KIM LAWTON, anchor: The Obama Administration launched a new initiative this week encouraging Americans to help fight hunger in their communities. The campaign is called  “United We Serve: Feed a Neighbor.” It urges people to donate money to local soup kitchens and food banks and also to volunteer their time and talents. The effort comes amid new government reports that hunger is on the rise in the US. Forty-nine million Americans struggled to put food on the table this past year—that’s an increase of 13 million—and a record number of Americans, 36 million, now receive food stamp assistance.

Joining me with more on all of this is Candy Hill, a senior vice president at Catholic Charities USA. Candy, it seems like this time of year, every year, we hear appeals from groups saying “Oh people are hungry, you need to give.” What makes this year different?

CANDY HILL, Catholic Charities: Well, we certainly are seeing such an increase, and new people that have never come to Catholic Charities for services before. Some of them are even our donors, and some of them are our former board members, so we see a real crisis in the number of people coming and who need assistance this year over the other years that we’ve been in business.

LAWTON: And there’s been some talk of food insecurity, I mean we’re not talking about starving in the streets, but we’re talking about people who are just having a harder time feeding their families?

Candy Hill, Catholic Charities USA

HILL: Yes, and I think when we talk about food insecurity we’re really talking about people not having food for three meals a day, so we find parents who are scrimping or not having a meal themselves in order to feed their children, and seniors who are making choices between whether they buy medicine or feed themselves, and in a country as great as this country we shouldn’t have people doing that.

LAWTON: And this is a function of the economy and all of the repercussions of that?

HILL: I think this is a perfect storm. We see the economy, and the people that we serve certainly were struggling before the collapse of Wall Street, but they were struggling first and will be the last to recover in this recovery.

LAWTON: And to what extent is it difficult in these tough economic times to make appeals for groups like yours, to say to people, give money to hungry people when individuals might be thinking, you know, I don’t know how I’m going to feed my own family?

HILL: Exactly. Well, what I would say as Americans we’ve always risen to the occasion, and this is one of these occasions. Our neighbors are suffering and we need to dig deep into our own pockets. The government has a role to play, all of us have a role to play, and we need to reach out and help each other during this really tough time.

LAWTON: Well, speaking of the government’s role, the U.S. government is urging people to give more in this new initiative, but is that enough? I mean, is it enough for individuals to give $20, a $100 or whatever, or do we need systematic changes in policy?

HILL: Well, I think long term we need systematic changes, but you know that’s a long term strategy and right now we have a short term problem, and so we need people to give and we also need the government to step up and do its part as well.

LAWTON: Are you pleased that the administration is having this initiative?

HILL: Absolutely, because I think it brings, it highlights always when the administration speaks on something and gives information, it helps connect to the things that we’re doing on the ground, and so this initiative, certainly, I think will highlight the need, but also the really creative things that are happening across America to try and meet the needs of individual people.

LAWTON: Yours is a faith-based organization. A lot of groups are trying to help the hungry. What is the specific role for religious groups and those from the faith community?

HILL: Well certainly we have a 2,000-year tradition that we’re supposed to feed the hungry and we take that very seriously and so we’ve been doing this for decades across the country and we see it as a moral issue, that people shouldn’t have to go hungry in a country as rich as ours, and we’re going to continue to try and meet the needs of people in local communities across this nation.

LAWTON: Again, we hear all the time people are hungry, people are hungry, the poor are always with us. Are there solutions? Is it possible to end hunger?

HILL: I absolutely believe it, and certainly the government is calling on that and Congress is as well. We have to think creatively. We have to think about 21st century solutions to 21st century problems, and the safety net in this country is badly torn and weakened, and we need to not just fix it. A repair is not sufficient. We really need to think about how do we eliminate the need for programs like food stamps, and like donations to feed the hungry through a food bank or a soup kitchen, and if we have the political will to do it in this country we can change this. You know, Bobby Kennedy forty years ago called attention in the Mississippi Delta to children being hungry, and yet today you and I are sitting here having the same conversation four decades later. We just need to rise to the occasion and have the political will to change it.

LAWTON: All right, Candy Hill, thank you very much.

HILL: Thank you as well.

And for most Christians, the Advent season begins this weekend (November 29). It’s the month-long period of spiritual reflection and preparation leading up to Christmas.

Click here to view the original July 24, 2009 story.

JANE STROM: Happy Birthday.

AL (Jane Strom’s father): Thank you.

JANE STROM: Do you know how old you are?

AL: Yeah.

JANE STROM: How old are you?

AL: I don’t know.

JANE STROM: How old are you? You are 90, 90 years old…

LUCKY SEVERSON (Contributing Correspondent): Not long ago, Dr. Joel Strom and his wife, Jane, were so convinced that Jane’s father was close to death, notwithstanding the attention he was receiving from ten specialists, they put him in a hospice, and then he got better.

DR. JOEL STROM (Cardiologist and Professor, University of South Florida Medical School): Part of it was that he had one person who took care of him. They cut out all the referrals because they didn’t expect him to live long, and they cut out all the medicines.

SEVERSON: Dr. Strom is a cardiologist and a professor at the University of South Florida Medical School. Like every doctor we spoke with, Strom is fed up with the health care system.

DR. STROM: It’s not a broken system. There is no system. Medical care is haphazard. Medical care is disorganized. There are pockets of superb care. There are pockets of very mediocre care.

SEVERSON: If Medicare costs are any measure, Miami-Dade County should have the best senior care in the country. The federal health program spends over $16,000 a year per patient. That’s about double the 2006 national average. Brian Keeley is the CEO of Baptist Health South Florida, the largest nonprofit health care system in that part of the state. He says huge Medicare costs do not translate to better health care.

BRIAN KEELEY (CEO, Baptist Health South Florida): We know that more can be injurious to people, and more health care services, more aggressively providing those services, can result in lower levels of care.

SEVERSON: He says there are several factors that bloat health care costs in the Miami area.

KEELEY: There’s a huge imbalance between the number of specialists and primary care physicians, and we have such a high percentage of specialists down over here, they utilize resources more, technology more.

SEVERSON: Dr. Strom, a specialist himself, says one reason there is such a shortage of primary care physicians is that Medicare doesn’t reimburse them enough for patient visits.

DR. STROM: If you spend a lot of time with a patient you will starve to death as a physician because you will only get paid for a certain amount of time. In fact, a lot of physicians will actually steer patients to their offices to have tests performed, because they collect both the professional component, and if they own the equipment, the technical component.

SEVERSON: Dr. Gloria Weinberg is a geriatrician and chair of the department of medicine at Mount Sinai Hospital in Miami Beach. She says when young doctors, fresh out of medical school and burdened with school loans, discover how much less a primary physician earns, they choose a specialty where they can make more money.

DR. GLORIA WEINBERG (Geriatrician and Chair, Department of Medicine, Mount Sinai Medical Center): If you look at the reimbursement, you are going to come away after paying expenses, if you are lucky, with $40 or $50 an hour. That’s not going to help the youngsters go into a field of medicine and pay off loans and do everything else that needs to be done.

SEVERSON: Here in Miami, a typical senior citizen will see a doctor 106 times during the last 2 years of their lives. Not just one doctor, several—specialists who will then prescribe a battery of expensive tests and procedures: MRIs, ultrasounds, CAT scans, and an astonishing assortment of drugs. It’s because that’s the kind of care patients around here often demand. Dr. Weinberg:

DR. WEINBERG: Patients are very sophisticated. They come, and they say, “I have a headache.” You take a headache history. They are not satisfied if you say, “You don’t need a scan.” They want a scan. If you are pushed, and you are suspicious enough, and perhaps you suggest a CT, which is less expensive than an MR, some of them will come to you and say, “I want an MR. I hear it’s more sensitive.” We have had patients in our center tell us, “If you don’t do what I’m asking I’m going to sue you.”

SEVERSON: The threat of lawsuits forces many doctors to practice defensive medicine, ordering more tests and procedures to protect themselves from being sued. Health care professionals here cited malpractice suits as another factor behind spiraling costs, and Medicare fraud in South Florida, particularly in the home health care industry, has been described as rampant.

KEELEY: The Miami Herald reported about a month ago that the FBI and CMS [Centers for Medicare & Medicaid Services] indicated that fraud was about $2.5 billion per year in Miami-Dade County. That, in and of itself, is a huge, huge difference, comparing our cost structure to the rest of the country.

SEVERSON: About 50 million Americans are uninsured, and that includes 30 percent of the population around Miami. Many of that number are undocumented and in the US illegally. Whatever their status, most who need care end up in a hospital emergency room where, by law, they cannot be refused treatment.

DR. WEINBERG: It’s our ethical responsibility to treat that patient as we would any other. That patient can go down the path of having a cardiac catheterization, ultimately having a pacemaker, a defibrillator at $30,000, ongoing medical care, and then we face the problem, when we discharge the patient, where does the patient get the follow-up care, and the hospital doesn’t get reimbursed for it.

SEVERSON: Perhaps the biggest chunk of Medicare expenditures, something like 30 percent, goes to end-of-life care for aging Americans. Professor Anita Cava directs the University of Miami business ethics program. She says Americans need to rethink the way we look at end-of-life medical care.

PROFESSOR ANITA CAVA (Director, University of Miami Business Ethics Program): I think we in the United States really need to reconsider our relationship with end of life and to realize it’s a natural process and that perhaps ending life in a more humane and comfortable way at home with family, rather than trying to prolong it for another day or week or month, is perhaps the best way to go.

SEVERSON: Joe Gasperovich would take exception to the ethical argument for withholding expensive medical treatment for aging, failing Americans. He was born in 1919 and would prefer to prolong his life as long as possible.

SEVERSON (speaking to Joe Gasperovich): If they say we need to go do a $1,000 CAT scan, is there a point, an age you reach where you should say no, I’ve lived 90 years?

MR. GASPEROVICH: No, I want more.

SEVERSON: You want more years?

MR. GASPEROVICH: Everybody—nobody want to die.

SEVERSON: Dr. Weinberg says the decisions about the ethics of distributive justice for society as a whole are often much more difficult when the doctor is meeting with a patient one-on-one.

DR. WEINBERG: The health care dollars, an inordinate amount, go to taking care of people in the last 6 months of their lives. But how do you know when those last 6 months are? You have a person who has worked all their life, paid taxes, done very well, and now they are 80, and they have a heart attack. That may be the person who lives 10 or 15 more years. Are we going to say no just because of age? That’s a very, very slippery slope.

SEVERSON: There is a huge ethical discussion about who should make these end-of-life decisions—the patient, the family, doctors, the government? Brian Keeley says some decisions are easier to make. For instance, Medicare should only reimburse for treatments and drugs that are known to work.

KEELEY: It ought to be evidence-based. If something is proven not to work, I don’t think the federal government ought to be paying for it. I don’t think anybody ought to be paying for it, except for the private patient.

SEVERSON: Dr. Weinberg says too many patients receive expensive treatments and surgery in their final years that very likely won’t prolong their life.

DR. WEINBERG: So if you have an Alzheimer patient who, your own belief may be, it’s time to let this person go naturally, and the family is telling you, “I’m the surrogate, and I’m insisting that a feeding tube be put in,” you cannot make the decision not to put the feeding tube on your own, even though you think it’s futile care, at least in the state of Florida.

SEVERSON: Dr. Weinberg says her 95- year-old mother has a living will that stipulates she will not be kept alive on a ventilator. Brian Keeley says preparing for end of life is not something that’s culturally accepted in South Florida.

KEELEY: Other parts of the country where people plan for end-of-life care, with the use of hospices and palliative care and what have you—down here there’s less usage for that, so people go to die in the hospitals.

SEVERSON: Everyone seems to agree that health care reform is urgently needed and that health care should be a right and not a privilege and that it should extend to everyone. They also agree that South Florida is a good place to start.

For Religion & Ethics NewsWeekly I’m Lucky Severson in Miami.

Note: Since this story first aired in July 2009, Dr. Joel Stroms’ father-in-law, Al Godin, passed away.

Click here to view the original April 10, 2009 story and additional Wintley Phipps videos.

Pastor WINTLEY PHIPPS (singing at National Prayer Service, Washington National Cathedral):  “Amazing Grace, how sweet the sound . . .”

KIM LAWTON:  Grammy-nominated Gospel singer Wintley Phipps is a familiar voice at big national events. At President Barack Obama’s National Prayer Service following his Inauguration, Phipps’s rendition of “Amazing Grace” brought the entire National Cathedral audience, including the new president and first lady, to their feet. But he says it’s just as meaningful to him when he sings in places like prisons.

Pastor  PHIPPS: There is a sense that you’re giving hope to people who really need it.

LAWTON:  For Phipps, who is also a Seventh-day Adventist pastor, music is a ministry and, he says, one of the deepest expressions of his Christian faith.

Pastor PHIPPS: Music is almost to me an echo of the sounds of the divine world, and when you hear these sounds, it stirs something deeply spiritual within you.  Music also is the most powerful way of impressing the human mind with hope.

LAWTON: Hope has been a hallmark not only of Phipps’s musical career, but in his charitable efforts as well.  In 1998, Phipps founded the Dream Academy, a national nonprofit for at-risk kids. Born in Trinidad, he says hope was crucial in overcoming his own at-risk childhood.

Pastor PHIPPS: I was born to a troubled home, and I used to get away from my parents’ troubles — I had a little red tricycle, and I’d go in the back yard of my house, and I would turn the tricycle on its side and use one of the backside wheels as a steering wheel, and I would sit there for hours, and I would dream that I was flying to faraway places in the world and meeting important people when I was six, seven years old, and then I wanted to be like Tom Jones.  I’d go around the house singing, “It’s not unusual to be loved.”  I just wanted to be Tom. But something was missing to me.

LAWTON: Despite a difficult family life, Phipps says his mother always prayed for him and told him that God had a special plan for his life.  As a teenager, Phipps embraced her faith as his own.

Pastor PHIPPS:  t the age of 16, God walked into my life and said, “I’ve seen your dreams. Give me your dreams, and I’ll let you see what I’ve been dreaming for you.”

Singing at National Prayer Service

LAWTON:  He attended an historically black Seventh-day Adventist college in Alabama, where he met Linda, now his wife of 32 years.  Then, Phipps says, God began providing opportunities for him to sing in national venues such as a 1984 appearance on “Saturday Night Live” with Jesse Jackson.  He came to the attention of Billy Graham’s team and became a frequent performer at the evangelist’s crusades.

Pastor PHIPPS (singing in Washington): “Talk about a child that do love Jesus.”

LAWTON: Phipps also became a favorite in Washington. He’s sung for every president since Ronald Reagan.

Pastor PHIPPS: I’ve never had a manager or never had an agent, and yet some of the most wonderful moments that a singer could ever dream of have happened to me, and I believe it’s providential.

LAWTON: The idea for the Dream Academy came after he got involved with a prison ministry.

Pastor PHIPPS: I did not know that so many young men in prison looked like my sons. , and when I saw it I was shaken. One of every three young black men in America between the ages of 18 and 30 are in prison today or supervised by the court system either on probation or parole.

LAWTON: Phipps then learned that 60 percent of the young people who end up in prison are the children of prisoners. He wanted to break the cycle of intergenerational incarceration. The Dream Academy offers after-school mentoring and interactive academic tutoring to children of prisoners and kids falling behind at school.

Pastor PHIPPS: One of the most exciting things that can ever happen in a child’s life is to know that , “You mean God thinks about me?  Or God dreams about me?”  And he’s got a dream for my life?”  And when you catch a little glimpse of what that dream is, wow, it changes everything.

LAWTON:  Phipps has enlisted the support of some of his famous connections for the project.  One of his biggest benefactors is his longtime friend Oprah Winfrey.  The lesson of faith, he says, is that things aren’t always as they seem and that hardship can be overcome.  In these uncertain economic times, he’s released a new music DVD called “No Need to Fear.”

LAWTON:  It’s a theme he finds throughout the old spirituals that he often performs.

Pastor PHIPPS (singing): “Swing low sweet chariot, coming for to carry me home . . .”

The Negro spiritual teaches us that you’re going come up rough sides of mountains, and you’re going to have difficulties.  But faith gives you that ability to weather any storm.

(singing): “I looked over Jordan and what did I see?”

LAWTON:  It’s the core theme as well for the song that has become his signature, “Amazing Grace.”  He finds great spiritual lessons in the history of the song.

Pastor PHIPPS:  A lot of people don’t realize that just about all Negro spirituals are written on the black notes of the piano, and they just keep recurring.  Probably the most famous white spiritual that’s built on this slave scale was written by a man by the name of John Newton who, before he became a Christian, used to be the captain of a slave ship and many believe heard this melody that sounds very much like a West African sorrow chant (hums “Amazing Grace”).  And it has a haunting, haunting, plaintive quality to it that reaches past your arrogance, past your pride, and it speaks to that part of you that’s in bondage, and we feel it. We feel it. It’s just one of the most amazing melodies in all of human history.

(performing “Amazing Grace” on stage): “To sing God’s praise than when we’ve  first begun. Hallelujah, hallelujah. Amen.”

LAWTON: Another lesson, he says, on how hope always triumphs. I’m Kim Lawton in Vero Beach, Florida.