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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>I have had my fair share of doctors and hospitals… with myself, my wife, and my 9-year old son (who looooooves to ride his dirt bike).<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Diagnostic tests are ADVISED by doctors, it’s the public that blindly follows their advice and assumes that it’s an ORDER. Short of your being unable to voice your own opinion (or have someone with legal authority to do so) a doctor can’t ORDER you to do anything.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Yes, you can, in fact, order your own MRI. (Feel free to do it yourself… that’s what we did with my wife’s shoulder injury last year… we got all the images from the MRI burned to a CD that we were able to take with us until we found a specialist we liked). The FACT is, society is dealing with doctors who THINK they have the authority to “ORDER” something, or that tests can’t get done unless they accompany a doctor’s ORDER … but when you cut through the crap, you are left with a series of businesses that trades consultations and services for currency. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Doctors sometimes (well, often) HATE being questioned. I’ve walked out of a doctor’s office more than once, unsatisfied with either the answer (or lack of their willingness to explain), and found another doctor. (From my personal experience… Texas was the worst in this regard).<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Yes, I have, in fact, had the experience of a doctor “ordering” an MRI (on my knee)… and I have, in fact, asked the doctor if it was truly necessary, and what the likelihood that a simple X-Ray would be able to pinpoint the problem. (I opted for the X-ray, I got lucky, and the problem was found…).<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Yes, I do, in fact, have a “high-deductible” on my insurance policy. I choose to pay for my own medical, dental, prescriptions, etc… and I choose to use insurance as a safety net, not a blanket. I take advantage of my HSA, and I make sure that I have sufficient capital stashed to pull the trigger on my high-deductible (should I or our family need it)… as a result I choose to scrutinize the costs and procedures with everything below that line and pay for it out of my own pocket. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>I make sure I am prepared… I make sure my family is taken care of… yet when I look around society I see an increasing number of ‘grasshoppers’ and a decreasing number of ‘ants’… and more grasshoppers pushing agendas and legislation punishing the ants for being well-prepared and informed.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Jay<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> keely emerinemix [mailto:kjajmix1@msn.com] <br><b>Sent:</b> Wednesday, January 18, 2012 12:46 PM<br><b>To:</b> Jay Borden; donovanjarnold2005@yahoo.com; vision2020@moscow.com<br><b>Subject:</b> RE: [Vision2020] More Proof Preventative Health Care Saves<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>I think, Jay, we have all seen a multitude of examples of "people making BAD decisions" in the healthcare climate we endure these days in the U.S. Most of the time, those decisions are made by insurers, whose approach to market-driven, business-model healthcare counts every single cost except for the very real personal costs inflicted on sick people.<br><br>I don't see the truth in your example that using "other people's money" in healthcare distribution is like you and me going to a restaurant and my ordering not the lobster I would've if I'd known you were paying and, lacking that knowledge, ordering only the soup-and-sandwich combo. Bad manners in social interactions are not the same thing as denying people access to preventative care that not only spends healthcare dollars wisely in prevention and early diagnosis, with better treatment outcomes, as well as empowers people to manage their own personal health. You seem to believe that the indignation I might feel that someone "orders up" if I'm paying is at all analogous to having access to and making use of comprehensive preventative, diagnostic, and treatment options that by every standard improves the life -- and life expectancy -- of the patient. It isn't.<br><br>I cannot imagine a scenario under which people "pig out" by availing themselves of "other people's money" -- which, given the tax-supported nature of government involvement in healthcare is actually THEIR own money -- to pay for their scooping up each and every test possible. You're aware, I know, that most diagnostic tests are ordered by doctors themselves, not by patients. In other words, while I might call and schedule my own mammogram (at my doctor's recommendation), I can't just wake up one morning and decide that an MRI would be a fun way to pass the day. No, those tests are ordered by physicians. I suspect you haven't had the experience of having your doctor suggest that you have an MRI to pinpoint the source of your pain, or a complete blood panel to rule out leukemia, only to have to tell her/him that you can't afford it -- either because you're uninsured, or because you carry a $10,000 family deductible and can't come up with your share of the cost. Further, it's hard for me to imagine that you actually envision a world in which "too much" medical care is a bad thing, unless, of course, you're in the camp that believes that Grandma really ought to have to have her case reviewed by managers disinclined to spend money on an 80-year-old. If you're at all "pro-life," you're not. But you tell me.<br><br>Finally, I think that you and I would measure the moral strength of a country in different ways. You seem to think that the market-driven, frankly discriminatory stinginess now evident in the way this nation deals with healthcare is not only a good business model, but an honorable way to have its citizens deal with each other -- and not as equals or as co-citizens, but in a hierarchical model that ensures that those in power, those who are not doctors, those who control the pursestrings and thus make life-and-death decisions that result in death, not life, are entitled to inflict a business model on people who are only "customers," disposable and easily forgotten. I disagree. The measure of this nation's moral character is when the gap between the have's and the have-not's, while evident in other areas, should never result in the acceptability of early death and prolonged suffering because it makes business sense to people whose healthcare needs are immune to the "silent hand of the market." That, I'd never apologize for. I'm just amazed that you and others would defend it.<br><br></span><span style='font-family:"Verdana","sans-serif";color:#8064A2'>Keely<br>www.keely-prevailingwinds.com<br><br></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><div><div class=MsoNormal align=center style='text-align:center'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><hr size=2 width="100%" align=center id=stopSpelling></span></div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>Date: Wed, 18 Jan 2012 11:35:41 -0800<br>From: jborden@datawedge.com<br>To: donovanjarnold2005@yahoo.com; vision2020@moscow.com<br>Subject: Re: [Vision2020] More Proof Preventative Health Care Saves<o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>It sounds great… the math might be right, but I believe the human nature component is wrong… human nature changes when dealing with “other people’s money”. </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>(“Oh, if I had known you were paying for dinner, I would have ordered something more expensive…”)</span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Putting the word “preventative” in the name doesn’t change the way humans would react to and use it. </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>If we had universal health care, it means that individuals would never see the benefit of money saved… they would simply be given a “blank check” in terms of their health care and how they care for themselves… and therefore dismiss risks with personal choices for their health. </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>I can tell you first-hand my experiences on how human behavior changes as soon as fiscal responsibility to pay is shifted to the individual as opposed to a faceless 3<sup>rd</sup> party.</span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>It’s sounds heartless to say (and even harder to defend)… but in order to have people making GOOD decisions, you have to have examples of people making BAD DECISIONS.</span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Jay</span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> vision2020-bounces@moscow.com [mailto:vision2020-bounces@moscow.com] <b>On Behalf Of </b>Donovan Arnold<br><b>Sent:</b> Wednesday, January 18, 2012 10:56 AM<br><b>To:</b> vision2020@moscow.com<br><b>Subject:</b> [Vision2020] More Proof Preventative Health Care Saves<o:p></o:p></span></p></div></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> <o:p></o:p></span></p><div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'>Numbers show high cost of skipping your meds</span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Numbers show how skipping your meds can have serious health impact, financial consequences</span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'><a href="http://finance.yahoo.com/news/numbers-show-high-cost-skipping-214621515.html" target="_blank"><span style='font-size:12.0pt'>http://finance.yahoo.com/news/numbers-show-high-cost-skipping-214621515.html</span></a></span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>"—Every dollar spent on medication decreases total health costs to patients, insurers and government health programs by about $10.10 for people with high blood pressure, by $8.40 for congestive heart failure patients, by $6.70 for diabetics and by about $3.10 for patients with cholesterol disorders."</span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>And what idiots would pass up $3.10 to $10.10 return on each $1 invested? The same idiots that pass up universal preventive health care. The same idiots that believe it is better to pay $10.10 of taxpayer dollars in medical treatment tomorrow than to a give the person the opportunity of insurance to spend $1 on medication today. But when your interests lie with the person who gets the $10.10, only then it becomes clear why denying them the insurance to get the medication is the preferred action. </span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'> </span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div><div><p class=MsoNormal style='background:white'><span class=ecxentry-title><span style='font-size:18.0pt;font-family:"Tahoma","sans-serif";color:black'>Donovan Arnold </span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p></div></div></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><br>======================================================= List services made available by First Step Internet, serving the communities of the Palouse since 1994. http://www.fsr.net mailto:Vision2020@moscow.com =======================================================<o:p></o:p></span></p></div></div></div></body></html>