and people in new york city neighborhoods are fed up with gun violence. they're starting something new. they are occupying the most dangerous street corners in each borough to see no more killing. the reverend al sharpton is one of the organizers of the movement. he calls it a symbol of the community's outrage over the bloodshed. i'm randi kaye, i'll be back at the top of the hour. "sanjay gupta m.d." begins right now. ♪ hello there, and thanks for being with us. a remarkable story about a big hospital chain, one that you've likely heard of, accused of doing heart procedures that were unnecessary just to make money. question for a lot of people -- what can you do to protect yourself. first we want to make sure you're up to speed on an important fight over medicare's future. plans put forth by mitt romney

and his running mate, paul ryan. one of the most divisive, important issues of the upcoming election. it's important for you to be educated so we're putting them under the microscope. ever since it was signed into law by lyndon johnson in 1965, medicare has been the safety net for americans over the age of 65. it provides health insurance for 47 million americans. now big changes are on the table. >> the truth is we simply cannot continue to pretend like a medicare on track to become bankrupt at some point is acceptable. >> reporter: mitt romney says his changes would not affect current seniors or anyone nearing retirement. but down the road, medicare would be mostly privatized. you'd get a government voucher to buy your own insurance. you could pick the medicare program like we have it now, or you could buy private insurance. and here's a key point -- in the budget drawn up by romney's running mate, brian, the size of the voucher would not grow as

fast as health care costs have grown in the recent years. >> great. will do. >> reporter: even if that point doesn't affect seniors now, it does make some of them nervous. >> is that voucher going to be enough to take care of your medical needs with the costs going up -- up and up? >> reporter: teresa walker is 67. in march, 2011, she discovered she had cancer. medicare covered most of her chemo and radiation therapy, and today she's back it her active self. >> if i did not have medicare, i don't know if i could survive. and when you're on a fixed income, you know, there's other things that you have to pay for. and i wouldn't be able to live. >> reporter: democrats think this is a winning campaign issue. but so do republicans. >> we want this debate. >> reporter: romney and ryan say competition, consumer choice, is the only way to push down costs. so that medicare can survive. and joining me is jonathan cone,

welcome back to the show. he's a senior editor at the "new republic" and author of the book, "sick." he's a supporter of the president's health care law. he's been following this closely trying to keep everyone honest which is what we try and do, as well, jonathan. welcome back. thanks for being with us. to be clear because i think a lot of people are paying attention to this -- they're not actually getting rid of medicare. they say that there's no changes for anyone 55 or older. but people beyond that are going to get a voucher from the government buy their own insurance. they can also stay on medicare. and my understanding is, tell me what you think, the thought is that this will create a more competitive market and that could help lower costs. >> right. that's absolutely true. and the theory behind what ryan, what republicans want is they believe, you know, changing medicare from the single government program that most people will enroll in to a system of multiple plans competing with each other, and then medicare, the old medicare

program just as part of the mix is that competition by itself will reduce prices. the question is, let's say the competition doesn't work. at that point -- say medicare keeps getting more expensive, you have this voucher, and the voucher is set at a certain value, and it's going to go up by a fixed formula every year. say at some point it's not enough to pay for a good insurance policy, what happens then? in the republican ryan approach, that is a fixed voucher. there's no changing that. if the voucher doesn't pay for a good insurance, individual seniors have to make up the difference somehow. >> for example, they say seniors on average pay 25% of their health care costs. it could go up to 68% over the next ten years. i keep hearing and it's an important point, if people are not as insulated from their

health care costs, they're more likely to pay attention to the health care costs, and that's also an important driver to bring health care costs down. do you think that that's important and that would work? >> i think there's a hot of evidence to suggest that the more you -- force people to pay out of their own pockets, the more careful they're going to be how hay spend money. i think that's common sense, right? if you have to pay for something, you're going to think about it, is this really worth. the question is, this a downside to that also which is that, well, if you start to make people pay more of their health care bills, you run the risk that they're going to skip the care that they need. they're going to say, well, that high blood pressure bill, that's really expensive. i'm going to skip that. that's a bad idea because then you're a lot more likely to get a heart attack. people who are really sick, the people with the high medical bills, they're going to end up just, you know, over time, they're going end to up paying a lot more for their bills. the trick is how do you balance the two. >> you almost get the sense that congressman ryan to some extent

governor romney are thinking about that very question. they're saying they're not going to cut the safety net. they're going to find a way to cover the people who really can't pay. but i know you're sent school of that. why? -- you're skeptical of that, why? >> the pre-existing conditioble them have committed to an overall plan for the federal budget that calls for a cap on federal spending. basically they'll say this is how much money the federal government's going to spend. it's an extremely low number. if you do the math, no matter how you change the numbers, play with the different options, there is just no way there's going to be enough money to provide for everybody. the amount of money they are calling to cut out of the federal budget would require drastic cuts to medicare over the long run. >> and of course, congressman ryan keeps saying, look, i'm worried that a program like medicare won't exist at all unless we do something. let me ask specifically about the cap you mentioned. you know, president obama also has proposed a cap on medicare spending. in fact, if you look at the

numbers, it seems to be almost exactly the same cap as paul ryan. so the president's plan, the plan that exists now, would have the same effect as the ryan plan, would it not? >> they do have the same cost trajectory, but there's a key difference. this brings us back to the question of is this ending medicare or not ending medicare. you know, when i think of medicare, when i think of what was created in 1965, it was a guarantee of benefits. it was a promise to the seniors that, look, no matter what happens, you will get these benefits. you will be covered. and if it costs more money, we'll find a way to do it. either we'll pay higher taxes or run a higher deficit, we'll take money from somewhere else. no matter what happens, those benefits are solid. and the way the obama plan is structure sudden true to the promise. -- structured is true to the promise. nothing will change the benefits. the republican approach does not do that. the republican approach says no matter what, this is how much the federal government's going to spend. if health care gets more expensive, something else is going to have to give. and that something else could

well be that seniors have to take up the slack. what's more important? is it more important to say no matter what, we're going to guarantee the benefits to seniors, even if we've to see pay more taxes, even if the deficit is higher, even if we have to take money from somewhere else, no matter what we're going to give you benefits? or is it more important to say to the government and to the taxpayers that no matter what you're not going to pay more for this for medicare. that's what this is about. who gets the guarantee? and that's really where we are. >> yeah. it's -- interesting. you have congressman ryan, governor romney and obviously president obama focused on health care. so i have a feeling we'll be talking a lot more about this in the weeks and months to come. always great to have you on the show. thank you very much. >> thanks for inviting me. >> see you son. we're going to stay on topic. coming up, the invasive heart procedures on patients who didn't need them. stay with us. n - n - that could be a question of blood flow. cialis tadalafil for daily use helps you be ready anytime the moment's right.

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welcome back to the show. there was a headline this month in "the new york times" that was pretty unnerving. the story was about hca, the largest for-profit hospital chain in the united states. says the company revealed it is under federal investigation. investigators curious if some of its cardiologists were doing heart procedures such as catheterizations and placing stent that patients didn't really -- stents that patients didn't ereally need. my colleague elizabeth co-send here. she talks about procedures by doctors. caught your eye and mine. does this seem real? i know it's under investigation. have you heard anything new? >> what's interesting is that studies have shown that this this is true and the investigation is still going on, it's not actually that uncommon.

researchers is locked at catheterizations and whether they're necessary in general not just at hca. there was the "journal of the american medical association" study that came out last year. they looked at half a million stenting procedures, that's a lot. one in eight were deemed inappropriate. there was one hospital that had a 55% inappropriate rate. more than half were inappropriate. >> wow. if there's no question these things can generate a lot of money for doctors and hospitals. but how do you -- how do you know that something's unnecessary? right, if you're a patient, you to your doctor. cardiologist says, you came in with symptoms, i think you need a stent. what do you do? >> that's a tough one. i'll divide is into categories. if there is an koosh out need, you're have -- an kooshs out need for a stent, you're having pain and they drive you to the emergency room, they do a test and say, mr. smith, you're having a heart attack, you need a stent. do not argue. i'm going to say that again.

i want to be clear. if you're told that you're having a heart attack, need a stent, you need that stent. you should not go about asking questions and getting second opinions. however, some stents are given electiontively. you know, we -- electiontively. you know, we think you is a blockage, you haven't had a heart attack, we want to help you with your symptoms. you want to ask, do i have time to make this decision? do i have a couple of days? maybe you want to get a second opinion. maybe you should get more tests done. as we've seen, the inappropriate rates are relatively high. >> the second opinion, should it be at a different hospital, different practice altogether? >> yes. most expert recommend that. if you go to the person's partner, that partner might feel compelled to agree with their buddy. someplace else they don't feel compelled to aggressive. >> most areas in public health, an area you're involved with, involves risk and reward. reward is obviously what the doctor is telling you you're trying to prevent. prevent programs later down the road. risks of the stenting procedure,

what -- >> interesting. let's talk about the benefits for a minute. we were told by a cardiologist that stents don't prevent heart attacks. they help with symptoms but don't necessarily prevent a future heart attack. there isn't a lot of science to show there. there definitely are risks. there's a risk of having a heart attack because of a stenting procedure. there's a risk of having kidney damage, a risk of having a stroke. when we talk -- let's talk about what a stenting procedure look like. people can understand why that happens. you're putting a catheter through an artery, usually in the groin. you're going up to the coronary arteries, and then putting that stent in. that stent can actually, if it's not placed correctly, can cause problems. that's why you have that risk of heart attack and stroke. this is an invasive procedure. >> how many do you say going done every year? >> there's hundreds of thousands of these done every year. most are done for acute reasons. you know, mr. smith, you've had a heart attack. but there are still plenty done

electiontive electively. you have time to think about it. >> the bottom line again, if you're having symptoms, crushing chest pain, you go to the e.r., that is not the time to get a second opinion. >> if they tell you had a heart attack you need a stent, get a stent. >> thank you very much. coming up, an 8-year-old girl who in many ways is already changing her world. now she's written a book. okay, team! after age 40, we can start losing muscle -- 8% every 10 years. wow. wow. but you can help fight muscle loss with exercise and ensure muscle health. i've got revigor. what's revigor? it's the amino acid metabolite, hmb

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as part of a heart healthy diet. that's true. ...but you still have to go to the gym. ♪ the one and only, cheerios one of my favorite parts of the show, every week we bring the story of someone who has

fought through adversity to achieve greatness in some way. this week we have our youngest human factor yet. samantha brownly, just 8 years old. she was born with hearing loss. she did something wise beyond her years. she saw it as a chance to help. something wise beyond her years. she decided to do something to help. >> the book is about my hearing aid. >> reporter: samantha brown is 8 years old and already a published author. her book she wrote at the ripe age of 6 is how she copes with hearing loss. some people have it, different problems they have in life, but they don't really want to share it. so i like to share it. >> reporter: samantha and her 11-year-old brother shawn were born with damage to the inner ear, permanent damage in both ear ears, but at an age when

taunting from the peers could shatter the self-image, samantha and shawn are uncounted. >> we never saw it adds a disability, but a facer tofrmt i wear glasses, and i don't have sight disability, but i need help with the vision. they are needing help with the hearing and not profoundly deaf, but they need help with the hearing. >> if anybody asks, just tell them. it is not something that you hate. it is like a hearing aid and is not to be embarrassed. >> without the word disability weighing her down, samantha found it in her to write this book. >> it makes everything better because it helps everything sound better. >> the name of her book is "fm book." >> i thought it was amazing, because she is amazing. it was a wonderful project at first and then it took on a life of its own. >> reporter: a life of its own including sales of samantha's book on amazon.com, and this psa

for the hearing health foundation. >> you can survive anything, and that is what i want from my kids. >> reporter: it seems that the idea of achieving anything has caught on and though she has many years ahead of her, samantha has advice about adults and children about how to overcome. >> no matter what happens, i try, try, try and you can help someone else with it. >> reporter: samantha is planning her next book and next four books, and they are going to be about hearing aids and also about candy. she is 8 years old. and also, now pulling up outsidef of the cnn center is mr. glen miller who is getting off of an 800-mile drive from texas. i want to see if he is ready for a big triathlon which is a month away. i'm a marathon runner,

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[ laughs ] you know, he drives more than 3,000 a week in his truck, so when glenn keller submitted his video to the fit nation challenge, we weren't so sure he could fit exercise into the hectic schedule. but this week, he steered the truck to cnn to give us an update on how he is keeping up. >> reporter: hey, how are you? your home away from home. >> the command center. >> you get to take a ride in this? >> yes, sir. you do.

>> reporter: i have to ask, how are you doing with the training? >> well, we have been doing p t pretty good, because in spite of the schedule recently i had a chance to set up with something with a pool in baltimore, because i was getting to baltimore every week and only swimming when i was home, but now that i have made this arrangement there to swim on both ends now. >> reporter: a lot of people have busy lives, but you just drove 800 miles, is that correct? >> yes, sir. >> reporter: and just fitting in time to exercise must be challenging? >> well, it is valely challenging and the thing where i can't wait to find time, and i have to actually make time. when i stop at the truck stop for fuel or when i get up, because by the time my day gets going, i don't know where i will end up or stop at or what the situation is going to be, and this is an opportunity and time to do something. >> reporter: you know, when we were in hawaii swimming, we talked about this briefly and we had said, look, if you don't feel comfortable or safe by the time the triathlon comes around,

we don't want you to swim. what are you thinking? >> at the time i was thinking, wow to, have gone through all of this and then get to malibu and not swim, that would have been the biggest letdown, so it nudged me to kind of start ko concentrating and asking people questions. >> reporter: right now, you think that you want to do the swim? >> i believely be ready to do the swim, but without a doubt. >> reporter: a lot of people may not know about you that you were displaced after katrina, and you made your life there after that. >> i did, yes, sir. >> reporter: there is a church, lower ninth ward who has asked you to come back to be their pastor? >> yes, sir, i have. >> reporter: i heard that today and that is really, aim sure it is very flattering and that is quite an honor. >> and i feel really honored. it is quite an experience. we had the chance to be the first service there. >> reporter: it is being rebuilt? >> in the process of being remodeled. >> reporter: so you did the service outside? >> well, i have a breaking box

inside of the truck so i have plugd up the electricity to the truck, and let there be light. >> i love it. i feel good about my job when i talk to you and i feel like we are making inroads. thank you. i appreciate that. >> i feel good being associated with you and your team, sir. and this week, chasing life, we know how important a good night's sleep is, but you might be surprised by this, a new study of heavy snoring in children. now, it is not necessarily cute, and in fact, it can be tied to serious medical issues associated with chronic poor sleep. there was a study in the cincinnati children's hospital, medical center who found that 2 and 3-year-olds who snored loudly had more problem with aggression and hype