America Is Exceptional in Its Political Divide

[Ron Wagner + 663]

8 hours ago, Polyphia said:

And when you look at particular subareas of healthcare, the US is abysmal. For example, from the 2020 WHO report, the US ranks 55th in maternal mortality in the world, which is the worst of any developed nation.

Medical care is available to all and it is up to them to go and get it. Unfortunately many immigrant and minority groups in America do not bother to take care of themselves and don't get what is needed. Many are not used to getting early care but instead wait until it is too late. What can be simpler than getting prenatal care? No woman should be that ignorant. They have nine months to worry about it. All they have to do is show up at a hospital. Our hospitals are not allowed to just turn people away. We just got 10 MILLION illegal immigrants in, thanks to Joe Biden. How many illegals did you get in last year???

My wife is a retired nurse practitioner and used to have hours at home doing stupid computer work without pay for all the extra hours. She would have made the same hourly amount as an RN but would get paid for every hour. I am a retired psychiatric RN, MA nurse and, after I left, they had to close the unit because it always lost money. It is a Catholic Hospital and serves all to the best of its ability, but the State and Federal governments do not pay Christian hospitals for the extra work they do with the poor. So, they are forced to provide less care. 

Medical care should be, and is, a top priority in government but there is not enough money to go around. Every student should be given the opportunity to attain some level of medical knowledge for their own family and their community. It is not rocket science, but requires a lot of study and experience. It starts with learning to be a nursing assistant, LPN, RN, Nurse Practitioner, Physician's Assistant, or Physician. It takes so long to become a physician that many do not want to pursue that occupation. The work, at all levels is difficult, with few exceptions. The education should be free, up to physician. There needs to be an easier way to for nurse practitioners and physician assistants to become full fledged physicians. They do pretty much the same work for far less pay. The ratio of numbers of N.P.s and P.A.s is eventually going to surpass physicians. 

[TailingsPond + 543]

1 hour ago, Ron Wagner said:

Medical care is available to all and it is up to them to go and get it. Unfortunately many immigrant and minority groups in America do not bother to take care of themselves and don't get what is needed. Many are not used to getting early care but instead wait until it is too late. What can be simpler than getting prenatal care? No woman should be that ignorant. They have nine months to worry about it. All they have to do is show up at a hospital. Our hospitals are not allowed to just turn people away. We just got 10 MILLION illegal immigrants in, thanks to Joe Biden. How many illegals did you get in last year???

 

Epic stupidity.

Why do women avoid prenatal care? $$  Simply too expensive.  They also do not have "nine months to worry about it."   Real prenatal care begins before conception.  It should start with family planning (including contraceptives, etc.), cessation of smoking, alcohol, and some medications / drugs, vitamin supplementation, counselling.

Biden didn't cause your problems nor did the minorities. No convicted felon is going to make it better either (he had his chance and failed).

"Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!"

 

Edited June 13 by TailingsPond

[turbguy + 1,484]

2 hours ago, Ron Wagner said:

Medical care should be, and is, a top priority in government but there is not enough money to go around.

Someone in power to change things actually said:

"Just two more weeks for a plan to replace the ACA act" (or something like that).

About 4+ years ago...

While it is understandable for many to opine "Why should I foot someone else's medical bill if they don't take care of themselves?",  it is still The Lord's command to do so, no?

Perhaps if it were possible to cut out most of the "middle men" and laborious "paperwork" associated with medical care, the cost just might go down...

I think the Health Insurance industry would have a problem with being dissolved.

What would Jesus do?

The insurance industry is like the Money Changers in the Temple.

They just "work" in Hospitals, Clinics, and Doctor's Offices instead.

Thank you, John McCain.

That's my view.

[TailingsPond + 543]

9 hours ago, turbguy said:

While it is understandable for many to opine "Why should I foot someone else's medical bill if they don't take care of themselves?",  it is still The Lord's command to do so, no?

 

Well their medical bill might be your fault if you release a bunch of coal pollution.

For all have sinned and fallen short of the glory of God.

[turbguy + 1,484]

15 hours ago, TailingsPond said:

Well their medical bill might be your fault if you release a bunch of coal pollution.

For all have sinned and fallen short of the glory of God.

I'm guilty!

Since I retired from that industry, EVERY SINGLE COAL-FIRED UNIT that I installed and maintained, has been retired (or converted to synchronous condensers).

Yet, somehow, the lights seem to stay on...

[specinho + 444]

On 6/13/2024 at 10:22 AM, TailingsPond said:

Epic stupidity.

Why do women avoid prenatal care? $$  Simply too expensive.  They also do not have "nine months to worry about it."   Real prenatal care begins before conception.  It should start with family planning (including contraceptives, etc.), cessation of smoking, alcohol, and some medications / drugs, vitamin supplementation, counselling.

Biden didn't cause your problems nor did the minorities. No convicted felon is going to make it better either (he had his chance and failed).

"Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!"

 

 

On 6/13/2024 at 11:55 AM, turbguy said:

Someone in power to change things actually said:

"Just two more weeks for a plan to replace the ACA act" (or something like that).

About 4+ years ago...

While it is understandable for many to opine "Why should I foot someone else's medical bill if they don't take care of themselves?",  it is still The Lord's command to do so, no?

Perhaps if it were possible to cut out most of the "middle men" and laborious "paperwork" associated with medical care, the cost just might go down...

I think the Health Insurance industry would have a problem with being dissolved.

What would Jesus do?

The insurance industry is like the Money Changers in the Temple.

They just "work" in Hospitals, Clinics, and Doctor's Offices instead.

Thank you, John McCain.

That's my view.

There has been a discussion on health care policy in an online course offered by WHO-UN/world bank. Someone highlighted this:

Generally, people who need medical care are :

a) infants, toddlers and their mothers

b) elderly 

c) people with rare diseases 

People whose age fallen in between are generally healthy or try to be healthy.

Most population demography charts usually have combined percentage of these three groups often less than 30% of population.

If a country has 30 million population. 30% would be 3 millions?

3 millions divided by 10 states, average patients per state ~ 300, 000 persons.

Divided by 10 districts per state, ~ 30, 000 persons.

Divided by ~10 development zones per district, ~ 3000 persons in need of care per month or 100 persons per day.

100 persons are spred out among

i) private hospitals,

ii) government hospitals,

iii) private clinics,

iv) government clinics and

v) other medicinal practitioners.

The number comes down to ~ 20 persons per setting.

Questions arisen.....

1. What is the reason a government and its health care employees are incapable to treat 20 persons per day per setting well, for free?

2. Why is there always a  shortage of medical staff, if one setting only takes care of 20 persons per day?

3. Why would they jam up government settings to make service unavailable to people in need, sometimes, targeting particular race in a multi racial country?

 

Judging from these, we could deduct that

- efficiency is lacking. The smarter modern brains in related field, make simple thing complicated.

e.g. when you have two teeth in need of repair, they make you come twice, one tooth per time, separated by weeks or months of waiting. Why? So that they will look busy every day. If everyone is idling most of the days in a month, how will sons, daughters, nieces and nephews of theirs get hired?

- poor financial planning and management by the government and officers who do not care.

e.g. import blood test containers instead of using generic ones offered by the same companies who set up production factories here. Purchased too high tech machines that no one knows how to use but neglected the need to change 486x very old computer processors that hang often for daily usages.

Etc

 

Insurance might have started as kind initiative of pioneers in western country, that livelihood of their employees, especially those involving dangerous work, would not be affected shall mishap happened.

Western training had been so stringent on work safety and quality of work produced. Mishap rarely happened. This industry becomes a lucrative field, only cash in, without the need to cash out. Smarter brains apply it to the public. Worse, persuading some governments to enforce it as policy.

People who can afford would not mind to pay, for nothing in return at the end, including saving-investment linked account that did not protect the seed/ capital money nor generate profit in investment portfolio. 

 

What they might need is not taught to memorize standard operating procedure on management level but how to work with the right ethic, right way, etc.

If do not have the heart to serve, but merely for the salary, pension and many holidays, why allow them to be there?

 

 

 

 

Edited June 14 by specinho

[turbguy + 1,484]

And then. THIS, condemming Medicare Advantage "insurance" plans:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819817?guestAccessKey=868d34eb-8ea3-4442-8a2b-10ac358bd17b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=061024

"Only 2% of FFS [fee for service] Medicare expenditures go for overhead. But MA [Medicare Advantage] insurers incur extra expenses for television advertisements, health care network management, benefit design, executive salaries, health care utilization review, prior authorization, and shareholder profits, driving their overhead up to 14% (just below the limit set by the Affordable Care Act) according to a report from Milliman on financial results for 2022)".

 

 

Edited June 15 by turbguy

[TailingsPond + 543]

On 6/14/2024 at 12:33 AM, specinho said:

 

There has been a discussion on health care policy in an online course offered by WHO-UN/world bank. Someone highlighted this:

Generally, people who need medical care are :

a) infants, toddlers and their mothers

b) elderly 

c) people with rare diseases 

People whose age fallen in between are generally healthy or try to be healthy.

Most population demography charts usually have combined percentage of these three groups often less than 30% of population.

If a country has 30 million population. 30% would be 3 millions?

3 millions divided by 10 states, average patients per state ~ 300, 000 persons.

Divided by 10 districts per state, ~ 30, 000 persons.

Divided by ~10 development zones per district, ~ 3000 persons in need of care per month or 100 persons per day.

100 persons are spred out among

i) private hospitals,

ii) government hospitals,

iii) private clinics,

iv) government clinics and

v) other medicinal practitioners.

The number comes down to ~ 20 persons per setting.

Questions arisen.....

1. What is the reason a government and its health care employees are incapable to treat 20 persons per day per setting well, for free?

2. Why is there always a  shortage of medical staff, if one setting only takes care of 20 persons per day?

3. Why would they jam up government settings to make service unavailable to people in need, sometimes, targeting particular race in a multi racial country?

 

Judging from these, we could deduct that

- efficiency is lacking. The smarter modern brains in related field, make simple thing complicated.

e.g. when you have two teeth in need of repair, they make you come twice, one tooth per time, separated by weeks or months of waiting. Why? So that they will look busy every day. If everyone is idling most of the days in a month, how will sons, daughters, nieces and nephews of theirs get hired?

- poor financial planning and management by the government and officers who do not care.

e.g. import blood test containers instead of using generic ones offered by the same companies who set up production factories here. Purchased too high tech machines that no one knows how to use but neglected the need to change 486x very old computer processors that hang often for daily usages.

Etc

 

Insurance might have started as kind initiative of pioneers in western country, that livelihood of their employees, especially those involving dangerous work, would not be affected shall mishap happened.

Western training had been so stringent on work safety and quality of work produced. Mishap rarely happened. This industry becomes a lucrative field, only cash in, without the need to cash out. Smarter brains apply it to the public. Worse, persuading some governments to enforce it as policy.

People who can afford would not mind to pay, for nothing in return at the end, including saving-investment linked account that did not protect the seed/ capital money nor generate profit in investment portfolio. 

 

What they might need is not taught to memorize standard operating procedure on management level but how to work with the right ethic, right way, etc.

If do not have the heart to serve, but merely for the salary, pension and many holidays, why allow them to be there?

 

 

 

 

All that can be answered with one word; greed.

Edited June 15 by TailingsPond

[turbguy + 1,484]

Now "Turning Point USA" is strongly promoting consumption of RAW MILK?

H5N1 strains have proven deadly for humans, with a fatality rate of +50%. That makes this type of flu among the most dangerous and deadly diseases on the planet. By contrast, the fatality rate of COVID-19 stands at just over 1%, with many of the deaths happening early in the pandemic when there was no vaccine and little understanding of how to treat an infection.

H5N1 flu is even more deadly than smallpox. 

We seem to have reached the mindset of a large part of our population, that takes in an FDA warning against jumping off cliffs, would lead to a serious mess at the bottom of the Grand Canyon.

(Gravity ALWAYS wins).

Edited Sunday at 06:06 PM by turbguy

[turbguy + 1,484]

...and then:

https://www.youtube.com/watch?v=7VG_s2PCH_c&t=3s

[specinho + 444]

On 6/15/2024 at 3:55 PM, TailingsPond said:

All that can be answered with one word; greed.

Our system was set up by the British. Everything deteriorated gradually with time... 

An author for a newsletter wondering if the United States regretted to gain independence from England. One day, out of the blue, some people in this land might be wondering the same... 

 

On unrelated matter...

Feeling regular golf ball is too small for the eyes? Here is something ultra large for the game: foot ball... 'o' The game is called foot golf.

For better or for worse... 'n'

 

[Ron Wagner + 663]

On 6/14/2024 at 1:33 AM, specinho said:

 

There has been a discussion on health care policy in an online course offered by WHO-UN/world bank. Someone highlighted this:

Generally, people who need medical care are :

a) infants, toddlers and their mothers

b) elderly 

c) people with rare diseases 

People whose age fallen in between are generally healthy or try to be healthy.

Most population demography charts usually have combined percentage of these three groups often less than 30% of population.

If a country has 30 million population. 30% would be 3 millions?

3 millions divided by 10 states, average patients per state ~ 300, 000 persons.

Divided by 10 districts per state, ~ 30, 000 persons.

Divided by ~10 development zones per district, ~ 3000 persons in need of care per month or 100 persons per day.

100 persons are spred out among

i) private hospitals,

ii) government hospitals,

iii) private clinics,

iv) government clinics and

v) other medicinal practitioners.

The number comes down to ~ 20 persons per setting.

Questions arisen.....

1. What is the reason a government and its health care employees are incapable to treat 20 persons per day per setting well, for free?

2. Why is there always a  shortage of medical staff, if one setting only takes care of 20 persons per day?

3. Why would they jam up government settings to make service unavailable to people in need, sometimes, targeting particular race in a multi racial country?

 

Judging from these, we could deduct that

- efficiency is lacking. The smarter modern brains in related field, make simple thing complicated.

e.g. when you have two teeth in need of repair, they make you come twice, one tooth per time, separated by weeks or months of waiting. Why? So that they will look busy every day. If everyone is idling most of the days in a month, how will sons, daughters, nieces and nephews of theirs get hired?

- poor financial planning and management by the government and officers who do not care.

e.g. import blood test containers instead of using generic ones offered by the same companies who set up production factories here. Purchased too high tech machines that no one knows how to use but neglected the need to change 486x very old computer processors that hang often for daily usages.

Etc

 

Insurance might have started as kind initiative of pioneers in western country, that livelihood of their employees, especially those involving dangerous work, would not be affected shall mishap happened.

Western training had been so stringent on work safety and quality of work produced. Mishap rarely happened. This industry becomes a lucrative field, only cash in, without the need to cash out. Smarter brains apply it to the public. Worse, persuading some governments to enforce it as policy.

People who can afford would not mind to pay, for nothing in return at the end, including saving-investment linked account that did not protect the seed/ capital money nor generate profit in investment portfolio. 

 

What they might need is not taught to memorize standard operating procedure on management level but how to work with the right ethic, right way, etc.

If do not have the heart to serve, but merely for the salary, pension and many holidays, why allow them to be there?

 

 

 

 

There are Christian missionaries and other volunteers around the world. Catholic hospitals used to have a lot of nuns, that is no longer true in most areas. "A laborer is worthy of his wages" Timothy 5:18

My wife and are both retired from the medical field and have two daughters that serve in that field. None of us would have been able to study for our positions and live a normal life without wages. Mother Teresa's are saints, not your average person who wants to serve and have a normal life. Medical workers generally work a lot harder and other difficult situations than most other occupations. Many physicians are leaving the field. Nurses and Nurse Practitioners are always in demand and generally overworked. 

[Ron Wagner + 663]

On 6/12/2024 at 10:55 PM, turbguy said:

Someone in power to change things actually said:

"Just two more weeks for a plan to replace the ACA act" (or something like that).

About 4+ years ago...

While it is understandable for many to opine "Why should I foot someone else's medical bill if they don't take care of themselves?",  it is still The Lord's command to do so, no?

Perhaps if it were possible to cut out most of the "middle men" and laborious "paperwork" associated with medical care, the cost just might go down...

I think the Health Insurance industry would have a problem with being dissolved.

What would Jesus do?

The insurance industry is like the Money Changers in the Temple.

They just "work" in Hospitals, Clinics, and Doctor's Offices instead.

Thank you, John McCain.

That's my view.

Many people could work in the medical field without licensure but guess what would happen in our litigious society. We have a highly controlled society, with many snares to entrap those who would like to do good things without licensures, certificates, etc. 

[TailingsPond + 543]

4 hours ago, Ron Wagner said:

 Mother Teresa's are saints, not your average person who wants to serve and have a normal life.

Mother Teresa was not such a great person according to many people.  She herself admitted to not believing in God for much of her life.

"Where is my faith? Even deep down there is nothing but emptiness and darkness. [...] If there be God – please forgive me. When I try to raise my thoughts to Heaven, there is such convicting emptiness that those very thoughts return like sharp knives and hurt my very soul.

[TailingsPond + 543]

4 hours ago, Ron Wagner said:

Many people could work in the medical field without licensure but guess what would happen

Snake oil salesman?

Edited Tuesday at 07:27 AM by TailingsPond

[specinho + 444]

On 6/18/2024 at 11:00 AM, Ron Wagner said:

There are Christian missionaries and other volunteers around the world. Catholic hospitals used to have a lot of nuns, that is no longer true in most areas. "A laborer is worthy of his wages" Timothy 5:18

My wife and are both retired from the medical field and have two daughters that serve in that field. None of us would have been able to study for our positions and live a normal life without wages. Mother Teresa's are saints, not your average person who wants to serve and have a normal life. Medical workers generally work a lot harder and other difficult situations than most other occupations. Many physicians are leaving the field. Nurses and Nurse Practitioners are always in demand and generally overworked. 

Watched a compilation of a drama series called " extraordinary doctors" yesterday.

It highlighted a few things:

1. In a total service year of 25, a senior doctor had consumed 342 bottles of glucose to sustain energy during hard surgery. 

- The colleague explained:" this means he has undertaken 342 surgical cases and saved 342 lives over the years".

Which is ~ 14 cases per year; ~ 1 per month?

- exception: rare cases involving large flock e.g. natural calamity, war, bus accident etc.

 

2. In the drama, surgical department took in only 3 outstanding interns for 2 vacancies. One of them was an autistic, or someone who closed himself up, upon witnessing the death of his sister helplessly when young. He vowed to be a surgeon and let no more casualty happen in front of him. The few who stood by his selection were equally outstanding head of departments and principal of the old upon seeing him saving a child by the road side with basic utility like alcohol, a art knife, and a tube.

During a ward round, an experienced middle age doctor in charged that day would like to discharge a patient who just had a surgery. The autistic doctor opposed it by stating the reasons.

The experienced doctor shouted at him:" Do you know your problem? You are arrogant and believe you know it all! In such a big hospital, all of us read through books you read. What makes you think you know better? All of us are experienced after years of working. How dare you to think you are better than us?" 

He insisted on discharging the patient. 5 minutes later, the autistic young graduate was found correct. The patient collapsed by the road side.

Questions raised would be:

a) there is probably no shortage of doctors.  Ten of thousands of graduates per year from private and government owned  universities.

But, they are probably not good enough to meet the  eyes of the outstanding old. No skill, no adequate ethic nor spirit to serve.

b) they are not always busy like the old days when quality was a stringent bar of entrance. They pretend so and dismiss patients hastily, carelessly. After some times, they end up doing basic duty poorly. 

Old doctors tried to be better everyday and encouraged closed friends to be equally outstanding.

Young doctors compete to find out who perform worse, yet not found out nor have the need to take responsibility and be punished.

Nurses likely the same. High in demand, yes.

Outstanding doctors and head of nurse will incline to choose the like.

But poor quality doctors or head of nurse will not choose anyone who is better. Do not want to be outcompeted. 

Doctors who choose to leave are very likely those who do not have the heart to serve but love the fancy title "doctor" nor they have skill to perform well. The sooner they leave, the better? Worse are those who can not cope but insist to stay to get by. 

So much has changed. Quality past is fading.

Edited yesterday at 05:04 AM by specinho

[TailingsPond + 543]

3 hours ago, specinho said:

 In the drama, surgical department

Medical dramas are very far off from reality. 342 surgeries over 25 years is an absolute joke.

I questioned the ~60 year old surgeon who repaired my inguinal hernia about his experience.  He reported he has done close to 5000 hernia repairs by the open technique and another 1000 repairs using modern laparoscopic techniques.  So a lot, and that is in addition to a bunch of other procedures.

Commonly a surgeon does 1-2 days per week at hospital which can entail up to 8 minor procedures or as low as one major one.  They spend another 1-2 days per week in clinic doing pre and post op care.  One day of administration work, one day on-call for emergencies.

[specinho + 444]

19 hours ago, TailingsPond said:

Medical dramas are very far off from reality. 342 surgeries over 25 years is an absolute joke.

I questioned the ~60 year old surgeon who repaired my inguinal hernia about his experience.  He reported he has done close to 5000 hernia repairs by the open technique and another 1000 repairs using modern laparoscopic techniques.  So a lot, and that is in addition to a bunch of other procedures.

Commonly a surgeon does 1-2 days per week at hospital which can entail up to 8 minor procedures or as low as one major one.  They spend another 1-2 days per week in clinic doing pre and post op care.  One day of administration work, one day on-call for emergencies.

Thank you for sharing.

I actually do not totally agree that figure given by the drama is a joke. The author would probably not comfortable to simply come out with a number. The shooting team the same. They must have investigated basic info before turning it into acceptable script?

There are many types of surgery. Some easier to perform, some harder. Government hospitals would get more cases than the private, generally. When the patients are spred over hospitals at each district, the sum is likely credible.

For example, in the old days, if the queue in A district is long, especially big city, B district has empty slot, a patient would be referred to B district for surgery. Or C, or D, whichever is available. Each district usually separated by half an hour, one hour to two hours.

But, modern smarter doctors have better idea. Not sure since when, they restrict treatment to zonal separation. Hence, if you are in A zone, you can not go to B zone for treatment. Each zone is probable 10 or 15 minutes away.

Likewise with surgery. Transfer of patients to save lives in the shortest time no longer allowed. Heavy surgical work load sharing no longer allowed. Standard operating procedure said "do less, not more". 

The worse i heard is some doctors would tell the patients:" your race go to private clinics. Government facility is for my race only."

At times, in an attempt to build a monoracial country, from multiracial, they might have overused their racial intelligence and dominance. Yet, deep down, some might have schizophrenic tendency to accuse other race for the unknown conspiracy in their imagination. Some of the leaders or people in power are so sick at times but proud to be so. 

They put an powerless innocent through so much danger and suffering because they are crazy, and do not mind to show it with friends, or in front of media.

Helpless is an understatement.

If you are awaken to your righteous sense, there would be a little anger arisen in you for the right things to be done. Send the pitiful kid some help for real before your anger loses its fight to indifference. 

 

Edited 17 hours ago by specinho

[TailingsPond + 543]

1 hour ago, specinho said:

Thank you for sharing.

I actually do not totally agree that figure given by the drama is a joke. The author would probably not comfortable to simply come out with a number. The shooting team the same. They must have investigated basic info before turning it into acceptable script?

 

It is not reasonable at all.  Like I said about two surgical days per week is normal with 1 - 8 procedures per day.  Orthopaedic surgeons dealing with routine fractures do even more, way more.  

Give a surgeon 6 weeks off for vacation or their own illnesses and that leaves 46 weeks per year of surgical work. 1.5 surgical days per week at about 8 procedures per surgical day is 552/year.  25 years x 552 is 13,800.

That figure fits well with what my hernia surgeon reported (6,000 common hernia repairs over 30 years, plus other procedures).

I once broke my finger really badly in a bicycle accident.  My hand plastic surgeon did two surgeries on me alone in one month.  The same plastic surgeon does skin grafts for burn patients two other days per week.  He does amazing work, and works a lot.

Doctors generally get paid per procedure.  If they did so few procedures they wouldn't make much money.

Edited 16 hours ago by TailingsPond

[TailingsPond + 543]

1 hour ago, specinho said:

 Government hospitals would get more cases than the private, generally.

For example, in the old days, if the queue in A district is long, especially big city, B district has empty slot, a patient would be referred to B district for surgery. Or C, or D, whichever is available. Each district usually separated by half an hour, one hour to two hours. []

Transfer of patients to save lives in the shortest time no longer allowed. Heavy surgical work load sharing no longer allowed.

 

I live in Canada.  None of that is an issue.

FYI I paid zero out of pocket for all the above surgeries with no private insurance. Zero.

Edited 16 hours ago by TailingsPond