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  1. #2481  
    As for pricing, you can get it, but yes, it require effort. Unfortunately, people don't like to put forth effort, they want it handed to them. When I had back surgery, I called in advance and asked whether the anethesiologist was in my network....turns out no. So, I called them up directly and worked out a deal and saved 40%. This took effort, and it saved me and the healthcare system money.
    Why should anybody have to do that work? Eliminate the whole network thing. That eliminates the overhead and staff required to process claims. It also allows your doctor to treat YOU and work on your problem, rather than putting the power of treatment in the insurance companies' hands. What if the best doctor for your problem is not in your network?
  2. piaband's Avatar
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    #2482  
    Quote Originally Posted by clemgrad85 View Post

    As for pricing, you can get it, but yes, it require effort. Unfortunately, people don't like to put forth effort, they want it handed to them. When I had back surgery, I called in advance and asked whether the anethesiologist was in my network....turns out no. So, I called them up directly and worked out a deal and saved 40%. This took effort, and it saved me and the healthcare system money.


    So what are you gonna do when you break your leg and you need emergency care? do you want to call up the doctor and negotiate amputee vs cast? Cmon man. Negotiating healthcare prices is a rediculous concept. The prices should be available online, so if necessary, we can all get a feel for general prices for services rendered. We shouldnt have to negotiate. They should give the same price for everyone, insurance or no insurance.

    What gives you the right to have your health administered better or lower cost than me? Thats the only thing I see unconstitutional around here.
  3. KAM1138
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    #2483  
    Quote Originally Posted by piaband View Post
    HSA's are great.....if you make enough money for that. HSA's do nothing to lower the cost of insurance.

    Right now the only way to get insurance is

    -Be a bum. yes, bums have free healthcare provided by me and you. its medicaid
    -Be old. Medicare.
    -Have a job that provides it for you (which wont last at current rate of ins. hikes)
    -Make enough money to afford it (private insurance runs a normal person [not family] $1200/month)

    HSA's are not the answer if your goal is to provide affordable healthcare to WORKING AMERICANS making between 30,000-50,000 who dont have employee-sponsored healthcare
    Actually, they can. First, the idea is that you pay less fixed costs, because you have a higher deductible. Second, the market-driven shopping around helps to lower costs. Thirdly, if someone gets this going when they are young, and less likely to have a lot of health costs, they can build a sizable fund to pay those higher deductibles when they do need some major healthcare. Additionally, even someone making a modest wage can benefit from the tax benefits.

    The problem of ANY insurance policy being high--as it is now...well, that's true, the HSA existing cannot instantly change that, but as the WSJ article demonstrates, it pushes things the right way.

    I'm not sure what policy you are looking at that runs $1200 a month, but that is significantly higher than what my insurance costs. A while back I priced out a policy with a $2000 deductible for a 40 year old (as an example) which would be designed for an HSA and it was something around $4000 a year. Not at all insignificant, but much lower than the $14,000 or so you are talking about.

    KAM
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    #2484  
    Quote Originally Posted by clemgrad85 View Post
    Well, don't make me find the page in the 2400 page docuement, but they want to reduce how much you can put aside into HSA savings accounts. If you reduce that element, it certainly does not make the plan as attractive. So, while they don't eliminate it directly (yet), they certainly don't make it as appealing and therefore it will become less relevant.
    Sounds to me like a reasonable request that with a little negotiating would be an easy fix. Its too bad there isnt much negotiating coming from the smaller side.

    You want to scrap 2400 pages for one sentence on one page? That sounds rediculous. Im starting to see a lot of rediculous and little common sense when it comes to actually solving problems.
  5. #2485  
    Quote Originally Posted by knobbysideup View Post
    Why should anybody have to do that work? Eliminate the whole network thing. That eliminates the overhead and staff required to process claims. It also allows your doctor to treat YOU and work on your problem, rather than putting the power of treatment in the insurance companies' hands. What if the best doctor for your problem is not in your network?
    If the best doctor isn't in the network then you have a choice....yes a CHOICE.....do you pay the higher cost that will result by going out of network or do you go with another doctor who is in network and is maybe the 2nd best. But you do have the choice. You say you should be able to go to the best no matter what? Well, wouldn't everyone be going to this one doctor? Would the other doctors just switch to a different specialty? What would the wait be for getting in line for this one doctor? Hmmm, I'll go to the other doctor, get it done in network and not have to wait.

    The networks are needed to negotiate lower fees. Medicare has a "network". Not all doctors accept Medicare reimbursements. The government has made the reimbursements so low that many doctors just refuse to play with the government. I've had to make the decision to stick with a doctor or change....only one time did I stick with the doctor. But again, it was my choice.

    As for doing the "work".....well.....do you get bids when you have work done to your home or your car? Should the government come in and say that a new roof costs $3000 for a set amount of square feet of roof? We have to get past this notion that these idiots in DC know best for us....they don't.....they just want you to think they do.
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  6. KAM1138
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    #2486  
    Quote Originally Posted by piaband View Post
    How in the world is anything that is being suggested an expansion of our current system? That is a flat out lie. Or you are misinformed.

    1. We dont currently have national healthcare exchanges.
    2. We cant buy insurance across state lines.
    3. We cant do anything if an insurance company drops us the second we need to use it.
    4. Medicare advantage will be abolished. Notice I said medicare ADVANTAGE. This is an unfunded liability that will save us a lot of money.

    If you dont think that is enough, why dont you push your rep to favor the public option?
    1) True, and I'm for that.
    2) True, and I'm for that.
    3) That's why you need an impartial arbiter (not a competitor) in the form of government. You'd think that they'd focus on such straightforward reforms that people can agree on.
    4) Yes, if we dropped medicare completely we'd save a ton of money, but it doesn't mean its the best solution. I'm not specifically against this however.

    When I say that what we is being suggested is an expansion of the current system, I am referring to the fact that we will continue to have a price-fixed mess (I posted a link to an informative article) a while back in this thread I believe. There are some improvements, but it isn't addressing the heart of the issue, and that is that the free market has been blocked out, which has resulted in skyrocketing prices. There are many others issues which I agree need to be addressed, but ignoring this one is likely to lead to the same problems.

    Public Option? Sure--I'm more than happy to have the government run their own insurance company, as long as it 1) receives zero tax payer money, 2) is strictly voluntary and 3) follows the exact same rules that other insurance companies have to. That of course will not happen.

    KAM
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    #2487  
    Quote Originally Posted by KAM1138 View Post
    Actually, they can. First, the idea is that you pay less fixed costs, because you have a higher deductible. Second, the market-driven shopping around helps to lower costs. Thirdly, if someone gets this going when they are young, and less likely to have a lot of health costs, they can build a sizable fund to pay those higher deductibles when they do need some major healthcare. Additionally, even someone making a modest wage can benefit from the tax benefits.

    The problem of ANY insurance policy being high--as it is now...well, that's true, the HSA existing cannot instantly change that, but as the WSJ article demonstrates, it pushes things the right way.

    I'm not sure what policy you are looking at that runs $1200 a month, but that is significantly higher than what my insurance costs. A while back I priced out a policy with a $2000 deductible for a 40 year old (as an example) which would be designed for an HSA and it was something around $4000 a year. Not at all insignificant, but much lower than the $14,000 or so you are talking about.

    KAM

    Whats a while back? With the rate insurance premiums are going up, you are probably right. It use to be 4,000...now its 14,000/year.

    BTW - I searched everywhere for private insurance. I couldnt find any that didnt have an extremely high premium, extremely high deductible, or a yearly cap that was absolutely unacceptable. I was quoted for a policy with an annual cap of $1000. I'm not kidding.

    Maybe you arent reading all the details of your policy.
  8. #2488  
    Quote Originally Posted by piaband View Post
    Sounds to me like a reasonable request that with a little negotiating would be an easy fix. Its too bad there isnt much negotiating coming from the smaller side.

    You want to scrap 2400 pages for one sentence on one page? That sounds rediculous. Im starting to see a lot of rediculous and little common sense when it comes to actually solving problems.
    LOL....yes.....I only find one thing wrong in those 2400 pages. Good grief.

    I agree, it is ridiculous that the democrats won't negotiate.....at least we can agree on that! That ridiculous "show" on Thursday was acctually quite good for the Republicans. At least it showed the Republicans have some ideas to work on the real problem, medical costs. The democrats, or at least some of them, simply want to push something through that sets the stage for a government take over. That is the ultimate goal, because, government knows best, right?
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

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  9. piaband's Avatar
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    #2489  
    Quote Originally Posted by clemgrad85 View Post
    If the best doctor isn't in the network then you have a choice....yes a CHOICE.....do you pay the higher cost that will result by going out of network or do you go with another doctor who is in network and is maybe the 2nd best. But you do have the choice. You say you should be able to go to the best no matter what? Well, wouldn't everyone be going to this one doctor? Would the other doctors just switch to a different specialty? What would the wait be for getting in line for this one doctor? Hmmm, I'll go to the other doctor, get it done in network and not have to wait.

    The networks are needed to negotiate lower fees. Medicare has a "network". Not all doctors accept Medicare reimbursements. The government has made the reimbursements so low that many doctors just refuse to play with the government. I've had to make the decision to stick with a doctor or change....only one time did I stick with the doctor. But again, it was my choice.

    As for doing the "work".....well.....do you get bids when you have work done to your home or your car? Should the government come in and say that a new roof costs $3000 for a set amount of square feet of roof? We have to get past this notion that these idiots in DC know best for us....they don't.....they just want you to think they do.
    You just made the democrats point. Thanks. The national health exchange (what democrats want to implement) is a lot like your network provider. It offers everyday people access to affordable health plans because they are grouping together into a national plan. It offers large-group negotiating affordability the same way network providers do.

    Its not free, everyone pays into it that uses it. Just a place for people to go who dont work for a large corporation or make a lot of money.
  10. #2490  
    Quote Originally Posted by clemgrad85 View Post
    I totally disagree with this statement. HSA's force you to pay closer attention to the cost and procedures that are being advised. I know, because I have one and I have saved not only my money, but the insurance company money as well. I was being prescribed a HBP medication and the first one worked fine. I tried some samples for 3 weeks and all was good. When I asked the doctor how much the pills cost (she told me it was a new medication) she said about $85 per month. Well, under the HSA plan that comes directly from my pocket. I asked if there was something else I could try and she had me try a generic HBP medication that had been around for awhile and it worked just fine. The cost? $5.60 per month!

    The second incident occurred when she was going to send me for a thalium stress test (odd EKG prompted this). So, I was cool with that until I found out that it cost over $2100 and was advised to determine if you had a stroke or if there was blockage. I ended up going to a cardiologist and after my 3rd EKG (grrrrrrrrr) and a review of my exercise program (I exercise quite a bit, and am in pretty good shape) he said the thalium stress test was not needed. So, I did have to spend $350 at the cardiologist, but that saved me $1750! No savings?



    I will agree with you here, HSA's are not for everyone. But, for folks who can afford to fund the HSA savings element, or if the employer is contributing, or if you have a fair amount of personal savings, it is a very good option. But, if you live paycheck to paycheck, I agree, not the best program. But why take it away from those people who can take advantage of it? It reduced my premiums, and it gives me incentive to ask questions and to "shop" my doctor (I know davidra will hate that some people would dare "shop" a doctor).
    I thought you actually knew something about the industry you work in. With managed care, you won't have the opportunity to use the $85 a month drug, which is a good thing (unless you are employed by a drug company). You shouldn't have that opportunity UNLESS there is firm evidence that it is better than the alternative. 95% of the time, it isn't. Managed care would have prevented, if done properly, the inappropriate use of a stress test as well. So would a good doctor.

    And finally, do you really think that there is a difference among prices charged? Given most people accept Medicare assignment (specifically 75% of doctors), and Medicare reimburses at 80% of "usual allowed costs", by and large people are being charged very similar amounts if they have Medicare. If they have private insurance, most large companies mirror Medicare reimbursement and additionally most are contractually related to the provider, so the providers are limited as to what they can charge. For inpatient charges, DRG's determine what is charged. The amounts are high to make up for indigent care; you know, that thing that you think everyone can just keep on getting whether they have insurance or not, because "nobody's paying for it". Ridiculous. We are all paying for it. I'd be willing to bet that if you look at what insurers pay for identical procedures, there is very little variation in similar communities. In fact, that's one of the main problems. There are virtual price controls and they are irrational. An ophthalmologist should not be paid $8000 for doing a 20 minute cataract procedure and an internist $80 for an hour and a half visit with a complicated patient. Those rules need to be changed and that's one way to control prices....reduce payments for specialty care. Of course, that's socialist doctrine because it involves "redistributing" charges. So what? That's what is needed to change costs. It will also help prevent the uneven direction that medical manpower studies have shown, with a shortage of primary care docs and excessive numbers of specialists....who provide more expensive care and in many cases, have no better health outcomes.
  11. piaband's Avatar
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    #2491  
    Quote Originally Posted by clemgrad85 View Post
    LOL....yes.....I only find one thing wrong in those 2400 pages. Good grief.

    I agree, it is ridiculous that the democrats won't negotiate.....at least we can agree on that! That ridiculous "show" on Thursday was acctually quite good for the Republicans. At least it showed the Republicans have some ideas to work on the real problem, medical costs. The democrats, or at least some of them, simply want to push something through that sets the stage for a government take over. That is the ultimate goal, because, government knows best, right?
    What were the republican ideas? having undercover patients. Wow, thats real ingenuity. Cmon. get real.

    republicans plan is the same crap we have now. and covers 3 million people.

    democrats plan is a NEW idea, and covers 30 million people.

    If we all agree there needs to be healthcare reform, what is so difficult about something different or something the same?
  12. KAM1138
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    #2492  
    Quote Originally Posted by piaband View Post
    A choice? What choice? They have no rules that bind them to anything. do you have a choice when you get cancer and your ins. company drops you because you had acne when you were 16? (preexisting condition). And I'm not kidding....a lady was diagnosed with breast cancer and that was the reason the denied her payments for the surgery. She had to come up with half the cost of the operation. Do you think she has a choice at that point? Only choice is what casket she wants.

    Right now the insurance company tells the doctors what they can and cannot do for you. If they wont pay, the doctor wont do it. What is the focus of insurance companies?....profit. I hate the FACT that the decision on my health/life is decided by someone elses profit. That happens RIGHT NOW.

    What the health insurance reform bills do is to set up laws stating that insurance companies cannot deny payment for things that doctors deem necessary to your health. Hmm, that sounds kind of nice, doesnt it?
    You have a choice to deal with whatever insurance company you want. If they are screwing the consumers, then it seems the government (who oversees things like Fraud) would rightfully have the power to stop that wouldn't they? They really aren't doing that are they? Why? What has failed in our legal system that this sort of thing can occur?

    Actually, an insurance company doesn't tell a doctor what they can or cannot do. A doctor can treat a patient however they want. The insurance company just says what they will pay for. See--these doctors work for profit as well.

    You aren't required to have health insurance, so you can completely remove them from decisions about your life/health can't you? Oh, except you want them to actually Pay for your healthcare. That's the funny thing--when you expect something from someone, they tend to want a say in what you do...which will be the exact same thing with government related care.

    As to your last paragraph...yes, sounds great, except there is this thing called economic viability. You can rail all you want against "profit" but economic realities remain.

    What we really need is smart healthcare, and in my view, removing the patient from the financial picture (which is what happens today) is a major component of increasing costs. Removing the patient (customer) more fully from the equation will not reduce costs.

    Also--you probably wouldn't know this, but my actual preference is to reduce the role of insurance companies/government healthcare to the maximum extent possible, because the collusion of these things is exactly what led to prices being what they are today.

    You are clearly eager to blame insurance companies, but seem to ignore the role government has played in creating this mess, instead favoring their having even more control.

    KAM
  13. KAM1138
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    #2493  
    Quote Originally Posted by piaband View Post
    Whats a while back? With the rate insurance premiums are going up, you are probably right. It use to be 4,000...now its 14,000/year.
    Middle 2009.

    Quote Originally Posted by piaband View Post
    BTW - I searched everywhere for private insurance. I couldnt find any that didnt have an extremely high premium, extremely high deductible, or a yearly cap that was absolutely unacceptable. I was quoted for a policy with an annual cap of $1000. I'm not kidding.
    Do you have some special conditions that are boosting this price. I can give you another example. High Deductible insurance ($5000), but 100% pay after that for a family of 3 is less than $700 a month. That is a very significant deductible for sure, and not a small premium, but still significantly less than you are suggesting.

    Quote Originally Posted by piaband View Post
    Maybe you arent reading all the details of your policy.
    Yes, that's possible. I'm pretty sure about what's being paid however. I know for a fact that in my particular situation, my low deductible insurance plan I've had for a number of years ended up costing me very significantly, whereas the same situation with an HSA would have been a major improvement.

    I won't say that HSAs work for everyone, but for some it does, and the benefits are outlined in that article.

    KAM
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    #2494  
    Quote Originally Posted by KAM1138 View Post
    1) True, and I'm for that.
    2) True, and I'm for that.
    3) That's why you need an impartial arbiter (not a competitor) in the form of government. You'd think that they'd focus on such straightforward reforms that people can agree on.
    4) Yes, if we dropped medicare completely we'd save a ton of money, but it doesn't mean its the best solution. I'm not specifically against this however.

    When I say that what we is being suggested is an expansion of the current system, I am referring to the fact that we will continue to have a price-fixed mess (I posted a link to an informative article) a while back in this thread I believe. There are some improvements, but it isn't addressing the heart of the issue, and that is that the free market has been blocked out, which has resulted in skyrocketing prices. There are many others issues which I agree need to be addressed, but ignoring this one is likely to lead to the same problems.

    Public Option? Sure--I'm more than happy to have the government run their own insurance company, as long as it 1) receives zero tax payer money, 2) is strictly voluntary and 3) follows the exact same rules that other insurance companies have to. That of course will not happen.

    KAM
    I have come to the conclusion that noone is actually paying attention to the ACTUAL legislation.

    3) Right now, the insurance companies are the arbiter. You would rather have insurance companies than government be the arbiter? If so, we fundamentally disagree and we will not come to any conclusion here. But I think you are frighteningly wrong. The day may come when someone is looking over your file, deciding between your life and profit. Karma may be knocking on your door.

    4)The reason you drop medicare advantage is because it is a HUGE expense to taxpayers (you know the unfunded liability that republicans passed), it doesnt not improve their health any more than regular medicare, those people being taken off medicare advantage will go to regular medicare, and it hurts noone.

    Whats the problem there?
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    #2495  
    Quote Originally Posted by KAM1138 View Post
    Actually, an insurance company doesn't tell a doctor what they can or cannot do. A doctor can treat a patient however they want. The insurance company just says what they will pay for. See--these doctors work for profit as well.
    KAM
    what an ignorant statement. Its a shame you get to live in this great country.
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    #2496  
    Quote Originally Posted by KAM1138 View Post

    You aren't required to have health insurance, so you can completely remove them from decisions about your life/health can't you? Oh, except you want them to actually Pay for your healthcare. That's the funny thing--when you expect something from someone, they tend to want a say in what you do...which will be the exact same thing with government related care.

    KAM
    This is where we fundamentally disagree. I view healthcare as a right. You view it as a privilege.

    what makes your life more important than anyone else? Nothing, thats what.
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    #2497  
    Quote Originally Posted by KAM1138 View Post

    Yes, that's possible. I'm pretty sure about what's being paid however. I know for a fact that in my particular situation, my low deductible insurance plan I've had for a number of years ended up costing me very significantly, whereas the same situation with an HSA would have been a major improvement.

    I won't say that HSAs work for everyone, but for some it does, and the benefits are outlined in that article.

    KAM

    What will you say when you get cancer and your insurance company pulls your insurance that you have paid on time for years. Not much, you'll be dead.
  18. KAM1138
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    #2498  
    Quote Originally Posted by knobbysideup View Post
    Ok, Knobbysideup's solution to healthcare.

    First, what are the problems?
    1. expensive
    2. inefficient
    3. inconsistent

    3 drives 2 which drives 1.

    How to fix?
    1. Stop tying healthcare to companies you work for. Make it illegal. Whether I have affordable coverage, and who is covering me should not be tied to who I work for. My company doesn't have car insurance or home insurance for me, why do they have health insurance? And why should I have to insure my health to begin with?
    I agree. Are you aware of how this got to be like this? BTW--you don't have to carry health insurance.

    Quote Originally Posted by knobbysideup View Post
    2. No more networks. I have insurance, I'm covered. Period. Let the government regulate minimum required coverage. You want competition? Compete on offering MORE for LESS. Why is it every time I go to the doctor, there are twice as many people there working on claims than there are actual healthcare staff??? I don't care if I put claims processors out of a job. It's a bull**** job to begin with.
    You know what else would reduce these claims costs? Paying your doctor money out of your pocket for common needs, eliminating the insurance element completely. Overhead slashed.

    Quote Originally Posted by knobbysideup View Post
    3. You don't need electronic histories to drive efficiency. Make it a standard paper form. You fill it out ONCE. If a new doctor requires the information, you give them a copy. Any doctor office should be able to print this and give it to you, which you can then give to any other doctor. They are free to put it in their own databases however they like, but they must accept the standard form. Let's work on efficiency of process before we try to automate and put it into computers, shall we?
    No comment one way or the other.

    Quote Originally Posted by knobbysideup View Post
    The only other problem left to solve, then, is litigation. This also drives up costs, but is beyond the scope of this rant.

    It's ridiculous that a couple of minutes of a doctor's time costs me $150 with no insurance sometimes! Especially when they don't solve the problem the first time around, and you have to go back. Then there is the issue of Insurance companies actually *CONTROLLING* my healthcare, and not my doctor. How the **** did we get into THAT situation?
    Again, the insurance company doesn't control what happens--only what gets paid for--which effectively controls this, because Doctors don't work for free. That's why I prefer removing them from the equation to the maximum extend possible.

    Quote Originally Posted by knobbysideup View Post
    I want to be able to pay my doctor, directly, a reasonable price for solving my health problems (you know, like in every other industry, except law). I want insurance to kick in for serious, long-term, or life-threatening issues. If costs were driven down to reasonable levels, I'd even pay for surgery for broken bones without insurance. But when I broke my ankle, the combined bill was $20,000. ***?
    Absolutely. We are largely on the same page. This is exactly what I've been advocating for months (well, actually years) but not here.

    KAM
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    #2499  
    We need to look at the people on the Hill that have been blocking REASONABLE health care reform for over 10 years now, vote them out of office. They are taking the campaign contributions (bribes) from the insurance industry. We need complete reform in Washington, before the nation is worse than it is now.

    There was a bill years ago to allow associations to cross state lines for health insurance it was defeated numerous times. Now they are pushing for this again and they were the ones who voted against it. They want to scrap and start over so they can keep delaying things, over and over. The president had the right idea to set them down together. But maybe should have taken it a bit further.
  20. KAM1138
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    #2500  
    Quote Originally Posted by piaband View Post
    What will you say when you get cancer and your insurance company pulls your insurance that you have paid on time for years. Not much, you'll be dead.
    Well, that's where you need a fair arbiter. That isn't reasonable, and in my view is fraud--when it occurs like you say.

    KAM

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