B-Large

Most Americans don't vote by issue, most have no idea about what happens in Washington, they vote part line no matter what, and the others tune in 30 days before and get emotionally charged over the capaign mud. We are in the minority since we actively take an interest in Politics and Policy.

I'd probably relate more to Obama than Romney, is my guess. Obama has money, but Romney is wealthy.... big difference... and it's not idealogy... I donated money to a Republican running a State race in Montana because I saw his commercial and was so impressed by his campaign. I e-mailed him, asked him about his views, they were very in line with mine... I thought we had a lot in common, he seemed like one of "mine".... he traveled across Montana and built his own signs for his campaign.... he struck me a guy who stated and through actions showed his belief in limited self government and freedoms... something I don't think man of our Federal polcticians do. Aside- I met John Kerry in 2004 when he was here at our hospital for a photo shoot or interview, he didn't strike me as someone I related to either... my thought was always "how can John Kerry relate to me, or my world".... I did not have an answer for that.

I didn't say that, I said I can see why many Americans would feel disconnected from Romney and the life he has enjoyed as a wealthy American. Perhaps my perpective is different, I work with the wealthiest people in Colorado on a daily basis, and there is a disconnect between my daily concerns, and many of their daily concerns- its not good or bad, it just is what it is- and my wife and I bing in generous income and live a very nice life, so we are not looking for handouts, bailouts of support. My vote would be for someone more like myself, middle class with the hope to secure and self sufficeint someday.... somebody who really identifies with my struggles... Our social groups and acquaintences tend to be people of familair social-economic levels, my view is voting is no different- me preference, someone like me.

From a middle class American's persprective, espcially independent voters, I can see how it is hard to identify with a candidate like Romney. 400K from speaking fee's is paulty money to him, but that pays off a home and sends the average American's two kids to college. He has elevators for his cars, most Americans struggle to pay for gas in their cars and manage they car payment... Wealth Envy aside, people wants leadership that understand thier needs... Romney may, but he certainly doesn't have the stuggles most Americans do...

We end up collecting very little, most of it ends up in bad debt and collection... now if we could lien Tax Returns, Homes, Assets, Wage Garnishment, then you're talking! The exact reason market economics and markets principles will not work efficiently in Healthcare.... If I don't pay my car loans, the bank gets the car. If I don't pay my Medical Bills, meh, there are options to get out of that Big Difference I adressed that, we know our Unit Cost of services we provide. As I said before, the cost of providing a MRI is pretty straightforward and we know the number on it. But as you know, when it is coded and gross charges are billed out, it includes all those non-test related costs that are an expense of running that MRI, or that department. The intention was not to dole out free care to 30M people.... many of those people are uninsured because no company will underwrite them... they are not asking for a hand out, just particpiation in the market...

Were simply asking each American to pay for their care, and we have decided in this Nation that third party payors are going to be the option for overage and payment.... evrybody has to hold coverage there just is no other way around it, unless, we are willing to turn away people who were adiment about not paying their share... and I am fine wiht that, but they always come back begging when the disease sets in... America is unique in many way that there are people who truly will live and die by their choices.... I commend them for that, but there is no changing minds when you get sick... if you pay, you get care... or if you don't/can't, tough luck hope you have a burial plot picked out. If we are going to make heathcare a market driven product and service, lets actually do just that and cut off the non-partcipators. it does not affect the Unit of Service Cost for said procedure/service, but it does have to get covered. if you get no State or Federal Monies to offset, it get allocated to every department in indirect cost and higher facility fees..... we had to cover 150M last year, it got shifted somewhere, and out charge on most items went up as usual by 7% again this year....

Yep that is the biggest issue. People will wait until they get sick, sign up, and drop it when they are well again... but you have to consider there are alot of honest, good Americans out there who would like to do it right, pay for coverage even if they are rated higher, and not in it to work the system. How do you serve the worthy and stop on the cheaters?? Insurance compaines operate where they think they can make money, and perfer States that have lax regulation to protect citzens and premium payors from fraud and abuse (not that all insurers are out ot screw people over, thats is another intrue blanket assumption). One of the the things you have to consider is that if we let insurance compaines operate from the National Level, they would be answering to Federal Regulatory scrutiny... you know how Washington works, there is little chance a Federal oversight of Insurance compaines would reduce overall costs... I just don't see how insurers would help reduce prices, in fact they would gain better favor for contracts by paying higher reimbuirsements to providers and facilities... Your not kidding about the buffet. the most entitled, the most irresponsible are often people on Medicaid. many of them freak out when you try to collect their $2 copay, and when they can't pay they scream because we tell them they will have reschedule. Much like understanding the home loans you are signing up for, people need to understand and god forbid keep track of their medical expeditures... geesh

good thoughts- I have long been an advocate of very high decuctible health plans where Amercians would be incented to get cost estimates, so they would "feel" the pain (no pun intended) of paying their bills... perhaps that would incent people to not be fat and lazy and stupid and start taking care of themselves. The contention with insurance carriers is pass-through money... why does it cost Cigna 30% of premium dollars to provide third party adminstration, when it costs Medicare 4%? They do the same thing, why the discepancy? The public option was proposed to have non-profit TPA's that had alower pass through cost, under 10% if not more. The Public Option could have been adminstered from the City of State Level, not the Federal Level and met the needs of citizens locally... but that was consider socilist or someting like that... heck, it would have been a nice solution, Liberals could habe their non-proficts cooperative and conservatives could habe still bought private insurance coverage from private compnaines, each side with high deductibel plans...

But America has always been about compromise, thats what make Democracies special. as far as Leadership, don't leaders set goals and get them accomplished? If the contetnion is sticking to single payor that has zero chance passing no matter what, unwavering, and continuing the bang ones head against the wall leadership, well then we should keep doing the same thing. I woudld argue that Obama was bold in his leadership of getting the ACA passed, now if your point of view is not from his idealogy, then I understand the questioning of leadership, its all relative to your politics, right? So he and the democratic congress bent, bent, bent and bent... and that is why you got a bills that was way more compicated than it had to be. From the beginning I have held the belief that we should not in absolute hold healthcare to the principles of market economics unless we are making sure 100% of Americans are partipcating, because at some point no matter how much we expercise, everybody uses it, no expections... by we continue to try to apply marketing priciples to a system where some people can play, and not pay. Look, I tend believe Americans need to be left alone, purchase what they want, and if they want to smoke and eat and get real big and fat and get cancer, that is their protected right to do so... but don't expect the rest of us to bail you out, when you are crying about not having the mean to pay for your healthcare... cry to someone else.

That is the biggest issue, you can buy it when you get sick, I have never liked that portion of the bill. Insurance compaines can do business in any State they wish, the competition across State lines really holds little merit as a way to decrease costs- and cost is not dictated from the insurance company, it is dicated as a billable from the hospital/ provider- and much of that starts as a percentage of Federal Payor reimbursement. again is goes back to the fact that we inflate prices to the carrier because we have so many unreimbursed costs... that is why the ACA attempted to fix the underlying issue, everybody paying their own bills, and not shifting the burden As far as litigation, I agree that the outlandish amount of lawsuits against compaines and providers does little to help the system, but we do want to make sure patients to do have realistic ways to get compensationed for malpractice. The real issue, from my study of the subject and years in Healthcare Administration, is shaping the expectation of Americans that healthcare is expensive, and we will not be able to acheive the Walmart cost model many Americans have come to expect. We have the best Machines, Minds and Meds of anywhere in the world (even though our outcomes are not always better, can you imagine Americans spending more to get less!!!!)so we need to cnvery to people if you want the best, it is a pretty penny- In my expereince, people don't like that..... they feel like it should be cheap, just like any product or service... it just isnt the reality.

The message will be formed that progress on the issue of healthcare has gone backwards. Some will hold that to be very true, others will be glad we are back to square one. The important questions are: 1. What do independent voters think? 2. If this is struck down and ACA is basically gone, what is the GOP answer to replace it with? I think that will be important, because there are alot of Americans that were happy something got done.... they will need to come up with some sort of plan. 3. What do small/medium business owners think? with the ACA, they could basically absolve themselves from having to provide healthcare to their employees through a group plan... they could simple give a stipend for employees to go an buy insurance on exchanges. This puts them in a position again for have two options, one not so great the other expensive.

wow, isnt that the truth

The system will continue to limp along with high prices and the same core issues as it did prior to the ACA being passed... Prices are not likely to go down anytime soon, it is simple a matter of better technolgies being adaopted everyday and people living much longer than they did even 50 years ago. We are also seeing a massive brick and sticks expansion as we try to make room for a large surge in demand, building although partly funded by private donation also take a very large chuck out of our hospital cash flow. Until the notion that we treat "everybody" regardless of ability to pay or have insurance, we will be in the same predicament. We wrote off 150 million in unreimbursed care last year, alot of it was indigent care but an even larger portion was just on people who failed to maintain insurance coverage. Until we are by law able to shut the door in the faces of those who cannot pay, we will continue to raise prices on testing and billiables to insurance compaines (not federal programs)to help offset the costs... It all get spaid for, directly or indirectly. We as a nation have decide whether we are going to hold each indivdual American to account, or simply whine when costs gets shifted onto the paying crowd.

sauron? What/ who is that?

or moving Bangladeshian Organs.... the mark-ups are massive......

I do find it ironic that Liberals like to think of themselves as compassionate, egalitarian, tolerant... as opposed to Conservatives.... until it is time to be compassionate, egalitarian and intolerant... As people typed those comments, did they think for one iota "uh oh, I am becoming the very person I like to think I rally against?" Empathy and Compassion does not require an accpetable name on the donor list....

and there just isn't a more stable place to plop down the war chest of a honest herder than in the Afghanny Opium Markets.... very stable

POST HASTE

Sweet- First ETF I would buy, Afghanny Growth and Emerging Markets Fund..... Yeah, it's risky..... but the return could be handsome.

The wait lists for organs are an attempt to be a egalitarian as humanly, humanely possible. But I agree personal medical history and risk factors with regard to a transplant should be the only criteria. But I will not pretend that people with means get far better accessto care and specialist than do the general masses. Not better care, but often to the front of the line as others wait.... sans organs, I have never seen evidence of better access in that case

Kalishnikov's, ammo, C4.... sounds about right

how did they arrive at the 50K figure? What model did they use? I am sure for the Afghan Civilian, 50K is alot of money.... does that make them targets now?.... if that country is that f'ed up, what do those people use that money for? I am sure a 50K payment will make it all better......

I wish him a full recovery. Partisan politics and the suspicionby some of him being pure evil aside, he is a father, probably a grandfather, and has other family I am sure. I take no pleasure is wishing death on anyone. I am glad he got his heart, my hope is he uses these borrowed years for the good. aside: I met Ted Kennedy when he was at the DNC, he did his speech but was staying at our hospital for treatment while in town. He made it a point, before he left to wheel over to my office and say thank you for the help while here was here... he was a very nice man. John Kerry, doosh- met him in 2004, he was at out hospital to do some photo shoot/interview deal... probably still a doosh.

I just left his website to refresh myself with his policies, and he is very different than any of those other 3. While there are some issues I don't agree with him on, details that is, I think his overall plan for the country is intriguing. I guess I am just tired of the GOP and Democratic Parties. My opinion, they are bought and love the power and control that come with elected office. From what I have heard from Paul, he doesn't have that same flavor.... could he bring real fundamental change in this country, that does not cater to Blue or Red, but caters to citizens? It sure would be exciting to find out. While I think Romney probably has better economcial sense than Obama, and more expereince in Executive management, he does not light my fuego as a "different" candidate.

IMO, the only truly different candidate, who has been consistent about his beliefs over time, unwavering, is Ron Paul. He is the only one that doesn't drool all over himself with pary talking points, leaves the BS aside and speaks his mind. The differences between Romney, Santorum or Obama for that matter are slim. They are from a two- party, entreched politcal system that offers the American people the same old **** as they did 10 years ago.... and are not that motivated to see it change.