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July 27th, 2009
04:19 PM ET

Ask Dr. Sanjay Gupta your health care reform questions

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

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


soundoff (373 Responses)
  1. LUIS Quintero

    Dr: Gupta, where you correct this morning in saying that Medicare pays for a Lipid test, only once every four years compared to private insurers once every year? I am in Medicare free and I get a lipid test cover 100% every four months, not 4 years. In addition, there were others statements made, that were false. Why are you taking the position against a public plan? Why are you so bad informed? Is Medicare a bad plan, is the VA a bad plan, pleased comment. I understand that some in the medical profession will not see any more the $500K annual salaries unless they get it from the rich people. We all must make sacrifices in order to take care of all of us. Talk about the end of year (very old sick people)solutions that we must go thru, we can not survive if we do not implement limits. Thanks.

    July 28, 2009 at 20:54 | Report abuse | Reply
  2. Matt Thys

    THE CANADIAN SYSTEM OF HEALTH CARE WITH SMALL PREMIUMS BASED ON A PERSONS INCOME IS A COMPLETE HEALTH INSURANCE SYSTEM. NO CANADIAN IS EXCLUDED, EVER. NO CANADIAN WILL EVER HAVE HIS OR HER HEALTH NEEDS CANCELLED FOR ANY REASON. PRECONDITIONS DO NOT APPLY TO GETTING HEALTH CARE SERVICE IN CANADA. NO CANADIAN IS EVER DENIED HEALTH CARE SERVICE AT ANY TIME IN THEIR LIFE FOR ANY REASON. NO CANADIAN IS EVER BILLED FOR ANY HEALTH CARE PROCEDURE. ANY CANADIAN FOR ANY REASON HAS ACCESS TO HEALTHCARE ANY TIME THEY WANT. DON'T BELIEVE IT. JUST MOVE TO CANADA AND FIND OUT FOR YOURSELF. NO CANADIAN HAS EVER GONE BANKRUPT DUE TO HEALTHCARE SERVICES. NO CANADIAN HAS EVER BEEN BILLED FOR STANDARD HEALTHCARE . THERE ARE NO EXCESSIVE HEALTHCARE CHARGES IN CANADA. THOSE ARE THE FACTS. WAKE UP AND FIND OUT FOR YOURSELF.

    July 28, 2009 at 21:05 | Report abuse | Reply
  3. Virginia Caron

    Dr. Gupta, What will happen when there is free health care and there are not enough doctors to oblige all the patients?
    If we had more doctors, many more, health care would be better and the cost would go down because everyone could have access to a physician. If medical school students had their tuition paid for, we would have doctors who would work off med school costs by working in a free clinic.

    July 28, 2009 at 21:31 | Report abuse | Reply
  4. ASA Member

    ps I meant to say medicare reimburses 33%, not medicaid. Sorry

    July 28, 2009 at 22:52 | Report abuse | Reply
  5. Kathy

    I hear the latest main concern is lowering costs. Noone is being SPECIFIC about how. That's one of my complaints about President Obama "informing" us about health care reform. He always speaks in generalities. And all this talk about preventative care sounds well & good, but people are still going to get sick obviously. Let's not make the mistake of having an HMO type system with a different name.

    July 29, 2009 at 01:38 | Report abuse | Reply
  6. fed-up health care worker

    As someone who has worked in the trenches of the health care field for almost 30 years, I truly believe the health care system is out of control and must be reined in immediately or it threatens to destabilize the whole economy of this country. In short, it is disproportionately frequent fliers who are over-utilizing the health care system due to their lifestyle related chronic conditions. There have to be limitations. We as a country must be brutally honest with ourselves and admit that we do NOT have unlimited resources, and the medical profession cannot continue acting as if we do. 97 year old ladies with terminal illnesses (and multi-organ failure) must NEVER be resusitated and placed on ventilators in the ICU; 695 pound men must NEVER be placed on ventilators in the ICU because their weight is giving them breathing difficulty; people in irreversible/vegetative states should NEVER be allowed to languish on total life support (ventilators, IV's, tube feeding, etc) indefinitely for months and years. End-of-life scenarios must be addressed openly and directly and there must be reasonable limitations. As for the immense cost of maintaining "ultra"-preemies in ventilators, etc in neonatal ICU's, I am not advocating withdrawing those life-saving measures, as the babies are innocent, but we need to discuss openly and directly the fact that drugs and lifestyle of the mothers are immense contributing factors. Something needs to be done in the way of preventative measures. By the way, since obesity-related health problems costs 10% of the total health care bill in this country, I would be all for the so-called "fat-tax." Something needs to be done. It's a small group of people who are destabilizing this country and making it hard on everyone. We need to get really honest and direct with ourselves as a nation.

    July 29, 2009 at 02:40 | Report abuse | Reply
  7. Toni King

    I would like to know if Dr. Gupta, in the absence of a high-paying job from CNN, would want to practice medicine under President Obama's healthcare plan. My guess is no.

    July 29, 2009 at 07:57 | Report abuse | Reply
  8. Stephanie LaFortune

    Dr. Gupta,

    I would like to bring your attention to a study that was done in California several years ago. I believe it addresses the fears of what some call healthcare rationing and the history of access and use of healthcare without regard for it's reasonable limits. Thank you.

    http://www.chcd.org/pub-reports.htm (Visible Fairness 2001)

    July 29, 2009 at 07:58 | Report abuse | Reply
  9. Nicole

    Dr. Gupta,

    My husband, a 68 years old Canadian Citizen with a US green card, is no longer insured in Canada (due to application for US residency) cannot seem to be insured in US without Medicare (although married to US Citizen and 68 years old, he cannot access Medicare with green card). How can we ensure health care insurance for him - He is currently covered under my family plan at work (group coverage) but I am planning to soon retire without health care benefits (I am 61 years old). How can we have my husband insured under these conditions? From your point of view, would the new health plan ensure that immigrants (especially older than 65 years old) receive health care insurance in the process of immigration.

    July 29, 2009 at 08:05 | Report abuse | Reply
  10. Don Bass

    I'd like to address the issue of health care access. I am a Process Improvement professional (Lean Six Sigma Master Black Belt) and I find it disgraceful that this issue is framed as entailing only one of 2 options, (1) either Tax and Spend, or (2) Limit Access to health care. People who do what I do for a living will tell you that NEITHER is necessary and that health care can easily be provided. Lean works for Toyota. Lean is why Toyota IS Toyota and not GM. Some hospitals and insurers are now (slowly) coming to the conclusion that Continuous Process Improvement (CPI) must be part of their makeup, but the health care industry is slow to move. From a Customer Value Added Perspective, Lean Six Sigma shows that virtually ALL operations are less than 10% efficient. Medical operations are no different. So, what I'd like to see is a REAL discussion of removing waste operations and the dramatic effect that Lean Six Sigma can have on this problem. To date, the entire Media has treated CPI as a caveat, when in reality, it is THE way. Framing the argument as either Tax and Spend or Limit Access is disingenuous.

    July 29, 2009 at 08:06 | Report abuse | Reply
  11. Uomam

    On CNN you just discussed the gross miscalculation made in Medicare costs predicted at the start of that program in the mid 60's. You went on to say that in President Obama's plan for health care reform that the plan will realize significant savings from preventative health care and by encourage healthy life style practices. That will not occur! What patient population and in whose practice are they basing these predictions on? I am an ENT/Sleep specialist, most of my patients diagnosed with OSA are obese. Once placed on CPAP for their OSA I routinely discuss the advantages of weight reduction and recommend dietary changes – NOT 1% OF THEM LOSE WEIGHT! Our society is an unfit one, people do not and will not exercise will not give up unhealthy eating habits unless a pill is created that allows them to lose weight without exercise and without changing their unhealthy eating habits. It is irresponsible to not challenge President Obama's stance that their will be significant savings realized by preventative health care and the adoption of healthy life style practices. Amazing!

    July 29, 2009 at 08:11 | Report abuse | Reply
  12. Judith Lasker

    I just heard on your news segment your response to a viewer who is worried about rationing. I'm sorry that you missed the opportunity to remind everyone that we ration health care NOW, all the time. We ration by how much money you have and what kind of job you have (or don't have) as well as by pre-existing conditions, and all kinds of risk factors. This is truly rationing but it is not based on any assessment of medical need, just the opposite–those most in need of medical care are most often the ones who are denied.

    And private health insurance companies ration services to their subscribers all the time, by deciding what they will and often will not cover.

    PLEASE don't let the mention of rationing go by again without making these important points about how we ration now.

    thank you.

    July 29, 2009 at 09:00 | Report abuse | Reply
  13. PJ

    My mother suffers from alzheimer and is in a nursing home under medicaid. Will this change in any way under Obama's thinking? I work part-time so I can help raise my grandchildren and had to buy my own help coverage which is expense ($213) a month when I only bring home under $700 a month. How will this new program help me?

    July 29, 2009 at 09:09 | Report abuse | Reply
  14. Frank Weitzel

    With the talk of high prices for companies to maintain health care for its employees I wonder if anyone has mention the cost of vision care. I wear glasses and I have to get an exam every year even though I feel my eyesight has not changed. I can not get buy new glasses unless my exam was less then a year old. I feel that this requirement should be removed. It is only feeding the pockets of the Optometrists and adding to the cost of insurances. My personal prescription has barely changed over the years. I think I could have gone 10 years at a time without an exam. So why doesn't the government or whoever decides these requirements for exam have them dropped or moved to a 5 year requirement?

    July 29, 2009 at 09:22 | Report abuse | Reply
  15. Marilyn

    Today you've been mentioning the increased cost from a projected $9 Billion in the 1960s to somewhere in the $96 Billion range for Medicare decades later. Please add the information about WHY that increased. It was not because of government waste or government bureaucracy but because Richard Nixon (in taped conversation with either Haldemann or Erlichman) chose to let "insurance companies" make a mint of money off of our healthcare. They started the leaching of big business off of healthcare in general and that lapped over into Medicare.

    The growth of layer upon layer of profiteering by HMO's, which basically didn't exist when Medicare was created, is an abomination that has virtually distroyed access to healthcare for millions of Americans and in many cases even those with HMO coverage can't get needed care because non-governmental HMO bureaucrats (some without medical degrees) decide who gets what care based purely on cost, profits, and bottom lines. Please go into this more extensively and please detail which congressmen that are tap dancing away from universal healthcare have HMOs supporting their elections.

    July 29, 2009 at 09:22 | Report abuse | Reply
  16. James Connelly

    Anderson cooper goes after the story no matter what, so since you are in the medical field, why does sweden give free health care to the citizens, just because they pay taxes in sweden?? please explain why does some of the european countries have policies that allow such and we who really pay for everthing, can not get something similiar??

    July 29, 2009 at 09:23 | Report abuse | Reply
  17. Chris Blask

    Hi Sanjay,

    I was disappointed with your piece this morning on whether health care reform would lead to the chain-mail fear being propagated that old people would be allowed to die. It would have been worth noting that this *has not* happened in any country that has created public health systems yet, despite those same chain-mail and anti-reform ads making those claims.

    In fact, while living in Canada in this decade my neighbor was offered knee replacements by his doctor – at 93 years of age – regretted turning them down at 96 and passed away at 99 after receiving every possible bit of advanced medicine. My Canadian father in law is 83 and receives every medical service that could be expected, including a minor surgery recently on a toe.

    As well, the "Daschle says old folks will have to suffer" chain-mail has already been debunked, worth sharing that on air as well:

    http://www.politifact.com/truth-o-meter/statements/2009/apr/03/chain-email/daschle-didnt-say-seniors-seniors-should-accept-ra/

    It would serve your viewers to clearly state what is within the realm of experience or fact and what is not...

    I do have concerns about public healthcare, but in the end I have concerns with public education, too. Regardless, after debating the *real* concerns (which do *not* include old folks being allowed to die or any of the hyperbolic risks being promoted by political and insurance lobbies) I have concluded that we cannot "promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity" without it. The US has social systems to ensure equal opportunities for citizens to enact their liberty, and health care has become a necessary system.

    -best

    -chris blask

    July 29, 2009 at 09:25 | Report abuse | Reply
  18. Heather Gaughan

    Dr. Gupta, I am a 34 year old Registered Nurse from Ohio, I have been unable to work in any capacity for over 1 year now and my 75 year old parents have had to step back in and take care of me again.(I live next door to them and vowed never to leave so that I could be here to help them as they aged). I have found myself in a position that I wouldn't want my worst enemy to endure. I have had 2 cervical neck fusions and a staff infection after the second fusion which has left my spine completely evicerated. Naturally, I don't want to return to this facility for obvious reasons. But 2 other local neurosurgeons will not help me saying that I have no choice but to return to this"clinic" which Pres. Obama visited just Monday I believe. Please tell me what you would do if YOU were in my position. Thank You, Heather

    July 29, 2009 at 09:28 | Report abuse | Reply
  19. MC Mitchell

    Why is my mouth not considered part of my health?

    Dentists are about to get off the hook, they are bigger crooks because dental care is not considered part of health care. How did this separation of dental and health get started?

    July 29, 2009 at 09:53 | Report abuse | Reply
  20. MC Mitchell of Bristol

    Why is dental insurance not considered part of health insurance?

    What is the origins of this seperation? You have to wait for a tooth to become life threatening before it is considered health care.

    Put that is the vegetable isle and smoke it.

    July 29, 2009 at 09:58 | Report abuse | Reply
  21. Robert Blazek

    The single most important issue in health care IS END OF LIFE CARE, this IS the issue that will make or break our health care budget. It is estimated to consume about 2 out of every 3 health care dollars in America. Again this IS the issue, however all we hear in the media is talk about how many payers or using cost-benefit analysis on procedures cover by Medicare.

    One possible solution is to gradually reduce publicly financed health care benefits as we approach our life expectancy. This value does not need to be zero, but some figure well below that provided a person in mid-life. This formula can yield a value that we can afford and truly reform health care in America for the long term.

    Just how do we get people in the media as well as Washington to begin discussing the real problem with our current health care system?

    July 29, 2009 at 10:07 | Report abuse | Reply
  22. Jacob Graves

    Yesterday I was shocked to learn from you that Medicare only covers a cholesterol test every five years instead of every year, like most other health insurance policies do. It sounds as though the federal government has decided to give only lip service to testing while leaving plenty of room for people to get heart disease and require some very expensive procedures which could have been avoided if people had received timely data and acted on them. This practice would enrich the medical profession while greatly damaging my health.

    At least twice such timely discovery of my cholesterol levels has resulted in my implementing a substantial fix which returned my lipids to recommended levels.

    What can be done to bring Medicare policy on cholesterol testing in line with accepted policy industry-wide, and are the health insurance bills working their way through Congress going to allow yearly testing of cholesterol and other parameters normally covered in a CBC?

    July 29, 2009 at 10:21 | Report abuse | Reply
  23. MC Mitchell of Bristol

    I only saw one comment on tort reform.

    This issue is a primary problem accross our economy. Insurance is based on tort law. Even the US Forest Service requirments increase operating expenses to my recreation, (ie, heart healthy hiking, biking, freash food) agri-tourism business costs are driven up by excessive insurance requirements.

    July 29, 2009 at 10:23 | Report abuse | Reply
  24. T Steel

    Couldn't do without Medicare. However, there seems to be a ripoff lately. Not only do I get the Doctor's Bill, but I also get a bill for a facility charge. The charge for the use of his office space is nearly the same as his bill. Is this being done all over the country??

    July 29, 2009 at 10:25 | Report abuse | Reply
  25. Martyn Bignell

    I am frankly disgusted by most of the media in the USA (CNN IS OKAY), I now live and have just started my second company here in the USA. I originate from the UK where they have (LOL) social medicine, what really scares me is that Americans have this preconcieved idea that social medicine is bad.
    Hear are some facts for you to consider, America is ranked by the world health organization at 37th in the world for health care, the fact is that in real terms it is probably lower than that. America currently spends nearly 18% of GDP on health care, America experinces 5 9/11's per annum in deaths due to inadequate health care. (An old friend of mine just died due to inadequate health care)
    America has one of the highest infant mortality rates in the western world, The cost for my family of four in America is $1,500.00 per month, then of course their is all the deductibles and co-pay to go on top of that.

    So lets look at a social system and lets take the number one in health care as listed by the world health organization, namely France who spend 9% of GDP on health, they suffer no public discontent with their health care system, a family of four pay less than one third of what I pay per month in taxes to cover their health, their infant mortality rate is one of the lowest in the world.
    On top of this and I know you may find it very difficult to believe, here in the US you can get a plumber at two in the morning; guess what you can get a doctor at your house at two in the morning in France, how amazing is that they rate a doctors call more important than a plumber.

    The basic problem is education and Americans are just not getting that, after all only one in ten of you have a passport; so your judgement is frankly biased as you have not experinced any other form of health care, another example is my country the UK is currently ranked 18th in the world and it is lacking.
    Therefore and beacause I could afford it I topped up my social system with a private plan at around $1,000.00 per annum, which meant if the social system could not take care of it then I had a back up.

    Finally what you all need to think about is the interests some politicians have, and of course the health insurance companies. They do not want to see a social system because they will lose out financially, frankly as the man said I do not give a damn. They have had it so good for so long it is not funny, as far as I am concerned the fact that they place profit before health simply means they are sick too; in the head that is. So what you should all do is not just take my word for it, get on line and educate yourselves because no one here is going to inform you especially rip off insurance companies.

    July 29, 2009 at 10:27 | Report abuse | Reply
  26. Patricia Kng

    I am 72 years old. I am covered by Medicare and supplementary AARP. Will the president's plan affect me?

    July 29, 2009 at 10:46 | Report abuse | Reply
  27. dick walker

    Dr. Gupta,

    Is there any way to know how people currently on medical (not prescription) will be affected by the bill. I kinda assume since Medicare is haled as an example of what works that it will not change.

    Thanks.

    July 29, 2009 at 10:53 | Report abuse | Reply
  28. T. Steel

    Couldn't do without Medicare, but am wondering if medical facilities all over the country are doing what mine recently started. Not only do I get the doctor"s bill per visit, but I now get an additional bill of almost the same amount for a facility charge. I guess that is the space I use in his office – sitting in a chair or maybe on the edge of the examing table. Is Medicare being ripped off?

    July 29, 2009 at 10:54 | Report abuse | Reply
  29. Ann Marohn

    I think you should do a story on the costs to Hospitals and other agencies that treat the uninsured because they come to the ER. These costs are passed along to insurance companies, for their insured clients are higher so the hospital can offset the cost of treating uninsured.

    July 29, 2009 at 10:56 | Report abuse | Reply
  30. Larry Lazarus

    As someone who has fought the Health Insurance Industry for 30 years, I believe it would prudent for you to promote the fact that the public should worry more about the insurance company's "rationing" than the governments. Many people have died because an insurance company employee denied service. Another fact to emphasize would be that we already pay for the uninsured when they go to the ER and the hospital does not get paid. The third issue would be healthcare fraud. While there is no way to eliminate all fraud, the government could save countless tens or hundred of millions of dollars going after the many crooks billing the system.

    July 29, 2009 at 11:24 | Report abuse | Reply
  31. Steven J Zweig, M.D.

    Dr. Gupta;
    I am a Clinical Breast Radiologist who practices in a small town in Northeast Michigan. I am in the process of trying to help a high cancer risk patient get her yearly mammogram paid for by her insurance company. Right now, against all accepted standards, they will only pay for a mammogram once every two years. This in commonplace and counterintuitive. It is much more expensive to treat an advanced breast cancer than to pay for a yearly mammogram.
    As a physician I have excellent medical coverage through my State Medical Society and BCBS of Michigan. My monthly premium, however is $2300!!!! That works out to well over $25,000 yearly. Combine that with my $25,000 yearly malpractice premium!!!
    Something needs to be done if a physician can no longer afford his own medical insurance!!!!

    July 29, 2009 at 11:30 | Report abuse | Reply
  32. CHANDRA S. ANAND MD

    DEAR DR. SANJAY GUPTA,

    THE FOLLOWING QUESTION IS WHAT YOU MUST ASK PRESIDENT OBAMA:
    FROM THE TIME SENATOR EDWARD KENNEDY HAD A SEIZURE TO THE TIME HE FINALLY WENT HOME, HOW MUCH DID IT COST?
    IS PRESIDENT OBAMA WILLING TO PAY PER PERSON, PER DISEASE, PER TIME, YES, OR NO?
    IF YES, HOW WILL HE PAY FOR IT?
    IF NO, WHAT IS THE DIFFERENCE BETWEEN HEALTH CARE IN AMERICA AND HEALTH CARE IN AFRICA?
    MONEY YOU LIVE, POOR YOU DIE.

    THANK YOU,
    CHANDRA

    July 29, 2009 at 11:48 | Report abuse | Reply
  33. L. Chandler

    Dear Dr. Gupta:

    I am a faithful listener of CNN and I am following the health care reform in your country. I enjoy your discussions very much.

    I am a 60 yr old Canadian woman who was diagnosed with breast cancer last year. I had the subsequent surgery and chemotherapy and all related medicines and I did not pay one cent! The cancer clinic is very busy no doubt but it is always extremely busy and all the patients get the same wonderful care I was given.Every person in Canada is covered by a heatlh care plan and in my case it is the Ontario Hosptial Insurance Plan. It is free for all Canadians. Each province has there own plan but one is as good as the other. I also have a private health care plan that pays for prescriptions, glasses etc.
    I pay a little less than $30. a month. For prothesis one may need because of surgery the government pays half and the private insurance company pays half. I also have a dental plan and the coverage is very good.

    I saw an ad on TV where a woman claims she had to leave Canada because she could not get treatment. I really doubt that was the case. There has to more to it.

    It is possible that we in Canada pay for heatlh care through our taxes but my land tax and personal income tax does not indicate exhorbitant fees. I do not think anyone in Canada would be happy without our excellent coverage.

    If we can do it, the US can do it.

    Thank you,

    July 29, 2009 at 12:09 | Report abuse | Reply
  34. Jennifer Polifka

    This morning (July 29) you answered a question about rationing health care. The question dealt with a family whose father battled brain cancer while receiving excellent care from his health provider. The questioner wanted to know if his father would have received the same care with the new plan or would it force rationing of health care.

    Well, the capitalist system already does force rationing. The wealthy or those with private health care get the standard of care his father got but those without healthcare or the means to pay get very little or inadequate care. My sister faced the same problem – a cancerous brain tumor which was removed with a poor prognosis. As long as her husband had healthcare with his work, she got good care. But when he lost his job, their house and their healthcare, she got very little. When she later suffered symptoms from post polio syndrome, she received no therapy or home care and very little hospital care. They couldn't afford it. When she broke her leg, no physical therapy so she ended up bedridden until she died at the age of 50. At the end she was in and out of the hospital with respiratory ailments and, on one visit, she was given a feeding tube because she could no longer swallow. After she pulled the feeding tube out several times, they advised us to let her die – peacefully. I am still haunted by that decision. Was she really unable to continue or did they just not want to spend the money?

    So want so many are saying now is that they don't want rationing for themselves – just for the poor! It makes me sick. My sister was every bit as valuable as their father but, evidently, she didn't deserve to live or be given the care needed to fight. She was just written off. Now my 21 year old, who has mental health issues, does not have a job or health insurance and I'm worried of will happen to him someday.

    Please, we need healthcare reform of some kind. The poor and needy should not have to die because they can't afford health care.

    Jennifer Polifka

    July 29, 2009 at 12:30 | Report abuse | Reply
  35. Bhardwaj Desai

    Why can't US decrease health care cost driven by physician charges by allowing foreign trained physician who has already undergone rigorous residency training in their country to tak sam evaluation as US trained physician, like boards and US licensing exams and if they pass offer 1 year or in surgical speciality 2 years residency training to increase more physician availibility there by decreasing cost due market forces of rapid rise in physician availibility.

    July 29, 2009 at 12:46 | Report abuse | Reply
  36. Bhardwaj Desai

    Also most other developed country did use this route to solve their physician staffing like Britain, Canada, Germany and Australia.

    July 29, 2009 at 12:50 | Report abuse | Reply
  37. Jaime Rojo

    Why are user of poor health habits charged a fee?:

    I have good health insurance program through my employer and strongly believe we need health care reform. However, people with health insurance or the wealthy should be required to pay for the new program. New revenues should be drawn from the products which are directly increasing the cost of health care.

    Let's add a tax to products which contribute to higher health care cost such as tobacco, liquor, sugar and fast food. A few pennies per dollar on these products will fund a state of the art and global model of health insurance program for all Americans. It places the cost at the foot of the origins for the rising health care cost. The user gets to directly pay for the use of these products which directly negatively impacts their health.

    It’s the right thing to do…

    Jaime Rojo

    July 29, 2009 at 13:33 | Report abuse | Reply
  38. c bernstein m.d

    As a Radiologist I can honestly say that perhaps 30% of imaging such as CT and MRI are performed on a defensive medicine basis.Unfortunately TORT reform is essential to bringing down costs.
    People are worried about "rationing " of health care,but should instead be afraid of gross overutilization.Costs are going up due to the replacement of common sense with inadvertent testing.

    July 29, 2009 at 13:40 | Report abuse | Reply
  39. Antal E. Solyom, MD, PhD, MA

    Dr. Gupta,

    I saw this morning on CNN the segment about Jason’s question regarding rationing (with reference to his father who died of a brain tumor). Both you and the White House handled the question defensively, as if everybody could get anything without any limits!

    That is overpromising falsehood, and flies in the face of the real goal of the reform, i.e., to do only such treatments that “work” and don’t waste money and time on those that don’t result in a positive outcome. When we move from a curative mode to a palliative mode we are “rationing” “rationally.”

    I suggest that both you and the White House consider the following regarding these types of questions:

    1. nobody is forced to choose the “public option” insurance, i.e., individuals may select their particular insurance menu that insurance companies offer and may choose to pay higher premiums for certain features of the coverage – but the truth is that there is lot of rationing in the current policies of the for-profit insurance companies (like pre-existing conditions) for the sake of profits, and the reform would make those unacceptable) – in other words, one has to worry first about the rationing by the for-profit insurance policies before worrying about the “public option”)

    2. one has to be careful with such buzzwords as “rationing,” because those may be used provocatively (!) to imply that somebody was going to be unfairly deprived – such false implication may prevent “rational” discussion of the issues – so, the answer should be that nobody will be unfairly deprived of the treatment he/she needs to get better! (If there is no treatment that would make the patient healthier, then he/she would get the care needed to feel as well as possible.)

    3. there is a great need for thoughtful and extensive national dialogue about definitions, goals and methods/strategies, because we also have to reform our thinking and attitudes both at the public and professional levels, and because not all the values of health care are monetary.

    With best wishes,
    Antal E. Solyom, MD, PhD, MA

    July 29, 2009 at 13:51 | Report abuse | Reply
  40. Jennifer

    I saw a blogger bunch report discussing the pros/cons of taxing junk food to lower obesity. Why not end the government's subsidy of corn? Most of the food that is bad for you contains some sort of high fructose corn syrup. By eliminating corn subsidies unhealthy food will become more expensive and those funds can be redirected towards subsidizing healthy foods. Additionally, the meat/dairy industries will no longer be able to feed corn to cows and will as a result have to feed cows grass and allow them to graze–what nature intended for them to do anyway. Feeding cows corn is unhealthy for them (they require more antibiotics to keep them alive) and unhealthy for those who eat them.

    July 29, 2009 at 14:02 | Report abuse | Reply
  41. Gloria Sabo

    Dear Dr. Gupta:

    I am very concerned about the health care reform because my husband has Interstitual Lung Disease and is currently getting excellent care from the National Jewish Medical Center in Denver. We drive there from Las Cruces New Mexico about every 3 months. We would both be devastated if we were not able to continue my husband's care with Jewish Medical. We were going to a pulmonologist in El Paso but the care was horrible. He more or less figured by husband had lived long enough (69 years of age). The doctors have no idea how he got this disease because he has never smoked or been exposed to anything, that we know of, that would cause this illness. He was a professor at U of A and NMSU for 30 years. We would like to be assured that we will be able to continue his care at Jewish Medical. He is doing great now that he is getting better care. Thanks so much for your time. Gloria

    July 29, 2009 at 14:37 | Report abuse | Reply
  42. Moi

    yes we need health care reform. health care cost reform, lawyer reform, hospital reform, doctor reform ,health insurance reform and people reform-because in order to have a national health system health care reform
    has to start with EVERYONE! every one needs to contribute to a national health system and health care reform-- citizens ,the patients, family members, the government, hospitals ,Drs . & other health care professionals, pharmaceutical companies, lawyers ....
    EVERYONE has to take personal responsibility for their own health!
    If Mr and Ms tax payer lives a responsible healthy lifestyle & pays a fair share of taxes then they should benefit from their tax dollars helping to cover their health care / medication costs. why should mr or ms tax payers taxes pay health care for someone that has never had a job,contributed to the system & refuses to be compliant /responsible for their own health care–and when these individuals are in the hospital make ridiculous high demands for service and care from the hospital staff and always threaten to sue if they do not get the care they demand ........meanwhile when mr and ms responsible tax payer get really sick....they don't get the same access to health care ,their insurance blocks them from getting the treatment they need & are unable to afford the unreasonable hospital bills & they loose everything they have worked for their whole lives–because they can not afford the outrageous bills and their credit status is damaged.
    every tax payer should get equal access to health care /medications without the worry of an outrageous bill that could drive them to bankruptcy or further illness due to the stress of mounting bills.

    doctors/hospitals/ need to stop the outrageous waste /excess cost of healthcare. health care should be no frills- get just what you need -no more, no less–patients need to stop making excessive & unreasonable ,unrealistic demands.....you are in a hospital not a 5 star hotel, spa or resort- this is not the place to be a VIP–hospital staff does not have the time to cater to VIPs–they have peoples lives in their hands & shouldn't have to waste time /staff catering to patients who think they are more important then everyone else . health care for everyone should be equal and you get only what you need depending on the severity of your illness--drs need to stop ordering unnecessary tests,procedures, inappropriate admissions, stop keeping patients in the hospital for an eternity–when the hospital has done everything possible- the family needs to take responsibility for the care of the patient or make appropriate arrangements- many times the families unrealistic demands /expectations lead to excessive hospital costs. there are situations when patients are in the hospital for a very long time& the family doesn't want to deal with them or care for them but does not want them in a nursing home or other long term care facility–there is a huge gap and huge costs when the hospital can not discharge a patient to another facility or with the family because they refuse to care for the patient and the family says no to putting them in another facility or nursing home and threaten to sue the hospital when the hospital tries to discuss discharging or transferring the patient. the hospital is forced to eat the cost of caring for this patient. –and the family makes unreasonable demands on the hospital staff for daily care and service –the same care they refuse to provide for their very own relative. we definitely need health care reform to stop waste ,fraud ,abuse- provide no frills health care /medications for everyone , NO VIPs ,control health care costs, medication costs and should definitely control & put an end to health insurance companies that deny care and lawyers who only add to the waste fraud and abuse.

    July 29, 2009 at 15:44 | Report abuse | Reply
  43. AMG

    In response to Bhardwaj Desai,

    Number 1: You are not hundreds of thousands in debt. You did not train at a US medical school so you have not debt. Simply allowing FMGs to take all the spots and drive salaries down will simply drive down the number of good, qualified, intelligent students from entering training at US medical schools. The reason why US medical schools charge what they do is because traditionally, US physicians make enough to pay back their loans. No one wants to force out all of the US grads because it is cheaper to outsource all US grads to a foreign country. Outsourcing is never the answer to help with domestic problems.

    Number 2: Your training is not the same as the training we receive here. For that reason, Step 2 CS was created. Many people come here in hopes of securing higher salaries, but cannot speak English, are not familiar with the customs and, to be honest, have poor bedside manners (worse the AMGs) because they are not trained in bedside manners, unlike what is a part of every US medical school curriculum now. That said, there are plenty of great FMGs and I have worked with them. They enrich our nation, the US medical education experience and are often great people. However, they all admit that one of the reasons that they came here because the way we practice medicine is better here.

    Number 3: Why are FMGs coming here in the first place? They are fleeing their country, their language, their family and their customs to come and practice medicine in the US? Lets be honest – they would be paid more here. Do not pretend like finances are not a concern to FMGs. In fact, I have worked with a number of FMGs during school and many of them are reluctantly pushed into primary care because they could not secure a more competitive specialist spot. Most of them are resentful of that and wish to switch to a specialist training.

    July 29, 2009 at 15:48 | Report abuse | Reply
  44. Carol G. Bush

    Dr. Gupta, what is the average life expectancy of U S Citizens compared to other Western countries? What country has the longest life expectancy and how does healthcare in that country compare to our current system?

    July 29, 2009 at 18:24 | Report abuse | Reply
  45. Medical Student

    A link for people to read regarding the complications of obesity:

    http://www.ncbi.nlm.nih.gov/pubmed/10696282?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

    This is an article from Harvard Medical School. In the midst of health care reform, we probably need to take a look at some of the costs of rising health care and strongly considering provided increased coverage for those patients who comply with medical recommendations for the management of their long term illnesses. Otherwise, we will never truly control health care spending.

    July 29, 2009 at 18:39 | Report abuse | Reply
  46. Dr M

    Dr Gupta,

    I'm in my 4th year of residency training. I personally see ridiculous amounts of MRI, CT scans and ultrasounds ordered just because ER and primary care docs are afraid to get sued. It's ridiculous how much money is wasted everyday in every hospital across the country on unnecessary imaging and tests. Why is tort reform not a main topic of discussion?

    Also most of the chronic diseases I see everyday are a result of obesity, smoking, drinking and unhealthy lifestyles. Why should I take a cut in pay and have to pay higher taxes to fund health care to treat such conditions?

    Dr M

    July 29, 2009 at 20:30 | Report abuse | Reply
  47. Elizabeth Koffron-Eisen

    Question: What is ahead to assist family/spousal caregivers in their work?

    Thought: Medical Health Care Reform Incentive: All legislators, major pharmaceutical, medical and hospital executives lose ALL health care coverage until all-inclusive plan takes effect... have to pay out of pocket, or, of course, qualify for Medicaid. Walk the walk.

    July 29, 2009 at 20:54 | Report abuse | Reply
  48. Irene Yellin

    Hi Dr. Gupta:
    I'm directing this comment to you for consideration. If you think there might be some merit to it, please see it gets to the proper authorities. This is in reference to the crash that occurred on the Taconic and the mother who was driving south in the northbound lane causing a crash which resulted in eight deaths. There is a certain type of Migraine that can cause a sudden loss of vision or visual impairment. I think it's one possibility that should be investigated. Her behavior is so mystifying, there has to be a legitimate explanation. Thank you.
    Irene Yellin

    July 29, 2009 at 20:56 | Report abuse | Reply
  49. ellis

    for the past four years I've been working in Taiwan where their universal health care system costs 6.2% of GDP. In Taiwan I'm able to go to any dentist, doctor, hospital or clinic of my choice. I can also choose Western or traditional medicine. If Taiwan can accomplish this why can't we?

    July 29, 2009 at 21:08 | Report abuse | Reply
  50. mandy

    With three children with autism, I cannot get private insurance that will cover them in the state I live. They qualified for SSI disability, which generally you gain Medicaid on, but the state revoked my children's Medicaid for budget cut reasons. We do have private insurance through work, but it doesn't cover autism or anything that could be autism related. That is the kicker, "autism related" is much like the 6 degrees to Kevin Bacon, everything can come back to autism, from my daughters seizures to Pica to breaking a leg all have been denied at one time or another becuase they are "autism related". As long as we allow for some things to be excluded insurance companies will continue to find ways to link all bills to that exclusion. So why if a disease is recognized and has been studied for years (autism was studied by Kanner in the 1940's) can insurance say it's uninsurable. When does insurance have to cover something? Insurance says there is no cure for autism so no treatment option, but they cover many disorders and diseases that aren't cured but are managable autism is in the same boat.

    July 29, 2009 at 21:53 | 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.