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tv   Sanjay Gupta MD  CNN  December 11, 2011 4:30am-5:00am PST

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>> another day, man. another day. >> anybody who sees this -- at the end of the day, we're the ones out here. >> i'll be back with more live news at the top of the hour. right now the good doctor. good morning. welcome to "sgmd." this morning i'm sharing an amazing piece of the past and also trying to sort through the a health insurance mess. a life--saving treatment but the insurance company says no. when the bill came, it was more than a million dollars. if you like science, you might know that animals like bats and dolphins can navigate by sound. we recently came across something remarkable. a man who trained himself to do the same thing. plus, would you deliver an electric shock just because a
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scientist told you to push the button? the experiment that shocked us all. now a man who was there is speaking out. millions of americans know what it's like to wrestle with insurance companies. i cover these stories a lot. what you're about to hear is a problem that i have never run across before. something quite like this. in 2008 the woman you're going to meet was diagnosed with a rare autoimmune disease that caused a scarring on her insides. it was choking off her trachea, her windpipe and her ability to breathe. she was treated at the university of miami hospital. her doctors believe that the treatment that she received there kept her off a breathing machine and probably saved her life. but she was left after all of this facing bills of more than a million dollars. now her story is complicated, but we want to try and break this down because we think it's important. there are some important lessons here. i'm being joined from miami. thank you for joining us. it's a remarkable story. i want to ask, how are you feeling? i understand the condition you
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have is a life-long condition. you've started more treatment recently. how's it going? >> it's going good. i've been into the second half of the treatment for two months. i go for another treatment next week for two days. i'm hoping to make a difference in how i'm feeling. it's an ongoing process. >> i want to sort of break this down a little bit for our audience, the simple version of what happened here. you received this treatment initially and insurance said it was covered. six months later, and i have a letter right here, they notified the hospital that, no, the claim is being denied, that essentially you were on the hook for about $50,000 per treatment. a few hundred thousand dollars at that point. you didn't hear about any of this for another year, is that right? do i have that right? >> yeah, that's correct. i was notified approximately 19 months into the treatment that the provider would not be
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covering the treatment and that i was essentially responsible for everything that had been previously billed to them. >> just to reiterate -- >> at that point -- >> it was a treatment your doctor recommended. it was a treatment that the insurance company initially approved and then you started getting these letters saying you're essentially on the hook. you got other letters, explanation of benefits letters showing that you could face billions, $1.2 million in total. the insurance company eventually paid the hospital $382,000 and settled the case. you're no longer on the hook for that million dollars. you know, it's a little hard to believe. i mentioned off the top, joan, as you heard, i'm a doctor. i treat patients. i get things preapproved on behalf of my patients all the time. i haven't run into a situation like this exactly. we asked the insurance company what happened here. this is what they wrote for us. i'm going to get your reaction. they say based on our review, this service is not approved because it does not satisfy the
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criteria for establishing medical necessity and appropriateness. they say there was a patient benefit booklet that specifically outlined the benefits that would be covered and that are appropriate. i'm sure you've seen letters like. this i'm sure you've been told this. what's your reaction to that letter? >> correct. i have that letter, and they told me it is not a covered benefit. i did ask for a booklet. i never received that. i still haven't received it. they do cover the treatment. it is an approved treatment for other illnesses, and they certainly do cover it for the other illnesses. they're saying that my illness specifically is not covered because it's not medically necessary. >> again, joan, we're not talking about people who don't have insurance. we're not even talking about people who were denied a claim. your claim was actually approved initially and then not approved and you were on the hook for a lot of money for a period of time. i'm glad you're feeling better. i'm glad you're getting the treatment.
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i hope we can check in with you to see how all of this goes. good luck. i think there's a lot of lessons that we're going to talk about. >> thank you very much. >> thanks, joan. now it's not usually a million dollars but it's not uncommon for insurers to roll back approval of claims they've already paid. we asked patient advocates specifically about this. they told us unfortunately, oftentimes there's not much you can do to protect yourself. what you can do is make sure your doctor gets a treatment pre-approved before starting. if coverage is denied before or after treatment, you have a right guaranteed by federal law to appeal. at that point your best advice is to get help from your doctor or from a nonprofit group that specializes in these cases. it's very frightening sometimes. they put a lot more information about this at cnn.com/sanjay. up next, a blind man who has taught himself to see using sound. ll getting dandruff? neutrogena® t/gel shampoo defeats dandruff after just one use. t/gel shampoo.
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[ male announcer ] enbrel. the #1 biologic medicine prescribed by rheumatologists. if you like science you might know that animals like bats and dolphins can navigate by sound. they use sound waves to help them find their way around the environment, even in the dark. we recently came across something we thought was pretty remarkable. a man who has trained himself to do the same thing. it's hard to believe, but seeing, and in this case hearing, is believing. >> the view. what is the view to a blind person? many people very much mistakenly, very much mistakenly, and tragically so, assume that the view means nothing or little to a blind person. a view is a composite of experiences.
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that's what people enjoy, even if they're not conscious of it. i have been echo locating for as long as i can remember. if my parents think back, i lost my first eye at seven months, my second eye at 13 months. i was probably clicking by the age of 15 months. so i don't remember learning to click. i don't remember really learning to echo locate. around here there's not lots and lots to detect, but immediately there's this pylon here. i think i can -- there it is. then there's an object about 20 feet away here and another one and another one about, i don't
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know, 50 feet away. the process of echo location in humans is very similar to the process in bats. in fact, it's virtually identical to that of bats. we're talking about airborne sonar either way. a bat can detect an object the size of a gnat from so many meters away. for me it has to be at least the size of a softball. we tend to teach the use of a discrete tongue click which can be as quiet as -- or as loud as -- or even louder as need arises. it's like seeing with dim flashes of light. our approach is well-supported in many arenas in many respects. at the same time, there is a lot of controversy and a lot of skepticism relative to our approach. it takes time for the established convention to
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recognize and to embrace anything that's new. convention by its nature adheres to itself and rejects what is not conventional. quite frankly, it isn't that difficult to teach. it really isn't. so i believe that the brain is already at least partly wired to do this. all that has to happen is the hardware needs to be awakened, activated. we believe we've found ways of doing this. >> daniel kish who lost his own sight at 13 months has founded a nonprofit called world access for the blind. he's teaching the technique. i'm told this is tremendously difficult and should be considered an experimental approach. not necessarily a solution for everyone. up next, though, a lesson in pursuing your passion no matter what. i love these stories. you'll meet a cancer patient who has his sites set on running marathons in all 50 states. dumb luck? or good decisions?
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he just turned 70. >> reporter: his career spanned engineering. being a company vice president and the law. at age 62, he discovered a new passion -- marathons. eight years ago, just days after running his first 26-mile race, though, he got some devastating news. >> i had gone to the doctor a couple of times for pain in my back. it was multiple myeloma. >> reporter: this is a cancer of the blood, where the white blood cells invade the bone marrow causing pain, usually in the back or the ribs. patients are rarely cured. but wright refused to let that slow him down. even qualifying for the boston marathon. >> i got this devastating diagnosis. my family and i, we just kept on going. there wasn't any reason to stop and be sorry, you know. we kept running marathons. >> reporter: incredibly now in the last eight years, wright,
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who's now 70, has run 60 marathons in 41 states. his wife and daughter have been by his side for most of them. his goal is to run a marathon in every state. >> after boston we started to pick off states, never imagining -- well, imagining it, yes, but never expecting to be able to finish all 50. now i'm really hoping for it. >> reporter: never expected that he could fulfill his dream because the median survival for his cancer is just five years. he's had a number of treatments that failed, but for the last three years wright's taken an experimental drug. it's one pill at night and it's kept the cancer at bay. >> it doesn't cure the cancer, but it keeps it stable so it's not hurting me. i can still run, and i can still enjoy life. i'm riding that for all it's worth. >> reporter: he has advice to others facing what's seemed like insurmountable odds. take charge of your destiny and
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never give up hope. you know, don wright isn't making any excuses about his health. how about you? why not consider joining us on the 2012 cnn fit nation challenge. you can log on to cnn.com/sanjay. submit a two to three-minute video about why you should be picked to join next year's six-pack. if you're selected, we'll give you everything you need to compete in the race, six months of training, three all expense paid training trips as well. in the end we'll race the nautica malibu triathlon together, that's next september. what do you eat on a typical day? can you take a guess how many calories you consume? that number may teach us something about each other. in a new book, "what i eat around the world in 80 diets," we learned that a simple snapshot of a person's food can tell a story about the
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circumstances in a person's life. >> reporter: this man is a herder in kenya. they have the drought has limited the food supply. today she eats porridge, a banana, black tea, whole milk. 800 calories. head to china. meet this extreme gamer. he lives at his computer station day and night. he sleeps there. he eats about 1600 calories a day, mostly takeout. rice, tofu, chicken. 3200, that's a typical day's worth of food for todd kinser who is a coal miner in kentucky. pop tart, about lobologna and c sandwich for lunch, and hamburger helper for dinner. this man lives on the central east coast of greenland. 6500 is his number. he eats what he hunts. typical day's worth of food for him seal meat, rice, rye bread,
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marmalade. this woman consumes 12,3 hundred calories. she's replaced her food drug addiction with food addiction. >> fascinating stuff. up next, as his biographer calls him, the man who shocked the world. >> 130 volts. [ scream ] >> it is difficult to watch, but we're marking the 50th anniversary of the famous obedience project. his graduate research assistant's going to be joining us with the inside story, next. our pipes just don't work as well as they should. sometimes, i worry my pipes might leak. but i learned there's something more i can do. now, i take care with vesicare. once-daily vesicare can help control your bladder muscle and is proven to treat overactive bladder with symptoms of frequent urges and leaks day and night. if you have certain stomach or glaucoma problems, or trouble emptying your bladder, do not take vesicare. vesicare may cause allergic reactions that may be serious.
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obedience to authority. the experiment was outwardly a study of memory and learning but the whole thing was rigged as we learned afterward. the volunteer would always assume the role of teacher and one the associates would be a learner. the teacher was instructed to deliver an electric shock to the learner every time he or she answered a question incorrectly. pressing a button would deliver a shock, everything from a light shock to a moderate shock, strong shock, intense shock, extreme intensity shock. look here at the very end. these switches were literally labeled "xxx," the danger shocks, maximum possible shock -- 450 volts. and it was remarkable as we learned how many times that button was pushed. the danger shock. but the learner wasn't actually being shocked at all. here to help explain what this was all about, allen elms, a graduate research assistant at
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yale university 50 years ago and he helped run the experiment. thanks for joining us. i've been fascinated by this study for some time. these people thought they were delivering shocks. people would moan, act as if they were getting shocked. what was your first imprex when the experiments started? >> i was startled, amazed at the emotional involvement of the people who were participating and also at the extent to which they were mostly willing to shock the victim. >> i mean that i think was the most stunning thing. even when you watch these experiments, beforehand what did you expect to see? you were obviously a graduate student at the time, had some interest in this area. what did you think was going to happen? >> i assumed they would get some obedience but probably not very much and stanley millgram made
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the same assumption. he thought he would need some very fine measures of subjects' responses in order to get any differences between different conditions. as it turned out, he didn't find those at all. all he needed was how many people obeyed completely and how many broke off at some point before the end. >> the study was in some ways a study about obedience to authority. and as you know, mr. elms, the vast majority of people kept going all the way to the end of the shock board even though they were clearly uncomfortable, sometimes the people delivering the shock, they would start fidgeting in their chairs and laughing nervously. let's take a look at how one of your participants reacted. >> 330 volts. 345 volts.
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something's happened to that man in there. we better check in on him, sir. he won't answer me or nothing. >> please continue. go on, please. >> you accept all responsibility? >> the responsibility is mine, correct. please go on. >> i mean it's unbelievable. i mean he's asking, obviously, but he keeps going even after he stops getting any responses from the learner. for all the subject knows, i mean the guy, he could be dead in the other room. i mean did it surprise you in retrospect how many people went so far, as you saw there? >> oh, it surprised us very much, yes. >> i mean were people rationalize their actions? when you talk to them afterwards, did they try to rationalize why they did what they did to you or dr. millgram? >> yes. they tried to rationalize. they tried to deny that they really did as much as they did. they used various kinds of psychological defenses to in
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effect convince themselves, not us, but to convince themselves that they really hadn't done anything bad. >> yeah, i guess that's a good point. the psychological trauma even to the person who is administering the shocks could be significant. here's how stanley millgram himself summed it up. take a listen. >> the results, as i observe them in the laboratory, are disturbing. they raise the possibility that human nature cannot be counted on to insulate man from brutality and inhumane treatment at the direction of malevolent authority. >> a lot of people who concluded do what they're told if they perceive the command comes from a legitimate authority. if a person they never met before can convince them to subdue a 50-year-old man with pain and shocks against his protests, mr. elms, what do you think that this experiment taught us about ourselves as a society? >> well, what it taught us essentially was in the words of
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the title of the novel by sinclair brutis, it can happen here. that is the main point, i think. we knew that things like that could happen in a place like germany during world war ii. but stanley showed that just average americans could potentially be obedient through destructive authority as well. and to what appeared to be very destructive authority. >> it's a fascinating study as i told you, a frightening one as well. i appreciate your time, mr. elms. this study is something i've known about and thought about for some time. i appreciate learning more about it from you. thank you. >> okay. i appreciate you talking to me. >> all right, mr. elms. we'll be right back. act my age?
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sunday night i'll be live at cnn.com, backstage at "cnn heroes." it will go from 8:00 to 106:00 p.m. eastern. you can scan this code over here to get a jump-start on the action. it's really amazing. take you to a site where can you meet the top ten cnn heroes, learn about their causes and even donate. the program itself is hosted by my colleague anderson cooper and

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