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Everyone is target of NSA – Snowden says

This seems like a movie – a lone person tries to tell the truth and big corporations and or a government make him/her to be the evil one – the traitor. In the name of “national security” anyone anywhere at anytime can be detained and targeted.
From what i have read, negating all the rhetoric in the news media and what our government is saying, i am confused as to exactly WHAT secrets this person snitched/stole? It seems after you remove all the misinformation, that he leaked that we are spying on China and that he NSA is recording EVERYTHING we say and do – even to Americans.

This is worthy of such a manhunt? Something is amiss here. We know our government is intercepting, storing and analyzing ALL our communications – this is evident by the massive data center being built i Maryland and the current “buzz” going around – so again, what secrets did this person reveal other than state the obvious – our government is spying on us and other countries?

Perhaps its the fact that its now clear that all our communications under this administration are under scrutiny – against the constitution, without oversight and without the constraint of our country’s laws. Socialism at its best – this begets several questions: 1) If the data is needed in a legal case, can we ask the government for it? If so, than NOTHING is private anymore privacy is a thing of the past. 2)If our government can and is recording all our communications, can insurance companies gain access? 3) can our government use this information against us, the people, without advising us of the information garnered? 4)What happens if we are “flagged” incorrectly? can we get off the “list”

I am the first to say whatever we need to do to protect our country – however, history tells us to be “wary” of government made national “crisis”, government made feeling of insecurity and governments stating “its a national security threat” – many have fallen to socialistic and tyrannical rule by these dangerous environments where slowly our constitution is bypassed and eroded – all in the name of national security.

Our founding fathers adopted the constitution to restrain government of such acts – they knew better than us by being English and under the influence of a king. History always repeats itself when we choose to ignore it or don’t have the will power to stand up to status queue. Look to NY where Weiner is running for mayor – we forgave him? I certainly did not – what makes us so sure he wont continue his poor behavior in office and than with unlimited power?

Leopards do not change their spots, people cant change people and certainly power corrupts and absolute power corrupts absolutely.

I am unhappy with the focus, direction, negation of our constitution and environment this country is moving in. WHEN THIS FOLLY ENDS!!!!!!!!

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A solution to the fake “health care crisis”

Up late last nite contemplating my existence in the world and its far reaching effects on mankind, i was greeted by a commercial that attracted my attention. It seems lately a large push in lawyer commercials advocating suing doctors for every procedure known to modern man. “if you ever had a headache and took an aspiring – – call today for compensation”. Well, what caught my attention amongst the sea of such gibberish, was 1 add advertising injuries from DaVinci robotic surgery’s. The DaVinci is a robot, that’s guided by doctors in performing specific surgeries. It supposed has higher precision and is more sterile to advocate some of the many benefits of the technological wonder. Having used one of these in a test setting at several medical shows, I can see the benefits of such a system for the military for tella-presence surgeries and understand the claims of how it can improve patient outcomes in specific surgeries. The system is relatively new, expensive an donly a select number of hospitals have it as of today and few surgeons are trained on its use – today. I see this field growing as its benefits and perhaps negatives are quantified as more patients go through the procedures.

Now back to this commercial – the Da-Vinci is NEW – yet, there was a commercial advocating people that if they had complications from surgery related to the Da-Vinci, they can call and get compensated. Anyone telling me i can be paid money for complaining will definitely get me to complain – Greed at its highest level! There are limited to no statistics on the machine – hence how can they advocate suing for its use?

Because they know hospitals and insurance companies will simply pay than fight. The true crisis are the lawsuits and massive ridiculous payouts given. Insurance companies are making too much money, lawyers are making too much money – all at the expense of US! the patients and the country as a whole. There is no crisis.

I suggest a social experiment – lets forgo any insurance for doctors – all doctors are capped at $50,000 limits. Lets limit attorney compensation packages to 5% of the winnings. Lets outlaw any commercials advocating suing any medical establishment or person. Lets perform this for 12 months ad run the numbers. You will see a dramatic decrease in the cots of doing medicine.

Of course we cant do this – because insruance companies and lawyers have too much political power – sheldon silver anyone?

What we need are more of these 12/24 month social experiments and watch the numbers yo will be suprised how many people will scream because their endless supply of MY/OUR money dried up.

I would not want to manufacturer any medical device or drug in this country  – why shoyuld i be sued? The downside of all this? Higher costs of medications (thast why we made purchasing drugs from other countries such as Canada illegal – because they are the same drug from the same manufacturer BUT not imposed with the same overhead of the US), stiffing innovation and a decrease in the so called “quality of care”

There is no health care crisis – its a government made problem with a great buzz word “crisis”
so they can tax us into submission – someone prove me wrong
When this folly ends

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Changing how doctors think to sell medications

[preamble]Obesity is a disease – hence doctors have to change their doctoring to advise patients to take diet drugs to lose weight – forget about will power or working it off or any other healthy life style change. No my friends what we see here is a method of putting people on drugs and keep them on them. Might sound crazy but while i do like the benefits of these drugs for specific people, it should not be a panacea for this new “obesity disease” we can see insurance companies “advising” their client that they must take the drug to maintain their insurance. – it will happen!

Why are these drugs so expensive? $150 a month? come on on! Phentamine on the market is $30 for 100 pills – well over 3 months supply – again money money monmey

The drug companies and other backers of the drug make the case that since obesity contributes to numerous other ailments like diabetes and heart disease, use of the pills to lower weight might actually produce a net savings for insurers, patients and Medicare.
Only about one-third of Americans with private insurance have coverage for the drug, but often with co-payments of $50 a month or more. People without coverage will pay at least $150 a month.


Few Signs of a Taste for Diet Pills

By Published: July 1, 2013
New York Times

Americans spend tens of billions of dollars each year to lose weight — gym memberships, Weight Watchers and other programs, operations, nutritional supplements and whatever the latest diet fad might be.

But the first new prescription weight-loss drug to reach the market in 13 years is having a hard time winning even a tiny slice of that huge market, despite an apparent need.

Sales of the drug, Qsymia (pronounced Kyoo-sim-EE-ah), have been minuscule since it went on sale last September. Sales totaled only $4.1 million in the first quarter of this year, even as Vivus, the manufacturer, spent $45 million on marketing, sales and administrative expenses.

Vivus’s stock price has plunged to $12.41 from $29 on the day after Qsymia was approved last July. And the company’s largest shareholder, saying the drug’s introduction was horribly botched, is battling to oust the entire board and top management at Vivus’s annual shareholder meeting on July 15.

More than a corporate drama, however, the slow start of Qsymia raises questions about what role prescription drugs really can play in combating the nation’s epidemic of obesity.

While there are some problems unique to Qsymia, it is also facing barriers that are likely to confront other weight-loss drugs as well, including Belviq, a drug from Arena Pharmaceuticals and Eisai, that went on sale last month. Another drug, Contrave from Orexigen Therapeutics, is in advanced clinical trials.

These obstacles include lack of insurance reimbursement, modest weight loss, safety concerns, the troubled history of diet drugs, and a feeling on the part of many doctors and obese people themselves that excess weight is a lifestyle issue best addressed by more willpower, rather than a disease that requires medical treatment.

“You’ve got this turning of the battleship to change how the medical community views obesity,” said Dr. Barbara Troupin, vice president for scientific communications and risk management at Vivus.

The attitude is turning at least a little. Last month, the American Medical Association, the nation’s largest group of doctors, declared obesity a disease. In April, the American Association of Clinical Endocrinologists included weight-loss drugs in its diabetes treatment guidelines.

Given that one-third of American adults are obese and another third merely overweight, an effective and safe diet pill would seem like the path to instant riches. Jack Lief, the chief executive of Arena Pharmaceuticals, said in 2009 that sales of obesity drugs could eclipse those of statins, the cholesterol-lowering pills like Pfizer’s Lipitor, which had peak annual sales of about $13 billion before falling to generic competition.

Yet no prescription drug for obesity has ever reached annual sales of even $1 billion, the lower boundary of what the pharmaceutical industry considers a blockbuster.

While it is estimated that more than two million people take weight-loss drugs, the vast majority using the old generic appetite-suppressor phentermine, that is still only a tiny fraction of the 70 million or more obese adults.

And patients typically give up on the drugs quickly. An analysis of prescription data by the Food and Drug Administration found that only one quarter of people kept using a drug for at least three months, and only 10 percent for at least 180 days.

One reason is that many people don’t lose much weight. The clinical trials showed that those taking the recommended dose of Qysmia lost an average of 7.8 percent of their weight after a year. At that rate, a 250-pound person would end up at about 230 pounds.

Some people can do better than average, however. Marty McNamara, who started taking Qsymia in November, said he had dropped from 424 to 332 pounds as his appetite has virtually disappeared. Mr. McNamara, a 6-foot 5-inch highway maintenance worker from Ridgecrest, Calif., said he now eats only fruit for lunch.

“It’s amazing, because I like food,” he said, but quickly corrected himself. “I used to like food.”

Diet pills have been plagued by safety issues that have marred the image of the class. Two drugs used as part of the popular fen-phen combination were taken off the market in 1997 for damaging heart valves. In 2010, Abbott’s Meridia was withdrawn after a study suggested it might raise the risk of heart attacks and strokes.

Neither Qsymia nor Belviq has won approval in Europe, in part because of safety concerns. And Consumer Reports advises people to skip what it calls “quick-fix weight-loss drugs” because “their benefits are usually minimal and their adverse effects can be troublesome.” It urges people to lose weight the tried-and-true way, by dieting and exercising.

The main safety concern with Qsymia is that it might cause birth defects. For that reason, the F.D.A. required that the drug be distributed through only a handful of mail-order pharmacies, a cumbersome process for doctors and patients. Recently, however, the agency agreed that qualified retail pharmacies could also dispense the drug. Vivus said on Monday that Qsymia was now available through 8,000 retail drugstores, removing a major barrier to sales.

“I feel we have been held in check driving around the pit lane, without being able to go out and put this formula racecar to the test,” said Peter Y. Tam, the president of Vivus, which is based in Mountain View, Calif.

But there are still other roadblocks. Medicare Part D does not cover weight-loss drugs, although a bill was just introduced to change that. Only about one-third of Americans with private insurance have coverage for the drug, but often with co-payments of $50 a month or more. People without coverage will pay at least $150 a month.

“Most people don’t find that amount of money is worth it for that amount of weight loss,” said Dr. Ethan Lazarus, a weight-loss specialist in Denver. Dr. Lazarus said that only about five of his 600 active patients were on Qsymia.

Qsymia is a combination of two generic drugs, phentermine and topiramate. Dr. Lazarus said he sometimes prescribed the two generic drugs, which can cost as little as $40 a month.

The drug companies and other backers of the drug make the case that since obesity contributes to numerous other ailments like diabetes and heart disease, use of the pills to lower weight might actually produce a net savings for insurers, patients and Medicare.

Because of the cost and cumbersome distribution system, when Qsymia first went on sale, as many as 30 percent of the prescriptions were abandoned before being filled.

To counter that, Vivus is now offering the first two weeks of Qsymia free and is limiting out of pocket costs to $75 for the next month. It hopes that by the end of the first six weeks, people will have started to lose enough weight to stay on the drug.

Terri Baker of Houston is approaching that point now. Ms. Baker said she had not lost any weight yet, but said the drug made soda taste flat to her, allowing her to break her soft-drink habit. She plans to give the drug some more time, even though it will now cost her $150 a month.

“I really want to try this,” said Ms. Baker, who is 52 and weighs 200 pounds. “Nothing else has worked.”

Another problem for Qsymia is lack of resources. Vivus has only 150 sales representatives, far too few to reach primary-care physicians. Its disgruntled biggest shareholder, the First Manhattan Company, says one of Vivus’s biggest mistakes was not to enlist a big pharmaceutical company to help it sell the drug.

Vivus executives say they planned to target mainly endocrinologists first, but are now talking with larger pharmaceutical companies. They also say the company plans to start direct-to-consumer advertising in the fall.

Meantime, the company saysthat its strategy is falling into place, with retail pharmacies coming on line and organizations like the Veterans Health Administration and pharmacy benefits manager Express Scripts agreeing to pay for the drug.

Qsymia had been prescribed by 15,000 doctors to 40,000 patients as of the end of March, the company says, but prescriptions have risen since then.

Replacing the board with First Manhattan’s slate, it argues, would only “throw Vivus into turmoil at a critical juncture.”

First Manhattan, which owns 9.9 percent of Vivus, disagrees, saying in one letter to shareholders: “The light at the end of the current ‘stay the course’ tunnel is an oncoming train.”

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The beginning of the end for ACO’s

[preamble]”Many hospital systems don’t have the information technology to track both patients and reporting measures — elements that CMS requires of pioneer ACOs, he said. Also, patients in ACOs are free to seek care outside that network, making it difficult for providers to remain clinically and financially responsible for those patients.”

– if patients can seek help outside the network, what happens if all in area ar eIN the network and we don’t want it? than we are forced into this shared savings where my health is cost controlled – i pay for quality service and my choices are now limited

“What they’re really trying to do is improve the quality of healthcare,” Fleming said. “They’re trying to get everybody away from the overall way medicine is practiced today, and that’s in silos.”

– NOT the problem – they keep stating “quality of care” but no one knows what that means – again define exactly what “wuality of care” means? they cant – because what it means is LOWERING THE COST OF CARE! which means less care and less service – that’s what this means.

“Only one of the 33 measures are based on cost savings or resource utilization. Meanwhile, the programs are judged harshly on their ability to save money. Many measures are screenings and preventive efforts, which generally save money only in the long run while driving up costs in the short term.”

That’s right – “harshly” because that’s what it is – save money or else!
this is bolstered by the attitude and nature of the ACO’s. at a recent seminar regarding these ACO’s in Atlantic City that i Attended, a NJ ACO spokesman clearly stated that doctors will watch each other and report on each other if they over spend – this sounds like socialism. The reference is justified in that the state is in complete control and others are severly punished if not in compliance as we report on each other for not following the rules.

Excuse me people – but i am paying for this service – top dollar – and i expect top dollar service not this metered sub standard care

when this folly ends – ![backtopost]

Leading ACOs Seek to Switch Models
Published: Jul 2, 2013
By David Pittman, Washington Correspondent, MedPage Today

WASHINGTON — The exodus of some of the leading accountable care organizations (ACOs) from one Medicare model doesn’t spell the death of ACOs as a whole but does single out problems, health reform experts said.

As many as 9 of 32 pioneer ACOs — the first and most advanced ACO model Medicare offers — may exit the program, according to a Centers for Medicare and Medicaid (CMS) spokesperson. Medicare couldn’t provide specifics on the numbers wanting to leave the pioneer program or reasons why they want to leave.

The news sent “shock waves” through the ACO community, Ken Perez, director of healthcare policy at MedeAnalytics in Emeryville, Calif., said, because these were the most prepared organizations to handle becoming an ACO and at the forefront of health reform.

“If they can’t succeed, how can the smaller ACOs who don’t have their advantages succeed?” Perez said to MedPage Today in a telephone interview.

However, the accountable-care model will still survive — just with different lessons learned, Perez and others said.

The pioneer ACO model is one of three ACO programs Medicare offers, but it’s the one with the most risk as well as the most upside. Like with other ACOs, the networks must achieve cost savings and hit quality targets to win bonuses from Medicare.

The shared savings model is the most popular and offers no financial penalties for the first 3 years. The pioneer model is more demanding and enforces penalties far sooner. Some of the 32 pioneers have indicated they are leaning toward becoming a shared savings model.

“We’re encouraged that these systems want to continue in these programs that promote better care at lower costs,” a CMS spokesperson said. “We fully anticipated that as these programs get up and running, some groups would shift between models. ”

The third — and least popular — ACO model is an “advance payment” model in which ACOs will be selected to receive advance payments to help themselves get established, with the money to be repaid from future shared savings.

Forney Fleming, MD, professor of healthcare management at the University of Texas at Dallas, said the pioneer program was established to allow large integrated systems like the Mayo Clinic in Rochester, Minn., and Scott & White in Temple, Texas, to participate in an ACO model. They have generally shunned the program as being too burdensome in regulations.

“Some of them (the current pioneer ACOs) are coming to the exact same conclusion as the Mayos and Scott & Whites … that it’s government top-heavy and they can put together their own system without all those government regulations,” Fleming told MedPage Today.

Many hospital systems don’t have the information technology to track both patients and reporting measures — elements that CMS requires of pioneer ACOs, he said. Also, patients in ACOs are free to seek care outside that network, making it difficult for providers to remain clinically and financially responsible for those patients.

“I think the big problem is how onerous are all the various requirements in order to get these bonuses,” Fleming said.

The failure or lack of success of the pioneers may be OK for CMS, since the ACO program can still accomplish its goal of moving healthcare toward a more integrated, coordinated system.

“What they’re really trying to do is improve the quality of healthcare,” Fleming said. “They’re trying to get everybody away from the overall way medicine is practiced today, and that’s in silos.”

This week’s news isn’t the first time the pioneer ACOs have been in the spotlight. Earlier this year, the pioneers expressed great concern over the quality measures and wanted to be judged less harshly and more like the shared savings ACOs — a request CMS rejected this spring.

“The concerns with quality measures are absolutely valid,” Perez said.

Only one of the 33 measures are based on cost savings or resource utilization. Meanwhile, the programs are judged harshly on their ability to save money. Many measures are screenings and preventive efforts, which generally save money only in the long run while driving up costs in the short term.

The best commercial ACOs — those supported by private payers and not Medicare — use a mere five or six measures, and all of them have to do with cost savings, Perez said.

The path forward is likely a model with less risk, but also less reward for hitting targets.

“I don’t foresee them leaving ACOs altogether,” Perez said of the pioneers. “There’s so much good thinking for their participation.” He said he expects a handful to leave the pioneer program, but most to stay and both succeed and “take it on the chin.”

Pioneers must decide by July 15 if they want to stay or go. At least four have started to notify providers of their intention to leave.

Dartmouth-Hitchcock ACO in Lebanon, N.H., Beth Israel Deaconess Physician Organization in Boston, Heritage California ACO in Northridge, and the University of Michigan in Ann Arbor all told MedPage Today they remain committed to the pioneer ACO model.

Presbyterian Healthcare Services in Albuquerque, N.M., said it was “still evaluating our options.”

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The Insiders: Democrats are trying to suppress the confusion and hide the cost of ObamaCare

[preamble]As i have foreseen – we are all forsaken……. We will be assimilated. Paying for a service we don’t need, paying taxes and penalties on services we don’t want. Paying the providers of these services LESS. For a president of The United States of America to state that we should pay private individuals less for their services and yet hold them accountable is socialism.

The problem with socialism is that eventually you run out of other peoples money – and when all this fails who will fix it? Our politicians have led us down this path – wait! no they have not WE THE PEOPLE have done it to ourselves – we can still vote them out!!!!!!!!!

Winston Churchill“Socialism is a philosophy of failure, the creed of ignorance, and the gospel of envy, its inherent virtue is the equal sharing of misery.”


By Ed Rogers, Updated:

I don’t know if Members of Congress will be hearing about it in town hall gatherings and other meetings back home over the Fourth of July recess, but the rolling thunder of the approaching ObamaCare train can be heard in the distance.  Smart Democrats are beginning to get frantic about the need to suppress the confusion and hide the cost of ObamaCare between now and the 2014 midterm elections.  We are just three months away from the October 1st enrollment start date and so far, nothing about the ObamaCare implementation process should be politically encouraging for Democrats.  In fact, the more people learn about ObamaCare, the more frightened they become.Right now, small businesses across America are making the final determinations on how to reduce the working hours of their employees so fewer employees qualify for the mandated, employer-provided health insurance.  Employers are also deciding whether it makes more economic sense to pay a fine to the government or pay for healthcare benefits for their employees.  What this means is that hundreds of thousands – and perhaps even millions – of Americans will learn that they are being dismissed from their employer’s healthcare coverage.

The healthcare pink slips will start raining down in late summer and early fall.  This will push people into the healthcare exchanges, where, in some cases, people will be writing health insurance checks for the first time.  And in many cases, people will be facing increased health insurance costs, particularly if they are young and healthy.  The negative effects on personal income and the overall economy will be undeniable.  Sometime next year, before the elections, the penalties associated with not having or providing health insurance will begin to pour in.  Will the fines come in the mail?  Will you be able to appeal?  What happens if someone doesn’t pay?  No one knows.  Or, no one who knows is talking.  The consequences of ObamaCare are being hidden.

Today’s Wall Street Journal article, “Health-insurance costs set for a jolt” hints at the debacle that is to come.  At some point soon, it’s going to be undeniable that ObamaCare is nothing but another federal entitlement, where those who are young and healthy bear the direct cost of subsidizing those who are not.

In midterm elections, those who vote tend to be more engaged voters. In other words, these voters will notice if they have health insurance that is more expensive but offers less coverage than what they had before ObamaCare. Some of the Democrats’ reactions will be predictable, i.e. blaming Bush and blaming Republicans, or for a while, denying the obvious. But that won’t work forever. One of the worst sins you can commit in politics is to say something that’s different from what people can see for themselves. There is no chance that Obamacare will perform as promised and when it doesn’t, voters will be looking for relief.

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Christine Quinn – proposes limiting calories to children at fast food chains

I told you this was coming – a mayoral candidate, Christine Quinn, wants to limit the number of calories (650 or so) to children at fast food chains. The ever tightening noose of our government – Don’t say you were not warned. Obesity is NOW a disease – hence it MUST be controlled by the state.

We cannot be this naive can we? Gone are families responsibility to take responsibility and manage their lives and children – leave it to the state! The state feeds them – did you know we supply FREE meals every day? – we house them, we give them spending money, and now we CONTROL how much they can eat and what they can eat.

It is only the beginning

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Its all still folly


Silver is still in office
Weiner has been forgiven
Brooklyn Hospital and others sink deeper in dept
Obama care is a complete disaster
The economy is in shambles
We are all fat
Interest rates continue to rise
Gas prices continue to rise