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.

 

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Virginian pilot article

I probably should not watch the news.  I get too upset over injustice.  A prisoner in our jail who was mentally ill died.  He was in jail for shoplifting candy.  Most times he would spend a few days in and be out.  He was detained for months on a mental health order.  No bed was available.  He did not get proper treatment.  He was malnourished and suicidal.  He died.  The news papers and TV are all over it.  But there are no beds it isn’t our fault.  Why was he in jail so long for a shoplifting offense.  He wasn’t even convicted.  Jail guards are not prepared to deal with chronic mental illness.  He was in solitary, which deteriorated his condition.  His family tried to get him out.  Many visits were denied due to his behaviors. If there was no bed, he should have been sent home with a mental health skill building agency to work with him.  Oh wait, there aren’t enough of those.  Why is that?  I applied in 02/15 to be a mental health skill builder provider.  I was number 178 on the list.  Now in May I am number 38 on the list.  They have two workers in Richmond processing all the applications for developmental group homes, outpatient, MHSB, TDT, IHH, IOP, substance abuse, and transitional living.  The whole state of Virginia has two workers to process at the present time 258 applications.  This isn’t the department that audits and monitors.  I bet the fraud unit to recoup medicaid money has more than two workers.

The young man needed help.  His family wanted to help him.  We let him down by trying to save money.

Do the math.  Each agency would probably hire about 10 workers at over minimum wage.   258 x 10=2,580 jobs in our state.  New graduates just out of school in all parts of the state. One of those workers could have helped him, but the paperwork has bogged down their agency.

We should be ashamed.  Call your state delegate and senator.  The next person might be someone you love.

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?

Patience is a virtue

I applied to be credentialed with Humana on December 23, 2014, along with several other companies.  I am good at following through with things.  I called on 02/03/15, 02/17/15, 04/06/15, 04/29/15, 05/20/15, 07/06/15, 07/19/15, 08/06/15, 08/12/15, 08/24/15, 08/27/15, and 08/29/15.  I was told many times that it was escalated and a supervisor was contacted.  I was credentialed with everyone else by March 2015.  I was given on 08/24/15 an actual supervisor with extension to contact if I had not heard by the 26.  I have called her twice.  I also emailed provider relations many time; 02/03/15, 07/09/15, 08/07/15 and 08/24/15.  Counselors need to be on panels to attract customers.  I am getting 4 or 5 from each panel, which means that Humana is costing me business in that their customers cannot utilize my services.  The usual fee is 60 to 80 dollars an hour.  So you do the math, 4 customers at 60 is 240 a week, since march.  When do I lose my patience?  My husband tells me to not get them riled up because they will stall longer or not credential me at all. What if Humana customers live in my area and I am the closest practitioner?  Aren’t they denying client care at this point?  What should I do now that my patience has worn out?