The medical balancing act

who think paying $400 for a hammer is OK deciding the value of a medical treatment?

:)

a heart transplant? That is good service.

Here in the US, HMO's were allowed to keep the health insurance from having hugh deductibles people could not afford. Now, HMO's are charging too much and companies are returning to high deductibles again. The deductibles are ok if you are young an healthy, but a sudden heath emergency will put you up the creek without a paddle.

Healthcare is a BIG concern in the US, just seems war is given money over people. Something is wrong with that.

Cause the way I've seen the medical system close up, and with a wife with lots of medical issues, I've lots of experience, is that the doctor does the procedure, and then bills the government - no pre approval. As long as the item is on the list of medical procedures, its approved.

Now a hospital may have a scheduling procedure where they determine the priority and who get ahead in line, but the hospitals are private institutions, who get government funds to operate, not government organizations.

James

If healthcare proposals in congress are always too expensive, what costs are they based on? The individual private prectice costs that doctors charge through insurance?

You see, our doctors are well paid but they are not 'rock star rich' like US doctors seem to be.

Private practices in Vancouver are like that though, you'd swear you walked into a boutique. But you are paying for the nice pictures on the wall, the pretty nurse, the fancy front desk, the free Latte's etc.

A good doctor should be paid well based on his good service in the medical community, not his marketing and sales skills.

So, not knowing how these costs are caluculated myself, do you have any idea?

In Canada it is a set cost for each procedure the doctor performs, it makes experience and constant retraining valuable to both them and the patient.

http://online.wsj.com/article/SB123413701032661445.html

[i]Bill Murray waited in pain for more than a year to see a specialist for his arthritic hip. The specialist recommended a "Birmingham" hip resurfacing surgery (a state-of-the-art procedure that gives better results than basic hip replacement) as the best medical option. But government bureaucrats determined that Mr. Murray, who was 57, was "too old" to enjoy the benefits of this procedure and said no. In the end, he was also denied the opportunity to pay for the procedure himself in Alberta. He's heading to court claiming a violation of Charter rights as well."[/i]

After reading it I question the validity of the article and the motives of the writer. I have ben for numerous MRI's, more than 6 anyway, and all have been pretty much right away, sometimes a couple of days wait but a couple right then and there too. None of this 6 months/year crap. In fact as the author has only quoted the words 'TOO OLD' and added "to enjoy the benefits of this procedure and said no to."

I seriously doubt the validity of such a claim.

Perhaps he was TOO OLD to undergo such surgery safely?
Perhaps he was deemed TOO OLD for the anesthetic, or recovery, or it was degenerative and only a temoprary fix, there are a million VALID reasons for such a denial.

Just because he went elsewhere, there no follow up?
How is he today?
Still suffering from a degenerative disease?

As for "government beaurocrats..." I think it was more likely administrative staff of doctors who deemed the operation unwarranted or that it would not resolve the problem. He claims it was due ot his age not allowing him proper quality of life, but I am confident there was a lot more to it. Canadian studies on hip replacement surgery prove that there is an increased quality of life in more than 88% of tested patients between 45 and 64.

There ALWAYS more to these stories than is reported by a po'd patient to the eager journalist. Face it people that are sick or in pain are the grunpiest, even normally happy people are like that, its miserabel being hurt and nobody enjoys being told it won't help.

I call bull$hit on this one anyway. My dad had hip replacement surgery, within a few weeks of it being suggested by his specialist, no problems or second guessing by 'government beaurocrats' there. His quality of life was not really improved as he was unable to return to his line of work, suffering from severe spinal and hip injuries. Having not seen nor heard from him in decades, I could not tell you what long term effects/benefits there were though.

The article I linked to above is EXACTLY why I posted this thread.

People like Tony will constantly bring up these individual cases aired to the US media as horror stories which are flooded through the US media to keep the people from demanding more form their government. [i]( I mean no offense towards yourself Tony) [/i]

"Ask not what your country can do for you, ask what you can do for your country." VERY clever indeed.

Get kids in school parroting that all day and they will soon conform and pay for everything the government should be paying for out of tax dollars. In fact they will grow to object to the thought of their money being spent to help them, as they will fear it helps others too, can't have THAT NOW.

So isn't it about time Americans sat down and asked the country, "So, what the f**k are you going to do for ME for a change?"

They take your money and spend it as THEY please. They waste trillions of your tax dollars and yet you are suposed to believe and have faith in "What MORE can I do for YOU, oh great country!"

Yeah, I would have been a great American. LOL :D

I can just see me standing at the White House gates as the president speaks, a loud voice from the crowd yells, "hey, ya pr1ck, what's in it for US? How about US for once you cheap arsed baystards?" ]:)

I think my constitutional right to free speech would be lost in a heartbeat.:D

Too many health care procedural decisions made by insurance company bean counters, not doctors.

Our HMO was changed recently, thankfully. The previous one had a rule about emergency rooms that was pretty ridiculous, meant to ensure the HMO didn't have to pick up the tab. We had to have our doctor's permission to seek out emergency room help if we wanted the HMO to cover it. WTF? It's a freaking emergency?

[i]The vast majority of all medical problems are minor[/i]

The vast majority are due to conditions or injuries which are:

A. the consequences of voluntary activities or lifestyle choices.

B. the consequences of negligence (by you or someone else).

If you choose to go skiing, and you break your leg, it's not right that the taxpayers pay for fixing it.

Likewise if someone causes an auto accident that causes you injury. THEY should be responsible, not the taxpayer.

It is wrong to hold someone responsible for something they had no control over!

Ya know...

In 1971, my parents had a son stricken with brain cancer.

The government did nothing to help.
My parents hit and passed the max cap on their insurance for caring for my brother.
No hospital donated "care".
St. Jude's turned down my parents because they "made too much".

My brother died, despite everything medicine could do at the time.

Sorry. Just cause your kid is sick, doesn't mean the system has to take care of them.

My parents had to pay back $100,000s over years to pay off what insurance didn't cover.

Those people can do the same thing to have that done.

Borrow the money if your child is so important.

Sell off everything, if you have to. Your child should be more important than your car, your couch, your watch, your TV.

I hope the baby doesn't die, but don't tell me it's the government's responsibility to pay for every child who is born with a congenital defect.

[i]So yes, the government picked an arbitrary number for an age at which the bone denisty of the average person makes the surgery non-viable. Is it the right age - don't know.[/i]

"not average", who is best equipped to make that determination?

[i]His doctor also runs a for profit surgery and had an interest in doing the surgery for him out of his own pocket.
[/i]

Then why did he initially recommend to the government that THEY should cover it?

Personally I'd rather have a doctor motivated by profit than one motivated to do just enough to meet government requirements. Lest I have my nose burnt off in a fire and some bureaucrat tell him "Just as long as he has two holes in his face, and doesn't drown in the shower..."

With not only Bastiat, but Locke, Hume, Smith, and a whole lot of others under my belt -- forerunners of The Fathers. And I still said it. In fact, I had in mind at the moment that exact expression: "I cannot undertake to lay my finger..."

Your shot falls under and beneath that of Neil's.

[i]The Real Truth About Medical Care in Canada (or the UK), and the Myths that Surround it.[/i]

If you'd like to submit such a document for consideration, feel free. I'd love to see it.

He says, she says, you say, they say. Who knows the real truth? Everything is either anecdotal or skewed in favor of a desired policy position.

Besides, in the United States, it should really be a moot point.

https://www.techrepublic.com.com/5208-6230-0.html?forumID=102&threadID=302996&messageID=3026536

If he is a private doctor he ha sa lo to gain either way. He either proves that elective surgery should be covered, makes the papers across teh country and boosts his own private medical practice...or...He proves that it is a viable surgery and should be compulsary for the government ot pay for, again boosting his own practive, having the government line up patients for him and pay their bills so HE doesn't have to incur the expense of collecting, and raising his rates accordingly.

I have had questionable back surgery, questionable kneck surgery, and many other'elective surgeries perfoemed on me withotu hesitation or delay by the government, without ANY concern of cost or who was paying for it, what was covered etc. They just say 'you should try this, it will probably help', you say 'Okay' and it is booked and you are done, covered no bills to pay."

You'd be surprised at how similar our medical is to your own, except you can go to any hospital, anytime here and don't have to pay for private insurance or go where you can afford it or are covered, you just go for help when you're hurt and go home when you are done being fixed up. I've never had an issue like these sensational stories that hit the news.

If ONE such story hits a year, with 30 million Canadians ALL covered the exact same way, why isn't it a daily issue that millions face?

Just complete BS, lies and crap someone made up to make teh news.

Law is juts a way of determining fault. Its not human, it is not considerate, it is not caring. If you ran a personal relationship/marriage based solely on laws, it would be the worst union imaginable. understanding, heart, caring are what makes society bond, independence, capitalism and personal greed are what creates weakness through personal greed.

Thankfully people do think it is their responsibilty and are coming up with the money needed, though not enough in a short time.

To think that such a mentalioty is actually supported by a human being is a bit disturbing though.

You would see a child die before you allowed the government to help it live? That's a pretty freakish and quite scary mindset!

This proves one thing beyond any doubt of any readers here, you deem war more important than human life.

Fact: You support war funding and teh govrenment controlling YOUR dollars and spending them to protect those who did not earn and pay for such protection. Taking it from those who earn it to protect thos ewho did not.

Fact: YOU feel that your money should not be used to save a child in need of a heart transplant. That child has not earned it nor is worthy of your tax dollars being spent on it. YOU don't feel they should take money from those who earn it and use it to help those who don't/

Protection of those people if fine, as it protects you too. But the health and welfare of those people is not fine, as you don't feel that you personally gain from that too.

Wow, now THAT's a scary brian, do you lock it up with your gun at night?

[i]So what about the little kid in Oregon that can't get a heart transplant because his medical doesn't cover transplants and the parents earn too much (and pay taxes on it) to qualify for assistance.[/i]

If I wasn't the cause of his injury or condition, I shouldn't be responsible for paying for it. As his parents are responsible, they should decide whether to sell off assets to pay for it or pass the hat.

[i]or tossed it in the little tray in case someone else needs a penny for convenience when paying for thier stuff.[/i]

Yes, but it was my CHOICE to do so.

[i]YOu are concerned abotu cost and them takign your money but teh amount is trivial, when spread across 330 million Americans. I could understand your concern, if it was across teh board, but you have no issue with the government spending countless trillions on a BS war they SAID was to help save American lives, while more and more American lives are lost for no reason every single day.

One would think that if you didn't care about tax dollars, which you obviously don't if you can turn your head on that kind of wasteful spending, that you would have no issue with medical support.
[/i]

I have no problem with expenditures that benefit EVERYONE EQUALLY. I have a problem with expenditures FOR AN INDIVIDUAL at the forced expense of everyone.

[i]This is a one-off case where elective surgery was recommended by a doctor who also had private practice.[/i]

I guess... if you don't mind severe hip pain!

Who decided it was "elective"? Not the doctor... He thought the planing procedure was a better solution for that patient. So who decided that that patient didn't deserve the "better solution"?

[i]By getting the government to cover THAT elective surgery, he can get a contract to do such elective surgery all the time. Doctors seek unique surgeries ot boost patients and income.[/i]

If they could prove that, they wouldn't have eventually approved the procedure.

[i]So he has a 'questionable' solution that perhaps a few doctors try, others just stick with standard procedures. [/i]

So some patients aren't tested for or even told of a procedure that might produce a better result for them??? "Just adequate" is "good enough" for them?

[i]What's funny, and quite hypocritical of Tony though, is that form one side of his face he says it is unfair for other people to pay for someone else mistakes. On the other side of his face he tries to make a point that Canadian elective surgery is not covering enough?[/i]

The point I'm trying to make is that it is not the Shangri-La its proponents claim it is, and the cost is likely much, much higher than you think it is.

[i]Just ask Tony...the baby should die if the parents can't raise the money...right Tony?
[/i]

Just send them to Canada :)

My point about the surgeon is that he owns a private surgery clinic which is a new thing - some of his procedures are covered, some aren't. He has a vested interest in helping publicize this to bring money to his clinic, so he may have more than one motive.

I've never said we had a perfect system, there are still issues, but it isn't always about throwing more money at it either.

As for costs look at this quote from the links I posted for Max:
Myth #4: Government-run health care programs are bureaucratic and inefficient. Introducing private health insurance and competition would make the system more efficient.

Reality: The evidence from all OECD countries shows that the private sector is far more bureaucratic and much less efficient than the public sector when it comes to providing health care.

The United States, which has the most privatized health care system of any OECD country, spends 14% of its GNP on health care, compared to 9% for Canada.

The U.S. pays $911 per person per year in administrative costs. Canada by contrast pays $270 per person.

The disproportion in insurance overhead costs is even more marked: insurance overhead per capita comes to $212 in the U.S., $34 in Canada. Blue Cross/Blue Shield of Massachusetts, a typical major insurer, employs 6680 people to administer insurance for 2 1/2 million customers, more than are employed to administer public health insurance for all 28 million Canadians.

When Germany recently shifted dental services from the public system to private insurance, administrative costs tripled from 5% to 15%.

Health care is more expensive in the US than Canada, and the insurance overhead is a big reason why. Seems many insurance companies is not as cheap as one payer.

James

Why do I bother? When you come up with comments that have nothing to do with what I've said, as some form of stupid rebuttal?

As for elective surgery and who decides, DOCTORS do. Doctors form the body that regulates medcial procedures province by province. They research and recommend procedures to the government. The government dictates nothing to the doctors.

Doctors in BC do not work FOR the government they all run independent practices and simply bill the government for procedures the offer.

Elective surgery is surgery that THE DOCTORS have deemed either cosmetic, non life threatening, not a prcatical solution for the problem, or they feel other solutions may be better.

As for finding out about surgery, unlike the USA, a Canadian patient can see ANY doctor or specialist they want to. If he wants to seek out 20 specialists opinions he can and it is covered by the medical system, again unlike the US system you can actually see who you want and go see someone else for the same problem, then someone else until you are satisfied with the results.

In the single case you cited, ONE doctor is recommending a procedure that most do not. In the USA, you'd get that first opinion and probably wouldn't hear about any issues other doctors may say could result from it.

So if ONE doctor feels it is a worthy procedure and a group of doctors say it is not a viable solution and is usually deemed elective (questionable) surgery, you can STILL get the surgery done in short time by seeing a doctor who bills privately, it's just that the government hasn't deemed it necessary based on their regulating body of doctors. There are also private insurers for those who want such extended medical coverage.

Once again, Doctors in Canada do not work for the government, they are all independent, private practitioners who simply bill the government for their services.

As James said, "we don't have the perfect system", nobody does, but you have to wonder when your country is the only industrialized nation without a government supported system and coincidentally has the highest government costs (especially considering it is all private practices billing insurer's and patients independently)and doesn't have a better mortality rate as a result.
Americans have a shorter life expectancy than Canadians too, is that because we get second class care?

The US has the only privatized system, a system that has the greatest government burden of all industrialized nations, the system where millions of people cannot afford insurance, and you feel it is supposed to be a paradigm of medical aid? get real, now THAT's blind arrogance.

'We are better because.....well, we are just better because that's what WE have!'

is life threatening!

and "immediate" is a matter of perspective :)

Rule of Law:

Generally, [i]Rule of Law[/i] can be understood as a legal-political regime under which the law restrains the government by promoting certain liberties and creating order and predictability regarding how a country functions. In the most basic sense, the rule of law is a system that attempts to protect the rights of citizens from arbitrary and abusive use of government power.

You can't define words to suit your current whim or narrow view. Do your homework, Oz, and open your mind.

Yeah, I know. Your brother's a lawyer and you're a legal expert. But in this case, you're just wrong - or narrow-minded - whichever you prefer.

[i]some of his procedures are covered, some aren't.[/i]

This particular procedure had been approved and used dozens of times by many surgeons on younger patients... You know, the ones who the government decided weren't "too old to benefit..."

Firstly, sorry for length but I did try to address all of your questions and concerns here.

[i]"... maybe because the requirements of keeping one's license to practice medicine demand it." [/i]

Nope all our doctors operate their own practices, they can opt out of the system and bill independently or are included in the current system where they perform their own work and simply send the bill to the government instead of arguing with insurers. As one doctor noted (from James' links)Most US doctors have less time to focus on patient care as they are spending countless hours of personal time and office time taking calls from insurer's and calling around/battling insurers for coverage, this does not happen here. It is noted that our doctors were more pleasant, satisfied with careers, able to provide better care and keep up to date on new training/retraining and still be home to lead a normal, fulfilling family life in the evenings.

[i]my comment: "The treatments is teh same, private or subsidised

Your reply: Actually if you read the case, it wasn't."[/i]

No, it actually WAS. One doctor deeming treatment necessary does not make it so whether you live in the USA or not. One common issue people have against the private US system is it can lead to unimperative surgery, unimperative medication, and rash diagnosis for th sake of generating a bill.
I am sure that it doesn't apply to all or even most doctors in the USA, but given such an opportunity many will will take it.

[i]"Yes... a bureaucrat has to decide... no different than the board of an insurance company or HMO... "[/i]

No not at all, in fact it is VERY different than a private insurer or HMO.

A private insurer will spend all day on the phone trying NOT to pay to, as that is the common goal of ANY insurer in any industry.
In Canada, a provincial board of directors, made up of seasoned doctors makes decisions and passes them to government. Why would you prefer an unqualified, pencil pusher and bean counter to evaluate what should or shouldn' be covered? They are not doctors they are there to retain company money, not help you find the right treatment.

James would know the details I am sure. We don't evaluate each patient on a per case basis and doctors do not spend time arguing with insurer's over what they can bill for and what they can't. I have never been denied treatment or told it was not needed, nor has anyone else I've ever known.

"According to the doctor, the proposed procedure was LESS risky."

ONE doctor, ONE, UNO! and he specializes in such treatment as a private practice.

These "standard acceptable procedures" are determined by a group of seasoned doctors and surgeons with a great deal of combined experience. I'd go with that concensus long before I went with a lone opnion or the opinion of a few with a motive of personal gain.

[i]"the problem is that you don't see that as a problem."[/i]
No, the problem is that you don't realize that you pay for that AND MORE already.

It's the same "problem" that everyone else in an industrialized nation ignores, except SOME Americans such as yourself who think they will pay mrepo taxes if they have to subsidize others. Face it, your monthly premiums subsidize others already AND you already pay taxes.

That same tax money could go to providing health care supplemetal and eliminate your private insurance costs, sure you'll still have to pay a monthly medical premium (just as we do) but it will be far less than you already pay today.

Why do you care abotu tax money helping others but you do not care that you pay an insurance company increasingly expensive premiums that are based on you paying for everyone else too?

Our coverage costs per person less than yours. We pay monthly premiums for medical, they are not elective like insurance.
But our fees are far less than yours, a small percentage of tax money is used to balance costs and upgrade hospitals etc.

You seem to see paying twice as much out of your own pocket as being better than that money taken out of the tax money you already pay anyway?

You know that whether you have or don't have a subsidized system that your tax money is still taken and spent on other things, whether you like it or not?

So let's put it into perspective, lets say you payed $18,000.00 in taxes each year.

You can either have a system where you pay $18,000/yr in taxes PLUS, $120.00/mo (just a random number) in health care insurance OR you can pay $18,000.00/yr in taxes and only $50.00 a month in health care.

Same taxes, lower monthly coverage costs.

YOU prefer the first choice and you prefer it so much so that you will adamantly argue that spending more money for something is better than not spending as much for it. That makes sense?!

Your constant referal that people visiting the hospital or doctor is due to their own doing and you shouldn't have to pay for it is old, inaccurate and poorly accounted for.

RIGHT NOW, you DO pay for those people to be taken care of.
However you see your system as fine.
YOU pay for their hapless idiotic mistakes.
As for people with disease, people who were run over by drunk drivers and such, that's different of course and quite rare apparently.

[i]"...even then wouldn't DREAM of demanding that someone else pay for it! It's called being responsible!"[/i]
You don't have to dream, it is reflected in your monthly premiums which are based on the total cost of health care for the insurer, even for those who are 'irresponsible' that you shouldn't dream of paying for, but must anyway in order to get your own health coverage.

Do you not think YOUR premiums are directly related to other people's costs too? Of course they are!

On top of all that you STILL pay taxes too!

Taxes which WOULD be allocated to medical instead, lowering your monthly premium cost and affording everyone equal treatment?

Again, our system costs us less than your system, how is spending more better? Simply put, it isn't.

Bottom line, my health care costs less to me, than your does to you.

End of story, you pay more for less.

NOTE: In BOTH systems you have to pay for someone who is irresponsible and gets hurt, that you cannot avoid. You just don't THINK you are paying for it already in the USA, though you do each and every month. the mroe peopl ethat are irresponsible, the more money responsible people pay for rpemiums.

Are you really not sure how insurance works?

[i]No good government but what is republican... the very definition of a republic is 'an empire of laws, and not of men.[/i]

So I only paraphrase John Adams when I suggest that ours is a government of laws, and not of men.

'Law of the land'

It's a set of laws applied to instill a countries Constitutional practices.

Or in other words, law, nothing more nothing less. To suggest it differs in reality from any other nation is pretty dumb. Only an American would be lead to think it is unique.

The way ou hang onto this crap as if it was written in stone for the first time, by some unequalled brainiac from Europe who saw the right way to build a new nation, is simply delusional. There's VERY little difference in the way your country's morals/values to the people are defined and any others; you just think they are unique, independent paradigms of how the world should be.

Seeing as he was known to be a VERY warm and generous family man, what woul dhe do in such a situation?

Would he do as Tony suggests? 'If the parents can't pay the the child it should die?'

Yeah that sounds like the origins of America in the making.
America: a generous and prosperous, leading society; a paradigm for all to follow, a banner on the horizon for those lost nations who care for one another without concern for where the money came from.

John Adams would be so proud of you Maxwell, if you were in a stockade.

so, if someone watched theives break into your car and then laughed as they stole your stereo but when asked who it was they said " I don't know, I don't care, its not mine" that would be cool then?
Or would you think he was an uncaring and sh1tty American citizen?

"Its not mine"
So, why do you support the military, fire department, police department, ambulance services, etc?
Your money is haphazardly wasted to help other people, not just you. Many of those people may be smokers while you are not, they are irresponsible and burn their house down.
YOUR tax money pays to save them, and yet that is not your complaint?
Why not just get billed when your house is on fire? You can't afford it? Too bad, it burns down then.

We don't have "social medicine" in Canada, our doctors run private practices. They have their own offices, their own employees, their own hours etc. They don't work for the government, they are independent and private practitioners. They simply bill ONE insurer instead of 100's and only have one to deal with and collect payment from, instead of hundreds.

If they don't WANT to bill the government, they can opt out and bill you privately, in which case you can also buy private, extended medical coverage to top up your basic monthly premiums.

"Just ask Tony...the baby should die if the parents can't raise the money...right Tony?"

As a parent, I don't know how you can even type the words.
How heartless and self centered, your nation would be a third world country if it was actually built with such a backward mentality.

I think the whole focus behind indepenedence is that people WOULD automatically see to such needs for others as well as themselves without government intervention, however modern day America seems to think that it is a ME and ONLY ME, world, doctors overcharge and over treat patients for personal gain.

Do you really think America's founders, John Adams for example, would see letting children die due to lack of coverage as being acceptable? I sure as hell don't, he was a father.

Fair enough, now lets say this happens to you.
They are both working and paying for premiums, they both earn too much to qualify for subsidies, so they are in a position just as you and I are....well you more accurately than myself as I am in Canada and don't have such concerns.

Would YOU be able to borrow 1.5 million dollars for a heart transplant in today's ecomoni ccrisis? Do you have that equity? Could you go and hawk some old jewelry or gold teeth to pay for it?

Now lets look at the reality, Canada does not have a socialized medical system, as I explained above.

I pay less income tax than you do.
I pay less in medical premiums than you do.
Our national medical costs to the government are lower than yours are.

So you obviously prefer paying higher taxes and having that money spent absent mindedly on...whatever, as long as you don't think someone else gets it.

You prefer paying higher monthly medical premiums, due to the costs of oyur medical services being higher than ours and your medical premiums counter the costs of all other Americans too, which is better than you only paying once for everyone, instead of twice.

Your government spend more on medical services and you STILL have a weaker child mortality rate, more mothers die during child birth and you have a shorter life expectancy than Canadians?

What part of paying more for less actually excites you?

Is it just some twisted moral agenda that you all cling onto as if it is relevant because you really don't understand the alternatives?

You actually think that YOUR insurance
premiums are not already paying for someone elses health?

My insurance premiums are lower and they cover everyone's health.

My taxes are lower than yours and they cover everyone's health too?

Our health costs per person are lower as a nation and they cover everyone's health too.

You people really need to step outside of the government myths and propaganda and start asking for answers, you are getting ripped off left right and center and STILL being denied health care but you are lead to believe its the better solution.

"ask not what your country can do for you..."
How convenient, how are you supposed to ask what they are spending your tax money on and why? "Instead, ask what you can do for your country."

Okay, but if everyone is looking out solely for themself and doesn't want the government touching THEIR money, isn't that unAmerican?

If I were a betting man (which I am), I would bet that John Adams would reach into his own heart and into his own pockets to help pay for that child's care.

I would further bet that he would not reach into someone else's pocket to do it.

And I would absolutely bet my entire life's savings (what's left of it, that is) that he would not use the power of government to reach into someone else's pocket to do it.

You constantly confuse personal compassion with forced compassion at the hands of government!

I might also add, that you have absolutely no idea how compassionate I might really be. But I do it with my own time and my own money - I don't want to use government to force my compassion on someone else! It's a simple concept to grasp, Oz - which is why it probably eludes you.

1. Neil said, [i]" Yes. I think that the government DOES have to take care of sick kids."[/i]

2. I said, [i]"Just because you think that the government DOES have to take care of (fill in the blank), it doesn't mean it should...... (and) it's for this very reason we're considered a nation of laws, not of men [/i] - Meaning we're governed (or should be) not on what an individual might think is right.

3. If the underlying basis for the laws of our nation is OUR Constitution, then the following quote is very relevant:

[i]I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.[/i]
- James Madison

James Madison, by the way, is often considered the father of our Constitution. (Yes, I know, others were also involved - including George Mason.)

4. That's the basis when I stated. [i]"At one time our Constitution was the underlying principle setting the law of the land. Unfortunately, somewhere along the way, things got skewed way out of wack."[/i]

Meaning, in this context, there is no [i]lawful[/i] basis in our Constitution allowing the government to take care of sick kids - regardless of what Neil (or anyone else) might think.

5. Oz said, [i]"Law is just a way of determining fault"[/i], which is a totally irrelevant and unrelated comment.

Thus, round-and-round we go, and where it stops depends on who decides to no longer reply. Personally speaking, I'm jumping off this merry-go-round.

You couldn't even offer one post without taking a character shot at me. I said nothign of the sort, those are purely your own condescending an innacurate words.

As for understanding the whole generosity and personal compassion thing, I do that in addition to paying taxes.
Do you not pay taxes?

What do you personally stand to lose through a less expensive, government supported medical system?

Do you think you'd pay MORE taxes? Why?

And again, you haven't explained why you don't complain about the other services your government steals your money to provide.

Like I told Tony, you are forced to pay for someone who is negligent and burns their house down, firefighters are paid for by stealing money from taxpayers pockets.

You pay for some junkie who just stole someone else's property to be caught, locked up, tried and sentenced. They steal money out of YOUR pocket to help others.

They take money out of your pocket to pay for a war to protect people in Iraq from a horrendous dictator, however you deem that more important than the welfare of your fellow man's infant being paid for from that same pocket?

I understand what you are TRYING to say quite well, you don't have to be condescending and rude about it. It's the backward mentality behind it that I can't fathom.
If you had always had medicare paid for out of your taxes this would be a non issue, just like fire safety, police protection, military efforts in other nations etc. you wouldn't even bat an eye or notice the difference.

As it is cool to stand against change to your inadequate system and you can refer to 200 year old statements and issues to support it, even when not in consideration of the surrent situation, you oppose that which would have NO effect on your pocketbook in any way, but would save an infants life.

As for John Adams, if he couldn't afford it the town would pay for it and his name would be posted in town for all to see that he was being cared for by 'The Town'. A little US medical history search show that anyway. They didn't need a licence to practice medicine then, there were VERY few trained dotors in North America.

In fact, many settlers didn't find 'the New America brochure' to be an accurate depiction of America at that time at all. They found great hardship and disappointment. More than 80% of the originalsettlers had died in the first two years, a lack of public health resulted in horrific living conditions for early settlers. They didn't have organized garbage removal, sewer systems etc. and disease ran rife for many years.

But hey, lets just think about what a man MAY have done in the same situation 200 years ago and base our future on it, he knew where you were headed, he saw today as he was a great visionary.

As far as the baby, it apparently would have been treated and paid for by the town, if they were able to perform heart tranplants in infants 200+ years ago of course.

Since that time, Americans decided they'd make more money as doctors if they could bill as them wanted, hospitals found out they could be as rich as Hollywood directors if they billed privately and tax payers were lead to believe that their money was more immportant if they spent more of it privately rather than having he government spend some of the existing tax dollars to fund public health instead or war.

Don't you see it? You already pay enough in your taxes to cover medical and have reduced premiums. Then you pay at least double what I pay for monthy premiums too.

You are paying more for your own health care than I do to support the whole country\s helth care!

If your money is so important, let them invest some of the existing money back into YOUR health, the same money that they steal from you anyway, and stop paying so much on top of that for personal insurance too.

Don't you get it, you personally get more for less?

You don't feel you should have to pay ANY taxes at all?

When your country was founded, people paid taxes and the poor were treated from them, how does not paying taxes for the betterment of the entire nation fit America or any other industrialized nation's history.

If it is just a matter of taxes for medical support, you already pay taxes anyway, who cares if the government starts putting that same money to good use instead of more expensive toilet seats in the white house?

I do not oppose taxation for infrastructure (including fire and police protection) and defense. The things in this category that can be metered should be metered and spread among the citizens that use it (roads, for example... something using pounds per mile would be a fair metric... as more miles and more pounds wear out roads and bridges more.). Things that cannot be metered should be paid for equally by all citizens (dollar for dollar the same, not a percentage).

I oppose taxes used to benefit an individual (whether it be a CEO, a politician, a welfare recipient, or a farmer) at the forced expense of other citizens. If some citizens CHOOSE to donate for this purpose,fine, but it should not be forced.

We have what's called "the equal protection clause" in the 14th amendment of our constitution. It essentially says that all citizens should be treated equally under the law. I submit that charging one citizen $300 for his share of running the government while charging another $3,000 is NOT treating them equally.

[i]Damn cheapo Canadian hospitals![/i]

that the quality of care is any worse in Canada than it is in the United States. The problem isn't in the actual medical part of it. It's in the bureaucracy part of it, and both countries have flaws (albeit different ones).

[i]The U.S. pays $911 per person per year in administrative costs. Canada by contrast pays $270 per person. [/i]

that EITHER is acceptable.

[i]NOTE: In BOTH systems you have to pay for someone who is irresponsible and gets hurt, that you cannot avoid[/i]

That's one thing that's wrong with both systems... but I have the choice to not participate in my employer's health insurance. I pay out-of-pocket for doctor visits and have spent maybe $1300 in the last 30 years. I pay $10 every 90 days for a long term generic prescription I have been taking for the past two years. Major medical will be available for no cost upon my retirement ($3,000 deductible) so I'll sign up at that time.

[i]Would he do as Tony suggests? 'If the parents can't pay the the child it should die?'[/i]

No, he would donate personally, and encourage friends and neighbors to do the same. I don't think he'd forcibly take their money or property though.

Is the concept foreign to you?

Let's you and me repair to the side and review charity, dearness, love, and goodwill. Before I smack you.

Then we'll do lunch, and law.

Okay Tony, its clear. You feel that you shouldn't have ot pay taxes to the government for ANYTHING, any government that collects taxes is simply stealing from you.

Any of the services that you deem worthy or not should all be provided for free or they should consult you to see what you are willing to pay for as an individual, not as a state or national vote. Democracy is a flawed solution in your eyes, it should be completely up to you as to where your money is spent.

That aside, and yes I know what YOUR point is, you seem to be missing that right now they are spending $911.00 per person to pay for medical deficits in ADDITION to your paying your own private insurance, in addition to the fact that the $911.00 does not even offer you medical coverage.

Your money is stolen from you by the government, then you happily and willingly pay more to a private company that charges you for everyone else's defaults too an dscrutinizes each and every visit to a hospital or doctor to see if they will cover you or not.

THAT'S INSANE and completely illogical.

This is a system that you PREFER to the alternative of having the government spend less money from your taxes, you NOT having to pay rising costs to a private insurer AND having all of your medical costs covered without question.

I know, I know, the record is still brokem YOU don't think that the government should take ANYTHING form you; isn't that nice but unrealistic and completely impractical.

So you HAVE to pay taxes, you MUST, fact of life and not a topic of discussion here.

++++++++++++++++++++++++++++

What would you rather do?

Pay more taxes and get nothing, or pay less taxes and be covered? (thank about it long and hard, you may just catch on to what others have been saying all along)

Pay more to gain nothing or pay less than you currently do and gain a benefit? hmmmmmm. real poser there.

Simple question, black or white.

Are you capable of answering it though?

Your objective is to die if you get seriously injured and if you should make it to retirement age, you will THEN jump in on teh system and make others pay for your costs. How American of you! How upstanding and patriotic! You despise a system that steals from citizens but are willing to use it to your advantage at your fellowman's expense.

The ONLY issue I have with Canada's system is moot really; you can't opt out of it, used to be able to but not any more. It is also an issue of liability and responsibility though, if I am seriously injured by someone I shouldn't have to undergo two years of court to place blame in a civil suit. With everyone being insured there is no need for medical expense recovery or blame.

It's similar to Auto Insurance, in that you HAVE to have insurance in order to drive your car, it is not an opt in system. That way another driver can always be held responsible for any injuries to you. You can't get blood out of a stone.

A medical system see that EVERYONE is covered, not just thme and you have to pay independently.

Just like Fire, police, ambulance etc. Individuals MAY need help, but that can be anyone, including yourself.
Nobody is taking your money and paying for MY hospitalization but not your own too.

John Adams actually DID have the town pay for medical costs for people without the money.

When your country was founded it was rife with sickness and disease, it wasn't rare for an entire billage or town to be quarantined with most of them dead in short time. BUT, when people couldn't pay for their own medical treatement "The Town" paid for it. Not by charity,m it was simply taken from the taxes/treasury of the town to pay for it.

Your nation has since changed into one that only looks after their own and those they deem worthy of personal support.

Being a citizen and fellowman is not enough anymore, until of course YOU need old age medical support, then you will mooch of the rest of those you refused to support for most of your life.

Tony, you oppose paying taxes for teh benefit of one.

You don't oppose fire, police, military, ambulance.

You do oppose medical.

IN what way does FIRE protection support ALL and not one, where Medical support does?

Fire: One person is irresponsible and burns his house down. YOU pay for it, how is that to teh benefit of all? Because it is available to all?

Medical: One person is burned when he hurns his house down. You have no problem paying to put the fire out but treating the person is an issue? Why?
Both are for the benefit of one person other than yourself.
You may never use the fire department or hospital, but you don't have issue with the fire department, just the hospital?

You don't mind paying for police protection.
YOu may never need police protection, but some crackhead that steals from someone and you have no issue paying to have him caught. However, if anyone is hurt in that incident, including eh police officer chasing him, you shouldn't have to pay the medical costs.

Your logic is seriously flawed, Tony. What you say you morally oppose paying for, you also say specifically you have no problem paying for.

You do't want ot pay for others, unwillingly anyway. But the services you DO support are seeing YOU pay for others and you may never need those services yourself, you may never see any personal benefit.

But a reduction in your medical costs that you DO alredy pay is unfathomable?

I didn't say that it was your opinion (however it is a very common one), otherwise I would have quoted you on it.

to take the necessary steps to protect themselves... They can drastically cut their cost for medical services by living a healthy lifestyle, and not participating in activities where the risk of injuries is high. If they refuse to take those steps, that they are in complete control of, why should someone else pay for the consequences of their refusal?

[i]You don't oppose fire, police, military, ambulance.[/i]

... of their standby cost in case I need them.

[i]Fire: One person is irresponsible and burns his house down. YOU pay for it, how is that to teh benefit of all? Because it is available to all?[/i]

I don't know about there, but here, police, fire, and EMS DO bill you for your individual costs! If your house catches fire and you are injured, you will get a bill from the fire department and from the ambulance. If the police respond to a traffic accident, the person at fault gets a bill from the police department for fuel used, flares, ect., and more if they have to appear in court later. If they arrest someone for DWI, he gets another fuel charge, maybe a hospital charge for the blood test (if he refuses the breathalyzer), a jail processing fee, and if he stays over a day, a charge for bedding and meals. I don't pay that.

[i]But a reduction in your medical costs that you DO alredy pay is unfathomable?[/i]

I don't know how much lower they can get... The only time in my life I've ever been hospitalized was 36 years ago when I was 15 and had to have my appendix removed. Since then, I've had checkups once in awhile, some therapy for depression when my first wife walked out, and a little medicine. The grand total of which is less than what a typical person would pay for insurance for a single year!

[i]know, I know, the record is still brokem YOU don't think that the government should take ANYTHING form you; isn't that nice but unrealistic and completely impractical.[/i]

... of attributing to me that which I have never said?

I am perfectly willing to pay my share of the cost for the government to do what it should be doing. What I am NOT willing to pay for is the things the government should NOT be doing, such as charity work. Yes, I know they take it from me anyway, and yes, I know that there is little I can do at this time except protest.

We're supposed to have equal rights... we're supposed to have a government that treats each of us the same, not one that enriches one at the expense of another. Like you said...

[i]Law is juts a way of determining fault. Its not human, it is not considerate, it is not caring.[/i]

"Fault" implies some action or negligence that causes something, thereby making me responsible. Show me how it is my "fault" that someone else has a medical need. Show me how it is my "fault" that someone had 8 kids they can't support. Show me how it's my "fault" that an earthquake destroyed homes on the other side of the country. What legal theory are you operating under that makes any of that my "fault", in order to force me to "care"? (oops, the law isn't supposed to do that, according to you)

As I am looking for YOUR definitions to YOUR statements, how about supporting services you do deem important and explaining hwo they are different than those you do not support?

You say that you believe in taxes going to help everyone, not just individuals. HOwever you support or feel that necessary services like fire and police are acceptable.

Your issue with medical coverage is people ar enot responsible and you should not be left paying for their mistakes. Obviously we could all live in bubbles and save more money with accidents too!

Fire department: Qn unemployed welfare mooch is cooking crack over the stove, burns the house down and your taxes pay to put it out and save them from the fire. However your issue arises when they go to hospital?

Why do you have no concern abotu teh fire department helpign them out at your expense but medical treatment is out of order?

Another example: A policeman stops a knife fight between two gang members. Yuo have no problem paying for the police to stop the violence and save one who may be harmed in the fight. Again though your issue is with them getting medical help.

Your tax dollars are being used to protect an unemployed gang member, but you oppose your tax dollars being used for medical reasons.

Do you see teh hypocrisy in what you are saying?

People shouldn't benefit from YOUR tax dollars, unfortunately that is teh way of industrialized nations, we pay taxes, the government that WE elect decides how ot spend teh tax money. We get a vote in that we elect the spenders.

SOME people getting your tax dollars, when its for the services YOU want, it is okay?

But other than your chosen aexceptions, the government has no right to take your tax dollars and spend them as they deem worthy.

I have but one solution, find a new planet.

I've trie dbut you just keep going in circles, not worth my attention anymore.

face it, there's f**k all you can do about it. You don't get to decide what your money is spent on and what it is not, beyond simply voting for and electing a government that says it will spend your tax dollars how you wish.
If that doesn't happen to your favour, you are ripped off, if it does happen, the other half of America is ripped off.

Sorry, it just doesn't work that way and that's a key reason why Americans are so divided, nobody cares about anyone but themselves, especially when it comes to their money.

First of all, I assumed that your taxes would at least cover necessary services. If they don't, and you pay more tax than I do, what benefits DO yo get as an American tax payer?

They tax you AND bill you? And yet you feel that is better than having your tax money support you too, even though it already supports those who don't even pay taxes?

You don't like your tax money going to help others (sorry, still can't accept that one myself) but apparently your tax money does NOT help others as they are billed for services individually on a case by case basis? Teh onlu people gaining benefit from YOUR taxes are the people not paying taxes. Why wouldn't you want in on that action as a tax payer too?

Your defense of this most inadequate system is getting harder to accept.

You pay more income taxes than I do and you get NOTHING in return, other than the ability to go to war in foreign lands, well we do that too, just not as spontaneously.

I pay less taxes than you do and yet those taxes offer me medical subsidy, fire protection, police protection etc. (Our ambulance service is privately operated now so we do get billed $80 for ambulance fees as needed).

You prefer paying more and getting nothing, but that's okay because at least nobody else gets it either, except welfare recipients and low income earners, the disabled etc.

You have no control over paying taxes, we all do it like it or not, I'm not saying I like paying taxes either. But at least by Canada offering me fire, police and medical services, I get SOMETHING back out of it, and don't just let them piss it away on those who don't work.

But you would prefer to just stay with it as is and get nothing in return?

Why would you want your tax money, which you already pay and get nothing back from, to at least cover your police, fire an medical protection?

The unemployed get this support from your tax dollars no matter what you support, your just cutting off your nose to spite your face to remove youself from wanting at least the same benefits that the unemployed get.

No logic to be found there at all.

So Tony, here's a fair question.

You have to pay taxes and don't mind paying taxes, that's fine.

What would YOU want to see from your tax dollars?

Why do you say I said something I never said?

I've paid into the system to the tune of almost half a million dollars over the last 30 years... Even with the economic downturn, it's still over double that in value and still increasing. It's MY money that's going to be paying MY costs, not anybody else's.

Now you are equating paying your taxes to saving up for OAP social scurity?

Don't you pay social security off of each paycheck already?

Are you expecting a big payout when you're 64, like an RRSP cash in?

That money is spent, gone done no longer exists, what did you get back out of it? nothing.

[i]Americans are so divided, nobody cares about anyone but themselves, especially when it comes to their money.[/i]

They just have to mean something to me...

Yes, Americans ARE divided... between those who thinks their mere existence entitles them to leech off other people, and those who thing people are responsible for themselves.

And yes, it is my money... I earned it, and I should have every right to determine where it goes. I had the foresight to sock away one third of my earnings for my family's future. It is grossly unfair to expect me to use those monies (that I was already taxed on once!) to support anyone except who I CHOOSE to support. Anybody trying to take that away from me unjustly is going to have to kill me first, I guaran-fuggin-tee it!

I do not currently pay into social security. I pay into Ohio's public employee's retirement system, and my wife and I pay 1/3 of our net earnings into a private account. We DID pay in, and my wife still does, but since Social Security is means tested, we'll never see a dime from it.

Now your fear is that they will take your savings away and spend it on someone else?

You paid tax on it, and gained interest on it, well done. In Canada that is called banking and saving (something I need to get much better at myself).

The government doesn't take my savings away and give them to others though, if I were you I'd run for the border, talk about getting screwed over.

But what about all yoru tax money you've paid fo r30 years? When do you get anythign otu of that? 64 you get social security, OAP? So what, that's not a return, especially when yuo could have added medical coverage ot that OAP too and still paid the same amount of taxes.

What you seem to be missing is that wihle you protest "socialized' medicicine, other people are already benefitting from your taxes, just not yourself, you are ripping youself off to support such a system.

You pay taxes but get no retirement benefits from them.

You pay taxes but get no medical coverage from them.

You pay taxes but get no police protection form them.

You pay taxes but get no fire protection from them.

Tell me Tony, do you get ANY benefits from paying taxes at all?

If not, why wouldn't you want to?

As for helping those who don't pay taxes, they GET benefits from your taxes already, but you don't.

Why do I say things you haven't said?

"I have no problem with expenditures that benefit EVERYONE EQUALLY. I have a problem with expenditures FOR AN INDIVIDUAL at the forced expense of everyone."

"The government should not take from ALL for the benefit of an individual, ANY individual, for ANY reason."

"I do not oppose taxation for infrastructure (including fire and police protection) and defense. "

What expenditures actually benefit everyone equally?

Military? they are saving Iraqi's from a horrible dictator (or so you are supposed to belive), they are saving SOME Americans from a possible attack but what if that attack never comes or never effects you but only harms peop ecollecting welfare? Then even the military support is unjustified.

You support the fire department, even though there is a SLIM possibilty you will need their services but they are out helping other americans, may of whom are irresponsible and burn down houses at YOUR expense.

Yo suport police, again as above, you may never need police support but you pay it for other Americans JUST IN CASE you need them yourself.

How is that different in any way shape or form to supporting a medical system?

What taxes benefit EVERYONE equally? Air tax? Even that isn't fair becuase SOME Americans get cleaner air than others.

If in order to appease you, all your tax money must be spent on the collective of America, you simply don't want to pay taxes as nothing will ever benefit every American, including the military. What about all of those people who oppose your military actions do they not get the same say as you do when their tax dollars are spent? This is where i get the impression you don't wan to pay any taxes at all, the only taxes yuo want to pay are those that YOU deem worthy and they simply don't exist.

Hoping for a cash back settlement one day that ALL Americans will get too?

No taxes benefit everyone, its just a matter of paying into services in case you happen to need them one day, just like military, fire and police services. You have been very lucky to have no medical issues for teh last 30 years and I don't wish any harm to you either but what happens if heaven forbid, you are all of a sudden diagnosed with diabetes? (thank Canada for inventing insuilin)
What if you are suddenly diagnosed with Colon Cancer, or heart disease or a brain tumor, will you start paying for medical insurance then?
Or will you be left wondering why you didn't support a system that could have kept you alive?

It's utter nonsense, Tony.

You want what's best for you today, screw the rest, and when you need something it better be there for you and someone else can pay for it even though you didn't support it for the last 30 years.

That 30 years of saving to help your family is vey nobel and I applaud you, seriously, I wish I could sock away money too.

But what about if Tony get sick in his senior years, before OAp kicks in? What if you are 58 and diagnised with heart disease and need 1 million real quick?

You probably have set yourself up enough that you will have the assets and equity to pull it off, which again I applaud in these most trying times. But then what happens to all your savings you have put away for others?

At no additional cost to you, you could have been covered in such a situation.

It reminds me of the old telecom deregulation objection.

"Sire, you are a Canadian that is paying an Americna monopoly the highest price possible for your long distance and local line services. the government has mandated that Canadian carriers must offer you a better price and in order to ensure that, Stentor has been blocked form price reduction, they cannot threaten lack of service if yuo choose another provider, they cannoto POSSIBLY charge you less than the same service, with the same lines being carried by a Canadian company."

'Well I think I'll stay with the American owned monopoly and pay more by choice. I prefer to have m money go to another country to support their infrastructure instead of my own'

You are making a concious choice to not benefit from your tax dollars yourself, meanwhile everyone you oppose getting your tax dollars already gets them.

[i]You are making a concious choice to not benefit from your tax dollars yourself[/i]

Having emergency services on standby IS a benefit to me. So are having highways available. They're available to everyone, so I have no problem paying for them.

[i]meanwhile everyone you oppose getting your tax dollars already gets them.[/i]

And I will continue to speak out against those I think should not be the government's job to provide. If enough others join me, we can effect change. Then you can bitch about how cold a nation we've become, but your voice will fade away into obscurity, because we'll be able to help our neighbors help themselves far more effectively than a government ever could.

Socialist methods are old-school dinosaurs. They don't work. They create dependency and disenfranchisement where a hand up was all that was needed. They cannot work except by dragging some down to lift others up. They use up the capital they started with until they completely break the will of the citizens to create more. Then people will be equal alright... equally miserable!

Democracy is little better. People learn pretty quickly that they can vote themselves things at the expense of others, and some learn to use this to pit one group against another. Pretty soon, everyone is the victim of someone else's selfish vote, and they vote in a way that restricts "the ones who did it to them".Eventually the nation will deteriorate, once again, into equal misery.

We need something better... Something that does not violate a person's individual liberties unjustly. Something that promotes pulling people up without dragging others down. Something that dissolves boundaries (political) that inhibit personal growth and achievement and denies them liberty and opportunity(why, because of their mother's physical location at the time of their birth?). I don't know exactly what it is yet, but it ain't on planet Earth right now, so all I can do is play the cards I've been dealt... discarding the bad cards whenever I can and hope the new ones are better. Some day I, or someone else, will get the right hand, show it to their friends and neighbors, and we'll soon be on our way.

I always thought it was an issue with the dust that keeps being brought in by spaceships from planet Zolkate. Once the great ruler of Namboza gets his act together and sends one of his four armed warriors out to defend Earth from Zolkate's rebels, we may just have a chance at relaunching the HL3400 to block their approach from the Begadon sector.

Then again, we can focus on reality and now instead. Don't bother Tony, I'm done with your insane, symantec argument.

Once they've taxed the creation of wealth to the point where less and less of it is being created, they're going to start on existing wealth. It's already starting... even though home values have plummeted, property taxes continue to increase.

The basic difference between us: You think you have the right to something you didn't earn!

Well pal, even your first breath required you to expend energy!

Taxes, I PAY for what I get, you just seem to pay and get nothing for it.

Do you send JCPenny a check each month for nothing too?

[i]Tell me Tony, do you get ANY benefits from paying taxes at all?[/i]

I have streets to drive on, emergency services available, clean water, and someone to pick up my garbage just for starters.