For years, we hear well-known preachers direct us to world events and interpret that as precursor of end-times. Time and time again, they were proven wrong. A friend of mine believed that “1975 in Prophecy” and quit medical school because he contended,why finish when the world was ending?; can’t blame him. Can humans really know ?

Sequence of human governments, who and why set this sequence?

What really is the timetable for the world’s human governments ? And who has control of that timetable-sequence of events to replace “human” governments? And, why replace “human” governments, at all?

Biblically, if one goes through history, the first powerful human government was that of Nimrod’s, represented by the “tower of Babel” in Genesis 11:1-9. But, this human government was only local (a city) and did not expand worldwide. Egypt, as a country, was very powerful and the one that enslaved Israel; still, though, not a global power.

On the other hand, the Babylonian Empire could be considered as the 1st one with global reach; also recognized by God as a global government through the dream of Nebuchadnezzar in Daniel 2. This appears convincingly, the start of recognized global governments worth recognition and the timetable from which to draw and follow subsequent events have to be based and predicated from that “human world government”, and not from any other world developments.

The sequence of global human governments from the Babylonian empire to the “government/kingdom of God”, on earth, is compelling. And, it was the sovereign Almighty God, who set this sequence as revealed to Daniel. Indeed, we are just incapable of knowing the future; no human would know unless revealed by God.

Let us now read the narrative in Daniel 2:

“2 And in the second year of the reign of Nebuchadnezzar Nebuchadnezzar dreamed dreams, wherewith his spirit was troubled, and his sleep brake from him.

² Then the king commanded to call the magicians, and the astrologers, and the sorcerers, and the Chaldeans, for to shew the king his dreams. So they came and stood before the king.

³ And the king said unto them, I have dreamed a dream, and my spirit was troubled to know the dream.

⁴ Then spake the Chaldeans to the king in Syriack, O king, live for ever: tell thy servants the dream, and we will shew the interpretation.

⁵ The king answered and said to the Chaldeans, The thing is gone from me: if ye will not make known unto me the dream, with the interpretation thereof, ye shall be cut in pieces, and your houses shall be made a dunghill.

⁶ But if ye shew the dream, and the interpretation thereof, ye shall receive of me gifts and rewards and great honour: therefore shew me the dream, and the interpretation thereof.

⁷ They answered again and said, Let the king tell his servants the dream, and we will shew the interpretation of it.

⁸ The king answered and said, I know of certainty that ye would gain the time, because ye see the thing is gone from me.

⁹ But if ye will not make known unto me the dream, there is but one decree for you: for ye have prepared lying and corrupt words to speak before me, till the time be changed: therefore tell me the dream, and I shall know that ye can shew me the interpretation thereof.

¹⁰ The Chaldeans answered before the king, and said, There is not a man upon the earth that can shew the king’s matter: therefore there is no king, lord, nor ruler, that asked such things at any magician, or astrologer, or Chaldean.

¹¹ And it is a rare thing that the king requireth, and there is none other that can shew it before the king, except the gods, whose dwelling is not with flesh.

¹² For this cause the king was angry and very furious, and commanded to destroy all the wise men of Babylon.

¹³ And the decree went forth that the wise men should be slain; and they sought Daniel and his fellows to be slain.

¹⁴ Then Daniel answered with counsel and wisdom to Arioch the captain of the king’s guard, which was gone forth to slay the wise men of Babylon:

¹⁵ He answered and said to Arioch the king’s captain, Why is the decree so hasty from the king? Then Arioch made the thing known to Daniel.

¹⁶ Then Daniel went in, and desired of the king that he would give him time, and that he would shew the king the interpretation.

¹⁷ Then Daniel went to his house, and made the thing known to Hananiah, Mishael, and Azariah, his companions:

¹⁸ That they would desire mercies of the God of heaven concerning this secret; that Daniel and his fellows should not perish with the rest of the wise men of Babylon.

¹⁹ Then was the secret revealed unto Daniel in a night vision. Then Daniel blessed the God of heaven.

²⁰ Daniel answered and said, Blessed be the name of God for ever and ever: for wisdom and might are his:

²¹ And he changeth the times and the seasons: he removeth kings, and setteth up kings: he giveth wisdom unto the wise, and knowledge to them that know understanding:

²² He revealeth the deep and secret things: he knoweth what is in the darkness, and the light dwelleth with him.

²³ I thank thee, and praise thee, O thou God of my fathers, who hast given me wisdom and might, and hast made known unto me now what we desired of thee: for thou hast now made known unto us the king’s matter.

²⁴ Therefore Daniel went in unto Arioch, whom the king had ordained to destroy the wise men of Babylon: he went and said thus unto him; Destroy not the wise men of Babylon: bring me in before the king, and I will shew unto the king the interpretation.

²⁵ Then Arioch brought in Daniel before the king in haste, and said thus unto him, I have found a man of the captives of Judah, that will make known unto the king the interpretation.

²⁶ The king answered and said to Daniel, whose name was Belteshazzar, Art thou able to make known unto me the dream which I have seen, and the interpretation thereof?

²⁷ Daniel answered in the presence of the king, and said, The secret which the king hath demanded cannot the wise men, the astrologers, the magicians, the soothsayers, shew unto the king;

²⁸ But there is a God in heaven that revealeth secrets, and maketh known to the king Nebuchadnezzar what shall be in the latter days. Thy dream, and the visions of thy head upon thy bed, are these;

²⁹ As for thee, O king, thy thoughts came into thy mind upon thy bed, what should come to pass hereafter: and he that revealeth secrets maketh known to thee what shall come to pass.

³⁰ But as for me, this secret is not revealed to me for any wisdom that I have more than any living, but for their sakes that shall make known the interpretation to the king, and that thou mightest know the thoughts of thy heart.

³¹ Thou, O king, sawest, and behold a great image. This great image, whose brightness was excellent, stood before thee; and the form thereof was terrible.

³² This image’s head was of fine gold, his breast and his arms of silver, his belly and his thighs of brass,

³³ His legs of iron, his feet part of iron and part of clay.

³⁴ Thou sawest till that a stone was cut out without hands, which smote the image upon his feet that were of iron and clay, and brake them to pieces.

³⁵ Then was the iron, the clay, the brass, the silver, and the gold, broken to pieces together, and became like the chaff of the summer threshingfloors; and the wind carried them away, that no place was found for them: and the stone that smote the image became a great mountain, and filled the whole earth.

³⁶ This is the dream; and we will tell the interpretation thereof before the king.

³⁷ Thou, O king, art a king of kings: for the God of heaven hath given thee a kingdom, power, and strength, and glory.

³⁸ And wheresoever the children of men dwell, the beasts of the field and the fowls of the heaven hath he given into thine hand, and hath made thee ruler over them all. Thou art this head of gold.

³⁹ And after thee shall arise another kingdom inferior to thee, and another third kingdom of brass, which shall bear rule over all the earth.

⁴⁰ And the fourth kingdom shall be strong as iron: forasmuch as iron breaketh in pieces and subdueth all things: and as iron that breaketh all these, shall it break in pieces and bruise.

⁴¹ And whereas thou sawest the feet and toes, part of potters’ clay, and part of iron, the kingdom shall be divided; but there shall be in it of the strength of the iron, forasmuch as thou sawest the iron mixed with miry clay.

⁴² And as the toes of the feet were part of iron, and part of clay, so the kingdom shall be partly strong, and partly broken.

⁴³ And whereas thou sawest iron mixed with miry clay, they shall mingle themselves with the seed of men: but they shall not cleave one to another, even as iron is not mixed with clay.

⁴⁴ And in the days of these kings shall the God of heaven set up a kingdom, which shall never be destroyed: and the kingdom shall not be left to other people, but it shall break in pieces and consume all these kingdoms, and it shall stand for ever.

⁴⁵ Forasmuch as thou sawest that the stone was cut out of the mountain without hands, and that it brake in pieces the iron, the brass, the clay, the silver, and the gold; the great God hath made known to the king what shall come to pass hereafter: and the dream is certain, and the interpretation thereof sure.

⁴⁶ Then the king Nebuchadnezzar fell upon his face, and worshipped Daniel, and commanded that they should offer an oblation and sweet odours unto him.

⁴⁷ The king answered unto Daniel, and said, Of a truth it is, that your God is a God of gods, and a Lord of kings, and a revealer of secrets, seeing thou couldest reveal this secret.

⁴⁸ Then the king made Daniel a great man, and gave him many great gifts, and made him ruler over the whole province of Babylon, and chief of the governors over all the wise men of Babylon.

⁴⁹ Then Daniel requested of the king, and he set Shadrach, Meshach, and Abednego, over the affairs of the province of Babylon: but Daniel sat in the gate of the king.

NOTICE;, that without any doubt, the sequence of human governments was revealed and acknowledged by God to have started from the Babylonian Empire of Nebuchadnezzar via his dream of an image; him being the head of gold. And, historically, what followed was the Medo-Persian Empire of Cyrus (breast and his arms of silver) , then subsequently , the Greco-Macedonian empire of Alexander the Great (belly and his thighs of brass), followed by the Roman Empire, which divided into Western & Eastern divisions (fourth kingdom shall be strong as iron).

All these kingdoms were of the _past but the feet and toes that came out from these 2 divisions of the Roman Empire (toes of the feet were part of iron, and part of clay, so the kingdom shall be partly strong, and partly broken), are still of the future.

These feet/toes kingdom of 10 conglomerate-countries will still be future,

(not the past ten kings, as others interpreted, viz,, Augustus, Tiberius, Caludius, Caligula, Nero, Galba, Otho, Vitellius, Vespasian and Titus.)

and will come in the future as an early indicator/ precursor of Jesus’ 2nd coming, 1st resurrection of the dead and change, of those who are alive from mortal to spiritual bodies, setting the stage for the coming “kingdom of God” to be established in Jerusalem, and, in time to worldwide.

Moreover, when (in the future) these 10 conglomerates of nations (10 heads/horns) are formed from the 4th kingdom(Roman Empire), then the “little horn” will arise to topple 3/10, to be the 8th head of the Beast of Revelations.

Also, these 10-conglomerates and little horn will have a “mark of the Beast” which is a currency like Denarius (Mark 12:15-17) of the previous Roman empire, that without it, “no one can buy nor sell”.

In summary, and in my humble opinion learned from the Bible, the sequence of events already prophesied commenced from Nebuchadnezzar’s Babylonian/Chaldean empire. And we have to watch world events, with that successive human governments, to see the subsequent creation of 10-nations conglomerate, coming out of the eastern and western divisions of the Roman Empire, and the world sovereign currency used for trading that will emerge, as well as the entry into future world events of the “little horn” that will displace 3/10 nations to be the 8th head of the resurrected Beast of Revelations

Composition of this post started 9/9/2023..recomposed 6/23/25; 6/29/25; and finished 7/1/2025

Your critique is welcome. But, please read all, including tapping the highlighted web link for biblical and historical references.

God bless. 🙏👍🌈🫶

Calvinism and Arminianism …A Commentary.
The subject of this commentary is what was written in italics from this link:
http://www.calvinistcorner.com/tulip.htm
“The system of Calvinism adheres to a very high view of scripture and seeks to derive its theological formulations based solely on God’s word. It focuses on God’s sovereignty, stating that God is able and willing by virtue of his omniscience, omnipresence, and omnipotence, to do whatever He desires with His creation. It also maintains that within the Bible are the following teachings: That God, by His sovereign grace predestines people into salvation; that Jesus died only for those predestined; that God regenerates the individual where he is then able and wants to choose God; and that it is impossible for those who are redeemed to lose their salvation.

Arminianism, on the other hand, maintains that God predestined, but not in an absolute sense. Rather, He looked into the future to see who would pick him and then He chose them. Jesus died for all peoples’ sins who have ever lived and ever will live, not just the Christians. Each person is the one who decides if he wants to be saved or not. And finally, it is possible to lose your salvation (some arminians believe you cannot lose your salvation”.

Here is my humble take (in bold parentheses) on these areas:

Calvinism
The teaching is summarized in the acronym TULIP. Is this biblical?
Total Depravity: (also known as Total Inability and Original Sin):
“Sin has affected all parts of man. The heart, emotions, will, mind, and body are all affected by sin. We are completely sinful. We are not as sinful as we could be, but we are completely affected by sin.

The doctrine of Total Depravity is derived from scriptures that reveal human character: Man’s heart is evil (Mark 7:21-23) and sick Jer. 17:9). Man is a slave of sin (Rom. 6:20). He does not seek for God (Rom. 3:10-12). He cannot understand spiritual things (1 Cor. 2:14). He is at enmity with God (Eph.2:15). And, is by nature a child of wrath (Eph. 2:3). The Calvinist asks the question, “In light of the scriptures that declare man’s true nature as being utterly lost and incapable, how is it possible for anyone to choose or desire God?” The answer is, “He cannot. Therefore God must predestine.”
Calvinism also maintains that because of our fallen nature we are born again not by our own will but God’s will (John 1:12-13); God grants that we believe (Phil. 1:29); faith is the work of God (John 6:28-29); God appoints people to believe (Acts 13:48);aCalvinism also maintains that because of our fallen nature we are born again not by our own will but God’s will (John 1:12-13); God grants that we believe (Phil. 1:29); faith is the work of God (John 6:28-29); God appoints people to believe (Acts 13:48); and God predestines (Eph. 1:1-11; Rom. 8:29; 9:9-23).”

Personal take:
(Mark 7:21-23 do not say “man’s heart is evil”, “see Jer. 17:9” , “slave of sin”(Rom. 6:20) and “does not seek God (Rom. 3:10-12). In fact, when man was created, he was perfect and “very good” (Gen. 1:31). One does not have to look far to see that evil can not come out of a newborn baby who has not develop enough to distinguish good and evil. As the baby develops and has the capacity to decide and act, he/she can choose good or evil, be a slave to sin or righteousness and can seek God. A prime example is Job who was “blameless and upright ..fears God and shuns evil”(Job 1:8). True, Job was in a “death row” because of the “imputed sin” of Adam, but of himself, he did not sin although he lacked the understanding of God that he was still a sinner because all are accounted with “death sentence”, as “Adam sinned , so all sinned” with the resulting death as a consequence. Likewise, David was a “man of God’s heart” and did “good works” before his adultery. Taking all these in consideration, the context suggests that no one can discern what is in the mind of man where evil comes out from. It merely explains that action taken by man originates in the mind and that no one can divine what is in his mind. Man is capable of choosing between right or wrong, good or evil, life or death. This choice was set before us, as in:

Deuteronomy 30:15-20 New International Version (NIV)

“See, I set before you today life and prosperity, death and destruction. For I command you today to love the Lord your God, to walk in obedience to him, and to keep his commands, decrees and laws; then you will live and increase, and the Lord your God will bless you in the land you are entering to possess.

But if your heart turns away and you are not obedient, and if you are drawn away to bow down to other gods and worship them, I declare to you this day that you will certainly be destroyed. You will not live long in the land you are crossing the Jordan to enter and possess.

Another example of change to choose what is right was Nineveh that repented and was saved but then reverted back to sin and was destroyed (Jonah).

Nevertheless, however upright a person is, whatever good works emanating from him, those are still “filthy rags” to God (Isaiah 64:6). The “works” that God requires are those that are secondary to the in-dwelling of the Holy Spirit to account as ”fruits of the Holy Spirit“(Gal.5:22-23).

Indeed, because of Adam’s sin that was counted as sin of all mankind, no one can bring humanity back and be reconciled to the Father were it not for Jesus‘ death counted as that of humanity’s. Jesus died instead of us, as far as the Father is concerned to pay for the consequence of Adam’s sin, which is “eternal or second death”.

Without the Passover sacrifice, humanity is totally hopeless. Predestination is about salvation at the time-period that God chose for a particular person to be offered the opportunity to receive the power of the Holy Spirit. Judgment does not occur unless the person has the Holy Spirit available to him at his predestined time-period. This was first offered to the disciples and received by others at Pentecost, then to others who believed who will then manifest themselves in the “first resurrection” of “overcomers“. Others will have their time for the Holy Spirit to dwell during the Millenium-rule of Jesus/Son of God on earth and after that, as in the prophecy about the “dry bones” (Ezek.37:1-14).

The last time this Holy Spirit of power will be available to humans will be at the Great WhiteThrone Judgment. Those who believed/received the Holy Spirit of power and voluntarily follow its guidance will bear “fruits of the Holy Spirit”; they are the “overcomers” who “choose good over evil”. Those who outrightly reject or do not believe Jesus and those who believed/received the Holy Spirit but did not become “overcomers“, i.e., did not bear fruits, will be thrown in the “gehenna fire” at each period of the Holy Spirit’s availability.

Jesus died for ALL humanity applicable to All at their predetermined time period. Jesus death is propitiation for the consequence of sin thereby a redemption for ALL from eternal death and reconciled us to the Father. But, not all will be saved; others may not achieve eventual future salvation, depending on whether they become “one” with the Son and the Father through following the guidance of the Holy Spirit.

Jesus’ death and redemption for all do not mean salvation for all, as being predestined in the “book of life” (Rev.20:12) does not necessarily mean “once saved always saved” because anyone can be blotted out (Rev. 22:19) and has to be an “overcomer” as in Rev. 3:5). All those predetermined to have the Holy Spirit available to them at their particular/predestined time-period does not necessarily mean all of them will follow, develop, mature and be saved as they have to be “overcomers“.

In essence, if “sinful nature“, “slave of sin”, and “man’s heart is evil” mean that because of Adam’s sin by imputation, that we naturally are doomed to eternal death, then this is true. If “incapable of doing good works” refers to “works that God requires” (which are fruits of the Holy Spirit), then indeed we are “incapable“. Otherwise, the teaching is problematic.)

Unconditional Election:

God does not base His election on anything He sees in the individual. He chooses the elect according to the kind intention of His will (Eph. 1:4-8; Rom. 9:11) without any consideration of merit within the individual. Nor does God look into the future to see who would pick Him. Also, as some are elected into salvation, others are not (Rom. 9:15, 21).

Personal take:
(Yes, God alone chooses who he elects and decides on what time period they will be, at which time, the Holy Spirit is available to in-dwell to them. This opportunity of “in-dwelling of the Holy Spirit” never happened until after Jesus’ resurrection. This is not merit-based as the best of human works are still “dung” to God. Election is about who are to be in a particular/predestined time period when the Holy Spirit will “dwell in us“. Salvation comes through the gift of reconciliation achieved by the death of Jesus and the gift of the Holy Spirit that needs to be “baptized in us” (same as in man-Jesus Christ ) to bear “fruits” through sanctification process. . Whether we follow its guidance or not, determines who will be “overcomers” and worthy of the reward of “immortal life“, which translates to “salvation from eternal death“.

In essence, if “some are elected into salvation, others are not (Rom. 9:15,9:21)” means elected as to their predestined time-period of election to receive the empowerment of the Holy Spirit’s in-dwelling then it is tenable teaching.

Limited Atonement:(also known as Particular Atonement):

Jesus died only for the elect. Though Jesus’ sacrifice was sufficient for all, it was not efficacious for all. Jesus only bore the sins of the elect. Support for this position is drawn from such scriptures as Matt. 26:28 where Jesus died for ‘many’; John 10:11, 15 which say that Jesus died for the sheep (not the goats, per Matt. 25:32-33); John 17:9 where Jesus in prayer interceded for the ones given Him, not those of the entire world; Acts 20:28 and Eph. 5:25-27 which state that the Church was purchased by Christ, not all people; and Isaiah 53:12 which is a prophecy of Jesus’ crucifixion where he would bore the sins of many (not all).

Personal take
(Matt. 26:28 “blood shed for many” is not necessarily exclusive. Rather, it’s context suggests his blood is not for a few, but so abundant and “for many”. While Jesus did not actually say in this verse that his blood was shed “for all”, it certainly “efficacious” for “all who believed” and those who did not believe” (because it was not their time yet).

John 10:11-15 the context is about protection of all from the wolf that may devour his sheep.

Matt. 25:32-33 differentiates people who were “sheep” and received eternal life from those who were “goats” and received eternal death. The “sheep” followed the guidance of the Holy Spirit whereas the “goats” did not. Nevertheless, Christ died for all, whether sheep or goats. The “actual salvation” is a process

John 17:9 In here, Jesus was praying ” for them”, “not the world” , his followers as their lives would be in danger after he leaves. Jesus loves all, whether believers or not. This verse does not mean that Jesus did not care for others, as they will have their chance in the future as in “ “… time and chance happen to them all” (Ecclesiastes 9:11)

Acts 20:28 and Eph. 5:25-27. True, “Christ loved the church and gave himself for it” but this does not necessarily exclude others from his love and that he died for all.

Isaiah 53:12 “bear the sin of many” is not exclusive as the following suggests “made intercession for transgressors“, meaning all transgressors. )

Irresistible Grace:

When God calls his elect into salvation, they cannot resist. God offers to all people the gospel message. This is called the external call. But to the elect, God extends an internal call and it cannot be resisted. This call is by the Holy Spirit who works in the hearts and minds of the elect to bring them to repentance and regeneration whereby they willingly and freely come to God. Some of the verses used in support of this teaching are Romans 9:16 where it says that “it is not of him who wills nor of him who runs, but of God who has mercy”; Philippians 2:12-13 where God is said to be the one working salvation in the individual; John 6:28-29 where faith is declared to be the work of God; Acts 13:48 where God appoints people to believe; and John 1:12-13where being born again is not by man’s will, but by God’s.

“All that the Father gives Me shall come to Me, and the one who comes to Me I will certainly not cast out,” (John 6:37).

Personal take:
(True, only God decides who will be called at any particular/predestined time-period to receive the Holy Spirit of power and the one who initiates every facet of salvation. But, why should this awesome gift of God be forced down our throat? No one is forced to obey him, even those who have received the gift of the Holy Spirit as the believer may still “vomit and eat”(Prov. 26:11; 2 Pet. 2:20-22). Overcomers are those who voluntarily overcome evil with the guidance and power of the Holy Spirit. Being “one” with God is imposed but not forced in such a way that we have no choice. Calling into salvation does not mean we can not resist because there are people who reject the Holy Spirit( I Thes. 4:8; Mk. 3:28).

Perseverance of the Saints:(also known as Once Saved Always Saved):

You cannot lose your salvation. Because the Father has elected, the Son has redeemed, and the Holy Spirit has applied salvation, those thus saved are eternally secure. They are eternally secure in Christ. Some of the verses for this position are John 10:27-28where Jesus said His sheep will never perish; John 6:47 where salvation is described as everlasting life; Romans 8:1 where it is said we have passed out of judgment; 1 Corinthians 10:13 where God promises to never let us be tempted beyond what we can handle; and Phil. 1:6 where God is the one being faithful to perfect us until the day of Jesus’ return.

Personal take:
(Only those who “persevere“, the “overcomers“, are the sheep that will never perish, are the ones who “passed out of judgment” to be rewarded with eternal life. True, God will not allow us to be tempted beyond what we can handle on hope that we would overcome as Jesus did in Gethsemane; unfortunately, some may still succumb. Indeed, God is faithful but we are not consistently so.)

Arminianism
Arminianism, on the other hand, maintains that God predestined, but not in an absolute sense. Rather, He looked into the future to see who would pick him and then He chose them. Jesus died for all peoples’ sins who have ever lived and ever will live, not just the Christians. Each person is the one who decides if he wants to be saved or not. And finally, it is possible to lose your salvation (some arminians believe you cannot lose your salvation”.

Personal take:
(Predestination is absolute as far as determining who are elected to partake in a particular time-period of “calling” and chance to have the Holy Spirit. God’s choice is not determined by “who would pick him” . Instead, he gives “sunshine to grass and weeds” (Matt. 5:45) as “time and chance happens to all”( Eccl. 9:11)

God bless.🙏😇

Original post: February 15, 2018

Hyperlink version posted 3/16/19

Other hyperlinks added for advancing the narrative: January 24, 2021

Critique is welcome at foundationacts@yahoo.com.

Throughout the whole U.S.A., the 4th Thursday of November by tradition has been set aside to give thanks to God for all the blessings we received individually and collectively, as a family or as a nation.

What did I do to deserve this?

While there are immutable laws that bring about blessing or curse, i.e., blessing follows good deeds and curse comes because of evil deeds, they are not necessarily exclusive. There are evil people, who in our eyes and yardstick, flourish and good people who are swaddling in a series of failures or setbacks. Even so called blessed and chosen nation Israel went thru slavery in Egypt and even now does not have peace and security with their neighbor-states. Abraham, Moses, etc. died in hope, without seeing the promised land. David, Job, Daniel, to name a few in the Old Testament account, suffered. Even the apostles were in constant danger for their lives, including Paul, considered chief of them all. But, most of all, the man-Jesus, the very begotten Son Of God, the most blessed of all men, experienced the worst curse of all, dying a horrible and painful death by crucifixion. Brethren, the wisdom, power and control of God are transparent in these events occurring in man. Consider the following verses that should give us proper perspective of who our God is:

Mother’s Day

If there is any particular person who has done more for the future of humanity, it is the mother. An overwhelming number of people will undoubtedly recognize and put her in that pedestal. And rightly so, as her sacrifice for the children (and spouse) will never be surpassed. As written in a poem by William Ross Wallace, “the hand that rocks the cradle is the hand that rules the world“. Therefore, as a token of gratitude, a special day was set to commemorate her immense role in society. For 2019, it is celebrated May 12 in the USA.

History

“Mother’s Day is a celebration honoring the motherof the family, as well as motherhood, maternal bonds, and the influence of mothers in society. It is celebrated on various days in many parts of the world, most commonly in the months of March or May. The modern Mother’s day began in the United States, at the initiative of Anna Jarvis in the early 20th century. Many traditional celebrations of mothers and motherhood have existed throughout the world over thousands of years, such as the Greek cult to Cybele, the Roman festival of Hilaria, or the Christian Mothering Sunday celebration (originally a commemoration of Mother Church, not motherhood). This is to honor all mothers because she believed a mother is “the person who has done more for you than anyone in the world”.

“The modern holiday of Mother’s Day was first celebrated in 1908, when Anna Jarvis held a memorial for her mother at St Andrew’s Methodist Church in Grafton, West Virginia. St Andrew’s Methodist Church now holds the International Mother’s Day Shrine.”

 “Her campaign to make Mother’s Day a recognized holiday in the United States began in 1905, the year her mother, Ann Reeves Jarvis, died. Ann Jarvis had been a peace activist who cared for wounded soldiers on both sides of the American Civil War, and created Mother’s Day Work Clubs to address public health issues.”

“However, owing to the efforts of Anna Jarvis, by 1911 all U.S. states observed the holiday, with some of them officially recognizing Mother’s Day as a local holiday?(the first being West Virginia, Jarvis’ home state, in 1910). In 1914, Woodrow Wilson signed a proclamation designating Mother’s Day, held on the second Sunday in May, as a national holiday to honor mothers.”

Religious Celebration

“In the Roman Catholic Church, the holiday is strongly associated with revering the Virgin Mary. In some Catholic homes, families have a special shrine devoted to the Blessed Virgin Mary. In many Eastern Catholic and Eastern Orthodox Churches, a special prayer service is held in honor of the Theotokos Virgin Mary.”

“In Islam there is no concept of Mother’s Day, but the Quran teaches that children should give priority to loving their mother over their father.”

“In Hindu tradition, Mother’s Day is called “Mata Tirtha Aunshi” or “Mother Pilgrimage fortnight”, and is celebrated in countries with a Hindu population, especially in Nepal. The holiday is observed on the new moon day in the month of Baisakh, i.e., April/May. This celebration is based on Hindu religion and it pre-dates the creation of the US-inspired celebration by at least a few centuries.”

“In Buddhism, the festival of Ullambana is derived from the story of Maudgalyayana and his mother.”

Metaphorical Mother?

“The symbolism of the “church as mother” is used throughout early church writings, continues into the medieval period, and, though it may surprise some, was embraced by the reformers. John Calvin quotes Cyprian and refers to the motherhood of the church throughout his Institutes.“

While motherhood is gender-specific, and refers to female parenthood, metaphorically, it includes all of humanity, as a composite of mother Jerusalem above, betrothed/prepared for a wedding as a church and individually. This is what the Bible prophetically renders us all to be.

Consider, what was the takeaway understanding, of Paul regarding “mother” in:

Galatians 4:26 “But the Jerusalem that is above is free, and she is our mother.”

Our “mother” is identified as “Jerusalem that is above”. She is the spiritual nurturing city/place for all, an allegorical place where we are now. We were “born after the flesh”, of the bondwoman/slave (flesh-composed); but our future is to be “born (again)by promise” as “children of the free“(Galatians 4:22-31), spirit-composed. This is figurative and being in the “womb of the church“, we are now considered “children of promise“. Those still “in fetal development” are considered “children” before “born/delivery”.

Proverbs 31:26-27 “She opens her mouth with wisdom, and the teaching of kindness is on her tongue. She looks well to the ways of her household and does not eat the bread of idleness.”

Proverbs 31:25 “Strength and dignity are her clothing, and she laughs at the time to come”

Ezekiel 16:44 “Behold, everyone who uses proverbs will use this proverb about you: ‘Like mother, like daughter.’‘

1 Thessalonians 2:7.”But we were gentle among you, just as a nursing mother cherishes her own children”

Being in the “womb of the church“, we are being nurtured for a “wedding“. Like any wedding ceremony, the “virgin bride” (spiritual members of the church), .”has made herself ready, as in:

Revelations 19:7 “Let us rejoice and be glad and give him glory! For the wedding of the Lamb has come, and his bride has made herself ready.”

And this preparation now is for us to be in “oneness with God” through the guidance and presence of the Holy Spirit in us, “writing the laws not in tables of stone but in the fleshly tables of heart and mind”.

Members of the spiritual church are being “formed“(Galatians 4:19), for the prophesied wedding ceremony at the “last trump” when our “flesh-composed body” will change into spirit-composed firstfruits and will meet Christ in the air to come down on earth with him towards Jerusalem. Together, they will have more children to be “formed” in the Millenium and post-Millenium as “latter fruits”.

Summary

No one has influenced the family more than our mother. It is therefore fitting to commemorate a special day for her, a gesture of respect and acknowledgment of her role in humanity.

Figuratively, the mother is a “spiritual church“ that nurtures and develops children from cradle to grave. And this is in the context of the power of the Holy Spirit in us and given by the Father to Christ as a gift for our “oneness“. This Holy Spirit is a “Helper” to the weaknesses of our “flesh-composed body” as emphasized three times in the narrative of Christ in the garden of Gethsemane. The “bride” has to be prepared with the help of the Holy Spirit. After having “formed” us from a “marred clay” to one befitting a “virgin bride”, the spiritual wedding ceremony will manifest at resurrection as “firstfruits” in a “twinkling of an eye” at Jesus‘ second coming. The “spirit-composed” mature children, his body/church, will meet Christ in the air and descend on earth to rule a Millenium and forever in the “new heaven and earth”. After firstfruits had manifested, more children will be prepared/formed from “marred clay“ at their own time for the marriage between the “bride and the Lamb” as “latter fruits“. Then will be fulfilled the promise to the seed in:

Genesis 22:17: “I will surely bless you and make your descendants as numerous as the stars in the sky and as the sand on the seashore. …,“(NIV).

All those in the family of spirit–composed God-kingdom that came out from an “image” are no longer temporary like a temple, but eternal/immortal beings. This is human destiny as members of the God-Kingdom ; not plant nor animal kingdom.

God Bless 🙏😇

Original post: May 12, 2019.

Hyperlink version

Dedicated to Motherhood.

Ice-Bucket Challenge: Defining when Life Begins and Ends

Pouring ice-cold water onto ourselves is indeed a “bone-chilling” challenge. This has picked up steam nationwide with participation from regular folks, celebrities and even billionaire Bill Gates(1). Funds “have come from 1.7 million donors.The ALS Association (as of August 25) has raised $79.7 million to combat Lou Gehrig’s Disease since July 29, as the Ice Bucket Challenge continues to encourage people around the world to dump ice over their heads and send in money.”(2). This did not come without detractors from animal rights’ supporter like Pamela Anderson and others of different views , including those against embryonic stem cell research (3).

McClaren & Beeson (4,5) commented that “much recent interest has focused on whether stem cell therapy could alleviate or even cure common degenerative diseases. This has been accompanied by debate on the ethics of destructive research on early human embryos. Stem cells derived from various sources raise different ethical issues, but their contribution to medical research could be immense.” While there are tailwinds in using placental and adult tissue sources, headwinds to embryonic stem cell research surfaced and related to an issue not dissimilar to debates between pro-life vs. pro-choice and questions related to the other end of the spectrum, end-of-life.

When life is defined as beginning at conception, rights are conferred at that time and had to be championed and supported (6). Similarly, end-of-life issues bring to bear the rights of those still “living” even in a “vegetative state” or, for any other reason, at the throes of death. In our healthcare system, private and public resources are at stake to fund efforts to support, terminate or prolong life. Reflexively, what then follow are moral values, religious overtones, socio-political agenda, personal upbringing and citizenship that stoke the fire of controversy. When does life really begin and when does it end, are questions that rise to a decibel of priority for society , whether personal or national.

This post is not about casting aspersions nor endorsing the merits of either side of the debate, a controversy aplenty (7,8,9,10,11,12,13). Rather, the goal is to give pause to the animus, make time for reflection and provide salutary perspective. Some may not like to hear the truth, but somehow, one needs “to tell how the cow ate the cabbage”, a Southern catchphrase. This subject is a difficult one to resolve in its entirety and we will not be able to “carry forests on my back” but at least let us put a “crack” on this “nut“(14). People have to muster gumption to tackle this dilemma of “when life begins and ends“. It is a yeoman’s task to venture on finding a balance among different perspectives, biblical or secular, cerebral or emotional they may be. That said, one recognizes the consequences emanating from issues about pro-life/pro-choice and life/death dilemma.

Consequences

“Incidents of violence have included destruction of property, in the form of vandalism; crimes against people, including kidnapping, stalking, assault, attempted murder, and murder; and crimes affecting both people and property, including arson and bombings” (15). In the U.S., violence directed towards abortion providers has killed at least eight people, including four doctors, two clinic employees, a security guard, and a clinic escort” (16). “Another abortion doctor, George Wayne Patterson, was shot and killed outside an adult movie theater in Mobile, Alabama on August 21, 1993, but authorities attribute his death to a botched robbery“(17). Other links are accessible regarding the problem (18,19,20).
End-of-life issues also affect society’s responses to longer longevity that “presents unprecedented ethical and fiscal challenge“, rationing healthcare, hospice care, etc.(21,22,23,24). Disregard for life may lead to the horrors and slippery slope of euthanasia and assisted suicide according to Krauthammer (25, 26,27).

Who defines?

All things considered, the trunk-of-the-tree origin of these conflicting positions stems from the question “when does life begin and end?“. While progress in scientific knowledge, like ultrasound, helps us determine a “functioning entity” in the womb, does life really begin “at conception“? Pro-lifers use biblical passages frequently to make the case for human life beginning at conception(28,29). Consider the following excerpts:

Luke 1:39-44: Mary’s visit to Elizabeth: “…And it happened, when Elizabeth heard the greeting of Mary, that the babe leaped in her womb; and Elizabeth was filled with the Holy Spirit. Then she spoke out with a loud voice and said, “Blessed are you among women, and blessed is the fruit of your womb! But why is this granted to me, that the mother of my Lord should come to me? For indeed, as soon as the voice of your greeting sounded in my ears, the babe leaped in my womb for joy”. (N.B. Does heart beat, motor function like “fetal kick”, response to pain sensation or Mozart effect in the womb constitute or define “life”?
And for that matter, do dummy patient simulators with heart beat, etc.,have life?(30)

Psalm 139:13–16
“For You formed my inward parts:
You covered me in my mother’s womb….My frame was not hidden from You, When I was made in secret….Your eyes saw my substance, being yet unformed….The days fashioned for me, When as yet there were none of them.”

Jeremiah 1:4–5
…“Before I formed you in the womb I knew you; Before you were born I sanctified you;….”

Psalm 51:5
“Behold, I was brought forth in iniquity, And in sin my mother conceived me.”

All the preceding verses confirm the omniscience, omnipresence and omnipotence of God Almighty. They are related to specific people who were already born and were living. They did not define when life begins, as these verses also include the period ” being yet unformed, “as yet they were none of them, “before formed in the womb“. It appears to be a stretch of one’s imagination to assume that the preceding verses support that “life” begins at conception. Moreover, this extrapolation minimizes other verses that actually define it. Let us now consider the following and comments that follow:

Gen. 2:7
•And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul/being”.

Notice, that a fully formed Adam from the “dust of the ground” was still “non-living” until the “breath of life” got into him from God. Then, he became a “living being“. This is akin to a “still birth” baby who was not breathing and therefore “non-living“. Or, a fully formed baby immediately after delivery, cyanotic and not breathing , no life in it although with heart rate and brain activity, “non-living“, but after a few seconds, with or without resuscitation, started to breathe in natural air as an evidence of “life“. This also reminds us of patients that are “brain-dead“, in a vegetative state, with flat-line EEG, sustained only by life-supporting means like ventilator and/or therapeutic interventions. Yet, when ventilator is turned off, they do not breath spontaneously, no natural breathing and subsequently declared “dead“, i.e., not breathing or no breath of life. Atmospheric air has to be breathe into, “before life begins”. It is arguable that by virtue of the oxygen derived from the mother, i.e., fetal respiration, that this is “breathing“. But, this denies the biblical definition of “living“, viz., presence of functional lungs (mature or premature) that have to breathe in natural and environmental air. The breath cycle continues until the last breath at death. Breathing air defines and sustains life. “In with your very first breath, out with your very last”(31). Without this “breath of life“, a person is “non-living”, as in:

Job 34: 14-15
“If he should set his heart to it and gather to himself his spirit and his breath, all flesh would perish together, and man would return to dust“. ( N.B. Without breath, the flesh is dead).

Ecclesiastes12:7
“Then shall the dust return to the earth as it was: and the spirit shall return unto God who gave it.”

Psalm 146:4
“His spirit departs, he returns to the earth; In that very day his thoughts perish.”

Also, notice the function of this “breath of life” to the “non-living“:

Ezekiel 37:9-10, 13-14
9 Then said he unto me, Prophesy unto the wind, prophesy, son of man, and say to the wind, Thus saith the Lord God; Come from the four winds, O breath, and breathe upon these slain, that they may live. 10 So I prophesied as he commanded me, and the breath came into them, and they lived, and stood up upon their feet, an exceeding great army.
13 And ye shall know that I am the Lord, when I have opened your graves, O my people, and brought you up out of your graves, And shall put my spirit in you, and ye shall live, and I shall place you in your own land: then shall ye know that I the Lord have spoken it, and performed it, saith the Lord.” (N.B.the word “spirit” comes from “ruwach” from 07306 in Concordance meaning breath or wind).

Schwartz concurs, “there is nothing in the bible to indicate that a fetus is considered to be anything other than living tissue and, according to scripture, it does not become a living being until after it has taken a breath” (32).

Also, notice the following controversial verses:

Exodus 21:22–24
“If men fight, and hurt a woman with child, so that she gives birth prematurely, yet no harm follows, he shall surely be punished accordingly as the woman’s husband imposes on him; and he shall pay as the judges determine. But if any harm follows, then you shall give life for life, eye for eye, tooth for tooth, hand for hand, foot for foot.” ( NB. When the “child” is viable and delivered prematurely but “no harm” done, then compensation maybe sought by the husband since the fetus did not mature to full term; if any “harm” follows after birth as when the fetus perished, then life for life, etc. In this accidental death after birth, the key point is viability by natural means to exact redress at that time. Today, by artificial means, fetal viability can be extended as a dying person’s life/suffering can be prolonged. However, this example should not be used to justify voluntary/intentional abortion, especially to viable fetus still in the womb).

Numbers 5:11-31
” …. And he shall cause the woman to drink the bitter water that causeth the curse: and the water that causeth the curse shall enter into her, and become bitter. Then the priest shall take the jealousy offering out of the woman’s hand, and shall wave the offering before the LORD, and offer it upon the altar: And the priest shall take an handful of the offering, even the memorial thereof, and burn it upon the altar, and afterward shall cause the woman to drink the water. And when he hath made her to drink the water, then it shall come to pass, that, if she be defiled, and have done trespass against her husband, that the water that causeth the curse shall enter into her, and become bitter, and her belly shall swell, and her thigh shall rot: and the woman shall be a curse among her people. And if the woman be not defiled, but be clean; then she shall be free, and shall conceive seed. This is the law of jealousies, when a wife goeth aside to another instead of her husband, and is defiled; ….. ” (N.B. This is what is generally known by biblical scholars as an “adultery test” by ritual of intentional abortion performed by a priest through drinking “bitter/curse water“. But this is not done anymore, even by priest; it has ceased a long time ago(33). Similarly, if Jewish priest discontinued this practice, all the more reason for this not be used to justify abortion by anyone, through pharmacological means.)

Job 3:3, 10-11, 16
“Let the day perish in which I was born. … Because it shut not up the doors of my mother’s womb, nor hid sorrow from my eyes. Why died I not from the womb? Why did I not give up the spirit when I came out of the belly? … Or as an untimely birth I had NOT been; as infants which never saw light.” ( NB. According to Martin & Sielaff (34) in their commentary, “…fetus was reckoned as “NOT HAVING BEEN” — and that is how God and the Bible defines the status of the fetus.”

Nonetheless, I do not support the connotation of outright disregard for fetus nor should it be summarily disrespected. The alternative interpretation may well be that Job may just be too remorseful for his suffering that he wished “NOT HAVING BEEN”; this was Job’s wish and not God defining the status of the fetus or how we should regard it.) From the same link, (which I could not confirm,) “An April 8, 2004 United Press International reported about this limitation:
“At what point is a human fetus viable? … a government witness testified in U.S. District Court in Nebraska that a 20-week fetus can feel pain, suggesting the fetus is a living being. Neonatology specialists have countered, however, that a 20-week fetus cannot yet survive outside the mother’s womb. … [Dr. Avroy] Fanaroff 2 [notes], ‘There may be a beating heart, there may even be some gasping attempts at breathing, but this is not a baby that can be resuscitated — it is not viable,’ … ‘such signs of life typically ‘last only seconds.’ …What, then, differentiates between live birth and viable birth? The maturity of the lungs, Goldsmith said. ‘It is the ability of the lungs to exchange oxygen and carbon dioxide,’ he said, which explains the reason why a non-viable fetus in 1973 can be a viable baby today.”On viability 3 See http://www.washtimes.com/upi-breaking/20040406-051104-8080r.htm.

Difference in counting child’s age among cultures
In Jewish culture, “.…it is their day of birth (or the year in which they first exited the womb) that gives them a legal existence. Thus, for a man to be able to go to war he had to be twenty years of age, or a priest to commence his official duties had to be thirty years of age. These ages for legal purposes were always reckoned from birth, not from conception. The reason for this is plain. No one could be sure in all cases just when conception took place, and even if one knew the exact moment of conception, for legal purposes one had to wait to be born to enter human society.“(35).

In Korea, China and East Asia, “..the countdown of children’s age does not begin with the birth of a child, like in the West, but starts in the beginning of the year, rounding up the time spent by a child in the mother’s womb. In addition, people become older not on the day of birth, but on January 1st, according to the lunar calendar. For example, a child born in late December of 2013 will turn two on January 1st, 2014“(36).

Summary

Now that the major elements firing the debate have been presented, the question still remains as to what the correct response should be? The decision to act, one way or another, for anyone at the crossroads of this question may still be problematic for any particular set of circumstances. Without being facetious, when one reaches “the fork of the road“, Yogi Berra(37) quipped,”take it”. But which side of the fork should one take? Even the advice from Apostle Paul about moderation (Phil. 4:5) may not suffice to confer peace of mind. Raw courage is needed to face criticism of whatever action one takes, as there will always be “Cannon to right of them, Cannon to left of them, Cannon behind them Volley’d and thunder’d” as in “Charge of the Light Brigade” by Alfred Tennyson (38).

As one may now deduce, the operative word for when life begins and ends, is “natural“,i.e., natural development to viability, not ex-vivo or in-vitro; natural breathing, not fetal respiration nor through artificial means; natural air, even augmented, but not artificial. How then should one respond to the biblical truth that breathing air defines and sustains life? “In with your very first breath, out with your very last”. The advice from Martin & Sielaff resonates well, “Children are an heritage of the Lord: and the fruit of the womb is his [God’s] reward” (Psalm 127:3).

Adoption should always be considered, so someone else can receive the “reward” from God. Life is important. Christians should respect it very highly. Not only should they recognize the sanctity of their own lives, but they should acknowledge that God has granted the same life to all in the world. All people should be honored and respected. This is a Christian duty which no one can deny.”(39). When the choice is between the life of mother vs. the fetus, there should be no hesitation that life of the mother takes precedence; there maybe exception even on this that we may not know, as in, the mother gives up her life for the fetus. As to rape and incest, adoption is a better alternative; here again, there can be exception and the victim needs tremendous emotional support to overcome an excruciating experience. A non-breathing baby just delivered and an adult who had a cardiac arrest should also be resuscitated to life. After sometime, how long artificial breathing should continue would depend on other factors, most especially the ability to be weaned off respirator and breathe spontaneously. Currently, with technology, the status of brain activity helps in decision-making. Similarly, judgment has to be made regarding sources that potentiate stem cell research depending on overwhelming evidence for “overall good”. Failure to act can delay progress to the detriment of population that needed it most. Vaccine and immunization have detractors, yet society as a whole decided in favor of general use; again this has exception, especially invoking the 1st( religion) and 4th ( privacy) amendments rights. When it comes to “euthanasia and assisted suicide”, our stance should be to advise against these methods. But, who will have the final say? Should it be the patient and/or immediate relative, society or the “death-provider“? Not privy to all the facts surrounding every case and in whatever action is decided by the “stakeholders“, one should not be judgmental but, in love, be commiserating and (sans approval) empathizing with the difficulties in arriving at any decision. True, one should not be dogmatic nor flexible every time and be mindful of the cautionary verses in

Ecclesiastes 3:1-8 :
“To every thing there is a season, and a time to every purpose under the heaven: A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted; A time to kill, and a time to heal; a time to break down, and a time to build up; A time to weep, and a time to laugh; a time to mourn, and a time to dance; A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; A time to get, and a time to lose; a time to keep, and a time to cast away; A time to rend, and a time to sew; a time to keep silence, and a time to speak; A time to love, and a time to hate; a time of war, and a time of peace.”

Defining when life begins and ends just opens doors. What action plan for any specific situation may still leave us with conflicted conscience and second-guessing. Hopefully, people will choose life and seek an obstetrician, rather than death from an obitiatrist (death-doctor)(40). Flee from temptation. Decide we must, is an “ice-bucket challenge” for all of us.

References:
1. Retrieved from: http://youtube/XS6ysDFTbLU

2. Retrieved from:http://time.com/3173833/als-ice-bucket-challenge-fundraising-total/

3. Retrieved from:http://www.politico.com/story/2014/08/ice-bucket-challenge-haters-110298.html

4. Retrieved from:Anne McLaren. Nature 414, 129-131 (1 November 2001) | doi:10.1038/35102194

5. Retrieved from: http://www.sciencedirect.com/science/article/pii/S1472648310606475

6. Retrieved from :http://www.nrlc.org

7. Retrieved from:Why is abortion so controversial? http://news-basics.com/2011/abortion/

8. End of life controversies. Retrieved from:http://ajcc.aacnjournals.org/content/18/5/401.1.full.pdf
85% of hospital trusts adopt controversial end-of-life care regime

9. Retrieved from:http://www.independent.co.uk/life-style/health-and-families/health-news/85-of-hospital-trusts-adopt-controversial-endoflife-care-regime-8273345.html

10. Baby Joseph.Retrieved from: http://abcnews.go.com/Health/baby-josephs-treatment-sparks-controversy-pediatric-end-life/story?id=13032001

11. Terri Schiavo case. Retrieved from:http://en.m.wikipedia.org/wiki/Terri_Schiavo_case

12. Survey of Controversial Issues.
Retrieved from:http://www.ncbi.nlm.nih.gov/pubmed/24093519

13. New and Lingering Controversies in Pediatric End-of-Life Care. Retrieved from: http://pediatrics.aappublications.org/content/116/4/872.abstract.

14. The mountain and the squirrel: retrieved from: http://www.familyfriendpoems.com/poem/the-mountain-and-the-squirrel-by-ralph-waldo-emerson#ixzz3AvpOfLJS

15. Retrieved from:http://en.m.wikipedia.org/wiki/Anti-abortion_violence

16. Retrieved from:Clinic violence and intimidation”. NARAL Pro-Choice America Foundation. 2006. Archived from the original on February 11, 2010.

17. Man Arrested in Killing of Mobile Abortion Doctor. Retrieved from:The New York Times. September 5, 1993.; H. Kushner, Encyclopedia of Terrorism, Sage Publications, 2003, p.39.

18.”Mental Health Risks of Abortion: Scientific Studies Reveal Significant Risk of Major Psychological Sequelae Of Abortion” . Retrieved from: http://www.wprc.org/21.46.0.0.1.0.phtml.

19. “The Emotional Effects of Induced Abortion”. Retrieved from: http://www4.plannedparenthood.org/pp2/portal/medicalinfo/abortion/fact-010600-emoteff.xml#1097838460671::-3808445079817008491.

20. Retrieved from:http://www.justfacts.com/abortion.asp#%5B184%5D

21. Callaghan, D. and Lawler, P., Ethics & health: Rethinking end-of-life care, Retrieved from:http://www.heritage.org/research/reports/2012/07/ethics-and-health-care-rethinking-end-of-life-care

22. Shepherd, Lois Rationing health care at end-of-life. Retrieved from: http://web1.millercenter.org/debates/whitepaper/deb_2010_0324_life.pdf

23. Ration end-of-life care. Retrieved from: http://intelligencesquaredus.org/iq2-tv/item/769-ration-end-of-life-care

24. Debate on hospice care. Retrieved from: http://jop.ascopubs.org/content/4/3/153.full

25. Krauthammer, Charles. The Dutch example, Things That Matter: Three Decades of Passions, Pastimes and Politics – 13 edition, Chapter 9, ISBN13: 978-0385349178
ISBN10: 0385349173, Publisher: Crown Business, Published: 10/22/2013

26.The lady of Assen and Dr Chabot in Holland. Retrieved from:http://articles.philly.com/1997-01-15/news/25560299_1_terminally-euthanasia-dutch-doctors

27. A Judge In Washington State Says The People Had No Right To Veto Mercy Killing by Charles Krauthammer. Retrieved from: http://articles.philly.com/1994-05-17/news/25826934_1_personal-dignity-and-autonomy-physician-assisted-suicide-abortion-decisions

28. Tommy Mitchell,Retrieved from:https://answersingenesis.org/sanctity-of-life/when-does-life-begin/)

29. When life begins. Retrieved from: http://www.openbible.info/topics/when_life_begin

30.One Smart Dummy: Patient Simulators Help Save Lives. Retrieved from: http://rushnews.rush.edu/2014/09/02/one-smart-dummy-patient-simulators-help-save-lives/

31. Life Begins at Breath, Not Conception
, originally posted by Will McLeod on Mar. 19/2014 ; http://www.dailykos.com/story/2014/03/19/1285933/-Bible-Life-Begins-at-Breath-Not-Conception

32. Retrieved from: http://joeschwartz.net/life.htm

33. Retrieved from: http://en.m.wikipedia.org/wiki/Ordeal_of_the_bitter_water

34. Abortion and the Bible by Ernest L. Martin, Ph.D., July 1991
Edited and expanded by David Sielaff, February 2005.
Retrieved from:http://www.askelm.com/doctrine/d050201.htm

35. Ibid

36. Retrieved from:http://english.pravda.ru/society/stories/16-07-2013/125145-korea_children-0/

37.Retrieved from: http://www.brainyquote.com/quotes/quotes/y/yogiberra105761.html

38. Charge of the Light Brigade” by Alfred Tennyson. Retrieved from: http://www.nationalcenter.org/ChargeoftheLightBrigade.html

39.Retrieved from:
http://www.askelm.com/doctrine/d050201.htm

40. Obitiatrist: Goodman, Ellen. Retrieved from:http://articles.baltimoresun.com/1993-12-28/news/1993362063_1_word-for-death-happy-mistakes-column

God bless🙏😇

Original post: September 10, 2014

Hyperlink version posted April 22, 2019

Health System Reform_ Competition in Cost aside from Price ; Key to Reform Payment System of Healthcare]

Change in Trading Dynamics: The Key to Successful Health System Reform

After $6B spent on federal campaigns, the country has chosen its leaders. Yet, problems with our health system still linger and fester. Physicians, the last bulwark of patient advocacy, have a ubiquitous role in reforming the system and must pick up the cudgels.

Even after passage of PPACA (Obamacare), issues like access to care, quality of service, insurance coverage, malpractice, over-utilization of resources, etc. continue to be at the forefront of the debate. Current efforts by medical establishments’ punditocracy focused on efficiency to cut costs, viz., reducing length of hospital stay, preventing “never-events”, quality guidelines, utilization criteria, accountable care organizations and the like. The converse of lack of efficiency is synonymous with waste. Since the base is financial, all of these segmented issues boil down to 3 general categories, viz., waste, fraud and abuse in the system, mired by “moral hazard” of having health insurance. Hopefully, all the preceding contending interests will be addressed with civility.

In my humble opinion, shaped by years of experience in the system, the above general categories do not constitute the root or core problem facing the entire healthcare industry. Worse yet, the proposed measures for reform will arbitrarily limit provision of services cloaked behind “evidence-based medicine” and will make future payment based on outcome that is uncertain or performance that is unpredictable. Moreover, responses by even well-meaning people will ration care and control eligibility to provision of healthcare services.

Assuming, for the sake of argument that all these issues come close to an ideal solution, these will still default to where they started due to the structural nature of the problems that rests on human nature. People take action based on rational choice and personal interest unique to each person. The strategy then for health system reform is to accept this reality of human nature and align it to an understanding about a key flaw in the financial underpinning related to payment methodology of our current health system. Human nature being what is, the only remaining recourse is to change the structure of trading dynamics that initiates payment.

To start with, our current payment system, whether public or private, healthcare or otherwise, is oblivious to the opaque pricing mechanics and corresponding arbitrary payment. Global markets thrive in such a scenario. “Buyers” have needs, wants and expectations of quality and service that have to be filled by “sellers”. Only the “sellers” determine and set the price. The buyer either pays that price, wait for discount or not buy altogether. When both “seller and buyer” agree with the price, trade is completed and payment is made. Unfortunately, the nature of this trading system favors more the seller than the buyer because of asymmetric costing information. To illustrate, a seller may price a product or service for $100 and may discount it down by 50%. As price went down to $50, the buyer sees a 50% discount as a good deal, and pays up. If the production cost of the product/service amounts to $10, but hidden from the buyer, then he just paid the seller a 5x profit mark up. This fog in “costing” and lack of transparency in “pricing determinant” favor the seller as he is the only one who knows the production cost and the spread/profit.

Extrapolating this to healthcare product/service, exorbitant medical inflation occurs as “suppliers” mark-up the price way above their costs. True, profit is crucial to the viability of any business. But there can be overpricing, overcharging, some call “gouging” that affects the entire spectrum of the healthcare system. Supplier-to-end-user, each along the supply-chain, marks up the price to profit from the trade. No wonder, healthcare expenditures turned exponential since private insurance came into being and in 1965 when a federal insurance, i.e., Medicare, became an entitlement program.

Historically, patients are generally insulated from the actual healthcare expenses as they are either insured or not at all. Payment is made, by and large, from decision of bureaucrats in the federal or private insurance based on the price charged by the provider of the product or service. They get that money from federal income taxes or private insurance premiums. As payment comes not from their own money but from others’, public and private insurance just “opened there wallet”. Their “skin not in the game”, little effort is expended to negotiate down the price and even when done through contracting, the “spread” may still be too high. When it became apparent that the upward trajectory of spending is unsustainable, cost control measures were instituted, akin to price control. Federal responses like RBRVS and SGR for physicians and DRG for hospitals came into being. Private insurance increased premiums, tweaked qualifying requirements through adverse “selection bias” and/or exclude pre-existing conditions. Other providers like pharmaceuticals, device companies and different suppliers responded in a similar fashion to maintain profitability.

What is apparent in these arbitrary responses is a pervasive theme of a pricing structure sans openness as to production cost. Only when there is transparency in production cost in relation to price charged, can a more rational payment system develop through a change in trading dynamics. When the buyer knows the “spread” between actual cost and selling price, he is in a level-playing field with the seller and can better negotiate down the price. This is the essence of a competitive market-based economy. Medical inflation will be replaced throughout the whole gamut of trading by deflation in prices, while profit will still be made, although lesser than before. The eventual agreed price will then be more affordable and the health system sustainable and durable. With “information symmetry” between buyer and seller, the trading dynamics will change. As in the preceding illustration when the seller priced a product or service at $100, but discounted it down to $50, now that the production cost is transparent and is actually $10, instead of the buyer happily paying $50 as before with 5x profit, he can now negotiate the price even lower. The ability of buyers to participate in the decision as to how much actual profit comes from the trade, brings parity to the parties involved in the trade.

In summary, reform of the healthcare system is complex when all the “moving parts”, as important as they are, detract us from the core problem, which is a payment system that marginalized and ignored trading dynamics. The payers, public or private, must fulfill their fiduciary responsibility and obligation to taxpayers and premium payers by demanding information about production cost and selling price before paying up. Knowledge of %Profit (spread) should be part of “buying drivers” for consumers to be in equal footing with the seller. One should not limit “price determinants” to supply/demand, needs, wants, expectations and ability to pay. They should include price differential with production cost. Physicians are the only ones that have costing-transparency with RBRVS which slowed down the rate of medical inflation. Other larger components of healthcare expenditures, i.e, hospitals, allied personnel, pharmaceuticals and device companies continue to wrap themselves in mystery. Even when the political winds sway towards conservatism or progressivism, the moral imperative is to bridge this chiasm. The challenge to our present generation is whether to keep the same culture in “buying/selling” or develop a new one, parity or disparity, opacity or transparency in the trading system. Which world and global market do we want to create? Shall we think outside-the-box or not? Only by looking at the culture and foundation of “buying-and-selling” through the prism of impartiality and even-handedness, will the payment system in healthcare system be equitable and reformed. With more healthcare dollars saved, a new dawn is in the horizon when payment is equitable, services not curtailed and access to healthcare available to all, whether the economy is yawning or booming.

Excerpted from Thesis in Master in Health Care Administration

Submitted: New England College

98 Bridge St, Henniker, NH 03242

By:

Aladin Mariano,MD, MHA, FACS, FCCP