All Blog Posts from Couric & Co.

Wyatt Andrews is a correspondent for CBS News based in Washington.

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Sometimes, my own, actual life bears a resemblance to what I cover.

This very morning, by coincidence, my doctor sent me to have a c/t scan, (cat scan) to help diagnose a minor pain which I keep complaining about but which he can't figure out. Cat scans, which typically cost several thousand dollars, are often cited as the key example of what's called defensive medicine: the practice of ordering too many tests or medical procedures "just to be sure" of a diagnosis. The costs of defensive medicine are likely in the ten of billions of dollars, but what are we are patients supposed to do? Should I have questioned such an expensive test? To save (CBS's) money, should I have asked for an x-ray instead?

Tonight's story, which is on the nationwide practice of defensive medicine, focuses on the case of a Richmond college student who went to the emergency room with stomach pain and (guess what?) was immediately given two cat scans.

She had a harmless ovarian cyst, but her father had a near stroke. He got an $8,500 bill -- most of which, $6,500, was for his daughter's two cat scans. The hospital defends the test, saying they had to rule out other complications, such as a kidney stone. But the student's father, who is also a physician, could have and should have found her cyst with a thousand dollar ultrasound.

However you judge this particular case, defensive medicine adds billions to the costs of health care, in unneeded imaging tests, diagnostic tests and surgeries. Too often, it's not about having an extra test "just to be sure;" the doctor is ordering extra tests to protect against being sued.

Several health care experts say there is a list of questions to ask your doctor to help screen the necessary from unnecessary procedure.

1) Why is this test needed?
2) Is there an alternate test that's less expensive.
3) Could the results of this test really change my diagnosis or treatment?
4) What's the risk if I decline the test?

You have a right to ask: Did I ask these questions before I got my own cat scan? Honestly? I asked two of the four, question 1 and question 3, essentially because I really want to know this pain isn't serious. (We'll know by Friday.)

Skeptics say we will never truly reform defensive medicine -- that we have to cap damage awards from malpractice lawsuits first -- because of this critical point: a test what might be defensive and unnecessary in one patient, might also help or save the life of another.

Wyatt Andrews is a correspondent for CBS News based in Washington.

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It's very odd to see a booth for state-sponsored health care planted under the bleachers at Boston's Fenway Park. Health insurance has a kiosk at the baseball game? The people manning the booth stand there hawking the program, directly across from the balloon guy and directly behind one of the dozens of beer stands where young men wait in line, six-deep, for 20-ounce beers.

All of which means the state people know what they are doing. They know who they are missing in the program. They are missing young men, perhaps up to 130 thousand of them--most of whom are Red Sox fans.

Just to review, last year Massachusetts became the first state to take a truly serious stab at universal health care insurance, using an approach you will begin to hear more of as the presidential election nears: individual mandate. The approach means you must buy private health insurance. You can get it through your employer or buy it yourself, but you have to buy--or be penalized on state taxes. The state will help you pay if you cant afford it. And the state has worked with a handful of insurance companies to offer several low cost policies that are much cheaper (family plan with drug coverage, $662 per month) than what the rest of us could buy on the open market, where the average price is $11,000.

Here's what's great about the plan...

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Wyatt Andrews is a correspondent for CBS News based in Washington.

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I admit the idea of a college "posse" sounded frivolous to me when producer Jill Rosenbaum asked me to consider doing a story on a graduating class of "Posse" students. The concept, pushed by Posse Foundation founder Deborah Bial, is that low income, inner city high school students will have greater chance at succeeding in college if they are admitted with a posse, the urban word for a group of friends who support you; who have your back. Think of it as going to college on a team. I scoffed at this because I've always thought high-achieving American students of any color or background can succeed anywhere-- without a fancy version of extended group therapy. Why would a smart, driven kid need a posse? My pre-conceived notion would prove to be--while not wrong--somewhat idealized...

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Wyatt Andrews is a correspondent for CBS News based in Washington.

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Forget the actual cost of health care, for one moment, and focus on this question: why are hospital bills so buried in code, so averse to plain English? The simple answer is: hospital (and most doctors') bills are written in codes endorsed by the AMA (American Medical Association) and used by reimbursement specialists with the Federal Government and insurance companies. We the patients, simpletons that we are, aren't supposed to understand.

But it's deep within these overly complex codes that many experts believe mistakes get buried--and that most "mistakes" are usually overcharges.

One growth industry in America today is the rise of a specialty service whose practitioners are called "Billing Advocates." An advocate is trained to read a complex bill from the doctor or a hospital and find the errors. In our interview for tonight's CBS Evening News, Nora Johnson, a no-nonsense billing advocate from West Virginia says that of the thousands of medical bills she has reviewed for clients, maybe three have not had errors. To be clear, that's three clean bills out of several thousand. Nora showed me one bill with a $1,000 charge for giving a patient a toothbrush.

"Are these errors deliberate?" I ask. "I call it profitable error," she responds...

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We begin our Evening News series on food safety tonight with a look at just how broken the food safety system is in America.

I have never seen official Washington so unanimous. Everybody knows the system doesn't work. Everybody, including the key members of Congress, knows that the fault lies with Congress. Everybody wants Congress to strengthen the system. How to do this exactly, what what agency, with which new regulations and with what funding are open questions. Needing to act is not an open question.

The problem is simple to define. Taxpayers spend most of their food safety dollars on the USDA, which has the primary job of inspecting animal carcasses inside slaughterhouses. Fine. Except that most Americans are getting sick today from e coli on produce; spinach and lettuce. And produce is regulated by -- the FDA. When the FDA tried to trace the source of the huge e. coli outbreak in spinach last September, it took weeks to find the farm, and the source was never precisely defined. The e. coli came from manure, either from cows or pigs, but they don't know how. Irrigation water? Soil? Splashing from rain?

It's tempting to blame the FDA, but given the agency's meager resources, it's lack of research dollars and the fact it does not have the legal right to proactively inspect farms, you can see why the problem is legislative.

Not to be graphic about this, but in the spinach outbreak four people died and almost 200 got sick because we are allowing animal poop to get on salad greens. Dozens of the people who got sick were very sick. They were on dialysis because of kidney failure, or plasma pherisis because of toxic blood.

You will hear a proposal in our story from Senator Dick Durbin to upgrade the Federal food effort by making one single food agency. I'm not sure this is realistic, and honestly, neither is Durbin. But Congress at a minimum does need to update the system, and put a much higher priority on research to make farm produce safe. Public confidence in fresh vegetables is on the line.

Want to get ahead? As Wyatt Andrews found, in some places you need to break a sweat. Really.

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How many of us work for companies that want us -- make that encourage us -- to go to the gym during lunch? Not many, right? But let’s keep going. How many of those companies feel so strongly about workers staying in shape, they’re willing pay cash as incentive? The list of these companies is short right now --but that’s changing. The idea of worker “wellness” is in vogue.

As part of our series, "Prescription for Savings," producer Jill Rosenbaum and I traveled to IBM headquarters in Armonk, NY, when in any given year an employee might pocket up to $450 cash by taking advantage of the company’s full range of wellness incentives. You get a one time payment of $150 to stop smoking. Then its $150 every year you agree to exercise 3 times a week, and another $150 for every year you fill out a personal health record -- a private, online survey--that once complete, tells you where you run the highest risk of future disease and recommends a personalized plan of prevention. The hallways at IBM headquarters are so full of power walkers, the place has the feel of an indoor track. And the gyms are full of people giving themselves raises by working out.

(Note to bosses at CBS: IBM workplaces have gyms!)

IBM officials aren’t spending all this cash to be nice. This is a corporation saving money. And it is saving by targeting the health cares woes Americans largely inflict on themselves: diseases related to smoking and obesity. IBM knows with certainty it’s $130 million investment has been paid off by fewer sick days, greater retention and by the diminished frequency of heart attacks and diabetes.

Outside of IBM, wellness has grown into a nationwide cottage industry, as employers and insurance companies discover the payback. Wellness incentives include discounted insurance rates, discounted gym memberships or a reward point system for workers to redeem merchandise.

(Note to bosses at CBS and CBS News. How come WE don’t do this?)

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Correspondent Wyatt Andrews has a glimpse of some casualties of war you may not have heard about: veterans buried by bureaucracy.

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We often lament the fact that over 3,000 Americans have died in Iraq, but here's another number the nation has yet to confront: 176,000. This is the number of veterans from Iraq and Afghanistan who have filed disability claims with the Department of Veteran's Affairs -- a number that has swamped VA, or to be more accurate, buried the VA in paperwork. Because of a pre-existing backlog of claims (which depending on how you count it ranges from 400,000 to 600,000!), thousands of returning vets are waiting far too long for claims determinations--and benefits--at a time when they've been retired from the service and are out on the economy, looking for work, searching for the next phase in their lives and expecting a bit more from the people who sent them to war.

In our Evening News story tonight, we profile a 23-year-old Iraq amputee, Sean Lewis of Dale City Virginia, a now-retired Army veteran who lost most of his right leg and some of this hearing to a mortar blast. Sean, like a lot of veterans we spoke to, tells the story of how there are two VA's. There's the VA Hospital system, which (after waiting for their appointments) most vets rate as excellent. And then there's the VA benefit claim system which Sean calls, "horrible...probably the worst in the world." After 8 months he's still waiting for a final disability rating, which determines his check. To be fair to the VA, the system began partial payments to him based on his lost leg, but the rest of the story he tells -- of lost records, duplicate doctors' appointments and constant bureaucratic delay -- amounts to what he calls "eight months of chasing your tail." The VA told him just last week they've resolved all but two of his claims--in other words, it's still not final.

His story is important because he isn't alone. Every major Veterans' Service Organization, the VFW, American Legion, DAV, AmVets, all of the agencies that deal with the VA every day say the agency is overwhelmed, burdened by a cumbersome appeals process and badly in need of more staff.

The only person we found to disagree with the staffing problem is the Secretary of the DVA, Jim Nicholson, who told me the VA is properly staffed and funded. My bet is he's in for a pounding from the new Democratic Congress, which has a whole series of hearings scheduled on how to reduce the backlog and upgrade the system after 5 plus years of war.

I think most Americans will find unacceptable the very notion that returning veteran's might be ill-served in any way.

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Tonight, Wyatt Andrews reports on a new frontier in medicine -- one that could change the way many of us are treated. And it's as close as your keyboard. -- Ed.

We are calling our series of reports this week "Prescription for Savings," but tonight's story really features the gathering power of the internet; in this case, how the internet may drive down the cost of health care.

We watched as a Richmond man, Gary Garcia shopped online--no exaggeration--for heart surgery.

Think about it. Isn't is just a shade crazy how most of us will drive several miles to shave two cents off gas prices, but when the hospital says your knee surgery costs $17,000, we say OK; we don't even question it? We tend not to question it for two reasons 1) we don't want to cheap out on health care, especially when we're sick enough to need a highly skilled, knife wielding surgeon and 2) we don’t have enough market/price information to compare the costs of surgery. Hospitals don't post a price list like McDonald's. The internet is rapidly changing this last part.

Gary Garcia shops for his heart surgery on a website called healthgrades.com, where for a fee he learns the best hospitals in the Richmond area and a regional average price for his procedure. He can also (we didn’t see him do this) look up his surgeon to check for quality ratings or court judgements. Healthgrades.com is just the beginning. On the radio in the DC market, Aetna health plans are advertising newly available cost information. Florida has a state run website where you can comparision shop for prescriptions!

Some health care economists predict that as more people like Gary do comparison shopping for medical procedures, it's a matter of time before the explosion of cost information leads to market competition, which can only drive down prices. There are naysayers out there---most of them in the hospital industry, who doubt that consumers will ever warm to the idea of bargain basement surgery, but watch Gary mouse click his way into this frontier and tell me you don't see the future.

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Our story on tonight's CBS Evening News took us, and will take you, into places the news rarely goes: deep into the inner city and-- into prison. But this is no story of despair. It’s a story of hope--at least, so far.

You will meet, as I did, 16- year-old Israel Rosario, a street kid essentially being raised by his grandmother in a crowded north Philadelphia row house. Israel’s father is in prison. His uncle just got out of jail. During our interview, there on the street, with a vacant lot and a car hiked up on cinderblocks in the background, Israel was happily surprised by the arrival of his grandmother’s boyfriend, who was also in jail, released just an hour before. As Israel hugged this man, a man he views as his grandfather, the central truth behind Israel’s life was right there visible in this embrace. Every close male relative he has is in the criminal justice system. Not one is successful in any traditional way.

Prison, quite literally, runs in Israel’s family.

In our research we learned Israel isn’t alone. Academic studies have estimated that 70% of the children with locked-up parents will wind up in jail themselves, mostly because these children are never taught how to behave and survive outside of a life on the criminal edge.

But that’s not the focus of our story.

Our story is mostly about how to reverse this pathway to crime. It’s about mentoring, specifically a national program called Amachi,which arranges mentors for the children of people behind bars...

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