NCAA money ma­chine keeps hum­ming along

Cecil Whig - - OPINION -

The Amer­i­can As­so­ci­a­tion of Nurse Prac­ti­tion­ers has des­ig­nated Nov. 12-18, Na­tional Nurse Prac­ti­tioner week. Dr. Loretta Ford and Dr. Henry Sil­ver launched the first NP pro­gram at the Univer­sity of Colorado more than 50 years ago. Since then, the guide­lines out­lined by the Amer­i­can As­so­ci­a­tion of Col­lege of Nurs­ing have raised the bar on the ed­u­ca­tional re­quire­ments of nurse prac­ti­tion­ers.

Plac­ing more strin­gent guide­lines the triad of preac­cep­tance, core cur­ricu­lum and ac­tual clin­i­cal prac­tice. Nurse prac­ti­tion­ers, oth­er­wise known as NPs, are reg­is­tered nurses with di­rect, clin­i­cal ex­pe­ri­ence and who have ad­vanced train­ing to eval­u­ate, di­ag­nose, treat and man­age many com­mon health con­di­tions. NPs pro­vide a full range of ser­vices, such as or­der­ing, per­form­ing and in­ter­pret­ing di­ag­nos­tic tests, di­ag­nos­ing and treat­ing acute and chronic con­di­tions, pre­scrib­ing med­i­ca­tions and treat­ments, and manag­ing over­all pa­tient care.

Ac­cord­ing to the Amer­i­can Academy of Nurse Prac­ti­tion­ers more than 1 bil­lion vis­its were made to a nurse prac­ti­tioner last year. With two of three pa­tients sup­port­ing leg­is­la­tion for nurse practi- tion­ers to gain full ac­cess na­tion­wide. In Mary­land, nurse prac­ti­tion­ers have in­de­pen­dent prac­tice, mean­ing they can prac­tice to the high­est of their ed­u­ca­tion and train­ing with­out over­sight.

NPs are li­censed, ex­pert clin­i­cians with ex­ten­sive clin­i­cal ed­u­ca­tion, most with mas­ter’s de­grees and many with doc­toral de­grees, who pro­vide care to per­sons across the life­span. With the fast-paced dy­namic of health care and its as­so­ci­ated sys­tems in­clud­ing tech­nol­ogy, in­for­ma­tion sys­tems, in­sur­ance and ad­vanc­ing re­search NPs like my­self, have ob­tained doc­toral de­grees to prac­tice to the ex­tent of their ed­u­ca­tion and train­ing to keep up with such changes. With the tur­bu­lent na­ture of health­care changes, NPs can treat pa­tients at lower cost, ef­fi­ciently, all while pro­vid­ing high-qual­ity care.

Spe­cial­ties of nurse prac­ti­tion­ers in­clude fam­ily, acute care, geron­tol­ogy, womens health, and pe­di­atrics, to name a few. NPs prac­tice across all set­tings from tra­di­tional pri­mary care of­fices to emer­gency rooms across the coun­try.

Creat­ing an en­vi­ron­ment in health­care where the fo­cus is on well­ness and prevention; nurse prac­ti­tion­ers are not only trained and ed­u­cated on wholism, but best suited in to­day’s health care sys­tem to pro­vide valu­able and qual­ity care. This will not only pre­vent gaps in health care to be nar­rowed, but re­duce ex­pen­di­tures.

Dr. Am­ber Man­ning is a board cer­ti­fied fam­ily nurse prac­ti­tioner who cur­rently prac­tices in pal­lia­tive care at Union Hos­pi­tal.

WASH­ING­TON — With Amer­ica’s elite col­lege foot­ball teams clos­ing in on the play­offs to de­ter­mine a na­tional cham­pion and a new race to bas­ket­ball’s March Mad­ness about to be­gin, the burn­ing ques­tion might be (ac­tu­ally is) who is in charge of the keep­ing the huge for­tune the two events pro­duce out of the hands of cheaters?

For more than three quar­ters of a cen­tury, the Na­tional Col­le­giate Ath­letic As­so­ci­a­tion has ruled ma­jor col­lege sports with an iron fist, clamp­ing down on any hint of scan­dal that might taint the as­so­ci­a­tion and its mem­ber schools... and dam­age the money flow.

At times, the NCAA’s leg­endary gum shoe com­mit­tee has seemed to have taken its duty to pre­serve pu­rity to the point of ab­sur­dity, pe­nal­iz­ing its mem­bers for triv­ial in­frac­tions of its Byzan­tine book of rules — so large now, it has be­come a lawyer’s dream or night­mare which­ever side you’re on. You can’t give that re­cruit a base­ball cap, T-shirt, etc., or your best player is sus­pended for ap­pear­ing fully clothed on a cal­en­dar that was be­ing sold for char­ity by a soror­ity, which ac­tu­ally oc­curred.

Of­ten it seemed to ob­servers that there was an un­holy se­lec­tiv­ity to the as­so­ci­a­tion’s pun­ish­ments. In other words, schools that were the most suc­cess­ful in pur­suit of records and the rev­enue they pro­duce were some­how less likely to be sanc­tioned. It has taken a long time for the Univer­sity of Louisville and its fa­mous bas­ket­ball coach, Rick Pitino, to fall, although his pro­gram’s not to men­tion per­sonal in­dis­cre­tions were com­mon knowl­edge for years.

The shadow of scan­dal and pros­e­cu­tion now hov­ers over the new bas­ket­ball sea­son.

The late UNLV coach Jerry Tarka­nian, once said only half in jest, “that the NCAA is so mad at Ken­tucky it prob­a­bly will tack an­other two years (sanc­tions) on Cleve­land State.”

While there has been no solid proof to back up these al­le­ga­tions of fa­voritism, there ob­vi­ously is plenty of cir­cum­stan­tial ev­i­dence. And the NCAA’s de­ci­sion not to pur­sue a hor­ren­dous breach of aca­demic pro­pri­ety by the Univer­sity of North Carolina, al­most puts a rub­ber stamp of au­then­tic­ity to the claims.

By not do­ing so, any cred­i­bil­ity the gov­ern­ing body has left may have been lost for­ever. If you have been un­aware, UNC had given aca­demic credit to fa­vored groups for what it at one time ad­mit­ted was a phony course. While some of those who took the nonex­is­tent course or cour­ses weren’t ath­letes, at least 50 per­cent to 60 per­cent were — in­clud­ing foot­ball and bas­ket­ball stars. The ex­cuse the NCAA gave with a straight face was that since there were nonath­letes also ben­e­fit­ing, dis­ci­pline was not an al­ter­na­tive (or some such inane jib­ber jab­ber) and that since the school told the NCAA that it was an ac­cred­ited course telling a na­tional ac­cred­i­ta­tion com­mit­tee that it wasn’t, the NCAA had no ju­ris­dic­tion. Mean­while the ac­cred­i­ta­tion folks re­port­edly have re­opened their in­ves­ti­ga­tion.

By the way, UNC is again listed in pre­sea­son bas­ket­ball polls as ex­pected to be one of the na­tion’s top 10 pro­grams with a head start on an­other March tri­umph...Ca-ching!

Is Wal­ter By­ers –the Torque­mada who built the NCAA and of­ten used a sledge­ham­mer to slap a wrist – whirring in his grave? Prob­a­bly. By­ers was the un­for­giv­ing cru­sader and self-ap­pointed ar­biter of all things le­git­i­mate and eth­i­cal in the world of big­time col­lege ath­let­ics. Back in the 1950s he was the most feared name in sports. Well, whirl away, Wal­ter. Your beloved in­sti­tu­tion, which you even came to see was out of hand, has gone from bad to “bad­der” as money con­sid­er­a­tions in­creas­ingly drive the col­lege sports en­gine. UNC’s rep­u­ta­tion as the old­est pub­lic univer­sity in the na­tion and cer­tainly one of its best aca­dem­i­cally has been se­verely tar­nished thanks to the re­lent­less, Pulitzer Prize-de­serv­ing re­port­ing of the Raleigh News and Ob­server.

I was in­stantly re­minded of an in­ci­dent a num­ber of years ago when I found my­self at a white tie Wash­ing­ton func­tion with sev­eral other peo­ple who had dis­cov­ered a place where a TV was show­ing a re­gional fi­nal of the bas­ket­ball tour­na­ment that in­cluded UNC. We were all strangers, but I said to no one of the oth­ers in par­tic­u­lar that I would feel bet­ter about the whole thing when the NCAA sanc­tions UNC, even then just a lit­tle too good ev­ery year to be on the right side of le­git­i­macy.

“I cer­tainly hope that doesn’t hap­pen,” the man stand­ing next to me said. “I’m the gov­er­nor of North Carolina.” Well, rest easy, sir. It hasn’t. Dan Thomas­son is an op-ed colum­nist for Tri­bune News Ser­vice and a for­mer vice pres­i­dent of Scripps Howard News­pa­pers. Read­ers may send him email at: thomas­son­

WASH­ING­TON — The Repub­li­cans’ tax bill would some­what im­prove the ex­ist­ing rev­enue sys­tem that once caused Mitch Daniels (for­mer head of the Of­fice of Man­age­ment and Bud­get, for­mer In­di­ana gov­er­nor) to say: Wouldn’t it be nice to have a tax code that looked as though it had been de­signed on pur­pose? To­day’s bill, which is 429 pages and is apt to grow, is an im­plau­si­ble in­stru­ment of sim­pli­fi­ca­tion. And it would worsen the tax code’s al­ready sub­stan­tial con­tri­bu­tion to “moral haz­ard.”

Economists use that phrase to de­note cir­cum­stances in which in­cen­tives are for per­verse be­hav­ior. To­day’s tax code is such a cir­cum­stance, and the Repub­li­can bill would ex­ac­er­bate this by ex­pand­ing the $1,000 child credit to $1,600 with an ad­di­tional $300 “fam­ily credit” for each par­ent and non-child de­pen­dent, and by dou­bling the stan­dard de­duc­tion to $12,000 for in­di­vid­u­als and $24,000 for mar­ried cou­ples. These mea­sures would in­crease the num­ber of per­sons not pay­ing in­come taxes and would fur­ther de­crease the per­cent­age of in­come tax rev­enues paid by low-in­come earn­ers.

Al­ready 62 per­cent of Amer­i­can house­holds pay more in pay­roll taxes than in in­come taxes. The bot­tom 50 per­cent of earn­ers sup­ply less than 3 per­cent of in­come tax rev­enues. Forty-five per­cent of Amer­i­can house­holds pay no in­come tax, either be­cause they earn too lit­tle or be­cause they qual­ify for enough ex­emp­tions and cred­its to erase their li­a­bil­ity. Sixty per­cent pay noth­ing or less than 5 per­cent of their in­come. Forty per­cent of earn­ers are net re­cip­i­ents from the in­come tax be­cause they qual­ify for re­fund­able tax cred­its. All this means that an al­ready large — and, if the Repub­li­can bill passes, soon to be larger — Amer­i­can ma­jor­ity has a van­ish­ingly small in­cen­tive to re­strain the growth of a gov­ern­ment that they are not pay­ing for through its largest rev­enue source.

These facts might be the re­sults of de­fen­si­ble tax and so­cial poli­cies. They should, how­ever, be dis­com­fit­ing to those re­main­ing con­ser­va­tives — they are on the en­dan­gered species list — who dis­pute Dick Cheney’s no­tion that “Rea­gan proved deficits don’t mat­ter.” Deficits mat­ter for their po­lit­i­cal as well as — ac­tu­ally, even more than — their eco­nomic ef­fects: Deficits make big gov­ern­ment cheap, en­abling the po­lit­i­cal class to charge tax­pay­ers rather less than $1 for ev­ery $1 of gov­ern­ment ben­e­fits dis­pensed. When the Bush-Cheney ad­min­is­tra­tion man­aged the last large tax cut, the pub­licly held na­tional debt was 33 per­cent of GDP. To­day it is 75 per­cent.

To­day’s Repub­li­can bill, drafted in the af­ter­math of the fail­ure to re­peal and re­place Oba­macare, is sup­posed to demon­strate to the party’s Trumpian base that con­gres­sional ma­jori­ties mat­ter and must be ex­tended. Rep. Mark Mead­ows, R-N.C., chair­man of the con­ser­va­tive House Free­dom Cau­cus, has said (to USA To­day): “If we had a whole bunch of wins on ma­jor items up to this point, would we per­haps be a lit­tle bit more de­lib­er­ate in our ne­go­ti­a­tions? I think the an­swer is yes.” But the facts about par­tic­i­pa­tion in the in­come tax mean that the bill is un­likely to as­suage the in­jured feel­ings of core Trump sup­port­ers, un­der­stood as down­scale white work­ing- class vot­ers who sup­pos­edly are seething be­cause they are not ben­e­fit­ing enough from bur­den­some gov­ern­ment. They might have valid griev­ances, but not ones that can be ad­dressed by in­come tax rate re­duc­tions for in­di­vid­u­als. Pay­roll tax re­duc­tions would be an­other mat­ter.

And all in­di­vid­ual earn­ers will ben­e­fit to some ex­tent from cut­ting the cor­po­rate rate from 35 per­cent to 20 per­cent. The in­ci­dence of cor­po­rate tax­a­tion — who ac­tu­ally pays it — is fiercely de­bated by economists, a re­mark­ably cock­sure co­hort with strik­ingly di­ver­gent views about the de­gree to which cor­po­rate tax­a­tion de­presses the wages of the cor­po­ra­tions’ work­ers, cur­tails share­hold­ers’ div­i­dends, and is passed on to con­sumers in the costs of cor­po­ra­tions’ prod­ucts. Suf­fice it to say that cor­po­ra­tions do not pay taxes, they col­lect taxes. Un­cer­tainty about the in­ci­dence of cor­po­rate tax­a­tion is one rea­son the Repub­li­can bill’s cor­po­rate tax rate is 20 points too high.

This year’s best tax bill, which Rep. Bob Good­latte, R-Va., has in­tro­duced six times since 2006, is four pages long and con­tains fewer words (411) than the new Repub­li­can bill has pages. It could be ti­tled “The ‘What You Wished For, Mitch Daniels’ Act.” It is ti­tled, with al­most un­prece­dented ac­cu­racy, the “Tax Code Ter­mi­na­tion Act.” It would nul­lify the ex­ist­ing 4 mil­lion-word code as of Dec. 31, 2021, and re­quire that by July 4 of that year it must be re­placed by a new one, which would nec­es­sar­ily be one de­signed on pur­pose.

George Will is a syn­di­cated colum­nist. Con­tact him at georgewill@wash­

www.ce­cil­ Serv­ing Ce­cil County since 1841 Phone 410-398-3311 • Fax 410-398-4044

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