Archives for the month of: November, 2015

With the 2016 presidential election swiftly approaching, one of the issues that many of the presidential candidates will attempt to tackle will be the topic of healthcare and the provisions thereof.  But just how informed are the candidates who are participating in the healthcare debates?  As a health care provider, I would like to assert that there is a health care crisis that few are aware of or are even talking about.

When most people discuss healthcare, they do so from the perspective of law makers, the insurance companies and from the general public.  However, oftentimes, there is one pivotal perspective that is typically missing from those debates—the point of view of the practitioner.  Most of the arguments that I have heard made against healthcare providers are usually based in ignorance and entitlement.  Our society has grown accustomed to the notion that healthcare should be free.  However, nothing in life is free.  For every freedom someone has paid an extensive cost.  If we as a society desire free or reduced healthcare, we have to have a system in place that will make it beneficial to those who are providing care.  Most doctors, even if they wanted to, could not afford to work for free or work at a reduced fee, which, unfortunately, includes participating in many HMO/DMO programs. Remuneration from Medicaid and various DMO plans can often fall below the fixed costs associated with the provision of care.  For example, if cost of basic supplies and materials associated with a certain procedure is below, equal to or slightly above the reimbursement, then not only is participation in that program non beneficial to the practitioner, it is also detrimental to the practice’s sustainability.  The true question is not whether or not practitioners want to provide service to those who are in need, but whether they can afford to do so responsibly.  At some point, there will be a tradeoff.

 

THE PROBLEM

  • Cost
    •  Education
    • Student Loan
      • Average Cost of medical/dental/professional education
    • Continuing Education
      • Making sure that practitioner is current
  • Initial Licensure
  • Operating a practice
    • Rent/Mortgage
    • Materials and Supplies
    • Lab fees
    • Equipment purchase/repair
    •  Staff
      • Training
      • Salaries
      • Benefits
        • Retirement Plans
        • Health Insurance
    • Taxes
      • Personal and Corporate
        • Federal
        • State
        • County
        • City
    • Malpractice Insurance
    • Licensure renewal
    • Accounting fees
    • Legal fees
    • Governmental regulatory agencies
    • Incidentals

 

What are some of the tradeoffs that occur when there is not a system in place to appropriately compensate and/or accommodate practitioners?

  1. Poor care
    1. Decrease in quality materials being used
    2. Decreased time spent with patients in order to ascertain the relevant information needed to make an accurate diagnosis in order to render appropriate treatment
    3. Decreased standard of care
      1. Decreased OSHA compliance
      2. Decreased protocol implementation
    4. Practitioner burnout
  2. Less access to qualified/skilled practitioners
    1. Those who are financially independent/secure (i.e. more seasoned practitioners) might not participate in plans that do not appropriately compensate them
  3. More sick people in our population
    1. More sick people result in a declining economy due to missed work days

 

I believe that there should be an open dialogue between law makers and practitioners.  As a society, we cannot continue to ignore the financial burdens being placed on our healthcare providers while maintaining an expectation that our treatment/care will not be negatively impacted.  That is just not realistic.  We all want to be treated in a clean, safe environment.  However, that comes with a cost.   There has to be some relief in place for our healthcare providers.  Loan repayment should not just be limited to Federally-designated areas.  It is not just the underserved populations that require quality healthcare providers.  We all do.   In addition to loan repayment, there should be tax reliefs for healthcare providers.  Truthfully, I don’t know what the answers should be, but that is exactly the reason for a dialog.  If we continue with the status quo, we will all be at risk.  Skilled clinicians will leave the practice of medicine and dentistry.  We will be left with a system riddled with mediocrity and apathy.  God forbid, if we are laying on the operating table, we want to know that our doctor is not worrying about whether or not the insurance will reimburse him (or her) for the procedure(s)?

A few years ago, I created this blog to challenge the way we think–to open our minds. Today the old adage, knowledge is power, is probably truer than ever before. Many of us fear what we do not know.

On Tuesday, I sat in front of my television, as perhaps millions of others, and watched as Charlie Sheen disclosed what was probably his biggest personal obstacle to date: his HIV status. As I watched him, I saw an individual who was the embodiment of the human experience–wonderful, flawed and broken, all at the same time. At times during the interview, he look bewildered, as if he were having an out of body experience–as if it were happening to someone else.

Days before the Matt Lauer interview, I already knew what Charlie Sheen’s disclosure would be. The Internet was already abuzz. The opinions and speculation varied from support to condemnation. As I read through some of the posts, I was reminded of King David. During one of his fallen moments, he declared, “It would be better to fall into the hands of God than to fall into the hands of man.”

God’s grace reminds us that we are ALL wonderful, flawed and broken. In all of our lives, we will experience moments where our actions will take us to dark places from where only God can deliver us. The truth is, only God can judge.

Romans 8:28 says, “And we know that in all things God works for the good of those who love him, who have been called according to his purpose.” Whether we know it or believe it, we are all called for God’s purpose. He can take our biggest mistakes, failures and shortcomings and use them for His glory. One of the positives that came from Sheen’s disclosure is the open dialogue about HIV and AIDS. There is still so much misinformation and stigma surrounding the disease. As having had the experience as an HIV educator and working with HIV researcher, I understand the value of these teachable moments.

Last year, I wrote and produced, “What is Your Status: An HIV Awareness Story ” to highlight some of the issues that still surround HIV and AIDS.
Please check out the video below:

THIS IS MY SEASON TO REAP WHAT I HAVE SOWN

A Season of Celebration, Praise, Rest and Harvest

For it is by grace you have been saved, through faith–and this is not from yourselves, it is the gift of God–
Ephesians 2:8

God “will repay each person according to what they have done.”
Romans 2:6

For the Son of Man is going to come in his Father’s glory with his angels, and then he will reward each person according to what they have done.
Matthew 16:27

38 Give, and you will receive. Your gift will return to you in full—pressed down, shaken together to make room for more, running over, and poured into your lap. The amount you give will determine the amount you get back.”
Luke 6:38

THE FEAST OF TABERNACLE

AKA:

  • The Feast of Booths
  • The Festival of Shelters
  • The Feast to the Lord
  • The Festival of Ingathering
    • Ingathering defined (Dictionary.com):
      1. a gathering in, especially of farm products; harvest.
      2. a gathering in together, as of persons; assembly.
    • Sukkot (Pronounced “Sue COAT”)

What is Sukkot?

  • The seventh and final feast given to the Israelites
  • Sukkot marked the end of the agricultural year. It marked the ingathering of the harvest of the summer season, providing for the upcoming winter.
  • Spiritual significance:
    • Christians are in a season of harvesting of souls for the Kingdom of God for the final celebration of the Coming of Christ and worshiping the Lord in Jerusalem.

When is Sukkot observed?

  • Observed in the fall from the 15th to the 22nd (8 days) of the Hebrew month Tishri, which usually occurs late September to mid October.

What were the Israelite celebrating when observing Sukkot?

  1. Provision during the current harvest season.
  2. Remembering God’s provision and protection during the 40 years in the wilderness.

When were God’s instructions for celebrating the Festival of Tabernacle given?

  • After God had delivered the Israelite from the Egyptians.
  • Leviticus 23:
    • 33And the Lord said to Moses, 34“Give the following instructions to the people of Israel. Begin celebrating the Festival of Shelters on the fifteenth day of the appointed month—five days after the Day of Atonement. This festival to the Lord will last for seven days. 35On the first day of the festival you must proclaim an official day for holy assembly, when you do no ordinary work. 36For seven days you must present special gifts to the Lord. The eighth day is another holy day on which you present your special gifts to the Lord. This will be a solemn occasion, and no ordinary work may be done that day, (Leviticus 23:33-36).

How did the Feast look?

  • It began and ended with a Sabbath day of rest set aside to worshiping God.
  • During the eight days of the Feast, the Israelites would live in booths, which served as a reminder to them of the makeshift huts that they dwelled in during their 40 years in the wilderness, the barren desert.
    • During that time God provided them with:
      • Water
      • Manna
      • Quail
      • Protection
      • Pillar of Cloud by day
        • Provided shade in the heat
      • Pillar of Fire by night
        • Provided light at night.
      • Each day of the feast, the Israelites made an “offering by fire to the Lord.”
      • Seven days of feasting, the eighth day was for rest.
      • Jesus celebrated at the feast and pointed to Himself as fulfillment of Scripture
        • The Great Day:
          • The seventh day became known as Hoshana Rabba-The Great Day
          • A priest would lead a parade of worshipers, flutist, choir to the pool of Siloam (the place where Jesus healed the blind man by putting clay over his eyes)Þ The priest would then fill one of his two golden pitchers with water from the pool. (The other pitcher would be for the wine which would be served as a drink offering to the Lord) Þ The parade would head back to the Temple ÞTwo silver basins would be awaiting at the altar of the TempleÞThe priest would pour wine into one of the silver basin and the water from the pool of Siloam would be poured into the other.
          • The purpose of the ceremony was to thank God for His great provision and to ask for rain for the crops in the upcoming season.
          • It was during the Great Day that Jesus stood in the Temple and said:
            • 37On the last day of the feast, the great day, Jesus stood up and cried out, “If anyone thirsts, let him come to me and drink. 38Whoever believes in me, as the Scripture has said, ‘Out of his heart will flow rivers of living water.’” 39Now this he said about the Spirit, whom those who believed in him were to receive, for as yet the Spirit had not been given, because Jesus was not yet glorified. (John 7:37-39).
          • Jesus is the Light
            • The Temple was illuminated with light at the end of the first day of the Feast
            • The Jews begin Shabbat each week by the lighting of two candles, which stood for “Keep” and “Remember.”  They did so in order to remember that God rested on the seventh day and as a reminder that we are looking forward to an everlasting rest.
            • According to oral Jewish History:
              • Four, giant (50 cubits-75 feet tall) candelabras, each with four branches, stood within the court of the womenÞA large bowl was atop each branchÞFour young men would climb ladders and fill each bowl with 10-gallon pitcher of oilÞThe 16 bowls were ignited and could be seen by the rest of the city below the hill where the Temple was locatedÞWhile the fires blazed, musicians played music to GodÞThe lights reminded the people how God’s glory once filled the temple.
            • John 8:12,20
              • It was during this time that Jesus declared:
              • 12 Jesus spoke to the people once more and said, “I am the light of the world. If you follow me, you won’t have to walk in darkness, because you will have the light that leads to life….20Jesus made these statements while he was teaching in the section of the Temple known as the Treasury. But he was not arrested, because his time had not yet come.”
                • The inner area of the Temple contained three courts. The easternmost court was the Court of the Women, and it contained the Temple treasury where people donated their money.

Who is entitled to God’s promises?

  • All:
    • Romans 11:17-18
      • 17But some of these branches from Abraham’s tree—some of the people of Israel—have been broken off. And you Gentiles, who were branches from a wild olive tree, have been grafted in. So now you also receive the blessing God has promised Abraham and his children, sharing in the rich nourishment from the root of God’s special olive tree. 18 But you must not brag about being grafted in to replace the branches that were broken off. You are just a branch, not the root.
        • In the very beginning, God ordered the Israelites to celebrate with branches, symbolizing people from all over:
          • Leviticus 23:39-41 (NLT).
            • 39“Remember that this seven-day festival to the Lord—the Festival of Shelters—begins on the fifteenth day of the appointed month, after you have harvested all the produce of the land. The first day and the eighth day of the festival will be days of complete rest. 40 On the first day gather branches from magnificent trees—palm fronds, boughs from leafy trees, and willows that grow by the streams. Then celebrate with joy before the Lord your God for seven days. 41 You must observe this festival to the Lord for seven days every year. This is a permanent law for you, and it must be observed in the appointed month from generation to generation.
          • Isaiah 56:6-8
            • 6“I will also bless the foreigners who commit themselves to the Lord, who serve him and love his name, who worship him and do not desecrate the Sabbath day of rest, and who hold fast to my covenant.7 I will bring them to my holy mountain of Jerusalem and will fill them with joy in my house of prayer.  I will accept their burnt offerings and sacrifices, because my Temple will be called a house of prayer for all nations. 8For the Sovereign Lord, who brings back the outcasts of Israel, says:  I will bring others, too, besides my people Israel.”
          • Solomon dedicates the Temple at Sukkot and calls on God to hear the prayers of all foreigners:
            • 2 Chronicles 6:32-33
              • 32“In the future, foreigners who do not belong to your people Israel will hear of you. They will come from distant lands when they hear of your great name and your strong hand and your powerful arm. And when they pray toward this Temple, 33then hear from heaven where you live, and grant what they ask of you. In this way, all the people of the earth will come to know and fear you, just as your own people Israel do. They, too, will know that this Temple I have built honors your name.

GOD is the ALPHA and the OMEGA

  • Revelations 22:13-13
    • 12“Look, I am coming soon, bringing my reward with me to repay all people according to their deeds. 13 I am the Alpha and the Omega, the First and the Last, the Beginning and the End.”
  • Leviticus 23:39 tells us that the 1st and the 8th (the last day) of the feast shall be holy. It should be a day of Rest
    • Implication:
      • Everything that is good and holy begins and ends with God.
      • God = Holy
      • God = Rest
      • Hebrews 4:1-11
        • 1God’s promise of entering his rest still stands, so we ought to tremble with fear that some of you might fail to experience it. 2For this good news—that God has prepared this rest—has been announced to us just as it was to them. But it did them no good because they didn’t share the faith of those who listened to God. For only we who believe can enter his rest. As for the others, God said, “In my anger I took an oath: ‘They will never enter my place of rest,’” even though this rest has been ready since he made the world. We know it is ready because of the place in the Scriptures where it mentions the seventh day: “On the seventh day God rested from all his work.” 5But in the other passage God said, “They will never enter my place of rest.”6So God’s rest is there for people to enter, but those who first heard this good news failed to enter because they disobeyed God. 7So God set another time for entering his rest, and that time is today. God announced this through David much later in the words already quoted: “Today when you hear his voice, don’t harden your hearts.” 8Now if Joshua had succeeded in giving them this rest, God would not have spoken about another day of rest still to come. 9So there is a special rest still waiting for the people of God. 10For all who have entered into God’s rest have rested from their labors, just as God did after creating the world. 11So let us do our best to enter that rest. But if we disobey God, as the people of Israel did, we will fall.

Conclusion

  • PLANT SEEDS –>REAP HARVESTS–>REST/PRAISE/CELEBRATE
  • ENTER INTO GOD’S REST

CREDITS (Re: The Festival of Tabernacles)

http://feast.icej.org/about

http://www.hope-of-israel.org/tabernac.htm

http://www1.cbn.com/biblestudy/finding-jesus-in-the-feast-of-tabernacles

http://www.gotquestions.org/Feast-of-Tabernacles.html

http://www.bible-history.com/court-of-women/the_temple_treasury.html

http://dictionary.reference.com/browse/ingathering

Scripture quotations are taken from the Holy Bible, New Living Translation, copyright © 1996. Used by permission of Tyndale House Publishers, Inc., Wheaton, Illinois 60189. All rights reserved.