ErikWoods
Orchestrator
Radio Host Extraordinaire
Posts: 686
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Post by ErikWoods on Oct 30, 2009 15:57:10 GMT -8
I think you addressed this to the wrong person. -Erik-
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Post by Brendan Anderson on Oct 30, 2009 22:46:28 GMT -8
Craig, I'm not sure how we switched from talking about health care to hunger, but my quick take is this: Billions of dollars worth of food stamps go unclaimed each year. Literally billions. So obviously the solution to the hunger problem is NOT that we're not spending enough taxpayer money. So maybe you could find us an article explaining what the actual underlying problem is for why these folks don't have food... As for your Taiwan article, its loose-lipped statistic-speak is a bit troubling. For instance, take this delightfully ambiguous statement: "A number of East Asian systems also enjoy high quality of care for a much lower cost."Lower cost to who? And what cost? Are we talking about the cost people have to pay out-of-pocket at the time of service? Are we talking about total taxpayer cost to subsidize the program? Or both? What is the income tax rate in these countries? Just because a program 'costs' less out of pocket at the time services are rendered doesn't mean it actually costs less when you look at the whole picture of how much of individuals' money is being taken away in taxes to support the government system. Hidden costs are still costs. If you could shed some light on the ambiguity, I would appreciate it so we can continue the discussion. -Brendan
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Post by Craig Richard Lysy on Oct 31, 2009 7:19:27 GMT -8
Ah, you were up late. I was partying!
(Brendan) Craig, I'm not sure how we switched from talking about health care to hunger, but my quick take is this: Billions of dollars worth of food stamps go unclaimed each year. Literally billions. So obviously the solution to the hunger problem is NOT that we're not spending enough taxpayer money. So maybe you could find us an article explaining what the actual underlying problem is for why these folks don't have food...
I was addresing an earlier post. Unlike Filmtracks, I am unsure how to directly link an answer to the person I am responding to.
As for your Taiwan article, its loose-lipped statistic-speak is a bit troubling. For instance, take this delightfully ambiguous statement:
"A number of East Asian systems also enjoy high quality of care for a much lower cost."
(Brendan) Lower cost to who? And what cost? Are we talking about the cost people have to pay out-of-pocket at the time of service? Are we talking about total taxpayer cost to subsidize the program? Or both? What is the income tax rate in these countries? Just because a program 'costs' less out of pocket at the time services are rendered doesn't mean it actually costs less when you look at the whole picture of how much of individuals' money is being taken away in taxes to support the government system. Hidden costs are still costs.
Cross-country comparisons Direct comparisons of health statistics across nations are complex. The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently underperforms compared to the other countries.[11] A major difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage. The OECD also collects comparative statistics, and has published brief country profiles.[12][13][14]
Country Life expectancy Infant mortality rate Physicians per 1000 people Nurses per 1000 people Per capita expenditure on health (USD) Healthcare costs as a percent of GDP % of government revenue spent on health % of health costs paid by government
Cross-country comparisons Direct comparisons of health statistics across nations are complex. The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently underperforms compared to the other countries. A major difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage. The OECD also collects comparative statistics, and has published brief country profiles.
Perhaps most efficient is Healthcare in Taiwan, costing 6 percent of GDP (~1/4 US cost), universal coverage by a government-run insurer with smart card IDs to fight fraud.
Efficiency and effectiveness of service are the focus of these profiles. Perhaps most efficient is Healthcare in Taiwan, costing 6 percent of GDP (~1/4 US cost), universal coverage by a government-run insurer with smart card IDs to fight fraud.
MAIN ARTICLE: HEALTH IN TAIWAN The current health care system in Taiwan, known as National Health Insurance (NHI), was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralizes the disbursement of health care dollars. The system promises equal access to health care for all citizens, and the population coverage had reached 99% by the end of 2004.[45] NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for both public and private providers. Most health providers operate in the private sector and form a competitive market on the health delivery side. However, many health care providers took advantage of the system by offering unnecessary services to a larger number of patients and then billing the government. In the face of increasing loss and the need for cost containment , NHI changed the payment system from fee-for-service to a global budget, a kind of prospective payment system, in 2002.
My reference is The Organisation for Economic Co-operation and Development (OECD) (in French: Organisation de coopération et de développement économiques, OCDE) is an international organisation of 30 countries that accept the principles of representative democracy and free-market economy. Most OECD members are high-income economies with a high HDI and are regarded as developed countries.
It originated in 1948 as the Organisation for European Economic Co-operation (OEEC), led by Robert Marjolin of France, to help administer the Marshall Plan for the reconstruction of Europe after World War II. Later, its membership was extended to non-European states. In 1961, it was reformed into the Organisation for Economic Co-operation and Development by the Convention on the Organisation for Economic Co-operation and Development.
(Brendan) - If you could shed some light on the ambiguity, I would appreciate it so we can continue the discussion.
I believe I have done so, hopefully to your staisfaction.
In conclusion, Medical and Health care experts accept what multiple studies and data present; 1. Our health care costs twice as much per capita 2. Our health care costs more 2 - 4 times more of %GDP 3. That our system underperforms and has poorer outcomes 4. That we are the only democracy that does not provide universal coverage to its citizens. 5. That 44,000 people die annually due to lack of timely and affordable health care.
Brendan, the facts and the science are correct and cross verified by multiple sources. That is the beauty and reliabilty of science. You publish and then if your conclusions are crossed verified by multiple independent sources, they are accepted. I'll take the scientific method over politics any day!
I can only conclude that you TJ, Hook and Mike continue to reject the science and findings because of ideology. I believe it is good to have strong beliefs, but when reality, facts and science contradict the ideological principle, it is ideology that must give way. The Catholic Church tried to suppress Galilean and Copernican science as it contradicted dogma and failed. Have you read the about he inquisition from his work "Dialogue Concerning the Two Chief World Systems?" The lesson I learned is always be amendable to science and facts that contradict your principles, for in doing so it facilitates personal growth and your intellectual evolution.
This should be construed as friendly advice, not any attemtp to impugn.
All the best!
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Post by TJ on Oct 31, 2009 11:21:54 GMT -8
Costs WHO? You mentioned Taiwan, which is a much smaller country with significantly less people. How is it even comparing apples to apples?
Then why so do many come here for surgery?
Are we? What other countries don't have universal coverage and what are their stats? I think you'll find our's is superior.
Are you suggesting that significantly less would die just because there was universal health care? What about longer waits, or losing the ability to choose your doctor? What if all the best doctors opt out of the government program and only are available to private insurance (which will probably be even MORE expensive, and maybe not provided by employers)? Most likely those physicians available for public care would only be those right out of med school, working in the public system to pay off their school debts.
You're not talking about "reality", you're talking about an ideology as well.
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Post by Carlton the Barbarian on Oct 31, 2009 15:46:14 GMT -8
Carlton, show me the place where I said we need to eliminate all government programs - I didn't. You're absolutely right that some government programs are necessary. But the more government gets involved in enterprise, the more convoluted it gets. Good post. I have to thank you for the informative reply. No, you haven't said we need to eliminate all government programs, but, the same arguments made by yourself, Chris, and Tj, against universal health care, can be applied to any kind of Medicare/Medicaid program and tons of other social programs. For the record, I'm not sure if I would support an universal health care system (for all), but I don't see how a market-based approach would solve health care problems for the poor, the sick, the elderly, and others who would have a "legitimate" health care need. Medicare, which is a universal health care program, for the elderly, was created partly because the elderly had a difficult time obtaining access to health care insurance. Market-wise, this makes sense. Why would a health care insurer want to insure someone who will be costly to cover? Leaving responsibility aside for the moment, if someone gets into a car accident every two weeks, is someone going to want to provide him with auto insurance? No, the market would tell them not to. The same applies to health care (think of someone's body breaking down every two weeks)... It's also very hard to lower the cost of health care services (instruments, tests, drugs, surgeries, staff, hospital stays, treatments, etc). So, a free market-based system would leave those with "pre-existing" conditions -- the sick, the mentally-ill, the disabled, the destitute, and others -- in a position where it's hard for them to obtain health care. Even with tons of private competition, it's not profitable to cover these people. So even with competition, it seems likely that the government will have to play some subsidized role in health care. That means taxes and no "easy" solutions. You've stated that government intervention makes things more convoluted, but it appears that you are ignoring the market reality (see Craig's earlier posts.) Medicare has problems, which need to be addressed, but is it a failure compared to what precluded it? As, it stands now, you pay Medicare taxes, along with your employer, to insure you will have heath care insurance once you become old and feeble. So, I gather that you don't like this - the idea of not being trusted, being forced to pay taxes, and potentially being "reliant" upon a government program. So, Brendan, I ask you, if most Americans didn't have to pay Medicare taxes, would they (be able to) save up enough money for health insurance/costs for their golden years? And, if their employer didn't have to pay Medicare taxes would they pass the savings onto their employee's? (Does your job pay you a higher salary since they don't provide health insurance and a pension plan?). My guess is that both answers are no. Also, what's to keep your current insurance provider from raising your premiums, and finding a way to drop you, if you become too costly to cover. The government is not trying to make you dependent. It's trying to provide an additional level of support (that you have paid for)... We've been talking about Social Security, and it's a similar (less complicated) situation. One can have a pension, but pension's aren't guaranteed. One can have an IRA account but the interest earned on these accounts are not FDIC insured. Again, the government is not saying that you should rely on Social Security for your sole source of retirement income. If that was the case, the government would not have created IRA's, or promoted 401K's, with the passing of the "The Employee Retirement Income Security Act of 1974,"The Tax Reform Act of 1986," and "The Taxpayer Relief Act of 1997." Social Security is just a layer of retirement protection, and I would say a potentially necessary proposition, considering how 401K's can evaporate... -CG
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Post by Craig Richard Lysy on Oct 31, 2009 16:41:03 GMT -8
T.J. - Costs WHO? You mentioned Taiwan, which is a much smaller country with significantly less people. How is it even comparing apples to apples?
Standard comparative methodology T.J. - per capita. As such, by definition, it is apples to apples.
TJ - Then why so do many come here for surgery?
1. Their country lacks a modern health care system
Please not, more Americans left the country to obtain surgery last year than foreigners came to us. Hospitals in India and Thailand offer state of the art surgery that many Americans are taking. They are cheaper even with the plane fare included.
TJ - Are we? What other countries don't have universal coverage and what are their stats? I think you'll find ours is superior.
First the countries that have universal coverage. I include the year their systems went into effect. You would agree we are some what late?
Norway 1912 Single Payer New Zealand 1938 Two Tier Japan 1938 Single Payer Germany 1941 Insurance Mandate Belgium 1945 Insurance Mandate United Kingdom 1948 Single Payer Kuwait 1950 Single Payer Sweden 1955 Single Payer Bahrain 1957 Single Payer Brunei 1958 Single Payer Canada 1966 Single Payer Netherlands 1966 Two-Tier Austria 1967 Insurance Mandate United Arab Emirates 1971 Single Payer Finland 1972 Single Payer Slovenia 1972 Single Payer Denmark 1973 Two-Tier Luxembourg 1973 Insurance Mandate France 1974 Two-Tier Australia 1975 Two Tier Ireland 1977 Two-Tier Italy 1978 Single Payer Portugal 1979 Single Payer Cyprus 1980 Single Payer Greece 1983 Insurance Mandate Spain 1986 Single Payer South Korea 1988 Insurance Mandate Iceland 1990 Single Payer Hong Kong 1993 Two-Tier Singapore 1993 Two-Tier Switzerland 1994 Insurance Mandate Israel 1995 Two-Tier
Now countries that do not provide universal coverage, we are in fine company!
Russia, India, Iraq, Yemen, Pakistan, Afghanistan, Bulgaria, Slovakia, Poland, Ukraine, Hungary, most 3rd world countries.
All statistics obtained from the WHO.
TJ - Are you suggesting that significantly less would die just because there was universal health care?
I suggest nothing! I work in health care my friend and we know this proven truth; early diagnosis and intervention saves lives. Late diagnosis and late intervention = late stage disease with complications and or death. AN example women without insurance are diagnosed usually in end stage breast cancer as opposed to women with insurance. As such their death rates from stage IV cancer are 10 times as high. Do you understand?
What about longer waits, or losing the ability to choose your doctor?
Waits depend on the countries investment in health care infrastructure! More investment = less waits. In the UK they had a terrible wait problem, but they recently fixed it with more investment. No one would wait for emergent care.
As to losing your ability to chose a doctor, propaganda! Where do you get your info? You chose your doctor, show them your card and they bill the government plan for expenses. You do not lose choice.
TJ - What if all the best doctors opt out of the government program and only are available to private insurance (which will probably be even MORE expensive, and maybe not provided by employers)?
A good question. In a single payer system, doctors cannot opt out. Your license to practice requires participation. In the plan being proposed by the democrats, some doctors may opt out, most will opt in as is the case with Medicare which reimburses at a much lower rate.
TJ - Most likely those physicians available for public care would only be those right out of med school, working in the public system to pay off their school debts.
No supported by the facts TJ. My doctor did not. The vast majority of doctors I know are dedicated to caring for the sick and are true professionals. They will take the public option, as they take Medicare which pays them less.
TJ - You're not talking about "reality", you're talking about an ideology as well.
Indeed my friend, I am. A simple ideology derived from my faith and family values. We take care of our own, and extend the honorable precept used by are military, "We leave no one behind." I believe we are one people and everyone is my brother and sister. If you read the history of the early Christan church, Christian communities functioned like Jewish Kibbutz's where you were a parent, teacher and guardian for all that lived in the community. The harvest and all resources were shared. The size of our country, the different races, ethnicities and religions are indeed challenges, but I retain hope.
I believe I have dutifully addressed all your key points.
Now we are off to West Hollywood for drinks, dinner and the worlds greatest Halloween spectacle! I hope you too have a fun night.
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Post by TJ on Oct 31, 2009 18:25:41 GMT -8
Then how come I had to change doctors when I went off my dad's PMO plan to my company's HMO plan? We ALREADY don't have all the choices...I can't imagine it's not going to get worse if UHC passes?
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Post by Carlton the Barbarian on Oct 31, 2009 23:48:32 GMT -8
The problem with Liberals is they seem to want to spend everyone else's money for them. Once again, what motivation whatsoever is there for one to strive to better oneself if they can get a free ride? Whatever happened to working hard for what you have? I'm just not sure if I buy this whole motivation and working hard argument. Tj, do you think poor and working class people don't work hard for what they have? Also, people can easily be motivated by the "Savings" concept. If someone took advantage of the "Cash for Clunkers" program, do you think they will not to be motivated to take care of their new car? If someone was giving a free (tuition-less) ride to school, do you think they will not be motivated to graduate? Similarly, if an elderly person has "free" health care, Medicare/Medicaid, do you think they will not be motivated to take care of their health? Yes, there will be some who will abuse the system. I'm not sure about Medicare, but with Social Security, under certain circumstances, one can be denied benefits even if they have paid Social Security taxes. The government can put attachments and cash requirements onto any service they provide. In an earlier thread, Tom mentioned his experiences with Medicare and how he was required to pay all of his prescription costs after he had paid for a certain amount of discounted (not free) drugs. Also, Tj, what do you say to children? "Hey, you haven't worked hard... You have no motivation to improve yourself, so you can't have access to 'free' (subsidized) health care." Btw, what is your stance on the State Children's Health Insurance Program (SCHIP) and taxes? This program was created by Sen. Kennedy, a liberal, and Sen. Hatch a conservative? Hatch stated that, "Children are being terribly hurt and perhaps scarred for the rest of their lives" and that "as a nation, as a society, we have a moral responsibility" to provide coverage. I think they pay income up to that level ($107,000), so Millionaires should be able to collect Social Security. It's a small tax, but is it fair? Btw, the Social Security tax actually puts a greater tax burden on lower income workers. For example, if you make around $10/hr (a few dollars above the federal minimum wage), or $20,000 in a year, you would pay around $1,400 in taxes. If you made $200,000 you would pay around $7,000 in taxes. Percentage-wise, the lower income person is paying twice as much in taxes (3.5 to 7%). Is this fair? Should taxes be "fair?" Also remember, that with Social Security, the more you work and the more you contribute to the system, the higher your benefits will be... (Motivation?) If you make the federal minimum wage, or around $15,000 a year, with a 17.5% flat income tax rate (for all), you would pay around $2600 in taxes. So this leaves you with $12,400. Then there are additional health insurance costs, retirement costs, education costs, saving costs if you want to "improve" yourself, and potentially property taxes, sales taxes, road taxes (tolls), and other things... Is your flat tax really fair for low income workers? Though, a bracketed approach "punishes" higher income workers, I think it is the way to go. Board-wise, I'm in the minority on this issue. And Jangles, you can stop posting cats because I disagree with this: ;D I see what TJ is getting at and agree with it. I don't think the rich or even the "upper middle-class" have to directly contribute to the welfare of society (as it were). The fact that these classes of people are spending money and allowing it to circulate within the economy is all the contribution necessary. Millionaires spend money and this allows industries to exist and people working in those industries can make and spend money which allow other industries to exist who also have people working in them who can spend their money, and etc etc it keeps going on forever. I guess it's just the classic example of what controls the flow money - free market or the government. I honestly feel like I am doing my duty to society by spending money. Spending money will not increase the military budget or cover other government expenditures. Let's bring back Dennis Kucunich's and a famous pie chart. ;D Also, the idea that families, churches, and community groups with Messianic community organizers ;D can provide all the necessary services is unfounded. Many sick people have friends or family or a church or some kind of community group who raise money for their care. There is no need for the government to step in and get in the people's business. People are more than able (and willing) to take care of their fellow man without the US government getting involved and playing Robin Hood, which I think was one of Brendan's main points? I really can't agree with this. Craig's response says it all. Also consider this, poor people (uninsured people), who go to the emergency room/hospital, still receive "free" health care, in my state, New Jersey, and this Charity Care cost hospitals [url= $1.3 billion in 2007. Tj, could a church, a friend, or a family member, or community group, located in a low-income neighborhood really finance health care costs which exceed a billion dollars? In my state "Charity Care" is funded by taxes and the government. Why do I have to be a jerk and throw in 'legitimate need'? Because of the reality of our self-absorbed, backwards-priority, entitlement society...if you don't believe me, just read this article (Chris linked to it earlier). What an article. I'm not going to challenge the notion that some poor people have made poor financial decisions. However, I'm not going to judge a person by the accessories they appear to have. A poor person can't have a cell phone, or an Ipod, or a GameBoy, fake fingernails, tattoo's, etc? How am I to know if the Ipod was given to them, or if someone else was paying for their cell phone? Or what if they maxed out a credit card to buy a new, low-gas mileage car? Or what if they got an item free (or discounted) from their job? Fraud is a major problem, but we should not ignore those "who actually lived in poverty... [where] luxury meant keeping the utilities on and having clean clothes for a rare visit to the doctor." Brendan, should I refuse to give money to any charity, or any church, just because one charity, or one pastor, misused funds or abused the system. Hey, this pastor built a "gold" encrusted church and brought two luxury cars for his family, so I shouldn't have to make any donations to charities or churches. This approach sounds like it will unnecessarily harm many just because of the actions of a few. With Medicaid, abuse happens on both ends. "According to Steven Malanga of the Manhattan Institute, experts estimate that "abuses of Medicaid (alone) eat up at least 10 percent of the program’s total cost nationwide -- a waste of $30 billion a year. Unscrupulous doctors billing for over 24 hours per day of procedures, phony companies invoicing for phantom services, pharmacists filling prescriptions for dead patients, home health-care companies demanding payment for treating clients actually in the hospital -- on and on the rip-offs go." PS: Swishalicious... Godzilla... The Yankees Win. The Yankeeeees Win! It's time to go to bed. ;D
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cheno
Conductor
Posts: 1,012
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Post by cheno on Nov 1, 2009 2:57:19 GMT -8
Well put, Carlton. Poor people aren't the lazy bums they're made out to be. The world just isn't fair, is all.
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Post by Craig Richard Lysy on Nov 1, 2009 7:15:12 GMT -8
TJ - Then how come I had to change doctors when I went off my dad's PMO plan to my company's HMO plan? We ALREADY don't have all the choices...I can't imagine it's not going to get worse if UHC passes?
HMOs are damnable health care providers. They limit choice, they limit access, they limit specialists, they limit hospitals that you can go to! They are FOR PROFIT entities. Translation, the more they limit and deny choice and care, the more money they make. I deal with HMO's all the time and have extreme contempt for them, and extreme sympathy for the people forced into them. I have literally seen people die because treatment and tests were delayed or denied.
Example I perform a cardiopulmonary stress test to provide pre-op clearance for surgery. One test on one day. A local HMO sends their pre-op patients to 3 different hospitals, for three separate tests that often require their patients to take 3 days off from work. This is not right. The HMO's do this not for patient convenience, nor to provide the best care, but for only one reason - to maximize their profits.
UHC, again will not limit choice of doctors. Like Medicare (the other government plan), the patient selects their primary care doctor. I am not lying to you. My mom and other seniors choose their own doctor.
You have my sympathy for being trapped in a HMO TJ.
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Post by Carlton the Barbarian on Nov 1, 2009 7:46:12 GMT -8
I was addresing an earlier post. Unlike Filmtracks, I am unsure how to directly link an answer to the person I am responding to. All you have to do is highlight the section and press the "insert quote" button, which is the next to last one above the emoticons, or you can manually write in (quote) at the start of the part your quoting and (/quote) at the end of the part your quoting, except that you will have to use brackets instead of parenthesis. Basically, the (quote) is the opening quotation mark and the (/quote) is the closing quotation mark. To have your quote specially include the posters name, use the same approach as above, but just leave in the initial "quote author=craigrichardlysy board=offtopic thread=4199 post=52595 time=1257002367" that appears at the start of the message when you reply. That would serve as the opening quotation mark... In this case instead of clicking on reply to respond to a message, you will have to click on the "quote" tag which is just below the reply tag, to the left of the post title, to respond to a message. -CG
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Post by Craig Richard Lysy on Nov 2, 2009 7:39:04 GMT -8
Ah! Thanks for the education!
Al the best!
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cheno
Conductor
Posts: 1,012
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Post by cheno on Nov 7, 2009 20:38:31 GMT -8
The bill (with a last-minute amendment that makes it so only rich people can get abortions) passed the House.
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Post by Jockolantern on Nov 8, 2009 0:31:37 GMT -8
The bill (with a last-minute amendment that makes it so only rich people can get abortions) passed the House. And judging by the razor-thin margin and Harry Reid's incompetence, getting a 60-vote majority on a Senate vote is unbelievably slim. Also makes me laugh how Pelosi decided to sneak this vote in on a weekend of all times. Oh and what ever happened to that promise of showing the bill 72 hours in advance? Huh... guess they sorta' "forgot" about that one, didn't they?
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Post by TJ on Nov 8, 2009 8:49:30 GMT -8
Is this a joke. Haha. Of all the things to add...
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