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3751  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 22, 2009, 08:25:24 AM
With regard to post 363 please take note of the increase in life expectancy from around 70 to close to 80 since the 1970s.
This is true.  Yet we have the self promoting Andrew Weil, the constantly reminding us guy who graduated Harvard Medical school  poinint out that medical htechnology only saves about one in 16,000 lives.  That was what I read in his post on the Huffington Post about a week ago.
Almost all the increase in lifespan since 1900 is imporved sanitation vaccines etc.
Well the last statement is true and obvious.
That was the easy gain.

But what about the increase since 1970?  Is he telling me that is from a decrease in cholera, typhoid, better sanitation and hepatitis B vaccine?

And the increase since than while only a couple of years is still an increase and no one would argue it is due to healthier life styles.

In fact the average lifespan would be even greater if it were not for less healthy lifestyles.
The only major killer that kills more today than then is diabetes obviously because of the epidemic of this from obesity.

So DESPITE less healthy lifestyles the field of medicine has achieved an increase in lifespan. 

Anyone who denies this is a total blow hard - as is Weil.

Perhaps this post would be better on the Huffington Post but I don't really want to bother.
3752  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Politics on: August 21, 2009, 01:15:53 PM
***Obama also has shown more adherence to his convictions than former Pres. Clinton who was happy to jump ship and sail a different direction whenever his poll analysts gave him the green light.  Obama instead will cling to incrementalism toward his goals versus abandonment.***
"cling to incrementalism"

He appears to be doing just that.

Those of us who are opposed to big government have no choice but to not give one inch.
He is not about compromise.  He is about suckering the right.

If we continue to stand up to him his fellow Dems will really start jumping ship when his numbers continue to tank.

I fear we are going to witness a gigantic counter offensive from the left with all sorts of smears, distortions, frenzy and the rest very soon.
"we need to hit back twice as hard"

This includes bribing more voting blocks.

I am surprised we have not seen more violence yet.
Just wait till we start getting double digit inflation.

3753  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: U.S. Census 2010 on: August 21, 2009, 11:08:48 AM
IIRC, the Census was constitutionally assigned to ask how people in your household - period - for congressional district and electoral college purposes, not to 'sample' populations or design or support new government programs.

excellent point.
What are all the questions about?

Good topic for a real investigative reporter if any exist.
3754  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Political Rants on: August 21, 2009, 11:05:19 AM
He has lived a charmed life.  I have always felt Ted Kennedys, in particular believes the rules don't apply to him.

***What Ted Kennedy Wants
He's trying to change election rules—again.Article Comments (108) more in Opinion »Email Printer
Senator Ted Kennedy, who is gravely ill with brain cancer, has sent a letter to Massachusetts lawmakers requesting a change in the state law that determines how his Senate seat would be filled if it became vacant before his eighth full term ends in 2012. Current law mandates that a special election be held at least 145 days after the seat becomes available. Mr. Kennedy is concerned that such a delay could leave his fellow Democrats in the Senate one vote short of a filibuster-proof majority for months while a special election takes place.

"I therefore am writing to urge you to work together to amend the law through the normal legislative process to provide for a temporary gubernatorial appointment until the special election occurs," writes the Senator.

Sen. Edward Kennedy, D-Mass.
What Mr. Kennedy doesn't volunteer is that he orchestrated the 2004 succession law revision that now requires a special election, and for similarly partisan reasons. John Kerry, the other Senator from the state, was running for President in 2004, and Mr. Kennedy wanted the law changed so the Republican Governor at the time, Mitt Romney, could not name Mr. Kerry's replacement. "Prodded by a personal appeal from Senator Edward M. Kennedy," reported the Boston Globe in 2004, "Democratic legislative leaders have agreed to take up a stalled bill creating a special election process to replace U.S. Senator John F. Kerry if he wins the presidency." Now that the state has a Democratic Governor, Mr. Kennedy wants to revert to gubernatorial appointments.

Beacon Hill has long sported heavy Democratic majorities, so the state legislature has the votes to grant Mr. Kennedy's wish. But does it have the chutzpah? An election is the more democratic option. After witnessing recent attempts by incompetent Governors in Illinois and New York to fill Senate vacancies, Massachusetts voters may have soured on such appointments. Especially when Mr. Kennedy's motivation for changing the law is so obviously born of partisan interest, not principle.***

3755  Politics, Religion, Science, Culture and Humanities / Politics & Religion / second us civil war on: August 21, 2009, 10:16:01 AM
I don't know if this deserves a thread but I think it does.
I have posted we are in a "soft" civil war.

Others have noticed and stated this.  It is not new.

This article suggest BO is creating it.  I don't agree.  It already existed and has for years.  But let there be no doubt - BO is certainly making it worse - far worse.

He has never been about conciliation or post partisanship or getting past the rancor except that he thought but persistantly claiming that he could ram his agenda down the throats of those who are against it.

It was all talk all shmooz.

In any case we need more people to point this out about what is happening.  IF the right can get a better spokeperson a better plan going BO is toast.  If not he will hang in there with the potential of a comeback ala Clinton.
Though he is far more of an ideologue the Bill and so far has not shown the ability to change or adapt to preserve his power.
I guess he will eventually.  He can't be that pig headed - or can he?
3756  Politics, Religion, Science, Culture and Humanities / Politics & Religion / BO will drive this country into the gutter. on: August 21, 2009, 09:36:04 AM
My arm chair opinion is that unless we all start sacrificing now this country is headed for a total collapse.
Even Buffett finally came out and said the obvious - all this spending will destroy us.
Entitlements will have to stop.
We should get the illegals to leave this country and stop allowing US employers to use them for beans on the dollar.

So some diners will close, gas stations, and consrtruction jobs.
Americans who are unemployed will have to take some of these jobs at lower rates and/or the owners will have to do the work themselves.

We need to stop giving life ling pensions to people who retire at 50 and then get other jobs.
Medicare and social security ages will have to increase to 70.

As a primary care doctor I have had to make due with less for years.
Nothing new to me.

I have had some skeptics decry that THIS IS the MO of BO.
Destroy the country so it has to be rebuilt from the bottom up - as a socialist state.
I am short of personally subscribing to this but I don't discount it altogether.

Yet the BO still has a 57% approval rating?

The only explanation for this is many still do not see any attractive alternative.
3757  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The electoral process, vote fraud (ACORN et al), corruption etc. on: August 20, 2009, 04:30:48 PM
***I don't have a smoking gun, but I do have the good sense to recognize when something doesn't pass the smell test. It might well be happenstance that Soros' "repositioning" was completely unrelated to the decision to invest American dollars in Petrobas, but there are too many dots that have at least a tenuous connection to assume that it's a completely innocent coincidence.***

This is to pay Soros back for all his support.
Plus it replenishes there own war chest so to speak as Soros we all know is happy to support their radical cause.

Even if there is a smoking gun somewhere we can all forget about anyone looking for it.
Not with a leftist controlled governent.
Reminds one of the famous cattle futures bribe.
3758  Politics, Religion, Science, Culture and Humanities / Politics & Religion / 2ndNew England Journal article - interview with Wilensky.W's 1st HCFA's administ on: August 20, 2009, 04:23:26 PM
Another NEJM:

01:53:23 PM August 20, 2009
from web
Reform, Regulation, and Research — An Interview with Gail Wilensky
Posted by NEJM • August 19th, 2009 • Printer-friendly
John K. Iglehart

Gail Wilensky, Ph.D., is an economist who served in the administration of President George H.W. Bush, first as the administrator of the Health Care Financing Administration (forerunner to the Centers for Medicare and Medicaid Services) and later as White House health policy advisor. In 1997, she became the first chair of the Medicare Payment Advisory Commission, and during the 2008 presidential campaign, she was an advisor to Senator John McCain (R-AZ). She is a senior fellow at Project HOPE. John Iglehart, a national correspondent for the Journal, interviewed Dr. Wilensky on August 7, 2009.

John Iglehart: Many Republicans oppose reform proposals put forward by Democrats. Do you consider the pursuit of health care reform an urgent matter?

Gail Wilensky: There is obviously a deep divide between the parties about what reform legislation should look like, but I do believe it is important that we press on with reform. We can’t continue the unsustainable health care spending of the past several decades, not to mention problems regarding the value of care, its clinical appropriateness, and a large and growing uninsured population.

Iglehart: How confident are you that by the end of 2009 a reform measure will be signed into law?

Wilensky: I think it’s likely that we will see a significant expansion in insurance coverage, maybe get to 93 to 95% of the population, through reform legislation. I’m quite discouraged that we will do anything significant about the other problems — slowing spending or improving value and clinical outcomes.

Iglehart: There are provisions in the Democratic reform bills that you oppose.1 Of them, which one gives you the greatest pause?

Wilensky: The public plan is one of the most contentious issues, and I hope it will not be in a final bill. I believe that a public plan would ultimately unravel private insurance coverage in the United States.

Iglehart: Do you favor the increased regulation of private insurance plans that their advocates, America’s Health Insurance Plans, volunteered to accept early in the negotiating process, such as guaranteed issue of insurance, elimination of preexisting-condition requirements, and so forth? Is that good public policy?

Wilensky: I believe it is good policy. I favor regulations that would guarantee renewability of insurance policies, place limits on how much premium rates could vary according to the health status of an individual, and eliminate preexisting-condition exclusions, as long as most people are covered. If large blocks of people are allowed to remain uncovered, the system could saddle some insurers with a higher risk profile of covered lives that could make their products unaffordable. But as long as most people are covered, these regulations are an appropriate quid pro quo, and they should be adopted.

Iglehart: Over the past generation, the GOP’s interest in health-related legislation has been modest compared with the emphasis that Democrats have placed on these issues. One exception was the relentless drive of President George W. Bush to enact a Medicare outpatient prescription-drug benefit, a pursuit that most Democrats opposed because of the enhanced role it gave private health plans. In your view, what’s the reason for the modest Republican record on health care issues?

Wilensky: People sometimes accuse the Republicans of not having any ideas in health care. But I don’t think that’s true; it’s more a failure to aggressively promote their ideas once they are introduced. For example, the first President Bush introduced a very good proposal that would have provided coverage to every individual whose income was below 133% of the federal poverty level, reformed private insurance, and changed the medical liability system. But it was released too late in his term, and perhaps even more importantly, the passion for health care reform that President Clinton demonstrated and that now engages President Obama has never been articulated by Republican leadership in the executive branch or, in some instances, the Congress.

Similarly, you could say that George W. Bush put forward a reasonable reform proposal to expand coverage by providing tax deductions for people without employer-sponsored insurance. John McCain offered a plan that called for taxing the employer-paid insurance premiums of workers, just as their salaries are taxed. At the same time, his plan would have granted refundable tax credits to employees so they could purchase their own coverage rather than accept the insurance offered by their employers. Don’t forget, during the election campaign, Obama attacked McCain repeatedly for this proposal, although equalizing the tax treatment of all workers has long been supported by virtually all economists because the current policy favors people with higher incomes. Health issues have just not been a primary focus for Republicans. Even on an issue that Republicans feel passionate about — reforming how professional liability issues are addressed — they have been unable to enact legislation during the brief periods when they controlled Congress and the White House, or at least Congress, in the past decade or so.

Health care reform is a difficult challenge for both parties, as the August [2009] town hall meetings are underscoring. We can see it now with our Democratic president and substantial Democratic majorities in the House and Senate, and still some uncertainty about if, let alone what kind of, health care reform may be enacted.

Iglehart: The Obama administration has been promoting the idea of creating an Independent Medicare Advisory Council within the executive branch,2 with the authority to make recommendations to the president on annual Medicare payment rates and other reforms, shifting some power from Congress to the executive branch. If the president disapproved the recommendations or Congress passed a resolution of disapproval, the recommendations would be null and void, although Congress would have to enact a bill with comparable savings within a short period. What’s your view of that idea?

Wilensky: I think it’s a bad idea. It would be trading off the difficulty Congress encounters when legislators face tough choices for granting power to a body that is unaccountable to the electorate. I find it very odd that the Congress has been unwilling to grant greater discretionary authority to the Centers for Medicare and Medicaid Services [CMS] at the same time that a few legislators — Senator Jay Rockefeller [D-WV] and Representative Jim Cooper [D-TN] — are sponsoring measures that would provide almost unlimited authority to an independent body of individuals who, once appointed, would be completely unaccountable to the American people. I think the right strategy is for Congress to approve the general structure of provider payment and the spending it deems appropriate, enact payment reforms, broadly defined, that it favors — bundling payments for physicians, moving to more accountable alignment between physicians and hospitals or between physicians and health care plans — and grant CMS far greater discretionary authority to implement these changes. After all, the CMS administrator is a presidential appointee, subject to confirmation by the Senate, reporting to a secretary who is similarly subject, who reports to the president, who is ultimately accountable to the American people.

Iglehart: So you favor providing CMS with greater resources to administer Medicare and Medicaid, even though members of Congress seem to criticize its performance at every turn?

Wilensky: Yes, and I’ve been one of a number of Republicans and Democrats3,4 who have indicated that all recent administrations — and Congress as well — have starved CMS in terms of providing the kind of management resources and administrative support the agency needs to capably run Medicare and Medicaid.

Iglehart: You’ve been a strong advocate of greatly expanding the government’s investment in comparative-effectiveness research [CER].5 The administration’s stimulus package included $1.1 billion to fund an accelerated CER program. Do you anticipate that reform legislation will expand the available CER resources? And what kind of impact will such research have on practicing physicians and the content of medical care?

Wilensky: I am hopeful that we will continue to see additional funding and program implementation policies for CER in whatever reforms are passed by Congress. There are many questions — about governance, about where an entity should be located, about how priority setting should occur, about the involvement of patient advocates and industry in some of these deliberations — that were not addressed in the stimulus package. That was a jump-starting action for CER, but these critical questions of place and priorities must soon be resolved.

We invest so much in the NIH’s pursuit of basic research but often fail to rapidly translate the results of those efforts into clinical care. It is just enormously frustrating to me that many interests, including quite a few physicians, do not recognize CER as a companion project to NIH’s basic research that would help doctors and patients determine what are the most effective therapies for a particular condition or disease. And I am frustrated and disappointed by some of the Republican posturing, too, which asserts that additional information provided through CER is a threat or a first step to rationing care. I believe that providing information about what works when, and allowing that information to be used as part of a reimbursement decision, is reasonable and sensible.

Iglehart: You have been emphatic that, initially, a CER agenda should focus its greatest attention on medical and surgical procedures and their value, rather than on drugs and devices. Why?

Wilensky: Because that’s where the money is. I’m looking at this as a way to learn how to spend smarter and treat better, and that involves the use of medical procedures because we’ve had so little investment in comparative-effectiveness information in that area.

Dr. Wilensky reports serving on the boards of Cephalon, Quest Diagnostics, SRA International, and UnitedHealth Group.

Source Information

This article (10.1056/NEJMp0907415) was published on August 19, 2009, at


Antos J, Wilensky GR, Kuttner H. The Obama plan: more regulation, unsustainable spending. Health Aff (Millwood) 2008;27:w462-w471. [Free Full Text]
Orszag PR. Letter to House Speaker Nancy Pelosi, July 17, 2009. Washington, DC: Executive Office of the President, 2009.
Butler SM, Danzon PM, Gradison B, et al. Crisis facing HCFA & millions of Americans. Health Aff (Millwood) 1999;18:8-10. [CrossRef][Medline]
Iglehart JK. Doing more with less: a conversation with Kerry Weems. Health Aff (Millwood) 2009;28:w688-w696. [Free Full Text]
Wilensky GR. The policies and politics of creating a comparative clinical effectiveness research center. Health Aff (Millwood) 2009;28:w719-w729. [Free Full Text]
Download a PDF of this article
Read this article at

Tagged as: politics  © 2009 Massachusetts Medical Society  Entries (RSS)  Comments (RSS)
3759  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 20, 2009, 04:09:56 PM
Can anyone think of any other profession whose pay is and will become even more complicated?
I would rather sit and attempt to invent calculus that try to figure this out.
One real concern is the incentive under these situations to with hold care.
Otherwise it is so complex I have no clue whether I should be for or against.  Whether it would save money, improve care, make my life better or God knows what.

All the more reason not to ram 1000 pages of craziness down our throats.

****Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model
Posted by NEJM • August 19th, 2009 • Printer-friendly
François de Brantes, M.S., M.B.A., Meredith B. Rosenthal, Ph.D., and Michael Painter, J.D., M.D.

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction toward accountability for high-value care. Ideally, these new structures would promote clear accountability for both improving quality and controlling costs and would encourage health care professionals to organize themselves into teams working on behalf of patients. For such structures to be sustainable, however, the payment system must reward professionals for the quality and efficiency of services, rather than the quantity.

Our fee-for-service payment schemes have contributed to, if not largely created, the current fragmentation. Fee-for-service payments create incentives to provide high volume rather than high value — more, not better, care. So what kinds of payment could promote and sustain high-value care and motivate the development of accountable care organizations? Most experts agree that some sort of bundled, episode-based payment would help to move the system in the right direction. Our own approach, the Prometheus Payment model, for instance, bundles services and provides a budget with three components: evidence-informed base payment with patient-specific severity adjustments and an allowance for potentially avoidable complications (see box, “The Prometheus Model”).1,2 The model has been developed and evaluated through several small pilot projects, which offer some lessons about the ability of episode-based payment to improve cost and quality within the current fee-for-service system. This kind of payment aims to foster outcomes-focused collaboration among otherwise unaffiliated providers and offers a bridge from our fragmented system to a more integrated, accountable one.

The model encourages two behaviors that fee for service discourages: collaboration of physicians, hospitals, and other providers involved in a patient’s care; and active efforts to reduce avoidable complications of care (and the costs associated with them). It accomplishes these goals by paying for all the care a patient needs over the course of a defined clinical episode or a set period of management of a chronic condition, rather than paying for discrete visits, discharges, or procedures.

When incentives are used to drive changes in behavior, it is important that people and organizations are held accountable only for the variables that are actually under their control.3 That’s why, in designing the Prometheus model, we decided to focus on the potentially avoidable costs of patient care. We separated the costs attributable to patient-related factors from those attributable to providers’ actions. These latter costs are critically important in terms of accountability. In Prometheus, these potentially avoidable costs are called PACs and are recognized as the result of “care defects” — problems necessitating technical care that are under the professionals’ control and that, with the best professional standards, could have been avoided. PACs might include the cost of hospitalization of a patient with uncontrolled diabetes or the readmission for a wound infection of a patient who had recently been discharged after cardiac bypass surgery.

The opportunities for improving quality while reducing costs are substantial, reaching far beyond the well-publicized problem of avoidable readmissions. Our analyses of several national and regional data sets, in addition to our pilot work, show that PACs account for 22% of all private-sector health care expenditures in the United States.4,5 The data show that PACs can account for as much as 80% of all dollars spent for conditions such as congestive heart failure that require intensive management and that there are significant regional variations in PACs. On the basis of our current findings, we project that even a modest reduction in PACs from one year to the next would have a considerable effect on the private sector’s portion of health care spending over the next 10 years (see graph). If such results were replicated in a Medicare population, the potential savings would double, reducing the country’s health care bill by more than $700 billion over 10 years.

Projected Private-Sector National Health Expenditures under Current Assumptions and If Potentially Avoidable Costs Were Reduced by Either 10% or 15% Per Year.

Data are from the Department of Health and Human Services 2009 and our own analysis. PAC denotes potentially avoidable cost.

Unlike the current payment system, Prometheus provides larger profit margins for providers who can eliminate these complications, since they keep any unused PAC allowance — they profit by delivering optimal care, not a greater volume of care. Prometheus also avoids some of the classic pitfalls of capitation. Capitation has the unfortunate effect of transferring essentially all risk (including insurance risk) to providers and then encouraging them to pursue undifferentiated reductions in services in order to maximize financial gain. Prometheus mitigates those capitation problems — in part because the occurrence of a new case simply triggers a new patient-specific, severity-adjusted case rate and in part because typical costs and PACs are tracked and accounted for separately and, for now, opportunities for increasing financial gain are limited to decreases in PACs.

Clinical integration may be one way for providers to succeed under Prometheus, but it’s not the only way. In fact, for most of the delivery system, the changes that are required to achieve full integration are neither feasible nor desired by many potential participants. Though there may be minimal organizational requirements for managing patient care in ways that minimize PACs, it is the act of collaboration, not a particular form of organization, that Prometheus attempts to promote.

One lesson from our pilots is that hospital-centric provider organizations can expect increased internal tension when they implement an episode-of-care payment system. Prometheus does provide a sort of bonus to the hospital and physicians for working together to avoid readmission (see box, “Prometheus in Practice”). However, physician groups that are paid under the model for managing chronic conditions have substantial opportunities to increase the profits that come from avoiding expensive hospitalizations. This incentive can highlight potential conflicts between the financial interests of physicians and those of hospitals and cause us to question the proposition that hospital-centric provider organizations will deliver the best results for the country.

Prometheus does not require that a single integrated organization accept payment for an entire episode of care; we recognize that unrelated providers often overtly or tacitly comanage a patient’s care. A limitation of many episode-payment programs is their reliance on prospective payment, which forces the payer to find organizations that will accept the global fee. The Prometheus model, by contrast, can be implemented in a fragmented, largely fee-for-service delivery system if the payer retains the role of financial integrator. Over time, as providers collaborate to improve patient care and optimize their margins, they could more formally integrate into accountable organizations. However, it will and should be their choice to do so.

To facilitate this transition, the current Prometheus pilot sites are not using prospective payment. Instead, budgets are set prospectively, and payers reimburse providers for all fee-for-service claims submitted. Quarterly actual spending for typical and potentially avoidable care is reconciled against the budgets, and detailed reports are made available. Yet the incentives are the same as they would be with prospective payment: if actual spending is under budget, the difference is paid out as a bonus; if it is over budget, some payment is withheld.

Prometheus is not appropriate for reimbursements for all conditions, but there is sufficient evidence to define both typical care and PACs for types of episodes that account for half to two thirds of health care expenditures. At a minimum, our efforts to translate our conceptual model into practice suggest that it can effectively provide a bridge from the current fragmented delivery system to an accountable care system in which collaboration and the pursuit of excellence are the norm.

The Prometheus Model

Developed in 2006, the Prometheus Payment model now has three pilot programs in operation, supported by the Robert Wood Johnson Foundation. The model attempts to go beyond pay-for-performance approaches to pay for individual, patient-centered treatment plans that reward providers fairly for coordinating and providing high-quality and efficient care. Prometheus packages paymentaround a comprehensive episode of medical care that covers all patient services related to a single illness or condition. Decisions about which services will be covered for a given type of episode are made according to commonly accepted clinical guidelines or expert opinions that outline the tested, medically accepted best method for treating the condition from the beginning of an episode to the end. The prices of all included treatments are tallied to generate an “evidence-informed case rate” (ECR),which becomes a patient-specific budget for the entire care episode. ECRs include all the covered services related to the care of a single condition — services provided by everyone who would typically be involved (hospital, physicians, laboratory, pharmacy, rehabilitation facility, and so forth). The ECR isadjusted for the severity and complexity of the individual patient’s condition, and it incorporates an allowance for a portion of the current costs associated with potentially avoidable complications.

Prometheus in Practice

A 63-year-old white man with chest pain and a history of unstable angina is admitted to a teaching hospital. The patient has hypertension and diabetes. An electrocardiogram reveals ST-segment elevation in the lateral leads. The man is taken to the cardiac catheterization laboratory, where coronary angiography reveals severe triple-vessel disease as well as 60% stenosis of the left main coronary artery. A left ventriculogram shows mitral regurgitation (grade 2 to 3) with papillary muscle dysfunction. The patient is then taken urgently to the operating room, where he receives two venousgrafts and a left-internal-thoracic-artery graft. In addition, a mitral-valve reconstruction procedure is performed to correct the mitral regurgitation. The surgery is a success, and the patient returns to the intensive care unit in stable condition. However, his blood sugar is out of control, and he requires an insulin drip. His stay in the intensive care unit is prolonged by 2 days, and he must stay another day in the step-down unit. He is discharged 8 days after surgery in stable condition. One week after discharge, he is readmitted for a wound infection in his leg from the vein harvest site. He requires wound débridement and a course of antibiotics.

Under fee-for-service payment, the hospital would receive $47,500 for the bypass surgery, and the surgeon would receive $15,000 for performing the procedure. The extended hospital stay that was necessitated by the uncontrolled diabetes would result in an additional $12,000 for the hospital and $2,000 for the physician, and the readmission costs would total $25,000, for a grand total of $101,500.

Under Prometheus, the case-payment rate for this patient would include a severity-adjusted budget for typical costs of $61,000 for the hospital and $13,000 for the physician. The severity-adjusted allowance for PACs would be $15,300, for a total budget of $89,300. Had the readmission been prevented, the hospital and physician would effectively have earned a bonus of $12,800 ($101,500 – $25,000 = $76,500, which is $12,800 less than the Prometheus budget).

Mr. de Brantes reports serving as chief executive officer of Bridges to Excellence, which runs the Prometheus Payment model. Dr. Rosenthal reports having served on the original design team for Prometheus Payment and on the board of Prometheus Payment and participating in the evaluation of Prometheus pilots with funding from the Robert Wood Johnson Foundation. Dr. Painter reports supervising the implementation grant for the Prometheus Payment pilots for the Robert Wood Johnson Foundation. No other potential conflict of interest relevant to this article was reported.

Source Information

From Bridges to Excellence, Newtown, CT (F.B.); the Harvard School of Public Health, Boston (M.B.R.); and the Robert Wood Johnson Foundation, Princeton, NJ (M.P.).

This article (10.1056/NEJMp0906121) was published on August 19, 2009, at


de Brantes F, Camillus J. Evidence-informed case rates: a new health care payment model. Washington, DC: The Commonwealth Fund, April 17, 2007. (Accessed August 13, 2009, at–A-New-Health-Care-Payment-Model.aspx.)
Gosfield A. Making Prometheus Payment rates real: ya’ gotta start somewhere. Princeton, NJ: Robert Wood Johnson Foundation, June 2008. (Accessed August 13, 2009, at
Rosenthal MB, Fernandopulle R, Song HR, Landon B. Paying for quality: providers’ incentives for quality improvement. Health Aff (Millwood) 2004;23:127-141. [Free Full Text]
Rastogi A, Mohr BA, Williams JO, Soobader MJ, de Brantes F. Prometheus payment model: application to hip and knee replacement surgery. Clin Orthop Relat Res 2009 June 23 (Epub ahead of print).
de Brantes F, D’Andrea G, Rosenthal MB. Should health care come with a warranty? Health Aff (Millwood) 2009;28:w678-w687. [Free Full Text]***
3760  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 20, 2009, 03:18:55 PM
***WASHINGTON – President Barack Obama guaranteed Thursday that his health care overhaul will win approval and said any bill he signs will have to reduce rapidly rising costs, protect consumers from insurance abuses and provide affordable choices to the uninsured — while not adding to the federal deficit.***

He still doesn't get it.

Who is going to pay for this???

He still is not being honest with the public.

3761  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / Simon Cowell yells foul. Plus: 100 to 150 missing songs & MJ's hard Drive on: August 19, 2009, 10:10:38 AM
***But it turns out there is a whole underworld of techie criminals who hack into emails and servers to get hold of the sought-after new tracks.***

Yeah no kidding.  I've been saying this for years.  And it is far worse than this.  We are not only talking hacking into servers, we are talking listening devices, surveillance, bribery (up to the US copyright office), payoffs and more.

And it isn't just people lifting songs from the suppossed creators of this music.  For example Justin Timberlake has done songs exactly like those stolen from Katherine. 

I must also point out the 100 to 150 songs (depeding on which story you read) that went missing from Michael Jacikson's home after he died (see the reports of the missing hard drive all over the news reports) is also no accident.

I strongly doubt it is as simple as Lotaya Jackson "backing up the moving van" and taking away the hard drive though elements in the music industry would like us believe it is that simple.

The hard drive was stolen.  It might reappear but it will likely be switched (if not already).
I VERY STRONGLY SUSPECT that the parade of people recently announcing they are coming out with new albums in September (including Gretchen Wilson - it will be  more rock than country this time) are going to get buy some of the materials from this HD.
I am not clear that Jackson didn't get the material for a price from those that steal and supply the material to the singers.
Now that he is dead these same elements aren't about to let Lotaya have it all.
I suspect they took it back and are out around the music world selling them off.

Remember those songs could be worth multiple millions.  People who don't think there is organized crime doing business in this realm are totally niave - as I was years ago.

"called the cops"

What a laugh - those guys are way in over their heads.  Plus they earn little - get my drift.

*****SIMON COWELL has called in cops after LEONA LEWIS's new track was leaked on to the internet.

On the case ... Simon Cowell
The X Factor boss discovered his record company Syco's computers have been targeted by hackers on a mission to nick tracks.

Last month I told you how these leeches had got their grubby mitts on some unfinished tracks by last year's X Factor winner ALEXANDRA BURKE and had been touting them around as the finished article.

The truth is the songs were rough, unmastered recordings and may not even make it on to the album.

But this latest leak is the hotly-anticipated single from Leona Don't Let Me Down, a collaboration with JUSTIN TIMBERLAKE.

The track is seriously being considered as the first release from her second album but it has found its way on to the web - and is the final straw for Cowell.

I always assumed songs that went missing were hard copies pinched from the studio.

But it turns out there is a whole underworld of techie criminals who hack into emails and servers to get hold of the sought-after new tracks.

It sounds like something out of Spooks.

These guys compete to be the first to get hold of a new song because there is huge kudos in it - and a shed load of cash to be made.

Dodgy file-sharing websites pay hackers top dollar for stolen tracks as they try to attract more downloaders to the site so they can rake in more money from advertisers.

The hackers put a bit of digital code - a geeky version of a graffiti tag - on to the tracks to prove they got there first when the track spreads like wildfire on the web.

A spokesman for Syco - part of Sony BMG - said: "Syco are working alongside the International Federation of the Phonographic Industry, the British Phonographic Industry, the police and investigators in this and they are making fast progress.

"We will certainly look to bring charges against those who are responsible. We cannot give any more details at this stage for operational reasons."

I hope the police manage to bang the criminals up.

They ruin it for everyone.

It is always better to hear the finished version than a stolen demo.****
3762  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 18, 2009, 10:17:36 AM
"He sounds like he is campaigning for the office instead of leading and he sounds like he competing not against Pelosi-Barney Frank-Durban-Schumer but against a Republican congress, which maybe he already sees coming..."

Yes,  and, I feel he always been this way.
*The pretend you are one of them, then you can change them strategy.*

Though at times he dons the sheep skin costume more then others depending on who he is conning.
3763  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 17, 2009, 03:46:40 PM
I only post this because it is actually humerous if not maddening.
Here is the biggest spender in the history of government who now is advised to come out speaking in defense of the *taxpayer*.

Of course if it isn't only to decry the waste in miliatry spending - true to form from a gigantic liberal.
We don't need any more tanks.  We need cultural compentancy and language experts to defend America:

Obama criticizes a Cold War approach to defense
PHOENIX – President Barack Obama chastised the defense industry and a freespending Congress on Monday for wasting tax dollars "with doctrine and weapons better suited to fight the Soviets on the plains of Europe than insurgents in the rugged terrain of Afghanistan."

"Twenty years after the Cold War ended, this is simply not acceptable. It's irresponsible. Our troops and our taxpayers deserve better," he told a national convention of the Veterans of Foreign Wars. "If Congress sends me a defense bill loaded with a bunch of pork, I will veto it."

Turning to the two foreign wars engaging the United States, Obama spoke of fierce fighting against Taliban and other insurgents leading up to Thursday's national elections in Afghanistan. He said U.S. troops are working to secure polling places so the elections can go forward and Afghans can choose their own future.

Attaining that peaceful future "will not be quick, nor easy," Obama said.

He said the new U.S. strategy recognizes that al-Qaida has moved its bases into remote areas of Pakistan and that military power alone will not win that war. At the same time, confronting insurgents in Afghanistan "is fundamental to the defense of our people."

As to Iraq, Obama reiterated his commitment to remove all combat brigades by the end of next August and to remove remaining troops from the country by the end of 2011. U.S. troops withdrew from cities and other urban areas in June.

Obama, in his third appearance before the VFW but his first as president, got hearty applause and standing ovations as he spoke at the Phoenix Convention Center to several thousand veterans, though only about two-thirds of the seats were filled.

That may have been partly because he started his speech nearly an hour before it was scheduled. Aides say he was anxious to get back to Washington after a four-day trip out West that was part family vacation and part business, including the VFW speech and town hall meetings in Montana and Colorado to push his health care agenda.

Obama told the veterans that overhaul would not change how they get their medical services — and that nobody in Washington is talking about taking away or trimming their benefits.

Instead, he said he's instructed senior aides to work with the secretary of veterans affairs to come up with better ways to serve veterans.

Obama said he wants each of the 57 regional VA offices "to come up with the best ways of doing business, harnessing the best information technologies, breaking through the bureaucracy."

He said the government would then pay to put the best ideas into action "all with a simple mission — cut these backlogs, slash those wait times and deliver your benefits sooner."

Even at a time when Obama needs as much congressional support as he can summon for his health care priorities, he spared no party from his harsh critique of business-as-usual by some in the military establishment, some defense contractors and some lawmakers who write defense budgets.

He assailed "indefensible no-bid contracts that cost taxpayers billions and make contractors rich" and lashed out at "the special interests and their exotic projects that are years behind schedule and billions over budget."

He took on "the entrenched lobbyists pushing weapons that even our military says it doesn't want" and blistered lawmakers in Washington whose impulse he said was "to protect jobs back home building things we don't need (with) a cost that we can't afford."

He said such waste was unacceptable as the country fights two wars while mired in a deep recession.

"It's inexcusable. It's an affront to the American people and to our troops. And it's time for it to stop," Obama said.

As a candidate and as president, Obama has held up the weapons-buying process as the perfect example of what's wrong with Washington and why the public doesn't trust its leaders. He essentially picked a political fight with a large part of the congressional-military-industrial alliance.

He sounded much like his campaign rival of a year ago, Arizona Sen. John McCain. And, while in Arizona, Obama praised McCain for seeking to rein in costs and reform the weapons-buying process.

In seeking to overhaul the weapons-buying process, Obama hopes to make good on a campaign promise to change the way Washington does business. But it certainly won't be easy to do; lawmakers protecting jobs at home are certain to put up enormous fights over Obama's efforts to stop production on weapons like the F-22 fighter jet.

Despite objections and veto threats from the White House, a $636 billion Pentagon spending bill was approved by a 400-30 vote in the House late last month. It contains money for a much-criticized new presidential helicopter fleet, cargo jets that the Pentagon says aren't needed and an alternative engine for the next-generation F-35 Joint Strike Fighter that military leaders say is a waste of money.

The Senate will deal with the spending measure in September.

The president laid out a vision of a nimble, well-armed and multilingual fighting force of the future, not one that was built to fight land battles against the Soviets in Europe.

"Because in the 21st century, military strength will be measured not only by the weapons our troops carry, but by the languages they speak and the cultures they understand," he said.

He praised McCain for joining him and Defense Secretary Robert Gates in opposing unneeded defense spending.

Shortly after Obama won the White House, McCain had pointedly suggested there was no need for the Marine Corps to bring on newer helicopters to ferry the president at a cost of billions of dollars.

On the subject of the helicopters, Obama told the veterans: "Now, maybe you've heard about this. Among its other capabilities, it would let me cook a meal while under nuclear attack. Now, let me tell you something. If the United States of America is under nuclear attack, the last thing on my mind will be whipping up a snack."

3764  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 17, 2009, 10:43:05 AM
Here is an example of research that is the kind of thing we do need more of.
There is a procedure called vertebroplasty wherein a cement is surgically or radiographically injected into a vertebra that has collapsed as a result of osteoporosis.
Two studies just published and released call into question whether or not this procedure is of any value whatsoever.
I have sent a few patients for kyphoplasty ( a related procedure) with some mixed though sometimes beneficial results - there pain was reduced.  Yet these two studies with a total of around 100 patients suggests the treatment may have no more benefit over a placebo sham procedure.
So these procedures may be a total wast of money except to those who perform them or supply the cement.

Isn't it remarkable these procedures get approved without better evidence they work?

Why should we pay for this?

How much more do we do that is a waste of money?

We do need more data on these kinds of things:

Orthopedic and Dental Industry News  Complete Archive »
NEJM Studies Challenge the Efficacy of Vertebroplasty
Two studies published this week in the New England Journal of Medicine cast doubts over the efficacy of vertebroplasty.

The first study, conducted in Australia, randomized 78 patients in a multicenter, double-blind, placebo-controlled trial in which participants with one or two painful osteoporotic vertebral fractures were assigned to vertebroplasty or a sham procedure. The authors found that "similar improvements were seen in both groups with respect to pain at night and at rest, physical functioning, quality of life, and perceived improvement." No significant advantage was found for vertebroplasty at any time point during follow-up.

The second study, conducted by the Mayo Clinic, found similar results. 131 patients with one to three painful osteoporotic vertebral fractures were randomized to undergo either vertebroplasty or a sham procedure. Improved disability and pain scores were noted immediately following both procedures, with the study authors noting a trend toward a higher rate of clinically meaningful improvement in pain (a 30% decrease from baseline) in the vertebroplasty group.

These results have been met with some surprise and disbelief among physicians treating VCF patients. The Wall Street Journal quoted Allan Brook, the director of interventional neuroradiology at Montefiore Medical Center in New York City, as saying, “We take a patient who’s been lying in bed in a hospital, bedridden, you do the procedure and they’re home the next day. That is not a placebo."

Some of the limitations of the analysis include a small sample size and crossover between the groups (that is, patients were able to guess they had a sham procedure and proceeded to have the vertebroplasty.) Additionally, the Wall Street Journal noted a type of enrollment bias in that the patients in the most pain, and therefore the most to gain from the procedure, may not have been willing to risk being randomized to the simulated procedure. Enrollment may also have been limited by physicians' concerns that the study was unethical, and the WSJ reported that some hospitals did not allow their doctors to participate.

In an editorial also published in the NEJM, James N. Weinstein (SPORT's principal investigator) described some of the possible adverse events associated with vertebroplasty, which, while rare, include soft-tissue damage and nerve-root pain and compression related specifically to the leakage of bone cement as well as pulmonary embolism, respiratory and cardiac failure and death. He also used the editorial as an opportunity to encourage collaborative decision-making between the physician and patient, stressing that patients prefer to be more informed and will make decisions based on the best available evidence, echoing a an opportunity for further study of vertebroplasty.

Among the companies that may be affected by this data, Orthovita CFO Nancy Broadbent told Reuters, "We don't expect our Cortoss business to be affected at all by this." The company recently launched Cortoss for use in vertebroplasty and closed down 25% yesterday afternoon, just a day after reporting a strong 2Q:09 and beating both top and bottom-line estimates.

Medtronic was also slightly down at the close. Their Kyphon business contributed $609 million to total spinal and biologics sales of $3.4 billion in fiscal year 2009, though it should be noted that kyphoplasty differs from vertebroplasty in several key aspects. Vertebroplasty involves the delivery of bone cement into a vertebral fracture; kyphoplasty first inserts a balloon to create space in the fractured vertebra, restoring its height and shape, before the balloon is removed and the bone cement is delivered to the resulting space. Both procedures are typically performed by interventional radiologists. Medtronic has not commented publicly on these results. Stryker and JNJ, who are among several companies developing VCF treatments, have also not commented.

While investors may be wary, it's unclear how these studies will affect procedure volumes or product penetration. The Wall Street Journal offered examples of other cases where study results questioned established treatments, including a 2002 study that found no benefit to arthroscopic knee surgery, which appears to have only a limited effect on practice habits. While we don't expect procedure volumes to change overnight, these studies may signal a different trend: level I evidence is somewhat rare in orthopedics, but similarly rigorous studies may become more common as payers and other stakeholders demand increasingly strong data and comparative effectiveness gains traction.

3765  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Noonan BO looking more like Jimmy Carter on: August 14, 2009, 09:10:01 AM
I wonder if this is the first time his charm isn't working.  Using his charm and a veiled means of bribery (well just take from the rich and share it with you all.) he was able to get by with deception.

I am not sure it is so much people finally seeing him for the person he is or people finally realize his policies will hurt and not help them in the long run.

Whether the independents finally see he despises the America we knew for 200 years and is intent on molding it into his conceptual ideal or simply that they will all be paying for it I don't know for sure.

I suspect he will compromise big on the health care plan.  I don't underestimate his need to cling to power and I don't think he will try to ram it through without huge compromises - and then of course claim credit.

Anyway her take:
OPINION: DECLARATIONS AUGUST 13, 2009, 10:51 P.M. ET From 'Yes, We Can,' to 'No! Don't!' Obama turns out to be brilliant at becoming, not being, president.By PEGGY NOONAN
Don't strain the system. Don't add to the national stress level. Don't pierce when you can envelop. Don't show even understandable indignation when you can show legitimate regard. Realize that the ties that bind still bind but have grown dryer and more worn with time. They need to be strengthened, not strained.

Govern knowing we are a big, strong, mighty nation, a colossus that is, however, like all highly complex, highly wired organisms, fragile, even at places quite delicate. Don't overburden or overexcite the system. America used to have fringes, one over here and the other over there. The fringes are growing. The fringes have their own networks. All sorts of forces exist to divide us. Try always to unite.

These are things one always wants people currently rising in government to know deep in their heads and hearts. They are the things the young, fierce staffers in any new White House, and the self-proclaimed ruthless pragmatists in this one, need to hear, be told or be reminded of.

The big, complicated, obscure, abstruse, unsettling and ultimately unhelpful health-care plans, proposals and ideas keep rolling out of Washington. Five bills, thousands of pages, "as it says on page 346, paragraph 3, subsection D." No one knows what will be passed, what will make its way through House-Senate "conference." They don't even know what the president wants, what his true agenda is. He never seems to be leveling, only talking. Everything's open to misdirection and exaggeration, and everything, people fear, will come down to some future bureaucrat's interpretation of paragraph 3, subsection D, part 22.

What a disaster this health-care debate is. It strains, stresses and pierces, it unnecessarily agitates and is doomed to be the cause of further agitation. Who doubts the final bill will be something between a pig in a poke and three-card Monte?

Which is too bad, because our health care system actually needs to be made better.

There are smart and experienced people who say whatever the mess right now, the president will get a bill of some sort because he has the brute numeric majority. A rising number say no, this thing has roused such ire he won't get much if anything. I don't know, but this is true: If he wins it, will be a victory not worth having. It will have cost too much. It has lessened the thing an admired president must have from the people, and that is trust.

It is divisive save in one respect. The Obama White House has done the near impossible: It has united the Republican Party. Social conservatives, economic conservatives, libertarians—they're all against the health-care schemes as presented so far. They're shoulder-to-shoulder at the barricade again.

More Peggy Noonan
Read Peggy Noonan's previous columns.

And click here to order her new book, Patriotic Grace.
The president's town hall meeting on Tuesday in Portsmouth, N.H., was supposed to be an antidote to the fractious town halls with members of Congress the past weeks. But it was not peaceful, only somnolent. Actually it was a bit of a disaster. It looked utterly stacked, with softball after softball thrown by awed and supportive citizens. When George W. Bush did town halls like that—full of people who'd applaud if he said tomorrow we bring democracy to Saturn—it was considered a mark of manipulation and insecurity. And it was. So was Mr. Obama's.

The first question was from a Democratic state representative from Dover named Peter Schmidt. He began, "One of the things you've been doing in your campaign to change the situation is you've been striving for bipartisanship."

"Right," the president purred. They were really holding his feet to the fire.

"My question is," Mr. Schmidt continued, "if the Republicans actively refuse to participate in a reasonable way with reasonable proposals, isn't it time to just say ,'We're going to pass what the American people need and what they want without the Republicans'?"

Stop, Torquemada, stop!

The president said it would be nice to pass a bill in a "bipartisan fashion" but "the most important thing is getting it done for the American people."

Then came a grade-school girl. "I saw a lot of signs outside saying mean things about reforming health care" she said. Here one expected a gentle and avuncular riff on the wonderful and vivid expressions of agreement and disagreement to be seen in a vibrant democracy. But no. The president made a small grimace. "I've seen some of those signs," he said. There's been a "rumor" the House voted for "death panels" that will "pull the plug on grandma," but it's all a lie.

I'm glad he'd like psychiatric care included in future coverage, because after that answer that child may need therapy.

The president seemed like a man long celebrated as being very good at politics—the swift rise, the astute reading of a varied electorate—who is finding out day by day that he isn't actually all that good at it. In this sense he does seem reminiscent of Jimmy Carter, who was brilliant at becoming president but not being president. (Actually a lot of them are like that these days.)

Also, something odd. When Mr. Obama stays above the fray, above the nitty-gritty of specifics, when he confines his comments on health care to broad terms, he more and more seems . . . pretty slippery. In the town hall he seemed aware of this, and he tried to be very specific about the need for this aspect of a plan, and the history behind that proposal. And yet he seemed even more slippery. When he took refuge in the small pieces of his argument, he lost the major threads; when he addressed the major threads, he seemed almost to be conceding that the specifics don't hold.

When you seem slippery both in the abstract and the particular, you are in trouble.

Looking back, a key domestic moment in this presidency occurred only eight days after his inauguration, when Mr. Obama won House passage of his stimulus bill. It was a bad bill—off point, porky and philosophically incoherent. He won 244-188, a rousing victory for a new president. But he won without a single Republican vote. That was the moment the new division took hold. The Democrats of the House pushed it through, and not one Republican, even those from swing districts, even those eager to work with the administration, could support it.

This, of course, was politics as usual. But in 2008 people voted against politics as usual.

It was a real lost opportunity. It marked the moment congressional Republicans felt free to be in full opposition. It gave congressional Democrats the impression that they were in full control, that no one could stop their train. And it was the moment the president, looking at the lay of the land, seemed to reveal he would not govern in a vaguely center-left way, as a unifying figure even if a beset one being beaten 'round the head by the left, but in a left way, without the modifying "center." Or at least as one who happily cedes to the left in Congress each day.

Things got all too vividly divided. It was a harbinger of the health care debate.

I always now think of a good president as sitting at the big desk and reaching out with his long arms and holding on to the left, and holding on to the right, and trying mightily to hold it together, letting neither spin out of control, holding on for dear life. I wish we were seeing that. I don't think we are.

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
3766  Politics, Religion, Science, Culture and Humanities / Politics & Religion / $200 cash for school supplies on: August 12, 2009, 11:39:59 AM
I give Soros credit for putting up some money.  Why he thinks it ok to confiscate tax payer money for the rest though I disagree with.
Why not just buy the books supplies and uniforms and pass out at school rather than hand out cash to people with the promise they will use it for school supplies?

That is a joke. 

Another politically correct adorable program that is wasted IMHO.
Oh sure the government can do these things.

****Back to school spree: Billionaire, feds give out $175M to aid neediest students around the state
BY Erica Pearson, Tanyanika Samuels, Kenneth Lovett and Adam Lisberg

Wednesday, August 12th 2009, 8:14 AM

Billionaire George Soros speaks at P.S. 208 in Harlem where he announced a $35 million gift for low-income families in New York to purchase supplies and clothing for the new school year.

Roberta Aguilar and her daughter Lilly Gomez (11) plan to buy a uniform for her first day of school wait at the Chase Bank on Junction Blvd in Queens.
People wait to receive 200 dollars given to disadvantaged families for school supplies.
Take our PollSoros, feds hand out $175M to needy NY kids
A $200 back-to-school giveaway for needy kids sparked a mad rush for money on the streets of New York on Tuesday.

"It's free money!" said Alecia Rumph, 26, who waited in a Morris Park, Bronx, line 300 people deep for the cash to buy uniforms and book bags for her two kids.

"Thank God for Obama. He's looking out for us."

Thousands of people lined up at banks and check-cashing shops to withdraw the cash that magically appeared on their electronic benefit cards.

Some rushed out because of rumors the money would vanish by the end of the day.

"Rumors, there's always rumors," said Teresa Medina, who waited four hours at a Pay-O-Matic in Clinton Hill, Brooklyn, to get $600 for her three teenagers - just in case they were true.

The no-strings-attached money went to families receiving food stamps or welfare.

Every child between 3 and 17 was eligible for $200, which worked out to 813,845 kids across the state - including 498,866 in the city.
"Times are really tough right now. The situation is bad with money. So it's easy to want to use the money for other things," said Ana Barcos, 31, of Corona, Queens, where 200 people waited outside a check-cashing business.

"But if the money's supposed to be for my kids, then I will use it for my kids."

Billionaire philanthropist George Soros gave $35 million toward the program, with $140 million in federal stimulus funds routed through state government making up the rest.

"It's a help," said Tania Gomez of Chelsea, who withdrew $600 for her kids. "Every penny counts nowadays. It's really something that was unexpected."

Storekeepers were glad to hear about the program, too - and the notebooks, clothes and backpacks it would buy.

"It's good for everyone," said Aziz Boughroum, 31, who works at Stevdan Pen & Stationers in the West Village.

Gov. Paterson and Mayor Bloomberg joined Soros to announce the payments at Public School 208 in Harlem, where the billionaire reminisced that as a penniless student in London, he survived because of a handout he got from Quakers.

"This gift has a special personal meaning to me, because I was once also a recipient of charity," Soros said in a choking voice. "I'm very pleased that I'm able to repay what they gave me."

Paterson's Republican critics blasted the giveaway, saying he should spend the money to reduce property taxes.

"It is a plan that is ripe for fraud and abuse," said Senate Republican leader Dean Skelos. "This is a totally irresponsible use of federal stimulus money."
3767  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 02:30:48 PM
 Doug,  I agree with you.  I got that idea from a few Rep. pundits on cable were saying it is the cost issue over the weekend though clearly others are pointing out just as Mr. Sowell is  with regards to some of the other issues.

The problem as I see it is I am just not sure how many people read Sowell who are not already inclined to agree.
Same is true for Fox and right talk radio.

It is truly a fight for the ears and minds of those in the middle.
BO and the msm still have the advantage.

3768  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Way too soon to celebrate on: August 10, 2009, 02:18:11 PM
I think Buchanan rejoices way too soon.
BO does not continue to crash in the polls like constantly stated by the right pundits.  Yes he is down but stabilizing.
And I think that they underestimate there are many people who do want a "public option" (not me), and do want a government nanny.
And I think he underestimated the Dems ability to spin this right back.
And there is still no spoke people for the Republicans.
Palin has a lot of studying to do if he thinks she can attract more than her base.
Who can convince the skeptical that the job of government is to keep level and honest the playing field and then GET OUT OF THE WAY?

The cans are still singing to the choir IMHO.

****A GOP That Can Say No
by  Patrick J. Buchanan


Reports of the death of the Republican Party appear to have been premature.
Not since Sen. Bob Griffin derailed LBJ's scheme to replace Chief Justice Earl Warren with crony Abe Fortas, before Nixon got to the Oval Office, has the GOP defied this city and voted to reject a liberal judicial activist for the court.
In 1970, after revelations of scandal forced Fortas to resign, Rep. Gerald Ford moved to impeach "Wild Bill" Douglas on similar grounds. Then the fire went out -- for 40 years.
Meanwhile, Democrats trashed Republican nominees Clement Haynsworth, Harrold Carswell and Robert Bork, forced Reagan to withdraw Douglas Ginsburg, and made Clarence Thomas and Sam Alito run an Iroquois gauntlet.
Finally, yesterday, Senate Republicans, defying threats of an Hispanic backlash if they voted to reject the first Hispanic nominee, stood up and said no more EZ passes for any liberal judicial activist.
And this is only the most recent act of defiance by a party that, at long last, seems to have found its conservative compass and to be finding its way home.
Recuperation began when House Republicans stood beside Middle America and rejected the Bush-McCain-Kennedy-Clinton amnesty for illegal aliens, inflicting a humiliating defeat on the establishment.
The next sign of recovery was the decision of John McCain to damn the torpedoes and put Sarah Palin on the ticket. The smashing reception Palin received stunned mainstream media, vaulted McCain into the lead, and signaled the party what America wants it to become again.
The next act of defiance was the Republican rebellion against the $700 billion bank bailout of last September. Though House resistance was swiftly broken, Republican instincts were subsequently proven right.
Next came rock-solid Republican opposition to the mother of all pig-outs, the Pelosi stimulus package. Not one Republican voted for it in the House and only three went over the hill in the Senate. How many Blue Dogs are back home bragging about having supported that beauty?
Then, yesterday, mirabile dictu, the Republican minority in the Senate voted four-to-one to send Sonia back to Greenwich Village.
Wailed retiring Republican Sen. Mel Martinez of Florida, "We have allowed ideology to hold a preeminent role as opposed to qualifications. I find it very, very appalling."
But what is truly appalling is the senator's inability to understand what is going in his country.
For decades, a leftist ideology has permeated the Supreme Court. Protected by lifetime appointments, liberal justices have imposed upon this once-democratic republic a social, cultural and moral revolution no Congress could ever have survived imposing and no majority would ever vote for.
Prayer, Bible study, the Ten Commandments were purged from public schools of a nation whose coins bear the inscription "In God We Trust" and whose Constitution never mandated any kulturkampf on the birth faith of the West.
Pornographers were awarded First Amendment protections. Abortion, a crime in every state half a century ago, was declared a constitutional right. New shackles were put on police and prosecutors. The death penalty was outlawed for 20 years because Bill Brennan and friends did not like it. Forced busing for racial balance was imposed, generating white flight, destroying urban schools, and tearing communities apart.
For decades, federal judges and justices were on a rampage. For decades, we lived under a judicial dictatorship.
As for Sotomayor, she was a political activist whose academic and legal career is marked at every step by clamors for raced-based hiring, promotions and admissions. As a judge, she trashed the appeal of Frank Ricci and the New Haven firefighters who had been robbed of promotions they had earned in competitive exams solely because they were white.
She declared the New York state law denying voting rights to convicts a violation of the U.S. Civil Rights Act because it had a disparate impact on minorities, who are overrepresented in prison. Using that yardstick, Justice Sotomayor would have to vote to outlaw the death penalty.
Suddenly, in national politics, the momentum has shifted.
The Republican Party is stirring. Its poll numbers are rising, as support for Obama has fallen to 50 percent in the Quinnipiac Poll, support for his handling of the economy and deficit has fallen into the 40s, and support for his health insurance scheme has plunged to 39.
Of his big initiatives, the stimulus bill is looking like a loser, cap-and-trade may not survive the Senate, and national health insurance may have to be pared back -- or be killed by nervous Blue Dogs.
In both big races three months off, the Virginia and New Jersey governors' contests, Republicans are running 14 points ahead.
As they say in the press box, "Fans, we have a brand-new ball game."
And the reason is that some exasperated Republicans decided to declare independence of the White Houses of both George W. Bush and Barack Obama -- and "dance with the girl what brunt ya."

Mr. Buchanan is a nationally syndicated columnist and author of Churchill, Hitler, and "The Unnecessary War": How Britain Lost Its Empire and the West Lost the World, "The Death of the West,", "The Great Betrayal," "A Republic, Not an Empire" and "Where the Right Went Wrong."****

3769  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The electoral process, vote fraud (ACORN et al), corruption etc. on: August 10, 2009, 01:10:44 PM
Except for Lou Dobbs everyone else is silent on the illegal issue. Even the cans are afraid of the racist label.

Geraldo Rivera states Lou Dobbs is "slandering" latinos (Dobbs is married to a latina!).

The crats are silent because they benefit from the invasion.  The media is silent because they are predominantly crat by nature.
The cans well...  are cowards?

3770  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 01:06:30 PM
Yes a lot of what is being claimed is unproven.

Even the concept of getting people to quit smoking may not reduce costs in thelong term.

From a long term financial cost vs benefit analysis it may be better to pay for the emphysema and lung and bladder cancers and till the patient dies than pay for them to live much longer lives and health cost, medicare, and social security utilization.

Surely I am not adocating this I am just stating the probable false premise that it is a cost saver.

"Even Republicans have been caught up in this idea that preventive care"

Your right.   So is the idea of moving everything to IT data based (a Gingrich focus).
No one has proven to me that this would save costs either in the short term or the long term.

I do agree it has theoretical benefits in this day of fragmented care, ie, people going to multiple hospitals, seeing multiple doctors, labs, imaging centers.  And it may have cost benefits.

But the more I read about computer systems the harder it seems to determine if they are beneficial.  Doctors' accounts that I read about are somewhat mixed.


3771  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 10:14:17 AM
You know the crats are dissecting every criticism on their health care reform.

They will be coming out all over the airwaves with the complicit media bombarding us with denials of all the legitimate criticisms.

The cans will have to continue to expose the deceit for what it is - just that.
They should not harp on just the cost issue as I hear some talking heads saying lately.

BO's doctor from Chicago was originally quoted as saying he was against this reform.
He was on one station this weekend.  He certainly sounded like a bonified BO supporter of Democratic health reform to me.
Someone got to him and persuaded him to change his tune.  I wonder what he got.
3772  Politics, Religion, Science, Culture and Humanities / Politics & Religion / The media and BO's health care on: August 08, 2009, 09:34:45 AM
It really is astouding.  After witnessing decades of liberal rallies, anti war protests (their glory days were back when they got to rally against the Iraq war) to watch the left howl and scream over protests against the Democrat health care bill.

Almost no comments about the many deceptions of the bill itself, or Bo himself saying clearly he is for single government sponsered single payer and implying that to get there will take years of maniulation, tricks, and deception.

Here was BO on the cover of TIME in a doctor's outfit - all about a bill he neither wrote or read.

***Can't Blame Liberal Media for Health Bill Stall
BMI Study: 70 Percent of ABC, CBS and NBC Coverage Promoted Obama's Huge Health Care Takeover
By: Rich Noyes and Julia Seymour | View PDF Version 
July 28, 2009 10:48 ET

Liberal hopes for a quick health care bill are in collapse, as Senate Democrats push any floor action off until the fall, a move House Democrats may match this week. But if the Obama White House is upset that their plans for a huge expansion of government health care have been delayed, they surely cannot complain about the media coverage.

Last week, a new study by the Media Research Center’s Business & Media Institute (BMI) found broadcast coverage during the first six months of 2009 tilted heavily in favor of Barack Obama’s big government plan. BMI’s analysts looked at 224 health care stories on the ABC, CBS and NBC morning and evening news shows from Obama’s January 20 inauguration through his June 24 prime time special on ABC.

Among the key findings:

# Fully 70% of soundbites (243 out of 347 total) supported Obama’s liberal health care ideas. Only nine percent of stories (21) suggested the total price tag for Obama’s “reform” would top $1 trillion.

# Reporters exaggerated the number of uninsured Americans. Omitting non-citizens, those capable of paying, or those eligible for assistance programs already in place, a reasonable figure would be between 8 million and 14 million uninsured, not the “50 million Americans” statistic BMI’s analysts found touted by the networks.

# The networks also spent virtually no time investigating states that had experimented with big government health schemes — just one story on how Massachusetts’ plan for mandatory health insurance is working out (costs are rising faster than expected), and no stories on Hawaii’s already-cancelled program to insure all children.

BMI’s study period ended in late June, but the networks’ favors for Obama have continued in July, even as public sentiment shifted against both the President and his plan. On July 16, for example, both the NBC Nightly News and CBS Evening News skipped over how, in the words of ABC White House correspondent Jake Tapper on World News, “the President's case was dealt a blow today” when the Congressional Budget Office chief told Congress the health care plans will require massive additional spending.

The next morning, after the House Ways and Means Committee had formally passed an estimated $554 billion tax increase to help pay for the ambitious health plans, CBS skipped that development, too, as ABC and NBC’s morning news shows offered only a single sentence. NBC’s Natalie Morales, on her network’s four-hour Today, gave it just 12 seconds: “During the night, the House Ways and Means committee voted to increase taxes on higher income earners as part of a health care reform bill.”

If these had been setbacks for a big Bush administration initiative, do you think the network coverage would have been so paltry?

Reporter commentary has also betrayed a lack of objectivity. In a July 22 interview with California’s Arnold Schwarzenegger on Good Morning America, ABC's Chris Cuomo painted Republicans as endangering Americans’ health: “Do you believe that Republicans are playing politics here, at the risk of people's health care....Is this getting to be a little bit of a reckless situation?”

That night on MSNBC, after the President’s press conference, NBC medical reporter Nancy Snyderman confessed she was “rooting” for him: “As a physician, you know, I felt like I understood the complexity of the problem. As an American citizen, I was rooting for the President to hit a home run.”

The public’s anxiety seems to have delayed the day of reckoning on health care until at least this fall. The big questions: Will network reporters continue their favors for ObamaCare? And will the tilted media landscape be enough to make liberals’ policy dreams come true?***

3773  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 07, 2009, 11:38:14 AM
"Instead of angering me, the dishonest people in my world bore me.  They tell me what happened and I still don't know what happened so they waste my time by speaking.  I don't know when, if not already, the overexposed Obama will start to have that affect."

Yes I agree but the larger issue is this what we should expect or should get from our leaders?
It is now common place to assume all politicians are liars.
Why even bother to complain about this one or that one doing it, "they all do it".
Is spin, bull, and lies effective leadership?

Don't people want someone they can trust leading them?
Is this where we are in today's world?

When the occasional lie from our leaders becomes an art form of spin and deceit we have lost our way.

Some would say that W lied about the weapons of mass destruction.

At the very worst he believed they were there and believed what he was doing was best for America.
I can't think of anything else that he lied about just to make himself look good.

I can say the same about Reagan.

Why can't we have honest leaders who say what they mean and mean what they say other?

I understand why BO won't say what he means because,

he clearly has a socialist agenda.  Clearly he wants single payer government controlled health care and to redistribute wealth and put the historically white male led America in "its place".
But all of our leaders this way??

Perhaps I am expecting too much.
3774  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 07, 2009, 10:27:55 AM
***The bottom line is that when the government spends money on health care, the patient does not. The patient is then separated from the transaction in the sense that costs are no longer his concern. And when the patient doesn’t care about costs, only those who want higher costs—like doctors and drug companies—care.***

Well the know it all Harvard types expect that the ultimate goal - single payer and governement controlled - and conversion of all health information onto the internet will give them the control to ration, and, in that way hold down costs.

***A patient-centered approach focuses on the patient-doctor relationship and empowers the patient and the doctor to make effective and economical choices.
A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.
By empowering patients and doctors to manage health-care decisions, a patient-centered health-care reform will control costs, improve health outcomes, and improve the overall efficiency of the health-care system.***

To some extent that already takes place.  Pts all the time ask for the cheapest drugs that will work.  Some would rather pay more, if they can or choose to take the expense.

I am less clear that doctors go out of their way to hold down costs when they do get paid to do more especially when they get paid for tests.
Of course if the patient pays for a substantial part of it then they might dissuade the doctor.

3775  Politics, Religion, Science, Culture and Humanities / Politics & Religion / The great conciliator on: August 07, 2009, 09:03:41 AM
From Bama
"I expect to be held responsible," Obama said. "But I don't want the folks who created the mess to do a lot of talking. I want them to get out of the way so we can clean up the mess. I don't mind cleaning up after them, but don't do a lot of talking."

One never really knows about a  person until he is under pressure.
The real Bama is coming out.

This kind of language will only anger people even more and lead to more divisiveness.

This guy appears to be cracking.

3776  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 06, 2009, 08:01:53 PM

The other night there was some discussion by the talking heads about this "rescue".
One asked the other who would you believe as to the true nature of what went on behind the scenes, the N. Korean government or the US government.  The intent was to suggest that only a crazy person would believe N Korea's story over the talking crats.

Sadly all I could think was that I wouldn't trust a Democrat any more than I would a N. Korean official.

Also I remember all too vividly that I could never know when Clinton was (if ever) telling the truth.  He would lie so much even if or when he was being truthful one could not know.  Clearly the same is true of BO.  Clearly the same is true of most if not all of the outspoken Democrats.

As for the picture you posted I wonder where the one is of Clinton carrying his bags full of cash on his way over to N. Korea.

3777  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 05, 2009, 05:56:19 PM
And yet BO remains popular - his ratings still over 55%.
He appears divorced from the health care issue in the polls.

How can the right convince so many people that socialism is not better for them?

Obviously there are people who are fine with this notion.
3778  Politics, Religion, Science, Culture and Humanities / Politics & Religion / We are in the midst of a "soft" civil war on: August 05, 2009, 05:52:45 PM
"Cash for clunkers is an example of government doing something right"?

first one billion than three.

A billion here, a billion there.
What's a billion dollars anymore anyway?

In an age of government wherein we speak of hundreds of billions and trillions the concept of  a billion has been relegated to pocket change.

I don't listen to Sullivan.  I have seen him on the talk circuit and I have never heard anything this guy has said that made any sense.
He always sounds bizarre and makes no sense.

I have said I was for compromise.  I thought the initial Tarp had saved a castrophe.  If there was no such thing as FIDC I am convinced we would have seen a rush on banks and a collapse like '29.

But, my idea of compromise was not to spend like crazy.

Jonah Goldberg was right when he said the Democracts are like Huns crashing the gates and going nuts looting and (my words) raping and pillaging, and stealing everything they can get their paws on and throwing it all around to their friends and cronies and allies.

We really are in a "soft" civil war.

Years ago the plundering would have been done with guns.  Now it is "legal" and legitimized because the plunderers have bribed enough of an electorate to get away with it.

And yet the Rebublicans have not yet found a savior of the United States of America if one exists.

I can only hope Dick Morris is right.

3779  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Buchanan: "No evidence" Iran is working on a nuclear bomb on: August 04, 2009, 10:12:00 AM
Buchanan on the threat to Israel:

Comments Tell Israel: Cool the Jets!
by  Patrick J. Buchanan


Former U.N. Ambassador John Bolton, who is wired into the cabinet of "Bibi" Netanyahu, warns that if Iran's nuclear program is not aborted by December, Israel will strike to obliterate it.

Defense Secretary Gates' mission to Israel this week, says Bolton, to relay Obama's red light, was listened to attentively, but will not be decisive.

Israel will decide.

One trusts Gates got into the face of Defense Minister Ehud Barak. For an Israeli strike on Iran, which Joe Biden foolishly said was Israel's call, would drag this country into a third war in the Middle East and destroy a policy that is visibly succeeding.

The Iranian regime is still reeling from the June 12 election, widely perceived in Iran and worldwide as stolen, and its tumultuous aftermath. Hundreds of thousands poured into the streets to protest the election, and then attack the legitimacy itself of the Islamic regime.

The government is gripped by its worst crisis since the revolution of 1979. Members of Iran's establishment with unimpeachable revolutionary credentials have declared the election a fraud.
Ahmadinejad's selection as first vice president of Esfandiar Rahim Mashaie, whose son is married to his daughter, and who has said some kind words about Israel, outraged conservatives.
Ahmadinejad was ordered by Ayatollah Khamenei to rescind the Mashaie appointment. For days he balked, then sent a curt note saying he would comply. Ahmadinejad further affronted the ayatollah by naming Mashaie his chief of staff.
Teheran is now ablaze over reports that scores of street protesters arrested in June may have been beaten to death in prison.
There is talk in Teheran, even before he has been sworn in for a second term, that Ahmadinejad may be impeached or ousted long before he can complete it.
America's policy of patience is working.
And as Ahmadinejad is Israel's bete noire, who Netanyahu cites as the religious fanatic who wants to "wipe Israel off the map" and will launch a nuclear weapon on Tel Aviv as soon as he gets it, why would Israel strike now, and reunite Iranians behind this regime?
Why does Israel insist that America has only five months to halt Iran's nuclear program, or Israel must attack?
Says Bolton: "(W)ith each passing day, Iran's nuclear and ballistic laboratories, production facilities, and military bases are all churning. Israel is focused on these facts, not the illusion of 'tough' diplomacy."
Now, Iran's nuclear "production facilities" may be "churning" out the low-enriched uranium of which it has produced enough for one test bomb. But IAEA inspectors still have their eyes on this pile. None of the LEU has been diverted anywhere.
There is no evidence Iran has built the cascade to raise LEU to highly enriched weapons-grade uranium, or that the facilities even exist to do this. The Iranian regime has declared it has no intention of building nuclear weapons, indeed, that their possession would be a violation of Koranic law.
And the United States has not rescinded its own National Intelligence Estimate of 2007 that Iran, in 2003, abandoned its weapons program.
Israel has been saying for years an Iranian bomb is months away.
Where is the proof? Where is the evidence to justify a new U.S. war in the Middle East to destroy weapons of mass destruction that may not exist in Iran, as they did not exist in Iraq?
Iran may wish to have a nuclear deterrent, considering what happened to neighbor Iraq, which did not. But the idea that the regime, having built a nuclear weapon, would launch it on Tel Aviv and bring massive retaliation by scores of Israeli nukes on Teheran and other cities, killing millions of Iranians and all the leaders and their families of all factions of this disputatious people, seems like total madness.
For Israel to launch a war on such reasoning would seem to meet Bismarck's definition of preemptive war as "committing suicide out of fear of death."
America lived for decades under a threat of nuclear annihilation. We relied on a policy of containment and deterrence, outlasted the Soviet regime in a 40-year Cold War, and are now at peace with Russia.
Ahmadinejad is not so tough a customer as Stalin, Khrushchev or Mao, who talked of accepting 300 million dead in a nuclear exchange. Moreover, Ahmadinejad has no nukes, no authority to take Iran to war, and is looking like a very lame duck before his second term has begun.
And when one looks to U.S. and Iranian interests, they coincide as much as they conflict. Iran detested the Taliban before we took them down, and no more wants them back than do we. Iran is even more pleased with the Shia regime we brought to power in Baghdad than we are.
Iran needs technology to restore its depleted oil and gas fields, and an end to sanctions to restore an economy whose disintegration helped put the regime in crisis and lose it the support of its young.
Obama should tell the Israelis, "Cool the jets!" literally.

Mr. Buchanan is a nationally syndicated columnist and author of Churchill, Hitler, and "The Unnecessary War": How Britain Lost Its Empire and the West Lost the World, "The Death of the West,", "The Great Betrayal," "A Republic, Not an Empire" and "Where the Right Went Wrong."

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Seems like every time the price of oil sags, Israel (or her apologists) start floating the idea of striking Iran. Funny, isn't it?
Jul 31, 2009 @ 10:18 AMWallaby, The outback
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Is everyone who posts here anti-Semitic or just plain ignorant?
Jul 31, 2009 @ 10:35 AMRandy, Dallas
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The problem with this, of course, is that US concerns aren't the primary concern of Israel; Israel is. They also aren't stupid so I find it unlikely that they will actually launch an attack until they are sure they have no choice because they are just as aware of the fallout they'll have to deal with. However, if they believe that Iran is close to a working bomb and knowing what the likely repercussions of that would be for Israel, they're not going to care what we think. Since we're obviously not overly concerned with the effect our policies have on them, I fail to think them blamable for that attitude.
Jul 31, 2009 @ 10:48 AMMDF, Mass
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Amen. I totally agree with this. Any strike now would reverse all the hard work already done
Jul 31, 2009 @ 10:51 AMGraham, Slough
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ISRAEL, SEND THE JETS TO IRAN. Let's get this show on the road.
Jul 31, 2009 @ 10:52 AMHarold Reimann, Lucerne Valley, CA
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One big problem with your analysis Pat. The leaders of the Soviet Union were not suicidal. The leaders of Iran are. The MAD policy worked with the Soviet Union because they had no personal interest in dying. Ahmadinejad on the other hand believes he will get lots of virgins and eternal drunken party if he dies in a conflict with the “Great Satan” or “Little Satan”. He has no reason to fear annihilation.
Jul 31, 2009 @ 10:59 AMRD, Texas
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Wrong, Pat. Israel has no choice but to attack Iran and she will. She is just waiting for Obama's popularity to fall.
Jul 31, 2009 @ 11:06 AMjorgen, SShare Your Comment  Show All Comments
3780  Politics, Religion, Science, Culture and Humanities / Politics & Religion / For further evidence of the distortion of what America is about on: August 03, 2009, 09:20:27 AM
Remember how I point out the multitude of left articles published in the New England Journal.  This one is only surprising because it is written by a guy from S. Carolina.

This guy who I presume got his history lessons while residing in Russia states he has no clue what is being talked about when we speak of "American Values".

Folks, the America I knew growing up is gone.   
******HEALTH CARE 2009

Previous Volume 361:440-441  July 30, 2009  Number 5

"American Values" — A Smoke Screen in the Debate on Health Care Reform

Allan S. Brett, M.D.

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Amid all the rhetoric about health care reform, one claim has emerged as a trump card designed to preserve the current patchwork of private and public insurance and to stop discussion of a government-sponsored single-payer system in its tracks: the claim that single-payer health care — a Canadian-style Medicare-for-all system — is antithetical to "American values." The idea that American values dictate a particular approach to health care reform is often stated explicitly, and it is implicit in the generalization that "Americans want" a particular system. The underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry. Remarkably, this premise has received very little scrutiny.

Two related assumptions are buried in the language of "American values." The first is that there are archetypical Americans — that if we know someone fits the category "American," it should be possible to predict his or her general worldview accurately. However, we have good reason to doubt that assumption. In nearly all respects — ethnically, culturally, religiously, politically, and socioeconomically — Americans are increasingly diverse. The recent presidential campaign provides evidence that a monolithic conception of what it means to be "American" is problematic and outdated: those who championed the idea of "real" Americans (as distinct from Americans who are somehow less representative of American ideals) were precisely those whose candidate lost the election.

The second assumption is that Americans' personal values predictably translate into certain organizational structures for the financing and provision of health care — and that a single-payer system is not among them. Exactly what might those values be? Are they self-regarding values directed toward maximizing individual well-being and potential? Or other-regarding values such as altruism or concern for community? Clearly, most people — regardless of political, ethnic, or cultural identity — regard both sets of values as important in varying proportions; nothing precludes a single-payer system as one possible means of realizing a blend of these values.

The notion that American values militate against a single-payer system is advanced not only by advocates of preserving the status quo or making incremental changes but also by some who propose major reforms that nibble around the edges of a single-payer system. For example, Ezekiel Emanuel — now a special adviser on the Obama administration's health care team — has proposed universal health insurance funded by a value-added tax on sold goods and services; all citizens would receive government-issued vouchers to purchase health insurance from private insurance companies. According to Emanuel, such a plan "coheres with core American values: individualism and equality of opportunity." He argues that equality of opportunity dictates universal coverage and government funding, but individualism dictates preservation of the private insurance system: "Americans clamor . . . for the chance to choose. . . . We want to choose our insurance plans, our hospitals, our doctors."1

The theme of "choice" also surfaces in the writing of Tom Daschle, President Barack Obama's initial pick for secretary of health and human services. In his book Critical, Daschle proposes universal coverage delivered through a private–public hybrid plan. He all but admits that a single-payer system is the best solution but abandons the idea because it is "politically problematic" and because "compared to residents of [European countries], Americans are more supportive of choice and suspicious of government."2

Suppose that "freedom to choose" is indeed the paramount American value relevant to health care. For many people, it would surely imply choice of physician, hospital, or clinic. For such choice, a single-payer system beats the competition hands down. Incremental reforms preserving the private insurance industry and employer-based insurance would probably perpetuate the restricted choice of health care providers that many Americans already encounter: private plans typically limit access to certain physicians or hospitals, and physicians often refuse to accept certain plans. In contrast, single-payer proposals eliminate those restrictions.

Another possible meaning of "choice" is the freedom to choose from an array of private insurance companies. Here it is important to acknowledge that insurance is only a means for collecting and disbursing health care funds — not an end in itself. The key question is therefore whether private insurance is superior to single-payer insurance in achieving the desired end of efficient, cost-effective health care. Here, too, the single-payer system would probably prevail. Because administrative costs are consistently lower in single-payer systems than in private-based systems, more of the health care budget goes directly to patient care (and less to administration) in single-payer systems. Thus, Americans have been misled by the rhetoric about choice. In contrast with the single-payer option, a system with multiple private insurers would continue to restrict one dimension of choice (selection of physicians) and perpetuate a choice most people would consider irrational (wasteful spending on administrative overhead).

A third dimension of choice is the freedom to choose whatever test or treatment a patient wants. This choice is system-neutral, pointing to neither single-payer nor alternative systems. Any reform initiative must control spending; unproven or unnecessary medical interventions should not be available in any system.

A closely related rhetorical device — the idea that Americans or American values are "unique" — also deserves attention. For example, Emanuel describes individualism and equality of opportunity as "uniquely American."1 Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, asserts that a public–private hybrid is essential because it is a "uniquely American solution."3 Others describe rugged individualism as a "uniquely American" value that makes us "reluctant to provide our tax dollars to support someone else's health care."4 Such defiant-sounding assertions imply that "uniqueness" is a matter of pride and an end in itself. But these generalizations are impossible to prove, a distraction in the debate, and ultimately irrelevant. What is relevant is whether a solution works, not whether it is unique. Indeed, the aspect of the current U.S. system that is truly unique among developed countries is its failure to cover everyone — hardly something to brag about.

In their book Benchmarks of Fairness for Health Care Reform, Norman Daniels and colleagues reject these "ungenerous" views of our values, arguing that past failures to reform health care are better explained by the influence of interest groups whose wealth and power are threatened by reform.5 The authors propose that fair equality of opportunity is a more promising and relevant American value. Opinion polls support this proposal: in multiple surveys of randomly selected Americans during the past decade, more than 60% of respondents have favored government-guaranteed health care for all. Although these responses don't necessarily specify a single-payer system as the only model for government-guaranteed insurance, they surely do not exclude it.

Policymakers debating health care reform should stop hiding behind the smoke screen of "American values." Discussions dominated by references to uniquely American individualism, uniquely American solutions, or narrowly defined conceptions of choice tell us more about the political and economic interests of the discussants than about the interests of the Americans they claim to represent. In an increasingly diverse country that has a widening gap between rich and poor, a more promising approach is to start with the questions that matter to everyone: Will the system care for us when we're sick and help prevent illness when we're well? Will we have access to medical care throughout our lives without risking financial ruin? Will we be able to navigate the system easily, without jumping through unnecessary hoops or encountering excessive red tape? Will health care spending be managed wisely? Health care reformers owe Americans a system that best addresses these questions — not one that merely pays lip service to ill-defined "American values."

No potential conflict of interest relevant to this article was reported.

Source Information

From the University of South Carolina School of Medicine, Columbia.


Emanuel EJ. Healthcare, guaranteed: a simple, secure solution for America. New York: PublicAffairs, 2008:12-6.
Daschle T. Critical: what we can do about the health-care crisis. New York: Thomas Dunne Books, 2008:144, 204.
Medical News Today. Sen. Baucus hopes to introduce comprehensive health reform legislation this summer. March 5, 2009. (Accessed July 10, 2009, at
Garson A Jr, Engelhard CL. Health care half-truths: too many myths, not enough reality. Lanham, MD: Rowman & Littlefield, 2007:131-2.
DanielsComments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.
3781  Politics, Religion, Science, Culture and Humanities / Politics & Religion / I don't know *big* government can be defeated on: August 03, 2009, 09:14:16 AM
"The wild success" raves we are hearing all over the air waves about the cash for clunkers situation just goes to show how tax payers have no say in anything.
One guy is on cable this am saying he bought his car some years ago for $4K and traded it in with 220K miles for $4500.
I don't get it.  This is not monopoly money.  This is tax money going to give this guy a huge discount - more than the value of his car.

Why is there not outrage?

Why is there this glee in the media that this plan is great?

Am I missing something?

Of course people willl  rush for these deals if they can qualify for free funny money.

The greatness of the US is over folks.
3782  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: July 31, 2009, 10:04:26 AM
"And providers could be paid an annual fixed fee for the primary care of an individual and a separate fixed fee for the treatment of a specific condition"
Hospitals are already paid by Medicare this way. It is called the diagnostic related groups.
As for providers our reimbursements have continually gone down for years.
The incentive for doctors is to see more patients if you are a thinking type doctor and do more procedures if that is how you get paid.
I am not sure how up front or say yearly payments to treat overall conditions would work.
Certainly the incentive is then to do less.
Is that good?  I don't know.
3783  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / correction on: July 29, 2009, 10:44:32 AM
I owe Friedman an apology.
Katherine tells me I mixed up Kelly Clarkson with Carrie Underwood who was the one who was "inducted" into the Gran Ole Opry.
My correction noted.  As for Clarkson, Katherine believes her lyrics were oddly like words she wrote and disappeared from her possesion (the same is believed for Underwood).  Perhaps that was the whole modus oper. behind Clarkson's suddenly deciding to "write her own songs".  Someone simply got her the songs and a deal was made.  It is possible Davis knew they stunk and after they proved to be bombs then said more or less, "I told you so".

Many of the lyrics are not that great.  It appears that when the crooks run low on material they start using the less good lyrics.
It only takes one really good set of lyrics out of ten songs to get one over the top.
And one never knows.  Songs thought to not be likely to sell sometimes do.

3784  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / Roger Friedman has no clue what he is talking about on: July 28, 2009, 04:39:57 PM
Friedman talks like he has the inside scoop.  This guy has no clue.  The reason Clarkson went to country is that is where the songs were.  Now there are none left so she goes back to pop.
He claims she can't write yet she was let into the Grand Ole Opry.  She was one of the biggest stars while she did her songs that I allege the lyrics were Katherine's.  Friedman, the dupe doesn't even mention this.  He just says she learned her lesson and is running back home to grand daddy Clive.  Is this what Clive has told him from the "inside".

Friedman are you that stupid or are you part of the scam:

By Roger Friedman

Kelly Will Go Back to Pop for Next Album

Kelly Clarkson gets the picture, finally.

There was no bucking the system, and no going against Clive Davis. Sources tell me that Clarkson has agreed, through her wise new manager Narvel Blackstock, to make a pop album for release in 2008 with songs selected by Davis and his team.

Clarkson's acquiescence comes at the end of a long melodrama concerning her current, turgid album "My December," which features a lot of ragged self-penned songs by Clarkson about a relationship gone sour.

Davis didn't like the album, considering it was the follow up to Clarkson's multimillion selling "Breakaway." But he released it, and Clarkson responded by dissing him and then apologizing earlier this week.

In the meantime, "My December" is sort of free-floating away now, and will probably sell a respectable 850,000 copies in the U.S. and maybe the same worldwide.

Clarkson gets points for trying out her chops as a songwriter, but demerits for not following anyone's advice, trying to take on the record industry's most astute executive maybe of all time and acting like a 25-year-old (which is, in fact, her age.)

The news about Clarkson's next move came Thursday during the annual UJA Federation lunch at which Davis was honored. Everyone in the biz was there — the room was so packed that there was little space between the tables for waiters to maneuver or for good schmoozing.
3785  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / Re: Music on: July 28, 2009, 04:32:51 PM
Clarkson has the lead name as writer of this song.  I allege she didn't write it.  My wife did.  Clarkson moved to the country scene because that WAS where the songs were.  Now they can't get songs she is going back to pop.
Despite her name on it she of course blames another writer whose name is on it.
I allege she is lying.  She didn't write the lyrics to the song, she can't wirte hit songs.
She is a bs artist.
That is my belief.  Now that we stopped them from stealing (for now) Katherine's lyrics by keeping her mother away you will see country songs drop off a cliff.  the country stations are keeping the radio/cable stations going by releasing new videos from songs that were not lead songs from previous albums from at least 6 months to even years ago.  Most people would not necessarily notice these are videos to songs that came out from older albums.  They make it look like they are brand new songs.
Where are all the songs from the dozens of writers out of Texas and Nashville???

****Kelly Clarkson says she isn't a rip-off artist despite having the same song as Beyonce
BY Nicole Carter

Tuesday, July 28th 2009, 1:57 PM

Boyd/Michael Ochs Archives/Getty; Winter/Getty
Kelly Clarkson is doing everything she can to explain she isn't ripping off of Beyonce.

Related News
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It's true: Kelly Clarkson's new single "Already Gone" sounds a lot like Beyonce's "Halo."

But Clarkson is doing everything she can to explain she isn't a rip-off artist.

After speculation that the "American Idol" winner had copied the R&B diva's power ballad, Clarkson claimed it's actually her co-writer Ryan Tedder- who consequently wrote Beyonce's tune- that's to blame.

"We wrote about six songs together, four or five of them made the album," Clarkson said on Canada's CBC radio earlier this week. "I"d never heard of a song called ‘Halo.' Her album came out when my album was already being printed."

And the 27-year-old doesn't hold back her feelings about getting, well, screwed.

"It sucks, but it"s one of those things I have no control over. I already made my album. At this point, the record company can do whatever they want with it," she added.

Clarkson has also said she "fought and fought" to prevent the song from ever going public.

The pop star knew what her fans would think.

"No-one"s gonna be sittin" at home, thinking ‘Man, Ryan Tedder gave Beyonce and Kelly the same track to write to." No, they"re just gonna be saying I ripped someone off."

Beyonce has yet to comment on the situation.****
3786  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / Gretchen Wislon reported Genius dumped on: July 28, 2009, 04:23:28 PM
Now we finally stopped them from stealing songs (I allege) she can't write her own - like she fasely claimed she ever did.
In any case she's got nothing left but cover songs:

Gretchen Wilson, Sony Music Nashville part waysThe Associated Press
Posted: 07/28/2009 02:33:15 PM MDT

NASHVILLE, Tenn.—"Redneck Woman" Gretchen Wilson and her longtime record label, Sony Music Nashville, have parted.
Sony announced the split Tuesday, describing it as a mutual decision.

Wilson shot to fame with her 2004 smash "Redneck Woman." Her debut album, "Here For the Party," sold 5 million copies.

Her next two albums for Sony—2005's "All Jacked Up" and 2007's "One of the Boys"—reached No. 1 but didn't sell nearly as well as her debut and produced only one Top 10 single between them.

Sony says in a statement that while Wilson will no longer record for the label as a solo artist, both parties look forward to working together on catalog projects.

Wilson was not immediately available for comment.

3787  Politics, Religion, Science, Culture and Humanities / Politics & Religion / California on: July 28, 2009, 11:31:49 AM
Solution is simple.  A 95% tax on all those in the entertainment industry - music, cinema, TV, networks, actors, sports, etc.
It's time they start doing their "fair share" instead of bossing the rest of us to cough it up.

****Schwarzenegger likely to veto social programs
Jul 28, 3:41 AM (ET)

(AP) Gov. Arnold Schwarzenegger talks with his staff about potential line-item vetos while going over...
Full Image
SACRAMENTO, Calif. (AP) - Gov. Arnold Schwarzenegger on Tuesday is expected to use his line-item veto power to make additional cuts to the California's latest spending plan - a move advocates fear could hurt the poor.

Social service advocates worry the Republican governor has little choice but to go after money counties receive to administer welfare and social service benefits. Likely targets include welfare-to-work assistance, in-home support, foster care and health insurance for poor families.

With much of state spending tied up by federal and constitutional requirements, the Schwarzenegger administration believes more cuts are necessary to provide a cash cushion for the state in case of emergencies such as earthquakes and wild fires.

"I just want to assure everyone that we will build up our reserve. We will make the necessary cuts," the governor said Friday in announcing he'll sign the budget passed by the Legislature.

(AP) Gov. Arnold Schwarzenegger talks with his staff about potential line-item veto's while going over...
Full Image
The governor and lawmakers had planned for a reserve in the revised budget, but the Assembly rejected two measures - raiding local transportation funds and authorizing additional oil drilling - that would have brought $1.1 billion to the state.

The governor's spokesman, Aaron McLear, said Schwarzenegger will try to fill that $1.1 billion but isn't expected to cut by that much. He declined to release details.

"We will always be in a position to aggressively respond to disasters," McLear said.

Advocates view additional cuts to social programs as another blow since the Schwarzenegger administration has reduced benefits in response to the recession.

California's economy has been hit by the housing market slump and high unemployment, and the latest efforts to close a $26 billion shortfall, just five months after lawmakers and the governor ended months of negotiations to close a previous $42 billion deficit.

Under the budget the governor will sign Tuesday, the state will impose tougher sanctions on CalWORKS recipients who don't meet work requirements. And in-home support workers will have to undergo background checks and have their fingerprints taken.

In earlier rounds of cuts, California lowered Medi-Cal reimbursement rates for health care providers and eliminated optional benefits such as dental and eye care for adult recipients.

"Why further punish children, low-income families, and the aged and disabled because the Legislature did not approve borrowing gas tax revenue?" said Frank Mecca, executive director of the County Welfare Directors Association of California.

Once Schwarzenegger signs the budget, his finance team is expected to begin briefing the state treasurer and controller, creditors and analysts on how the latest spending plan will impact day-to-day cash flow.

The governor and lawmakers are hoping their latest plan provides the assurance lenders need for the state to take out loans and stop issuing IOUs to thousands of vendors. Representatives for the treasurer and controller said it would take a few more days after that to assess the state's borrowing needs and decide whether California can stop issuing IOUs.

Matt Fabian, a bond analyst at Municipal Market Advisors, based in Concord, Mass., said the plan was filled with accounting tricks and will likely do little to improve the state's poor credit rating.

Fitch Ratings placed at California's general obligation bond debt at BBB. Most states have a AAA or AA rating.***
3788  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Clinton prepares to jump from the SS Obamatanic on: July 27, 2009, 06:18:05 PM
"We are going to do everything we can to prevent you (Iran) from getting a nuclear weapon. Your pursuit is futile"
Perhaps the guy from N Korea is right.  Not only does she look like a clown she sounds like one.

3789  Politics, Religion, Science, Culture and Humanities / Politics & Religion / backroom deals on: July 27, 2009, 05:51:24 PM
We always hear about the back room deal making among our legislators.

Maybe there should be some transparancy about the stuff behind the scenes.

Why should not a congressman not be able to vote his beliefs or conscience and not have his arm twisted, his pocket lined, or threatened, or cojoled, or paid off in some way to vote the party line?

Or is that an oxymoron?
3790  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: July 27, 2009, 09:54:42 AM
So why is the original BC kept from pulbic viewing?

And as for the birth announcement does anyone know how they get into the paper in 1947.  From hospital records or does simply the mother send a note to the paper annoucing birth in which case this is not there fore proof but circumstantial evidence?

Say he was born before his mother returned to the US.  Would it not be reasonable for her to call the paper after they get here and make an annoucement?

I am not yet convinced.
3791  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Philli police on: July 25, 2009, 11:44:06 AM
Interesting you say Phila.
I remember going to a wedding with a friend and driving through Phila sometime around 1979 or so.
I didn't even notice but I guess I drove through a light that was turning red and didn't get to the other side of the intersection in time.
We were stopped by a Black policeman.

My friend warned me to be polite and not to mess with the Phila police.  He was very clear about this.
They had a reputation of being tough.

The officer was polite and did the usual ID check.
My white friend and I were dressed up and had gift boxes in the back seat on the way to the wedding and we explained that, and I apologized.

And that was it.  Happy ending and otherwise boring story.

The officer was actually OK.  He accepted my apology, could plainly see the gifts in the back seat and we were in suits and ties and let us off with a warning.
I never thought much of it and still don't, but could this have been reverse profiling?

3792  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Pompous hypocracy is rampant. on: July 25, 2009, 09:37:22 AM
Just for argument sakes.

Chuck Schumer made a statement that doctors should make no more than 80K a year.
Sure that is of course because we should be all about caring for our fellow men.
If that is his argument lawyers who require far less schooling should make no more than 40K per year.
Everyone knows they should be *in* law profession to protect the legal rights of all.
Afterall they are there to uphold justice, and our "legal rights".

Additionally the media should stop corrupting our politicians who have to raise obscene amounts of money to pay for obscene costs of advertising.
The politicians who are in "public service" to better the lives of all Americans and our way of life should stop cashing in by writing or at least profiting from books, speeches, working as pundits, getting jobs at hedge funds, lobbyists the minute they leave office.

Working in pulbic office has now become a roadmap to "richdom".

Teachers, police officers, firemen, and other government employees should stop accepting pensions, and other benefits after they stop working since of course they are doing what they do to better and protect mankind.

Can I go on.

My message is clear.

3793  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: July 24, 2009, 01:28:23 PM
Kind of interesting isn't it that BO's comments over the Gates Crowley flap stirred up the emotions of so many.
It was OK for him to circumvent the globe insulting the United States and the previous President without hardly a peep except from rightest radio and Fox. 

But offend a policeman and suddenly we have a whole new ballgame.

Here we go again with the races taking sides like they did with OJ.

3794  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Political Economics on: July 24, 2009, 08:50:57 AM
Does this seem stupid or what?  Federal money to help people buy cars, and of course stimulate Governement Motors.
Hopefully the majority of non Dem diehard Americans are waking up to how we are being screwed over by the radicals in government.
The joke is on us:

Friday, July 24, 2009
$1 billion 'Cash for clunkers' program to kick off Monday
David Shepardson / Detroit News Washington Bureau
Washington -- The National Highway Traffic Safety Administration will release a final regulation today, clearing the way for the launch of the $1 billion federal "Cash for Clunkers" program.

The program gives buyers of new, more fuel-efficient vehicles up to $4,500 in government rebates to turn in cars and trucks up to 25 years old that in most instances get less than a combined highway/city fuel efficiency of 18 miles per gallon.

NHTSA's final rule will explain the process for registering dealers, the manner in which dealers will be reimbursed for eligible transactions, the requirements and procedures for disposing of trade-in vehicles, and the means for enforcing the program's requirements. NHTSA is working to guard against fraud, but also to ensure prompt payment.


Transportation Secretary Ray LaHood will kick off the program on Monday with an event at the department's headquarters that will include fuel-efficient vehicles from major manufacturers and some members of Congress.

Charles Territo, a spokesman for the Alliance of Automobile Manufacturers, the trade group representing General Motors Co., Ford Motor Co., Chrysler Group LLC, Toyota Motor Corp. and six other automakers, said the program should help customers with the purchase of about 250,000 vehicles. But once the money runs out, there is no guarantee that Congress will approve more funds.

Similar programs -- though typically less restrictive -- in other countries have dramatically boosted auto sales.

Chrysler Group LLC has offered to match the $4,500 government rebate with its own $4,500 rebate on new vehicles. Chrysler's rebate also applies to people buying new cars who don't qualify for the government rebate.

The federal program ends Nov. 1 even if consumers haven't exhausted the rebates. The vouchers apply only to new vehicles that cost $45,000 or less, and consumers must have owned the driveable clunkers for the past year.

3795  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Israel, and its neighbors on: July 22, 2009, 12:16:55 PM
Well today's headlines are a final "explanation point" to BO's policies all along.
Remember when McCain said he would be Hamas and Hezbollah's worst nightmare and BO said we need to meet, hug and kiss them more or less.
I keep reading how politicians, military personel state how it would be a "disaster" or catastrophe" if we, or Israel were to use military force against Iran to slow or halt their nuclear weapons persuit.  Not one ioda that if Isreal were laid to waste by a nuclear attack that that would be a disaster. 
It is clear to me that those in power today have decided it is more in the US interest to risk annhilation of Israel than use war with Iran.  People who are not Jewish who otherwise don't care about Jews, do have an argument that Israel is not enough of a major player that it would be worth it to the US.  I can't rationally deny that. 
As a Jew I hate the thought.  As a Jew I will feel sorry for the 80% of Jews who gave up their fellow Jews to vote for a liberal who made his intentions know throughout his life.  For them to say now they are surprised that Bo is siding more with the Jew haters than the Jews is hypocricy.  It is and was obvious.

We can only hope for some sort of political change in Iran before it is too late.
If only we allowed our oil companies to drill for off shore oil off the continental US 5 or 10 years ago we wouldn't be as much at the mercy of foreign oil.  All the darn windmills, corn, solar panels covering the entire midwest won't solve our problems any time soon.
The environementalist have won.  And we have lost.  And indirectly it hurt the Jews in Israel.  The risk of flow of oil throught the Persain gulf is obviously one factor that is being considered in siding against military force against Iran.

Just my arm chair thoughts on today's Drudge headlines:

  Secretary of State Hillary Clinton on Wednesday stirred Israeli fears that Washington would accept a nuclear armed Iran when she raised the idea of a US "defence umbrella" for Gulf allies.
However, Clinton, during a visit to Thailand for an Asian security conference, said later that she was not announcing a new policy and simply wanted to turn Iran away from pursuing a nuclear weapon.

Clinton told Thai television in Bangkok that President Barack Obama's administration was still open to engage Iran in talks about its nuclear programme but warned that Tehran would not be safer if it obtains a bomb.

"We will still hold the door open" to talks over its nuclear program Clinton said.

"But we also have made it clear that we will take action, as I've said time and time again, crippling action, working to upgrade the defence of our partners in the region," she said.

Her previous references to "crippling action" have referred to sanctions.

"We want Iran to calculate what I think is a fair assessment: that if the US extends a defence umbrella over the region, if we do even more to support the military capacity of those in the Gulf, it is unlikely Iran will be any stronger or safer," Clinton said.

"They won't be able to intimidate and dominate as they apparently believe they can once they have a nuclear weapon."

In Jerusalem, Israeli Intelligence Services Minister Dan Meridor criticised her remarks.

"I heard without enthusiasm the American declarations according to which the United States will defend their allies in the event that Iran uses nuclear weapons, as if they were already resigned to such a possibility," he said.

"This is a mistake," Meridor said. "We cannot act now by assuming that Iran will be able to arm itself with a nuclear weapon, but to prevent such a possibility."

Clinton made her initial comments during a recording for a Thai television show before heading to Asia's largest security forum in the Thai resort island of Phuket, where talks were expected to focus on possible nuclear links between North Korea and Myanmar.

Speaking at a press conference in Phuket later, Clinton suggested her remarks were misunderstood.

"I'm not suggesting a new policy. In fact we all believe that Iran's pursuit of nuclear weapons is unacceptable, and I've said that many times," she said.

"I'm simply pointing out that Iran needs to understand that it's pursuit of nuclear weapons will not advance its security or achieve its goals of enhancing its power regionally and globally," she said.

"The focus that Iran must have is that it faces the prospect -- if it pursues nuclear weapons -- of sparking an arms race in the region," she said.

"That should affect a calculation of what Iran intends to do and what it believes is in its national security interest because it may render Iran less secure, not more secure," she said.

US lawmakers on Monday stepped up pressure on Obama to ready tough new economic sanctions on Iran in the event Tehran fails to freeze its uranium enrichment programme by late 2009.

Iran, labouring under UN sanctions for its defiance, has rejected the West's charges that it seeks nuclear weapons under cover of a civilian atomic energy program.

Obama has said he wants a diplomatic solution to the standoff but has repeatedly warned that he has not ruled out the use of force.

3796  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: July 21, 2009, 04:15:51 PM
The implication is that this is some sort of scandal.
600 million doses at a cost of 2.6 billion.  Isn't that cheap - ~$4 a dose.
What does it cost to drive the tunnel from NJ to NYC - 10 dollars for the port authority tax?  Ten dollars to drive into NYC???!!!
What is the tax on a single pack of cigarettes?
So why are the pharmaceutical companies not entitled to ~4 bucks for a squirt of influenza vaccine?

****Drug groups to reap swine-flu billions
By Andrew Jack in London

Published: July 20 2009 19:40 | Last updated: July 20 2009 23:43

Some of the world’s leading pharmaceutical companies are reaping billions of dollars in extra revenue amid global concern about the spread of swine flu.

Analysts expect to see a boost in sales from GlaxoSmithKline, Roche and Sanofi-Aventis when the companies report first-half earnings lifted by government contracts for flu vaccines and antiviral medicines.

In depth: Swine flu - Apr-28Health Blog: The advice about swine flu - Jul-21Date put on school swine flu decision - Jul-20WHO backlog hampers swine flu battle - Jul-21Swine flu warning to pregnant women - Jul-19UK braces for 100,000 swine flu cases a day - Jul-03The fresh sales – on top of strong results from Novartis of Switzerland and Baxter of the US, which both also produce vaccines – come as the latest tallies show that more than 740 people have died from the H1N1 virus, and millions have been affected around the world.

GlaxoSmithKline of the UK confirmed it had sold 150m doses of a pandemic flu vaccine – equivalent to its normal sales of seasonal flu vaccine – to countries including the UK, the US, France and Belgium, and was gearing up to boost production.

GSK also produces Relenza, an antiviral medicine that reduces the length and severity of the infection, and is preparing to increase manufacturing towards 60m annual doses. The UK placed an order for 10m treatments this year.

One beneficiary of the fears about the pandemic has been Roche of Switzerland, which sells Tamiflu, the leading antiviral drug, and has seen a sharp rise in orders from private companies as well as governments.

A report last week from JPMorgan, the investment bank, estimated that governments had ordered nearly 600m doses of pandemic vaccine and adjuvant – a chemical that boosts its efficacy – worth $4.3bn (€3bn, £2.6bn) in sales, and there was potential for 342m more doses worth $2.6bn.

It forecast that fresh antiviral sales could boost sales for GSK and Roche by another $1.8bn in the developed world, and potentially up to $1.2bn from the developing world.

But there were also uncertainties for the pharmaceutical manufacturers. With demand likely to outstrip supply, and initial production suggesting that the yield for the pandemic vaccine is relatively low, they may face difficult choices in determining how much to supply to the countries seeking orders.

They are also under pressure to provide more drugs and vaccines for free, or extremely cheaply, to the developing world.
Copyright The Financial Times Limited 2009

3797  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: July 20, 2009, 02:07:38 PM
I can't wait till he crashes in the polls.
I can't wait to see that strut and pompous grin wane.
I can't wait to see the crats go after Cheney, the CIA.
I do hope we get a huge repudiation of their socialistic idealogy.
I can only hope.

That said the repubs still need better and clearer application of conservative values to todays problems in my view.
3798  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Wow on: July 20, 2009, 09:32:20 AM
RASMUSSEN 2012 poll released at 10:30AM ET

Obama 45% Romney 45%
Obama 48% Palin 42%

3799  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Political Rants on: July 18, 2009, 08:36:49 AM
Just for argument sake:
If W was still president and Goldman execs were giving themselves and their employees 12 billion in bonuses after all this would you think the msm would be almost completely silent about this?

I don't hear the left protesting us now that we have the Bama.
I don't hear the right speaking out about this since of course this is just an example capitilism.
Now that's said and out of the way it is obvious to me the rest of the country was robbed.
We were robbed EOM.
3800  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Rules of the Road/Fire Hydrant on: July 17, 2009, 12:06:30 PM
I don't know if I irritated him but I appreciated his opinions.
The diversity of opinions is better.
Hopefully he will reconsider and return.
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