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We need single-payer



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Published: February 6, 2009

I recently attended the health care meeting put on by the Worker's Center at the Barre Labor Hall. The most interesting point that I came away with was that all of our budget problems (state, municipal, education) could be solved by switching to single-payer health care. Yes, our taxes would go up but there would be no premiums or co-pays or deductibles. This would be a much more fair way to apportion the costs as our taxes are based on our incomes. And everyone would be covered.

This would also help small businesses who are struggling under the high costs of providing health care to their employees.

In other countries which have single-payer health care (which includes all of the other industrialized countries in the world), they pay half what we do for health care and they are healthier – this should tell us something! (Maybe it has something to do with not having the stress of worrying…)

Sandra Bettis

Middlesex



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READER COMMENTS


I agree about the magic pill, Doug, but the gov. does run some medical programs with a great deal of success -- medicaid/medicare. It ain't magic but it works. The trouble is that we cannot expect gov. to run something when we say that gov. is the problem, not the solution. As Obama said, it is not "how big or how small the gov. is, it is how it works for everyone." As far as the constitution, well, is not this supposedly a gov. by the people for the people? And constitutions can be amended:) don't forget that the original constitution prohibited women from voting and said that afro-Americans counted as 3/5ths of a human being.

This is true about the constitution. So I say lets see if it can be changed. I am not saying I want it changed and I would campaign aginst it with every fiber in my body. That said, until the constitution is changed what some people are advocating is illegal. However, that also goes for much of what happen in gov't. don't get me started. As far as women voting that is awesome :) However, the electorial college can even ***** up how people vote :) see.. gov't screws up a lot of things.

Medicad and medicare suck. They are broke and ration care. The gov't makes it illegal to have another health care if you have medicare. you can have something that supliments it but you cannot have another primary. whats up with that? Rationing at it finiest.

Douglas Duprey
Marshfield, VT
-- Posted by Douglas Duprey on Wed, Feb 11, 2009, 7:07 am EST

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No system is perfect.... Canada has outdated equipment and long waits. We have the best equipment and some of the brightest medical minds here in the states. That's why there are Canadians that come, with regularity, to places such as Fletcher Allen to receive care -- because it's of a higher quality and often quicker than they can receive in their home country. Single payers are a great idea, but definitely reserved for a utopian society in which we will never life.
Medicare/Medicaid are programs that were thrown together (especially Medicaid) and were perceived in a time in which the cost of health care had not exploded to the point at which it is today. The cost of quality care is outpacing the insurer's ability to deal with it. The current government run systems work (kind of) in that they cover a large number of people. The thing that doesn't work, however, is that they do stipulate who a person can see and what procedures and devices will be covered... not to mention the fact that the rates at which they reimburse are so poor that the physicians, hospitals, and all other health care providers often lose money (especially with Medicaid). I have no solutions and I don't think anybody will come up with one soon. What is known is that something needs to be done to level the playing field in terms of access to care, as every individual deserves a right to health care, regardless of their ability to pay.
-- Posted by Brian Rodriguez on Tue, Feb 10, 2009, 11:23 pm EST

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"While I concede that private insurers are apt to do the same, at least with the current system if I am not satisfied with the process, I can change to a different insurer. While it may not be entirely practical, I still have choices."

Private insurers do do the same, though I have never experienced this with the single-payer such as we have it now, but with private insurers...look out. And if you change, my friend, good luck. I have gone through this before.

"There is NO magic pill and the Gov't can't run a single program with success."

I agree about the magic pill, Doug, but the gov. does run some medical programs with a great deal of success -- medicaid/medicare. It ain't magic but it works. The trouble is that we cannot expect gov. to run something when we say that gov. is the problem, not the solution. As Obama said, it is not "how big or how small the gov. is, it is how it works for everyone." As far as the constitution, well, is not this supposedly a gov. by the people for the people? And constitutions can be amended:) don't forget that the original constitution prohibited women from voting and said that afro-Americans counted as 3/5ths of a human being.

"We sure have a lot of health care experts on this site."

LOL, Olde Man...well, at least we're experts on something:)
-- Posted by Watercloset on Tue, Feb 10, 2009, 11:16 pm EST

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"Under single-payer type plans, government is the insurer not the doctor. Under medicaid or medicare, for instance, Uncle Sam is not telling you what you can and cannot have for treatments and prescriptions."

Not exactly true citizen...

As the insurer, they will deny payment for treatment and prescriptions they do not determine to be "medically necessary". I can only imagine the appeal process involved in telling them they were wrong...

While I concede that private insurers are apt to do the same, at least with the current system if I am not satisfied with the process, I can change to a different insurer. While it may not be entirely practical, I still have choices.

I simply have to agree that once they figure out how to administer Medicaid and Medicare effectively, perhaps we can offer that same plan to all citizens. However, only as an alternative to private health care insurers of course!

Health care needs to shift from reactive to proactive in this country.
-- Posted by Etli on Tue, Feb 10, 2009, 9:02 pm EST

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We sure have a lot of health care experts on this site.



.
-- Posted by Olde Man on Tue, Feb 10, 2009, 4:39 pm EST

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American already has single-payer health systems, it's called Medicare and Medicaid - very similar in structure to Canada's federal and provincial health systems. As a society we have so far chosen to provide tax-supported health care only to the old and the poor. The rest of us purchase health insurance to pay for what Medicare and Medicaid won't.

Single-payer health system won't improve our health status. We will have lousy infant death rates and cancer rates as long as we are fat and smoking. And we are fat and we do smoke - which has nothing to do with the healthcare system.

As for low administrative costs - the government health systems don't include the cost of their own personnel expenses when they calculate overhead. As for quality of care - improvement occurs when there is one datasystem for all healthcare related needs and that is indeed achievable with a single governmental system - but at a very high cost and extended period of time.

When we figure out how to honestly and efficiently administer Medicare and Medicaid, I'll believe we are ready to expand those services to the rest of the population.
-- Posted by Rebecca Bowen on Tue, Feb 10, 2009, 12:30 pm EST

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"Sorry, I'd much rather keep the government out of my health care. I don't particularly want Uncle Sam telling me what treatments I can and cannot receive, and what medications I can or can not receive."

Under single-payer type plans, government is the insurer not the doctor. Under medicaid or medicare, for instance, Uncle Sam is not telling you what you can and cannot have for treatments and prescriptions. They may insist on the lower, generic one, over a higher-priced one, but they do not say what can and cannot have. I have experienced this, both under private health care and medicaid; the difference is almost unimaginable. The abuses of private health care are almost surreal, what they tell you what treatments you can and cannot do, and what they will insure versus what they do not insure. More often than not you do not find this out until you are midway through a major operation or cancer treatment, such as happened to a friend of mine, when they denied his treatments because they said his policy did not cover them.

Private insurance companies want profit and if you need care you are costing them money. If you need long term care, this can become a massive nightmare. They will seek any way they can to deny you coverage. I have experienced this before. You spend as much time fighting the insurance companies for coverage as you do trying to recover. Then they will try to drop you from their coverage. They only want healthy insurees. Our health care is unimaginably expensive because of this profit, this free-market, this need to satisfy shareholders, and it comes at the expense of the patient. If all of you that think single-payer, whatever type of system it is, and there are many, is just government control, try private health care and see where you get. You need a lawyer as much as a doctor or a nurse.

The problem is how it is done, how to merge our cobbled together non-functional system into something that works and actually does allow health care rather than health denial. Where there is the will there is the way. We have the will, at least among the people, and we have the pieces of the way. Just put them together.
-- Posted by Watercloset on Tue, Feb 10, 2009, 12:47 am EST

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Let's imagine we go to a single payer system.

Let's also imagine we're in another fiscal crisis like we are now.

People are already facing benefit reduction, every year they look to trim budgets somehow. There is always talk of reducing Medicare benefits for the elderly...

What makes anyone think it would be any different if the government was administering health care for all?

Sorry, I'd much rather keep the government out of my health care. I don't particularly want Uncle Sam telling me what treatments I can and cannot receive, and what medications I can or can not receive. Sure insurance companies do that as well, but if that's the case I currently have the option to change insurers. With a single payer system, I don't.

That isn't to say the current system doesn't need improvement and reform... But that's a different letter altogether.
-- Posted by Etli on Mon, Feb 9, 2009, 10:19 pm EST

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So everybody is against single payer, then give us an alternative that works?
-- Posted by Dave Erwin on Mon, Feb 9, 2009, 2:12 pm EST

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Anyone who is in favor of single payer healthcare should read this article in the Wall Street Journal by Nadeem Esmail "Too Old for Hip Surgery"
WWW.WSJ.com - Opinion: 'Too Old' For Hip Surgery
-- Posted by Bobbie Palmer on Mon, Feb 9, 2009, 12:26 pm EST

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Guess why so many Canadians visit the US to go shopping? Because the sales tax in Canada is outrageous. It's cheaper to come here, even when paying for gas and food.

I know people that live in Europe and Japan. They have long waits to see a doctor. Simple surgeries here in the US are considered complex over there and the recovery time is three to five times longer.

I agree that everyone should have access to health care. I agree that the costs are way too high. Allowing the Feds to control it will only increase costs (e.g. Medicare) and lessen services (e.g. Europe). For anyone that was against the Patriot Act, I ask you this: you're afraid of "Big Brother" knowing too much but you're prepared to hand over your medical history to them without blinking an eye? I'd rethink that a few times before making a final decision if I were you.

May we all be and live healthy.

Average Joe
-- Posted by Joe Friday on Mon, Feb 9, 2009, 9:30 am EST

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Watercloset: I have had to pay out of pocket for family surgery. I have been there done that. I stills ay keep the damn gov't out of it. I paid the bills also, no bancruptcy for me.

You all want single payer and hype how great it will be... I will use 2 examples with a few comments: Medicaid and Medicare

These are both single payer plans. One administered at state level and one at federal level. Both are broke... and we are still paying into them.

I see the figures for Canada's health care system, seems to me they are tryingt o administer on the cheap.. sounds like rationing by underfunding. I have a friends in France, the wait can be long and treatment mediocure. I had a good friend in Australia don't go there about the care.. I was listening to new on radio and heard this year alone 14 people have died in Japan from treatable issues and they were turned away all 14 died. I am sure more were probably turned away but sinc they didn't die they didn't make the news over here. Along those line, I have a friend from Japan and care is excellent there, waits are all over the place, however they way it is rationed (yes they admit it also) you get what I mention above. It is also going broke.

I always hear how if you don't have insurance you get turned away in USA. I call BS on statement. You get turned away if you are NOT willing to pay for it. That is like anything else you can't pay you don't get it.

My point is: There is NO magic pill and the Gov't can't run a single program with success. Never mind no where in the constitution does it say we have a right to this.

OK end of rant.

Douglas Duprey
Marshfield, VT
-- Posted by Douglas Duprey on Mon, Feb 9, 2009, 8:57 am EST

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"France can't have shorter waits than the US because there is almost no wait for care in the US."

Darin, you are dead wrong. Waits can be just as long here as in France, if not longer, especially if you lack health insurance. If you need to see a specialist, for example, like a liver or gastronomist, your wait can be months. I know: I had to wait months. I have also been denied care because I lacked insurance, or have had to wait hours beyond my appointed time for a procedure, or even go find the particular doctor that I was supposed to see, and have constantly had to fight the insurance companies "claim denied," procedures to try to not pay insurance.

And thanks to andrew desmarais for putting up those statistics. They tell the grim story.

"I love it when some simple head thinks there is a magic pill for all of society's ills."

Doug, if you ever need an operation and do not have insurance because of one reason or another, I hope that you remember what you said when you are losing your home to medical bills. I know this well. Remember, it can cost a thousand dollars to just walk through the door of the hospital. Remember that your free-market private deduction can be $5,000, not to mention what they will not cover, or more and that a single operation can cost $30,000 and up. Remember that.

"If things are so bad in the US why is it that people come from all over the world to have their treatment in the US? Canadians, Europeans etc all come to the US when they are sick."

They do? The Canadians I meet love the system. It is imperfect, but at least they have it. We also go there to afford health care.

"So, I can't dismiss the idea as quickly as some do, until we get a clear picture of the vehicle used to deliver this and find a needed solution to the rising cost of care."

Olde Man (we are both olde men:)) I think you are right. The high cost is probably the result of our free-market system which drives up costs. What vehicle would be the best is hard to say right now, but the free-market at least has to be regulated somehow because health care is not a commodity.
-- Posted by Watercloset on Sun, Feb 8, 2009, 11:29 pm EST

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Its to bad that everything I said is true. Here is your proof:
http://www.consumeraffairs.com/news03/health_costs.html

Per Capita U.S. Health Care Costs Triple Canada's

August 21, 2003
The overhead cost of operating the United States health-care system is more than three times that of running Canada's on a per capita basis, and the gap is getting bigger, according to a study published today in the New England Journal of Medicine.

Savings gleaned from a national health insurance system like Canada's would be enough to provide medical insurance for the 41 million Americans who now lack coverage, the researchers said.

The study puts the administrative cost of the U.S. system at $294 billion per year, compared to about $9.4 billion in Canada. That translates to a per-person cost of $1,059 in the U.S. and $307 in Canada. A similar study, conducted in 1991, put per-capita costs in the U.S. at $450 and Canadian costs at one-third of that.

http://en.wikipedia.org/wiki/Health_care_in_Canada

Canada's healthcare spending is expected to reach $171.9 billion, or $5,170 per person, in 2008. Health expenditures are expected to be 10.7% of the gross domestic product.



Health Care Expenditures by State of Residence (in millions), 2004

NH
US
$7,050 $1,551,255

http://www.statehealthfacts.org/profileind.jsp?ind=592&cat=5&rgn=31

BTW Darin there is the truth. Prove me wrong or deal with it. Keep in mind we spend that much still to have an estimated 40% of our people without good health care.
-- Posted by andrew desmarais on Sun, Feb 8, 2009, 9:47 pm EST

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"Keep in mind that the state of New Hampshire right now pays more for its health care coverage than the entire country of Canada does."
Show me a study that proves this, cause it's BS
France can't have shorter waits than the US because there is almost no wait for care in the US. Also show me someone in the US that has been denied care, this is a giant myth. The biggest reason for the rise cost of health care is cost shift, the government makes promises to cover people then doesn't pay! The hospitals etc have to shift the costs to private insurance, that is the real reason insurance is so expensive.
There is no doubt that the US has the best health care, now we just need find a way to make it more affordable.

BTW andrew ML is free to take my words, because they are the truth. People don't want to hear the truth, they just want someone else to take care of the problem.
-- Posted by Darin on Sun, Feb 8, 2009, 4:38 pm EST

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It is official. M. L. has stopped spreading his own BS, and is actually using the arguments of someone else as his own. He has officially stop trying to even pretend like he is thinking.

The problem with the health care right now is the cost. People say wait until the government gets its hands on it, because the cost will go up. My question is how? The United States right now already pays more for its health care than anyone else in the world, and we do so for less service. Keep in mind that the state of New Hampshire right now pays more for its health care coverage than the entire country of Canada does.

Also keep in mind about the myth of waiting periods in universal health care. The two models that are most commonly thrown out as examples for the United State are the models of Canada and France. France has shorter waits on average than the United States. They are longer in Canada.
-- Posted by andrew desmarais on Sun, Feb 8, 2009, 3:03 pm EST

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"The worst thing is the wait, you have to wait for everything. You wait for a doctor, you wait for an MRI, you wait for a hospital bed etc etc. In Alberta now, the richest province in Canada, you wait 3 -6 months for a test like an MRI or to see a specialist. You also wait 3 to 6 months for a hospital bed once they actually figure out what is wrong with you.
My dad died from cancer last year, I wouldn't put my dog in the hospital he was in! There were people in the beds in the hallway because there weren't enough rooms. The food was absolutely horrible, way beyond anything around here. The treatment was mediocre, the equipment was old and worn out. It was disgusting. My wife, a former LPN, was completely disgusted with the hospital, and this is a typical Canadian facility."

olde man, you should read that again.
-- Posted by M. L. on Sun, Feb 8, 2009, 2:37 pm EST

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.

I don't know if "single payer" is the answer. Much more information needed to form an opinion. It's not as simple as voting "yes" to a single payer system. The "system" has yet to be described. How much would it cost? What would the limitations be? What is the plan design?

Underlying all of this, and almost never debated: is the rising cost of health care itself. How to pay for it, e.g. single payer, is a worthwhile discussion. It may well become a moot point if the cost of care continues to exceed the cost of living.

So, I can't dismiss the idea as quickly as some do, until we get a clear picture of the vehicle used to deliver this and find a needed solution to the rising cost of care.



.
-- Posted by Olde Man on Sun, Feb 8, 2009, 2:31 pm EST

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because most participants here lack the intellect needed to understand what you are saying, i pose the over-simplified direct question below...
-- Posted by M. L. on Sun, Feb 8, 2009, 12:49 pm EST

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Thank you darin, finally a person who knows what the heck they are taling about.

In your opinon, who provides better quality care, the US or Canada (free market or socialized)?
-- Posted by M. L. on Sun, Feb 8, 2009, 12:46 pm EST

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Sandra you have obviously never lived in a country with single payer healthcare, I have. I grew up in Canada and chose to move to the US as an adult. Almost everything you said about single payer is wrong except for the higher taxes. You still have to purchase insurance, for things like prescriptions or upgrades to your hospital room or chiropractic etc. The insurance costs are not much less than in the US, also you have to contribute to the health care fund, this varies by province in Canada but it is also quite expensive. The worst thing is the wait, you have to wait for everything. You wait for a doctor, you wait for an MRI, you wait for a hospital bed etc etc. In Alberta now, the richest province in Canada, you wait 3 -6 months for a test like an MRI or to see a specialist. You also wait 3 to 6 months for a hospital bed once they actually figure out what is wrong with you.
My dad died from cancer last year, I wouldn't put my dog in the hospital he was in! There were people in the beds in the hallway because there weren't enough rooms. The food was absolutely horrible, way beyond anything around here. The treatment was mediocre, the equipment was old and worn out. It was disgusting. My wife, a former LPN, was completely disgusted with the hospital, and this is a typical Canadian facility.
Single payer is just wrong, it's the first step to rationing healthcare, that is not the American way. If things are so bad in the US why is it that people come from all over the world to have their treatment in the US? Canadians, Europeans etc all come to the US when they are sick.
Do things need to change? Absolutely, is single payer the answer? Absolutely NOT!
-- Posted by Darin on Sun, Feb 8, 2009, 11:49 am EST

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Why do I want to trust the gov't with more of my money? Why? They can't run a single issue properly. You, me, nor anybody has a right to any of this. It is way outside the Constitution. It is way outside the role of Gov't in our current form.

The Gov't is corrurpt. It is inefficient and open to bribry, why do I want to add more money to their coffers.

I love it when some simple head thinks there is a magic pill for all of society's ills.

Say NO to Gov't run single payer!

Douglas Duprey
Marshfield, VT
-- Posted by Douglas Duprey on Sun, Feb 8, 2009, 10:28 am EST

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You think health care costs now, just wait till the bloated Government takes it over. The only program the Government manages well is the Military. Medicare, Medicaid even Catamount are broke and sinking deeper in debt.
-- Posted by alisha whitney on Sun, Feb 8, 2009, 8:28 am EST

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Don't stop with healthcare. In the name of "fairness", demand that all levels of government do more to create equality in the areas listed above. Government could obviously provide all those things cheaper than the big, bad market does.

So what's wrong with equal health care for all citizens? Does a poor child also deserve health care the same as a rich one. The big bad market cannot provide for the social well-being of the citizenry, as has been proven time and again, only its material enhancement.
-- Posted by Watercloset on Sun, Feb 8, 2009, 12:48 am EST

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Jest,

Don't assume I'm a fan of the GOP or Limbaugh. I usually find them as insufferable as I do the Washingtonian progressives. It seems to me that both sides have an unending desire to 1)centralize power in DC, and 2) attempt to legislate as many facets of my life as they can get away with. In my mind, bipartisanship isn't dead...it's all too prevalent and evil. Quite simply, I just want to return more power to local, accountable governments that don't have their own printing presses.
-- Posted by Jeff Andrews on Sat, Feb 7, 2009, 8:50 pm EST

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JA, you so silly! It's ridiculous statements like that that have turned off all but the most confirmed GOPs and El Rushbo listeners. The rest of us recognize hyperbole when we see it. Bluster on if you must but you do it for fewer and fewer people as the days go on.

Get it?
-- Posted by Jest Askin on Sat, Feb 7, 2009, 10:45 am EST

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Don't stop with healthcare! Is it right that some people live in larger houses than other people? Is it right that some people own nicer cars than other people? Is it right that some people are able to spend more on food than other people? It it right that some people wear nicer clothes than other people? And why is it that some people are able to go on nice vacations while others have to stay home?

Don't stop with healthcare. In the name of "fairness", demand that all levels of government do more to create equality in the areas listed above. Government could obviously provide all those things cheaper than the big, bad market does.
-- Posted by Jeff Andrews on Fri, Feb 6, 2009, 9:36 pm EST

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Come on, Sandra. We don't want affordable heath care. We don't want to stop our major corporations from moving to other, more enlightened countries where they don't have to foot the bill for health care. We don't want America to be like all those countries that have better health services provided at much lower costs. We don't want to live longer, have healthier babies, have more babies actually live past their births. We're Americans. We believe in doing things just a tad different from the rest of the world whether it's good for us or not. We're happy to pay for the excesses of insurance company interference in the provision of heath services. We see no need to reducing administrative costs to 4% or so from the current 20-25% that it takes to do the required paperwork for the insurance companies. We like the fact that insurance companies import cheap foreign labor or send jobs overseas in support of their real goal: not paying claims. We enjoy seeing all those foreign cars on the roads because American car companies have to pay for heath care on top of the actual costs of building the cars.

We love all that. We'll pay any price to retain our bloated, costly, poorly-serviced ways of providing health care. Don't you understand that, Sandra?

Why do you hate America?
-- Posted by Jest Askin on Fri, Feb 6, 2009, 10:49 am EST

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Pretty simply Sandra... NO WE DON'T !
-- Posted by Douglas Anthony on Fri, Feb 6, 2009, 7:23 am EST

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