generally the care is excellent. I trained as a neurologist and an ophthalmologist an NY Presbyterian Hospital and I can tell you the care these patients received was excellent and it is absolutely insulting when they say there is a rascist policy in place.

    Dean Cestari, MD

    July 22, 2009 at 11:45 | Report abuse | Reply
  11. Travis Brown

    Dear Dr. Gupta, (RETT SYNDROME)
    Don't know if this
    goes under healthcare reform or not but it's need to be address to the public and in the government and medical field ,lot's of Dr's and the public don't know much about this , that it just attacks young girls. I have a grand
    daughter, it took 18 months to find it., she look normal ,happy but had no strength in her muscles. She is now five years can't walk, talk or make any motions with the use of her muscles.
    She has seizures sometime two or three a week you can take her to the hospital get the seizure under control start home and have another this is a 24/7 job .
    The government is very hard to get any finacial help and the government don't want to help with funds to research , this can be stopped with research. This is sad because these girls and parents don't have a life. And these girlscan die at any age.
    BUT NO ONE WILL HELP !!!!!!!! PLEASE MAKE THIS KNOWN TO THE PUBLIC.
    Thanks,
    Travis Brown

    July 22, 2009 at 11:51 | Report abuse | Reply
  12. The big picture of healthcare reform is fragmented

    There is no unified model of the history, situation, decision/control points, and decision impacts of the US Healthcare Reform situation. Everyone is presenting their "facts" and viewpoints from a limited and fragmented viewpoint (i.e., partial facts). It's like trying to diagnose and treat an illness by only considering a body-part and its local appearance.

    A simple and repeatable public domain collaborative, concurrent, and cooperative method is available, using open-source technologies, to create such a unified model (from global to local to individual scales). This unified model would give everyone (e.g., nations, organizations, communities, groups, persons) the ability to contribute and see the most complete, integrated, unified view of all of the diverse factors and interests of an issue from their vantage point. (This could be called a "localized view of unified knowledge", like looking through a single facet of a multi-faceted crystal.) This unified model is built using modeling techniques common in the medical, legal, and a few other professions with an organized and shared body of knowledge.

    I used this method under Federal contract to build a prototype knowledge-model repository for US Federal Executive Branch (FEB) business continuity in 2004-2005 to satisfy Executive Orders resulting from the events of 9/11. It was called the Continuity Communication Enterprise Architecture (CCEA) project, and was a combined effort of the Executive Office of the President (EOP), DHS, and DoD. Internal FEB politics, narrow-interests, and clouded vision kept the effort from moving into pilot and then production stages. The same prototype was offered up as a means to support emergency management and local/regional continuity, several months before Katrina hit New Orleans, but there was no interest from those with the authority and resources to achieve this emergency planning/response/management capability.

    This unified modeling method can be used to take an "issue" like Healthcare Reform (or Economic Recovery, Financial and Automotive Bailout Performance Results, etc.) and create a single mechamism that everyone can use to submit their own viewpoints and provide their own analyses and "facts", which is then "merged, integrated, and unified" into that single model. Large numbers of diverse viewpoints can each contribute to building a shared viewpoint.

    Note that many will resist such a unified view. A unified view puts diverse viewpoints into a broader context. It can thus weaken the diverse rationale when a broader shared viewpoint and solution is developed.

    Experience tells me that government or industry will not pursue such a unified view for political or economic reasons, so I have come to accept that Non-Profit (e.g. watchdog), Academic, or News Organizations, or combinations of these in collaboration with government and industry, can be successful in building such a unified view of an of these issues.

    The public-domain unified modeling method is published at http:gem-ema.one-world-is.org.

    July 22, 2009 at 11:55 | Report abuse | Reply
  13. Nava Livne

    I was inspired by my late Dad to eat four raw cloves of garlic daily for the last thirty years of my life. I was wondering whether this amount is too much for a daily use; and if so, what are the side effects/phenomena that might develop, such as a tendency to develop bruising on the hand palm. My dermatologist could not provide any information on this issue. As a whole, I am very healthy and is considered skinny in American terms.

    July 22, 2009 at 12:04 | Report abuse | Reply
  14. Joseph W Arabasz MD

    Physicians should received tax credits to treat their Patients who are without Health coverage.
    As if that's gonna happen.
    Best wishes always.

    Cordially,

    Joseph W Arabasz MD

    July 22, 2009 at 12:06 | Report abuse | Reply
  15. Mary Johnson Strociek

    I just went through major surgery in PANAMA to remove 3 tumors in my pelvic region (10, 5 & 4 cm). I was in the hospital for 10 days, including intensive care for 2 days. I am a U.S. citizen and have residency in PANAMA.

    This is the same cancerous tumors I had 11 years ago and was removed vaginally in Chicago at a cost of $500k. I had insurance at the time and paid $500 deductible.

    My costs this time was $400.00. This included 4 cancer specialists fees, hospital room, ICU room, surgery, medications, etc. My pre-surgery expenses included $750 for 2 CAT scans with dye, $300 for 2 ultrasounds, $75 for colonoscopy, $10 for EKG, $27 for chest x-ray, and $150 for numerous blood work over 3 week period of time.

    I have NO insurance.

    Now if I was still in the states instead of PANAMA I would be bankrupt and no place to live. My daughter came down from OMAHA, NE to check out my care and was here for my surgery. She was really impressed with my care and the hospital–she has her Bachelor's in Hospital Administration and is currently working on her LPN license.

    Healthcare costs have gotten way out of HAND and needs to be reformed BIG time!

    Mary Johnson

    July 22, 2009 at 12:07 | Report abuse | Reply
  16. Don Ziebell

    I am the owner of two businesses currently employing 20 people (down from 40 a year ago). Over the past five years I have struggled to continue to provide meaningful health benefits for all employees, and have been forced to increasingly shift the burden to these employees due to the exponential rise is coverage costs. The layoffs over the last year have been particularly painful to me, not only because of the devastating financial impact to those laid off and their families, but also because I know that after the subsidies for COBRA end many of these former employees will not be able to obtain insurance because of cost, and in some cases due to pre-existing conditions (I have in fact retained some individual employees due to this fear). Last year, we instituted a "wellness" aspect to our benefits, and increased our cost to establish this program for employees (fitness memberships, individual counseling and screening, susidized organic farmers market produce, etc.) in an effort to do something to solve the problem ourselves.

    The question is being asked "what would I give up to provide health care reform". I will answer this on two levels. As an employer, I would be willing to pay a tax on the benefits we provide, for a defined period, if this helped provide coverage for all in America, and helped to turn the tide of rising costs. As an individual, I would be willing to do any of the proposals I have heard including a tax on my benefits, a tax on high-income earners (though this year I am certain not to hit the threshold in consideration), and I absolutely support the idea of a public option if that was a vehicle for coverage and competition.

    As the only country in the developed world without universal coverage, I am embarrased for my country that we can't (aren't willing) to make the neccessary changes. The partisan politics need to end, or I will never vote Republican again due to the stance of the leadership in this debate.

    On another note, I am a six year cancer survivor (lymphoma), so I understand the importance of access to good, affordable care, but at times I wonder how and why it was my good fortune to have access to this care when so many don't. In any event, in the current state of the health insurance world, I won't be able to get insurance. This is a vicious circle- the rising cost of health care is one of the factors that is putting my businesses at risk. If these go under, 20 employees won't have health care, I won't be able to get replacement insurance, and the problem keeps compounding.

    I am hopeful that we all, as humans, realize the importance of this effort, and support reform even if imperfect and biased. Self-interest needs to be balanced with concern for the welfare of my neighbors- that is, in my mind, one of the prime definitions of what it is to be American. I am willing to make sacrifices, for my sake and that of my family, but also for my current and former employees, and all others in the same boat.

    July 22, 2009 at 12:23 | Report abuse | Reply
  17. Nancy

    I am uninsurable because I have MS. No company will sell me a policy other than indeminity type insurance which will not help. I have not neard what health care reform will do for people like me.

    The cost isn't really a big factor for me. I have repeatedly tried to get insurance, but always get turned down. How can I be forced to buy insurance when no one will insure me?

    I am 60 years old, work part time, and the small office I work at offers no group medical insurance. Hopefully when I reach Medicare age, Medicare will still exist so that I can finally get the medical care I have been missing for so long.

    Can you please tell me what the President's plan is for people like me who cannot buy insurance due to health problems?

    Thank you!

    July 22, 2009 at 12:24 | Report abuse | Reply
  18. Harish Bhatt

    The cost savings from PBMs.No body is talking about them.If congress makes their dealings with drug companies transperent then more savings can be obtained.
    PBMs will always argue that transperency will increase drug cost.Nothing in health care refrom addresses this issue.Transperency can only increase savings.

    July 22, 2009 at 12:35 | Report abuse | Reply
  19. W Wallace Watson MD.,CM., FACS, FRCS

    I am a retired general surgeon who practiced in Canada for more than 30 years. I am outraged at the ad featuring Shona Holmes stating that she could have died if she had not been treated in the US. She had a Rathke Cleft Cyst which was inpinging on her optic nerves and apparently secreting ACTH. Her statement that she could have died was based on a statement by one physcian, who should have known better.
    It is unfortunate that her primary care physician did not bother to pick up the phone and call one of his colleagues to expedite her treatmnet. I have never, nor do I know of any instance of a surgeon not seeing a patient immediately when requested by a colleague when indicated.
    My wife was diagnosed with breast cancer in Oct 2008. Had I not intervened her surgery and treatment would have been delayed by several weeks. This was not in Canada this was in Massachusetts!
    I would be happy to discuss with you our one of your colleagues about the intricacies of the system in Canada and the situatioin in the US.
    I have practced fee for service before Canadian Medicare came in in the 1970s. I practiced in Medicare. My wife and I have been consumers of medical care in both Canada & the US and can provide a clear understanding of the differences.
    I have been a consultant to hospitals for their surgical departments performing operational reviews and insurance companies since retiring from active clinical practice.
    These inflammatory misleading adverts are of no help to the understanding of the issues and are destructive.

    July 22, 2009 at 12:36 | Report abuse | Reply
  20. Jack Beyer

    Every time I hear the President talk about health care, I hear him use the phrase "all Americans". Will this health coverage I am expected to pay for include coverage for the 11.6 million illegals in the U.S.?

    July 22, 2009 at 12:39 | Report abuse | Reply
  21. mary king

    I saw the report regarding the wheelchair yesterday. If a manual chairs cost surprised you, take a look at the cost of an electric. I am a C5-6 spinal cord injury and my electric wheelchair cost $17,000 and it doesn't have either a radio or refrigeration.

    Thanks

    Mary

    July 22, 2009 at 12:40 | Report abuse | Reply
  22. Jane Boucher

    I don't care if I have to pay taxes on juice and soda, Health care is an American issue and it has to be reformed NOW.Going to the ER room for care if you are uninsured is no Answer , you will be sent on your way with a referral for followup care which you can't afford, this happened to my 41 yr old son abt 3-4 yrs ago , the working poor with no ins. he broke his foot in 3 places, ran up a 1600 dollar- bill at the dr's and quit going, it never healed and now after work his ankle swells up and he walks like a cripple half the time, Now the ER room says he may have arthritis in both knees, he could not walk and had to be wheeled into the ER room. and they say he needs a MRI and followup care, RIGHT, He is back at work now still hobbling, THIS is what the uninsured goes thru, he will not get a MRI cause he has no money for it. My message to both the republicans and democrats is GET IT DONE. We don't want free care just affordable. THANKS. Jane Boucher.

    July 22, 2009 at 12:53 | Report abuse | Reply
  23. laurie bobskill

    What would I be willing to give up for health care reform? The health insurance companies. Their bite of the apple is more than half a trillion dollars a year–25 cents of every dollar spent every year on health care in the U.S. I'd also be willing to give up the health care we provide our senators and congressmen.

    July 22, 2009 at 13:01 | Report abuse | Reply
  24. Brian

    Hello out there,

    Just another day in the office for me…..I live in this whole debate and have to hear about the discussions from all the politicians and “TV” people while us doctors and patients fates lie in the balance.

    There are a lot things wrong with healthcare and the Obama administration’s approach that we should mention the uninsured first and foremost is wrong. They are the LEAST of the problem. Yet they make out this group as the poster child for the need for this government intervention. They (government) still have A LOT of work to fix Medicare???? Why would the public throw another trillion dollars into the Medicare abyss? These uninsured are not devoid of healthcare. They can go get a check up or visit a medical doctor for illness for a reasonable cash price. They have access. Let’s stop saying they are WITHOUT care. This is just not true. They are without payment help and serious health issues become difficult to pay for. However the uninsured can save money for that emergent need. I have personal knowledge of a self pay patient who had a mass in his abdomen and saved his money for six months and then had it removed. He negotiated a cash price for treatment. He sacrificed. He saved. He is better. He did not need the government. Americans pay for their healthcare. Stop pretending that the insured have some gift or hand out. Either they pay personally or their employer pays some or all of the cost. We need cost control for all Americans but not at the expense of all Americans.

    Reform can occur from two areas and both can be initiated by the government and DO NOT require ANY NEW TAXES…….

    1) Limit the misuse of the courts to pursue lawsuits against doctors and hospitals.

    Putting a cap on medical malpractice lawsuits will stop the practice of “defensive” medicine and help doctors with lower malpractice premiums. More labs, medications, tests, and imaging is used then is usually necessary to make sure EVERY differential diagnosis is covered. Bad outcomes happen in medicine and this is not the doctors’ fault. Hindsight is always 20/20. Remember that doctors “practice” medicine. This is not an exact science.

    2) Institute Citizen’s Rights and stop Medical Insurance Profiteering Practices

    Protect tax paying citizens from being prayed upon by insurance companies with ambiguous rules, escalating fees and higher deductibles for less care. This is not fair and does not make sense. Create a uniform standard for all companies to follow if they provide health insurance. Fees and rules need to be fixed for a longer contract term like 10 year term life insurance for an example. Provide doctors the ability to manage the care of their patients instead of the insurance company bottom line. This type of change would require a battle with the way the insurance companies currently pull the strings to manipulate patients and doctors to protect their profits.

    Please keep these thoughts in mind as you bring this debate to the public....Thank You

    July 22, 2009 at 13:01 | Report abuse | Reply
  25. Joseph Madden

    As I watched your comments today about possible racist medical practices and insurance bias', I am compelled to ask you a few questions. In the cases that were at issue, you never inquired where these people got their medical help, either from a clinic, or doctors office, and whether or not these individuals were treated by African American doctors. It would make sense that they were treated by African American doctors by the mere fact of ease and association. If this were the case, then it would appear that problem lies in who treats patients, not the insurance companies as you have indicated, and it might also be the case that these physicians were not qualified to be treating patients at all. So the question should be who treated whom and what were their qualifications, and the issue should not be a racist issue as you have indicated. I would appreciate a response. Thank you, Joseph madden

    July 22, 2009 at 13:05 | Report abuse | Reply
  26. Linda Kenney

    I am a proud Canadian with a free healthcare system. I have 2 brothers in the states. One brother in Florida before age 65 had cataracts, he had to go to the Lions Club to pay for it, and work off the debt. My other brother in Maryland, has to pay over and above his Medicare $300 monthly from AARP to receive the same care we get for FREE. The (Canadian) woman denouncing our healhcare system must have received a great deal of money from the HMO's to pay off the house she had to mortgage to get the U.S. treatment. A close friend received breast cancer surgery within two weeks here. Yes, there are horror stories, but your country has millions I will wager.

    July 22, 2009 at 13:08 | Report abuse | Reply
  27. Barbara Mead

    I am an RN working in Ontario Canada for 40 years in a hospital.The right to universal health care goes to the heart and psyche of the Canadian people. Our system is not perfect, but not all Canadians agree with Shona Holmes that our system will let you down.We try to look after our own here at home.Most costs are covered through federal and provincial taxes, based on one's income, but no one is turned away, even the unemployed.We will fly them to the states if we have to. It is unheard of that people lose their homes to cover health care costs.

    Canada has roughly 1/10th population of the US, and one of the problems we have is the 'brain drain' of some of our brightest and best professionals being drawn to the US by the lure of the dollar, leaving us with a shortage. We are now also concerned about job losses and the economy, the same as you.
    My advice to those seeking health care reform is take small steps to make these changes, in each state, getting feedback from the people along the way, while keeping a national coverage goal in mind.
    Each state should have reciprocal agreements to cover at least some of the cost of it's citizen's care if service cannot be found within its own boundaries.This is a complex problem that cannot be fixed overnight, so one has to be careful not to throw out what is good about your system with what is not, but don't give up!

    July 22, 2009 at 13:45 | Report abuse | Reply
  28. Dr. Murray Girotti

    I am the medical director of a Canadian Trauma centre. I am sick and tired of US polticians 'slagging' the Canadian health care system. Most of these politicians are very ill informed as to how our system actually works. We know it is not perfect but we work hard to provide the best care possible. I am proud of the centre I work in and we treat many Americans who get injured and have to be treated by our dedicated group of nurses and doctors. We do not care if you have health insurance we look after you. Many of the Americans we treat say quite openly how pleased they are with their care and say it as good as anything they would have had in US. I have many close American firends and I do my best to help then understand the pros and cons of universal health care in Canada.<

    July 22, 2009 at 13:55 | Report abuse | Reply
  29. steve taylor

    I was wondering how the new reform act will help me.
    1. I am Disabled
    2. I live on Social Security and Insurance Income(UNTIL 65)
    3. mY wife has HEP C and not qua;ified for Medicare as she never worked..She is 53 and I am 59
    4. I pay 800.00 per month for her insurance with The State of Texas.

    When the Prescription Insurance was reformed, I automatically lost my Prescription Insurance and was forced to use medicare. This was OK for the 1st year. The scond year the prescription insurance was changed. The donut hole was introduced and brand name meds were no longer paid for after 2400.00..However generic was still covered. Now if I want brand coverage after the deductible, I must pay for the next 4000.00 myself/. The insurance I had before was much better.
    Is there anything in the new reform act that will help my situation. WHAT WOULD MY WIFE DO IF i CANNOT PAY HERE INSURANCE . This will be reality in 7 years. I will then live off SS only with no other income and my wife is 6 years younger.
    Thank You
    Steve Taylor

    July 22, 2009 at 14:20 | Report abuse | Reply
  30. Peter Sanchez, M.D.

    Dear Dr. Gupta:
    Government controlled healthcare programs are certainly very frightening, especially for the American consumer, given all the negative propaganda we've seen on TV recently. It seems to me that a public health system similar to that of countries such as Germany or Sweden, which seemingly are very good in terms of actual delivery of services should be worth investigating and emulating. Why is it that all we hear about are the government sponsored programs that have such a bad reputation? Hasn't anyone done a piece on Germany or Sweden's healthcare systems?
    Thanks.

    July 22, 2009 at 15:16 | Report abuse | Reply
  31. Joanne Cook

    Hello Dr.,

    I am the mother of a 20 year old girls who recently has had major medical issues. This is a young lady that has over the past 14 years been playing soccer year round and has been in excellent health. On April 16, 2009 she was diagnosed with MS. On May 13th she began having siezures. She was transported to Kaiser Hospital and soon after was intubated to protect her airway. She spent 2 weeks in the hospital and a cause was not determined for the siezures. About 1 1/2 weeks later she began having difficulty breathing and I attributed the problem to the pnemonia she had. It soon became clear that it was not pnemonia. We spent 3 nights at our emergency room where they continued to tell us that she was having anxiety or it was asthma. Finally one of the doctors at Kaiser referred her to an ENT for further tests. They tried to put us off for 2 more weeks until I insisted with the threat of an attorney and they found an appointment for her. Several more tests were done and they realized that she had tracheal stenosis and would require surgery. After further review, it was clear that because of the extent of the damage, she would not be a candidate for the surgery, they had a stent put in. Since then she has been doing fairly well until recently when she began to cough alot and have a fever. She will be 21 in August and we will only be able to insure her for 2 more years. Since she has MS and now this problem with her trachea, what will the health care reform do for someone like her? Will it be much harder than it already is to get the necessary medical care? As it is now, unless you are very firm with your health care provider (only from my experience), they give you a pill and send you on your way.

    HELP!

    July 22, 2009 at 15:57 | Report abuse | Reply
  32. Ms. M

    I am more in line with the 'blue dog' democrates. I believe in pro-choice. However, I do not think we should include the cost of abortions in the health bill reform. Take it out. Thankfully, I have private health insurance. However, I support providing needy citizens with coverage. I just think that an abortion or paying for someone to have plastic surgery and/or surgery to reduce weight should be included in the reform.

    July 22, 2009 at 16:18 | Report abuse | Reply
  33. Dean Olson

    RE: GRAPHIC EXAMPLE HEALTH CARE NEEDS IN US

    Dear Dr. Sanjay:

    Recently saw your graphic show on Haiti and condition of children sold for domestic use.

    Closer to home this weekend in Wise County, Va is Remote Area Medical whose volunteer medical staff will probably see 5,000 Americans.

    This is the program that impacted Wendell Potter, who then left VP at Cigna and now speaks out about health care needs.

    You probably saw him on Bill Moyers or recently on Amy Goodman.

    Over a thousand of your fellow medical personnel will volunteer their time and expertise.

    Isn't it about time that such programs and people get visibility nationally? Bill Moyers and Amy Goodman do a great job of bringing such issues before us. Think of the audience you have and this opportune time of highlighting graphically the issue.

    Wendell Potter spoke of walking thru the crowds at such an event, like being in a third world country....people waiting in the rain, procedures being done in animal stalls, no privacy.

    This is not in the jungle but right here in America.

    Wise County, Va

    This weekend.

    Would love to see your coverage of it. (If not interested or not available, could you pass this on to Elizabeth Cohen?).

    Sincerely,

    Dean Olson

    July 22, 2009 at 16:35 | Report abuse | Reply
  34. Ann Evans

    Hello Dr. Gupta,

    We must reform the Health care system in our country. I appreciate the fact that I live in a Democracy but I wish that President Obama would simply mandate universal health care today. No one will get rich on a universal system. Could we just start by taking care of all kids under 18?
    Dr. Gupta, please stay strong, speak out against the Insurance industry or the AMA if that is what it takes. I have written to my Congressmen from Pennsylvania. Encourage your viewers to do the same. Thank you very much for your time, Ann

    July 22, 2009 at 16:45 | Report abuse | Reply
  35. Tim

    Government Health Insurance Program is no bargain.

    The health insurance program is said to cost over $1,000,000,000,000. I figured if there are 300,000,000 Americans and 10% is un-insured or about 30,000,000 Americans. It is said the congressional health program would include only 70% of the uninsured American. So the congressional program would only include 21,000,000 additional Americans. The math shows it would cost $47,616 per person to insure just another 21,000,000 Americans.

    Sams Club has a health insurance policy they sell $350 a month with a $1,000 deductable and $30 co-pay. This would cost $4,200 in premiums and $1,000 in deductibles a year for a total cost of $5,200 per person. Insuring 21,000,000 Americans at $5200 a year would total $109,200,000,000 a year. The co-pays can be pay upon need.

    A program costing $1 Trillion compared to $109 Billion performing the same thing is no bargain.

    Actually the Sam Club insurance may be better than what the government is offering for about a 90% cheaper cost.

    July 22, 2009 at 17:04 | Report abuse | Reply
  36. KAREN

    Dear Dr Gupta,
    I have been a nurse for thirty years and i have seen many changes in the delivery of health care,some for the better and others not,in my professional opinion to allow the goverment to oversee health care is a diaster waiting to happen. I have never seen anyone refused health care because of there economic status,color or beliefs,most of the complaints are from the patients who want what they want and not what is right for them,if people truely believe they are not reciving health care wait until obamas plan it is a joke,a blunder and a diaster and the people who understand what he is trying to do know this and are against it .I would like to known how many children in our own country are ill because there parents cant afford to properly feed there children or how many elderly die in the winter because they cant afford their gas or electric,or their medication yes there are free programs but how many people are informed about them,i am against goverment controlled health reform,give health care back to the doctors and nurses who dedicate their lives to caring for the sick let them run the system not a bunch of buraccrates who dont know a urinal from a bedpan

    July 22, 2009 at 18:00 | Report abuse | Reply
  37. Beatix Vizkelti

    Dr Gupta
    I am following closeley all the issues of the HC reform.
    In brief; To lower the cost of delivering health care without busting the bank the Drug comp. need to be regulated, they created and hold monopoly over the drugs we use and the cost of it,the cost is stagarring! Also medical supply is very costly! No wonder the cost of heatlh care is a problem.Natures medicine is much more human friendly than all these drugs,wile syntetic drugs do a quick job it's like using an expensive bandaid.Prevention ,education daily preventive pactice diet and excersise is a better way to go.These great drugs that are developed are coupled with many side effects, addictions and sometimes death.I feel that the natural way is the way to go.

    July 22, 2009 at 19:32 | Report abuse | Reply
  38. HONEST DOCTOR

    Re: Healthcare cost debate or “heist of the millennium”

    Dear Sir or Madam,
    It troubles me when I hear endless discussions about little things that don’t really matter that much while avoiding the most fundamental problem.
    Here is what I think it is:
    It is a well known fact that At 16+% of GDP or 2.2 trillion dollars per year American healthcare costs twice as much as healthcare in any other developed country, while the outcomes (morbidity and mortality) are worse and 15% of the population (45 million) is not covered. Unfortunately the debate at this point focuses only on the 45 million people that are not covered and how to find even more money to cover them. In addition an argument is frequently made that American healthcare is the best in the world, without any evidence to prove it, and thus needs to be preserved. At the end of the discussion a passing reference is usually made to the need to do something about the rising costs.
    What about the costs that are already there?
    Unfortunately, not a single person said this – by doing simple arithmetic, based on the above facts, one can easily arrive at the following – If this extra 8% of GDP isn’t producing any improvement in the health of this nation, then it is a WASTE?
    In other terms, more than 1 trillion dollars per year goes to the “Medical industrial complex” without producing any benefit for the country. Clearly this amounts to massive and systematic wealth transfer, comparable to the Wall Street deeds over the last few years. This astronomical amount of waste exceeds the GDP of the most countries in the world. And there is nothing to show for it.
    So this trillion dollars is either stolen or wasted every year and it is rising at the rate of 12-15%per year.
    Who pays for it? We, the taxpayers, through lower wages, higher taxes and insurance premiums.
    Some of this extra $1trillion/yr cost is illegal (like overbilling, etc), some is borderline, although should be illegal (like price fixing by the providers in the particular part of the country), some has to do with plain mismanagement, but most of it is probably legal and done “by commission or by omission”. In other words, it had to be intentionally designed into the system.
    This system is designed to “be best at being the most expensive”. One can only imagine the amount of influence the stakeholders on a receiving side can afford to buy with just 5 percent of this extra trillion dollars per year.
    One can also imagine that if this waste were to be eliminated, assuming that the government had the courage to do it (and no one else can even try to handle this task), the savings to the economy would be sufficient not only to cover the 45 million people (this would cost less than 100 billion dollars per year), but also, enough to rebuild the whole American industrial and transport infrastructure within just a few years.
    If so, then the whole different set of issues has to be discussed:
    1. Why is this 1 trillion dollars continues to be wasted? Why is this allowed to go on? How do we as a nation get our 1 trillion dollars/year back?
    2. Who are the main beneficiaries of this 1 trillion/yr of national wealth transfer and who allowed them to do this to us? Where specifically is all this money going, to whom?
    3. Why do the lawmakers, the law enforcement, federal and state governments allows this to go on? Who and why allowed this to happen?
    4. how do we get the healthcare cost down to 8% of GDP? How and when will this nation get its 1 trillion dollars/year back
    5. Who will be responsible to stop this “heist of the millennium”?

    Even Pres. Obama hinted in one of his earlier speeches that this problem is so bad that it might bring this country to bankruptcy (and as such is a matter of national security).

    Unless we address these issues, rather than talk around them, we don’t stand a chance as a nation.

    The Honest Doctor

    July 22, 2009 at 19:38 | Report abuse | Reply
  39. D. PATEL

    WHY NO ONE TALKS ABOUT WHY THE HEALTH CARE COST IS HIGHER?
    FREVIOUS LAW SUITES.
    INSURANCE COMPANY PROFITS.

    July 22, 2009 at 20:23 | Report abuse | Reply
  40. Matt Thys

    I am writing from Canada and am completely perplexed with all the rhetoric going on in the USA about healthcare reform. Our Canadian system has been up and running for going on 45 years now and is largely based on the European system in place for at least 100 years. Canadians have access to doctors usually within 30 minutes if attending the walk-in clinics or emergency rooms anywhere in Canada. FREE. THEY HAVE ACCESS TO THEIR OWN DOCTORS WITHIN ONE WEEK AT THE LATEST BY APPOINTEMENT. Again this is FREE. I am 72 years old and my wife is 71. We have both had major healthproblems and have been served over the years by the system here in Canada. FREE. 90% OF MOST DOCTOR VISITS ARE FOR REASONS THAT ARE MINOR. Usually it involves kids coughs ,flu symptomes, aches or pains in joints.etc. AGAIN THESE MINOR VISITS ARE FREE. Canadians can visit their clinics FREE OF CHARGE ANYTIME. They don't have to declare bankruptcy because they are NEVER CHARGED FOR A MEDICAL PROCEDURE.... .THIS MIGHT SOUND UNBELIEVABLE TO THE AMERICAN PUBLIC BUT HEALTHCARE TO THE CANADIANS AT ANY AGE IS FREE,FREE,FREE, AT ANY TIME.

    July 22, 2009 at 21:06 | Report abuse | Reply
  41. Yvette

    Health Care Reform- just FYI
    Just to make you aware of why I believe that the Health Care System needs to be reformed and why there is plenty $ been wasted. I am a healthy female so far. I used to be in the US Army. I used to be 20 lbs lighter and toned and I used to have better “bad cholesterol”. Now I am out of the Army. I have a great Insurance plan that I am very happy with, as happy as I was with TRICARE.

    I go to see my Doctor 4 X a yr because my “bad cholesterol” has been inching up. I see my Doctor; he orders labs 4x yr to check my cholesterol and a full chemistry panel, sometimes he does my urinalysis to make sure that I am not breaking down. It costs my Insurance about $1000.00 total for the visit + labs. He also not too long ago sent me to a Specialist which I requested to check my heart because I am always tired. While at the Cardiologist, he ordered about $2000.00 worth of tests excluding his bill. My insurance this year has paid about $3500.00 for me. The verdict, I need to exercise more, that is why I’m tired and that is why my cholesterol is going up.

    I knew that much and when I called my insurance earlier I asked for them to get me in a gym. They said no, that is not an option. I am used to working out with other people. I am not getting on my treadmill because it’s boring. I asked for them to hook me up with a couple of people with similar issues. It costs $30.00/month to get me in a gym. It will cost my insurance company $100.00/month to get me and my three friends who have the same insurance in the gym to lose the extra weight we gained when we got out of the Army. That is $1200/year for 3 people plus maybe a $600.00 for yearly labs.

    My math tells me that if my friends are getting the same care as I do? My insurance company could save about $6000.00/yr for the three of us. Now, I live in a military town and there are a lot of ex-military here. We all are getting fatter for obvious reasons. If BCBS had a gym in my town, they would be saving tons. I don’t know why the Insurance Companies are not bankrupt yet; maybe my employer pays them well for my health care. By the way, my employer is the US Government.

    July 22, 2009 at 21:44 | Report abuse | Reply
  42. Sam V

    1. Keep government out of insurance business and direct provision of health care (personal impact)

    Neverever government bureaucrat can make better health care decisions for you (may be cost efficient not better). Have we forgotten all the past scandals of VA? If you think insurance companies are bad, imagine calling a government agency for your benefits.

    2. Incentive alignment is important (talent impact)

    We don't want to see doctors make less. You don't want to go to a doctor who will make 100K in the future since bright and talented won't go into medicine and old doctors may leave the profession. All you will get is mediocre and average. Also, it'll make rural and border towns pretty much scrounging for doctors (they already lack proper care). So pay them well and align their incentives (share) to cost savings.

    3. Make people own their care (cost impact)

    If we give care for free to every one with out any mechanism to reward good and healthy behaviour, where is the incentive to keep oneself healthy.

    4. Make insurance affordable/provide subsidies to who can't afford (moral impact)

    We need make sure every body has an insurance. Health care is a right as long as you follow healthy behaviour.

    July 22, 2009 at 22:36 | Report abuse | Reply
  43. Gregg Dewire

    Our beloved politicians and endeared talking heads frame healthcare from a reactive perspective – why are we looking at fixing healthcare from a medicinal perspective? By the time we have a doctor involved the damage has been done. Eight of the top 10 illnesses that kill us are self inflicted.
    We can absolutely reduce healthcare costs but it starts with the individual. We have known for a long time that eating properly (in moderation, vegetables, fruits, fish, whole grains, minimal processed foods, etc) and regular exercise provides for a healthy life. To be blunt, fat kills. 60% of Americans are obese. On a recent visit to a hospital, I was shocked at the preponderance of obese people that were there for treatment.
    We need to change the behavior of Americans. They have not been able to do it on their own, even with all the evidence that has been provided that a sedentary lifestyle consuming fatty and sugary foods is a failed path.
    It was not until we started taxing cigarettes at a considerably higher rate did we see a significant drop off in use. It is time to look at pricing food at the true cost. In other words, tax foods that we know are bad for us. Type II Diabetes is one of the fastest growing diseases in the US and primarily due to the foods we consume. To look at this from another perspective, why should people that take care of themselves subsidize the cost of healthcare for people that chose to be irresponsible with their own bodies?
    If we want to fix healthcare, it starts at home. It’s time for personal accountability to be healthy. If we can’t do it on our own, it’s time to provide disincentives for poor choices and incentives to make the healthy choices necessary to be healthy and reduce America’s health care costs.
    It’s not complicated but it does require effort.

    July 22, 2009 at 22:55 | Report abuse | Reply
  44. Jean Wilder

    I was a nurse anesthetist for 30 years. At the Cleveland Clinic, where I worked for many years, everyone was on salary and we were there to provide the best care we could to our patients...it was a wonderful system. When I moved to private practice in South Carolina, the only thing that was important to the physicians I worked with was money, money, and more money. I was so disgusted that I left medicine.

    I now am a student at Clemson University and I purchse health care through their system. I have experienced first hand, to the detriment of my personal health, that the function of a health insurance company is to deny and delay all that they can. Making health insurance available to everyone will only create more mountains of paperwork and frustration for physicians and patients. I have a good friend that is a physician and in her office of 4 doctors, they need 10 people just to work on health insurance claims....! I am totally behind a national health care plan that can control costs and provide the care that people need. Bring it on!

    July 22, 2009 at 23:05 | Report abuse | Reply
  45. B.A.

    Hi.

    I just want to comment on all the weird stuff I've been hearing about the Canadian health care system.

    I'm a 57 year old woman and I have never had the kinds of problems mentioned on certain American ads by certain Canadians. Nor do I know anyone who has.

    My mom died in February of this year. She was 88. In the last 8 years or so, she lost a breast to cancer, both legs (in 3 different surgeries), broke a hip falling out of her wheelchair and was hospitalized more times than I can count.

    Although she was elderly when all this started, she received top notch care throughout. The amount of time, effort and expertise put into trying to save her legs was remarkable. Each time she was sent to the emergency she got excellent treatment. A couple of times, she was at death's door and it would have been easy for the doctors to write her off due to her age. But they never did. All we had to pay during all of this is the extra amount for a semi private room.

    For some bizarre reason, Americans and perhaps other countries, seem to think that our Government dictates what care we get and what doctors we see. Nothing is further from the truth.

    We see the doctors we want and they decide what tests are required. We are constantly encouraged to have preventative tests such as colonoscopies, mammograms, all kinds of scans etc.

    When people talk about wait times for certain tests, it's usually for non life threatening issues. If a doctor believes your life is at risk or if you're in a lot of pain, you won't wait an undue amount of time.

    While no system can be perfect, I believe that the horror stories we hear about are the exception, not the rule and that the vast majority of Canadians support our health care system.

    I can't remember a time when I was worried about the prospect of getting sick and not being able to afford the care needed.

    Thanks for your attention.

    July 22, 2009 at 23:57 | Report abuse | Reply
  46. Been18

    Please do a piece on Switzerland's health care system. We see a lot on Canada and Europe's failed systems, but what about a system that is seeming to work. The public needs more detailed information on this. Not in a book, because that does not reach the masses. I think the piece should start here: http://www.hbs.edu/news/releases/090804_JAMA_herzlinger.html

    My thoughts:

    There are hurdles upon hurdles for health care reform. To craft the right plan you need both Republicans' fiscal conservatism and the Democrats' idealism among other things.

    For example, a person is smartest when they master using their left brain for essential habitual acts (walking, talking, breathing) and their right brain for morality and spirituality. We are unbalanced when the left brain tries to create habits in religion or human interaction; it was not meant for such things. These tendencies can lead to depression in a person. And the analogy, of these mental loops we get in, demonstrates that everything has a purpose and that purpose must be fulfilled wholeheartedly to avoid failure. Therefore, I would like to see a valid attempt at consensus in Congress not compromise or failure. Failure is not acceptable for this and compromise gives too much up. Consensus on the republican and democrat strengths is the only way to optimize our results on a healthcare plan.

    Without the correct "blade sharpening blade" approach, we may make some major costly mistakes. However, we have to start sharpening this plan with all the tools we have now, so that we do not lose this opportunity.

    July 23, 2009 at 00:29 | Report abuse | Reply
  47. Harry

    A great solution is to lock up all of the Republicans in congress until the work on health care reform is over. If the "party of no" have their way, it will be the status-quo forever.

    July 23, 2009 at 00:44 | Report abuse | Reply
  48. Mark

    I run a nonprofit where most of my staff are paid under $12/hr and we are forced to keep them on a part time schedule because we can not afford the cost of health insurance. Our company renewal this past June went up 48%, the cost to cover a family was over $1250/mo or $15,000/year when the employees annual wages are about $24,000/year that makes the cost of providing health insurance 62.5% or more of the cost of the labor and this doesn't include the cost of dental or vision. This just doesn't make any sense. We want to contribute to our employees health coverage but neither we nor they can afford this. So we are forced to limit who can get insurance and this is a gut wrenching decision and goes so far against our culture and mission. I'm not sure what the solution is but I can say that trying to force us to pay more than what we can pay today will just force us to close our doors since as a nonprofit we can barely cover our costs as they are today and often don't and rely on reserves to cover operating cost loses.

    July 23, 2009 at 01:03 | Report abuse | Reply
  49. Mark

    There are some innovative solutions for health coverage that can be substantially more cost effective. In Washington State they passed a bill allowing doctors to operate in a coopoerative fashion. One group that is based in Seattle is called QLiance (www.qliance.com). The offer preventitive care, unlimited office visits, lab work, cardio testing, etc with no office co pay for simple flat monthly rate; Adults $62/mo and Kids $38/mo, presriptions can be purchased at their pharmacy at just above cost. They do not accept insurance providers other than medicare/medicade in order to keep their costs low. This is an individual protection and therefor stays with they employee. An employer can contribute to the cost and can offer a high deductable coverage for the more catastrophic hospital stays. Generally if you have more than 25 employees the overal premium savings the company can self fund the employee deductable in a year and then bank the ongoing savings. The problem is that this is so new that there are only a few clinics open, it is still just expanding access.

    July 23, 2009 at 01:17 | Report abuse | Reply
  50. John Hyde

    Medical Reform by using medical royalties

    I am not a medical professional but I was just thinking about how I thought a successful medical system could operate by keeping medical costs as low as possible, reward good doctors and give patients the best medical care.

    Requirements:

    • Massive data base for electronic records (meaningful tax incentive for implementing e-record system)
    • Medical administration to evaluate patient care and release point-of-service (POS) reimbursement and eventually profit royalty
    • Medical & Finance panels to review:
    o Best treatment methods for all illness
    o Universal identification of illness (patient based)
    o Total cost determination for treatment of all illnesses
    o Determine fair profit royalty for all illnesses and when
    should it be paid, refunded if necessary, etc
    o Ethical dilemmas
    o How will the medical field try to circumvent the system?
    Overview:

    Basically, I think medical professionals need to be rewarded when they provide excellent and appropriate care, and keep the medical cost low. I think this is done by incenting them to provide the best medical treatment up front. Initial claims result in only getting reimbursed for costs up front (supplies, overhead, standard hourly rate * standard time, etc.) After they submit their claim (maybe 1 month)… their profit royalty comes later (maybe 6+ months later) after all medical care has been completed and patient is healthy and ALL costs from all sources (multiple doctors, multiple pharmacies, public health insurance used vs. any private insurance that patient might have) have been verified.

    Medical panels (Medical Standards Board (MSB)) will discuss the best methods for treating specific illness. There probably needs to be a tiered system based on severity of illness, as well as a range of treatment options.

    Based on this standard, a finance panel will determine and aggregate standard costs (# of visits required, supplies required, standard wages * standard time, prescription costs, etc.).

    The profit royalty will be determined and added to the range of costs. The longer it takes for a patient to get well, the more costs that will be incurred and the more the profit royalty is reduced. However, perhaps the profit potential is higher for saving a patient with more severe illness. Perhaps if a patient’s live is saved there is a profit kicker, and conversely if patient dies reduced or no profit royalty. A tiered system may be needed based on the severity of the illness. Also profit royalty may be reduced on some ratio system… 200% if life is saved, 100% profit royalty if treatment works in specified standard time/cost range, 60% royalty for a second visit, 0% if patient dies etc.

    Medical costs need to be primarily identified to the patient to capture all costs, not by doctor because multiple doctors could treat same patient for same illness. The universal identification system would work like this: if a patient went to two doctors for treatment of sore throat because doctor A did not remedy illness, but doctor B did, doctor A’s royalty should be decreased (to some degree) by the expenses of the treatment provided by doctor B… while doctor B gets full royalty.) The system would require doctor A and B indicating on patients electronic medical records that patient discomfort identified in zone (2.2.123 = neck.throat.sorethroat… or some similar system).

    There should be a separate, unbiased board to discuss ethical issues of proposed system.

    Finally, there should be a panel to discuss how this system will be circumvented, i.e. doctor’s intentionally diagnosing patient with illness that is not what they have, but has higher profit royalty, while the doctor treats the lesser, easier to treat illness. Maybe there will need to be peer audits or some other oversight.

    I doubt that my suggestions are perfect or complete, but maybe there are some good ideas for others to pull out and develop further. We all have a vested interest in making this work!

    John Hyde

    July 23, 2009 at 05:12 | Report abuse | Reply
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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.