being a people. >> we really need to figure this out now. communities living in danger all over the world. >> only on al jazeera america. on america tonight a miracle drug that can save the lives of millions of americans if they can afford to pay for it. the doctor has told you you're sick enough and the tests and the insurance company says?

we've heard a lot about transcription drugs. you will remember the disturbing story of the price of a fill jacked up five thousand%. produce gouging from those most desperate to be saved but what are we willing to pay for the amazing things that can save lives. the end stage of the disease is horrible. it can take decades for sirosis to destroy the live. >> there are an unpleasant ways to die but this is certainly unpleasant. the bleeding in particular that can happen both internally and then outside can be extremely difficult to control > it can reach the brain. >> it really requires a lot of specialized care, it can be very painful, is really difficult to

watch if you're a loved one and watching someone suffer two of the most common causes of liver disease in the united states are alcoholism and hepatitis c, a blood born illness often spread through dirty needles. an estimated three million americans have the hepatitis c virus and experts warn most of it. >> i didn't know until i had a hip replacement in 05. so they had to do preliminary blood work, dental work, blah, blah, blah. that's when it came up hepc positive she said she traced her infection back to a tattoo. at first she didn't realise how serious it was. >> every

now and then i feel lethargic, like . if you get this, that's it. i'm not ready to die. >> reporter: under treatment for other unrelated health problems, she asked her doctor about a new hepatitis c drug she saw on tv >> he explained how much, it's the latest things, everyone is using it, it can treat you in eight to 12 weeks and it's a cure. no remission about it. it is a cure. so i got really excited about it and then >> reporter: what did you think about this drug? reporter: before you get sicker >> before i get sicker. >> reporter: harvoni and

another drug have proven to be much more effective than old hepc terre therapys which clues well over 90% in three months of treatment or less, but the cost of the cure is patient. >> it's very expensive. so even if there is a cut rate discount, it's still expensive. >> reporter: this is her doctor. like most of his low-income patients at the john bell health center, his health care is medicaid. >> we treat predominantly all inner city, low income . >> reporter: that means taxpayers and cash strapped states are left to foot the bill. across the nation states have quietly thrown up road blocks. most states have added

restrictions that delay or make it difficult for hepc medicaid patients to get their treatment. her application was rejected four times. >> denied completely because harvoni is not medically necessary because you do not meet the hepatitis c criteria. >> reporter: translation. the provider is telling her it won't pay for the mirror axle drug until her liver disease gets worse. the doctor has told you you're sick enough >> yes. >> reporter: the tests show you're sick enough >> yes. >> reporter: the insurance company says?

health care for the poor, it is a pragmatic and necessary decision. mat sailer's organization medicaid. >> if we were to simply open up the doors and say, yes, everyone who is suffering from this disease at any stage, at any condition, everyone gets it, we would be spending as much on that one drug as we would on every other single person in the program combined. >> reporter: you're going to bankrupt the system >> yes. we would have to figure out a way to stop providing as much nursing home care for frail seniors, stop providing as much prenatal care for pregnant women or something else. >> reporter: so you're telling society we've got to choose >> medicaid has to choose every day. we cover 70 million americans and we do so under very, very

constrained budgetary parameters. >> reporter: he says even though pharmaceutical companies are required by law to negotiate with medicaid programs, the maker of the break-through hepc treatment resisted giving the states much of a deal >> they didn't really want to play because they didn't have to. because they knew that they had the product, the law was-- >> reporter: the only product >>. the only product that works behind them so they can say, no, we think you will pay our price because we think um have to >> reporter: the drug maker declined an interview, but in an email defended the price of its treatments arguing that the one cost of this pales in comparison to the lifetime cost of treating the disease, but with drug costs already as much as 15% of state medicaid budgets, more mirror axle drugs, hepc drugs could be just the first test of how far

americas's health care budget can be stretched and who se cure is prepared to pay for. >> people who are not paying into the system, many have attracted the disease due to their own behaviour and that they are potentially going to continue to pursue health threatening behaviours, even once they're cured of hepatitis. it's a real issue >> reporter: the argument doesn't hold water with this man who must treat his patients knowing they won't be able to get the medicines that could save their lives. >> my job is to make people feel better and try to cure diseases that we can cure and so when you know you can do that but you can't because of availability, it's - you do, you feel like you're letting someone down >> reporter: he says repeated delays and denials of approval

for hep space pace c treatments for patients is discriminatory. >> a perception of a drug user is the public perception, doing it to themselves, so why should we spend money on that. do we withhold to cardiac surgery to people because they have high cholesterol, because they're overweight. no. we don't do that. so we shouldn't withhold again curative life-saving therapys for people who have another underlying condition. >> reporter: this woman who has no history of drug use sees the denials of proof insurers don't care if she lives or dies. >> i think that's what the insurance companies want you to do, they want you to get discouraged. >> reporter: she isn't about to give up. >> i'm worth having this drug. i'm worth it. >> reporter: even if it's a hundred thousand

>> the only live national news show at 11:00 eastern. >> we start with breaking news. >> let's take a closer look.

millions of american women it's a medical story that raised alarm. as many as throw three out of four

women will have uterine fibroids. the investigation of allegations of a married couple, doctors themselves who say the use of the power morcelator comes with its own potentially deadly risks. >> it is the last place up read, a successful boston person ever expected to be in a hospital ward as a cancer patient, accompanied by her husband who is a boston heart surgeon. she had a rare and deadly form of cancer, stage 4. >> it was a complete shock. when they called me a week later and said are you home alone or is someone with you, i knew prat away that-- right away that that was not a good thing. >> reporter: walking in you felt confident?

how could it be possible? i'd been screened, i'd had tests, i had spoeb to all of the right people. >> reporter: she did have cancer and an especially aaggressive and heart to detect one with a survival rate of three to five years. he had the couple has been waging war ever since, not only against the disease but a routine procedure performed on process. >> when i found that this was a routine standard of care, i knew he were dealing with a hazard >> reporter: what they discovered during a surgery, her surgeon used a device called an mor shall celator to mince it into small pieces.

cells. >> you can see chunks dripping down. it's not a refined procedure. >> reporter: she said she was never informed or consulted for this process. had she known, she wouldn't have allowed it. >> they didn't say your surgery went well, we shredded them up. i learned that my chance of recurrence, the disease coming back, was somewhere in the ballpark of 80% of because of how they handled the tumour. if it comes back, i knew that i had a life expectancy of two years. >> reporter: she has gone surgery. >> my wife was hit in a way that was, as a surgeon i recognised that as a catastrophic hit. if you disrupt the cancer in

someone you make it to a stage 1. >> reporter: it is a very rare cancer, but for women who undergo surgery for fibroids that goes up. for those women this exercise is a risk. this man is channelling his grief into a campaign telling anyone who listening that there is no place for an mocellation. the couple first took their concerns to the people at the hospital where amy had her surgery and where the husband works. toll. >> we went to the women's hospital and said this is happening, this is going on, what are you going to do about it and they shut us out and shut him down. basically told them don't come back to work. >> reporter: he has been relieved of his surgical duties. he spends the majority of his

time researching and sharing his wife's story. >> the magnitude of the truth of what we confronted there, which is that they're doing this to about a hundred thousand women a year in the united states alone. this happens in europe and south america and other places in the world, so the mass is not small. this is going to be a global epidemic in stage four cancers of women caused by doctors. >> reporter: the hospital declined our request. they did confirm in writing that they have stopped using the implement. many surgeons stand by the procedure. this doctor is the director of surgery at new yorke university school of medicine. she specializes in minimally invasive surgery. she performs over 300 robotic procedures a year.

she says this implement is an appropriate approach >> we don't think it's for everyone, but again everything has some benefits. the implement does have benefits as opposed to open surgery. we can't take the choice away from women. it should be up to the patient and the women. it should be her right to choose whether or not she is going to go through it with minimally invasive surgery or open surgery. >> reporter: associations have to place a ban on the implement, but are asking for more data. they have taken their fight to the media and washington dc, including the food and drug administration which responded with an alert to the medical community. the fda also declined our interview request and referred us to their written statement that read in part:.

this man says the fda warning didn't go far enough >> if i told you that campbell soup was causing cancer, they would be pulled off the shelves. that's a no brainer. >> reporter: nyu says banning the implement would be a mistake >> we have 15 years experience with this. alternatives would be largely an experiment. we're happy to look into alternative sperpts, but it's an experiment. that's the way medicine is >> reporter: you may do so many of these, but i have such and such cancer. i'm the one who is now sick, the one who is dying. what do you tell me when i say i'm that few who is the rare case?

they work with them. same thing could be argued on the other side. take the implement off the table, open her up, have an extensive small bowel adhesion later up. a blood clot in her lung, which kills thousands a year. what about her? what do you say to her?

last fall the fda recommended against it in most fibroid patients. an open letter has been published saying that the fda is wrong and the implement is still needed to save lives. next, blowing smoke, e cigarettes billed as the best way to quit and the warning that they have their own risks. keeping secrets. why that could be hazardous to your health. >> i felt like i was just nothin'. >> for this young girl, times were hard. >> doris' years in a racist, impoverished setting had a major impact. >> but with looks, charm... >> i just wanted to take care of my mom. >> and no remorse... >> she giggles every time she steps into the revolving door

of justice. >> she became legendary. >> the finer the store, the bigger the challenge.

one more story tonight about a cure that comes with added

risk, the e cigarette is an increasingly popular way for smokers to quit. studies have found respiratory disease linked to more than 25% of the chemicals. so they may suffer long damage . lung damage >> no-one know what the health effects are of puffing these things every day for 20 years. >> reporter: behind some of the toughest anti smoking laws in the country. >> we worked very hard to counteract the factor of smoking cigarettes. if the e cigarettes become cool that might be so in the future >> reporter: the dream of a no combustion cigarette began in the 1980s when rj wren olds.

>> an odourless and smokeless cigarette. we will test and market the new high tech cigarettes >> reporter: the company spent three hundred million dollars. it was abandoned in less of a year. charcoal isn't on the menu here. they offer did you sees of flavour shall-- dozens of flavours here. this man helped open the business, his combination with his own battle of smoking. >> i was a smoker for 36 years. i bought one of these and i researched it, saw an opportunity for myself to stop smoking, which i was able to do and then thought it was a great business opportunity. we have just exploded. the world has found out about e cigarette. there is an alternative to smoking a product that kills you and we offer ways to learn more

about that, to experience it, try it and go home with something that is a better alternative. >> reporter: alternative is how you might describe the vibe here, and that image is part of the problem. critics fear the atmosphere will hook non-smokers, especially young one. >> we are all for the law, selling to minors. >> reporter: you sell a lot of flavours, the idea that they would ale to my nors. do you agree with that? reporter: the ingredients

like liquid nicotine is controversial. >> traditional cigarettes kill you. anything we can do to move people away from traditional cigarettes is a reduction and we support that one hundred per cent. we know that kills you. this may not. so let's do all we can to keep the doors open to this product >> reporter: in the absence of hard science, what happens in the long-term is fuelling passion and politics on all sides >> i don't think anybody knows where there is going to go in five or teab years. the tobacco companies are businesses. they want to make money selling whatever they want to sell. they can create a whole market of people who are afraid of these. >> let's keep the door open until there's more definitive evidence against these cigarettes because it might be a way of getting people off the

product that is killing them >> reporter: after a decade, can big toe back co be trusted again? -- co back owe. >>-- tobacco. >> e cigarettes may have the potential under the right circumstances to help millions of people quit. if they were responsibly marketed, if they were responsibly made. e cigarettes could be helpful, but the actions of the e cigarette manufacturers themselves may become the biggest impediment to us actually finding out how helpful they could be that's america tonight. please tell us what you think at al jazeera/america tonight. talk to us on twitter or facebook and come back. we will have more of america tonight tomorrow.

>> we are scared. >>...have an organized right-wing movement trying to kill others. >> if we don't have a verdict by one o'clock it's gonna be another day. >> well it's either gonna be before noon, or they get to come back at one thirty. >> the waiting is what will knock you for a loop. if she goes to jail again i think she'll come out in a body bag. >> are they out?