The Diary Of My Mind

Shut Downs and Emotional Turning Off

Since I was a child, I’ve experienced what is commonly called a shut down. Basically this means I stop talking, get completely quiet and I look completely emotionless. Behind the scenes, in my mind, there is a lot going on. I am generally trying to work through something that requires my complete and total focus.

Things that might cause a shut down

  1. Stress
  2. Anger
  3. Sadness
  4. Problem solving
  5. Being Insulted

The fifth one there is actually a big one. If I’m insulted I almost instantly shut down. Now shut does can lead to a few results. With the other four, I can generally get over them fairly easy with some coping mechanisms I’ve developed over the years. Number one is a bit hard to deal with but removing myself from the situation, even for a few minutes, seems to work fairly well.

Number five though is another story.

When I am insulted my mind rushes and I am faced with several choices,

  • Vacate, it’s not worth getting worked up over.
  • Emotional outburst, often ending with their feelings hurt worse than mine ever were.
  • Turning my emotions completely off.

The third choice there is, I believe, a holdover from all the bullying that I went through as a child. My mind developed a defense system where I can completely turn my emotions off towards a person or a group. If this happens, that person is more or less dead to me.  Eventually I have to deal with the pain of this type of shut down but that can be months or even years into the future. 

I’ve had friends who were fairly close to me, one day they said something that really bothered me, or did something to me in an insulting or mean fashion. I turn off the emotions and then I don’t care if I ever see that person again. Maybe years down the road I’ll remember them but rarely do I feel bad for a friendship ending in this fashion.

For example: My ex used to scream and throw things at me. Usually this would lead to me having a meltdown lasting several days. Eventually, this occurred so frequently that I simply shut off my emotional response to her. We stopped talking and eventually got divorced. A shut down helped lead me away from an abusive relationship. 

People might find my shut downs odd but they have helped me in numerous ways throughout life. The peace that can be found in a completely emotionless experience is therapeutic in a way. Helps me sort or what needs sorting. 

Do you experience anything along these lines? I wonder how prevalent this is as a coping mechanism. Let me know in the comments below,

Eat Me

Eat Me #2: Stores, Stress, Sleep Issues and Storms

For last weeks article, click here.

1.)Stores

I absolutely hate going grocery shopping or any kind of shopping in particular. If I could, I would do all of my shopping on-line. Unfortunately once a week we need to go to the store for food and other items. Jen wasn’t feeling well today, so my daughter and I went to the store on our own. This trip would be even more awkward because our daughter needed a new bra and wasn’t thrilled to be going bra shopping with dad.

So we make our way to the store and it was about three times busier than usual. Already not good but we head on in. We head straight to the section with the girls bras and it is awkward… My daughter picked out one and went to try it on. While she did that I sat there looking at my shoes. Why are the dressing rooms at Wal-Mart always situated directly next to the lingerie? Very Annoying.

Anyway, she found one and we moved on to our other items on the list. Recently, the store we go to updated their entire floor plan, which means nothing is where I remember it being. Being someone who is adverse to chance, this makes shopping even more stressful. I’d go to where I think something should be and then realize I was in the wrong area. It might not seem that bad to most people but to me it is a nightmare.

Lastly, it seemed like everything on our list had someone standing directly in front of it. So I would patiently wait for the person to move on, yet more often than not it seemed like the people were statues just standing there. This drove me absolutely up the wall, I didn’t want to be rude but several times I had to ask people to move so that i could get the item that we came for. Anyway, it’s over, but shopping can definitely Eat ME!

2.)Stress

Today wasn’t as bad as the rest of the week as far as work goes, but the entire week as a whole has been awful. One stressful situation after another. I work in a high stress career, accounting, but generally things don’t hit you left and right. This week though was really bad.

On top of this, many of my old coping mechanisms seem to be working less since my diagnosis. I know that this is psychosomatic but it is very bothersome. The fact that my stimming and quiet moments don’t seem to be working at calming me down has made the days seem to last forever and the stress simply compound. At the moment the only thing that seems to have a calming effect on me is my writing and Star Trek. I’ll go more into Star Trek in a later post, but I’ll only say that the show has an effect on me that almost nothing else does. I’ve watched all of the shows and seasons multiple times but find new things to love each time I watch them.

Anyway, the stress has led me to have some severe stomach issues and headaches. It has been bright and sunny all week which has led to my sensory issues being even worse. As I’ve said many times, I love my brain and I hate my brain, this week I’ve been more along the lines of hating my brain. I’m just glad it’s over and this week can eat me.

3.) Sleep Issues

So I finally got on Ambien which has helped me get to sleep and stay asleep, yet I am no more rested. The doctor and Jennifer believe that I have sleep apnea. So on the 20th of this month i have to go in and do a sleep study. Basically that means that I will go to the hospital, have a bunch of electrodes attached to my body, and be forced to sleep like that so that the specialist can judge whether or not I have Apnea.

In all honesty, I probably do have Apnea but the thought of the test is awful to me, the idea of having a CPAP machine is awful to me, and the whole thing is just plain awful to me. I’ll go through with it and do as the doctors say, but it is not going to be easy on me. I am incredibly stressed about this, How is it that I can’t even sleep right? Anyway, my sleep issues can EAT ME!

4.) Storms

I swear if I see another religious person blaming the severe weather that we have been experiencing nationwide to the wrath of god I will spit. Whether that is the hurricanes, wildfires, or extreme droughts, these folks are completely willing to blame it all on an invisible man, instead of calling it what it actually is, the effects of climate change.

Some people will say they don’t deny that climate change is real only that they don’t believe it is actually caused by man. Well the science is in, it is due to us, grow up or get used to these severe weather patterns.  To continue denying this fact is to leave our children and grandchildren with a worse world to clean up, if they are even able to survive on this planet by that point.

What makes this worse currently is I have two kids that live in Florida. They aren’t expecting to get the full brunt of the storm where they are at but it is still concerning to me. I hope they will stay safe and things remain calm for them throughout the next week. Seeing folks act as if god is doing this because he is pissed off about something, or that this is actually some insidious plot by the government, is incredibly annoying to me.

Science deniers, whether they be religious or conspiracy theorists are doing the world an incredible disservice. It absolutely sickens me that a huge chunk of the American population falls into these two categories. If you do fall into one of these categories, EAT ME!

 

Freethought Friday

Free-Thought Friday #5:

For last Weeks Free-Thought Friday, click here.

Today’s article comes to us from the UK. Alan Solomon has been a reader of my blog for some time now. He has shared with me his interest in my journey from the perspective of someone who was never a believer. Here is his ideas on how to improve the healthcare system in the USA. I find it interesting, his take on our healthcare and the possible fixes that he proposes.


Repeal and replace Obamacare.

Trump.jpgThis is the Holy Grail that Trump promised (and he said he had a cunning plan during the electoral process). The cunning plan turned out to be “dump the problem on Congress”. And it all went downhill from there. They called it the “American Care Act”. The Democrats voted solidly against it, so it only took a few Republicans to think it didn’t go far enough, or it went too far, and the plan ended up in the “too difficult” drawer.

But it can be done.

First, a few prelimiaries. 

Medicare is a healthcare program, paid for out of taxes, that covers people who are 65 or more, certain younger people with disabilities, and people with End-Stage Renal Disease, which sounds pretty dreadful and I hope I never find out what it is. Medicare comes in four parts; A is hospital coverage, B is … well, read it here. Part A costs you $451 per month = $5412/year. To get part B (which also gets youC and D), you pay $105 per month = $1260 per year. So the whole package is $6672/year.

But there there’s “deductibles”  (you pay extra if you actually go to hospital), and there’s coinsurance (co-pay). Yes, it gets complicated.

55 million people are on Medicare. The Medicare budget in 2017 is $709 billion

Medicaid is for anyone who is low-paid, if you feel low-paid, then google for details, maybe you qualify. 74 million people are on Medicaid; Obamacare expanded Medicaid as of 2014. Oh, and 9 million are on both Medicare and Medicaid. The Medicaid budget in 2017 is $553 billion.

And then there’s Obamacare, the Patient Protection and Affordable Care Act, also called the Affordable Care Act or ACA. After you’ve read that explanation, maybe you can explain it to me, because it’s much too complicated for my tiny brain, which probably means that it’s *far* too complicated for politicians, who often struggle to comprehend how arithmetic works. Obama said it would cost $94 billion per year, this is disputed. And I can’t work out who pays what. No wonder there’s controversy. The CBO, which is supposed to be non-partisan, say $134 billion per year. I’ll take that figure.

And finally, if you’re a Veteran, you can go to The Veterans Health Administration (VHA).  The Veterans (VHA) budget is $68 billion

So I added all these up. It comes to $1464 billion, which works out at $4531 per head, since there are 323.1 million Americans (I’m ignoring the detail that some Americans are older than others).

So that’s what the government pays – that means that this much comes out of taxation. In addition, there’s all the co-pays and deductibles, and additional insurance paymens made by people in these plans, and I haven’t even tried to estimate how much that adds to the total, because it’s just too complicated. And to that, you should add the money spent by Americans on the various privately-run insurance schemes. Aetna, for example has a revenue of $63 billion, Anthem takes in $85 billion and Met Life gets $70 billion. And that’s just three companies of many. I could have included those in my total, but I didn’t.  I don’t need to dip into the healthcare insurance company revenues to make the case I’m making.

How good is American healthcare?

Flag.jpg

How do you measure how good a healthcare system is? I don’t care how many CAT scanners you have, or how much profit is made by the healthcare companies. What matters to me, and what should matter to you, is the outcome. Are you healthier? But it’s difficult to measure “healthiness”. Do you live longer? Ah, now that we can measure. So I will.

It’s always tricky to compare countries, but there’s a few things that are comparable. The first of these is the mortality rate for under-fives. In the USA, that’s 6500 per million, in the UK it’s 4200. Please try to imagine a pile of 2300 dead toddlers.

And there’s also infant mortality; deaths per million live births. USA is 5800, UK is 4300. So now imagine a heap of 1500 dead babies.

My older daughter is about to have a baby. It’s all very exciting, and eagerly anticipated, but a couple of weeks ago we had a family discussion about “what if”. Because giving birth is not without risk. In the USA, there’s 21 mothers dying of pregnancy or complications, per 100,000. In the UK, that’s 12 per 100,000. So that’s 75% more in the USA – I’m glad that my daughter is in the UK!

And life expectancy in the USA is 78.8 years. In the UK that’s 81.1, that’s 2.3 extra years. Nice!

And on average, 643,000 Americans declare bankrupcy per year owing to medical bills. You break a leg – you lose everyting you own. And each of those 643,000 has a family.

I’ve compared with the UK, but if you follow the links, you’ll see just how poor US health outcomes are compared with a great many countries. Look at the rankings, and ask yourself, why isn’t American healthcare the best in the world? Because it really ought to be. Because the USA is a highly educated, prosperous and technologically advanced society, that spends a lot more per head on health care than any other country.

Compare that with the UK.

UK

So that’s public healthcare in the USA. And I’d like to compare that with public healthcare in the place I know best, the UK.

The NHS budget is £124 billion, which is $161 billion, and works out at $2453 per head.
For that cost, UK citizens get healthcare, period. And pretty much everything is free (meaning, paid for out of taxation). A medication prescription costs $11, and if you’re getting a lot of pills, you can pay $38 to cover all the charges for three months. But there’s a lot of people get presciptions for free; I do, because I’m over 65 (also cancer patients, pregnant women, and so on). You also pay extra for dental work; $27 for routine stuff, $73 if you need a filling or root canal. Hospitals are free – I’ve never paid for any hospital visit. And there’s a thing called the “Small injuries unit” which I’ve been to for a nasty scalp cut and before that for a splinter under my fingernail that I just couldn’t get out. A nice nurse cleaned up the scalp cut and then glued it (apparently they prefer to use glue for small stuff). Another nice nurse got the splinter out while I shut my eyes and tried not to scream.  In my experience, you turn up and they just deal with it, 24/7. I get free spectacles and have for the last 60 years, although I can pay extra to get designer frames. And when my free biennial vision test discovered excessive pressure in my left eyeball, diagnosis and treatment has been free (a drop in my eye each morning seems to have fixed it).

Oh, and doctor’s appointments are free. And I don’t see how anyone in the UK could be bankrupted by medical bills.

And I don’t think that the UK is exceptionally good. Yes, the NHS is good, but I’ve heard very good reports of the French system, and Germany was the first country to move to universal healthcare, in 1883.

The American Health Service  

healthcare

So right now, Americans are paying twice as much as people in other countries, for an inferior health outcome.

So let’s imagine a service which I’m going to call the American Health Service, AHS. It’s free at point of need (with maybe a few exceptions, as above) and it’s paid for out of taxation. If it costs the same as in the UK (I’ll discuss this later) then that would be $2453/head, $793 billion per year. Which is a saving of $671 billion per year, and if you put that back into the pockets of the taxpayer, that’s $2078 per person, which would be $8312 for a family of four. Tax cuts!

So all Americans would get healthcare to a high standard, wouldn’t have to raid their income for health insurance, no co-pay, no deductibles, no cap on spending (sorry, you’re only covered up to $1m, your insurance ran out, please die quietly now). And no “pre-existing condition”. The way it works is, if you’re sick, then you get treated.

Sounds good. Sounds very good. In fact, it sounds too good to be true! So where’s the catch? How can you get univeral healthcare at cost of about half of what you’re already paying?

There’s two reasons why universal single-payer healthcare is so much cheaper.

The first is the cost of medication. 

medicine

A recent Trump tweet said “Now that Ken Frazier of Merck Pharma has resigned from President’s Manufacturing Council,he will have more time to LOWER RIPOFF DRUG PRICES!” When Trump thinks that drug prices are too high, then maybe they are. Also, drug prices for the same drug in Canada are much lower. But why should Frazier lower drug prices? If there are people willing to pay his high prices, he’d be a fool to lower them.

The reason is monopoly and monopsony. If a company has a monopoly on something important, you can be sure that the price of that thing will be somewhat higher than a situation where there are several companies competing for your business. And, of course, that works the other way round – if there is only one buyer of a product then that buyer has tremendous leverage; that’s called a monopsony. So the American Health Service (which doesn’t exist, but ought to) would A) be buying in bulk, and that’s always cheaper, and B) would be the only buyer, so you sell your Epipen to us, or you you don’t make many sales. And here’s the price we think we should be paying … see above.

healthcare2

The second reason is insurance companies. 

In an UK NHS hospital there is no team of administrators working out the costs of treating each patient and filling in the necessary forms to claim on the insurance (and the insurance companies are not eager to pay unless it can be shown that the claim is valid). That team of administrators is matched by equivalent teams in each of the insurance companies, checking those forms. The entire cost of the processing of insurance claims is avoided, as is the profits made by those companies. You see, they aren’t non-profits working out of the benevolence of their hearts.

The pharmaceutical companies are, of course, aware of this threat and they will fight tooth and nail to avoid having to face a monopsony. No tactic will be too underhand, no “sponsored research” stone will be left unturned. But, you might ask, why doesn’t Medicare use its buying power to negotiate better prices? Because your congress won’t let them. The Medicare Modernization Act of 2003 (MMA) included a ban on price negotiation. The pharma companies spend more than $100m on lobbying, seeking to persuade lawmakers by hook or by crook to maintain their high (or as Trump puts it, “RIPOFF”) prices. That $100 million is a wise investment of a small fraction of the $374 billion that Americans spend on medication per year.

And what of the insurance companies? They will see most of the reason for their existence wiped away. In the UK, there are a few medical insurance companies, but nothing like the American behemoths. And they too will fight like cornered leviathans to maintain their lucrative business. Currently, they’re spending over $10m per year.

So that’s why it’s possible to have a single-payer, universal healthcare system at around half of what the government is currently paying.

BUT … 

“But this is socialism”, I’ve heard people say. Yes, it is. And? It’s a service for the whole population, paid for out of taxation. Just like the fire service, the police service, the public school service and the military. I don’t hear cries from the anti-socialists “stop taxing us to pay for the military, we’ll defend ourselves”.

“But it’s unfair, I’ll be paying for a service used by other people”. That’s right. The rich will help the poor, the healthy will help the sick. If you’re a Christian, then you’ll probably approve of this because that’s what Jesus wanted. If you’re an Atheist, you’ll definitely approve of this, because it’s the Right Thing To Do.

“But taxes” you might say, if you’re Republican. Or also if you’re Democrat – no-one actually likes being taxed. Um, no. Because the AHS would cost half of what’s currently being spent out of taxes, that leave room for a tax cut once the system is in place. TAX CUT!

“But it’s untried, untested, how can we know if it would work?” Look at the 58 countries that already have a universal healthcare system. And these aren’t just Western countries like the UK, France, Germany and Italy. They include Burkina Faso, Ghana, Bhutan and Sri Lanka  (and I bet many Americans won’t be able to find any of those on a map).

The taxation will fall more percentage-wise on the rich; the sick will consume more of the healthcare that the healthy. And that’s a good thing.

So I do support the repeal and replacement of Obamacare, but only if it’s replaced by something like the American Health Service that this essay proposes.

And there’s even something for you, Mr Trump. You can call it “Trumpcare”, because as long as Americans get the healthcare that they need, I don’t care what you call it.