As of 2016, the percentage of the Gross Domestic Product in the USA spent on healthcare was appropriately 17.9 %. Healthcare expense grew 4.3% or around $10,348 per person (National Health Expenditures Data) Our healthcare costs are higher than those found in other higher income countries such as Great Britain (9.7%), Netherlands (10.5%) Germany (11.3%), France (11%), and Denmark (10.8%). (Health Care Spending in the United States and Other High-Income Countries)
Health outcomes regarding average life expectancy in Hawaii, Minnesota, Connecticut are similar to those in Sweden, Germany, Great Britain, and Denmark. Dr. Ashish Jha of the Harvard T.H. Chan School of Public Health and senior author in his study Health Care Spending in the United States and Other High-Income Countries study indicates that many healthcare outcomes comparison in some states to these countries is similar. Many of these countries have similar populations as some of these states. The USA is much larger and more diverse nation than those to whom our healthcare system is often compared. It seems once a person gets into the healthcare system they do well as those in other high-income countries. Health Care Spending in the United States and Other High-Income Countries
Utilization of services in the USA as reported by the Organisation for Economic Co-Operation and Development data. The USA does not appear much different than other high incomes countries regarding structural capacity, access, and quality, and healthcare utilization. Dr. Ashish found utilization of healthcare services in the USA was not different than that in Denmark, Netherlands, Germany, France, and the UK.Health Care Spending in the United States and Other High-Income Countries - Video
The primary contributors to higher costs are administrative costs, healthcare professional labor, and pharmaceutical. Administrative costs in the USA average 8% compared to other countries 1% to 3%. Medicare while many opponents of government managed care administrative costs are around 2% (Medicare is More Efficient Than Private Insurance). Physician and nurses salaries are also higher in the USA than in most other countries. Primary care physician average $218,173 while in other high-income countries salaries are $86,607 to $154,126. The USA medical education system is more costly and more prolonged than those in other countries. Regarding pharmaceuticals in different counties, the average cost ranges between $466 to $939 while in the USA is $1,443. Health Care Spending in the United States and Other High-Income Countries
In the past several years the Congress, as well as the President, have failed to find solutions to address this issues at least from a Federal level. There has been some progress made at the State level by some to create an expansion of Medicaid, require individual mandatory insurance purchases thus lowering the costs of premiums, and well as provide insurance companies “safety” coverage in case of unexpected losses. Read more about this at 4 States Are Restoring the Individual Mandate to Buy Health Insurance with 9 states considering individual mandate rules: report
Maybe change will only come when the private sector takes ownership of creating health policy and innovations to reduce the costs of healthcare. Amazon, Berkshire Hathaway, and JP Morgan Chase have announced Atula Gawande a well-known surgeon and best selling author to be the lead in a new company formed by this partnership with an aim to reduced healthcare costs. With the combined companies having over one million employees the deep pockets of Jeffrey Bezos of Amazon, Warren Buffett of Berkshire Hathaway, and Jamie Dimon of JP Morgan Chase just might interrupt the healthcare system that is often inefficient and absorbed by seeking financial incentives that may or may not relate to improving quality. Clearly, Congress and the healthcare industry has been unable to accomplish this task Washington Post June 20, 2018
Dr. Bob
Wednesday, November 28, 2018
Wednesday, November 21, 2018
For-Profit Nursing Schools – Creating Success
Nursing schools owned by a profit-oriented organization are often stigmatized as not “being good enough” to educate nurses. This source of stigma is hard to pinpoint as to the etiology. Perhaps it stems from a historical perspective at least in the past where education was provided by government-sponsored programs. With this model, the taxpayers funded the schools. This paradigm has changed significantly in the past 20 years because of the decrease in state funding and schools are expected to raise tuition in part to support student education. As a result, in many states, the costs of attending public sector or private non-project schools have “skyrocketed” as schools must act as a “for profit” enterprise to support their operations.
The shortage of nurses created an opportunity for alternative educational modules given the public sector simple was not able to be adapted to meeting the needs of the healthcare industry for nurses. The inability to the public and to a lesser extent non-profit schools to be more entrepreneurial often because of state regulatory prohibitions created an opportunity for private for-profit schools to emerge. The trend for profit was non-only isolated to nursing as other professions, as well as occupational majors, saw new educational opportunities appear.
The Obama administration who tended to lack an understanding of for-profit schools through the Department of Education decided (because of some outliers who were gaming the system) created new regulatory oversight which for the most part created significant closures of these schools. Thus at least in nursing while attempting to provide more funding to public sector nursing programs through the Division of Nursing within the Health and Human Resources Administration restricted growth or made doing building nursing programs impossible. The action contributed to the shortage of nurses and in some way continues today even though the Trump administration has lifted some of the restrictions.
As in any business venture particularly something as complex as nursing being able to provide a high-quality program can be very challenging. Given the stigma mentioned earlier often nurse educators are hesitant to move to the for-profit sector. The workload expectations are also different in that having a tenure-track position and focus on the creation of research agendas is mostly missing in the for-profit sector. The focus is on teaching and the scholarship of such. Faculty appointments are full time with no time off in the summers other than accumulated vacation time. Thus, finding nursing educators and administrators willing to give up these “perks” can be challenging.
Many of the for-profit schools have managed to address these issues adequately and as a result, provide a high-quality education. Notable are some of the Fortis schools including the Denver College of Nursing who have some quality program. Others such as publicly traded Chamberlain and Walden Universities are known for the quality of their graduates.
The variability in student outcomes and educational experience is directly related to several variables. From my perspective, the primary driver of quality is the ability of nursing administrators and faculty to create a successful learning experience. Often for-profits have limited experience under their belt in regards to nursing education. To develop successful programs can be very challenging. Success, while not guaranteed, can be fostered by using nursing consultants experienced with the for-profit sector. RL Anders and Associates given our extensive experience in both public sector and the for-profit schools can be a cost-effective resource to foster faculty development, student retention, satisfaction, and success on the NCLEX®.
Our clients are willing to share with you their experience and how together improvements and successful outcomes have been achieved. Our cost-effective consultant services which often can be done virtually thus saving traveling costs may make the difference in your NCLEX® results and EBITDA.
Check out these videos regarding how to achieve NCLEX® success.
Nursing schools owned by a profit-oriented organization are often stigmatized as not “being good enough” to educate nurses. This source of stigma is hard to pinpoint as to the etiology. Perhaps it stems from a historical perspective at least in the past where education was provided by government-sponsored programs. With this model, the taxpayers funded the schools. This paradigm has changed significantly in the past 20 years because of the decrease in state funding and schools are expected to raise tuition in part to support student education. As a result, in many states, the costs of attending public sector or private non-project schools have “skyrocketed” as schools must act as a “for profit” enterprise to support their operations.
The shortage of nurses created an opportunity for alternative educational modules given the public sector simple was not able to be adapted to meeting the needs of the healthcare industry for nurses. The inability to the public and to a lesser extent non-profit schools to be more entrepreneurial often because of state regulatory prohibitions created an opportunity for private for-profit schools to emerge. The trend for profit was non-only isolated to nursing as other professions, as well as occupational majors, saw new educational opportunities appear.
The Obama administration who tended to lack an understanding of for-profit schools through the Department of Education decided (because of some outliers who were gaming the system) created new regulatory oversight which for the most part created significant closures of these schools. Thus at least in nursing while attempting to provide more funding to public sector nursing programs through the Division of Nursing within the Health and Human Resources Administration restricted growth or made doing building nursing programs impossible. The action contributed to the shortage of nurses and in some way continues today even though the Trump administration has lifted some of the restrictions.
As in any business venture particularly something as complex as nursing being able to provide a high-quality program can be very challenging. Given the stigma mentioned earlier often nurse educators are hesitant to move to the for-profit sector. The workload expectations are also different in that having a tenure-track position and focus on the creation of research agendas is mostly missing in the for-profit sector. The focus is on teaching and the scholarship of such. Faculty appointments are full time with no time off in the summers other than accumulated vacation time. Thus, finding nursing educators and administrators willing to give up these “perks” can be challenging.
Many of the for-profit schools have managed to address these issues adequately and as a result, provide a high-quality education. Notable are some of the Fortis schools including the Denver College of Nursing who have some quality program. Others such as publicly traded Chamberlain and Walden Universities are known for the quality of their graduates.
The variability in student outcomes and educational experience is directly related to several variables. From my perspective, the primary driver of quality is the ability of nursing administrators and faculty to create a successful learning experience. Often for-profits have limited experience under their belt in regards to nursing education. To develop successful programs can be very challenging. Success, while not guaranteed, can be fostered by using nursing consultants experienced with the for-profit sector. RL Anders and Associates given our extensive experience in both public sector and the for-profit schools can be a cost-effective resource to foster faculty development, student retention, satisfaction, and success on the NCLEX®.
Our clients are willing to share with you their experience and how together improvements and successful outcomes have been achieved. Our cost-effective consultant services which often can be done virtually thus saving traveling costs may make the difference in your NCLEX® results and EBITDA.
Check out these videos regarding how to achieve NCLEX® success.
The success of for-profit programs and achievement of your
EBITDA is possible once the foundation for success is in place. Given us a call at 915-383-1653 or send an
email to rlanders10@gmail.com
Our webpage is https://www.rlaassociates.com/
Sunday, September 9, 2018
What Are Some Solutions to Address the Shortage of Nurses?
The traditional approaches to increasing the number of registered nurses are failing. Public sector nursing programs while understanding the need for more nurses merely is in most cases not able to come up with creative solutions to address the problem. Federal and state government funding, for the most part, has remained relatively flat for several years. Boards of Nursing continues to base many of their regulatory requirements on unproven beliefs on what is, for example, appropriate curriculums and clinical hours. There is no consistent policy regarding either of these issues. For example, some state reported in NCSBN Educational Program for Entry into Practice require clinical experience in a pediatric and maternity setting to meet the mandatory hours of clinical. The rule continues despite ample evidence that few students will ever practice in these setting given the limited opportunity. Nor is there a consideration that the NCLEX® has few questions regarding these competencies in their assessment. There is ample evidence the clinical competency can be met via simulation is provided by the NLN Center for Innovation in Simulation and Technology. The Boards of Nursing continue to operate in many states without updates to reflect today’s nursing competencies.
Impact of Boards of Nursing
An excellent example of the lack of congruency is how Boards allow the use of simulation to substitute for clinical hours. Some states do not allow any simulations (or minimum hours) while others such as the Texas Board of Nursing- Simulation in Pre-licensure Nursing Education regulations allows up to 50% of clinical to be used for simulation. These practice of not using standardized national guidelines for the use of simulation continues despite significant evidence to support the use of simulation. The resistant to changes continues regarding what should be an adequate number of clock hours. The regulations regarding the number of clinical hours are usually left up to Boards of Nursing’s subjective opinions. The amount varies from high of 900 hours in American Samoa found in the NCSBN Educational Program for Entry into Practice report to some states being nonspecified. There is no validity to either of these parameters. The regulations are based on what Board members think is appropriate. In the meantime, the shortage continues in many locations and patients suffer because of the lack of professional nurses to provide care.
First Time NCLEX® Pass Rate Impacts Viability of Schools of Nursing
Another factor impacting schools is the arbitrary rules set by the Board of Nursing regarding first time NCLEX® pass rates. Schools are rigorously regulated by their first-time pass rates. If a school (in many states) fails to achieve the national first-time pass rate typically over a period of time can be placed on probation and even closed. There is little or no evidence that students who pass the NCLEX® on the second attempt are less competent than those who pass the first time around. 2018 Number of Candidate Taking NCLEX Examination and Percent of Passing report reveals that the first-time pass rate for first and second quarter 2018 was 89.54% for a total of 95,904 new nurses and another 17,155 passed on the second attempt. This means 18% more nurses passed NCLEX© on their second attempt. New Jersey has a 70% passing rule while Texas has an 80% first time passing rule before the Board will begin to monitor program’s performance. If your program is located in Texas and your passing rate does not meet the first time pass rule of 80% over a three year period the school is closed.
The first-time pass rate rule is discriminatory against private sector schools who typically admit all students who have the potential to be nurses. Given the highly competitive nature of admission to public schools, few of their students should fail the NCLEX® on the first attempt. Board still follow these rules regarding first-time pass rates and this means some schools are forced to close during a time of significant shortages.
There needs to be a comprehensive, evidence-based review of Board of Nursing regulations that is national in scope. The result should be regulations that are designed to educate competent nurses and protect the public. What exists now is a mixed bag of “beliefs” not based on substantial scientific evidence. This process needs to be driven by the consumers, employers, policymakers as most Board, if left to act alone, are often not able to be innovative. Boards do not seem to understand their apparent lack of innovations and creativity are contributing to the loss of lives of their family members, neighbors, and friends who do not have access to competent professional nurses.
Push for BSN Entry into Practice
Another factor has been the Institute of Medicine which changed its names to National Academy of Medicine (NAM) in 2015, who advocates having at least 80% of the nurses prepared at the Bachelor of Science in nursing (BSN) level. While there is some research that shows hospitals with a higher percentage of BSN have in some cases better patient outcomes, there is no evidence what specifically in a BSN curriculum contributes to these higher outcomes. American Association of Colleges of Nursing which represents BSN and graduate nursing programs have assembled a summary of several studies supporting in part this statement. Associate Degree (AD) and BSN nurses all take the same NCLEX® examination. One would then assume the competencies of both graduates at least on entry into practice should be the same. The push for BSN graduates has created significant bottlenecks in the educational system because BSN programs are unable to meet the demand for registered nurses. Most of these BSN students take five years or more before they can graduate primarily because waiting for a slot to open. For public sector AD programs while the student should theoretically graduate in two years because of waiting lists and required pre-requisites the length to graduation can be up to four years.
A Place for Private For-Profit Schools
In contrast most, private for-profit schools admit four times per year and students in most cases can graduate within two years. These students take all the required course within their prescribed curriculum and are not delayed waiting to take pre-requisites courses. There is no “cherry picking” of only selecting the best students as typically all who meet the admission criteria are admitted. Some will argue that the education in the private for-profit sector is “less than” even though the final passing rate on the NCLEX® is similar to the public sector when first and second-time pass rates are calculated many schools will meet the benchmark requirement for graduate success on the NCLEX®. Yes, in many cases the first time passing rate is higher in the public sector as they should be given they only admit the very best applicants. Their pass rates should always be 90% and higher. There is little evidence that supports a second-time candidate for the NCLEX® is less competent than those who pass on the first attempt. Forcing schools to close because their overall pass rated based on first and second attempts at the NCLEX® is very short cited. These actions mean fewer nurses in times of urgent needs.
A Call for Action
There needs to be a call to action for Boards of Nursing as well as educators to join forces with consumers and employers to create new curriculum models using the latest evidence-based approaches and innovation in curriculum and instruction to address factors contributing to limiting the number of graduates. While not a part of my discussion equal attention needs to be placed on new nurse orientation and mentoring programs and overall working conditions. There needs to be an openness to encouraging students to seek AD programs so they can enter the workforce sooner. The requirement for seeking the BSN within a pre-determined time frame is reasonable assuming the RN to BSN curriculum is adding competencies. At this point, this statement has yet to be proven. My suggestion would be for those AD nurses who want to remain at the bedside be promoted and compensated for a demonstration of excellence thought national certifications and performance reviews linked in part to patient outcomes. At this point, with a reported bedside nurse turnover rate is 18.2%, 2.0% greater than 2016, should there not be some new approaches considered? Data regarding the percentage of BSN degree nurses turnover is not reported in the National Health Care Retention & RN Staffing Plan. There is speculation that BSN nurses tend to leave bedside nursing to seek positions which require a BSN and/or to pursue graduate education. Most of these non-bedside positions lack a requirement for shift rotations and no weekend and holiday hours. They are 40-hour week positions with little or no mandatory overtime nor require 12-hour shifts including weekends. No wonder it is thought that BSN nurses are fleeing bedside positions.
The time to act is now and I “get” a number of my nursing colleagues may not agree with my statements. I encourage dialogue and with open minds based on substantial evidence lets together work on resolving the nursing shortage.
Dr. Bob
Shortage of Nurses Continues and Getting Worse
The shortage of registered nurses particularly those with baccalaureate and higher degrees continues. The shortage is evidence in long-term facilities as reported by Kaiser Health News in their story regarding how Medicare lower ratings for 1400 nursing homes because of the lack of nurses. It is encouraging Medicare is using payroll data to confirm staffing. When seeking a long-term facility for a loved one asks about their staffing ratio of RN to the patients. Also, ask about their ratio of certified nurse’s assistance to patients. Both ratios will provide an idea if the staff is available to support their patients.
Growing Demand for Healthcare Services
The aging population and increasing demand for health services contribute in part to the demand for more registered nurses. With more individuals now having health insurance the need for healthcare services will continue to grow. As the baby boomer continue to increase many have at least one if not two chronic health conditions. All this means a need for more registered nurses.
Arizona State University provides an excellent summary of some of the nursing shortage issues. The shortage is exacerbated by nursing school turning away thousand on applicants. CNN Money in an April 2018 story illustrates the problems and has an excellent video on how hospital deserts area forming in rural America.
Collaboration is Urgently Needed with All Stakeholders
Board of Nursing, as well as nursing schools across the country, have to a limited degree responded to the demand for increasing their enrollments. Innovations in a curriculum that includes the use of simulations, accelerated programs for those who have degrees in other areas have been developed, and new partnerships between academia and healthcare service settings have been forged. The ability of schools of nursing to rapidly increase their capacity has been hampered by a shortage of resources and qualified faculty, limited clinical sites, restrictive Board of Nursing regulations, and inadequate budgets to expand enrollments.
Hopefully, this dialogue will start conversations about the shortage and potential solutions.
Dr. Bob
Saturday, September 8, 2018
Wednesday, August 22, 2018
Dear Nursing Colleagues
Attached is a link to a short video on the first foundational steps towards improving NCLEX scores. Let me know your thoughts?
NCLEX Success - Step 1 Faculty
Dr. Bob
Speaking up, being patient and using simple math can be the best medicine for your wallet.
Prescription medications are one of the most expensive and reoccurring costs you’ll face. The burden of high costs of drugs falls mostly on those who are the sickest. The New York Times The Price They Pay is revealing on the cost of drugs for those who need them the most. Fortunately, many of them have generic counterparts that are available and less expensive. The U.S. Food and Drug Administration requires that generic drugs be as safe and effective as their brand-name counterpart. More than half of all prescriptions are for generic drugs. When your provider writes a prescription, ask for the generic substitute. If the provider gives you a sample drug, also ask for a generic medicine so you can use it for a refill if needed.
You also can call different pharmacies to find out their price for your prescribed medicine. In most cases, the costs will be similar. In others, you’ll be thanking yourself for making an effort.
If you have prescription coverage that includes a co-pay, it may be cheaper to pay the generic price of $10 of the medication versus the co-pay depending on your co-pay amount. For example, the co-pay on a prescription plan for a 90-day supply could run from $27 to $75. In this case, it is more cost effective to pay the $10. The big retails stores such as Walmart offer many of the generic medications at low prices.
Individuals on Medicare should shop for plans that include the medication which they are taking. Many of the MedicareAdvantage Plans offer prescription covered. Before selecting a new plan check to learn if your drugs are covered. The saving can be extensive.
In some cases, non-profits and some state assistance programs, as well as pharmaceutical companies, offer special assistance programs. Many of these programs offer free or low-cost access to medications. You may even want to call the pharmaceutical company directly to ask if they have free or a discounted drug program. One website that might be useful is the Patient Assistance Program Center.
Mail order also may be another option when the medicine is not needed immediately. Mail order usually is substantially cheaper, and a 90-day supply is a usual order.
In some cases, over-the-counter drugs may be substituted for some prescribed medications. For instance, Claritin (Loratadine) can be purchased over the counter while its counterpart requires a prescription from a health care provider. The savings between the two can be substantial while the results are similar. Do yourself a favor and check with your healthcare provider or pharmacist.
Most of the time, the cost of medication does not depend on the dose. For example, a 100 mg Viagra tablet could cost the same as a 50 mg. Ask your provider or the pharmacist if the medication can be split. You may also find relative information on the Internet or through Consumer Reports about splitting drugs. If yes, you can save some money by getting a double dose of your prescription.
Using Pravastatin as an example, if your provider approves and your daily dose is 20 mg you can cut the 40 mg tablet in half and get a 180-day supply for $10. This is a substantial cost saving.
Those with numerous chronic illnesses may be in a situation where different providers prescribe a variety of medications. Ask your primary provider to review the medications and together you can determine which are needed. This could result in cost savings as well as the benefits to your health.
The pharmaceutical industry spends millions of dollars marketing directly to consumers. We are bombarded daily with television and print ads that promote numerous medications. The industry has found that their campaigns can direct patients to their specific product when other less costly options might be available.
Be careful about being persuaded that a heavily marketed medication is appropriate for you. A substitute drug for a 10th of the cost may be just as beneficial.
So be aware and speak up when it comes to your health. You’ll save money and not sacrifice quality medications.
Saturday, July 28, 2018
Creating NCLEX Qustions
In 2018 the NCLEX practice analysis is in the process of being completed and analyzed. For future information visit Practice Analysis. Because of the analysis, there will be some changes in the test plan. Detailed test plans for both RN and PN are available from NCSBN Test Plans for RN and PN. There are also a variety of test preparation services available from NCSBN to assist students in preparing for the NCELX exam. One particularly useful review tool is NCSBN's Review for NCLEX -RN and PN Examination.
Faculty writing testing items using the NCLEX test plans that are the foundation for creating their examinations often find the process very challenging. The test plan must carefully mirror as much as possible the NLCEX categories to ensure the students are exposed to the appropriate content as well as to the assessment of the appropriate learning context. For example, with entry level courses the questions may contain more knowledge-based questions, and as the student progresses in the curriculum, the question mix focuses on critical thinking and analysis. Sorting through this process is often a struggle for even the most seasoned educator.
Do not be seduced to use publisher tests bank which lacks validity and reliability assessments including peer review for compliance with NCLEX standards. Students can readily find on the internet the exams. Thus, investing in having an expert conduct an item writing workshop for faculty is a wise investment. At the end of the workshop, faculty will have a better understanding of the current NCLEX exam, alternative format questions, how to create a curriculum and course test plan, the use of item analysis, and perhaps most importantly how to write items. Additional follow up expert consultation can assist faculty with creating their own valid and reliable test banks. Shared is information about how to access and use free online test administration software as well as tips on test security and academic integrity proven solutions. Given the critical importance of maintaining a high pass rate on the NCLEX exam a small investment in faculty to support this effort is a cost-effective decision. Workshop fees are very cost effective and typically are substantially less than sending one or two faculty to an item writing workshop.
For further information give me a call or send an email to rlanders10@gmail.com
Dr. Bob
So You Want to Be a Nurse? Success Strategies for Nursing School
I have updated my short ebook for those considering nursing
school. There are also many helpful tips designed to assist students with
being successful in nursing school. Would you please take a few minutes to
look at the information and share such with any potential or current nursing
students? l
Dr. Bob
Centers for Medicare and Medicaid Proposes Flat Payment
Historically provider payments differ between the setting in which the services are delivered. For example, the same procedure done in a hospital-based clinic will be reimbursed at a higher rate than the one done any medical office. The justification made by the American Hospital Association that because of the higher fixed costs there should be a higher reimbursement rate. Thus, even though the services were similar patients were required to pay higher co-pay in some cases for the care given hospital-based system versus an office setting. Taxpayers were the one footing the bill for this difference in payments which had little or nothing to do outcomes of care.
Many physician groups particularly specialists are complaining that this change in a flat payment system will impact their revenue. Some physicians are hypothesizing that the reduction in payments will decrease their income. The Center for Medicare & Medicaid is proposing a change in the paperwork requirement for submission of billing information. It will move from a four-step process to a single form that needs to be submitted. If the provider can justify that additional time is needed to care for complex care patients an additional payment can be requested. The government proposes that the flat payment will improve efficiency and outcomes of care.
While the government does not indicate that the proposal will reduce the cost of care, it does seem at least in my reading of the proposed regulations that there is some intent to level the payment across multiple settings for the same procedures. Traditional taxpayers have been told by many provided groups their cost of doing business is unique and higher in certain geographical areas, therefore, they should not be forced to become more cost-efficient and simply receive higher compensation from the Centers for Medicare and Medicaid. The new payment is scheduled for implementation on January 1, 2019. For more information about this particular proposal, please view NPR Story Regarding Flat Payment
Dr. Bob
Saturday, February 17, 2018
Keeping Our Schools Safe
I am writing to ask that you do everything possible to keep
our own schools safe. The continuing mass killings of our children is
unacceptable and we cannot assume that something similar cannot occur in our
local schools.
Our schools must have secured entry, metal detectors, and armed guards. We need a system to insure rapid response from the police department. I am hopeful there is already internal procedures in place for most of our schools. We need a method of tracking known people who could be threats to follow “see something...say something”.
Our schools must have secured entry, metal detectors, and armed guards. We need a system to insure rapid response from the police department. I am hopeful there is already internal procedures in place for most of our schools. We need a method of tracking known people who could be threats to follow “see something...say something”.
Mental laws in most states are very lack.. Efforts to force mental health holds on those with serious mental issues have continued to fail. We need laws that law enforcement and mental health professional can use to protect the public. While not want to further stigmatize the mentally ill there is a need to provide more compassionate care to those who by the various nature of their disorder lack understanding and insight to their illness. While most mass murders have not suffered from a serious and persistent mental illness being able to provide needed resources is urgently needed.
The issue of gun controls evokes emotional and often unfounded reactions on both sides of the issue. The argument is that guns do not kill our children it is the people. This is partially true. However, the AK-15 has been the weapon used in the majority of mass killings. What can be done to ensure owners of these weapons are responsible individuals? No other economically developed nation has this issue. What can we learn from them?
.
Please join me in contacting your local
school administrators, board members, state and federal senators and
representatives. Parents must take the lead to hold these stakeholders
accountable to create a safe environment for our children and teachers.
Finding solutions are possible when there
is an open mind to collaborate on solving the problem. Unfortunately in today
environment please do not just sit back and offer your prayers please take
action. Enough is enough....
Dr. Bob
Reflection on Religion and Being Gay
Many evangelical Christians have a foundational belief in the literal interpretation of the Bible. There is a belief that all words in the Bible are factually the words of God. The context of the Bible is without fault. They believe in creationism that the earth was created in seven days solely through the work of the Lord. There is also a belief by some of these evangelicals Christian the earth is less than 10,000 years old. They believe that Adam and Eva are the sources of all people and so forth. These beliefs exist even with overwhelming scientific evidence to the contrary. Most fail to understand there can be both a “big bang” theory (by which God created the universe including the earth) and the evolutionary process that explains how God made the earth and all in it.
The Bible has been used and continues to this day to support slavery, war, hate crimes against non-believers, interracial marriage, genocide, gay bashing, and so forth. These acts perhaps based on what the followers thought were well intentional beliefs were taken out of the context of the Biblical text and are used to justify their actions. Fortunately, at least in the Western economically developed countries many Christians, when confronted with facts their beliefs evolve. For many years it was thought the sun revolved around the earth. In fact, Christians persecuted Copernicus for this belief. Forgiveness only came after substantial evidence emerged of proof that the earth’s rotation was around the sun.
This same evolution on the etiology of homosexuality is also occurring. The homosexual behavior exists even during Jesus’s time on earth. He did not speak against loving and caring individuals in a gay relationship. The context often cited in the New Testament (Matthew 19:1-12) against homosexuality is when Jesus is discussing marriage and divorce.
There is also a lack of understanding that the term homosexuality as used in the New Testament is the translation of three specific Greek words. Religious scholars have debated what is meant by these three Greek words. The contemporary interpretation is the words were intended to serve as a prohibition against prostitution rather than homosexuality. The debate among religious scholars regarding the context of these words is to begin the journey to understand the evolution of a social and biological understanding that has evolved regarding homosexual. St. Paul’s multiple statements about sexual behavior needs to be viewed in this context given widespread prostitution (both men and women) as well as pederasty. These behaviors from St Paul’s perspective were incongruent with Christian teaching.
Bottomline beliefs evolve depending on the issue. It is common to “pick and choose” language particularly when discussing homosexuality for example from the Old Testament book of Leviticus. Many other prohibitions described in Leviticus are merely ignored by most evangelical Christian.
There has become an increasing understanding that homosexual behavior is primarily a biological determinate. Aversion therapy conceptualizes that being homosexual is a lifestyle choice. Attempting to change the orientation using aversion therapy has proven unsuccessful. No gay person wakes up one morning and decides that he/she be going to be a homosexual. Who in their right mind would choose a lifestyle where so many people who still lack an understanding of the etiology chose to be gay. The persecution and hate generated by many people in societies all over the world usually based on some religious beliefs would make choices to be gay illogical. It is like for heterosexuals, did he/she wake up one day and decided he/she are straight? Of course, not it is a biological factor that merely exits.
In a free society, we have the right to believe whatever we have come to view as right. We can justify our position on a literal interpretation of the Bible. If this is the position chosen, then one needs to be careful not become a hypocrite by only picking those passages or translations that fit a viewpoint.
A statement by the Nashville Christians United in Support of the LGBT + Inclusion in the Church Statement in their August 30, 2017, a report signed by over 300 religious leaders, educators, and activities from ALL major Christian denomination sum up an approach that reflects Jesus’s teaching. It reads:
“WE AFFIRM that every human being is created in the image and likeness of God and that the great diversity expressed in humanity through our wide spectrum of unique sexualities and gender identifies a perfect reflection to the magnitude of God’s creative work.”
Dr. Bob
The Bible has been used and continues to this day to support slavery, war, hate crimes against non-believers, interracial marriage, genocide, gay bashing, and so forth. These acts perhaps based on what the followers thought were well intentional beliefs were taken out of the context of the Biblical text and are used to justify their actions. Fortunately, at least in the Western economically developed countries many Christians, when confronted with facts their beliefs evolve. For many years it was thought the sun revolved around the earth. In fact, Christians persecuted Copernicus for this belief. Forgiveness only came after substantial evidence emerged of proof that the earth’s rotation was around the sun.
This same evolution on the etiology of homosexuality is also occurring. The homosexual behavior exists even during Jesus’s time on earth. He did not speak against loving and caring individuals in a gay relationship. The context often cited in the New Testament (Matthew 19:1-12) against homosexuality is when Jesus is discussing marriage and divorce.
There is also a lack of understanding that the term homosexuality as used in the New Testament is the translation of three specific Greek words. Religious scholars have debated what is meant by these three Greek words. The contemporary interpretation is the words were intended to serve as a prohibition against prostitution rather than homosexuality. The debate among religious scholars regarding the context of these words is to begin the journey to understand the evolution of a social and biological understanding that has evolved regarding homosexual. St. Paul’s multiple statements about sexual behavior needs to be viewed in this context given widespread prostitution (both men and women) as well as pederasty. These behaviors from St Paul’s perspective were incongruent with Christian teaching.
Bottomline beliefs evolve depending on the issue. It is common to “pick and choose” language particularly when discussing homosexuality for example from the Old Testament book of Leviticus. Many other prohibitions described in Leviticus are merely ignored by most evangelical Christian.
There has become an increasing understanding that homosexual behavior is primarily a biological determinate. Aversion therapy conceptualizes that being homosexual is a lifestyle choice. Attempting to change the orientation using aversion therapy has proven unsuccessful. No gay person wakes up one morning and decides that he/she be going to be a homosexual. Who in their right mind would choose a lifestyle where so many people who still lack an understanding of the etiology chose to be gay. The persecution and hate generated by many people in societies all over the world usually based on some religious beliefs would make choices to be gay illogical. It is like for heterosexuals, did he/she wake up one day and decided he/she are straight? Of course, not it is a biological factor that merely exits.
In a free society, we have the right to believe whatever we have come to view as right. We can justify our position on a literal interpretation of the Bible. If this is the position chosen, then one needs to be careful not become a hypocrite by only picking those passages or translations that fit a viewpoint.
A statement by the Nashville Christians United in Support of the LGBT + Inclusion in the Church Statement in their August 30, 2017, a report signed by over 300 religious leaders, educators, and activities from ALL major Christian denomination sum up an approach that reflects Jesus’s teaching. It reads:
“WE AFFIRM that every human being is created in the image and likeness of God and that the great diversity expressed in humanity through our wide spectrum of unique sexualities and gender identifies a perfect reflection to the magnitude of God’s creative work.”
Dr. Bob
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