Legal But Immoral Medicare Ripoff?

According to a CNN report, By Wayne Drash, Sergio Hernandez and Aaron Kessler, CNN, published June 29, 2018, entitled,

"Medicare spent $2 billion for one drug as the manufacturer paid doctors millions"

 Ref. https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-medicare-claims-doctor-payments/index.html

Quotes shown below are from the above referenced article.

While the vast majority of doctors consider the needs of their patients first, and, in general, try to use generic drugs when writing their prescriptions, there are a significant number, who, apparently, consider their financial needs first.  I can attest to that because myself I have experienced where proprietary drugs were ordered, when compatible generic drugs were available, which were ultimately successfully used, upon my insistence.

"(CNN)More than 80% of doctors who filed Medicare claims in 2016 for H.P. Acthar Gel -- a drug best known for treating a rare infant seizure disorder -- received money or other perks from the drugmakers, according to a CNN analysis of publicly identified prescribers."

CNN shows the following quotes:

"The evidence that this drug is any better than synthetic steroids is either weak or does not exist. Daniel Hartung, Oregon State College of Pharmacy"

"We clearly found that as you ratchet up the payments to doctors, there were more prescriptions generated and more spending in the Medicare program on this drug," said Daniel Hartung, the study's lead author."

"Acthar is best known for treating babies with infantile spasms, a rare and catastrophic form of epilepsy. Hartung, an associate professor at Oregon State's College of Pharmacy, said he found it troubling the drug is being marketed in adult medicine, with taxpayers footing the bill for hundreds of millions of dollars." 

It appears, an infant drug is now prescribed for seniors, for a variety of reasons, at a staggering cost to Medicare.

"A steroid like prednisone can cost as little as $2.50 for a bottle of pills -- less than a venti coffee from Starbucks -- compared to Acthar at nearly $39,000 a vial of injectable liquid. Over a course of treatment, those figures get even more dramatic: $7.50 for three bottles of prednisone vs. $117,000 for three vials of Acthar."

Year	Claim Count	Total Spending
2011	1,471	$49,456,911
2012	3,387	$141,451,608
2013	6,752	$262,581,602
2014	9,611	$391,189,653
2015	11,209	$503,999,371
2016	12,867	$636,174,840
Total:	45,297	$1,984,853,985

The meteoric rise in claims is surely the result of massive payoffs to the doctors involved.  The CNN article, shows some amounts spent on doctors, and even names a few of them.

"Since Mallinckrodt purchased the drug from Questcor in 2014, the price of Acthar has gone from $32,000 a vial to nearly $39,000. In 2000, before Questcor purchased it, it was $40. Questcor shocked the medical community when, on August 27, 2007, it raised the price overnight from $1,600 to $23,000 a vial."

CNN shows this quote:

  

"Medicare having to spend almost $2 billion on a drug that is of questionable benefit is very disturbing.  Rita Redberg, cardiologist and professor at the University of California, San Francisco, School of Medicin" 

"Multiple doctors familiar with Acthar told CNN that the drug shows little benefit in adults over steroid treatments, which they said could range anywhere from $2.50 for prednisone to $5,000 for a high IV dose of methylprednisolone. Even at the high end, these doctors said, prescribing steroids over Acthar could have saved Medicare nearly $1.8 billion."

"Why would Medicare pay nearly $2 billion over five years when there was a far cheaper alternative?

Stephen Schondelmeyer says you can thank lawmakers for that: Medicare is not allowed to negotiate drug prices or tell doctors what drugs to prescribe.

"Our Congress has told the Medicare program, you cannot control drug prices," says Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. He directs the College of Pharmacy's PRIME Institute, which studies economic and policy issues related to pharmaceuticals. "We don't have any government process for evaluating, regulating and managing drug prices." 

 

It is this pervasive behavior, bordering on fraud, by the Pharmaceutical industry, and by some doctors that add to the high cost of medicine in the US, when compared to other industrialized countries.

 

This $1.8 Billion fraud connected to this one drug, is surely just the tip of the iceberg.

 

For more details, I suggest one reads the article/report, referenced above.

 

Past and Present Wrongs Do Not Make a Right

The recent separation of families produced many self-righteous protests; over and over we hear the critiques shout, this is not what we are as a nation.  If we really want to know what we are as a nation, when it comes to separating families, then we owe it to ourselves to read the article by By Harmeet Kaur, CNN, published June 24, 2018.

https://www.cnn.com/2018/06/24/us/us-long-history-of-separating-families-trnd/index.html

Even history of not too long ago shows that children were taken from their families under other Presidents as well, in that regard President Trump is not unique.  Many of the little wars we partake, openly or covertly, around the world result also in family separations.  These latest family separations are as gruel as the rules of law facilitating them.  But, please let us not say, this is not what we are as a nation.

Fake News/Image At Its Best

The following was published, in part, by the BBC today.

"A little girl who became the public face of US migrant family separations was not taken away from her mother at the US border, says her father."
For the full story follow this link: https://www.bbc.com/news/world-us-canada-44578339

"A photograph of the Honduran toddler sobbing in a pink jacket was taken at the scene of a border detention."

"Time magazine has used the image for its latest cover, depicting President Donald Trump looming over the girl with the caption: "Welcome to America"".

"The image was taken by a photographer for the news agency Getty Images, John Moore, on 12 June at McAllen, Texas.
The Pulitzer prize-winner told the BBC that the mother had been breastfeeding her child after crossing the Rio Grande in a raft in the moments before they were detained."
"Mr Moore said they were taken away together by border patrol."
 

"Mr Valera said his daughter and her mother, Sandra Sanchez, have been detained together in the border town of McAllen as Ms Sanchez seeks asylum.
Honduran Deputy Foreign Minister Nelly Jerez verified Mr Valera's version of events to Reuters.
The Border Patrol agent who stopped Ms Sanchez and her daughter, Carlos Ruiz, said the mother was asked to set the child down so she could be searched.
"The kid immediately started crying as she set her down. I personally went up to the mother and asked her, 'Are you doing OK? Is the kid OK?'
"And she said, 'Yes. She's tired and thirsty. It's 11 o'clock at night.'"
The little girl is two-year-old Yanela Denise, according to the Daily Mail newspaper.
Mr Valera said Ms Sanchez and their daughter had left the Honduran city of Puerto Cortes without telling him or the couple's three other children."


 

Fabricating wrong impressions is the new media standard; I would expect this from Tabloids, but not from, so called, respected media outlets.  They should have selected an image that had an ounce of truth.

Apparently, lawmakers put gruel laws into the books in order to satisfy a current need, hoping it would not be enforced; when such laws are enforced these very same scoundrels cry out in protest, again satisfying another present need.

Small And Insecure Bullied Children Take Their Own Life - Older Bullied Children Take the Life Of Others

The BBC reported 6/20/2018 with photos included, on the unfortunate story about Mallory, a New Jersey girl.  For the sad details follow this link: https://www.bbc.com/news/world-us-canada-44552864.  As I stated in previous posts, as long as bullying is going on, suicides and mass-shooting will be here to stay.  Parents must seriously become involved in the prevention of these tragedies, to-date it appears they are not.  If anything, by providing these cell-phones and tablets to their children, they are actually facilitating the abuse of other children, by their own flesh and blood, unless they step in and put a stop to this.

Parents must regularly inspect these electronic devices of their children for tale tale signs of bullying, or messages showing them to be the Bully.  When your child is on the receiving end, report it to the school by all means, but don't stop there, file a police report, it can save the life of your child.  Equally, counsel your child, and boost their self-esteem in a big way, every chance you have!

Talk to your friends with children about this major problem, become involved, don't be a spectator, become an activist.

 Mallory

 I tried to make contact, by emails, with the leaders of the Parkland School Survivors, but was entirely ignored.  Apparently, while they are ready to lay blame on anybody-else, they themselves view themselves entirely blameless, and therein lies the problem.  In their defense, as long as their parents ignore the real problem, and thus fail to counsel their children, they will remain what they are, self-righteous spoiled brats, harassing others, just for the fun of it, even if it means driving them to suicide. 

BBC reported, "Speaking at a news conference on Tuesday, the Grossmans' attorney, Bruce Nagel, said complaints to the school had been "terribly ignored" and called smart phones "a lethal weapon in the hands of the wrong child."

I fully agree with the above quotation, these electronic devices can be as deadly as firearms, and worse; guns don't psychologically torture their victim to death.

How Much Worse Can It Get?

Dr. John D. sent me the following report, as part of his regular news digests, etc.

I must warn you the article, by Chris Hamilton, referenced in the link below is very disturbing, at least it should be.  Thankfully it includes a number of charts (pictures), which, as the saying goes, are more worth than a thousand words.  For myself, I was never in doubt that our economy is in serious trouble, I just did not know by how much.

Just follow this link for the full story and more charts.
https://econimica.blogspot.com/2018/06/americas-greatest-crisis-upon-usdebt-to.html

https://econimica.blogspot.com/2018/06/americas-greatest-crisis-upon-usdebt-to.html

The Forgotten Gentile Victims Of the Holocaust

The article, by Karen Silverstrim, MA Candidate, referenced below, makes some very important points regarding the Holocaust.  Indeed when anybody makes reference to the Holocaust, the masses immediately equate that to the Jewish dilemma during the Nazi period, and WW II.  Many more Gentiles were the victim of the Holocaust than were Jewish people.  This is why a careful reading and understanding of the referenced article is so important; all of the victims must be honored, and not be forgotten, just because the noise level of one people is drowning out the voices of the over 16 million forgotten Gentiles lost in the Holocaust.

Ref.  http://www.ukemonde.com/holocaust/victims.html
By Karen Silverstrim, MA candidate
University of Central Arkansas

Who Creates These Women/Men Abusers?

Over the past few months we read in the media, and seen on TV, stories about women, who have been insulted, and/or abused by powerful men, many years ago; I do not know of any male that has come forward recently.  These women, apparently, valued their careers more than their own dignity, why else would they wait until the perpetrator was no longer of use to them for their career advancement, one could ask?  Their convenient silence apparently benefited them, but did nothing to stop these ugly abusers from hurting other women.  One would hope that a once of social empathy with their sisters, at large, would have been another reason, why to speak out right there and then, and not wait for many years, to finally come forward.

In the movie industry, and many places of work, connection is everything for people with exaggerated ambitions; often they would sacrifice their self-esteem, just to achieve a goal.  They, apparently, buy their movie roles, or positions at great moral expense.  Like in commerce, there is such a thing as buyer's remorse, and, apparently, this is what is taken place over and over of late.

Sexual harassment was a big no, no for many, many years, and organization, including the Government, had published policies, as well as rules of law, dealing with this problem.  A great number of perpetrators had their careers shortened because of it.  Women and men who were victims of sexual harassment were protected by Title VII of the Civil Rights Act of 1964, a federal law that prohibits employers from discriminating against employees on the basis of sex, race, color, national origin, and religion.  This law is very far-reaching, and most certainly includes unwanted sexual advances, and most definitely sexual assault and rape.  Criminal laws have dealt with statuary crimes like sexual assault and rape, for much longer than that.  Ref. 10 U.S. Code § 920 - Art. 120. Rape and sexual assault generally.

I recall, not too long ago, when a famous actress, on TV, referred to a recent outed perpetrator as God, by name; it is this kind of, self-serving, adoration which, in the eyes of the perpetrator, gives him or her license to do whatever comes to mind.  After all, Gods can do no wrong!  The world always had these Brown Noses, and probably always will have them in the future; this appears to be the only way that such individuals think they can achieve their goals.  I saw, also on TV, when somebody proudly proclaimed, when you are rich you can get away with everything; unfortunately this appears not to be an isolated opinion, by the looks of it.

Should one shed a tear for all these victims?  I ponder about these stories, and find no clear-cut answer; the time intervals between the acts and the reporting seem unnatural.

A Picture Is Worth A Thousand Words

Ref. Wikipedia

"A picture is worth a thousand words" is an English language-idiom. It refers to the notion that a complex idea can be conveyed with just a single still image or that an image of a subject conveys its meaning or essence more effectively than a description does."

I made the image as large as possible, for your reading pleasure.  I refrained from making a comment, because the pictures says it all. 

Ref. https://www.aljazeera.com/news/2018/05/opens-embassy-jerusalem-countries-attended-180514141915625.html

 

A Chain Of Nastyness All-Around

The nasty, cruel and inappropriate remark by the special advisor to the President, regarding Senator McCain, became only hurtful when an equally nasty act was committed by a person, unknown, present at the meeting, leaking it to the likewise nasty media.  This media outlet did not stop itself from hurting McCain and his family.  Whichever media company broke this story, should also apologize to the McCain's family for their willful act to hurt them publicly.  The old adage is, what you don't know can't hurt you, but the nasty media wanted to make sure it became publicly known and therefore hurtful.

There was a time when the media would refuse to publish such garbage, especially when it could hurt an individual, a war hero to boot, but that was then.  Today, the media at large is in serious competition with the tabloids, and very successfully I might add.  President Trump has serious confidentiality problems; he is the captain of a leaky ship, navigating in dangerous waters.  To add to his problems, he himself is not shy of hurling insults at others, and his crew desperately wants to emulate the captain, hence, this latest stupid remark by one of the crews.

Now the captain has a problem, throwing the crew member  overboard validates the leaked information, and rewards the 'Leaker' for his/her breech of confidence.  Keeping the crew member gives the appearance that the captain agrees with the crew member.  What to do?

All the foregoing is proof certain that we live in a very nasty world; it appears it is not getting any better, with the next generation, their so called 'Social Media' has become very unsocial to downright nasty, as well.

Regrets They Have A Few

For those of you who have read some of my earlier blogs, know that I don't have much use for the so called social media, mainly because it makes too many of us, act in a very unsocial manner.  Youngsters have been driven to suicide, people are getting killed or seriously hurt because people insist on using this media, while acting in an antisocial manner, even when driving a car.

Ref. https://medium.com/@mustaphahitani/ex-facebook-executive-you-dont-realize-it-but-you-are-being-programmed-618242134d

The following quotations were taken from an article by Mustapha Itani, dated April 23, 2018.

"Several months ago, one of the early pioneers of Facebook and its first President Sean Parker, voiced his regret regarding helping create social media in the form we know it today, saying: "“I don’t know if I really understood the consequences of what I was saying, because of the unintended consequences of a network when it grows to a billion or 2 billion people and it literally changes your relationship with society, with each other,”…”God only knows what it’s doing to our children’s brains.”"
"Parker says the social networking site exploits human psychological vulnerabilities through a validation feedback loop that gets people to constantly post to get even more likes and comments. "“It’s exactly the kind of thing that a hacker like myself would come up with, because you’re exploiting a vulnerability in human psychology,”" he said. "“The inventors, creators — it’s me, it’s Mark [Zuckerberg], it’s Kevin Systrom on Instagram, it’s all of these people — understood this consciously. And we did it anyway.”"

"Later on, another former Facebook executive opened up about the same concerns."
 "Chamath Palihapitiya, former vice president of user growth at Facebook stated at a recent public discussion at the Stanford Graduate School of Business,
"“I think we have created tools that are ripping apart the social fabric of how society works.""
 "”The short-term, dopamine-driven feedback loops we’ve created are destroying how society works,”" Palihapitiya said. "“No civil discourse, no cooperation; misinformation, mistruth. And it’s not an American problem — this is not about Russians ads. This is a global problem.”"

"Palihapitiya then expressed the feeling of guilt, "“I feel tremendous guilt. I think we all knew in the back of our minds — even though we feigned this whole line of, like, there probably aren’t any bad unintended consequences. I think in the back, deep, deep recesses of, we kind of knew something bad could happen. But I think the way we defined it was not like this.""

"Concerning the issue of social media as a whole, Palihapitiya stated that he doesn’t use it anymore since he "“innately didn’t want to get programmed.”" And as for his kids, "“they’re not allowed to use this shit.”"
 "“So we are in a really bad state of affairs right now, in my opinion. It is eroding the core foundation of how people behave by and between each other. And I don’t have a good solution. My solution is I just don’t use these tools anymore. I haven’t for years.“"

"“Bad actors can now manipulate large swaths of people to do anything you want. It’s a bad, bad state of affairs. And we compound the problem. We curate our lives around this perceived sense of perfection, because we get rewarded in these short term signals: Hearts, likes, thumbs up. And we conflate that with value and we conflate it with truth, and instead what it really is is fake, brittle popularity that’s short term and that leaves you even more, and admit it, vacant and empty before you did it. Because it forces you into this vicious cycle about what’s the next thing I need to do, because I need it back. And think about that compounded by two billion people.”"

"He finishes this up by warning the audience not to think they’re too smart to fall for the implications of social media, and stated that those who are best-and-brightest are the most likely to fall for it, "“because you are fucking check-boxing your whole Goddamn life.”"

I recommend you follow the link below, and read the entire article; you will be glad you did.

https://medium.com/@mustaphahitani/ex-facebook-executive-you-dont-realize-it-but-you-are-being-programmed-618242134d

Miscalculation Or Wishful Thinking?

The BBC reported today, in part, the following quoted below. - ref.  http://www.bbc.com/news/world-us-canada-43818752

"What have investigators said?

NTSB chairman Robert Sumwalt told reporters that a fan blade had broken off due to metal fatigue and that a second fracture had been recorded about halfway along its length.
He could not say if the incident indicated a fleet-wide issue with the Boeing 737-700.

Mr Sumwalt also said a casing on the engine was meant to contain any parts that come loose but, due to the speed, the metal was able to penetrate the shell.
The FAA did not say how many engines would be inspected. It said that any fan blades that failed the inspection would have to be replaced.
In 2016, a Southwest Airlines flight made a safe emergency landing in Florida after a fan blade separated from a similar CFM engine.
Debris ripped a hole more than a foot long in the fuselage of the jet above the left wing, causing cabin decompression. An investigation into that incident also found signs of metal fatigue, according to the NTSB."  There were other fan blade failures in recorded history.

There is no doubt, in my mind, that economics won the day, when it came to taking proper corrective action, following a similar Fan Blade failure in 2016 on a similar engine, experienced by the same Airline (Southwest).  The failure rate, and the Mean-Time-Between Failures (MTBF) are certainly (or should be) known, based on Lab testing and limited field data, and depending on the 'Confidence Level', at which these were calculated, timely re-inspection of in-service fan blades should ensure that such catastrophic failures are not part of the consumer's flying experience.

Apart from inspecting for evidence of cracks the Airlines must also ensure that the fan blades were properly shot-peened, when required.   This process, when properly performed, will prevent cracks in critical parts.  For info on this process follow this link.  https://www.youtube.com/watch?v=l05Bqotp4N0

The irony in all this is that when some years ago, some fellow had explosives in his shoes, everybody was required, and still is, to have their shoes screened 100% of the time, but when a critical part, such as the fan blade of a jet engine explodes in-flight, we do not take similar drastic actions, it appears.  Therefore, I say, apparently, the industry is only interested in preventing the loss of life, when the inconvenience affects only the consumer, and no tangible costs are involved for the corrective action. 

Objection - Interviewer is leading the Interviewee!

https://www.cnn.com/2018/04/14/politics/comey-clinton-emails/index.html
ABS reported, in part, the following:
"Former FBI director James Comey says his belief that Hillary Clinton would win the 2016 presidential election played a role in the way he handled the investigation into her use of a private email sever as secretary of state."

"Wasn't the decision to reveal influenced by your assumption that Hillary Clinton was going to win, and your concern that, she wins, this comes out several weeks later and then that's taken by her opponents as a sign that she's an illegitimate president?," Stephanopoulos asks.
In a court of law, an objection would have been raised, no doubt, for asking a leading question.  Good journalism does not put words into the mouth of the interviewee because doing so is the root of fake news.

"It must have been," Comey responds, adding, "I don't remember consciously thinking about that, but it must have been. I was operating in a world where Hillary Clinton was going to beat Donald Trump. I'm sure that it was a factor. I don't remember spelling it out, but it had to have been. That she's going to be elected president, and if I hide this from the American people, she'll be illegitimate the moment she's elected, the moment this comes out."

In his book, "A Higher Loyalty," Comey expresses a similar sentiment, writing, "It is entirely possible that, because I was making decisions in an environment where Hillary Clinton was sure to be the next president, my concern about making her an illegitimate president by concealing the restarted investigation bore greater weight than it would have if the election appeared closer or if Donald Trump were ahead in all polls."

From the foregoing, it appears, Comey is speculating about what prompted his actions.  To me that sounds like Comey is fabricating stories, on the fly.  An important decision, such as he made must have made an indelible impression in his mind, and should rule out any statements, like " It is entirely possible that...", or "I don't remember consciously thinking about that, but it must have been."

Comey, apparently, is in the habit of making notes, at least he claims that he memorialized his meeting with Trump, with written notes, so why would he be so uncertain about his assertions?  The truth can be repeated over and over, fiction on the other hand is another matter.  Moreover, why would the FBI Director overseeing an investigation into possible  wrongdoing by a public servant, worry about a political issue,  and base his actions on the possible outcome of an election?  This is, in my opinion, very troubling; the FBI must focus on their duty, and not be influenced by anticipated election results.

You may ask, why is the foregoing a social concern?  My reply would be, if anyone can publicly tell stories, in writing or during media interviews, based on, "... it must have been, or I don't remember spelling it out, but it had to have been.", then we have a social problem.  Yes, it concerns me because we teach our younger generation that success is achieved with B. S. and the truth no longer matters.  More importantly, Comey admitted his political concerns, which may be a violation, of existing FBI policy, and rules of law.  This makes this story a social concern, when we can no longer trust in the integrity of the FBI.

Parkland Students Mock New Backpacks

NBC reported 4/3/2018 the following.   https://www.nbcnews.com/news/us-news/parkland-students-mock-new-security-measure-clear-backpacks-n862176

"Parkland students mock new security measure — clear backpacks"

"But on Monday, as teens at Marjory Stoneman Douglas High School in Parkland, Florida, returned from spring break, they took to Twitter to mock the clear backpacks now required by their school district, describing them as a violation of privacy, a meaningless gesture and a distraction from real gun reform."

“I feel sooo safe now," wrote Lauren, the younger sister of David Hogg, a Stoneman Douglas senior who has emerged as one of the leading student voices for gun control. "As much as I appreciate the effort we as a country need to focus on the real issue instead of turning our schools into prisons.”

CNN showed 4/3/2018 the following images, which I cropped to protect the students' privacy.
https://www.cnn.com/2018/04/02/us/marjory-stoneman-douglas-clear-backpacks/index.html

While I agree, these transparent backpacks will not solve the problem, however, it seems to be an honest simpleminded attempt at a partial preventive action.  By stuffing these backpacks with items for the purpose to hide their contents, clearly shows that these kids are not mature enough, to understand that little actions are better than no action.  Unfortunately, neither is the school administration, who to this day does not yet understand, what the root-cause of this mass shooting was.  They have not figured out yet, that when former expelled student, returns to his former school, and kills some of his former classmates, he must have felt badly hurt by a few of them.  I have to belief that some of these smart students already figured this out, but prefer to point the finger at others.

Therefore, the priority should be the coaching of these young immature students, along with the administration, on how to behave in a compassionate fashion towards their fellow men.  They must eliminate any kind of bullying on the school premises, and talk to the parents to ensure that they are aware of their responsibility outside of the school.  Cellphones must not be allowed in classrooms, under any circumstances, but must be kept in lockers, where they can be used during breaks.  This action will ensure that students pay attention to their lessons.

We need a formal mandatory course in civility, at least once a week for one hour.  The current young generation has been poisoned, by all the garbage the media feeds them; we have blunted their capacity for empathy.   We have to counteract this anomaly in our youth, as well as the school administration.

The Root-Cause Of School Shootings

This article was posted today on Trump's webpage.

 I truly appreciate the fact that our young adults/students are capable to mobilize not just others in our nation, but also students in other parts of the world; we adults can learn a lot from this.  Having said that, we have not yet identified the root-cause of this major problem; so far we are trying to address only some of these contributing factors, while totally ignoring the root or primary cause of these mass school shootings.

The root-cause for these school shootings are not the existence of guns, or the lack of background checks, nor the age of the gun buyer; these factors always existed, in previous times, when we did not have this phenomenon.  We have to ask, what has changed?

Our children/students have now a very powerful tool, the 'Social Media', which can be used for good, as well as for evil.  We have here, one example where the social media is used for the good; young people organize and come together, for a common cause, and that is good.  However, this very same tool has been used in very destructive ways, driving some of our children to suicide because of cyberbullying.  This social media tool, unfortunately, allows some users to insult and malign others anonymously, thus emboldens those cowards to be extra vicious in their destructive messages.

While we always had a few isolated Bullies in Kindergarten or School, we now have entire groups of young people ganging up on a single person.  In the past a bully, acting alone, was more easily set straight, with proper discipline but now we are no longer faced with a single bad actor, it is an entire group or click that is acting badly.  When a child, in the past, was bullied someone (a teacher, friend or parent) usually came to the rescue, and stopped the bully.  Now, these bullies find security in their number, and like a school of fish, it became much harder to identify, single out, and stop this anti-social behavior.

As a Quality Engineer, I spent 40+ years looking for, identifying, and lecturing about Root-Cause determination.  Drawing from this experience, my conclusion is that the Root-Cause of these mass school shootings is the antisocial behavior by too many of our young people/students towards their peers.  While the students currently cry for their protection at schools by society, too many of them make life, at school, pure hell for others, outside of their click.

Let them refrain from bad social behavior, and make school a place where everyone is a friend, odd looking or not.  Let them come together not only in a crisis situation but every day.  This would be the only effective corrective action necessary to eliminate the root-cause for these mass school shootings.  Of course, better gun control would be the icing on the cake.

Please talk to your children about this problem, ask of them to be always social towards others.

Added 3/30/2018, taken from my comment posted earlier.  I want to be sure that the following will not be missed.
Please visit: http://www.cyberbullyhotline.com/07-10-12-scourge.html, for more information.

The following was taken from the linked site shown above.
42% of kids reported having been cyber-bullied.
7.5 million Facebook users are 13 years old.
81 % of teens say bullying online is easier to get away with.
3 million kids, per month, are absent from school due to bullying.
20% of kids cyber-bullied think about suicide, 1 in 10 attempt it.
4,500 commit suicide each year.
Suicide is the No. 3 killer of teens (car accidents #1, homicide #2).

Per the foregoing, on average over 12 children kill themselves daily; where is the outcry?

I think our teens need to take a hard look at themselves, before they look elsewhere. The number of young children and young adults (teens) killed by gunfire pales by comparison to the above suicide statistics. 

Acknowledgement by President Trump