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View Poll Results: How is Obama doing? (poll started 6/6) | |||
Great - above my expectations | 18 | 6.87% | |
Good - met most of my expectations | 66 | 25.19% | |
Average - so so, disappointed a little | 64 | 24.43% | |
Bad - sold us out | 101 | 38.55% | |
Trout - don't know yet | 13 | 4.96% | |
Voters: 262. You may not vote on this poll |
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06-09-2009, 11:12 AM | #2101 | |
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vastly
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06-09-2009, 11:30 AM | #2102 |
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Let me just add that the pro-con Tarp argument cannot be won by either side so its a stupid one at best. The people who were for it (sans Paulson Torpedo) argue that things wouldve been worse without it and the people who are against it think it's being wasted and will come back to hurt us during the next downward turn (which will happen sometime anyways)
So both sides will be able to claim they were right. PLUS when inflation occurs both sides will claim victory or defeat based on the same data: Inflation means growth too much loosey goosey spending so too much inflation silly. I was for TARP and for the bailout sand think, as shown today that the tax payers will get back aome if not all of the Tarp money PLUS interest from the bank portion. I am very happy with the way the auto dismantling has been handled since it wasnt allowed to implode. I am very happy that AIG has been used as the 'bad bank' I think that SOME books and economists will look back on what occurred as some of the smartest people in the world making decisions at the right time that SAVED capitalism in the long run. Than youll have some on the other side that will argue the opposite. Some will argue from a standpoint of economic policy and some will be partisan and argue based on that vein... I know where MBBF falls....
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06-09-2009, 12:09 PM | #2103 | |
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I think one the points that is missed when comparing to "lower cost per person" socialized systems of Europe is ours is that we put in the R&D and clinical trail dollars for our equipment and drugs. These foreign countries are able to make deals with these companies for lower costs, while we get footed with the bill. |
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06-09-2009, 12:13 PM | #2104 | |
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06-09-2009, 01:29 PM | #2105 | |
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06-09-2009, 02:45 PM | #2106 |
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The cost of anything, including Health Care, can be reduced to two things: "parts" and "labor". The labor part of the equation in the US is a lot higher than in other countries. This is a bit old (data is from 2004): http://mdsalaries.blogspot.com/2008/...-european.html
Average salary of a doctor working in a hospital
At least auto mechanics are up front and tell us how much of our car repair went to "parts" and how much is for their time, "labor". I'd like to know how much of a $900 CT Scan goes towards the salary of those who took it and read it, and how much of it is the cost of the scan itself. Did a radiologist get $300 for the 30 minutes (or however long it takes) that they looked at the scan? A $100,000 heart surgery requires the attention of several doctors and nurses for several hours. More if you include all of the prep work and the attention needed after surgery. How much of that is going to "parts", and how much of that is going to "labor"? I'm not saying the doctors don't deserve the money. They do. But if people want to get serious about reducing the cost of health care, the cost of health care personnel have to be accounted for as well, and not just the people working for insurance or drug companies. Putting everyone on a national health care system isn't going to alter the costs of medical procedures, and I highly doubt that many doctors/nurses/etc. are really going to be receptive to the idea of changing their pay to be more inline with what doctors in France or Britain make (let alone Spain or Germany). And I'm far from an expert so I have no idea if they even could. The cost of medical school, malpractice insurance, whatever other kinds of insurance they need, whatever other costs they need to keep being "certified" or "licensed" or whatever doctors need to do to keep doing their job. How much do these things cost a doctor in France vs. a doctor in the US? (ending rant) The point being there is a lot that has to be done to significantly reduce the cost of health care while keeping or increasing the quality. Not just reducing the price of drugs, getting everyone insured and going to the doctor to prevent things, etc. The entire culture of health care in this country needs to be changed, everything that touches the health care system needs to have it's cost reduced without affecting its quality. (And it wouldn't hurt if everyone would stop being fat ass smokers and heavy drinkers....) Call my cynical, I don't think it can be done. Or it would at least be as difficult as drastically changing our interstate highway system... |
06-09-2009, 03:32 PM | #2107 | |
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You can get all of this itemized if you ask for it. Most people don't because the insurance company pays the large part of the bill. There's a rate built into everything. It's just a lot more complicated because it's not comparable to your mechanic/parts analogy. There's multiple doctors and procedures for everything involved in a procedure. Most people would be pretty shocked just how large of a component malpractice insurance is as a total portion of the doctor's salary. It can easily run 25-30% of total salary. In some locations, it's even more. Last edited by Mizzou B-ball fan : 06-09-2009 at 03:34 PM. |
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06-09-2009, 04:41 PM | #2108 | |
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The malpractice/tort reform crap is an old myth that right-wing sites pick up to defend the crap system we have. |
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06-09-2009, 04:53 PM | #2109 |
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I don't know if this is the norm for people, but let me give you my experience of staying in a hospital for a week. Note that this is a supposedly high end hospital in a wealthy Chicago suburb.
- One doctor charged me for 5 days that I wasn't even in the hospital. The insurance company denied it and they kept sending me the bill. I had to explain to them that I wasn't in the hospital and it's impossible that he saw me there for those 5 days. They would "look into the error" and never fix it. It finally took me threatening to report them to the state for fraud that they handled the matter. - One doctor billed my insurance company $400 a day for examining me (he supposedly examined me each day). This doctor literally walked in the room, said hi when I was awake, read my chart, and left. That was the extent of his "exam". His name never came up amongst other doctors and he never really did anything. I didn't even know his name. - A psychiatrist came in one day and said that sometimes people who are there for an extended period of time get depressed and find comfort in talking to a psychiatrist. I told him nicely that I was fine and I was leaving tomorrow. He said if I need him to give him a call and left. He billed my insurance company a couple hundred bucks for that. - I got charged for feminine products on my itemized bill. I am a male. It was actually sad when I looked at the total bill. It was like these guys saw someone who was going to be staying for a little while and they all went nuts. It was a field day for them. Like someone walked into their store with a blank check. Doctors who I didn't need would stop by just to be able to charge me for the visit. They ran a crapload of unnecessary tests. The funny thing was when I asked my main internist about this a few months later, he was pretty frank with me and said that guys will just pad their bills on people like me. Just walking into my room and saying hi was a few hundred bucks to them. Certain doctos there were notorious for calling their buddies in for a "consult" all the time. My insurance company paid most of it so I didn't push it much. Was the first time I actually felt bad for the insurance company. Last edited by RainMaker : 06-09-2009 at 04:56 PM. |
06-09-2009, 05:00 PM | #2110 |
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That's pretty ridiculous, but its similar to what happens when people are billing the government. And the insurance companies are at least trying to make a profit.
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06-09-2009, 06:17 PM | #2111 | |
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My father pays 22%. My wife pays 24%. Neither have had a lawsuit filed against them. That's fact. |
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06-09-2009, 06:17 PM | #2112 | |
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Good post. Here, doctors have $100,000's of loans to back once they get out of the resident programs (which is what, early-to-mid 30's). You really don't have that overseas with taxpayer-funded education? Also, this is after or before malpractice insurance (another thing a lot of other countries don't have)? What is the % of doctors that move from a lower-paying country to a higher-paying country? |
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06-09-2009, 06:20 PM | #2113 |
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06-09-2009, 06:21 PM | #2114 |
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Let me ask you this...Do we demand too much out of healthcare system when it comes to quality (the lastest drugs, tech, the top-notch doctors) and don't want to pay for that quality? Why give senior citizens life-saving treatment when it costs an huge amount of money (and usually at the taxpayers expense)?
Last edited by Galaxy : 06-09-2009 at 06:22 PM. |
06-09-2009, 06:36 PM | #2115 |
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Good news. Our tax dollars are now going to help people buy new cars!
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06-09-2009, 08:00 PM | #2116 |
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06-09-2009, 08:14 PM | #2117 |
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06-09-2009, 08:35 PM | #2118 | |
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Good post, sabotai. You bring up some excellent points. Just to add a few things... You can and should always ask for a full itemization when it comes to your hospital bills, etc. This applies to not only hospitals but to individual healthcare providers who may have contributed to your care (i.e., radiologists, ER docs, surgeons, or other specialists). I propose that health care needs to also be looked at in terms of supply and demand. Nobody will argue that there isn't a demand for greater access to (hopefully quality) health care in the U.S. The problem lies on the supply side. Nowadays, medical students go into the higher paying subspecialties. They do not go into primary care. There is no incentive for them to enter the field. Reimbursement is falling. The reimbursement you are able to get comes anywhere from weeks to months after the work has been done, and it is oftentimes something given out only after more time has been spent on the phone with insurers than with the patient in the first place. I don't pretend that I have all the answers. I'm just an FP who is as unsure of where this is all going to end up as everyone else seems to be. Some suggestions... -- subsidize medical school education: this is currently an out-of-pocket expense for the student (six figures easily) -- subsidize medical liability: do this however you need to...tort reform, government-mandated and controlled liability insurance at no cost to the healthcare provider. -- make provisions for free licensing examinations: also out-of-pocket (approximately $5k), four such exams must be passed...one is notorious (I should say infamous) for the test and travel fees involved -- streamline the credentialing process for licensure of physicians: an inefficient system in its current form, it takes a matter of a few weeks to get licensed in certain states but up to a year in others -- go all the way with e-prescribing: until Schedule II drugs are included, this is simply not an efficient practice from a financial standpoint or a drug diversion standpoint -- decrease the disparity in emphasis on preventive vs. reactive healthcare: read into this what you will. I'm biased of course as an FP, but I think our healthcare system as a whole could do tremendously better than it does at preventing development or progression of debilitating disease. I have more but I will leave it at that. I'll just end on this note. If I had to do it all over again, I'm not sure that I would've picked the same career path. I love practicing medicine and the idea that I may help the occasional person, but not at the expense of my family (who currently do not have health insurance) and being able to provide for them. That's right, the health care system in the U.S. is so dysfunctional that some physicians have to choose between practicing medicine without covering their own health insurance needs or paying for insurance and going out of business. |
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06-09-2009, 08:43 PM | #2119 | |
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I actually like most of that quite a bit. Though I would rather see larger incentives for trading in your SUV for something that gets significantly more mileage no matter what it is, not $3500 and $4500 for upgrading to a newer SUV that gets 2 or 5 MPG more :P |
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06-09-2009, 09:15 PM | #2120 |
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(This is not an original thought and I am sure it has probably been said numerous times throughout this thread, but it makes so much sense that I don't understand why our country is doing the exact opposite)
A portion (what percent is left to democrats/republicans to debate, but we can all agree that a portion) of these problems were caused by people spending more than they had. Buying new cars and houses that were outside our means. So what does Obama do? Convince people maybe they don't need the 2010 Toyota Prius and a 2000 Ford Escort will get them where they need to go. No, we write laws to try and convince people to go right back to the irresponsible behavior they had 2 years ago. It's scary what a combination of irresponsible people and irresponsible government can team up to do. |
06-09-2009, 09:22 PM | #2121 |
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But it's complicated, because if everyone just goes into lockdown savings mode, they spend a lot less, companies sell less, and therefore have to lay off employees and people lose jobs. And at that point it's a domino effect.
I think that's the main problem today - job loss. We need ways to keep people working. But at the same time, people need to live within their means. There are no easy answers. |
06-09-2009, 09:31 PM | #2122 | |
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My guess is if the small used car dealer down the street donated as much to the Democrats or Republicans as Chrysler and GM we would hear about the amazing new idea of saving money by driving a used car. It is flat out irresponsible to convince somebody who can't afford a new car that they should to keep the economy rolling. This helps nobody. |
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06-10-2009, 12:35 AM | #2123 |
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If drugs were legalized and taxed. What a bonanza for the federal government. Imagine what a pack of government issued joints on sale for $20 would do for the economy?
A sidebar to it would be less criminal activity. Less money spent on prisoners. Tax the crap out of cigarettes and alcohol (even more). All of this could go to paying for a free health care system. |
06-10-2009, 01:08 AM | #2124 |
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The average cost is still 7% despite your surveying of 2 doctors. I'm sorry your family has exceptionally higher rates than the average doctor in this country.
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06-10-2009, 01:15 AM | #2125 |
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Yeah, that's why I wouldn't support a single payer plan until there is some major reform in the health care industry. Right now it's just a big circle jerk with the insurance companies, pharmaceutical companies, and doctors dropping their loads on our forehead.
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06-10-2009, 01:19 AM | #2126 | |
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My only exception would be for fuel efficient cars. I have no problem with tax incentives on those to put them more in line money wise with regular cars. Those at least benefit everyone in this country (less gas bought from overseas and cleaner air to breathe). |
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06-10-2009, 06:47 AM | #2127 | |
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Given that you prefaced your comments with comments about more general comments concerning 'right wing' groups, its obvious your not interested in the truth. You're interested in circulating talking points that downplay the costs of health care. I'd love to see the source of your 7% cost. I spoke with a few other doctors after my post last night and they laughed at your estimates. |
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06-10-2009, 06:54 AM | #2128 | |
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HUGE +1 on this. Have a family member right now that is a general practice doctor. He finally was old enough to get covered under Medicare/Medicaid. Before that, he had no health insurance coverage. As you mention, one of the main issues is reimbursement. He has to harass the insurance company for weeks or months to get them to pay him for things as simple as an office visit. Meanwhile, he has bills that are going unpaid even though he's already earned the money to pay those bills. I know it's a fun endeavor to pretend that all doctors drive sportscars and live in million-dollar homes, but those same people would be shocked to know just how many doctors are struggling under the current health care arrangement. |
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06-10-2009, 07:28 AM | #2129 | |
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MBBF demanding sources /snicker
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06-10-2009, 07:38 AM | #2130 |
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Normally, I wouldn't. But everyone on this board knows that Rainmaker is pretty unreliable with his general statements that lump half a nation into one group. I'd also like to see if his information is from an interest group or not, as that's generally the case regarding this topic. |
06-10-2009, 10:01 AM | #2131 |
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ROFLMAO
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06-10-2009, 10:08 AM | #2132 | |||
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From today's New York Times: Economic Scene - How the U.S. Surplus Became a Deficit - NYTimes.com
Selected excerpts: Quote:
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06-10-2009, 10:29 AM | #2133 | |
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In summary, we're electing economic idiots to our government. Isn't this old news? Wait, there's a Nobel Laureate supporting it somewhere. Push forward! |
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06-10-2009, 10:58 AM | #2134 | |
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It makes too much sense to ever happen. |
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06-10-2009, 11:08 AM | #2135 |
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On the foreign policy front, two days from now will be a very important event, the Iranian presidential election.
No idea which way this will go, but while Ahmadinejad has been busy with his anti-American and anti-Israeli rhetoric, the economy has suffered (much like everywhere else). Things appear tight, but I expect Mousavi to defeat Ahmadinejad. This won't heal things overnight, but it would definitely be a step in the right direction. That's the nice thing about Iran. They actually do have a functioning democracy similar to ours. We're not stuck with Ahmadinejad as a dictator. Sure, the clerics can shoot down anybody from running that they want, but it's not much different than than the leadership of the Democrats or Republicans making sure nobody stirs the pot too much. |
06-10-2009, 11:15 AM | #2136 |
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/hands flame-retardant suit to lungs
For what it's worth, I agree, but I know a lot of people think Iran is an Islamic version of North Korea (or worse). |
06-10-2009, 11:21 AM | #2137 |
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Agreed on Iran, though I have a bit of a different take. If Mousavi wins, things should proceed as the are. But if Ahmadinejad wins, there is a growing youth movement that may lead to a revolutionary civil war. That's a scary proposition with nuclear technology in the balance.
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06-10-2009, 11:27 AM | #2138 |
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06-10-2009, 11:31 AM | #2139 |
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OMG
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06-10-2009, 11:31 AM | #2140 | |
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That's why I think Mousavi will win. Ultimately, the clerics hold the power and I doubt they'd allow Ahmadinejad to take the country to the brink of civil war. My prediction is that Mousavi wins and things will be similar between our two countries as they were during the Clinton-Khatami days of the 90's. We certainly we weren't friends with Iran in the 90's but we also weren't at each other's throats. |
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06-10-2009, 12:44 PM | #2141 |
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Excuse my stupidity, but why do we give a shit who Iran's President is or what weapons they have?
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06-10-2009, 12:45 PM | #2142 |
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06-10-2009, 12:48 PM | #2143 |
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Iran is a major, major power player (formal and informal) in the Middle East that has typically been hostile to U.S. allies. Our relationship with them (good or bad) has a bearing on how successful our efforts (or peace efforts in general) can be in the region, with all the knock-on effects that has.
We care about weapons because: 1. They're the kind of state that will sell advanced weapons technology (well, advanced for them) on the black market. 2. They're the kind of state who might be tempted to use something like a nuclear weapon on a neighboring state (or empower a terrorist to do so). I still think #2 is rather unlikely because the clerics, the real "power behind the throne" are relatively astute, geopolitically. |
06-10-2009, 12:55 PM | #2144 |
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06-10-2009, 01:27 PM | #2145 | |
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Like the United States? 1. Aren't we usually fighting wars against our own technology? 2. How many countries have detontated a nuclear weapon on another state? So we don't want Iran to join us, Russia, and China is the better response. |
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06-10-2009, 01:34 PM | #2146 | |
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Sorry, I should have been more clear: by "advanced weapons technology" I really mean nuclear weapons.
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I think it depends who you talk to. In an ideal world, I'd prefer it if no states had nuclear weapons. In a slightly less ideal world I'd prefer it if only very stable countries had nuclear weapons. In general, however, I think I'd prefer it if we could keep nuclear-armed countries to a minimum and also keep them from selling their technology on the black market. The hypocrisy and missteps of U.S. non-proliferation policy are well known and not lost on me, however. Neither do I think Iran is the international bogeyman a lot of people want to make it out to be (compared to some others). Still, I would greatly prefer it if they did not have nuclear weapons. But I would have preferred Pakistan to not have nuclear weapons either, so there you go.... |
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06-10-2009, 01:43 PM | #2147 | |
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No doubt, I absolutely agree with you. I have more of an issue with the US policy on Iran than what you posted. Just think if some country were at war with both Mexico and Canada at the same time. I wonder if the United States would do any postering? |
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06-10-2009, 04:55 PM | #2148 |
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06-10-2009, 05:06 PM | #2149 |
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Interesting that they are talking about all the emails they receive from these "amped up" crazies, but they don't seem to acknowledge that some of their programming may contribute to this. One only has to listen to little bits of Hannity, Malkin, Coulter and the lot to know where some of this is being fueled (not to say that these people are responsible, but they do contribute because it obviously helps their ratings/book sales).
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06-10-2009, 10:24 PM | #2150 | |
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The 7% figure is laughable. I pay 12% myself and I'm in one of the "low liability" fields in one of the more "low liability" states (Texas). Texas was able to turn around some of its liability problems with malpractice reform in 2003. The key was to amend the state constitution by referendum to make caps constitutional. Many other states have tried or are trying reform only to see it fail in their state courts, but supporters of reform in Texas got the constitution changed so it wouldn't fail. I'm not sure if there's a definitive single figure nationally where average liability insurance costs are involved. The figures vary depending on geographic location, specialty, years in practice, prior complaints, etc. Here's a snippit showing just how large the differences can be: http://www.ama-assn.org/amednews/200...gprl11229a.pdf And don't forget that any figures out there in cyberspace only take into account people who are willing to answer surveys. |
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