Therapsit needs Iced Coffee

Artist. Storyteller. Mother. Wife. LPC

[Second Lady Usha Vance @SLOTUS]

As four-time subscribers to Dolly Parton’s Imagination Library and lifelong fans of her music, our family knows that Dolly Parton loved a good story. I hope that you’ll pick up a book and celebrate the magic of storytelling in her honor today.

[Sassy Devil Dog 🔥 @VinoNStrosGal]

Last night, I got off the phone with a family member in New Jersey who is dealing with cancer.

Their doctor ordered an imaging study.

Their insurance company denied it.

Think about how insane that sentence is.

A physician treating a patient with cancer determined that imaging was medically necessary and somewhere between that examination room and the scanner, an insurance company decided otherwise.

After we hung up, I couldn’t stop thinking about it.

So I started reading.

And reading.

And digging through the numbers.

I wanted to understand how we got to a place where someone can have a doctor say, “You need this,” and still have to convince an insurance company that their doctor is right.

What I found pissed me off even more.

America does not have a healthcare spending problem.

America has a healthcare accountability problem.

On May 28, 2026, a major international comparison of 20 countries found that the United States spends MORE on healthcare than any country studied.

18% of our entire GDP.

Nearly TWICE the OECD average.

And what do we get for it?

Americans still die younger.

Our life expectancy is nearly FIVE YEARS shorter than Japan, Spain, and Switzerland.

We are more likely to skip medically necessary care because we cannot afford it.

And while patients are trying to stay alive, insurance companies are still deciding whether the treatment their DOCTOR ordered is “medically necessary.”

In 2024 alone, Medicare Advantage insurers denied 4.1 MILLION prior-authorization requests.

Here is the part that should make your blood boil:

When those denials were appealed, more than 80% were overturned.

So I have a proposal.

If an insurance company overrules my physician, I want the name of the person who made that decision.

Their medical degree.

Their specialty.

Their license number.

And their signature.

No hiding behind “internal policy.”

No hiding behind “utilization management.”

No anonymous committee.

If you have the authority to tell a cancer patient they cannot have a scan…

tell a chronic pain patient they cannot have medication…

tell a disabled person they cannot have therapy…

or force someone who is already sick to fight an insurance company for treatment their doctor says they need…

PUT YOUR NAME ON THE DENIAL.

Because this is not a spreadsheet.

This is someone’s mother.

Someone’s father.

Someone’s child.

Someone’s life.

We spend more than everybody else.

Patients ration care.

Doctors drown in paperwork.

And corporations call it efficiency.

Enough.

Healthcare does not exist to protect an insurance company’s bottom line.

Insurance exists to pay for healthcare.

We have somehow allowed those two things to become reversed.

Put patients back in the center of medicine.

Put physicians back in charge of medical decisions.

And if you are going to stand between a sick human being and the care their doctor prescribed,

have the courage to put your fucking name on it.

PUT YOUR NAME ON THE DENIAL.

[Therapsit needs Iced Coffee @wiscolpc]

@DoctorPerin This is my entire summer. I’ve taken so many naps that I brought my own special napping blanket to the office.

[Therapsit needs Iced Coffee @wiscolpc]

I miss HEB so much.

[NOBUNAGA🇯🇵🏯_夏樹蒼依 @japan_nobunaga]

In Texas I was taken to a grocery store called H-E-B.

I asked what the letters stand for. My friend said, "Howard Edward Butt."

I waited for the rest of the name. There was no rest. The man built an empire on his actual name, and the empire did not flinch.

Inside, a woman in a red apron said, "Welcome! Finding everything okay?"

I had been inside for eleven seconds. I had found nothing. I had not begun to look.

"...I have only just arrived."

"Well, let me know if you need anything, sweetheart."

Sweetheart. From a stranger with a price gun. I held the cart handle with both hands and tried to proceed as a man who had not just been loved at the produce section.

The store was clean in a way that suggested someone cared about it the way my grandmother cared about her kitchen floor. Not for the guests. For the floor.

A man named Dale in the meat department was cutting brisket behind glass. I watched him work. He held the knife the way a calligrapher holds a brush. Each cut landed in the same place twice.

I bowed slightly. I could not help it.

Dale looked up. "You want a sample, boss?"

"...I was paying respects to your blade work."

He paused. Then he cut a piece, put it on a toothpick, and handed it over the counter.

"Well, that's a first. Most folks just ask if I got any ribs left."

I ate it. It was perfect. I told him it was perfect.

"Appreciate that. Twenty-six years behind this counter."

Twenty-six years. The same counter. The same knife. In my country we would call this man a living national treasure and put him on television. Here he wore a red apron and asked if I wanted it wrapped.

Then the storm came.

I do not mean this as a metaphor. A hurricane was approaching the coast, and I learned something about this grocery store that I did not believe until I saw it with my own eyes.

H-E-B has mobile kitchens. Disaster relief trucks. A full-time Director of Emergency Preparedness. Over a hundred and fifty thousand employees they call Partners, and when the wind starts to build, the Partners do not go home.

They drive toward it.

During Hurricane Harvey, this grocery store fed thousands. They sent trucks into flooded towns before the government arrived. Before the Red Cross set up. Before anyone asked.

A grocery store. With a meat counter and a bakery and a sign that says HERE EVERYTHING'S BETTER.

Texans have a name for H-E-B during hurricanes. They call it the FEMA of Texas. I have confirmed this. Multiple Texans said it to me without smiling, the way you state the name of a general who does not lose.

I asked Dale if he had worked during Harvey.

He stopped cutting. He set the knife down, which I had not seen him do.

"Drove in at four in the morning. Water was up to my truck doors. Store was the only thing open for nine miles. We made sandwiches till we ran out of bread. Then corporate sent more bread. Then we ran out again."

"...How long?"

"Sixteen days."

I stood there holding a package of brisket in both hands and tried to find the word.

"...You are not a butcher, Dale."

He picked up his knife. "Sure I am."

In my country, a man who feeds his village through a disaster is honored for the rest of his life. In Texas, he is called a butcher, and he goes back to the counter on Monday, and he does not mention it unless you ask, and even then he picks up his knife before he finishes the story, because the brisket is not going to cut itself.

The store was founded in 1905 by a woman named Florence Butt, who put sixty dollars' worth of groceries on a shelf on the ground floor of her family's home in a town called Kerrville. That was the whole store. One shelf. One room. Sixty dollars.

A hundred and twenty years later, the family still owns it.

I walked out with four bags. A boy in a red apron carried two of them to my car. I told him I could carry my own bags. He said, "I know you can. But I'm already here, so."

I did not tip him. He would not let me.

I drove home past the highway where the flood line was still visible on the guardrail, three feet up, and I thought about Dale, and the bread, and the knife, and the name Howard Edward Butt, who was not embarrassed by it, because the name is not the point.

The shelf is the point.

Florence Butt put sixty dollars on a shelf in 1905. A hundred and twenty years later, when the water rose and the power died, the shelf was still standing, and there was bread on it.

A store is not its name. A store is whether the bread is there when you need it.

The bread was there.

[Therapsit needs Iced Coffee @wiscolpc]

@FixingEducation I am a Licensed Professional counselor. I can now work with parents in a way I never could in the classroom. My favorite quote is from Mr Rogers—“Discipline is love.”

[Therapsit needs Iced Coffee @wiscolpc]

@DoctorPerin Same! I work in partnership with a play therapist. They treat the kids and I work with the parents. It’s a wonderful system when the parents are open to it.

[LCMS Youth Ministry @LCMSYOUTH]

We have every reason to celebrate with joy and confidence on Easter. God has won salvation for us, and so we boldly confess and praise His name. He is risen, indeed! Alleluia!

[Therapsit needs Iced Coffee @wiscolpc]

@SoadTabrizi Brilliant!

[Therapsit needs Iced Coffee @wiscolpc]

@DougRussell Plows came down our street at 35 MPH. Snow spray was 15 feet back into the drive. We live on a busy road so the end of our driveway was at least 2 feet of wet mess. My hubby tore up his shoulder digging out. Always frustrating.

[Therapsit needs Iced Coffee @wiscolpc]

@nieboh @Parkerlawyer Don’t think I haven’t thought about it! I was a paralegal in a former career and I help calm down clients all the time during the discovery process!

[Juanita Broaddrick @atensnut]

Merry Christmas Eve. 🙏🏼❤️

[Therapsit needs Iced Coffee @wiscolpc]

Hosted a baby shower today for our oldest. I cooked enough food for 3x of people we had attending. I told everyone to eat and take leftovers. At least I won’t have to cook for a few days.

[Therapsit needs Iced Coffee @wiscolpc]

@DerrickEvans4WV When I was a single mom and the grocery store had Halal chickens for 99 cents I bought them up. We pray “Come Lord Jesus” table prayer before the meal so was thankful that I could feed my children

[Therapsit needs Iced Coffee @wiscolpc]

Dems shut down the government so illegals can have Medicaid. Meanwhile, my 100% disabled Vietnam Vet Dad can’t get his pain meds. There’s no one available to help him. He was calling DC today looking for help. That’s wrong on so many levels.

[Therapsit needs Iced Coffee @wiscolpc]

Make heaven crowded! Yes, we will, Charlie!!

[Therapsit needs Iced Coffee @wiscolpc]

I see God working in this world. When you accept Christ peace comes and your world is never the same.

[Therapsit needs Iced Coffee @wiscolpc]

Why does @Sling show us the same commercial 2-3 every commercial break?? I pay a lot of money to see stupid commercials!

[Therapsit needs Iced Coffee @wiscolpc]

@TheDonStein I graduated with my LTD from CUA in 1997. Moving from CLC to CUA in the mid 90s was the start of this. So sad.