Attacking Health Care Costs from All Angles

[Benny B]

May 11, 2009
The President The White House Washington, D.C. 20500

Dear Mr. President:
We believe that all Americans should have access to affordable, high quality health care services. Thus, we applaud your strong commitment to reforming our nation’s health care system. The times demand and the nation expects that we, as health care leaders, work with you to reform the health care system.

The annual growth in national health expenditures—including public and private spending—is projected by government actuaries to average 6.2% through the next decade. At that rate, the percent of gross domestic product spent on health care would increase from 17.6% this year to 20.3% in 2018—higher than any other country in the world.

We are determined to work together to provide quality, affordable coverage and access for every American. It is critical, however, that health reform also enhance quality, improve the overall health of the population, and reduce cost growth. We believe that the proper approach to achieve and sustain reduced cost growth is one that will: improve the population's health; continuously improve quality; encourage the advancement of medical treatments, approaches, and science; streamline administration; and encourage efficient care delivery based on evidence and best practice.

To achieve all of these goals, we have joined together in an unprecedented effort, as private sector stakeholders—physicians, hospitals, other health care workers, payors, suppliers, manufacturers, and organized labor—to offer concrete initiatives that will transform the health care system. As restructuring takes hold and the population's health improves over the coming decade, we will do our part to achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more. This represents more than a 20% reduction in the projected rate of growth. We believe this approach can be highly successful and can help the nation to achieve the reform goals we all share.

To respond to this challenge, we are developing consensus proposals to reduce the rate of increase in future health and insurance costs through changes made in all sectors of the health care system. We are committed to taking action in public-private partnership to create a more stable and sustainable health care system that will achieve billions in savings through:

• Implementing proposals in all sectors of the health care system, focusing on administrative simplification, standardization, and transparency that supports effective markets;

•Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency;

•Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies; and,

•Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms.

These and other reforms will make our health care system stronger and more sustainable. However, there are many important factors driving health care costs that are beyond the control of the delivery system alone. Billions in savings can be achieved through a large-scale national effort of health promotion and disease prevention to reduce the prevalence of chronic disease and poor health status, which leads to unnecessary sickness and higher health costs. Reform should include a specific focus on obesity prevention commensurate with the scale of the problem. These initiatives are crucial to transform health care in America and to achieve our goal of reducing the rate of growth in health costs.
We, as stakeholder representatives, are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers. We stand ready to work with you to accomplish this goal.

Sincerely,
Stephen J. Ubl President and CEO Advanced Medical Technology Association
J. James Rohack, MD President-elect American Medical Association
Karen Ignagni Billy Tauzin President and CEO President and CEO America’s Health Insurance Plans
Rich Umbdenstock  President & CEO, American Hospital Association (AHA)
Dennis Rivera President and CEO Chair, SEIU Healthcare

[Benny B]

May 11, 2009

Today the President hosted a meeting that marked one of the most promising signs for health reform to date, and not only because the topic was saving more than $2 trillion on health care costs. Representatives from hospitals, the insurance industry, medical device and pharmaceutical companies, labor and physicians came to the White House to discuss major steps being taken to lower health care costs across the board.  The President explained the significance of having so many diverse stakeholders at the table:

And that's what makes today's meeting so remarkable -- because it's a meeting that might not have been held just a few years ago. The groups who are here today represent different constituencies with different sets of interests. They've not always seen eye to eye with each other or with our government on what needs to be done to reform health care in this country. In fact, some of these groups were among the strongest critics of past plans for comprehensive reform.

But what's brought us all together today is a recognition that we can't continue down the same dangerous road we've been traveling for so many years; that costs are out of control; and that reform is not a luxury that can be postponed, but a necessity that cannot wait. It's a recognition that the fictional television couple, Harry and Louise, who became the iconic faces of those who opposed health care reform in the '90s, desperately need health care reform in 2009. And so does America.

In short, the coalition has agreed to reduce the annual health care spending growth rate by 1.5 percentage points for the next 10 years, a change that could result in savings of roughly $2,500 for American families. Some of the changes the coalition is working on, explained fully in the fact sheet, include:

·         Improving Care after Hospitalizations and Reduce Hospital Readmission Rates.
·         Reducing Medicare Overpayments to Private Insurers through Competitive Payments.
·         Reducing Drug Prices.
·         Improving Medicare and Medicaid Payment Accuracy.
·         Expanding the Hospital Quality Improvement Program.

The President closed his remarks making clear that this was just the beginning, and certainly no stopgap measure: "So the steps that are being announced today are significant.  But the only way these steps will have an enduring impact is if they are taken not in isolation, but as part of a broader effort to reform our entire health care system." And while so much debate over politics and policy can get lost in the mire of facts and figured, the President made clear that his focus is squarely on one thing:
 
Ultimately, the debate about reducing costs -- and the larger debate about health care reform itself -- is not just about numbers; it's not just about forms or systems; it's about our own lives and the lives of our loved ones. And I understand that. As I've mentioned before during the course of the campaign, my mother passed away from ovarian cancer a little over a decade ago. And in the last weeks of her life, when she was coming to grips with her own mortality and showing extraordinary courage just to get through each day, she was spending too much time worrying about whether her health insurance would cover her bills. So I know what it's like to see a loved one who is suffering, but also having to deal with a broken health care system. I know that pain is shared by millions of Americans all across this country.

Today is a hopeful day.

[headhuntersix]

Yeah I missed where this is in the Constitution. End of thread.

[Benny B]

The President gives remarks after hosting what was a remarkable health reform meeting, both for the $2 trillion in national savings that was discussed, and for the stakeholders in attendance. May 11, 2009

[Benny B]

Coming Together to Bring Down the Cost of Health Care
Fact Sheet

RISING HEALTH CARE COSTS ARE BURDENING FAMILIES, BUSINESSES, GOVERNMENTS, AND THE ECONOMY: For years, rising health care costs have been a burden on families, businesses, and the entire economy. Since 2000, health insurance premiums have almost doubled and health care premiums have grown three times faster than wages. These rising costs have eroded the financial stability of all Americans as families have had to pay more for insurance coverage; have been exposed to a greater risk of personal bankruptcy as deductibles and co-payments increase; and have seen their actual benefits decrease as employers search for ways to rein in escalating health care costs. As families and businesses have struggled with these rising costs, states have also been forced to cut back on investments in areas that are critical to long-term prosperity such as higher education and infrastructure. Overall, health care is consuming an ever-increasing amount of our nation’s resources: at the current rate, health care will eat up more than 20 percent of GDP in 2018. Reforming health care is the key to restoring financial stability for American families and businesses and for securing our fiscal future.

THE TIME TO ACT IS NOW: For too long, politics and point-scoring have prevented our country from tackling this growing crisis. As we work our way out of an economic and financial crisis of historic proportions, the American people are eager to put the old Washington ways behind them and put us on a steady path toward a patient-centered health care system that reduces costs, preserves an individual’s choice of doctor and plan and assures quality, affordable health care for every American.

HEALTH CARE INDUSTRY LEADERS ARE NOW PLEDGING TO MAKE A MAJOR REDUCTION IN COST GROWTH AS PART OF COMPREHENSIVE HEALTH REFORM: Today, we are seeing the beginning of a change for the future as a wide array of leaders in the health care field – insurance companies, hospitals, pharmaceutical companies, medical device manufacturers, and providers – have come forward with a proposal that could save the country $2 trillion over the next 10 years. They are proposing to take aggressive steps to cut health care costs that, if done in the context of comprehensive health reform, will reduce the annual health care spending growth rate by 1.5 percentage points for the next 10 years. As they take the steps they have outlined and as we work with Congress on health reform legislation, our Administration will continue its commitment to reducing costs so we can achieve similar savings. Working together, these initial steps, combined with enactment of comprehensive health reform, could result in savings of roughly $2,500 for American families – savings consistent with the President’s statements on the campaign trail. These are savings every American family will see - and that will benefit our country for years to come. These are important steps toward comprehensive health care reform both for the savings identified and the improvements these efforts will make to health care delivery in our country. Moreover, if groups as disparate as – AHIP, AMA, AHA, PhRMA, SEIU, and AdvaMed – can come together around the cause of cost-cutting and greater affordability, the possibility for fundamental reform in the weeks ahead is great.
2

HEALTH CARE INDUSTRY LEADERS ARE JOINING WITH THE ADMINISTRATION TO IMPROVE EFFICIENCY AND QUALITY. Controlling spending is about more than just saving money, it must be about ensuring that we provide the best patient-centered health care system that promotes health and prevents illness. As we do this, we need to reform our payment system to promote efficiency and accountability while we eliminate waste and cost shifting; align incentives toward quality care and healthy outcomes; encourage shared responsibility; reduce fraud and abuse; build the base of information to undertake future program modernization; address the underlying causes of unnecessary health care spending; and encourage care coordination, prevention, and other services that are found to promote high quality, efficient health care.

THE ADMINISTRATION WILL BUILD UPON ITS BUDGET PROPOSALS TO ACHIEVE SAVINGS IN MEDICARE AND MEDICAID. In the President’s FY 2010 Budget and the Recovery Act, there are policy proposals that will improve the efficiency and quality of the Medicare and Medicaid programs while reducing average annual spending growth and extending the life of the Medicare Trust Fund. The Budget proposals aim to align incentives toward quality, promote efficiency and accountability, and encourage shared responsibility. These proposals include:

• Improving Care after Hospitalizations and Reduce Hospital Readmission Rates. Nearly 18 percent of hospitalizations of Medicare beneficiaries are the result of the readmission of patients who had been discharged from the hospital within the previous 30 days. Sometimes the readmission could not have been prevented, but many of these readmissions are avoidable with better discharge planning and follow-up care. To improve this situation, hospitals will receive bundled payments that cover not just the hospitalization, but care for the 30 days after the hospitalization. Hospitals with high rates of readmission will be paid less if patients are re-admitted to the hospital within the same 30-day period. This combination of incentives and penalties should lead to better care after a hospital stay and result in fewer readmissions – saving roughly $25 billion of wasted money over 10 years.

• Reducing Medicare Overpayments to Private Insurers through Competitive Payments. Under current law, Medicare overpays Medicare Advantage plans by 14 percent more on average than what Medicare spends for beneficiaries enrolled in the traditional fee-for-service program. The Budget proposes to replace the current mechanism to establish payments with a competitive system in which payments would be based upon an average of plans’ bids submitted to Medicare. This would allow the market, not Medicare, to set the reimbursement limits, and save taxpayers more than $177 billion over 10 years, as well as reduce Part B premiums.

• Reducing Drug Prices. The Administration proposed accelerating access to make affordable biologic drugs available through the establishment of a regulatory, scientific, and legal pathway for FDA approval of generic versions of biologic drugs. The Budget also proposed bringing down the drug costs of Medicaid by increasing the Medicaid drug rebate for brand-name drugs from 15.1 percent to 22.1 percent of the Average Manufacturer Price, applying the additional rebate to new drug formulations, and allowing States to collect rebates on drugs provided through Medicaid managed care organizations.
3

• Improving Medicare and Medicaid Payment Accuracy. The Government Accountability Office (GAO) has labeled Medicare as “high risk” due to billions of dollars lost to overpayments and fraud each year. The Centers for Medicare and Medicaid Services (CMS) will address vulnerabilities presented by Medicare and Medicaid, including Medicare Advantage and the prescription drug benefit (Part D). CMS will be able to respond more rapidly to emerging program integrity vulnerabilities across these programs through an increased capacity to identify excessive payments and new processes for identifying and correcting problems.

• Expanding the Hospital Quality Improvement Program. The health care system tends to pay for quantity of services not quality. Experts have recommended that hospitals and doctors be paid based on delivering high quality care, or what is called “pay for performance.” The President’s Budget will link a portion of Medicare payments for acute in-patient hospital services to hospitals’ performance on specific quality measures. This program will improve the quality of care delivered to Medicare beneficiaries, and save over $12 billion over 10 years.

THE ADMINISTRATION LOOKS FORWARD TO HEARING UPDATES ON THE GROUPS’ PROGRESS

[Benny B]

[Benny B]

BUMP for healthcare!

[Benny B]

Attacking Health Care Costs from All Angles

Yesterday, the President held a landmark meeting with a wide array of leaders in the health care field – insurance companies, hospitals, pharmaceutical companies, medical device manufacturers, and providers –who pledged to work together to control costs in health care to the tune of $2 trillion in savings over the next ten years.  Today, the President held another meeting with five employers, a state health department, and a union to discuss innovative ideas that are being implemented in the workplace to improve the health of workers and reduce the rising rate of health care spending.


(President Barack Obama listens to Safeway President and Chief Executive Officer Steve Burd during a meeting with business leaders in the Roosevelt Room of the White House to discuss employer health care costs, May 12, 2009. Official White House Photo by Pete Souza.)

The President directed the Office of Personnel Management to work with the Office of Health Reform, the National Economic Council, the Department of Labor, and the Office of Management and Budget to examine successful employer wellness and prevention practices that lower health care costs and improve employees’ health, and to explore possibilities of developing a plan for federal employees and their workplaces.
 
More generally, the discussion was designed to expand on the theme that the health care system in America needs comprehensive reform, including a much greater focus on wellness and prevention.  As the President stated in his remarks afterwards, "what we've done here today is to gather together some of these stories and best practices to make sure that they are going to be informing the health care reform discussions that take place here in Washington."  If these companies have been able to implement proven measures in the private sector, "there’s no reason why we can’t do that for the country as a whole."  The White House fact sheet details the attendees and the kinds of practices they have been implementing:

    * H.E.R.E.I.U. Welfare Fund (Dr. Jerry Reeves, Chief Medical Officer):  The Hotel Employees and Restaurant Employees International Union (H.E.R.E.I.U.) Welfare Fund offers multi-employer health insurance coverage for 90,000 eligible employees and their family members.  It redesigned its health benefits and health plan administration and implemented wellness and chronic disease management programs to generate millions of dollars in overall savings.  The H.E.R.E.I.U. Welfare Fund has also aligned incentives with desired behaviors by informing patients which physicians were high-performing, providing performance bonuses to high-performing doctors, and giving pregnant patients incentives to receive prenatal care.  These initiatives have effectively engaged workers to improve their health through widespread use of employee risk assessments, risk-based interventions, and behavior change programs.  The H.E.RE.I.U. Welfare Fund also has worksite pharmacies that give out free generic drugs for chronic conditions and provide special care centers for workers and family members who have high cost and complex chronic conditions.

    * Johnson & Johnson (Bill Weldon, Chairman of the Board and CEO):  Johnson & Johnson has one of the longest-running workplace health programs in the United States.  The company has a sophisticated set of disease management and prevention interventions, risk-based incentives, pedometers/exercise goals, treadmills available for offices, and other health related programs.  According to its recent employee health scorecard for United States employees, at the end of 2007, Johnson & Johnson continued to make health improvement progress and its health initiatives avoided an estimated $15.9 million in health care costs in 2007.  As well, from the late 1990s to 2006 in the United States, smoking declined from 12 percent of its workforce to four percent, high blood pressure dropped from 14 percent to six percent, and high cholesterol went from 19 percent to six percent.  A 2002 Rand study found that Johnson & Johnson’s initiatives had improved employee health and employees had saved an average of $225 per year because of a reduced need for doctor visits.

    * Microsoft (Cecily Hall, Director of US Benefits):  Microsoft creates personalized health goals and has a staff of doctors that makes house calls to avoid emergency room visits.  Its obesity program assigns employees to a primary care doctor, behavior health specialist, and nutritionist, and Microsoft provides free meals consistent with diet recommendations to eat on site or to take home.  The result of its initiatives has been very low premium growth and a healthier workforce than other companies with workers of similar age.  Microsoft has been continually recognized as one of Fortune’s 100 Best Places to Work.

    * Ohio Department of Health (Dr. Alvin Jackson, Director of Ohio Department of Health): The State of Ohio created a "Take Charge! Live Well!" program to reduce health risk factors for state workers, with more than 50 percent of eligible workers participating.  Until 2005, health care programs for state employees in Ohio focused on disease management and improving the health of high-risk groups.  After reviewing data, the state discovered that while 27 percent of total health care costs were related to high-risk employees, 44 percent of costs were associated with preventable conditions.  Ohio’s "Take Charge! Live Well!" comprehensive health management program includes online and telephone health assessments, health coaching, online health improvement program, on-site employee health screenings (offered at about 40 locations), preventive care, chronic condition management, and monetary incentives of up to $100 in incentive payments, or $200 when spouses are enrolled, if employees complete a health assessment and participate in a health improvement program.

    * Pitney Bowes (Murray Martin, Chairman of the Board, President, and CEO):  Pitney Bowes offers onsite comprehensive health clinics and fitness centers, redesigned food merchandizing and prices in their cafeterias, incentives management for the health of their employees, and low cost drugs for chronic diseases.  The company has also adopted infection control practices and offers low-cost or no-cost
preventive screenings and immunizations on-site and off-site.  The company’s initiatives and its commitment to increase employee participation in managing their own health have resulted in $40 million in savings over the last nine years.

    * REI (Sally Jewell, President and CEO):  REI offers health benefits to all of its full and part-time workers and has been continually recognized as one of Fortune’s 100 Best Places to Work.  The company offers employees support for outdoor activities ranging from outdoor gear and apparel discounts, free rentals, and outdoor challenge grants.  REI employees can earn extra healthy lifestyle dollars to put toward the cost of coverage by engaging in specific "good behaviors," such as getting regular aerobic exercise.  REI also supports personal health goals and provides equipment support, discounts, and time off so employees can achieve their goals.

    * Safeway (Steve Burd, President and CEO):  Safeway has innovated in benefit design to reward employees’ healthy behaviors and improve adherence to recommended treatments for chronic diseases.  Over 74 percent of Safeway’s 30,000 nonunion workers have signed up for its "Healthy Measures" program.  Under this program, participants undergo screening tests (including cholesterol, blood pressure, and weight control), and employees who score well pay lower health premiums.  Safeway has saved millions by making employees accountable for their weight, smoking, cholesterol, and blood pressure.  The company also has a free fitness center at its headquarters, offers gym membership discounts, and provides a 24-hour nurse health hotline.  In 2006, Safeway’s efforts reduced their total health care spending by 13 percent, and employees who signed up have saved more than 20 percent on their premiums. 

 

[Benny B]

[Soul Crusher]

Of all the people in that picture, Luger, Zero, Pelosi, et al, none of them has ever created a job, a product, a service, a good, a patent, am idea, anything.

What makes them qualified to know what will work???

What is their expertise in these matters???

[The True Adonis]

Of all the people in that picture, Luger, Zero, Pelosi, et al, none of them has ever created a job, a product, a service, a good, a patent, am idea, anything.

What makes them qualified to know what will work???

What is their expertise in these matters???

uh, thats just not true.

Republican Senator Lugar manages his family's 604 acre (2.4 km˛) Marion County corn, soybean and tree farm. Before entering public life, he helped his brother Tom manage the family's food machinery manufacturing business in Indianapolis.

[240 is Back]

uh, thats just not true.

Republican Senator Lugar manages his family's 604 acre (2.4 km˛) Marion County corn, soybean and tree farm. Before entering public life, he helped his brother Tom manage the family's food machinery manufacturing business in Indianapolis.

333386 speaks more out of emotion than fact.

[Soul Crusher]

333386 speaks more out of emotion than fact.

Ok, he is one person, how about Pelosi, Rangle, Obama, Hoyer, et all who actually run the show now?

Name one job any of them have ever created. 

[Soul Crusher]

333386 speaks more out of emotion than fact.

Ha ha.  Look at the jobs report today. 

[Deicide]

Yeah I missed where this is in the Constitution. End of thread.

Since when do you care about the Constitution? Our illegal wars and occupations aren't in it either, but that doesn't seem to phase you.

[shootfighter1]

Watching closely to see where this goes.  I'm all for improvements but don't want the gov to run healthcare.

"Healthcare for everyone" sounds good and makes for a popular slogan, but its going to be incredibly complicated and expensive.  Not to mention the biggest issue they are not talking much about...rationing of care.  There will be limited funds in the system and care would have to be rationed.

Why don't they force insurance company competition across state lines, I have yet to hear an arguement against this.

[Benny B]

 

[headhuntersix]

Sure thing.....


Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.

Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.

My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.


 
Martin Kozlowski
 The problems were brought home when a relative had difficulty walking. He was in chronic pain. His doctor suggested a referral to a neurologist; an MRI would need to be done, then possibly a referral to another specialist. The wait would have stretched to roughly a year. If surgery was needed, the wait would be months more. Not wanting to stay confined to his house, he had the surgery done in the U.S., at the Mayo Clinic, and paid for it himself.

Such stories are common. For example, Sylvia de Vries, an Ontario woman, had a 40-pound fluid-filled tumor removed from her abdomen by an American surgeon in 2006. Her Michigan doctor estimated that she was within weeks of dying, but she was still on a wait list for a Canadian specialist.

Indeed, Canada's provincial governments themselves rely on American medicine. Between 2006 and 2008, Ontario sent more than 160 patients to New York and Michigan for emergency neurosurgery -- described by the Globe and Mail newspaper as "broken necks, burst aneurysms and other types of bleeding in or around the brain."

Only half of ER patients are treated in a timely manner by national and international standards, according to a government study. The physician shortage is so severe that some towns hold lotteries, with the winners gaining access to the local doc.

Overall, according to a study published in Lancet Oncology last year, five-year cancer survival rates are higher in the U.S. than those in Canada. Based on data from the Joint Canada/U.S. Survey of Health (done by Statistics Canada and the U.S. National Center for Health Statistics), Americans have greater access to preventive screening tests and have higher treatment rates for chronic illnesses. No wonder: To limit the growth in health spending, governments restrict the supply of health care by rationing it through waiting. The same survey data show, as June and Paul O'Neill note in a paper published in 2007 in the Forum for Health Economics & Policy, that the poor under socialized medicine seem to be less healthy relative to the nonpoor than their American counterparts.

Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction. In 2005, Canada's supreme court struck down key laws in Quebec that established a government monopoly of health services. Claude Castonguay, who headed the Quebec government commission that recommended the creation of its public health-care system in the 1960s, also has second thoughts. Last year, after completing another review, he declared the system in "crisis" and suggested a massive expansion of private services -- even advocating that public hospitals rent facilities to physicians in off-hours.

And the medical establishment? Dr. Brian Day, an orthopedic surgeon, grew increasingly frustrated by government cutbacks that reduced his access to an operating room and increased the number of patients on his hospital waiting list. He built a private hospital in Vancouver in the 1990s. Last year, he completed a term as the president of the Canadian Medical Association and was succeeded by a Quebec radiologist who owns several private clinics.

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.

In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.

Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?

Dr. Gratzer, a physician, is a senior fellow at the Manhattan Institute

[GigantorX]

How are we supposed to pay for all of this? I mean, if 95% of all Americans are going to be getting a "tax cut" one would figure that making ends meet concerning health care "reform" may be a little tough.

[Bindare_Dundat]

How are we supposed to pay for all of this? I mean, if 95% of all Americans are going to be getting a "tax cut" one would figure that making ends meet concerning health care "reform" may be a little tough.

The Fed will print fifteen, 1 trillion dollar bills and everything will be ok.

[GigantorX]

The Fed will print fifteen, 1 trillion dollar bills and everything will be ok.

Oh, phew, good thing that's taken care of then.

[Kazan]

I am at a loss, how can anyone support this? Show me one government program that hasn't balooned into a red tape filled buracratic mess, just one!

It has become all to apparent that the gene pool needs to clorox

[Cap]

I think they should send out an envelope to every American citizen and those who feel the burning desire to pay for everyone elses health care can contribute money.  He's trying to push this agenda now but bottom line, people don't want to pay their taxes for this, cap and trade, etc.

[GigantorX]

I think they should send out an envelope to every American citizen and those who feel the burning desire to pay for everyone elses health care can contribute money.  He's trying to push this agenda now but bottom line, people don't want to pay their taxes for this, cap and trade, etc.

People don't want high taxes but the majority will blindly vote for whoever promises the most and then never pays for it through taxation. Hence our giant deficit and 70 trillion dollars in unfunded liabilities.

[Bindare_Dundat]

lol, is this 333386?