revolutionary fighters took custody of him after a stakeout and desert gunfight. international criminal court in the hague wants to put him on trial for war crimes. his capture, news of it, set off celebrations across libya. his captors say he was trying to make it to niger, which has granted astyleum to one of his brothers -- astyle emto one of his brothers. i'm be back at the top of the hour. right now the good doctor. hey there, i'm dr. sanjay gupta. three complicated stories that we'll make sure you understand at the end this half-hour. america's health system is changing. that means your insurance coverage is changing, as well. why the supreme court is now getting involved. then -- using stem cells to fix the damage from a heart attack. the surprising new evidence. and what's behind a critical shortage of cancer drugs? plus, rapper fat joe drops a body. why he's not so fat anymore.

in washington, the supreme court will decide a challenge to the sweeping health care law that president obama signed last year. a lot of people have been paying attention to this. the main issue is that controversial requirement that everyone be covered by insurance. it's called the mandate. starting in 2014, if you don't have coverage through a job or medicare or medicaid, you have to buy it yourself. while this are subsidies for those who can't afford it, the specific part of the law requiring the mandate has been unpopular. according to a new cnn/orc poll, a majority of americans are in favor of it overall. joining me from new york is nyu medical center andrew rubin. he's been on the show before. host of health care connect on siris xm talk radio. let me start off, did it surprise you the supreme court was taking this on? >> no, we knew it would happen. it's the best way to get to the finish line on whether health care verchl going to survive --

reform is going to survive. >> patients ask me as a doctor, if the supreme court overturns health care reform, what does that mean for health care -- what does it mean for the whole plan, the bill overall? >> you have to remember health care reform has two parts, one is health insurance reform. that's what the individual mandate is about. if the individual mandate is overturned by the supreme court, then it really throws into question the entire health care reform bill and law at this point which is really restructuring the entire health care system. >> andrew, i don't know if you've done this recently, i did open enrollment. a lot of companies have these to figure out their health insurance. there are some big changes for big year. you shouldn't assume coverage for next year is going to be the same as it was for this year. do you have advice? i mean, based on everything you know, what you're seeing, for people filling out open enrollment in terms of changes coming down? >> yeah.

big changes this year. insurance premiums for employers went up 10% last year. for the average employee, it's $10,000 across the united states. >> wow. >> it's a big -- really big number. so last year about 20% of employees offered these high deductible, consumer-directed plans. this year the number's 32%. and the problem is with the high deductible, consumer directed plan, they look similar to older plans. if you're not reading the fine print, you could be surprised to see that you have a $2,500 deductible. last year the same insurance came with a $1,000 deductible. the message is, make sure you read your benefit plan, and you understand what you're buying before you actually enroll in it. >> do you -- when you are giving advice and you manage a big provider network, is there some basic advice that you say in terms of people saying, to make sure they get the best coverage, best insurance overall, and they protect themselves from huge bills? >> i do. there are a couple of things. number one, i've been saying this a lot lately, and i believe it. it's a hard concept for a lot of americans to understand.

an hmo or epo, like an hmo but doesn't require a referral to see a specialist, can be a cost-effective insurance plan for a lot of people to choose. you don't typically have deductibles, and there are no co-insurance amounts. the problem is you have to stay in network. you're essentially turning the management of your health care over to a very controlled network of doctors. if you're willing to make that compromise, you can save yourself a lot of money, heretofore, a lot of americans didn't like that restrictive behavior on the part of employers or insurance companies. they went with these ppo plans where they had out of network benefit. those out of network benefits are becoming increasingly expensive for employees. the more you go out of network, the more the employers are making you pick up a bigger percentage of costs. >> you know, you're so good at giving us the big picture. obviously the details of the picture, as well. you know, i have a feeling we'll be talking quite a bit over the next few years. >> absolutely. many years. >> thanks for joining us. as always, andrew rubin. you know, prevention is key, as andrew was talking about, to

keeping people healthy and controlling medical costs. we also need new treatments. this week we saw some pretty exciting results. some things that really were fascinating from two studies that were treating patients with stem cells taken from their own hearts. think about that for a second. joining me from washington is dennis buxton, overseas stem cell research for the national heart, lung, and blood institute. thanks for joining us. i'm fascinated by these studies. to clarify, both these studies and other big ones, as well, announced this week used adult stem cells, not embryonic creme stels th -- stem cells, one that i saw you led at cedars-sinai giving stem cells for patients recovering from a heart attack. someone recovering, heart function went down. what did they find when they injected stem cells into the hearts? >> thank you, sanjay. what they found was that the patient's scar tissue, the part

of the heart that had been damaged, was reduced in size. and apparently new muscle was formed to replace the scar, tissue. this should help the patient's heart to function better in the future. >> first point about growing new tissue. the scar is what forms in response to damage, a heart attack in this case. scar tissue went down and new tissue took its place. is that a first? >> i think this is the first time that we've seen a significant decrease in scar volume, and its replacement by what appears to be functional pumping -- heart tissue. so i think this is potentially very exciting. >> there was another study, as well, just published in "the lancet." fascinating. gave stem cells to patients with severe heart failure due to heart attack a long time ago. they didn't mention growth of heart tissue like the cedars-sinai study did. what did they find in the "lancet" study? >> well, so they did also look

at scar tissue, and they found a decrease in the scar tissue in the heart. but the most exciting thing that they found was an increase in the pumping capacity of the heart. so after six months, they saw basically a six-point increase, and after 12 months, this was a 12-point increase in heart function. so this is larger than has been seen in other studies using different types of cells. and so while this is a small patient population, it's potentially exciting. >> if you can, you know, because you talk about taking stem cells and injecting them into the heart. can you briefly describe exactly how does that work? what is the process for someone who's watching this and saying, maybe i will be a candidate for this someday? >> so they took tissue from the heart, either using biopsy, taking a little bite of the heart through a catheter, or during bypass surgery.

and they grew this up in -- basically in a dish to create millions of stem cells. and then they inject the cells into the heart. they fed a catheter, a tube into the heart, and inject the cells into the coronary artery, while they've stopped flow in the artery, and the cells then migrate to the heart tissue, providing the functional improvement. >> and again, that can take some time to actually see the increase in performance. that's why part -- part of why i found this fascinating. i appreciate you bringing it to us. we'll keep an eye on it, as well. thank you. coming up, what's behind a shortage of lifesaving cancer drugs? we'll explain. . while a body in motion tends to stay in motion. staying active can actually ease arthritis symptoms. but if you have arthritis, staying active can be difficult. prescription celebrex can help relieve arthritis pain so your body can stay in motion. because just one 200mg celebrex a day can provide 24 hour relief

for many with arthritis pain and inflammation. plus, in clinical studies, celebrex is proven to improve daily physical function so moving is easier. and celebrex is not a narcotic. when it comes to relieving your arthritis pain, you and your doctor need to balance the benefits with the risks. all prescription nsaids, like celebrex, ibuprofen, naproxen, and meloxicam have the same cardiovascular warning. they all may increase the chance of heart attack or stroke, which can lead to death. this chance increases if you have heart disease or risk factors such as high blood pressure or when nsaids are taken for long periods. nsaids, including celebrex, increase the chance of serious skin or allergic reactions or stomach and intestine problems, such as bleeding and ulcers, which can occur without warning and may cause death. patients also taking aspirin and the elderly are at increased risk for stomach bleeding and ulcers. do not take celebrex if you've had an asthma attack, hives, or other allergies to aspirin, nsaids or sulfonamides. get help right away if you have swelling of the face or throat, or trouble breathing. tell your doctor your medical history and find an arthritis treatment for you.

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right now in hospitals around the country, patients are being told the drugs they need to treat their illness simply aren't available. shelves are empty, and doctors are being forced to use second best alternatives to treat their patient or delay treatment altogether. this week the american medical association weighed in and declared this a national public health emergency. hundred of drugs in short supply. in fact, three anti-seizure medications i regularly prescribe to patients are on the list of drugs in steep decline. what's going on? a new report says drugs to treat

cancer, infections, cardiovascular disease have taken the biggest hit. some 550,000 cancer patients this year alone have been told the cancer drugs they need simply aren't available for them. one of those patients is renee mozer. she has a very resistant form of ovarian cancer. a drug called daxol is most effective to treat her type of tumor. the doctor can't get the medication for her as thing stand now. renee and her oncologist, dr. wendell nowman, joining me. thank you, first of all, for joining us. how are you doing, rene? >> i just started a clinical trial. my occur has recurred. it was in remission twice for 2 1/2 years each time. this time i was only able to get one chemo drug, i could not get the doxal. my cancer recurred while taking team e chemotherapy. >> is it because -- the thinking it occurred because you couldn't get the other medication? >> well, it -- i took two chemo drugs each time before and went

into remission. this time i was only able to take one. so just have to draw conclusion about that. >> it seems we have a certain expectation, doctor. you prescribe a medication, your patient will get it. it's a faulty assumption now. what do you suppose is going on -- >> this is a huge crisis, growing crisis in this country where we're actually having to ration drugs. this is something that is really unbelievable. >> did you have to tell renee this? >> we did. we had one course, and then the doxal was unavailable. we had to go with single agent. no other alternative. >> what was your reaction when you hear this? >> you feel like you're in a fight with one hand tied behind your back. at the time we said, let's go about what we have and see what happens. and the cancer rapidly recurred. >> a lot of drugs are made by a single company. so if the company has trouble

with their manufacturing, they may have to shut down production of their drugs altogether. that is reality. what does one do? what are you to do? what am i to do? >> hospitals have been pro-active in stockpiling drugs when we know that there's a looming crisis. that can't be done everywhere. we have to have a contingency plan. i think the ama has addressed that in their statement. i'm not sure the pending legislation will fix all of the problems. >> president obama specifically talk good asking drug companies to flag a problem prior to the problem occurring or trying to anticipate it. will that be helpful? >> if they're going to discontinue production, they have to notify the fda. sometimes in this case, it was a production problem that was noted on an fda inspection. and the company voluntarily shut down. we don't have any contingency plan there. and there's no other company in the world that makes this drug.

you're getting good care and talking about how effective it had been in the past. was there part of you that said -- there's something else that we must be able to do here. do i need to look overseas? do i need to go somewhere else? were there other options at all for you? >> no, i put my trust in the doctor, and hoped that the single agent drug would work. didn't and since then we've turned to other medications. not chemo medications. i'm in a clinical trial and trying other drugs. hopefully that will put me back into remission. >> is there something else going on here, doctor? i'm sure you talk about it with your colleagues. this is -- not a novel problem. we've heard about this before. it does seem to be getting worse, the ama calling it emergency. is there a peek behind the curtain? >> probably a perfect storm. we have few drug incumbents manufacturing these.

these are outsourced to single drugs -- some that are hard to find, a drug used in breast and ovarian cancer in short supply. this is a problem. we get a list of drugs that are in short supply and have to make alternate plans. we have a committee in our hospital that does this, has to decide which drugs will be short. >> it's hard to ask because you're both here, but you wanted to provide a different medication that available. you went to plan b. it's not plan a. plan a is what you wanted to do. excuse me for asking, but is that inferior care or less than standard or optimal care for renee? >> it's not what i wanted do. i think the response rate and remission would have been clearly higher with both drugs. there's no way i could get the

drug. >> how long is this going to last? have you heard? >> that's the problem. we don't know. so this inspection, the fda inspected this plant, they voluntarily shut down in may. we were told two months. so we were hoping that by the third or fourth cycle that renee could go back on the combination. that -- that process has not been resolved. and so we're sort of in limbo. there's no contingency plan for production right now. >> yeah, so many problems we talk about, we don't know how to solve. this while complicated seems like something we can do something about, for you, renee, and people like you. i hope people are listening to this. thank you both very much. >> thank you. ahead, taking a turn. rapper fat joe comes clean about the changes he's try to save his own life. >> i guess what happened with me is like they say, you know, a crackhead or drug addict hits rock bottom. you know, i just hit rock bottom to where i knew like if i don't

make this a lifestyle change, i'm going to die. i remember the days before copd. my son and i never missed opening day. but with copd making it hard to breathe, i thought those days might be over. so my doctor prescribed symbicort. it helps significantly improve my lung function, starting within 5 minutes. symbicort doesn't replace a rescue inhaler for sudden symptoms. with symbicort, today i'm breathing better, and that means... game on! symbicort is for copd, including chronic bronchitis and emphysema. it should not be taken more than twice a day. symbicort may increase your risk of lung infections,

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♪ >> rapper fat joe there. he's huge in the rap world but he's not quite as big in person after losing half a dozen friends to heart attacks. he decided it was time to get his weight under control. >> you know, i was talking to my trainer yesterday, and i realized that heed sahe said wh is the last time you were slim? i think that was it. >> fat joe, joey crack.

joseph antonio. the larger than life rapper grew up in public housing and was taught from an early age that food equals love. ♪ >> when joe hit the big time he felt he deserved all the good food his lavish lifestyle could afford. >> i'm rich now i can eat all the lobster and steak i want. >> in 2000, joe's friend and fellow rap store big pun suffered a heart attack. >> i think i weighed 450, 460, at my heaviest, i always took pride in being fat. that's why i was called big joe. i represented the big people. >> i realized all of big people were dying. >> last year alone, six of his big friends died of heart attacks. most were younger but the same

size. >> i couldn't see a clearer picture. what's the difference of me and him, me being in a casket and my daughter running around the funeral home. you know, he doesn't have a dad no more. >> no's eating healthier food in smaller portions. he's lot 100 pounds and counting. >> and this breaking news, this is like my best, best, best friends on the earth don't even know this, but i was diabetic for 16 years. since i was 14, being that i lost weight, no more diabetes. ♪ >> when he's not working out, chances are you'll find him at the gym. ♪ >> even though he's dropped the pounds, fat joe says he has no intention of droching the name. ♪ >> we've gotten so much response to his story. one of the comments suggests

that the leaner, meaner fat joe is rapping faster. he definitely says he's got more energy on stage. his rapping might be the same. if you're looking to potentially drop a body yourself, today could be your lucky day. we're kicking off our 2012 cnn fit challenge. hopefully you've heard about this. i've committed to racing in the nautica -- >> that's right you have. hey, buddy. >> are you going to join me, too? >> yeah, michael phelps -- i mean sanjay gupta. see you later, thanks. >> he's going to be joining us. one of my producers, michael hudson, he will train with me. make a video about why you should be picked to join next year's sick pack. if you're selected, we'll give you everything you need to keep including a bike, wet suit, six months of intense training including extra all-expense paid training trips. look at how much fun this year's six pack had on their journey.

>> we're the 2011 six-pack. woo! >> use that wall. ready, go! >> 60 is the new 40, we better be getting busy. >> definitely feels better than i did when i first started. >> a year ago could you have imagined yourself doing there this? >> no way. you want more information about the challenge? submit your own entry video? it will change your life. logon to cnn.com/sanjay and you can share your story with us. last, but not least, this morning a sneak peek at my latest project. it is called "the next list." it is up next. stay with us.

people would smell like everyone else disgust me, so says the man i'm profiling this week on "the next list." it is an exciting new program i am working on where each week we'll spend time win know vative thinkers in all fields. he is a new york city cab driver turned award winning maker of perfumes. >> all of the fragrances that i do here in the library, burning leaves, the tomato leaves, had he mean very specific things to me. they are very -- they're my memories. to a degree they are me. but when another person smells them, they're having a very, very different experience. >> he wants to convey a feeling through these smells. it is really remarkable stuff. see more with christopher, including his quest to perfect an invisible perfume. that's sunday