>> abernethy: coming up, does expensive health care mean better health care? not always. >> 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. >> abernethy: and, in los angeles, the irish priest who came to be accepted by both blacks and latinos, in the troubled neighborhood of watts. >> one time, i was talking to the black kids and this little girl said to me, "father peter, you aren't white, you're irish." captioning sponsored by the lilly endowment

>> abernethy: welcome, i'm bob abernethy. it's good to have you with us. president obama continued pushing his health care agenda this week, calling on congress to move forward with a reform package. much of the discussion centers on rising health care costs, and a special report on that is coming up. obama calls health care reform a moral issue, and many in the religious community have been lobbying for new measures. but their efforts are complicated by new debates over whether tax-funded abortion coverage should be included. the u.s. catholic bishops warned

congress not to make abortion part of health care reform. the religious coalition for reproductive choice said including abortion coverage is a matter of justice. obama has long urged finding common ground in the overall battle ababt abortion, and this week, a broad coalition of activists and clergy said they have found some. advocates and opponents of abortion rights announced their joint support for a new bill designed to reduce the number of u.s. abortions. the bill includes several measures to help prevent unintended pregnancies and provide support for pregnant women. >> perhaps the most important is that it helps us all move forward on the issue beyond the question of legality and toward actually reducing the need for abortion in this nation. >> abernethy: among those supporting the bill are the pro- choice group planned parenthood and florida evangelical leader joel hunter, who is anti- abortion.

>> it links together traditional adversaries in a way that advances each of our goals without compromising any of our values. >> abernethy: in new jersey and brooklyn, after a huge federal corruption investigation, five rabbis were among 44 public officials and others arrested. the rabbis were alleged to have laundered several million dollars through charities associated with their synagogues. on capitol hill this week, confirmation hearings for obama's nominee to be the next ambassador to the vatican. miguel diaz teaches at the college of saint benedict and saint john's university in minnesota. during his hearing, diaz said he believes interfaith dialogue builds bridges that lead to action. >> i have worked with religious leaders to engage local communities in exploring the role of religion in uniting people.

if confirmed, my service to the united states as ambassador would be a natural extension of this work. >> abernethy: president obama hosted leaders of the church of jesus christ of latter-day saints at the white house. church president thomas monson and other mormon leaders gave the president five-volumes of genealogical records about his family history. senate majority leader harry reid, who is also a mormon, arranged the meeting. imams and rabbis from ten european countries visited the united states as part of an effort to combat islamophobia and anti-semitism in their part of the world. the group met with american muslim and jewish leaders to learn how interfaith efforts work in the u.s. in washington, they toured the holocaust museum and discussed the dangers of intolerance. they also had a private meeting at the white h hse. fewer muslims may make the annual hajj or pilgrimage to

mecca this fall. because of concerns about swine flu, arab health officials have asked children, the elderly, and those who are chronically sick to stay away. the virus has already killed an egyptian woman who died after returning from a pilgrimage to mecca. roughly three million people trek to the holy cities of mecca and medina every year. worldwide, deaths from the h1n1 virus have doubled in the past three weeks to more than 700. >> abernethy: as the president and congress wrestle with health care reform, their debate has centered on how to provide health insurance for everyone, and how to pay for that. but the president and many others also say the increasing costs of care must come down. >> we've got to change how the health care delivery system works so that doctors are paid for the quality of care, not the

quantity of care. >> abernethy: in our special report today, lucky severson examines why health care costs are so high in one city, miami, florida. >> happy birthday. >> thank you. >> do you know how old you are? >> yeah. >> how old are you? >> i don't know. >> you are 90 years old. >> reporter: not long ago, dr. joel strom and his wife jane were so convinced that jane's father was close to death, not withstanding the attention he was receiving from 10 specialists, they put him in a hospice, and then he got better. >> part of it was 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. >> reporter: 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. >> 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 mediocre care. >> reporter: 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 c.e.o. of baptist health south florida, the largest non-profit health care system in that part of the state. he says huge medicare costs do not translate to better health care. >> 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. >> reporter: he says there are several factors that bloat health care costs in the miami area.

>> 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 and technology more. >> reporter: 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. >> 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. >> reporter: dr. gloria weinberg is a geriatrician and chair of the department of medicine at mt. 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. >> if you look at reimbursement, you are going to come away after you pay expenses, if you are lucky, with $40 or $50 an hour. that's not going to help the youngsters to go into a field of medicine and pay off loans and do everything else that needs to be done. >> reporter: here in miami, a typical senior citizen will see a doctor 106 times during the last two years of their lives. not just one doctor, several, specialistssho will then prescribe a battery of expensive tests, procedures, m.r.i.s, 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. >> patients are very sophisticated. they come in and 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 c.t., which is less expensive than an m.r.i., some of them will come to you and say, i want an m.r.i., 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." >> reporter: 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. >> the miami herald reported about a month ago that the f.b.i. and c.m.s.-- centers for medicare and 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. >> reporter: about 50 million americans are uninsured, and

that includes 30% of the population around miami. many of that number are undocumented and in the u.s. illegally. whatever their status, most who need care end up in a hospital emergency room where, by law, they cannot be refused treatment. >> it's our ethical responsibility to treat that patient as we would any other. that patient could go down the path of having a cardio catheterization, ultimately having a pacemaker, a defibrillator at $30,000 ongoing medical care. then we face the problem when we discharge the patients, where does the patient get the follow up care and the hospital doesn't get reimbursed for it. >> reporter: perhaps the biggest chunk of medicare expenditures, something like 30%, 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.

>> i think we in the u.s. need to consider our relationship with end of life and to realize it's a natural process. and that perhaps ending life in a more humane way 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. >> reporter: 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. if they say we need a $1,000 cat scan, do you... there is a( point, an age you reach where you should say no, i've lived 90 years? >> no, i want more. >> reporter: you want more years? >> everybody, nobody wants to die. >> reporter: 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. >> the health care dollars, an inordinate amount, go to taking care of people in their last six months of life. but how do you know when those last six months are? you have a person who has worked all their life, done well, paying taxes 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. >> reporter: 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. >> it ought to be evidence based. if something is proven not to

work, i don't think the federal government ought to be paying fofoit. i don't think anybody ought to be paying for it, except for the private patient. >> repepter: dr. weinberg says too many patients receive expensive treatments and surgery in their final years, that very likely won't prolong their life. >> 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 a surrogate and i'm insisting that a feeding tube be put in." you can not 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. >> reporter: 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. >> 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. >> reporter: 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. >> abernethy: despite his recent medical problem, pope benedict the sixteenth is still making public appearances. the 82-year-old benedict led prayers and greeted well-wishers after he underwent surgery to set a broken wrist. the pope injured himself in a fall while on vacation. benedict also offered special greetings to cyclists in the tour de france, which passed near the alpine village where he is staying. we have a story today about a remarkable man in california. he is a catholic priest from ireland who has ministered for

37 years to both african americans and latinos in the watts section of los angeles. saul gonzales reports. >> reporter: the los angeles neighborhood of watts has long been synonymous with inner-city desperation and despair. it's, after all, the neighborhood that exploded in urban unrest in 1965, and then again during l.a.'s 1992 riots. today, watts is still home to some of the meanest streets in the city, but they're streets walked regularly by father peter banks, a catholic priest who, dressed in his robes, rope belt, and straw hat, looks like a fish very much out of water. born and raised in rural ireland, banks arrived as a young priest in watts in 1973, assigned to the saint lawrence of brindisi church. >> my picture of america before

i came, of los angeles, was hollywood, disneyland and beach. so i got into the car and we drove up century and crossed vermont and i began to realize this is a very different world, it was all black. and the very first sunday, i stood up on the altar and said "what am i doing here? how will i ever understand the people? will they understand me?" >> in my weakness, i find strength. >> reporter: in the decades since, though, this irish priest and the people of watts have come to know each other very well. and father banks has become a beloved figure, both in his church and the wider community. >> that will look great on television, you giving me a big kiss. another one. okay. >> we're standing here in the heart of watts. >> reporter: father banks says his taking an active role in the day-to-day life of the community has been key to being accepted by the people of watts. how important is it for you to

do what we are doing now, to get out, to walk the streets? >> oh, i feel part of the flesh and blood and soul of watts. >> my brother, my brother. >> reporter: as he walks through the community, banks meets, and ministers, to the casualties of drugs, poverty and violence in watts. one of them goes by the name "redmann." >> now, he never minds me saying this, but this man was shot 13 times and survived. >> i love this man, he is the only white man that can walk watts with no gun, just walking by faith. and walk here and know everybody, everybody knows father peter. he is a true father of watts, a real servant of god. >> redmann and a friend then ask father banks to lead them in an impromptu street corner prayer. when god dwells within nothing but good can come out. >> reporter: central to the story of watts and father banks church is the incredidile demographic shift which has occurred in this community in recent decades.

once synonymous with the african american community, watts is increasingly latino. with that change has come tension. >> they call it the black and brown conflict. how do we get black and brown to come together? >> reporter: that conflict sometimes expresses itself in violence, but often its face is a soft, unofficial form of segregation: latinos largely stick to themselves, african- americans with african-americans as well. >> you wouldn't go out of your way to hang out with hispanic kids? >> personally, no, i really wouldn't because i know that might sound racist. when i see a mexican girl or a latino girl, i'm not hanging out with her because she's just not my people. i know that's wrong but that's just the way it is in our society and our community. >> ♪ the power of the lord. >> reporter: it's such feelings that father banks has tried to battle in watts, making both african americans and latinos feel welcome in his congregation

and breaking down walls of mutual suspicion and hostility. >> ( speaking spanish ) >> reporter: he's done that by learning spanish, slowly integrating some church services, and developing sensitivity to the problems of both latinos and african americans. >> i love the cap. it's an irish cap. do you have an irish cap? >> reporter: father banks says being irish can actually be an advantage in his work in watts. >> i feel it is. ne time i was talking to the black kids when i came first, and they were saying something about the whites, and i held up my arms and said "look at me." and this little girl said to me, "father peter, you aren't white, you're irish!" i can relate very much to the black in the sense of the irish being persecuted. it used to say in the states "no black and irish need apply." so i do identify a lot with the african american people and their pain and their suffering. i'm able to relate to the latinos and say i'm an

immigrant. and as i tell the latinos, i am an immigrant, too. i came here. i'm far away from my own land. i know what you go through. >> reporter: members of father banks' congregation say they appreciate his efforts to build bridges of understanding between african americans and latinos. >> ( translated ): he helps all the people, african americans, latinos, the entire community. to us, father peter doesn't recognize borders. he's a person who helps everybody, and that's why we're here. >> if p.r., public relationship, communication was a gift from god, poof, he got it 10 times because he can get out there and talk to different people. and they just feel his love. and he will tell them to come here and they feel the love. it's just a relationship that blossoms. >> reporter: as he's gotten older, banks says he's increasingly focused his energy on the education and safety of watts' youngest at the elementary and middle school operated by his church.

>> is this the best school in the whole world? yeah! >> they know more about pain than i do in my lifetime. and they are only six, seven, eight, nine years old. you saw them this morning, dying for affection. >> if i don't feel optimistic and i feel tired i came over to the school. i get energy from the school, energy from these children. hope is to be able to sing in the middle of the darkness. and i think that's what hope is for me. i can still sing in the middle of the darkness. >> reporter: however, after serving the spiritual and material needs of this community for much of his adult life, father peter banks will soon depart watts. he's been asked to take a job as a church recruiter in a rural area of california. although he says he feels duty- bound to fill the position, banks acknowledges he feels conflicted about leaving this community. >> that's an emotional issue for me. it's going to be a big struggle to leave here. i'm at peace with god. that's all i can say. i am at peace with god.

i feel it is god's will that i continue his work. we need priests for the church and brothers. >> reporter: but it hurts? >> oh, it hurts deeply. i have put so much of my life in here. i have invested so much in children. it is the biggest change of my life. i feel like i am leaving home twice. i left ireland 37 years ago and i feel like i am leaving home again. but i've come to terms with it. and i know that i am doing it for a higher cause, a higher power. >> ♪ happy birthday to you. >> reporter: the people whose lives father banks has touched in watts hope his example will inspire others to continue his work of cultivating peace and understanding in a community that so needs them. for "religion and ethics

newsweekly," i'm saul gonzalez in los angeles. >> abernethy: on our calendar: jews mark the solemn holiday of tisha b'av at sundown on wednesday. it's a day of lament for the destruction of the first and second temples in jerusalem. the western wall, judaism's holiest site, is all that remains of the second temple. believers have long left handwritten prayers between the stones. but now there's a more high tech idea. a new website allows people to send their prayers through the online social network "twitter." the messages will be printed and taken to the wall. the name of the website is "tweet your prayers." finally, as the country celebrated the moon landing, 40 years ago, this image of the earth seen from the moon remains one of the space program's most powerful

messages-- a reminder of how fragile and isolated our planet is. and other images of space are at least equally humbling and beautiful. they're from the hubble space telescope, orbiting the earth above the atmosphere. ♪ the hubble telescope also helped in the discovery of so-called dark matter-- the 90% of everything in the universe that science can not yet describe or explain. that's our program for now. i'm bob abernethy. there's much more on our web site. audio and video podcasts are also available. join us at pbs.org.

as we leave you, more images from the hubble telescope. ♪ captioning sponsored by the lilly endowment captioned by media access group at wgbh access.wgbh.org