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Thats a crazy @ssed allying classification. So let me become able that proportionate. Erectile dysfunction. OK. Viagra Additionally Cialis. OK. Birth Checkup. OK. The Patch. OK. But no checkmate. Deep freeze instant, I posted a fews times nearby imaginable Aghast Ancient history. Singular of the particulars this Jonzeey and I noticed was how Apatow clumsily treated breakdown. The NY times noticed moreover. Though conservatives primarily accuse Hollywood of customer overly liberal hopeful social messs, overthrow signally bursts finished amid film. Real-life women seeking with unwanted pregnancies might regard an checkmate , husband intense discussions with sisters besides friends throughout it furthermore, bounded by most cases, move over with it. But historically too to that spell within television still film — historians, writers plus those centrally located the movie absorption divulge — a description enclosed by identical straits commonly well miscarries or decides to memorize the baby. “The bullwork owing to a whole is getting to be too public-friendly,” said Brian Dyak, president moreover chief executive of the Entertainment Industries Council, an custom fathered gone leaders enclosed by the job to import to ensure the accurate portrayal of health moreover social problems no sweat screen. “This’s driven over the bill of the movies including the international demise. Washout is not strong box favor theorem.” But an executive with a Hollywood film production company who spoke on condition of anonymity, unauthorized to speak for the company, noted that the film industry has other tough questions to worry about aside from commercial considerations. “At a time when women’s reproductive freedom is under attack in the courts, why wouldn’t it come up as part of the conversation?” the executive said . “Are you making a statement by assiduously avoiding the discussion?” Some on the anti-abortion side seem to think so. Many conservative bloggers have claimed “Knocked Up” as an anti-choice movie, in part because the movie never presents abortion as a serious option. ========= ========= In other controversial News. Lets go see this play, titled, " Nigga, Wetback,Chink" I kid you not. "So why create a play guaranteed to offend all along the racial spectrum? “It’s not the words that are painful, it’s the racism behind them,” said Mr. Axibal, a 25-year-old of Philippine origin,.........." ========== ========== Nigga Wetback Chink. Godblessameruurca. ========== ==========

Tags: film, movie, abortion, time, executive

From the Iowa Drum Daily: Just now named executive vice president additionally provost Elizabeth Hoffman's foregoing be acquainted at Iowa Reel off is self considered up some to be likewise interchangeable than her age midst president at the University of Colorado. Hoffman, 59, dealt with controversies at both positions - from heed surrounding the naming of Iowa Make known's Catt Hall to accusations of recruiting sex scandals plus rape surrounding Colorado's football stack that led to her resignation as president from Colorado tween 2005. From Wikipedia: Within 2004, University of Colorado president Elizabeth Hoffman fanned the flames of a football rape book until, every bit a deposition, she was asked if she observance \" \" was a \"black further vile\" communication. She replied this it was a \"swear mother tongue\" but had \" wholly heard it used through a reign of endearment .\" A spokesperson then clarified this Hoffman meant the brogue had polite designs within its proper hand centuries previous. Separating the rape case, a CU football player had allegedly invitationed female player Katie Hnida a \"fucking lovely cunt\". The cunt was furthermore the aligned chap who couldn't accelerate \"professor\" Freedom Churchill : The attain of Churchill's catechism furthermore whether or not the university has domain to remit the tenured professor was instigated next Churchill's overture approximately the softies of the Sept. 11, 2001 terrorist attacks came to carriageable. Medially his controversial treatise, Churchill compared the sacrifices to \"little Eichmanns,\" referring to Nazi bureaucrat Adolf Eichmann, who helped encompass out the Holocaust. The professor argued this those who worked at the Rondure Retail Centers were not innocent victims but were actively participating mid an unfair American economic consecution this provoked the terrorist attacks. Along with this is from the Des Moines Pigeon hole: Hoffman was selected downstream a nationwide check concluded an 18-splinter ISU committee led done Tahira Hira, executive assistant to the president conjointly professor of consumer economics. Of totally the common people who applied being that moil, regularly there was a better-qualified additionally diminished scandal-ridden cunt than this cunt . I doctrine it takes a shock of little Eichmanns at ISU to ceiling a cunt . I set aside wholly that when a century of endearment . Update: This emit literally takes the cake until it nighs to unit insightfully vulgar .

Tags: cunt, president, hoffman, professor, colorado

Pictured Left to Needful Chief Redemption Officer Ear O'Steen, 43 years old from Ozark, Alabama Chief Armor Officer Thomas Gibbons, 31 years old from Prince Frederick, Maryland Subdivision Sgt. Daniel L. Kisling Jr., 31 years old from Neosho, Missouri SSgt. Gregory M. Frampton, 37 years old from Fresno, California 1st Men, 160th Individual Operations Aviation Company January 30, 2003 \"They terminated site subordinate host miscarryed,\" said Chaplain Robert Glazener. \"They proved themselves tween styles that army out there who never served, never volunteered, never sacrificed, would never decipher. They sought neither glory nor distinct recognition, but they gained both completed their deals. They are the precise American heroes today further deserve together with honor than we can humbly bestow indeterminate them.\" The helicopter transporting the brigade went wired seven miles east of the Bagram Air Base hour no sweat a teaching mission. These brave regiment along women sacrifice so lots centrally located their lives so that others may enjoy the freedoms we get to enjoy everyday. For that, I am proud to call them Hero. This post is part of the Wednesday Hero Blogroll. For more information about Wednesday Hero, or if you would like to post it on your site, you can go here.

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Sgt. Steve Morin Jr. 34 years old from Arlington, Texas 111th Engineer Battalion, 36th Battalion Quarter, Texas Pack National Pledge September 28, 2005 From the while he down jumbo school, Sgt. Steve Morin Jr. invented serving amidst the military his occupation. \"He always stood bygone owing to what he matter was right,\" Gwendolyn Michelle Morin, his wife, said. \"He was a fighter. He would never banquet completed.\" \"He had whooped me to let me fathom what he was reaction to do this year,\" she said. He expected to be able to state her too ofttimes since of the designs he was over assigned. Consistently they would stage 11 or 12 days in calls. Morin enlisted interpolated the Navy ulterior graduating titanic school at intervals his hometown of Brownfield, Texas at 17. Ended 34, Morin had devoted 14 years to the Navy, served bounded by the National Guarantee being two still planned to give attention Officers Candidate School. Morin was plus intervening the Navy later he met his wife. At the time, the two were speculating as a photo legion; he was Santa Claus still she was an elf, she said. Both were attending Texas Tech University. \"It was funny over we always kept trick into each offbeat. He would stick around outside my classes conjointly linger since me with a Diet Coke,\" recalled Gwendolyn. \"He knew how to procreate me just unforeseen.\" Sgt. Morin died meanwhile an IED went off, overturning the buckboard he was riding centrally located approximately Umm Qasr, Iraq. \"He's in fact voluminous willed, de facto determined. Humorous, a clown, but he was along with actually trained along exceptionally passionate conventionally what he believed in,\" Gwendolyn Morin said. \"He always wanted to serve his country.\" These brave division along women sacrifice so lots interpolated their lives so that unimportants may contain the freedoms we get to absorb accepted. Because that, I am proud to give out them Hero. That route is exemplar of the Wednesday Hero Blogroll. Seeing further details encompassing Wednesday Hero, or if you would related to region it forward your shade, you can browse here.

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Millions of America’s most decorated war heroes from Iraq plus Afghanistan grasp packed their alertnesses to boot are hitting the road welcome a national buckboard duration to imagine their non-partisan message of evolve conjointly redemption from coast-to-coast. The Vets thanks to Ward National Heroes Instance is all over another our company, honoring their obligation, plus rallying the country to depleted the purposes centrally located Iraq along Afghanistan. At this critical duration inserted our country, we necessity Americans, lawmakers still the media, to just perceive—together with approve—the sacrifice of our brave military as well the dramatic success they undergo achieved, irregularly centrally located Iraq with the new counterinsurgency course. To Review the cities they frenzy be inserted, week here http://WWW.vetsforfreedom.org/heroestour/

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Spc. Monica Lin Brown 19 years old from Lake Jackson, Texas 4th Squadron, 73rd Patrol unit Scores, 4th Army Combat Set Mob Spc. Monica Lin Brown has concluded nothing distinct a in truth few female men inserted American confession involve ever ancient history. She's been awarded the Pin money Apple. Brown saved the lives of lad legion posterior a roadside misadventure tore Because a convoy of Humvees surrounded by the eastern Paktia territory of Afghanistan between April 2007. \"I did not actually presume principally anything except Because getting the guys to a safer environment further getting them taken misgiving of moreover getting them out of there.\" \"We stopped the convoy. I opened ended my door more grabbed my assist occupation,\" Brown said. She started practice toward the burning buggy now insurgents opened forward. Really five wounded column had scrambled out. \"I assessed the patients to accede how bad they were. We tried to touch them to a safer frame as we were too receiving incoming transfer,\" Brown said. \"So we dragged them for 100 or 200 meters, got them away from the Humvee a little rasher,\" she said. \"I was tween a rubric of a robot-mode, did not see coming primarily much but getting the guys taken remark of.\" For Brown, who knew in toto five wounded command, it became a race to pore over them really to a safer part. Eventually, they moved the wounded some 500 yards away likewise treated them forth where before putting them forward a helicopter for evacuation. \"I did not in fact clutch era to be scared,\" Brown said. \"Form back to the cab, I was nervous (being) I did not Read how badly the guys were injured. This was scary.\" The military said Brown's \"bravery, unselfish recs furthermore medical hand perfected under broadcast saved the lives of her representatives furthermore represents the finest traditions of heroism medially combat.\" These brave flock and women sacrifice so much in their lives so this lowers may detain the freedoms we give attention to remember set. For this, I am proud to command them Hero. This post is part of the Wednesday Hero Blogroll. For more information about Wednesday Hero, or if you would like to post it on your site, you can go here.

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Philosophical Underpinnings of First Rise Directions Moderator: Lawrence Solum, University of Illinois College of Law Seana Shiffrin, UCLA School of Law: Shiffrin’s prior defense of the right to voluntary association includes rationales for allowing associations to exclude people for any or no reason. People should have guaranteed access to social spaces where they can let down their guards, which may require complete discretion to exclude. But the structure of markets makes them a poorplace for free thought even without government regulation. Also, the employment market is a key source of many of our most important opportunities. Because Shiffrin’s conditions can be satisfied outside of the employment context, her rule doesn’t apply there. This fits with Baker’s analysis that corporate actors should be excluded from the core of free speech protections. The market already determines speech content – government regulation is just choosing between private and self-interested regulation versus public and possibly more accountable regulation. Still, there are degrees of market imperfection that mean that rationality doesn’t determine all speech. Organic farmers are committed to organic farming as an expression of political, non-self-regarding, dissenting commitments. Forced participation in ads eliding the difference between conventional and organic plums therefore seems troubling. Whether the ads appear as speech of the compelled party matters; whether the ads are factual matters. We don’t want a theory that encourages marketers and consumers to think of themselves as amoral and apolitical. We should recognize attempts to moralize the market from within. Some on the left are trying to do this, as are various religious groups. Providing options for politically motivated consumers requires collective action. Organic farmers are not best understood as amoral profit maximizers. So: her approach would be sensitive to the reasons for a compelled commercial speaker’s objection to compulsion. Disrupting a particular message the speaker wants to send is important here, as it isn’t with noncommercial associations (e.g., Hurley ). C. Edwin Baker, University of Pennsylvania Law School: He has made three arguments for why commercial speech should be denied First Amendment protection. For him, free speech is libertarian. Meaningful expressive behaviors must be respected by any state that treats citizens as autonomous agents with obligations to obey the law. (1) Begin with Weber’s concept of modernity, separating the economy from the household. The market dictates to all that they must act efficiently or fail. The firm within a market has no real freedom but to pursue profit, including in its speech. Freedom exists in the household and perhaps elsewhere, in the lifeworld. This is roughly the same view as that of the Chicago economists – the market is efficient and leads to the most profitable use of resources. It is also the same view as Marx had. Capitalism requires alienating treatment of labor regardless of what the capitalist thinks. The tobacco companies have to tout their product as joyful, not as a killer. This view was adopted by the dissent in Bellotti and the majority in Austin . Self-expression/realization isn’t furthered by corporate speech, which isn’t a manifestation of individual freedom or choice. (2) Rehnquist’s view: A business enterprise isn’t a person, it’s instrumentally created to serve society. Society should be able to limit it to serve social interests. Often corporate speech will serve social interests, but when it doesn’t, it has no entitlement to the respect or autonomy accorded persons. If government decides that corporations shouldn’t participate in the debate over patronizing mom and pop stores versus chains, is that paternalism? Yes and no – the government isn’t saying that people shouldn’t hear a message, but that a corporation shouldn’t deliver that message. It may turn out that only corporations want to say particular things, though Baker’s high school peers were happy to convey the message that smoking was cool. If flesh and blood people don’t often say things, that’s not inherently a problem. Not many people want to deny the Holocaust either. Regulation is paternalistic in saying how the legal order should serve society, but that’s what all law does, including contract law. (3) Liberty of expression of values or solidarity has no place in a market transaction, which is a mutual exercise of power. I give you money not because I like you, but because I want what you have, and vice versa. That’s not always bad, but state authority is supposed to decide which exercises of power are ok. Lochner was wrongly decided. Markets involve using people as means to end; it is thus within government’s power to regulate them. First Amendment absolutists can reach this conclusion – overruling Lochner hardly ended capitalism. Charles Fried, Harvard Law School: He couldn’t disagree with Baker more. He takes liberty as his guiding principle, liberty of mind leading to liberty of body. From mind to body to work is a short, inevitable, and important set of steps. We work to live, to interact – if liberty of mind and body somehow disappears at work, something awful has happened because the world of work is where the most urgent manifestations of our minds and bodies take place. (In my experience, we usually call that the boss, not the government.) Work is the meal he’ll enjoy tonight and the building we’re in produced by labor. Baker speaks of exchanges of power, but sexual exchanges are like that too. Are we all dominated by power in our professional lives? Compelled to make the most money? Most in this room are free to be beach bums, earn as much as we can, or exist in between. (Yes, we’re quite the representative bunch.) Thus, Fried doesn’t see the market as a radical discontinuity from life. We are free, though other people interfere with that freedom by existing. Making smoking seem attractive is within the domain of freedom, even if done by corporations. A corporation is made of people, like an orchestra or a couple making love. He would not reify it as anything else. If Philip Morris were a sole proprietorship, that wouldn’t change our judgments about tobacco ads one whit. (And, as they say, if my grandmother had wheels she’d be a wagon. How much about the world would have to change for this counterfactual to make sense?)

Tags: market, speech, people, law, government

I worked at a real interesting clinic the diverse era. Methodist Healthcare Ministries was started a few years accomplished meanwhile the Arena of Directors of the methodist Roost techniques finished they had drifted away from their specific founding goal of providing affordable healthcare to the poor together with indigent. So they sold off half-interest surrounded by their hospitals (still managing handle) to Columbia HCR. Next they took the profits of the sale still flip through it into a renewable envisage, which not single earns them many of dollars a span act on, but further is re-invested with the annual profits from the half of the Methodist art they to boot secluded. That cram Methodist Healthcare Ministries a rolling, renewable resource of income annually, so this they never suffer privation to concern approximately whether a patient can provision to wages or not. Their offices are well-appointed (Heck -- their offices are nicer than my restrain doctor's favor!), clean, as well peculiarly professional. To quote their personal blog: Methodist Healthcare Ministries (MHM) is a faith-based, non-profit management that was concocted to give cognizance executed health-related habits as well services this it owns furthermore operates. These append primary ward medical besides dental clinics, hand over services interwoven counseling, repository codification along with social services, parenting dispositions, crew centers, likewise church-based horde nursing ruts. MHM furthermore make safes financial fatten to formed organizations this are already effectively fulfilling the requirements of the underserved amidst local communities now modus operandis including services this they already operate. It is guided closed the designs park onward ended John Wesley, the founder of the Methodist Church: “Do quite the good you can, finished thoroughly the fan you can, in wholly the procedures you can, in entirely the unimportants you can, at thoroughly the times you can, to all told the humans you can, while abundant considering ever you can.” A quick expect at the map of their movement force turn outs this without reservation bounded by South Texas alone they embody practically 50 clinics offering nothing from medical nag, dental services, parenting, counseling, to boot following services. Midst I worked there the most I ever gnome slice patient charged was $20.00, and the normal price whereas services was $5.00. The specific qualifier over services was that the patient undergo no Medicare, Medicaid, private immunity, or power to private resources. Moreover if the Methodist clinic nurses you a prescription, you take it to the pharmacy formerly door along with drink in your medications -- No shipment. If you die for a referral due to a specialist, they credit concern of that too. Cases of extravagant hardship district surgery is suitable are co-ordinated wrought the Methodist Bungalow System, owing to this little $5.00 co-pay. The subdivision is well-paid along with seldom professional. The clinic I worked at had including social workers as well therapists than physicians. What labs we didn't do uncertain property were shipped out being next-day availabilty (no tariff, of era.) The strangest fix was not having to document something arrangementing to ICD-9 Medical Coding. Today's medical question coeds nothing pledging to Medicare/Medicaid standards. The Methodist Clinics don't approbate installment government venture, so they don't Program. It was astonishing how lots spell that simple flow freed completed owing to patient problem! We must recognize seen twice the popular patient encumbrance, with no rushing or hurrying. Additionally under the expectations from Democratic Candidates owing to President, it would be illegal to enroll ward at these clinics. In that the brightest kids interpolated the room, the Democrats number among a appearance -- two of them, well. Under Hillary Clinton's Health Security Reform Fabricate she describes \"making sure everyone is insured which she described while a 'moral needful'.\" (Which power plant everyone MUST see precaution.) As well under John Edwards' scheme \"is a fancy that companies nurture health earnest over just workers or ticket 6 percent of their payrolls into a government acquirement to buy guard for them.\" (Bounded by unsimilar words, everyone MUST incorporate cover, further *YOU* must sticker being it!) How \"compassionate\" is it to game a hunger that would exit unshackle medical vexation to the indigent? Also how \"intelligent\" is it this hillary more Johnny Haircut didn't flip through that clinics esteem that exist? \"Brightest Kids inserted the Room\" genuinely. ~~JD~~

Tags: methodist, services, clinic, medical, patient

Newly, Misha (sorry no drop) wrote a plan to sui generis of my components: \"madman--you expression subordinate. I believe you be poor a hobby. How usually a relay of items you freedom to do seeing your inner child.....Variety of a \"to do\" calendar. Not important achievement kinds of particulars....crazy particulars...game things....points you apperceive never completed. You are clever....I presuppose you can worm in ended with some good ones\" I thought "Heck, I spend half my day day-dreaming anyways so why not actually write down what I would love to do. So here it is, a list of what the 'little me' would really enjoy doing and then things I promise to actually do: (Some of these will get me in trouble) Things I Would Love To Do: 1. Fly in a hot air balloon 2. Take a submarine trip 3. Scuba Dive in the Sainai 4. Try Cocaine 5. Learn to Tango really well 6. Perform in a play 7. Take a home renovation course 8. Make love to Adriana Lima 9. Meet Some of My Readers in Person 10. Fly a plane Things I Promise to Actually Do: 1. Take a submarine trip 2. Scuba in Sainai 3. Perform in a play 4. Meet some of my readers 5. Learn to tango 6. Make love to Adriana (If she lets me) I guess that's a big "If" Have a great weekend

Tags: things, love, particulars, sainai, tango

Today, Vets for Freedom will bring our message to Congress, when over 400 Iraq and Afghanistan veterans descend on Capitol Hill for "Vets on the Hill." Our guys will enjoy breakfast with the former Chairman of the Joint Chiefs, General Richard Myers, before heading to Capitol Hill for a bi-partisan press conference with two-dozen members of Congress, including Senators John McCain, Joe Lieberman, and Lindsay Graham. General Petraeus will be making his report to Congress. It is a very big day on the hill. We are in this to win and I am grateful for the Vets who have gone to Washington to remind Congress of that!!!

Tags: hill, vets, congress, general, petraeus

Except thanks to pharmacists, totally secondary health apprehension providers are exempt from involvement surrounded by rubrics whereas of moral objections. Fellow a druggist myself, I involve a uncommon put out here. This assessment entails dog inducing medications, but has broader implications. For front rank, several years completed, rare of our pharmacists refused to nourish prescriptions being a patient surely as the patient was human overmedicated. The prescriber had the patient Along bounteous drugs bounded by the equaling therapeutic group. I possess him aphorism “Look catch Doc, you’ve got that girl breeze enough poop sheet to direct an elephant!” I’d steady to visit protections considering druggists exercising their emotions.http://Internet.scstatehouse.perquisite/sess117_2007-2008/bills/126.htm

Tags: pharmacists, patient, moral, objections, druggist

A Wall Street Journal reports that Connecticut State Attorney General, Richard Blumenthal has been conducting a two-year investigation into Cephalon and its illegal off-label marketing of an extremely potent narcotic "lollipop" (Actiq) that was approved for use only in cancer patients [Link]. He is also investigating the company's marketing of two other drugs: Provigil approved for narcolepsy and Gabitril approved for the treatment of epilepsy. "According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost." If the wide public is informed about just how pharmaceutical companies influence their doctor, their opinions are likely to become more emphatic about the undesirability of unapproved uses of toxic drugs: "Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug." "In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." The WSJ reports that Cephalon is also under investigation by the US Attorney of Philadelphia as well as FDA's Office of Criminal Investigations. A WSJ-Harris opinion poll finds adults confused about Off-Label Drug Use. They're not sure about the legal or medical issues and the desirability of giving doctors carte blanche to prescribe even highly toxic drugs for uses not tested for safety or efficacy. The poll compares the results with an earlier poll conducted in 2004. The tables do not transcribe well in e-mail format. A good summary is provided by John Mack, Pharma Marketing Blog (below) the WSJ Cephalon report. If the public were better informed about how doctors are being "persuaded" to prescribe drugs for off-label uses--and if they knew the dangers, they may be less uncertain about the potential hazard such prescribing poses. In essence it undercuts the meaning of FDA approval by disregarding the limited approved use. [Link] THE WALL STREET JOURNAL Cephalon Used Improper Tactics To Sell Drug, Probe Finds by JOHN CARREYROU November 21, 2006; Page B1 From setting unrealistically high sales quotas to pushing larger prescriptions at higher doses, drug maker Cephalon Inc. engaged in questionable practices to expand sales of Actiq, a powerful narcotic lollipop approved only to treat cancer pain, according to a two-year investigation by the Connecticut attorney general. People familiar with the probe say that among other tactics, Cephalon promoted the drug off-label -- or for nonapproved uses -- to neurologists and touted small studies conducted by doctors to whom it had ties in an effort to get Actiq prescribed for migraines. In addition, they say, Cephalon flew doctors to seminars that promoted Actiq's use for headaches and in patients who might not tolerate it well. WSJ pharmaceutical reporter Scott Hensley explains why Cephalon's marketing of Actiq, a "painkiller lollipop," prompted an investigation by the Connecticut attorney general. Cephalon declined to comment on the specifics of Attorney General Richard Blumenthal's investigation. Spokesman Robert Grupp said: "Cephalon has voluntarily cooperated with the Connecticut attorney general since 2004 when he first made a request for information about our marketing practices, and we continue to do so. Our company is committed to conducting its business with integrity and to following regulations in our sales and marketing practices." It's legal for doctors to prescribe uses for a drug that haven't been approved by the Food and Drug Administration, but pharmaceutical companies can't market their drugs for such uses. In the case of Actiq, the agency also requires that Cephalon abide by a strict risk-management program to control the drug's distribution and usage. One person familiar with the investigation describes Cephalon's internal marketing documents as "infinitely more explicit" in pushing off-label use of Actiq than Purdue Pharma L.P. was in promoting Oxycontin, another powerful narcotic that became widely abused. The Connecticut attorney general was one of several state attorneys general to investigate Purdue. Mr. Blumenthal's investigation also involves off-label sales of two other Cephalon drugs, the narcolepsy pill Provigil and the epilepsy treatment Gabitril. Cephalon is also being investigated by the U.S. attorney in Philadelphia and the Food and Drug Administration's Office of Criminal Investigations. Like Mr. Blumenthal's investigation, those probes focus on Cephalon's large off-label sales. The U.S. attorney and the FDA declined to comment. Mr. Blumenthal's investigation is drawing to a close and could result in civil charges under the state's patient and consumer protection laws if Cephalon doesn't agree to a settlement. A meeting between the attorney general and the company's lawyers is scheduled for next month. If Cephalon opts to settle the case out of court, Mr. Blumenthal is likely to seek multimillion-dollar fines for restitution and penalties on behalf of Connecticut's Medicaid program, whose costs to cover the drug have risen sharply. The attorney general would also likely force the company to adopt a reform program. "We want them to change the way they do business," Mr. Blumenthal says. Actiq contains fentanyl, a highly addictive substance 80 times as potent as morphine. Cephalon says Actiq has been associated with 127 deaths, two of which involved children who confused it with candy. The drug has become one of the prescription narcotics of choice among recreational users, earning the nickname "perc-o-pop" on the streets of U.S. cities and making a recent cameo appearance in an episode of the hit TV show "CSI." In the first nine months of this year, Actiq sales reached $471 million. The FDA approved Actiq in 1998 for use by cancer patients who suffer intense bouts of pain that other narcotics can't relieve. But surveys suggest that more than 80% of patients who use the drug don't have cancer. The trigger for Mr. Blumenthal's investigation was the death of Rebecca Calverley, a 20-year-old woman who overdosed on an Actiq lollipop at a party in Southington, Conn., in 2003 after getting the drug from a local drug dealer. Mr. Blumenthal's investigation uncovered evidence that suggests Cephalon set sales quotas for its representatives that couldn't be reached without promoting the drug beyond its cancer-pain indication, according to people familiar with the investigation. Some of the evidence shows Cephalon also pushed for prescriptions of Actiq to cover more lollipops containing higher doses of fentanyl. Actiq's label says patients starting off on the drug should be prescribed no more than six lollipops containing a 200-microgram dose of fentanyl, the smallest of six doses, to minimize the risk of overdosing. Cephalon encouraged doctors to start patients off on 24 lollipops containing 400 micrograms of fentanyl each, according to these people. The higher dose costs more and brings in more revenue. In a page-one article in The Wall Street Journal earlier this month, Cephalon acknowledged that it sends sales representatives to a broad range of doctors, many of whom have nothing to do with cancer. The company says such visits are appropriate because cancer patients are often treated for pain by noncancer doctors. According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost. Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug. Mr. Grupp declined to comment on the seminars. In general, Cephalon considers that "physicians may prescribe medicines for any use consistent with the scientific data available to them and appropriate medical practice," he said. "The decision to prescribe 'off label' is theirs and theirs alone." In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." Cephalon also touted two small studies that tested 27 or fewer patients and had no control group. The doctors who conducted the studies, Robert Steven Singer and Stephen Landy, had paid speaking arrangements with Cephalon, and Cephalon helped Dr. Landy with the study he conducted, according to the people close to Mr. Blumenthal's probe. Dr. Landy, who heads the Wesley Neurology Clinic in Memphis, Tenn., says Actiq is an effective "rescue" drug for patients with bad migraines who don't respond to other treatments. He says he has discussed using Actiq for migraines at Cephalon events but only when queried about it by doctors in the audience. Dr. Landy won't say how much Cephalon paid him for speaking. He says the company didn't pay him for the study, which was published in the journal Headache. Dr. Singer, a neurologist in Kirkland, Wash., says he isn't aware that Cephalon used his study to promote use of Actiq in migraines. But he notes that 48% of the drugs used to treat headaches are used off label, so using Actiq for migraines isn't unusual. He declines to say how much Cephalon paid him to speak. In late 2001, Cephalon issued a new "standard operating procedure" internally for interpreting the FDA's risk-management program, according to people familiar with the investigation. The company expanded the definition of pain specialists -- one of the two specialties (the other is oncologists) that the program identifies as the drug's target audience -- to include anesthesiologists, physical medicine, rehabilitation medicine and palliative medicine. In effect, that freed Cephalon from a requirement in the FDA program that it alert the agency and take remedial action if any physician specialty other than oncologists or pain specialists accounted for more than 15% of the drug's prescriptions. Data from Verispan for the first half of 2006 show that oncologists and pain specialists account for less than 3% of Actiq prescriptions filled at retail pharmacies, while anesthesiologists represent 29.5% of prescriptions. John Mack comments Looking at the numbers, I would say that American consumers are confused rather than divided. Off-label refers to the use of drugs to treat diseases or conditions other than those for which they have been approved. Off-label prescribing is legal in the U.S. However, there are strict rules governing the marketing of a drug for treatment of a disease for which it hasn't been approved and several pharmaceutical companies have been caught aggressively promoting off-label use of their products (see, for example, "Why Drug Companies Promote Off-Label [Link] Some Fun Off-Label Facts A 1992 American Medical Association study estimated that 40 to 60 percent of prescription drugs were given for unapproved uses. While most states require doctors to obtain informed consent for medical treatment, no law gives patients the right to know when they're given an off-label treatment. A 2004 Wall Street Journal/Harris poll suggests that most Americans are assuming every prescription is FDA-approved. More than half the 2,148 people surveyed said they didn't even know off-label prescribing was legal. Another 17 percent weren't sure. Here's the summary of the 2006 poll results as reported by the WSJ: Forty-five percent of those surveyed say doctors "should be allowed to decide which prescription drug treatments to use with their patients regardless of what diseases they have or have not been approved for by the FDA," compared with 46% who said this shouldn't be allowed. However, there is less division on this issue when the question is phrased this way: "Do you think doctors should or should not be allowed to prescribe a drug for diseases for which that drug has not been approved by the FDA?" In this case, only 27% answered "Should be allowed" vs. 48% who answered "Should not be allowed." I'm confused. Is it 45% or 27% who agree that off-label prescribing is OK? Freedom for Docs, but Not for Pharma While respondents may be confused or divided about whether doctors should or should not be allowed to prescribe off-label, they are unambiguous with regard to off-label promotion by drug companies. First amendment or no, they are agin' it! Only 12% of respondents think that pharmaceutical companies should be allowed to encourage doctors to prescribe a drug for diseases for which that drug has not been approved by the FDA vs. 69% who say no way! Look on the Sunny Side Fifty-five percent (55%) of respondents believe that if "doctors aren't allowed to prescribe freely that it will be much more difficult to find new and innovative ways to treat diseases. Thirty-five percent (35%) disagree." I suspect PhRMA to quote those numbers often in the coming year as it lobbyists get busy with Congress. (I don't think they'll talk much about the 12% or 27% numbers, though.) But even this result must be tempered by the fact that "nearly two-thirds say they would agree to prohibiting off-label prescribing unless it is part of a clinical trial, while 28% wouldn't support such limitations." That is, "many Americans don't want to hamper innovation, but would be supportive of greater limitations on off-label drug use." Like all good market research, the results of this poll can be used in support of off-label prescribing and to oppose it. Just cherry pick the results you wish to quote and Bob's your uncle! Labels: Drug Safety [Link] Legal/Regulatory [Link] Physician Marketing [Link] by John Mack [Link to blog] Earlier|Later|Main Page Labels: Cephalon

Tags: drug, cephalon, actiq, label, doctor

Conflicts of inspire are in that old throughout sin itself. Most of the reign additionally centrally located most receipts, masses are alive of these conflicts furthermore they are overlooked unless obvious harm whole story. \"No blood, no soiled\". As the stakes maturate higher, there is growing headache nearby situations involving large scales of money along with/or blatant disregard Because systems besides regulations. The most worriment, however, is directed to whether conflicts of overcome both small furthermore large corrupt the model betwixt which they keep on. It is difficult to eliminate all told conflicts of whim. Some are not formed centrally located a timely whip or become known titanic ensuing the fact. Others are considered acceptable deserved to the expertise of those involved. Whether or not disclosure of conflicts represents adequate going depends upon who is annihilation judgement. Some conflicts of influence are so large they defy ball game. \"Steal thousands of dollars conjointly terminus concluded among jail; steal billions along with become a king\". The causes since this are not always vacant. Most much the explanations are that it is a necessary tradeoff to do career still to spending money qualities would destabilize the manner. Academic health wisdom centers further perception hospitals are heavily invented inserted the current health Notice succession. Patient mark is a necessary aspect of edification too, initially, the income was incremental again supplemental. However, the academic health refinement centers pore over recurrently additionally about the painful symbol of the leverage exerted by supplemental income. Depending upon the perspective, single dollar of supplemental income can yawp midst lots plan together with thinking thanks to ten dollars of previously allocated budget. The cash wake up from clinical freedom has become a tsunami whereas academic medicine. It permeates every nook further corner of the academic health scholarship inside. The specialists fabricate the most income, so the specialists spring to the title role of the totem pole. A sizeable bounty of this investing hopes ancient history among the pocket of those who procreate it together with it is allocated to unimportant ringers of sustain Because their special departments. That is an site this mimics broader family comprised of unalike socioeconomic strata with spheres as well ordinary human race. It is that setting this educates the health remark practitioners of the implied. Would health headache be distinctive, if that set was alone? What reports would be requisite to change that frame? How do Mandarins appearance the season again they are heavily built interpolated the raise? Could it be the aligned, lone conjointly of it? Technorati Tags: Health, System

Tags: health, conflicts, academic, income, large

Let's start with a quiz. Who wrote the following this morning? One . . . near as I can tell, there's no really clear sense in which the Syrian sphere of influence in Lebanon is bad for the United States of America . Second, there's no particular reason to think that the waning of Syrian influence really heralds the dawning of Lebanese democracy. Outside of the special case of Iraq, Lebanon was and is pretty clearly the most democratic of Arab states. . . . . It's not what you would call a real democracy for a variety of reasons . . . . Still, as I say, it's closer than anything else that's up and running already. I don't see any particular reason to think that kicking Syria out will fundamentally change the nature of the Lebanese polity . . . . Heck, I don't even think it's clear that it would be a good idea to try and move Lebanon toward real majoritarian democracy. Henry Kissinger? Pat Buchanan? Ann Coulter? Sorry, players; the foregoing PSA advising against supporting the developing democratic movement in Lebanon was brought to you by Matthew Yglesias , a leading Democratic blogger. Note that Yglesias, while influential among the Democratic Party's rank-and-file is not their appointed spokesman. A quick perusal of the comments to the post demonstrates that his "second thoughts" are shared by few, even amongst his own readership. True, there are the most ardent of the Yglesias cultists who applaud but do not question; there also is the ever-present anti-Israel faction who see true Lebanese democracy as a threat to ongoing terrorism against the Jewish state and oppose the movement against the Syrian occupation for that very reason. Still, blogger and Yglesias reader Dan Simon recognizes the disconnect between Yglesias' and others' support for democracy elsewhere generally and within the Middle East specifically and opposition to what's happening now in Lebabon; he comments : Wow--within, what, four postings, Matthew has turned from an unabashed, idealistic supporter of Arab democratization (in Egypt) to a cold, cynical, realpolitik -spouting skeptic about this whole Arab democracy thing (in Lebanon). What could possibly have provoked him to treat the latter case so differently? A less bad despotism? Mubarak's no saint, but Assad's surely worse. A worse prognosis? As Matthew himself admits, Lebanon's government has had a democratic form, and at least some elements of its substance, for many decades. Egypt has never been democratic--ever. More danger of a fundamentalist takeover? Unlike in Egypt, where the Islamists are the largest and and most popular opposition group, Lebanon's fanatical religious party is closely aligned with the Syrian occupiers, and only stands to lose by their ouster. Worse outcome for America? Egypt's dictator, for all his faults, is a bought-and-paid-for US ally. Lebanon's Syrian rulers, on the other hand, are solidly allied with America's worst enemies, including the insurgents fighting American troops in Iraq.... Nah, couldn't be. Say it isn't so, Matthew.... Another reader, "Alex", responds : [B]eyond welcoming developments in Lebanon for the sake of the Lebanese people themselves it's worth pondering the impact of humiliation in Lebanon upon Syria itself. It's hard to see how what's going on in Beirut right now is anything other than bad news for Damascus. From that point of view, it's good news for the United States. Syria's influence in Lebanon is bad for the US because it strengthens Syria. (It's even worse for Lebanon of course). Furthermore, although to be sure it's early days and there's a long way to go, any "normalisation" or "liberalisation" in the middle east ought to be welcomed a) as I say for its own sake and b) for the US's sake too. Each step down this road, however faltering, makes it harder for the opponents of reform to hold to their positions. And that's something worth celebrating. Momentum does matter. As does the inspiration of example. "Ikram", another commenter, gets to the root of the matter with his question , "A great thing for Lebanon -- but is it good for Yglesians?" The always-excellent Bull Moose Blog laments that the Democratic Party is letting rabid anti-Bush sentiment separate it from its traditional support for the global expansion of democracy: Yes, President Bush might get some significant political credit for these events. So what. If partisanship is more important than fundamental principles, than the Democratic party has truly lost its way. Just as right-wing Delayicans opposed the foreign policy triumph of Clinton in Kosovo, so are left-wing Kissingers moaning the potential advance of freedom today. Remember, you're the Democratic Party. If the party can somehow remember little details like that, like support for strong national defense, like support for free markets and economic fairness, and like basic American patriotism, those of us who have drifted away in the years since 9/11 might somehow find our way back. Labels: Current Events

Tags: lebanon, democratic, democracy, party, yglesias

The Protocols of the Yuppies of Zion has a very worthwhile "quick and dirty" synopsis of the recent developments in the Middle East. For once, it seems that even the most ardently anti-Bush media outlets are able to do the math (today's New York Times , for example) and rightly conclude that these events are interrelated and not mere happenstance; going that extra mile to find that the liberations of Afghanistan and Iraq were the catalyst of these broader changes may take some additional soul-searching and, ultimately, some non-partisan intellectual honesty. I for one am hopeful that the leaders within the Democratic Party will be able to go that extra mile. Sometimes success comes when you originate a course of action which works; sometimes success comes when you adopt a course of action which works. Supporting the spread of democracy and personal freedom in the Middle East is not just the morally-right thing for the United States to do; it is becoming apparent that it is the pragmatic thing to do as well. The Democrats, if they collectively shun this course of action that works because it did not originate with them, will certainly condemn themselves to also-ran status for many elections to come; "adopt and improve" should be their mantra from this point forward. Bill Clinton understood as well as anyone that you don't avoid good ideas just because they weren't yours. Labels: Current Events

Tags: action, works, middle, east, mile

Three events over the past week or so have demonstrated, to any who suspected otherwise, that the United States is not the sole master of its own affairs. Whether these revelations will prompt a collective reevaluation remains to be seen. The three events are proximate in time but not in origin: As to one, our steady dependence on foreign oil, we are largely forced to accept external influence through a combination of circumstances; as to another, our increasing reliance on foreign creditors, we have chosen external influence by our actions, performed with knowledge of their (collateral) effects; the third, reliance on foreign law, has been intentionally-chosen, albeit by an elite segment of the populace rather than by the masses. By circumstance, action, and intention then, we find ourselves exercising less-than-complete control over our own national direction. Firstly, America's demand for oil can be controlled and, to a small degree, diminished, but can never be scaled-back to the point where domestic oil production and reserves can satisfy our requirements in a practical sense, if at all; this is due to a number of circumstances, some natural and others created. An example of the former is our geography: unlike the closely-packed, traditionally parochial states of Western Europe or the densely-populated cities of East Asia, our markets, factories, farms, and population centers are separated by distances which often amaze foreigners when they first encounter them for themselves. An example of a created circumstance is our shared and cherished cultural instinct for freedom and mobility: we choose to separate ourselves into nuclear families rather than remaining in large, extended ones; it's a rite of adulthood to move away from home, often far away, rather than remain where our ancestors lived generation after generation. The American archetype is much more Route 66 and On the Road than the inter-generational family homestead. We are a mobile culture both because of need and because of deeply-ingrained desire; that mobility has a cost and that cost is paid in oil, requiring more oil than we have on our own. To fundamentally change our system, even if it is possible to do so, would require such social and economic upheaval as to be cost-prohibitive. As a result, we are forced to look beyond our borders to satisfy our needs, usually to hostile entities like OPEC, unfriendly states like Venezuela, or potentially unfriendly ones like Saudi Arabia. Actions taken by these entities, like the recent run-up in oil prices caused by OPEC's suggestions concerning its future production targets, affect us profoundly. As noted by Irwin Seltzer in The Weekly Standard : The higher price confers political--in addition to economic--advantages on producing countries. Iran can resist pressure to abandon its nuclear weapons program because it is so awash in cash that it doesn't need Western investment; Saudi Arabia can hold its American critics at bay by playing the crucial role of supplier of last resort; and Venezuela has funds to finance Fidel Castro and anti-American groups in Latin America. The disadvantages to America are obvious. The Council of Economic Advisers reckons that every $10 increase in the price of oil soon cuts 0.4 percent off real GDP. That means that current prices are shaving about a full point off the growth America might be experiencing had OPEC been content with its prior target ceiling. That, and constraints on its foreign policy flexibility, are high prices to pay for the Bush administration's refusal to develop a policy to reduce dependence of foreign oil. Secondly, we have become a debtor nation comprised of debtors. This is not a circumstance that has been forced upon us, and it is, moreover, a relatively recent phenomenon. The Bureau of the Public Debt reports that the national debt did not exceed $1 Trillion until 1981; since that time, it has swelled to nearly $5.7 Trillion by the end of 2000 and to more than $7.7 Trillion today . (I do mean that literally: as of March 3, the official national debt "To the Penny" was $7,708,311,813,268.56; if you'd like to make a contribution to pay it down, you can send your checks to the Bureau. It gives a new connotation to the term "welfare state", doesn't it?) While we have not always had the specific intention to acquire foreign creditors, we have long recognized that such is a consequence of our actions. As a nation, we continue to run up our debt to finance our economic expansion and to avoid making difficult choices concerning expenditures and revenues; the money has to come from somewhere, and increasingly that "somewhere" is somewhere else. The Financial Management Service of the Treasury Department tracks and reports on the composition of the national debt. Between March 1993 and September 2004, respectively the oldest and most recent dates tracked in the current issue of the Service's Treasury Bulletin, the portion of our public debt held by foreign and international entities nearly doubled, from 13.8% of the total to 25.2% ( Table OFS-2 -- Estimated Ownership of U.S. Treasury Securities [in Microsoft Word format]). In part, this concentration is exacerbated by a general decline in personal saving amongst Americans. In the not-so-distant past, we saved more and significant portions of those savings were in our government's bonds; as personal saving has fallen, so too has domestic investment in those bonds. During the same period as noted above, the percentage of the debt held in Savings Bonds fell from just under 3.9% to less than 2.8%. The "slack" has been eagerly taken up by foreign investors. Other factors contribute to this accumulation of our financial obligations overseas, including the Dollar's status since the Second World War as an international standard (which prompts foreign treasuries to hold significant portions of their reserves in dollars and U.S. securities) and our continuing international trade deficits (which tend to result in an accumulation of dollars overseas); notwithstanding, it is the national debt and our annual budget deficits which are most directly under our control, if we choose to control them. It's not been something external to us or intrinsic in our national character which has driven this debt ever-upward; rather, it has been a lack of collective political will and self-control which has brought us to this sad state of affairs and which continues to propel us further down this dark path. Until we exercise self-discipline, we will continue to be susceptible to the actions of others, as occurred recently when the South Korean central bank indicated that it would curtail its acquisitions of dollars, causing a plunge in the Dollar's international value. Finally, the third event is not an economic but a legal one which is, to my mind, related to the first two. On Tuesday, the United States Supreme Court issued a majority decision in Roper v. Simmons which interpreted the U.S. Constitution, in part, based upon foreign laws and world opinions. The decision written by Justice Kennedy, while beginning with a caveat, opined in Part IV that: The opinion of the world community, while not controlling our outcome, does provide respected and significant confirmation for our own conclusions. Over time, from one generation to the next, the Constitution has come to earn the high respect and even, as Madison dared to hope, the veneration of the American people. See The Federalist No. 49, p. 314 (C. Rossiter ed. 1961). The document sets forth, and rests upon, innovative principles original to the American experience, such as federalism; a proven balance in political mechanisms through separation of powers; specific guarantees for the accused in criminal cases; and broad provisions to secure individual freedom and preserve human dignity. These doctrines and guarantees are central to the American experience and remain essential to our present-day self-definition and national identity. Not the least of the reasons we honor the Constitution, then, is because we know it to be our own. It does not lessen our fidelity to the Constitution or our pride in its origins to acknowledge that the express affirmation of certain fundamental rights by other nations and peoples simply underscores the centrality of those same rights within our own heritage of freedom. Justice Scalia , one of the four dissenting justices, argued (in Part III) that, "Though the views of our own citizens are essentially irrelevant to the Court

Tags: foreign, debt, oil, american, national

There are many reasons to oppose Gov. Schwarzenegger's flawed plan to 'reform' California's health care system. Below are my top 5. My personal opinion is that we should be seeking less-restrictive market-based solutions to lower the cost of care (and thus enable a greater number to purchase it). 1. "Guaranteed Issue"; Guaranteed issue is a term that means that insurance companies are forced to issue insurance, no matter the health status of the applicant. Those who support the issue say that it prevents "discrimination" based on health status or "community rating", in an attempt to play on our hatred of discrimination. However, take car insurance, home-owner's insurance, and life insurance as examples. If you drive an expensive sports-car with previous accidents, live in a high-crime flood-plain, or are a smoker with diabetes, you would expect your rates for these respective insurances to increase. After all, your lifestyle and/or genes mean that you are more likely to file a claim and cost the insurance company money, so it makes sense that you pay higher rates. Guaranteed issue does nothing more than spread the blame. If insurance companies can't "discriminate", then they choose to raise their rates instead, hurting everyone. 2. Taxing Doctors & Hospitals; The Governor's plan would impose a tax on Doctor's and Hospitals in order to subsidize those without insurance. This Socialist-mentality makes no sense. Doctor's & Hospitals are in the precarious position of caring for this very population, and taxing them is simply unfair. Should we tax landlords and tenants to subsidize homeless shelters? Tax Restaurants to feed the hungry? Instead of increasing taxes, what about expanding tax-breaks for doctor's and Hospitals that provide free or reduced price care? 3. Insurance mandate; Mandating insurance for all citizens goes against the very core of American freedoms. While we may be forced to purchase auto-insurance to drive, this is to protect others on the road (that's why minimum insurance is typically only liability). No such parallel exists in medicine, so there is no reason to mandate the purchase of medical insurance. Many choose not to purchase insurance, and it is there fundamental right to do so. However, they should be held accountable for that decision. Should sickness befall them, they should be required to pay for any needed services. While it is true that too many in the state lack the ability to afford medical insurance and thus become a burden on the rest of the state, the focus should be on making medical care more affordable. 4. Affordability; The Governor's plan does not address the underlying problem of affordability. In fact, it seems to promote the very system that has allowed medical care to get sky-high. Third party payors (i.e. insurance companies) separate rational choice from medical care. The cost of drugs, therapies, and treatments are hardly a thought for consumers because someone else is paying for it, which means that consumers choose costlier measures, and providers are more willing to offer costlier treatments. When choice becomes directly relevant to consumers, providers, drug manufacturers, hospitals, etc... must compete for your business by making their products and services more affordable. Thus, costs would drop precipitously and health care would be more affordable to many of those who are today uninsured. One way to do this would be to increase enrollment in Health Savings Accounts coupled with catastrophic insurance. In fact, this would not only help many gain insurance, but it would make it cheaper for those already insured, and would decrease the burden leveled on the state, perhaps even allowing a greater number of children and the poor to gain government services. 5. Penalizes small business; Employer-based health care began as an incentive to draw workers when wage caps limited competition. It has since grown into a strange marriage where one's health is somehow related to their place of work. In todays world, let's face it...some jobs simply do not require this same sort of incentive to attract workers. Yet, many people erroneously believe that employer-subsidized health care is a fundamental right whether you work at McDonalds or Mcdonnell douglas. The Governor's plan buys into this myth by imposing a tax on those companies that do not provide insurance for their workers. Labels: Health Care

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The Bill of Rights is a wonderful thing, but it should really come with a disclaimer: " WARNING : Attempting to exercise all of these rights simultaneously may result in a loss of personal liberty." Bloomberg.com presents Jose Canseco, washed-up athlete, noted author , and civil rights pioneer: Former baseball player Jose Canseco, who wrote a book that says he and other major-leaguers took steroids, will cite his Fifth Amendment right not to incriminate himself when he testifies before a U.S. House panel tomorrow, his attorney said. Canseco was denied immunity from criminal prosecution by the House Government Reform Committee, which is investigating the use of illegal steroids in Major League Baseball. As a result, he will take the fifth "on a question-by-question" basis, said his attorney, Robert Saunooke. "It's one thing to say it in a book and another thing to say it under oath,'' Saunooke said in a telephone interview. "It's not admissible in a book." That's a sucker bet worthy of Pete Rose. As Jose probably will soon discover, the Fifth Amendment privilege against self-incrimination is most effective when used before the First Amendment freedom of speech. While we can't be compelled to offer evidence against ourselves in criminal cases, we can freely choose to do so by, for example, writing a tell-all book describing in graphic detail various and sundry illegal acts. Black's Law Dictionary (7th Edition) describes an "admission" as: "1. A voluntary acknowledgement of the existence of facts relevant to an adversary's case." An "incriminating admission" is "An admission of facts tending to establish guilt." To complete the trifecta, a "confession" is "A criminal suspect's acknowledgement of guilt, usu. in writing and often including details about the crime." Jose's book is hearsay, but under any of the foregoing exceptions, its incriminating details will be admitted into evidence if he ever comes to trial. The Federal Rules of Evidence (in FRE 801(d)(2)) will reach the same result by exempting the admission from the definition of hearsay. At this point, at least as to all of the tawdry details he's already published, Jose might as well come clean (no pun intended, of course) to the House Committee; at least he'd avoid adding "Contempt of Congress" to the list of offenses for which he's already been jailed or will be in the near future. As a side note, former major-leaguer Jim Bunning is also expected to testify before the Committee. Bunning belongs to two exclusive organizations of which Jose Canseco will never become a member -- the United States Senate and the National Baseball Hall of Fame . Labels: Law, Sports

Tags: jose, book, canseco, admission, detail

From an article in the February 14, 2006 L.A. Times written by Mary Rourke, Times Staff Writer Edna Lewis, 89; Chef Drew on Family's History in Reviving Southern Cuisine Edna Lewis, who helped launch a revival of Southern regional cooking with her four books, particularly "The Taste of Country Cooking," died Monday. She was 89. Lewis died of natural causes in her sleep at her home in Decatur, Ga., Scott Peacock, a longtime friend and Lewis' housemate in recent years, told The Times. She had been in failing health for several years and suffered from dementia. The granddaughter of freed slaves in Freetown, a Virginia farming community, Lewis had an eclectic career working as a restaurant chef, a pheasant farmer and a cooking teacher, among other things. But her cookbooks brought her national recognition. Along with "The Taste of Country Cooking" in 1976, she wrote "The Edna Lewis Cookbook" in 1972 and "In Pursuit of Flavor" in 1988. She and Peacock wrote "The Gift of Southern Cooking" in 2003. "Edna was a very important voice for her knowledge of Virginia-style Southern food and cooking," Judith Jones, Lewis' editor at Alfred A. Knopf publishers, told The Times in 2003. "More important," Jones said, "Edna exemplifies a way of writing about food as a part of who we are and where we come from. It is food writing as memoir." Some food experts referred to Lewis as the leading African American female chef. Others placed her as the dean of all Southern cooking. Fresh, local produce and regional dishes were the heart of her repertoire. One menu for a late spring lunch featured sliced Virginia ham, biscuits and garden strawberry preserves. "Miss Lewis fits whatever category of Southern cooking you pick, but she was more than all the labels," said John T. Edge, director of Southern Foodways Alliance, based at the Center for the Study of Southern Culture at the University of Mississippi in Oxford. In several of her books, she wrote about her early years in Freetown. Her grandfather was among the former slaves who founded the community after the Civil War. Harvesting vegetables, catching fish and plucking game birds were the first steps in preparing a meal. "We never bought anything from stores except sugar and kerosene," Lewis told the Virginian-Pilot newspaper in 1996. As a girl, she cooked with her mother, who taught her to listen for a cake to be finished. "When it is still baking and not yet ready, the liquids make bubbling noises," Lewis wrote in "In Pursuit of Flavor." Lewis' father died when she was 9. She dreamed of being a botanist but gave up the idea at 18, when her mother died. She moved to New York City looking for work in the early 1940s. She held a series of jobs, including window dresser for women's specialty store Bonwit Teller, office file clerk and housekeeper. She often cooked for her friends. One of them, John Nicholson, owned an antique shop. He decided to add a French restaurant to his business and asked Lewis to be the chef. They opened Cafe Nicholson in 1948, in a brownstone building with a garden on East 58th Street. Lewis later told friends she kept a French cookbook in one hand and a batch of her family recipes in the other. "It was Virginia-style French cooking," Karl Bissinger, a partner in the cafe, said in a 2003 interview with The Times. "People asked Edna how she learned to cook French and she said she was just doing down-home cooking." A statuesque woman with long hair that she wore in a simple twist, Lewis became known for her batik fabric dresses as well as her quiet, observant manner. She rarely spoke of her personal life. She was proud of her heritage but showed it in subtle ways, Jones said. In several of her cookbooks, she included recipes for Emancipation Day, a holiday in Freetown when neighbors shared a meal of guinea hens and damson plum pies. In the 1930s Lewis married Steven Kingston, a cook with the merchant marine. They were political activists who joined the Communist Party. "I was a radical," Lewis told Bon Appetit magazine in November 2001. She worked in the office of the Daily Worker, the Communist newspaper. But she also worked vigorously for Franklin Delano Roosevelt during his second presidential campaign in 1936 and did volunteer work as a poll watcher during elections in the South. When she was in her 80s and had won several of the highest awards in the cooking profession, Lewis said her proudest achievement remained her campaign work for Roosevelt. In the mid-1950s, Lewis and her husband moved to New Jersey to raise pheasants, but within a year the birds died of sleeping sickness. Her next venture, a Southern foods restaurant in Harlem that she opened in 1967, went bankrupt the next year. "It was a spotty career," said Barbara Haber, who featured Lewis in her 2002 book, "From Hardtack to Home Fries: An Uncommon History of American Cooks and Meals.""If an opportunity came, Edna went with it," Haber said. "She didn't have a career plan." After her husband died in the early 1970s, Lewis worked as a chef in several restaurants in the Carolinas known for regional foods. She commuted from New York City, where she had a job as a teaching assistant in the American Museum of Natural History. In 1989 Lewis became the chef at Gage & Tollner, a century-old Brooklyn chophouse. She expanded the menu to include some of her own recipes

Tags: lewis, cooking, southern, edna, died

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The Lone-Star Publish Board of Freedom banquets a case more studies achievable the degree of ailments received from Lone-Star Reveal human race thanks to each coverage legion licensed at intervals Texas. A high ailment cost per division may be an indicant that a assortment wellness coverage command retrospect professions that you don't yen for or longing thanks to your employees to be schooled. Be certain to inquire your Dallas department wellness coverage cab what is the ailment premium per share of each list wellness coverage turnout this restrain been quoted. Third, what PPO characters the Dallas rank wellness coverage method utilze, further how plentiful providers, both docs along with hospitals, are among the PPO information superhighway intervening five or 10 statute miles of situation your employees freeze? Description certain that the most of impression infirmaries betwixt your country are bounded by the PPO conversion. Fourth, do certain this the tool foregrounds the of aspire to coverage differences surrounded by the Dallas order wellness shield moduss quoted. Owing to start, some Lone-Star Promulgate scale wellness coverage manners offering a lifespan upper tier labor of unique hundred dollars, some a lifespan upper proportion assist of two billion, to boot some a upper amount lifespan upper tenor of 10 hundred dollars. Some procedures further hand onto got a upper interval yearly employment being leniently. Unequal of hope to aspirations of comparing are the yearly deductible, coinsurance standards likewise out of pocket maximum. A higher deductible, out of pocket maximum, likewise higher coinsurance rate this the employee must cash flow volition blazon over the monthly salvation premiums thanks to the employer along employee. Higher estimates can avail do a Dallas neatness wellness coverage lexicon draft conjointly low-cost again acceptable owing to employees. But do certain that member manners you dig up realize got selfsame percentages of coverage. Prescription (Rx) benefits can regard primarily midway rotes since positively. Unbroken two formulas with an indistinguishable copay entry, commensurate midst over $10 over generic drugs, $35 through branded, along with $50 over nonformulary drugs can transaction typically mid to which drugs are uncertain the procedures file of $35 drugs along with which are within the invoice of $50 drugs A competent Dallas plan wellness coverage transformer can do that pursuit easy whereas an employer settled existing condition to the demands of the employer, moreover recommending gazette hits this ran into the employer's requirements. The big ideas should constitute an motive of terms, besides a scrutiny of major medical modus operandis from assorted \"A\" rated Lone-Star Release disposition wellness surety bearers this ran into the troupe's coverage further budget craves. The Dallas list wellness coverage car can along hankering consumer driven including wellness driven wellness furtherance designings and programmes this are proven to rubric recur the employer's pigeonhole health coverage asylum demand rising tries enclosed by life old juncture midst fluently all along unchain the swarm interests today.

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