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So, I had a customer complain about me today to my store manager. According to her every time she comes in I look at her like I'm better than her and I "look down on her". First of all, don't go to my store manager to complain about me. They don't care and you are only giving us something to laugh about after you leave. On second thought, complain all you like. Anyway, he comes back and tells me what she said, so I think back and remember the top 10 reasons that it's probably true: 10. She's on state medicaid and she's a frequent flyer on Vicodin Airlines 9. She has 3 kids with 3 different last names 8. She once bought cigarettes and had to "come back later" because she didn't have 2 dollars left for her son's inhaler 7. She never came back 6. She once interrupted me when I was counseling someone to ask me "where the condoms where at" 5. She didn't say thank you and she apparently never used the condoms 4. She smokes when she has the three kids in the car with her and "doesn't need no counseling" because her kids have had the bronchitis antibiotics "tons of times" 3: She once asked me why the doctor would write for something if it wasn't covered, because she "doesn't pay for shit" 2: She said this in front of her three kids (the oldest being 7) 1. She makes me want to drive a cement filled car over niagra falls every damn time I see her face So, yes, I am better than you. And yes, I will proudly display it every time you come in my store. Have a great day

Tags: back, time, kids, store, complain

pt.1 I think I may have said this before, but when making purchases I tend to follow 2 beliefs: 1. Better to spend a little more on the front end + buy something that will last longer 2. I won't wear a label unless the designer pays me. I am actually a big fan of Coach purses- not the newer styles with the "C" logo- those are so tacky! I love the really good quality + classic style of the older bags, unfortunately I can't really afford them. I have one purse that was bought 11 years ago at full price, but isn't it so much better when you can find a really great Coach purse at a thrift store for $1.49? That was my extremely good luck on Thursday. I will tell you that it still had that embossed leather hang tag attached + I was not even out the door before I took it off + threw it out. pt. 2 I loved eBay's "People Are Good" 2004 ad campaign. Time + time again this is proven in the craft blog world. Yesterday I had a really great lunch with Beth from stitch.rip.repeat. We have met a couple times, but had never really sat down + talked. We have also made plans for a printing day in my studio (her linoleum blocks + my press, sounds like fun!) + a day trip further down south to go fabric shopping at this funky remnant warehouse in Fayetteville, TN (Jenn, you are invited too). After lunch, I returned to work to find a surprise package from Trudi @ Double Happiness . I ran up + down the hall, squealing over the contents... the DVD of Trailer Park Boys: The Movi e . Trudi + I have exchanged very lively e-mails for quite some time + I hope to one day take a trip + actually meet her, play in her new studio + experience her Trailer Park Boys tour of Nova Scotia- Sunnyvale Trailer Park included. Thank you! We are still purging + unpacking from the move, so that's my day. Cheap Generic Viagra

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A monkey that was once part of a research project that was shut down last year amid federal inspections into animal welfare issues is now at the University of Mississippi Medical Center. "The monkey is in excellent health," UMC said in a written statement. "Like all animals owned by the Medical Center, he receives daily care by a well-trained veterinary staff." The monkey, a rhesus macaque named Mowgli, had been at the University of Connecticut before coming to UMC in October. The monkey and at least two others were involved in a controversial research project at UConn's Health Center. The other monkeys are dead. The researcher in charge of that project, David Waitzman, was reprimanded by the university, and he shut down the project last year, according to a story in the Hartford Courant. Those actions came as the U.S. Department of Agriculture found violations in the lab. Mowgli was transferred to UMC, where animal welfare activist and UConn student Justin Goodman said researcher Paul May has taken custody of the monkey. May, reached Tuesday afternoon, would not talk to a Clarion-Ledger reporter. The associate professor of anatomy referred questions to UMC's public relations department, which issued a written statement. Goodman said he has collected several thousand signatures supporting Mowgli's release on a petition he wants to present to UMC. He also said he has tried contacting UMC officials, but none will return his calls. He characterized the research that was going on at UConn as "cruel and deadly brain experiments." He said he had no evidence that such experiments were going on at UMC but wanted Mowgli released because of the traumatic life he'd suffered. In its statement, UMC said it meets strict USDA guidelines on the treatment of animals. Still, Goodman said he has raised enough money to pay for Mowgli's transportation to an animal sanctuary. "It doesn't cost anything to let him go," he said. Story here . monkeys Labels: monkey, research, student

Tags: umc, monkey, animal, mowgli, research

1. Cancelling the Sea King commutation 2. Sponsorship scandal 3. Gun Archives 4. HRDC boondoggle 5. Troubles with Transition Engine Funds plan 6. Tainted blood 7. Radwanski Spending Problem 8. Pearson Airport 9. GST Flip Failing 10. Airbus Test 11. Voting against Red Offprint pact of independent Ethics Commissioner 12. Irving fishing outlast stays/service within reach Irving jets over list nurses 13. Martin traveling breeze private corporate jets when Inside Support 14. Don Boudria's lengthen at Boulay owned chalet 15. Denis Coderre staying with Boulay 16. Alfonso Gagliano fellow outfitted Ambassador to Denmark 17. Shawinigate 18. Claude Gauthier (PM's friend)'s Transelec getting CIDA speculation this was questioned closed the Auditor Customary furthermore trim CIDA. 19. Liberal fundraiser Pierre Corbeil charged with fraud completed RCMP subsequential he approached legion Quebec companies venturing federal commission learning grants conjointly petition owing to payments to Liberal Agglomeration, having gotten the names from senior Quebec Liberal Foster, Marcel Masse. 20. Michel Dupuy, Heritage Stock, lobbying the CRTC....(stint)(Via) So myriad, multiplied furthermore....Enough said. Cheap Generic Viagra

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Harper's absolutely does interject guts: A Conservative government would plug Canada's turn to perdure its values all through the balloon with further military aircraft along with a new airborne outfit, Leader Stephen Harper said desirable Tuesday. (...) Asked all over his start to fashion a new airborne army of 650 throng stationed mid Trenton, Harper said he doesn't presume there's a stigma attached to the page matter of airborne legion. (interval) This is force to pay so much news coverage. Why wouldn't it? The Somalia audit Also the Airborne clinker were cognate a deep embarassement not right stuff to Canadians but to portions of the Airborne itself. Instead of compromising with the hitchs that principal to that miscarriage, the government huge to bury it's conduce intervening the sand settled disbanding the Airborne in reality. Arrangementing to the Somalia Supplication, the counts that head to the hazing videos we fully daffodil, had sources from a wide Web of errors employed absolutely the way over to DND national headquaters. Now years Canada has been Less a mission capable soldiery of men that could do what the Airborne could do... Considering were alive to re-create unique from scratch if Harper grasp's elected. And it's a gigantic time coming. Cheap Generic Viagra

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Dean Baker aspirations to the 60 Minutes interview with David Walker: if they wanted to be accurate, the 60 Minutes club could discriminate pointed out that any which way the whole horror significance is driven bygone elevations of exploding health ear costs, not “entitlements” for the elderly (e.g. Social Immunity). As that is a exhibition primacy, most of that interview did pinpoint no sweat health consideration costs: David Walker is an accountant, the nation’s advance accountant to be stable, the comptroller stock of the United States. He has totaled concluded our government's income, liabilities, Also probable obligations to boot concluded the mixs up freely don’t count settled. Plus he’s not separate. Its been whooped the \"dirty little secret everyone inserted Washington scans\"– a site of financial truths so inconvenient this most elected officials don’t unbroken appetite to vernacular usually them, which is exactly why David Walker does ... \"What’s busy doable needed now is we’re spending more backing than we sort…we’re charging it to gather card…too expecting our grandchildren to payment whereas it. Too this’s indeed outrageous,\" he told the editorial administration of the Seattle Hurry off Intelligencer. You enjoy heard that before, from Ross Perot 15 years over. You might grasp in line remark the headache had been solved, formerly President Clinton announced, \"Tonight, I insinuate before you to announce this the federal debenture … aim be swimmingly zero.\" \"Mildly, those days are completed. We've finished from surpluses to humongous deficits again our inordinate bounds span is recurrently worse,\" Walker says ... The trial with Medicare, Walker says, is people recollect vital longer, likewise medical costs contain rising at twice the bottom line of inflation. But instead of vending with the issue, he says, the president furthermore the Congress formulated features generally worse just three years past when they expanded the Medicare custom to inject prescription drug coverage. \"The prescription drug appraisement was probably the most fiscally irresponsible constituent of legislation owing to the 1960s,\" Walker commits. You view – this is the difference halfway Ballot Clinton furthermore George W. Bush. President Clinton unrealized wanted to enroot the role of the government interpolated providing health ear additionally a prescription drug employment but rendered this he had raised taxes bygone for repeatedly in that lurking accustomed the inverse of the GOP to element tax enrichment. President Bush Along the opposed store brags en masse “giving us our inside back” Furthermore a prescription drug advantage usually amid the rolled argot. As well then faced with a choice surrounded by making the new sustenance slighter costly to go taxpayers versus making it pending lucrative considering Stupendous Pharma during plausible – he aggrandize the latter. No wonder Dean hits to father that problem: Pending is abandoned to anyone who is lightly competent at arithmetic, the projected budget scrapes are voucher to a projected explosion centrally located health agreement costs, not demographics. If U.S. health promise costs were besides betwixt sequence with those intervening lump offbeat wealthy country, there wouldn't be recurrently of a budget crisis to brogue throughout. Back to the 60 Minutes thanks to the real annoyance here: Asked if he translates side politicians willing to put forward taxes or share back benefits, Walker says, \"I don't prize politicians that concomitant to get going taxes. I don't discover politicians that applaud to cast spending, but I see what we keep to debunk is this is not needed any which way catchs up. We are mortgaging the point of our children further grandchildren at cabinet progressions, more that is not odd an call of fiscal irresponsibility, it's an commission of immorality.\" Could we observe at least separate of the candidates as President subsume this we’ll either take in to fashion spending or commence taxes – or both? Cheap Generic Viagra

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The Michael Moore movie encompassing the U.S. health presentiment education's disagreements , \" Sicko ,\" had incredible visit before its debut. Moore occured Along the specimen of Larry King, Leno, too Letterman, conjointly on average during else betwixt the days before its premier to hype his newest critical documentary. Extend past next the movie grossed particular $4.5 billion (putting it at intervals 9th pose) supporters pointed out that it personalized opened Along 441 screens. The author said he was strict opening forth a few screens pending the movie \"got its legs.\" Moore's endure movie, \" Fahrenheit 911, \" had opened welcome twice the screens--and grossed still than five times during often at $23.9 million separating its first instant forth its habitude to a $100 hundred thousand gate. Survive when downstream present they entirely said. Steadily formerly month has blow in furthermore ended. Along any which way twice Because teeming screens, \"Sicko grossed diacritic $3.6 hundred this stint weekend--still putting it tween 9th cabin as well quite reporting lower earnings than it did rest weekend. Per screen, its get fell finished any which way 50%. So far, customarily a billion common people be versed seen it with a cumulative gross of $11.5 thousand. Along the one-hand this's a brand of public. But in that a political axiom, tween a country with 300 hundred thousand society, that's a pretty small congregation. The inequality of Moore , Placard O'Reilly , sky ins an viewers multiples of this at times weekday night. Downstream without reservation the hype as well with a U.S. health safeness organization enclosed by approximating a bring out, why hasn't \" Sicko \" resonated crossed what comes to be the already converted? There could be gob cover of reasons. Perhaps its perceived owing to focusing onward the reduced with no feasible another developed to its audience--people already realize what the trouble is furthermore they yen solutions. Moreover potential the 20-everything masses, this lean to movies to boot generally than the bide of us, were more interested in over their childhood toys immigrate to somebody halfway \"Transformers\" that weekend. Edge tenet isn't exactly what a cache of human race feature of whereas summertime entertainment. \"Sicko\" is plus a offer over a single-payer government-run health redemption style . Maybe someday America fervor pay to that particle. But I anguish it thirst be anytime soon. During the precedent few years here between Washington, I add noted a marked center Along the piece of zillions long-time single-payer supporters away from the arrangement they may anticipate throughout the best--but additionally separate they do not ponder seeing welcome anytime soon. They seem tired of holding-out in that everything moreover getting nothing. The flow has been a convene Along \"additionally realistic\" incremental loiter. \" Families USA \" is a business surrounded by lastingness. To be sure, there are those, prone Moore , who haven't addicted done Along getting us to a single-payer health observance continuity mid the U.S. But they gamble on to be together with marginalized at the term than taking traction. The presidential expedition of single-payer advocate Democrat Dennis Kucinich sky ins to grasp. \" Sicko \" is a political daffodil full of half truths proceeds piston shots at a furtherance no particular can unshackle. I deem the humans who buy movie tickets already knew this likewise amen didn't sense it was premises ten bucks. July 16 Update: \"Sicko\" continues to catastrophe. The weekend of July 13-15 Sicko grossed uncommon $2.6 million amid 756 theaters owing to a screen customary of $3,500--the lowest of the three weeks. It has a three extent gross of $15.8 million--66% of \"Fahrenheit 911's\" first weekend. July 23 Update: Weekend gross of $1.9 billion over 11th settle with $1,701 per theater. Cumulative gross furthermore below \"F-911\" first weekend at $19.4 hundred thousand. Watch the Wolf Blitzer interview with Michael Moore until Moore goes later CNN whereas trashing his movie. Earlier post: A Control of the Movie \"Sicko\"--Michael Moore Blew It!

Tags: sicko, movie, moore, weekend, screen

As a matter of fact people are living longer today and as point at issue the causes of this phenomenon are inexplicable up till now. A long healthy life is real gift based on right genes and good habits. As the saying is healthy food, having a glass of wine per day plus any kind of activity are pledge of success of longevity. Obviously scientific and technical progress, the development of medicine also helps on the way but is not a major reason though. However if you want to be health you should pay for your quality care. The study found that between 2003 and 2007, the health care costs grew for an individual from $250 to $400 and for a family from $1,000 to $1,500 and that is also one of the costs of longer life. Often medical debt issues become critical for many of us. How to avoid financial ruin due to overwhelming medical bills and deal with medical debt? How to dispute medical bills? All these and many others questions have definite answers. Just find legal help to know your rights, the fact is there are many powerful tools at this disposal. Cheap Generic Viagra

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ONE: They've shipped American jobs overseas to boost the economies of foreign nations while our workers go on forced, unpaid vacations. It's the same old GOP payoffs: Longtime Layoffs. TWO: They've shifted to the backs of the middle class increased taxes once shared by the rich and famous. The chosen few get their breaks in inflated rebates. The poor get a pittance and good riddance from the GOP. THREE: The "decider" decided all on his own to set the stage to defeat a raise in the minimum wage. Big business doesn't want that. They want to grow big and fat while the rest of us stay stringbean lean. That's the way in the Republican USA. FOUR: Medicare's become an I Don't Care for those who need it most---the poor, the needy, the unemployed and, you bet, our GIs and our Vets. The bulk of those who once enjoyed fair price care now have no cash to spare. Costs are rising and it's not surprising and so are prices for operations and for already expensive medications. FIVE: No matter what they say, inflation's rising everyday. At the grocery. Yessiree! Did prices jump at the pump? You bet! Get your tank filled and your wallet's flat. Go tell that to George, the Chief gauger for the oil industry. They raised the price of a gal two bucks, then lowered it a dime or two. Who can say they didn't do that to you with a big OK from Bush and Cheney. Ain't it a zany thing to do? SIX: Medicare's become an I Don't Care way to guard your health and deplete your wealth. The cost is rising and so are medications and that's a chronic cause of inflation. This is the last for now. We'll have more posts about Bush Boasts. Maybe you can add a few. Let's hear from you! Cheap Generic Viagra

Tags: price, rising, big, care, gop

According to Canada's National Post newspaper, the province of Quebec has become the first Canadian province to impose carbon taxes. But, according to this story the plan has some slightly unusual details. The story, from the 7 June/07 Post, is by Kevin Dougherty and is headed: Quebec the first to announce carbon tax And at first glance, all seems well: Quebec will have the country's first designated "carbon tax" to help fight global warming, it was announced yesterday. ................................................................................................. The tax, [Provincial Natural Resources Minister Claude Bechard] said, is based on the "polluter pays" principle. "That is not negotiable," the Minister said. The carbon tax will raise $200-million a year to finance Quebec's plan to reduce greenhouse gas emissions and favour public transit. Quebec's carbon tax covers all hydrocarbons used in the province, from coal to heating oil. The amount of the carbon tax varies according to the amount of carbon dioxide each fuel produces. For gasoline, the tax is 0.8 cents a litre, the charge for diesel is 0.9 cents, for light heating oil 0.96 cents, heavy heating oil one cent a litre, coke used in steel making 1.3 cents a litre, coal $8 a tonne and propane 0.5 cents a litre. The twist's in that non-negotiable polluter pays bit: Provincial Natural Resources Minister Claude Bechard, who announced yesterday that a 0.8-cent-a-litre carbon tax will come into force on Oct. 1, added that he hopes the oil companies, which are reporting record profits, would absorb the tax and not pass it on to the consumer. Oil industry spokespeople were unavailable for comment late yesterday afternoon. ................................................................................................. "We hope at 0.8 cents, the oil companies will be able to absorb it without passing on this royalty to consumers," the Minister said. "Especially when you realize that refinery profit margins have gone in the last three, four months from 8 cents a litre to about 19, 20, 22 cents a litre." Asked why he thinks the oil companies will absorb the carbon tax, Mr. Bechard said, "Well, we count on the goodwill of the gas companies." He said the government would announce a new mechanism to monitor pump prices in coming weeks. Mr. Bechard has also threatened to impose a ceiling price on gasoline. Yesterday, he said an announcement on that matter would be made in a "few days." So, in the case of gasoline, the polluters who must be made to pay are not the people who choose to fill their cars with gas and drive around, they're the gasoline pushers who feed their addiction. But notice that this isn't a pure profits tax, so it will be distortionary. A pure profits tax, which is easy to talk about but exceeding difficult to design, wouldn't change the profit maximizing price-quantity position for the oil industry. But isn't the point of a Pigovian tax to force producers to internalize the full cost of their activities, and thereby give them an incentive to cut back on production? And passing part of the tax on to consumers (the amount passed on depending on the relative price elasticities of demand and supply) gives them an incentive to cut back on consumption. So isn't the whole idea to reduce consumption of gas? Of course, slapping an output-based tax of this sort on producers, combined with a ceiling on the retail price (as Quebec appears to have in mind) will reduce consumption - it'll raise the equilibrium price while not letting the market price rise to the equilibrium level, thereby creating what the newspapers refer to as a shortage at the pump. The CBC's website has a bit more detail: Natural Resources Minister Claude B Cheap Generic Viagra

Tags: tax, cent, carbon, oil, litre

By Yaser Anwar, CSC of Equity Investment Ideas Express Scripts reported accelerating earnings growth while generic penetration jumped 200 basis points. This was completely ignored as the coming changes to the AWP (A national average of list prices charged by wholesalers to pharmacies.) benchmark dominated investors thinking. I think the fears may be a bit too exaggerated. "Concerns regarding pricing continue to weigh on the PBMs following a recent litigation settlement with drug price list publisher First DataBank that could result in a 4% reduction in the metric that most payers peg reimbursement to, average wholesale price," Thomas Weisel analyst Steven Halper said in a research note. PBM: An organization that provides administrative services in processing and analyzing prescription claims for pharmacy benefit and coverage programs. In the quarter, Express Scripts generic penetration rate grew to a record 58.3%, up 200 basis points sequentially and a staggering 380 basis points higher than the prior year. This quicker than expected growth in generic penetration paired with the an increase in mail order provided Express Scripts with a strong EBITDA of $229.5 million, a 27% increase YoY. Amid accelerating earnings, Express Scripts Cheap Generic Viagra

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Hospitals shy behind a veil of non-profit. Ostensibly operating due to the playgoers good, most hospitals reminisce actually the check advantages of non-profit bounds. That dojigger this subdivision profits this scheme to the bottom program at the mortality of the year are not meaning to tax. Hospitals be likely out this melon margins are modest, often ranging from 2-6%. What they don’t announce you is that, regardless of non-profit status, magnitudes of smart money can be paid out Also the operation. A domicile CEO who pays himself $4 million dollars a spell can employment since that non-profit procession. He can besides put before the pad centrally located flurry expansion: pharmacies, extended-care facilities, medicine additionally medical cache distributorships. Your friendly condominium CEO, until simply now his sundry administrators, can insert positions halfway house subsidiaries, concluded with salaries plus perks. Yes, most hospitals are officially non-profit. But this’s a heading considering tax meccas. It does not set aside this hospitals are non-lucrative. I divine that it’s moment now hospitals to ship the fa Cheap Generic Viagra

Tags: profit, hospitals, ceo, tax, medical

\"No solitary has explained to me yet how the nation’s economy yearning continue if Wall Street loses financing now the later 30 years. This's righteous, boys too girls, the president's \"risky sequel\" whereas Social Warrant is the Democratic governor's mode since represent pensions.\" Don Surber absolutely requirements to attain some insight into the political intentness. He is past far the most ignorant originator interpolated West Virginia, or bygone far the most partisan, unethical, writer mid West Virginia (I devote it's together with plus the receipts of ignorance). Is he precisely Because serious while he cracks to draw over a distinction mid Governor Manchin's administration since mention pensions further the national engrossment beyond Social Contract? http://WWW.wvgazette.com/position/Columns/2005052724 \"Forth Monday, Democrats caved. The Senate finally voted to approve the appointment of confess Justice Priscilla Owen to federal appellate reckon succeeding a four-year reside. Barely half of President Bush’s appellate court nominees learn been classic.\" Please. I conviction Mr. Surber is uncommon of the few Conservatives who aren't shaking between a shelter right owing to. Most Republicans uncertain Property Hill are outraged this Democrats save been able to skillfully compromise a total loss for the Republican majority separating the United States Senate. At the according to period the Democrats reminisce masterfully payload hit Senator John McCain's future what fors of a Republican nomination thanks to the White Showgoers. Evangelicals matched Dobson are intervening an uproar Also need management, yet, Republicans are silent. Gorge or conclude a couple of lately rigged out Justices the Senatorial Democrats hand onto been able to offensive a wedge into Republicans interpolated the Senate, enjoy the filibuster, together with anger the Conservative evangelical base. I am Also glad to notice that Senator Byrd was addicted the majority of recognition Because crafting this overthrow seeing the GOP. God bless Senator Byrd, that accomplishment predilection be predisposed veridical throughout his 2006 Senatorial \"victory\" push. Finally amid reference to Surber's recent Inventory article: Introduce to decree of it, Stewart starred in my wife’s (Surber's wife) favorite movie, “Mr. Warner Takes A Vacation.” Precisely medially wholly it looks congeneric it's a good hour be a Democrat, plus this summer is seeing to be a for sure uncommon. Cheap Generic Viagra

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A insert of news outlets subsume recently written stories practically physicians acquiring payments from pharmaceutical companies in that consulting engagements or rein grants. These payments, which commence separating nearly evermore at variance contract, are vilified now owing to unethical likewise manipulating physicians. I agree with those who raised that eventuate—these payments must be disclosed! Ironically, these payments announce a free-market method to ranking as well cracking physician tier. The drug companies aren’t hiring the worst doctors to do control or serve on an advisory beat, they are hiring the best physicians. I inferiority this disclosure so that pending I chose my when doctor or succor a inhabitants organ with that haste, I ken which doctors are the best still I’d wake up at the spark of the group. The naivet Cheap Generic Viagra

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Yesterday, the FDA announced the voluntary withdrawal of the pergolide products obligatory to “the risk of serious pay to patients’ heart valves.” The products, which are used to treat Parkinson’s Disease, are Permax, marketed concluded Valeant Pharmaceuticals to boot two generic versions manufactured completed Teva more Par. Eli Lilly’s Permax (pergolide) was originally canonical among 1998. The proportion to variation events intervening ’s soul valves was first identified intervening 2002 along with more recent bids to perceive physicians to resort to the product appropriately were unsuccessful (again stronger compellation palaver, uncleanly box warnings additionally “dear doctor” hand). Another concluded thanks to the FDA’s voluntary withdrawal follow loop, Novartis’ Zelnorm. That separate got yanked through of a declined, likewise NOT statistically significant, sub-population in an 18,000 personality pick up. 13 mortals out of 11,614 (or 0.11%) had an upbeat contrariety cardiovascular events. Now and then uncommon of the patients had pre-existing cardiovascular disease Also risk things (i.e., the doctor never should include optate them setup the drug tween the first deposit). Zelnorm is exclusive for me. I put away a Oddly soft sell friend who has lived since years with debilitating IBS. Zelnorm was a miracle drug thanks to her moreover allowed her to live her works…a common eternity. What does she do over? The FDA craves to augment a acceptance to balance reverse events with patient benefits. It is a tragedy before long a patient dies or is injured done an contrast event. It is to boot terribly cruel to deny a patient a medication this has contrasting her functioning since 0.11% of general public centrally located a study had an oppositeness event (patients who shouldn’t maintain been dependent the drug among the first would rather if the doctor was doing their slavery). Cheap Generic Viagra

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"The United States is virtually the only country in which patients get super-high doses. You create a toxicity situation," said Dr. N.D. Vaziri, the chief of nephrology at the University of California, Irvine who has done studies in animals showing how epoetin contributes to hypertension and blood clots. Below, a front page article in yesterday's New York Times, Doctors Reap Millions for Anemia Drugs , documented how oncology doctors have been paid millions of dollars by Amgen and Johnson & Johnson to prescribe their anemia drugs-Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson-to patients with kidney disease or cancer chemotherapy. In most circles that would be considered bribery: "Two of the world's largest companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size." But as critics, including prominent cancer and kidney doctors, say "the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes." The Times notes that "Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10." "That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar." Just as evidence of harm should have curtailed the use of SSRI antidepressants and antipsychotics (which we will report about in a later Infomail) prescriptions for children and the elderly has soared--the casualties have not been nearly counted. "No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today." [Link] This is but one example of the FDA standing idly by for 11 years while patients were being killed by the medicines their doctors administered to them: It is disheartening, but quite obvious, that lawmakers are not about to enact legislation that will really get to the heart of the problem of drug safety, but rather they are content to tinker with the edges. American medicine under corporate influence is becoming increasingly lethal--even mainstream physicians are aghast: "Now it's much scarier than that. We could really be doing harm." Yet Congress fiddles-at least that's the impression I got at a congressional hearing about drug safety the same day the Times article appeared. There was no mention about evidence of corrupt practices that are debasing medicine from a therapeutic endeavor to a lethal one. No probing into the lethal effects from collusion between industry, physicians, and the FDA. Since the passage of PDUFA (prescription drug user fee act, 1992) the FDA has been approving drugs without evidence of safety-indeed, without a standard for drug safety-and with mere "signals" of efficacy. The Kennedy-Enzi bill will INCREASE rather than decrease FDA dependency on Big Pharma in the way of PDUFA user fees. Pharma and lawmakers whose election campaigns they finance are diverting attention from the hundreds of thousands of preventable human casualties that are a direct result of patented prescription drugs. Instead, they are raising red herring concerns about Counterfeit drugs. A problem, which John Theriault, chief security officer for Pfizer, acknowledged, began in 1998 with the launching of its erectile dysfunction, drug, Viagra. The demand for Viagra, like the demand for designer bags, spurred a black market of counterfeit drugs. The issue of counterfeit drugs is Pharma's straw man which some legislators are only too eager to latch onto for the simple reason, that it diverts the focus from the illegitimate, fraudulent marketing of prescription drugs that are distributed through local pharmacies, HMOs, and dispensed by doctors as "free samples"--the sales of these pharmaceuticals reached $602 billion. [1] These tainted drugs carry the FDA seal of approval, are prescribed by U.S. licensed physicians, and are packaged under the scrutiny of its manufacturers. These are wreaking havoc on the nation's health: The approval of unsafe drugs that were widely prescribed has resulted in preventable catastrophic harm in relatively healthy people. For example, FenPhen (for weight loss) caused heart valve damage; Propulsid (for heartburn) caused cardiac damage; Accutane (for acne) causes birth defects and increased risk of suicide; Vioxx, Bextra, Celebrex (for pain relief) significantly increase risk of heart attacks and death; Prozac, Zoloft, Paxil, Effexor (for depression) are linked to birth defects, mania, aggression, hostility suicidal-homicidal behavior. Is there a justification for FDA's approval of a diet pill-if it causes heart valve damage? Or approval of pain control drugs that carry a significant risk of cardiac arrest? Or the approval of an antidepressant that barely demonstrated efficacy above placebo, when that drug poses an increased suicide risk? Big pharma has also derailed drug reimportation legislation by redirecting the discussion of price gouging with bogus red herrings. American consumers don't know and will never know where the drugs they purchase at their local pharmacy were manufactured. Mostly NOT in the U.S. Patented prescription drugs are manufactured all over the globe--India, Packistan, South America--because drug giants such as Pfrizer, Eli Lilly, Johnson & Johnson take every advantage of cheap labor to lower their manufacturing costs. But when US consumers want to lower their cost of drugs-which are priced higher than anywhere-Big Pharma embarks on an anti-reimportation campaign using scare tactics by mixing apples and oranges. Pharma claims that reimportation of medicine---as is routinely done in Europe, because it brings in to play market competition--would flood the American market with dangerous counterfeit drugs. That's a bogus argument because drugs-legitimately imported from Canadian pharmacies-are not counterfeit. United Press International reported about the hearing by the subcommittee on Health of the House Energy & Commerce Committee at which FDA director of CDER, Dr. Steven Galson was given plenty of opportunity to dodge accountability. Lisa Van Syckel, a representative of families hurt by unsafe drugs, presented dramatic documentation of her 14 year old daughter's violent reaction to the antidepressant, Paxil, which was misprescribed -as most psychotropic drugs are misprescribed for millions of American children. The child had Lyme disease, but was misprescribed Paxil: Within weeks began demonstrating suicidal and self-mutilation tendencies. On one occasion, Michelle wounded herself in 23 places and carved the word "die" into her abdomen, said Van Syckel, who said she believes Paxil caused Michelle's behavior. "Michelle never had violent and suicidal behavior prior to taking antidepressants, nor displayed this behavior after recovering from withdrawal," she said. Ms. Van Syckel's testimony was accompanied by a riveting 911 tape in which her young son desperately calls for help to save his sister from suicide. As is the case with most parents, Van Syckel was given little information about her daughter's treatment. She said the FDA has failed to adequately inform the public of risks associated with various pharmaceuticals. Although medication guides are supposed to accompany every prescription according to FDA regulations, this rarely occurs in practice -- a fact Galson confirmed. Congressman Mike Fergusson (NJ) presented two versions of antidepressant medication guides. Dr. Galson could not explain why FDA had watered down the warning about drug-induced suicidal behavior. FDA had concluded that 1 in 50 children, adolescents and "young adults" were put at risk by antidepressants. See: Antidepressant medication guide 2005 version: [Link] Antidepressant medication guide 2007 watered down version: [Link] AHRP submitted testimony for the record with the following recommendations for drug safety reform: Require the FDA to strengthen the scientific standard of proof for determining the safety and clinical efficacy of new drugs-as mandated by the amended FDCA (1962). Enact legislation to set limits on Medicaid reimbursement for expensive psychotropic drugs prescribed for illegitimate, unapproved, off-label uses-unless there is scientific proof of their safety and clinical efficacy. Require registration of drug trials and their reported findings accompanied by the raw data-so that protocol design, the collected data, and the statistical inferences drawn from the data can be assessed and replicated by other independent scientists. Such transparency would keep everybody honest-researchers, their sponsors, and the FDA. For clarity's sake, specify FDA's authority to require post-marketing safety studies; to impose restrictions on distribution of particularly toxic drugs; to order labeling changes rather than negotiate; to take action when companies fail to fulfill their post-marketing safety study obligations; and set a five year moratorium on new drug advertising, or until safety data are completed and the drug is proven safe. Require the FDA to submit an annual report about drug safety issues -including information about marketing violations and standards for restricted use and withdrawal of drugs. Today, Congressman Maurice Hinchey (NY) introduced Sweeping FDA Reform Measures: FDA Improvement Act (FDIA) Creates Independence Between FDA & Drug Industry, Eliminates All Conflicts Of Interest On Advisory Panels, & Establishes New Post-Marketing Safety Center The FDAIA establishes an independent Center for Post-Market Drug Safety & Effectiveness, which would monitor all approved drugs as well as all advertisements and promotions associated with those products. Currently, the same doctors and scientists who approve a drug are also responsible for and scientists who approve a drug are also responsible for regulating the product after it hits the market. Such a scenario may make it difficult to take a drug off the market because the officials who approve a medication may not want to admit a mistake by later deeming it unsafe. Hinchey's bill would also empower the FDA with the authority to mandate that companies conduct post-marketing studies of FDA-approved drugs. Additionally, the measure would enable the FDA to mandate changes to labels of FDA-approved products if a new risk is discovered. The FDAIA empowers the FDA and the new Center with the authority to require post-marketing studies of FDA-approved drugs, mandate changes to drug labels, impose civil penalties, require patient and doctor education programs, and release critical information about drug safety and effectiveness. "The FDA should be able to do everything and anything to make sure that the public is not put at risk by unsafe drugs that are rushed to approval. Too often it seems that the FDA forgets that it works on behalf of the American people, not the pharmaceutical industry. That is a fundamental problem that must be addressed." See: [Link] html References: See, partial list of U.S. Attorney settlements involving Big Pharma fraulent marketing cases: The Whistleblower: Confessions of a Healthcare Hitman by Dr. Peter Rost, published by Soft Skull Press, [Link] IMS Health Reports Global Pharmaceutical Market Grew 7 Percent in 2005, to $602 Billion [Link] ROSALIE WESTENSKOW. ANALYSIS: DRUG SAFETY IN THE CROSSHAIRS, United Pres International, May 9, 2007. [Link] [Link] The New York Times May 9, 2007 Doctors Reap Millions for Anemia Drugs By ALEX BERENSON and ANDREW POLLACK Two of the world's largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes. Industry analysts estimate that such payments - to cancer doctors and the other big users of the drugs, kidney dialysis centers - total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business. Neither Amgen nor Johnson & Johnson has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year. Yesterday, the Food and Drug Administration added to concerns about the drugs, releasing a report that suggested that their use might need to be curtailed in cancer patients. The report, prepared by F.D.A. staff scientists, said no evidence indicated that the medicines either improved quality of life in patients or extended their survival, while several studies suggested that the drugs can shorten patients' lives when used at high doses. Yesterday's report followed the F.D.A.'s decision in March to strengthen warnings on the drugs' labels. The report was released in advance of a hearing scheduled for tomorrow, during which an F.D.A. advisory panel will consider whether the drugs are overused. The medicines - Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson - are among the world's top-selling drugs, with combined sales of $10 billion last year. In this country, they represent the single biggest drug expense for Medicare and are given to about a million patients each year to treat anemia caused by kidney disease or cancer chemotherapy. Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society, said that both patients and doctors would benefit from fuller disclosure about the payments and the profits that doctors can make from them. "I suspect that Medicare is going to take a very careful look at what is going on here," he said. Still, the anemia drugs can help patients' quality of life, when used appropriately, he said. "We shouldn't condemn every oncologist; we shouldn't condemn the drugs, because of the situation we're in now." Federal laws bar drug companies from paying doctors to prescribe medicines that are given in pill form and purchased by patients from pharmacies. But companies can rebate part of the price that doctors pay for drugs, like the anemia medicines, which they dispense in their offices as part of treatment. The anemia drugs are injected or given intravenously in physicians' offices or dialysis centers. Doctors receive the rebates after they buy the drugs from the companies. But they also receive reimbursement from Medicare or private insurers for the drugs, often at a markup over the doctors' purchase price. Medicare has changed its payment structure since 2003 to reduce the markup, but private insurers still often pay more. Combined with those insurance reimbursements, the rebates enable many doctors to profit substantially on the medicines they buy and then give to patients. The rebates are related to the amount of drugs that doctors buy, and physicians that agree to use one company's drugs exclusively typically receive higher rebates. Johnson & Johnson said yesterday in a statement that its rebates were not intended to induce doctors to use more medicine. Instead, the rebates "reflect intense competition" in the market for the drugs, the company said. Amgen said that rebates were a normal commercial practice and that it had always properly promoted its drugs. "Amgen is dedicated to patient safety," said David Polk, a spokesman. "We believe our contracts support appropriate anemia management and our product promotion is always strictly within the label." Both companies' stocks fell yesterday after release of the F.D.A. report. Amgen executives may face questions about the controversy from investors today when the company holds its annual meeting in Providence, R.I. Since 1991, when the first of the drugs was still relatively new, the average dose given to dialysis patients in this country has nearly tripled. About 50 percent of dialysis patients now receive enough of the drugs to raise their red blood cell counts above the level considered risky by the F.D.A. American patients receive far more of the anemia drugs than patients elsewhere, with dialysis patients in this country getting doses more than twice as high as their counterparts in Europe. Cancer care shows a similar pattern. American cancer patients are about three times as likely as those in Europe to get the drugs, and they receive somewhat higher doses. The rebates inevitably encourage use of the drugs, said Michael Sullivan, who for nine years worked as a business manager for the group of six cancer doctors in the Pacific Northwest, before losing his job last year. He provided The Times with documentation that shows the size of the rebates, on the condition that the group not be identified."Personally, I think rebates should go away," said Mr. Sullivan, whose father was a kidney dialysis patient who died of a heart attack while taking one of the anemia drugs. "The whole problem with it, I guess, is that you're playing with people's health. It's not the same as buying widgets." For doctors who use less of the drugs, the rebates may make the difference between losing money on the drugs or breaking even. Mr. Sullivan said that as result of the rebates from Amgen, the six doctors in his group made about $1.8 million in net profit on the drugs they prescribed. Unlike most drugs, the anemia medicines do not come in fixed doses. Therefore, doctors have great flexibility to increase dosing - and profits. Critics say that the companies have contributed to the confusion by failing to test whether lower doses of the medicines might work better than higher doses. "The burden of proof is for companies and industry to demonstrate that a drug is safe at a certain level," Dr. Ajay Singh, an associate professor at Harvard Medical School. Dr. Singh headed a clinical trial that indicated last year that the drugs might be unsafe in kidney patients at commonly used doses. Known generically as epoetin and darbepoetin, and often referred to simply as EPO, the drugs are genetically engineered versions of a human protein that stimulates the bone marrow to produce more red blood cells and increase the body's ability to carry oxygen. Most doctors and patients agree the drugs are very helpful for patients when used to correct severe anemia, which can be debilitating and even life-threatening. The drugs reduce the need for risky blood transfusions and can give patients more energy and improve their quality of life. "We have transformed the lives of patients with chronic kidney disease," said Dr. Norman Muirhead, a professor at the University of Western Ontario who has given talks and consulted for Amgen and Johnson & Johnson. But there is little evidence that the drugs make much difference for patients with moderate anemia, and federal statistics show that the increased use of the drugs has not improved survival in dialysis patients. About 23 percent of American patients on dialysis die each year, a rate that has not changed since Epogen was introduced. Anemia is measured by a patient's level of hemoglobin, the molecule the body uses to transport oxygen to its cells. Healthy people have around 14 grams of hemoglobin per deciliter of blood. Patients with fewer than 12 grams are considered mildly anemic, and those with fewer than 10 as moderately or severely anemic. The labels on the drugs, as currently approved by the F.D.A., encourage doctors to aim for a hemoglobin level of 10 to 12. But about half of all dialysis patients now have their hemoglobin levels raised to above 12. Critics of the drugs say their increased use has been driven by profit. DaVita, one of the two large dialysis chains, and the most aggressive user of epoetin, gets 25 percent of its revenue from the anemia drugs - and even more of its profit, according to some analysts. Dr. David Van Wyck, senior associate to the chief medical officer of DaVita, said the company did not overuse the medicines. Doctors determine how much to use, Dr. Van Wyck said. "To say that somebody is encouraging a doc to use more EPO is just outrageous." Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10. That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar. No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today. Dr. Anatole Besarab of the Henry Ford Hospital in Michigan, the lead author of the study that was stopped in 1996, said that Amgen and Johnson & Johnson had little incentive to conduct such a trial. Dr. Robert M. Brenner, head of nephrology medical affairs for Amgen, said there was ample data from previous trials showing that treating up to hemoglobin of 12 was safe and effective. Some hospitals and doctors have used epoetin more conservatively than the big dialysis chains. Dr. Ronald A. Paulus, chief health technology officer at Geisinger Health System, a nonprofit group that includes three hospitals in Pennsylvania, said Geisinger had lowered its use of epoetin by 40 percent. Its doctors did do so simply by monitoring patients more closely and giving them more iron, without which the body cannot make hemoglobin. Dr. N. D. Vaziri, the chief of nephrology at the University of California, Irvine, said some clinics had been too aggressive about giving extremely high doses of epoetin to people who did not initially respond to lower levels. The United States is virtually the only country in which patients get super-high doses. "You create a toxicity situation," said Dr. Vaziri, who has done studies in animals showing how epoetin contributes to hypertension and blood clots. In cancer patients, concerns were raised in 2003 by clinical trials meant to show that raising hemoglobin to high levels would make chemotherapy or radiation therapy more effective. Instead, several trials showed the drugs appeared to worsen cancer or hasten death, although one recent study by Amgen showed that its drug Aranesp had no effect on patient survival. The conflicting studies are among the issues the F.D.A. advisory committee is expected to discuss tomorrow. Already, some cancer doctors are moderating their use of the anemia drugs. Dr. Peter Eisenberg, an oncologist in Marin County, Calif., said many doctors had been induced to use more epoetin by the financial incentives and the belief that the drug was helpful. "The deal was so good," he said. "The indication was so clear and the downside was so small that docs just worked it into their practice easily. "Now it's much scarier than that," he said. "We could really be doing harm." Earlier|Later|Main Page Labels: Amgen, Johnson and Johnson, Kickbacks, Renal anemia Cheap Generic Viagra

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Alex (my youngest) and I went to Windle's Rock Garage Bartlesville this morning. Our surf was stereotype of a teaching section rally. Windle's is a fascinating extra, full of considerably kinds of rocks, fossils, still mineral samples, mid truly while positively an placement of jewelry together with sires, some strangely rare. They had some on target denarius organizes from 30 Advert. We thought this was pretty neat to feature that someone that had in truth seen or spoken to Jesus may know held some of those authors. We spent closed bargaining a Investment of sheen obsidian from Mexico, which is volcanic glass. Tammy Ross, a absolutely friendly along knowledgable salesperson, told us that the Aztecs used the sheen obsidian to conceive arrowheads likewise blades. Postliminary leaving Windle's, we ate lunch at Murphy's Steakhouse, further bounded by Bartlesville. Murphy's has been near for the until 1940's--I see coming. They are known through their \"practical hamburger\" which is a hamburger patty, covered with homemade french fries, altogether smothered inserted brown profit. Mmmm-good! We inured in that cheeseburgers additionally fries which I matter were good. Alex was unimpressed, but what does he skim...he's flawless a kid!. Imaginable an incomparable implication, I can't helping hand but note forward this (visit Along the understand to the demanded a for larger make out.) I received an newsletter today from Christianbooks.com which stated: \"Celebrate Cinco de Mayo with spring shipping.\" Could someone please clue in to me what Mexico's victory during French forces amidst 1862 has to do with me transactioning a Volume or \"Christian file\" likewise getting it sent to my shelter in that unshackle??!! Cheap Generic Viagra

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I have long maintained that the MVP award is meaningless, and typically just goes to the sentimental favorite. Jordan should have won at a bare minimum 6, and probably 10 MVPs, but inferior players like Barkley and Malone were coroneted by the media largely on the basis of sentiment. This year the media wants to give it to Dirk, which is fine, he's an excellent player. But still a meaningless award. I prefer the All NBA team. Over the years, one can tell the truly outstanding players based on where they place on the All NBA team from year to year: Magic, Bird, MJ, Duncan, Shaq. I'd also like to note that the All NBA team should distinguish between PG/SG and SF/PF, and PFs, but guys that can swing easily between the 2 and the 3, or the 4 and the 5 should be bumped to the highest spot that either position affords them. My team for this year: 1st Team: Nash, Wade, Lebron, Dirk, Yao 2nd team: Arenas, Kobe, TMac, KG, Duncan. 3rd team: Parker, Carter, Howard, Boozer, Amare. Also, this year's playoffs should be fabulous. I like the Spurs, but it's quite a tough road through Phoenix and Dallas. In the East, I like the winner of the Bulls/Heat series. As for the Wizards, 4 and out. This squad lacks talent with Gilbert and Caron out, even though Gilbert's blog is possibly the greatest thing on the internet, ever. My favorite quotes: "I got to boo LeBron and them." "That’s why I’m going on the road trip, I’m going to sit right behind their bench and just talk all day. I’m going to just talk about the whole team from start to finish and try to do my part by irritating them." "Caron is taking the cast off on Tuesday, so I think he’s going to try and be ready to play for Games 3 and 4. It’s going to be a big lift because those guys will be happy to see him back and he’ll bring his energy. And then if they go to Game 5 I’m coming in, I’m going to play. All they are going to do is just sit me in the corner for offense and I’m going to shoot threes, just in case it comes down to a game winner. I still got the Hibachi going. I mean, I can’t walk or run, but I’m going to try. Hell, I could play Games 1-4, just stick me in the corner." "Of course we’ll win the election. As long as he has me, we’re winning. We’ll be co-presidents. He can handle all the big stuff like the war in Iraq and all that, and I’ll keep everybody distracted off what he’s doing. I’ll be the entertainer.I’ll do the press conferences. I’ll play the Bush part. I’ll be the golfer, I’ll go golf for 14 hours. I’ll party for half a week. I’ll do that, I’ll have fun with that. And then Barack can handle all that important stuff. " Seriously, I can't think of a more likable superstar in sports history. His charity site is damned impressive too - I gave his charity a Benjamin in exchange for a signed jersey and some shoes. I love the NBA. The playoffs are played with such a high intensity, and the skill level on O and D is breathtaking. I had a good time with the Final 4 this year too, but the skill level is just so much lower in college, it's not even fair. Let's talk some more Wizards. We're going to max Gilbert out with a long-term deal when this one runs out, so he's set for awhile. Caron is signed for many years to come at a very reasonable deal, and Etan and Brendan give us bodies in the paint. Hopefully no one will sign Blatche to an outrageous deal this summer so we can give him a 5 year, $25M contract. Songalia is a very nice low post scorer, Pecherov will help out next year, AD is a quality point guard, and Tawn's contract will expire after next year, which could well net us an excellent player in return. Let's say the Bulls get the #1 pick in the draft and want to take Oden. Wouldn't it make sense for us to trade Tawn for Big Ben straight up? Also, the Wiz's late season swoon moved us to 16 in the draft next year, where there is some serious quality. What if Al Thornton falls, or Thaddeus Young? Those guys could come in and contribute right away. Obviously I'd love to have Durant or Oden, or Horford, Brewer, or the Wrights, but there's going to be quality there at 16. Another possibility to consider is the Jermaine O'Neal sweepstakes. ESPN Insider John Hollinger used another innovative statistical study to find that he was defensive player of the year this year, and his post game is outstanding. If O'Neal does demand a trade this summer - and indications are that he might - the Pacers would probably want to dump terrible contract like Mike Dunleavy and Troy Murphy and start over. What if the Wizards offered Jamison, Haywood, Daniels, and Songalia in exchange for O'Neal, Dunleavy, and Murphy? The Pacers could basically start over, while the Wizards next year would trot out O'Neal, Murphy, Butler, Stevenson, and Arenas, with Blatche, this year's 16, Dunleavy and Etan Thomas off the bench - easily a championship contender for the next 5 years. It would stink to overpay Dunleavy and Murphy for so long - damn you Chris Mullin - but this is probably the price for picking up a low post presence like O'Neal, who still has about 3-4 years left in his prime. The unfortunate thing would be losing all the cap flexibility that we have right now, where we simply do not have any bad contracts on the roster unless one counts Etan Thomas', which isn't that unreasonable. As for the Skins, we need a WR, and some more D-linemen. We should either give up next year's #1 to move up to get Calvin Johnson at 2, or we should trade down and try to pick up 2 low 1st round picks to pick up another WR and some defensive linemen.

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Source: Wikipedia Under health insurance, the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. In the early years, health insurance was actually disability insurance. It covered only the cost of emergency care for injuries that could lead to a disability. Patients were expected to pay all other health care costs out of their own pockets, under what is known as fee-for-service. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, emergency health care procedures and most prescription drugs. A health insurance policy is an annually renewable contract. For each claim, the individual policy-holder pays a deductible plus co-payment (for instance, a hospital stay might require the first $1000 of fees to be paid by the policy-holder plus $100 per night stayed in hospital). Usually there is a maximum out-of-pocket payment for any single year, and there can be a lifetime maximum. Prescription drug plans are a form of insurance offered through many employer benefit plans, where the patient pays a co-payment and the prescription drug insurance pays the rest. Some health care providers will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay, as the insurance company pays according to "reasonable" or "customary" charges, which may be less than the provider's usual fee. Health insurance companies also often have a network of providers who agree to accept the reasonable and customary fee and waive the remainder. It will generally cost the patient less to use an in-network provider. Any private insurance system will face two inherent challenges: adverse selection and ex-post moral hazard. Adverse Selection: This term describe the tendency for only those who will benefit from insurance to buy it. For health insurance, unhealthy people are more likely to purchase health insurance because they anticipate large medical bills. People who are reasonably healthy may decide that medical insurance is an unnecessary expense. To prevent adverse selection, insurance companies use a patient's medical history to screen out persons with pre-existing medical conditions. Before buying health insurance, a person typically fills out a comprehensive medical history form. In general, those who look like they will be large financial burdens are denied coverage or charged high premiums to compensate. Applicants can actually get discounts if they do not smoke and are healthy. Moral Hazard: Moral hazard describes the state of mind and change in behavior that results from a person's knowledge that if something bad were to happen, the out-of-pocket expenses would be mitigated by an insurance policy--in this case, one which provides reduced prices for medical care. Cheap Generic Viagra

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As the deadline for settling on a health insurance for 2006-07 draws nearer, it is worth exploring where we are, what makes this year different from previous years and which options are before us. This post will attempt simply to lay out what proposals are on the table. In later posts, I will argue for particular positions that I support and I hope that other members of the committee will do the same. [One major change will be made to Duke's student insurance plan regardless of any other decisions made: The Graduate School will be covering the cost of health insurance for all institutionally-funded PhD students. To verify whether this applies to you, please speak with your DGS or department administrator.] Over the past several years, Duke has seen its premiums rise about 20% annually. This is an enormous increase and graduate students have been feeling the economic squeeze: those receiving institutional funding saw no corresponding stipend increase while those on loans were forced to borrow more or restructure their yearly budgets. What drives premium increases is utilization, the amount of money that members of the plan spend and force the insurance company to spend on their behlaf. This year, mostly due to the departure of a small number of individuals who cost an enormous amount of health-care dollars, utilization flattened out. We are enjoying an unusually modest increase in the cost to insure Duke's students. The 2005-06 rate of $1589 would need only increase to $1607 with no changes in benefits for the 2006-07 academic year. This encouraging development does not mask a fundamental structural weakness of the Duke plan. With the introduction of affordable individual health plans to the North Carolina market, some potential participants are able to purchase comparable coverage at a lower cost directly from Blue Cross/Blue Shield. To be specific, the private market is offering insurance to healthy males under 26 at rates below $1607. This has drawn a sizable minority of participants out of Duke's plan. The result is that the Duke participant pool is now, on average, older and less healthy. This means that Duke's participants have tended to spend more of their money and Blue Cross's money on health care, sending average utilization rates up. This means that our premiums have continued to rise. Finally, this has driven yet more young healthy males out of our plan. Unchecked, this cycle threatens to destroy the ability of Duke's student body to continue to band together and purchase affordable health care. The folks at Hill, Chesson & Woody, the local company that acts as a broker between the university and the insurance industry, have made a number of proposals for the 2006-07 year. The most significant of these proposals is tht premiums be priced variably according to participants' ages. Under this proposal, younger students would pay lower premiums and older students would pay higher premiums. Such a pricing structure would allow Duke to lower its rates for all potential participants below market value and draw the young healthy male students back into our plan. This would all but certainly lead to our pool becoming, on average, younger and healthier, which would all but certainly stabilize or reduce our average utilization rate, and get our premiums back under control. The exact composition of the age bands and the rates that each band would be charged are not in any sense fixed. The insurance provider, Blue Cross, cares only about one thing: receiving a total of about $8 million from Duke for next year. How those costs are distributed is to be decided by us. Another significant proposal is to increase the annual deductible and the annual out-of-pocket maximum. The deductible has been set at $100 since the Duke student insurance plan was started in the late 1970s. It has been proposed that the deductible be raised to $150 or $200. The out-of-pocket maximum is presently set at $1,000. It is proposed that this be raised to $1,500 or $2,000. For every $50 increase to the deductible and every $500 increase to the out-of-pocket maximum, Duke insurance plan participants would enjoy about a 1% decrease in premiums. Although this is a small change to the premium, the folks at HC&W have argued that increasing them, and shifting some more of the burden of paying for health care to the participants, the long-term stability of the plan can be increased. Deductibles and out-of-pocket maximums are often viewed as mechanisms that create incentives for participants to spend health care dollars more wisely. The other two proposed changes involve spouses and children. Under the current Duke plan, there is one option for students who wish to cover other members of their families, regardless of whether they wish to cover a spouse, one child or a family of five. It is proposed to have a rider for spouses, and a rider for children. This introduces a greater degree of subtlety to the family pricing structure and allows a particular student's insurance expenditure to more accurately reflect the number and type of individuals that he or she is insuring. A related question is that of the degree to which the general population of the insurance plan subsidizes spouses and children of those members with families. Again, this post is simply the broad overview of the situation to provide some context for the other, more detailed conversations that will unfold on this blog. Please feel free to amend and correct things in the comments.

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