The peculiar presidential politics of the Murphy Bill

May 4, 2016 by

http://www.cnn.com/2015/08/27/politics/donald-trump-virginia-shooting-mental-health-gun-laws/

https://www.washingtonpost.com/news/inspired-life/wp/2016/02/19/nut-job-wacko-basket-case-donald-trumps-put-downs-perpetuate-mental-health-stigma/

http://www.theatlantic.com/politics/archive/2015/10/donald-trump-gop-debate-mental-health/413023/

DJ Jaffe at one point talked about how Hillary Clinton was the enemy of the “seriously mentally ill” and that the Republicans are much better advocates for the seriously mentally ill. Donald Trump is now the Republican nominee for President. Talk about an advocate for the “seriously mentally ill.”

The three articles linked above are just 3 of the first I found describing Trump’s views on mental health. There were plenty more. If you are not familiar with them you need to take a look and seriously consider them. Take a look and consider what his leadership would mean to the lives of millions of people with psychiatric diagnoses in this country. Really…. Take a look.

I sent these articles to a friend tonight. His response was quick, “If you take Murphy and take out the veneer of clinical appropriateness, if you translate Murphy into meanness I think you would get something that looks a lot like Trump.”

It will prove interesting how the Murphy Bill in particular and mental health reform in general navigate today’s coronation of Mr. Trump. He may be too busy with Mexicans right now and mental health may be buried deep on his agenda but nothing will save Rep Murphy from being a Republican and the notion that Donald Trump will approach anything as a bipartisan issue seems to me to be wishful thinking.

What will happen when Trump describes the Murphy Bill or any effort for that matter as the way the “looneys…. the nut jobs…. and the basket cases” should be treated? What happens to the Murphy Bill when it becomes a topic of discussion amongst presidential candidates?

I don’t know the answer to any of this. Perhaps Trump will remain too busy with Mexicans to notice. If I was Murphy I would cross my fingers and hope so.

I have wondered for a long time if mental health reform and particularly the Murphy Bill would survive a presidential campaign. Perhaps I am wrong and political ambition and partisanship will be frozen out of the discussion but seeing is believing.

I know several people who hope there is no mental health bill this year. They are appalled by the Murphy Bill and see the Senate bill as the lesser of evils.

Somehow I think some of them might be smiling a little tonight. Donald Trump is running for president.

What if

May 3, 2016 by

(based on an earlier post)

What if
Poverty was not a crime
Or moral failing
Or judgement of sin
But an extraordinary experience
Of ordinary people
What if
We believed that
People deserved to be
Treated right
Regardless of
Social status or
Financial standing
Or what label or
Tag we place on them
What if human being
Was a sufficient condition
Of kindness
And care
What if everyone was
Our neighbor
And we really
Believed we were theirs
What if we knew
But for the grace
Of God
There go I
And life was
About sharing that
Grace
What if everyone
Was against needless death
And for better life
What if care and love
Were not measured by
What they cost
But treasured for
The opportunity to give
What if everyone could
See and hear and feel
And knew that injustice
That diminishes one
Diminishes all
What if these
Were not things
We prayed for
But things we celebrated
What if Tennessee was
For all Tennesseans
If that is our journey
If that is our hope
Then must we not
Step today
And find another
With which to step tomorrow
And the next day
And the day after.
Walk for those
Who cant walk
Sing for those
Who have no voice
And above
Way above all else
Care for those
Convinced no one
Really cares

Hipaa…. the therapeutic effect

May 3, 2016 by

I know a psychiatrist who hates the idea of any legislation relaxing hipaa restrictions.   His view was one of the most unique I have heard.

“It is a terrible idea to put parents in charge of an adult child and ultimately that is what that does. It defines their relationship as a struggle for control that, in my experience, almost always ended in disaster for everyone concerned. No one trusts anyone. Everyone blames everybody for any problems that occur. Even well meaning parents almost always end up trying to define their “child” as good when he listens to them and irresponsible when they don’t. It is a losing proposition for everyone. It is not the information shared that is most important. It is how sharing that information defines their relationship. ”

It certainly makes sense to me. Just thought I would share.

What would happen if we won the election??

May 2, 2016 by

(This post is a companion piece to the post earlier today “What matters?”)

What would happen if none of the politicians running for election won this time around?

What if we won?

What if those got elected thought they owed us more than a speech or a sound bite?  What if they thought government was not about them looking better but our lives going better?

What if they thought being a better person was part of being a better official?  

What if they thought public life was not about who you walked over but who you walked with?

What if they saw no circumstances in which the public good was served by hate?

What if they thought promises mattered?

What if they thought my welfare was not served by making your life worse?

What if they didn’t like others too much to work with them but cared too much not to.

What if they thought that important things are actually worth doing?

What if they thought the public welfare was not served simply by what made them look good?

What if they did not think they were too important to tell the truth?

What if they were as concerned about the people with no money to give as they were about those eager to give?

What if their voice could not be bought?
What if they thought the welfare of their party was not the same as the welfare of the country?

What if they knew blame was not a political program nor hate a political principle?

What if they believed that leadership was not about how tall you stood but how wide you reached out?

What if they thought that national security was best served by a government that operated with integrity?

What if they thought when life got better we all won rather they voted for it or not?

What if they never thought it was in their best interest to tolerate injustice?

What if they really believed there was hope for this country and it was not a political slogan who is to blame for our problems?

What if they were as willing to do the right thing even if it threatened their reelection as they were to do nothing to keep from having their reelection threatened?

What if the people in this country won every election? What if????

What matters…

May 2, 2016 by

What if there was only one political question….. what matters?

And what if all the politicians who believe that nothing mattered other than them would start buzzing or ringing or making some obnoxious noise that got louder and louder the more they talked and tried to convince everyone they that their campaign was more than self promotion?

What if politicians has to go 24 hours without calling names or pointing fingers or blaming everyone that disagrees with them for the world’s problems before they were eligible for election?

What if there was a medication that would cause politicians to forget how to lie?

What if any politician who wanted to accept large contributions had to take an add out in the paper saying he was for sale?

What if any politician who tried to say hate was a good idea starting laughing and couldn’t stop?

What if all voting machines had a “none of the above” option?

What if it was illegal for politicians to quote the Bible who had never read it?

What if politicians could only receive health insurance after everyone they represented had it?

What if politicians knew poor people did not cause poverty?

What if politicians knew their job description was justice?

What if politicians couldn’t get rich by being a politician?

What if politicians knew who their boss was?

What if politicians could only go on vacation when you could afford to go too?

What if somehow politician became more than a 4 letter word?

What if politicians had to have real life experience in being good people?

What if you didn’t have to ask politicians what matters about this country because you knew they knew?

What if what really matters mattered to them??

A 4:30 song…… A 4:30 prayer

May 2, 2016 by

Middle of the night posts seldom go well and I hope this will be different but sleep is not there tonight and this is my song…. this is my prayer….. for Linda…

When you read this, when you hear this song I hope you will stop and say a small prayer for her…

She prays to feel good again but does not remember the last good day. Walking is harder now…. the pain in her feet is steadily worse. Neuropathy is out of control now. The last 3 or 4 weeks have been a lot worse. It is a new place, a new space. Right now it seems where we will live.

In a person of lesser grace it would be a place to give up but Linda does not know that. We still go. Sometimes late at night I wonder how but then I know we just will. Courage is a real thing and in the courage for small things is at its most real.

The headaches came about 2 months ago and have yet to leave. They wake up with her in the morning and sleep with her night. I asked her yesterday how bad on a scale of 1-10 they were and she said it was a better day… She was a 7.

We don’t know why. Seizures are part of the problem. They come after every seizure now and lately there have been a lot of seizures to come after. But other things are going on to….. Scarier than seizures and we still wait to know for sure.

I know God has children for she is a child of his. I simply marvel at the strength of her assurance and the joy she tries to share with others. I marvel at her open heart and gracious spirit.

The death of Insure Tennessee has been a kind of death for us. Both of us know we will probably never live together again. And that is a real sadness and a real grief. The terrorists in my life are not Moslem, but legislators who would keep us apart for some kind of agenda, something they call principle that honestly eludes me. I think a lot of the people we know that will be left behind this year, some who don’t know if they will be back to fight next year and I just want to scream. I am afraid if I start I can not stop.

In the last couple of weeks Linda and I have maybe spent a days time together. It looks now like this week will be better and I am grateful for that. She has missed choir the last couple of times because of seizures and we both hope we will know music this week.

It is after 5 now and I need to try sleep again. I hope it will be a good day for you. I hope it is for us too.

Take very good care.

Good bless and thank you for these few minutes.

What if saying something was evidence based was the same thing as saying it was honest????

May 1, 2016 by

What if saying something was evidence based was the same thing as honest….

What if evidence based meant you actually helped people to build a better life?

What if evidence based meant you tried to give people expectations of what you did that were realistic and not based on making you look good??

What if the value of being evidence based was not that it rewarded you but was a measure of your service to the people you work with??

What if being evidence based meant that you thought people could make a  good decision about whether or not you could help and acted like you meant it?

What if being evidence based meant you would be okay if something better took your place?

What if being evidence based meant you were not afraid to tell people what you didn’t know?

What if being evidence based meant that you told people they mattered and acted like it??

What if being evidence based meant that you thought the credit was due to the people you work with and not yourself?

What if being evidence based meant that you thought the human rights of the people you work with did not get in the way or inconvenience what you were trying to do?

What if being evidence based meant that you believed the people you worked with could live a meaningful and purposeful life?  

What if being evidence based meant that you thought everyone was more than what was hard in life for them.

What if being evidence based meant you thought addressing the injustice and injury someone lives with was vitally important?

What if evidence based meant that you thought what mattered to the people you worked with mattered?

What if evidence based meant that you knew that being a good person with the people you work was important as anything else you did?

And finally what if evidence based was more a measure of how much you actually mattered to the people you work with and not a measure of how important you want other people to believe you are?

Being an outsider… the battle for a mental health narrative

April 30, 2016 by

Suppose you were told that because of some characteristic you had or some characteristic others assumed you had that you are somehow deficient as a human being and as such not entitled to the rights or opportunities afforded to others.   What if you were told that the fundamental reality of you was the label someone placed on you,  the social or cultural group you belong. to,  your religious faith,  your race,  your gender,  your disability,  your sexual orientation,  your physical appearance or any of countless other characteristics or attributes?    What if there really no “you”, that your identity was strictly limited to being nothing more than “one of them”, a member of some category or group you were placed in?

What if this “identity” was in some way spoiled leaving in some sense a mark or tag on you saying you were not as able as others and that because of that you should be treated differently than others? What if this treatment was unfair, unjust, and hurtful and still justified as appropriate and deserved regardless of what you thought about it? What if any argument you have, any complaint you make, any refusal on your part to accept this identity is defined by those who would control you as proof that you are indeed what they say you are and in fact need the control they say you need?

What if this “identity” had very real life consequences for you? What if it had real economic consequences for you? What if it influenced the kind of jobs you would be considered for and the likelihood of success in those jobs? What if it affected your health or access to health care? What if it affected whether or not you had a home or what kind of home you had? What if it affected your interactions with police or other authority figures? What if it affected your social standing or status? What if it affected your ability to make friends and be accepted by others? What if it made life harder, much harder and seemed to close off most paths to a better life?

For many people all these things are true. They are identified as different, as alien, as outsiders in their own world. And as outsiders they find that the wider culture habitually and chronically exercises power over them in a fundamentally unjust and hurtful manner.

Too often to be poor means to be treated in this fashion.

Too often to be black or brown or yellow means to be treated in this fashion.

Too often to be a woman means to be treated in this fashion.

Too often to be disabled means to be treated in this fashion.

Too often to be anything other than heterosexual means to be treated in this fashion.

Too often to be an immigrant or anything other than native born to this country means to be treated in this fashion.

All of these things are commonly recognized and in some way, to some degree some kind of fight is being fought to try to change these things. Some of these fights have made some progress. Some have made little. For some people things are getting worse, not better and their struggle is long term.

But there is another group that is not commonly recognized as falling into this narrative. For thousands of people, maybe millions to be given a psychiatric diagnosis (to be called crazy however polite the terminology) means to be treated in this fashion.

Even really good people sometimes don’t recognize this. They assume that diagnosis is a morally neutral act and an objective expression of medical science. Some people see it as a kindness done to poor suffering people to help find them relief. They do not see it as a social act with multiple consequences that are hurtful and unfair. They don’t see that it is an act with real life consequences different than any other kind of diagnosis. They don’t see it as being a question of human rights.

They don’t see the arbitrary and artificial nature of many diagnosis. They don’t understand they are more constructed than discovered. They assume a reliability and diagnosis that just doesn’t exist. They don’t understand how the assumption of a discrete biological entity is more a simple minded prejudice than it is a scientific fact. And they don’t understand how that assumption that problems in living are a symptom of illness helps to excuse and hide very real trauma and injury in the lives of so many.

They don’t understand the danger of many “treatments”. I read one person a list of the side effects of psychiatric medication and asked him what would happen if this was a list of the side effects of heart medication. He responded quickly, “A revolution in health care…”

They don’t understand how many things don’t work very well. We just do them because we are used to doing them. And they don’t understand how an approach that is so naive about the effects of adverse circumstances in our life is so often useless if not harmful.

Rather the fault be in our ability to explain or in the ability of others to hear and understand a lot of people just don’t buy the narrative. They don’t see or understand the idea of mental health advocacy having anything to do with human rights. It is a tragedy of major proportions.

I have heard all kinds of explanations as to why. Some point to the splits and divisions amongst advocates and say that people who don’t stand together give at best mixed messages about what they stand for. I have heard others say the problem is language. How do you translate your experience into terms that resonate and move someone who does not share that experience. I have heard we are far too negative. It is easier to understand what people are against if you understand clearly what they are for. I have heard that we are perceived as trivializing or minimizing the very real misery that so many people live with. We, I have been told, have nothing for people in serious distress. I don’t know the answer but I am sure of the problem. For too many people it has little or nothing to do with human rights, stigma and prejudice, or people being hurt by what is supposed to help them. It is about making sure that people who need medical care get it.

There is a great conversation going on about national mental health reform laws. No one really knows what if anything will happen. Perhaps nothing. But……

One of the outcomes possible with something like the Murphy Bill is that one mental health narrative…. the medical model…. will actually acquire not just medical standing but legal standing. It will become, particularly in time, the legal way to treat people with mental health issues. Anything contradicting it will be seen, in one of Murphys terms, as reprehensible and irresponsible.

The results of this battle may be substantial and long standing. Everyone should matter. Everyone does matter. The task before us is to craft a narrative that people will buy into that takes us closer and closer to the day that is true and better life is a real possibility for everyone who struggles with life.

The task force train…..

April 29, 2016 by

For years my passion had been the struggle for health care reform in Tennessee.   I thought everyone who had to go to the doctor ought to be able to. It was really that simple.   It seemed like the most obvious justice.   I never understood (still don’t)  the idea that any legitimate rules would say poor people should die for being poor.   I never understood (still don’t) the idea that some people hadn’t earned health care and that they were somehow acceptable casualties.   I  never understood (still don’t)  the idea that a decent people could as a matter of policy and choice leave the more vulnerable of their number behind.

At the beginning it was really I suppose very self centered for us. Gov Bredesen’s rules are going to take away Linda’s health care and I wrote him a letter asking him not to kill my wife. And then we started to meet the people who were to die, the people who could do nothing, the people who had no way to get any help for their suffering. We found a world we didn’t even know existed.

The moment I realized that the state of Tennessee could and would continue to commit health care violence on thousands and thousands of innocent people in the service of some kind of barbaric political agenda was the moment Linda and I both became radicalized in this struggle.

When the battle for expansion started long before there even was an Insure Tennessee we were told that there was no path forward. Tennessee would never cover the uninsured. And then Insure Tennessee happened and what would have been a silly dream not long before seemed to be a real possibility. The impossible seemed possible.

Two crushing years and I don’t know. I have never seen facts be so irrelevant to a political debate and have never seen public opinion so ignored. And now at best maybe the whole thing is on life support. I don’t know.

Speaker Harwell has convened a task force to find an answer based on “conservative principles” (the governor thought he had already done that). Right now it is the only train leaving the station and if it is simply political theater perhaps we are all screwed. People are still dying. Thousands who can no longer wait will possibly be left behind. It sure seems that way.

A lot of people are cautiously optimistic right now. There have been two task force hearings and they have listened to the same people who told them the things people were told about why Insure Tennessee was a good idea. But at least they asked. And I hoped they listened.

One friend told me he thought it was a good idea. He said it gave the Republicans control over something they had lost control of and if there was a way to make it look like their idea maybe they would rush to take credit and something good will happen. A lot of people I know share that hope.

Another friend saw it very differently. He said they were folding the issue of Insure Tennessee into what they saw as the larger issue of Tenn Care. The Republicans never really bought the idea of the urgency of 280,000 uninsured Tennesseans he thought. Their urgency was about a program they thought too big and they never really felt okay about doing one new big thing (Insure Tennessee) while an existing big thing (Tenn Care) was too big to manage effectively. The “pilot programs” the task force has talked about so much are in his eyes about finding a way to bring down Tenn Care costs and not insuring the uninsured. I dont know the answer and at this time don’t know if anyone knows. I think the intent of advocates will be to define the issue as those stuck in the coverage gap in the most intense way possible as the task force meets throughout the state.

One thing does seem to be clear. Whatever their plan it seems apparent it will be small, a pilot program that might take a long time to become statewide. That seems to be a core part of their agenda.

It raises, if it does turn out to be true, a real fundamental issue. If it is seemingly the only political path forward and if, as seems true now, even in the best of circumstances, to focus on far less than everyone in the gap – – if people will be left behind – – how do we respond? Right now every single person I regards the coverage of all 280,000 people as a non negotiable expectation. But the simple truth is that it never made a difference with Insure Tennessee and who is to say the task force will really care what we think. If political reality and moral urgency collide where do we draw the line or should it be redrawn at all? I hope not but I think it might easily be a choice we face.

I hope this train really is leaving the station and I hope it is large enough to take everyone on board. Large enough no one is left behind. Long past time.

The IMD change

April 29, 2016 by

The Center for Medicaid Studies announced a few days ago a change in the use of Medicaid funds for psychiatric hospitalization. I have been talking to friends all day long who I think understand things better than me. I have been told some different things but the bottom line was shared by everyone. The CMS action not only makes more hospitalization and longer hospitalization likely. It makes it legal.

Sections of the article about it are reprinted below.

CMS is loosening up restrictions on Medicaid reimbursement for institutional-based mental health and substance abuse services by allowing states to make a capitation payment for enrollees with a short-term stay in an institution for mental disease (IMD) in its massive Medicaid managed care final regulation released on Monday (April 25)….The final rule says states may make a capitation payment for enrollees with a short-term stay, no more than 15 days, in an Institution for Mental Disease (IMD) to address access problems for inpatient psychiatric and substance use disorder services. The provision will be implemented 60 days after the rule is published….. The National Health Law Program noted that CMS also included a requirement that IMD services must meet requirements for “in lieu of” services. This policy allows states to cover alternative services or settings “in lieu of services” covered under the state plan, according to NHeLP. NheLP pointed out that CMS said this will allow the enrollee to have a choice between IMD and community-based services and that the agency said a managed care plan cannot force an enrollee to get services at an IMD.

How it affects things will depend on your particular state. I don’t know that it will exactly be the same in any two states. So much of what I have to say is directed specifically towards what I believe will be issues in Tennessee. Some of the issues are probably common to most states.

1. The first thing to realize is somebody still has to pay regardless of the rules and how this is done will have a lot to do with how this rule affects specific states.

2. The articles reference “capitation payments.” What this means is that mco’s are paid not so much for the needs of the people served as much as a lump sum per person served. This means if a person costs more than the lump sum payed you are in the hole. Your hope is that there are enough people who cost less to make up for the people who cost more.

3. Insurance companies will not passively take a loss. If they are presented with the possibility of loss due to significant new expenses they have a couple of options.

A. Insist the state pay them more money. In Tennessee Medicaid takes about a third of the budget. State lawmakers have a task force right now whose big hope is to significantly cut that budget. A demand for a significant increase in budget because of a rule coming out of Washington is not likely to be warmly met.

B. If the state does not adequately meet anticipated new demands then one option would be to regulate that demand. Even if something is legal it still must be justified by medical necessity. If you make it difficult for people to justify on the basis of medical necessity longer stays then that will decrease the amount of financial loss you incur.

C. But you will still incur massive loss. This rule change means much state hospitalization formally paid for by state mental health budgets will now fall on state Medicaid budgets. In Tennessee that is not an insignificant amount of money. Everyone in the state hospital will not be on Medicaid but the expense will still be real.

D. One option, that will be a primary option, will be to change other benefits you pay. It means ending coverage of some service or services currently provided or decreasing reimbursement rates to providers. Tennessee will do both I believe. Case management services have been on the chopping block before and I wonder if they won’t be amputated this time. Dropping reimbursement rates to providers had also been a topic of discussion. The rate is already extremely low. Rate drops will put some providers, particularly small providers in rural areas in danger of going under.

E. There is another term used in the new rule that depending on how it is interpreted may really muddy the waters. The rule says that IMD services can be “in lieu” of contracted services. If the rule actually means what it says people on Medicaid can not be forced to accept services in lieu of contracted services. In other words, hospitalization by this rule would have to be voluntary. Voluntary.

F. No one knows how exactly the rule will be interpreted. In Tennessee there is no voluntary state hospitalization. All state hospitalization is based on committal. How will this affect things??

G. Aside from how this might affect the rights of individuals what would happen if a state Medicaid trying to manage a potential ocean of new expenses said that based on this rule they would not approve hospitalizations that are not voluntary? I don’t know if such a thing is even likely. Just food for thought.

All this is to say there are more questions than answers. The potential for this rule to have unintended consequences is real. It could easily mess up far more than it “solves.” Again I think it may well vary from state to state. As salvation it does not solve much. At most it gives political victory to some folks passionately searching for it.

It will doubtlessly affect in some way the ongoing debate about mental health legislation on the federal level. That effect will be much clearer in coming weeks.

Pointing fingers… On politics and the descent to madness

April 28, 2016 by

Much of our political discourse just seems to be an argument about who to blame and a promise to  do something about those people who keep messing things up.   It is not about a call to any higher vision or principles or any hopes for a better life.   It is about men and women of immense egos telling us we deserve to get even and we can count on them to help.   It is about America reduced to a reality TV and trying to articulate the truth of our lives in a 140 character tweet.

We are constantly being sold solutions in search of a problem. We are told our anger, or fears and our fears and prejudices are now moral sensitivities and no one has the right to offend them. Tennessee has tried to solve the threat of who goes into what bathroom. We have tried to make the Bible our official book (It is not dangerous unless you read it.). Finally we decided that our mental health system need not serve anyone our therapists and counselors think are morally challenged.

Meanwhile, 280,000 people remain without access to health care after our legislators refused to even talk about a plan already approved that would help everyone at no cost to the state. The Speaker of the House has know convened a task force to figure out how to do attack this problem using genuine “conservative principles.”

National politics help to keep Tennessee from looking totally pathetic. The scariest thing is not so much who wins. It is that someone will. Right now even though I like some candidates more than others I have a real problem seeing a path that will arrest our further descent into madness and chaos. I fear it is reality TV destined to run forever and I wonder what happened and where we are yet to go.

I have a friend who tells me that democracy is something that must be done everyday and instead we sold it to people who think a better country is defined by what makes them richer and more powerful. Perhaps we need to demand our country back, and insist that our principles need to be more than apology for the injustices we inflict on the poor and vulnerable and that a government that prizes the voice of ordinary people can not be run by people who think they are better than everyone else.

I simply refuse to believe this is the way it had to be. If I matter, if you matter and if it matters that we matter can there not be a path to something better? Must our politics, must the way we use power simply be about the misery we perpetrate on each other?

I am sick of pointing fingers. Maybe it is time for all of us to say that life is more than who is to torture and who is to be the victim. Maybe it is time for us to say we all live in the same boat and the water is rising so very fast.

Maybe it is time.

The torture of mentally ill prisoners

April 28, 2016 by

http://www.newyorker.com/magazine/2016/05/02/the-torturing-of-mentally-ill-prisoners

On poor people and Insure Tennessee

April 28, 2016 by

The post below was written some time last year but still really relevant.  Speaker Harwell’s task force is really about not just telling a story about what  it means to be without insurance in Tennessee but selling that story.   As you listen to them consider the story they are telling.

This is the story often told about poor people……

Life is much about trying to figure out how it makes sense- trying to find a story that tells us what’s going on and why. Politics is a competition of stories.   Advocacy is the fight to give one story primacy over another.

In the last months I have become as emotionally invested in the battle to expand healthcare in Tennessee as I have anything in a long time.   The personal stake has been great but in larger context it has been a battle of stories.

There is a frame of reference, a story, that says that being poor is a willful condition of a large group of people who are lazy and gleefully dependent upon whatever they can get from the government. Their appetites, the story goes are insatiable. They chronically cheat and without management will literally steal us all blind. Some states are now at the point where they not only manage how much food they eat but what kind. It is viewed as a legitimate consequence for the kind of people they have chosen to be.

The lack of health-care is also viewed as a consequence of willful choices. If they only worked harder, tried harder, if only they paid their way they would not be asking, no demanding, for what others work hard for.

Bigotry to have wide commerce must be cloaked in common sense. And the story about poor people is to too many the ultimate common sense. It explains clearly that they bring bad things on themselves. It explains why helping them is bad for them (it makes them more dependent and thus less likely to try harder to make life better) and why the poor are a threat to regular working people. (Personally I think the threat of poor people just gives the rich cushion from too many difficult questions but that may just be me.)

There is increasingly a polite bigotry. It says the problem is not with the poor (after all we are not bad people) but in the misguided and dangerous ways some would have us help them. They counsel patience and waiting. Sometimes though the nastiness seeps out but most are more polished than Senator Gardenhire. But bigotry in the end does not depend on the clothes it wears.

Poverty should not be a crime or seen as God’s judgement on our character and there
is a political vision that sees it that way. For too long in Tennessee it has been a too common vision

The legitimization of evil… The Tennessee assault on LGBT people

April 27, 2016 by

Counselors In Tennessee Can Now Legally Refuse LGBT Patients – http://huff.to/24kRdc4

Today Tennessee made a giant step towards the legitimization of evil in its mental health system. Governor Haslam made it legal today for counselors in Tennessee to refuse to provide treatment to people they have sincere and deeply principles against. The target of this law was the LGBT population in Tennessee.

It means that people who by training, commitment and the ethics of their profession are supposed to help people with the worst of personal problems and issues can now say those issues offend my sensibilities. People who are told they can trust their counselors with their most personal secrets are now told “… except your sexual orientation”. People who are told to be honest and open are now told “… well not too honest….”

In Tennessee counselors are now told you have the right to discriminate “as long as you are sincere.” Bigotry and hate are now expressions of sensitivity according to Tennessee law. There might be a word to describe the utter meanness of this law but it is past any word that comes to mind.

Point blank…. This law will not simply be a law that discriminates. It will be a law that kills, a law that results in the death and unnecessary suffering of hurting people. It is a law that attempts to legitimize evil.

With one signature Governor Haslam has put an asterisk next to the name of one whole group of people. He has said the unconditional personal regard that you may have thought of as due to you as the client of a professional counselor is highly conditional for you. He has said that the prejudice of any counselor is a legitimate determination of rather or not they will ever work with you. He has said that it is legitimate for counselors to regard a whole population as too dirty and too disgusting to work with.

According to research I have read one of the most common issues that people in the LGBT population most frequently seek help for has to deal with issues of suicidality. How long will it take before someone who sees a mental health system that defines his identity as to dirty to tolerate, someone who badly needs help decides he can’t trust the very system that is supposed to help and ends up dying? How long??

This law attacks the integrity and credibility of the mental health system. How can a “helping profession” tolerate the legitimization of hatred as a legitimate part of its operation? On a million different levels this is wrong.

Mental health makes strong claims to be founded on medical science. Are we next to say that doctors don’t have to deal with heart attacks or other chronic diseases if the identity or life style of a patient offends them? When do you draw the line?

What happens when somebody says he has deeply and sincerely held personal principles about race. This law would really make no distinction. Once licensed hate knows no boundaries, no limits.

This law is so bad. It really legitimized evil. Add your voice today to others already speaking out. Make your voice count. Silence will make all of this so real.

The man who kept kids from starving

April 26, 2016 by

From 2011

Hopeworks Community

from 2011

One of my favorite stories is the story of Jerry Sternin. He came to Vietnam in 1990 to try to come up with a way to address the issue of malnutrition especially that of child nutrition. Without any great theory of malnutrition or any great resources he found a solution and in the process showed the amazing power of a theory of human change called the theory of positive deviance. His idea was real simple. Even in the worst of situations he assumed there were people who were successful. Not all kids were dying of malnutrition. His idea was find the people who were doing things differently, who were successful and teach others to do the same thing. Find out what works and do more of it. And not only did it work it worked spectacularly. A description of his story can be found in many places but…

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