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  #181  
Old May 7th, 2009, 7:58 am
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by OldLupin View Post
I think that is the core misnomer, it isn't free at all. On the contrary, it is very expensive, people just pay in installments called taxes.
Actually compared to the US it's incredibly good value - in 2003 (the latest year I could find figures for) the UK spent 7.8% of GDP on healthcare whereas the US spent 15.2%. In other words you spend nearly twice as much in real terms as we do but we get universal coverage (even tourists get free emergency care here) and you have a huge number of uninsured people.

There are instances where Government can be more efficient than the private sector and this is clearly one of them. Of course a large part of the saving is because we don't have the massive accounting system you have to have in the US. I doubt the scale of medical malpractice cases is much lower here than in the US - certainly satellite TV here is full of adverts for 'Ambulance Chasers Direct.'
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chparadise wrote
I will concede that in the end it's likely that a universal health care system will result in increased government costs - but I think it's important to note that we the taxpayer and insured are already footing part of the bill for uninsured people.
Nobody in Britain can avoid paying for the health service assuming they purchase goods or services. The evidence from Europe is that you will pay substantially less for health with a social system - France which consistently comes out top in comparisons of health systems pays 50% less than you.


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  #182  
Old May 11th, 2009, 3:05 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by kittling View Post
unconvinced didn't say it was free - he said it was 'free at the time of need', And indeed it is free at the point of delivery
Please don't "bold print" all over me. It isn't free ever. Free at point of delivery is an inaccurate statement. It is pre-paid, not free. The use of the word Free is a misnomer no matter the contention because it is not ina ny way shape or form free.

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Originally Posted by kittling View Post
The wonderful thing about the NHS is that if you are taken seriously ill you will recieve treatment and you won't end up in debt for the forseable future, if you get knocked down by a car the abulance will take you to hospital and the only questions asked will be about making sure you recieve the care you need - medical history, next of kin etc - no-one worries if you have insurance just hat you get the treatment you need.
If you are taken to a U.S. hospital in an abulance, your insurance or lack thereof is not of consequence when it comes to recieving care and emergency treatment. The only thing you are asked are questions pertinent to treatment and if you are uninsured you are entitled to medical assistance unless your income is too high to qualify, in which case most medical facilities will allow for partial payments and payment in installments. This idea that accident victims are being polled about their insurance before even being treated is a fallacy. A docter and/or hospital can be in a lot of trouble if they were to do something like that, not to mention emergency responders and care givers don't handle issue of insurance anyway.


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Originally Posted by kittling View Post
Yep - that way everyone is covered! No complaints here
O.K., I'll ask, who in the U.S. currently isn't covered for emergency medicine and is without a way to recieve regular medical treatment? Between government assistance and free clinics as well as donated medical time and forgiven debts who is left out and untreated? If the government runs it here, is anybody niave enough to think eveyone will still get treated? If so what program run by the U.S. government is the basis for this belief?



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Originally Posted by kittling View Post
Well I can't speak for your country but having seen that argument fall flat on its face when all the utilities in the UK were privatisatised and cost to the consumers have sky rocketed I ahve to say I would ahte to see the same thing happen to healthcare.

The Show me that example in the U.S. in any program. Show me one thing our government runs efficiently at all. I have no background on U.K. utilities, but I have extensive background on U.S. government and I have almost absolute certainty that they will not well manage or run anything close to the massive machine that healthcare is in the U.S.


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Originally Posted by kittling View Post
Also in the UK the NHS provides extreamly good qualty care and frequently has to bail out private health care patients when thier treatments go wrong - it doesn't tend to happen the other way, so I know where I'll be more likely to get good quality care.
Government medicine in the U.S. works the other way. Having been military I have recieved government sponsored medical care and I have seen the number of refferals to private facilities required because of the inability or failure of military hospitals. I have also seen the abuse inherent in "free" medical care as every sniff or sneeze gets a doctor visit.

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Originally Posted by Mundungus Fletc View Post
Actually compared to the US it's incredibly good value - in 2003 (the latest year I could find figures for) the UK spent 7.8% of GDP on healthcare whereas the US spent 15.2%. In other words you spend nearly twice as much in real terms as we do but we get universal coverage (even tourists get free emergency care here) and you have a huge number of uninsured people.
O.K., U.K. tort law is less friendly to people suing and judgments are far smaller in cases that are persued. Also, I believe, though I could be mistaken, there is a looser pays system for tort, isn't there?
Either way, the U.S. and its medical industry spends significantly more on R&D than the U.K.'s NHS and the U.S. has one of the least healthy populations on Earth. This is for a variety of reasons, mostly lethargic lifestyles and poor diet and health habits by comparison, but it does play into the difference as well.

As for tourists, everyone, even foriegn fighters gets emergency treatment in the U.S. I am not sure what kind of rubbish is being sold, but emergency medicine is an absolute and no one can be turned away if they are in need. Again, maybe we need to look a little closer at what percentages are being spent for what to make that comparison. I would bet insurance for medical providers is a significant differential as well as research and developement spending and salaries for medical professionals and individuals.

There is also the licensing and reviews that are done in 50 seperate states and federally monitored that the U.K. doesn't have and the disperity on illegal aliens in the U.S., and issue many times larger here than in the U.K., which costs billions of dollars a year as well. I don't see how federalizing will eliminate any of that expense, unless it reduces treatment, limits tort (which it should do anyway) and reduces research and developement. Expanding the government involvement, whch is the most costly portion already has no chance, IMO, of reducing cost at all.


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Originally Posted by Mundungus Fletc View Post
There are instances where Government can be more efficient than the private sector and this is clearly one of them. Of course a large part of the saving is because we don't have the massive accounting system you have to have in the US. I doubt the scale of medical malpractice cases is much lower here than in the US - certainly satellite TV here is full of adverts for 'Ambulance Chasers Direct.'
Show me one in the U.S. That are show what costs were reduced when the U.K. changed over. I only need one U.S. example of a program well managed that would be a model to use for healthcare. As discussed many times before, the geography and population of the U.S., coupled with its federal and state beuracracies makes any foriegn model virtually unusable as by expansion the dynamics are seriously changed and costs exponentially raised.


Quote:
Originally Posted by Mundungus Fletc View Post
Nobody in Britain can avoid paying for the health service assuming they purchase goods or services. The evidence from Europe is that you will pay substantially less for health with a social system - France which consistently comes out top in comparisons of health systems pays 50% less than you.
This isn't evidence of anything of the sort. That is an apples to oranges comparison. There are litterally hundreds of variables that differ to influence this comparison and while people make simplistic assertions of this sort routinely, look at any comparable socialized system that exists in both nations and tell me they cost anywhere close to the same or are run as easily here as they are in smaller more condensed nations. Education alone should be the counter-example to illustrate what I mean. We spend incredibly on socialized education and it only gets worse as the system gets older. It can't compete in either cost or results with private schools which are better run and more efficient spending less per student and getting better results.


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  #183  
Old May 11th, 2009, 6:54 pm
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Re: International Healthcare: The good and bad of your area!

What about specialized doctors, Lup? Not plain old Physicians? I don't know of any place where I can go and get a free eye exam. My two years are up, and last time I went to the eye doctor, despite *** fact I had no insurance anymore, I paid out of pocket. Free Clinics usually only provide the basic stuff, not the specialized stuff like a GYN visit or Eye Doctor visit, etc.


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  #184  
Old May 11th, 2009, 8:18 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by SSJ_Jup81 View Post
What about specialized doctors, Lup? Not plain old Physicians? I don't know of any place where I can go and get a free eye exam. My two years are up, and last time I went to the eye doctor, despite *** fact I had no insurance anymore, I paid out of pocket. Free Clinics usually only provide the basic stuff, not the specialized stuff like a GYN visit or Eye Doctor visit, etc.
Fair enough. The contention was that accident victims were being left untreated or were being questioned before treatment because of insurance, so I answered that. If you are uninsured and have an income below a certain amount, aren't you eligible for medi-care benifits to cover GYN and general/preventive medicine visits as well as emergency medical? As for optical, I am not sure how that works exactly as I didn't need it when I was uninsured. I did use government assistance and it wasn't stellar, but was available, albeit after a frustrating application and approval process.

I don't know how accessable GYN, dental and optical will be if government does take over, but I don't hold out any hope that it will be all that easy to get or very helpful if it is covered. I know options were very limited in that regard during military service so it isn't likely to be better if the same folks run the show with hundreds of millions more people who aren't generally healthy to start with to take care of.

I think there is a certain utopian idea of what government universal healthcare would be like, but in reality, the red tape and massive demand would make some aspects very costly and many aspects difficult to obtain. Elective versus required would take on new meaning and I can definitely see the referal system making HMOs look like streamlined systems.


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  #185  
Old May 11th, 2009, 8:25 pm
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Re: International Healthcare: The good and bad of your area!

What do you think of the "assurance" that the various health industry groups will "cut" 2 trillion in costs over the next decade? It's been all over the news today. I'd love to see more details than just the assurance, but I haven't been able to find much.


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  #186  
Old May 11th, 2009, 11:52 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by OldLupin View Post
Fair enough. The contention was that accident victims were being left untreated or were being questioned before treatment because of insurance, so I answered that. If you are uninsured and have an income below a certain amount, aren't you eligible for medi-care benifits to cover GYN and general/preventive medicine visits as well as emergency medical?
No job...still...sorta. I just started one, but no benefits.
Quote:
As for optical, I am not sure how that works exactly as I didn't need it when I was uninsured. I did use government assistance and it wasn't stellar, but was available, albeit after a frustrating application and approval process.
I've been wearing glasses since I was five years old, and my eyes have gotten worse over the years. I'm at the point now where I can't see much without them (mainly with reading, though). Paying for eye-doctor visits are horrible! It's so expensive! Wish there was something affordable to get the insurance to go. For me, insurance period will be difficult to get because I have a "pre-existing condition".
Quote:
I think there is a certain utopian idea of what government universal healthcare would be like, but in reality, the red tape and massive demand would make some aspects very costly and many aspects difficult to obtain. Elective versus required would take on new meaning and I can definitely see the referal system making HMOs look like streamlined systems.
I don't really see that at all. I'm one of those who have no problem paying an extra tax to help those who need it, especially when it comes to medical stuff, and I guess I'm like that because I can't go to the doctor for the stuff I need (I really could use a check up with the GYN, dentist, and optometrist just to make sure I'm okay), and know that there are way too many people who don't have it, and these people have jobs. As I mentioned before, out of all of my first cousins, only three of them have health insurance coverage. Two are minors and the other, in her 20s, works in a hospital. The rest have full-time jobs, but no insurance benefits. I just find this completely wrong.


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Last edited by SSJ_Jup81; May 11th, 2009 at 11:54 pm.
  #187  
Old May 12th, 2009, 5:05 am
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Re: International Healthcare: The good and bad of your area!

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SSJ_Jup81
I've been wearing glasses since I was five years old, and my eyes have gotten worse over the years. I'm at the point now where I can't see much without them (mainly with reading, though). Paying for eye-doctor visits are horrible! It's so expensive! Wish there was something affordable to get the insurance to go. For me, insurance period will be difficult to get because I have a "pre-existing condition"
I had to get glasses recently. I didn't have to pay anything for a consultation with the optometrist. The only thing I had to pay for was the glasses themselves (although they were covered by my private cover so they cost next to nothing).
When I go to the doctor it might cost me... $30? But then I'll get given about $25 of that back from Medicare. If it was going to cost me $30+ every single time I go to the doctor I'd probably never go (I'm a student. No money).
I'd hate to think what would happen to people here if we had to pay a lot out of pocket for medical treatment or check-ups. I like knowing I can go to the orthodontist, optometrist, GP, dentist and whatever other kind of doctor I want and not have to worry about spending all of my money.


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  #188  
Old May 12th, 2009, 2:35 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by Hysteria View Post
I had to get glasses recently. I didn't have to pay anything for a consultation with the optometrist. The only thing I had to pay for was the glasses themselves (although they were covered by my private cover so they cost next to nothing).
When I go to the doctor it might cost me... $30? But then I'll get given about $25 of that back from Medicare. If it was going to cost me $30+ every single time I go to the doctor I'd probably never go (I'm a student. No money).
I'd hate to think what would happen to people here if we had to pay a lot out of pocket for medical treatment or check-ups. I like knowing I can go to the orthodontist, optometrist, GP, dentist and whatever other kind of doctor I want and not have to worry about spending all of my money.
Last time I went to the optometrist in spring 2007 (and I had no choice since my glasses I had then broke, and it was affecting my work performance since I could barely see what I was doing), I had to pay for the entire visit on my credit card. The visit ended up in the hundreds (I think it was a little over $400 or either it was close to $500) along with having to get new glasses and lenses. I need to go back, though, since it has been two years, just to check up on it. I wish it did cost only $30 for me to go, but I definitely need new glasses, or new frames at least.


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  #189  
Old May 12th, 2009, 6:04 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by chparadise View Post
What's the cost to society, the taxpayer, and the like from care for uninsured Americans right now? It's suprisingly high, and any calculation of the cost of any universal health care system would do well to make sure that this factor is included. I work next to a county hospital which treats thousands of uninsured patients per year (I don't have the exact figure handy). Those costs come back to taxpayers indirectly in two ways: first, by increased hospital bills for those who carry insurance; and second, via increased taxes to cover the part of the bill that government foots already. Give these uninsured people preventive care instead, and the overall health cost drops and the quality of life improves for society as a whole.

I will concede that in the end it's likely that a universal health care system will result in increased government costs - but I think it's important to note that we the taxpayer and insured are already footing part of the bill for uninsured people.

Most of that cost comes from unpaid bills, and that loss being deferred upon the insured or the pay-capable. If the bills get paid, much of the costs per person will go down.

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What do you think of the "assurance" that the various health industry groups will "cut" 2 trillion in costs over the next decade? It's been all over the news today. I'd love to see more details than just the assurance, but I haven't been able to find much.
Questionable. They can make that claim now, but they really have no one to answer to if it doesn't provide fruit. They can easily claim that one group or another didn't keep up its end, so they couldn't keep up theirs.

However, the only evidence I see that this might hold true is that many on The Hill think that Obama will be the only President to finally get National Healthcare. This is something that insurers and many providers fear. So, they are responding to it, in an effort to stave that off.


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  #190  
Old May 12th, 2009, 6:17 pm
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Re: International Healthcare: The good and bad of your area!

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Most of that cost comes from unpaid bills, and that loss being deferred upon the insured or the pay-capable. If the bills get paid, much of the costs per person will go down.
The government is the biggest culprit for non-payment and partial payment, though. I think the idea that costs will be reduced doesn't allow for the already slow and inconsistent payment the government already has been imfamous for. The idea that they will be a good payer is kind of difficult to believe given the years of poor history, isn't it?

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Questionable. They can make that claim now, but they really have no one to answer to if it doesn't provide fruit. They can easily claim that one group or another didn't keep up its end, so they couldn't keep up theirs.

However, the only evidence I see that this might hold true is that many on The Hill think that Obama will be the only President to finally get National Healthcare. This is something that insurers and many providers fear. So, they are responding to it, in an effort to stave that off.
Claims of cutting costs are based partially in policy changes that have little to do with nationalized healthcare, IMO. Tort reform and liability limits, as well as adopting a "looser pays" system for liability cases would easily reduce costs by more than 2% if enacted almost immediately.

The reduction in liability insurance and legal fees alone would reduce operationg costs by more than that at every hospital and doctor's office in the country.

The real question is, how much fight will trial lawyers put up to keep these measures from being passed. They are after all one of the most powerful lobbies in the country and a strong financial backer of many of the sitting government, including the President and both majority leaders.


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  #191  
Old May 12th, 2009, 8:04 pm
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Re: International Healthcare: The good and bad of your area!

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Originally Posted by OldLupin View Post
The government is the biggest culprit for non-payment and partial payment, though. I think the idea that costs will be reduced doesn't allow for the already slow and inconsistent payment the government already has been imfamous for. The idea that they will be a good payer is kind of difficult to believe given the years of poor history, isn't it?
Agreed, mostly. The government tries to scrutinize the bills, paying only portinos, and denying if they don't cover, but this is nothing more than what insurance companies already do.



Quote:
Claims of cutting costs are based partially in policy changes that have little to do with nationalized healthcare, IMO. Tort reform and liability limits, as well as adopting a "looser pays" system for liability cases would easily reduce costs by more than 2% if enacted almost immediately.

The reduction in liability insurance and legal fees alone would reduce operationg costs by more than that at every hospital and doctor's office in the country.

The real question is, how much fight will trial lawyers put up to keep these measures from being passed. They are after all one of the most powerful lobbies in the country and a strong financial backer of many of the sitting government, including the President and both majority leaders.
Tort reform is something we should do before we instill National Healthcare. Once we place serious limits of liability, then we can start establishing flat fees for services.


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  #192  
Old May 12th, 2009, 8:39 pm
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Re: International Healthcare: The good and bad of your area!

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Agreed, mostly. The government tries to scrutinize the bills, paying only portinos, and denying if they don't cover, but this is nothing more than what insurance companies already do.
Insurance companies don't have the leadway to refuse on nearly as much or as often and have the disadvantage of being blocked or refused by providers for late or bad payment. The government is the biggest offender for many reasons, not the least of which being the lack of direct consequences that can be inflicted and the inability of providers to refuse them. An advantage and practice that would only expand with a larger, more comprehensive system under their control, IMO. Hostory and track record are usually good barometers in my experience and all signs point to this outcome, don't they?


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Tort reform is something we should do before we instill National Healthcare. Once we place serious limits of liability, then we can start establishing flat fees for services.
These are all important and potentially very effective steps that could be enacted without government running the system or becoming a national healthcare provider. There will always be government programs for those who can't obtain healthcare otherwise, but the less government the better and reduced cost and outlay would mean more access and cheaper rates.

All of this would make healthcare more affordable, more accessable and less cumbersome while eliminating the need for a massive government program. Especially one that I think would become mismanaged, poorly run and corrupt from the moment it was funded.


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  #193  
Old May 13th, 2009, 3:13 pm
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Re: International Healthcare: The good and bad of your area!

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Insurance companies don't have the leadway to refuse on nearly as much or as often and have the disadvantage of being blocked or refused by providers for late or bad payment. The government is the biggest offender for many reasons, not the least of which being the lack of direct consequences that can be inflicted and the inability of providers to refuse them. An advantage and practice that would only expand with a larger, more comprehensive system under their control, IMO. Hostory and track record are usually good barometers in my experience and all signs point to this outcome, don't they?
You are preaching to the choir when we talk about government slow-paying. But, we have to face facts. We ARE going to have a national healthcare system. The only question is how to run it. You bring up a good point about government oversight...and OVERSIGHT is the operative word. What else with they overlook?

My proposal has been a government body, free of the Executive or Legislative Branches, that answers directly to The People. They will be separately elected, and serve terms. If lines get long, and important surgeries and treatments are delayed or refused, or budgets get out of whack, heads will roll!




Quote:
These are all important and potentially very effective steps that could be enacted without government running the system or becoming a national healthcare provider. There will always be government programs for those who can't obtain healthcare otherwise, but the less government the better and reduced cost and outlay would mean more access and cheaper rates.

All of this would make healthcare more affordable, more accessable and less cumbersome while eliminating the need for a massive government program. Especially one that I think would become mismanaged, poorly run and corrupt from the moment it was funded.
You are incorrect about there always being programs for those that can't afford healthcare. Someone who has a pre-existing condition, or is generally in poor health, and loses their health coverage, but is not destitute becomes a self-payer. This person often gets wiped out finanacially. They may be capable of working, but they are working for nothing more than to pay their medical bills. Or...they continue to put food on the table, while their health is neglected because providers won't provide to someone who still owes them money.

Remember, the law only provides protection and the right to treatment for those in urgent need. A diabetic, who needs insulin, testing equipment, and regular doctor's visits isn't protected. That person still has to pay upfront for that care...however, if they can't, and their blood sugar goes through the roof, landing them in the ER, then the hospital can't refuse them. This is a charge the hospital either can't collect, or the government subsidizes. Now which do you think is cheaper? Doctor's visits, insulin, glucophage, and test equipment for a year, or a 5 day stay in the hospital?


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