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I pulled up to just a bit south of the intersection of 'This and That Streets.' On this day, I had my usual water, bananas, and song sheets. I also had apple sauce and fruit cocktails in single-serving containers thanks to "Loaves of Love."
As I glanced toward the intersection, I saw 'Susan' standing and waiting for an as of yet unknown guy to pick her up to 'do a date.' I organized each of my items for her into an earth-friendly vanilla-scented plastic bag and walked over to her. Two seconds earlier, a white minivan with Delaware tags pulled down 'That Street.' Susan walked toward the passenger side. As she did so, I called out to her from about 20 feet away and asked her if I could give her the bag. With a smile of appreciation, she said she would be right back and to hold it for her if I was willing. She hopped in that white minivan with Delaware tags and off they went.
True to her word, a few minutes later, she hopped out of that white minivan with Delaware tags at the corner of 'This and Another That Streets' one block south. She slipped her new money into her pocket as she walked toward me. I gave her the bag as the guy drove off in his white minivan with Delaware tags.
As I gave her the bag, with all the casualness of a morning conversation over coffee, 'Susan' started talking about the hazards of 'doing dates' and life on the streets in general. The details she shared were frightening. I asked her if the high that she gets from the drugs is so good that it makes the hazards somehow worth it.
"Absolutely Not!" She declared. "I rarely get high anymore." She added.
"So what keeps you doing this?" I asked.
Her answer was amazingly simple.
"It's the disease
itself."[1]
Now hold that thought for a bit…
The very next day, I parked right at the intersection of 'This and That Streets.' 'Susan' was standing there waiting for yet another as of yet unknown guy to pick her up to 'do a date.' We greeted each other as I handed her another banana, water, and song sheet. I thanked her for sharing her thoughts with me the day before. I told her that I found her answer "It's the disease itself." to be so to the point and profound.
I then asked her how she handles the risks to herself when dealing with potentially dangerous men while 'doing dates.'
Again, her answer caught my attention and it should you as well…
"My husband
watches me as I get into each car. He
writes down the car description and license plate. If I come up missing, he'll at least have
that information to share with authorities."
Did you read that? "My husband watches me as I get into each car…"
WOW!
What other disease requires its sufferers to 'do dates' and, in the case of a married couple, engage in open adultery while the other spouse is forced to watch her leave and take notes regarding the car in which the act of adultery will take place?
'Susan' recognizes that she has a disease.[2]
The disease is not making this requirement of its sufferers!
When will the powers that be within the realm of Medicaid-based health care recognize these people as having a disease and begin to treat them as patients with the dignity and respect that they deserve and do so in a prompt manner?
[1] "Substance Use Disorder" is the official title.
[2] Her husband also has the disease and lives on the street with her.
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Legislative Briefing Addendum: "It’s the Disease Itself"
Case Study: Susan and the "Adultery of Necessity" Strategic Objective: To eliminate "Administrative Delay" in Medicaid-funded care by reclassifying Substance Use Disorder (SUD) as a progressive, terminal illness requiring immediate stabilization.
I. The Human Narrative: Survival Under Watchful Eyes
In this account, we witness a profound breakdown of the traditional family structure, not due to a lack of love, but due to the biological demands of a hijacked nervous system. Susan, a married woman, engages in "dates" with strangers in minivans while her husband stands nearby. He is not a passive bystander; he is a witness, recording license plate numbers in a desperate attempt to ensure that if his wife goes missing, the authorities will have a lead.
When asked if the "high" is worth the risk, Susan’s clarity is a stinging indictment of our current system: "Absolutely Not! I rarely get high anymore... It’s the disease itself." To those currently living this reality: We see the immense strength it takes to survive another day. We see the love in a husband’s watchful eye and the exhaustion in a wife’s smile. This legislation is designed to replace that license-plate notepad with a medical intake form.
II. The "Lynne’s Laws" Priority Framework
Susan’s story identifies a critical failure in the "Prior Authorization" process. We propose the following:
Priority Pillar: The Immediate Diagnostic Access Act.
The Mandate: This law dictates that a clinical diagnosis of SUD—whether by a street medicine team, a first responder, or a social worker—serves as an Automatic Prior Authorization for immediate inpatient or stabilization care.
The Professional Application: For the Medicaid administrator, this removes the "Waiting Game." It acknowledges that while the paperwork sits on a desk, the patient is sitting in a stranger's car. The diagnosis is the authorization.
III. The Professional Tension and Consensus
The Supportive View: Medical professionals argue that no other terminal disease requires a patient to engage in life-threatening exploitation to manage their symptoms while waiting for a bureaucrat’s approval. They see this law as the only way to provide Prompt and Respectful Care.
The Skeptical View (Addressing the Legislator): Skeptics worry about the "Financial Floodgates" of immediate access. However, the data shows that the cost of an inpatient bed is a fraction of the cost of a "Missing Persons" investigation, a homicide trial, or the long-term treatment of the trauma and infectious diseases inherent in the street economy.
The Consensus: This is an Anti-Exploitation measure. By funding immediate access, the Commonwealth actively reduces crime and protects the most vulnerable members of the workforce from predatory violence.
IV. Legislative "Teeth": The Environmental Safety Standard
The Objective Standard: Under Lynne’s Laws, "Medical Necessity" is redefined to include Environmental Risk. If a patient is forced to engage in high-risk activity (like "doing dates") to fund their physical stability, they are legally classified as "Clinically Unstable."
Strict Liability: If an insurer or hospital denies an immediate bed to a patient in an "Exploitative Environment," and that patient is harmed, the facility is held liable for Negligent Denial of Care. We remove the "Addicts Lie" defense by focusing on the documented environmental hazards.
V. The Corrected Path
Under Lynne’s Laws, the moment Susan identifies her condition as "The Disease Itself," the system would pivot from "Observer" to "Intervener." Her husband would no longer be a lookout for a crime; he would be a partner in a coordinated medical intake. The "White Minivan" would be replaced by a transport vehicle to a stabilization center where both spouses could begin the walk toward a health-filled victory.
#LynnesLaws
The Lynne’s Laws: Master Priority List (Ranked by Leverage)
Priority One: The Medical Necessity and Parity Act. (The Foundation). Legally defines the "Disease Itself" and its withdrawal symptoms as a life-threatening emergency.
Priority Two: The Clinical Stabilization Act (The Beba Clause). (The Safety Net). Prevents the "Hostile Discharge" of patients in physical or environmental collapse, like Dakota or Susan.
Priority Three: The Immediate Diagnostic Access Act. (The Bureaucracy Breaker). Mandates that a diagnosis of SUD is an automatic "Prior Authorization" for care, ending the Medicaid waiting game.
Priority Four: The Right to Patient Identity Act. (The Dignity Law). Forces all professionals to see the "Husband and Wife" or the "Professional Counselor" behind the diagnosis.
Priority Five: The Mandatory Continuity of Care Statute. (The Bridge). Ensures a "Warm Handoff" to keep patients from being returned to the street corner once they have requested help.
Priority Six: The Strict Liability / "Addicts Lie" Bypass. (The Justice Clause). Ensures that a patient’s medical records and environmental risks provide the evidence needed for a jury, regardless of the social stigma of addiction.
