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This entry concludes Sunday's article on the comments of Victor DeSa, M.D., who spoke to senior citizens at Batavia's First United Methodist Church last week.

Please remember, this is a summary of DeSa's presentation and does not necessarily reflect the views of The Batavian:

Medicare, Medicaid and senior services

By requiring insurance companies to expand coverage, the new health care law will drive costs up, according to DeSa. The government has told consumers that these costs will be offset by subsidies for people making less than $80,000 per year.

These subsidies will be coming, in part, from a $500 billion cut from Medicare -- and that's where senior citizens and others eligible for Medicare should be concerned.

But this is not the only problem. Both Medicare and Medicaid, which DeSa called "the original two public options," have met with disaster. Medicaid has already failed, and Medicare is on the brink of failure.

"The government has no idea how to handle the rising costs. Their idea of handling the costs is to take a machete to (the programs) and cut."

The result is the "doctor fix," a 21-percent cut in doctors' reimbursements. This could be disastrous in a system where the cost of providing services is already greater than what the doctors receive in compensation.

For that reason, many doctors no longer accept Medicare. The Mayo Clinic in Arizona has already determined that because of the new health care legislation, it will no longer deal with the program.

"So Medicare patients are going to have fewer and fewer choices of who is going to take care of them."

With fewer doctors available, waiting periods will increase. So the direction Medicare is taking presents seniors with a double disadvantage.

The government "carved the 21-percent doctor fix out of the bill" in order to avoid upsetting America's seniors, but that doesn't mean they've addressed the cost. They are simply pushing it to the side and will have to deal with it later.

"Six months down the road, they have to still come up with a fix for this 21-percent cut that they are going to make on Medicare payments to the doctors."

So that's the story with Medicare and Medicaid. As far as insurance for retired citizens goes, people who worked in the public sector should be okay (although DeSa said it's not impossible that this could change, because "anything is possible" with what the government is doing), but people in the private sector should be concerned.

What to do?

When asked how we can change the course we've taken, DeSa answered: "We've got to kick out the guys who did this."

He appealed to the power of senior citizens -- which he became two years ago -- who are "feared in Washington because we vote."

Many seniors were suspicious when the government said that $500 billion had to be cut from Medicare to cover health care.

"If they really addressed costs the way we asked them to do, a person making $40,000 a year be able should be able to afford health care coverage without subsidies, don't you think?"

Failure to address the problem of cost in the current system was one of DeSa's main critiques of the health care bill. He said that in looking for alternative plans, we need to look for one that does address them.

Counting the costs 

There are three main factors driving health care costs:

1) Overuse

Back in the old days, when there was usually only one doctor in town and he had to go to patients' homes to treat them, people only went to the doctor when there was something really wrong.

Now, with easy access to medical examination and treatment, people will go to the doctor -- and even to the emergency room -- whenever they have a minor health concern.

"We have to change that if we want to truly address the cost of health care."

But it's not just patients -- doctors sometimes overuse the system, too.

"I hate to admit it, but there's greed in every profession. There are bad apples in every bunch, and you've got to admit it."

2) The fact that people have insurance in the first place

Strange as this may sound, this can be a problem.

"Insurance is like a credit card, but you don't have to pay every month. So there's no incentive for you to be prudent with the costs. You don't even want to know what the cost is, you just want the health care."

DeSa believes that while insurance cannot be eliminated altogether, people should reduce their dependence on it. For health purposes, they should only turn to insurance in times of emergency.

Generally speaking, the way people take care of this part of the cost is by having "skin in the game."

"If you shop around for a car or a house, why shouldn't you be able to shop around for a doctor? Especially in this day and age, with the Internet and everything."

3) Liability

"Everything from a Band-Aid to a heart valve has a mark-up depending on the risk."

In other words, the more dangerous the a product or its failure can be -- and, therefore, the greater the likelihood of a lawsuit -- the more expensive the product.

Because the liability cost is factored into the price of the product itself, "the little guy gets it in the neck every time."

DeSa fully supports the patient's right to sue when a doctor has done something wrong or is incompetent, but he also believes that the whole liability issue should be looked at when considering the cost.

Government out, skin in (the game)

Costs are going down for procedures that are not covered by insurance (Lasik surgery is one example). The reason?

Competition.

"Costs come down if there are market forces in place."

DeSa saw this in his native India, which had a socialized health care system until the early 1990s.

When he was studying at Jabalpur University in the mid '60s, the Indian government had total control of health care and sent all competing forces out of the country.

The effect of this was what DeSa called a "brain drain."

"The best and the brightest (doctors) were all leaving the country."

He sees the same thing happening here in Western New York, where there is a serious shortage of doctors.

"Over 80 percent (of young doctors surveyed at Western New York teaching institutes) say they'll train here, but they're not going to stay in New York to work. We are known as one of the most heavily taxed and over-regulated states in the country."

Our response to this situation should mirror the response taken in India back in 1990. At that time, India began to default on its World Bank loans. Finance Minister Monmohan Singh -- who is now India's Head of State -- saw that the system was not working and started the country on a different path.

"He got rid of the government, encouraged entrepreneurship and lowered taxes."

Above all, the patient must take responsibility and be in control of his/her own health care. It can't fall to the federal government to make important decisions regarding people's health care, no matter how well-intentioned they might be.

Déjá vu

In addition to drawing from the experience of his native country, DeSa also discussed two other examples of what he sees as a health care system set up for failure.

The U.S. government's new health care model is based on the Massachusetts health care model, which DeSa called "an abject failure." He cited problems related to his comments about young, healthy citizens abusing health insurance.

"Just Google 'Massachusetts Health Law -- success or failure?'"

Socialized health care has proven disastrously ineffective in Britain as well.

"Just this month, Britain recognized that its system is a failure and said they are going to change the whole thing."

Part of that change will be a shift in power from bureaucrats -- of which there are 1.5 million overseeing the United Kingdom's National Health System -- to the doctors. As good as this sounds, DeSa fears it may be too late for it to work.

"The doctors (in the UK) have no business experience. Up to this point, the government has been taking care of everything."

His concern is that U.S. doctors will share a similar fate. As his presentation drew to a close, he told everyone that under the government's new plan, there will be over 120 new bureaucracies controlling health care.

DeSa admitted right at the start of his presentation that he had a bias as a health professional. He encouraged everyone to do their own research and decide for themselves whether or not the new health care reforms are to be welcomed or feared.

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.

Elba resident Chantal Zambito and her family will be parading through Elba this weekend at the Elba Onion Festival. Their vehicle: a LEGO float promoting the town's FIRST LEGO League team.

FIRST ("For Inspiration and Recognition in Science & Technology") LEGO League is an international organization that partners with experts in the fields of science and technology to get kids ages 9 to 14 involved in working with robotics and engineering.

The float will showcase robots made by the kids in Elba's FIRST team, which Zambito coaches along with Evelyn Hunt. These 'bots are connected with very simple tools and can be made to move by being hooked up to laptop computers.

Zambito says her goal is not only to promote Elba's team, but also to encourage other kids to join the leagues and form their own teams -- which can be associated with towns, local organizations, etc.

Zambito has been working closely with Genesee County communities and school districts for this purpose.

"Right now I think there are only three teams in Genesee County," she said. "I'd like to see at least six to eight teams -- that way we'll have enough teams that we can build a Genesee County Region section for the leagues."

At this time, Genesee County teams need to go to Monroe County -- which has 72 teams -- in order to compete.

"I hope to change that," Zambito said.

Zambito has been in talks with technology personnel at GCC, and they are very interested in doing this in conjunction with their Tech Wars program for high schoolers.

Each year, a different challenge is issued to the teams in terms of building their robots. This year's challenge is called "Body Forward" and will have the kids exploring the world of biomedical engineering.

Zambito and her family will be handing out informational brochures as the float passes along the parade. These brochures will include contact information.

The LEGO float will be featured in Friday night's parade -- which starts around 7 p.m. at Oak Orchard Road and lasts until about 8:30. It will also be in Saturday's "Kiddie Parade," which starts at noon on Maple Avenue and lasts about a half-hour.

Photos submitted by Chantal Zambito

Watch out for the little old man hobbling along with his walker the next time you're at the store -- he could be dangerous.

Dangerous on the road, that is.

Batavia resident Catherine Roth said she has seen a number of people out in public -- most of them senior citizens -- who drive even though they shouldn't.

"I once saw this man who could barely walk, and he's got an SUV!" Roth said.

Roth is well-known in Batavia for voicing her concerns about elderly drivers. This started with the death of her 30-year-old son almost 20 years ago.

Jim Roth was killed in October 1991 by an 81-year-old man driving the wrong way on Route 481 in Syracuse.

Catherine and her husband, who died two years ago, both worked hard to toughen the rules regarding elderly citizens on the road. Roth defends her position by citing laws in other states -- including "Katie's Law" in Texas, and a New Hampshire law requiring drivers over 65 to be tested every five years -- that regulate and limit senior drivers.

She has caught wind of some resistance to her efforts among Batavia's older population, but she sticks to her guns nonetheless.

"We have all these laws for young drivers," Roth said, "but when we talk about laws for elderly drivers, forget it!"

The trouble is, Roth has come to the point where she herself might have to surrender her place behind the wheel. She will be 90 years old soon, and has concerns about whether or not she should still be driving.

"I've been thinking about giving up driving for the past several years," she said. "When I realized I would be turning 90 and that my license was going to expire (this month), I realized I had to decide whether to renew the license or quit driving."

Roth said she doesn't have any specific problems that compromise her ability to drive safely, but she worries that "reaction time" might slow with age.

"Right now I drive as little as possible," she said. "I drive to Stafford three or four times a week to work at the museum. Everone who's rode with me has said I'm a good driver. But I've already begun to explore different ways of getting around (like taking a taxi)."

Roth actually asked to be re-tested to see if her driving skills were up to par -- her request was denied.

At this point in time, New York State has no system set up for that sort of thing. Re-taking the driver's test is only possible for those who have been reported.

This is an important issue for Roth, because better testing for senior drivers is one of the reforms she and her husband pushed for over the years.

"A lot of times, all it seems to depend on is eyesight," she said. "If someone's eyesight is good, he can mail in his license and get it renewed. That's just wrong!"

She then pointed out that the person in question could have very good eyesight, but at the same time barely have the ability to walk.

Sometimes, according to Roth, even a doctor's caution is unhelpful.

"If their doctor tells them they shouldn't drive, they'll go to a different doctor."

Roth understands seniors' reluctance to give up their licenses and, by extension, their independence.

"I've been without a car for the past week, and it's been driving me nuts!" she said.

Most of Roth's friends are in their 80s and in the same boat. She is far from unsympathetic to the tough decision facing older drivers.

"I know you want your independence -- but darn it, don't kill my son or anyone else."

She shared some recommendations for seniors who would like to continue driving, but not be a danger to other drivers: don't drive at night; avoid streets near schools around the end of the school day; and avoid big cities.

In addition, she listed some decent alternatives to driving for seniors who still need to get around.

"The Office for the Aging has some good programs," she said. "And you can take a taxi in Batavia for about $5. And then there's always the option of turning to friends, but you try not to bother people for little things.

"It's best to do all of your errands in one trip (so you don't have to call your friends whenever, for instance, you need some milk). You try to keep your independence, even if you have to be dependent in some ways."

 ADDITIONAL FACTS ABOUT ROTH:

Roth is on the Board of Trustees for the Stafford Historical Society, and just finished -- after nine years -- serving on the Board of Trustees for Batavia's First Presbyterian Church. She is also a volunteer at the Batavia Cemetery.

A most interesting fact about her is that she is a triplet. She and her two sisters will be celebrating their 90th birthday very shortly.

"As far as we know, we're the oldest living triplets in the United States," Roth said.

Pictured: two Boy Scout troupes from the Iroquois Trail Council (ITS), which covers Genesee, Wyoming, Livingston, Orleans and Niagara counties.

This band of 36 youths -- ages 13 to 17 -- are going to Fort A.P. Hill, Va., for the Boy Scouts of America Jamboree, which takes place from July 26 until Aug. 4. Fort (Ambrose Powell) Hill, named after a Confederate general, is an active-duty Army installation near the town of Bowling Green.

The Jamboree normally takes place every four years; this time, however, there was a five-year interim so it would coincide with the 100th anniversary celebration of Boy Scouts of America.

The boys will be accompanied by two adult Scoutmasters -- Guye Smith, of Lima, and Jim Yencer, of Avon, and two youth assistant Scoutmasters (one of whom is from Alexander), making a total of 40 area scouts attending this national event.

Planning for this trip started about two years ago, according to Smith. Since then, the boys have worked very hard to raise money in order to cover the cost.

"Some of them raised every penny (that they needed to pay their individual fares)," Smith said. "That's part of the scout way -- to pay your own way."

The ITS scouts raised money by doing two bike-a-thons, one in July 2009 and the other in October 2009.

The boys biked all the way from Lockport to Brockport -- with an overnight stay in Albion for the first one -- and then from Holley to Macedon all in one day for the second.

The troupes are leaving by bus today. Yencer said they will spend Saturday in Philadelphia, then take the U.S.S. New Jersey (a retired navy vessel) to Aberdeen, Md., to visit the U.S. Army Ordnance Museum on Sunday morning. From there, they proceed to Fort A.P. Hill.

While attending the Jamboree, the boys will be treated to a wide variety of activities such as air-rifle shooting, scuba diving, canoeing, archery and a 5K run; there will also be a musical group performing at the "arena show" (which will be broadcast online) on Saturday, July 31, and if tradition is kept, they may also get a visit from President Barack Obama.

Not only is this Jamboree historic because it is being held during the scouts' centennial, it is also the last one to be held in Fort A.P. Hill (where it has taken place since 1981).

For more information on the Jamboree, please visit www.bsajamboree.org.

For more information on the ITC, visit www.itcbsa.org/Joomla/index.php.

Photo courtesy of Jim Yencer

Middle-schoolers from all over the county came to Batavia Middle School on Tuesday for the "MST Explorer Camp" (see June 19 article for more information). The camp involved students in hands-on learning activities using math, science and technology.

A 13-year-old race car driver and Batavia Middle School student Val Stephens -- pictured center -- helps with a demonstration designed to give the kids a lesson in aerodynamics:

Kevin Raymond, a teacher in the Keshequa School District and a hot-air balloon enthusiast, talks to the kids about the type of energy that powers hot-air balloons. He shows them how they work, using an ultra-light balloon as an example (keep in mind that about 10 of these could fit into one of the larger ones):

(Inside the balloon)

Batavia Middle School technology teacher Frank Panepento shows them how to go about designing CO2 cars. 

The students designed their own cars, put them in a wind tunnel (in order to determine how much speed they could handle), weighed them and, when they finally had all the necessary data, raced them. The students whose cars fared poorly in the race were simply asked to modify their designs and see what effect their modifications had on the cars' efficiency.