Sunday, September 11, 2011

Double Indemnity

"We're both rotten!"
                                 "Yeah, only you're a little more rotten!"

Fellow bloggers, Barbara Stanwyck's and Fred MacMurray's dialogue in the American film noir co-written by Billy Wilder and Raymond Chandler can be an appropriate description of the spine world that we live in.  Life can imitate art. Potentially our moment will play itself out  beginning in November of 2011. If life does imitate art, then Senator Chuck Grassley (R-IA) and Herbert Kohl (D-WI) will play the dual role of Barton Keys (Edward G. Robinson), whose job it was to find phony claims in the movie Double Indemnity.

November 2011 and the subsequent date of March 31, 2013 will usher in a new era of compliance.  The Secretary of Health and Human Services shall establish policies and procedures to ensure compliance with the requirements authored into provisions within the Sunshine Act, aka the Patient Protection and Affordable Care Act of 2009, passed by the Senate on December 24, 2009, and the House on March 21, 2010.  On November 1, 2011 the Secretary will begin conducting audits to determine that hospitals are also under compliance.  No longer will some of our highly esteemed hospital administrators be able to look the other way when it comes to questioning some of the current concepts in spine. Hospital compliance officers will actually have to start being accountable.

If there ever was a time to accelerate the arrival of March 31, 2013, the time is now. TSB can hear the outcry, especially, from our celebrated commentator whose constant derision of our blog includes labeling us a socialist and liberal forum.  Our only response is that some people wouldn't know the boogeyman if he jumped out and bit one in the derriere.  If your personal freedom's are so threatened, please do not read our blog, your utter non-sense will not be missed, but then we do believe in free speech, therefore, rant on.  Whether one agrees with our opinions, the reality is that once again our society needs to find balance in the individual roles we play in our lives, in our financial expectations, and the fact that maybe the illusion that we have created can no longer be translated into reality. Dr. Leary, where are you when you are needed?  Change will be good, and everyone will learn how to adapt or perish.  The recent outcry for less government is theater at its best. TSB can hear all those phony teabaggers, only to be contradicted by the recent events of Hurricane Irene whom invited herself into many of your lives and showered you with the wrath of Mother Nature.  And you know what Michelle Bachmann says, "it's not nice to full Mother Nature."  Ironically, the cry from Democratic and Republican bureaucrats on the state level in the East has been for more federal intervention, blaming the federal government for the mismanagement of their finances, and lack of action when it came to addressing the damns, rivers and streams that were never fortified in the event of a major disaster. Whatever happened to personal accountability and less government?  But this isn't what this post is about.

On March 31st, 2013 and the 90th day of each calendar year beginning thereafter, any applicable manufacturer that provides a payment or other transfer of value to a covered recipient shall submit the following to the Secretary,

Name of that individual
Business Address
Amount of Payment
Date of Payment
Description of Payment
Cash or Cash Equivalent
In Kind Items or Services
Stock or Stock Options
Any Other Form of Payment or Transfer (POD)
Description
Consulting Fees
Compensation for Services other than Consulting (POD)
Honoraria
Gifts
Entertainment
Food/Travel
Education
Research
Charitable Contributions
Royalty or Licensing Fee
Current or Prospective Ownership or Investment Interest (POD)
Direct Compensation for Serving as Faculty or Speaker for Medical Education
Grants
Any Other Nature of Payment or Other Transfer of Value,

These are just a few of the guidelines that will be enforced.  Hopefully the DOJ will look at every company excluding no one, especially some of the smaller companies that attempt to fly under the radar.   There are plenty of lawyers, surgeons and distributors burning the midnight oil in anticipation of how to circumvent the law. Whether the law will reign in the terror that we have inflicted upon ourselves will be determined by time.  Will this legislation dampen the endless schemes that are hatched by individuals in our industry whom condemn the law, yet rely on the law to find new and creative ways to circumvent the very laws that they decry? Will we see a return to innovation?  Will we see the demise of POD's, and phony consulting agreements?  Regardless of your role in the industry, the stench that many of you smell is the infestation of corporate dollars in buying business rather then developing newer and innovative modalities of treatment.  By leveling the playing field, we can separate the contenders from the pretenders, and stop the insanity that many of us are consumed with on a day to day basis.  Who knows?  So in closing TSB wants to know, is the Moon in the seventh house and will Jupiter align itself within Mars, is this the dawning of the Age of Aquarius?

Let the sunshine, let the sunshine in, the Sunshine in...........................................................

109 comments:

  1. Hmmmmm,, I'll be 1st to respond:

    Did government guidelines & regulations clean up Wall St. & prevent the market & mortgage meltdown seen the last few years? NO.

    The same thing will happen w/ this attempt to police the industry. Does somthing need to be done,, Yes, of course. But this will prove to be nothing more than a step in the right direction. Some companies will abide but the guidelines, but there will always be those that will look for ways to circumvent the rules.

    There is simply too much greed & money to be made in this industry to ever allow it to be cleaned up completely, just like on Wall St. So, while there may be some temporary inconveniences to doing business, the beat will continue to go on.

    If you REALLY want to see the shennanigans come to a halt, then go after a few individuals who are behind the courruption & make examples out them. Prosecute a few people, lock them up and see if that sends a message that enough is enough.

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  2. I am curious if congress would be willing to enact similar standards regarding the various entities that provides payments or other transfer of value to government officials?

    Now that would be a sunny day!

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  3. This reminds me of criminals and counterfeit money. They are alwasy one step ahead of the government. I am sure the people who want to get paid, will find a loop hole to get paid. Per usual, this will only change the behavior of the large companies and honest customers.

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  4. Much ado about nothing here.There is a big difference between sunshine i.e. disclosure laws and outlawing the activities themselves. Massachusetts and a few other states already have this on the books. The big companies are already voluntarily disclosing. Besides, this bill is on life support anyway and if you haven't noticed, there is this little election between now and 2013 when this would supposedly go into effect.

    TSB, I respectfully think you are reading into this what you want to see, not what really is.

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  5. "Well those drifter's days are past me now
    I've got so much more to think about
    Deadlines and commitments
    What to leave in, what to leave out"

    -Against the Wind

    Bob Seger

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  6. What impact will this have on Spinal USA?

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  7. Regulatory and compliance law is the only "boom industry" left in medical devices. For as much as you criticize the lack of innovation in our industry- do you not see how adversely all of these regulatory requirements affect the ability to innovate? We have all seen the corruption around us with surgeon payments in return for business, but bringing light to the situation is not a guarantee that those problems will stop- and introduces a whole new set of challenges for industry.

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  8. Double Indemnity was a great movie.

    That is all.

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  9. Musculoskeletal Man,
    I like you better when you don't back ObamaCare, which will end many peoples' livelihoods if installed. I can handle the unscrupulous competitors, the jackass hospital administrators, the difficult surgeons, etc. What I have a hard time with is a bunch of utopian Libs F-ing up over a decade of my life's work, and painting me as the enemy to boot. Thank God for the Tea Party, without them ObamaCare would be implemented easily. Fight on!

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  10. TSB the posting was interesting until you just blew it again with your stupid little comments "let the sunshine in" or quoting some dumb ass song. Why is it that you can't seem to put together a decent story without quoting someone that has either died or some stupid song? I really wonder what goes on in the head of yours.
    To be honest with you, I have stopped reading your blogs. I come to see and read how some reps make fools of themselves and this business.
    Let me see if I can do you justice "Its a shame".

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  11. All the hypocrisy with TSB, et al. Calling for full disclosure, yet won't tell us his name, and allows anonymous posts to libel innocent companies. John, you are a scumbag, can't you see your own hypocrisy?

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  12. TSB finally confirms himself as an Obamacare-loving liberal! The true colors have shown. Thinking back, a lot of the points he has taken make a lot more sense through the lens of the left.

    Make no mistake. If enacted, OC will end the spine industry as we know it. Perhaps thats what TSB is hoping for.

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  13. "Obamacare loving liberal". Huh. Wish you Fox loving folks would get at least a little bit original.

    45 million people in this country have no healthcare. Most of them work full-time (If you don't work, you get Medicaid or Medicare). 45,000 died last year because of a lack of health-care (Harvard University study IIRC). We pay almost twice as much per capita as any other comparable country for health care (the facts are out there). Every year companies charge back more of the costs for health care to their employees and give us less (Ask me!).

    But all you deep thinkers can do is call names. And worry about your livelihood. Screw the other guy, I want mine, right?

    No, I don't think Obamacare is so great. Or Obama either. But at least Obama recognized there was a problem and tried to do something about it. More than the posters here, or their Congressional Representatives seem able to do.

    But go ahead, laugh, you sheep, while America falls further and further behind by every standard--from availability of health care to educational attainment to standard of living, on and on.

    Laugh you fools. Laugh at the liberals.

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  14. Regulation isn't holding back innovation. Regulation is keeping these companies from killing people. I work in R&D; you can take what I say to the bank on this one.

    The FDA sucks, but letting someone implant any damn thing they want into your Mama would suck worse.

    The literature is full of promises--Dynesys is a good example. Dynamic stabilization! Thousands of cases in Europe! They bring it here, do the study, guess what? It. does. not. work. It stabilizes, sure but dynamically? Ah, no.

    Science based medicine is not possible without some kind of regulation. Money would overwhelm any kind of scientific overview, take that to the bank. Did I already say that? Well, maybe it needs to be said twice.

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  15. Amen, 6:11. Spine needs two things
    (1) A DISRUPTIVE Innovation - not new fangled, poorly conceived devices - like that Cervical Spine DTRAX, or whatever it is. That thing WILL NOT WORK. We need someone to come up with a disruptive innovation. Unfortunately, so many surgeons are wedded to companies, either through $$$ or long time use that makes them "more comfortable" using the implant system, than switching, that it will be difficult for anyone other than one of the big companies to do this. We don't need new fangled devices, and "Ferrari" type pedicle screws. We need Toyotas.
    (2) Biologics that do not yet exist. And this does not mean new, hogwash DBM type "biologics." This means things that do not yet exist, like something to induce ankylosing spondylitis at a single level, to fuse a level without instrumentation, with just a needle and syringe.

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  16. If anyone believes even 1/10th of this will ever be reality then I have some oceanfront property in Iran for sale! TSB, the medical device industry is an ant on an elephants ass compared to other much larger issues needing addressed than what you point out. Do you think the makers of Prozac or Tylenol give a flying flip about the reporting you bring up and if you do then call me about that beachfront property in Iran that is at rock bottom pricing!

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  17. 6:11 what does Dynesys have to do with anything? Why single out that product? Why not something like Prodisc or any of the other cervical or lumbar "disc"?? And how do you define Dynamic Stablization? I have seen the good that Dynesys has done for a whole hell of lot of patients that would have otherwise been fused.
    YOu may think that we are just implanting anything in any given patient but if you spent any time in Europe instead of at your cubicle you would know that most of the devices on the market start there and yes, Dynesys is one of them and I haven't read of any deaths from that. How many patients died during and after the IDE study for the first lumbar disc???

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  18. TSB, you and Anderson Cooper can teabag D's nuts. To spout this progressive trash on September 11th shows you clearly don't understand what is special about America. I'm sure you'll claim not to care, but you officially lost at least one reader from these continually biased and uninformed rants.

    "the problem with socialism is that eventually you run out of other people's money"
    - Margaret Thatcher

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  19. Wow, 6:03 needs to let the sun shine in. Fun guy.

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  20. TSB's dream of the future:

    Single payer health care
    Central price controls on med devices (sorry no $ for reps)
    Total separation of providers and industry
    Three big companies with volume govt contracts, the rest out of business

    ...But LOTS of innovation! Right?

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  21. It's almost as if TSB is working for the large companies.... I wonder if he is a paid consultant. TSB., how about some transparency for you and post your 1099's?? Slander and libel of small companies since 2009, it's a TSB tradition.

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  22. Reverse Engineering, innovation at its best.

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  23. The present system is so deeply flawed and corrupt, that it really does not matter what you replace it with. Anything else will be at least one degree better. This sorry situation only is possible because to this day nobody understands back pain, which justifies any gimmick to be given a chance. IDET anyone? The industry would go a long way to clean itself up if surgeons only operated on patients with anatomical abnormalities that have been proven to cause pain and dysfunction. So, do cut the patient with a bulging disc pressing on the cord, keep your hands off the patient with some local pain and a black disc. The number of surgeries would fall by at least 50%....

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  24. TSB,

    This was your worst post ever. Your liberalism completely blinded you. If the post wasn't about partisan politics, why did you include the rant about "phony teabaggers" and a Michelle Bachmann misquote of a margarine commercial. If you what to examine some language, try a quote from Pelosi that is more scary and relevant: "we'll have to pass the health reform bill to find out what's in it".

    Is there a problem with healthcare in this country? sure there is. There's a problem in every country, you just have to pick your poison. For 6:03, if you think access is better in ANY country with socialized medicine, I believe you are wrong. Provide me with some facts. Access in America is too easy, and that's the way we want it for the most part and that is why we pay so much for it. It is a product after all. The hard reality is that those who cannot, or choose not to pay for it should not have equal access. They should have access to basic services, which they already have (although we can surely do a better, more efficient job of providing that care than a law requiring ERs to accept them all).

    You liberals will discount the Tea Party at your own peril. Remember that it is a grass roots movement of regular folks that are fed up with government intrusion that is beyond the intended power of the government. If they ever get organized, nationally, the landscape will probably change dramatically. And, yes TSB, there is a place for the Fed government for infrastructure so of course, everyone is calling for The Fed and FEMA to help in natural disasters. FEMA exists and is funded by taxpayer dollars, so it's not hypocritical to ask for those dollars when they are needed. It's a bad idea to make ridiculous comments like implying The Tea Party wants NO federal govt. It just further deteriorates your credibility. You are a decent writer, but not as gifted as a thinker.

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  25. There is no such slander on this blog except towards TSB!
    Please name one person/ company that has been publically affected by this blog?

    “The worthiest people are the most injured by slander, as is the best fruit which the birds have been pecking at.”
    ~ Jonathan Swift

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  26. 6:54, here is a little known fact:

    In a European country that all Americans think has socialized health care, ~89% of costs are paid by private insurance, ~5.5% out of pocket and ~5.5% by general government. In contrast, in the United States the numbers are ~42% private, ~10% out of pocket ~32% general government and ~16% social insurance.

    The European country spends 9.9% of GDP on healthcare, the US 16.0%. It has the highest quality index score in Europe. As someone who lives in the US, works in the field, and has family in that European country I have fairly good insights in the relative strengths and weaknesses of both systems. As things stand today, 99% of the US population would be better of under the European system for 99% of illnesses.

    Maybe we should stop being so myopic and anxious, and learn from others. As an aside, I'm curious if anyone knows which country described here.

    (Source of data: OECD)

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  27. I bet after reading these comments, TSB's stomach feels a lfittle bit like mine does when you go over that big peak at the top of the roller coaster.

    Oh well, it's hard to come up with content on a regular bases. I too strictly come here to read the comments section. These posts are rather slanted and boring. I'd still love to know who he works for. Also, can someone paint the picture for me as it relates to the device reps future if ObamaCare goes into place? Would we really be out of a job? If so, why?

    Signed,

    I already follow real sports - thats why I don't follow the sport of politics.

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  28. Confused writes: isn't Medicare and Social Security funded by taxpayers dollars?
    Confused writes: Honestly I don't read your blog anymore, I read the comments that sales people write.
    Confused writes: TSB writes anonymously, I post anonymously.

    i'm confused

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  29. 7:18 AM may want to read about the news unfolding in Europe today. The EU and Euro are falling apart. I think there is something to learn from them but I do not want to copy their system.

    The problems are complex. The free market is the only solution.

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  30. 9:35, I do follow the news, and the problems are complex. But read my entry again: in that European country 95% of costs are covered by private insurance or out of pocket. How much more free market do you want? 100%? If only Europe had the US system, they than would have an easy task in reducing their deficits.

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  31. Transparency is on its way folks! Soon inventory will follow.

    -Automate everything!

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  32. I too come to this blog strictly for entertainment purposes. I'm not in medical or spine sales, but I'm curious to see if someone could please explain to me why the Federal Govt really cares about the "inducement thing"

    1. I've read that every implant is basically the same so that blows the whole "whats best for patient" out of the water.

    2. (most) All companies are offering surgeons something to make working with their company more attractive than the other guys company.

    3. The surgeon selects implants indicated for surgeries based on the shape and sizes of the implants, so it doesn't seen to matter what company is used.

    4. Taxes. no matter what company sells what implant to what Doctor the IRS collect the same amount of tax.

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  33. I'm curious to see if someone could please explain to me why the Federal Govt really cares about the "inducement thing"



    Don't know what you do for a living. I hope it's nothing that requires too much problem solving.

    The reason the Feds care is because inducements add to the price of the product. And we thus all pay more than we should in our contributions to Medicare and Medicaid (among other things) when inducements are part of the process.

    Also, of course, if you allow inducements, you by definition NO LONGER CARE as to whether a product is actually superior or not, so you allow mediocrity to rule the market, and no one has a reason to design or manufacture something better. I mean, why bother, if you're Synthes, and you know that Zimmer already bribed docs to use their product? (Names for example purposes only, of course).

    If you think bribery is a good thing, you oughta try getting something done in India sometime. Even the Indians are getting sick of it.

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  34. The Tea Pary, huh? Never anywhere was such a small group of ignorant morons so celebrated. You oughta read Taibbi's piece in Rolling Stone sometime. Buncha old fools driving motorized scooters paid for by Medicare complaining about taxes.

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  35. It's not really a surprise to me that a bunch of people whose main life skill is sucking up (to get and keep docs as clients) find the Tea Party enchanting, and MSM a dirty liberal.

    Our host is trying to tell you the field is panned out. All the good nuggets are gone. Life is hard and is going to get harder. No free ride any more. And why should there be? You got to the party too late. It's over.

    Doesn't really have anything to do with Obama, or the Tea Party, or over regualation, or anything else. But go ahead and blame those things if it makes you feel better.

    If you could think, you probably wouldn't be in Sales.

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  36. I love the posts that contain the words "I dont read this blog..... I just visit for entertainment purposes". Obviously, you took the time to comment... you must have a lot of time for entertainment!! Or maybe you are more interested than you would like to admit.

    This is a blog, TSB has the nuts to put something out there for discussion, and provides a forum. Unfortunately, this blog is plagued by the 5-10% of the scumbags that give this industry a bad name, who I have a feeling, are behind the most ignorant posts on this blog.

    Get a life, or better yet, start your own blog and put it out there. Dare you! Or better yet, use this forum appropriately, and with some pride - it should serve as a vehicle to better our field.

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  37. 12:33, no, not correct...

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  38. 7:18

    Which point of mine is myopic? seems you proved my point with your mystery country example with little governmental involvement that is both efficient and high quality in your opinion.

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  39. 7:18/12:56 I was thinking Germany. They are the most solvent and people tend to perceive that the government pays for everything, yet they really don't.

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  40. 12:54 aka TSB - Whatever dude. You sound like the same tough guy that pulls his car over in the other lane or shoulder so that people can't merge into traffic further ahead.

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  41. 3:20

    WTF do you have a personality disorder

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  42. 3:20... thanks for proving my point.

    -12:54

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  43. This comment has been removed by a blog administrator.

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  44. Hey 5:55 if you can't disagree respectfully, please don't read blog. The absurdity of your commentary is that you continue to come back and torment yourself. Que Sera Sera.

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  45. comment removed by TSB...just what I thought!

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  46. One good thing about this thread. It's driven away the Globus troll.

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  47. Hey Rocklinn California why all the anger? You know what Sting sang " I'll be watching you."

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  48. hey TSB I noticed when you see it fit that you can tell who is posting on this blog...hench your comment at 6:40. You are totally self serving and watch all you want...the word is getting out my friend!!

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  49. Sure bet TSB is shaking in their boots.

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  50. 12:24 would it be considered an inducement to hire a surgeons children? How many offspring can you hire without the feds taking notice? How will that be reported? Under "any other nature of value" ????

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  51. Any Other Nature of Payment or Other Transfer of Value,

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  52. While thinking about the Spine market, listen to "In the Hall of the Mountain King" by Grieg. Madness.

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  53. Hey Rocklin California why don"t you get back to making your frozen yogurt

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  54. To all of the libs who do nothing but call the Tea Party advocates derogatory names....How do you not realize that you do nothing but lose credibility by doing this? Maybe try making a cogent point or argue for what you believe in.
    If you even took the time to understand what the Tea Party stood for you would realize that they are fighting for the same things our forefathers did. "TEA" stands for "taxed enough already" NOT, "racist, right wing nut job"

    Maybe you should expand your horizon and not let the media shape your entire opinion of an organization.

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  55. FYI, Blogspot.com gives its users (aka bloggers like TSB/MM) the ability to see your computer's IP Address and the geographic location from which your computer is connected to the internet when you post a comment on this board. Translation...your "anonymous" comments are nowhere near anonymous.

    Use a proxy server like I do if you want to remain truly anonymous. It'll basically give Blogspot a fake IP Address and a location based on the location of the proxy server.

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  56. 6.54, I did not say you were myopic, it is all the people who blindly defend the present system and a priori declare all European systems socialist and inferior. What is socialist about having a system that is run by private insurance but where virtually everyone has access? And no, it is not Germany, although their system is reasoanbly ok too.

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  57. Looks like someone got caught, LOL

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  58. 914pm. The Tea Party has 3 basic principles that they stand for:
    1. Lower taxes,
    2. Smaller government, and
    3. Fiscal responsibility.

    My only question for the Tea Party is where were you during the Bush years when we took a surplus and created a deficit by massively increasing govt spending (by 77% - Obama's increase is 8%), increased the size of govt, and did the first federal bailout (of banks) to prevent a total collapse of the economy. As for taxes, we currently have the lowest ratio of tax income to GDP EVER and Obama has just proposed some additional cuts.

    The principles of the Tea Party are fine, but the fact you were silent during the Bush years kills any credibility.

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  59. Curious Question. I am now an independent spine rep and am looking to generate revenue in a couple different ways based on relationships. Anybody know of any smaller hip/knee, sports, or podiatry surgical lines worth checking out? Also,what about surgery center products? Is DME dead? Sorry, to change subject, but I prefer to talk about generating revenue moreso than discussing the lame ducks in washington.

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  60. 4:57 Could it possibly be that they saw problems under big government bush getting worse under the current administration saw the future didn't like it and spoke up. Please don't worry about responding to me I see you are already having a great conversation with yourself 6:59.

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  61. Bravo, 4:57. Signed, MFFR (Moderate in Favor of Fiscal Responsibility)

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  62. 7:44, this is NOT 4.57. Yours is the typical busshit answer you get anytime you point out that the federal government grew faster under GWB than at any other time in history. Nobody on that side of the spectrum also recognizes that GWB is the first despot/leader in the history of mankind who went to war and LOWERED taxes to keep his subjects happy. Never, ever happened before.

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  63. hey TSB, this is Rocklin, wrong!!!! Dumb ass!

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  64. 744, this is 457: short answer, NO, I don't believe that. People are playing politics!

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  65. So let me understand....the TEA Party is late to speak up and unite against waste and fraud in government and they lose all credibility as a result? Sounds like you are the one playing politics as it only really bothers you that they organized during O'Bama's administration.
    The obvious reasons for their formation was a result of the massive bailouts at the end of GWB's term in office! (no one knows if they would have formed anyway as he was leaving office, they very well may have???)
    You can cite all of the skewed data you want, but NO ONE can deny that our president has spent more than almost every other president combined up to this point in time and he is not even through his first term in office!!! and don't even get me started on what the money was spent on!! Or on what the f%^king results of that "stimulus" spending has accomplished!

    So now here we are at this moment in time and you are trying to shoot the messengers because you don't like when their movement started? incredible!

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  66. 10.43, you're again as wrong as can be. Of the total debt of 14.3 trillion, 1.0 was there before Reagan took office, 1.9 was created by him, 1.5 by Bush senior, 1.4 by Clinton, 6.1 by GWB, and 2.4 by Obama. This was the score as of the date of the debt ceiling deadline. The stutterer from Texas still holds the record. Make sense, because he has not done well in any of the jobs he had in his life. Scary thing is that Perry seems even dumber.

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  67. 10:59, if your numbers are correct, the score is Republicans 9.5, Democrats 3.8. Hmmmmm.....

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  68. Can we please bring this topic back to spine?

    Thank you.

    The reason the medical field, and the world, is in this impending bankruptcy, is that politicians of both parties have no spines.

    Thus what is needed is total spine replacement technology. Fast.

    Your welcome.

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  69. 11.51, completely agree. Only problem is that even if you had a nice new spine there would be nothing to attach it to.

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  70. 10:59 There you go again calling people names! (stutterer) so very mature of you!
    You are the one that is wrong. It would be helpful if you could cite references from where you pull your numbers. Do you think we should simply believe you because you heard it somewhere? Maybe that is your problem, you only believe what you want to believe?
    Here is a reliable source, The Heritage Foundation, and it is non-partisan:

    http://www.heritage.org/research/reports/2009/03/the-obama-budget-spending-taxes-and-doubling-the-national-debt

    Please let us all know where your numbers came from, and by the way you said George W. never did succeed at any of his jobs he ever had. What were his jobs, (he was reelected as Governor of Texas) and how do you know that? Has O'bama ever had a job prior to being senator? (he did vote "present" quite a few times, but that makes it hard to tell if he was a success or not)

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  71. President Bush presided over a $2.5 trillion increase in the public debt through 2008. Setting aside 2009 (for which Presidents Bush and Obama share responsibility for an additional $2.6 trillion in public debt), President Obama's budget would add $4.9 trillion in public debt from the beginning of 2010 through 2016- nearly double the amount accumulated under President Bush over the same number of years. Overall, the public debt level would double over the next decade to $15.4 trillion ($12.5 trillion in inflation-adjusted dollars). (See Chart 1.) At 67 percent of GDP, this would constitute America's largest debt burden since immediately following World War II.[14]

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  72. 12:51, the sources are: Department of the Treasury, Financial Management Service, Bureau of the Public Debt, Federal Reserve Bank of New York, Office of Management and Budget.

    The Heritage Foundation a reliable source? Really?

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  73. http://www.freerepublic.com/focus/f-chat/2775509/posts

    Everything you wanted to know about the debt.

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  74. Just stumble across a website claiming that Medtronic is working on getting FDA approval for what they are calling the "Orgasmatron". WTF? This is a spinal stimulator implanted for the purpose of stimulating orgasms. Now there's your game-changing new technology in spine!! Haha...here's the link to the site:

    http://techflesh.com/9-implants-that-make-human-healthy-body-even-more-useful/

    The "Orgasmatron" is #9 on the list.

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  75. *stumbled

    Oops!

    ~3:34pm

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  76. What's happening at Life Spine? Third big wave of layoffs? Word has it that they let Marty Jones, WesternArea VP of Sales go as well....Let him do all the dirty work of cutting distributors, then cut him as well KARMA......

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  77. 3:34 Medtronic always gets all the fun stuff. Infuse, Orgasmatron, what next? All roads lead to generating solid bone....

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  78. So Stryker is going to issue 750M in notes. Another acquisition coming? Hmmmm.

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  79. Life Spine with another wave of lay offs? They only have like 30 employees so the waves must be small.

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  80. Has Globus been acquired?

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  81. No, Globus has gone pubic.

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  82. Life Spine is on life support.

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  83. Stryker has a strong interest in LDR ...

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  84. What does LDR have that Stryker doesn't? Why would they be interested in LDR?

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  85. Stand alone, oblique, lateral, and disc?

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  86. 5:52 heard it's being done to buy Globus.....just what I heard.

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  87. Is Stryker buying Amedica?

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  88. Does anybody know of a 17 mm or wider cervical peek cage that is on the market and being used?

    What companies? Contact info?

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  89. SpineArt has a 17mm cervical cage. They are out of Geneva Switzerland so I think it's made out of 24ct gold.

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  90. 24 karat gold is plenty soft. Probably a dynamic cage. Now that's innovation!

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  91. and it comes with a cute little butterfly on each implant.

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  92. Old Scient'x cervical peek was 17mm M/L......not sure if Alpha still has it?!

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  93. Nuva has 15, 17, 19

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  94. Alphatec Spine had a 17mm plate but they fired it!

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  95. Any comments about the latest Orthopedics this Week Publication 9-13-2011?

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  96. Holland. Huh. Bunch of commies.

    :-)

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  97. Hydroponic pot smoking beer guzzling giants walking on clogs sticking fingers in dykes.

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  98. 5:55 am what are you sayin'? There was a Mis -Carragee of justice???

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  99. Verdict in the NUVA/ MDT patent case tomorrow?

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  100. So Robin Young in his throw away/ industry supported rag mag (OTW) attacks The Spine Journal; a clinical journal..... Time for a new Blog and thread me thinks!

    http://www.prnewswire.com/news-releases/orthopedics-this-week-accuses-the-spine-journal-of-methodological-errors-and-bias-129802093.html

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  101. Robing Young will stop at nothing to defend the nefarious practices of this industry and the profits he makes through both his sycophantic rag and the amniotic tissue company he owns, AF cell. Despicable.

    Carragee has the moral courage and cojones to expose a wrong that everyone was whispering about behind the scenes but did not dare talk about openly. He's a breath of fresh air.

    On another note, Medtronic's new CEO will set a new moral course for the industry. I wish him well.

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  102. I wouldn't wipe my dog's butt with OTW.

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  103. I have to say, I enjoy Stock Market India reading your blog. Maybe you could let me know how I can subscribing with it

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