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Are you sure you want to open that can of worms? The public debate here in the US has not been very thoughtful. Mostly one side trying to scare the other, and both making questionable arguments. I will apologize in advance if my comments sound partisan, they sound reasonable to me. We are in the weakest economy in my lifetime, so now is not the right time to make such a huge expansion to entitlement spending, without adequately considering "costs". It is not sustainable to borrow money to pay recurring expenses, so this will require a significant expansion of taxation. Despite claims that the opposition is devoid of ideas, here are a few. --Tort reform. Reducing risk of career ending malpractice lawsuits will not only reduce malpractice insurance, but there are estimates of significant wasteful spending on unneeded tests and procedures just to cover the doctors posterior.-Rationalized tax treatment- Employer paid heath insurance gets different tax treatment than individual health insurance, this should be leveled.- Open up health insurance to competition across state lines. While there is an issue with the commerce clause in the constitution, car insurance is open and competitive so it can obviously be done. - Level drug prices- I am getting a little tired of subsidizing the rest of the world's drug costs. Legislation saying that drug companies can't sell the same drug cheaper elsewhere would likely raise drug costs in other countries, while dropping them here. (sorry folks).-Expand HSA- Private managed health accounts combined with high threshold catastrophic insurance introduces more market forces into self managed healthcare which will reduce wasteful spending on procedures. - there are plenty of other details to clean up.. Drug companies should not be allowed to pay generic drug makers to "not" make cheaper drugs. Drug companies shouldn't be allowed to subsidize co-pays which reduces the influence of co-pays on patient choices. Hospitals shouldn't be able to charge individuals more if they don't have insurance, but this is very conflicted as medicare only compensates hospitals at roughly 80% of their actual cost so the money must come from others. The whole one payer system is horribly distorted and doesn't need to be made bigger and stronger. FWIW Germany has universal coverage with private insurance and private healthcare delivery. Domestic health insurance companies waste 20-30% of every dollar spent on administration. While admittedly medicare only losses some 3% to administration, the private German system is something like 5.5% which is several times better than we get now, and not government run. There are IMO better solutions than what we are being offered. I get most angry when the party in power, claims the opposition has no alternative plan. That is just majority party politics as usual (actually remarkably effective politics so not that usual). Rather than a broad sweeping (very expensive) change now, I advocate smaller incremental improvements more focussed on reducing costs, and expanding availability, than increasing spending and government control. Of course I could be wrong... /end rant/JROn Sep 9, 2009, at 9:00 AM, Francesca Skelton wrote: Up to now we haven't had any discussion on the U.S. President's health care initiative which is a major issue here in the States. I'd be interested in hearing pros and cons from this very intelligent group we have. I'd especially like to have input form our members living in other countries where the health care system is working better than here in the U.S. (where actually it isn't working very well at all). Thanks in advance for any input on this subject.

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Thanks . I guess I’ve already opened the can.

The problem was brought home to me personally when the doctor we’ve been using for longer than I can remember, suddenly stopped taking our insurer (who is Blue Cross – just about the biggest insurer in the U.S.). She says that they were reimbursing her less and less every year until finally she said “enough”. We here at my house have the choice of either choosing another primary care physician who takes our insurance, (even though we are happy with the doc we have) – or paying her fee out of pocket, something we can afford but would prefer that our very pricey insurance take care of (or else what good is it?). Fortunately as problems go, it could be a lot worse – we could be unable to afford that choice, and nobody in this house (knock wood) is seriously ill at a time when we might be changing to a doc unknown to us.

I can’t fathom what happens to the many less fortunate who can’t afford insurance, and the other health care dilemmas that our high cost system burdens us with.

There seems to be a correlation with health issues and the economy i.e. Health care costs are bankrupting individuals and small businesses in some instances, especially if a family or individual has a health care crisis, major illness, or needs nursing care.

On 9/9/09 10:53 AM, " " <robertsjohnh@...> wrote:

Are you sure you want to open that can of worms?

The public debate here in the US has not been very thoughtful. Mostly one side trying to scare the other, and both making questionable arguments. I will apologize in advance if my comments sound partisan, they sound reasonable to me.

We are in the weakest economy in my lifetime, so now is not the right time to make such a huge expansion to entitlement spending, without adequately considering " costs " . It is not sustainable to borrow money to pay recurring expenses, so this will require a significant expansion of taxation.

Despite claims that the opposition is devoid of ideas, here are a few.

--Tort reform. Reducing risk of career ending malpractice lawsuits will not only reduce malpractice insurance, but there are estimates of significant wasteful spending on unneeded tests and procedures just to cover! the doctors posterior.

-Rationalized tax treatment- Employer paid heath insurance gets different tax treatment than individual health insurance, this should be leveled.

- Open up health insurance to competition across state lines. While there is an issue with the commerce clause in the constitution, car insurance is open and competitive so it can obviously be done.

- Level drug prices- I am getting a little tired of subsidizing the rest of the world's drug costs. Legislation saying that drug companies can't sell the same drug cheaper elsewhere would likely raise drug costs in other countries, while dropping them here. (sorry folks).

-Expand HSA- Private managed health accounts combined with high threshold catastrophic insurance introduces more market forces into self managed healthcare which will reduce wasteful spending on procedures.

- the! re are plenty of other details to clean up.. Drug companies should not be allowed to pay generic drug makers to " not " make cheaper drugs. Drug companies shouldn't be allowed to subsidize co-pays which reduces the influence of co-pays on patient choices. Hospitals shouldn't be able to charge individuals more if they don't have insurance, but this is very conflicted as medicare only compensates hospitals at roughly 80% of their actual cost so the money must come from others. The whole one payer system is horribly distorted and doesn't need to be made bigger and stronger.

FWIW Germany has universal coverage with private insurance and private healthcare delivery. Domestic health insurance companies waste 20-30% of every dollar spent on administration. While admittedly medicare only losses some 3% to administration, the private German system is something like 5.5% which is several times better than we get now, and not government run.

There are IMO better solutions than what we are being offered. I get most angry when the party in power, claims the opposition has no alternative plan. That is just majority party politics as usual (actually remarkably effective politics so not that usual).

Rather than a broad sweeping (very expensive) change now, I advocate smaller incremental improvements more focussed on reducing costs, and expanding availability, than increasing spending and government control.

Of course I could be wrong... /end rant/

JR

On Sep 9, 2009, at 9:00 AM, Francesca Skelton wrote:

Up to now we haven't had any discussion on the U.S. President's health care

initiative which is a major issue here in the States. I'd be interested in

h! earing pros and cons from this very intelligent group we have.

I'd especially like to have input form our members living in other countries

where the health care system is working better than here in the U.S. (where

actually it isn't working very well at all).

Thanks in advance for any input on this subject.

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In another unintended consequence, expansion of this single payer squeezing of healthcare providers by medicare is already steering new doctors away from geriatric care. So while the demographic trend is increasing demand market forces are chasing care providers away from that segment. In fact doctors in all the counties with socialized healthcare get significantly lower salaries, so I predict we will see more foreign doctors moving here in the future. I don't claim there are simple answers, and even socialized systems are suffering from similar demographic trends. Countries like Germany are adopting our co-pay technique to introduce modest market forces into demand. France who has been running a deficit for years is also trying to introduce market forces to reduce demand. Doctors are getting killed, not only by under reimbursement for medicare, but the paperwork hassle from insurance, which is probably not accidental. JROn Sep 9, 2009, at 10:33 AM, Francesca Skelton wrote: Thanks . I guess I’ve already opened the can. The problem was brought home to me personally when the doctor we’ve been using for longer than I can remember, suddenly stopped taking our insurer (who is Blue Cross – just about the biggest insurer in the U.S.). She says that they were reimbursing her less and less every year until finally she said “enough”. We here at my house have the choice of either choosing another primary care physician who takes our insurance, (even though we are happy with the doc we have) – or paying her fee out of pocket, something we can afford but would prefer that our very pricey insurance take care of (or else what good is it?). Fortunately as problems go, it could be a lot worse – we could be unable to afford that choice, and nobody in this house (knock wood) is seriously ill at a time when we might be changing to a doc unknown to us. I can’t fathom what happens to the many less fortunate who can’t afford insurance, and the other health care dilemmas that our high cost system burdens us with. There seems to be a correlation with health issues and the economy i.e. Health care costs are bankrupting individuals and small businesses in some instances, especially if a family or individual has a health care crisis, major illness, or needs nursing care. On 9/9/09 10:53 AM, " " <robertsjohnhbellsouth (DOT) net> wrote: Are you sure you want to open that can of worms? The public debate here in the US has not been very thoughtful. Mostly one side trying to scare the other, and both making questionable arguments. I will apologize in advance if my comments sound partisan, they sound reasonable to me. We are in the weakest economy in my lifetime, so now is not the right time to make such a huge expansion to entitlement spending, without adequately considering "costs". It is not sustainable to borrow money to pay recurring expenses, so this will require a significant expansion of taxation. Despite claims that the opposition is devoid of ideas, here are a few. --Tort reform. Reducing risk of career ending malpractice lawsuits will not only reduce malpractice insurance, but there are estimates of significant wasteful spending on unneeded tests and procedures just to cover! the doctors posterior. -Rationalized tax treatment- Employer paid heath insurance gets different tax treatment than individual health insurance, this should be leveled. - Open up health insurance to competition across state lines. While there is an issue with the commerce clause in the constitution, car insurance is open and competitive so it can obviously be done. - Level drug prices- I am getting a little tired of subsidizing the rest of the world's drug costs. Legislation saying that drug companies can't sell the same drug cheaper elsewhere would likely raise drug costs in other countries, while dropping them here. (sorry folks). -Expand HSA- Private managed health accounts combined with high threshold catastrophic insurance introduces more market forces into self managed healthcare which will reduce wasteful spending on procedures. - the! re are plenty of other details to clean up.. Drug companies should not be allowed to pay generic drug makers to "not" make cheaper drugs. Drug companies shouldn't be allowed to subsidize co-pays which reduces the influence of co-pays on patient choices. Hospitals shouldn't be able to charge individuals more if they don't have insurance, but this is very conflicted as medicare only compensates hospitals at roughly 80% of their actual cost so the money must come from others. The whole one payer system is horribly distorted and doesn't need to be made bigger and stronger. FWIW Germany has universal coverage with private insurance and private healthcare delivery. Domestic health insurance companies waste 20-30% of every dollar spent on administration. While admittedly medicare only losses some 3% to administration, the private German system is something like 5.5% which is several times better than we get now, and not government run. There are IMO better solutions than what we are being offered. I get most angry when the party in power, claims the opposition has no alternative plan. That is just majority party politics as usual (actually remarkably effective politics so not that usual). Rather than a broad sweeping (very expensive) change now, I advocate smaller incremental improvements more focussed on reducing costs, and expanding availability, than increasing spending and government control. Of course I could be wrong... /end rant/ JR On Sep 9, 2009, at 9:00 AM, Francesca Skelton wrote: Up to now we haven't had any discussion on the U.S. President's health care initiative which is a major issue here in the States. I'd be interested in h! earing pros and cons from this very intelligent group we have. I'd especially like to have input form our members living in other countries where the health care system is working better than here in the U.S. (where actually it isn't working very well at all). Thanks in advance for any input on this subject.

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Absolutely right about doctors steering away from geriatric care.

Many Doctors out right refuse to take medicare patients.

And the ones who do often don't provide good care.

One of mine did ridiculous office tests at every office visit.

(breathing tests, claiming I suffer from shortness of breath on walking...

even though I'm a runner....

plus 2 other tests for heart function at every office visit)

and having me come in every 3 months for these tests.

It's the only way to make money off medicare patients.

I stopped seeing that doctor.

I'm almost 70 years.

If I get sick and can't cure my self, I'm dead. Ann

Up to now we haven't had any discussion on the U.S. President's health care initiative which is a major issue here in the States. I'd be interested in h! earing pros and cons from this very intelligent group we have. I'd especially like to have input form our members living in other countries where the health care system is working better than here in the U.S. (where actually it isn't working very well at all). Thanks in advance for any input on this subject.

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JR: you are a stitch. So this is the “simply put” short version?

On 9/9/09 4:05 PM, " jwwright " <jwwright@...> wrote:

I could write a ton of words, but simply put, people must react to meet

their $ obligations. The gov't does NOT.

Let's not confuse economic decisions with HC. The gov't will spend too much

and the deficit will increase the rest of our lives whether they provide

more HC or not. They deficit is NOT important.

I had to drop my company sponsored insurance because it got too high, and I

found I could manage that 982$ per month better then they. I saved 500$ per

month going to AARP sponsored Part D.

I saved even more by buying " cheaper " drugs.

Today I have witnessed a 17 yo unwed getting complete care for her and her

baby, graduating from HS with her class and will go to college with a $

grant. The gov't might help with the 16 yo illiterate fathers with no sign

of a job, but I doubt it. HC has to start in the school system and be

integrated, especially in places like TX where the schools are ISDs not

subject to Fed, state or county laws.

Not subject because those who would set a req't must provide the money to do

it, else the low class school has no funding other than the low class

district they school.

The 17 yo literally, has no way to get out pof her environamnt except

getting pregnant. Then there are options. Before that there are no agencies

she can appeal to. She can't walk into a police station and say the men

where I live are screwing me and I need a place to live.

So do I want the gov't to send a billion $ to Polk county - hell no, they

first reduce all the land taxes.

OTOH, I would love to see a systemetized HC system, so a vet doesn't hafta

travle 135 miles passing the world largest cancer hospital.

So the first 69.3 B is already allocated starting 2010, and the args are

after the $.

The first thing is to STUDY the problems. That 69.3 B will not fix anything

next year.

Look up TMC or any large state and start making a list of all the hospitals.

There are thousands - hopsitals , not clinics, or Dr offices.

I dare say the prinout will be 8 " tall.

But that's where I'd start if I were allocted the analysis job.

WRONG APPROACH.

The hospitals are already working the problems. No one is refused HC, but

the ER's are sometimes packed with people seeking routine care.

So fund a clinic for routine care.

IOW, add a facility where there is a problem, don't try to reinvent the

wheel. And make the counties responsible if you're going to give counties

money.

It's like fixing a human body from a wreck, stop the bleeding, a few

stitches/a cast to heal the body to well enough to operate. Then fix the

remaining problems.

Most of all, those that get that free health care, EXPECT THEM to

participate in the process - give them a job dragging in the drunks off the

street, etc.

FORCE them the live in the system, rather than take advantage of it.

HC is to be a mjaor major economy for th U.S. if we can figure out how to do

it.

And if someone walks in, BMI 44, complaining of fatigue work it off him.

Regards

Re: [ ] Health Care.. oh-oh

Thanks . I guess I've already opened the can.

The problem was brought home to me personally when the doctor we've been

using for longer than I can remember, suddenly stopped taking our insurer

(who is Blue Cross - just about the biggest insurer in the U.S.). She says

that they were reimbursing her less and less every year until finally she

said " enough " . We here at my house have the choice of either choosing

another primary care physician who takes our insurance, (even though we are

happy with the doc we have) - or paying her fee out of pocket, something we

can afford but would prefer that our very pricey insurance take care of (or

else what good is it?). Fortunately as problems go, it could be a lot

worse - we could be unable to afford that choice, and nobody in this house

(knock wood) is seriously ill at a time when we might be changing to a doc

unknown to us.

I can't fathom what happens to the many less fortunate who can't afford

insurance, and the other health care dilemmas that our high cost system

burdens us with.

There seems to be a correlation with health issues and the economy i.e.

Health care costs are bankrupting individuals and small businesses in some

instances, especially if a family or individual has a health care crisis,

major illness, or needs nursing care.

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Share on other sites

I could write a ton of words, but simply put, people must react to meet

their $ obligations. The gov't does NOT.

Let's not confuse economic decisions with HC. The gov't will spend too much

and the deficit will increase the rest of our lives whether they provide

more HC or not. They deficit is NOT important.

I had to drop my company sponsored insurance because it got too high, and I

found I could manage that 982$ per month better then they. I saved 500$ per

month going to AARP sponsored Part D.

I saved even more by buying " cheaper " drugs.

Today I have witnessed a 17 yo unwed getting complete care for her and her

baby, graduating from HS with her class and will go to college with a $

grant. The gov't might help with the 16 yo illiterate fathers with no sign

of a job, but I doubt it. HC has to start in the school system and be

integrated, especially in places like TX where the schools are ISDs not

subject to Fed, state or county laws.

Not subject because those who would set a req't must provide the money to do

it, else the low class school has no funding other than the low class

district they school.

The 17 yo literally, has no way to get out pof her environamnt except

getting pregnant. Then there are options. Before that there are no agencies

she can appeal to. She can't walk into a police station and say the men

where I live are screwing me and I need a place to live.

So do I want the gov't to send a billion $ to Polk county - hell no, they

first reduce all the land taxes.

OTOH, I would love to see a systemetized HC system, so a vet doesn't hafta

travle 135 miles passing the world largest cancer hospital.

So the first 69.3 B is already allocated starting 2010, and the args are

after the $.

The first thing is to STUDY the problems. That 69.3 B will not fix anything

next year.

Look up TMC or any large state and start making a list of all the hospitals.

There are thousands - hopsitals , not clinics, or Dr offices.

I dare say the prinout will be 8 " tall.

But that's where I'd start if I were allocted the analysis job.

WRONG APPROACH.

The hospitals are already working the problems. No one is refused HC, but

the ER's are sometimes packed with people seeking routine care.

So fund a clinic for routine care.

IOW, add a facility where there is a problem, don't try to reinvent the

wheel. And make the counties responsible if you're going to give counties

money.

It's like fixing a human body from a wreck, stop the bleeding, a few

stitches/a cast to heal the body to well enough to operate. Then fix the

remaining problems.

Most of all, those that get that free health care, EXPECT THEM to

participate in the process - give them a job dragging in the drunks off the

street, etc.

FORCE them the live in the system, rather than take advantage of it.

HC is to be a mjaor major economy for th U.S. if we can figure out how to do

it.

And if someone walks in, BMI 44, complaining of fatigue work it off him.

Regards

Re: [ ] Health Care.. oh-oh

Thanks . I guess I've already opened the can.

The problem was brought home to me personally when the doctor we've been

using for longer than I can remember, suddenly stopped taking our insurer

(who is Blue Cross - just about the biggest insurer in the U.S.). She says

that they were reimbursing her less and less every year until finally she

said " enough " . We here at my house have the choice of either choosing

another primary care physician who takes our insurance, (even though we are

happy with the doc we have) - or paying her fee out of pocket, something we

can afford but would prefer that our very pricey insurance take care of (or

else what good is it?). Fortunately as problems go, it could be a lot

worse - we could be unable to afford that choice, and nobody in this house

(knock wood) is seriously ill at a time when we might be changing to a doc

unknown to us.

I can't fathom what happens to the many less fortunate who can't afford

insurance, and the other health care dilemmas that our high cost system

burdens us with.

There seems to be a correlation with health issues and the economy i.e.

Health care costs are bankrupting individuals and small businesses in some

instances, especially if a family or individual has a health care crisis,

major illness, or needs nursing care.

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Well, really what do we DO about it?

I see these things from AARP to write the congressmen.

I reply to the AARP and find out THEY don not want to listen either.

We have no role in the decision making.

So what is the media hype for?

Not for me. We don't get to vote, even if we could understand the legalese in the bill.

I could institute HC for all in a heart beat - make every SS card a Medicare card.

Congress just has to worry paying for it (plus all the kickbacks), like every thing else they do.

Regards

Re: [ ] Health Care.. oh-ohThanks . I guess I've already opened the can.The problem was brought home to me personally when the doctor we've beenusing for longer than I can remember, suddenly stopped taking our insurer(who is Blue Cross - just about the biggest insurer in the U.S.). She saysthat they were reimbursing her less and less every year until finally shesaid "enough". We here at my house have the choice of either choosinganother primary care physician who takes our insurance, (even though we arehappy with the doc we have) - or paying her fee out of pocket, something wecan afford but would prefer that our very pricey insurance take care of (orelse what good is it?). Fortunately as problems go, it could be a lotworse - we could be unable to afford that choice, and nobody in this house(knock wood) is seriously ill at a time when we might be changing to a docunknown to us.I can't fathom what happens to the many less fortunate who can't affordinsurance, and the other health care dilemmas that our high cost systemburdens us with.There seems to be a correlation with health issues and the economy i.e.Health care costs are bankrupting individuals and small businesses in someinstances, especially if a family or individual has a health care crisis,major illness, or needs nursing care.

__________ NOD32 4389 (20090902) Information __________This message was checked by NOD32 antivirus system.http://www.eset.com

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Is this a Medicare advantage plan or company provided HI?

Regards

Re: [ ] Health Care.. oh-oh

Thanks . I guess I’ve already opened the can.The problem was brought home to me personally when the doctor we’ve been using for longer than I can remember, suddenly stopped taking our insurer (who is Blue Cross – just about the biggest insurer in the U.S.). She says that they were reimbursing her less and less every year until finally she said “enough”. We here at my house have the choice of either choosing another primary care physician who takes our insurance, (even though we are happy with the doc we have) – or paying her fee out of pocket, something we can afford but would prefer that our very pricey insurance take care of (or else what good is it?). Fortunately as problems go, it could be a lot worse – we could be unable to afford that choice, and nobody in this house (knock wood) is seriously ill at a time when we might be changing to a doc unknown to us.I can’t fathom what happens to the many less fortunate who can’t afford insurance, and the other health care dilemmas that our high cost system burdens us with. There seems to be a correlation with health issues and the economy i.e. Health care costs are bankrupting individuals and small businesses in some instances, especially if a family or individual has a health care crisis, major illness, or needs nursing care. On 9/9/09 10:53 AM, " " <robertsjohnhbellsouth (DOT) net> wrote:

Are you sure you want to open that can of worms? The public debate here in the US has not been very thoughtful. Mostly one side trying to scare the other, and both making questionable arguments. I will apologize in advance if my comments sound partisan, they sound reasonable to me. We are in the weakest economy in my lifetime, so now is not the right time to make such a huge expansion to entitlement spending, without adequately considering "costs". It is not sustainable to borrow money to pay recurring expenses, so this will require a significant expansion of taxation. Despite claims that the opposition is devoid of ideas, here are a few. --Tort reform. Reducing risk of career ending malpractice lawsuits will not only reduce malpractice insurance, but there are estimates of significant wasteful spending on unneeded tests and procedures just to cover! the doctors posterior.-Rationalized tax treatment- Employer paid heath insurance gets different tax treatment than individual health insurance, this should be leveled.- Open up health insurance to competition across state lines. While there is an issue with the commerce clause in the constitution, car insurance is open and competitive so it can obviously be done. - Level drug prices- I am getting a little tired of subsidizing the rest of the world's drug costs. Legislation saying that drug companies can't sell the same drug cheaper elsewhere would likely raise drug costs in other countries, while dropping them here. (sorry folks).-Expand HSA- Private managed health accounts combined with high threshold catastrophic insurance introduces more market forces into self managed healthcare which will reduce wasteful spending on procedures. - the! re are plenty of other details to clean up.. Drug companies should not be allowed to pay generic drug makers to "not" make cheaper drugs. Drug companies shouldn't be allowed to subsidize co-pays which reduces the influence of co-pays on patient choices. Hospitals shouldn't be able to charge individuals more if they don't have insurance, but this is very conflicted as medicare only compensates hospitals at roughly 80% of their actual cost so the money must come from others. The whole one payer system is horribly distorted and doesn't need to be made bigger and stronger. FWIW Germany has universal coverage with private insurance and private healthcare delivery. Domestic health insurance companies waste 20-30% of every dollar spent on administration. While admittedly medicare only losses some 3% to administration, the private German system is something like 5.5% which is several times better than we get now, and not government run. There are IMO better solutions than what we are being offered. I get most angry when the party in power, claims the opposition has no alternative plan. That is just majority party politics as usual (actually remarkably effective politics so not that usual). Rather than a broad sweeping (very expensive) change now, I advocate smaller incremental improvements more focussed on reducing costs, and expanding availability, than increasing spending and government control. Of course I could be wrong... /end rant/JROn Sep 9, 2009, at 9:00 AM, Francesca Skelton wrote:

Up to now we haven't had any discussion on the U.S. President's health care initiative which is a major issue here in the States. I'd be interested in h! earing pros and cons from this very intelligent group we have. I'd especially like to have input form our members living in other countries where the health care system is working better than here in the U.S. (where actually it isn't working very well at all). Thanks in advance for any input on this subject.

__________ NOD32 4389 (20090902) Information __________This message was checked by NOD32 antivirus system.http://www.eset.com

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