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    Friday, January 29, 2010

     

    4Q GDP Up 5.7%, Wages/Benes At Record Low

    by Dollars and Sense

    Brad DeLong thinks that the GDP reading suggests that next week's productivity numbers will be around 7%, adding yet another astonishing number to that series. This is not good news for employment; it suggests that workers can continue to be squeezed, notwithstanding all the sweat and tears of the last year.

    On the GDP numbers, here's Calculated Risk:

    Any analysis of the Q4 GDP report has to start with the change in private inventories. This change contributed a majority of the increase in GDP, and annualized Q4 GDP growth would have been 2.3% without the transitory increase from inventory changes.

    Unfortunately - although expected - the two leading sectors, residential investment (RI) and personal consumption expenditures (PCE), both slowed in Q4.

    PCE slowed from 2.8% annualized growth in Q3 to 2.0% in Q4.

    RI slowed from 18.9% in Q3 to just 5.7% in Q4.

    Note: for more on leading and lagging sectors, see Business Cycle: Temporal Order and Q1 GDP Report: The Good News.

    It is not a surprise that both key leading sectors are struggling. The personal saving rate increased slightly to 4.6% in Q4, and I expect the saving rate to increase over the next year or two to around 8% - as households repair their balance sheets - and that will be a constant drag on PCE.

    And there is no reason to expect a sustained increase in RI until the excess housing inventory is absorbed. In fact, based on recent reports of housing starts and new home sales, there is a good chance that residential investment will be a slight drag on GDP in Q1 2010.

    Read the rest of the post


    The Wages/benefits story is from the Wall Street Journal
    JANUARY 29, 2010, 4:16 P.M. ET

    Wage and Benefit Growth Hits Historic Low

    Staff Reporter of The Wall Street Journal

    Wage and benefit costs, both before and after adjusting for inflation, grew more slowly in 2009 than in any year since the U.S. government began tracking data in 1982, as double-digit unemployment weakened workers' ability to command higher pay.

    In the past 12 months, the cost of wages and benefits received by workers other than those employed by the federal government rose 1.5%, according to the Labor Department's employment cost index. In the same period, consumer prices rose 2.7%.

    Adjusted for inflation, wages and benefits fell 1.3%, after rising by 2.8% in 2008, the first year of the recession. The inflation-adjusted cost of wages and benefits at the end of 2009 stood just 1.1% higher than at the end of the previous recession in 2001, the Labor Department said.

    The Employment Cost Index measures the cost of labor independent of the influence of changes in compensation caused when high-wage sectors grow more or less rapidly than low-wage sectors. Unlike widely cited data on wages, the index includes the cost of benefits, which account for about 30% of total compensation costs.

    Before adjusting for inflation, the index rose 0.5% in the fourth quarter, slightly higher than the 0.4% increase in third quarter. "The weak labor market will help keep inflationary pressures benign," said economist Anika Khan of Wells Fargo Securities. "As such, the Federal Reserve continues to have the flexibility to keep short-term interest rates at the current level."

    State and local government workers' compensation in 2009 grew 2.4%, twice the pace of the 1.2% increases in the private sector. State and local government employees' compensation has outpaced private-sector increases for the past several years.

    Private employers' health-insurance costs rose 4.4% in 2009, after increasing 3.5% the year before. The 2009 increase, though, was the second-lowest rate of increase in more than a decade, according to the survey. The Labor Department noted that this reflects, in part, employers' reducing their contributions to employees' health insurance or switching to lower-cost health plans. It added that the data in this part of its quarterly survey weren't as reliable as the rest of the report.

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    1/29/2010 06:55:00 PM 0 comments

    Tuesday, September 22, 2009

     

    Mankiw on Statins

    by Dollars and Sense

    Orthodox economist Greg Mankiw weighed in on the health-care debate in Sunday's New York Times, with a heavy dose of cost-benefit analysis, plus a personal note about the doses of cholesterol-lowering statins he takes every day. Makiw reasons that since his daily pill costs roughly "$150,000 for each year of life saved," this shows that health care can't be equal. "Society" just can't afford to keep everyone healthy!

    Here is a nice response to Mankiw from economist Jeff Ely, on the blog Cheap Talk:
    The centerpiece of Greg Mankiw’s column in the New York Times is this paragraph about the little white pill he takes every day:
    Not long ago, I read that a physician estimated that statins cost $150,000 for each year of life saved. That approximate figure reflects not only the dollars patients and insurance companies spend on the treatment but also — and just as important — an estimate of how effective it is in prolonging life. (That number is for men. Women have a lower risk of heart disease.)

    Mankiw used the word cost but I would say that what he is referring to is price. With monopolized drugs and dysfunctional health care insurance there is a huge difference between price and cost. And with this in mind, Mankiw’s column completely misses the real economic problem exemplified by his pills.

    For a more in-depth discussion of statins and how they relate to "monopolized drugs and dysfunctional health care insurance," check out the article by Mark Hyman, MD on Why Cholesterol May Not Be the Cause of Heart Disease (on Huffington Post; hat-tip to CKS). Even though I, too, take my dose of statins every day (and I'm willing to bet that my dose is higher than Greg's!), I don't have any trouble understanding Hyman's argument: that part of the reason it is widely believed that high (LDL) cholesterol causes heart disease is that the pharmaceutical companies have developed a pill that lowers (LDL) cholesterol! In fact, as Hyman points out, the causes of heart disease are much more complex.

    Yet more evidence that it may be easier for an MD to be critical about economics and policy than it is for an economics PhD.

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    9/22/2009 09:54:00 AM 0 comments

    Wednesday, September 16, 2009

     

    Obama vs. the Lobbyists (TomDispatch)

    by Dollars and Sense

    From Tom Engelhardt of TomDispatch; a link to Andy Kroll's article follows:

    Congressman Joe ("You lie!") Wilson is undoubtedly not completely ignorant about how our health care system actually works. After all, in the course of his career, according to the Center for Responsive Politics, he's received $244,196 in contributions from the health-care profession -- and that doesn't even count another $86,150 from the pharmaceutical industry or the $68,000 that came in from hospitals and nursing homes. In fact, if you go to the page at that organization's OpenSecrets.org website on Congressional contributions and start clicking around among the members of Congress, you'll be struck by how many times the health and pharmaceutical industries (and their lobbyists) pop up.

    It's not so surprising, of course, since there are staggering sums of money at stake, which means striking amounts of the same to inject like some potent drug directly into the bloodstream of our political system. Consider but one figure: since 2002, according to Harper's Magazine, the profits of the top 10 health insurance companies have increased by 428%. And the CEOs of those top insurers have a personal incentive for ensuring that those profits don't slide due to new health-care legislation; after all, they made a combined $690 million in the last nine years.

    In fact, any administration arriving in Washington wanting to do anything these days walks into a blizzard of money, not to speak of the fact that the wind at its back, the campaign wind that got it there, was already blowing strong with similar contributions. TomDispatch regular Andy Kroll offers a vivid portrait of that world at this moment and what it means for the Obama administration. —Tom

    Read Andy Kroll's article.

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    9/16/2009 10:03:00 AM 0 comments

    Tuesday, September 15, 2009

     

    How Tort Reform Can Raise Health Care Costs

    by Dollars and Sense

    Texas has been a magnet for doctors since they enacted tort reform a few years ago. (See Doctor's Flock to Texas After Tort Reform from the Wall St Journal).

    The result? Insurance premiums have nearly doubled.

    From the Austin American Statesman:

    Insurance premiums rose 91.6 percent in Texas

    By Mary Ann Roser | Tuesday, September 15, 2009, 12:48 PM

    A national report that was released today says family insurance premiums in Texas increased 91.6 percent since 2000 - 4.6 times faster than earnings.

    The report by the nonprofit consumer organization Families USA says the rise in health care premiums for workers went from $6,638 for the average Texas family to $12,721 a year, but folks got less for their money rather than more, according to the report. At the same time, median earnings of Texas workers rose from $23,032 to $27,573, a 19.7 percent increase.

    "Our conclusion is that rising health care costs threaten the financial well-being of families across the country," said Ron Pollack, executive director of Families USA.

    The report argues throughout for health care reform, and as Pollack said, if it doesn’t happen soon, more families will be priced out of the market.

    In a report last year, Families USA said health insurance premiums grew 5.8 times faster than earnings in Texas. And this year, the growth rate in Texas is even below the national rate in which premiums grew 4.9 times faster than income between 2000 and 2009.

    Even so, Pollack said he doubted "anyone in the state will be delighted" by the results this year.

    Asked why premiums are growing so fast in Texas and nationally, the report cited four key issues:

      *Increased spending on health care. The report says that nearly half of Americans have chronic conditions, with diabetes alone costing more than $174 billion annually.


      *Lack of regulation of the insurance industry. Insurance companies can charge more, plus refuse coverage to people based on a variety of factors, including dropping or denying people because of illness, the report says.


      *A lack of competition in the insurance market. The report says in some areas, too many companies have merged, leaving consumers with too little choice. The report claims health care reform will provide more options.


      *The "hidden health tax," in which people with insurance help cover the uninsured. Last year, the portion that insurance companies charged families in insurance premiums to cover people who did not have insurance was $1,017.


      Pollack said he believes insured people would pay less to cover uninsured people under health care reform.


    Link to the study by Families USA (pdf).

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    9/15/2009 03:48:00 PM 2 comments

    Friday, September 11, 2009

     

    Baucus's Public Option

    by Dollars and Sense

    Yes, here it is (thanks to Emptywheel for bringing it to our attention):

    Health Insurance Exchange. The Baucus plan would establish the Health Insurance Exchange through which individuals and small businesses in the market for insurance could obtain affordable health care coverage. ...

    The Exchange would also include a new public plan option, similar to Medicare. This option would abide by the same rules as private insurance plans participating in the Exchange (e.g., offer the same levels of benefits and set the premiums the same way). Rates paid to health care providers by this option would be determined by balancing the goals of increasing competition and ensuring access for patients to high-quality health care. A number of options could be considered to determine who runs the plan, who is eligible for it, and how to ensure that the public-private insurance competition lowers costs and improves quality. The Independent Health Coverage Council, described below, would inform these decisions.

    This is from “Call to Action: Health Reform 2009,” put out by Sen. Finance Committee Chairman Max Baucus. The title may have you confused for a few minutes; why is everyone saying the Baucus plan has no public option? But then you notice the date on the document: November 12, 2008.

    A few interesting numbers from the current Baucus plan:

    The plan puts limits on insurance company “rating”—i.e., charging higher or lower premiums based on characteristics of the insured such as age. (The plan allows rating based on age, tobacco use, and family composition.) With the limits, premiums for the same-size family could vary by 7.5 to 1. That sounds pretty unaffordable for the late-middle-aged smoker.

    The plan defines affordability: as long as the lowest-cost plan available has annual premiums equal to 10% of household income or less, then “affordable” coverage is deemed available and the mandate to have insurance will apply—enforced by fines of up to $950/year for an individual and $3,800/year for a family.

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    9/11/2009 04:29:00 PM 0 comments

    Wednesday, September 09, 2009

     

    Whole Foods and Health Care

    by Dollars and Sense

    John Mackey, the CEO of Whole Foods (or as we call it here in Boston, Whole Paycheck), wrote a hide-bound and ideological op-ed for the Wall Street Journal last month (find it here). The first tip-off that it's going to be silly is that it calls health-care reform "Obamacare" (nothing like a little derision right in the title of an op-ed to command the interest of the readers of the WSJ opinion pages). What follows are all the usual canards of the Right's views on health care, and all their usual free-market, individualistic, deregulatory policy solutions.

    A movement has developed to boycott Whole Foods because of Mackey's opposition to meaningful (i.e., single-payer) health-care reform. The group Single Payer Action is also part of this boycott. Now would be a good time to shift over to farmers' markets and food co-ops to send Mackey and Whole Foods a message.

    Here's an interesting tidbit from the Boycott Whole Foods website: Michael Pollan, author of The Omnivore's Dilemma and other books about food and food production, has weighed in against the boycott, because although Mackey is wrong about health care, "Whole Foods is often right about food," Pollan tells us. According to the Boycott Whole Foods website, Pollan has spoken at a conference put on by America's Health Insurance Plans (the main lobbying organization for the health insurance industry), on a panel entitled "Leaving the 'Fast Food Nation' Behind: Challenging American's Attitudes Towards Personal Responsibility and Health." (The other speaker on that panel was Richard Thaler, co-author of the pop-behavioral economics book Nudge.) And he posted against the Whole Foods boycott on the website of archconservative David Frum (newmajority.com).

    Now, I don't begrudge Michael Pollan an appearance at an AHIP conference (Howard Dean also spoke on a panel at the conference), or a comment on a website "dedicated to the modernization and renewal of the Republican party and the conservative movement," as its "About" page says. The man is pretty much omnipresent, so why not in these venues? But it doesn't surprise me that he doesn't seem to get the importance of collective action. I heard a radio version of a talk he gave a couple of years ago--it was about the prevalence of corn in the American diet (via corn syrup, mostly, but also as feed for the animals that become our meat), and the history of overproduction of corn post WWII. A terrific talk--the whole time I was craving broccoli (which I don't usually care for too much), because I figured there's no way they'd figured out how to make broccoli with corn. But in the question period, someone asked him early on what we could do about this, and all he had to say was something about making good choices about what we eat, choosing to shop at places (like Whole Foods) that offer fresher food, etc. There doesn't appear to be a truly political bone in his body--for him it's all about individual consumer choice. (It reminded me of Al Gore's otherwise terrific movie, ending with rousing call for us to change our lightbulbs.) So I'm not surprised that Pollan blandly opposes this boycott.

    Joel Harrison, who wrote this terrific article for us last year, has written a point-by-point rebuttal of John Mackey's WSJ op-ed. Here are the basics; click on the links to get the details on each point.

    YES, TO HEALTHCARE FOR ALL, NO, TO MACKEY'S WHOLE FOOD CARE

    Rebuttal to John Mackey's Wall Street Journal Op-Ed, "The Whole Foods Alternative to 'ObamaCare'"

    By Joel A. Harrison, PhD, MPH | September 8, 2009

    John Mackey's editorial in the Wall Street Journal is merely a continuation of the myths propagated by the for-profit health insurance and pharmaceutical industries and the right-wing think tanks they fund. His suggestions would take us farther in the direction that has already failed.

    For this rebuttal I'll focus on the following points:

    * Healthcare IS a right in other countries. So, what does our Constitution "guarantee?" The European Union's Constitution includes Health Care as a Right. The U.S. Supreme Court ruled in 1936 that Article II Section 8's "Promote the General Welfare" applied to Social Security. Medicare falls under this ruling. Though not binding, the Universal Declaration of Human Rights, signed by the United States, includes medical care as a right. (Details and references)
    * Does health reform mean a "government take-over?" Ridiculous question but NO! Free markets do not work without rules and an independent arbiter. All Bills before Congress maintain the private sector for delivery of health care, both hospitals and doctors; but include regulations such as protection from arbitrary loss of health insurance and greater transparency. (Details and references)
    * Repealing mandates on what insurance must cover & state laws which prevent insurance companies from competing across state lines. Without some minimum national regulations and means of enforcement, companies will incorporate in states with the least regulations and enforcement, leaving consumers vulnerable. (Details and references)
    * Health Savings Accounts—Why they don't work. 80% of health care costs for individuals in the U.S. exceed $2,500 and 73% exceed $5,000, so people would rapidly exhaust their health savings accounts. Sick and injured people trust their doctors to make appropriate decisions and neither have the skills for making the decisions nor the availability of data to base such decisions on. High deductibles leads to reductions in both appropriate and inappropriate care, e.g. blood pressure monitoring. (Details and references)
    * Medicare reform and finances—Why we will not allow Medicare to go bankrupt. Medicare has done a better job than private insurance companies in keeping costs down. Medicare covers the costliest sector of our population, altogether over 43 million Americans. Private insurance would either be denied due to pre-existing conditions or prohibitively expensive. Medicare pays for all specialty residencies and subsidizes hospitals with a high proportion on uninsured. Without Medicare, besides the human tragedy of seeing our loved ones experience both reduced quality and length of life, emergency rooms will collapse under the additional strain, hospitals will close, and many doctors will go out of business. Medicare's cost cannot be separated from a health care system whose current projectory is unsustainable. (Details and references)
    * Wait times here and abroad (including emergencies)—Mackey's misleading statistics. Wait times in Canada are far better than reports given here and they are investing vast sums in improving both quality and timeliness of care. Wait times in many other nations with non-profit universal health care are actually quite good. And wait times in the U.S., especially for the un- and underinsured are worse than in many other countries and, even for those with insurance, wait times exist and are deteriorating. (Details and references)
    * Medical Liability/Tort Reform—why this won't solve the healthcare crisis. Malpractice costs are an infinitesimal portion of total health care costs. Up to 100,000 Americans die from preventable medical errors. Just five percent of all doctors are responsible for approximately 40% of malpractice suits. Truly bad doctors seldom lose their licenses. Only about 1/10th of all medical errors that cause death or serious disability lead to malpractice suits. So-called "defensive medicine" is often just an income generator for physicians who own or are invested in labs and radiology facilities. (Details and references)
    * Healthy life styles are good but don't save us enough. Many factors affect health, including genetics, air and water pollution, infectious diseases, commercial food interests targeting children, even in our schools, availability of recreational facilities, physical education in our schools, and longer and longer working hours. Healthy life styles are important; but almost everyone will sometime in their lives need health care. A healthy life-style can often delay the onset of chronic diseases and/or if ill or injured contribute to a more rapid recovery; but it is naive to believe that healthy life styles can solve our health care system problems. (Details and references)

    CONCLUSION: John Mackey doesn't know what he is talking about. In essence, he is just parroting the myths and propaganda created by the for-profit insurance and pharmaceutical industry together with their well-funded right-wing think tanks.

    I don't wish to support a platform of policies that allow private insurance companies to continue to take undue advantage of average citizens for profit, much less make it easier for them by adopting any of Mackey's ideas. I am joining thousands of former Whole Foods loyalists to redirect my dollars to support organic co-ops and local farmers' markets. I hope you will join me.

    Joel A. Harrison, PhD, MPH, lives in San Diego, where he does consulting in epidemiology and research design. He has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. He has lived and studied in both Canada and Sweden.

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    9/09/2009 09:43:00 AM 7 comments

    Monday, September 07, 2009

     

    Life Insurance Securitization

    by Dollars and Sense

    Is Obama planning to kill grandma? Probably not, unless grandma is Afghani or Pakistani, and the murder weapon is an aerial drone. Or maybe you consider capitulation to private health insurance companies in health care reform an indirect way of killing grandma, given that the true death panels are the ones convened by those companies to deny coverage to, among other people, some grandmas.

    But another industry that the Obama industry is busy capitulating to—Wall Street—has figured out another way to profit from grandma's death: securitizing her life insurance. Here's how it works, according to an article in today's New York Times: Investment banks would give policy-holders cash for their policies, which would then be securitized and bundled as "life settlements" (with fees going to the bundlers), sold, traded, resold—just the way subprime mortgages were. And there are similar possibilities for fraud and conflict of interest as with the complex derivatives that played such a big role in the current financial crisis. The most striking aspect of this new scheme, though, is that it bets against grandma: "The earlier the policyholder dies, the bigger the return—though if people live longer than expected, investors could get poor returns or even lose money."

    Hat-tip to Mike P., who points out: "The article gets better the farther you read. It's like a description of the mortgage bubble written before it happened. You can picture gangs of insurance salesmen ripping through elderly housing complexes, badgering old deaf people to sell their life policies. On the first page of the link, to the left of the article, is a fascinating graph showing that 'the market for mortgage securities has shrunk to less than a fifth of its peak size'—a picture of a bubble."

    Read the full article.

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    9/07/2009 11:57:00 AM 2 comments

    Wednesday, September 02, 2009

     

    The Empire and the Robots

    by Dollars and Sense

    From The Hindu. Fidel claims that those lacking health insurance in the United States are "mostly blacks and Latinos"—is that true? The idea of replacing Congress with robots is hilarious.

    The Empire and the Robots

    By Fidel Castro Ruz

    A short while ago I dealt with the United States' plans to impose the absolute superiority of its air force as an instrument of domination on the rest of the world. I mentioned the project that by 2020 they would have more than a thousand latest generation bombers and F-22 and F-35 fighter planes in their fleet of 2500 military aircraft. In twenty more years, every single one of their war planes will be robot-operated.

    Military budgets always count on the support of the immense majority of American legislators. There is hardly any state in the Union where employment does not depend in part on the defence industries.

    On a global level and with constant value, military expenses have doubled in the last 10 years as if there were no danger at all of any crisis. At this moment, it is the most prosperous industry on the planet.

    By 2008, approximately $1.5 trillion were invested in defence budgets. The U.S. spends 42 per cent of world expenses in this area—$607 billion—not including war expenses, while the number of people who go hungry in the world has reached the figure of 1 billion.

    Two days ago a western news dispatch informed that in mid-August the U.S. army exhibited a tele-guided helicopter along with robots capable of working as sappers, 2500 of which have been sent into combat zones.

    A company marketing robots maintained that the new technologies would revolutionise the manner of directing the war. It has been published that in 2003 the U.S. barely had enough robots in its arsenal and, according to AFP, "today it has 10,000 land vehicles as well as 7,000 air devices, from the small Raven that can be hand-launched right up to the gigantic Global Hawk, a spy plane 13 meters long and with a 35 meter wingspan capable of flying at great altitudes for 35 hours." This dispatch lists other weapons as well.

    While the United States is spending such huge figures in killing technology, the president of that country is sweating buckets trying to bring health services to 50 million Americans who don't have them. There is such confusion that the new President said that he felt he was closer than ever to achieving reform of the health care system but that the battle is becoming fierce.

    He added that the story is clear, that every time health care reforms seem closer on the horizon, special interests fight with everything they've got applying their leverage, launching publicity campaigns and using their political allies to scare the American people.

    The fact is that in Los Angeles 8,000 people—most of them unemployed, according to the press—turned up in a stadium to receive medical care from a travelling free clinic that provides services to the Third World. The crowds had spent the night there. Some of them had travelled from as far away as hundreds of miles.

    "'What do I care whether it's socialist or not? We're the only country in the world where the most vulnerable people have nothing,' said a college-educated woman from a black neighbourhood."

    According to the report "a blood test can cost $500 and a routine dental treatment more than $1,000."

    What kind of hope can that society offer the world?

    The lobbyists in Congress make their profits working against a simple law intended to provide medical care to tens of millions of poor people, mostly blacks and Latinos who lack it. Even a blockaded country like Cuba has been able to do it and is even cooperating with dozens of countries in the Third World.

    If robots in the hands of the transnationals can replace imperial soldiers in the wars of conquest, who will stop the transnationals in their quest for a market for their artefacts? Just as they have flooded the world with automobiles that today compete with mankind for the consumption of non-renewable energy and even foods converted into fuel, so too they can flood the world with robots that would displace millions of workers from their workplaces.

    Better yet, scientists could also design robots capable of governing; that way they could spare the U.S. government and Congress that terrible, contradictory and confusing work. No doubt they would do it better and cheaper.

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    9/02/2009 12:26:00 PM 1 comments

    Thursday, August 06, 2009

     

    Sick for Profit

    by Dollars and Sense

    Robert Greenwald's Brave New Films, which has produced hard-hitting documentaries like "Outfoxed," "Wal-Mart: The High Cost of Low Price," and the newly released "Rethink Afghanistan," has started a campaign to publicize health insurance industry profits and to counter the industry's campaign against reform.

    From the "Sick for Profit" website:

    Welcome to the American health insurance industry. Instead of helping policyholders attain the health security they need for their families, big insurance companies get rich by denying coverage to patients. Now they're sending lobbyists to Washington, DC to twist the arms of lawmakers to oppose reform of the status quo. Why? Because the status quo pays.

    Learn more about the glamorous lives of billionaire health insurance executives and tell us your story of being victimized by their greed...

    Watch the video, read patients' stories, and see the obscene salaries of health insurance profiteers at the "Sick for Profit" website.

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    8/06/2009 01:17:00 PM 0 comments