Assessing Value: The Cost of Meat and Potatoes

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Assessing Value: The Cost of Meat and Potatoes

An Open Letter to an Advocate Who Questions Her APHA Membership Received last week from Esther (not her real name): If you would please clarify a few things I’d really appreciate it.It’s time for my PACE membership to renew and I am trying to decide whether to spend that money. I want to have my name listed in your directory in the future, but your Premium membership is quite out of my budget. . Do you not offer beginner discounts? Secondly, I currently am an unemployed family caregiver and have no income. A basic renewal at $49, which is more in my budget, is only for 6 months time, why not a full year? And it really lacks access to the meat and potatoes of your site which would most benefit me starting out in this line of service. So as you may have gathered, I’m at a crossroads for renewing at this point in time. I’m trying to understand the real value in APHA membership for me. Perhaps you have other financial options for people in my situation? I do look forward to hearing from you. My reply to Esther: You are not the first person to ask me about discounting the price of membership. In fact, I have been asked that for years. Because I want you to understand the answer thoroughly, I will simply direct you to a post that includes the answer and its reasons. You asked about a “beginner membership” – that is exactly what the PACE membership is, at less than half the cost of the “regular” membership which is the Premium. PACE stands for Patient Advocate Career Exploration. It’s for people who want to learn more about the profession, but aren’t yet committed to it. Once committed, the right membership is the Premium, and that opens the door to all the benefits we make available. You asked about the “real value” – and my answer is this: it has taken us a great deal of time, and some major expense to develop the resources we offer to advocates. You asked specifically about the…


 

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Atychi-what? Overcoming Atychiphobia

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Atychi-what? Overcoming Atychiphobia

Over the years, dozens of professional advocate wannabes have talked to me about fear, including Fear of failure Fear of doing the wrong thing for a client Fear of failure Fear of losing their savings Fear of failure Fear of making a mistake in their work Fear of failure Fear of standing up to authority Fear of failure If your fears stand in the way of your success, then you have only two choices: You can either give up and decide not to move forward with your dream of becoming a successful, professional, independent advocate. Or … you can work to overcome them. Because…. Atychiphobia is the word for a persistent fear of failure. In the past, I’ve also described it as the paralysis of analysis – the idea that you can’t move forward because your analysis of what might happen is failure. If you are in the “give up” group then don’t bother reading the rest of this post. This post is written for those who are brave enough to face their fears; those who know their advocacy is vital to the patients they will help, who dream of helping people professionally to improve their health care and cost outcomes, and is therefore worth the effort to overcome their fears. I hope that means YOU! If you are fearful of any aspect of starting and growing a professional advocacy or care management practice, then it stems from only one thing:  the inability to control an outcome. Pause. Think about that. Repeat:  Fear stems from feeling as if you cannot control an outcome. What I’m not going to do here is psychotherapy. We’re not going to figure out WHY you are afraid. Instead, what I am going to do is give you a different way to look at your fears, and I’m going to suggest to you that YOU can control how you think about them. Therefore YOU can face your fears head-on – and overcome them. Let’s begin with one of those fears at the top of this post:  the fear of losing one’s savings.  Let’s break it down:…


 

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“When I’m Sixty-Four” and If I’m Alone….

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

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“When I’m Sixty-Four” and If I’m Alone….

Back in 2004, I was between husbands, and in my early 50s. As silly as that may sound (“between husbands”), the truth was, I spent 18 years with that status, between divorce and remarriage… and I was alone. “Alone” is the key to today’s post. Back in 2004, I was also diagnosed with a rare and terminal lymphoma. Yes – terminal – and yet here I am writing about it in 2019. You can read the story in its entirety here. Obviously it didn’t turn out to be terminal. But it did launch an entirely new career, and profession, and sparked today’s topic about being diagnosed with something horrible, and being alone. Of course, back in 1967 when John Lennon and Paul McCartney wrote “When I’m Sixty-Four” neither of them was alone, and yet the lyrics indicate they might have been putting themselves in the shoes of someone who was. Even though I wasn’t in my 60s at the time of my misdiagnosis, believe me, i was just as frightened as I would have been then. I had no one to turn to who could be my caregiver. No one who would hold my hand through tests and appointments. No one who could rationally think through the conflicting pieces of information I was receiving. No one to help me sort out the bills and insurance. No one I could trust and rely on (or not feel I was imposing on) …  I was solo. I was alone. There was no one I knew of who I could ask to help me out. All these years later, the emotions and struggles that arose during that time still haunt me. Today the landscape for “solos” is different. If you are alone, and fear the challenges healthcare is already presenting to you, or those that may arise in the future, then you have options I didn’t have in 2004. In fact, there is major movement in this area – professionals who study and learn more about how to help “Solo Seniors” or “Elder Orphans” or even younger people who are alone and need assistance (my situation at the time) and are facing medical care without a handholder or guide… The best metaphor I can think of to help you understand is this:  to prepare for your older age and your demise, you’ll work with an attorney to help you plan your estate, or…


 

 

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Starting Out? Why a Non-Profit Practice Is NOT the Right Answer for You

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Starting Out? Why a Non-Profit Practice Is NOT the Right Answer for You

This is a question – or a statement – I hear frequently from those who wish to be independent health or patient advocates who are considering which business formation they need to set up to be independent.* After considerations of LLCs, or S-Corps or others, they tell me they want to establish a non-profit, then ask me if we offer resources to help them. Fay is one such advocate wannabe. She asked, “Do you have any advice for establishing a non-profit or not-for-profit agency to help patients?” Unfortunately, her question was being asked for the wrong reasons. Why? When asked why they think a non-profit is the right answer for them, I hear a handful of replies: “So many people need help but can’t afford to pay for help. Establishing a non-profit would mean I don’t have to charge them.”  (A fair statement – and a solid answer, but requires a follow-up – see below.) “I have only ever done advocacy as a volunteer, so I want to keep doing it that way.” (Also a fair statement, but not helpful to this advocate – see below.) Fay’s reply to me was the one I hear most often: “I hate asking for money, so if I set up a non-profit, I won’t have to.” (A fair assessment of ask-for-money fears, but a ridiculous overall statement about business formation.) The point being… almost every advocate-wannabe who asks about setting up a not-for-profit organization believes that will mean she can deliver advocacy services at no cost to the patient. She may also believe, then, that she can continue doing advocacy work as a volunteer – because she will still get paid by the non-profit organization. The problem is, those who think a non-profit is the cure to the “asking for money” aspects of business, haven’t yet thought of this question:  Where will the non-profit organization get ITS money? The leap not made is that a non-profit is just as much a business as a profit-making business is. Both require business skills; both require asking for money. Here’s Where Fay Went Wrong To begin…


 

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How Does a Patient Choose the Best Advocate to Hire?

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How Does a Patient Choose the Best Advocate to Hire?

I’ve been working on updating the AdvoConnection Directory website because it was time, because search engines look favorably upon updates. And because my not-frequent-enough review of the site’s analytics produced a big surprise! A surprise I’ll share with you here today. To be clear – no changes were made to the actual search and profile areas – those all belong to our listed advocates who make those changes themselves. Instead, I edited and updated the support pages – everything from the homepage to the About Us page to the “how to choose and interview an advocate” page. For some background:  I monitor and track the advocate listing pages diligently (and encourage our listed members to monitor their own – we provide them with stats each month.)  I know people are finding our advocates in the Directory in HUGE numbers (examples: 16,000+ in January and 15,500+ in February, a shorter month, of course). However – true confessions here – as in “do as I say, and not as I do” – I rarely look at the analytics on the basic site pages.Just not something I make time for… although as I learned this week – I should!  Because I was actually very surprised by what I learned. What I found: First, that beyond the profiles, the MOST accessed page is the one entitled, “How Much Does It Cost to Hire an Independent, Private Advocate?”  That really wasn’t a surprise… Found on the other pages is supporting information like master list of services advocates provide, an About Us link, lots of blog posts to help patients become smarter and savvier… So what elicited such surprise? That the SECOND MOST accessed page is the one called, “How to Interview and Hire a Patient Advocate“.  I don’t know why it surprises me… but it does. (Honestly, I expected the list of services to be at the top and it’s not.) More importantly, it made it obvious to me that I needed to point this out to all of YOU, because it informs you of what questions will be asked when people reach out to…


 

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PracticeUP! Introducing Online Courses for Advocates and Care Managers

podcast and resources belowAPHA Expert Call-in

February 2019

Starting and growing a successful advocacy or care management practice requires so much knowledge, and so many resources. Business skills, advocacy background, resources... While APHA provides support for so much of what we need to know, that doesn't mean it's easy to learn it all.

Examples:

  • APHA might give you an overview of public speaking - why it's important, and the major steps to making it happen. But how can you learn how to master those steps?
  • APHA might suggest you develop a newsletter for potential clients, but just how are you supposed to develop it, and where do you get the content and email addresses you need?
  • APHA might explain about why contracts are necessary, but how do you actually talk to a client about a contract, and convince them to sign it?

Enter PracticeUPOnline.com - a new website, launching in early 2019, that will provide you with online learning: courses you can take online, that will teach you step by step how to accomplish those necessary tasks, and how to develop those necessary skills for building the advocacy practice you have planned for. We'll talk about the courses being developed, the teachers who will be involved, and the marvelous cost benefits for APHA members (many courses will be free!)

Trisha Torrey, founder and director of APHA, and the developer of PracticeUP! will be our guest.

 

headset Podcast Available: 42 minutes Note! Please save this to your own computer to listen. Attempting to listen from the APHA website server may crash the server.
(Right click with your mouse on a PC, or *Command-Click* on a Mac, then choose "save as" or "save link as")

 

resources-sm Resources:

 

Discuss this topic:

connect-icon-smCheck in with APHA Members Connect! Discussion Forum

 

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A Riddle: When Is the “Best Doctor” Not the Best Doctor?

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


A Riddle: When Is the “Best Doctor” Not the Best Doctor?

… followed by a second riddle: When Is the “Best Hospital” Not the Best Hospital? Everyone loves a good riddle. I think it’s because the answer is often clever, maybe a play on words. We chuckle (or groan!) at the answer, and sometimes the first riddle will trigger a handful more… just fun. I wish I could tell you these two are clever, chuckle-inducing riddles, too. Unfortunately, not only aren’t they funny; they can be deadly. There are two circumstances under which the description of “best” in relationship to medical professionals or facilities needs to be reconsidered. Circumstance #1: “I need knee replacement surgery, so I’ve chosen the best ortho surgeon in town!” my neighbor Joe told me after putting up with a bum knee for years. I had to ask him, “What makes that ortho the best? And why?” Joe’s reply was that he asked around and “Everyone told me to call him.” What Joe couldn’t answer was “why?” And as it turned out, after a bit of research, the “best ortho surgeon in town” did have great ratings and a good track record – for shoulder surgery. Now that may not seem like too big a stretch – if that surgeon is good at replacing shoulders, he might be good with knee replacement surgery, too… But – how can we know? It’s a little like saying that just because your auto mechanic has a great reputation for rebuilding a transmission, it means he might also do a great job replacing a broken axle, or fixing your steering. Or if a lawyer is good at drawing up your last will and testament, she might also be able to keep you out of prison…. But how can we know that? I think we all want “the best” when it comes time for our care, but we must be sure we’re comparing apples to apples, and applying that label under the right circumstances. So – back to riddle #1: when is the “Best Doctor” not really the best doctor? When his or her area of specialty is really something else. A very important distinction. Circumstance / Riddle #2: The answer to riddle #2 will also inform our question about the “Best Doctor” but it’s probably more likely you’ve had this experience in relation to your local hospital. When Joe first went in search of an ortho for his knee replacement, he…


 

 

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Johnny Carson, Game Shows, and a Lesson about Trust

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Johnny Carson, Game Shows, and a Lesson about Trust

Back in the 1950s, into the 1960s, a game show called Who Do You Trust? aired where couples were asked questions, and one had to “trust” the other to answer it (or not!). If you remember the show (some of us do) you may also remember that Edgar Bergen (yes, Candace Bergen’s father) was the MC for the show. However, what you may not remember is that a year or two into the show, Bergen was replaced by Johnny Carson – who often “helped” the couples get the right answers. He helped them – well – TRUST. The irony of this particular game show, one with TRUST in the title, is that it aired during the years of the game show scandals – yes – scandals! The game show scandals were all about cheating, and giving answers to pre-determined winners, and money changing hands in ways it shouldn’t. Perhaps the anti-irony is that this was one game show that did not get caught up in the scandal, and its producers were never charged with any crimes. … which tells us something about how it was run, and how it avoided that broad brush of scandal… and is a lesson for us, as advocates and care managers, who work in a healthcare world that is RIFE with unfairness (at the least) and downright crime (at the most.) We must remain above the fray. We must always behave with integrity, behaving ethically and honestly. We must always be trustworthy. Our clients, and potential clients, must be able to instantly assess that we are those things, so they can have faith in us throughout our relationships. How? It’s really not difficult, but it requires a certain demeanor, a certain way of being and doing (or not doing). It’s about your integrity and character – who you are as a person. What are those character traits that help others know you are trustworthy? Here are a few: You are your authentic self. You never appear to be pretending you are someone you are not, or claiming to do something you really can’t do. You…


 

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The Momma Test

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The Momma Test

Over the years, one of my favorite things to do has been to work with / speak to / address college students. They are young, aren’t yet set in their ways, still hope to save the world, are naive to the “follow the money” aspects of healthcare and, honestly, it’s just plain fun. Last week I had the privilege of participating in an ethics debate for a well-known and respected university in a course called Controversies in Healthcare (medical, legal, and bio ethics), to a combination group of law students and medical students, on the topic of independent advocacy – vs – hospital advocacy. My co-debater was the Director of Ombudsman at a very well-known and respected hospital system. The idea, since it was a “controversies” class, was that we were supposed to argue that our own solutions were the better solutions, and that the opposing solution was not a good choice. But we totally missed that mark! The Director of Ombudsman, who I will call Susan (because I didn’t ask for permission to write about her) and I tried as we could to find places to argue our own points – but mostly we just agreed. It turned out to be a marvelous conversation about how advocates, interior and exterior to the hospital, could be complementary.  To me, it was a great lesson in how good hospitals (note – not ALL hospitals, but GOOD hospitals) are shifting their management of patient problems, admitting when they are not the best choice for a patient or family member, and are becoming more aware of what independent advocates can do for their own hospital patients. As Susan and I discussed those situations and capabilities, I was reminded of a conversation I had years ago with a C-suite administrator from a hospital who had the patient advocacy staff working in his group. He was trying to convince me that their patient advocacy staff were focused solely on the hospital’s patients, and then told me how he measures their success. He called it the Momma Test. He told me that whenever a patient complaint…


 

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Loaded for Bear May Mean No Care

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Loaded for Bear May Mean No Care

Last week, I received an email from a woman, I’ll call her Miranda, taking me to task for an article I had written that she found online. If Miranda had her way, I’d be walking the plank about now, or on my way to life in prison. The article she found is about patient modesty and how it affects one’s ability to get medical care. It poses the problem, considers the roots of the situation, then offers ideas to help someone get beyond modesty hurdles in order to benefit from better medical care. Oh, but Miranda was not happy about that article!  She graced my email inbox with a missive (out of curiosity I pasted it into a word document to see how many printed pages it would be – about 5!), as if she was the prosecutor outlining all the reasons I should get life in prison, taking me to task because I had not taken into account survivors of sexual abuse. Further, the fact that I used a car as a metaphor offended her because people aren’t cars!  (She’s right. They aren’t. I didn’t say they were. I used cars as a metaphor.) She expected me to rewrite and republish the article, and she wanted a “public apology” for being so callous and ignoring the plight of sexual abuse survivors. Wow! A little back story: I wrote that article almost 8 years ago when I was writing patient empowerment articles for About.com. I stopped writing for them in early 2014, and I no longer have access to change or edit the 1,000+ articles I wrote for them. In the meantime they have changed the name of the site to VeryWell. They edit the articles themselves from time to time, and change the dates to be more current – all to keep Google happy, but confusing people who think I wrote them recently. So – for Miranda – I replied – politely – that I was sorry she had suffered sexual abuse, and I was sorry she wasn’t satisfied with the article, but that the intent of the article…


 

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So What Are You S’Posed to Do With Those Hospital Prices?

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

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So What Are You S’Posed to Do With Those Hospital Prices?

In the category of “be careful what you wish for…”  Well-meaning policy people have now created a monster.  We can name this monster “Good Start,” but it’s not a very useful monster – yet. That monster rears its ugly head in the form of the new law that became effective January 1, 2019 that requires most hospitals to make their pricing available to the public. The idea – a good one – is that there is nothing else in this world that we are required to buy or pay for where we can’t find out what the pricing is before we commit to the purchase, so why should hospitals be any different? The result is what thousands of patients – and journalists – have discovered during the past week or so. That is, that master lists of service-by-number, codes, and prices that are indecipherable by the lay person. So what use are they? Rather than just throw in the towel, let’s take a look to see what they are and what, at this early stage, we can really do with them. First – how can you find pricing for the hospital you might need to use? It’s a great question, and believe me, most hospitals have done everything they can to obscure the pricing from your peering eyes. But a little diligence and you should be able to find their list. Here’s one way to get your hospital’s pricing: Do a search (Google, Bing, Yahoo) with the name of your hospital, and “pricing” or “price list” or “prices”.   From there you should see something that references these lists of charges, or tells how you can get an estimate. What you will probably find is what hospitals call the “Charge Master” – their document, sometimes hundreds of pages long, with lots of med-speak and pricing that means very little to us. My local hospital’s Charge Master is 143 pages of lists like you see at right. The Cleveland Clinic’s Charge Master lists 5,760 CPT codes (Current Procedural Technology) and their pricing.  But nothing that lines up a CPT code with a need for services. Now, there is almost nothing YOU can do with this list. Why? Because any one service from the hospital is actually made up of many of these charges. There might be a price for a room, but there will also be prices for the bedding, the equipment,…


 

 

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Pricing Your Worth

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Pricing Your Worth

This post was contributed by Caryn Isaacs, Get Health Help a mentor for those who are building an advocacy practice. You may have noticed that all of the Patient Advocate Mentors, recommend some form of business planning. We all have successful businesses because we learned to price our services in a way that fits our individual approach to doing business. I previously worked as a practice management consultant. The doctors I helped to start or expand their practices, never wanted to take the time to develop a pricing strategy for their services. They allowed the insurance companies to dictate what they would get paid. This led to a price war, to the bottom of the health care dollar. This in turn, caused many doctors to go out of business. Each Patient Advocate has their own unique path to follow. After deciding on the services that you will offer, the next step is to put a value price on each item. It must be a dollar amount that will cover your costs and make you a profit. In the current marketplace, there are no rules as to who can advertise advocacy services. It is tempting to look at other Patient Advocates…


 

 

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What Do You Want to Learn?

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What Do You Want to Learn?

While many independent advocates and care managers spent their holiday time either celebrating, spending time with their families, and/or putting out fires for clients…  I’ve been right here at my desk during the holidays, preparing for THE LAUNCH. It’s been SUCH a long time coming…many years, really. Certainly not because the will wasn’t there, nor because the technology wasn’t available. I plead only the lack of enough hours in my days along with a few conflicting priorities (like completing the launch of patient advocate certification, and rebuilding the AdvoConnection profiles site, and moving 1200 miles!)  Those aren’t excuses. They were realities. But now these new efforts have (finally!) moved to the TOP of my to-do list…  all to the benefit of advocates and care managers who want to improve their knowledge and skills in the many areas of building successful practices… So what required so much effort? Introducing PracticeUP! Online Online learning opportunities for you! In all these years of working with advocates, one consistent message has come through loud and clear. Many advocates want access to online learning because: Online courses are quick Online courses can be inexpensive Online courses are ready when you are Online courses are à la carte – one skill or piece of information at a time Online courses can be revisited as necessary Online courses don’t require expensive travel… Voila!  PracticeUPOnline.com The site consists of two main sections: 1.  Courses Over time, dozens (hundreds?) of courses will become available, taught by advocacy and care management’s best and brightest teachers. At the launch, later this month (January 2019), several free, sample courses will become available to everyone including Is Certification Right for You? Best Practices for Naming Your Advocacy or Care Management Practice Understanding the Allegiance Factor … plus other courses to be launched within the next few weeks including our first “big” course about the basics of client acquisition and marketing. You’re invited to submit ideas for courses, too. We hope you will! 2.  Trisha’s TIPS Trisha – that’s me . I’m the author of this blog, the founder of The Alliance of Professional…


 

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Because Greetings Should Be All About Them

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Because Greetings Should Be All About Them

Honestly, I’m tired of the argument. I live and work in Florida where you would think it was some sort of national disgrace to wish someone “Happy Holidays”. As if somehow the failure to wish a “Merry Christmas” has been co-opted by political correctness as a personal insult to them. In my (not so) humble opinion, it has gotten worse in the last couple of years. I chalk that up to the facts that (1) I didn’t live in Florida until about two years ago (and therefore heard far less vitriol than seems to be standard fare here) and (2) that we now live in a society where too many of our political leaders are focused solely on improving their own lives, incomes, and status, and not those of their constituents, as in, “It’s all about me!” I’m just sick of it! Here’s why: In the world *I* live in – focus is and should be all about the other person. In a world of advocacy, and in the world of business, I am focused on the needs and wishes of the people I serve, and not myself. Not that I don’t take care of me; I most certainly do! But one way I do that is by focusing on my audiences, and to do that best I first consider their needs and wishes. As a health or patient advocate, that is true for you, too. So – returning to where we started with the greeting of “Happy Holidays” – vs – “Merry Christmas” – vs – whatever anyone else might wish…  This is definitely the time of year for sharing holiday greetings. In our INDEPENDENT ADVOCACY world, where we focus our work on the needs of the other person, the greeting should be appropriate to THAT person – not a reflection of your personal holiday (unless it’s the same one, of course): That means: you wish your Christian friends and clients a Merry Christmas. you wish your Jewish friends and clients a Happy Hanukkah. you wish your African American friends and clients a Happy Kwanzah. you wish your Hindu…


 

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