By Stephanie Smith
CNN Medical Producer

The national conversation about medical marijuana - in particular smoked marijuana - is complex and often polarizing.

I liken it to having a conversation with my father-in-law about politics/race/religion/poverty/health care – you name it. We start off meaning to have dignified conversation, but we inevitably spiral into growling matches peppered with words like, “those liberals…” and “c’mon, you’re smarter than that…” or “that’s crazy! That’s insane.” In reality, we are not so far apart on the issues, but somehow we can muddy the conversation so that it seems like we are.

The medical marijuana debate has been historically cast in equally polarizing terms: Groups are either for or against legalizing it.

That is what makes a subtle, nuanced move by the American Medical Association at a board meeting on Tuesday such a remarkable twist in the dialogue. The AMA shifted a 72-year-old policy about smoked marijuana, acknowledging that there could be some medical benefits, and urging reconsideration of the drug’s Schedule I status (Schedule I is a drug of abuse with “no accepted medical use.” Heroin and ecstasy are also Schedule I).

The AMA’s new policy language suggests that “marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines.”

What that means is that marijuana should be reconsidered as a Schedule I drug so that wider studies can be conducted that may establish that it is worthy of prescription drug status.

The organization is quick to add that it is by no means endorsing state-based cannabis programs or legalization. It also does not go as far as to say there is evidence that cannabis meets the rigorous standards met by prescription drugs on the market now – yet.

But that “yet” is key. What the new policy - and a forthcoming study - concede is that several short-term trials have shown that smoked cannabis is effective to treat neuropathy (nerve pain) in patients with HIV and hepatitic C. It is also effective, again, in a small number of trials, for stimulating appetite for people on chemotherapy; it may also be useful for patients with multiple sclerosis, to ameliorate pain and spasms.

The idea behind this policy shift is to widen the berth of studies about smoked marijuana, and to conduct them in a controlled manner, just as is done with prescription drugs, so that the debate can quiet down and give way to scientific evidence.

Now if only I could quiet down those debates with my father-in-law.

What do you think about the AMA’s new position on medical marijuana? Do you agree that it should be taken off of Schedule I status to make way for more studies in this area?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Miriam Falco
CNN Medical News Managing Editor

20 years ago today, the Berlin Wall began to come down. I vividly remember standing in the CNN newsroom with tears rolling down my cheeks, watching images of people crawling on top of the wall. It was something I never imagined I would see, having spent the first half of my life growing up in West Berlin. Now a lot has happened in the past two decades – on both sides of the pond. But one of the things that sticks in my mind as a person, as the journalist in me continues to cover health reform in the U.S., is that growing up as a child in West Germany, I always had health insurance. Now it wasn't the upper-echelon, "you'll get a private room in the hospital" kind of coverage. But if my siblings or I were sick, we went to the doctor – it was as simple as that. Not so in the United States, where over 45 million Americans lack any kind of health insurance and many million more may be covered, but are one major illness away from bankruptcy.

The reunification of Germany didn't come cheap and the German government is facing fiscal crises too, including a health care system that is going broke. But as the years have gone by my friends in Deutschland who needed treatment for cancer or multiple sclerosis or the common cold – got it, no matter if they had a job or not. Now the U.S. Senate has been tossed the health reform hot potato, after the House of Representatives narrowly passed its health care bill this weekend. We’ll see what happens next.

Do you think every American has a right to health coverage? Or does the ongoing political battle cause your eyes to glaze over? Tell us what you think.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Ashley J. WennersHerron
CNN NY Medical News Intern

Come May 2010, I may be forced to trade in my health insurance for my college diploma. The results of the ongoing health care reform debate may determine what happens.

My current insurance carrier, TriCare Standard, is common for military families. I am coverd by them until I’m 23 years old, or until I can no longer classify myself as a full-time student. If I continue through graduate school, I can keep my health insurance for two more years. The problem is that when I finish graduate school, I’ll have to work to pay off any loans. With the current job market, my chances for finding long-term work that provides healthcare coverage, are slim to none. Not only will I have to worry about loan payments, I will also carry the extra concern of finding and paying for a health insurance plan.

My predicament is a familiar one for most college students. About 20 percent of us are uninsured, according to a report conducted by the U.S. Government Accountability Office. For the 80 percent of us with coverage, our insurance will turn to dust soon after we flip our tassels to the right side of our mortarboards in May.

However, we can protect ourselves. We must learn the details of our current plans, and our options for the future. Insurance regulations vary state to state, meaning a plan based out of Virginia may strip me of insurance the day after graduation, but the same plan in Florida may allow me to keep my insurance until the age of 30, as long as no one becomes dependent on me.

President Obama’s health care plan calls for a national age limit of 25 years old before a person is removed from his or her family’s insurance plan, which would provide the time necessary to find a job and make a dent in loan repayments. Students and recent graduates might also consider short-term coverage plans with catastrophic caps, to be used for unforeseeable health emergencies. It’s something, but that type of plan doesn’t provide for the every-day possibility of minor injuries or common illnesses.

Consider moving out of the college dorms the day after graduation: You can accidentally cut your hand with the scissors you are using to cut tape. That’s an out of pocket expense for stitches. You could drop a heavy box on your foot. That’s another expense. The dust you inhale from under your bed may induce an asthma attack. There’s the possibility of an ambulance ride and a hospital stay, none of which is covered in a short-term plan, because it’s a pre-existing condition.

Are you a college student, or a parent of a college student, worried about your future health care insurance options? Are you a recent graduate who can’t find a job that offers health care?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By David S. Martin
CNN Medical Senior Producer

President Obama is scheduled to address a joint session of Congress tonight in an effort to breathe new life into his health care overhaul. Critics have gone after the cost of his proposal and claimed the president’s plan is a first step in a government takeover of health care. Central to this second charge is the specter of a faceless government bureaucrat standing between you and your doctor.

I thought of this the other day when a neighbor approached me, his voice shaking with frustration. He had just received a letter from Blue Cross Blue Shield, rejecting his application for health insurance. The letter was signed, if that's the word, "Sincerely, Underwriting Department L 24.”

What makes this case curious is that Blue Cross Blue Shield had been insuring my neighbor and his family for the past 15 or so years through his wife's state job. When she resigned to stay home with their 1-year-old, he never dreamed Blue Cross Blue Shield would not accept his application to purchase private insurance. After all, he thought, the insurance company was familiar with his family’s medical history. There are no expensive chronic diseases such as diabetes or expensive life-threatening ailments such as cancer on their record. My neighbor says he occasionally suffers from allergies. That’s it. His 1-year-old is healthy. To further confuse matters, Blue Cross Blue Shield accepted his wife and teenage daughter for health insurance.

The whole story sounded strange. I asked him if he’d mind if I called Blue Cross Blue Shield. Here is the response I got:

To protect the privacy of our members and their medical information, Blue Cross and Blue Shield of Nebraska (BCBSNE) does not comment on the specifics of individual cases. In general terms, however, each individual application for medical coverage is reviewed thoroughly and carefully, based on standard criteria which differs between individual and employer group business. BCBSNE accepts most applicants, but there are occasional denials based on health conditions and eligibility requirements.

I asked Blue Cross Blue Shield about L 24 and was told that’s not a person but the code for the form letter my neighbor received. As we listen to the president make his case for health care reform, we should remember “L 24” and know that the government does not have a monopoly on faceless bureaucrats.

Has a faceless bureaucrat ever stood between you and your doctor?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Tim Langmaid
CNN Medical Managing Editor

Some of the dust has settled from the health care reform debate surrounding end-of-life care (otherwise known as the "death panels"). To say that it became a focal point of the debate doesn't fully capture what happened. It was such a hotly contested issue that a leading senator said such discussion would not be part of the reform bill that emerges from the Senate.

How we choose to spend our final days is not only a very personal decision, it also touches on a number of other intimate issues including our religious beliefs. In fact, there may not be a more personal question than "How would you like to spend the days before you die?"

One potential benefit of all the talk (and indeed some of the shouting) about end-of-life care during the health care reform debate is that it may have spurred some folks to have the discussion with their loved ones. That certainly would be the "glass half full" view. So I wanted to ask you: Did the debate over end-of-life care prompt you to think about your preferences? Have you talked with your family? How did it go? Are you still waiting to have the talk with your loved ones? Why are you waiting? We'd like to hear from you.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By John Bonifield
CNN Medical News Producer

It's a loaded issue - will health reform include coverage for illegal immigrants? President Obama has said no, with a possible exception for children, and the plans being drafted by Congress bar illegal immigrants. However, opponents say that the House bill leaves loopholes that may allow undocumented residents to benefit.

"There's no system for verification," said Ira Mehlman, media director of the Federation for American Immigration Reform, a lobbying group that aims to reduce immigration.

"On the one hand, they have language in there that says illegal aliens are not going to be eligible, but at the same time they're getting a lot of heat from the Congressional Hispanic Caucus, from the Hispanic leadership groups, that say we want everybody covered including illegal aliens," Mehlman said. "They're trying to have it both ways here. They're saying to the public, 'Don't worry. Illegal aliens aren't being covered,' and they're turning around to these special interests and saying, 'Well, don't worry. There really is no system to prevent them.'"

In July, Democrats voted down an amendment to the House bill that would have required mechanisms to verify citizenship. The Congressional Hispanic Caucus, which advocates on behalf of Latinos, said in a statement to CNN that health reform should include legal immigrants who have followed the rules.

"The issue of undocumented immigrants is a separate one that is too often used to confuse the health-care debate. When it comes to undocumented immigrants, the caucus' priority is seeing comprehensive immigration reform enacted," said Rep. Nydia Velázquez, a Democrat from New York, chairwoman of the Congressional Hispanic Caucus.

That's something Obama has said he'd like to see as well - immigration reform that would provide a pathway to citizenship - and legal access to the health plan.

It's estimated that illegal immigrants and their children make up about 17 percent of uninsured people in the U.S., according to recent data by the Pew Hispanic Center. Long-term estimates by the Congressional Budget Office predict that 17 million people will remain uninsured under the reforms of the House bill. Nearly half of them are projected to be illegal immigrants.

Tell us what you think. Should health reform include coverage for illegal immigrants?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By David S. Martin
CNN Senior Medical Producer

An orthopedic surgeon told me the story recently about a 300-plus pound man whose feet gradually failed under his immense weight - until he walked on the inside of his ankles.

He required complicated surgery on each foot and ankle – 3 ½ hours in the OR, a night in the hospital and months of rehab each time. The bill ran into the tens of thousands of dollars for a problem largely attributable to his weight.

“Bones aren’t any bigger than they were thousands of years ago,” the surgeon told me. Unfortunately, we are. And bones and tendons don’t grow to accommodate body weight.

The debate about health care is largely about dollar figures. How much will it cost? How will it affect the deficit? How much will it raise our taxes?

There are a couple of figures that don’t often make the debate, and they may pose an even greater challenge. I’m talking about the obesity rate and the percentage of Americans who continue to smoke.

A government-sponsored study recently estimated that medical spending for obesity reached $147 billion in 2008, almost doubling in the past decade. It’s not surprising. About 32 percent of American adults are obese, a condition linked to diabetes, heart disease, even cancer. As the story above illustrates, obesity can also do a number on your bones and joints.

If you want an idea of how big $147 billion is, it’s roughly 6 percent of all health care spending in the United States.

How about smoking? Almost 21 percent of American adults are addicted to cigarettes, according to the Centers for Disease Control and Prevention. That’s more than 45 million people. The estimated health care costs pegged to smoking: $96 billion.

It’s virtually impossible to live in the United States and not be aware of the health risks associated with smoking, yet the addictive habit continues – with tragic consequences for smokers and an immense burden on the health care system.

The Congressional Budget Office caused an uproar when it projected that Obama-backed changes in the health care would add $239 billion to the deficit over 10 years.

That’s nothing compared with the cost of obesity and cigarettes. Over 10 years, those costs top $2.4 trillion.

And that leads to the obvious question: How would you get Americans to lose weight and quit smoking?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Stephanie Smith
CNN Medical Producer

Three words - health care reform - have transformed the national conversation. And with the vigorous debate elicited by those three words - in Congress, on newscasts, on blogs, in opinion pieces, average Americans are coming out of the woodwork to tell their health-care horror stories.

One of those stories came to our health blog from P.J. May of Ohio, who is the primary caregiver to her 87-year-old mother, who suffers from Alzheimer's disease. A few years ago, before taking on that role, May was working full time, and had what could be considered a decent health-care plan through her employer. However, as her mother's health deteriorated, May made the tough decision to cut her hours to part time to help care for her, and with that she lost her health benefits.

Next, May. did what many in her position would do - she shopped around for private health insurance. She found a plan, but for her budget, the payment was going to be steep. You see, working fewer hours, May brings in only $700 a month, and $213 of that goes toward private health insurance.

May’s situation probably sounds familiar to many Americans who purchase private plans. She's paying an exorbitant amount on premiums, and on top of that, out-of-pocket expenses. In her case, premiums alone constitute about one-third of her income.

She, and many other bloggers, viewers and tweeters writing to us want to know: Will a new public health care plan be affordable for me?

"I don't know if Obama's decisions are going to help me or make it worse," May wrote in an e-mail to CNN.

To find out more about the cost of health care under a public plan, we pored over the 1,000-plus-page health care bill currently in the House with policy expert Kenneth Thorpe of the Rollins School of Public Health at Emory University in Atlanta, Georgia.

Thorpe crunched the numbers, and what he found may not match most people’s idea of “cheap.”

The uninsured, along with small business owners, would get first crack at purchasing a public plan, with the government providing subsidies to reduce costs.

Under the House plan, as it is drafted today, May's entire health care bill would be subsidized by the government. She would not pay a dime out of pocket for health insurance. So, for her, the news is good.

As income creeps above the poverty line, the cost of health care would also creep up, on a sliding scale. So an individual making $21,660 a year, according to Thorpe, would pay $1,083 under the House plan, while an individual making $43,320 would spend $4,704 a year, which is $392 a month.

The same goes for a family of four. At the lower end of the spectrum, a family of four with an income just above the poverty line - $44,100 - pays $2,205 under the current House bill, while a middle class family, making $77,175 a year would pay around $77,15, which is about $650 a month.

Ouch.

A caveat, however, is that those figures include co-pays and out-of-pocket costs.

Still, even considering subsidies, the cost of the public plan is concerning to some legislators. They say that the cost burden on the middle class is too high.

But Thorpe says to keep in mind that on average a family of four today pays around $12,700 a year for health care - more than $1,000 a month.

"[The public plan] sounds expensive, but it's thousands less than what the average family of four pays right now," said Thorpe.

What do you think? Does the public option sound too steep for your budget, or is this alternative better than what you're paying now?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a regular feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From iReporter Jason in San Antonio:
"Four years ago my father was diagnosed with terminal brain cancer.  [For] 18 months we fought that disease with everything we had because we felt like every day was precious, every day we kept him alive we were one day closer to a cure for that disease. I guess my question is, under a public option or government run health care system, would that type of care be possible? Is it something that 10 years from now we're going to have to sacrifice or come up with a tremendous amount of cash to pay for it because it would be rationed under our government run health care system?"

Answer:
First, Jason thanks for sharing that personal story. Our best wishes are with you and your family. The idea of rationing really strikes at the core of all that we are talking about with regard to health care - this idea of lowering costs, trying to increase access. The question is, will we have to ration health care as a result?

There was a New York Times editorial a couple of weeks ago by Peter Singer, a bioethicist at Princeton University, where it was put like this: "The death of a teenager is a greater tragedy than the death of an 85-year-old and this should be reflected in our priorities."  Think about that for a second. He's saying we should assign value of life differently in certain situations.

Jason, we took your story specifically to the White House and asked them to respond. They said, "Our heart goes out to Jason and his family. We know families across America are dealing with issues like this every day. There are a number of different bills making their way through Congress right now but we do know this: The reform bill that the President signs will not lead to rationing. It will be fully paid for and bring down costs over the long term." They went on to say, that the President won't sign a bill that doesn't guarantee coverage to all people of all ages regardless of  specific health conditions.

But as you're saying, Jason,  it may come down to numbers and whether estimates of the cost of  health care reform are accurate. When Medicare hospital insurance was conceived in 1965, the House Ways and Means Committee projected that in 25 years it would cost 6 billion dollars. The actual cost? 67 billion, according to the Centers for Medicare and Medicaid Services. You can see how far off costs for Medicare were, based on initial projections –much, much higher. Now the president says they'll add prevention programs and wellness programs, creating a healthier population and that will be a cheaper population with regard to health care costs. But who knows? You've got more people that you're trying to cover; more people, more tests, more screening. How that all adds up, we're just not sure.

Do the health care reform headlines leave you with more questions than answers? Dr. Gupta is your health care reform insider – and he wants to hear from you!

Post your questions for Dr. Gupta in the comments below or tweet him @SanjayGuptaCNN.