Friday, August 17, 2012

Profits Over Patients

Spine Nation:

As another season comes to a close, as the melancholy sets in for the many that love summer, it has become apparent that everyone is anxious to get closure on the upcoming election. Politics like the spine industry is not for the faint of heart. Confusion reigns when it comes to Medicare, and many ask why does the government continually attempt to stick its fork in an industry that has resembled the wild wild west. In many respects this weeks national and local news exemplifies the environment that we all will be challenged with in the years to come, regardless of whomever wins the upcoming election.  Whether you concur or dissent, the current healthcare environment is not sustainable even if the smartest guy in the room believes otherwise.  This weeks news was that there were more distributor cuts on the general orthopedic side at Biomet/EBI and the fallout from the DePuy/ Synthes merger says it all. "Legacy" reps, what a joke. After years of loyal dedication and commitment, a swift boot in the butt speaks volumes about the mercenary attitude that corporations continue to exhibit to those that gave their blood, sweat, and tears. Loyalty is a word that doesn't exist in the corporate lexicon.  Yet, for all the hoopla surrounding those companies, the investigation by the DOJ into HCA Hospitals speaks volumes about why healthcare continues to place profits over patient care, and why the government is compelled to intervene.

In 2006 three private equity firms bought HCA for $33 billion, proceeding the $1.7 billion fraud settlement between HCA and the U.S. Government.  With new ownership came a new strategy. Under the auspices of these firms and their representation on the board of HCA, the alleged strategic plan was how can HCA get more money out of private insurance companies, patients, and the U.S. government?  Did TSB say the U.S. government?  It seems that many common folk would like the government to stay out of healthcare, yet, maybe the powers to be love the government more than they are willing to allude to? Could new ownership at HCA have been looking for creative ways to aggressively increase their billing? Like any new owner, HCA immediately looked to reduce its emergency room services to those that were not qualified as emergent, in addition to cutting to its overall expenses, along with a reduction in staff.  The result of these policies was a compromise in patient care. The public can fully support profiling non-emergent patients and directing them to another provider, but inadequate staffing in critical areas and placing profits over patient safety is unacceptable.  As more and more hospitals are gobbled up by for profit organizations the question must be asked, are these entities even qualified to make the necessary decisions to influence the delivery of healthcare? What tactics will these for profit hospitals employ as lower reimbursements become a reality. If companies like Kravis, Kohlberg and Roberts have a 40% stake in HCA, as Cerebus Capital and the Blackstone Group acquire other healthcare systems, what is the future of medicine?  

At the heart of HCA's problems was the introduction of a new coding system for its emergency room care. Overnight the billing coming out of HCA emergency rooms was alleged coding for sicker patients. Doctors complained of quotas and financial objectives mandated by the powers to be at HCA. In addition, patients in HCA facilities were getting more bedsores, wounds, infections and complications.  In an independent survey, HCA owned eight of the top fifteen hospitals in patients developing bedsores. There were complaints regarding a shortage of nurses.  So the question must be asked of our readers, is this the future of modern medicine?  Who needs the government to take away your healthcare, you can go to a HCA hospital for a first hand experience. So TSB wants to know what our readers think?  Is this a healthy antidote?  For Profit Hospitals by For Profit Private Equity Groups?

Another long summer's come and gone,
I don't know why it always ends this way
The boardwalks quiet and the carnival rides
Are as empty as my broken heart tonight
But I close my eyes and one more time
We're spinning round and you're holdin' on tightly

100 comments:

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

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  2. Nosocomial is a good word to know. It means acquired or occurring in a hospital. This was an informative posting and explains the grumblings I've heard in my community about the poor care and low caregiver moral at the local HCA hospital.

    The private equity guys need to take the Hippocratic Oath and understand the first rule of medicine; Primum Non Nocere...First, Do No Harm.

    Life is a bitch and then you die.

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    1. First you marry one and then you die.

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  3. Here are some criminal connections. HCA was a creation of now Florida Governor Republican Rick Scott and former Senator Republican Dr Bill Frist.

    HCA was found guilty on thousands of counts of up coding and fraudulent billing and substandard patient care. Rick Scott should be in prison.

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  4. The corruption and greed at the top of hospital systems like HCA make the spine industry look like a bunch of choir boys.

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    1. They are all part of the same industry and are very closely connected. There is a very small percentage of the 1% who serve on the board of directors for the medical corporations. Medtronic for instance has 2 criminals from Goldman Sachs on their board. Comparing the hospital industry with the medical device industry with the pharmaceutical industry is like asking what smells more foul, dog shit, pig shit, or lion shit.

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    2. You bitch and do nothing about it. Go sleep outside wall street and see if you can change things that way. People have the ability to research before they have most procedures. I assure you I know what hospitals I will and will not go to for care because I am a grown up and take accountability for my life. Your view that we have to coddle all these Loosers like they are children is insane. 50% of this country has to wake up and get to work.

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    3. 9:58, you are on the mark. What is this 1% crap??? No way to discredit (or maybe reveal) yourself like identifying with the scumbags that "occupy" the dregs of society. Bill Baldez is an entitlement minded moron that obviously can't think for himself.

      Suck it Baldez, you are a pinhead.

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    4. Boy Wonder there are no jobs, why don't you hire someone

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    5. AnonymousAugust 17, 2012 9:58 PM

      You bitch and do nothing about it. Go sleep outside wall street and see if you can change things that way. People have the ability to research before they have most procedures. I assure you I know what hospitals I will and will not go to for care because I am a grown up and take accountability for my life. Your view that we have to coddle all these Loosers like they are children is insane. 50% of this country has to wake up and get to work.

      ________________________________________________________________________________________________________________________

      Why do losers spell loser L O O S E R S?

      Anyone who opposes the regulation of the medical industry is to stupid/Republican to live.

      There are not reliable reporting agencies that can tell you whether a hospital is safe or not. Only a moron would make such an uniformed and Republican statement.

      Leave it to a Republican loser to defend the ruling class who from 2002 until 2008 engineered the greatest transfer of wealth in the history of the world.

      I predict that the recent Iraq vets are going to wise up and identify the real enemy and apply their trade.

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    6. The greatest transfer of wealth is the oil money going into the middle east you dumb shit. I just prayed for you and your family to get cancer so you can not go through our horrible healthcare system to save your life.

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    7. WOW! That is amazing, this "blog" gets better every day

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    8. Balldez and I both have blogs that warn people about the corrupt medical industry.

      @ AnonymousAugust 18, 2012 3:19 PM

      The greatest transfer of wealth is the oil money going into the middle east you dumb shit. I just prayed for you and your family to get cancer so you can not go through our horrible healthcare system to save your life
      +++++++++++++++++++++++++++++++++++++++++++++++++++++++

      Sorry dummy CON. over 20% of the US GDP is health care making the health care industry the 4th largest economy in the world.

      To the other dummy, Most of US oil imports come from Canada and Mexico. The biggest export for the US is gasoline.

      Domestic oil drilling is now higher than it has ever been. You dummy are either stupid or you are lying.

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    9. I will say it again. The largest transfer of wealth in human history has been oil purchased from terrorist countries. You are 100% wrong!

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    10. Look up fracking boys. Natural gas drilling is bringing in billions for the gas/oil companies. All this fracking is happening in the US.

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    11. Domestic drilling is down and dead in the Gulf. Look up current rig counts and compare to the past, or you could work in the oil industry like I do. It's real easy, do your research before repeating and spewing lies. So let me educate you dumb ass, there is a difference between drilling (exploration) and production. Companies are able to produce oil from wells drilled 10 years ago or even more. Production is high because oil prices are high, however without further drilling and exploration the demand will continue to soar and we are left purchasing foreign oil. As for Natural Gas, there is a surplus. Big natural gas fields like in North Louisiana, South Texas, North Dakota and Pennsylvania are creating a huge supply and driving down prices. Natural Gas is dirt cheap. Also, fracking is not to be confused with drilling for oil. Gas exploration has nothing to do with oil prices or oil exploration it also has nothing to do with us having to purchase foreign oil or being dependent on foreign oil. We are getting ass raped by OPEC, we need to produce more energy domestically plain and simple. You are a drone who is ignorant and believes what he wants from his deceitful party.

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  5. WWKD?

    What a would Kelly do?

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    1. Kelly would sing the song "Patience" from her 1990 album "Appetite for Destruction"", because all patients need is a little patience.

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  6. TSB is still a lil bitch who got fired from spine, like those weak and uninsured patients who get boated from the best hospitals. TSB needs to get a real job and quit bitching about the industry that dumped his punk ass.


    TSB will remove this posting, musculoskeletal can suck it!

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    1. Hey poser, you can not use Suck It, that is my line. I may not always agree with MSM, but if he did get fired from spine, it is an indication that he has more character than the narcissists that comprise this industry. Please go blow a dog.

      Suck it plagiarizer.

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  7. Sounds like the regional manager that TSB fired for using company money in an attempt to start his own venture while, 5:10 be weary of what you ask for LMAO or TSB may boot you in the ass and cure you of you anal fetish LMAO BTW if you can't spell go back to school fool

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  8. Synthes leaders in place + de-selected long term Depuy reps X around the country= class action...?

    In the south, west, northwest and Midwest all experienced similar actions. Some credo....lol! Glad I ran when I did!

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  9. Hail Costa!!!!!

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  10. Ahhh..how sweet. Looks like 5:26 is a TSB groupie. Thats why he speaks of TSB and anal fetish, he's knee deep in TSB as we speak. Lick up 5:26! Mummmmmmmm

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  11. Did anyone see the Wall Street Journal article about the HCA hospital that covered up the Cardio doctor doing unnecessary valve procedures on patients. Apparently a nurse reported the surgeon to HCA. HCA's response was to fire the nurse. Please god, don't let me get sick because the last place I want to go is a hospital in America. All you Repubs/Retards can have your healthcare that puts profits above patients. See what it will get you, a screw or valve when your fat ass probably just needed to lose some weight. I know let the comments begin. Well you all ought to be pretty happy because you will certainly have four more years to cry about it while others go about making meaningful change that improves the economy and healthcare. Look at the election map and although I am not a big fan of Obama and don't think he has done enough he is going to win in November and hopefully we can vote out the obstructionist Republicans in the House and Senate. I don't want to hear any stupid comments about deficits and debt. Republicans have added more to debt and deficits and the biggest reason we are in this predicament. Look it up. I know your taxed to much. I guess you feel 13% is too much?

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  13. Jenna,

    I believe you have the "worlds largest and most used" Bush. On a serious note the deficits and debts incurred by Obama are future costs of two wars, the fist tarp bailout (Bush passed), second stimulus Obama passed, and a depression/recession all while the country provided tax breaks for the wealthy. I don't know I am not an accountant but I am pretty sure that is going to put you in the red. Get ready to pay your fair share and quit your crying or move to some other third world country where they tax their wealthy 13%. I realize you missed most of these courses in college when you were popping X, slugging whiskey drinks and puking in the streets (or was that your father) but try and pay attention and learn something.

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    1. Bush and Obama are the same. Cutting government spending is simple and should be attempted before increasing taxes. We do not have a revenue problem we have a spending problem. History tells what works and what does not work. Just remember it is not the republicans or the democrats that decide the election, it's the independents.
      Any patient that has a procedure done that is not necessary needs to take just as much blame as the surgeon. Have surgery without a second opinion is idiotic.

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    2. Logical and moderate argument but incorrect. The deficits and debt are so large that there is no way to reducing spending enough to seriously decrease either. Obviously of the two deficits will be easier to reduce but the current deficit is roughly twice the the budget and current tax revenues. I am all for cutting government spending but anyone that takes a serious and objective look at the issues we face will have to acknowledge that reasonable tax increases will have to accompany cutting government spending to solve fiscal irresponsibility of both parties (although primarily Republican if you look back through history). The last link is something everyone should read. Clearly the author has no love for Republicans, Democrats or politicians. In the years Democrats were in office the annualized increase of debt was 8.3% and the years Republicans were in white house the average annualized increase of debt was 9.2%. The most often debt was paid down was when there was a Democrat in the White House and majority in House and Senate. Where were all of these so called "deficit hawks" when Regan, Bush, Bush II were in office? Facts are unfortunately difficult to get around.

      http://home.adelphi.edu/sbloch/deficits.html
      http://www.davemanuel.com/history-of-deficits-and-surpluses-in-the-united-states.php
      http://www.americanprogress.org/issues/2012/01/deficit_blame.html
      http://www.factcheck.org/2012/02/dueling-debt-deceptions/
      http://cedarcomm.com/~stevelm1/usdebt.htm

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    3. My point is step one of the process is cutting spending. Once we do that we can look at the tax rates. We also need to realize that the current entitlement programs are not sustainable. There is no difference between republicans or democrats, they are both puppets.
      If you are in debt your first solution is not to increase revenue, it's to cut spending.

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    4. I don't care which one you do first but your not going to be able just cut your way out of this mess. Tax revenues must increase, which hopefully will through and economic recovery but also need to through moderate increases in taxes. Effective tax rates of 13% are way to low to fight wars, fund defense, social security, Medicare (80% of all spending) and all the other government programs. Clearly a lot can be cut but unless your prepared to get out of all wars and not get in any others, seriously reduce Medicare, Social Security and Defense spending the country will need additional revenues to reduce the deficit and debt. It is math.

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    5. I am prepared to do all of that and keep taxes low. I pay an effective rate of 34% which is more of the norm....not 13% which is taxes on dividends.

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    6. Ok but that entails decreasing military spending from 600+ billion and military discretionary spending (funding two wars) from 800 billion to around 400 billion combined/total. Should be easy seeing how the US spends more on the military than the next 30 countries put together but I think it will be politically very difficult. Figures taken from Republican website, notice elect Mitt Romney.

      Also, you may pay 34% but I would guess that is your base rate not your effective rate (you would know better than me). However, the average effective rate of the top 5% is less than 20%. If your paying 34% I would say your clearly not in the top 5% but than you would think your base rate would be much lower. Great article posted below by a Libertarian, Republican or flat tax advocate neither of which am I. I don't suggest we go back to 70% tax rates or flat tax but an increase to 39% at the top, closing some of the loop holes and increasing capital gains tax makes sense to me. Instead of keeping as much as you can let's worry a little about an environment where you can make as much as you can, which will require a strong consuming middle class. Let's worry a little less about supply and a little more about demand. Just my thoughts.

      http://www.usfederalbudget.us/federal_budget_detail_2011bs12011n_30#usgs302
      http://www.americanthinker.com/blog/2011/06/the_real_tax_rates_on_top_earners.html

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    7. That is my effective rate and I am in the top 3%. I am very straight forward on my taxes and do not search for loopholes. I like the idea of a flat tax because it keeps everyone honest.

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    8. Reagan cut the tax rate, and increased revenue by increasing the base. That is how it works, it is so damn simple, but you fools forget that 50% of the population pays nothing, and many of them take 10's of thousands of dollars in handouts. Getting 100 million people to quit taking, and start paying "their fair share" will go much further toward fixing our problems than raising the rate on the wealthy, who create jobs. It is simple, but you liberal revisionists (radicals) just can't get it.

      Suck it socialists.

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    9. Reagan raised taxes 11 times. He cut the tax rate for the filthy rich. He had higher unemployment than any other president.

      Everyone pays taxes in on form or another. You need to get your fact straight CON.

      Trickle down voodoo economics didn't work and the best part of you trickled down your mother's leg CON.

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    10. Balldez, you are a drone. Your facts are comlete fantasy. Standard liberal nonsense. Did I call you libs revisionists yet? Oh yeah, I did. Thanks for proving me right. You are clearly too young to know better, or too stupid to understand what really happened. Now go wipe your snotty nose, little boy, and get back to the books. You clearly have lots to learn.

      Suck it, punk, ignorance is not an excuse.

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    11. In 1980, the highest federal tax rate was 70% with tiers all the way up to that level. By 1987, the highest tax rate was 38.5% with only two rates. Tax revenue had tripled in 8 years, and we were experiencing the greates period of economic growth our country has ever seen. Get your facts straight, revisionist.

      Suck it drones.

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    12. By the way, I would like to rest my nards on your chin if you have the time.

      Suck it, sucker.

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    13. Greatest unemployment was in 1932 and 2007 you dopey idiot.

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    14. Sheen/Lohan 2012!!!!

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  14. Typical Republican counter - Your a fag, you don't like leave the country or the best is your surviving on government handouts. Meanwhile back in reality the Retards are tapping the shoes in bathroom stalls hoping to catch some balls, crying about the present administration with no plans for leaving the country (I guess crying about it is their God given right) and siphoning more money out of the Government than anyone. We don't want Government healthcare but we want to siphon all we can from Medicare and Medicaid. We don't want welfare but tax breaks for businesses and subsidies for oil, transportation, farming and banks make perfect sense. We don't want taxes but let's bomb anyone and everyone that fucks with us and some that don't and we will just borrow the money. You have to love hypocrisy.

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  16. Will the latest whistleblower suit from Florida finally sink Ortho-Stone, or will they just cut another check?
    I thought I read that if penalty exceed the $52M they have in escrow account, the former Blackstone guys are liable up to $66M...but only for another month?
    Anybody have facts?

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    2. Man there is some serious hostility on here. I bet if either of you turds met me both of your tones would change. I'm a triple yellow belt with a black stripe in karate and once took a shot of 151. Anonymous 8:47, you sound like a white belt, I would dominate you up and down whatever alley you wanted to meet in. And for you 9:00, I actually am intimidated by big, ferocious dumps so I have no beef with you.

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    1. Ru, you are pathetic. Birth defect or not, scrawny is as much a mindset and attitude as it is a stature. I am sooooo glad I am out of spine, soooo many complete idiots, and roid ragers. You are all so pathetic. God save us!


      Suck it!

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    2. If you are out of spine why are you still trolling this blog? Also, any grown man that uses "sooooo" in a sentence, twice, is a class 5 D-bag, thats about as douchey as you can get. And by the way, how is being scrawny a mindset? I'm 152 pounds you dickhead, obviously if some neanderthal like you came at me I wouldn't win. So, I think it you sir that should "suck it." Lastly, you sound kind of like a bitch

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    3. There are plenty of 152 lb men out there that are not scrawny. Whiney, excuse making, entilement minded laggards are scrawny, even if they are 6-4, 240. Think Ryan Leaf. Anyhow, I come here to try to inject a little reality into an industry that used to be proud, used to have ethics and character, and used to be honorable. It is sad to see what it has become. I still have great affinity for many of my old customers, and many of my old colleagues. By the way, if I could dot my "i's" with a heart on here, I would. If that makes me a d-bag, so be it. By the way, I think calling me names like d-head and d-bag is proof that your scrawniness resides in your character, not your shoulders. Pathetic.

      Suck it, 152 pounder.

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    4. I actually have huge shoulders. 2/3 of my total body weight is actually in my shoulders, so your insult just backfired. Ryan Leaf was a great QB, he still has 75% of the passing records at Washington State. However, he did have a terrible substance abuse problem, just like a significant percentage of Americans and probably a lot of people on this blog. If insulting people that have a chemical dependency makes you feel like a big man...that is just sad.

      Suck it yourself and then suck your buddy's.

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    5. Joey Sunshine, I can't believe that you are defending Ryan Leaf. You are a sad, sorry man. I would call you pahtetic again, but that would almost be cruel. I take it all back.

      Suck it, 100 lb shoulder boy.

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    6. 1:08 My bet is two thirds of your body weight is your mouth. Probably well formed from all the sucking you subscribe others to do but always end up doing yourself. What do you add of value in anything you do in life besides the occasional swallow?

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    7. So you take it all back? That's nice that you had your boyfriend at 1:28 come to your defense, its amazing you guys can type while dressed like ninja turtles and 69ing each other. Speaking of two thirds, I heard 1:28 was at a party last weekend and took a beer bong that was 1/3 beer and 2/3 jizz of every other guy at the party. Way to go champ, that WASN'T a milk mustache...

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  19. Moochers elect looters who steal from producers. Do you liberal idiots not realize that the government is 99% beyond the constitution? Do you not realize that your socialist friends take from job producers under the threat of a gun and imprisonment? "Democrat" is just another word for "socialist". Socialist are just lazy and/or stupid people who would rather "occupy" than work. Why are you so socialist? Start a business or work in a job, but keep your f*cking hands out of my wallet.

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    1. Your first line is brilliance. I couldn't think of better terminology to describe libs. Well done.

      Suck it liberals. Suck it hard.

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    2. 9:01 I vote you pay no taxes. Your to stupid to have any income worth taxing. Keep on repeating what Rush Limbaugh's soundbites and I am sure it will take you far in life. Hell if you work really hard you just might get promoted to assistant manager at the local gas station where two people work. Something tells me you lost your lemonade stand and blame the government. Didn't have anything to do with you.

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    3. 9:31, You're too stupid to compose a literate sentence.

      Suck it imbeciles.

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    1. I can't believe you deleted the honey pot guy.

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    2. Did I miss a honey pot guy post? Shoot. I love that guy.

      Suck it if you don't love the honey pot dude.

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  22. And they shall build houses, and inhabit them; and they shall plant vineyards, and eat the fruit of them. They shall not build, and another inhabit; they shall not plant, and another eat: for as the days of a tree are the days of my people, and mine elect shall long enjoy the work of their hands. They shall not labour in vain, nor bring forth for trouble; for they are the seed of the blessed of the LORD, and their offspring with them. (Isaiah 65:21-23 KJV)

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  23. Selective post removal!

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  24. Obama's plan is to put the U.S in debt while subsidizing the 3rd world nations. Based on what we know of his upbringing I have no clue how he is our president. He was raised and mentored by card carrying communists and left wing radicals yet we still elected him through desperation because of what the true liberal Bush did to our country. We need to get rid of 50% of the government agencies and allow the states to govern themselves. Until that happens I will continue to buy guns and gold. I disagree with a lot of what Romney says but at least he believes in American Exceptionalism.

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    1. Not only are you a moron, you are a certified idiot. American Exceptionalism, can I sell you some swamp land LMAO

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    2. Yes American Exceptionalism! Why is it so trendy to hate your own country. We have the best quality of life in the world. The poor people in the U.S have more than most in the rest of the world. With all the flaws our system has worked better than any other in history. My family in Italy pay 74% in taxes and their country is going BK. by the way I am not a certified idiot I am a certified bad ass.

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    4. 12:59 America is only first in having ignorant conservatives like you that have no grasp of reality, facts or the issues at hand. Largely because we have fallen so far behind in education and the easily manipulated listen way too much to a drug induced fat slob.

      1:01 Right back at you. Your number one.

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    5. 1:24, conservatives bang your wife, and she likes it.

      Suck it, lefty.

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    8. How did a turd take a turd? You ruined the story starting off with you about to "bang" a her. Nice try, the last time you had some it had you. I am sure your mom/sister still wishes that day never happened. Your dad left home in disgrace for procreating with that 800lb whale (sis) and you have never been the same. Running around sucking it and getting dumps taken on you, I shouldn't make fun of you I truly feel bad.


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    9. Huh? That was awful. If you knew me you would know I pound the vag like nobodies business.

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  25. Slash military spending. The cold war is long over

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  26. I have to laugh at the comments of the right wing salesmen who think they understand how this loathsome industry and economics in general function. The scumbag companies for which you idiots work have no loyalty to you. Since you 3rd rate wet behind the ears sales reps are selling junk the same as the competitor's junk you don't have to be that bright to do your job. Your company could hire a guy who works at a auto parts store, teach him the bullshit nomenclature, put a monkey suit on him and he could do your job much better than you peasants without the arrogance.

    You salesmen are as disposable and unwitting as the patients who get the junk you sell implanted in them

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    3. Tarzan can you post a pic? MSM can you allow pic posts? I think this guy might be lying.

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    4. Bally, you exemplify understanding how the system works by saying that if everyone is selling the same shit, anybody can do it. If my stuff and your stuff is the same, how come all the docs are buying my stuff? The only variable is you and me, and you lose!

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  27. why don't the lefty libs on this blog all start a hospital of their own and work for free? dedicate your life to taking care of the sick...oh wait I forgot, you don't actually work do you, you just occupy and stink up shit! scratch that, maybe then you could stand on the strret corners with your hand out and collect change to help feed the poor...oh wait you already do that, but the money goes to buy the weed and meth! scratch that, maybe we could just take more of your taxes to help those in poverty, oh wait you pay no taxes, and your union dues go to your own liberal fat cats! well shit, then maybe you should just suck it !!

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    2. Reverend Cracker JacksAugust 19, 2012 at 5:08 AM

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    3. SO WHAT if we spend more than any other country on healthcare? We also spend more money on IPADs, is that an indictment? We also spend more money on candy bars, is that horrific? I see healthcare spending as a luxury only available to a tiny privileged few in human history, so let's spend some more!
      BTW, slimy terrorists deserve to die at the hands of our brave and handsome pilots, and God bless our troops, especially our snipers.
      To encapsulate: When we spend money on healthcare, we get healthy. When we spend money on defense, we get dead terrorists and more freedom. When we spend money on welfare queens, we get more welfare queens.

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    4. 5:51 AM - You are largely right on the money. However, a fact most people don't understand is that private insurance in the USA subsidizes public pay such as Medicaid and Medicare. Medicaid and Medicare reimburse at less than cost, so those losses are passed on to the private payers. Another reason that the US spends more on healthcare is that the rest of the world is subsidized by the US. As you know, product sold OUS are sold at close to cost. Most of the rest of the world is socialized medicine. The only benefit to selling OUS (pharmaceuticals, devices, and yes spinal implants) is to reduce the cost of manufacturing with greater volume purchases. All of the development, research, and profits are earned almost entirely on sales within the US. So, the fact is that US private insurance is subsidizing US public pay, and the entire world. THAT IS WHY WE SPEND MORE IN THE US!! Here is a simple fact: If the US went to socialized health care, there would be nobody to pay for research and development. Healthcare innovation would come to an end. Quality would slowly but surely fall to eventually equal the East German Trabant, rather than the BMW we enjoy today.

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    5. 5:59 Medicare and Medicaid reimburse less than costs. Really? I don't think that is accurate.

      Nobody knows for sure the effect that decreased pricing would have on the markets as that is only one variable. Perhaps the reduced costs, decreased profits and commoditized products would drive a young entreprenuer to innovate? Nobody knows for sure unless you have a crystal ball. Trying to predict how a market will perform with one variable is foolish and un-factual and shows just how little you know about how global markets perform. There are plenty of French implant companies that sell primarily in one of the most depressed price markets do to "socialized" medicine. Some French companies don't participate in the US market and some have just started to so not everyone is in love with the US Healthcare system and calls good ole USA home to get rich off our pricing.

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  30. Which Biomet distributor was dumped?

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  31. This post (along with its comments) exemplifies the warring factions within our industry and our culture in general, and I see that war going on inside the author's head. This is understandable when one stops to think about what we are taught in school about the history and make up of the "American System". I was taught, through the lens of the Great Depression and the so-called progressive era, that the nation learned the virtues of moderation and threw off the shackles of the dangerous laissez-faire experiment with social programs and government "regulation" of industry and markets. I was taught that our "mixed" economy was a harmonious compromise between greed and restraint. I inferred that greed was powerful and functional; a little greed was good but too much was dangerous. The corollary of course is that a “reasonable” amount of profit is ok, even good, but too much is bad, perhaps evil. The conclusion to this line of thinking is that “regulation” of industry is necessary and justified, even if it is cumbersome and costly. What I have learned since about the historical narratives told in any venue is that they do little more than to demonstrate the preconceived notions of the narrator. I now see the story as fantasy and the conclusions as false. Regulation is neither morally justified nor necessary. Less fundamental but more obvious, it has a demonstrably poor track record of efficacy. The fact of human nature is that people trade. Some are honest, others are not and the rest of us play for either side at one time or another. The situation an individual is in greatly influences his/her propensity to dishonesty. The existence of systemic protections creates moral hazards resulting in ignorant consumers and unscrupulous marketeers. Responsibility in a broader field of things is shifted to the bureaucrat who has less incentive and less specific knowledge to make appropriate decisions in real time. Further, the conundrum arises, as immortalized by Dr. Seuss, “Who will watch the bee watcher?”
    In a truly free market (not like any we have or will see) the doctor’s only rational incentive is to provide the absolute best care to his patient possible. His reputation and his livelihood are on the line, and he has no one to hide behind. He doesn’t belong to a guild, because they wouldn’t exist. There is no mother-hen bureau to declare treatments as safe and efficacious and to take the heat for him. This applies equally well to the hospital administration, management and other staff. I know this is heresy, but it especially applies to the patient for whom the price of good care is eternal vigilance. In this system everyone is the bee watcher. Profits in this system represent the value of quality services rendered. In our current system, all bets are off with respect to what profits represent.
    Like the well meaning, wealthy parents, we have spoiled the individual responsibility right out of our culture with too many hand-outs and too wide of a safety net.

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