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Old 11-10-2015, 11:48 AM   #31
sundialsvcs
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I used that expression, obviously, for effect.

And, believe me, I could relate a long list of horror stories, all of them verifiably true.

I think that fundamentally, "the right to receive health care" is a basic, inalienable, human right. It is impossible to say that "Life, and the Pursuit of Happiness," are "inalienable rights" to Everyman if Everyman, should he become sick or injured, will be subject to the competing self-interests of two corporations ("health care" (sic), and "insurance"), both of whom are driven by p-r-o-f-i-t motives.

The legislation euphemistically called "Obamacare" was engineered by the insurance industry in an effort to force people to buy "their product," and to put the Federal Government into the position of collecting those insurance premiums for private companies through the power of taxation. No judicial challenge to this notion has ever been raised, although it probably would be if the product in question were, say, "shoes." Since when does the government have the power to collect tax revenue and pay it to a private for-profit corporation to be booked as their private profit? The government isn't "buying" anything for the public good: it is acting as a bill-collector, and as an agent of a private company that is not performing any public service. Why is public money allowed to be spent in that way? This is a tax that is not being levied for the purpose of "raising revenue." It is being levied for the betterment of private corporations who may do with the money as they please in the pursuit of their own "profit."

Nevertheless, all the preceding legal mumbo-jumbo notwithstanding: "this is not health care to me." We swallowed the kool-aid that said that "private industry, with a profit motive, will always do the right thing, better than government can," and this is simply not true. Furthermore, the people who are saying it ... probably remember "Ike" Eisenhower talking about "fine, well-equipped hospitals," and they also remember going to community and public colleges that cost them very little ... not the quarter-million dollars (and rising) that the diploma costs today at those same public schools.

We are quite literally at a crisis-point ... and, it is a point of our own making. We're erasing words (like "bribery") from our own Constitution. Although the people making these decisions were themselves the beneficiary of the socialist programs that followed World War II, we are utterly destroying these things for the present and future generations. (And, both political parties, consumed by bribery, are doing it apace.)

You cannot provide "health care" for profit. Nor can you provide "education" for profit. If two stated purposes for the construction of the government of this country were "Life" and "the Pursuit of Happiness," it is impossible to do these things if an illness or injury would thrust you into bankruptcy, and/or if an attempt to better yourself through education would yoke you down with debts that you could not pay for the rest of your born days.

Where is the public outcry? How long will it be that people are told, "Hello, there, I'm going to rob you blind and there's nothing you can do about it (because I said so)," and their response is: "Duh, okay."

Has it not yet occurred to people that "the Government of the United States" consists of about 700 people, the majority of which only hold office for two-year terms, and that "the public" consists of well over 300 million people? Do the math: "you are seriously outnumbered, dudes." Whatever 300 million people want, they can get. If they want it bad enough, and if they stop taking "No" for an answer. An absolutely peaceful transformation can take place, changing the direction and destination of the nation to be anywhere they want it to be. If they want it bad enough, and won't take "No" for an answer.

Last edited by sundialsvcs; 11-10-2015 at 11:55 AM.
 
Old 11-10-2015, 03:52 PM   #32
mostlyharmless
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Some countries feel broadband internet access is a right. The UN, if I recall correctly, recently called for food, meaningful work and peace as fundamental human rights. It's hard to argue with the value of basic human needs, including healthcare. Passing a mandate from the government does not provide them, and all of these "rights" require collective immense effort to provide. The providers also have needs and are not slaves, nor is it reasonable to expect one portion of the population to be more selfless and self-sacrificing than everyone else. It doesn't work. It's not human nature. It's economics and it is complicated.

How do we fairly compensate efforts and encourage people to innovate? Trying to feed everyone with total control over farmers and planting does not work. Nor does total control over doctors or pharmaceutical researchers. Or bandwidth providers. Or software engineers. On the other hand, unfettered free markets frequently degenerate to pandering to greed, fear and the worst in people. We don't have a free market or total control in the US. We could disagree on exactly what we have: complete wage and price controls on doctors, none at all on pharmaceutical companies or lawyers, with increasing controls on insurance companies. Other industries have different models: I for one am happy that private police forces are not the rule, but am likewise glad that most food providers are not hospital or public school cafeterias.

How do we implement policy that enables the best outcome? That is a fundamental political question, and people may honestly disagree about it. There are a lot of hardworking people in Washington DC trying to solve those issues. They are not all venal bribe takers, though I doubt not that, as in any group of people, you have good ones and bad ones. We have a system to pick these people; it's not perfect either. It's arguably better than some of its historical alternatives.
 
Old 11-11-2015, 12:21 PM   #33
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You can "encourage people to innovate" without making health care a "competitive, for-profit industry." In fact, people are far more likely to innovate if they know that their innovations can be accepted into a health system that, backed by the Federal Government, is able to adopt these things and to give them to anyone who medically needs them. Doctors will be much more interested in being doctors, and in providing care, if they know that they do not have a financial incentive in what they prescribe, and if they know that what they prescribe will be given, without consulting with actuaries who've calculated that the company's better-off if their patient is dead.

Today, we have skilled physicians who have quit their public-facing practice to provide "boob jobs" to people who can afford it. Surgeons are transplanting hair for bald people. Emergency rooms are under-staffed and over-crowded with people who are there because they could not timely go to the doctor, and there get timely treated before their condition became desperate.

And I lay the blame for all of this upon: the "for profit" motive, simultaneously in health-care providers and insurance providers ... whose "for profit motives" are at cross-purposes with one another and which, in various ways, profit most by denying patient care according to medical assessments. There are things which, I argue, cannot be provided "for profit." Health care is one of these. Education is another.

Society needs these two things, whether or not a "for profit" equation can be balanced to provide them. "I am a human being, just like you. Why does my Government spend billions of dollars a day(!) blowing people up halfway around the planet, and it cannot spend money on me?!"

These (maybe) well-meaning people in Washington ... are still trying to follow what "the Senator from HCA" (Frist ... his family owns the Hospital Corporation of America) started. They're trying to make "for-profit health care" and "for-profit health insurance" work. But, they cannot work.

Health Care is "an Inalienable Right." Likewise, access to higher education ("the pursuit of happiness ...") is also an Inalienable Right. The fundamental need of society is that everyone have access to these things, whether or not it is "profitable" to provide them.

I don't want to prepare another "bed revenue report." I don't want to read hospital guidelines for doctors, which dictate, as an employer to his employee, when a patient may be assigned to a bed, and for how long. The actuarial incentive of the corporation is "to maximize revenue." Your revenue potential is calculated on a scale of 1 to 5. My uncle, a retired Air Force Major, was kept in a private room with mahogany furnishings for many weeks, even when he asked to go home, because "Uncle Sugar" would pay princely sums (medically unnecessary) to keep him in this "scale-5 wing" of the f-o-r ... p-r-o-f-i-t hospital.

Incidentally, this hospital has a sign on the ER door advising that, if you don't have great insurance, they will minimally treat you and then transport you to another hospital in town (of their choosing), and basically dump you there. Implication: "if you're not at least a scale-4 financial prospect, why don't you just go ahead and leave now?"

Nothing illegal about it ... the hospital exists to maximize financial return for its shareholders, just as any corporation does.

"The rich will live, and the poor (good riddance!) will die ... somewhere else,please. But the stock dividends look terrific."

No, I am not wearing a tin-foil hat, nor a three-cornered one. This is the status quo in the United States of America right now, and I, for one, am not accepting of any of it. This country(!), above all, can lead the world in doing the right thing for its sick. I'm not gonna settle for less. I'm not gonna settle for this crap.

Last edited by sundialsvcs; 11-11-2015 at 01:02 PM.
 
Old 11-11-2015, 02:41 PM   #34
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I saw this and decided to post it here after only reading the headline. I think that's in keeping with the General forum's standard for intellectual rigor.

http://www.thestar.co.uk/news/local/...ract-1-7547494
 
Old 11-12-2015, 08:06 AM   #35
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Nice story; agree with the intellectual rigor

@sundialsvcs I don't disagree that profit motives lead to evil. That is not new; the love of money is the root etc.
However I don't limit that to one profession or industry. Why do you? Is it that you recognize your desires for healthcare are impossible for providing other basic human needs: food, meaningful work, peace? Want to pick on healthcare because you have been hurt? I get that: people who hurt, turn on the source of their pain.

Capitalizing Inalienable Rights doesn't change the economics of the situation.

Furthermore, you sound like someone out of Ayn Rand''s paranoia. {sarcasm alert ahead} The People have a inalienable Right to your Services. You have a Duty as a Citizen and as a Doctor to care for everyone. If your patients don't follow your advice, it's your fault. If they get sick as a result it's your fault. Accept our terms or You are a Bad Person who shouldn't practice. We'll tell you what you'll get paid next year. That's working out real well for teachers in this country. {end sarcasm alert} We arguably have the worst secondary schools in the industrialized world. NB: I am not, definitely NOT a fan of late Ms Rand.

Nobody is happy with the status quo. Try not to demonize the opposition. It isn't constructive.
 
Old 11-12-2015, 09:24 PM   #36
sundialsvcs
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Believe me, I'm not "whining."

People require health care because they are sick, or because they have been hurt, or because they are dying.

Since the dawn of time, we've heard: "care for the sick, feed the hungry, clothe the naked." Yes, if you are a doctor, you have a duty to care for the sick ... not to make a ton o' money based on what you did and did not decide to do. You should be so handsomely paid that people strongly desire to be a doctor. You should be stoutly defended by law, not by "malpractice insurance" that you have to buy from a private company, against negative outcomes. It's not "your fault" what your patients do or don't do. It can only be "your fault" what you do, as determined by the collective judgment of your peers and your profession.

In other words: "The people have an inalienable right to your services." "You as a doctor have a duty to care for everyone." But the outcome is not 'your fault.' You are not going to be paid based on 'outcomes,' because it is impossible to know what medical situation might walk into your door next, and we want you to be free to tackle that case based on your own professional medical judgment (consistent with "best care" professional standards established by the profession), "without fear or favor." We will protect you, by force of law, and at no cost to you.

No, I am not "whining," and I'm certainly not Ayn Rand. I simply know that we are not fulfilling very fundamental public duties to millions of people right now, in this and other venues, and I am not willing to accept this.

Like I said: we spent billions of dollars a day "blowing people up, halfway around the world," and we've been doing this for decades while keeping it out of the news. Meanwhile, we're stripping basic public services dry, and insisting that "it must be so." Well: I know the symptoms of anemia and massive blood loss when I see them. I know that War does have a horrific cost, financially and otherwise, and I see that America is pouring her own vitality out, as a libation poured upon the altar of War. The public's money should be spent first and foremost upon the public interest.
 
Old 11-13-2015, 09:43 AM   #37
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Quote:
Originally Posted by mostlyharmless View Post
Furthermore, you sound like someone out of Ayn Rand''s paranoia. {sarcasm alert ahead} The People have a inalienable Right to your Services. You have a Duty as a Citizen and as a Doctor to care for everyone.
Er, by "someone out of Ay Rand's paranoia", did you mean "the kind of person Ayn Rand was paranoid about"? That sounds like the exact opposite of what I understand Ayn Rand would have wanted.

Last edited by dugan; 11-13-2015 at 03:29 PM. Reason: Naah, I'm keeping the typo. ;)
 
Old 11-13-2015, 09:52 AM   #38
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Yes, you read correctly, thanks. From sundialsvcs's statement that he is not Ayn Rand, I have to conclude that he's not familiar with Atlas Shrugged. He should have said he was not Ayn Rand's fictional bad guys, who justified their soviet style command economy program in the same way he is proposing for medicine. Or perhaps it was simply a mistake and I misunderstood.
 
Old 11-13-2015, 03:22 PM   #39
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Greetings It is not my intention to derail this thread to an offramp but since we are talking about a combination of Government and Enterprise and the subject of Ayn Rand has come up I have a few comments. When I was a teenager and on up through college I was an avid Ayn Rand advocate. I read every book she ever wrote, subscribed to The Objectivist Newsletter (as well as the Libertarian "Freeman") and even ushered at one of her lectures in Washington DC where we got to meet her and ask a few questions. The question I asked here was about whether or not self-interest and altruism are binary and mutually exclusive. For example, I asked, "Do you have confidence that the US can rid the government of ALL commerce legislation, both beneficial and restrictive, and thus manage to actually have a true Laissez-Faire economy"? She said "No. Not in my lifetime, but possibly in yours." So then I asked if, since she was convinced she would never live to see and enjoy the fruits of her labor, how could she justify by self-interest alone, how hard she worked for what then must be akin to "pie in the sky"? She responded that it was enough to be a part of a process that worked toward the goals she viewed as correct.

Just a few months after that lecture the blowup occurred between she and Nathanial Brandon and I was shocked at the vitriol she spewed at and about him. It was only later that I learned it was the classic "woman scorned" scenario as Mr Brandon had the unmitigated gall to cease sleeping with her and begin a monogamous marriage with someone else. This was when I broke with the whole movement because while the idea of Laissez-Faire with dollars as votes did seem to equate to Democracy in Economy, I could easily then see that Ms Rand lived in an Ivory Tower that refused to come to grips with the fact that while reasoning to a degree, we are still animals who do have instinctive behavior that can drastically affect our logic to the point of blind rationalization. Since then this has not only been tested and proven that not one of us is completely free of this limitation, but Stephen Hawking, just to mention one scholar, has outlined the gulf between physical Evolution and the powerful effect of language, especially written language, that has caused huge leaps in one kind of Evolution, and one that tends to minimize or even disregard the instincts we have inherited from some million years of Hunter-Gathering existence and selection..... things like blindly following the leaders of the tribe and accepting Status Quo in order to survive.

As it applies to this thread, and to Ms Rand she seems to have valued Individualism so highly that she completely disregarded The Social Contract, that we all stand on the shoulders of giants, some of whom were both brutal and ruthless. John Galt, Francisco D'anconia, Hank Reardon, etc. while certainly Alpha Males did not exist in a vacuum. Had they been born in a ghetto they would just as likely have been Gang leaders as heads of corporations. This is why that as soon as we accept the fundamental value of civilization, of living as a part of a society that it is valuable to that society to provide some basic means to all members so the likelihood is greatly increased that anyone who can contribute to the good of that society will, instead of being a blight on it.

It just isn't as simple as a battle between "each according to his need" vs/ "each according to his contribution". People often ask what is he value of Scientific Research, especially on esoteric subjects ans some great mind whose name escapes me at the moment replied "Of what use is a baby?".

As it applies to healthcare people do not feel loyal to a society in which health costs, government supported loan and investment institutions can wipe out an entire family's ability to care for itself or even survive. Now that some super wealthy and powerful people ^^cough^^ Koch Family ^^cough^^ spend millions of dollars to reduce even education support as well as basic healthcare we are beginning to see the short-sightedness of Insatiable Greed. Now that most real Journalism is all but dead, I am afraid we are in for a pretty long haul of near serfdom and it's accompanying attitude of "if you (or even millions) die...... so what?" One of the reasons Baseball USED TO BE the National sport was because Offense is Individual and Defense is Team. Ayn Rand assumed all "games" were Tennis.
 
Old 11-13-2015, 04:30 PM   #40
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Well said enorbet.
 
Old 11-15-2015, 12:14 PM   #41
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Quote:
Originally Posted by dugan View Post
I saw this and decided to post it here after only reading the headline. I think that's in keeping with the General forum's standard for intellectual rigor.

http://www.thestar.co.uk/news/local/...ract-1-7547494
Yeah, in Europe I'm not even sure it is worth being a doctor. You study so much, do so much, and are treated like garbage. Very unrewarding. You would have to have immeasurable inner strength to be a doctor in Europe. All my respect for them though.

Quote:
Originally Posted by sundialsvcs View Post
Ahh, I wish I were. Unfortunately, I've had too many hospital clients.

I also lost an uncle to a C. Diff infection because his insurance company would not pay for the antibiotic that can actually stop that infection.

And then, I almost lost my father to exactly the same thing. The drug cost $800. We walked into Revenue Management at the hospital with a certified check. The Revenue Management person then called the doctor and authorized him to administer the drug, which is also what the physician had originally ordered. My father survived.

Yes, at the present state of affairs, this is how the medical industry thinks. This is also how the insurance companies think. Notice also how these two industries are in opposition: hospitals want to make profits, but they get those profits from insurance companies who also want to make profits. Where does the patient fit into all of this? Nowhere.

You are "a unit." (Literally. That's what they call you in the office.)

This is not a work of fiction. It is also not a tolerable state of affairs for "medical care in the United States." And the very first thing that must be done is: "to refuse to tolerate it anymore." It is impossible to provide 'health care' for 'profit!'
I totally agree that if you eliminate the 'for-profit' from healthcare it would greatly improve. However, this should not mean that hospitals will not get any funding, will have to deal with broken CT machines, will have to make patients wait days to be seen, patients would only be able to afford generic drugs. If the gov't will fund this, make damn sure they do a good job, because in parts of Europe they do a piss poor job and it really ruins healthcare.

I've seen many situations similar to yours, and in some of them, the doctor paid for the treatment, because they did not want the patient to die, while the clerk at the insurance company couldn't care less. To the insurance company you're just a statistic, and so are the doctors, and this is how they treat you. They calculate whether it is economically viable to let you live. They also do their best to make it as hard as possible for the doctor to get paid for their work. They put up as much bureaucracy as possible, to slow things down, make them inefficient and put extra burden on doctors and hospitals. You cannot imagine how much money has to be spent by doctors and hospitals just to deal with insurance companies, not even counting the losses from insurance companies not paying.

Last edited by metaschima; 11-15-2015 at 12:24 PM.
 
Old 11-16-2015, 12:11 PM   #42
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Quote:
Originally Posted by mostlyharmless View Post
Yes, you read correctly, thanks. From sundialsvcs's statement that he is not Ayn Rand, I have to conclude that he's not familiar with Atlas Shrugged. He should have said he was not Ayn Rand's fictional bad guys, who justified their soviet style command economy program in the same way he is proposing for medicine. Or perhaps it was simply a mistake and I misunderstood.
Of course I am familiar with Ayn Rand and Atlas Shrugged! In high school I read that book and endured many discussions about it.

Let me put it to you this way:
  1. You (still ...) have the right to mail a letter. For the price of a stamp, you can mail a letter from Podunk, Alaska, to New York City. For exactly the same price, you can mail a letter to the same address from Newark, and your letter will be treated exactly the same, even though it costs far more to mail from Alaska, and even though the "postal" service is certainly not profitable. The authors of the Constitution stipulated that the Federal government was to provide for "postal service and post roads," knowing that the Republic could not operate without it, "profit or not."
  2. For my generation, at least, [i]higher education was affordable. You could take night classes at the community college. You could get a diploma from a State university. No one was trying to "profit" from this.
  3. In the same way, "if you are sick in America(!), even in Podunk, you should be able to Go To The Doctor! Or, to the hospital, where you should be able to get the highest quality of medical care according to your medical needs ... not according to your present economic stature.

OMG ... what a radical, "un-American" idea! (Strange that it was not "un-American" to Dwight D. Eisenhower, who spoke of "fine, well-equipped hospitals" ...) How dare we stoop to what Britain has done, with its Public Health Service, or Finland, with its guarantees of public higher education!

At the end of the day, it's a matter of what a society(!) determines to be "most important." Those who suppose that "capitalism has all the answers," necessarily believe that all of "the answers," to all of the questions that a society might consider to be "worth asking," can be achieved with a net-gain on a private balance sheet.

That is to say, "there exists no public balance sheet."

Heh . . . "except military, which without-question justifies (sic ...) the expenditure of vast sums of money, the 'sum' of which necessarily(!) must remain 'profoundly secret.'"

Personally, I think that we have w-a-s-t-e-d vast(!) amounts of public money on "sacrosanct assumptions" that came from World War II and the Cold War, none of which have actually "defended us." Yet, we have sacrificed every other(!) legitimate concern of Government to its cause. Every warning that "Ike" Eisenhower gave to us has become horribly, stunningly, true, yet we still refuse to see.

The Preamble to the United States Constitution stated several fundamental social promises that the new Government would make to its people ... not just one: "The Common Defense."

There is no "anyone else" to decide these matters. Specifically, there is nothing to "enshrine eight-hundred people" with the supreme powers of decision ... over what intimately affects many hundreds of millions of otherwise-identical people.

Last edited by sundialsvcs; 11-16-2015 at 12:12 PM.
 
Old 11-30-2015, 07:25 PM   #43
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Very interesting discussion on this thread which is of relevance to all. This link (mentioned earlier in this thread) shows health care of Australia, Japan, Spain and Finland to be most efficient. Why so and is there anything common in those systems?

Last edited by rng; 11-30-2015 at 07:27 PM.
 
Old 12-01-2015, 06:51 AM   #44
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Isn't the answer in the article?
Quote:
The unifying factor seems to be tight government control over a universal system, which may take many shapes and forms -- a fact evident in the top-three most efficient health care systems in the world: Hong Kong, Singapore, and Japan.
 
Old 12-01-2015, 12:21 PM   #45
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There is a very popular notion being batted-around since the late 1970's, just as it was in the late 1920's, that "free markets" can do everything that needs to be done. That they would do it "profitably," ergo "efficiently," and this was perceived as Ultimate Goodness. Government should stay out of the picture and let private enterprise earn More Profits, and the More Profits they earned, the more Ultimately Good-er it was.

However, we can very plainly see that this is not true ... just as America did in the 1930's when Herbert Hoover steadfastly refused to do anything about the Great Depression that he and his economic pundits insisted could not happen and therefore was not happening.

Today, we have made "college education" patently unaffordable. We are therefore introducing a new generation that will not have such an education. (But we don't mind: the University of Bangladore will turn out all the "college educated" people we need ... "For Less, Always!")

We have also wiped out consumer credit. Banks aren't lending, because they're lending to title-loan pawnshops which flagrantly loan money sometimes at interest rates of over one thousand percent to the people who are already the poorest.

And, we have wiped out health care. "Unprofitable" hospitals are closing, and if a longer ambulance ride (if you can afford to buy an ambulance ride, and if the ambulance company can profitably deliver you to somewhere that can profitably treat you) causes you to "die en route," then that of course means more profit for the hospital as well as for the funeral home.

There is a strong move afoot to replace the US Interstate Highway System with 100 toll-roads, run by private companies who will be entitled to charge you whatever they wish for the privilege of commuting to work each morning. They insist that they can "profitably" do better, and that there should be no laws or regulations "getting in the way of their 'free-market choice'" of whom they will allow to be on their roadways and how much they may charge for the privilege.

And so on.

Gentlepeople, there is a reason why we create "governments." One of the principal reasons is that we know that there are things which "society" requires, which must be provided to an agreed-upon standard of performance, even though there is no financial profit to be found in doing so. Another reason is that we know that we must impose legal strictures and prohibitions upon things that an un-restrained "free market" would otherwise do. (A "free market," pursuing a profit-motive ber alles, is not beholden to its 'customers.' It is beholden to its shareholders.) A third reason is that we recognize that certain things must be provided to citizens (and to all other "people"), which are not "customers" in the sense that these people do not "voluntarily elect to do business with." These are, indeed, social requirements, in the sense that they are required "by the society, itself."

I am reminded of this phrase from Dicken's A Christmas Carol: (The Ghost of Christmas Present)
Quote:
"Oh, to hear the insect on the leaf, pronouncing judgment upon his brethren in the dust!"
Particularly in the United States, "we can Afford these things." Especially if we confront the Military Industrial Complex which is sapping our vitality while providing nothing to us in return. "Ike was Right."

Last edited by sundialsvcs; 12-01-2015 at 12:22 PM.
 
  


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