According to the National Assessment of Educational Progress (NAEP), the 2024 Report Card says only 30% of eighth grade students performed at or above NAEP Proficient standards. This reflected little change form 2022, but was lower compared to 2019. You may be familiar with these numbers since they have been reported widely in the media. They reflect the growing concern with our educational system.

But what may be news to you is many of these same deficient readers are getting into college! Patrick Keeney, PhD, tells us about this in an article published in The Epoch Times. Keeney refers to an essay called “The Average College Student is Illiterate” by Hilarius Bookbinder.

Here’s what Keeney has to say: “It is a sobering account. Bookbinder (a pseudonym) teaches in the humanities and draws upon years of classroom experience. He observes that many of his students are functionally illiterate in that they are unable to engage with serious adult literature, and often find the very act of reading tedious. As a result, they avoid it whenever possible. This aversion manifests in predictable ways: skimming texts without comprehension, failing to identify key arguments, and struggling with exam questions simply because they haven’t read them carefully.”

Keeney goes on to say his reflections provide a sobering glimpse into the current state of liberal learning and the formidable challenge educators face in fostering genuine intellectual engagement. Bookbinder places the blame squarely on society. “I don’t blame K–12 teachers,” he writes. “This is not an educational system problem. This is a societal problem.”

Keeney thinks this overlooks the significant failures within the K-12 system itself – failures that have deprioritized foundational literacy, neglected intellectual rigor, and left student unprepared for the demands of higher education.

Over the past several decades, elementary and secondary schools have increasingly adopted a pedagogical model that prioritizes technological fluency and emotional well-being over the development of serious intellectual habits. As one parent noted in response to Bookbinder’s piece, children are now “pushed into technology (computers, iPads) as early as kindergarten” and “are not required to read entire books, let alone write about them.”

Keeney says, “But this is not merely an educational failure. It is a moral one. Literacy is not simply a technical skill—it is a form of ethical and intellectual development. It requires cultivating patience, empathy, and sound judgment. It demands that we sit still and listen attentively to the minds and voices of others. If students cannot do this, then we are not educating them. At best, we are merely credentialing them.”

Reading has played a critical role in my life and continues to do so. Good reading skills were crucial to my success in graduating from college and medical school and no amount of technical skills with a computer could have replaced them. Though I use a computer every day in my life now, I also continue to read voraciously, averaging three or more books per month for the last 25 years!

It has been suggested by some that medical students today need not learn the foundational facts of our profession but only need to know how to find those facts on their computers or cell phones as needed. Please! I hope that when I find myself in the emergency room fighting for my life, the E.R. doctor isn’t spending time on his or her computer trying to figure out how to save me!

Reading is essential to a successful life and it’s about time our educational system figured out how to get back to the basics – reading, writing, and arithmetic.

After months of ads telling Republicans to call on President Trump to eliminate the “Biden Pill Penalty,” it seems the message is getting through. President Trump issued an executive order this month aimed at reducing prescription drug prices while eliminating the Inflation Reduction Act’s “pill penalty” that makes lower-cost small molecule drugs subject to Medicare price controls.

I wrote about this subject in an earlier post called Biden’s Pill Penalty, which explained that the Inflation Reduction Act  (IRA) of President Biden passed in 2022 threatens to distort innovation by pushing investment towards expensive biological products. Trump’s order aims to reverse all this and restore the incentives to increase research and development of new drugs.

The Wall Street Journal editorial board calls on Republicans to fix this in the tax bill – “even if they can’t muster the courage to repeal the IRA’s price controls, which have done nothing to reduce overall drug prices.” Prescription drug prices have increased more since the IRA passed in August 2022 than in the five previous years, in part owing to market distortions caused by price controls.

The controls have also led to cuts in pharmaceutical research and development. That’s one reason investors have sold off pharma and biotech stocks. Nasdaq’s biotech index has risen only 10% over the last five years while the Nasdaq is up more than 100%.

Declining biotech investment has some Republicans fretting about the U.S. losing its competitive advantage to China. “We lost our leadership in semiconductors, and we are close to losing that position in biotech if we don’t act now,” said Indiana Sen. Todd Young last week.

The WSJ editors say, “One way to act would be to stop Mr. Trump’s mooted 25% tariff on imported medicines. Most generics and active drug ingredients are made in India or China because of lower manufacturing costs. The U.S. doesn’t want to depend on China for critical drugs, and many manufacturers have been shifting production to other low-cost countries.”

Clearly, the WSJ editors are not fond of Trump’s tariffs, but they don’t seem to understand that tariffs are a weapon in the negotiations that makes change possible. The elimination of the Biden Pill Penalty is a good start and I believe the tariffs will come down when fair trade practices are achieved. The goal has to be security for our country by encouraging pharmaceutical companies to manufacture their drugs in the U.S. We will all be better off in the long run when that happens.

We’ve all been to the doctor and been told our cholesterol is too high. For years a good cholesterol was considered anything below 220, then it was 200, and now it’s less than 200. The bar seems to be changing as doctors learn more about the science of good and bad cholesterol.

We’ve been told for a long time that LDL (low density lipoproteins) are “bad cholesterol” and HDL (high density lipoproteins) are “good cholesterol.” A blood test showing our HDLs are high and our LDLs are low has always been considered ideal. But all that seems to be under scrutiny as new information becomes available.

Jennifer Sweenie, writing for The Epoch Times, tells us emerging research is painting a new picture: Focusing solely on “bad” cholesterol misses pivotal pieces of the puzzle. Factors such as the size and composition of particles of high-density lipoprotein (HDL) cholesterol—the so-called good cholesterol—along with triglyceride levels and overall metabolic health, are equally, if not more, important in preventing heart disease. This new understanding is reshaping how we assess heart health, shifting the lens to a more comprehensive, preventive, and personalized approach that prioritizes lifestyle changes such as diet and exercise,

Cholesterol is a fat-associated substance essential for building healthy cells and producing vital hormones such as vitamin D. It’s not inherently bad. Your liver produces most of the cholesterol circulating in your body. The real issue lies in how cholesterol is transported.

“Your liver makes most of the cholesterol that’s circulating around, and your body’s pretty good at maintaining a homeostasis, “ said Nick Norwitz, a Harvard medical student and Ph.D. in physiology from Oxford University.. ”So if you eat more cholesterol, your liver makes less. If you eat less cholesterol, your liver makes more.”

Since cholesterol doesn’t dissolve in blood, it’s transported by lipoproteins, which resemble tiny “delivery buses” on the highway of your bloodstream. LDL primarily carries cholesterol to cells, and excess LDL—especially small, dense particles—can contribute to plaque buildup. HDL helps remove excess cholesterol from the bloodstream and returns it to the liver. In short, cholesterol is the cargo, and LDL and HDL are the vehicles that transport the cargo.

LDL gets its reputation as bad cholesterol because excess amounts can contribute to plaque buildup in the arteries. These smaller particles are more likely to damage the artery wall and cause inflammation. Davis compared them to tiny buses that zip in and out of traffic, increasing the chance of crashes. These “crashes” represent inflammation, which can lead to “traffic jams” or plaque accumulation.

Conversely, larger, “fluffy” LDL particles are less likely to cause problems. HDL helps clear excess cholesterol from the bloodstream and transport it back to the liver for disposal, reducing the risk of buildup. In other words, the real concern lies in how LDL and HDL behave. It’s not the cholesterol itself but the actions of its carriers that can yield plaque buildup.

For years, we’ve been told that lowering LDL cholesterol is the primary way to protect our hearts, but the reality is more nuanced. While elevated LDL can contribute to risk, its impact is conditional, as it’s inextricably linked to overall metabolic health and other factors.

One factor is the amount of apolipoprotein B (ApoB) in your blood, a protein that transports cholesterol and other fats. This can be measured with the ApoB test. “The risk associated with ApoB and LDL counts is context-dependent,” Norwitz said. This context involves an intricate interaction of lipids, metabolic factors, and lifestyle.

Without getting too much farther into the weeds with this discussion, the point is we have more to learn about cholesterol and our current way of measuring good and bad cholesterol is probably inadequate. Stay tuned for more as we learn how we can live longer through a balance of exercise, sleep, and stress management along with controlling our cholesterol levels, good and bad.