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California Universal Health Care Bill Passes

California 2006 Health Care Financial Ruin Democrats

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#81 Themis

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Posted 19 September 2006 - 11:00 AM

View PostBroph, on Sep 19 2006, 03:56 PM, said:

^Could you clarify that "you"? I'm not sure who you're addressing and I hope it is not me, as I don't think I had implied any such thing.

I addressed SW earlier in the post and was still addressing him when I said "you."

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#82 Godeskian

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Posted 19 September 2006 - 11:21 AM

View PostBroph, on Sep 19 2006, 04:41 PM, said:

You say it does work, but do you know that everyone gets the level of care that they want

I know that in holland nobody is denied urgent treatment. I know that holland has one of the shortest waiting lists for surgery in the world. I know that the dutch pay through the nose for the privelidge of living in a wellfare state.

I'm not going to sit here and play what is frankly a stupid 'what if' game with you about specific procedures, because it's a game I can never win. If I provide evidence for one set of events, you'll just say 'but what if the goverment does this, or does that or does the other'

It works, if you're willing to pay for it, and have a medical establishment that is more interested in providing care than collecting fees.

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#83 Godeskian

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Posted 19 September 2006 - 11:23 AM

View PostThemis, on Sep 19 2006, 04:59 PM, said:

Heck, the risk pool would be huge so the "premiums" aka additional taxes would probably cost me less than individual coverage.

I don't have any statistical knowledge to cover a country the size of the US, nor do I have valid data on medical costs for the US. So you may be right, you may not be.

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#84 Themis

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Posted 19 September 2006 - 12:55 PM

For me to convert my group coverage to individual for the allowed three months would be in the neighborhood of $350 a month.  An individual policy would probably be more, so lots of folks get basically disaster coverage so they can afford the premiums and hope they can manage the fairly routine stuff out of their pockets - or credit cards.  As I am now classified uninsurable (according to my dr.), I couldn't get a policy at any price and would have to live in a state (yep, there are 50 variations on the theme, nothing national) with pool risk coverage of some sort.  No such thing in Tennessee at the moment though it's been talked about.   Fortunately my doctor is tied in with Vanderbilt and thinks I could work out a minimum payment plan with them, but if I kick off, they'd be left with a mountain of unpaid bills.  I'll have Medicare in just over 4 years, if it's still there, but that wouldn't pay charges incurred before age 65.  Two more years with the Bushies in control, so who knows?  That'll cost me $100 or so a month, plus more for supplemental and prescription coverage - theoretically I'd be on social (in)security then, but I plan to work at something as long as I'm capable.  

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#85 Eskaminzim

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Posted 19 September 2006 - 01:57 PM

If I were subjected to what the US considers, currently, 'universal healthcare', I think I would jump out of a window, and I'm saying this even though I'm not at all sure my post op cervical spinal surgery coverage will continue to be covered by my existing workman's comp claim since I'm resigning my position in a few weeks.  And don't know if my potentially new empolyer's health insurance will pick me up at all for the preexisting conditions that were prior to this damn neck thing.  

The reason private insurance companies require prior authorizations for most diagnostic tests anymore is because they've been grossly overutilized for decades.  MRIs are hugely expensive, and doctors prescribe them for sprained knees, normal headaches lasting all of one day without any other presenting symptoms, the works.  Why?  Because half the time, the doctors own a portion of the MRI facilities, and they're making money with every test done.  It's just the way it works.  Same with OB ultrasounds.  A normal pregnancy doesn't require a furking monthly OB ultrasound, but many doctors willingly do them because they'll get paid for services that aren't needed.  Expensive services.  I don't blame the insurance companies for wanting to prior authorize.  They're the ones paying for it, not us.  

The ONLY problems I've EVER had with my HMO is being illegally balance-billed by my doctor (or in one memorable case, my own hospital...the one I worked for!).  But a call to the local provider rep of my insurance company got those butt munches off my back right quick.

Government sponsored healthcare for all just scares me, especailly here in the US.  I want the government's face OUT of my business, not IN it, thank you very much.  ::shudder::

#86 Palisades

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Posted 19 September 2006 - 01:57 PM

View PostThemis, on Sep 19 2006, 09:53 AM, said:

I've always thought of insurance as legalized gambling.  Insurance companies bet you won't need it and you bet that you will need it.
That's incorrect. Insurance companies bet that the total amount they get in premiums will exceed the total amount they pay out with enough left over to cover overhead and provide a profit.

Most people who get health insurance (or any other type of insurance) don't get it because they're betting they'll need it; rather, they get insurance because while paying the insurance premiums is sapping, the alternative could be financially devastating in the unlikely event something catastrophic happens.

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If I leave my job or get fired, and don't find a new job that provides health insurance within three months, I'm uninsurable via private insurance.  What do I do then?
Get an HSA and still probably go into debt if you keep having mental therapy and cardiovascular surgery.

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And fyi, SW, I eat nutritious food, have NO sweet tooth, drink water and not sodas, use olive oil for almost anything requiring oil and have been on cholesterol meds for decades - and I STILL had a 90% blocked artery that needed a stent in March.
Arteries don't clog themselves. They get clogged because of excessive intakes of bad fats and cholesterol and insufficient exercise. You must have done one or more of these things for a prolonged period of time. Or are you telling me that people evolved in such a way that the arteries to their heart just clog up all by themselves?

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But I guess you think that I should've just had the heart attack and rid the earth of my presence if I'd been on my own.
No, I think that people shouldn't be forced to pay for your medical care. If they opt to pay premiums to the same insurance plan that you're in, that's their decision.

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Fewer employers are offering insurance; those that are raise deductibles and rates employees pay.
Because Americans aren't taking care of themselves. We have the most overweight population in the world, and we're among the sickest in the developed world. Rather than eat veggies and exercise, many Americans wait until their bodies break from self-abuse and expect the doctors to do some extravagant treatments to make things better.

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Gode, I've always said I'd be willing to pay more in taxes to make sure everyone had decent health insurance, because that would include me.
That's very generous of you considering that you'd be paying less in taxes into the national health insurance than you'd be using in medical benefits.

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Blue Cross doesn't believe in them either. You now have to get prior approval for MRI's, CAT scans and anything similar, which could result in a delay or lack of diagnosis, which could result in serious health consequences. And it's better in that everyone is covered.
Then, choose a private plan that doesn't require prior approval for MRIs if that's something you care about. Or go with an HSA if you think you're getting such a bad deal from your private health insurance. You have those options.

Edited by Solar Wind, 19 September 2006 - 02:21 PM.

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#87 Rhea

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Posted 19 September 2006 - 04:30 PM

View PostEskaminzim, on Sep 19 2006, 11:57 AM, said:

If I were subjected to what the US considers, currently, 'universal healthcare', I think I would jump out of a window, and I'm saying this even though I'm not at all sure my post op cervical spinal surgery coverage will continue to be covered by my existing workman's comp claim since I'm resigning my position in a few weeks.  And don't know if my potentially new empolyer's health insurance will pick me up at all for the preexisting conditions that were prior to this damn neck thing.

I've just had my second back surgery (my third surgery in the last six years, thanks to the long-term effects of being hit by a drunk driver on the Golden Gate Bridge back in the 70's).

I never had a problem with my HMO either - until now. And it's over such a stupid thing it ought never to have happened.

The HMO's don't do their own paperwork - they contract with local IPA's (Individual Practice Associations). When your doctor asks for approval for a service for you, your IPA is the one who sends you the approval. They're administrative paper pushers, pure and simple.

When it came time for me to do physical therapy this time, it turned out my IPA had inexplicably gone into the physical therapy business for themselves. This is already hugely weird because the people responsible for awarding and administering physical therapy contracts have awarded it to - yes, themselves! In any other business that would be considered unethical.

That was the only choice they gave me. They neglected to tell me, for example, that the physical therapist I saw after the other back surgery still had a contract with them. So I went - and they screwed me up and almost landed me back in the hospital.

So my surgeon said he didn't want me going back there (gee, no sh*t - he didn't want anybody to muck up my incredibly expensive surgery). He wrote a letter to the IPA saying so - and they said tough sh*t, that I could go to their physical therapist or no one.

I'm currently appealing to my HMO and meanwhile, I'm paying for physical therapy with the good physical therapist, because ain't no way I'm going back to see people that laid me out flat on my back for two weeks.

But guess what? The appeal takes thirty days and my return to work has already been delayed due to the damage done by these bozos. I need to be back to work by the end of October. If they diddled around long enough with the appeal and it took the full thirty days, I might cram in a couple of weeks of PT before going back to work.

I can't afford to go back to work with no PT - I work in a crazy, wonderful job, but it's physically stressful and demanding and I need to be in decent shape when I go back to work. Otherwise I end up working in a world of hurt, which is dumb.

I SO resent having my choices taken away not by my HMO, but by the people they contract with to do their paperwork. I'm on state disability and paying for the physical therapy out of my own pocket is a huge hit - but it beats the hell out of having my back wrecked.

Turns out NOBODY regulates the IPA's. There's a state Department of Managed Health Care that is supposed to oversee HMO's, but turns out that as far as they're concerned if there's a problem with the IPA it's up to the HMO that contracts with them to resolve it.

Edited by Rhea, 19 September 2006 - 04:40 PM.

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#88 Shalamar

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Posted 19 September 2006 - 05:49 PM

SW

Quote

Arteries don't clog themselves. They get clogged because of excessive intakes of bad fats and cholesterol and insufficient exercise. You must have done one or more of these things for a prolonged period of time. Or are you telling me that people evolved in such a way that the arteries to their heart just clog up all by themselves?

Actually SW you have that one fully half wrong - high cholesterol ( the major cause of clogged arteries )  can also come as much from genetics as it can from life style - and clogged arteries can come from other than high cholesterol

Edited by Shalamar, 19 September 2006 - 05:50 PM.

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#89 Themis

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Posted 19 September 2006 - 06:44 PM

Furthermore, SW, as stated I'd been on cholesterol meds for decades, my cholesterol checks were all within normal for decades - and I was PUT on cholesterol meds for high cholesterol when I was an average weight for my height, was ice skating three times a week, and not eating high fat foods, which I've never done other than the occasional splurge at Mickey D's.  Read my lips - occasional.  Less than twice a month on average.  It can definitely be genetic.

My doctor informed me that HSA's were NOT for people with chronic conditions.  We had a choice starting last year and she helped me make mine.

So take that superior attitude and (she said, risking board guidelines) put it where the sun don't shine until you've got a lot more life experience and/or an MD.  As in degree, not doctor.  You are so far off base as to be out of the stadium/park/whatever (not too good with sports metaphors!). (Yes, still addressing SW.)

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Eskaminzim:  And don't know if my potentially new empolyer's health insurance will pick me up at all for the preexisting conditions that were prior to this damn neck thing.


If your employer now has over 25 employees and your health insurance is group insurance through them, COBRA and HIPAA say that a new group plan has to take you if you enroll within 3 months, and cannot exempt pre-existing conditions from coverage as long as they were covered by your prior plan.  Google COBRA and HIPAA.

Amazing how Western Europe and Canada can pull off things this so-called greatest country in the world can't.   It's not like we don't have many countries with successful programs for example and advice.  We were happy enough to get most principals of law and democracy, not to mention language,  from the UK, but we can't follow them on health insurance or gun control.  I chalk it up to our frontier history for the individual-first attitude.  I personally prefer "the needs of the many outweigh the needs of the few - or the one."

May everyone never be in need of health care they can't afford - especially if they are US citizens, who really need that prayer.  And I don't even pray!!

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#90 Palisades

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Posted 20 September 2006 - 08:40 AM

View PostShalamar, on Sep 19 2006, 04:49 PM, said:

SW

Quote

Arteries don't clog themselves. They get clogged because of excessive intakes of bad fats and cholesterol and insufficient exercise. You must have done one or more of these things for a prolonged period of time. Or are you telling me that people evolved in such a way that the arteries to their heart just clog up all by themselves?

Actually SW you have that one fully half wrong - high cholesterol ( the major cause of clogged arteries )  can also come as much from genetics as it can from life style - and clogged arteries can come from other than high cholesterol
AFAIK, people genetically predisposed to high cholesterol can compensate by eating an even healthier diet and exercising even more.

Themis said:

My doctor informed me that HSA's were NOT for people with chronic conditions. We had a choice starting last year and she helped me make mine.
The reason HSAs don't work well for people with chronic conditions is that these people do better financially if other people pay for their treatments through insurance.

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Amazing how Western Europe and Canada can pull off things this so-called greatest country in the world can't.
Based on posts earlier in this thread and my own reading, I'm not convinced they have. Canada's health care system is notorious for waiting lists despite the U.S. picking up the tab for Canada's defense. How much worse would the situation be for Canada's health care system if Canada had to take money away from health care to pay more of the cost of its own defense?

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I chalk it up to our frontier history for the individual-first attitude.
Or the fact that the U.S. health care system works fine for most Americans.

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I personally prefer "the needs of the many outweigh the needs of the few - or the one."
I find it more likely that switching to a universal health insurance system in the U.S. would benefit the few to the detriment of the many.

Edited by Solar Wind, 20 September 2006 - 09:07 AM.

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#91 Broph

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Posted 20 September 2006 - 09:53 AM

View PostSolar Wind, on Sep 20 2006, 01:40 PM, said:

AFAIK, people genetically predisposed to high cholesterol can compensate by eating an even healthier diet and exercising even more.

SW, I have a friend who would be considered "thin", who only eats healthy food, drinks nothing but water and still has high cholesterol. He was put on medication to try to lower it, but it was doing damage to his liver and he had to stop. Meanwhile, I could stand to lose a few pounds, don't exercise as much as I should (though I walk 2 miles a day most days), don't eat like I should (though I've cut back on McDonald's food), but my cholesterol is fine.

I, too, have heard some of the stories of long waiting lines for healthcare in other countries, though. While it's a work of fiction, there is one Jack Ryan novel where he goes to live in England for awhile and his wife goes with him to continue being an eye surgeon. She's appalled at how few patients they see each day and how little her colleagues seemed to care about the patients - even going out for a drink in the middle of an operation once. Granted, it's a work of fiction, but I assume it is based on some real-life experience or stories.

#92 Themis

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Posted 20 September 2006 - 10:41 AM

SW, go get that medical degree.  You can become rich AND find out how many of your so-called medical facts are wrong, wrong, wrong.   Maybe you can treat yourself at home too so nobody else will have to chip in a penny to even maintain a facility.  Or since you seem to know everything, maybe you can do that now.  

You don't seem to believe anybody's real life experiences count for anything and everybody brings their health problems on themselves.  Tell that to my office manager who just found out her mother has brain cancer and has two months to live.  I suppose that's her mother's fault.  Tell that to non-smokers who aren't exposed to asbestos who get lung cancer.  Tell that to anyone who gets pancreatic cancer.  Tell that to life-style advocate Jim Fixx who died of a sudden heart attack.  Tell that to anyone with Parkinsons or muscular dystrophy or lupus.  Tell that to any type 1 diabetic.  Tell that to any of a million people who are diagnosed with some kind of illness they did nothing to cause.  Tell that to the mother of a Down's baby or the mother of any baby with a birth defect.  Sure, the baby caused its own problem.  Absorbing too much nutrition from the placenta, I suppose.  Bad baby.

And please don't ever have any kind of medical coverage on yourself because if you ever need to use it, somebody else might be paying for part of your care and that's totally against your principles...  

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#93 Palisades

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Posted 20 September 2006 - 10:49 AM

^ I wish people would stop making things up and claiming that I said them. If you check back through my posts, I never said that all people bring their health problems on themselves. I said that most of them do.

Themis said:

And please don't ever have any kind of medical coverage on yourself because if you ever need to use it, somebody else might be paying for part of your care and that's totally against your principles...
Actually, it would only be against my principles if they were forced to pay.
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#94 Kosh

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Posted 20 September 2006 - 01:41 PM

View PostCheile, on Sep 4 2006, 10:54 PM, said:

um why is this a bad thing?  i thought the fact that the US does NOT have universal healthcare made us "backwards" to the Europeans/Canadians/et al cuz they've had it for years?

i'm confused.  isn't this what would be BETTER for all, because all will be able to be covered instead of those without insurance paying the price?


Our health care system, hospitols Doctors and RN's are better then anywhere else in the world.


Those without insurance mostly don't pay the costs, hospitols make up the difference by charging extra high prices for everything, which in turn pushed the Insurers to change rules, and regulate which doctors you can see, how many times, what meds you  can get, and so on and so on.

I'm not sure there is a good answer here, Universal leaves a lot of systems wanting (Russia, for instance), while insurance cost go through the atmosphere.
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#95 Kosh

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Posted 20 September 2006 - 01:49 PM

Quote

Arteries don't clog themselves. They get clogged because of excessive intakes of bad fats and cholesterol and insufficient exercise. You must have done one or more of these things for a prolonged period of time. Or are you telling me that people evolved in such a way that the arteries to their heart just clog up all by themselves?

Smoking is the worst thing.

Genetic colesteral problems are real, but not so common. Most people eat/drink/smoke their way to heart trouble. There are of coarse exceptions.
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#96 Themis

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Posted 20 September 2006 - 02:12 PM

View PostSolar Wind, on Sep 20 2006, 03:49 PM, said:

If you check back through my posts, I never said that all people bring their health problems on themselves. I said that most of them do.

Bolding of "most" mine, and that is simply NOT true.

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Actually, it would only be against my principles if they were forced to pay.

If you have health insurance, even private health insurance, you are in a group of people insured by the insurance company.  As you continually point out, in that group, some are going to claim more benefits than others.  Ergo somebody may very well have to pay for your benefits.   If you think you're immune from cancer, heart problems, dystrophy, accidents, being run down by a car or many other problems that have nothing to do with what you eat or how much you exercise, you are sadly mistaken.

But you have blinders on so there's no point continuing.

Edited by Themis, 20 September 2006 - 02:13 PM.

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#97 Palisades

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Posted 20 September 2006 - 03:17 PM

View PostThemis, on Sep 20 2006, 01:12 PM, said:

View PostSolar Wind, on Sep 20 2006, 03:49 PM, said:

If you check back through my posts, I never said that all people bring their health problems on themselves. I said that most of them do.

Bolding of "most" mine, and that is simply NOT true.
Evolution would have selected against people who became chronically unhealthy even with a proper diet and frequent exercise. The body parts of the elderly eventually wear out, but that's different from what we've been talking about. Modern medical care with its smorgasbord of exotic treatments hasn't been around long enough to give the gene pool time to regress enough for poor genetics to be the primary reason why so many Americans are unhealthy.

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Actually, it would only be against my principles if they were forced to pay.

If you have health insurance, even private health insurance, you are in a group of people insured by the insurance company.
Right, but no one forced the other people in the group covered by my private insurance to be in the group. They can opt out if they don't think the premium they pay is worth the benefits and peace of mind that they get. In contrast, people couldn't opt out of mandatory national insurance.

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As you continually point out, in that group, some are going to claim more benefits than others. Ergo somebody may very well have to pay for your benefits. If you think you're immune from cancer, heart problems, dystrophy, accidents, being run down by a car or many other problems that have nothing to do with what you eat or how much you exercise, you are sadly mistaken.
Heart problems are most definitely related to diet and exercise. Cancer may well be related to diet.

In any case, the quoted point is academic since I probably wouldn't get myself treated for high cholesterol, high blood pressure, cancer, heart problems, dystrophy, and the like even assuming I ever develop one of those conditions. Something will kill me eventually. As ways to die go, heart attacks are relatively quick and merciful. Treating cancer via radiation and chemotherapy causes more pain and suffering than it prevents. Last I checked, the only thing the medical establishment did for people with dystrophy was take their money.

I have health insurance in case I break a bone or gash myself open or something like that. Considering that the health insurance is taking in $300+ per month between the premiums I pay and the premiums my employer pays on my behalf, I think that should more than cover sewing up a gash or setting a broken bone from an accident provided it doesn't happen too often. There's a small chance that some catastrophic accident might befall me in which case other people might end up paying for my medical care; however, by far the most likely case is that this will not happen, and I will not take out more than I put in. This is in contrast to people who get insurance knowing a priori that they will take out more than they put in. So twist my words to your heart's content, but my actions are perfectly consistent with my principles, and I'm using health insurance the way it's intended to be used.

Edited by Solar Wind, 20 September 2006 - 05:38 PM.

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#98 Kosh

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Posted 20 September 2006 - 03:40 PM

Quote

Heart problems are most definitely related to diet and exercise. Cancer may well be related to diet.

A good portion of people get their heart problems from the ancetors.

My mothers family had a problem, brothers,Robert, Ira, John and Jack earl all died young. The oldest was 49 (John) and Jack Earl was 34. All died suddenly, Robert and Jack in their sleep, Ira driving a car(no one was injured) and John had a heart attack while eating dinner and died shortly there after. Roberts son Bobby was in a McDonalds one morning, having the morning coffee and talking to some friends. His heart stopped, paramedics who were already on the scene managed to revive him. Doctors put a shocker in his heart, and if it stopped, he had to shock his heart. He had some other health problems, but all of them were born with the defect that killed all but Bobby, with the possible exception of John, the only one who had a regular heart attack, that we all know about.

Ira was driving, and slupmed over dead, the car eased into an embankment.
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#99 Delvo

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Posted 20 September 2006 - 03:44 PM

The contrast between the two sides' behavior here is tremendous and stark. The ones that are ganging up on SW here keep on flinging personal insults and flames, acting like he's said stuff he hasn't said, and responding to statements/questions on one subject with responses on some other irrelevant subject instead.

The pointless, unfounded hostility and personal sniping, the sleazy "debate" tactics, and the refusal to make a real, rational, serious point that addresses the actual subject or most of what SW has said, all only make that other side look like it must have no case at all.

#100 Kosh

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Posted 20 September 2006 - 04:03 PM

oops, my mistake!! Never mind!! :crazy:

Edited by Kosh, 20 September 2006 - 04:04 PM.

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