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 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.

By Stephanie Smith
CNN Medical Producer

When he, without warning, snatched my arm from my lap and nestled my hand into his, I must admit I was startled. My 10-year-old "captor," Darian Sepulveda lightly squeezed my hand, and would not let go. I turned to him and for the first time that day, found myself really looking at him.

In his eyes, I thought I saw glints of struggle and pain - but also a light, a profound understanding of the disorder that has hijacked his brain and his body. Darian, who is living with autism, has not been able to speak since he was 2 years old and he seldom gives people more than a split second of eye contact.

Just before he grabbed my arm, I had finished interviewing his mother, Ada Sepulveda, about the crippling costs associated with the care and therapies for Darian. From the moment Darian’s autism was diagnosed, when he was 2, the Sepulvedas began to rack up bill after unpaid bill. They have been devastated financially - taking out innumerable loans from family and friends, draining their 401(k) accounts. They've exhausted all of their resources trying to pay for Darian's treatment.

Ada is bitter about the almost daily battle she wages against her health insurance representatives to get Darian's autism-related health problems - including colitis and neurological and speech problems - covered by her health insurance carrier.

She was angry when she said, "Why do they do this with autism? Why is it treated differently than other diseases? It's inhumane. You don't tell a person that has a diabetic child, 'Oh well there's no cure for this.' You give them insulin. You treat them."

I posed the Sepulvedas' and other families’ cases to the Center for Affordable Health Insurance, which represents small businesses and health insurance companies. I asked why, when families are paying tens of thousands of dollars out of pocket for autism therapy and treatment, won't insurance companies foot the bill?

Kevin Wrege, a CAHI spokesperson, says that that services for autistic children are provided by each state: At schools, and through early intervention programs. CAHI's position is that the state should continue to help children with autism through the state system, instead of shuffling the burden of care to private health insurance companies. The result of that burden, he says, is that insurance rates will spiral even further for small businesses and individuals.

He added that diagnosis and medical treatment for autism are covered by most private health insurance plans. But therapies that are not definitively proven to help with autism - like applied behavior analysis, which is popular among parents - are not covered.

The coverage problems, according to families like the Sepulvedas, is not the more experimental treatments, but basic medical care. She says her claims have been repeatedly denied for basic medications that are not related to Darian’s autism and for things like an MRI when he exhibits neurological problems.

I turned to Christina Peck, who has 6-year-old twins on the autism spectrum, and who used to work in the health insurance industry. She says while the financial burden can be devastating to families, there is hope.

Peck helps families to work around the insurance companies coding system. She has advised families to, instead of calling an insurance representative and saying, “My child has autism, and we need occupational therapy,'” to simplify, by saying, “My child has low muscle tone, and we need occupational therapy.'”

Peck tends to get involved with families after they receive numerous insurance claim denials. She is trying, family by family, to decode and demystify the health insurance system so that families can get coverage while awaiting a cure for autism. Over the past two years, she has helped families recover $1.1 million in denied claims.

Still, Ada Sepulveda often feels defeated by the health insurance system. She resents that while attending to the exhausting schedule dealing with Darian's medical needs, she and her family also expend so much energy fighting insurance companies.

When they have time to think about it, Darian's family is tormented by questions. What if they had not had to fight so arduously for insurance coverage? Would he be better? Would he have progressed more?

I wondered the same things after leaving the Sepulvedas’ home. Would that flicker of understanding, of light, that I detected when I looking into Darian’s eyes be more brilliant, would he even be able to form a few words, communicate more if he had received all of the therapies his family believes he needed?

That is a question that may never be answered.

What do you think? Should autism therapies be covered by private health insurance or should states provide care and therapy for children with autism?

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.