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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 (460 Responses)
  1. Mike

    Dr. Gupta

    Your piece on obtaining narcotics from pharmacies was quite interesting. I would like to invite you to familiarize yourself with the most advanced prescription tracking system (Pharmacare) in North America which serves the entire Province of British Columbia. I would be happy to put you in direct contact with the Registrar of the College of Pharmacists of BC.

    July 30, 2009 at 02:43 | Report abuse | Reply
  2. Will

    Dr....

    I don't understand why doctors, especially yourself, even take the Hypocratic oath. Does it even mean anything to you? Western medicine has turned into a money machine as doctors treat broken arms with bandaids by prescribing drugs for everything.
    For instance, and I'm sure you are aware of this but not willing to use your stardom to promote it, why don't doctors put away all the meds being used on all gastro-intestinal issues and just have their patients squat on the toilet as opposed to sitting down? A whole century of Western society has passed with usage of the sit-down toilet. A dilemna has developed with all of the problems people have with their colons. These problems are almost non-existant in societies where squat toilets are common.
    Today I read your article about your opinion on marijuana reform and I laughed out loud. What a hypocrite!

    July 30, 2009 at 06:52 | Report abuse | Reply
  3. Mark

    I saw your prescription abuse segment. I am a Dentist in Texas. If I am suspicious of a patient I start calling the pharmacies in town to get a narcotic history. This takes at least 45 minutes but I dont like getting taken advantage of. Seems like there should be some kind of centralized data base to instantly track all prescriptions.

    July 30, 2009 at 08:59 | Report abuse | Reply
  4. Rebecca DeWitt

    Dear Dr. Gupta,
    Thank you for providing so much useful information on your segments. I always listen to your advice.
    My question has to do with our 20 year-old son who's starting his junior year in college. He has juvenile diabetes and will be covered under our health care through the end of his four-year degree. We are worried about his health care after he finishes. He wants to go on to get a Ph.D. but we don't know if he'll be denied coverage because of his pre-existing condition. We'll face this problem in almost 2 years. Thank you very much. Regards, Becky

    July 30, 2009 at 09:25 | Report abuse | Reply
  5. Bill Knowles

    Hello Dr. Gupta: My wife recently had surgery to repair a tear in her right shoulder rotater cuff. The surgery went well, the surgeon, a very experienced Doctor in his mid fifties, was excellent. On our last visit he sadly told us he was retiring early because he was too frustrated dealing with the medical group bureaucracy. The last straw? He was being denied the right to take his annual 3-week vacation. My question? If Doctors are so frustrated dealing with bureacracy now how will that improve with health care reform? We can probably afford to lose a few administrators, but not qualified surgeons.
    Thanks, Bill Knowles,
    Point Roberts, WA

    July 30, 2009 at 09:27 | Report abuse | Reply
  6. Charles Preston, MD

    Dr. Gupta,
    As the health care reform debate heats up I have noticed a conspicuos lack of discussion on malpractice tort reform. Why aren't you keeping this issue at the forefront?
    As a physician in clinical practice trying to keep my patients best interest forward, I am alarmed at the villification of physicians and a total lack of inspection of the health INSURANCE industry. I don't find many patients who have any issues with the type of medicine practiced in the US, it always comes down to how it is paid for. They all want the CT or MRI they simply are upset the insurance company won't pay for it until they've jumped through hoops. For example, no matter how severe or persistant a patient's back pain is, rarely will they be able to have an MRI paid for until they have had 4 weeks of NSAID treartment. I could site numerous examples of silly protocols driven by insurance companies that almost always delay or deny treatment or ultimatley cost more money.
    Again, I would ask you to emphasize the imortance of tort reform and reform of the insurance industry over regulations to tie the hands of practicing physicians.

    July 30, 2009 at 09:43 | Report abuse | Reply
  7. Aaron B

    Dear Dr. Gupta,

    Much talk is centered around "bending the curve" of health care costs. This is absolutely essential for any healthcare reform. But it is not clear to me HOW the curve will be "bent". What are the best ideas for reducing long-term healthcare inflation & which ones are actually in the current legislation.

    Thanks!
    Aaron

    July 30, 2009 at 10:07 | Report abuse | Reply
  8. June Borrer

    Dr. Gupta,
    I understand that you have read all of the proposals for goverment health care. I would appreciate an answer since my HMO agent hasn't
    received any nortification on the following matter.
    Don't know if I just missed the point that does concern me and other seniors and disable people.
    IF the goverment health care passes...what happens to seniors , & disable people that are now on medicare along with an approved HMO by the goverment? Are we going to be thrown into this pool and expected to pay more for coverage? What happens to Medicare and Medicad coverage?
    Thanks..

    July 30, 2009 at 10:51 | Report abuse | Reply
  9. Thelma Nevitt

    Dr. Gupta, I am a 56 year old female with health insurance under the DOD Tricare system. I am a civilian, ex- Navy wife. Will the new proposed health pland change my insurance? Thank you, TYN

    July 30, 2009 at 12:33 | Report abuse | Reply
  10. Martha

    Dear Dr. Gupta:

    Like Congress and President Obama, journalists and media are not including the expansion of Medicare or single-payer health insurance in this conversation. Today there is a rally in Washington, organized by Healthcare NOW, speaking out for reform. I haven't seen it reported on television, or on CNN's website. Single-payer was taken 'off the table' before it was even discussed. Why?

    July 30, 2009 at 12:41 | Report abuse | Reply
  11. philip lacombe

    I do understand that socialized medicine and rationing will have to take place in this noew proposal. WHY???? I have lived in UK and Canada and our system was awful, as a matter of fact, we came here to get treatment much quicker – whats srong with that? The reason its the most expensive is because we have the best health and research team in the world. I worked for a pharmaceutical firm and invented a heart drug. Yes it cost alot, but its the best in the world. The uninsured, that is a separate issue to work on, leave the happily insured alone. Your thoughts????

    July 30, 2009 at 12:54 | Report abuse | Reply
  12. Bill Huggins

    Dr. Gupta,
    I would like for you or your staff to publish Obama's Health Care Reform in the form of a product brief that will enable the average person to understand his plan. Perhaps someone could explain it on the air so a large number of people can view the program. Please include retired people in this program. Also, please include cost impact to groups of people in different circumstances. Please pass this on to management if you are not the person that will respond to the interested people. Thank you for the excellent job you are doing.
    Regards,
    Bill

    July 30, 2009 at 13:58 | Report abuse | Reply
  13. Marcia Santos Elder

    I would like to see how the health system works in others contries. I know that Brazil uses Universal Health Care . It will be interesting for everybody to know what could be done here that is already working good in others democratics nations or maybe their mistakes in Health Care can help the USA develop a new concept of health system where it will be standard for others nations.

    July 30, 2009 at 14:00 | Report abuse | Reply
  14. P.B.Menon

    Dear Dr. Gupta

    The "PRESCRIPTION" drug manufacturers advertise their products in detail with a caption "ask your Doctor whether it suits.you" in daily news papers, commercial journals, electronic media etc. at the cost of the patients. The prescription of drug is at the discretion of the Physician after assessing the illness of the patient. This universal practice and professional ethics accepted or established by the drug manufactures. . Patient is not the deciding factor as to which "prescription" medicine a patient should take over ruling physician. In view of these facts, what is the purpose of educating pulic or patient abourt their drug through news papers, commercial periodicals.and electronic media?

    These are to be addressed to phycicians through the respective and concerned professional jourals. In certain countries advertisement of the scheduled (prescription) drug in dailies, commercial journal and electronic media are prohibited or consered as unethical to medical profession by Medical Association/ Drug manfacturers or Regulatory authoritiy.

    Pharmacy deliver printed educative materials of the drug along with medicine supply to the patient. The same material, in a different format, is inserted in each packet of the medicine by the manufacturers. Once pharmacy provide the patient's name to manufacturer, they send the same, in a format of their liking, by post.

    Discontinuation of drug promotion through dailies, commercial periodicals, and electronic media alone can reduce cost of drug.

    P.B.Menon

    July 30, 2009 at 15:25 | Report abuse | Reply
  15. victoria

    Dear Dr. Gupta: I grew up with the Canadian health care system and after living in California for 15 years have witnessed the horror of uninsured and underinsured families and children, a shameful abomination in the developed world. I love the United States, but it looks to me like the powerful fear-mongers are manipulating the public for money, not out of concern for the best interests of the average American citizen. There are oodles of statistics showing how countries with nationalized medicine have healthier populations with longer lifespans than the US – it's time for us to give this a try!

    July 30, 2009 at 15:45 | Report abuse | Reply
  16. Johanna

    Dr. Gupta,
    I know that blood plasma alone is straw-colored, but the red blood cells change color depending on the state of the hemoglobin: when combined with oxygen the resulting oxyhemoglobin is scarlet, and when oxygen has been released the resulting deoxyhemoglobin is darker, appearing bluish through the vessel wall and skin, but what i want to know is if the droplets of blood experience any change itself just as a previously mentioned?

    July 30, 2009 at 17:39 | Report abuse | Reply
  17. Medical Student

    I just wanted to throw this out there for all the "Everyone else in other countries has better access to better care" routine...

    Recently, I took the Step2 Clinical Skills exam. This is an exam where physicians and student doctors come to a designated site in the United States to meet with standardized patients who represent common illnesses to be encountered in practice and take a history, perform a physical exam and then make suggestions for diagnosis and additional tests needed.

    Interestingly, many foreign medical graduates come to take this exam. I had the pleasure of meeting a few. One of the physicians had already completed a residency program on obstetrics – notoriously one of the most grueling, demanding and thankless professions. When I asked him why he would want to come here to the US to go through ANOTHER obstetrics residency, his answer surprised me. I thought it would be because physicians get paid more here. His answer was that it is because the American system is better and the care provided for patients is done right. He said in his country, they get a lot more practice (volume) but the quality is less. I then met a student doctor from Canada. He told me that Canada has a real doctor shortage because no one wants to work there. He said that they graduate far fewer students each year, pay them less and subsidize primary care such as family medicine only if you agree to practice in a rural area. The same is true here, but the salaries are high enough that one could expect to have less of a problem paying off their hundreds of thousands of debt here than in Canada. Furthermore, he said that a lot of his colleagues from Canada, including himself, want to come practice in the US because the system is better, care is better and contrary to what the media, Michael Moore and the far left tell you, access is actually better here in the US! I was shocked! He told me that most citizens do not have a family medicine doctor that they see regularly and that there is a two tiered system where patients with money go and see private clinic doctors. Shocking! Strangely, there were more foreign medical graduates at this session than American medical students. In talking with my classmates, many of them also had similar experiences. Each year, thousands of foreign trained medical graduates attempt to enter the US medical training system because they feel that the training here and the practice of medicine is simply superior here. Why would they do that if their care is so great in other nations?

    Again, to all the people who think it is unfair that doctors get paid what they get paid, I understand your concern. If you want our salaries to come down, push you legislatures to raise taxes to pay for our medical education so that we, like you, are not hundreds of thousands of dollar in debt. Also, push your legislatures to cap malpractice awards and push tort reform so that physicians do not have to pay tens of thousands a year to protect themselves, their practices and their family from get-rich-quick schemers. Lastly, do no demand of your physicians to work the insane hours that we have to work now. No other profession regularly works 60-80 hours a week and often working 30 hours in a 48 hour period and neither should we. Furthermore, you do not want a physician treating you who works like that. Would you want a cab driver working like that (and falling asleep at the wheel as he drives)?

    Will and others who push such anger at doctors – do not make such demands on us and we would not be paid what we are paid. It is that simple. Will, were you forced to take on hundreds of thousands in debt, to train for 14 years (like Dr. Gupta) and to work 80+ hours a week like Dr. Gupta? Do you pay thousands a year for malpractice insurance? We are people, too and the demands you and people like you are making are unfair and unrealistic.

    July 30, 2009 at 19:29 | Report abuse | Reply
  18. Pat from St. Louis

    HAPPY FRIDAY!! WOO HOO
    I have a question regarding the proposed health insurance reform bill. I have coverage thru my employer. Over the years, like everyones employer benefits they have changed drastically. I now have to pay 30% for all charges except for MD visits and preventitive testing. It's very hard to come up with 30% for a MRI which for me was over $450.00 when you leave from paycheck to paycheck. Is there any relief for these types of situations or maybe the goverment sponsered plan could be better than the benefits your own employer offers?

    Thank you for you valuable time spent reading this.
    Have a safe and wonderful weekend.

    July 31, 2009 at 06:41 | Report abuse | Reply
  19. Charles Pitts

    Dr. Gupta – In all the healthcare discussion about the 'government getting between me and my doctor', how is this different than having some HMO giant (whose primary motivation is NOT my health) between me and my doctor? Frankly if I don't pay 100% of all my medical costs myself, there will be SOME entitiy involved. As a Gov't run program, Medicare seems to work (fraud and abuse aside) – or am I fooling myself?

    July 31, 2009 at 08:15 | Report abuse | Reply
  20. Victoria Moyer

    I am a 60 year old woman with diabetes. I own my own business in North Carolina, so I qualify for a small business insurance policy, which is half the cost of a regular policy. So, I ONLY pay $1,250.00 a MONTH for health insurance, which is HALF the cost of what I was quoted for private insurance. While I can pay $15,000.00 a year for health insurance, it is a bit of a pressure point on my budget, and well over the 10% income top that a government plan would cost. The county that I live in has a below average income level, and I am often ashamed of the fact that I pay more for insurance than some of my neighbors make a year. I know that they are probably without insurance coverage, just because of the cost. Something has to been done to correct all of this!

    July 31, 2009 at 08:27 | Report abuse | Reply
  21. Will

    My grandfather was a Dr. and he always said that his oath to serve mankind overrode his desire to be wealthy. Do Doctors today still take oaths and if so why don't they abide by them? Have the insurance companies hijacked the ethics in American medicine?

    July 31, 2009 at 08:53 | Report abuse | Reply
  22. Ann

    We have a HSA will this new health care program eleminate this?

    July 31, 2009 at 09:05 | Report abuse | Reply
  23. GClare

    I worked for many years in the cancer field ex-US and it was difficult–horrible to make it available to patients (much much worse than in US). I'm talking Canada, US, India, Latin America, Africa - all different health systems. A key learning - best way to provide access was to work within the existing system and try to find where it wasn't working and beef that up. The current proposal before Congress appears to be trying to revamp the entire healthcare system and all that will do is shift access problems around - I've seen that happen. Based on what I've seen work - they should steer clear of grandiose "solutions" at the 80,000 foot level and look at very specific problems they can fix - at least first. Both sides could claim victory and it would start helping provide access. The current proposal frankly creates a different health system and I've NEVER seen that work better for the long-term health of a nation. And I'm out of work right now looking for health insurance - but definitely not the one proposed before Congress.

    July 31, 2009 at 10:06 | Report abuse | Reply
  24. Patti

    Shona Holmes has recently been the featured Canadian in a commercial scaring Americans "If I'd relied on my government for heath care, I'd be dead". It has now been reported that she had been diagnosed with a Rathke's cleft cyst (initially in 1998). Is a Rathke's cleft cyst life threatening? As a Stage 3 breast cancer survivor who received prompt and excellent health care from the Canadian Health Care, I am afraid Americans are getting a false impression about a single-payor plan from someone who is misleading them into thinking she was months away from death by a cancer that she did not have.

    July 31, 2009 at 10:09 | Report abuse | Reply
  25. Maureen Mower

    I'm 47 years old, post-menopause, overweight, and suffer from several chronic conditions that have me in constant pain, including arthritis in cervical and lumbar spine, 4 bulging spinal disks, hip and knee problems (undiagnosed), pain in my heels that shoots up my legs after even minimal walking or standing (within 15 minutes), high cholesterol, a fungal infection, rotting teeth & gum disease (hereditary), and a newly developed sun allergy that has had my arms broken out in an itchy, bumpy rash for 2 weeks with no relief in sight (this was from just one episode of sun exposure lasting approx. 15 minutes).

    I cannot have ANY of these conditions treated, nor can I get screenings for breast and cervical cancer, osteoporosis, or heart disease/circulatory problems. I can't even get the broken and loose teeth pulled, let alone replaced with a denture.

    I have difficulty finding work because of my difficulties with walking/standing and even sitting in one position for too long. I also present a rather scary first impression with my lower teeth sticking up out of my gums so far that I can barely speak properly, let alone eat anything other than scrambled eggs and mashed potatoes (NOT the ideal diet for someone with high cholesterol and who wants to lose weight).

    Why am I in such bad shape? I have no health insurance. My husband is disabled and gets Medicare. My son, who is 17, is eligible for SCHIP. I'm the caretaker for my family – but I'm also the one most likely to die suddenly of an undiagnosed illness simply because I can't even get a physical unless I can afford to pay out of pocket for the dr. visit, lab work, mammogram, xrays, etc. – which I can't do.

    I've had 3 jobs since moving to PA several years ago. The first two were with small businesses that did not offer any coverage at all. The third, with a national temporary employment agency, had a plan available – but it was so limited, and excluded all pre-existing conditions, that it was effectively the same as no insurance at all for someone with my health issues. I was laid off in January, so now I've got a small unemployment check that would not cover the cost even if I could take advantage of COBRA to join the plan from my former employer.

    By the way, I am not eligible for Medicaid, even though our family income is barely enough to keep the bills paid. In fact, when we first moved to PA and I had no job yet, we applied for Medicaid based on the fact that our monthly income at the time was only my husband's SSD of approximately $1500/month for a family of three. I was turned down even then because they claimed our income was too high.

    Obviously, I support healthcare reform, and especially a public option that I could take advantage of no matter where I live or work, and where the monthly cost would be based on our income. But what bothers me is that I keep hearing that even if everything is approved the way Obama wants, that option won't be open to me until 2013 or 2014. I honestly don't know if I have that much time.

    Is there anything in the current healthcare reform plans being proposed either in the House or Senate that will help me sooner than that?

    July 31, 2009 at 10:24 | Report abuse | Reply
  26. john

    My income is about $24,000 a year, and I am a single male.
    Under the new health care bill; what would I have to pay for health care per year?

    July 31, 2009 at 11:46 | Report abuse | Reply
  27. MIKE ALEXANDER

    share this information. keep republicans and their allies the insurance companies host. what they don't want us to know.

    http://www.pbs.org/moyers/journal/07312009/watch3.html

    August 1, 2009 at 01:09 | Report abuse | Reply
  28. Stacy Wardell, RN

    I am a Registered Nurse and would like to know how the new healthcare reform bill will affect nurse patient ratios, if medical assistants will replace LPN's and assume their scope of practice (i.e., medication administration, sterile procedures), and finally, will RN salaries be cut across the board.

    Thank you for your time.
    Stacy Wardell, RN
    Washington

    August 1, 2009 at 02:50 | Report abuse | Reply
  29. Susan Turner

    I was on an employer provided HMO plan. The doctors on that plan nearly let me die by diagnosing and treating me with for an on-going bladder infection. I joined Medicare and my doctor found that I had a stage 4 cancer.

    Medicare saved my life.

    I feel that all Amerecans should receive the same good treatment that I have gotten from the "Government Run" program, if they want it.

    There are rumors that the new Oboma plan would cut the Medicare services that I now receive. Although I have emailed several governement enities, including the president with this question I have never received an answer. The DNC has asked me to help support the proposal but I am in the dark can you hepl please.

    August 1, 2009 at 17:15 | Report abuse | Reply
  30. CORNELIUS VANBOXTEL

    Please read. Could you not have people that make like $5 an hour & then$10hour,then$15 hour,etc,etc Pay say 50Cents a day if making $5 hour $1,a day,for $10 an hour $2 a day if making $15 an hour etc etc. And then have the company match that 3 to 1 .Now these prices are just an example .But would spread the burden evenly . This would give a great contribution to paying for health care , without putting the burden on all the rich people. The amount that you would have to pay could vary acording to how much you make . I really think this could be a way of solving the money problem . PLEASE get this into the right peoples hands before it is to late .

    August 1, 2009 at 17:26 | Report abuse | Reply
  31. Sylvia

    Can you comment on dr Kiran Tamirisa's post? I find it fascinating that we trust insurance companies and politicians that fight for their livelihood. We must wean ourselves off employer provided health insurance. It is bad for patients, bad for doctors, bad for businesses, bad for economy, bad for health of the nation, it is outright BAD.
    Go with government run alternative! Republicans say they don't want it and actually admit that the reason is that it may actually work!!!

    August 1, 2009 at 17:39 | Report abuse | Reply
  32. jessica marston

    my husband is 29 years old and has DOUBLE COVERAGE HEALTH INSURANCE and is in DESPERATE need of two disk replacements (right now as we speak it is bone on bone) but can not get either one to cover the surgery,Every one comments on how most American people are satisfied with their health insurance,but what happens when they need a major surgery and are DENIED like my husband? WHAT DO WE DO?

    August 2, 2009 at 12:19 | Report abuse | Reply
  33. Lauren R. Wheeling, WV

    Speaking of rationing health care; would people with more important jobs, better education etc., be given better health care? Would a cancer patient working at a convenience store be given less care than an engineer? On paper, this makes some ligical sense, but it makes me sick to my stomch to think bioethisists could someday rationize such actions.

    August 2, 2009 at 16:37 | Report abuse | Reply
  34. stephen thompson

    I am a person living with HIV. I live in rural north Alabama and am covered under Ryan White insurance.I live 2 hours away from the clinic that provides me care as well as my life saving medication. Some months I wounder if I will have the gas to get to the clinic to pick up my medication. I have missed doctor appointments because of a lack of transportation. I work full time and would like know how the current bills being considere by congress will affect me. I would like to have the option to purchase health insurance that will allow me to see a local doctor. I would like to be able to pick up my medication at a local pharmacy. Will health care reform give me these two options? Or will I be forced to keep Ryan White insurance and continue to worry weather or not I can pick up my medication each month?

    August 3, 2009 at 06:13 | Report abuse | Reply
  35. Chad

    Who is to blame for the high cost of health care? A lot of blame is laid on insurance companies, but I see the charges from my doctors and for my prescriptions and they are extremely high. Insurance companies claim they add 10% cost to the system. Who is addressing the other 90% of the cost? How is the current reform going to curb these costs?

    August 3, 2009 at 09:06 | Report abuse | Reply
  36. Stacy Wardell, RN

    With healthcare reform, I'd like to know how it will impact nurse patient ratio, and coming from a surgery background, would like to know if patients who are having elective surgeries will be put on a waiting list. Further, how will the healthcare reform bill affect nursing salaries?

    August 3, 2009 at 10:53 | Report abuse | Reply
  37. Gareth Armson

    Dear Dr. Gupta,

    I am a single, healthy, 23-year-old graduate student in Minnesota and I am still on my parents' health care plan provided for my mom by her employer. As far as I know, Minnesota allows insurance companies to drop my coverage when I turn 24 in December. I expect that our carrier will jump at such an opportunity.

    Should I begin searching for another health insurance option now, expecting that my coverage will be dropped in December? If so, how likely is it that the government's health insurance plan will be available to me by then? Lastly, assuming the government plan isn't possible by then, how much should I expect to pay for a standard health insurance plan?

    Thank you,

    Gareth Armson,
    Minneapolis, MN.

    August 4, 2009 at 08:15 | Report abuse | Reply
  38. A L Smith

    Dear Dr. Gupta,
    I am a Medical Technologist at a conservative community hospital. Even in such a conservative organization, there is an amazing amount of wasted supplies, people with jobs that aren't necessary and general accepting of poor practices. I rarely hear any comments from politiciansabout reforming the alarming amount of .waste in medicine. Is this going to be addressed?

    August 4, 2009 at 08:18 | Report abuse | Reply
  39. Alan T Falkoff, MD

    How Healthcare Should be Reformed

    Medicare is Broke
    Medicaid is Broke
    Social Security is Broke
    The Government can’t even run the Cash for Clunkers Program correctly
    How can the Government (single payor) ever run something so complex as Healthcare?

    Katherine Sebilius and the Senators with her in Hartford, CT got HAMMERED!

    They keep harping on 47 Million Uninsured. They were called out as liars.
    Even if it was so, it likely is true and likely underestimated, however, it still only represents 10% of the U.S. population.
    So they will “reform” Healthcare to cover the 10% that likely will make things worse for the 90% who do have coverage.

    Systems in place should be:
    Cap on Insurance Company Profits

    Anything in Excess of Profit should be turned around to fund the uninsured and underinsured

    Catastrophic insurance, and subsidize it if necessary, should be the ONLY mandate

    No demands on businesses to purchase insurance insurance for all employees.

    Employer choice but tax credits to small to large businesses for contributions towards employer payment of Healthcare Insurance.

    No pre-existing conditions should prevent patients from getting or changing insurance, but at the same time will have to make certain while the Insurance companies will have to accept all comers, they can not just set premiums at any price they want – must have premium controls otherwise all they will do is accept all people regardless of preexisting condition, or claim that of course they do so, but they control the premium costs which ultimately will still put insurance out of reach for those patients with preexisting conditions.

    Improve reimbursement to Primary Care – Immediately, and increase this by 100-150% of present level. Only this will enable Primary Care to survive, thrive, reinvest and become
    a career that would encourage future generations of quality Primary Care Physicians. Encourage quality by thoroughness and comprehensiveness of care, which can only also
    be done by limiting Practice volume, Practice population size.

    Subsidize Healthcare IT Adoption, Integration and ongoing support for All Physicians – but get this into the hands of Primary Care now (presently the biggest adopters of Healthcare IT at 24-27%, while the rest of medicine is still at 10-18%).

    Medical School Students and College Student loan forgiveness to those who go into Primary Care and sign an agreement to remain in that field for a minimum of 3 years.

    Allow Physicians to once again choose the best therapies for their patients. It does not mean that just because there is a Generic drug that “does the same thing” and that
    it is cheaper, is the most effective and appropriate treatment for an individual patient. The converse also is true, just because there is a new brand name drug doesn’t mean
    that it is better than the generic. This choice has to be left up to the Patient-Physician evaluation and NOT driven by Formularies who’s only reason to exist is to control
    treatment choice and preserve Insurance Company Profits (directly) and increase Pharma Profits (indirectly), it is NOT controlling costs. Not every generic drug is as effective
    as a brand name drug for a particular patient and may indeed affect outcomes. It is not enough to prescribe a Generic Beta Blocker, that does not get as good documented
    blood pressure control than a Brand Name drug, or one for elevated Lipids. For if the patient suffers for a delay in adequate treatment what have you gained other than cost
    savings at the risk of patient goals and in the case of pain meds as well, patient suffering. Is it fair to make patients wait through titrations of generic medications, to relieve pain or get them to goals that will prevent future illness and complications? I think only the patient and the physician in the exam room can truly make this choice.

    Education of the public that every treatment all the time, every test, multiple second third fourth fifth sixth opinions is unreasonable and costly. This is not truly rationing just practical utilization of healthcare resources.

    Education of the public to reduce poor, unhealthy behaviors (smoking, obesity, sedentary lifestyle, alcohol, drugs, dangerous activities, etc…) and promoting and ?rewarding healthy
    behaviors.

    Help physicians and the public accept appropriate standards for end of life care, futile care, terminal care treatments.

    MUST have TORT reform.
    Must have Medical Malpractice Premium price controls.

    Must stop having Turf battles on Scope of Practice between Nurses (RNs, LPNs, CNAs), Medical Assistants, APRNs, Physician Assistants, Physicians etc.

    Physicians have vastly different training and experience that can not be equated with the education and experience of these other Healthcare professionals.

    If Nurses, APRNs, Medical Assistants, Physicians Assistants want their scopes of practice to reach into Medical Care at the level of Physicians, then they should apply to and go to Medical School and complete Residency Training Programs.

    Capping Pharmaceutical Company Profits. Any excess, such as described above with the Insurance Companies, goes into funding the Uninsured and Underinsured.
    Limit Pharmaceutical company direct advertising to Consumers.
    Change the patent process for Pharmaceuticals. Decrease the length of time a medication can remain on patent, unless that product is show to meet certain standards
    of being significantly outside the effectiveness (better) than most all other drugs in its group / class. But these drugs that remain on patent must decrease in cost
    each year towards the end of the patent time frame.
    Tax credits to certain limits for Research and Development.

    I am sure there are a number of other issues that I will realize that I forgot once I post this, but we can get to them later.

    Especially ways to handle Pharmaceutical, Insurance Company and Medical Device manufacturers processes.

    Now how do we get this information in to the Media and into the Public Mainstream and up to the Governmental Levels?

    Sincerely,
    Alan T. Falkoff, M.D., D.A.B.F.M., F.A.A.F.P.
    High Ridge Family Practice
    30 Buxton Farms Road
    Suite 210
    Stamford, CT 06905
    (203) 322-7070
    http://www.HRFP.net

    Confidential: The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this E-mail transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you.

    August 4, 2009 at 13:40 | Report abuse | Reply
  40. Ronald Holness MD

    Dr. Gupta,
    In a recent interview you mentioned in response to a question about Doctor's fees that in some localities Medicare might pay $6000 to 17000 for the same surgical procedure. I am a surgeon and have never heard of this level of reimbursement. Can you please give an example of what procedure would pay so well? Also please let me know which state pays so well- I would immediately move there.

    Ronald Holness MD Los Alamitos,CA

    August 4, 2009 at 13:57 | Report abuse | Reply
  41. donel wagner

    I AM 65 years old and a 12 year simultaneous breast cancer survivor. while i am legally blind and not allowed to drive i still volunteer with breast cancer. i have a question for you. mammograms are covered as preventative but lots of women in idaho do not get them either because of no insurance AND WOMEN;S HEALTH CHECK PROVIDES THEM FREE TO SOLVE THIS PROBLEM BUT WOMEN STILL WON'T GET MAMMOGRAMSBECAUSE IF IT COMES BACK 'BAD'" THEY CANNOT GET ANYTHING DONE ABOUT IT SO THEY WOULD RATHER NOT KNOW. HENCE, NO MAMMOGRAMS. THANK YOU IN ADVANCE, FOR YOUR FEDBACK IN THIS SITUATION.

    August 4, 2009 at 15:29 | Report abuse | Reply
  42. Caryn Carter

    Health care reform needs to be done, but there are way too many ideas on how, and even those who do not want it at all. I kinda like the idea of a public option, however I am wondering if this option would be anything like Medicare, Medicaid, or the Basic health plan, for one? Second, I wonder how much insurance companies are spending on negative ads for healthcare reform, lobbyist, and campaign contributions and if this money could be better allocated to cover larger portions of their insurance obligations to their consumers or to even add on consumers with preexisting conditions? Third, I want to know if the public option is anything like Medicare or Medicaid, and if so, how can we afford it when we already have Medicare going broke?

    August 4, 2009 at 17:46 | Report abuse | Reply
  43. Jennifer John

    Hello Dr. Gupta, I was wondering if President Obama's health care plan will include TMJ? I am a professional violinist/teacher and have had TMJ since I was a teenager.
    I have not found any dental or health insurance plans that will cover this problem and feel that I do need to have my jaw looked at by a health care professional before I develop more serious issues such as arthritis. My dentist suggests splints which start at $600 that may or may not work. I have a friend who is spending over $40,000 to fix her jaw and insurance does not cover any of her expenses. (not an option for me at that price)
    If I was walking on my jaw, not only would I look funny but I am sure that I would not be able to walk at all. Why is TMJ not covered by dental or health insurance plans?
    Thanks for all of your great insight on CNN. You are fantastic! Jennifer

    August 5, 2009 at 13:13 | Report abuse | Reply
  44. Mr. Willie L. Wade III

    Will the reform include reforming the antique
    benefit evaluation scale for the military? The scale used now is not up to speed for illness/ disease that are coming out these days. I have malaria from military service, and can't get private insurance due to a pre-existing condition. The VA, says it is less than10%, and non-compensable. What now?

    August 5, 2009 at 14:14 | Report abuse | Reply
  45. Debbie Iding

    Dr Gupta, I am very concerned about the press I am hearing that the elderly will receive severely curtailed care under the proposed health care plan. Also will be forced to take end of life counseling every five years and more frequently if diagnosed with a serious illness. Can you sort out what it true versus what is political fear mongering?

    August 5, 2009 at 22:12 | Report abuse | Reply
  46. NJ

    ABOUT A YEAR AGO LEGISLATORS TRIED TO PUSH A BILL IN SUPPORT OF GREATER AWARENESS PREVENTATIVE AND INTERVENTIVE CARE FOR POP (PELVIC ORGAN PROLAPSE). AS A PATIENT WHO HAS SUFFERED LOSS OF A CHILD DUE TO NOT BEING GIVEN RHOGAM INJECTION DURING SECOND PREGNANCY AND AS A WOMAN WITH POSSIBLE NEED FOR UROGYNECOLOGICAL SURGERY; I WOULD LIKE TO KNOW HOW REFORM WILL ADDRESS ACCESS TO QUALITY CARE IN PROACTIVE RATHER THAN REACTIVE WAYS TO PREVENT UNNECESSARY LOSS OR INJURIES. I HAVE HAD DIFFERENT TYPES OF MEDICAL COVERAGE AND HAVE FOUND THAT GREATER CARE COMES ONLY AFTER SOME INJURY/LOSS/ SERIOUS RISK IS IDENTIFIED....I WOULD LIKE TO SEE MORE PREVENTION BUILT IN TO HEALTH CARE REFORM. SOCIOECONOMIC STATUS DICTATES TO SOME DEGREE THE LEVEL OF CARE ONE HAS ACCESS TO. THIS IS AN UNFAIR REALITY. EMPHASIS ON FRONT END COSTS IN SCREENING AND EDUCATION SHOULD BE INCORPORATED TO SAVE BACK END COSTS OF TREATMENT FOR ILLNESS OR INJURY THAT OS PREVENTABLE. I WOULD ALSO LIKE TO KNOW HOW REFORM MAY IMPACT PHYSICIAN EDUCATION PROGRAM STANDARDS/PRACTICE STANDARDS. THERE IS A GREAT NEED FOR BALANCE IN ACCESS TO QUALITY CARE AT THE APPROPRIATE TIME. FOR WOMEN ACCESS TO SCREENINGS AND EFFECTIVE DIAGNOSIS CAN PREVENT SO MUCH SUFFERING. PLEASE ADVOCATE FOR EQUITY ON BEHALF OF WOMEN'S HEALTH BEYOND BIRTH CONTROL/ABORTION.

    August 6, 2009 at 02:27 | Report abuse | Reply
  47. Frank Olbrish

    Dr. Gupta,
    First I want to thank you for the service you provide the USA. I have watched your show for as long as it has been on CNN and it is great. I also wish that you would have accepted the US Surgeon Generals position.

    On July 10, PBS-TV host Bill Moyers interviewed former health insurance insider Wendell Potter. It was a most compelling show. Would you please consider bringing Mr. Potter onto your show. My hope is that this part of the health care story could be seen by a wider audience.

    Thank you,
    Frank

    August 7, 2009 at 09:19 | Report abuse | Reply
  48. Lee

    By any chance does health care reform include regulating the Long Term Disability carriers who arbitrarily deny well documented claims for patients with life altering disabilities and sometimes terminal diseases. At this point there are no penalties for insurance companies like CIGNA for repeatedly denying patients the benefits they paid for in the event they fell seriously ill. It's almost impossible to get anyone to listen to you unless you have an attorney. And getting an attorney – most don't work on contingency – at a time when bankruptcy is in your very near future because you have no income – is not realistic for most. The disabled need an advocate who will take up their cause. We were hard working individuals who contributed to society and by no fault of our own have been adversely affected by illness and then compounded by financial ruin. Please help. Thank you.

    August 7, 2009 at 12:01 | Report abuse | Reply
  49. Victoria Nikolov

    Ruin Your Health With the Obama Stimulus Plan: Betsy McCaughey ...(Betsy McCaughey is former lieutenant governor of New York and is an adjunct senior fellow at the Hudson Institute. The opinions expressed are her own.) ...
    http://www.bloomberg.com/apps/news?pid=20601039&sid...

    The above is the only qualified person who has read the bill three times and believes it is the worst bill to impose on free Americans. .Betsy McCaughey should be on the show every day with Dr. Gupta to answer questions. That is of course if you really DO want people to know the TRUTH about Government run Health Care. Let's just see what you want known.

    August 7, 2009 at 22:06 | Report abuse | Reply
  50. Sheri Webster

    What will the new health care plan do to Anesthesia reimbursement and why will it be any different than other medical specialties?

    August 9, 2009 at 00:02 | 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.