Trump fever or furor

One of the first things I do before I take a job is research the company.  High turnover is usually a sign to not go there to work.  It is a sign of chaos and problems with management.  People have mixed feelings about Trumps constant personnel shift.  Some feel that it is a sign of strength to get rid of bad people quickly.  Others think he is too difficult to work with.

Trump wants loyalty.  I would want loyalty in my company too.  I am in the process of hiring as well.  But I would want my employees to trust me that if they feel I am wrong that they can come to me without a fear of retailiation.  No person is right or wrong all the time.

Many people said to give him a chance and some time to settle in.  Most places I have worked that is 90 days.  It has been past 90 days.  I realize that transitioning from the private sector where you did not have to deal with congress or the senate or the courts will be challenging.  A CEO is not used to being questioned.  But the Presidency is different.  Companies can go bankrupt.  The united states can’t bankrupt and start over. Our founding Fathers created checks and balances to avoid one person having absolute power over any one branch of government, like monarchies.

I have never seen so much protesting in any presidency since Johnson and vietnam.  Those protests were to stop the war and not really about Johnson as a person.  We now are told not to trust the media, protestors are being paid and just read Trumps tweets and all is well.

I have skin in the game.  If my patients lose health care, I do not have patients and I close down.  I have two daughters with pre existing conditions.  I have pre existing conditions.  My husband has been in the Navy hospital for almost a month.  I am grateful.  His care has been excellent and it hasn’t cost us anything.  I have the same arrangement as his wife. I want this quality of care for everyone.  We pay premiums for our health care.

I hear repeal and replace, but no clear option.  Most people with pre existing conditions need insurance.  Your health can change at any time.  I was first denied health care insurance in 1996 due to a thyroid condition treated and managed well with medication.  I had to keep a job with insurance or i was in trouble.  My children were at one point on Medicaid.  My late husband used the VA.  I have been on four different insurance plans that denied procedures, medications, orthodics, etc.  They previous Obama system was not great- admit it.  Obama care has flaws.  But the real problem is greed.  Insurance companies are in business to make a profit and they should.  But how much money does a CEO need to make, what is fair compensation.

As a provider I am paid anywhere from 30 to 86 dollars for the same service.  Some patients pay nothing, others from 15.00 to 45.00 a co-pay. Some have deductibles some do not.  No wonder people are confused.  They blame the high costs on the government.  The government can only regulate so much.  Companies pull out of states they don’t make a profit in making less choice for care.  Allowing people to be excluded due to preexisting conditions gives them no choice.

What is the answer?  I am no expert, but I have been a patient, a provider, and have had to deal with accidents and medical surgeries.  I have worked with about 10 insurance companies and Medicaid.

My health care plan

A.) Eligible for Medicare at age 55, option to enroll or not.  This is when most medical conditions start happening.

B.) All insurance companies must cover pre existing conditions and can only charge 10% more than healthy people premiums. This way they can make some profit.

C.) Raise the income level for Medicaid and include people without children that are working. More people will qualify and won’t have to quit their job or have a kid to get medical care.

D.) Tax credits for companies that provide health insurance. Incentives for them to provide it.

.E.) Lower the tax credit to any bills exceeding 3 % of someones income. This will offset some of the costs that insurance doesn’t cover.  Include massage, accupunture, over the counter medications, etc.

F.) Cap deductibles at 1000.00. This will keep a hospital stay from being too costly.

G.) Subsidize any hospital that takes people that cannot pay for each patient. This will encourage some indigent care.

H.)  Allow private individuals to negotiate fees like the insurance companies. We should have the same playing field.

I.)  Allow individuals to buy a group plan with only two people to encourage mom and pop  businesses to get insurance.

J.) Cover preventative care, birth control and physicals and vaccinations.

L.)  Remove caps and high risk pools. Also cap the salaries of CEO’s to not exceed 1 million dollars.

M.)  Congress and the Senate must be on the same policy as their constituents.

 

Number 27

I am number 27 on the list for Mental Health Skill Building. I applied for it in Feburary 2015.  Yes that is right almost a year and a half ago. What is mental health skill building?  It is an in home service for the chronic mental health patients that have been hospitalization. We help them go to their medical appointments, their medications, socialization, and other needed services for 10 hours a week.  There professionals have a bachelors or better.  They are paid well.  They keep people out of the hospital.

These agencies like mine can hire about 10 people.  Right now an agency is number 285 on the list. That is 2,850 jobs waiting for almost 10,000 clients. We have shootings of and by mentally ill people.  The hospitals are full and can’t keep them.

I called to find out why.  They have two people for the whole state of Virginia to process the paperwork.  Virginia has 8.401 million people. If 10 % are mentally ill, that is 840,000 people.  These workers have to verify information, do office inspections, background checks and see if forms and procedures match current laws.  2 people.

If they move 3 steps a time, it will take an additional 9 months for my application to start the process.  That will be next year. How long can our mentally ill people wait?  How many jobs go unfilled?

I have contacted the papers, and wrote a Senator.  I am pushing on.  Next I go to television. I want to serve the disadvantaged, employ people.  Do my civic duty.

Number 27 is not so great after all.

 

 

Most common marriage issue

Communication.

You spend the first few months enthralled at everything they say and find the jokes witty.  You ignore the little things that normally make your flesh crawl.  You expound on the wonderfullness of the other person.

Then you reside together either through cohabitation or marriage.  You notice he doesn’t put the towels up.  She leaves her dishes out.  He goes out without telling you.  She wears ugly sweatpants to bed.  You don’t bring it up.  It festers.  Then boom you have a fight and everything comes up at once.  They don’t understand because you never said anything before now.

Rules for cohabitation:

  1. Make a household budget and 3 accounts.
    everyone should have some of there own money.
  2.  Make a list of household chores and decide who does them.
  3. Each person has a bathroom to call their own and a space.
  4. You make decisions about children, discipline, visits.
  5. Elderly parents who cares for who?
  6. You have a weekly meeting to discuss the household and what is getting on your nerves.
  7. If you need space, ask for it, but give a time frame.
  8. Remember no one reads your mind.
  9. Say I fee _____________ when you _____________.
  10. Always and never and fine are not used.  No one is good or bad all the time and we all do things sometimes.  Plus fine stands for f’ed up, insecure,neurotic and emotional.
  11. Say what you mean.
  12. Paraphrase what the other person says.
  13. Don’t threaten to leave or throw someone out when you aren’t going to do it.
  14. Say something nice everyday to your person.
  15. Do not hit, throw things, break things or use insults.
  16. Do not tolerate such behavior.

 

Accusations

How often do you put up with something before you leave?  How long do you let something go before you complain about it?  What level do you complain to someone high up?

The scenario.  I had a client call the EAP over four months from the visit.  They alleged that I spent the entire session on the phone.  Who would sit in a session for an hour while someone was on the phone?  Why wait four months to complain about it?  The whole thing of suspect from the beginning. My word against hers.  I have answered the phone during a session, but I usually do not.  After hours you don’t have a secretary, and a client could be in crisis.  The next client could be calling for directions.

So now I hang in the balance and could be kicked off the panel on the word of one person.  I even sent a letter to her about why I hadn’t seen her in awhile. Why would I do that if I had been on the phone for an hour?

I shouldn’t let this bother me.  My practice has seen almost 128 clients in a year with no compalints.  128 vs. 1.  Do counselors get the benefit of the doubt?

First page of my novel

I finally have started my novel on my career as a therapist.  I will post exercpts from time to time and hope you will critique it.  I will try to be as honest as possible without giving away any client privledged information.  I also will shed light on various diagnosis, failed treatments, modalities.  I hope to have me grow as a person and learn as I write.  Many people go into this field wanting to save the world.  They have no clue.  The textbooks do not tell you about assessments in the hood, walking the park to engage the homeless, going into homes to look after children,  watching people detox,  doing therapy in a soup kitchen and jail.  It is a journey for me and for my clients. I also apologize to my first clients that I learned with and hope they got better anyway.

And don’t get me started on insurance billing.  They don’t touch that.