Radio Times; Rendell Health Plan and Child Discipline

Today at noon, right here on WHYY 91 FM. You're listening to WHYY FM Philadelphia, your member, support and news and information station, serving Pennsylvania, New Jersey and Delaware. Good morning. It's 9.59. On Monday morning, I'm Brenda Jarette. We hope you enjoyed BBC NewsHour and Morning Edition today. It's Radio Times after the news. The Franklin Institute forecast a little bit of snow to sweep off the steps, otherwise clouds and 38 today. Cloudy breezy 28 tonight, sunshine and clouds breezy 38 for Tuesday. On Independence Mall this morning, 28 degrees, it's 10 o'clock. From WHYY in Philadelphia, this is Radio Time, Somardimas, Coane. Last week, Pennsylvania Governor Ed Rendell called for an overhaul of the healthcare system, including coverage for the uninsured, improved quality of care and access, and steps to reign in the rising costs of healthcare in the state.

The response so far has been muted, with many waiting for more information about the cost of reforming the system. Coming up on Radio Times, we get three reaction to Rendell's prescription for Pennsylvania. Alyssa Halburn is with the Pennsylvania Health Law Project. Carolyn Scanlon heads up the Hospital and Health System Association of Pennsylvania. King Hansen-Tertan is CEO of the National Nursing Centers Consortium. Stay with WHYY in Philadelphia, first news from National Public Radio. From NPR News in Washington, I'm Carl Castle. In Iraq, 75 people have been killed and another 110 injured in nearly simultaneous bomb attacks in Central Baghdad. In Pierce, Diana Douglas reports from Baghdad. The first bomb was left in a bag, among the stalls of vendors selling DVDs and second-hand clothes in the Babel Sharky area of Central Baghdad.

It's a predominantly Shiite commercial area. The explosion from that bomb was followed almost immediately by a blast from a parked car a few feet away. The explosion rattled windows across the city. This is the second spectacular bombing attack against Shiites in less than a week. Multiple bombs at a university here last Tuesday killed and wounded hundreds of people as classes let out for the day. The U.S. military is beginning a new campaign to take Baghdad back from such sectarian violence. They announced yesterday that 3,200 troops from the 82nd Airborne Division have joined the other American forces fighting here already. Diana Douglas and P.R. News Baghdad. President Bush spent the weekend at the presidential retreat at Camp David Maryland. Today he returns to Washington to finish preparing for his state of the Union message tomorrow night. The president has previewed some of his speech and an interview with USA Today. He told the newspaper that he will warn Americans that what happens in a rock matters to national

security at home. The president also says the war on terror will be a problem for his successors. AIDS say the president's address to a Congress controlled by Democrats will again defend the Iraq troop build-up plan and also will emphasize ways he and Democrats can work together. A meeting between Palestinian leader Mahmoud Abbas and Hamas leader Khalid Mashal in Damascus has failed to reach agreement on a Palestinian unity government. In P.R. Linda Grantstein has a report from Jerusalem. After three hours of talks, the two men agreed to continue negotiations on forming a Palestinian unity government and to focus on ending factional fighting between Abbas's Feta and the ruling Hamas. The meeting originally scheduled for Saturday was postponed after the two sides had serious differences over a unity government. Syrian officials pushed hard for the meeting the first between Abbas and Mashal in two years. After where Abbas told reporters the talks had been fruitful and that dialogue on a unity

government will continue. Palestinians hope such a government will lead to a lifting of the international aid embargo that has crippled the Palestinian economy. Linda Grantstein and P.R. News, Jerusalem. Prices are lower in early trading on Wall Street. At this hour, the Dow Jones industrial averages down 33 points to 12,530, trading amounts to 303 million shares. The NASDAQ is down 8 points to 2442. This is NPR News. The NPR shop invites you to shake off the winter blues with music featured on NPR programs. I heard it on NPR CDs are at npr.org slash shop. 28 degrees as we head to 38 in cloudy. It's 10.04. Good morning. I'm Brenda Jurrat, W-H-Y-Y News. New Jersey lawmakers are back in action in Trenton today. Democrats are trying to advance property tax reform proposals. They'll consider revamped measures to bring more oversight to government spending and produce taxpayer-paid benefits for elected officials.

Minority Republicans contend the revised legislation weekends the six-month bid to cut the state's highest in the nation property taxes. Also, today, a state senator introduces a measure that would ban parents from smoking in the cars if their children are riding with them. W-H-Y-Y Eugene Saun reports. This all started when Senator Ray Lesniak was waiting at a stoplight. Notice that the mother in the car next to him was smoking away with the windows closed and two children in the back seat. The Union County Democrat says that's child abuse. We don't allow parents to punch their kids in their mouth and break their drawers or throw them down the stairs and break their legs. Well, the smoke that's going into their lungs causes not only cancer, but asthma and in children even spinal disorders. This is a serious offense. Lesniak says he has no plans to outlaw parents smoking near kids at home, but he says the enclosed space of a car is a different matter. If passed, those comp would face fines of up to $500 and up to 30 days in jail. Lesniak says he thinks the bill has a good chance of passing.

Two years ago, another lawmaker tried to ban all smoking while driving. That bill never got a hearing. In Trenton, I'm Eugene Saun, W-H-Y-Y News. A Johns Hopkins education study indicates the Philadelphia school district's plan to phase out failing middle schools in favor of K-8 schools is not working in improving student achievement. School's chief Paul Balles disagrees. You look at our test scores at the middle grade level and you look at the serious incident reports and you look at attendance. I mean, the numbers are very positive. You know, the numbers really support the conversion. Balles says there are no plans to phase out middle schools where students are performing well. Ten failing middle schools are scheduled to be shut down in the school district in the next three years. The Franklin Institute forecast the worst of that win-tree mix is out of here with cloudy skies, 38 today, breezy 28 tonight, sunshine and clouds breezy and heading to 38 for Tuesday. On Independence Mall, 28 degrees, it's 1006. Good morning, I'm Marty Moss, Cohen. Welcome to Radio Times.

Pennsylvania Governor Ed Rendell announced an ambitious plan to reform health care last week that he said would make health care more affordable and more accessible. Called prescription for Pennsylvania, he said it would improve health care for state residents while controlling costs. Rendell said that problems and weaknesses in the current system cost of state and estimated $7.6 billion a year. That includes the cost of caring for the uninsured. Hospital acquired infections, which result in longer and expensive hospital stays. Medical errors and inadequate care for people with chronic diseases. Today on the show, we get reaction to the plan as it would affect the uninsured hospitals and nurse practitioners. It's estimated that 767,000 adults in Pennsylvania do not have health insurance. Joining us in this first portion of Radio Times is Alyssa Halprim. She's managing attorney for the Pennsylvania Health Law Project. That's a nonprofit that advocates for health access to low income consumers, the elderly and people with disabilities.

Alyssa Halprim, nice to have you with us on Radio Times. Good morning. Good morning, Marty. Thanks for having me. You're very welcome. Before we get your reaction to this plan as it applies to the uninsured, help our listeners understand who in the state makes up the 767,000 uninsured adults. The data released by the insurance department through a study that they contracted with a group of consultants to complete about a year and a half ago shows that about 71 percent of these 767,000 adults or about 544,000 or so are actually low wage workers. They are employed, but they are employed by employers who either do not provide health insurance or they provide health insurance that simply cannot be afforded with the cost sharing that is imposed on the employee. And then the others are individuals who are either self-employed or unemployed, including many college students, I guess, as Governor Ralph Randall pointed out to us. Now there's something like 130,000 children in the state also uninsured.

Right, those are in addition to the 767,000 adults. And they will be insured through the new Cover All Kids Initiative, which was passed back in the end of 2006. So what was your initial response then to this plan outlined by Governor Randall? I think it is, as you stated earlier, really ambitious and I think it's optimistically ambitious. I think that it kind of tackles sort of instead of taking a bucket and pulling a little bit of water out of the sinking ship. It does try to plug all the various holes and I think that's part of why the reception thus far across the Commonwealth has been pretty warm to this because it really does take on a lot of pieces, at least, thus far with what's been announced, that it's hard to object to reducing hospital acquired infections. It's hard to object to better managing people's chronic conditions and improving wellness education in schools. So I think overall, thus far, you know, the impression is that

it's really ambitious. It's not quite clear what all the details are, how it'll play out, how it will be accomplished when you get down to the nuts and bolts. But there's great promise here, certainly for our clients. Well, and part of this plan outlined, the governor said that the cost for the uninsured for the state of Pennsylvania is $1.4 billion. Can you explain why that cost so much? Sure, there's a significant amount of money that goes to hospitals to pay for emergency care that they provide to the uninsured. And, you know, studies show that people without insurance are, you know, extremely likely to forego, you know, sort of intermediate level care. They don't get preventative care. They don't go to the doctor, you know, they don't pay out of pocket because they can't afford to, you know, when something just kind of doesn't feel right, you know, usually they wait until they've significantly deteriorated and they need the most costly level of care, you know, and the emergency room is designed to provide sort of emergency care and it tends to be the most costly level of care.

So, you know, the cost of that is spread over increased premiums, you know, paid for by individuals and employers who already provide insurance and it's doled out to hospitals through disproportionate share payments as part of Medicaid. There is also some of the tobacco settlement act from several years back that includes additional payments for uninsured that are being cared for in the hospital. Some are being written off by the hospitals of charity care, but it is the most expensive care that the uninsured end up obtaining if and when they do end up obtaining care. Now, this proposal of the governor's, the prescription for Pennsylvania, does outline a plan to get these uninsured who are working access to health insurance. Explain to us as you see how this would work. Well, essentially what it does is it says for the low wage workers, the state is going to subsidize through a mixture of methods, low cost insurance. The employer of employees, I guess

under 50 employees would be able to purchase at a cost of $130 per month, per employee, low cost insurance, the employee would pay a sliding scale premium depending on their income up to 300 percent of a federal poverty level and the amount that they would pay would max out at $70 a month, you know, to pay for the insurance being provided. Largely, it's going to be required to be provided by the Blue Cross insurers under their charitable social mission obligations, under state law. It will also be available through other insurers who choose to offer it and are approved, I guess, by the state to offer it. But what it does is it provides somewhat of a basic benefit, although a better benefit than is already available to low income employed adults through the state's existing adult basic program, including prescription drug and some behavioral health coverage, which we don't

already have. So it offers a better benefit, it offers it to more people, people who are un, whose incomes are still, you know, at a point where they can't afford to purchase their own insurance, will be able to actually purchase the cap plan that cover all Pennsylvanians plan at cost if their income does exceed the 300% of the federal poverty level. And by most estimates that is about $280 a month is what we're told, which is less than if they were to purchase the existing and basic coverage, for example. So $280 a month for someone over 300% of the federal poverty level still sounds like might sound like a lot, but it still is less than most of the private insurance offering available on the market that we're aware of. And from a, I guess, a low income point of view, do you see that then as affordable health care for someone that's making maybe minimum wage or just above minimum wage? Absolutely. We have, you know, an existing program that I

reference the adult basic program, but it has had a huge waiting lift, and it doesn't go as high in terms of income and eligibility, and doesn't offer as rich a benefit package. Not that this is going to be a rich benefit package, but, you know, some of the glaring holes have been the lack of prescription drug coverage and behavioral health, you know, mental health coverage in the adult basic program. So this is, you know, sort of a more comprehensive basic program that is going to be affordable and available to people who have thus far simply been priced out of purchasing insurance. I mean, again, the majority of them are people who work, but simply cannot afford to eke out the cost of the rising premium insurance out there on the market right now. And it does put some pressure then on these businesses to offer affordable insurance to their employees? Absolutely. And I think that is, you know, a large part of this goal is to really, you know, sort of try to overhaul the whole system. The, you know, Governor Rendell has stated repeatedly

that part of his goal is to reduce premiums for everybody. It's also to incentivize businesses to provide this. And I guess, you know, part of the way he's discussed structuring the funding mechanism for the cover all Pennsylvanians, you know, does include an incentive for employers to buy into it, as opposed to paying a fair share assessment, you know, for the program without actually buying into it. And it might be too early to begin predicting whether this is going to pass or not, but from what you know about the legislature and also from what you know about the response so far, especially from the business community, do you have some degree of optimism that this piece of this plan will pass? I think, you know, the strategy of releasing all these pieces all at the same time, it was, it was really interesting when you think about it because, you know, Governor Rendell announced it is requiring some 47 different pieces of legislation plus some, you know, regulations, but thus far the response has really been, you know, warmer than I, than some might have expected,

because there really are a lot of good pieces here, and it's hard to argue with some of these initiatives, no matter what side of, you know, the fence you sit on, you know, as a provider or an advocate or just a consumer. So, you know, I don't have a crystal ball. Right, of course. But, you know, it certainly would be a fabulous thing if Pennsylvania could pull the majority of this off if not all of it. And it is interesting that it states that seem to be making the, taking the steps to try to figure out how to ensure the uninsured of thinking of California, Massachusetts. Does that surprise you? No, not recently because, you know, the federal government has, you know, simply been silent on this and refused to take any action to, to, to, to bring about changes that have been needed. You know, it was interesting over the weekend. I did notice that the President Bush is about to announce some tax deductions for people to help the uninsured. I'll be interested to see what that actually amounts to, but that,

you know, that, that nowhere begins to get at the immensity and enormity of this problem. And are there, included in the uninsured in Pennsylvania, people that just literally choose not to be insured? They don't want to be insured, no matter how affordable the insurance is, they don't want it. You know, those aren't the people that we see. What we see are the people, you know, who come to us, you know, either in a good faith effort to get insurance before they have a problem and simply cannot find something, you know, or the people who are in a crisis. And they need, you know, they go to the hospital, they're told they have, you know, cancer, maybe they were in the ER and they had an emergency procedure. But, you know, emergency room coverage doesn't include the ongoing chemotherapy that they would need to, you know, pretty much recover fully. You know, these pieces are, you know, people who, I mean, we see people who have just been approved for Social Security Disability. And there's this, you know, gaffly 24-month wait before your Medicare kicks in.

And we've seen so many people suffering through those times. They have permanent disabilities. Their income is just above Medicaid limits and they, they can't afford or they have pre-existing conditions that exclude them from purchasing and getting coverage for their condition. So, I mean, this will help so many people if this does proceed. And, you know, we don't see the people who intentionally choose not to have coverage, not here. And final question before we have to say goodbye. But do you see this as kind of a piecemeal solution to a national problem? And some have called for, you know, a single payer system that if we had that across the country, this would solve a lot of the problems that these states are trying to figure out how to solve. I think, you know, I agree that many people do believe that that is possible, you know, to solve this problem. And I think that, you know, in light of the fact that my work is here in Pennsylvania, this is, this is really go very far towards getting us close to where we need to be. And, you know, unless this Congress can focus itself on the health insurance crisis.

And I'm not sure whether it will. I did see that, you know, AARP and some other national organizations called on Congress to make dealing with the uninsured, a priority, and doing such things actually very similar to some of the things that Governor Vendel has proposed. I was found that interesting. But, you know, for Pennsylvania, this seems like a fabulous comprehensive first step if it can all go through. And if, you know, the details are not ones that include any injury. And of course, we don't know what the details are. But, um, I hope I've answered your question. You certainly did and I appreciate you caught joining us today in radio times. Thanks a lot, Alyssa Halperin. Thanks so much for your welcome. And she's managing attorney for the Pennsylvania Health Law Project of the first of three guests in this hour of radio times. As we get reaction to Governor Randell's prescription for Pennsylvania, coming up will get a response from hospitals. Stay with us. We'll be right back. The University of Pennsylvania supports WHY. Have you been treated for bipolar disorder, or experienced a manic or mixed episode within the last three months? If so, you may be eligible

to participate in Penn's clinical study of an investigational medication for bipolar disorder. To learn more, 215-573-8582, eligible participants may receive study-related medication, lab work, and evaluations. 215-573-8582. Next time on day-to-day. High schoolers are shocked when they open this book. There's so much more to it than a book and a yuck. The better battle book is a fabulous civics lesson. I wish I could take Congress and send them Dr. Seuss. Teaching kids to compromise. How should you guide? Don't miss NPR series crossing the divide. Next time on day-to-day. This afternoon at one on WHYY. Forgiveness is often discussed in a religious context, but lately scientists are paying a lot of attention to the concept of forgiving. Psychologists argue that it helps people heal

and can reduce anxiety and depression. On the next voices in the family, Dan Gottlieb and his guests will discuss forgiveness, how it is defined, what it means, and how it affects people's mental health. Today at noon, right here on WHYY, 91 of them. This is Radio Times here on WHYY in Philadelphia. I'm Marty Moskoane and today on the show, we're getting reaction to Governor Ed Rendell's prescription for Pennsylvania, a program outlined and unveiled last week aimed at expanding access to affordable healthcare coverage, improving quality of healthcare and getting healthcare costs under control for employers and for employees. One part of this initiative focuses on patient safety on eliminating hospital acquired infections and targeting medical errors. And here with us to talk about this portion of this prescription for Pennsylvania is Carolyn Scanlon. She's president and CEO of the Hospital and Health System Association of Pennsylvania. That's a statewide membership services organization

that advocates for the nearly 250 Pennsylvania hospitals as well as for patients and communities, Carolyn Scanlon. Nice to have you with us on Radio Times. Good morning. Good to be with you. And to our listeners, lines open at 1-888-477-9499. That's 1-888-477-WHY. Do you share the governor's concerns about the level of hospital acquired infections in Pennsylvania? Hospitals have targeted and actually have set a goal eliminating all hospital acquired infections as well as errors and complications. And there are major projects around the state on such issues. In your part of the state in the southeastern part of Pennsylvania, there is a partnership, partnership for quality with Independence Blue Cross to address just that, reducing and eliminating infections. This is a difficult issue. It is as a result of antibiotic resistant germs. We all hear about those all the time. It's as a result of individuals who have otherwise

compromised healthcare status coming into the hospital, perhaps even carrying those germs with them. And so hospitals are vigilant, have staff, infection control, practitioners, nurses and physicians always focused on this issue. So do you think the governor was singling this out unfairly or is helping to ensure that these initial hospital initiatives get carried forward? Well, you know, I wouldn't say unfairly. The core of what he announced last week was covering Pennsylvania's who are currently not insured. And as I think your first guest talked about, that is probably the core of the entire prescription for Pennsylvania and one that hospitals have been calling for and support pretty strongly. There are other pieces to the proposal, such as the one we're talking about, that the governor's proposed that I would call tangential to the core

issue. And clearly, we all need to focus on quality and patient safety. But I think the core of the healthcare reform is and should continue to be covering me on insured. One of the things that the governor talked about last week when he unveiled this was the overuse of the emergency rooms in Pennsylvania and actually a much higher use of emergency rooms in Pennsylvania. Help us understand and is that tied to the uninsured and their and their misuse of the system? I think it's in part tied to the uninsured who generally don't have a family physician that they can call or go to when they have a problem other than seeking out what we would consider to be the emergency department, which is the safety net. If you have no other place to go to, the emergency department is always there for you. And for that, the hospitals provide themselves in being the safety net. The other I think is that we have a growing pockets of shortages of physicians. We've talked about that in the context of liability reform

and concerns about certain kinds of physicians being available. When they're not readily available, an individual will again use the emergency department when they don't have access to those physicians. And so I think in part those contribute to the use of the emergency department. In part, there is a need to educate individuals that if they do have a family physician, please use that family physician first before going to the emergency department. Of course, if somebody is having a acute problem or has been in a car accident or another kind of trauma, they should always go to the emergency department. And we want to make sure that people understand that that's why the emergency department is there. I'd be curious then your reaction to the governor calling for greater use of nurse practitioners to provide some of that basic care in a system where there are pockets of shortage of doctor shortages. We support that whole heartedly and we would want nurse practitioners, physicians, assistants, other physician extenders,

midwives and others to be able to practice to the scope of their practice as detailed in our state licensure statutes. And over half of the hospitals in the state are currently trying to do what the governor called for in sort of a fast track in the emergency department. But just as there are shortages of physicians, there are shortages of nurses and nurse practitioners. And so we think that the other part of the plan that was proposed which is helping to support individuals go to nursing school or other kinds of healthcare professional schools is a very helpful one. There we've been talking about an overall workforce shortage and in particular a pretty acute one in nursing for several years. And so linking that workforce incentive, scholarships, loan forgiveness along with this sort of expanded use of those individuals I think is very helpful. Do you think Pennsylvania has a worse shortage, healthcare shortage, healthcare provider

shortage than other states where this is a national problem? It is a national problem. We have it depending upon where you are in the state, pockets of probably more extreme shortages. I think on the physician side we may have a higher than national average on shortages. And on the nursing side we've made some pretty remarkable strides in getting our nursing schools totally full trying to expand their capacities, working with the Pennsylvania Higher Education Foundation on scholarships, loan forgiveness, both for entry nurses, for nurse educators and for nursing schools. And that's Carolyn Scanlon. She's the president and CEO of the hospital and health system association of Pennsylvania. And we called her up to get her reaction to Governor Ed Rendell's prescription for Pennsylvania, which he unveiled last week. It's an ambitious and complicated program, especially to the uninitiated, uninitiated, but it's aimed at expanding

access to affordable healthcare in the state. And that would be through affordable healthcare coverage for the uninsured, improving quality of care, access of care, and getting healthcare costs under control. Lines open at 1-888-477-9499. That's 1-888-477-WHY. The governor also talked about medical errors in the cost of re-hospitalization because of medical errors. Again, you share his concern about that aspect of the healthcare system. We are always striving to deliver care in the best possible way. And as there are many regulatory agencies, the patient safety authority, the Pennsylvania Department of Health, the healthcare cost containment council, that are collecting and providing information back to hospitals. In particular, the patient safety authority looks for trends and issues around complications or errors that help hospitals understand when two different kinds of drugs come in similar

packaging, but do very different kinds of things, have to treat them and store them and use them. A whole series of information that on a one-on-one basis in a hospital may not look like a trend or an issue, but when captured by the patient safety authority, have become quite helpful and they put out quarterly advisories to clinicians and to hospitals on what they are seeing and ways to try to prevent that. And so from that vantage point, increased support of that kind of work, I think, is very helpful. The governor's plan, as we talked about, deals with the coverage, deals with quality, and deals with what I would call wellness. And there are some remarkably solid pieces like banning smoking in all public places. We would support that and look forward to a timeline. Pennsylvania is a smoke-free state.

The same issues around dealing with chronic disease, wellness around the children and school age programs on nutrition and other such activities. This is a plan that is so far reaching in what it deals with healthcare. That we need to be able to examine all the pieces and understand how they all fit together. And do you see them all fitting together and then we'll get to our callers? Well, you know, there are some pieces that could be standalone, like the coverage piece. And as the governor has indicated on all of his public conversations around this, the financing really becomes critical for how that coverage piece works and we're likely to see that unveiled as part of his budget during the first week of February. There are pieces that are clearly standalone. I mean, you could do nothing else and still ban smoking in this state. Clearly, hospitals are committed to working on quality and patient safety. That's been ongoing.

We'll continue, regardless of what happens with the governor's plan. And then there are a series of other pieces around how insurance is sold in this state, particularly how premiums are developed using different kinds of rating systems and a community rating system as the governor's proposed. I think would be a good thing to do again. That could be done singly or as part of an overall plan. But again, I think there's a lot more detail that we all need to understand in his proposal, understand how it all gets financed, how understanding all the new mandates on hospitals get paid for, understanding how Medicaid, which is the current state payer for state-supported patients gets paid. And so again, a whole bunch of sort of questions. I'm sure the legislature will be holding hearings over the next several months around this and we are open for that kind

of conversation and look forward to it. Well, let me get some callers in on our conversation. Line's open at 1-888-477-9499. We've got John from Cinnamonson joining us. John, go ahead, your radio times. Good morning. I'm a mechanical contractor and I do a lot of work in the hospital system in Philadelphia. And I've seen many conditions that make me believe that a lot of the infections that patients get, they get them from the hospital from HFAC systems that aren't properly maintained, refrigeration equipment, which is not clean. And also, I see many of the people that work in the food service area that are not using hand gloves, they're not wiping things up and seeing these things make me believe that I think the hospitals do have a serious issue there that they're really not addressing. John, I appreciate you calling it a radio time. Let me get a response from Carolyn Scanlon and that's an anecdotal response from John, but he

says from his observations in hospitals, he sees the problem right in front of his eyes. Well, you know, interestingly, he identified himself as a mechanical engineer and so what he would also know is that the physical buildings that the hospitals have are old and there are times where hospitals are trying to update those. And as part of those updating are the basic systems that the caller talked about, the heating and ventilation system or the refrigeration systems. Clearly, we need to have the ability to do the capital investment in those physical plans to continue to update them. You know, there was a time where most hospitals were built where there were two patients to a room. The latest thinking on controlling infections is that every room should be a single room that no patient should share a room with anyone else. Well, in order to make that kind of progress and progression, we're going to have to do a significant amount of rebuilding of our hospitals. And that kind of capital, both dollars and effort, is a big issue that

we're going to need to address as part of this conversation. But certainly, people have to wash their hands if they work on a hospital. They absolutely should. We tell patients, we have a website called careforpa.org where we have information on that on what patients of the people that they see, like the caregivers coming into their room, what they should be saying to those patients, to those caregivers. Have you washed your hands before you come in? Have you washed your hands after you've done a procedure on me before you do the next one? Why are you here? And what are you doing to me and for me? I would advise people who are in cafeterias or watching the food service handlers to be asking those same kinds of questions. And hospitals have those same kind of campaigns and goals with their workers to try to get them to do basic hygiene and basic cleanliness. Let me, John, thanks for the question or the comment. Let me get Hugh from

Artmore to join us this morning on radio times. Hi, Hugh, go ahead. Thank you. You're welcome. I was wondering to make an example of my position regarding the advanced practice nurse. I'm a clinical nurse specialist in psychiatry. I was educated in Pennsylvania at the University of Pennsylvania and living in Pennsylvania. But in order to work in advanced practice nurse, I have to drive over a new jersey every day. Because you can't work in Pennsylvania, you mean? Yeah, I can work in Pennsylvania as a registered nurse. A foreign nurse, but I can't work as an advanced practice nurse in New Jersey. I can prescribe medications. I can diagnose psychiatric illness. I can order labs. I'm on hospital staff at several hospitals and nursing homes. And you know, I treat a lot of poor people in New Jersey. And this is just a resource that goes to waste. Well, and it's interesting that you call because our third guest can speak very directly to that. But let me just get a response from Carolyn Scalen. And you were talking earlier, Carolyn, about empowering practitioners so that they can provide the kind of care that

Pennsylvania needs need. We really want to, you know, it sounds like the individual who just called has a skill and an ability that is going to waste by not that New Jersey isn't just as worthy, but we'd like to keep our residents in the state delivering care. Part of the issue is they can sure that our advanced practice nurses can do that if they're in practice according to their licensure. But also, there are regulations that the Department of Health has in regard to hospitals, nursing homes, and other entities that are 20 years old and they preclude these advanced trained and educated individuals from doing the kind of work that they can do within our facilities. And so we wholeheartedly supporting, supporting bringing them up to date, bringing them into the 21st century. So such individuals as you can do the practice that he has been trained to do. And we only have a minute or so before we have to say goodbye. Do you imagine that you're going

to spend the next six months in Harrisburg? Well, I imagine that we're going to spend a lot of time talking with the governor, with his secretary, with the office of healthcare reform, led by Rosemary Greco, and with the legislature on hearing. This is a very ambitious and aggressive timetable that the governor is pressing for on this. And we would welcome that conversation. And I think the next six months will be pretty busy. And do you think there are the kinds of savings that the governor has talked about? I certainly talked about the $7.6 billion in excess cost, but do you think there are real savings in the system, especially such an expensive system, complicated one? It's unclear. It's unclear where those estimates come from and what they're based on. Are they based on a patient's entire stay so that a transplant patient that has developed an infection? Are we talking about that patient's entire care or just the piece associated with the infection? And I'm not quite sure how you carve out the dollar amount just associated with the

infection. So we really have a lot of conversation on just the details and the facts to go through over the six months. And I think that there will be a significant amount of work in Africa going on here in Harrisburg. Well, much more to talk about. Thank you, Carolyn Scalen. Thank you. And I look forward to further conversations as you try to educate your listening public. Thanks a lot. And she's president and CEO of the Hospital and Health System Association of Pennsylvania. The second of three guests giving us their reaction to Governor Ed Rendell's prescription for Pennsylvania, a plan outlined last week to control the cost of health care in this country to improve the quality of health care and improve access as well. We'll be talking about nurse practitioners after this short break. Stay with us 1-888-477-9499. We'll be right back. The Penn State Smeal College of Business Executive MBA Program in Philadelphia supports WHOIY. Classes with experienced professionals taught by professors from Penn State's University

Park campus begin in August and are held on alternate weekends across 21 months. The Smeal Executive MBA offers executive coaching, communications training, and coursework focused on your firm. To learn more and for a schedule of Smeal informational sessions, psu1.org or 1-866-999-EMBA. Some communities have banned so-called dangerous dogs like rotwilers and pit bulls from living there. Other cities and towns around the country have put a cap on the number of pets you can have and one Connecticut cat was placed under house arrest for attacking the neighbors. Breed bans, pet laws, and whether the law should treat phyto like a person or property this week on Justice Talking. Tonight at 10 on WHOIY. On the next fresh air actress Maggie Gyllenhaal, her films include Secretary, Happy Endings, World Trade Center, and Stranger than Fiction. She was nominated for a Golden Globe for her role in the independent film Sherry Baby coming out soon on DVD. Join us for the next fresh air.

This afternoon at 3 and again tonight at 7 here on WHOIY. 91 FM. This is Radio Times here on WHOIY in Philadelphia. I'm Marty Mascoeane. Last week Pennsylvania Governor Ed Rendell called for an overhaul of the healthcare system, including coverage for the uninsured, improved quality of care and access, and steps to reign in the rising cost of healthcare in the state of Pennsylvania. We're getting three reactions to Rendell's prescription for Pennsylvania, and joining us now as I scramble here and find my other piece of paper is Teen Hansen Tertan, CEO of the National Nursing Centers Consortium Vice President for Philadelphia Health Management Corps. A nursing center is a health center located in an underserved area, and in many ways provides some of the same function as primary care providers, and focusing on primary care and disease prevention, and nice to have you with us in Radio Times.

Good morning. Good morning Marty. How you doing? I'm doing very well. Let me just quote something from this proposal from last week, and part of the proposal calls on essentially empowering people like nurses, dental hygienists, and other licensed care providers to practice to the fullest extent of their education and training. What does that mean to nurse practitioners? Well, it means that for our perspective, this plan goes further to just to cover to provide health insurance coverage for close to 800,000 people in Pennsylvania, which is very important, but the next step is really to look at how do we utilize the full healthcare team that's available in Pennsylvania? That includes certainly advanced practice nurses and nurse practitioners. That means for us getting rid of regulations or changing or outdated regulations and outdated policies that really need to replace often what's called physician-only language that has been there since the 1950s with the current language, which is qualified licensed healthcare practitioners that can provide

the types of services that the plan calls for as well as how we operate now in healthcare is a whole team, which includes physicians, nurses, nurse practitioners, physician assistants, you had a clinical nurse specialist call in, and other non-physician providers, we need the full team to really to make a difference in Pennsylvania. You have a piece in today's Philadelphia Daily News and Op-Ed where you talk about the, and I'm quoting here, arbitrary practice, reimbursement, and regulatory barriers to enabling nurse practitioners to provide and offer, I guess, the care that they're trained to do. That's right. One of the challenges we've seen, we've done studies over the last few years, we know in Pennsylvania and nationally that, for example, health insurance companies will only, only 40% of them in both the state and the federal level will support nurse practitioners as primary care providers, despite the fact that both state governments like Pennsylvania have said that nurse practitioners are primary care providers and that nurse practitioners can prescribe medications in all 50 states. One of the things that this plan will do is really

asks insurance companies to say credential and contract with these nurse practitioners to provide care so we can utilize them in our role in urban areas where they may be assured it's a family physician or where nurse practitioners currently are providing care or can't get reimbursed for it. But you also write in this piece and I mean, I think we all know from certain kind of experience that nurse practitioners are already providing a lot of care to Pennsylvania. That's right. We have over 6,000 nurse practitioners that are right now providing care and nurse management health centers around the state as well as in physicians offices and hospitals and in private settings. So they're there, but the challenge is that they're all facing is that the reality of keeping their businesses alive, which means that they want to be sustainable and that can get paid for the services they're already providing. And that's a challenge. And in addition, we also know one of the pieces of the plan is really to focus on both regulations and outdated policies that need really to focus on who can provide certain types of care and what forms can nurse practitioners for

example sign. And that's a very important piece because if you're a primary care provider in Pennsylvania and as service and nurse practitioners right now, for example, you can't sign methadone treatment forms and evaluations. You can't necessarily, you know, refer to psychiatric and psychological evaluations. You can't provide medical assessments that preclude utility shot off and which is a really a challenge if you are in a nurse practitioner and a nurse man's health and are and tend to provide care for more of the underserved. And you can't sign forms for them to prevent the pico and others to turn off their gas when it's cold outside. Other forms that they can't sign for example is homeschooling certifications, physical from municipal police officers, as well as temporary, temporarily disability assistance forms. All things that, you know, obviously, you know, if your primary care provider are the types of forms and the types of services you want to provide to your patient as a primary care provider. And then do you want to get some collagen in the conversation? A couple of follow-up questions here, though. Do you anticipate

resistance from physicians who might see this as a territorial issue? Well, I think, and the reality is that we are in Pennsylvania and that was what, you know, the governor's plan will talk about. We live with some very outdated, you know, regulations and policies that have not been changed since the 1950s. So I think actually the physician community because a lot of nurse practitioners work alongside with physicians and in their offices will welcome some of these changes because it's time has come. And we have a well, excuse me, 141,000 nurse practitioners around the country that are working, you know, in primary care teams with physicians and, you know, the physician community in hospital. So I think, really, this is, you know, a time that's come and really what the plan tries to do is utilize the full healthcare team, you know, and utilize available providers that are willing to provide care to people that are insured and on insured. With more responsibility, would come higher, though, malpractice insurance, I'm assuming? That's, I mean, we haven't seen that yet. We certainly have tracked that from the National Nursing Center's consortium perspective. We haven't seen increases in malpractice yet,

despite the fact that we have 141,000 nurse practitioners out there practicing, you know, primary care. But obviously that is there. Certainly, you know, we will think there will be somewhat of an increase. But I think one of the important things about the difference in care with nurse practitioners more so that other providers is that the due tends to spend more time in the primary care setting, educating, and working with the patient to really around chronic disease management, you know, working with them to really educate them about, you know, asthma and the diagnosis and the chronic diseases that may impact, you know, them taking better healthcare, better care of themselves and obviously empowering them to be better healthcare consumers. When you talk about underserved areas in Pennsylvania, is it both rural and urban areas? It's both rural and urban and it's defined really by the federal government, but it's where there are shortages often of physicians or other primary care providers. So correct. And that's a teen Hanson Tertan. She's CEO of the National Nursing Center's consortium, also Vice President for the Philadelphia Health Management Corp. And we invited her to join us

this morning or radio time to give her reaction to the governor's prescription for Pennsylvania outlined last week by Pennsylvania Governor Ed Randell. And part of this initiative is to empower nurse practitioners and others within the healthcare system to provide more service, more direct service to patients. Lines open at 1-888-477-9499. That's 1-888-477-WHY. Why questions, reactions, comments, do give us a call. We have an anonymous caller. Go ahead, your radio times. Yes, I'm a physician in Chester County. And speaking of the issue of physician extenders, I think we have to acknowledge that there are market forces that have created opportunities for more physician extenders in our county and in our state. The cost per capita, for the healthcare cost per capita, have increased over the last decade,

as have the number of physician extenders out there providing care to patients. The byproduct of this is that we now realize that there's a role for a greater role for physician extenders in delivering lower cost healthcare to patients. However, it is important to acknowledge that the very reason that this has occurred is because of the problem with the way that insurance and managed care has gotten between physicians and their patients and increased the cost for delivering care to patients. If we just focus on the issues that the governor has raised and decided to pay attention to, and we don't come up with some solutions on how to reduce or how to regulate the products that are available from the insurers in the state and come up with lower cost alternative perhaps in the form of HSAs, etc. We're not really going to get at solving the issue. And then the other thing that the

governor doesn't talk about is the issue of liability reform. Let me just call on hold on hold on hold on hold I got to pull you down because you're not I need to jump in here because I do want to get a response from our guests to our callers criticism and comments saying basically that this because of the the expensive way that healthcare is delivered and the fact that insurance companies get between patients and their physicians that this is a low cost solution to a problem but not the kind of solution that he's looking for. What's your thought about that? I mean I think it was important is really to understand when you know nurse practitioners and also physicians you know assistants came into being and that was really in the late 60s. So these are qualified providers that have been out there practicing care alongside with physicians and also independently for about 40 years. So I think we know from you know from studies that have been done nurse practitioners you know provide high quality care patients are very satisfied with the care that they're receiving from them and really studies have shown now for the last 30 years that

you know they can probably provide about 80 percent of what a typical family physician can provide but I think what's really driving also in addition to that obviously payment isn't issue for physicians but what's also driving this is a physician shortage and not seeing we saw it in the late 60s early 70s fewer family physicians going a fewer adolescents going into a family physician care and we're seeing the same thing now with you know a tremendous shortage you know we are estimating something like I think 200,000 family physicians in terms of a shortage in 2020. So I think you know one of the things that's important for I would now would sort of throw that back maybe to the caller and to all medical professionals we need to you know as a healthcare profession come together as a team and really you know work this out as well so it can always be about the money that has a big component to it as well but it's also about how providers work with one another and again I think the time has come where all providers with its physicians and nurse practitioners and other advanced practice nurses and physician assistants,

psychologists, pharmacists need to come together and say no there's a role for all of us and we really want to make sure that people have access to care. And our caller I'm sorry I had to pull you down because you just weren't hearing me trying to get in on the conversation but he also mentioned insurance companies and medical malpractice reform it's not really part of this initiative outlined last week by the governor. Right I mean I think that I mean obviously we as the nurse practitioner community and nurse management health and a community face some of the same challenges as I mentioned early on which is that only 40% of the insurance companies in the state will really contract with nurse practitioners so you know we have many of the same issues around reimbursement but part of this plan what this plan will do is you know at least try to push those insurance companies that are not you know contracting with nurse practitioners and other you know non physician providers and to make sure they can get reimbursed and that's an important piece for us as well as it is for the family physicians. Does the public does a patient want a non physician provider or is there first choice still a physician a doctor? I think you

know it's the things that change we you know we work with different clinics and the nurse management health centers that have been around for now you know 25 years you know we have you know high patient satisfaction so I think once you know a patient comes and gets exposure and and to a nurse practitioner I think they like the nurse practitioners so I think and one of the things we've seen over the last five probably five to ten years is that nurse practitioners certainly become much more visible and patients like him but obviously it's all you know you're pretty to choose what care you want but I think in general what they do like about nurse practitioners is the extra time spent with them and more of the focus I think on education and learning about you know the health conditions and we we've seen that we know for example in our nurse management health centers where we track data is that our patients come to the nurse management health centers twice as often as other types of health care providers and family physicians so they utilize the nurse management health center as their primary care home more often which yields better you know outcomes in terms of lower emergency room utilization lower hospital

station rates but obviously they are seeing that provide them off and so that indicates that indication to us that you know they're very satisfied with the care they're getting from nurse practitioners. What do other states do when it comes to you know non-physician providers? It's it's really a state-by-state issue all in 50 states and also the territories will allow nurse practitioners to prescribe medications in about half of the state's nurse practitioners are defined as primary care providers and but really it's a state-by-state issue in some states they're very independent and other states they require a closer partnership and relationship with a physician in Pennsylvania for example to prescribe medications that has to be a collaborating agreement with a physician a usually a family physician so it's really a you know each of the each of the states have different regulations and obviously that's also a challenge when you you know you operate a practice but there are some states have a more lenient compared to others and Pennsylvania is sort of the middle of the road in terms of how the you know allow

nurse practitioners to practice but really in the nurse mess you know the health centers were born out of this area because we've had so many wonderful nursing schools that have really supported the nurse practitioner and nurse matter health in the moment now for about in 25 years. And it sounds as if what existed today is is a relationship that that comes from the doctor nurse relationship and how much she or he as the nurse is empowered to do. Absolutely I mean one of the things on on your question in terms of you know you know what do people think we we also work with and community care clinics which are the newer clinics that are really opening up usually by hospitals or you know the private sector in the pharmacies and retail settings and supermarkets and we they these types of clinics tend to provide more basic health services so more of the common you know colds and rashes and ear infections for children so forth and we are seeing high utilization from really everybody because they're very accessible they're pretty much open you know in evenings and on weekends where traditionally you know a lot of us

I have a five-year-old would end up going to an emergency room with an ear infection where you can go to a nurse practitioner in one of those retail based clinics and you know be seen right there or have your child be seen right there so I think they're in general you know both from the private sector and the hospital community you know it's it's more of a push to try and get more access to both nurse practitioner and physician assistant care for you know more common illnesses well I thank you for joining us today and radio times thanks so much so much Marty you're welcome thank you you too and that's a teen Hanson Tertan CEO of the National Nursing Center's consortium also vice president for Philadelphia Health Management Corporation the third of three guests this morning as we got just initial reaction to governor Ed Rendell's prescription for Pennsylvania which was unveiled last week for more information about radio times go to whyy.org slash radio times I'm Marty Moscoa and you're listening to whyy FM Philadelphia you remember supported news and information station serving Pennsylvania New Jersey and Delaware

and this programming note I did an interview last week with governor Ed Rendell about his health care plan among other things this was in front of a live audience at the greater Philadelphia chamber of commerce that interview will be aired on radio times on TV and that's Friday night 10 o'clock February 2nd Friday night 10 o'clock February 2nd do stay with us for the second hour of radio times today we'll be talking about whether spanking should be legal or not mine's open at one eight eight four seven seven nine four nine nine and the franklin is a due forecast for today cloudy high of 38 degrees tonight cloudy breezy low of 28 Tuesday sunshine and clouds breezy high of 38 Wednesday partly sunny skies high of 41 degrees Thursday partly cloudy high of 36

and looking ahead to Friday we've got partly sunny skies windy big colder high 26 degrees President Bush concluded his state of the union address last year with these words and so we move forward optimistic about our country faithful to its cause and confident of the victories to come his confidence has not wavered but it has been tested i michelle noris join us for the state of the union address from npr news tomorrow night at nine on wh wy from wh wy in philadelphia this is radio time samardim oscoane a california state assembly woman is said she's going to introduce a bill that would make spanking a child younger than three against the law if past california would be the first date to band spanking a young child

reactions to this proposal have been swift and according to the assembly woman mostly negative a number of countries have banned spanking and 29 states banned spanking in schools coming up should spanking be illegal we'll talk with law professor tomis nazario who consulted with the california legislator on this proposed spanking ban and with child psychologist howard stevensson stay with wh wy in philadelphia first news from national public radio from npr news in washington i'm carl castle yoraki police are reporting that two nearly simultaneous bombs struck a predominantly chite commercial area in central back that today killing at least 75 people and wounding dozens of others it was the bloodiest attack since 70 were killed in a double bombing outside of bagdad university six days ago the united states

has formally proposed to pollin and the check republic building part of the missile defense system in the two former communist countries negotiations are expected to take months from briland npr is emily harris reports the u.s. has long been considering building a radar base in the check republic and an anti-missile system in poland as part of its controversial missile defense system over the weekend the check prime minister and the polish defense minister announced that the u.s. has now made formal proposals to carry out those plans prog expects the radar base could be up and running in four years public opinion surveys show check people have been wary of hosting missiles that would try to intercept an attack but are more comfortable hosting a radar station poland's defense minister said his government will look at whether being part of this u.s. defense project will increase poland security the u.s. says having a few missile interceptors and radar stations in europe could help defend against a potential attack from iran russia says it views these plans as a threat emily harris and pier news briland advocates on both

sides of the abortion debate are marking the 34th anniversary today of roe v. wade the 1970s supreme court ruling legalizing abortion nationwide in pierced julie roffner reports for the first time in a dozen years the tables are turned in washington congress is now controlled by democrats who are more sympathetic to abortion rights while the supreme court with two new members is thought to be tilting more anti abortion president bush is set to address participants in the anti abortion march for life by speakerphone the rally traditionally draws thousands of pro-life activists abortion rights advocates meanwhile are breathing a small sigh of relief this year they picked up votes in both the u.s. house and senate and defeated several anti abortion ballot measures in the states last fall both sides however are waiting for the supreme court to rule on the constitutionality of a federal law banning so-called partial birth abortion that's expected later this spring julie roffner npr news washington the supreme court has struck down california sentencing law the decision could affect thousands of california prisoners

it could mean shorter sentences for them the ruling is the latest in a series of high court decisions over the past seven years to limit judges discretion and sentencing defendants the court has held repeatedly that a judge may not increase a defendant's sentence based on factors they were not determined by a jury unwalsweet the downjones industrial averages down 99 points to twelve thousand four hundred sixty five trading amounts to eight hundred million shares the nasdaq is down twenty six points to twenty four twenty five this is npr news some new jersey war veterans are anxiously awaiting governor john koresign's action regarding a bill that would no longer require new jersey schools to teach about veterans day and memorial day ducked oil at member station w b g o in new work reports governor koresign says he'll conditionally veto parts of the measure because he says it's important that children understand the sacrifices people have made for their country some veterans have been irate since the bill was unanimously passed by the legislature last month the legislation was included as part of a larger measure

designed to help control property taxes mostly by abolishing some laws on school purchasing and public hearings state senator john adler the sponsor of the bill says he understood and respected the veterans concerns but argues curriculum not state mandate should drive instruction a conditional veto would allow governor koresign to propose amendments for npr news i dug oil in new work the senate foreign relations committee begins to baton wednesday on a resolution condemning president wishes group build up in a rock a vote could come the same day it would be the first on the war since democrats regain control of congress the resolution is non binding backers are defending it against critics who want congress to do more including a cutoff of funds the chairman of the senate armed services committee carol livin says it's still a very powerful message to the president tomorrow night the president delivers the state of the union addressed to congress and he will discuss iraq in a preview for us a today the president called on his critics to back off the president will say the best way to show the truth build up will work

is to give it a chance i'm carol castle npr news in washington support for npr comes from camels maker of v eight one hundred percent vegetable juice with three vegetable servings in every twelve ounce bottle you could have had a v eight the delaware symphony orchestra presents the dupont champagne series on Tuesday january 23rd in the gold ballroom of the dupont hotel with my strode david amato at the piano the evenings performance features the piano trio and e minor by shostakovich with champagne and or derves available at intermission for tickets one eight hundred three seven four seven two six three or online at delaware symphony dot org the delaware symphony proudly supports w-h-y-y this is radio time samarit mas koei a recent abc poll found that americans approve of spanking by a ratio of two to one and about half say they spank their own children southerners are more

supportive of spanking compared to other regions of the country so are people with less education compared to their more educated counterparts california state assembly woman sally labor has said that she's going to introduce legislation that were prohibit spanking children under the age of three she admitted that her office has been flooded with phone calls and emails mostly critical of her proposal she told the new york times i have to question why our society holds so tightly to physical discipline among the very young today and radio times should spanking be illegal and we begin our conversation with howard stevenson he's an associate professor chair of the applied psychology and human development division at the university of pennsylvania howard stevenson nice to have you back with us on radio times good morning good morning marty thank you you're very welcome so when you think of legislation to make spanking illegal is that a good a good way to go well um i don't know if it's a good way to go given my time spent with parents face to

face that trying to legislate this kind of thing from a distance doesn't get at the sort of emotional struggles that parents go through that are much more important to understand when you're actually trying to help people um not abuse their children and not go overboard with their children so i have questions about the policy i do understand the why um are one belief i have as to why you would want to legislate this is related to the the fatality rates of children under the age of four or five in our country is quite astronomical if you look at child fatalities related to abuse it's the one under four years old that are most at risk almost eighty percent of child deaths related to abuse are related to um are under four so i understand the reasoning the health risk as to as to what sort of uh promoted such a bill um i just worry about how these things get actualized and that who's spending the time with parents who have a host of issues uh when they're

involved in these kind of um parents how difficult to do you understand also the fact according to this uh assembly woman that her her office has been flooded with phone calls and emails mostly critical of her proposal now of course i don't have access to what people are actually saying but she seems surprised by the public response are you surprised by it? no because i think um in one of the challenges is the the sort of a lack of connection between how we think of policy in our country and what happens in the daily lives of folks when you look at the research on what happens to parents and children and discipline um they're just a host of factors that go on in this in these relationships that a policy just can't account for so you're really trying to take a sort of large scale strategy to address something that's much more complex in the daily lives of parents so it's it's not surprising to me that people will be calling because they want people to understand what is it like to raise a child under the age of four what's it like to parent a child and um even the use of physical discipline there's a very

use of that sort of form and while i do not advocate it as a parental strategy um my experience has been there's much more uh that one has to understand as to why people decide to use it why some people decide not to use it and what impact it actually has um in children's health? well you know what i found interesting in reviewing some of the literature from psychological organizations and psychologists such as yourself is that there isn't this definitive spanking is bad do not do it i mean that everything seems to be contextual there are caveats around spanking and this is from people within your own profession yes um and some people have uh looked at uh Dr. Elizabeth Gershaw's meta-analysis work she's from Columbia and looking at 88 studies on child on corporal punishment and what she found is that there are strong associations between heavy doses of corporal punishment and child negative outcomes but um when you look at mild forms you don't find those associations

and that um while there is a strong statement from her research that psychologists and mental professionals should not be advocating the use of spanking and in child discipline it's much more complex when you look at the kinds of relationships that parents have with their children whether there's teaching going on or not in the process of the use of mild discipline um and and um what are the sort of emotional issues going on in in the parents and children when these issues are going on that's what makes it so complex and i guess if a parent spanks out of fear let's say their child you know runs into a road with oncoming traffic and the parent fishes the kid out of the street and gives them a little whack on the behind and the kind of spanking that might come with a much more angry parent yes in fact the kind of work we've been doing with parents has tried to distinguish between you know what's going on in parents' minds when they're engaged in these activities again not advocating them but folks are going to

use it can we find out what is what's behind the use of it you know um sometimes one of the uh issues that come out in the research is that the immediate cessation of a behavior actually can reduce the anxiety and the parents of a parent is stressed out you really want to look at where parents are emotionally if they're stressed out the use of some physical punishment reduces the stress of the say a child doing a behavior and so instead of just looking at the discipline issue we should be looking at what are the emotional issues going on to which some people say this is why i use this behavior you know howard if you wouldn't mind just hold on just one second only because we've got Sally Lieber on the telephone she is the California State Assemblywoman who wants to introduce a bill that would ban spanking of children under the age of three she's a Democrat represents uh California's 22nd District and that sits just north west of San Jose California uh Sally Lieber nice to have you with us on radio times and good morning good morning what inspired you to think about introducing this piece of legislation i was talking with one of

our local law professors Tom Nisario about the prevalence of violence among our young people and about the use of uh California's law providing for life without parole for juveniles and we were both uh very frustrated by the the conversation obviously because this kind of violence is very prevalent in young people and uh so i pose the question what is so obvious that we just haven't thought about doing it and he immediately brought up a ban on corporal punishment of children and so the legislation that we are putting forward would ban the use of any punishment that's intended to cause physical pain among infants and toddlers those that are three years old or younger and we've had a lot of comments coming forward from parents about what about the the occasional uh SWAT and that kind of thing but i think the difficulty is uh California like most states

under our law says that parents can use any punishment that is not unjustifiable so it's this gray area of uh what is justifiable or not that leads to the situation where we have children that are being seen by pediatricians and are uh ultimately ending up uh in in court cases where a child is beaten black and blue and uh the defendant who is beaten the child this way uh ends up walking because the defense that it was somehow justifiable so what we're seeking to do is to create a very bright line in the law that says that for infants and toddlers no level of physical punishment is appropriate and what's been the response to your office and you know this this has been with a big story in the last couple of days i don't need to tell you that what has been the the general response to what you've introduced well we've really been flooded with calls and email

and are expecting many letters as the news gets out um many of the emails and calls that we're getting are uh quite heated and there is a pretty significant overlap between the the angry caller or uh emailer and the people who are angry in general at child protective services and so many of these folks are people who have had extensive contact in the past with child protective services uh we're also getting grandparents who say that if there's one thing that they could have gone back and changed about their parenting style they wouldn't have spanked their children and uh also the uh now adults who were uh physically punished in painful and humiliating ways and it's very difficult to hear their voice break 30 years later with the anger and frustration and humiliation that is still present from their experiences then i think what what uh part of the

public response also to this uh piece of legislation is that certainly in cases of abuse uh parents should be stopped and there actually are laws on the books they're not always um abided by or or uh used to prosecute parents but i think in many parents mind there might there is a difference between the excessive violent attack of a child and a little swift whoop to the rear end because they did something wrong well i think we'd all like to believe that that difference is present in the law but it just simply isn't there and this is a very large gray area and so it is admittedly asking uh parents who are restrained in their use of discipline to give up physical discipline of a very young children uh for the sake of sparing the children that don't get a spanking uh once in a blue moon or very infrequently but many many times a day

and uh that's just uh a difficulty is that we can't say in the law well uh if the parent is responsible and uh loving and kind then they can slot well uh does the slot from uh 120 pound mother equate to the same pounds per square inch of uh pressure that uh a slot from a 250 pound male would deliver you know these these are the gray areas in the law that have led to the current situation where children are being hurt and there is not a recourse under the law but isn't this a matter of parental education that that really would go a long way perhaps even a longer way than changing the law making it illegal to spank a child well i think that there definitely is a role for that and by making this a misdemeanor one of the things that can be mandated

is uh parental education anger management courses uh those kinds of things and i would add that in the the 15 countries where corporal punishment is banned absolutely uh we see that there are many more supports for parents so that parents don't get to the the breaking point without uh support and and how would you enforce a law like this and if someone if if it were passed and someone in california saw someone giving a child a uh a spanking what would that individual be required to do and we're almost we got 45 seconds i'm sorry but go ahead well currently uh corporal punishment is banned among uh teachers and uh daycare providers as well as foster parents in california and we're not seeing a rash of philly prosecution so i think that this will uh also have a common sense uh approach to enforcement and what it's been the response from some of your colleagues in the california state assembly uh well i'm very pleased that uh governor short

tanger has come out with a very strong leadership position in saying that he and the first lady have never used a physical discipline and uh i i'm hopeful that i can get the bill through the legislature and get it to governor short tanger's desk for him to consider and you're going to do that this week it introduced the bill officially uh we plan to introduce this week and obviously there will be a lot of discussion over the coming year well sellie leber thanks for joining us thank you you're welcome she's california state assembly woman who will introduce a bill later this week that would ban spanking of children under the age of three she's a democrat representing california's 22nd district and that sits just uh just outside of san jose california we will continue our conversation with psychologist howard stevensson about spanking and discipline one eight eight eight four seven seven nine four nine nine stay with us we'll be right back in filadalfia everyone is reading waiting for snow in havana confessions of a Cuban boy by

carlos air over 130 one book related events for children and adults will take place between now on march 15th including book discussions dance lessons and cooking demonstrations details online at library dot fillet dot gov one book one filadalfia a project of the office of the mayor and the free library of filadalfia supports w-h-y-y i'm for raichidea whether they help shape our world i don't believe it's possible to gank the rapids could be nearly as ganked as our government or simply react to it we look to hip-hop artists for leadership we're in serious trouble their people you want to hear and the people you'll find on news and notes from npr news tonight at nine on w-h-y-y on the next fresh air actress maggy jill and hall her films include secretary happy endings world trade center and stranger than fiction she was nominated for a golden globe for her role

in the independent film sherry baby coming out soon on dvd join us for the next fresh air this afternoon at three and again tonight at seven here on w-h-y-y 91 fm this is radio times here on w-h-y-y in filadalfia i'm ardemas cohen today on the show should spanking be illegal in california a lawmaker wants to introduce legislation this week that would ban spanking for children under the age of three that would be three and under we just said goodbye to her her name is sali leber and we'll continue our conversation with howard stevensson he's an associate professor chair of the applied psychology and human development division at the university of pennsylvania lines open at one eight eight four seven seven nine four nine nine that's one eight eight four seven seven w-h-y-y howard you know we we had a chance to hear a little bit from the assembly woman who wants to introduce this legislation this week and i think what you can hear

is based on what you were saying before we talked to her and then what she's saying is that the law looks at spanking and discipline in one way but psychologists like yourself look at it in another way is it possible you think to reconcile these two points of view i think it's a little hard the place that i would reconcile it is at the level of child death and i think that one reason you would have a policy is that you're worried about the least among us the ones who are most vulnerable child fatalities being the fact that when you think about child abuse leading to death and under four is the most vulnerable group it's some somewhat surprising to people that the older you get the less likely you are to be not only abused but injured and and fatally injured by abuse so that fact is enough to say okay what in the world can we do about this particular problem the challenge is when you say apply that particular reality of a small percentage of kids who die from abuse to everybody else's practices with respect to parenting under four that's

where the challenge becomes and i think that's where it is hard to reconcile if you're looking just at the health crisis for for those child fatalities which i think in about two the last couple years have been fifteen hundred child deaths and then eighty percent of those being under four then you're then you're really talking about a crisis but to generalize it to everyone else is where the problem and begin you said at the top of the show that that you don't favor spanking and you see that as do you see spanking as a parent who's lost control of either their child or the situation i think when you're trying to give advice in general to parents you don't advocate spanking because you don't know how people use it and and the fact is that i mentioned earlier what what a parent's thinking what are they going through when they engage in these activities are the things you really want to know if you're an educator or your counselor therapist or teacher before you go on and sort of advocate large sort of you know big statements but

the i the kinds of things you want to know if i see someone spanking the kinds of questions i would ask is you know are they doing it in a condition of stress i think that's a big issue under under the use under alcohol or or in a way to sort of make a public statement around their own social status i mean in a book that we've written we we we don't recommend physical punishment but we do make a statement for those of you who use it we we make it we recommend that you don't use it under like fourteen different conditions and some of them include you know to show people how good a parent you are to have control kids or when you observe that it does not work or when you've been drinking alcohol to humiliate embarrassed a child when you're angry those are the conditions under which we try to understand to help parents say when this is not a good strategy to use over the weekend i was having conversations you know about this issue of spanking because it has gotten a fair amount of attention in the last couple of days and these are people like myself raised in the fifties in the sixties and most of them said you know that they weren't

a spank routinely but it wasn't that unusual for a parent to spank a child yes and i think context does matter in the sense that you know we have much more social outrage about these public demonstrations of spanking than we did then and then certainly where people identify spanking as a statement of good parenting you really have a whole nother ballgame people and family struggle through this all the time you can get messages from some family members that say you spank too much and others that say you don't spank enough and they're only looking at one or two issues but i think what the representative from the said from from california that was interesting for those of us who've been therapist of of adults who go back and look at their childhood they have some very different feelings over time about the physical discipline that need to be explored you know it's not a reason to say you know drop all spanking together people aren't saying because i had these back experiences i wouldn't spank but they are starting to say you know i used to think

this was absolutely okay but now that i look back on things i start to question whether it was always okay and she mentioned Arnold Schwarzenegger he was quoted in the paper saying that when he was a kid growing up he was spanked a lot or sounds like even maybe even hit a lot but that he and his wife vowed never to hit their own children and i think that's also true for a lot of contemporary adults even ones that were intermittently or or you know spank quite a bit that they at least resolved in many ways not to do that to their own children yes and i think i'm i'm i also do not believe in sort of beating up on parents who say they use physical discipline because of the complexity of how they use it i mean the research that i mentioned earlier dr. Gershaw found that it's the frequency of spanking and physical discipline at them at the more severe levels that is the most problematic we have evidence for being very problematic underneath that is where it gets a little murky so i don't believe in beating up on folks who say

they use physical discipline and so even in in Arnold Schwarzenegger's case i would say let's understand why you don't use spanking as much as we understand why some people do use it because of your emotional experiences during childhood because permissive parenting without engaging in some form of of discipline which doesn't have to include physical issues is also problematic and the other question i do want to get colors in in the conversation but you know here's a practical question do you think though that spanking works that if a parent wants and i realize we're talking about many different uses of spanking but that it can work to get a child to do something that a parent wants i think this is one of the issues that people really don't talk enough about it there's a reason why people use it and one of those reasons is people do believe that it works and when you're talking about the example of someone walking out to the street that you used earlier there's a certain immediacy to physical punishment or immediate punishment as it were that gets the attention of an individual or child so that the behavior is stopped in that

moment if you're stressed out that released some of your stress the challenge is over what time and what frequency what lesson is the child learning in that sort of immediacy and you know so the idea that it works is really one of the questions you'd want to ask a parent and i think if you romanticize your childhood you're more likely to also exaggerate how often it works and sometimes the therapy is asking them did it always work and hearing a sort of different story so immediacy is a big issue the only other thing i would say is that if you look at dr. Gershaw's research there were two findings that she found one is that there was a relationship between severe spanking and negative health outcomes for kids but they also found a positive relationship with the compliance so for many parents they are getting compliance out of this it's interesting and i would assume you'd want to know it as a psychologist then what happens after the spanking right absolutely and the notion of discipline a better definition of discipline is teaching and so

where you're more likely in my view to get negative health outcomes is where the punishment is the statement of your relationship not other issues like um... you're carrying and nurturing um... teaching the kid about why you the behavior is problematic why you are um... trying to build a closer relationship with the child when those issues aren't engaged in and the child only has this physical behavior as a statement of my relationship with the parent that's when i think you're going to have more difficult well we're talking about spanking children today on radio times in a california lawmaker says she wants to introduce legislation which would ban spanking in that state for children uh... under the ages of three or that'd be three and under we talk briefly with that california state assembly woman howard stevensson our guest uh... for today's addition of radio times he's an associate professor chair of the applied psychology and human development division at the university of pennsylvania he's also the author of a book called sticking to watching over and getting with an african-american uh... parents guide to discipline

we're talking about all parents uh... today a radio times in the lines are open at one eight eight eight four seven seven nine four nine nine that's one eight eight four seven seven w-h-y-y so what do you think of the legislation and what do you think of spanking give us a call we've got alan from center city philadelphia joining us alan go ahead you're on the air yes uh... my wife and i uh... didn't spank our children we we read a book that's rated number one by the american psychological association called p-e-p parent effectiveness training and it was very good for us uh... we think that generally parents spank because they don't have other uh... tools available for handling the situation and so that's what they resort to the uh... the uh... your guess just said that the study showed a producers compliance in some cases well that's true you can force a child to do things by spanking but at some

time at some point in time that child's going to get too old to be spanked and the compliance mechanism is going to disappear and you've built nothing internal in that child to guide him in the future alan is an interesting comment let me get to how it's even to respond thanks for the call to radio times how would go ahead i think that's very right i mean the the idea that you can get compliance is an immediate moment issue it's not about long-term and so um... where you'd really wouldn't be concerned and this is an issue even when we talk to parents who say look i would spanked and nothing happened to me over time when we have more time with them we might say something like well did it always work and they will say uh... most of the time they say no and uh... and then we ask them another question is did um... what in what way that it didn't work if you were spanked and did you try and to get around it and that and often the issue comes up that

in the parent's presence i didn't do the behavior but outside of the parent's presence i was free to do whatever i wanted and so in some respects it raised the issue that some parents um... are getting fear from their kids when they're getting even though they're getting immediate compliance but they may not either have respect and they may not be able to stop the behavior out of the present so it might work but at excuse me but it costs of the parent child relationship at a cost yes and again those other issues of you know what is the content of that relation what's the structure that relationship outside of the physical abuse there are many more factors that go into whether we're close to our children how much do we know about them i mean one one element even about any form of discipline is how much we know about the kids many parents will say look i have three kids and they're all different you know and i tried one thing with one and the next thing i can't use the same strategies with with my second as i did with my first and that's because they're different people and the parents who know their kids more even time out is not going to be useful the same way for all kids knowing your child will make a difference in how that discipline is applied let me get

uh... alan thanks for the call we've got jerry from camden joining us this morning already at times hi jerry go ahead yes i don't know i enjoy you so daily a little bit very safe all you're doing fine jerry go ahead uh... one i didn't know that the speaker that's going to make until you just said in my heart was on hold but i think historically we have a lot of issues with with corporal punishment even back to slavery time so it kind of passed down i was personally received corporal punishment i don't like he just said i don't think i have any problems with it but just a few notes here the person said he read a book about parenting most people in the american community don't have time for that or don't even have the resource to do that you can come on that later and one parent is a whole gambit it takes back it takes talking and a lot of time it takes absolutely doing nothing but we're trying to invoke a behavior on our children and if you look at this generation special urban teams i think we went to a whole generation of lack of parenting and lack of spanking all right jerry thanks for calling into radio times and and how it's even said i know you've looked at african americans and parenting and some of

the research seems to point to geographic uh... regions of the country where spanking is more popular uh... socio economic differences uh... on how parents view spanking can you speak to that well the the some of the research and i think a colleague of mine at tufts university uh... ellen pinder hughes is part of that work i was done um... found that that the folks who um... have less uh... monetary resources are more likely to use spanking the big issue there is just the amount of stress the parents go through who are poor that uh... the issues that children bring developmentally the the mobility the sort of loudness whatever kids are being doing being themselves it's hard to tolerate that when you have of ten thousand things to worry about so sometimes the immediacy uh... compliant media compliance that comes with spanking is uh... is a tool that people use now the comment and i think there are cultural reasons why people say that spanking is working and uh... does well for them i just think that

the issue of the generation is important because i think it's been more than just spanking it's been relationship and i think this is what the caller saying to it's the kind of relationships that we have with our kids that are more important as to how kids behaves and i think parent behavior parent relationships are probably the biggest sort of pieces of that pie but their relationships with others that are also important i think the neglect issues are just as powerful as the engagement spanking the question i would have is what kind of relationships are we having with our children to to to determine um... how what outcomes that that they're at their experience i ran across a quote from a a woman who publishes mahogany baby it's an online magazine for black parents it was actually in time magazine almost a year ago and she did she has four children and she says that you know when she's out in public she wants her children to behave and the quote here's what uh... when i go out with my four kids i feel like if they misbehave people will think i'm a welfare mom and the kinds of pressures i guess to have well-behaved children in public that that uh... black families black parents

often feel do you understand oh yeah absolutely and this is what the caller with one one point the caller making to at least for our american families but i think for others and and certainly those who are poor you the public impression of you your family your parenting is rested sometimes in your child's behavior so you don't often get a second chance to make a first impression and so it could influence a lot of things and uh... particularly using slavery as an example uh... you want to be well-behaved in public sense so that you incur less negative um... punishment in general whether it's physical or whether it's psychological you want to be perceived uh... available for the opportunities that afford it so parents often parent with public uh... views stereotypes in mind and i think that's very real it with respect to spanking but does it have do you think i or could have an unintended consequence that if it's if there's the overuse of of spanking that then you create a problem you're trying to fix

yes in fact part of the idea is if it's discipline around teaching and building relationship not just about stopping the behavior those are very different things you know it's like the difference between accountability and punishment punishment focus on just stopping a behavior accountability is about bringing me closer to you in relationship making you accountable to me to my my culture to to our to our neighborhood to whatever larger sort of institution that's important those are very different realities and i think that we can say in the relationships with our children what we think about them what we think about the public what we think about the world and our own anxieties one one little point i'll make uh... is that if you talk to parents who's who often spank they'd not a hundred percent sure that what they're doing is correct and so one intervention for families and for parents is just to have them have the freedom without other people telling their right or wrong how did it feel when you did that and uh... did you have any remorse and let's talk about it without blaming you without saying you did right did it wrong

that process is very important helping parents make better decisions and choices and how to build relationships with their children and we're talking with Howard Stevenson today on radio times about spanking and uh... some of the more uh... corporal punishment uh... uh... tactics that some parents do use a california lawmaker wants to have a uh... statewide ban in that state uh... a ban of spanking children uh... under the ages of uh... three and Howard Stevenson is an associate professor chair of the applied psychology and human development division at the university of Pennsylvania we've got a full bank of calls stay with us we'll be right back so some communities have banned so-called dangerous dogs like rotwilers and pit bulls from living there

other cities and towns around the country have put a cap on the number of pets you can have and one Connecticut cat was placed under house arrest for attacking the neighbors breed bands pet laws and whether the law should treat phyto like a person or property this week on justice talking tonight at ten on w-h-y-y next time on day-to-day high schoolers are shocked when they open this book there's so much more to it than a zook and a yook the better battle book is a fabulous civics lesson i wish i could take congress and send them doctor suits teaching kids to compromise how should you go don't miss npr series crossing the divide next time on day-to-day this afternoon at one on w-h-y-y forgiveness is often discussed in a religious context but lately scientists are paying a lot of attention to the concept of forgiving psychologists argue that it helps people heal

and can reduce anxiety and depression on the next voices in the family Dan Gottlieb and his guests will discuss forgiveness how it is defined what it means and how it affects people's mental health today at noon right here on w-h-y-y 91 of them this is radio times here on w-h-y-y in philadelphia i'm marty mascoeane we're talking with psychologists howard stevensson about a children and spanking he is a professor and chair of the applied psychology and human development division at the university of pennsyvania a couple years ago wrote a book called sticking to watching over and getting with an african-american parents guide to discipline uh and lines open at one eight eight eight four seven seven nine four nine nine howard our boys spanked more than girls and the boys have more sort of physical punishment than girls um there are different stories on that you do have uh it's it's the stats on um if you look at us department of health human services there really are no differences the kinds of um issues that come up as kids get older is boys

mobility so that boys mobility is is more of an issue of control so the older boys get the more they are disciplined in school settings um and they're more likely to be referred for um suspension or expulsion or to the principal's office than girls but you don't have um under for young kids different uh abuse rates uh by gender let me get to anthony from dover delware to join us hi anthony go ahead your radio times hi marty thanks for taking my call you're very welcome um yes i was raised by a father that was physically abusive and as bad as that image might have been to me i also had a stepmother who was verbally abusive and constantly demeaning me and that i feel had much more of an effect on me long-term as in terms of self-esteem and it just seems ridiculous to me to legislate one type of punishment where other forms might be uh you know whereas i might traditionally swap my two-year-old on the butt for running out in front

of a car whereas another mother might be constantly demeaning her child yeah how can you justify i wasn't sure if you had another thing you were going to say after that anthony first of all i really appreciate you calling in a radio times i just have a uh a quick follow-up question do you do you have a relationship with your father and stepmother today uh yes i have a relationship with my father but he had divorced the woman uh my stepmother and were you able to talk about how he and and she treated you as a kid uh my father and i had been separated for a very long time uh we hadn't been in contact for a period of over 16 years and now that we're back in touch with each other that's kind of just something we don't even go into but you have some kind of relationship with him today yes Howard what are your thoughts about uh what anthony's uh mentioning well he's raised a big issue in recent abuse literature about how emotional abuse is considered to be more difficult of form of child maltreatment because you can't get a handle

on it in a big way and in some research has shown it to be more difficult and physical abuse in ways because the child can't make sense of where all of this is coming from um the the scars are are they're not visible there's no one to come and and to your aid sometimes you know and so um you can never quite get a handle on why somebody has taken such a tack um towards you where there there's no discernible connection and it's because does it is it is yelling more and saying insulting things to children is that more personal from from a child's perspective than being spanked it's more personal but I mean ironically in the in the minds of children there's a behavior that one could attach and sometimes this this is leading to self blame you know if I hadn't done the behavior then my daddy or mommy wouldn't be mad at me but then there's the reality of the emotional abuse where there may not be anything going on behavioral that a kick can attach to the offense it may be my very present so um my view is that the emotional

abuse is affecting the kids sense of who he or she is in the world so my very being is a problem my very being is is faulty uh and damaged and so whether I look right look left when I wake up in the morning or whether I go to sleep or I'm just walking or talking everything I do is the problem not just my behavior and today I appreciate you called the radio times it's an important point as well uh let me get Claudia from Warwick to join us uh Claudia go ahead your radio times hi thank you um I was just thinking that first of all thank you for putting this topic on the radio I think a lot of times it's not even talked about enough in society um my question was actually about the enforcement laws for abuse um there is probably at least I would hope that there is some kind of definition of what is abuse and what is harming physically harming another human being and um what are the what are the laws in Pennsylvania to enforce those those laws against abuse Claudia thanks for calling into the show Howard Stevenson I know you you've looked

at that and and is there a definition you could come up with um it's hard but um you know I think most of the definitions of of abuse vary because um you have physical emotional psychological and sexual um as sort of large categories um when teachers or counselors um are trying to make sense of what's going on with kids sometimes they're looking at scars they're looking at marks that don't go away um it depends on the context um sometimes you know the psychological abuse is sort of a public humiliation so if you're talking about physical abuse the definition definitions are different um the psychological abuse the definitions are different sexual abuse the definitions are different perhaps a lawyer could give a better idea of what sort of the legal sort of definitions are I think from a psychological standpoint you can actually have a case of you know abuse being small in the in the minds of sort of the legal sort of arrangement but emotionally are quite

challenging and still need to be addressed and perhaps even need a kind of elastic definition only as you keep saying and it's important underscore about the context and about the relationship between the parent and the child yes um because uh context matters how you know what kinds of issues I mean the one of the weirdest things is having a parent who uses pretty heavy physical abuse on occasion but does these other things that kids have been interpreted as nurturing so one of the reasons you just don't want to go in sort of willy nilly to people is to understand for the child what is the context like to have someone who is um nurturing and abusive those those are complicated issues yeah Claudia thanks for the call let's get Fiona from Amlar to join us this morning uh Fiona go ahead you're on the air hi good morning good morning actually my personal experience relates to the comment you just finished with is I have a very complex relationship with my mother who was both um nurturing and abusive she was the child of an alcoholic so

received some very intense abuse herself when it came to raising my sister and I she went from trying to be close to us to being very physically and sometimes very emotionally abusing um so much so that since I was 18 I moved away from my home city and never returned they found it very difficult to to have a close relationship we get on great by phone but physically I I can't live there when my biggest concern is that raising children of my own now is when you don't have a frame set or a tool set from your own experience how do you find ways to cope um and to create a new style of parenting that you would never expose to it's a good question and Fiona I do you want to get a response from Howard Stevenson how old are your children um I have a two-year-old right now and definitely a pregnant seven months pregnant with a baby boy or the baby boy in just a couple months away how are what are some of your suggestions to Fiona well um I'm actually a parent of a 16-year-old and a two-year-old so I'm all over the place at times but I think one of

the things that's very important is to talk about what happened to you and to find a people who understand who you can talk with about the experience I think secrecy is one of the most difficult challenges to getting help or to to not use the experience of the childhood in one's parenting so the secrecy almost locks in the sort of lesson that you learned exposure so being able to talk to someone about the experience being able to make the separation between the nurturance and the abuse that it's not okay the the nurturance is okay but the abuse was not okay and how can I come to grips with that as opposed to for you know pretending the abuse didn't happen because the nurturing was there you know sort of making a sort of comparison to other people who didn't have the nurturance you want to be able to call call it what it is and um talking to other people not by yourself and not keeping secrets it's a very you know healthy process so that it doesn't intrude into your parenting if you own a good luck and and good luck with that upcoming baby and

and being a parent yourself thank you you're very welcome and and how was Stephen said I mean I think it's fair to say that most parents probably all parents at some point have wanted to hit their child or spank their child I mean it's just their their their times when you feel so rageful and so out of control it's not like the thought doesn't cross your mind oh absolutely and it does and I think I struggle with anyone who says that it doesn't um and I I don't I don't want to put any particular blame on anyone who goes beyond that thought but I think one of the the things that's helpful to folks who are really so we we use a quote in the book and in in our work is that parenting is a lifelong acquaintance with helplessness and so you think you got at one moment and the next moment you realize oh my god I don't have I thought I knew who this person was I brought him into the world a broader into world but then they change on me and I think uh in some respects that brings you to a level of frustration that people think about using uh punishment but if that's where I think talking about that frustration rather than think you got it all together or having to prove to family and people that you do have it all together

it's not that's not a healthy way to go um so talking about it allows you to say you know I really didn't want to go off but I didn't and here's why and here's where I need help and I would think especially for let's say single parents um that there isn't another adult within the household that you can turn to when you're just you know you've had it up to here yes it's got to be an extra added stress and pressure yes and I and I think you know back to the legislation in some respects one of the reasons that the lawmaker may be getting so many calls is it's do you they're they're really asking do you really understand what it's like for me as a parent and it was a single parent um when I have more intrusion from a government so even if I am having some hard times with my kids if I get referred for some services are those services going to understand what I go through as a single parent and that's where I think um a lot of healing a lot of help can can go a long way that even if someone is referred for help are those services sensitive to know what

is it like to be a single parent under these conditions with a two-year-old who says no all the time you know I mean that that appreciation of that world is very different than the sort of legal draconian kind of uh punishment focused let me get to Olivia from Mount Erie Olivia Olivia go ahead your radio times hi thank you my call you're welcome I'm really for the law I think because of the exposure it'll give to this situation and maybe some more resources I think it needs to happen at a very young age if parents want to choose between respect and fear and and relearning that because if a child raised for a while and fear and then the parent tries to switch it's probably difficult um this was a real struggle in my marriage and I wanted to have a ask to guess to come on on three points one is it doesn't make sense to me that we would do something to our child and role model of behavior that we would be arrested for doing to another adult and the second thing is that our aren't some children uh misbehaving because banking is a form of attention that

they'll get with and perhaps time out where it's much more like a real world consequence and they don't get attention works even better in some cases and then the third thing is that adults of children that are growing grow up being motivated by fear then tend to be adults that are motivated by fear many times which is probably why you know there's a lot of fear in the adult society now because they don't learn to think for themselves as an earlier caller is pulling it out Olivia thanks for calling it a radio time she puts several things on the table how we're doing I do want to get one more caller and before we have to say goodbye but um she did say you know you would get arrested for hitting another adult out in public why you know essentially why wouldn't you if you hit a kid well I think you know in that sense yes the the challenges um not all forms of banking is hitting and so one of the things that people need to think about is what is the range when we they're actually talking about spanking and I think this is where your childhood becomes important in my work with social workers and other psychologists and training I find that

their own family experience pushes their position for or against banking without a sort of serious discussion as to why some people would engage in it and and and the like and so um under any condition which someone say no I will never ever do banking the other thing I would say is that intention is important is still back to the notion of relationship um and I think where you're getting fear and not respect that is that is a serious problem let me get to Sabrina from Brynmar to join us our last caller this morning or radio times Sabrina go ahead you're on the air hi I was actually responding to an earlier point made by another caller about um spanking in the black community and I felt a little bit offended that um everyone was you know everyone in black community was being grouped under umbrella of people who spank children um my parents while they were a minority amongst their own family for not thanking my sister and I um definitely seemed to be much more successful parents I don't think that um you know bad behavior increasing in bad behavior in any community is attributed to on less banking I think it's attributes of parents

not being there enough and not taking their children a reason I think the best thing that my parents did for my sister and I was to teach us how to reason that help us in school as well as in regulating our own behavior etc so I feel like it's not really appropriate I think to justify you know hitting children you know by saying that it leads to better behavior anything like that because I don't see that even happening I feel like plenty of those kids out committing crime becoming pregnant any of the things that you're going to talk about being ill in any community those kids get thanked all the time you know they get beaten all the time whatever else and so I think that perhaps if their parents have you know had the time maybe they don't have the time and not the bigger issue I'm gonna if they took the time to teach their kids how to make better decisions then that would you know see the client of that behavior has nothing to do with spanking or not thanking I appreciate your call to radio time so how is Stevenson final thoughts oh just that I think you know if you look at the research this is not a issue germane just to one racial community the issues of SCS are bigger ways to understand and I just think that there are cultural reasons that people the reason we wrote the book is we wrote two parents about making their own

decisions in the process but this is not unique to African-Americans are any particular racial group in fact the American pediatric association makes this point quite clear so bring it thanks for calling it a radio times and Howard Stevenson thanks once again for joining us today on the show thank you very much Mari you're welcome Howard Stevenson is an associate professor chair of the applied psychology and human development division at the University of Pennsylvania and a couple of years ago he wrote a book called stick and two watching over and getting with an African-American parents guide to discipline and earlier in the hour we heard from Sally Lieber she's the California State Assemblywoman who's going to introduce a bill this week that would ban spanking for children ages three and under go to whyy.org slash radio times to find out more about the program and you can leave us an email there as well devor illicit Alan two Susan Greenbaum produced the program i'm ardemas coaine you're listening to whyy fm philadelphia your member

supported news and information station serving Pennsylvania new jersey and Delaware and do stay with us for voices in the family with your with your host doctor Dan Gottlieb and that's coming up next here on 91 fm in philadelphia tomorrow in the first hour of the show we'll be talking about illegal gun trafficking in philadelphia my guess is the president of the Brady Center to prevent gun violence author of a new report uhs going to be issued today called shady dealings then in our two tomorrow calvin trillin is my gassy's got a new book it's called about allis and it's about his beloved wife named allis who died some five years ago the franklin

is to do forecast for today cloudy skies high of thirty eight degrees tonight cloudy breezy low of twenty eight to say sunshine and clouds breezy high of thirty eight when say partly sunny skies high of forty one for Thursday partly cloudy skies a bit cooler high of thirty six and looking head to friday we've got partly sunny skies windy colder high just twenty six degrees president bush concluded his state of the union address last year with these words and so we move forward optimistic about our country faithful to its cause and confident of the victories to come his confidence has not wavered but it has been tested i miss y'all norris join us for the state of the union address from npr news tomorrow night at nine on w a twa wine i'm dan got leave and this is voices in the family

Gerald Ford will always be remembered for his pardon of Richard Nixon an act of forgiveness an act of courage but perhaps all acts of forgiveness take courage webster defines forgiveness as letting go of resentment simply that it has nothing to do with the other person condoning their behavior or reconciling a relationship today shows an open one about forgiveness but how can we forgive what appears to be unforgivable how can one let go of resentment simply because it's a good idea we'll hear from an expert in the field of forgiveness and we want to hear from you what have you forgiven what do you need to and what have you been forgiven for all that more but first the news from npr from npr news in washington i'm craig windom more than 100 people have been killed in a series of bomb and mortar attacks in a rock today two powerful car bombs exploded nearly simultaneously

in a busy market area of central Baghdad killing at least 88 people and wounding more than 140 others hours later a bomb explosion followed quickly by a mortar attack in a predominantly Shiite town killed at least 14 people and injured 30 others white house press secretary Tony snow says insurgents are using dramatic acts of violence to maximize their media exposure they know that the media will focus on body counts and will focus on large acts of violence because that for the terrorists is a victory also today the u.s military up the death toll for american forces in a rock over the weekend to twenty seven jordan is calling for an international conference to discuss the influx of a rocky refugees fleeing the violence in their country up to a million Iraqis are now in jordan more than a million have settled in syria and about one hundred fifty thousand are in egypt del gavlak has more from among jordan's government spokesman nasser judy said that while iraqis were welcome in jordan their presence was straining the

country's meager economic and natural resources said jordan and iraq's other neighbors need financial help from the international community has more iraqis stream across the border the perfect solution would be to have perhaps some sort of an international conference to talk about Iraqi refugees and financial assistance to the countries that are hosting them jordanian officials at the influx of iraqis has tripled infrastructure and real estate prices over the past three years they said they've imposed some entry restrictions on iraqis mainly for security reasons for in pure news i'm del gavlak and i'm on jordan a jury pool has been chosen for the cia leak trial of lewis scooter liby the former chief of staff for vice president dick cheney liby is accused of lying to investigators and to a grand jury and pierce are you superior has the story jury selection in this high profile politically sensitive trial has been difficult in a city where many people have connections with or strong opinions about the federal government one potential juror was excused after she said i don't really believe the administration another was excused after he told the judge i think there's been