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Break Glass in Case of Human Beings

Conservatism has often struck me as a philosophy that works better in theory than in practice. Evidently, Eric Cantor agrees:

Yesterday in Richmond, Rep. Eric Cantor (R-Va.) reminded us how hollow Republicans can sound addressing real people with real problems. When a woman told the story of an uninsured friend stricken with cancer, Cantor suggested she seek out "an existing government program" (presumably the ones Republicans haven't succeeded in eliminating yet), a charity, or one of the "hospitals here who do provide charity care."

And in a bold statement of principle, Cantor declared: "No one in this country, given who we are, should ever be sitting without an option to go be addressed."

You see this sort of thing a lot in town halls and constituent meetings. Many Republican politicians keep a little box filled with government programs that they break open in the event that they run into actual human beings with real problems.

By Ezra Klein  |  September 23, 2009; 11:45 AM ET
 
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Comments

There's a difference between limited government and NO government.

Posted by: Ynot1 | September 23, 2009 12:02 PM | Report abuse

The GOP is only following their Patron Saint, Ebenezer Scrooge. After all even he allowed for poor houses.

Posted by: endaround | September 23, 2009 12:03 PM | Report abuse

I think most in Congress are out of touch with how the real world works. Cantor (and Coburn in another town hall meeting) think there are programs that don't exist, charities that don't exist, or that you can get your problem taken care of and somehow the bill vaporizes.....hospitals that provide charity care? As if that bill is not going to be attached to you forever..

Posted by: scott1959 | September 23, 2009 12:05 PM | Report abuse

Modern Republicans have as much in common with conservatism as modern Democrats have with classical liberalism. Klein will always fudge it in the way he builds the straw man, because it suits the sort of dishonesty it's his business to peddle.

Posted by: msoja | September 23, 2009 12:13 PM | Report abuse

I keep seeing Cantor's declaration that "No one in this country, given who we are, should ever be sitting without an option to go be addressed."

That literally makes no sense.

Posted by: bdballard | September 23, 2009 12:16 PM | Report abuse

I'm always finding random government programs in my pockets, along with the loose change and pocket-lint.

One time, I left Medicaid in there when I did the laundry. Whoo, that was not pretty, let me tell you!

Posted by: adamiani | September 23, 2009 12:18 PM | Report abuse

I think it does make conservatives uncomfortable to imagine that there is a hospital and within a mile of it there is someone dying from lack of care. So they ignore this, and have the idea of charity care. Of course, charity care is paid for by....taxpayers mostly.

Posted by: HalHorvath | September 23, 2009 12:30 PM | Report abuse

msoja, seriously, while I might agree with you about unprincipled thugs like Tom DeLay and John Boehner, if Eric Cantor isn't a conservative, who do you think is? Ron Paul? Pat Buchanan? Michelle Bachmann? David Duke? Glenn Beck?

Sorry: Edmund Burke, William F. Buckley, and Barry Goldwater are dead.

Oh, and while you're at it, name one large modern society that is succeeding by implementing the conservative principles you believe in. Don't say Singapore: its widely-praised healthcare system engages in government-driven paternalism and regulation of service delivery that would outrage you if Obama ever dared to try it.

Too many of today's conservatives remind me of the Communists I met on campus in the early 1970s. When you asked them to account for the catastrophic record of Communism throughout the 20th century, they insisted that "real" communism had never been tried!

So it is that the most right-wing politicians in the western world, whose policies fail over and over again, are simply called "not conservative" by their faithful followers, once the horrid outcomes of their handiwork becomes obvious. If they HAD been conservative, doubtless everything would've worked out just fine!

Posted by: bcamarda2 | September 23, 2009 12:31 PM | Report abuse

Oh, those pesky real people with their real problems! Who wants to hear about them? All we care about are those Town Hall Meetings, with crazy people screaming at each other. Poor Cantor's brain must have short-circuited...

Posted by: gmcduluth | September 23, 2009 12:32 PM | Report abuse

msoja,
Dishonesty is rampant on the Right, which continues to randomly makes up facts. I don't think Mr. Klein is particularly dishonest though I don't always agree with him. So projection, attributing to others your own faults, is a pretty common phenomenon in people coming from your political perspective.

Posted by: michaelterra | September 23, 2009 12:41 PM | Report abuse

This is simply the right wing equivalent of "when John Kerry is president, people like Christopher Reeve are going to walk."

Posted by: kingstu01 | September 23, 2009 12:59 PM | Report abuse

This reminds me of Senator Tom Coburn of Oklahoma telling a desperate woman struggling to care for her ailing husband that his office would try to help her, but government isn't the answer. He says what's missing in this debate is "us as neighbors helping people who need our help ... but the idea that government is the solution is a ... very inaccurate statement."

What an ass! => Poor people in poor neighborhoods should rely on their poor neighbors, rich people in rich neighborhoods should rely on their neighbors in the unlikely situation that they need it, and the middle class should rely on their middle class neighbors who are watching their own boats go down.

Posted by: bcbulger | September 23, 2009 1:02 PM | Report abuse

Interesting, isn't it, how he doesn't specify the existing government program to help her. I assume that's because he knows Medicare, Medicaid and VA will not be of much assistance in that situation. Or the other options given of charity, or a hospital providing charity care because it's padded the bills the insured pay. Charity, not to raise funds to research a cure for cancer, but for an actual case of cancer. What a completely absurd answer when confronted with a real problem. I'm surprised he didn't suggest she set up a coffee can at the register of the local Quickie Mart with her story on it. Why don't Republicans want to live in a first world country? Why doesn't this stuff actually appear to bother them beyond some asinine platitudes? Didn't their mothers ever teach them that walk-a-mile-in-their-shoes thing?

Posted by: Jenn2 | September 23, 2009 1:02 PM | Report abuse

Conservatism has often struck me as a philosophy that works better in theory than in practice.


You know Ezra I've thought he same thing about liberals. In theory covering everyone for every medical procedure they'd ever want or not even need sounds like a wonderful thing. But when the bill comes and we have to stop printing money, well then reality sets in.

Posted by: visionbrkr | September 23, 2009 1:03 PM | Report abuse

The conservative theory, I suppose, is that supply and demand eventually meet if things are left to develop by themselves. And in many cases this seems to work out - those who want to buy and sell cauliflowers seem to converge reasonably well, so that the market for caulis is cleared and no one feels badly cheated. Same perhaps with television sets, soap, potatoes and editions of the works of Charles Dickens. Competition has some beneficial effect in all these cases.
It doesn't work in healthcare and I don't see how it can in the presence of a monopoly. You can, in effect, only get medical treatment from doctors. This may be a necessary mono, but if it is necessary so is some sort of exemption for health care from the free market.
Theories that don't work in practice aren't good theories.

Posted by: MHughes976 | September 23, 2009 1:04 PM | Report abuse

"In theory covering everyone for every medical procedure they'd ever want or not even need" You really, really, don't read this blog, do you. Maybe you should find something more on your level, I hear Glenn Beck is on the teevee.

Posted by: Jenn2 | September 23, 2009 1:05 PM | Report abuse

Jenn2,

really? Seriously? Yes I read it and disagree with a lot that is said around here but I try my best not to degrade anyone on here. Maybe YOU should learn that lesson. Do we all need our "left wing Huffington Post card" to be able to post on here?

Oh and BTW, I think Glenn Beck's an idiot and have said so several times on here. You can try to paint people into a box if you like (like you're trying to do to me)to fit your narrow view of the world, but you're only doing damage to yourself when you do that.

Posted by: visionbrkr | September 23, 2009 1:40 PM | Report abuse

visionbrkr, nice try with your "both sides do it!" claim particularly in the wake of people you support actually repudiating your beliefs when they have to answer to voters. Cantor's job depends on helping constituents in need, which is why he abandons his supposed principles when a real-life situation comes up. That's also why liberals support health care reforms based on actual, working systems. Republicans don't. Trying to set up a false equivalence between the two is just a defense mechanism to justify your continued adherence to a failed ideology (one which did no tangible work on health care reform over the last 8 years).

My advice, visionbrkr, would be to accept that your ideology is a failure and not try to fool yourself into thinking "liberals are just as bad" when the evidence indicates otherwise. You failed. You attached yourself to a false ideology. There's no use trying to justify it.

Posted by: constans | September 23, 2009 1:57 PM | Report abuse

constans,

I'm not defending Cantor as I think he's wrong in what he says. My only point was to provide a counterpoint to what Ezra said and my feelings towards how liberals don't live in reality. I don't support Cantor or the Republican's in general. I vote in my area for a Democrat for congress and a Republican for govenor. I look at each person and where he or she stands on the issues that matter to me.

To me, Republican's have failed more than Democrats but that doesn't mean Democrats haven't failed because they absolutely have.

What most don't get on here is that every Republican isn't evil and every democrat isn't good. People need to stop being polarized by what initial is in front of a person's name and start looking at what they do and judge by that.

Posted by: visionbrkr | September 23, 2009 2:07 PM | Report abuse

visionbrk,
It's so transparent that you allow your ideology to lead you to conclusions rather than allowing the data to do so. Yes, there are people on the liberal and further left who do the same but Ezra is generally not one of them. In fact, I feel that Ezra could take at times a stance further to the left and be truer to facts...he sometimes is looking too hard for the wheat in the Washington chaff.

You appear to arguing primarily from ideology because the "facts" you dredge up are generally so weak. In this case, the pitiful spectacle of right-wing politicians attempting to solve the problems of real individuals by recommending contacting the government escapes you because it goes against a form of religious training you have had in anti-government right-wing stuff.

Posted by: michaelterra | September 23, 2009 2:09 PM | Report abuse

visionbreaker, I just assumed that since Ezra writes and links extensively regarding the need for cost controls, bending the cost curves, graphs, wonkery, out the wazoo, that you just hadn't read it since you characterize the position as "free procedures no one wants or needs". If you have read it and just didn't understand it, there's also that guy on the radio, with the divorces and the Oxycontin and the welfare history. He seems like a good source of information.

Posted by: Jenn2 | September 23, 2009 2:12 PM | Report abuse

*my feelings towards how liberals don't live in reality.*

translation: you wanted to say "look! over there!"

Your problem is that your feelings are distracting you from reality. Given the fact that liberals were the ones who created a reality-based health care reform proposal and that such universal health systems *actually exist* in reality tells me that it is you, like most Republicans/conservatives, who is not operating in reality. Regardless of your "feelings" on the matter. Your problem is that you have too much invested in an ideological failure that you have to keep on coming up with reasons and excuses for why the opposing ideology really isn't the workable one. Because then you'd have to concede that you chose wrongly and wasted your life following those false beliefs.

Heck, you've spent your time here ranting against health care reform because the fact that there is going to be a national reform of the system is an implicit admission that you chose a career that is part and parcel of a broken system, and so advocating for reform would be implicitly admitting that you made a poor career choice in life.

Posted by: constans | September 23, 2009 2:17 PM | Report abuse

michaelterra,

its amazing that you (just as Jenn2 seemed to do) try to paint me in a box. It shows how narrow minded you are.

What facts are you speaking of that are "so weak"?

I AGREE WITH YOU CANTOR IS WRONG.

Exactly how much plainer can I put that???


Religious training? exactly WHERE does that part of your rant come from? The last real religious training I got was from St Mary Margaret in the 8th grade which was a long time ago (in fact so long ago i made up the name of the nun.)


Jenn2,

keep up your talking points. I don't know who you speak of regarding the oxycontin nor do i care. Again as i said above:

I AGREE CANTOR WAS WRONG. What he should have done is directed his staff to find a way to help the person in need.

Oh and if you're going to QUOTE ME. I'd suggest doing it RIGHT. I said:"covering everyone for every medical procedure they'd ever want or not even need"

My original post had nothing to do with cantor but had to do with Ezra's broad brush that he painted conservatives with. I guess to a point I'm doing it too. I'm sure there are some liberals out there that are concerned about costs, no? Please??? ONE???

Posted by: visionbrkr | September 23, 2009 2:25 PM | Report abuse

constans,

I'd agree with you except for the fact that Medicare is going broke and that the only time when costs were in line were during the 90's when HMO's kept costs down.

Oh and then there are those pesky countries that have all privatized systems that work just fine like Germany.

Oh and then the fact that I live in a state that's been guaranteed issue for health insurance since I started in business (1993).

But other than that every point you make is right on! Again what is it that you do that brings you here daily???

What's your SLANT on the topic? Seems everyone knows mine but I don't know anyone else's? I'd be happy if everyone bore their soul like I have mine (and i've asked for this before and gotten little response). Lensch is a mathemetician. But that was about it from the "regulars" around here.


ANd I've ranted FOR reform, just what is to me the proper reform. I'd be more upset if they did nothing than if they put a public option that is on a level playing field into place because I know that if we don't at least do the Finance committee's proposal then we'll be back here in 5-10 years with a greater population of uninsured and greater issues than we have now.

Do you really believe that every single conservative has exactly the same beliefs on everything? I'd stated here many times that i'm for a woman's right to choose (not that it has anything to do with this topic) and I'm against the war in Iraq and Afghanistan. My God, they're going to take my Glenn Beck card away right Jenn2?

Posted by: visionbrkr | September 23, 2009 2:35 PM | Report abuse

Ezra and all other intelligent liberals are concerned about costs, it is a dual obligation along with expanding coverage. Costs cannot continue to outpace wages four times over, they cannot continue to double every ten years. This is something you will see on Ezra's blog, and every other liberal blog, time after time after time again. It was repeatedly in the president's speech. It is one of the main reasons we cannot continue to kick the can down this line. I could not begin to count the number of times liberals have made this point. There is very little point in coming to intelligent, wonky, policy-oriented blogs if you are going to ignore the information provided. The use of the quotes was not to directly quote you, although you'd be hard pressed to find any substantive difference between the two, but to provide the "shorter" version, the same way you might say Chuck "for the individual mandate before he was against it" Grassley, even though Chuck Grassley did not say those words.

Posted by: Jenn2 | September 23, 2009 2:40 PM | Report abuse

constans,

oh and while you were doing whatever it is you do, I've spent my morning while not on here doing 3 things mainly.

1-helping a client of mine whose doctor never mentioned they didn't accept her insurance and billed her $1500. I spoke to the office manager for the third time and got them to write it down to $93.

2-helped a client of mine who is having surgery on Friday find a home health aide that is participating with his insurance and has the services he needs when he comes out. He's racked up $500,000 in total bills to date (of which his insurer has paid all but $5,000 which is his cap for this year). In fact he wanted to change earlier this year but I told him not to because if as expected he was going to have another surgery he would have a new cap with the new insurer.)

3-worked with a client of ours whose son has autism in helping to find a provider who handles ABA therapy and is covered under their insurance plan.


My God you are right I am evil.

Sure we could go to a single payer system and instead of making a commission I'd have to make a living on a consultancy basis and I'd certainly be able to do that. But the point is that I don't believe single payer works because of the waste, fraud and abuse in the current single payer system (er actually captive market) medicare. Fix Medicare first and then I'll gladly pick up your HR 676 banners at meetings with you.

Posted by: visionbrkr | September 23, 2009 2:49 PM | Report abuse

And who doesn't recognize that Rush when they hear him described as an Oxycontin addict? They're pretty much synonymous to me, like O'Reilly and falafel.

I never said conservatives have the same set of beliefs. My father is a pro-choice, anti-death penalty, pro-gay marriage, anti-religious, Republican. He is one of about four in the country and I would be hard pressed to explain why he has decided to stay with the party as it becomes less tolerant, more doctrinaire, and more just flat crazy, but he is nonetheless there. I just feel like this "debate" involves a pro reform side breaking out data, polling, studies from other countries, analyses, think tank reports, expert opinions, and the anti reform side yelling "Well u think its expensive now wait til health care is free the dimmocrats are tryin to take away ur freedom" This makes me insane. I cannot understand how you could possibly come to Ezra's blog and read his posts and links and ask whether there is a liberal who believes in controlling costs. It's just a huge facepalm moment for me. I can only assume Ezra never reads the comments, or he would have no hair left.

Posted by: Jenn2 | September 23, 2009 2:52 PM | Report abuse

Jenn2,

well i guess your father and I have a lot in common. He sounds like a good man. To me I look at each politician seperately. I believe in less government interference and more as a regulating body that needs to keep private industry in check to make sure they're not taking advantage of those less fortunate than them which they do far too often. In fact earlier today I scolded an employer client of mine that wanted to cancel a former employee's coverage who they're having a dispute with. I may lose them as a client but I'll know I did the right thing.


And I admit that I went too far in saying that NO liberal (or Ezra in specific) doesn't care about controlling costs. I've read him and know he does. I guess I just took offense to the slap at "all conservatives" being somewhat of one myself.

This is really and truly the only line that I read when it set me off:

Conservatism has often struck me as a philosophy that works better in theory than in practice

To me that's painting all conservatives as an Eric Cantor clone and that's as wrong as me painting all liberals one way.

Posted by: visionbrkr | September 23, 2009 3:04 PM | Report abuse

He is a good man, just stubborn as all hell. Me, I'd be a little disheartened if in my lifetime my political party moved so dramatically out of step with my opinions while mine didn't change much at all, but he's a creature of habit, and it's not a hard habit to maintain if you're not too aware of day to day politics. The people who Bush converted away from Republicanism are for the most part just the people with a little sense who were paying attention. Ezra was not painting all people one way, he didn't say "all conservatives", he said "conservatism". It's how I feel about libertarianism, that it's a philosophy best confined to unrealistic, overly long novels favored by middle schoolers and not something we should actually be trying to base actual livable public policy on. There's a reason there aren't any libertarian paradises out there, unless you count failed states.

Posted by: Jenn2 | September 23, 2009 3:18 PM | Report abuse

"Fix Medicare first and then I'll gladly pick up your HR 676 banners at meetings with you."

You fix Medicare by changing it from being seen as the free senior buffet for people lucky enough to make it to their mid-60s.

And again, you seem not to appreciate that your client work exposes the failings of the system -- relying on someone to grease the wheels of the private insurance bureaucracy is an indictment of how it works.

It may make you feel like you've done a good day's work, and your clients are the better for it, but that's like saying that the best solution to having a beater car is to hire a mechanic to sit in the passenger seat.

Posted by: pseudonymousinnc | September 23, 2009 7:00 PM | Report abuse

" ...liberals don't live in reality."

Well, I guess I live in reality now, but I guess I didn't when I lived in England, France, Sweden, Switzerland, etc.
*******************
"Oh and then there are those pesky countries that have all privatized systems that work just fine like Germany."

Wikipedia on the German health care system:

"Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance..."

Posted by: lensch | September 23, 2009 8:21 PM | Report abuse

pseudo,

when they change the system, I'll adapt. For now I'll fix what needs fixing and help who needs helping. Again i give the idea of an army doctor being a soldier. Should he not treat the soldier if we're all against war?

And i wasn't as much speaking to the "senior buffet" as much as I was about the waste fraud and abuse in Medicare. Again as i've said before Waste fraud and abuse of medicare >>>>>> Insurers profits.

Posted by: visionbrkr | September 23, 2009 8:50 PM | Report abuse

And again, you seem not to appreciate that your client work exposes the failings of the system -- relying on someone to grease the wheels of the private insurance bureaucracy is an indictment of how it works.


You do realize pseudo that there are agents and brokers like myself in Canada right? Most days I'm nothing more glorified than a customer service rep similar to those that work for Medicare? Are they bad too? How about the single 25 year old who processes claims for an insurer? Is she evil? The medical biller for a doctor's office, is she a shill for the system??? Exactly where do your lines start and stop as far as who is to blame in pseudo-world?

Posted by: visionbrkr | September 23, 2009 11:38 PM | Report abuse

The conservative theory is that goverment's job is to fill the gaps that the private sector can't handle. That's way different from saying that markets can solve every problem. It's just that when you compare the way markets work with the way governments work that the market-based solutions are better, over and over, albeit not in absolutely every case.

@bcamarda2 - "name one large modern society that is succeeding by implementing the conservative principles you believe in."

Isn't the more interesting question about direction? Aren't more countries moving right (shrinking the welfare state) than going the other way. Is socialism reviving? Don't think so.

"Singapore"

This country is a special case. While it goes way beyond "nudging" its citizens, it remains a leader in incenting private actors to work in the public interest. That's a lot different from the infantilizing "free" stuff that European governments adopt.

"they insisted that "real" communism had never been tried!"

Fair enough, but the real question is what would happen if it had been tried. Communism would have been a disaster. Libertarianism or conservatism might well not be.

@MHughes976 - "It doesn't work in healthcare"

It certainly could. (Why couldn't it?) Kill the monopolies, empower consumers (including those you have to subsidize) and things will work much better.

Posted by: lfstevens | September 24, 2009 3:45 AM | Report abuse

The conservative theory is that goverment's job is to fill the gaps that the private sector can't handle. That's way different from saying that markets can solve every problem. It's just that when you compare the way markets work with the way governments work that the market-based solutions are better, over and over, albeit not in absolutely every case.

@bcamarda2 - "name one large modern society that is succeeding by implementing the conservative principles you believe in."

Isn't the more interesting question about direction? Aren't more countries moving right (shrinking the welfare state) than going the other way. Is socialism reviving? Don't think so.

"Singapore"

This country is a special case. While it goes way beyond "nudging" its citizens, it remains a leader in incenting private actors to work in the public interest. That's a lot different from the infantilizing "free" stuff that European governments adopt.

"they insisted that "real" communism had never been tried!"

Fair enough, but the real question is what would happen if it had been tried. Communism would have been a disaster. Libertarianism or conservatism might well not be.

@MHughes976 - "It doesn't work in healthcare"

It certainly could. (Why couldn't it?) Kill the monopolies, empower consumers (including those you have to subsidize) and things will work much better.

Posted by: lfstevens | September 24, 2009 3:46 AM | Report abuse

Ifstevens: "'It doesn't work in healthcare'

It certainly could. (Why couldn't it?)"

While markets usually produce higher quality and lower prices through competition, they don't always do so.

Higher education is one example. Costs have been rising far higher than inflation for some time. But why, if they're competing with each other?

It's precisely because of competition. Schools are bidding for the same star professors, so salaries go up. When one school builds a fancy, new, and expensive state-of-the-art lab, the others have to build one too if they're going to keep up. On the student side there's pressure to offer ever better dorms, athletic facilities, and food. The effects on educational outcomes may be marginal, but the costs are not.

There may be similar pressures in health care. When one hospital gets a fancy, new, expensive diagnostic machine, the others need to get one also. And then they all have to use them in order to justify the cost. Those incentives are not in the right places for good health outcomes, much less cost control.

"It's just that when you compare the way markets work with the way governments work that the market-based solutions are better, over and over, albeit not in absolutely every case."

I think the evidence from other countries shows that health care falls into the "not in absolutely every case" category. I agree that markets work better in most situations. But we've had competition in many areas of health care, and our outcomes are not better than our peer nations while our costs are far higher. Competition in health insurance has led to the consolidation we have today. The profit motive produces incentives for insurance companies to enroll only the healthy and deny payment, and for providers to "do more" to generate income whether or not it's really medically necessary.

We generally like markets not just because they're markets but because of the results that markets usually produce. I'm trying to keep an open mind regarding health care, but it seems to me that markets don't get the results we want in this area. And if they don't, then some degree of government intervention is warranted.

Posted by: dasimon | September 24, 2009 8:33 AM | Report abuse

Government has massively intervened in US health care for decades. We have nothing like a market system here.

On your education point, the education system is about to explode under the burden of cost escalation. And again, government is part of the problem. Check this out:

http://www.washingtonmonthly.com/college_guide/feature/college_for_99_a_month.php

Posted by: lfstevens | September 24, 2009 8:30 PM | Report abuse

Ifstevens:

Your link to the higher education article does not explain why government is partly responsible for the increased costs of higher education. And it reinforces the idea that what cuts costs isn't competition, but new ways of delivering services. Many people say the same about health care: that it's not competition that will lower costs, but technological innovations that will allow people other than expensive doctors to provide services that only doctors offer at the moment.

Nor do you refute the examples that I gave about why the market does not necessarily work in every circumstance. We have had much more "free market" health care than our peer nations, and we've wound up paying a lot more than just about all of them. Now, it's possible that our middle ground is worse than going strongly in one direction or the other, but I doubt it, especially when it seems so clear that the for-profit model puts the incentives in the wrong places for good health outcomes.

Do you dispute that insurance companies have the incentive to cover only healthy people and deny payment whenever they think they can get away with it? Do you deny that our system provides incentives for doctors to "do more" regardless of whether it's likely to lead to the most cost-effective outcome? Blind faith in "free markets" don't answer these questions. And if the market puts incentives in the wrong places, then why stick with the market model?

Posted by: dasimon | September 24, 2009 11:46 PM | Report abuse

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