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President Obama Holds Bipartisan Health Care Summit; Breaking Down Health Care Costs

Aired February 25, 2010 - 22:00   ET


SANJAY GUPTA, CNN ANCHOR: Good evening. I'm Sanjay Gupta, in for Anderson tonight.

You can look at what happened in Washington today as a bunch of politicians simply arguing. Or you might reach into your wallet and pull out one of these, because, at the end of the day, this health insurance card is really what today was all about, getting a card like this to 31 million Americans who don't have one, making it more affordable for the rest who do, keeping the insurance companies accountable, and making sure we all don't go broke in the process.

Today, President Obama brought Democrats and Republicans together in another last-ditch attempt at hammering out their differences, all day back and forth. To be honest, all of it just wasn't must-see TV. So, tonight, we're going to do some triage, to borrow a medical term. We watched all of it, so you don't have to.

Here's Ed Henry on the moments that counted.


ED HENRY, CNN SENIOR WHITE HOUSE CORRESPONDENT (voice-over): The stakes couldn't be higher. He's betting his presidency on getting a health reform deal. This was his last-ditch attempt to save it.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: What I'm hoping to accomplish today is for everybody to focus not just on where we differ, but focus on where we agree.

HENRY: A tall order, when you throw dozens of members of Congress into a made-for-TV drama at the historic Blair House.

SEN. JOHN MCCAIN (R), ARIZONA: Can I just finish, please?

HENRY: The president's 2008 rival, Republican John McCain, quickly tweaked him over campaign promises.

MCCAIN: Eight times you said that negotiations on health care reform would be conducted with the C-SPAN cameras. I'm glad more than a year later that they are here.

Unfortunately, this product was not produced in that fashion. It was produced behind closed doors. It was produced with unsavory -- I say that with respect -- deal-making.

HENRY: The president defended the transparency of the talks and gave as good as he got.

OBAMA: Let me just make this point, John, because we're not campaigning anymore.

The election's over.


MCCAIN: Well, I -- I'm reminded of that every day.


OBAMA: Well, I -- yes.

HENRY: Even the sharp exchanges were civil, if a bit jaded, each party hammering familiar talking points.

SEN. JAY ROCKEFELLER (D), WEST VIRGINIA: The health insurance industry is the shark that swims just below the water. And you don't see that shark until you feel the teeth of that shark.

REP. PAUL RYAN (R), WISCONSIN: Should (AUDIO GAP) regulate all this? Should (AUDIO GAP) people in Washington decide exactly how this works and what you can and cannot buy?

HENRY: After about six hours, Republicans believe they made their case to the American people that the president's plan is simply too costly.

SEN. LAMAR ALEXANDER (R), TENNESSEE: It means that, for millions of Americans, premiums will go up, because those -- when -- when people pay those new taxes, premiums will go up, and they will also go up because of the government mandates.

HENRY: But Democrats believe the president got the better of the Republicans.

OBAMA: So, Lamar, when you mentioned earlier that you said premiums go up, that's just not the case, according to the Congressional Budget Office.

ALEXANDER: Mr. President, if you're going to contradict me, I ought to have a chance to -- to...


BARACK OBAMA: Oh, no, no, no, no. Let me -- and this is an example of where we've got to get our facts straight.

HENRY: A CNN fact check gives the edge to the president. The CBO found that his plan would lower premiums for millions of Americans, and those facing hikes would get better coverage.


GUPTA: I will tell you, Ed, sort of listening there, both sides really claiming victory, but we understand you have got more reporting that sort of moves the ball a little further?

HENRY: Well, yes. It shows how the Democrats are more nervous than they're letting on publicly.

What I'm picking up from Democrats close to this White House is, they have started warning the president and his top advisers that, if they don't get this health care deal done by late March, when Congress is going away for the Easter recess, they're going to move on when they come back in April, and they want to go back to jobs and the economy, the things the president -- other things the president's been talking about.

And what that tells us is, the president has a very narrow window. Basically, from this summit meeting that has ended today, he has one month until the end of March to really move the ball forward. It shows you the clock is ticking.

And as much as they were publicly trying to project some confidence, behind the scenes, what I'm picking up is that Democrats are very nervous about trying to get this through quickly in the next month. It's a tall order for sure, Sanjay.

GUPTA: Yes. You definitely felt that sense of urgency today, for sure.

Ed Henry, thanks so much.

Let's dig a little deeper now with senior political analyst David Gergen, who was on the Clinton White House staff the last time health care reform was tried, Dr. Bernadine Healy as well, former head of the National Institutes of Health and currently health editor for "U.S. News & World Report," also with us, Dr. Sandeep Jauhar, cardiologist and author of "Intern: A Doctor's Initiation."

Thanks to all of you for joining us. A fascinating day.

David, you know, it was interesting. Right off the top, it seemed like the president took away this idea that people have been bandying around for some time that maybe the whole thing should just start all over again. I know you spoke to David Axelrod about that as well earlier today.

David, where does this go from here? How important was this day?

DAVID GERGEN, CNN SENIOR POLITICAL ANALYST: Well, I think it was an extremely good day for American politics, because the people of the country had a chance to listen to what I thought was a robust exchange over the course of the day. And we will come back to the politics.

But I think the -- Sanjay, where this winds up is that any idea of a grand bargain or compromise between the Republicans and Democrats is now gone. The Republicans want the president and the Democrats to start over. They're not going to do that.

The Democrats are asking the Republicans, well, give us some of your amendments. Maybe we will tack them on to our bill. The Republicans are not going to do that. So, that's gone. And what is now left is whether the president and the Democrats are going to use this so-called process of reconciliation to try to pass a comprehensive bill.

And, at this point, they may -- they do not appear to have the votes to do that, but they will try to do that over the coming month. If they -- if they feel they can't do that, that they don't have the votes, then they may revert to plan B, a watered-down version, which, as "The Wall Street Journal" reported today, and CNN has been confirming, would involve extending health insurance to about 15 million Americans, instead of 30 million Americans. But even that could be a heavy lift.

GUPTA: That's sort of a field goal, instead of a touchdown, if they are on the 99-yard line, as they have been talking about.

David, later on, I'm going to ask you if this should pass and can it pass.

But let me go to Dr. Healy for a second.

Dr. Healy, you heard -- you heard Ed Henry's report just a little bit ago. The nonpartisan Congressional Budget Office says the president's plan would lower premiums for millions of Americans, and those facing hikes would actually get better coverage. I mean, what -- you -- you have written about this extensively. What is wrong with that?

DR. BERNADINE HEALY, FORMER NATIONAL INSTITUTES OF HEALTH DIRECTOR: Well, I think what's wrong with it is that you have to define what better coverage is.

Sure, you get a more comprehensive, more detailed plan, but maybe you're a 30-year-old person who could -- who could get coverage for $1,000 with a catastrophic plan and with primary care, inexpensive primary care visits, and you don't want the $5,000 plan, you don't want to pay that extra few thousand dollars to have that bigger plan, and, as a matter of fact, you can't afford it, and you don't want to have to go on the government dole. Just give me my $1,000 plan.

So, that is the fundamental problem. The -- the fact is that premiums will go up, and they will go up on people who don't necessarily need that expensive policy. And what -- what this is showing is that the -- the individual, the patient, has been left out of this whole discussion.

And I listened to the whole thing. Where is the patient?

GUPTA: Right.

HEALY: We have heard lots of politicians. We hear lawyers. We hear everything else.


HEALY: Where is the patient consideration? GUPTA: Well, we're definitely going to talk about that a lot.

But let me -- before I get to Dr Jauhar -- should everybody has insurance, Dr. Healy? Should -- should everyone -- is everyone supposed to have it, or should they have insurance? Should it be mandated?

HEALY: I think everybody should have insurance that suits them individually, at their stage in life and at -- considering their personal needs.

And I think, for young people, a catastrophic policy, in which they save money for the future, they have a health savings account, that makes a lot of sense. When you're older, something different is better, and a more expensive policy is more important.

GUPTA: All right.

HEALY: And the fact that the president almost scorned it, he called the catastrophic policy Acme insurance, says that he has a very rigid notion that there is one-size-fits-all policy for every American. And I think that's wrong.

And it made me think, boy, we have to start over.


GUPTA: Well, I know Dr. Jauhar has some -- something to say about this.

A lot of the president's critics, Sandeep, say spending nearly a trillion dollars on health care reform is simply not the right way to save money, that, on a fundamental level, it would just make the federal government more bloated.

Do you share that concern? I mean, should the federal -- what's the federal government's role here? And what about what Dr. Healy said?

DR. SANDEEP JAUHAR, AUTHOR, "INTERN: A DOCTOR'S INITIATION": Well, I mean, if -- if you listen to the -- the estimates from the White House, the -- their plan will cut the budget deficit by about $100 billion over 10 years.

So, you know, we're talking about a system that occupies one- sixth of our economy. It is, by all accounts, tremendously wasteful. And it's not working for more than 50 million Americans. So, something has to be done to correct the inequities and the waste.

And the fact is, you know, I keep hearing that the system -- that the plan is so revolutionary. But the fact is that it builds on what we already have. And if you compare the -- the -- the reform measures that are being proposed and -- with what was done in Western Europe post-World War II, I mean, these are very -- these are fairly incremental measures that -- that we're talking about. GUPTA: All right, we -- we're going to drill down on some of the specific details. And, to Dr. Healy's point, we're going to talk about what this means to you folks.

We're going to get back to all of you in just a moment.

Let us know what you think. The live chat is up and running -- You can also send your questions and comments to me on Twitter at SanjayGuptaCNN.

Up next: David Gergen just mentioned it, the way President Obama might try to push a reform bill through Congress. It's called reconciliation. Do you know what it really means and why everyone is really yelling about it? Stick around.

Later, what's with that big stack of paper, the body language, all the catchphrases that were used today? You know what? We're going to translate this into plain English, all the stagecraft, tonight -- all of it on 360.


GUPTA: President Obama wrapped up the meeting today with a request and a warning as well. He asked all sides to search for common ground but also warned that time is running short, before he starts to think about other measures to pass a bill.

Now, you might have heard about this, one possible strategy -- or at least heard Democrats and Republicans arguing about it. The "it" in question is reconciliation.

And Jessica Yellin is here to explain how it all works -- Jessica.


Let's first start with some basic civics. In the U.S. Senate, all it takes it 41 votes to stop a bill in its tracks. So, even though Democrats have a big majority, it's not big enough. Republicans have enough votes to block health care. All those red votes is enough.

Now, there is a way around this, and it's called reconciliation -- big word, simple concept. It's basically a rule that says, in some circumstances, you can pass a bill the way most of us probably think the Senate works, with a simple majority, just 51 votes.

So, Democrats, now they're threatening to use reconciliation to pass health care, and that has everyone fighting. That's because you're supposed to use reconciliation in only limited circumstances, on budget bills, you know, taxing and spending, stuff that's just too crucial to hold up.

So, Republicans say it would be an outrageous violation of the rules to use it to pass health care. That just doesn't apply. Democrats, they say, stop whining, get on board, or get ready for reconciliation -- Sanjay.

GUPTA: Hmm. So, can they -- can they use reconciliation to pass a health care bill? I mean, is that even on the table?

YELLIN: Right. What's the bottom line? The answer is, yes, they can.

It's been used on health care measures plenty of times. OK. You know, the law that helps you keep your health care after you leave a job, COBRA?

GUPTA: Right.

YELLIN: That was passed using reconciliation. In fact, the R in COBRA stands for reconciliation.

GUPTA: Right.

YELLIN: The Children's Health Insurance Program, known as SCHIP, that extended health coverage to millions of kids, also passed by reconciliation. Medicare has been amended many times using reconciliation. So, yes, there is precedent for using it to pass health care -- Sanjay.

GUPTA: All right. This is obviously a big deal and much broader, potentially. Jessica, we will be back with you later in the show.

Back with our panel now, though, digging deeper with senior political editor David Gergen, Dr. Bernadine Healy, and Dr. Sandeep Jauhar.

Welcome back.

David, let me go back to you, if I can. You know, the president seems to be in a tight spot here. If he doesn't get something passed this year, his -- his -- his base is going to be furious. Ed Henry was just talking about that.

If he pushes it through via reconciliation, Republicans are going to cry foul.

Let -- let me ask you this. First of all, can it happen? And, second of all, should it happen, based on everything that you have known and have seen?

GERGEN: Yes, I think it can happen. He's going to have to scramble to get the votes for -- to move this bill through the Senate and the House with a reconciliation process. So, it can happen.

The question, I think, Sanjay, is it wise to move forward in that way?

GUPTA: Right.

GERGEN: It's going to be -- clearly, the Republicans are going to call foul and say it's yet another deal by the Democrats.

But there's also this question, is it wise to pass a bill, major, landmark social legislation, with only one party voting for it, and the other party completely opposed? We haven't seen that in this country stretching back to the New Deal.

And is it wise to pass major social legislation when the polls show, on a consistent basis, that the public is basically, you know, 15 points against it? And -- and we haven't seen that either.

So, today's -- I want to come back to the politics of today. What the Democrats hope to do is use this, as the president did in Baltimore, when he met with the House Republicans, use this as an opportunity for the president to show his mastery and really give momentum to health care.

And the president deserves credit for having this session. He was -- I thought he was gracious throughout it. He was fair-minded. He made his -- he made his points very well.

But the surprise was how forceful and robust the Republicans were in responding to that. From my point of view, intellectually, the Republicans had one of the best days they have had in years, because they showcased a group of senators and congressmen, especially younger congressmen, who were very interesting and I think more than held their own with the president.

I think it came out to be a draw. And I don't think the president probably got the momentum he hoped in order to -- to get over this reconciliation mountain.

GUPTA: Did he get it with the public, do you think, if not in the room?

GERGEN: I -- we will have to wait and see. You know, you -- I may have totally misjudged this. But my sense is that the arguments were at least evenly balanced on both sides. And I doubt it moved the needle in the way on public opinion in the way the White House had really hoped.

It was -- it certainly didn't turn out to be a trap for Republicans. They -- they were -- they came ready to play this time.

GUPTA: Yes. I mean, it was a very smart discussion, no question. I watched all of it.

Dr. Healy, Republicans -- you have heard this -- they say they want to start from scratch. Basically, anything short of that is unacceptable, deal-breaker. Is that a realistic approach, when you're the minority party? And, you know, as you know, you're a doctor. There's a lot of people waiting for this to happen. You know, people have been waiting. You know, they have been suffering without health care insurance, as you know. You have talked about that.

HEALY: Well, I think that starting from scratch, I think what they're really saying is starting with a clean slate. They have a lot of building blocks. They have a lot ideas. What are the ones that really belong in this bill?

You and I have both read this 2,700-page bill, and it's filled with a lot of nonsense and a lot of things that don't focus on the two issues. Can we bring -- we must bring down the cost. We have a cost crisis. We must bring it down.

And, number two, we have to cover all Americans in a very reasonable and healthy way. Now, it's not clear that you need 2,700 pages to get that accomplished. And there is so much noise in the bill that it is not clear that it is going to happen.

GUPTA: Well...

HEALY: And, in fact, when I heard today, I said, wait a minute. This sound like they're just starting the process, not ending it.

GUPTA: Right.

HEALY: And, most importantly, I couldn't figure out what dollar they were going to save in that whole discussion on cost saving. They weren't saving money at all, except maybe the FBI would come in and get a few crooks.

GUPTA: Well, and, to be fair, the Republican plan, as it was outlined, didn't seem to offer the access that you -- you have been talking about as well, the three million potentially more Americans.

We will talk about that in a second.

But, Dr. Jauhar, you say the president's plan doesn't go far enough. You support it, but you wish there was a public option, which isn't on the table, as you heard today. And then you also heard David Gergen talk about potentially a plan B, sort of a skinny plan, as it's being called.

What happened here? I mean, this seemed to have so much momentum last year, even part -- partly into the summer. What happened?

JAUHAR: Yes, I -- I would like to see a public option, because I -- like many Americans and many doctors, I would like to see the private insurance companies held accountable for some of their excessive behavior.

And I think that more competition in the marketplace is a good thing. I would like to see the plan go forward on several fronts that -- where it hasn't. I would like to see malpractice reform. I think doctors do undoubtedly practice defensive medicine because of fear of lawsuits.

I would like to see universal health care coverage. This plan doesn't achieve that, but the fact is that the Republican plan doesn't expand access to health care as much as the Obama plan does.

And I would like to see the -- the cost curve bent. I think the Obama plan does that credibly. I don't see the Republican plan doing that as effectively. GUPTA: OK.

You know, we could talk all day about this. Obviously, some of the things you're talking about simply aren't going to happen, as we know now, Sandeep.

But a great discussion. Hope to continue it.

David Gergen, Dr. Healy, Dr. Jauhar, thanks so much.

GERGEN: Thank you.

GUPTA: And just in case the mere invitation wasn't enough to bring lawmakers to the table, they also served lunch -- you always get people with food -- a nutritious spread, as it turns out, of hot chicken, grilled salmon, a selection of spinach and seasonal veggies, also salads, cold turkey, grilled tenderloin.

When asked what he had, President Obama said the chicken.

Good thing he didn't have a cheeseburger. It was the health summit, after all.

Up next: how each side treated the room at Blair House like a stage, and why. Tom Foreman is going to break it down for us.

Plus: new video of the moments leading up to this deadly killer whale attack. It's remarkable, scary -- all of it when A.C. 360 continues.


GUPTA: You know, one thing you can say for sure is that today's health care summit involved a large dose of showmanship, even stagecraft, so to speak, on both sides.

Tom Foreman reports.


OBAMA: Everybody, please have a seat.

TOM FOREMAN, CNN CORRESPONDENT (voice-over): From the opening curtain, the president made it clear what he did not want as director of the show.

OBAMA: I hope that this isn't political theater, where we're just playing to the cameras and criticizing each other.

FOREMAN: But, on both sides of the stage, the players had other ideas. So, act one started with a turf war over speaking time -- Republicans calling foul.

SEN. MITCH MCCONNELL (R-KY), MINORITY LEADER: To this point, the Republicans have used 24 minutes, the Democrats 52 minutes. Let's try to have as much balance as -- as we can. FOREMAN: As political stagecraft, that served two purposes. It implied the Democrats were being unfair and put the president on the defensive.

OBAMA: I don't think (AUDIO GAP) quite right, but I'm -- I'm just going back and forth here, Mitch.

FOREMAN: Act two: the casting. The president time and again referred to everyone in the room by first name.

OBAMA: Thank you, George.

MCCONNELL: Mr. President...

FOREMAN: It looked friendly, but protocol demanded that they still call him Mr. President, giving him the upper hand, even when they tried to call him out.

MCCAIN: Could I just say, Mr. President, the American people care about what we did and how we did it?

OBAMA: We can have a debate about process, or we can have a debate about how we're actually going to help the American people at this point.

FOREMAN: Act three: the props. It was no accident that a huge copy of the health care bill dominated the table on the Republican side. That's Republican Whip Eric Cantor peeking over it. It was so his party could remind voters of just how big, complicated and expensive it is.

RYAN: And the Senate Budget Committee chairman said that this is a Ponzi scheme that would make Bernie Madoff proud.

FOREMAN: And act four: the monologues.

REP. NANCY PELOSI (D-CA), SPEAKER OF THE HOUSE: Certain things are facts.

REP. JOHN BOEHNER (R-OH), HOUSE MINORITY LEADER: Why can't we come to an agreement?


ALEXANDER: We want you to succeed.

FOREMAN (on camera): Over and over, despite a fair amount of meaningful discussion, lawmakers broke into speeches, implying that the facts supported them, that the other side was being unreasonable, and, if no agreement comes, it will be the opposition's fault.

(voice-over): In the end, there were no bows, only exits, and, in D.C. a true oddity of political theater. The president, normally the first to depart, was the last to leave.

OBAMA: You guys are still here?


FOREMAN: Tom Foreman, CNN.


GUPTA: That was a pretty big stack of papers. Cantor looked like he was having a hard time actually looking over them.

Tom Foreman, thanks so much.

Coming up, though, out-of-control health care costs, it's been the buzzword the entire day today. I'm going to take you into my operating room and show you how a typical hospital bill really breaks down.

But, first, latest on some other important stories, and Jessica Yellin joins us with a 360 bulletin -- Jessica.

YELLIN: Hey, thanks, Sanjay.

We start out with breaking news from Afghanistan, where two explosions have rocked Kabul. The blasts erupted near the Safi Landmark Hotel, not far from several government buildings and U.N. offices. We will be following this story closely as it develops.

Well, that trainer killed by a whale at SeaWorld yesterday died from multiple traumatic injuries and drowning. That's the verdict of the county medical examiner in Orange County, Florida, in the death of 40-year-old Dawn Brancheau. This is video now shot by a spectator just minutes before the attack. Now, you can see Brancheau feeding the 12,000-pound killer whale named Tilikum.

The body of actor Andrew Koenig, who had been missing since February 14, was discovered by friends today in Vancouver's Stanley Park. The 41-year-old Koenig co-starred on the 1980 sitcom "Growing Pains," and he had a history of depression. His father, "Star Trek" actor Walter Koenig, confirmed that his son committed suicide.

Well, Sarah Palin will headline the National Rifle Association's annual meeting this may in Charlotte, North Carolina. The NRA's executive director described the former vice presidential candidate as -- quote -- "an outdoorsman, hunter, and a steadfast supporter of our Second Amendment freedoms."

OK, and check out this video, some amazing footage of an avalanche as it happens. It's a Slovakian snowboarder. He's wearing a camera on his -- on his goggles. And he was on a run in the High Tatras mountains when the snow just -- it began to crumble around him. Check that out, just terrifying. Unbelievable.


YELLIN: But, lucky for us and for him, he survived, and, also, so did the camera with that footage. (LAUGHTER)

YELLIN: Unbelievable.

GUPTA: That is -- that is truly remarkable.

Have you -- have you ever been snowboarding before?

YELLIN: I -- I'm terrified of snowboarding, for exactly that reading -- reason.


YELLIN: Have you?

GUPTA: I have been. I have of course never been through anything like that. But that is just remarkable. I mean, it's -- terrific, obviously, that he survived. But though -- that avalanche looked like it happened really fast and very frightening.

YELLIN: Scary. Scary

GUPTA: Yes. All right, Jessica, thanks. We will see you later on the show.

Up next, though, how big a role do medical mistakes, lawyers, and malpractice insurance, how big a role does all of it play in the cost of health care? Well, the Republicans say a lot. We're going to run the numbers and we're going to put their claim to the test.

Plus, I'm going to take you on a tour of my own operating room item by very expensive item.

Stay with us.


GUPTA: And we're back. Let's get to another hot-button issue when it comes to fixing health care. What to do about doctors who make mistakes and whether patients suing doctors really drives up the case of medical care, in extreme cases even driving doctors out of the profession. We've heard stories like this, some pretty dramatic moments, on this particular subject today.


SEN. RICHARD DURBIN (D), ILLINOIS: There's a great hospital which I will not name. And at this hospital a woman went in for a simple removal of a mole from her face, and under general anesthesia, the oxygen caught fire, burning her face. She went through repeated surgeries, scars and deformity. Her life will never be the same. And you are saying that this innocent woman is only entitled to $250,000 in pain and suffering? I don't think it's fair.

(END VIDEO CLIP) GUPTA: You know what he's talking about is a Republican call for caps, what patients can collect, especially when it comes to punitive damages. Big payoffs intended to punish mistakes and possibly even deter future mistakes.

The question is, what do the facts say? We've been digging into this a bit.

According to an extended study by the "Vanderbilt Law Review," on average about a million people claim some sort of injury because of malpractice in a given year. Of those one million people, around 85,000 filed a lawsuit. But of those 85,000 lawsuits, only a fraction got any type of payout.

Now, of course, there are some big-money, high-profile cases like the $40 million to a family in Massachusetts for a baby born with severe brain damage. But that's -- you know, that's far from typical.

The real question is, do malpractice lawsuits have a major impact on overall health-care costs? The answer seems to be no, according to the Congressional Budget Office. Malpractice lawsuits payouts account for nearly 2 percent, roughly 2 percent of all health-care costs.

But here's where these costs do add up. The fear of being sued is pushing more and more doctors to practice what is called defensive medicine. Recent poll, in fact, found that nine out of ten doctors say they ordered tests not because a patient needed them but to avoid getting sued.

Even worse, some physicians avoid complex operations or complex medical problems for the same reason: defensive medicine. It's where things really start to add up for you, the patient. That's why we're talking about it. This constant concern about being sued can add up to about $850 billion a year. That's according to a recent Gallup survey.

And finally, there's this. In some cases the cost of medical malpractice insurance has gotten so high doctors say they are forced to stop practicing medicine altogether, and that's making it hard for some of you to find a doctor.

In Mississippi, for example, there are certain areas where women in their last trimester of pregnancy may have to temporarily live up to 100 miles away from home just so they can receive proper care from an obstetrician, because there wasn't an obstetrician closer to home.

Let's talk more about this issue that gets so many people worked up. Anthony Tarricone is president of the American Association of Justice. It's the largest trial bar in the United States. He's represented plaintiffs in medical negligence suits. Also here with us, Dr. Albert Strunk. He's vice president of the American College of Obstetricians and Gynecology. He used to be a practicing lawyer, as well, interestingly enough.

Dr. Strunk and Anthony Tarricone, thank you for joining us. This is a fascinating topic. It was a big topic, as you may note, today. Critics of tort reform say it takes away the patients' rights, does nothing to provide insurance for the uninsured, and it doesn't create better health care. Earlier today President Obama said medical malpractice is not the single biggest driver of medical inflation.

So can tort reform help our viewers? Can it help patients?

DR. ALBERT STRUNK, VICE PRESIDENT, AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGY: I think that the American public has clearly indicated that it's not happy with the system as it is. A Common Good and Committee for Economic Development poll last fall indicated that 83 percent of respondents favored some type of medical liability reform.

What Americans really want is a system that is going to allow doctors to disclose, air, to apologize and for them to get prompt and fair compensation for medical injury.

They also know that, by and large, the American health-care system and the American technology is -- is really terrific, but no system is free of mistakes. And we need to be able to have a system that is -- that deals with the issue of adverse medical outcomes, whether they're due to negligence or not due to negligence.

The figures that you mentioned in terms of the cost of defensive medicine are very significant, and our polls show that more than 65 percent of our doctors indicate that they've changed their practice because of concerns about fear of litigation, and they do practice defensive medicine.

GUPTA: I have a feeling Mr. Tarricone is not going to agree with all of this. And to be fair, President Obama, even before today, has talked about the idea of setting up panels to create more safety standards.

But Mr. Tarricone, what about the notion that lawyers are benefiting financially from malpractice suits? Doctors like ob-gyns are retiring early because they can't afford the liability insurance and causing stories like the one I told you.

ANTHONY TARRICONE, PRESIDENT, AMERICAN ASSOCIATION OF JUSTICE: The truth is taking away the rights of patients who are injured through no fault of their own will do absolutely nothing to reduce the costs of health care, to provide insurance to the uninsured, or to improve the quality of health care.

Ninety-eight thousand patients are killed every year in the United States as a result of preventable medical errors. And the focus should be not on taking their rights away but on patient safety, improving patient safety.

Every week in this country we have 48 wrong-sided surgeries. Every year we have 2 million hospital-acquired infections, many of which could be -- the number of which could be reduced substantially with simple hand washing programs. We have countless medication errors year after year, which could be reduced with simple changes, with electronic and bar coding of medication orders.

When a patient, through no fault of his or her own, is overdosed or given the wrong medication, they shouldn't have their rights taken away.

And with respect to defensive medicine, I have to say the proof really is in the pudding. In states like Texas, which already have the most restrictive limitations on lawsuits, doctors order tests at the same rate as they do in states that have absolutely no limitations. In fact...


GUPTA: The issue there, I mean, it could be possible, as you, I think, suggested, that sometimes doctors, people order more tests because it may be lining their pocketbooks, as opposed to practicing defensive medicine.

But let me give Dr. Strunk a chance to respond here. We've talked about how doctors may be changing medical practice. But what about what Mr. Tarricone is saying, Dr. Strunk?

STRUNK: It's commonly stated by the trial bar that this issue is about taking away patients' rights. And the thing that's never stated is that relatively few patients who have an adverse medical outcome, whether that's a medical adverse outcome because of negligence or because of other factors, actually get the kind of representation or get any kind of an outcome that is favorable to them in terms of compensation.

And why is that? Because the only connection between liability, a finding of liability, is the severity of injury. So the way the tort machine works is you've got to have a stream of patients with very severe injuries coming in to make the practice profitable, because it's only in those kinds of cases that there's a correlation with these very large awards. This is the jackpot justice that we're all aware of.

And while -- and patients don't want to wait four or five or six years for the tort process to have a roll of the dice and a 50/50 chance of getting a recovery. Fifty-fifty may be a good business model for the trial attorney, but it's a terrible model for the patient.

So there are a number of alternative systems which I'd be happy to talk about, which we think would align -- would give the patient the kind of compensation that's needed. Give it to them expeditiously, and also give us a more reliable system for determining good and bad medical care.

GUPTA: And it sounds like what you're suggesting would take some of the lawyers out of the whole thing. I need to let Anthony Tarricone respond quickly to that. Anthony, I don't know if you watched the closing remarks by President Obama today. He did seem open to this idea of tort reform, at least more open than I've heard him speak in some time.

TARRICONE: Well, the one thing the president has said is that he's completely against the idea of caps on damages, which is the number-one restriction that we hear floating day after day by the proponents of so-called tort reform.

Caps on damages, applied by their very definition, only to the most serious cases and cases that are deemed meritorious, already where liability has been found. The Harvard study in 2006 showed that 97 percent of cases file the were, in fact, meritorious and that over 80 percent of them involved serious medical injuries.

So, you know, the numbers that Dr. Strunk is -- is putting out there about not enough patients receiving compensation is no reason to take away the rights of patients who have been catastrophically injured.

GUPTA: All right. You know, again, another big topic. And I wish we could continue. Dr. Strunk sorry to cut you off there. But obviously stay tuned. A lot more on this. Anthony Tarricone, Dr. Albert Strunk, thanks so much.

Up next, I'm going to take you through my operating room, item by high-priced item. I'll explain it to you.

Also, can President Obama's health-care plan, or anyone's, bring those costs down? We're going to "Keep Them Honest."

Also ahead, it's not surprising that eating more vegetables can help you live longer. But there are other easy things you can do, as well. This is about personal responsibility, and we have lots of tips coming up.


GUPTA: Today's summit comes on the heels of a congressional showdown over skyrocketing health-insurance rates. You've probably heard some of the stories.

One major insurance company, WellPoint, is raising premiums 39 percent for policyholders in California. Think about that. Thirty- nine percent. That is hard to hear for a lot of people out there. And that's why many health executives continue to get pay raises.

To be clear, there's no proof that the rate hikes has anything to do with executive compensation, but it's also clear that insurance rates are rising. And so are medical bills. The price tag for a single hospital admission can make your head spin.

"Keeping Them Honest," I want to show you how these eye-popping bills really break down.

(BEGIN VIDEOTAPE) GUPTA: This is the hospital where I work where I'm a neurosurgeon. And just having an operation performed in a room like this costs about $3,000 an hour. That's for starters. Come on in.

Let's give you a couple of quick examples. If you look at a hospital bill you might see an I.V. bag charge. It's an I.V. like this. About $280 just for the I.V. bag. That might strike people as very high.

A stapler. This is a stapler that's often used in surgery. Something like this costs abut $1,200.

(voice-over) And like everything else I'm going to show you, it's used once, and then thrown away. Now, keep in mind: all these prices are what you, the patient, are getting billed for. It's all itemized. Hospitals buy these supplies at cost, and then like a retailer, mark it up at a higher price to charge for it.

(on camera) You'll find examples like that really all over a room like this. Suture. Something that's used in just about every operating room in the world. This type of suture over here costs about $200.

And if you look at even devices like -- this is a needle that's used for biopsy. So if there's a concern that someone has a tumor, they would use a needle like this. This is going to cost about $800.

Now, it's important to keep in mind, if you ask a manufacturer of a device like this, why so much money? They'll say, well, it took years to develop something like this. The research and development costs are significant. Also, they're guaranteeing a certain level of effectiveness of this needle. That costs money, as well.

Something maybe you didn't know. When you look at a hospital bill, it's not just the cost of the supplies. There's also administrative costs that are built in. There's the cost of covering people who simply don't have insurance or can't pay. That's built into these costs, as well.

And finally, keep in mind that what is charged and what is ultimately paid are two very different numbers.


GUPTA: In fact if you talk to some executives of hospitals they'll say, you know, for every dollar that is actually billed, sometimes the collections can be as low as 4 percent or just 4 cents on the dollar.

And I'll tell you, that right there is sort of the problem with health care. Everyone is sort of saying, "Hey, it's not my fault" and sort of pointing fingers like this.

And we did ask the hospitals directly, and they said they have to hike up prices so that patients that have private insurance will pay extra to compensate for those payers who pay less or are uninsured altogether.

And hospitals insist they're not making the profits that you might expect, having just watched that piece. We decided to check this all out. In fact, about 50 percent of our nation's hospitals are actually unprofitable, operating in the red.

We also found that the makers of many of those products that you just saw, they seem to be doing OK. Last quarter, companies like 3-M, which makes everything from adhesive to stethoscopes, profits were up by $935 million. Medtronics, that's the maker of pacemakers, implantable defibrillators, reported a profit of about $831 million. Gives you a little bit of perspective.

Still ahead, five simple things you can do right now to live a longer, healthier life. It's all about that. Best-selling author Dan Buettner is going to join us. That's next.


GUPTA: We're talking a lot tonight about health care and the high cost of it. As part of that, we also want to talk about personal responsibility. In fact, we didn't think we could have this discussion without it.

Personal responsibility. The hope for living a longer and healthier life. You have the power to make it happen, right now. Tonight we're going to show you five things you can do to increase your chances of living a long and longer life.

Joining me is Dan Buettner, a friend of mine. He's also a bestselling author of "The Blue Zones: Lessons for Living Longer from the People who Have Lived the Longest." Great stuff.

Dan, great to see you. You look well. I know you just flew in from Tokyo, which I've got to say, I'm not sure that's the best thing for longevity. But thank you so much for joining us.

DAN BUETTNER, AUTHOR, "THE BLUE ZONES": But I ate tofu so they balance each other out.

GUPTA: You ate tofu. Arguably, nature's finest food. You eat it, and you immediately metabolize it. So -- so good for you.

I want to get to these tips.


GUPTA: That's right.

I want to get to these tips. You say the first thing people can do to live a longer life is eat a big breakfast. Now, some people may hear that and say that seems counterintuitive.


GUPTA: Most people associate a hearty breakfast with one that's not particularly good for you. But studies do show that people who start off with a big breakfast, big meal, weigh less, make healthier food choices throughout the day compared to others who don't. What -- what's going on there? Why does that work?

BUETTNER: Well, first of all, we see it among all five longevity hot spots around the world. The longest-lived people start with, you know, oatmeal or nuts or beans with tortilla or stir fry with tofu. And the idea is to get complex carbohydrates, protein and fat. Because if you start your day with a full stomach, research shows that you actually consume fewer calories throughout the day, because you're not snacking, as compared to those people who start their day with a breakfast bar.

GUPTA: So what did you eat today? What was your breakfast?

BUETTNER: Well, I started it in Tokyo, so I had a bento box. And it actually had salmon in it and a sort of rice porridge and all kinds of sort of root vegetables.

GUPTA: So you got good -- you got vegetables. You got the good antioxidants and some good carbs, as well.

BUETTNER: To boil it down, I think the best breakfast, and you hear this from centenarians among the Seventh Day Adventists: oatmeal with nuts and raisins and a little bit of milk or soy milk. You cannot go wrong.

GUPTA: I'm going to live forever, because that's what I had this morning. Perfect.

BUETTNER: There you go.

GUPTA: The second thing on your list, sticking on a diet theme, is eating lots of vegetables. So less meat, more leafy greens, but also more beans and nuts, you say.


GUPTA: Super foods, right? That's what you call them?

BUETTNER: Yes, and I actually take that from the -- the longest- lived people in the world eat mostly a plant-based diet. And I think the way to think about it is to think about trying to cut as much meat out of your diet as possible.

We know that people eat especially processed meats have higher levels of cancer, higher levels of heart disease. So if you can cut meat to two times a week, a portion about the size of a deck of cards, you have it about right.

Beans we know are in every longevity diet. And interestingly, people who eat nuts four times a week, about two ounces at a time, live an extra two years. So that's an easy takeaway.

GUPTA: Now, the next one you say is -- is having sex. Now, we're not talking about progeny here. We're talking about longevity. But you visited communities around the world where there seems to be a link between -- between regular sex and longevity. Is that scientifically proven?

BUETTNER: Well, no. Let me -- we did a research expedition in Ikaria, Greece, and we found a group of men who had been studied by researchers for 45 years. They're 90 years old, and they have eaten the Mediterranean diet the whole time. And they report having -- 70 percent of them report having regular sex.

Now, we don't know if the sex made them live long or they lived long to have sex. But we do know that regular sex is associated with lower rates of depression, higher rates of sociability, higher rates of intimacy.

And if you looked at evolution, you know, we are here for one purpose. And that is to procreate. So it only makes sense that the more we do it, the more we'll be favored by evolution.

GUPTA: Of course, Darwin said that once you procreate your Darwinian warrant has expired. So you don't need to live that long. I'm not going to let you respond to that one, Dan. We'll pick that up another time.

BUETTNER: You know where I'll go.

GUPTA: Get some sleep, all right? Yes, right.

BUETTNER: Good to see you, Sanjay.

GUPTA: You, too. Thanks so much. Dan Buettner.

Next on 360, face to face. George W. Bush, Dick Cheney meet for the first time since leaving office. We get all the details coming up.


GUPTA: The health-care summit was big news today, but it wasn't the only stories. Let's get caught up on today's other headlines. Jessica Yellin back again with a "360 News Bulletin."

YELLIN: Thanks, Sanjay.

Charles Rangel, he's the chairman of the House Ways and Means committee, and he says he will be admonished tomorrow by the House Ethics Committee for accepting Caribbean trips from a corporation. That's a violation of House rules. Rangel's office says the ethics committee approved those trips.

George W. Bush and Dick Cheney met today for the first time since last year's inauguration. The former president visited the home of his former vice president outside Washington, where Cheney is now recuperating from that mild heart attack he had.

In the thick of Toyota's recall controversy, chief executive Akio Toyoda visited his company's largest North American manufacturing plant. Toyoda told workers on the Georgetown, Kentucky, assembly line the country -- company was at a cross roads and needs to, quote, "rethink everything about our operations."

And get this one. The man known as Mr. Las Vegas, he won a standoff with Nevada deputies, at least for now. That singer, Wayne Newton, the one and only, and he rebuffed the officers who brought moving vans to his 38-acre ranch. They were trying to collect on a debt for a breached contract.

But Newton's home -- which you can see is protected by a big gate -- was put up by collateral for a loan, and that house could be at risk, Sanjay. It's weak, but I've got to say no one's saying "Danke Schoen" here.

GUPTA: Where does all the money go? I mean, you hear that story so much. Celebrities clearly made a lot of money and then stories like this.

YELLIN: You've got to imagine they're paying their lawyers even more than they'd have to pay the court to just get it over with.

GUPTA: See, this dovetails really nicely into our whole show today. The lawyers, the doctors...

YELLIN: Right. Money, the logic.

GUPTA: So Jessica, I don't know if you know this, but for tonight's "Shot." Do you know the "Shot"?

YELLIN: I'm not sure.

GUPTA: You haven't been told. It's not a "Shot." In fact, it's a shout. A shout-out to you, Jessica.

YELLIN: Oh, my gosh.

GUPTA: Happy birthday.

YELLIN: Sanjay.

GUPTA: Happy -- you know, you worked on your birthday. That is such diligence. Amazing.

YELLIN: That's so nice.

GUPTA: To celebrate the occasion we wanted to give you a carrot cake. Carrot cake.

YELLIN: After your whole segment on what to eat that's healthy, am I allowed to eat this? It's so pretty.

GUPTA: Funny you should ask. Funny you should ask that. Because as a doctor after spending the last hour talking about health care, I have some bad news for you. That -- a slice of -- go ahead and have a slice. You're allowed to have the slice there.

YELLIN: Wait. How do I have a slice?

GUPTA: There's no knife?

YELLIN: Can I use a pen?

GUPTA: You, you can.

YELLIN: Wait. I want to blow out the candles. I got it.

GUPTA: Congratulations.

YELLIN: How many calories?

GUPTA: Five hundred.


GUPTA: Fifty grams of fat. But you know what? You deserve it and you look good. Jessica, can you see me over here?

YELLIN: I can see you.

GUPTA: Just got to point out something. This is what I got. Carrots. Just carrots.

YELLIN: You're eating the carrots, you're giving me the cake?

GUPTA: You got the cake. I got the carrots. Thirty calories here. No fat. So enjoy that cake but don't eat the whole thing. All right?

YELLIN: Just tonight. Thank you. Thank you. So sweet.

GUPTA: Happy birthday, Jessica.

Got a lot more ahead at the top of the hour for sure. A reminder, as well. Join me Saturdays and Sunday at 7:30 for my own program "SANJAY GUPTA M.D." What's up with that title, by the way?