CNN "Larry King Live" - Transcript
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KING: Since most of tonight is devoted to medicine, we want to remind you that Friday night a major program -- the full hour dealing with prostate cancer. And among the guests will be Colin Powell and Michael Milton. That's Friday night, one hour devoted to prostate cancer.
Three more doctors join us. In Clute, Texas, Congressman Ron Paul, Republican of Texas, medical doctor. By the way, he was a flight surgeon in the U.S. Air Force and an OB-GYN in private practice.
Here in L.A. Dr. Paul Song, radiation oncologist. He supports the president's health care initiative and believes there must be a public option.
And in Atlanta, our own Dr. Sanjay Gupta, CNN chief medical correspondent and a practicing neurosurgeon.
How will this debate about public access and the like affect you?
Your public -- will a public option affect you -- Sanjay?
DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Well, probably not. And, in fact, the president's come out and said that people who have private insurance right now, who have access to private insurance and who -- whose premiums are not above a certain percentage, overall, of their income, aren't going to be eligible for the public option.
So there's a lot of people who it won't affect. And I think that's really important, Larry, because there was all these -- this sort of talk about people sort of flooding the public option. Not everyone is going to qualify, myself included; you, as well, Larry.
Dr. Song, you favor it, do you not? DR. PAUL SONG, RADIATION ONCOLOGIST, SUPPORTS HEALTH CARE REFORM BUT WANTS PUBLIC OPTION IN FINAL PLAN: Yes. And I think the big reason is that Milton Friedman, who is an economist that a lot of the conservatives like to quote, in 2001, had an essay that basically said that the third payer system that we have right now was the most cost ineffective system that was available.
But since that time, the insurance companies continue to grow. Their -- their overall profits have increased by over 400 percent. And the premiums have raised by greater than 87 percent during that time.
And I think the big concern is that if we don't have a public option, all you're doing is putting more money into this system that will basically go to the insurance companies without any regulation for patients.
KING: Congressman Paul, if you agree something's wrong and you don't like public option, what do you like?
REP. RON PAUL (R-TX), MEDICAL DOCTOR, WAS FLIGHT SURGEON IN THE U.S. AIR FORCE, RAN FOR PRESIDENT: Well, I'd like to see a little bit more freedom. Most of the time people do say there's problems and nobody's denying that. But, you know, the problem is that we've had managed care -- we've had government manipulation of medical care for 40 years now. And so we can hardly say it's the private sector that has caused the trouble.
So I would like to see renewal of the spirit of freedom in this country, where we can trust the market, but not trust the government, because the government doesn't deliver. They've had Medicare. It's broke. They have veterans care. It's a lousy system. Nobody likes that. People aren't taken care of.
But what do we do?
KING: Do you...
PAUL: We have rejected the notion of, say, the church hospital. We've wiped them out of the business. We have Shriner Hospitals, 22 of them, that gives free care to all children. And they are having a trouble because of the inflation, because of the cost.
KING: Do you...
PAUL: So I think our biggest failure in this debate is we have not analyzed where the problems came from, rather than just saying let's go on with more government.
KING: Before I get back to Dr. Gupta, do you want to respond, Doctor?
SONG: Yes, I have a lot of respect for Dr. Paul. But one of the things that I think he's saying is incorrect. The idea that the V.A. system and, also, Medicare being failures or not being popular are absolutely false. The Rand Corporation, which is actually a conservative think tank, recently published a study that showed excellent satisfaction with the V.A. system and the Kaiser Family Foundation actually showed that Medicare is actually run more efficiently with much more dollars going for actual patient care than the private sector.
So -- and the other thing I want to touch on is this idea of freedom. We have less freedom when you are told by an insurance company where to go, where to get your pay -- treatment, where -- what hospital you need to get seen at. Some patients need to drive extra distances because their insurance companies won't let them go to the hospital that's in their own neighborhood.
If you had some sort -- type of single payer system, patients would be free to go wherever they wanted.
And I would also add, if you're really concerned about freedom, that if you're an employee who is stuck in a job that you don't like but you're there strictly because of the health benefits, if you had some sort of universal system, you could go to take a job anywhere you wanted.
KING: Dr. Paul, before we get to Sanjay, what do you think of the co-op idea?
PAUL: Well, if it's private, it's OK. But a government-mandated co-op won't work.
But the doctor mis -- misinterpreted what I said, because he didn't accept the fact that we've had managed government care.
So if he says it's -- it's not doing well, then you have to blame managed care, the tax code, tort law, how -- how well people can sell insurance across the borders and the inflationary problem...
KING: And you...
PAUL: And I did not say that Medicare didn't work, I said it was broke. And you've got to admit that. And here we're putting another program on the government system, the government's broke.
KING: All right...
PAUL: We have $2 trillion worth of debt this year...
PAUL: ...and you think we're going to add this new program and the government -- and the country's grown -- we're bankrupt.
PAUL: We're not being practical at all...
KING: Sanjay where...
PAUL: ...by talking about this.
KING: Sanjay -- Sanjay, where are you in this?
GUPTA: Well, you know, no one's good at controlling costs here. I mean, that's one thing that's an irrefutable fact. Whether it's the private sector or the public sector, you can't hold up any of these sectors and say, look, this is a good example of how to do this right.
And, by the way, it's not just the United States. It's around the world, where health care costs have outstripped -- outpaced, rather, inflation in just about every country in the world.
So this is -- this is something that we're dealing with as a global society, Larry. Whether it's people are using technology more, using more prescription drugs, whether it's chronic disease. You know, we spent over -- almost $150 billion on obesity-related diseases in this country alone.
So, you know, health care is expensive. And I think that that's really at the heart of a lot of this -- how exactly you pay for it, who's going to pay for it, exactly. I think that's where this debate is really centered.
KING: Let me get a break.
Still ahead, by the way, later on, Michael Jackson's doctor speaking out for the first time since his death. But our health care debate continues when we return.
KING: Sanjay, can you briefly explain the co-op idea?
GUPTA: A co-op is not government-run, although it may have some government seed money. It is a non-profit organization that, you know, typically is made up of people who are often members insured, meaning people that want to get health care insurance from a co-op, but also members of the board of the co-op. So they can help determine premiums. They can help determine what sort of services are covered.
The way that a co-op is successful, typically, is that it's based on scale. If you have hundreds of thousands of people involved in a co-op, actually buying into it, you can negotiate prices well and be competitive with the private insurance industry. So, you know, for example, a house mom in Tennessee watching right now, and she's uninsured, she's trying to get herself and her kids in church, she might join a co-op and it could be cheaper than private insurance, if they have a lot of people involved. If they don't, it's hard to compete.
KING: Dr. Song, does that appeal to you?
SONG: I think the problem with that, in my study of this, is that unless you have at least 500,000 people that will form a network, that it's going to be hard to do particularly in rural areas. And what you're seeing more and more in the past seven years is monopolies that have been formed by insurance companies that make it real hard for any type of negotiating power. And premiums have gone up.
So if you can't get 500,000 people together to really put together a good economy of scale, I'm not sure how this will work in large parts of our society.
KING: Congressman Paul, you're there in the House. Where do you think it's going? What are we going to get?
PAUL: A little incrementalism. I don't think Obama's going to get what he wants. But we'll have more government and the cost will continue to go up and the quality of medical care will go down. They put 50 billion dollars in the bill just for surveillance of every single medical transaction. And they have the legislation to control that in Washington.
So there will be no medical transaction that isn't controlled electronically and known by the government for so-called monitoring. So it's going to cost 50 billion dollars to try to find out where the waste and the fraud is, but the system is wasteful and fraudulent.
KING: Sanjay, you look puzzled.
GUPTA: Yes, I was -- I'm not -- I guess I was a little confused as to what specifically Congressman Paul was talking about there. I'm not sure if he's talking about the health IT or what, or if he's saying that's a bad idea. My understanding was that was to try and streamline a lot of the unbelievable paperwork.
You have primary care doctors who are seeing over 5,000 patients in their clinic. Each one of those patients comes with insurance forms and all sorts of other forms. To try to streamline that in some way has been one sort of tactic to try to increase the number of primary care doctors. I was a little confused by what you were talking about.
PAUL: OK, let me tell you. The stimulus package gave the authority to the executive branch to set up a computer system to record every medical transaction in the country. Now they put 50 billion dollars of seed money in there for somebody to monitor everything the hospital does, everything the lab does, everything a doctor does, everything a pharmacy does.
Now that is not going to be efficient. That's going to cost a lot of money, very confusing, and it's going to distort the whole concept. But when the government's in charge, and they want this one- payer system, this is socialized medicine. It doesn't work. It fails all the time. Some people may get care for a while, but eventually everybody's going to get equal care. But quality is going to go down. That's what it's all about.
KING: But you're not -- we don't have the best care now, do we, Dr. Song?
SONG: No, I would argue that no one agrees -- we can all agree that the current system is absolutely broken. And as far as the track record of how government programs work, I think Medicare has been in business for 45 years. My own father who was --
PAUL: But they're broke.
SONG: -- diagnosed with cancer is able to get access to care on a much more timely fashion than my own patients who are coming to me, who have private insurance.
KING: All right, tell you what, guys, we're going to have you all back, maybe tomorrow, because this needs a lot more attention than it's getting. And it's getting a lot. By the way, if you don't have insurance and need medical attention, a man helping to provide that care -- and we'll keep the panel for a little while too -- will join us next.
KING: Our panel returned momentarily. Many Americans have been shocked, dismayed during the past week by the sight of thousands of their fellow citizens waiting hours overnight for medical services from a free clinic set up at the Los Angeles forum. The event is the work of Remote Area Medical, a non-profit foundation that's generally focussed on bringing health care to rural America.
Joining us from the site is Stan Brock, the founder of Remote Area Medical. It's a non-profit volunteer airborne relief corps. Known to millions, he is, as the co-host and associate producer of "Wild Kingdom." Stan, how did this come about? What do you do?
STAN BROCK, REMOTE AREA MEDICAL: Well, it's -- the whole idea was born when I lived down in the Amazon, Larry. And I had a very bad accident with a wild horse. And when they were pulling me out from underneath the horse, they said the nearest doctor from here is 26 days on foot. It was about that time that I got the inspiration for trying to bring those doctors just a little bit closer.
KING: And that led to this? So how does this work? What's behind you?
BROCK: Well, you know, I formed this organization to provide care in the other situations around the world. But shortly after we started, I started getting requests to bring care to some of the areas in rural America. And that was many years ago. And it's just sort of grown from there.
And now 64 percent of all of the work that we do is here in the United States. And so we're sort of backing off from some of the places where we really need to be, like in Haiti and Zimbabwe, because of the pressure here from all of the millions of patients that need the care we give free of charge.
KING: And what can Congress learn from this?
BROCK: Well, I think one of the things they need to learn from it is that the greatest impediment to what we do, Larry, is that for some extraordinary reason that I've never been able to understand, a fully qualified and licensed doctor, dentist, nurse, veterinarian in one state is not allowed to cross state lines to provide free care in another state, except in the state of Tennessee, where the law was changed in 1995 to allow it.
So in Tennessee, we get doctors coming from all over the country to help out. Then we came to California, one of the other 49 states that does not allow it. And although we've seen many thousands of patients here, we could've seen twice the number had we brought in forces from outside the state to help.
KING: Stan, we salute you. It's not our hero of the week time, but you are our hero of the week. Thanks for joining us. What do you make of this idea, Dr. Song?
SONG: Well, I think it's a sad statement on our society that we need to set up these free clinics in major cities like Los Angeles, and have lines out the door and people waiting for many, many hours. If you talk about a waiting line, there's a prime example of that.
But I do think that there needs to be a partnership within the private sector and public volunteers to offer this. I don't think it can just be shared just by one aspect of our society.
KING: What do you think, Dr. Paul, Congressman Paul?
PAUL: Well, I disagree. I think it shows the greatness of America. If we had a free society and a prosperous society and no inflation, no wasteful wars that we spend trillions of dollars on, there'd be so much wealth in this country. There'd be thousands of clinics like this. And like I said before, there would be church hospitals. There would be more shrine hospitals. They wouldn't be closing down because of all this government interference and inflation.
Yes, we do have inflation. Just because the CPI isn't going up, the money -- because the government policies channels the money into medical care. That pushes prices up. That doesn't give you more quality care.
KING: Dr. Gupta, what do you think of this?
GUPTA: I've been to several of these places around the world, including Haiti, where RAM, Remote Area Medical, works. It is amazing to see some of those same practices now here in the United States. I'm not sure I completely agree with Congressman Paul on one point, though. And that is that if you leave it to sort of the better -- the goodness of man to try and take care of these problems, I don't know that it has been taken care of. Our private health insurance industry has not -- has created a situation where you have things like this sort of needed, necessary.
So I don't know. You know? It's somewhat hard to imagine that things I saw happening in Haiti are happening right there.
KING: I said it earlier, I'm going to bring you all back because we've just touched the surface. Thank you so much. Ron Paul, Paul Song, Sanjay Gupta, doctors all.
Michael Jackson's doctor speaks for the first time since his death. You'll see it next.
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