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The Health Care Divide


Sen. Hillary Rodham Clinton talks health care policy in Des Moines. (AP).

There are few divides larger this year between Republican and Democratic presidential candidates than on the issue of health care -- and at this point, according to a Washington Post-ABC News poll, public opinion is on the side of the Democrats.

With 47 million Americans lacking health insurance and many millions more worried about rising costs and potential disruption to their coverage, the issue occupies a central place in the presidential debate.

Republicans favor a combination of tax cuts and market forces to ensure that most Americans have affordable health care coverage. Democrats say government needs to take a more direct role in assuring that all Americans are covered and would raise taxes to pay for it.

The Democrats' advocacy for universal coverage represents an important shift to the left for the party. After the defeat they suffered over health care during Bill Clinton's presidency, Democratic presidential candidates in 2000 and 2004 offered more cautious reforms aimed at covering most, but not all, Americans.

This year they all support universal coverage and most have offered plans to achieve it. Hillary Clinton is the most notable, given her role as the architect of the proposal and the strategy that crashed in 1993-94, but others like John Edwards have acknowledged how much they've moved in just four years. "So has America," he said in the New Hampshire Democratic debate a week ago.

The Post-ABC News poll sought to gauge public impressions of the health care system, as well as possible approaches for changing it. What we found was that three-quarters of all Americans said they are generally dissatisfied with the overall system -- 49 percent of them say they are very dissatisfied.

Americans are far more likely to say they are satisfied with the qualify of the care they receive. Eighty-three percent of them -- and 88 percent of those with some kind of coverage -- said they were generally satisfied. More than four in 10 -- and almost half with insurance -- said they were very satisfied.

But that represents a modest decline in confidence over the past few years, when generally half or more said they were very satisfied. And the percentage who said they were dissatisfied, while still low, is as high as it was in the beginning of 1994, when Congress was plunging into what would become a defining battle of Bill Clinton's first term.

Americans are far less happy with the cost of care, which has been escalating rapidly in recent years. In the latest poll, barely half (53 percent) of all Americans said they were generally satisfied. That's the lowest level of satisfaction since the question was first asked in 1994. Those who were very dissatisfied with the cost exceeded those who said they were very satisfied (26 percent to 22 percent).

And two-thirds of Americans worry about they might not be able to afford coverage in the future.

At this early stage in what will be an intensifying debate over health care, Americans overwhelmingly favor the idea of finding a way to cover everyone, even if that means raising taxes. The poll found that 70 percent said they would support higher taxes in return for universal coverage, compared to 27 percent who said holding down taxes is more important than covering everyone.

No matter how we sliced the country, there were majorities in nearly all demographic, regional, political and ideological groupings who said they favored raising taxes to provide universal coverage. One notable exception is among conservative Republicans, 53 percent of whom prioritize minimizing taxes.

Republicans have denounced Clinton's plan in strong terms. Mitt Romney said it would lead to "European-style socialized medicine." Rudy Giuliani and John McCain also have warned that Clinton and other Democrats favor big government or government-run health care.

The public, as of now, does not see it that way. When the outlines of Clinton's and some other Democrats' plans are described to people -- including requirements that business offer insurance or pay a fee and that individuals buy insurance or face some penalty -- there is broad support. In the Post-ABC poll, two-thirds said they supported such a proposal, including majorities of Republicans and conservatives.

Americans also trust government rather than the insurance industry to help set the parameters for quality and affordability of care and coverage. Asked whether the federal government must make rules or whether private health insurance companies and providers can achieve quality and cost goals without government intervention, two-thirds said government needed to be involved. Most groups offered majority support for government's role in setting rules, but support is lowest among Republican women (46 percent) and among conservative Republicans (39 percent).

Public opinion alone will not determine the outcome of the legislative battle over health care that could begin in 2009 if a Democrat wins the White House. The record of 1993-94 shows what can happen when a powerful lobby and a determined opposition sets out to block an idea that Americans seem to favor in the abstract.

But in the context of the presidential campaign debate, Republicans begin on the defensive. They have been far less willing to push health care reform as part of their basic message, and the ideas they have embraced lack support from the public.

Many Republicans argue health care can become a winning issue for the party -- or at least one on which they are closer to parity with the Democrats. But the Post-ABC News poll underscores the advantage Democrats enjoy as the campaign debate is joined.

--Dan Balz

By Washington Post editors  |  October 4, 2007; 1:15 PM ET
Categories:  A_Blog , Dan Balz's Take  
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Comments

the "Well Worth the Read" post appears by "thurli" here, by "Jim" on Google groups, by "Eyeman" on the Minnesota Fishing Forum, and numerous other "Canadians" on blogs around the web. In Canada, is everybody's wife named "Shirley?" Or are these all health insurance salesmen feeding lies to the public?

Posted by: wmharvey | October 14, 2007 11:37 AM | Report abuse

"WELL WORTH THE READ

I am forwarding this email I received from a buddy in Canada. Take the time
to read it so you can do whatever you wish....research, verify, etc., but
please read it."

The above reference is from a fake post made by: thurli | October 8, 2007 02:38 AM

http://message.snopes.com/showthread.php?t=17352&page=2

Posted by: laughsonian | October 11, 2007 3:05 PM | Report abuse


WELL WORTH THE READ

I am forwarding this email I received from a buddy in Canada. Take the time
to read it so you can do whatever you wish....research, verify, etc., but
please read it.

Hi, I saw on the news up here in Canada where Hillary Clinton wants a new
health care plan. Something similar to what we have in Canada.
I also heard that Michael Moore was raving about the health care up here in
Canada in his latest movie. As your friend and someone who lives with the
Canada health care plan I thought I would give you some facts about this great
medical plan that we have in Canada.


First of all:

1) The health care plan in Canada is not free. We pay a premium every month
of $96. for Shirley and I to be covered. Sounds great, eh? What they
don't tell you is how much we pay in taxes to keep the health care system afloat.
I am personally in the 55% tax bracket. Yes 55% of my earnin gs go to
taxes. A large portion of that and I am not sure of the exact amount goes
directly to health care our #1 expense.

2) I would not classify what we have as health care plan, it is more like a
health diagnosis system. You can get into to see a doctor quick enough so he
can tell you "yes indeed you are sick or you need an operation" but now the
challenge becomes getting treated or operated on. We have waiting lists out
the ying yang some as much as 2 years down the road.

3) Rather than fix what is wrong with you the usual tactic in Canada is to
prescribe drugs. Have a pain here is a drug to take- not what is causing the
pain and why. No time for checking you out because it is more important to
move as many patients thru as possible each hour for Government
reimbursement.
4) Many Canadians do not have a family Doctor.

5) Don't require emergency treatment as you may wait for hours in the
emergency room waiting for t reatment.

6) Shirley's dad cut his hand on a power saw a few weeks back and it
required that his hand be put in a splint - to our surprise we had to pay $125. for
a splint because it is not covered under health care plus we have to pay
$60. for each visit for him to check it out each week.

7) Shirley's cousin was diagnosed with a heart blockage. Put on a waiting
list . Died before he could get treatment.

8) Government allots so many operations per year. When that is done no more
operations, unless you go to your local newspaper and plead your case and
embarrass the government then money suddenly appears.

9)The Government takes great pride in telling us how much more they are
increasing the funding for health care but waiting lists never get shorter.
Government just keeps throwing money at the problem but it never goes away. But
they are good at finding new ways to tax us, but they don't call it a tax
anymore it is n ow a user fee.

10) A friend needs an operation for a blockage in her leg but because she is
a smoker they will not do it. Despite paying into the health care system
all these years. My friend is 65 years old. Now there is talk that maybe we
should not treat fat and obese people either because they are a drain on the
health care system. Let me see now, what we want in Canada is a health care
system for healthy people only. That should reduce our health care costs.

11) Forget getting a second opinion, what you see is what you get.

12) I can spend what money I have left after taxes on booze, cigarettes,
junk food and anything else that could kill me but I am not allowed by law to
spend my money on getting an operation I need because that would be jumping the
queue. I must wait my turn except if I am a hockey player or athlete then I
can get looked at right away.
Go figure.. Where else in the world can you spend money to kill yo ur self
but not allowed to spend money to get healthy?

13) Oh did I mention that immigrants are covered automatically at tax payer
expense having never contributed a dollar to the system and pay no premiums.

14) Oh yeh we now give free needles to drug users to try and keep them
healthy. Wouldn't want a sickly druggie breaking into your house and stealing your
things. But people with diabetes who pay into the health care system have
to pay for their needles because it is not covered but the health care system.


I send this out not looking for sympathy but as the election looms in the
states you will be hearing more and more about universal health care down there
and the advocates will be pointing to Canada. I just want to make sure that
you hear the truth about health care up here and have some food for thought
and informed questions to ask when broached with this subject.

Step wisely and don't make the same mistakes w e h ave.

Posted by: thurli | October 8, 2007 2:38 AM | Report abuse

Put simply, what cfuentes006 wants is someone else (the rich?) to pay his medical bills.

lensch states:

"The basic problem is that the rules are made by private insurance companies whose only goal is to make money, not efficiency or good health care. If they can save a buck by having a physician fill out a 40 page form, they will do so."

Consider that with Medicare, a Regulatory Agency established by Congress decides what will and what will not be covered. This Agency doesn't even bother with having a physician fill out a form. It just decides what it will and will not cover. Ever try to argue with the Social Security folks or the Post Office or the Veteran's Administration or for that matter, the Medicare folks?

"What about choice? I am 69 years old and retired. During my career I had 5 HMO's and 5 indemnity health plans. I have much more freedom of choice under Medicare than I had under any of the private insurance plans. I have no more referrals, no more in plan - out of plan nonsense. As for choice of insurance plan, why would anyone want choice if everyone had a plan that covered everything? In any case, you could still have private insurance for those who can afford it as most European countries still do. "

lensch falls into a common dilemma here. All health care plans must look at three items: cost control; range of services offered; and universal access. Medicare does offer pretty good coverage (range of services) and freedom of choice but this is only offered to a limited group of individuals, those nominally older than 65 years (access control). If you offer the equivalent of Medicare to the population generally (universal access), you suddenly profoundly increase the costs. Government will move to "control" those costs and it will do it exactly like it is done in Canada and the United Kingdom----ration access and diminish services. Medicare, in fact, isn't a very good role model. As currently structured, it is simply not sustainable----not enough money.

Posted by: rhfalk | October 5, 2007 4:46 PM | Report abuse

I'm sorry but what the hell was mitt romney's remark about. "European-style socialized medicine." Way to go Mitt, attack the people we have to work with, and at the same time getting the arguement completly wrong. Double Whammy Romney

Posted by: billyfromtheblock | October 5, 2007 5:22 AM | Report abuse

People need to stop allowing themselves to be bullied by the Right, and take this country back. They have used fear and intimidation to lower our standard of living.
I just heard where 22 hospitals in So. California are in serious trouble, and that includes the rich area of Orange County. We are in trouble folks.

Posted by: shag11 | October 4, 2007 8:42 PM | Report abuse

Medicare works great. Single payer. Raise taxes to do it. The only ones complaining will be the very rich who can afford the $250,000 in the Republican fantasy "medical savings account" for heart bypass or a serious cancer.

Posted by: kinoworks | October 4, 2007 8:14 PM | Report abuse

In my view, our current health care industry is little more than a government-protected monopoly that is .. predatory... and ruthless

we know more about the quality and quantity and price of an auto or a TV than we know about health care.

However.. I tend to think that people need to have some dollar responsibility or else they simply won't care about the costs.. and expect full coverage of any/all medical care - even elective procedures.

Posted by: larryg1 | October 4, 2007 7:44 PM | Report abuse

garcon - you may be interested to know that
1. Practically all basic research on drugs is done by the National Institutes and Universities &
2. The drug companies spend 11% of their budget on research, 19% on profit, and....34% on marketing!
3. The main purpose of their marketing is to get doctors to prescribe new expensive drugs even in the cases where cheap old drugs are better.
(A source for this is Prof. Alan Sager of BU.)

Posted by: lensch | October 4, 2007 7:20 PM | Report abuse

If government run medicine is so bad why aren't seniors running for the doors from Medicare. Hardly. It works well with far less overhead than private insurance. The wide acceptance of Medicare and the failure of private insurance Medicare (HMOs) to catch totally refutes the Republican argument in favor of the free market, which would exclude all seniors because of preexisting illnesses. The Republicans have always wanted to dismantle Medicare as that would make it easier to cut taxes without reducing spending.

Posted by: manager | October 4, 2007 7:12 PM | Report abuse

If average folks were making legislation, passing laws, and making choices for the highest good of the nation, then I feel UNIVERSAL HEALTH CARE in some form could be considered normal. Similarily, we have PUBLIC SCHOOLS providing education for all children K-12. Why we have a debate over FREE MARKET medical services vs. a Government paid service is somewhat mystifying. What are FREE MARKET advocates afraid of? Other countries have successfully implemented UNIVERSAL HEALTH CARE. This debate makes the US look backwards, when compared with other industrialized nations. I find it ironic that when I was in the military, government health services were used by all ranks, and these services were extended to military dependents. Obviously, if a soldier is sick his ability to defend the constitution against all enemies foreign and domestic is impaired. When an average citizen is sick, his/her productivity and contribution to our FREE MARKET is impaired. It seems like FREE MARKET advocates would want to keep workers healthy. I understand the economics of CAPITALISM, yet "pure" HEALTH CARE is not really based on a PROFIT motive. The Hippocratic Oath is about the ethics of practicing medicine (not the profit). Certainly health care providers should be paid for services, but at reasonable, affordable levels of compensation. Certainly health care providers should be licensed to practice medicine. Certainly health care providers should be accountable to ethical review boards. These same standards apply to teachers, firemen, policmen, etc. All folks who provide public services for the highest good of the nation. All of these services are paid for by tax dollars. Why is public health paid by private dollars?

Posted by: rmorris391 | October 4, 2007 7:09 PM | Report abuse

I have a lot of friends in or from European countries and they all think we are barbaric for not giving people access to universal healthcare.

They honestly do not feel that we are fully civilized here in the US and that is their main reason.

They also pay a FRACTION of what we pay for drugs, often the same exact drugs from the same companies.

(Why are we in the US expected to subsidize their research programs when they sell their drugs everywhere?)

Lack of universal healthcare is understandable in third-world countries like Brazil and China but not here.

The tying of insurance to one's job seems especially sadistic to them because people often lose their jobs when they get ill, thus ensuring a crisis for their families that worstens the effect of the illness itself.

Ive heard it said that illness is now the major cause of bankruptcies in the US. Banks and hospitals can and do take homes for unpaid medical bills.

Insurance companies take ONE THIRD of each healthcare dollar.

Posted by: garcon | October 4, 2007 7:05 PM | Report abuse

Okay, so if the RepubliCONS are able to pass us a tax cut to help us deal with high insurance rates; what's to say that the healthcre industry won't jack up rates and suck us dry some more.

Look at it this way; this will take pressure off of corporations that pay an incredible amount to help insure their employees. It's more money they will have to hire more employees since the financial burden will be reduced.

If healthcare becomes socialized, it takes ALL of the power out of the hands of the insurance companies. Not only that, but we get to hear the RepubliCONS wail and gnash their teeth because we will have something that rich people wanted all to themselves (greedy ba$tard$).

I'm ALL for socialized healthcare.

Posted by: camera_eye_1 | October 4, 2007 6:47 PM | Report abuse

The government caused the problem with health care in America by over socializing medicine to the extent it is not completive, and we want to exacerbate the problem? U.S. Capitalism refers to an economic system in which the means of production are all owned and operated for profit, and in which investments, distribution, income, production and pricing of goods and services are determined through the operation of a market economy. It is the right of individuals and groups of individuals acting as "legal persons" or corporations to trade capital goods, labor, land and money (see finance and credit). see http://www.InteliOrg.com/

Posted by: DrColes | October 4, 2007 6:33 PM | Report abuse

The "market" is not a cure-all (forgive the pun) for everything. That is why monopolies are regulated. The AMA has a stangle hold on the market. They accredit medical schools. If conservatives are so willing to tinker with the medical care market by restricting legal rights in malpractice matters and reigning in the out of control greedy trial lawyers, why can they not adopt policies promoting the contstruction of more medical schools and the licensing of more physicians. Doctors will never admit it, but even common specialities earn high six figure and often multi-million dollar salaries. We would see how fast this would come down if we simply adopted a policy of promoting more trained physicians. The government does it all the time (e.g., teachers, scientists) so why not doctors?

Posted by: tkallenbach | October 4, 2007 6:18 PM | Report abuse

To captain3292,

Basically Hillary's plan calls for tax credits so that working families only pay a certain percentage of their income towards healthcare. Personally I agree with the other poster that said what good is a tax credit when your income isn't that great and you may develop some terminal illness. My own lifestyle I just chose to eat an dliive healthier because I do not want to get caught up in the treacherous healthcare system we have here.

Posted by: BUTLER19532002 | October 4, 2007 5:38 PM | Report abuse

What's Hillary got to hide?
Sen. Hillary Rodham Clinton cites her experience as a compelling reason voters should make her president, but nearly 2 million pages of documents covering her White House years are locked up in a building at the national archives, obscuring a large swath of her record as first lady. The healthcare papers that have been released contain gaps when it comes to the part played by Hillary Clinton. A number of records involving her have been kept secret because they include confidential advice between presidential aides. Among the withheld documents are memos about meetings between Hillary Clinton and Democratic Sens. Christopher J. Dodd and Joseph R. Biden Jr. -- now her rivals for the Democratic presidential nomination. (LA times 8/14/07)

Posted by: aaronkarmin | October 4, 2007 4:51 PM | Report abuse

Nearly a fourth of American citizens are with out health care insurance due to the exorbitant cost of the policies. The system needs fixing soon. all the republicans are only offering a tax credit not a tax deduction for medical insurance.What happens when a person gets ill in the middle of the year, Your physician needs his money asap and a tax credit is only good at the end of the year and doesn't provide for any type of cash rebate to pay the bill. Let have a single payer system that will include an inevitable tax increase, but America will be better off health wise.

Posted by: mgibbosh | October 4, 2007 4:32 PM | Report abuse

Other industrialized nations have tamed the medical tiger. There is no free market in medicine. Entrance to the field is limited and expensive, and other reports have shown that doctors earn twice here what they do in Europe. This is true throughout the system, where a 2-year RN degree student can expect to earn twice or more than twice what another associate degree holder can earn. Costs are administed and the debate is over who administers them: the people getting paid or those who pay. So far those getting paid have set the prices and the rest of us just pay.

Posted by: george11 | October 4, 2007 4:18 PM | Report abuse

Tax credits? Oh that's right there isn't a problem that a tax credit couldn't fix is there? A complex problem and the solution is of course to cut taxes. If you are poor and have no money to begin with how is a tax credit going to help you? How about castastrophic event like cancer? How is a tax credit going to help you?

Posted by: sargon20 | October 4, 2007 4:15 PM | Report abuse

Are the Republicans telling us that Americans can't run a single-payer health care system better than the Europeans?

Why, that's downright unpatriotic! Let's show those nasty French how it oughta be done.

USA! USA! USA!

Posted by: daa1972 | October 4, 2007 3:56 PM | Report abuse

Who said anything about health care being a right? It is simply good for the country like good roads, good education (I wish), safe meat, on time airlines, solid bridges, etc., etc., etc.

Posted by: lensch | October 4, 2007 3:41 PM | Report abuse

I'm sorry, since when is healthcare a right? Let's start with the right to clean water, food and shelter. Without those, all the healthcare in the world isn't going to keep someone healthy.

Posted by: klnam | October 4, 2007 3:37 PM | Report abuse

SHOCKING that many Americans respond positively when you ask them if they want something for free!

It is utterly laughable how the various media outlets conduct these worthless little polls.

Posted by: gthstonesman | October 4, 2007 3:31 PM | Report abuse

Of course people favor the Democrats on health coverage. Providing care for others requires a generous spirit and a good heart.

If you think that's unfair, I would like to know where you have been for the last 6 years or so.

Posted by: mobedda | October 4, 2007 3:28 PM | Report abuse

The Republican tactic on health care is to ignore it. Maybe it'll go away.

Of course, they say that let market forces fix it.

You know what - if markets could fix it, THEY WOULD HAVE ALREADY.

The reality is, it's good for the health care "markets" to have these problems. It keeps the insurance companies/HMOs profitable and the drug companies as well.

They don't care if 47 million Americans don't have health care coverage; as long as nothing gets in the way of profits and pleases shareholders.

The truth is disgusting. In fact, it's kind of making me sick just to think about it. Luckily I have health coverage.

Posted by: scorbett1976 | October 4, 2007 3:19 PM | Report abuse

Let's forget the immorality of the uninsured that lets poor people die. Forget the burden on businesses that make them less competitive. Just consider health care financing as a business decision. Develop statistics for measuring how we are doing. Look at the competitors (other countries). Look at their cost. If you are honest, you will become an advocate of a single payer system. Here are some facts. They can be checked at www.pnhp.org.

If you look at the 13 wealthiest countries and rank them according to the 16 basic public health statistics, the US ranks 12th or 13th in each one. Yet, yet we spend 2.5 TIMES as much per person as the average of these countries. Other countries get much better health care at much lower cost. (As a sanity check, WHO ranked the US 37th in the world in health care, above Bolivia , but below Slovenia.) All of these other countries use some form of single payer system. Of course, they have some problems, but most of these are because they are not spending enough. We would not have those problems. In spite of all these so-called problems, they get better care. Also Medicare is a single payer system, and it is one of the most popular programs in the history of our country. The plan I like simply gives Medicare (without limitations, co-pays or deductions) to everyone. We could do this without spending any more than we are now.

The reason for this is that we waste at least $200 Billion a year on excess paperwork by physicians and at least $100 Billion a year on high overhead (15% vs. 1.3% for Canadians) of private insurance. Look here is a simplified example of what we are doing.

Suppose you have 100 dollars to give to 10 people. You could give $10 to each person. Alternatively, you could develop criteria that determine who is deserving, and then investigate each person. You might find that according to your criteria, only 5 people deserve the money. You spent, however $75, on your investigations, so now you can only give $5 to the 5 deserving ones. We spend much too much money denying people health care.

The basic problem is that the rules are made by private insurance companies whose only goal is to make money, not efficiency or good health care. If they can save a buck by having a physician fill out a 40 page form, they will do so.

What about choice? I am 69 years old and retired. During my career I had 5 HMO's and 5 indemnity health plans. I have much more freedom of choice under Medicare than I had under any of the private insurance plans. I have no more referrals, no more in plan - out of plan nonsense. As for choice of insurance plan, why would anyone want choice if everyone had a plan that covered everything? In any case, you could still have private insurance for those who can afford it as most European countries still do.

Some opposition to a single payer system is that it is pie-in-the-sky; we will never get it through. Maybe so. That's what they said about Social Security and Medicare. One thing is for sure. We will never get a rational health care system if we do not try.

Posted by: lensch | October 4, 2007 3:09 PM | Report abuse

Leave it to a republican to come up with willy nilly solutions to serious problems facing this nation. Awhile back during the high gasoline price rip-offs one republican Congressmen had a real brainer solution to help alleviate high prices to families by giving out a one time $100 rebate. Now the republicans want tax cuts as a solution to help the poor pay for healthcare. Maybe I am naive or just don't' understand simple math. If monthly premiums are between $800 and $1000 to insure a family and your tax cut is a trivial $50 what am I not understanding. Seems republicans solutions to everything is tax cuts for the rich and obviously things aren't working out.

Posted by: cfuentes006 | October 4, 2007 2:48 PM | Report abuse

Free market is great as long as it is transparent.

Get rid of the quilt-work of prices for the same service or drug. Insurance pays one price, Medicare another, Uninsured pays another price for the same service or drug.

Market dynamics don't work if the consumer only has a partial picture.

Absent a real market, a greater government role is bound to happen.

Posted by: mvalluri | October 4, 2007 2:45 PM | Report abuse

A friend (a stalwart Republican) was diagnosed with cancer last spring. He happened to have just gotten a job with a large, high-quality company, after almost running out of COBRA coverage.

If he hadn't landed the job (and if the company hadn't kept him after the diagnosis), he and his wife, after decades of continuous hard work, would be broke today.

We need national, one-payer,universal health care. Now.

Posted by: news3 | October 4, 2007 2:43 PM | Report abuse

Instead of spending billions of tax dollars on socialized medicine, change the tax laws to provide a tax credit for all medical expenses that is not income restricted. Notice I indicated a tax credit not a deduction. Elliminate restricting medical expenses only to the amount of that is above a specified percentage of the gross income and allow all medical related expenses.

It sure must be nice for congress to have all their medical paid for and to be able to retire comfortably on the retirement benefit they receive after only one term in office. But us poor working folks have to pay thru the ear nose and throat!

Posted by: captain3292 | October 4, 2007 2:28 PM | Report abuse

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