Why are Republicans Wrong about Everything?


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Trad climber
Philadelphia, PA
Feb 5, 2013 - 12:29pm PT

I don't care if they were born in the USA or Pakistan
if they are plotting to harm America, kill them
Including US citizens who publicly state that they are stockpiling weapons and ammunition for the explicit purpose of preparing to overthrow the US Government?

oops, wrong thread, or maybe not?



Social climber
the Wastelands
Feb 5, 2013 - 12:39pm PT
Including US citizens who publicly state that they are stockpiling weapons and ammunition for the explicit purpose of preparing to overthrow the US Government?

quite easy enough to simply arrest them, no need to kill them as we have to do in other countries that won't extradite to us
Dr. F.

Big Wall climber
Topic Author's Reply - Feb 5, 2013 - 04:38pm PT
Question for these "all of a sudden concerned about Americans being killed" folks.

How many of these "terrorist" Americans have Obama and his CIA killed?
Really, How many have died, I want to know, so I can get out rageD.

and then lets compare this to the number of INNOCENT Americans that died because of Bush incompetence (911, Katrina, illegal wars)

and then add that number to the number of "terrorist" Americans Bush Killed
Ron Anderson

Trad climber
Soon to be Nipple suckling Liberal
Feb 5, 2013 - 04:41pm PT
whats up with N Korea?

North Korean Video: A 'New York City' in Ruins After Missile Attack
Tuesday, 05 Feb 2013 11:37 AM
By Alexandra Ward

Share: More . . . A A | Email Us | Print | Forward Article

North Korea released a bizarre YouTube video over the weekend depicting a missile attack on a city that closely resembles New York City — all part of what's assumed to be a public relations stunt to gear up for yet another nuclear test.

The video, which uses an instrumental version of Michael Jackson's "We Are The World" in the background, was posted Saturday on the YouTube channel Uriminzokkiri, which distributes news from the country's state-run media.

The three-minute clip features a dream sequence depicting a city — it could be NYC — shrouded in an American flag and burning down in flames.

"Somewhere in the United States, black clouds of smoke are billowing," reads a caption superimposed over the footage, translated by The Guardian. "It seems that the nest of wickedness is ablaze."

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The video was posted just a day after North Korea threatened to retaliate against the U.S. for backing a resolution to censure and sanction the country for a rocket launch in December that breached the United Nations' rules.

"We are not disguising the fact that the various satellites and long-range rockets that we will fire and the high-level nuclear test we will carry out are targeted at the United States," North Korea's National Defense Commission said Saturday in a statement through state news agency KCNA.

North Korea performed nuclear tests in 2006 and 2009, and a third test appears imminent, sources say. The two previous nuclear tests both occurred after North Korea was condemned by the U.N. for rocket launches.

John Bolton, former U.S. ambassador to the U.N., called the YouTube video "disturbing."

"The film is yet another disturbing reminder that a nuclear-capable North Korea is a threat in its region and worldwide," Bolton told Fox News.

But Doug Bandow, a senior fellow for the Cato Institute, which specializes in foreign policy, said the video is little more than "bluster."

"For years, they have used vivid imagery in their rhetoric — they once threatened to turn Seoul into a lake of fire — so they’ve figured out a way to put pictures to the rhetoric," he told Fox News of the video. "But it doesn’t look to me to be more than an amplification of what they’ve said for years. The good news here is that while they're evil, they're not stupid. They know they would lose."

Read Latest Breaking News from Newsmax.com http://www.newsmax.com/TheWire/north-korea-video-new-york-city-missile/2013/02/05/id/488963?s=al&promo_code=1255D-1#ixzz2K4idxgCa
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Dr. F.

Big Wall climber
Topic Author's Reply - Feb 5, 2013 - 04:42pm PT
Credit: Dr. F.

Trad climber
lost, far away from Poland
Feb 5, 2013 - 05:13pm PT
Health Reform in 2013: What's Happened, What's Left & What it Means for Providers

Written by Jim McLaughlin | February 05, 2013

With just one year remaining before the largest parts of the federal health reform law take effect, 2013 will be a busy year for hospitals as they prepare for the biggest changes in healthcare since Medicare was introduced in 1965.

The Obama administration has embarked on a comprehensive overhaul of the way Americans deliver and pay for healthcare, aiming to make care more affordable through eliminating waste, incentivizing efficiency and requiring more recipients to pay in. It plans to achieve those goals at the cost of the traditional funding mechanisms and levels that providers have come to rely on, which could spell disaster for the unprepared.

Being prepared requires providers to not only know and adapt to what’s coming, but also to be able to explain what has changed to their patients and business partners. The Patient Protection and Affordable Care Act represents enormous upheaval to the healthcare industry's status quo, so here is a recap of what's happened, what's to come, and what hospitals should be doing to ready themselves for the PPACA.

Reform so far
President Barack Obama signed the PPACA into law March 23, 2010, but the lead-up to its passing was a hard fought battle. There were rumors of "death panels" enabling government-sponsored euthanasia resulting from rationed funding for healthcare. A public health insurance option intended to compete with private insurers was rejected twice. And although the Supreme Court upheld the constitutionality of the law's contentious individual health insurance mandate in June 2012, it struck down the requirement for all states to expand their Medicaid programs, relegating that part of the law as optional for each state.

Much of the law so far has begun to turn the wheels of the health industry in the direction of growing primary care, promoting and protecting consumers' access to coverage and introducing funding models that share payors' risk and gains with providers.

2010 — Expanding access to more people, the 2010 law immediately began to disburse tax credits for small businesses' health plans and rebates to seniors for prescription drugs. Children could no longer be denied coverage due to pre-existing conditions, and some state and federal insurance plans were created for adults with pre-existing conditions who had been uninsured for six months or more. Young adults under 26 not offered insurance from their employer were permitted to stay on their parent's plan. Anticipating the boost in demand, education assistance was established to attract more primary care nurses and physicians into underserved areas.

Within the health plans themselves, types of preventive care became covered without charging a copay or deductible, and no lifetime limits on hospital stays or other essential benefits can be imposed. More assistance is given to seniors buying Medicare Part D-covered drugs and receiving preventive services, and at the same time the Obama administration added defenses against corruption and unreasonable business practices. Extra funding was pumped into fraud-busting programs to cut unlawful billing of Medicare, Medicaid and CHIP, and into state groups with authority to review or regulate insurance premium increases.

2011 — In 2011, a major limit on insurance companies was imposed that required them to spend at least 80 to 85 percent of premium dollars on healthcare or quality improvement, rather than administrative costs or profits, or else send rebates to customers. Gradual reductions to insurance companies in the Medicare Advantage program began, slowly shrinking the $1,000 bonus paid per beneficiary on average compared with traditional Medicare.

Elderly and disabled beneficiaries gained a wealth of new services designed to decrease the amount of time they spent hospitalized, free preventive care for certain services, assistance designing care plans and coordinating support services when they were discharged from a hospital visit, and freedom for states to use Medicaid funding to pay for cheaper at-home care versus nursing home admittance. Medicare beneficiaries also began to receive a 50 percent discount on Part D-covered brand-name prescription drugs.

Money was granted to public health programs and services to help Americans purchase sensible private insurance. Efforts to build and renovate community health centers gained new financial support, and payments for rural providers went up.

2012 — Last year saw a swath of changes including the advent of accountable care organizations established in order to design cost effective approaches to care delivery in exchange for sharing in CMS' savings.

In October 2012, hospitals meeting certain benchmarks for electronic health records became eligible for incentive payments as part of provisions included in the American Reinvestment and Recovery Act. That same month, CMS began its value-based purchasing program, which alters how much it pays hospitals through Medicare depending on its performance on various quality measures including patient satisfaction and hospital readmission rates.

2013 — Beginning this year, funding changes to Medicaid will reimburse primary physicians at Medicare rates through 2014. The federal government will also increase funding to states that craft Medicaid programs with better benefits for preventive care. And a national pilot program to promote bundled payment models has gone into effect, which would allow providers to take on risks and profit potential from efficient use of Medicare funds.

Coming soon
There's more to come from the law, especially next year in 2014. That's when nearly all adults and children must obtain health insurance or pay a fine, which will be the greater of 1 percent of income or $95 per adult ($285 for a family) next year but will balloon to the greater of 2.5 percent of income or $695 ($2,085 per family) by 2016. Penalties for much wealthier families can grow as high as the average basic-level government-approved health plan's annual premiums. Employers of more than 50 full-time workers will need to offer minimum essential coverage or pay a fine for each eligible worker above a threshold who is not offered coverage.

Each state will have an online health insurance marketplace, referred to as an exchange, that will offer qualified private plans for individuals and small businesses, and screen customers to see if they are eligible for subsidies, tax credits or Medicaid. Enrollment for these begins in October this year, with coverage going live Jan. 1, 2014. All but a few Republican states have shunned the idea of running their own exchanges, opting instead for the federal government to take on the job. Supporters say the marketplaces increase competition and will benefit consumers, thus creating less need for government insurance programs.

One of the most hotly contested features of the PPACA, even today, began to receive funding in 2011. The Independent Payment Advisory Board, an appointed panel of healthcare experts, will be charged with making binding cost-cutting plans for Medicare payments beginning in 2015 that Congress can override only through new legislation that achieves the same level of savings. Republicans have vowed to eliminate the IPAB, and even some Democrats have raised an eyebrow at the concept.

Originally, the law intended for all states to be required to expand Medicaid to more poor and childless adults at 133 percent of federal poverty line. But when the Supreme Court nixed that mandate, the Obama administration fell back on incentivizing states to volunteer to expand Medicaid with a guaranteed three years during which the increased cost of the expansion will be covered entirely by the federal government. After that, states will only contribute 10 percent of the extra cost.

Medicare Disproportionate Shares payments, the lifeblood of some critical access and safety-net hospitals, will plummet 75 percent in October, but they’ll be offset by larger payments based on a hospital’s proportion of uninsured served and uncompensated care provided.

What hospitals can do to get ready
It's going to take strong hospital leadership to weather what could either be a windfall or a typhoon. Following is some advice from healthcare leaders and experts for how to prepare for the flood of changes and regulations.

Expect upfront costs. The law's goal is to lower healthcare costs over the long term, but in the short term, most will feel the changes in their checkbooks. Doug Fenstermaker, a former hospital CFO now serving as managing director and vice president of healthcare at Atlanta-based Warbird Consulting Partners, says he's skeptical of significant savings for providers in the near future, because the cost of implementing the law has a lot of upfront cost.

"It is hard to tell whether the PPACA will result in a lower amount of GDP being consumed by healthcare and if costs will actually decline. In the short-term, that is not at all likely, as investments in infrastructure to make it all work will skyrocket," he says.

While the law aims to improve coordination in the delivery of care and better use of ramped up technology to lower costs, the initial capital cost of that infrastructure will take time to be paid off.

Preserve margins with more savings, not more revenue. Bundled payments, Medicare Advantage and shared savings programs with CMS and private insurers can be lucrative for health systems, especially if fewer patients are uninsured. True, that may bring a flood of new patients, says Aurelio Fernandez, executive vice president and chief operating officer of Memorial Healthcare System in Hollywood, Fla., but political instability in his state and Washington alike means he's not counting on seeing revenues rise.

"I'm not basing our future on the ability of generating [additional] revenues, but on having cost-efficiency," Mr. Fernandez says.

Back in 2011, he says Memorial's leaders did a study and learned its cost structure was too high. So in 2012 he says they embarked on a cost reduction initiative that looked at contractual arrangements, staff reductions and eliminating unnecessary services through partnerships. They set a system-wide cost reduction goal of 5 percent, in excess of $75 million, by the end of their fiscal year which ends this April. So far they've reached 85 percent of that goal, even after realizing costs to implement their EHR system this year.

Track your performance. The sharp drop in Medicare Disproportionate Share funding will be a blow to systems like Dignity Health. The San Francisco-based organization's Vice President of External and Government Relations Wade Rose says since Dignity Health is among the California's largest providers of Medicare services, the cuts will be a challenging obstacle. He and his system's leaders support the law overall, but he acknowledges that expectations are quite high on providers' to fix inefficiencies that are easy to identify but difficult to improve because of changes that must be systemically implemented. "The reality on the ground can be very different than the elegant logic of the bill," Mr. Rose says.

In response, his team is gathering and analyzing copious amounts of data to learn where they can be more efficient, from speeding up imaging test results to designing a nurse's station to maximize productivity, and tracking the impact of these changes on performance.

Mr. Rose says that's why this law might be more successful than efforts of the past — he says 95 percent of the bill has to do with delivery system change, rather than mere funding changes.

Look beyond a hospital's four walls. Some of the greatest cost inefficiencies occur after elderly patients leave providers' care. Not following physicians' orders after being discharged from the hospital can lead to higher readmissions, which the health reform law now penalizes through lower reimbursement rates. As a result, many hospitals have focused much of their efforts into transitioning seniors from the hospital to the home, helping them help themselves stay healthy.

Nathan Anspach, CEO of Phoenix-based John C. Lincoln Health Network's accountable care organization says his organization's solution was to collaborate with physicians, clinicians and pharmacists within the ACO to design a systemwide formulary plan. "We see a pretty significant dollar savings," he says.

"We're all about the 5 to 60 rule — 5 percent of our members will use 60 percent of the resources of our ACO," Mr. Anspach says. He and his team have addressed that with greater attention on patients with chronic conditions like congestive heart failure and diabetes.

Keep patients satisfied. Among other metrics, hospitals have begun to see patient satisfaction account for a rise or deduction of up to 1 percent in their Medicare reimbursements. In an era where providers' margins are shrinking for a number of reasons, hospitals can hold on to what's theirs with a focus on patient experience, says Kristin Baird, a registered nurse and CEO of Baird Group, a Fort Atkinson, Wis.-based healthcare consulting firm.

"Patient satisfaction, once seen as fluffy or soft, is now an important measure that cannot and should not be ignored," Ms. Baird says. "Consumer Assessment of Healthcare Providers and Systems surveys have leveled the playing field and give the consumer a voice along with other important outcomes. Healthcare organizations recognize now, more than ever, that providing good service directly impacts the bottom line. That realization has not been so clear before."

Partner to absorb risk. It's no secret that hospitals are employing more physicians, and that trend of employing or contracting with physicians is likely to continue, says Adam Powell, PhD, a health economist and president of Boston-based healthcare consulting firm Payer+Provider Syndicate in Boston.

"In 2013, I expect to see acceleration in the wave of payor-provider integration and hospital consolidation that began in 2012. The recent merger between Baylor Health Care System and Scott & White Healthcare is but one example of how integrated delivery systems are expanding by merging with hospital systems. Hospitals are increasingly being asked to own their risk, and merging with payors and integrated delivery systems provides them the know-how to do so," Dr. Powell says. "Providers are hoping that mergers will provide them with both more leverage in negotiating with payors and economies of scale that will enable them to lower their costs."

As scrutiny builds over unnecessary inpatient care, Mr. Fenstermaker says hospital systems are likely to divest specialties that aren't core to the business in favor of integrating those services with other systems. For this reason, he says he expects rural hospitals will begin to operate more like ambulatory care clinics and transfer more patients to larger hospitals' specialty centers.

The current number of primary care physicians will struggle to meet the anticipated demand brought on by the newly insured, so Mr. Fenstermaker predicts the industry will rely more heavily on physician assistants, practical nurses and technology to compensate for the physician shortage.

Social climber
So Cal
Feb 5, 2013 - 06:35pm PT


ay Carney said today all the Obama administration drone strikes are “legal, ethical and wise”. If so, then why have they failed to explain the killing of 16 year old American Abdulrahman al-Alawki who was killed in a drone strike in 2011? The closest thing to an “explanation” is the video above, where, in pertinent part between 2:00-3:00, Obama advisor Robert Gibbs says the boy should have had a more responsible father. His father was a suspected terrorist. Yet the son had no association with terrorism and in fact, hadn’t been living with the father for more than two years.

This video shows the clear disdain afforded anyone who dares question the action. What was his crime deserving of death? Having a bad father apparently.


Technically expert, safe belayer, can lead if easy
Feb 5, 2013 - 06:39pm PT
TGT is back...where ya been?

Social climber
So Cal
Feb 5, 2013 - 06:55pm PT
Climbing, fixing things that needed fixin, and making my capitalist pig boss lots of money
Dr. F.

Big Wall climber
Topic Author's Reply - Feb 5, 2013 - 07:05pm PT
TGT having a Tea Party
TGT having a Tea Party
Credit: Dr. F.

Trad climber
Living Outside the Statist Quo
Feb 5, 2013 - 07:36pm PT

Would you agree that Laissez faire capitalism is an extremely dangerous perversion of capitalism?

No, I believe the power in the hands of central state authoritarians is extremely dangerous. Capitalism works best when the State has its hands off. Outside of protecting everyone’s right to Liberty, the State has no role; that’s no small role and if each person’s rights are protected, why fear Laissez faire?

Also I believe the best description of our economic system is a "Mixed economy" which generally speaking strike the historically best balance for the most successful nations world wide.

Yes we are a mixed economy but USA’s has a terrible twist in that big money and the State are committed to each other’s mutual benefit. Look at the Fed’s actions, bailouts, and tax loopholes. Sure other ME’s have their challenges but crony capitalism does suit Americans very well. Yet the voters tolerate it as long as the ruling political class offers incentives to each pet project. Go Party members!

Trad climber
Is that light the end of the tunnel or a train?
Feb 5, 2013 - 08:09pm PT

Coulter to Obama: Gun background checks mean ‘universal extermination… screw you!’

By David Edwards
Tuesday, February 5, 2013 11:18 EST

Conservative columnist Ann Coulter is telling President Barack Obama, “Screw you!” because she says that his plan implement universal background checks for all gun purchases “means universal confiscation, universal extermination.”

Following Obama’s Monday speech in Minnesota calling on Congress to implement “real and lasting change” on gun control, Fox News host Sean Hannity blasted “The Anointed One” for being concerned with “accepting gay scout masters, gay marriage, gun control, watering down welfare requirements, abortion rights, war on women.”

“Connecticut, Aurora, Tucson, these are crazy people,” Coulter ranted in agreement. “That is the problem. Everything they are telling you about what they can do about guns is lie. The problem with universal background checks is we basically have universal backgrounds check now. Any licensed gun dealer is performing a background check.”

“The only way to enforce a universal — the last 0.1 percent of guns that are transferred by collectors and so on is to have universal gun registration,” she added. “Universal background check means universal registration, universal registration means universal confiscation, universal extermination. That is how it goes in history. Do not fall for universal background checks.”

In fact, the Law Center to Prevent Gun Violence estimates that about 40 percent of gun purchasers do not go through background checks, but opponents of gun control dispute this claim.

“If Obama talks about gay rights, if Obama talks about guns, immigration and climate control, then the media race to every Republican, ‘What do you think about what Obama said?,’ and we don’t focus on the economy,” Hannity opined.

Coulter replied: “Not only that, just to follow up on your point right there, it’s just that they are talking about it, they must demonize people that are legal gun owners and, ‘Obama, look at him. He cares about the children.’”

“Screw you!” she exclaimed. “You think we don’t care about the children? You’re the one who won’t do anything about the mentally ill.”

Watch the video below from Fox News’ Hannity, broadcast Feb. 4, 2013.

Raw Story (http://s.tt/1zp1C);

When it comes to Coulter, calling IT a Skank would be a compliment, But it would be an insult to other Skanks.

Gold Canyon, AZ
Feb 5, 2013 - 09:54pm PT
Capitalism works best when the State has its hands off. Outside of protecting everyone’s right to Liberty, the State has no role; that’s no small role and if each person’s rights are protected, why fear Laissez faire?

Because laissez faire markets have never worked before in the history of the world. What did I win?


Trad climber
Living Outside the Statist Quo
Feb 5, 2013 - 10:20pm PT
Bull it sure did, Im not here to teach history but the above statement from a gentlemen I respect is....


Feb 6, 2013 - 12:00am PT
"Including US citizens who publicly state that they are stockpiling weapons and ammunition for the explicit purpose of preparing to overthrow the US Government? "

Hahahaha, stockpiling what would actually be needed to take on, let alone defeat, the United States Army is probably beyond the reach of your average gun nut

One Apache helicopter/drone strike against one fortified gun nut compound would quiet things down in Gun Nut Fantasy World pretty quick.

Looking forward to it!
Bruce Kay

Gym climber
Feb 6, 2013 - 12:22am PT
Nohea - I get the feeling that L F capitalism worked just fine and dandy for you over the past couple of decades. It worked for me too but at what cost. It is easy for us to gloat and rest on our laurels eh? It is a short term pleasure that will bite our kids on the ass - or better yet, some other kids ass.

Mountain climber
Anchorage AK, Reno NV
Feb 6, 2013 - 12:50am PT
Slavery was a fun LF Capitolist endeavour.

Lotsa folks got rich.. didn't hurt nuthin right?

Love that competition stuff.. its great till someone wins. And someone always does.

Monopoly is a fun game.

The fact is the founders were shortsighted in their distrust of government power. Their system of checks and balances in order to protect and serve the people. They did not anticipate or provide adequate checks and balances of private/corporate financial power.

Government power is dangerous..Financial power and all power is dangerous.

Both are both critical useful and important tools in societies. But to pretend one of them is somehow not dangerous if not carefully controlled by various checks and balances..

is asinine.

One thing they missed doing was limiting campaign contributions. Our whole supposed democratic system is now fundamentally undermined by the highest bidder. The whole foundation of getting into elected office is one thing only.

How many bribes.. er how much can you fund raise.

Feb 6, 2013 - 06:32am PT
Four more years, righties: suck on that.

Social climber
So Cal
Feb 6, 2013 - 07:10am PT
So the President of the United States can kill any American citizen he wants, as long as somebody he decides is informed and high-level says it’s okay. And our friends on the left are okay with that, because the President of the United States isn’t George Bush or some other evil Republican.

Water on the face: “You monsters. It’s the end of the republic!”
Hellfire missle in the face: “Whatever you think is best, Barry.”

In related news, if you determine that someone is posing a threat to your personal safety, you’re not informed or high-level enough to defend yourself as specified in the Second Amendment.

Dr. F.

Big Wall climber
Topic Author's Reply - Feb 6, 2013 - 08:34am PT
Why are there Government Regulations??

Because they were mandated by the circumstances in history.
People and property were destroyed,

To avoid short term gain over long term health.
No control allows money and power to be directly controlled by the most criminally minded.................

What kind of brainwashing does it take to make someone soo forgetful of history to think that L F And totally free markets with no Government overview can work..

It does work for some, but it sucks, just look at all the countries that Suck.
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