hello there. thanks for being with us. a remarkable story today 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? but first, want to make sure you're up to speed on a very 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 on this 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 but now big changes are on the table. >> the truth is we simply cannot continue to pretend like a medicare ontrack to become bankrupt at some point is acceptable. >> mitt romney says his changes would not affect current seniors or anyone nearing retirement but down the road medicare would be mostly privatized.

he'd get a government voucher to buy your own insurance. you could pick the medicare program like we have it now or buy private insurance. here is a key point. in the budget drawn up by romney's running mate paul ryan the size of the voucher would not grow as fast as health care costs have grown in recent years. >> great. >> 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? >> theresa 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 to 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 are other things you have to pay for. and i wouldn't be able to live. >> democrats think this is a

winning campaign issue but so do republicans. >> we want this debate. >> and romney and ryan say competition, consumer choice, is the only way to push down costs so that medicare can survive. >> joining me now is jonathan kohn. he is a senior editor at "the new republic" and author of the book "sick" and is a supporter of the president's health care law. he has been following this whole thing 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 there are no changes for anyone 55 or older but people beyond that are going to get a voucher from the government to buy their own insurance but they can also stay on medicare. my understanding is, and tell me what you think, the thought is this will create a more competitive market and that could help lower costs. >> that is absolutely true. the theory behind what ryan,

what republicans want, is that 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, and let's say medicare keeps getting more expensive. you have this voucher and the voucher is set at a certain value and is going to go up by a fixed formula every year. let's say at some point that voucher is not enough to pay for a good insurance. what happens then? in the republican approach in the ryan approach that voucher is a fixed value and there is no changing that. therefore if the voucher doesn't pay for a good insurance policy individual seniors are going to have to make up that difference somehow. >> so for example they say seniors on average pay about 25%

of their health care costs now. it could go up to as high as 68% of their health care costs over the next ten years. but one of the things i keep hearing and again it's an important point is that 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 is also an important driver to bring health care costs down. do you think that's important and that would work? >> i think there is a lot 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 they spend money. i think it's common sense. if you have to pay for something you'll think about it. is this really worth it? the question is, there is a down side to that also which is that well if you start to make people pay more of their health care bills you run the risk they're going to skip the care that they need. they're going to say, oh, well that high blood pressure bill is expensive. i'm going to skip that. that is a bad idea because they are a lot more likely to get a

heart attack. people who are really sick, people with high medical bills, they're going to end up just over time paying a lot more for their medical bills. so the trick here is how do you balance those two? >> you almost get the sense that congressman ryan to some ix tent 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 those people who really can't pay. but i know you're skeptical of that. why? >> the problem is both of them have committed to an overall plan for the federal budget that calls for a cap on total federal spending. basically they're going to say this is how much money the federal government is going to spend. it's an extremely low number and if you sit and do the math, no matter how you change the numbers, no matter how you play with the different options, there is just no way there is 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 then of course congressman ryan keeps saying

look. you know, i'm worried a program like medicare won't exist at all unless we do something. >> right. >> let me ask specifically about this cap you just mentioned. because, 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 right now would have the same effect as the ryan plan would it not? >> they do have the same cost trajectory. but there is a key difference. this actually brings us back to the question of, is there ending medicare or is it not ending medicare? when i think of medicare and what was created in 1965 it was a guarantee of benefits, a promise to the seniors that no matter what happens you will get the benefits. you will be covered. if it costs more money we'll find a way to do it. either we'll pay higher taxes, run a higher deficit, take money from somewhere else. no matter what happens those benefits are solid. and the way the obama plan is structured is true to that

promise. nothing will change benefits. the republican approach does not do that. what the republican approach says is that no matter what this is how much the federal government is going to spend. and if health care gets more expensive then something else is going to have to give and that something else could very well be that seniors have to take up the slack. what is more important? is it more important to say to seniors no matter what we're going to guarantee those benefits even if we have to pay more taxes, even if the deficit is higher, even if we have to take money from somewhere else? we're going to give you those 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 is what this debate is about. who gets the guarantee? that is really where we are. >> yeah. it's interesting. you have congressman ryan, governor romney, president obama all very 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. thanks so much. >> thanks for inviting me.

>> see you soon. we'll stay on topic. coming up, invasive heart procedures on patients who didn't need them. stay with us.

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welcome back. 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 and says the company revealed it is now under federal investigation. investigators curious if some of its cardiologists were doing heart procedures such as catheterizations and placing stints patients didn't really need. the allegation is the doctors were doing it to make money.

my friend my colleague elizabeth cohen is here. her specialty is reporting on ways patients can challenge and communicate better with their doctors. it caught your eye and mine as well. does this seem pretty real? i know it is under investigation. have you heard anything new on this investigation? >> what's interesting is that there have been studies that show that if this is true, this investigation is still going on, it's not actually that uncommon. researchers have looked at catheterizations and whether they're really necessary in general not just at hca. there was a journal of the american medical association study last year. they looked at 500,000 stenting procedures and 1 in 8 were deemed inappropriate. there was one hospital that had a 55% inappropriate rate, more than half of them inappropriate. >> if there is no question these things can generate a lot of money for hospitals and even for the doctors specifically depending on the relationship of the hospital but how do you know that something is unnecessary? if you're a patient and you go

to your doctor and the cardiologist says you came in with some symptoms. i think you need a stent. what do you do? >> that is a tough one. i'm going to divide it into two categories. if there is an acute need for a stent, you're having chest pain. it is bad enough it drives you to the emergency room and they do a test and they say mr. smith you're having a heart attack, you need a stent. do not argue. and i'm going to say that again. i want to be very clear about this. if you're told you're having a heart attack and you need a stent you need that stent and you should not go about asking questions and getting second opinions. however, some stents are given electively. they'll say you know what? we think you have a blockage. we're going to give you a stent. you haven't had a heart attack. we want to help you with your symptoms. in that case you want to ask, do i have some time to make this decision? do i have a couple days? maybe you want to go and get a second opinion. maybe you should get more tests done. as we've seen these inappropriate rates are relatively high. >> the second opinion, should it be in a different hospital, different practice all together?

>> yes. most experts do recommend that because if you go to the person's partner that partner might feel compelled to agree with their buddy but if you go somewhere else they don't. >> an area you are familiar with, most areas of public health involve risk and reward. doctors tell you what you're trying to prevent but risks of the stenting procedure, what -- >> interesting. let's talk about the benefits for a minute. we were told by cardiologists that actually stents don't prevent heart attacks. they help you with your symptoms but they don't necessarily prevent a future heart attack. there isn't a lot of science to show that. there definitely are risks. for example there is a risk of having a heart attack because of a stenting procedure. there is a risk of having kidney damage, a risk of having a stroke, and when we talk, let's look at what a stenting procedure looks like. i think people can better 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 cause problems and that is why you have the risk of heart attack and stroke. this is an invasive procedure. >> how many of these are done every year? >> hundreds of thousands of these are being done every year. most of them are done for acute reasons. mr. smith, you've had a heart attack. but there are still plenty done electively to hopefully make people's symptoms better. that's the time, the case where you have some time to think about it. >> right. and then the bottom line again you said 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 you've had a heart attack, get a stent. >> thanks so much. coming up an 8-year-old girl who is already changing her world and now she has written a book. ♪ [ male announcer ] its lightweight construction makes it nimble... ♪ its road gripping performance makes it a cadillac.

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one of my favorite parts of the show every week we bring you the story of someone who fought through adversity to achieve greatness in some way. this week we have our youngest human factor yet. samantha brownly is just 8 years old and was born with hearing loss but did something wise beyond her years. she saw it as a chance to help. >> mostly about my hearing aid, what i do in life. >> samantha brownly is 8 years old and is already a published author. >> i have a hearing aid. i wear it in my left ear. >> reporter: her book which she wrote at the ripe age of 6 is about how she copes with hearing loss. >> some people have a problem, different problems that they

have in life but they don't really want to share it. i like to share it. >> reporter: samantha and her 11-year-old brother shawn both were born with damage to nerves in the inner ear, permanent damage in both ears. but at an age when taunting from their peers could shatter their self-image samantha and shawn are undaunted. >> we never saw it as a disability. it's just a factor. i mean, i wear glasses. i don't have a sight disability. i just need help with my vision. you know, they're hard of hearing, not profoundly deaf. so they need help with their hearing. >> we always taught the kids if anybody asks just tell them, it's not -- if somebody asks what's in your ear just say a hearing aid. no cover up. don't be embarrassed. >> without the word disability weighing her down samantha found it in her to write and illustrate this book. >> it helps me hear better because it makes the sounds louder. >> it's called samantha's fun fm

book. her name is on the cover. >> i was so proud of her. amazed but not amazed because she is pretty amazing. i just thought it was a wonderful project at first and then it sort of took on a life of its own. >> a life of its own including sales of samantha's book on amazon.com. and this psa for the hearing health foundation. >> you can do anything or go anywhere, achieve anything, survive anything, if you get knocked down you can get back up and that's what i want from my kids. >> it seems that idea of achieving anything has caught on and though she has many years ahead of her samantha has advice for children and adults about how to overcome. >> no matter what happened i just try, try, try. you can help someone else with it. >> and samantha says she is already planning her next book. in fact, she is planning her next four books. she says they're going to be about using hearing aids. also about candy. she is 8 years old. coming up next you can see a

special visitor pulling up outside the cnn center. it's mr. glenn keller one of our fit nation lucky seven athletes just getting off the road from an 800 mile drive from texas. i'm going to go see if he is ready for the big triathlon which is just a month away. well who said breakfast. on a tuesday. can't be special. get that great taste anytime. with kingsford match light charcoal who dreamed she could fly. like others who braved the sky before her, it took a mighty machine, and plain old ingenuity to go where no fifth grader had gone before. ♪ and she flew and she flew, into the sky and beyond. my name is annie and i'm the girl who dreamed she could fly. powered by intel core processors. ♪

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my brother doesn't look like a heart attack patient. i'm on a bayer aspirin regimen. [ male announcer ] be sure to talk to your doctor before you begin an aspirin regimen. i'm a fighter and now i don't have that fear. . you drive more than 3,000 a week in his truck so when glenn keller submitted his video to the fit nation triathlon challenge frankly we weren't so sure he would be able to fit exercise into that hectic schedule.

this week he steered his truck to cnn to give us an update on how he's keeping up. >> hi. how are you? your home away from home. >> the command center. >> i get to take a ride in this? >> yes you do. >> i've been wanting to. all right. i have to ask. how have you been doing with the training? going all right? >> we've been doing pretty good. in spite of my schedule recently i had a chance to set up something with a pool in baltimore because i was getting to baltimore every week and only getting to swim just when i was home. now that i've made this little arrangement there i can swim on both ends now. >> a lot of people have busy lives. you just drove 800 miles is that right? >> yes, sir. >> and just fitting in time to exercise must be challenging. >> it's really challenging. it's kind of a thing where i really can't wait to find time. i've got to make time. i stop at the truck stop to fuel and before i go to bed or something when i first get up

because by the time my day gets going i don't even know where i'm going to end up or where i'm going to stop or what the situation is going to be. so okay. this is an opportunity of how i'm going to do something. >> when we're in hawaii swimming you and i talked about this briefly and i -- we have said, look. if you don't feel comfortable or safe by the time the trap line comes around we don't want you to swim. >> exactly. >> what do you think? >> at the time i was thinking wow to have been going through all this and get to malibu and not be able to swim would be probably the biggest let down. it nudged me to kind of concentrate and ask people questions. >> right now you think you want to do the swim? >> i believe i'll be ready without a doubt. >> a lot of people may not know but you were displaced after katrina. >> yes, sir. >> and then you moved to -- and made your life there after that. >> i did. yes, sir. >> there is a church lower ninth ward i believe that has asked you to come back and be their pastor. >> yes, sir they have. >> i heard that today.

that's really very flattering i'm sure. it's quite an honor. >> and i feel really honored. it's been quite an experience. we had a chance to have the first service there. >> it's still being rebuilt. >> it is in the process of being remodeled. >> you did the service outside? >> we did the service inside. i have an invertor that runs my stuff in the truck so i got an extension cord and ran it to the box and all the lights came on, ceiling fans, wall sockets. >> let there be light. >> i love it. always great to see you. i feel good about my job when i get to talk to you. i feel like we're making an impact. i appreciate that. >> i feel great being associated with you and your team, sir. >> this week's chasing life, we know how important a good night's sleep is. but you might be surprised by this. it's a new study o heavy snoring in children. it's not necessarily cute. in fact, it