Medicare

Dr. Victor DeSa talked with seniors Friday about the federal government's new health care legislation. This followed his hour-long presentation, sponsored by the "Older Adult Ministries" program of Batavia's First United Methodist Church.

DeSa is a retired surgeon who had a private practice in Batavia for many years and currently serves on the United Memorial Medical Center Board of Directors. He is well renowned and respected in the community and very knowledgeable about how the health care field works -- including the role of legislation and the relationship between health care and the government.

There is a lot of misinformation about the new health care law and how it could affect  people -- especially Medicare and Medicaid recipients.

The doctor expressed disappointment in the mainstream media's handling of the topic.

"The people in the media are not doing their job," DeSa said. "The media used to look out for the common man, but now they have a bias and a preference. (Consequently), the news we get is filtered and we don't have all the information we need in order to make informed decisions."

For those who could not be there, here's the gist of DeSa's presentation (it will be divided into two parts for the reader's convenience) -- it reflects the arguments he made based on careful and meticulous research, and does not necessarily reflect the opinion of The Batavian.

Health care: rights and responsibilities

The question of whether health care is a right or a privilege came up early in the presentation. This language, said DeSa, is problematic. The real question is this:

"Is health care a right, or is it a personal responsibility?"

He pointed out that health care is considered a right in socialist countries, where people "have abrogated their rights to the government" so that the government "will take care of (them) from the cradle to the grave -- and that includes health care."

"The United States is not yet a socialist country," he said (and yes, he did emphasize yet), "so here, health care is a personal responsibility."

What he meant by this, is that each person has a certain amount of control over his/her own health (diet, exercise, etc). For instance, if someone chooses to live on bacon, cheeseburgers and cigarettes all the time, then he/she is indirectly "choosing" to have weight problems, heart problems, high blood pressure, etc.

"If I'm responsible for my own health, should everybody pay for it or should I?"

Misconceptions about U.S. health care

DeSa assured his listeners that we here in the U.S. do, in fact, have the best health care in the world. To prove it, he spent some time debunking two popular myths that lead people to believe the contrary: that our infant mortality rate is higher than in countries with socialized health care, and that lifespan is shorter in the United States than in said countries.

On infant mortality, he said: "We (in the U.S.) over-report infant deaths, while other countries under-report them. Here, we're so meticulous about reporting, that if a baby takes a couple breaths and has a couple heartbeats after birth, it's reported as infant mortality. But in developing countries, a baby dies an hour or two after being born and it's reported as a stillbirth."

He also pointed out that a large percentage of infant deaths take place in the inner-cities, where there are a lot of crack cocaine and AIDS babies.

"These babies die in spite of very good health care. Their deaths are due to social problems, not medical problems."

As far as lifespan goes, he said that longevity is about the same in this country as in those that have socialized health care; what doesn't get factored in with lifespan studies is the fact that the U.S. is the "murder and accident capital of the world."

"If you took the murders and deaths from accidents in Chicago, Detroit or New Orleans in one month, they are more than the deaths of our soldiers in Iraq or Afghanistan in one month."

In short, the evaluation of U.S. life and health often ignores social problems and unfairly puts all the blame on health care.

Universal care vs. universal insurance

...Wait a minute, aren't they the same thing? Not according to DeSa.

"We do have universal care in the U.S. The EMTALA Law ensures that no one who comes into the emergency room will be refused care -- even illegal immigrants. That's the right thing to do, the humane thing to do and the moral thing to do, and I support it."

He says there is a "subtle but important difference" between this and universal insurance, which we don't have. There are currently 47 million Americans uninsured.

The Congressional Budget Office predicts that as a result of the new health care legislation, 32 million people who were previously uninsured will be insured at the end of 10 years. However, there will still be 21 million people uninsured -- and this is in spite of the fact that the new law will require people to buy insurance!

Who are these 21 million uninsured, you ask? Young, healthy people making between $35,000 to $82,000 a year.

"When you're young, and you're starting a family, and you have mortgage payments, you have a whole host of other host of things you have to worry about. You're going to say, 'Well, I'm young, and I'm invincible...maybe I won't fall ill. I'll take the chance and hold off on buying health insurance.'"

This is going to have a couple of important consequences. First of all, DeSa said, "the IRS is going to need about 16,000 new agents to track them down."

Even if they do track them down, not much is likely to change.

"If I'm a young person," DeSa said, "and a federal agent tells me I have a choice between a fine -- which starts at $95 and over the course of seven years will go up to about $700 -- and purchasing health insurance for $12,000-$13,000, it's a no-brainer."

Secondly, these people will cycle in and out of insurance programs. Faced with a serious condition like cancer, a young person will go to an insurance company for coverage -- and they cannot be refused under the new law. But when they get better, they will forego the insurance.

"People will abuse the system. That's just human nature."

While uninsured, these individuals will be able to make partial payments for hospital visits about 27 percent of the time; the rest will be covered by the state's "uncompensated care pool," into which each hospital in the state pays.

But even this won't cover the whole cost. To whom does the remainder of the cost shift? The taxpayers.

"This varies from state to state depending on the percentage of uninsured they have, but the average each person pays is $300."

The second and final part of the article will be up soon.