November 12th, 2017 @ 05:32 [flag]
Vanya is not the author!, https://www.gitbook.com/book/galtorove/-no-match-with-you/details no_match_with_you, https://www.gitbook.com/book/sestbestnonpcomp/-tinder-app-op-laptop/details tinder_app_op_laptop, https://www.gitbook.com/book/raftbehori/-kjreste-fra-usa/details kjreste_fra_usa, https://www.gitbook.com/book/sarenriridd/-gratis-datingsite-gehandicapten/details gratis_datingsite_gehandicapten, https://www.gitbook.com/book/tiomistiablum/-sukker-formel/details sukker_formel, https://www.gitbook.com/book/rawistgasli/-ts-icet-counselling-dates-2015-rank-wise/details ts_icet_counselling_dates_2015_rank_wise, https://www.gitbook.com/book/acizwiper/-chat-qui-peche/details chat_qui_peche, https://www.gitbook.com/book/acattafo/-christian-dating-for-free-europe/details christian_dating_for_free_europe, https://www.gitbook.com/book/hustducknalo/-niche-dating-sites-list/details niche_dating_sites_list, https://www.gitbook.com/book/limotazo/-damer-bergen-xl/details damer_bergen_xl, https://www.gitbook.com/book/raperaro/-singles-ward-lds/details singles_ward_lds, https://www.gitbook.com/book/biponeti/-battlenet-voice-chat-diablo-3/details battlenet_voice_chat_diablo_3, https://www.gitbook.com/book/rawistgasli/-finnno-mteplassen-vgs/details finnno_mteplassen_vgs, https://www.gitbook.com/book/khalarempi/-uk-single-release-dates/details uk_single_release_dates, https://www.gitbook.com/book/exobanhyp/-a-single-man-tear/details a_single_man_tear, https://www.gitbook.com/book/ecigperfarm/-online-dating-site-pros-and-cons/details online_dating_site_pros_and_cons, https://www.gitbook.com/book/raftbehori/-kjrlighetsdikt-til-henne/details kjrlighetsdikt_til_henne, https://www.gitbook.com/book/chrisalamgi/-free-online-chat-sites-for-singles/details free_online_chat_sites_for_singles, https://www.gitbook.com/book/singteevicour/-chat-terra-mexico-edades-20-30/details chat_terra_mexico_edades_20_30, https://www.gitbook.com/book/raftbehori/-elitepartner-zielgruppe/details elitepartner_zielgruppe, https://www.gitbook.com/book/atprepercroch/-italiaanse-flirt-zinnen/details italiaanse_flirt_zinnen, https://www.gitbook.com/book/galtorove/-hd-webcam-chat/details hd_webcam_chat, https://www.gitbook.com/book/duchasipa/-chat-rooms-for-dating/details chat_rooms_for_dating, https://www.gitbook.com/book/battcabriwhoo/-kristen-stewart-date-de-naissance/details kristen_stewart_date_de_naissance, https://www.gitbook.com/book/mererosen/-best-free-webcam-for-iphone/details best_free_webcam_for_iphone, https://www.gitbook.com/book/probreasibli/-kjrlighetsdikt-til-jenta-mi/details kjrlighetsdikt_til_jenta_mi, https://www.gitbook.com/book/ecigperfarm/-drone-yuneec-q500g-typhoon-g-rtf/details drone_yuneec_q500g_typhoon_g_rtf, https://www.gitbook.com/book/prizboiplactib/-flirt-fiche-technique/details flirt_fiche_technique, https://www.gitbook.com/book/sestbestnonpcomp/-sms-dating-test/details sms_dating_test, https://www.gitbook.com/book/planuzecher/-tinder-rules-who-messages-first/details tinder_rules_who_messages_first, https://www.gitbook.com/book/exobanhyp/-dating-advice-single-mom/details dating_advice_single_mom, https://www.gitbook.com/book/surtiabanpi/-100-percent-free-japanese-dating-sites/details 100_percent_free_japanese_dating_sites, https://www.gitbook.com/book/clovexaplia/-free-dating-site-for-young-singles/details free_dating_site_for_young_singles, https://www.gitbook.com/book/limotazo/-baixar-app-tinder-apk/details baixar_app_tinder_apk, https://www.gitbook.com/book/ecigperfarm/-first-text-message-to-a-girl-online-dating/details first_text_message_to_a_girl_online_dating, https://www.gitbook.com/book/inmurroty/-beste-datingsider-i-norge-hndball/details beste_datingsider_i_norge_hndball, https://www.gitbook.com/book/raftbehori/-dating-websites-cupid/details dating_websites_cupid, https://www.gitbook.com/book/chrisalamgi/-eharmony-advert-music/details eharmony_advert_music, https://www.gitbook.com/book/limotazo/-emo-singles-dating-site-for-14-years-old-on-43th/details emo_singles_dating_site_for_14_years_old_on_43things, https://www.gitbook.com/book/gannodetna/-singelklubb-gvle/details singelklubb_gvle, https://www.gitbook.com/book/gannodetna/-norske-jenter-p-tumblr/details norske_jenter_p_tumblr, https://www.gitbook.com/book/sestbestnonpcomp/-chatt-library/details chatt_library, https://www.gitbook.com/book/exobanhyp/-casual-dating-norge-wiki/details casual_dating_norge_wiki,
November 12th, 2017 @ 10:12 [flag]
google.com/reader, https://www.gitbook.com/book/paisubspifea/-smokvica-chat-forum/details smokvica_chat_forum, https://www.gitbook.com/book/sterobcheni/-avtobuska-stanica-skopje-megunaroden-soobrakaj-s/details avtobuska_stanica_skopje_megunaroden_soobrakaj_skopje, https://www.gitbook.com/book/tioxboxoplui/-cri-du-chat-infant-symptoms/details cri_du_chat_infant_symptoms, https://www.gitbook.com/book/interdiaberg/-halo-oglasi-licni-kontakti-on-trazi-nju-lyrics/details halo_oglasi_licni_kontakti_on_trazi_nju_lyrics, https://www.gitbook.com/book/mytholiva/-bogata-zhena-t-rsi-mlad-m-zh-you/details bogata_zhena_tiersi_mlad_miezh_you, https://www.gitbook.com/book/tualesmali/-oglas-baram-maz/details oglas_baram_maz, https://www.gitbook.com/book/chaheeberfpa/-upoznavanje-ona-trazi-njega-za-brak-dijaspora-og/details upoznavanje_ona_trazi_njega_za_brak_dijaspora_oglasi, https://www.gitbook.com/book/gratoralba/-t-rsya-si-zhena-windows-7/details tiersia_si_zhena_windows_7, https://www.gitbook.com/book/nosedelbay/-ona-trazi-posao-kragujevac/details ona_trazi_posao_kragujevac, https://www.gitbook.com/book/bobdiporci/-trazim-devojku-oglasi-francuska/details trazim_devojku_oglasi_francuska, https://www.gitbook.com/book/gratoralba/-licni-oglasi-trans-kragujevac/details licni_oglasi_trans_kragujevac, https://www.gitbook.com/book/britpolusop/-zene-traze-muskarca-hrvatska/details zene_traze_muskarca_hrvatska, https://www.gitbook.com/book/bobdiporci/-zene-udaja-za-papiere/details zene_udaja_za_papiere, https://www.gitbook.com/book/chaheeberfpa/-radio-upoznavanje-chat/details radio_upoznavanje_chat, https://www.gitbook.com/book/guslandtrepceo/-oglasnik-traktori-srbija/details oglasnik_traktori_srbija, https://www.gitbook.com/book/ovexstincest/-free-chat-online-hr-test/details free_chat_online_hr_test, https://www.gitbook.com/book/pellmateco/-devojke-za-udaju-sa-slikama/details devojke_za_udaju_sa_slikama, https://www.gitbook.com/book/ipadbeta/-licni-oglasi-sabac-loznica/details licni_oglasi_sabac_loznica, https://www.gitbook.com/book/taidaronli/-zeni-za-edna-vecer-tekst/details zeni_za_edna_vecer_tekst, https://www.gitbook.com/book/elinmape/-licni-horoskop-za-2017-besplatno/details licni_horoskop_za_2017_besplatno, https://www.gitbook.com/book/nosedelbay/-dzabe-oglasi-licni-kontakt-kragujevac/details dzabe_oglasi_licni_kontakt_kragujevac, https://www.gitbook.com/book/guslandtrepceo/-licni-oglasi-masaza-crna-gora/details licni_oglasi_masaza_crna_gora, https://www.gitbook.com/book/antonchita/-sajt-za-upoznavanje-zena-crna-gora/details sajt_za_upoznavanje_zena_crna_gora, https://www.gitbook.com/book/elinmape/-sms-oglasi-licni-kontakti-gradiska/details sms_oglasi_licni_kontakti_gradiska, https://www.gitbook.com/book/pellmateco/-najljepsi-ljubavni-statusi-ask/details najljepsi_ljubavni_statusi_ask, https://www.gitbook.com/book/laagrapinmi/-halo-oglasi-licni-kontakti-on-trazi-nju-nemacka/details halo_oglasi_licni_kontakti_on_trazi_nju_nemacka, https://www.gitbook.com/book/guslandtrepceo/-erotska-masaza-vo-tetovo-university/details erotska_masaza_vo_tetovo_university, https://www.gitbook.com/book/ipadbeta/-besplatni-licni-kontakti-vo-makedonija-online-sa/details besplatni_licni_kontakti_vo_makedonija_online_sa_prevodom, https://www.gitbook.com/book/elinmape/-trazim-vezu-za-brak/details trazim_vezu_za_brak, https://www.gitbook.com/book/ovexstincest/-oglasi-gay-hr/details oglasi_gay_hr, https://www.gitbook.com/book/bobdiporci/-oglasi-ona-trazi-njega-vrsac/details oglasi_ona_trazi_njega_vrsac, https://www.gitbook.com/book/pellmateco/-erotski-oglasi-makedonija-znamenitosti/details erotski_oglasi_makedonija_znamenitosti, https://www.gitbook.com/book/guslandtrepceo/-erotska-masaza-halo-oglasi-qori/details erotska_masaza_halo_oglasi_qori, https://www.gitbook.com/book/ipadbeta/-plavi-oglasnik-fotoaparati/details plavi_oglasnik_fotoaparati, https://www.gitbook.com/book/taidaronli/-brani-oglasi-youtube/details brani_oglasi_youtube, https://www.gitbook.com/book/gratoralba/-dopisivanje-preko-interneta-online-video/details dopisivanje_preko_interneta_online_video, https://www.gitbook.com/book/chrisalamgi/-sms-oglasi-dnevni-avaz/details sms_oglasi_dnevni_avaz, https://www.gitbook.com/book/lasnocenbau/-stranice-za-chatanje-wikipedia/details stranice_za_chatanje_wikipedia, https://www.gitbook.com/book/brutsaratan/-omegle-samo-devojke-voznje/details omegle_samo_devojke_voznje, https://www.gitbook.com/book/chrisalamgi/-licni-oglasi-novi-sad-masaza/details licni_oglasi_novi_sad_masaza, https://www.gitbook.com/book/bobdiporci/-licni-kontakt-dama-cena/details licni_kontakt_dama_cena, https://www.gitbook.com/book/giftlingdore/-erotski-sms-poraki/details erotski_sms_poraki, https://www.gitbook.com/book/gratoralba/-oglasnik-od-a-do-mostar/details oglasnik_od_a_do__mostar, https://www.gitbook.com/book/tualesmali/-oglasi-devojke-online-sa-prevodom/details oglasi_devojke_online_sa_prevodom, https://www.gitbook.com/book/platonartsun/-upoznavanje-preko-tindera-nema/details upoznavanje_preko_tindera_nema, https://www.gitbook.com/book/tualesmali/-hrvatski-chat-date-wrong/details hrvatski_chat_date_wrong, https://www.gitbook.com/book/sejazranktemp/-bosanke-za-udaju-oglasi-traktori/details bosanke_za_udaju_oglasi_traktori, https://www.gitbook.com/book/giftlingdore/-ona-trazi-njega-oglasi-sa-slikama-youtube/details ona_trazi_njega_oglasi_sa_slikama_youtube,
November 12th, 2017 @ 09:41 [flag]
CIA spam its database, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1BObf0w8EDAoMfrUOVdU2FVYd9LlmlQU7 vruce_dopisivanje_jezika, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1DseQveBlxgP2F4wShFd2JlljoFpgPmHf samotni_zheni_online, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1cKInOjnyNUs6U87q9l7DPBk5hNhNzOwo upoznavanje_ona_trazi_njega_za_brak_telefon, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1jlDsVRot-O2Kj1FAUJkkDZdl6fAFSDwc licni_oglasi_dama_trazi_njega_fotografija, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1iWWok4bFSlfrVPDRYQOODlp6sP9gkjW3 dzabe_oglasi_arandjelovac, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1YFws2B_51iKVPko7Go2pV9FsDce0FuSL devojke_za_brak_sa_slikom_prodaja, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1mRIIs8sFtVEtIKIVJkp7yvnzngPcHBj1 super_oglasi_licni_facebook, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1HS5Hp_loid5xL-2ulvKwvYvTYbjjggpp best_free_indian_dating_app_for_android, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 12x86-4Wlf23EZZoG3oxMEcFPqmovUg-y traim_mukarca_za_rad_kod_mene_na_imanjure, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1HkN2ZVoTuIgjenE56ByidzRqiL50WGwD one_traze_njega_oglasi_kragujevac, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 19O7xCdLpXJJmrmI02sBvw2TNpmxqLZYu licni_oglasi_matorke_you_tube, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1izHyGr_x31dCgJ-Bf68tIgB3CQRy9z_Z was_muss_eine_attraktive_frau_haben, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1YJdAuINsNKY3alaTD0jRB_Cz0OySQ36R wo_ist_der_g_punkt_bild, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1d1RihOXy5BOjXyEb4w4l_wb_FgHG43-7 devojke_traze_momke_web, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1hmf5ujIYUMsIgKL2v-O6NC7LYTHakO_i deutsche_handball_nationalmannschaft_kader_2011, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1fHxnAfLha5zPyWKA3XnmInIrZ6zqjxaJ eine_frau_im_internet_richtig_anschreiben, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1dy_M10ylVCEPrmfuR5qZRY_dt93mC5Uf erotski_cet_wiki, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 156-FwZi-wVvf-GzhwicHxZ3x7A-HdgGK ebanje_bez_prdenje, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1Dnzsf7sSs4JNG29U83_zp0eKJGFsIRjf ona_trazi_njega_radi_braka, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1mgGn-K84ge0P-tnZE6J40-Xyd4zMcqkn one_traze_njega_plus, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1SEf0-cNIaZy9eGkgiKZK0ug8-Gx5YSPD cri_du_chat_maladie, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 16vaQE6CRFJtuvxqUAybnWpl6D4rxEbec meet_singles_wagga, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1-dt01DmbyhcrsYUHJ8fCB3S5m0_3r7Md oglasi_za_poslovnu_pratnju_wikipedia, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1ZFE5lwtf1nXLPIoUlHAEUW744qsfsaXD oglas_trazim_zenu, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1LbnYea01D4CstwKYFWP9WTGEjIhTWFhq sms_caskanje_forum, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1pmlNHyhY5ZM6uTWLkTdVkDGF93e3vsfO devojke_za_avanturu_varadin, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1tkxqALpuRU5NfquMa7ZAOEZWVhwk5l0Y free_webcam_chat_online_dating, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1QUvCXRSbgODXsK8wjo-3bkYq5Tke3tDS alte_frauenkirche_dresden, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1XQVloxlpXxAnWNI2ShDuNt0_zUdpH6Ug liebe_frau_prof_dr, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1fQal7b-2Z4rwz-IhNQy2d73htv994xPi devojke_za_brak_iz_rusije_radio, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1D4k4bLFjXjIrpMwpXrdBuDpBvGuRX6fR meine_stadt_biedenkopf_singlebrse, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1DNqLyOI5qVrfRgKYmFyPYFvmZ8GI9lmQ devojka_sa_sela_trazi_muskarca_za_brak_leskovac, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1OzTw6_BzJE_418JM0rHdCh5Wo8ZDwzJ1 srpkinje_za_udaju_oglasi_qr_code, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 18AKsS1ga9c_TYb6Sgcr7SEAd4Il9ru4D trazim_muskarca_hrvatska, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1YCXZH1FWvuODXvDZYzP54By8jLGJyI2D upoznavanje_ona_trazi_njega_za_brak_vojvodina, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 18-piuiYreitxKzQhMabZR2XPzcK17bkD oglasi_gay_quiz, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1LSIyEYZvF6viQiAhiOQEPipEU7IUBJ2r zene_za_brak_sa_brojevima_telefona, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1ZbuUXIoxCQ5WfCXuc86--UCPqh1e8DwH besplatno_upoznavanje_preko_interneta_gledanje, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1zx5FxCq-i2FSAIYJnhFrfdVd1tSll-KU ona_trazi_njega_beogradski_oglasi_cena, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1sxVspq7Htyw9byrKu103Nrl22vroMQkR suche_mdchen_zum_schreiben, https://www.google.com/maps/d/viewer?usp equals sharing&mid equals 1Z05fA1C3K0JBTjia6fHzhsmwQaKCrZ0S kennenlernen_schler_spiel,
November 12th, 2017 @ 08:32 [flag]
First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher? To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2P of the U.S. population at the time! Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a "wait and see" approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions. This very basic review of American medical history helps us to understand that until quite recently (around the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; "nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual. What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today. I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the "perfect storm" for higher and higher health care costs. And by and large the storm is only intensifying. At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16P, heading for 20P of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions? The Obama health care plan is complex for sure - I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care. Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance. To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs. To cover the added costs there were a number of new taxes introduced, one being a 2.5P tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans. The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs. The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide "free" (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision. As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to "give up" something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative. Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as "big government control" of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction. A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to "go to the doctor" when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems. OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary. I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens - health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition. Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because "health care is there" and somehow we think we have no responsibility for reducing our demand on it. It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame. There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, "Google" "preventive health care strategies", look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then - take charge and increase your chances for good health while making sure that health care is there when we need it.
November 12th, 2017 @ 08:11 [flag]
for the fact that he draws on it stsuko, https://www.gitbook.com/book/discnorsirigh/free-online-dating-austria/details free_online_dating_austria, https://www.gitbook.com/book/elhuvenport/meet-joe-black-free-download-movie/details meet_joe_black_free_download_movie, https://www.gitbook.com/book/lehealthgura/une-rencontre-streaming-vf-gratuit/details une_rencontre_streaming_vf_gratuit, https://www.gitbook.com/book/draforator/lesbian-dating-app-singapore/details lesbian_dating_app_singapore, https://www.gitbook.com/book/kannamysa/where-can-i-meet-guys-online-for-free/details where_can_i_meet_guys_online_for_free, https://www.gitbook.com/book/homilliton/sites-de-rencontres-gratuit/details sites_de_rencontres_gratuit, https://www.gitbook.com/book/icpronrendchip/online-dating-india-without-registration/details online_dating_india_without_registration, https://www.gitbook.com/book/bourleodira/exemple-pseudo-homme-pour-site-de-rencontre/details exemple_pseudo_homme_pour_site_de_rencontre, https://www.gitbook.com/book/ifirenmi/site-de-vetement-homme-street/details site_de_vetement_homme_street, https://www.gitbook.com/book/ovsidchiga/one-page-responsive-website-tutorial/details one_page_responsive_website_tutorial, https://www.gitbook.com/book/discnorsirigh/rencontre-mariage-maroc-sans-inscription/details rencontre_mariage_maroc_sans_inscription, https://www.gitbook.com/book/ropasfibe/streaming-sans-pub-ni-virus/details streaming_sans_pub_ni_virus, https://www.gitbook.com/book/ropasfibe/site-de-vetement-en-ligne-france/details site_de_vetement_en_ligne_france, https://www.gitbook.com/book/discnorsirigh/dateline-tonight-72117/details dateline_tonight_72117, https://www.gitbook.com/book/bourleodira/100-free-dating-australia/details 100_free_dating_australia, https://www.gitbook.com/book/antonchita/free-web-hosting-couk/details free_web_hosting_couk, https://www.gitbook.com/book/lehealthgura/meilleur-site-de-rencontre-usa/details meilleur_site_de_rencontre_usa, https://www.gitbook.com/book/tiogerehot/personal-portfolio-examples-design/details personal_portfolio_examples_design, https://www.gitbook.com/book/homilliton/raconter-ses-vacances-en-espagnol-seconde/details raconter_ses_vacances_en_espagnol_seconde, https://www.gitbook.com/book/balanlaycomp/site-de-rencontre-gratuit-avec-chat/details site_de_rencontre_gratuit_avec_chat, https://www.gitbook.com/book/homilliton/site-de-chat-gratuit-sans-inscription-algerien/details site_de_chat_gratuit_sans_inscription_algerien, https://www.gitbook.com/book/xandrepatta/site-de-vetement-fashion-pas-cher/details site_de_vetement_fashion_pas_cher, https://www.gitbook.com/book/elhuvenport/responsive-web-design-tutorial-step-by-step-video/details responsive_web_design_tutorial_step_by_step_video, https://www.gitbook.com/book/ovsidchiga/online-indian-voice-chat-rooms/details online_indian_voice_chat_rooms, https://www.gitbook.com/book/alloihelroy/site-de-rencontre-message-gratuit/details site_de_rencontre_message_gratuit, https://www.gitbook.com/book/muechilranchger/rencontre-femme-veuve-catholique/details rencontre_femme_veuve_catholique, https://www.gitbook.com/book/tiogerehot/dating-profile-maker-download/details dating_profile_maker_download, https://www.gitbook.com/book/muechilranchger/site-de-chaussure-femme-usa/details site_de_chaussure_femme_usa, https://www.gitbook.com/book/discnorsirigh/site-de-chat-mariage-france/details site_de_chat_mariage_france, https://www.gitbook.com/book/alloihelroy/responsive-html5css3-site-template-free-download/details responsive_html5css3_site_template_free_download, https://www.gitbook.com/book/alloihelroy/responsive-layout-css-template/details responsive_layout_css_template, https://www.gitbook.com/book/gadovifi/trouver-l39amour-de-sa-vie-15-ans/details trouver_l39amour_de_sa_vie__15_ans, https://www.gitbook.com/book/gadovifi/wedding-cake-responsive-website-template-free-dow/details wedding_cake_responsive_website_template_free_download, https://www.gitbook.com/book/feizeberkcor/meet-local-singles-on-facebook/details meet_local_singles_on_facebook, https://www.gitbook.com/book/muechilranchger/premier-contact-site-rencontre/details premier_contact_site_rencontre, https://www.gitbook.com/book/elhuvenport/site-de-rencontre-serieux-belge/details site_de_rencontre_serieux_belge, https://www.gitbook.com/book/muechilranchger/site-vente-maison-gratuit-quebec/details site_vente_maison_gratuit_quebec, https://www.gitbook.com/book/gifsevasen/free-online-kundali-matching-for-marriage-by-name/details free_online_kundali_matching_for_marriage_by_name, https://www.gitbook.com/book/ifirenmi/black-dating-uk-free/details black_dating_uk_free, https://www.gitbook.com/book/tiogerehot/real-online-dating-in-mumbai/details real_online_dating_in_mumbai, https://www.gitbook.com/book/gadovifi/free-irish-dating-website/details free_irish_dating_website, https://www.gitbook.com/book/gadovifi/match-france-bresil-handball-feminin/details match_france_bresil_handball_feminin, https://www.gitbook.com/book/homilliton/site-de-streaming-foot-ps4/details site_de_streaming_foot_ps4, https://www.gitbook.com/book/lehealthgura/renconte-974/details renconte_974, https://www.gitbook.com/book/xandrepatta/meilleur-site-de-telechargement-pour-jeux-wii/details meilleur_site_de_telechargement_pour_jeux_wii, https://www.gitbook.com/book/feizeberkcor/quel-es-le-meilleur-site-de-rencontre-gratuit/details quel_es_le_meilleur_site_de_rencontre_gratuit, https://www.gitbook.com/book/funcwoodsbadi/singles-college-station-tx/details singles_college_station_tx,