Skip to main content

tv   Sanjay Gupta MD  CNN  March 20, 2010 7:30am-8:00am EDT

7:30 am
we have to shop all day, right, honey? yep, all day. good thing you're starting here. we compare your progressive direct rate to other top companies', so you can save money! look! we saved a lot! and quick, too. and no more holding her purse! it's a european shoulder bag. it was a gift. mm-hmm. shopping less and saving more. now, that's progressive. call or click today. we will be back in just 30 minutes at the top of the hour to continue with our coverage of the big health care showdown on capitol hill this weekend. >> but now "sanjay gupta md" begins now. welcome to a special place, a place to learn how to live longer and stronger and i'm your doctor and your coach. and there's battle going on out there over biologics.
7:31 am
maybe something you have never heard of but that could be the reason we pay so much for drug costs. speaking of costs, go to hospitals around america. the concern is always that we pay too much and get too little but there are places doing it right. we'll talk to the leader of one of those places. and finally, a medical mystery. potentially an epidemic out that so many people are ignoring. do you know what it is? we'll tell you. let's get started. we start, though, with news to affect your wallet. there's a battle going on out there, this battle over biolo c biologics. the power of big pharmaceutical companies and the wonder drugs that they make are all very expensive. we know that. they're likely to stay that way for at least a dozen years and you can blame it on the power of lobbyists. here's cnn's senior congressional correspondent data bash. she's been investigating the
7:32 am
story. >> reporter: to watch jim greenwood is to watch old fashioned bare knuckled washington lobbying. >> i went office to office in the house and in the senate with my little molecule. >> reporter: and pushed a provision buried inside the health care bill that could save the pharmaceutical industry he works for billions in profits o. poe innocents say at the expense of you, the consumer. what happened? >> well i think what happened, unfortunately, politics trumped policy. >> reporter: so what that's all about? nothing short of miracle drugs and the crossroads between how much it costs to make them and what you pay for them. the drugs are called biologics. made from living organismings and programmed to target specific, thoord treat maladies. >> we have protein biologics now for multiple sclerosis or for respiratory viral infection or for oncology. >> reporter: and they sell for blockbuster prices.
7:33 am
they're cash cows. consumers spend more than $40 billion a year on them. sharon brown say it is biologic enbrel rescues her from debilitating rheumatoid a arthritis. >> that's four injections. >> reporter: her insurance has a cap and takes the weekly drug every other week. >> i just cannot simply afford the medication. >> reporter: for chemical drugs like these, there is a law that allows generics which are cheapers and doesn't apply to biologics so democrats in the health care legislation which they say is aimed at lowering costs decided to make a path for generic biologics which would bring the cost of the drugs down. to do that, the president wanted to give brand biologics exclusive rights for seven years before cheaper generics could enter the market but the pharmaceutical industry lobbied
7:34 am
for more, 12 years and prevailed. their argument? development takes an average of 12 years and a billion plus dollars. >> if we want people to invest in new cures for cancer and diabetes and aids and all of that, then you have to make sure that they're going have some chance to get their return on their investment. >> reporter: and keeping them honest, brand name biologics had major reinforcements to make their case. last year, pharmaceutical manufacturers spent more than $263 million in lobbying. do the math, more than $721,000 a day. in 2008, they gave $30 million in campaign contributions, a record half of that to democrats. >> the brand industry with the deep pockets have made some really great friends in the democratic, you know, party. >> reporter: to be sure, the generics lobby did have power allies, not just the president but aarp, unions and more but brand name biologics outspent them and worked the system. jim greenwood isn't just the
7:35 am
president of bio, a former member of congress. you are a former member of the club. >> right. >> reporter: that helps. >> it helps in this way. i know what people need, kind of information they need before they vote. >> reporter: the result in this committee and others, many democrats voted to give brand name biologics a longer corner on the market. >> this language now is anti-competitive. it will help the drug companies reap billions of dollars more in profits. it will restrict access to all kinds of life-saving drugs for people and too many democrats side with the drug industry. >> reporter: thanks, in large part, to the money and manpower behind their washington lobbying. dana bash, cnn, capitol hill. >> all right. dana, thank you. later on, i'll talk with the former head of the mayo clinic, it is one of the hospitals in the country that seems to get it right. patients get great care and also the costs are kept relatively low.
7:36 am
he says most of us aren't getting what we pay for. we'll have that ahead. do you know what causes low blood pressure? a viewer e-mailed us, wanted to know. we'll ask the doctor. that's next. stay with us. as we're finishing up, i mention i'm going to the bathroom more often. he checks it out. good thing. turns out... my urinary symptoms -- such as going frequently, trouble going, flow starts and stops... and going often at night -- are due to bph, also called enlarged prostate. he says over time, avodart has been shown to shrink the prostate, improve urinary symptoms, and reduce the risk of prostate surgery. only your health care provider can tell if your symptoms... are from bph and not a more serious condition... like prostate cancer. do not donate blood until 6 months after stopping avodart. tell your doctor if you have liver disease. rarely sexual side effects, swelling or tenderness... of the breasts can occur. avodart is for men only.
7:37 am
women should not take or handle avodart... due to risk of a specific birth defect. today's the day to talk to your doctor... about your urinary symptoms and find out... if avodart is right for you.
7:38 am
we're back with the program. every week at this time i answer your questions. think of this as your own
7:39 am
appointment. no waiting. no insurance necessary. let's get to a question of irs in gainesville who asks this, what's hype tension? a lot of people ask about this and a lot of people don't necessarily know about hypertension, what the differences are. it's also known as low blood pressure. it happens when blood pressure during and after the heart sbaet lower than usual and what that means obviously is your heart, brain, other parts of the body are simply not getting enough blood. there's no specific threshold, your day-to-day blood pressure has to hit before it's considered too low. some people simply run low. that's what you may have heard at the doctor's office but anything below 90 over 60 is considered low. hypotension is often the number one cause of people fainting. happens a lot when you get dehydrated. blurry vision can also occur when the blood pressure is low. they also may have clammy skin and simply hydrating, more often than not, to take care of this.
7:40 am
too many people are simply dehydrated. your diet could also be playing a role here. low in sodium, for example, we talk about people taking too much salt, too much sodium but there are people who don't take enough and medications to watch. medications like die retdices, alpha blockers, beta blockers, drugs for parkinson's disease, anti-depressants, pregnancy, heart problems, allergic reaction, severe infections, blood loss, of course, lack of nutrients in the diets. this affects a lot of people and consult with your doctor and direct any questions if you have any concerns. now for fit nation this week, we talk about something i'm very interested in. i think about this all the time. people say they don't have enough time to exercise. a lot of people say, look, that's not an excuse anymore. there's research saying you can exercise less and get just as fit. now, this is going to sound
7:41 am
gimmi gimmicky. the key is known as h.i.t. high interval training. high intensity training burns more calories and possibly build more muscle than someone that jogs leisurely for even an hour. here's why. the dper size very intensely for a minute, take a break for a minute, exercise for a minute and take a break and so on and so forth for 20 minutes for hard exercise and ten minutes of a little bit more rest. what they found was, first of all, the heart rate while did it drop in the rest periods, did not drop significantly. so you were continuing to have an aerobic workout. the second thing was your endurance measured after a period of time seemed to be almost as good as someone who did the longer, more leisurely workouts. a lot of benefit in a much shorter time. there's all types of exercise to work. cycling, running, swimming. these sports are better for this
7:42 am
type of training so here's something i thought of. running, for example, find a hill. takes about minute to run up. then walk back down the hill. run it back up. do this back and forth for 20 minutes. bottom line here, take a look at the fitness goal faens lack of time is an issue, far lot of people it is, then the high intensity short intervals could be a solution that works for you. little bit of advice for you there. i'll talk with a man who ran one of the best hospitals in the country and the keys he says are to saving your money and getting better care. that's next. it's delicious. delicious. i know. but it can't have... can't have about half a i assure you it does. i was expecting... expecting sawdust and cardboard? i know. i can only taste... only taste the crunchy clusters,
7:43 am
honey, and brown sugar. no madam, i don't have esp. ok. i'll take a box, but you probably already knew that. (announcer) fiber one. cardboard no. delicious yes. announcer: wherever the game takes you, transitions is your best playing partner. transitions lenses adapt to changing light to help you stay comfortable and in the zone in all light conditions both on and off the course. kenny perry and trevor immelman have made transitions part of their game. transitions is proud to be the official eyewear of the pga tour and title sponsor of the transitions championship.
7:44 am
7:45 am
welcome back. today i'm with dr. denny cortez at the business and engineering schools at arizona state university. until very recently, president of the mayo clinic in minnesota famous for delivering high quality care and efficiently. not surprisingly, given these times, dr. cortez is very much in demand these days. thank you for joining us. >> you're welcome. it's real pleasure to be with you, sanjay. >> when did you decide to go into medicine? >> that's an interesting question but i've known i wanted to be in medicine since i was 13. i don't know exactly why. i know i was playing a fair number of sports going through junior high and high school and
7:46 am
i always enjoyed and admired the team physician and he was a local practitioner in the community where i grew up in pennsylvania. >> you've had, obviously, a remarkable career and, you know, most recently president and ceo of the mayo clinic but did you ever get disenchanted with medicine? ever have second thoughts? >> no, never. if i did it again, i would do the same thing. the miserable part about medicine is the surrounding things, the insurance and the billing and all of the rest of that. but the caring for patients is the most exciting thing and taking new knowledge and bringing it to the care of patients is the main reason far physicians i think to be practi practicing. >> you know what's remarkable about mayo is a world class institution, often referenced at the place where medicine is practiced and best medicine, perhaps in the world but you also do it with less cost and much more efficiently. how do those two things go hand
7:47 am
in hand? most people think about those two things as being opposite. you f you provide the high quality care and mayo clinic care, it costs more. why doesn't it? >> first of all, within -- i've been at mayo clinic 40 years and practicing medicine and during those 40 years we paid just about no attention to the specific total amount of cost we were incuring on people. as a matter of fact, many of us would have thought we were a high cost organization. however, what we did concentrate on was not amount we were costing. we concentrated on what were the needs of the patient? what did they really need have done and, also, the incentive that physicians were all already on a salary. so we weren't incented to do more if we didn't have to. somehow, when people many years later looked at the outcomes of that kind of a practice model, it turns out that we're less expensive and the main reason it is less expensive is because we
7:48 am
tend to do fewer things to people than might be occurring elsewhere. we tend to have fewer days in the hospital. fewer days in icu. fewer procedure that is are being done. fewer excess testing and that sort of thing. >> that seems like where we should have evolved, right, as a medical establishment. i would say that most doctors, most health care providers want to do those things. why doesn't it happen except for the places -- some of the places you mentioned? >> there are many places in the country that have done this with different models and as they have done that, as the patients -- as the care has become safer, with better outcomes in every instance it's turned out to be lower expense, also. >> we have to take a short break now. i'll be back with dr. dennis cortese in just a moment. and let cheerios help tackle your cholesterol. now you could win a free box to get started.
7:49 am
[ woman ] nine iron, it's almost tee-time. time to face the pollen that used to make me sneeze, my eyes water. but with new zyrtec® liquid gels, i get allergy relief at liquid speed. that's the fast, powerful relief of zyrtec®, now in a liquid gel. zyrtec® is the fastest 24-hour allergy medicine. it works on my worst symptoms so i'm ready by the time we get to the first hole. and that's good because the competition's steep today. new zyrtec® liquid gels work fast, so i can love the air.™ and that's good because the competition's steep today. girls: snickerdoodles, shortbread, fudgie nut bars... announcer: the smallest moments can have the biggest impact on a child's life. girls: go, dad! go, dad! one foot! one foot!
7:50 am
7:51 am
cortese. he's foundation professor at the business school and engineering school at arizona state university. until recently he was president and ceo of the mayo clinic in minnesota. they're known for their high quality and unique approach for patient care and lower cost as well. the mantra right now, as you well know is that this is a country that costs -- i mean charges and pays way too much and gets too little in return. who's wearing the black hat? is there someone that you point to and say there's the problem? there's the black hat in all this? >> i don't think there's any one place to point to. i think it's been an evolution over many years. over the past several years payment has really been linked very much to whatever is done. we ended up with a model that is
7:52 am
now called fee for service where we are paid for doing things to people. the ultimate of that, if carried to the extreme would be the sicker you are, the more money we make as physicians. the more times you come into our office, the more money we make. the more procedures we do, the more money we make. that's just the opposite of what high value care should be all about. do we pay the most amount of money to people that may do procedures or should we be paying a little more money to nurses and primary care doctors to keep you from needing those procedures? >> are there greedy people in the system the way you just outlined it? doctors greedy? pharmaceutical companies greedy, insurance companies greedy? is that what has driven some of this? >> i think so. i think that's part of it. there's an element of greed there. there's always the element of fraud that is lurking in there, and to me, whatever those
7:53 am
ancillary drivers are that have pushed prices up have been sort of caused by the fact that the country has not focused on getting its money worth out of health care. >> let me broach one topic with you which is difficult to explain, will there be rationing of care and the term that makes people's eyes glaze over is comparative effectiveness, this idea that you figure out what works and you pay for those things or reimburse for those things and things that don't work you don't necessarily pay for those things or it's not as easy for those particular procedures or treatments. is that a type of rationing and let me take it a step further, given your background, how much is it over skience?
7:54 am
>> with respect to comparative effectiveness. what that really means is if i were sick and i were a patient and say i had high blood pressure and given my circumstance, maybe my genes, moo proteins and family history, there might be two or three drugs that are available for me. well, the patients and the doctors ought to be interested in what is the comparative effectiveness for each one of those three. effectiveness means what might be best for that person? what might work best for that particular person? comparative effectiveness is the science side of the question. now when you end up working with a patient in making the final treatment, you may have to bring in the art of medicine because the way you treat a patient going forward might very much depend on their personal needs, their family needs and some patients will decide and say doctor, thank you very much, i prefer no treatment, just keep
7:55 am
me comfortable. we should use science in the way we make a decision. >> you're such an important voice in all this, and i'm delighted to to be able to speak to you and hope to speak to you much more often in the future. thanks for joining us. >> you're welcome. thank you.
7:56 am
7:57 am
welcome back to the program. a quick update now on baby patricia. as you may remember she's a 2-month-old rescued after spending five days in the rubble following haiti's earthquake. she had multiple serious injuries and was flown to miami for urgent care. a few weeks ago a couple came forward claiming to be the baby's parents and dna testing has now confirmed that. her parents are free to take jenny, that's her real name, incidentally, back home to haiti once her treatment in florida is done. former president george w. bush and bill clinton will go to haiti to relief efforts and they're going on behalf of the
7:58 am
haiti fund. we have time now for medical mystery of the week. this is a disease that so many people are ignoring and is now becoming an epidemic. the answer is skin cancer, specifically nonmelanoma skin cancer. skin cancer has become an epidemic in the united states. non-cancer rates have more than doubled in the last 15 years. this is payback for people not paying attention in the '60s and '70s not taking adequate sun prevention. what surprised me the most about these cancers is it affects individuals more than all other cancers combined. the reason, people still aren't protecting themselves against the sun. most people think it's not going to happen to me and also people are living longer and getting more diseases just like this one. skin cancer develops in the younger years when we spend too much unprotected time and it starts to accumulate over time. we're talking about non-melanoma skin cancers and there are two types.
7:59 am
basal cell carcinoma. that's an image of the skin and you can see the lesion in the skin there. that is what basal skin carcinoma looks. if you take a closer look, what you're looking for is the indented area on the top. that can be a red flag that maybe you should go see your dermatologist. there's also squamous cell carcinoma. take a look. it tends to be rougher, patch dwrer and a scaly sort of nature to it. that is camous cell carcinoma. both are rarely fatal, but if left untreated they can be painful, cause deformities and cause scarring as well. a lot of people ask, how do i know if something is potentially a problem. it's as simple as the abcds, a, when you're looking for when looking at a suspicion mole or lesion, asymmetry, the borders,

250 Views

info Stream Only

Uploaded by TV Archive on