I believe Americans need a new way of thinking about health. Look where our current perspectives on the subject have gotten us – we are last among the world’s 17 most industrialized nations in all the key indicators of health. It’s hard to believe but true: we’re last in life expectancy; we have the highest rates of obesity, infant mortality, low birth weights, heart disease, diabetes, chronic lung disease, homicide rates, teen pregnancy and sexually transmitted diseases.
The lead author of the Institute of Medicine, NIH sponsored study that revealed this situation remarked that “Americans get sicker, die sooner and sustain more injuries than people in all other high-income countries.” (That’s a quote from the report.) Then he added this coup de grace: “We were stunned by the propensity of findings all on the negative side – the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society. If we fail to act, life spans will continue to shorten and children will face greater rates of illness than those in other nations.”
Two Ways to Think of Health
I believe Americans are overly passive about their health. Good health can only be attained and maintained by conscious deeds. These deeds require planning and disciple. Examples include exercising regularly and vigorously, dining in ways that nourish the body without causing problems and otherwise behaving in positive, active ways.
The level of health you will enjoy is clearly affected by your lifestyle choices. Your health status depends to a great extent on whether you invest in your well being or not. If you make little or no such investments, your health will depend on chance, genetics, the aging process and the timeliness of the quality of medical care you receive.
If, on the other hand, you do invest, if you seek, protect and defend an advanced state of well being, the nature of the health status you will have will be dramatically different – and better.
Therefore, we need to distinguish these two kinds of health situations – one passive, one active.
The Institute of Health report that places America last reflects that segment of America that is passive. If the quite small segment of the American population that practices active health were separated, if their health data were compiled and compared, I’m sure we would be #1.
For these and related reasons, I propose we view health in two different ways – by making a distinction between static health – which is how most view and approach their health, and earned health. The latter is what you get when you invest wisely in your own well being.
It’s a way of life I call REAL wellness.
Health As Currently Perceived
The WHO definition of health is unrealistic (nobody, not even the most devout wellite, enjoys “complete physical, mental and social well-being,” at least not every day). Most think of health in far less exalted ways. Most think they are well if they are not sick. This is pathetic. It equates with not needing immediate medical attention. For the vast majority, this is a “good enough” view of health. Thinking that way is a self-fulfilling prophesy. It means that not healthy is the best you can hope for. This is the static definition of health and it must be reformed and at least accompanied by another, comparison perspective for those Americans willing to do their part. That would be earned health.
I think we need ideas about health that remind people of a key fact, namely, that a passive situation is not as effective, desirable, protective or rewarding as a dynamic earned state of health. We should all be aware that static health, the default setting you get for just existing and doing nothing special to enhance health, can and must be reinforced and boosted.
Employing a term like earned health might remind people that health can be much more than non-illness. The term earned health can signal the availability of a richer level of well being. It can remind everyone that health at its best is more than a static condition. Health is a dynamic state; it gets better with effort, worse if ignored.
Earned health represents a higher health standard. Earned health is more ambitious and more consistent with a REAL wellness mindset and lifestyle than the current norm of health as non-sickness.
The Static/Earned Health Continuum
This continuum is another way of expressing Dr. John Travis’ original, simple line drawing model of health along a continuum, with “premature death” on the far left side of his continuum) and an ever-changing dynamic of “high level wellness” at the other, right side extreme. The “0” in the middle represents a neutral point, which could be simple non-sickness.
Earned health is what happens from the neutral point to the +10 indicator. Everyone moves along an imaginary continuum of this kind every day, because health is dynamic, under constant change. By living wisely with the right behaviors, we fuel a state of health that is better than if we allow health status to be determined by the passage of time (i.e., the aging process, chance, medical interventions, circumstances and events.
This continuum is a simple way of depicting the basic fact that earned health evolves largely due to our own efforts to improve and protect our well being; static health, on the other side is affected by what happens to you.
By the way, Dr. Travis made regular expansions to his original model. You can view the latest edition and read more the continuum here. A related construct that will interest wellness enthusiasts is Dr. Travis Wellness Energy System.
Earned health is not determined or advanced by medical interventions. Static health, that is, health along the continuum from the center to the left of the of the continuum, is so influenced.
The Path to REAL Wellness
To become healthier in an earned sense, it’s up to us to act so as to move along the right side of the continuum.
The failure to appreciate the different nature of health, earned from static, partly accounts for why America can have so much medical care and yet not enjoy the best quality of health status. After all, modern medicine is a wonderful thing but there are two problems: people expect too much of it and too little of themselves.
The rapid development of workplace health protective and preventive services has been driven by government strategies and recommendations, as well as by the European Union legislation in the areas of health and safety at work and by the European Commission programme in public health. This was also largely due to the new demands and expectations from employers, employees and their representative bodies as they recognize the economic, social and health benefits achieved by providing these services at the workplace, thus providing the available knowledge and evidence necessary for the continuous improvement of workplace health management. Comprehensive workplace health management is a process involving all stakeholders inside and outside any business. It aims at empowering them to take control over their own health and their family’s health considering environmental, lifestyle, occupational and social health determinants and quality of health care. It is based on health promotion principles and it creates a great challenge to health, environment and safety professionals providing services, advice, information and education to social partners at work. It involves also taking care of considerable socioeconomic interest of all involved stakeholders. It has been shown in several instances that the business utilizing a well managed research based occupational health service can gain a competitive advantage by:
Protecting human health against health and safety hazards occurring in the work environment.
Promoting human health workplaces for all ages and healthy aging by appropriate work culture, work organization and support to social cohesion.
Promoting mental health, healthy lifestyle and preventing major non-communicable diseases using specific workplace health policies and management tools.
Maintaining work ability thus also employability throughout working life.
Reducing health care costs caused by employees’ and employers’ injuries, diseases, illnesses and premature retirement resulting from or influenced by occupational, environmental, life style and social health determinants
Using resources effectively, protecting the natural environment and creating a health supportive environment.
Improving social communication and literacy on health, environment and ethics.
This article series describes the author’s observations of various roles undertaken by the occupational health nurse. Whilst recognizing the wide variation that exists in occupational health nursing practice between different industrial and blue collar environments this series reflects the standards that have already been achieved where occupational health nursing is at its most advanced. However it has to be recognized that the level of education, professional skills and the exiting national legislation determines what role can be actually undertaken by occupational health nurses. Even more important is to remember that no one professional out of the exiting workplace health professions is now capable to meeting all health needs of the working population. A multi-disciplinary approach is needed to effectively manage the growing workplace health and safety demands in business today.
The workplace health services use the skills of many professionals such as specialist occupational physicians, safety engineers, occupational hygienists, occupational health nurses, ergonomists, physiotherapists, occupational therapists, laboratory technicians, psychologists and other specialists. The role and tasks actually performed for the companies by representatives of different health and safety professions vary greatly depending upon legislative needs, scope of the workplace health concept perceived by directors, enforcement practice, the level of their education, position in the occupational health infrastructure, actions undertaken by insurance institutions and many other factors. Occupational health nurses are the largest single group of health professionals involved in delivering health services at the workplace and have the most important role to play in the workplace health management. They are at the frontline in helping to protect and promote the health of the nations working population.
The role of the occupational health nurse in workplace health management is a new and exciting concept that is designed to improve the management of health and health related problems in the workplace. Specialist occupational health nurses can play a major role in protecting and improving the health of the working population as part of this strategy. Occupational health nurses can also make a major contribution to the sustainable development, improved competitiveness, job security and increased profitability of businesses and communities by addressing those factors which are related to the health of the working population. By helping to reduce ill health occupational health nurses can contribute to the increased profitability and performance of organizations and reduce health care costs. Occupational health nurses can also help to reduce the externalization of costs onto the taxpayer, by preventing disability and social exclusion, and by improving rehabilitation services at work. By protecting and promoting the health of the working population, and by promoting social inclusion, occupational health nurses can also make a significant contribution towards building a caring social ethos within the UK. This article provides guidance to employers and employees on establishing workplace health management systems within their own organizations. On how to determine and develop the role and functions of the occupational health nursing specialist within each enterprise and where to go for additional help and advice in relation to occupational health nursing.
Changing nature of working life and the new challenges
The world of work has undergone enormous change in the last hundred years. To a large extent the very heavy, dirty and dangerous industries have gone, and the burden of disease, which came with them, in most European countries, has declined. However, the new working environments and conditions of work that have replaced them have given rise to new and different concerns about the health of the working population. Exposure to physical, chemical, biological and psychosocial risk factors at work are now much more clearly linked to health outcomes in the mind of the general public. Expectations of society in regard to health at work have also changed, with increasing demands for better standards of protection at work and for the improvement of the quality of working life. Employers are also recognizing that health-related issues, such as sickness absence, litigation and compensation costs, increasing insurance premiums, are expensive; ignoring them can lead to serious economic consequences. The best employers’ emphasize the important message that good health is good business, and that much can be achieved in this field simply by introducing good management practices.
The Need for Workplace Management
There are approximately 400 million people who work in the EU Member States. The majority of whom spend more than one half of their waking life at work. However, fatal accidents at work are still common. The standardized incident rates per 100,000 workers in the European Union show that the fatal accident rate varies between 1.6 in the UK to 13.9 in Spain, with Austria, Greece, France, Italy and Portugal all above 5.0%. In the entire European region there are approximately 200 to 7500 non-fatal accidents per 100,000 employees per year, of which around 10% are severe leading to over 60 days absence from work, and up to 5%, per year, lead to permanent disability. It has been estimated that the total cost to society of work related injuries and ill health in the European Union is between 185 billion and 270 billion ECU per year, which represents between 2.6% to 3.8% of Gross National Product (GNP) in member states. The cost of workplace accidents and ill health, in both financial and human terms, remains an enormous, largely unrecognized burden in UK. The majority of those accidents and diseases could have been prevented if appropriate action had been taken at the workplace. Many responsible employers have consistently demonstrated that by paying attention to these issues this type of harm and the subsequent costs can be avoided, to the benefit of everyone concerned. Increasing concern is the growing awareness of occupational stress. Up to 42% of workers in a recent survey complained about the high pace of work. Job insecurity, fear of unemployment, lack of a regular salary and the potential loss of work ability are all additional sources of stress, even for those in employment.
The wide ranging social and health effects of occupational stress on the health of the working population are well documented, for example 23% of workers surveyed claimed that they had been absent from work for work related health reasons in the previous twelve months. The resulting cost of sickness absence in United Kingdom is considered to be substantial. In the UK 177 million working days were lost in 1994 as a result of sickness absence; this has been assessed at over 11 billion in lost productivity. HSE statistics are encouraging given in 2009; only 29.3 million days were lost overall, 24.6 million due to work-related ill health and 4.7 million due to workplace injury. Much of this burden of ill health and the resulting sickness absence is caused, or is made worse by working conditions. Even where ill health is not directly caused by work, but by other non-occupational factors such as smoking, lifestyle, diet etc. Interventions designed to improve the health of the working population, delivered at the workplace, may help to reduce still further the burden of ill health. At present the socioeconomic impact of environmental pollution caused by industrial processes on the working population is uncertain, but it is likely to contribute further to the burden of ill health in some communities.
OHA’s can contribute by helping managers to manage sickness absence more effectively. The nurse may be involved in helping to train line managers and supervisors in how to best use the OH service, in how to refer staff, what type of information will be required, what to expect from occupational health. By developing transparent referral procedures, ensuring that medical confidentiality is maintained and that the workers’ rights are respected the OHA can do much to ensure that employees referred for assessment due to sickness absence are comfortable with the process.
OH nurses, with their close relationship with workers, knowledge of the working environment and trends in ill-health in the company are often in a good position to advise management on preventing sickness absence. In my experience referral to General Practitioners have a limited use for work related issues, and gain best results by as well as keeping the GP aware, referring to a specialist occupational physician.
Planned rehabilitation strategies, can help to ensure safe return to work for employees who have been absent from work due to ill-health or injury. The nurse is often the key person in the rehabilitation programme who will, with the manager and individual employee, complete a risk assessment, devise the rehabilitation programme, monitor progress and communicate with the individual, the OH physician and the line manager. Nurses have also become involved in introducing proactive rehabilitation strategies that aim to detect early changes in health before such conditions result in absence from work. Improving and sustaining working ability benefits many groups, the individual, the organization and society, as costly absence and other health care costs are avoided.
In many cases the OH nurse has to work within the organization as the clients advocate in order ensuring that managers appreciate fully the value of improving the health of the workforce. OH nurses have the skills necessary to undertake this work and may develop areas of special interest.
The occupational health nurse may develop pro-active strategies to help the workforce maintain or restore their work ability. New workers, older workers, women returning to work following pregnancy or workers who have been unemployed for a prolonged period of time may all benefit from health advice or a planned programme of work hardening exercises to help maintain or restore their work ability even before any health problems arise. Increasingly the problems faced by industry are of a psychosocial nature and these can be even more complex and costly to deal with. OH nurses, working at the company level, are in a good position to give advice to management on strategies that can be adopted to improve the psycho-social health and wellbeing of workers.
Health and safety
The OHA can have a role to play in developing health and safety strategies. Where large, or high risk, organizations have their own in-house health and safety specialists the OHA can work closely with these specialists to ensure that the nurses expertise in health, risk assessment, health surveillance and environmental health management is fully utilized into the health and safety strategy. Occupational health nurses are trained in health and safety legislation, risk management and the control of workplace health hazards and can therefore make a useful contribution to the overall management of health and safety at work, with particular emphasis on ‘health’ risk assessment.
The nurse often has close contact with the workers and is aware of changes to the working environment. Because of the nurses expertise in the effects of work on health they are in a good position to be involved in hazard identification. Hazards may arise due to new processes or working practices or may arise out of informal changes to existing processes and working practices that the nurse can readily identify and assess the likely risk from. This activity requires and pre-supposed regular and frequent work place visits by the occupational health nurse to maintain an up to date knowledge and awareness of working processes and practices.
Legislation in Europe is increasingly being driven by a risk management approach. OHA’s are trained in risk assessment and risk management strategies and, depending upon their level of expertise and the level of complexity involved in the risk assessment, the nurse can undertake risk assessments or contribute towards the risk assessment working closely with other specialists.
Advice on control strategies
Having been involved in the hazard identification and risk assessment the occupational health nurse can, within the limits of their education and training, provide advice and information on appropriate control strategies, including health surveillance, risk communication, monitoring and on the evaluation of control strategies.
Research and the use of evidence based practice
Specialist OHA’s utilize research findings from a wide range of disciplines, including nursing, toxicology, psychology, environmental health and public health in their daily practice. The principal requirement for an occupational health nurse in practice is that they have the skills to read and critically assess research findings from these different disciplines and to be able to incorporate the findings into evidence based approach to their practice. Research in nursing is already well established and there is a small, but growing, body of evidence being created by occupational health nursing researchers who investigate occupational health nursing practices. OHA’s should ensure that they have access to and the skills necessary to base their practice on the best available evidence. At the company level occupational health nurses may be involved in producing management reports on for example sickness absence trends, accident statistics, assessment of health promotion needs and in evaluating the delivery of services, the effectiveness of occupational health interventions. Research skills and the ability to transfer knowledge and information from published research to practice is an important aspect of the role.
OHA’s, along with other health, environment and safety professionals in the workplace health team, are in a privileged position in society. They have access to personal and medical information relating to employees in the company that would not be available to any other group. Society has imposed, by law, additional responsibilities on clinical professionals to protect and safeguard the interest of patients. The ethical standards for each discipline are set and enforced by each of the professional bodies. Breaches of these codes of conduct can result in the professional being removed from the register and prevented for practicing. Nurses have a long and well-respected tradition in society of upholding the trust placed in them by patients. This level of trust in the occupational health nurse’s professional integrity means that employees feel that they can be open, honest and share information with the nurse in the confidence that the information will not be used for other purposes. This allows the nurse to practice much more effectively than would ever be possible if that trust was not there. The protection of personal information enables a trusted relationship between employees and the nurse to be developed and facilitates optimum working relationships and partnership. The International Commission on Occupational Health (ICOH) has published useful guidance on ethics for occupational health professionals’. This guidance is summarized below “Occupational Health Practice must be performed according to the highest professional standards and ethical principles. Occupational health professionals must serve the health and social wellbeing of the workers, individually and collectively. They also contribute to environmental and community health the obligations of occupational health professionals include protecting the life and the health of the worker, respecting human dignity and promoting the highest ethical principles in occupational health policies and programs. Integrity in professional conduct, impartiality and the protection of confidentiality of health data and the privacy of workers are part of these obligations. Occupational health professionals are experts who must enjoy full professional independence in the execution of their functions. They must acquire and maintain the competence necessary for their duties and require conditions which allow them to carry out their tasks according to good practice and professional ethics.”
The United States is facing the largest shortage of healthcare practitioners in our country’s history which is compounded by an ever increasing geriatric population. In 2005 there existed one geriatrician for every 5,000 US residents over 65 and only nine of the 145 medical schools trained geriatricians. By 2020 the industry is estimated to be short 200,000 physicians and over a million nurses. Never, in the history of US healthcare, has so much been demanded with so few personnel. Because of this shortage combined with the geriatric population increase, the medical community has to find a way to provide timely, accurate information to those who need it in a uniform fashion. Imagine if flight controllers spoke the native language of their country instead of the current international flight language, English. This example captures the urgency and critical nature of our need for standardized communication in healthcare. A healthy information exchange can help improve safety, reduce length of hospital stays, cut down on medication errors, reduce redundancies in lab testing or procedures and make the health system faster, leaner and more productive. The aging US population along with those impacted by chronic disease like diabetes, cardiovascular disease and asthma will need to see more specialists who will have to find a way to communicate with primary care providers effectively and efficiently.
This efficiency can only be attained by standardizing the manner in which the communication takes place. Healthbridge, a Cincinnati based HIE and one of the largest community based networks, was able to reduce their potential disease outbreaks from 5 to 8 days down to 48 hours with a regional health information exchange. Regarding standardization, one author noted, “Interoperability without standards is like language without grammar. In both cases communication can be achieved but the process is cumbersome and often ineffective.”
United States retailers transitioned over twenty years ago in order to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to think of patients as inventory, perhaps this has been part of the reason for the lack of transition in the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any square in mid America packed with inventory on shelves, ordering duplicate widgets based on lack of information regarding current inventory. Visualize any Home Depot or Lowes and you get a glimpse of how automation has changed the retail sector in terms of scalability and efficiency. Perhaps the “art of medicine” is a barrier to more productive, efficient and smarter medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more rapidly thanks to increases in standardization of regional and state health information exchanges.
History of Health Information Exchanges
Major urban centers in Canada and Australia were the first to successfully implement HIE’s. The success of these early networks was linked to an integration with primary care EHR systems already in place. Health Level 7 (HL7) represents the first health language standardization system in the United States, beginning with a meeting at the University of Pennsylvania in 1987. HL7 has been successful in replacing antiquated interactions like faxing, mail and direct provider communication, which often represent duplication and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions in the same way that grammar standards foster better communication. The United States National Health Information Network (NHIN) sets the standards that foster this delivery of communication between health networks. HL7 is now on it’s third version which was published in 2004. The goals of HL7 are to increase interoperability, develop coherent standards, educate the industry on standardization and collaborate with other sanctioning bodies like ANSI and ISO who are also concerned with process improvement.
In the United States one of the earliest HIE’s started in Portland Maine. HealthInfoNet is a public-private partnership and is believed to be the largest statewide HIE. The goals of the network are to improve patient safety, enhance the quality of clinical care, increase efficiency, reduce service duplication, identify public threats more quickly and expand patient record access. The four founding groups the Maine Health Access Foundation, Maine CDC, The Maine Quality Forum and Maine Health Information Center (Onpoint Health Data) began their efforts in 2004.
In Tennessee Regional Health Information Organizations (RHIO’s) initiated in Memphis and the Tri Cities region. Carespark, a 501(3)c, in the Tri Cities region was considered a direct project where clinicians interact directly with each other using Carespark’s HL7 compliant system as an intermediary to translate the data bi-directionally. Veterans Affairs (VA) clinics also played a crucial role in the early stages of building this network. In the delta the midsouth eHealth Alliance is a RHIO connecting Memphis hospitals like Baptist Memorial (5 sites), Methodist Systems, Lebonheur Healthcare, Memphis Children’s Clinic, St. Francis Health System, St Jude, The Regional Medical Center and UT Medical. These regional networks allow practitioners to share medical records, lab values medicines and other reports in a more efficient manner.
Seventeen US communities have been designated as Beacon Communities across the United States based on their development of HIE’s. These communities’ health focus varies based on the patient population and prevalence of chronic disease states i.e. cvd, diabetes, asthma. The communities focus on specific and measurable improvements in quality, safety and efficiency due to health information exchange improvements. The closest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100,000 grant by the department of Health and Human Services in September 2011.
A healthcare model for Nashville to emulate is located in Indianapolis, IN based on geographic proximity, city size and population demographics. Four Beacon awards have been granted to communities in and around Indianapolis, Health and Hospital Corporation of Marion County, Indiana Health Centers Inc, Raphael Health Center and Shalom Health Care Center Inc. In addition, Indiana Health Information Technology Inc has received over 23 million dollars in grants through the State HIE Cooperative Agreement and 2011 HIE Challenge Grant Supplement programs through the federal government. These awards were based on the following criteria:1) Achieving health goals through health information exchange 2) Improving long term and post acute care transitions 3) Consumer mediated information exchange 4) Enabling enhanced query for patient care 5) Fostering distributed population-level analytics.
Regulatory Aspects of Health Information Exchanges and Healthcare Reform
The department of Health and Human Services (HHS) is the regulatory agency that oversees health concerns for all Americans. The HHS is divided into ten regions and Tennessee is part of Region IV headquartered out of Atlanta. The Regional Director, Anton J. Gunn is the first African American elected to serve as regional director and brings a wealth of experience to his role based on his public service specifically regarding underserved healthcare patients and health information exchanges. This experience will serve him well as he encounters societal and demographic challenges for underserved and chronically ill patients throughout the southeast area.
The National Health Information Network (NHIN) is a division of HHS that guides the standards of exchange and governs regulatory aspects of health reform. The NHIN collaboration includes departments like the Center for Disease Control (CDC), social security administration, Beacon communities and state HIE’s (ONC).11 The Office of National Coordinator for Health Information Exchange (ONC) has awarded $16 million in additional grants to encourage innovation at the state level. Innovation at the state level will ultimately lead to better patient care through reductions in replicated tests, bridges to care programs for chronic patients leading to continuity and finally timely public health alerts through agencies like the CDC based on this information.12 The Health Information Technology for Economic and Clinical Health (HITECH) Act is funded by dollars from the American Reinvestment and Recovery Act of 2009. HITECH’s goals are to invest dollars in community, regional and state health information exchanges to build effective networks which are connected nationally. Beacon communities and the Statewide Health Information Exchange Cooperative Agreement were initiated through HITECH and ARRA. To date 56 states have received grant awards through these programs totaling 548 million dollars.
History of Health Information Partnership TN (HIPTN)
In Tennessee the Health Information Exchange has been slower to progress than places like Maine and Indiana based in part on the diversity of our state. The delta has a vastly different patient population and health network than that of middle Tennessee, which differs from eastern Tennessee’s Appalachian region. In August of 2009 the first steps were taken to build a statewide HIE consisting of a non-profit named HIP TN. A board was established at this time with an operations council formed in December. HIP TN’s first initiatives involved connecting the work through Carespark in northeast Tennessee’s s tri-cities region to the Midsouth ehealth Alliance in Memphis. State officials estimated a cost of over 200 million dollars from 2010-2015. The venture involves stakeholders from medical, technical, legal and business backgrounds. The governor in 2010, Phil Bredesen, provided 15 million to match federal funds in addition to issuing an Executive Order establishing the office of eHealth initiatives with oversight by the Office of Administration and Finance and sixteen board members. By March 2010 four workgroups were established to focus on areas like technology, clinical, privacy and security and sustainability.
By May of 2010 data sharing agreements were in place and a production pilot for the statewide HIE was initiated in June 2011 along with a Request for Proposal (RFP) which was sent out to over forty vendors. In July 2010 a fifth workgroup,the consumer advisory group, was added and in September 2010 Tennessee was notified that they were one of the first states to have their plans approved after a release of Program Information Notice (PIN). Over fifty stakeholders came together to evaluate the vendor demonstrations and a contract was signed with the chosen vendor Axolotl on September 30th, 2010. At that time a production goal of July 15th, 2011 was agreed upon and in January 2011 Keith Cox was hired as HIP TN’s CEO. Keith brings twenty six years of tenure in healthcare IT to the collaborative. His previous endeavors include Microsoft, Bellsouth and several entrepreneurial efforts. HIP TN’s mission is to improve access to health information through a statewide collaborative process and provide the infrastructure for security in that exchange. The vision for HIP TN is to be recognized as a state and national leader who support measurable improvements in clinical quality and efficiency to patients, providers and payors with secure HIE. Robert S. Gordon, the board chair for HIPTN states the vision well, “We share the view that while technology is a critical tool, the primary focus is not technology itself, but improving health”. HIP TN is a non profit, 501(c)3, that is solely reliant on state government funding. It is a combination of centralized and decentralized architecture. The key vendors are Axolotl, which acts as the umbrella network, ICA for Memphis and Nashville, with CGI as the vendor in northeast Tennessee.15 Future HIP TN goals include a gateway to the National Health Institute planned for late 2011 and a clinician index in early 2012. Carespark, one of the original regional health exchange networks voted to cease operations on July 11, 2011 based on lack of financial support for it’s new infrastructure. The data sharing agreements included 38 health organizations, nine communities and 250 volunteers.16 Carespark’s closure clarifies the need to build a network that is not solely reliant on public grants to fund it’s efforts, which we will discuss in the final section of this paper.
Current Status of Healthcare Information Exchange and HIPTN
Ten grants were awarded in 2011 by the HIE challenge grant supplement. These included initiatives in eight states and serve as communities we can look to for guidance as HIP TN evolves. As previously mentioned one of the most awarded communities lies less than five hours away in Indianapolis, IN. Based on the similarities in our health communities, patient populations and demographics, Indianapolis would provide an excellent mentor for Nashville and the hospital systems who serve patients in TN. The Indiana Health Information Exchange has been recognized nationally for it’s Docs for Docs program and the manner in which collaboration has taken place since it’s conception in 2004. Kathleen Sebelius, Secretary of HHS commented, “The Central Indiana Beacon Community has a level of collaboration and the ability to organize quality efforts in an effective manner from its history of building long standing relationships. We are thrilled to be working with a community that is far ahead in the use of health information to bring positive change to patient care.” Beacon communities that could act as guides for our community include the Health and Hospital Corporation of Marion County and the Indiana Health Centers based on their recent awards of $100,000 each by HHS.
A local model of excellence in practice EMR conversion is Old Harding Pediatric Associates (OHPA) which has two clinics and fourteen physicians who handle a patient population of 23,000 and over 72,000 patient encounters per year. OHPA’s conversion to electronic records in early 2000 occurred as a result of the pursuit of excellence in patient care and the desire to use technology in a way that benefitted their patient population. OHPA established a cross functional work team to improve their practices in the areas of facilities, personnel, communication, technology and external influences. Noteworthy was chosen as the EMR vendor based on user friendliness and the similarity to a standard patient chart with tabs for files. The software was customized to the pediatric environment complete with patient growth charts. Windows was used as the operating system based on provider familiarity. Within four days OHPA had 100% compliance and use of their EMR system.
The Future of HIP TN and HIE in Tennessee
Tennessee has received close to twelve million dollars in grant money from The State Health Information Exchange Cooperative Agreement Program.20 Regional Health Information Organizations (RHIO) need to be full scalable to allow hospitals to grow their systems without compromising integrity as they grow.21and the systems located in Nashville will play an integral role in this nationwide scaling with companies like HCA, CHS, Iasis, Lifepoint and Vanguard. The HIE will act as a data repository for all patients information that can be accessed from anywhere and contains a full history of the patients medical record, lab tests, physician network and medicine list. To entice providers to enroll in the statewide HIE tangible value to their practice has to be shown with better safer care. In a 2011 HIMSS editor’s report Richard Lang states that instead of a top down approach “A more practical idea may be for states to support local community HIE development first. Once established, these local networks can feed regional HIE’s and then connect to a central HIE/data repository backbone. States should use a portion of the stimulus funds to support local HIE development.”22 Mr. Lang also believes the primary care physician has to be the foundation for the entire system since they are the main point of contact for the patient.
One piece of the puzzle often overlooked is the patient investment in a functional EHR. In order to bring together all the pieces of the HIE puzzle patients will need to play a more active role in their healthcare. Many patients do not know what medicines they take every day or whether they have a living will. Several versions of patient EHR’s like Memitech’s 911medical id card exist, but very few patients know or carry them.23 One way to combat this lack of awareness is to use the hospital as a catch-all and discharge each patient with a fully loaded USB card via case managers. This strategy also might lead to better compliance with post in patient therapies to reduce readmissions.
The implementation of connecting qualified organizations began earlier this year. To fully support organizations to move toward qualification the Office of National Coordinator for HIE (ONC) has designated regional education centers (TN rec) who assist providers with educational initiatives in areas like HIT, ICD9 to ICD10 training and EMR transition. Qsource, a non-profit health consulting firm, has been chosen to oversee TNrec. To ensure sustainability it is critical that Tennessee build a network of private funding so that what happened with Carespark won’t happen to HIP TN. The eHealth Initiatives 2011Survey Report states that of the 196 HIE initiatives, 115 act independently of federal funding and of those independent HIE’s, break even through operational revenue. Some of these exchanges were in existence well before the American Recovery and Reinvestment Act in 2009. Startup funding from grants is only meant to get the car going so to speak, the sustainable fuel, as observed in the case of Carespark, has to come from value that can be monetized. KLAS research reports that 54% of public HIE’s were concerned about future sustainability while only 35% of private HIE’s shared this concern.
Hospital Implications of HIP TN (A Call to Action)
From a Financial perspective, taking our hospital into the future with EMR and an integrated statewide network has profound implications. In the short term the cost to find a vendor, establish EMR in and outpatient will be an expensive proposition. The transition will not be easy or finite and will involve constant evolution as HIP TN integrates with other state HIE’s. To get a realistic idea of the benefits and costs associated with health information integration. we can look to HealthInfoNet in Portland, ME, a statewide HIE that expects to save 37 million dollars in avoided services and 15 million in productivity reduction. Specific areas of savings include paper or fax costs $5 versus $0.25 electronically, virtual health record savings of $50 per referral, $26 saved per ED visit and $17.41 per patient/year due to redundant lab tests which amounts to $52 million for a population of 3 million patients. In Grand Junction Colorado Quality Health Network lowered their per capita Medicare spending to 24% below the national average, gaining recognition by President Obama in 2009. The Santa Cruz Health Information Exchange (SCHIE) with 600 doctors and two hospitals achieved sustainability in the first year of operation and uses a subscription fee for all the organizations who interact with them. In terms of government dollars available, meaningful use incentives exist to encourage hospitals to meet twenty of twenty five objectives in the first phase (2011-2012) and adopting and implement an approved EHR vendor. ARRA specified three ways for EHR to be utilized to obtain Medicare reimbursement. These include e-prescribing, health information exchange and submission of clinical quality measures. The objectives for phase two in 2013 will expand on this baseline. Implementation of EHR and Hospital HIE costs are usually charged by bed or by the number of physicians. Fees can range from $1500 for a smaller hospital up to $12,000 per month for a larger hospital.
While consumers search for affordable health insurance, they have price in their mind as the top priority. A general conception among the consumers is that cheap health plans should not be costly-the cheapest health plan available in the market is their target. However, this approach is not good. Sometimes, paying for a cheap health insurance plan but still not getting the required level of coverage results only in wastage of money.
With the implementation of the affordable care act, the reach of affordable health plans is set to increase. Or at least, this is what is believed to be the objective of healthcare reforms. However, lots of consumers are still in confusion about how things would work. In this article, we will discuss some detailed options that consumers can try while looking to buy affordable health plans.
To get a hand on affordable health insurance plans, consumers need to take of certain things. First among them is about knowing the options in the particular state of the residence. There are lots of state and federal government-run programs that could be suitable for consumers. Knowing the options is pretty important. Next would be to understand the terms and conditions of all the programs and check the eligibility criteria for each one of them. Further, consumers should know their rights after the implementation of healthcare reforms, and something within a few days, they may qualify for a particular program or could be allowed to avail a particular health insurance plan. If consumers take care of these steps, there is no reason why consumers can’t land on an affordable health plan that could cater to the medical care needs.
Let’s discuss some options related to affordable health insurance plans state-wise:
State-run affordable health insurance programs in California
While considering California, there are three affordable health insurance plans that are run by the state government. Consumers can surely get benefitted by these if they are eligible for the benefits.
• Major Risk Medical Insurance Program (MRMIP)
This program is a very handy one offering limited health benefits to California residents. If consumers are unable to purchase health plans due to a preexisting medical condition, they can see if they qualify for this program and get benefits.
• Healthy Families Program
Healthy Families Program offers Californians with low cost health, dental, and vision coverage. This is mainly geared to children whose parents earn too much to qualify for public assistance. This program is administered by MRMIP.
• Access for Infants and Mothers Program (AIM)
Access for Infants and Mothers Program provides prenatal and preventive care for pregnant women having low income in California. It is administered by a five-person board that has established a comprehensive benefits package that includes both inpatient and outpatient care for program enrollees.
Some facts about affordable health insurance in Florida
While talking about affordable health insurance options in Florida, consumers can think about below mentioned options:
• Floridians who lost employer’s group health insurance may qualify for COBRA continuation coverage in Florida. At the same time, Floridians, who lost group health insurance due to involuntary termination of employment occurring between September 1, 2008 and December 31, 2009 may qualify for a federal tax credit. This credit helps in paying COBRA or state continuation coverage premiums for up to nine months.
• Floridians who had been uninsured for 6 months may be eligible to buy a limited health benefit plan through Cover Florida.
• Florida Medicaid program can be tried by Floridians having low or modest household income. Through this program, pregnant women, families with children, medically needy, elderly, and disabled individuals may get help.
• Florida KidCare program can help the Floridian children under the age of 19 years and not eligible for Medicaid and currently uninsured or underinsured.
• A federal tax credit to help pay for new health coverage to Floridians who lost their health coverage but are receiving benefits from the Trade Adjustment Assistance (TAA) Program. This credit is called the Health Coverage Tax Credit (HCTC). At the same time, Floridians who are retirees and are aged 55-65 and are receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), may qualify for the HCTC.
Some facts about affordable health insurance in Virginia
While talking about affordable health insurance options in Virginia, consumers need to consider their rights:
• Virginians who lost their employer’s group health insurance may apply for COBRA or state continuation coverage in Virginia.
• Virginians must note that they have the right to buy individual health plans from either Anthem Blue Cross Blue Shield or CareFirst Blue Cross Blue Shield.
• Virginia Medicaid program helps Virginians having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, and elderly and disabled individuals are helped.
• Family Access to Medical Insurance Security (FAMIS) helps Virginian children under the age of 18 years having no health insurance.
• In Virginia, the Every Woman’s Life Program offers free breast and cervical cancer screening. Through this program, if women are diagnosed with cancer, they may be eligible for treatment through the Virginia Medicaid Program.
Some facts about affordable health insurance in Texas
While talking about affordable health insurance options in Texas, consumers need to consider their rights:
• Texans who have group insurance in Texas cannot be denied or limited in terms of coverage, nor can be required to pay more, because of the health status. Further, Texans having group health insurance can’t have exclusion of pre-existing conditions.
• In Texas, insurers cannot drop Texans off coverage when they get sick. At the same time, Texans who lost their group health insurance but are HIPAA eligible may apply for COBRA or state continuation coverage in Texas.
• Texas Medicaid program helps Texans having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, elderly and disabled individuals are helped. At the same time, if a woman is diagnosed with breast or cervical cancer, she may be eligible for medical care through Medicaid.
• The Texas Children’s Health Insurance Program (CHIP) offers subsidized health coverage for certain uninsured children. Further children in Texas can stay in their parent’s health insurance policy as dependents till the age of 26 years. This clause has been implemented by the healthcare reforms.
• The Texas Breast and Cervical Cancer Control program offers free cancer screening for qualified residents. If a woman is diagnosed with breast or cervical cancer through this program, she may qualify for medical care through Medicaid.
Why are Americans so worked up about health care reform? Statements such as “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are in my opinion uninformed and visceral responses that indicate a poor understanding of our health care system’s history, its current and future resources and the funding challenges that America faces going forward. While we all wonder how the health care system has reached what some refer to as a crisis stage. Let’s try to take some of the emotion out of the debate by briefly examining how health care in this country emerged and how that has formed our thinking and culture about health care. With that as a foundation let’s look at the pros and cons of the Obama administration health care reform proposals and let’s look at the concepts put forth by the Republicans?
Access to state of the art health care services is something we can all agree would be a good thing for this country. Experiencing a serious illness is one of life’s major challenges and to face it without the means to pay for it is positively frightening. But as we shall see, once we know the facts, we will find that achieving this goal will not be easy without our individual contribution.
These are the themes I will touch on to try to make some sense out of what is happening to American health care and the steps we can personally take to make things better.
A recent history of American health care – what has driven the costs so high?
Key elements of the Obama health care plan
The Republican view of health care – free market competition
Universal access to state of the art health care – a worthy goal but not easy to achieve
what can we do?
First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?
To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!
Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.
This very basic review of American medical history helps us to understand that until quite recently (around the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.
What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.
I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.
At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?
The Obama health care plan is complex for sure – I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.
Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.
To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.
To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.
The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.
The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide “free” (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.
As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to “give up” something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.
Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as “big government control” of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.
A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to “go to the doctor” when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.
OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.
I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens – health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.
Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because “health care is there” and somehow we think we have no responsibility for reducing our demand on it.
It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.
There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, “Google” “preventive health care strategies”, look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then – take charge and increase your chances for good health while making sure that health care is there when we need it.
At some point in each individual’s life on Earth they undoubtedly and eventually come around to question their purpose for existing. The basis of this profound question usually begins with thoughts centered around- the reason why am I here, and my purpose in what appears as an experiential journey through this mystery we call life.
Many of us have experienced these seemingly bizarre moments of life in which we find ourselves reaching for answers to help solidify our existence permitting us to feel as though we are not building our lives on sifting sand. Although these moments in life allow for a conscious awakening that demands our attention, they are often masked or shrouded throughout our lives as momentous events.
It does not always happen this way because many apparently mundane moments within our lives carry the seed of questions yet unanswered- and if we look closely, profound answers are lovingly contained in those special moments of time. Having exposed in a previous article, Timewave Zero the premise that our universe and all within it is being sourced continuously from the same fountain of life through cycles, it surely makes plausible sense to conclude certain natural laws of life govern our existence and could very well offer solace in a turbulent sea of life’s questions. It is through the proper understanding and personal application of these “Laws of Life” that enable us to live life fully in the moment appreciating the journey of life right where we find ourselves at any given moment, in the Now. However, it must be added, we still live in a delicate world that requires of us to plan for a future while co-existing in the moment.
Could these well defined universal Laws of Life help us better understand life’s mysteries while at the same time provide a solid foundation upon which we can receive direction and answers? In short, the answer is yes! By applying a level of understanding and reliance upon these laws of unwavering reliability we may soon find ourselves aligned with powerful forces which conspire to lift our lives higher up the ladder of joy.
If we could accept that all possibilities exist in the present moment and remain focused in the Now of life, consciously allowing the Laws of Life to freely operate through us, we would soon recognize that we are in a co-created world which we have personal responsibility for bringing into existence. It is through these simple Laws that we are building a new Earth as we become receptive to our ultimate purpose for life itself. We are powerful co-creators and life is our school and playground too.
The Power of the Four Laws of Life
I would concede there are many Laws of Life; however in this post we will turn our focus only upon four important master laws that birth all the others. Given that all life within the universe of creation is encapsulated within the boundaries established by certain laws, some known and some of these we are just starting to unravel and comprehend.There are four basic, universal laws of utmost value for human life and these are the one we shall address.
It is through our understanding and application of the wisdom contained within these four Laws of Life that will determine our experiences we will entertain throughout or lives. During our lives many of our questions arise through the awareness of the very contrasts that exist having been created by the choices we made. Some of these experiences are on an individual basis while others can be experienced by the entirety of those on Earth.
Our collective (or individual) reaction to events which create our life experience are needed thus enabling us by way of contrast between various experiences to question what it is we then want to experience. Combine life’s cyclic movement and how we experience it with understanding the four Laws of Life- The Law of Love, The Law of Gratitude, The Law of Cause & Effect and The Law of Attraction you find many of life’s poised questions and formerly out-of-reach answers become vividly obvious.
Before we get into each of the Laws, it would be good to know that these laws are immutable and one cannot “break” them in the process of life here as we operate within the parameters of Free-Will. You may by choice either consciously or unconsciously turn against any of these fundamental Laws of Life and your life experience would reveal that something was “amiss”, essentially out of balanced alignment. If your course in life was not adjusted through the questioning/answer process we all go through, your subsequent experiences would become more amplified while the essence of your life experience would remain the same.
We have all heard the question phrased this way: “Why does this always happen to me?” Read on to discover the nature of these four Laws of Life and how to recognize their individual signatures in your life. Upon gaining a more thorough understanding of how they permeate all facets of our lives, we become internally empowered to co-create our own lives, and indeed our world at the same time through the infinite power residing in these Laws of Life.
The Law of Love
It is often said and conceptualized that “God is Love”. In the scale of humanities expression of this concept, for now it, falls dismally short and understandably so. Our human reflection of this first Law of Life- The Law of Love can be a very difficult one to express in such a way to foster a genuine flow of this all encompassing power. Generally, human expression of Love is often limited and in the worst case, conditional. I’m not trying to convey human love in all its beauty and shortcomings but rather the first source of the Law of Love that empowers us by attempting to express love through a filtered, human perspective.
While we may feel like love is a by-product created by something that is precipitated by an external influence, in truth, we embody the Law of Love by allowing Unconditional Love to forever flow through us. This powerful Law is never removed from our access, only by not allowing does it appear lost. It is only through this understanding or at least recognizing this limitless source of Unconditional Love is the originating source of our human expression of Love.
“Unconditional Love is the Law of Love”
Like all the Laws, Unconditional Love is pure energy and is present throughout the entire universe from the greatest to the least of creation. The Law of Love is the building block which binds all of creation together and we in human form can either allow or disallow it to be active in our lives. When you allow the Law of Love to govern your actions you have become unattached to preconceived or forced outcomes having released your will and allowed acceptance of what already is. The Law of Love binds all of us together by unifying opposites into one; and when we apply this truth the false human condition of perceiving everything as separate from us falls away opening our hearts allowing the Law of Love to freely operate.
By practicing an open heart especially in situations needing resolution that seem utterly impossible to overcome, all of a sudden they are transformed by the Law of Love. The Law of Love teaches us we cannot experience utter joy while holding onto resistance through non-acceptance of our experiences. Letting go allows the Law of Love to flow and offers answers to those difficult questions of life. The Law of Love- Its part magic and part energy science.
“Unconditional Love is the only truth everything else is an illusion”
The Law of Gratitude
Much like the Law of Love, the Law of Gratitude exists as a by-product of having an open heart. This Law is the key to unlock greater well-being and abundance in your life. One great reason for allowing the Law of Gratitude to flow in your life is because it will promotes endorphin chemicals to be released within the body affecting every cell promoting feelings of optimism, relaxation and happiness. By your body releasing endorphins, simultaneously stress hormones called cortisol and norepinephrine decrease rapidly.
That alone could be reason enough to daily apply the Law of Gratitude; feel great and automatically become healthier! Further abundance comes from the assurance of knowing you are an important part of expressing gratitude, so have compassion on yourself and acknowledge your greatness. If you focus on the personal gifts you have been given along with other points of gratitude, you cannot help but notice that it’s impossible to contemplate negative emotions at the same time.
To understand gratitude is to comprehend opposites since this is how the most powerful, beneficial effects are experienced. This Law is often expressed as an “attitude of the mind” and that is true to a degree. Actually, the Law of Gratitude is initiated from the heart then our mind follows adding imagery to the momentum reminding us of more to be grateful for if we will allow the process to unfold. We sometimes misunderstand the real meaning of gratitude and its expression simply because we again need an opposite or opposing viewpoint to posses the ability to identify that which we are grateful for. It is commonplace for most of the population to identify what is absent in their lives rather than go deliberately in the opposite direction into a treasure chest full objects worthy of appreciation, thankfulness and ultimately reflect gratitude for each.
For example, by recognizing the absence of something you appreciate, you bring a defining clarity that easily produces gratefulness for its existence- no matter what or where the object is, physical or non-physical. Even thoughts can remind us of the Law of Gratitude at work in addition to the more common sources- those outward, visible objects of appreciation or thankfulness. By a conscious and deliberate daily practice of the Law of Gratitude brings us into a renewed optimism and appreciation for all of life while banishing the power robbing opposites of fear, anger and other negative emotions. Every acknowledgment of gratitude for what you have is rewarded by awareness of more to be grateful for and anything you want in your life originates by the law of Gratitude. Your choice should be clear, allow the Law of Gratitude to flow more abundance of joy into your life.
The Law of Cause & Effect
This is one of the most misunderstood Laws of Life due to the belief that all events are predestined to transpire as a result of some previous action. It is true from the standpoint of action-reaction that expectations of future events should come to fruition if no alternative adjustments are made, simply because the root cause was set in motion. A belief that even if root causes are altered by a future event, they cannot alter one’s destiny can lead to fatalism whereby you resign that all is predestined and alteration is impossible. This is an error and is to be avoided in the mind as it has no basis in how this law operates.
The Law of Cause and Effect also known in the Buddhist doctrine as karma, ascribes that an individual’s present condition is a reflection previous life choices and these decisions could even encompass many past lifetimes of accumulation. In Hebrew doctrine this is expressed as a generational curse and in some way is related to parental DNA inheritance. It important to note regardless of doctrine, we have the power to override any possible predispositions through our current actions and emotional/mental state. Therein lays the beauty of the Law of Cause and Effect.
One of the best ways to allow this powerful trans-formative law to flow through your life is to apply the Golden Rule seeded into your heart. Doing so from the perspective that not only will you personally benefit greatly, but also the world around you will as well. Karma or, the Law of Cause and Effect can carry a bit of foreboding if ignored because if abused, time will take its toll surfacing into events and the scales of life will become balanced. Again, the accumulation of past deeds only instigates the flow of this energy and it is malleable. This forceful energy exists in both polarities and is experienced as what could be deemed as positive or negative actions-reactions.
“As you sow, so shall you reap”
This law’s application is easily practiced when we deliberately aspire to give away that which we seek for ourselves. Whatever form of energy we radiate regardless whether they consist of thought-forms or physical actions, the Universe responds accordingly. This is because- that which is like unto itself is drawn forth into existence. So, consider your thoughts and following actions. Much in the same way the Law of Gratitude operates, if you want more of anything like love, friendship, good health etc. give these away from an open heart and watch as the Universe responds in kind.
When this law is firmly rooted into your being through you heart you need not be concerned to police your thoughts as this process soon becomes automatic just like breathing. As most of us primarily exist in the 3rd dimensional Universe, we need not overly concern ourselves that the Law of Cause and Effect response time is immediate. Fortunately for now, there is a delayed response; however, you may begin to notice as you set this law into motion that your awareness can jump quickly and you begin to notice its effects are sometimes near instantaneously occurring in your life as well as others. When this is observed, know that you are receiving information from the 4th dimensional realm.
To experiment with this law at an observational level, pay close attention to events that are now transpiring on Earth. Pick any category- politics, economics, social changes, geophysical changes etc. all these are exponentially unfolding at an ever increasing repetitive pace. These action-reaction events can in many ways be associated with cyclic action playing out through the Law of Cause and Effect. For the purpose of life’s direction regarding the power and influence of the Law of Cause and Effect, one should come into agreement that we are through our willpower, are an active, interconnected participant and what we do in fact causes a ripple in the pond of life and the lives of others. As you build your own experiential evidence you become acutely aware of this law’s power because whatever you believe becomes your truth and that sets in motion elements of your life displayed and played out through the Law of Cause and Effect.
The Law of Attraction
I suspect that nearly anyone who has a passing interest in self improvement or is driven in the hope to find the magic “potion” or “spell” to live a specific life, has encountered the basic idea of the Law of Attraction. It is no shock that a whole industry has arisen attempting to cash-in financially with the ever expanding popularity of this subject. If this is what it takes to help some of us come to the realization that we each are endowed with the power to transform and actually co-create or world, then this is a great beginning.
This Law of Attraction states that whatever you focus your attention on with a higher degree of emotional energy and do not have a conflicting opposite thought on the subject, that energy will amass to the point where the essence of the desire will establish itself in your life. It could also be summarize as- That which is like unto itself is drawn.
There is an ever expanding knowledge-base derived from quantum theory that affirms the validity in the fundamental aspects of this law. While this law is by far nothing new, because the Universe is the designer and it has been in operation since the dawning of creation. We are seeing on a global scale, the infinite power contained within this law and I suspect, it has and is being used to direct the thoughts of those who are unconscious of its ability to deliver whatever one focuses their thought on (given the correct application) into a world that is of their design and desire.
There is also very good evidence to suggest that a large portion of the “2012 shift” relates to our awakening into a scientifically based realization that we are fully able on a global scale, to transform this planet into one that the majority of the Earth’s inhabitants would call heaven. The amazing point in the Law of Attraction is that all physical manifestations are first birthed by emotions, then thought. This does make sense as emotions are really energy-in motion. In the purest way, when thought is intensely and passionately focused its essence coalesces into our reality.
“Ask and ye shall receive”
What many do not understand while attempting to apply this law, it that your conscious AND subconscious thoughts each play a significant role in the speed at which the desired outcome appears. The Law of Cause and Effect are not far removed from the Law of Attraction. Both are similar laws, just like the two conscious and subconscious minds are involved, both laws operate in harmony with each other. You can apply the creation power encapsulated in this law by the very act of become a deliberate thinker. Emotions that surround thoughts are the primary indicator of what you’re beginning to create and will eventually show up in your life. This emotional component is a wonderful tool that is indispensable in knowing the direction and eventual outcome of what you are inviting into your life.
There is responsibility associated with wielding this law in unnatural, manipulative ways. The universe does not judge nor filter end results of what is delivered. In time, you will always receive the essence of your thoughts. And just like the non-instantaneous manifestation of thought-forms in operation within the Law of Cause and Effect, the Law of Attraction provides a built-in, indisputable guidance system in the form of emotions. Be aware of how your thoughts make you feel when focusing on that which you want to create. When those thoughts feel good, you are in agreement with your desire and intentions; when feelings do not feel so good, re-direct your thought back into a better feeling thought. In doing so, emotional energy remains amplified in the direction of your desire.
Finally, the speed at which thoughts physically are transformed into existence in our reality is determined by the level of agreement without doubts or conflicting beliefs to the contrary, and the proportionate level of emotional energy present. All these elements must be a match with each other and flow effortlessly in your life to have full effect.
Yes, it can be a fine balance to effectively and knowingly use the Law of Attraction and it presently requires our physical interaction to follow through with a higher level of active intuition to move things forward in their proper direction. This is never done in a forceful manner. In fact, the true full power is all in the balancing of our thoughts, emotions, and burning desire without any internal conflict for that which we want to create. The Law of Attraction is always at work, so be a deliberate creator and manage and choose thoughts wisely- thoughts eventually become things.
In the end, we are all willful creators in the world we personally experience and create on both an individual and collective level. There is great life-affirming power contained in these four Laws of Life and when you apply them or rather let them guide you life, those unanswered questions are diminished.
It would be wise to remember that now upon Earth there are many co-creative partners all bringing into creation their diversity of beliefs and desires. Soon we will hit a tipping point where as partners we will agree on key provisions that promote life on earth equitably rather than destroy life while maintaining an ever expanding universe governed by free-will.
Above are the words of Yahshua Messiah (the Lord Jesus Christ) from Matthew 5:17 in the King James Version of The Holy Scriptures, and just lately I have been going head to head with a satanic Judaizer who repeatedly used this verse from Matthew’s Gospel and the one that follows it i.e. Matthew 5:18 to try and prove that The Law and The Commandments are still binding upon Born of God sons and daughters of God.
Matthew 5:17-18 (KJV) Think not that I am come to destroy The Law or The Prophets: I am not come to destroy, but to fulfill. 18 For verily I say unto you, Till heaven and earth pass, one jot or one tittle shall in no wise pass from The Law, till all be fulfilled.
To be honest, I have always found these Holy Scriptures to be a slight thorn in my flesh. The reason for this is that they can too easily be abused and misused and thereby used in a very negative sense in order to support the erroneous demonic ideas of Graceless blasphemers who want to put sons and daughters of God back under The Law of Moses – The Commandments.
We must understand that these outward show commandment keepers (those of the 21st century Pharisee concision) truly believe there is salvation in Moses. They will deny it, of course, until they’re blue in the face, but that changes nothing. That is what they believe and they only ever pay lip service to His Grace. They believe salvation is in obedience to The Law – The Commandments and not through living under Yahshua Messiah’s (the Lord Jesus Christ’s) Glorious Saving Grace.
So, let’s analyze what Yahshua Messiah was saying here in these verses – the opening statement first:
“Think not that I am come to destroy The Law or The Prophets.”
And from the Greek MSS transliteral:
Matthew 5:17 (Greek Transliteral) No ye-should-be-inferring that I came to-down-loose the law or the before-avengers (prophets), not I came to-down-loose but to fill.
I will be returning to one crucial word here later.
And from Young’s Literal Translation:
Matthew 5:17 (YLT) Do not suppose that I came to throw down the law and the prophets—I did not come to throw down, but to fulfill.
I have used the YLT version here because I believe the words ‘throw down’ is more accurate and descriptive than the KJV word ‘destroy’, and because Yahshua Messiah is NOT a destroyer. Satan The Devil is The Destroyer, not Yahshua Messiah. We, therefore, learn from this that Yahshua Messiah did not come to throw down The Law and The Prophets nor do away with them or what they represented, and why would He? He was under The Law Himself and were The Prophets not His messengers in Old Covenant (Testament) times and did they not uphold The Law? Didn’t Yeshua Messiah Himself instruct Moses about The Law and tell him what to write down over a period of forty days and forty nights? Doesn’t Paul also make it all clear?
Gal 3:24-26 (KJV) Wherefore The Law was our schoolmaster to bring us unto Christ, that we might be justified by Faith (righteousness). 25 But after that Faith comes, we are no longer under a schoolmaster (The Law). 26 For ye are all the children (sons) of God by Faith in Christ Jesus. (Brackets and emphasis mine)
The Law WAS our schoolmaster in order to bring us to Yahshua Messiah. That is all The Law is for, IF you are a follower of Yahshua Messiah – The Way and have Faith in Him for your salvation. If you do not have Faith solely in Him for your salvation then you must have your faith in yourself and in something else i.e. YOUR vain attempts at keeping The Law and The Commandments.
Paul also said:
Romans 7:12 (KJV) Wherefore The Law is Holy, and The Commandment Holy, and just, and good.
So what is Paul saying? He’s saying The Law and The Commandments are perfect and Holy – no fault can be found in them. However there is one BIG PROBLEM – man CANNOT OBEY THEM and has never obeyed them. Man in the weak fleshy condition is incapable of keeping The Law or The Commandments. So why do Graceless Judaizers think the opposite is the case? Why and how do they think that man can achieve the impossible? Where in the Holy Scriptures does it state that man will one day (sometime never LOL) obtain the ability to OBEY The Law and The Commandments? It ain’t their folks!! Nowhere in The Holy Scriptures does it say that man will one day OBEY The Law or The Commandments. Yes, he will follow Yahshua Messiah willingly and voluntarily, but not obediently. Furthermore, this is a question I have put to these wretched Judaising people a hundred and one times before and never once received an answer. How can they give an answer, there isn’t an answer other than simple Faith in Yahshua Messiah, to which they can never humble themselves.
OK, back to the Greek Transliteral Version and that crucial word and I will copy again:
Matthew 5:17 (Greek Transliteral) No ye-should-be-inferring that I came to-down-loose the law or the before-avengers (prophets), not I came to-down-loose but to fill.
Now notice right at the end it says ‘to fill’ NOT ‘fulfill’. So what I hear you say? Ah but this is far more significant than we may at first realize. The word ‘fulfill’ as used in the KJV does not convey The Truth correctly!! Now there’s a surprise!! And how many times do we find these subtle satanic changes within the pages of the KJV? Too many times is the answer to that.
Moreover here’s an analogy: Imagine that The Law and The Commandments are an empty bucket and an empty bucket that always needs filling in order for the demands of The Law and The Commandments to be met.
Now in Old Covenant times under The Law and The Commandments all they could do was offer and sacrifice animals in order to meet the demands of The Law and The Commandments so they would slaughter animal after animal in their attempts to fill The Law Bucket, but never accomplishing their aims, because the sacrifices were not substantial enough and always temporary so turned to ash, blew away on the wind, and the bucket never filled.
However, after John the Baptist ALL THINGS CHANGED which Yahshua Messiah confirms for us here:
Matthew 11:13 (KJV) For all The Prophets and The Law prophesied until John.
Luke 16:16 (KJV) The Law and The Prophets were until John: since that time The Kingdom of God is preached, and every man presseth into it.
So what does this mean? It means quite simply that Yahshua Messiah’s death (total sacrifice) and resurrection FILLED THE LAW AND COMMANDMENT BUCKET!! Yahshua Messiah is the water (The Living Water) that easily fills the bucket. This is why the word ‘fulfilled’ is a very weak or even a false and ever so slightly deceptive translation, because The Greek MSS says “to fill” and the KJV says “fulfill”. If we put it another way, can something that needs filling, be fulfilled or completed? No, because ‘to fill’ has a different meaning from ‘fulfill’ and the translators knew it and they deliberately mistranslated it.
As a final point I will quote Strong’s Concordance for the word ‘fulfill’ and reveal more Truth:
G4137 – fulfil – pleroma – play-to’-o – From G4134; to make replete, that is, (literally) to cram (a net), level up (a hollow), or (figuratively) to furnish (or imbue, diffuse, influence), satisfy, execute (an office), finish (a period or task), verify (or coincide with a prediction), etc.: – accomplish, X after, (be) complete, end, expire, fill (up), fulfil, (be, make) full (come), fully preach, perfect, supply.
If we now copy Strong’s definitions for ‘fulfilled’ from Matthew 5:18 what do you think we will find? Answer: a different word entirely, would you believe it? Much mirth for the author!!
G1096 – fulfilled – gino mini – in’-om-have – A prolonged and middle form of a primary verb; to cause to be (“gen” -rate), that is, (reflexively) to become (come into being), used with great latitude (literally, figuratively, intensively, etc.): – arise be assembled, be (come, -fall, -have self), be brought (to pass), (be) come (to pass), continue, be divided, be done, draw, be ended, fall, be finished, follow, be found, be fulfilled, + God forbid, grow, happen, have, be kept, be made, be married, be ordained to be, partake, pass, be performed, be published, require, seem, be showed, X soon as it was, sound, be taken, be turned, use, wax, will, would, be wrought.
We can now see their plot unraveling because ‘fulfill’ or ‘fulfilled’ are the correct words for the Greek word ‘gin mini’ and yet they translated the word ‘pleroma’ as ‘fulfill’ when it clearly wasn’t. We need to understand, too, that these 17th-century translators of the KJV were highly educated people and very literate in more than one language so this was not an innocent mistake.
Furthermore, see how the above first definition of the Greek word ‘pleroma’ fits nicely with my Law and Commandment Bucket? The first definition for ‘pleroma’ is ‘replete’ which means to be ‘filled to satisfaction’ – or filled right to the brim and so it is with The Law and Commandment Bucket in terms of Yahshua Messiah’s sacrifice and His resurrection. His sacrifice filled the Law and Commandment Bucket right to the brim and flowing over.
The 7 Universal Laws, the Law of Attraction, the 12 Universal Laws of Success, the 6 Spiritual Laws of the Universe… All those terms, one talks about 6 Laws of the Universe, the other talks about 7 Universal Laws, yet other talks about 12 Laws of Success, I’ve even seen people talking about 21 Spiritual Laws of the Universe, or rather 21 subsidiaries Universal Laws. All sources of knowledge promise the same magic of manifesting and attracting all desires and dreams of people applying one or more of these Laws.
Yet so few people are actually living their desires, dreams, and success. Despite all the available knowledge about the 7 Universal Laws, the Law of Attraction, the 12 Universal Laws of Success, the 6 Spiritual Laws of the Universe and the subsidiary Universal Laws or Spiritual Universal Laws, there’s only a handful of people reaping the benefits that are promised to accompany the application of the Universal Law of Attraction or the interplay of Universal Laws in general.
So why don’t all those people not ‘attract what they desire’, ‘manifesting their dreams’, or ‘achieving the success they’ve always longed for’? Even the hundreds of thousands of people who have seen the movie ‘The Secret’, or the documentary ‘What the Bleep Do We Know’, or read the ‘Attractor Factor’ by Joe Vitale, or the Laws of Success by Napoleon Hill, or the ‘Secrets of the Millionaire Mind’ by T. Harv Eker, or any other popular self-help or self-improvement book, movie, film or other resource? One reason is that there’s no such thing as “effortless attraction”. As much as you’d like not having to put in any effort whatsoever, there’s always a bit of effort involved. But that’s a subject for another time… But there’s another, very important reason.
Here’s what the problem is. People can’t see the forest because of all the trees anymore. They completely lose track of the big picture. There’s just too much information about the 6 or 7 Universal Laws, the Universal Law of Attraction, the 12 Laws of Success, and so on. People don’t know which book, film, movie or other resources to pick. Are there 6 or 7 Universal Laws? Or are there 12 Universal Laws of Success? Or is there just 1 Law of Attraction? Or do you have to know about 21 Subsidiary Laws or Spiritual Laws or whatever?
Who’s right? Well, in a way, none of them are right. Or all of them are right. It depends on how you look at it. Let’s set this all straight.
The Universe is infinite. There are no boundaries and no limitations. As humans, we are aspects of this Universe. In one way, we are the Universe, in another, we are separate aspects of this Universe. This is not the time and place to get into the details of this, but if you want to learn more about this, scroll down and click the link in the bio box.
The truth is that our lives unfold through the application of Universal Laws, among which the Universal Law of Attraction. We can do this either consciously, or unconsciously (as most people do). If you do it unconsciously, life appears to be a series of ‘accidents’, and the big bad outside world appears to be making things hard for you in achieving your success.
However, as you apply the Universal Law of Attraction or the Universal Laws in general consciously, you can engineer your own success. You can set the stage for achieving your desires, and then act accordingly. The acting part is absolutely crucial, and this is where the effort comes in. But what’s important for now, is that you need to be aware of the way in which the Universal Law of Attraction or the Universal Laws work together and the nuances of how they need to be applied.
So, how can all different sources be right? How can there be 6 and 7 Universal Laws at the same time? How can there simultaneously be 12 Laws of Success or 21 Subsidiary Laws of the Universe or Spiritual Laws of the Universe?
The answer is simple. Once again, the Universe is infinite. You can make things as complex as you like. Or as simple as you like for that matter. Make it more complex, and you can easily make up 21 Universal Laws, or 21 Subsidiary Laws. Make it a bit more simple and you can easily get to 12 Laws of Success. Or just stick to 7 Laws of the Universe. Every version may be potentially correct. What’s important is to what extent a resource is right for you.
I always like to make things as least complicated as possible. It’s not that I can’t make things complicated. If you want I can give you at least 100 subsidiary laws of the universe, and call them spiritual or required to attract and manifest whatever it is you want. But that’s not going to help you. A Universal Laws you need to remember, the more difficult you make things for yourself, and the less likely it becomes that you achieve all your desires and dreams.
True enough, just knowing about the Universal Law of Attraction isn’t enough. There are some other Universal Laws to know about and understand if you want to apply the Universal Law of Attraction correctly. However, it doesn’t help you if you must think about a whole bunch of additional Universal Laws, Subsidiary laws, spiritual laws, and so on all the time.
You know, there’s a way around this whole mess of 7 Universal Laws, Subsidiary Laws of the Universe and Spiritual Laws of the Universe, 12 Laws of Success, every average Joe and Jill pretending to be an expert in the Universal Law of Attraction these days, and so on. You can just get yourself an extremely clear and straightforward description of just 6 Universal Laws, or Laws of the Universe if you like. One of these is the Universal Law of Attraction. The fact that there are only 5 others doesn’t mean that this resource is less accurate or comprehensive than the 12 Laws of Success, or the 21 Subsidiary Laws of the Universe, or the 7 Universal Laws, or the ‘100 merry-go-round Spiritual Laws of the Universe Rolodex’, or whatever fancy thing people come up with these days. There’s too much information, a too complex web of knowledge these days already anyway, so the last thing you need is an even more complex and overly detailed description of the Laws of the Universe.
Discussing just 6 Universal Laws, or Laws of the Universe if you will, done in the right, clearest and most straightforward way possible, allows you to automatically cover any subsidiary Universal Law you or any other can possibly think of. These 6 Universal Laws are the main Laws of the Universe or the main Laws of Success. By pulling the levers on these main Laws, you’ll automatically set the stage and create the circumstances for reaping more benefit than you can even imagine possible from your application of the Universal Law of Attraction alone.
And because you don’t make things too hard on yourself by keeping things simple, you don’t need more than that in the form of 12 Laws of Success or 21 Subsidiary Laws of the Universe, or 21 Spiritual Laws of the Universe, or whatever. You can just cut to the chase, apply the Universal Laws and the Universal Law of Attraction in the right way, covering any potential subsidiary law, and you’ll create the life you’ve always wanted in the quickest and most straightforward way possible.
Give yourself a break, and make things easy on yourself for a change. It’s been hard enough for long enough already. Apply the Universal Law of Attraction and the other main Laws of the Universe together in the right way, and start changing your life.
If you think the Law of Attraction is all you need to know about the spiritual law, think again…
Using spiritual power to change your life and the lives of others depend on knowing Spirit (or being aligned with God/universal intelligence) and applying spiritual laws wisely. Much attention has been paid of late to the Law of Attraction due to huge amounts of publicity around “The Secret”, which started as a book, expanded to a DVD, and then became a movie. But there are other spiritual or universal laws that can be studied and applied. The two sets of seven laws that I will describe briefly in this article are probably the best known.
Seven universal laws are attributed to Hermes Trismegistos of ancient Greece. These seven Hermetic laws are quite well known and are generally accepted by many as containing great truths. Other people believe that this is all a bunch of new age hooey; but from my own experience, I believe the truth is indeed there. The best treatment I’ve seen of the Hermetic laws is by Alan Seale in his book, Soul Mission, Life Vision.
The Seven Universal or Hermetic laws are:
The Law of Mentalism — Also known as the Law of Mind or the Law of Spirit. The law has two aspects. The first aspect states that everything is mind or spirit. Everything arises out of thought or universal consciousness. Thought creates. The second aspect is that everything exists within the mind of God, and the mind of God exists within everything. This is the core idea of many mystical traditions — that there is a great unity or oneness with God.
The Law of Correspondence — This is often stated as “As above, so below. As below, so above.” The microcosm level of the human being corresponds to the macrocosm level of the universe. The inner level of objects held in thought corresponds to the outer level of objects in reality.
The Law of Vibration — Also called the Law of Resonance. This law says that everything is in motion. Matter, energy, thoughts… everything is vibration. This law has two subsidiary laws: the Law of Attraction and the Law of Change. The Law of Attraction says that like attracts like — i.e., similar vibrations attract or resonate with one another, and dissimilar vibrations repel one another. For example, health thoughts can attract health; wealth thoughts can attract wealth. The Law of Change says that, since everything is in motion, change is constant and to be expected as normal.
The Law of Polarity — The subsidiary law is the Law of Relativity, which says that everything is relative and nothing exists alone. Everything is relative to other things. The primary law is that everything exists on a spectrum. What are often referred to as polar opposites are the ends of a spectrum but there are points throughout the spectrum which are degrees between the poles or opposite ends?
The Law of Rhythm — This law says that all of life, and even non-life (such as planets, moons, and stars), exists within an order or pattern or combinations of cycles and patterns.
The Law of Cause and Effect — Often described as “As you sow, so shall you reap”. This law states that in interacting systems, actions or events cause or lead to resulting conditions. Cause precedes effect.
The Law of Gender — This law is often referred to as “yin and yang”, and it has two parts. The first part says that within everything there are masculine and feminine energies… masculine being strong, forceful, and assertive; feminine being contemplative, nurturing, and yielding. The second part is that things come in their own time and that there is a natural gestation period for things to develop and manifest.
Another famous seven laws are the Seven Spiritual Laws of Success from a book of that same name by Deepak Chopra. For many years, I have used these seven laws as subjects for contemplative meditation, and so am quite familiar with them. His seven laws are:
The Law of Pure Potentiality — Spirit is pure consciousness, and we human beings are pure consciousness. Pure consciousness is pure potentiality — the field of all possibilities. The universe is creative and abundant.
The Law of Giving — This law says that the universe operates through dynamic exchange. Energy and intelligence naturally flow. From the human point of view, giving and receiving are necessary to participate in this dynamic process.
The Law of Cause and Effect — Every action generates a force of energy that returns to us in like kind. Giving love brings love to us in return. Giving money or value produces money or value that returns to us in kind.
The Law of Least Effort — Effort can get in the way of natural participation in the universe. The natural effort — that is, the effort that is true to one’s own nature — is “least” effort.
The Law of Intention and Desire — Inherent in every intention and desire is the mechanics for its fulfillment; intention and desire in the field of pure potentiality have infinite organizing power. Intention and desire can lead to action (cause) which will produce an effect. Intention and desire are also themselves thoughts (causes) which can create the intended result if clearly focused (attention) in the present.
The Law of Detachment — Detachment is giving up the attachment to the result. It is being free to step into the unknown, the field of all possibilities, and to surrender to the creative intelligence of the universe. It allows the universe at the quantum level to respond and react. It allows creation to happen most freely.
The Law of Purpose in Life — Everyone has a purpose in life based on a unique gift or special talent. When we use this unique talent in service of others, we experience the glory of our own spirit accomplishing a divine goal and living a dream of the soul.
There are occasional references to other spiritual laws such as the Law of Love, the Law of Abundance, the Law of Growth, and the Law of Giving — and these may or may not map to the fourteen laws mentioned above. I think they do, but I will leave it to your reasoning (or imagination) to work out how.
Now, the spiritual laws can be (and have been) studied and analyzed for what they mean to us human beings and for their potential consequences. They can and do have many different or subtle interpretations. But the key thing is that the laws have spiritual meaning and also practical usefulness in how they can be applied to benefit us — both spiritually and materially.
The key is learning how to use the spiritual laws effectively. The laws can be applied singly but can be used most effectively when taken together or in combination. True spiritual power is when a person knowingly and wisely applies the spiritual laws to produce further insights, spiritual bliss, peace of mind, loving relationships, health, happiness, abundance, and true enjoyment of life.
Learn about the universal or spiritual laws. Get familiar with the laws — the more you learn about the universal laws, the more you are learning about spirit. The more you know the spiritual laws, the more you can apply them. And the more you can apply all of the laws, the more you will be able to use your spiritual power. Through spiritual power, you will: come to know yourself, get closer to a spirit, change your beliefs, cause new circumstances through your actions, attract what you want in life, feel peace and bliss, and know the spiritual power that connects you to the Universal.