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Doc the idea is that uninsured ER visits will magically decrease, b/c the mandate has pushed more people into the market. And part of it is that yes, many ER visits can be avoided by preventative care which is mandatory under the insurance reforms, so the would-be non-insured person in the ER w/ a huge bill he can't pay is now someone who either 1) got the preventative care they needed under their insurance and avoided the costly ER visit or 2) is in the ER w/ insurance.

 

Will there still be some people in the ER who simply have no insurance? Yes. Point is not as much. Everyone constantly attacks this Bill as if it has to be perfect. NO BILL IS PERFECT!

 

Oh the mandate won't work on everyone...ok well it will work on most people according to the damn insurance companies that support it and other places it is in effect. Oh there will will still be some people that end up being diagnosed w/ an ongoing illness while uninsured who then receive help managing the condition while insured at a later date...no **** until we go to single payer that can never COMPLETELY be eliminated. The point is can it work? The answer is clearly yes. Can it start as in and be tweeked? Yes. Is "the government can't do anything right" a valid excuse for not reforming an industry that is bankrupting us? No. blah blah...and so on and so on...

 

 

 

What freedom are you so concerned about? The freedom to not purchase health insurance? Guess what...it's chalked up right there with the millions of other freedoms that you don't actually have. It's bankrupting the country, so you have to buy it. Don't like it? Then push for a true public option. Don't like the public option? Then deal w/ the mandate. Don't like either? Then propose something different that could work or suck it up. We have to do something. We aren't doing nothing about this anymore. BTW as you point out over and over saying it won't actually compel many more people into the market (which nobody else agrees with)...if you refuse to comply you pay a tax penalty. So don't comply...and pay your damn tax. Wow you are so oppressed b/c you pay a tax penalty for not doing something the government wants you to do. Your rights have changed over night that has never happened in American history before....

 

 

So where are all these doctors going to come from that are going to be needed to care for all these people? How long will it now take to get a an appointment with my doctor? Oh this is going to be fun.

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No. It. Isn't. Health CARE costs are bankrupting this country. NOT health insurance costs. This bill, by your own admission several posts back does not address health care costs in this country. No amount of shifting the money around is going to stop healthCARE costs from rising. They're rising because people have almost no idea what they're paying for or why they're paying for it because of the lack of transparency of costs inherent in 'Health Insurance', which (surprise surprise) wasn't addressed in this bill.

 

For one thing if I ever said it "doesn't address costs" then I simply misspoke. It clearly does do things that address costs. My point was that the level of impact this Bill will have on cost is debatable and that's an area for fair game. Like I've said over and over the basic reform in this bill will go to the cost of both insurance for the person as well as to the cost of service itself (the fee shifting the uninsured make happen)...and so and so on. The idea that healthCARE and healthINSURANCE are not intrinsically linked is absurd. One of the big things they're doing with medicare is implementing new experimental payment plans trying to coordinate change with the providers in a way that helps the natural movement from fee-for-service to fee-for-result. The idea being that the government being such a big spender is an ideal entity to lead the charge with these experimental payouts and hopefully the private sector can then adopt them (when of course the providers themselves are adjusted to take them which will take time). Reforming the system of CARE through reform targeted at INSURANCE is just the way it is going to be done. What do you want caps on rates doctors can charge? (I already know the answer to that so don't bother I'm just making a point...this is how it will be done...reforming the CARE through the method of payment...unless of course you do want a cap on service charges... :blink: )

 

So where are all these doctors going to come from that are going to be needed to care for all these people? How long will it now take to get a an appointment with my doctor? Oh this is going to be fun.

 

First off if part of that response is basically saying "I like that people can't see doctors b/c I want to and there aren't enough"...I can't really address that. Secondly pages and pages back I described how I see the insurance market reforming (with the main focus that we will have to shift form a fee-for-service to fee-for-outcome payments system and then we have to make individual patients put more skin in the game so they actually shop and the market for the services they actually do need functions more like an actual free market). That change (which will happen btw it's just slow moving and we are really only just now starting to move that way) will put a larger demand in the service market for general practitioners and lower the demand for specialists.

Edited by TheNewBills
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No, it's not conceptually better because it is NOT the only option. Forcing Americans to buy a product simply because they are American is the exact opposite of what has made this the country that everyone else wants to live in. I know liberals like to point at the crazy tea party folks who yell about protecting their freedoms, but at what point did protecting our freedoms become a JOKE to the left? This freaking country was FOUNDED on freedom and the expressed need to PROTECT that freedom, and this bill does the absolutely opposite of that. How is it NOT possible for anyone to see that?

 

There are better ways, and working together we can find them. You do not find them by piecing together a ridiculous piece of legislation, voted on by people who didn't read it, many of whom had guns to their heads, with the implicit explanation of "We won, you lost, suck it up and get on the back of the bus."

 

You genuinely need to stop breaking out the "It's better than nothing" story because it is, quite frankly, embarrassing to anyone who believes we can do better together.

 

Whether one thing is conceptually better than something else or not does not implicate other options. I was speaking as between one option and another.

 

Secondly, what is this "better way" and who have you held to account for not pursuing it? If you're pissed about the ACA then surely you're enraged by the trillions in waist and folly from being forced to subsidize the inefficient and wasteful practice of making the taxpayer account for inflated after-the-fact healthcare costs incurred by the indigent and uninsured.

 

You've held the WH to account for the ACA, who have you held to account for the last 40 years? Any links to posts and diatribes? Any thoughts or articles? Letter to congresspersons? Emails? Now ask me if I do...

 

Thirdly, I never said that it was "better than nothing." I have been very clear in stating that the ACA is a beginning point to accomplishing better things legislatively around the idea of health care reform. The ACA is not "better than nothing." However, putting something in place that is a template upon which better ideas can be forged and implemented is better than the status quo.

 

The same people who bemoan the idea of "2700 pages," "trillions in cost," "huge bueracracy," "government intrusion," "too much," "Big Government," "built on freedom," etc. are the same people who have had five presidents in the last 50 years and umpteen opportunities to do something about the system that they, themselves, acknowledge is broken.

 

I blame every Congress, Democrat and Republican, and every WH who for the last 40 years, has let this mess transpire on their watch: trillions and trillions of waisted dollars, hundreds of thousands of hours of medical effort and attention waisted, trillions in expeditures that could have been appropriated for bridges, schools, buildings, infrastructure, human capital, research, stimulus, beautification, defense, environment, tax decreases, etc. that didn't happen. In comparison to the shortcomings of the last 40 years, the current WH and the problems with the ACA are infinitesimally small. Yes, 2700 pages: infinitesimally small. Yes, 1.76 trillion: infinitesimally small.

 

The status quo is unsustainable. The ditherers of "leave it alone" fame have allowed a self-perpetuating system of health-care incompetence to exist unaltered for decades. Documented cases of the inaccessible $50 penicillin regimen turning into $15,000 surgery and consultation fees is ridiculous.

 

And we're paying for it.

 

Every dime.

 

Why do you think that ER visits will magically decrease? Is EMTALA being repealed?

 

They won't. But those who consider the ER as their primary care physician will decrease substantially. I imagine that billions will be saved as a result.

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Whoo....don't you belong at a town hall meeting screaming your lungs off while dressed like a revolutionary soldier? IT'S ABOUT MAAAHHHH FREEEDDDOOOOOMMM!!! AND I HATE WHAT I SEE AS "INTELLECTUAL!" :blink:

I love it when the "enlightened" mock the concept of freedom as being sooo passe.

 

 

First off if part of that response is basically saying "I like that people can't see doctors b/c I want to and there aren't enough"...I can't really address that. Secondly pages and pages back I described how I see the insurance market reforming (with the main focus that we will have to shift form a fee-for-service to fee-for-outcome payments system and then we have to make individual patients put more skin in the game so they actually shop and the market for the services they actually do need functions more like an actual free market). That change (which will happen btw it's just slow moving and we are really only just now starting to move that way) will put a larger demand in the service market for general practitioners and lower the demand for specialists.

You should be smacked for making such a stupid statement. You know, we get a lot of self-righteous libs who got a little learning and think they've got it all figured out, but you really take the cake. You're so condescending yet obtuse which is a highly annoying combination. Every semi-valid point you make is far outweighed by a myriad of baseless assumptions and misrepresentations stacked upon a foundation of broad generalizations. I know in your mind it all fits together in an airtight puzzle that you and your enlightened self-proclaimed "intellectuals" masturbate to; but the truth is you're just some dude who wants to believe so badly that he'll buy anything.

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But those who consider the ER as their primary care physician will decrease substantially. I imagine that billions will be saved as a result.

 

J8, as someone who has worked many, many years in emergency rooms, I respectfully disagree with your supposition.

 

People will still head to ER's and Urgent Care centers, just as the ones with PCP's have always done.

 

In fact, I would surmise, since there certainly is no sign in any increase in MD's in the future, the increased number of clients will precipitate the doctor into referring more and more of his patients (who call the office for service) to go directly to the ER.

 

Causing an increase in costs, not lessening.

 

.

Edited by B-Man
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J8, as someone who has worked many, many years in emergency rooms, I respectfully disagree with your supposition.

 

People will still head to ER's and Urgent Care centers, just as the ones with PCP's have always done.

 

In fact, I would surmise, since there certainly is no sign in any increase in MD's in the future, the increased number of clients will precipitate the doctor into referring more and more of his patients (who call the office for service) to go directly to the ER.

 

Causing an increase in costs, not lessening.

 

.

 

 

...which, for example, is what happens when you confuse health insurance with health care...

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I love it when the "enlightened" mock the concept of freedom as being sooo passe.

 

 

You should be smacked for making such a stupid statement. You know, we get a lot of self-righteous libs who got a little learning and think they've got it all figured out, but you really take the cake. You're so condescending yet obtuse which is a highly annoying combination. Every semi-valid point you make is far outweighed by a myriad of baseless assumptions and misrepresentations stacked upon a foundation of broad generalizations. I know in your mind it all fits together in an airtight puzzle that you and your enlightened self-proclaimed "intellectuals" masturbate to; but the truth is you're just some dude who wants to believe so badly that he'll buy anything.

 

 

LOL you are so mad. Keep on raging.

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What freedom are you so concerned about? The freedom to not purchase health insurance? Guess what...it's chalked up right there with the millions of other freedoms that you don't actually have. It's bankrupting the country, so you have to buy it. Don't like it? Then push for a true public option. Don't like the public option? Then deal w/ the mandate. Don't like either? Then propose something different that could work or suck it up. We have to do something. We aren't doing nothing about this anymore. BTW as you point out over and over saying it won't actually compel many more people into the market (which nobody else agrees with)...if you refuse to comply you pay a tax penalty. So don't comply...and pay your damn tax. Wow you are so oppressed b/c you pay a tax penalty for not doing something the government wants you to do. Your rights have changed over night that has never happened in American history before....

I swear, it's like trying to teach a pig to whistle.

 

Pay attention, now, Skippy, because this is the last time: Forcing a United States citizen to BUY something based exclusively on the fact that they are a United States citizen is wrong. I don't care if we're talking about health insurance, tooth paste or toilet paper. You do not force a free people to do something against their will STRICTLY because they exist as a citizen in a free country. When you are forced to BUY something against your will simply because you exist, you are no longer a free people. You either do not care about, or do not understand, the basic concept of freedom (as noted by how easily you mock it), so there is no sense trying to advance the conversation.

 

And for the record, I am doing something about it. I'm working to get the idiot in charge out of office because his solution is an abortion. I have to do something, and I'm not doing nothing any more.

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I swear, it's like trying to teach a pig to whistle.

 

Pay attention, now, Skippy, because this is the last time: Forcing a United States citizen to BUY something based exclusively on the fact that they are a United States citizen is wrong. I don't care if we're talking about health insurance, tooth paste or toilet paper. You do not force a free people to do something against their will STRICTLY because they exist as a citizen in a free country. When you are forced to BUY something against your will simply because you exist, you are no longer a free people. You either do not care about, or do not understand, the basic concept of freedom (as noted by how easily you mock it), so there is no sense trying to advance the conversation.

 

And for the record, I am doing something about it. I'm working to get the idiot in charge out of office because his solution is an abortion. I have to do something, and I'm not doing nothing any more.

 

Are you a free person by virtue of living in the state of NY? B/c as I'm sure you are aware the debate is about the commerce clause in the federal constitution (not about "freedom"). Forcing people to by health insurance is totally fine on the state level. Does that get you riled up too under the general concept of freedom? Well then you are working to elect a guy who did that! Questioning the commerce clause? Fine. Questions of federalism...ok as well. Questions of "FREEEDOOOOMMM!!!" Not really questions. You don't have some vague/general right "to be free" and that's the end of it. You aren't free in a million different ways. One of them may or may not include buying health insurance and that determination will depend on the FEDERAL GOVERNMENT's abilities under the commerce clause. As for just your right to not be compelled to buy a private good...there is no such federal law (as of yet anyway)...and there was no such state law in Mass when Romney did just that.

 

Just screaming "freedom" and making the 3rd grade point that you make above over and over as if I cannot understand it isn't going to inform me of anything that may change my mind. I know you may not care, and I certainly am not trying to change your mind I can see that is pointless. But I do like to try and understand WHY you are so set in your logic...and screaming "freedom" doesn't do much to that end. Other than you think somehow this is drastically different than a million other things concerning your freedom already which it really just isn't...

 

I would love to here you bash this concept on grounds of general "freedom" and explain how you are working to elect a man who will defend you b/c he feels it isn't freedom to have a mandate.

Edited by TheNewBills
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Doesn't matter, most business owners, corporations, independents and Americans don't like it, oh and the supreme court isn't too hot about it either. The bill will most likely be struck down and as a result more certainty will filter its way into the economy, which will lead to more job hiring and net net, the undoing of the bill will be a good thing that will be cheered on by most Americans

Edited by WorldTraveller
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Are you a free person by virtue of living in the state of NY? B/c as I'm sure you are aware the debate is about the commerce clause in the federal constitution (not about "freedom"). Forcing people to by health insurance is totally fine on the state level. Does that get you riled up too under the general concept of freedom? Well then you are working to elect a guy who did that! Questioning the commerce clause? Fine. Questions of federalism...ok as well. Questions of "FREEEDOOOOMMM!!!" Not really questions. You don't have some vague/general right "to be free" and that's the end of it. You aren't free in a million different ways. One of them may or may not include buying health insurance and that determination will depend on the FEDERAL GOVERNMENT's abilities under the commerce clause. As for just your right to not be compelled to buy a private good...there is no such federal law (as of yet anyway)...and there was no such state law in Mass when Romney did just that.

 

Just screaming "freedom" and making the 3rd grade point that you make above over and over as if I cannot understand it isn't going to inform me of anything that may change my mind. I know you may not care, and I certainly am not trying to change your mind I can see that is pointless. But I do like to try and understand WHY you are so set in your logic...and screaming "freedom" doesn't do much to that end. Other than you think somehow this is drastically different than a million other things concerning your freedom already which it really just isn't...

 

I would love to here you bash this concept on grounds of general "freedom" and explain how you are working to elect a man who will defend you b/c he feels it isn't freedom to have a mandate.

You are deeply flawed, but I'll give you credit for a reasonable attempt at reductio ad absurdum. You first equate the argument to one of freedom, then apply only to this issue, draw an equivalence between something else, pretend that something else is the same, and voila, if we follow you down the rabbit hole the initial argument is absurd. Problem is freedom is being used broadly and you're trying to use it narrowly and obscure the real concerns. Let me share a metaphor.

 

It doesn't bother me that my county prohibits me from owning goats in a residential area. I would be irate if the feds had the same rule, regardless of the fact that I have no desire to own goats. Does this mean state and local government can't be oppressive? Of course not. Do I approve of Obamacare at the state level? No. Do I give a **** that they passed it im MA? Hell no. These distinctions may seem random to you. If that's the case you should ponder it for a bit because if you can't see why you don't understand the counter-argument. You can't even see how and where you could be wrong.

 

You remind me of my cousin, who is fairly smart, but not smart enough to realize how likely it is that he is wrong, which he often is. He is of the opinion that if the government becomes tyrannical he'll change his government, which is kind of like saying if the fire gets out of hand I'll just put it out.

Edited by Rob's House
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No. It. Isn't. Health CARE costs are bankrupting this country. NOT health insurance costs. This bill, by your own admission several posts back does not address health care costs in this country. No amount of shifting the money around is going to stop healthCARE costs from rising. They're rising because people have almost no idea what they're paying for or why they're paying for it because of the lack of transparency of costs inherent in 'Health Insurance', which (surprise surprise) wasn't addressed in this bill.

Not to mention people aren't taking good care of themselves, which is the root cause of most of the problems. People would rather take a pill than work on the underlying pathology.

J8, as someone who has worked many, many years in emergency rooms, I respectfully disagree with your supposition.

 

People will still head to ER's and Urgent Care centers, just as the ones with PCP's have always done.

 

In fact, I would surmise, since there certainly is no sign in any increase in MD's in the future, the increased number of clients will precipitate the doctor into referring more and more of his patients (who call the office for service) to go directly to the ER.

 

Causing an increase in costs, not lessening.

Exactly. There will be a shortage not only from the (theoretically) increased number of people with insurance, but also from the number of non-retirement age MD's who leave medicine and the fewer number of people who go to med school. It will be a fustercluck of gigantic proportions.

 

And those who have no insurance but could afford to purchase it is probably a tiny fraction of ER visits (because they can go to urgent care centers or MD's and pay out of pocket), with the vast majority being those who are illegals or those who never bothered to sign up for Medicaid. It will just be cost-shifting, and like with all the other entitlements and government programs, it will be rife with fraud and cost overruns.

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You are deeply flawed, but I'll give you credit for a reasonable attempt at reductio ad absurdum. You first equate the argument to one of freedom, then apply only to this issue, draw an equivalence between something else, pretend that something else is the same, and voila, if we follow you down the rabbit hole the initial argument is absurd. Problem is freedom is being used broadly and you're trying to use it narrowly and obscure the real concerns. Let me share a metaphor.

 

It doesn't bother me that my county prohibits me from owning goats in a residential area. I would be irate if the feds had the same rule, regardless of the fact that I have no desire to own goats. Does this mean state and local government can't be oppressive? Of course not. Do I approve of Obamacare at the state level? No. Do I give a **** that they passed it im MA? Hell no. These distinctions may seem random to you. If that's the case you should ponder it for a bit because if you can't see why you don't understand the counter-argument. You can't even see how and where you could be wrong.

 

You remind me of my cousin, who is fairly smart, but not smart enough to realize how likely it is that he is wrong, which he often is. He is of the opinion that if the government becomes tyrannical he'll change his government, which is kind of like saying if the fire gets out of hand I'll just put it out.

 

LOL. Well I disagree that's all I can say. If the argument is one of general personal freedom as the good sir who posted that was making...then the conclusion that he will remove Obama for an official that is on the side of freedom doesn't make much sense when that same person enacted that legislation when he was governor. I said in the damn post you quoted to respond that questions of commerce clause, federalism, and the like are debatable and general claims of freedom are not. What we had there, was a general rambling about personal freedom which makes little sense.

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Are you a free person by virtue of living in the state of NY? B/c as I'm sure you are aware the debate is about the commerce clause in the federal constitution (not about "freedom"). Forcing people to by health insurance is totally fine on the state level. Does that get you riled up too under the general concept of freedom? Well then you are working to elect a guy who did that! Questioning the commerce clause? Fine. Questions of federalism...ok as well. Questions of "FREEEDOOOOMMM!!!" Not really questions. You don't have some vague/general right "to be free" and that's the end of it. You aren't free in a million different ways. One of them may or may not include buying health insurance and that determination will depend on the FEDERAL GOVERNMENT's abilities under the commerce clause. As for just your right to not be compelled to buy a private good...there is no such federal law (as of yet anyway)...and there was no such state law in Mass when Romney did just that.

 

Just screaming "freedom" and making the 3rd grade point that you make above over and over as if I cannot understand it isn't going to inform me of anything that may change my mind. I know you may not care, and I certainly am not trying to change your mind I can see that is pointless. But I do like to try and understand WHY you are so set in your logic...and screaming "freedom" doesn't do much to that end. Other than you think somehow this is drastically different than a million other things concerning your freedom already which it really just isn't...

 

I would love to here you bash this concept on grounds of general "freedom" and explain how you are working to elect a man who will defend you b/c he feels it isn't freedom to have a mandate.

Look. We have different opinions on what constitutes freedom, so let's stop pissing in the wind, okay, but it's a waste of time...at least for me.

 

Meanwhile, we both agree the law is an embarrassment of epic proportions because no matter how many times you say it reforms health care, it simply doesn't. It's a crappy law, but you believe it's all we got, so you're willing to compromise by accepting it as the flawed document that it is with the fallback plan that a new government agency in charge of Obamacare will somehow make it a better law. I think it's a piece of crap, and if the Supreme Court doesn't get rid of it (and they likely will because the liberal interpretation of the commerce clause is a joke), then we go for repeal in another way. And please stop comparing the MA law to Obamacare. It's an embarrassing liberal talking point on the same level of "Well, you have to get car insurance, don't you?" and in spite of our differences, you at least seem to have some intelligence in there.

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Look. We have different opinions on what constitutes freedom, so let's stop pissing in the wind, okay, but it's a waste of time...at least for me.

 

Meanwhile, we both agree the law is an embarrassment of epic proportions because no matter how many times you say it reforms health care, it simply doesn't. It's a crappy law, but you believe it's all we got, so you're willing to compromise by accepting it as the flawed document that it is with the fallback plan that a new government agency in charge of Obamacare will somehow make it a better law. I think it's a piece of crap, and if the Supreme Court doesn't get rid of it (and they likely will because the liberal interpretation of the commerce clause is a joke), then we go for repeal in another way. And please stop comparing the MA law to Obamacare. It's an embarrassing liberal talking point on the same level of "Well, you have to get car insurance, don't you?" and in spite of our differences, you at least seem to have some intelligence in there.

 

For one I'm not sure the law creates any new agency...but that's a small point I concede it will expand the roles of existing agencies anyway.

 

The reason that I come off like a "freedom hating elitist" though is b/c the "freedom arguments" really are just political noise to me. It's partisan hurling of crap and yes it's done by the left and right depending on the issue. But "freedom" ... with nothing is more more often than not (not never) just a load of BS. Certainly if you use a general freedom argument then comparing ACA to MA law is not only relevant but it would be a logical crime not to. Now if the debate centers around legitimate discussion of law or policy then that is different. But just know it isn't freedom I hate, it's people defending what they call freedom.

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LOL. Well I disagree that's all I can say. If the argument is one of general personal freedom as the good sir who posted that was making...then the conclusion that he will remove Obama for an official that is on the side of freedom doesn't make much sense when that same person enacted that legislation when he was governor. I said in the damn post you quoted to respond that questions of commerce clause, federalism, and the like are debatable and general claims of freedom are not. What we had there, was a general rambling about personal freedom which makes little sense.

 

 

I thought I was done responding to you, but I'll leave you with this. Do you understand that the Federal Government has been granted certain powers and nothing more? Do you understand that the states have been prohibited from certain areas and not much else said about the rest of things? Do you believe in the Constitution and its avenues of change? Do you think that our founders were pretty smart?

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I thought I was done responding to you, but I'll leave you with this. Do you understand that the Federal Government has been granted certain powers and nothing more? Do you understand that the states have been prohibited from certain areas and not much else said about the rest of things? Do you believe in the Constitution and its avenues of change? Do you think that our founders were pretty smart?

 

I think you can look at the post you quoted and get all the answers you just asked for, save for maybe the last one. Should I drive you into a state of madness and say no to that? ...now that would be trolling...

 

Also sorry to hear you have to stop responding to people who you don't agree w/. Hell I couldn't even post here if that was the case. It would probably be less eventful...

Edited by TheNewBills
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