Source: Are you getting overcharged by your hospital? Time to become a Smart patient | VentureBeat.
If you’re a patient represented by Medicare or Medicaid, you’re well served because these programs have significant market muscle: They negotiate prices below what it costs to treat patients. …..
With few exceptions, private insurers tend to be relatively weak when bargaining with hospitals, so that hospitals can extract from them prices substantially in excess of the full cost of treating privately insured patients, with profit margins sometimes in excess of 20 percent.
Finally, uninsured patients — also called “self-pay” patients — have effectively no market power at all vis-à-vis hospitals, especially when they are seriously ill and in acute need of care. Therefore, in principle, they can be charged the highly inflated list prices in the hospitals’ chargemasters, an industry term for the large list of all charges for services and materials. These prices tend to be more than twice as high as those paid by private insurers.
A fellow blogger clued me in on this report about why our medical bills are so high. I now have an electronic copy of this Time issue and plan to do several posts on it in the coming weeks. We have a major problem with out present healthcare system. We are currently spending twice as much as any other country in the world on our healthcare and actually more unhealthy and dying earlier than most.
It seems that most in Washington, especially the conservatives, want to solve our problem by denying care to those who can’t afford to pay the full bills. They want to reduce coverage for those on Medicare and Medicaid and want to repeal Obamacare; they say that will fix our problems. That and suggesting that people die early if possible. The Time article above shows us a very different scenario of the causes for our exorbitant spending.
I certainly hope that the results of this study are taken to heart by our legislatures. But since the article basically puts much of the blame on our hospitals and caregivers I doubt it will get much response from them. The medical lobbies in this country are among the strongest around; they spend millions every year to keep these sort of reports in the background of life.
The quote above is the crux of the problems that are further explained in the article. The guy that can afford it the least is the one to bear the brunt of hospital overcharges as they have no market power. While Medicare and Medicaid patients are “well served” as the quote says there are still many ways to reduce costs even further. The most obvious one that the Republicans in Washington so object to is the ability of that system to bargain with the drug manufacturers for reduced rates. That seems a no-brainer to me. It would reduce costs in those systems by several billion dollars every year. It is indeed a low hanging fruit in healthcare containment that has been left untouched because of lobbying power.
Somehow or another we need to convince our lawmakers and regulators to start looking at cost containment instead of service denial. I will be posting several more times about what this article found on “why medical bills are killing us”. I hope you will be as astounded by the facts as I am and possibly spurred to some sort of action.
Source: Paul Ryan’s new Medicare plan could be tip of the iceberg (+video) – CSMonitor.com.
A parallel factor is rising income. As a society grows richer, it tends to spend more of its income on health care. Add in demographics (an aging population) and a lack of competition among health-care providers in many markets, and you have a recipe for more people to consume more health-care services at higher prices.
For once I am not going to comment on Mr. Ryan’s seemingly enthusiasm to balance his budget on the backs of the poor while asking for increases in our bloated military budgets and more tax breaks for the rich. That continues to be insane to me but is not the focus of this particular post. Instead this post is about fixing Medicare and Medicaid. The quote above is at the end of this news article but says much about how some view the problem of spending our healthcare dollars.
The quoted argument seems to say that we choose to go to doctors because we can. I don’t know about you but I don’t sit down in the morning and try to decide whether I will go to the mall, the park, or to the doctor that day. I go to the doctor when I am sick or have what I think might be a serious medical problem. I don’t use doctors as a form of entertainment! Yeah, I know about the hypochondriacs out there but I hope they are a very small group.
Of course the quote also deems that the lack of competition is the cause for increasing prices for healthcare. We just don’t have enough McDoctors and McHospitals around yet I guess. Maybe I am naive about all of this but I kind of believe that competition is more of a cause than a solution. When Hospital “A” gets the latest multi-million dollar piece of medical equipment then Hospital “B” has to get it too so they can compete. It doesn’t matter that one machine could provide all the tests needed by the community. It doesn’t matter that hospitals will use the machines where they really aren’t necessary because they have them.
If we really want to get our healthcare costs down we need to do what the rest of the world already knows and that is a single payer regulated system. We spend more than twice as much as everyone else and actually live shorter and less healthy lives. It continues to amaze me how we in the U.S. fail to understand this very basic approach to healthcare.
Source: Fact check: Bill Clinton at the DNC – USATODAY.com.
CHARLOTTE, N.C. – Former president Bill Clinton’s stem-winding nomination speech was a fact-checker’s nightmare: lots of effort required to run down his many statistics and factual claims, producing little for us to write about.
Republicans will find plenty of Clinton’s scorching opinions objectionable. But with few exceptions, we found his stats checked out.
The worst we could fault him for was a suggestion that President Obama’s Affordable Care Act was responsible for bringing down the rate of increase in health care spending, when the fact is that the law’s main provisions have yet to take effect.
I must admit that I have always enjoyed listening to Mr. Clinton’s speeches. He just has a way with finding just the right words for every story. If someone had just super-glued his zipper on that fateful day of his “improper relationship” there would be little to fault him with during his presidency. After all he was the only president in 50 years to have a surplus budget. I’m sure if any of my radical right friends dared to listen to his speech last night they are probably still uncontrollably wincing.
During his speech he step-by-step dismantled every argument against President Obama found in the many vitriol comments given at the RNC last week. About the only thing the fact-checker could find in it was that maybe he gave too much credit to Obamacare in causing the healthcare declining costs last year. I know the Republicans gave the Affordable Care Act (ACA) the name Obamacare as a slam but it is now being commonly used as showing an achievement for the president.
If there is anyone who still is on the fence in this election I would strongly advise them to get a copy of this speech and read it. It was a forty-five minute speech given in the typical “Now listen this is important…” Bill Clinton mode. I would attempt to put down some of the most memorable things here but there are just too many to keep below my self-imposed five-hundred or so word limit for blog posts.
The one thing in the speech that I will mention is his comment that during his lifetime he has never seen such hatred displayed toward a president. That is the most distressful part of the Tea Party version of politics to me. We had some very good friends in the past who are now spewing this hatred. To see the anger and hate in their eyes when they talk about the President of the United States is truly scary to me. But maybe the scariest part of this is that they are doing it in church related functions such as Bible study classes. I seem to remember Jesus telling us to love our enemies. My past friends seem to have forgotten that phrase as well as so many other found in their bibles!
But what do I know…
I was a small business owner for six years after I retired from the big business corporate world. But being a sole proprietor with no employees I really don’t have a good view of just what small businesses are really about. The Republican political leaders say small businesses are the growth engine of our country and we shouldn’t tax them by taking away the Bush tax cuts for those making over $250,000 annually.
How many of the so-called small businesses were like mine just a guy in a shop building things for customers? How many hire more than a handful of employees? I decided to look into this.
Here is a link to a bunch of numbers in this area: http://www.census.gov/econ/smallbus.html
- There are approximately 29 million business in this country
- Of those 29 million about 22 million are business with no employees
- Only one million firms have more than 9 employees
- Only 90,000 (0.3% have more than 100 employees
- Across the United States, small business failure rates rose by 40% between 2007 and 2010
- Only about one if five small businesses will be in existence five years after its creation
Source: Insurers like that health law ruling sets their path – USATODAY.com.
Companies are spending hundreds of millions on technology already to cut administrative costs, he said. Instead of buying individual health policies through agents who take up to 10% of the policy’s cost in commissions, consumers will buy coverage online or on the phone, he said, to help meet the law’s requirement that insurers spend 80% of premiums on health-care services.
This is an article about how the private insurers are trying to cope with the new healthcare laws recently found to be constitutional by the Supreme court. One of the many beneficial provisions is that at least 80% of premiums must be spent on actual health-care services. That means that the profits of these private business must come from the other 20%. It seems like a reasonable thing to do to me. But what do I know.
One of the solutions as mentioned here is to cut administrative costs. Buying on-line seems to be the wave of the future. I must admit that I still get my insurance coverage (house/car) through an agent, who happens to be my neighbor across the street.
I don’t know how big a change this 80% rule has on these companies. I wonder what was the common percentage before this law. But it seems that yet again our government is forcing private business to find the most efficient way of doing things. Now if they would only follow their own advice and seek those same kinds of efficiencies in the public sector! Maybe we need a regulator for our government services as well as our private companies?
Medicare, which along with a supplemental, is now my insurance carrier. I know they are a government agency and that they have the lowest percentage of revenue going to administrative purposes. I hope private carriers are learning how they do it. I also know that Medicare is rife with fraud, much of it coming from people and companies gaming the system. Maybe the regulators need to force Medicare to reduce fraud the same way they are forcing private carriers in reducing their overhead.
What is good for one is certainly good for the other.
But what do I know…..
Source: Lew Says Republicans Should ’Get Over’ Health Law Debate – Businessweek
In Massachusetts, where former Governor Mitt Romney, the presumptive Republican presidential nominee, implemented a similar law, just 1 percent of the population is subject to the penalty, Lew said on CNN’s “State of the Union” program.
As the White House Chief of Staff says in this article the Republicans in Congress need to get over it as far as ACA (American Care Act) is concerned and move on to something that will actually do some good for the country. They fought tooth and nail to repeal Social Security, Medicare, Medicaid, and such and lost every time.
I have heard that their present battle now that the Supreme Court decision didn’t go their way, is like a dog chasing its own tail. They just don’t know when to stop. They keep growling and groaning that the present law is bad for us but they also give us no idea of just what they would replace it with other than to give us some minimal “voucher” and then turn us over to whatever the insurance companies want to provide. Is it acceptable to them that 30 million Americans have no healthcare? Is it acceptable to them to deny healthcare because you are sick? We don’t know the answers to those questions because they haven’t gotten around to addressing them. They would much rather just complain that the current version is unacceptable.
If they really hope to gain the White House next year they need to quit whining and start offering solutions other than to just tear down the existing establishments. Sometimes destruction is necessary to assemble something better to take its place but when you are just tearing down for the sake of tearing down it serves absolutely no purpose. I guess those folks who do nothing but complain hope that the rest of you don’t come to the same conclusions I have. If you do we will end up voting all those scoundrels out of office. Then they might have to find some real work.
But what do I know…
I just saw a segment on CNN about kids, high school age and younger, who are dropping out of school to take care of a home bound love one. These kids are caring for a mother, father, grandparent, or sibling on a full-time basis because there is no one else available to do it. The compassion they show is inspiring indeed. But at the same time it is totally shameful that they are even be put into a situation like this.
It is estimated that there are about 1.3 million kids in this situation. They have dropped out of school to give constant care to a loved one. By leaving school at such an early stage they are almost guaranteeing that they will live a life of poverty. This situation does not occur in any other developed country besides the U.S. We are the only developed country in the world that chooses to make healthcare a privilege of those who can afford it instead of a right to all its citizens. This terrible situation is a direct result of that choice. Unfortunately there are hundreds of other examples to be found.
I pray that someday we will provide universal healthcare for our elderly and disabled so that future kids do not have to make the choice of staying in school or seeing that a love one is cared for. SHAME ON US FOR EVEN PUTTING THEM IN A SITUATION LIKE THIS…..
Source: Foodies enjoy different tastes than the rest of us – USATODAY.com.
Foodie flavor preferences are in stark contrast to that of the general population, whose favorite flavor characteristics are far more familiar: sweet (81%) and salty (67%).
I don’t think I am a food snob but I really do enjoy savory and sour food as opposed to salty and sweet. I have been on a low salt diet for about six years now and have come to totally detest very salty things. For instance, for the most part, canned soup is no longer on my list of things to eat. If you haven’t looked lately almost all canned soups have 1,000 or more milligrams of salt per eight ounce serving. I just don’t understand the obsession with salt in our society? It has been shown to be detrimental to your health in a number of ways so why do we continue to put so much of it in our foods?
Sometimes I do enjoy sweets but they must be taken in moderation or the weight starts piling on. It is estimated that within ten years more than half of us will be approaching the morbidly obese category. This seems the epitome of the old saying “too much of a good thing”. We in this country have the luxury of being able to afford much more food than is good for us. It’s a shame that we can’t somehow take this problem of having too much food and move it to just about any country in Africa. Of course we can, we just shamefully choose not to make that a priority.
What is going to be the consequences of our love for sweet and salty? Are we heading for a tsunami of healthcare problems down the road? Let’s hope not as we can’t even manage our healthcare as it is…..
We in the U.S. have chosen to get our health insurance primarily through our employers. But that proves to be a very complicated process. The rest of the world has chosen their government to provide for their healthcare through their tax dollars.
Employer Paid Healthcare is Complicated:
- If our employer is small he is likely unable to afford the going insurance rates. Therefore those employees are pretty much own their own.
- If our employer is a religious based institution they will likely exclude things that other might be covered for.
- If our employer is having some financial problems they will likely drop our coverage. That would put us at a severe risk of being overwhelmed by even one significant medical event.
- Since our employer is just one of many he doesn’t have much influence on driving medical costs down that other countries do.
- Since our employer is burdened with this responsibility he has trouble competing against companies in other countries who don’t have that load. That, I am convinced, is one of the reasons companies choose to take their jobs off-shore; they will not have the burden of providing expensive insurance to their employees.
Employer paid Health care is complicated and burdensome to both the companies and their employees. When will we ever learn to take the lessons of others and make them our own? Healthcare should be a right to all not a privilege to some. Universal healthcare would accomplish that fact. Despite the world rankings that show us pretty far down the list U.S. healthcare is pretty good for those that can afford. The trouble is that fewer and fewer of us can afford it now days. And if Obmamcare is repealed the insurers will go back to excluding the sick by their “pre-existing conditions” clause that they seem to love.
Most people, especially those in the U.S. like to proudly proclaim we are number one. We shout it from the rooftops. We scream it about our favorite sports team. We are often caught with that silly large rubber hand to show our pride. We as a country are number one in several areas.
- We’re number one when it comes to our war machine. Heck, you could combine all the other war machines in the world together and that would still not knock us out of first place. We spend many times more in this country than in country in the world on our war machine.
- Because of the above item we are also number one when it comes to our debt load. No other country in the world has borrowed as much as we have from our children and grandchildren to finance our way of life.
- We’re number one in global weapons sales. That is probably our number one export. We sell more weapons of mass destruction than anyone else in the world. We sell to our neighbors, even those who eventually become our enemies and use them against us (take Iraq for example, or Iran as a future example).
We pride ourselves that we are number one. But let’s look at some of the areas where we fall very very short of being number one.
- We’re number 34 in the world when it comes to educating its citizens. Finland, which many here call a socialist country claim the number one mantle in education. As a matter of fact almost all industrialized countries are ahead of us in education. This fact does not bode well for our future citizens.
- We’re number 16 when it comes to infrastructure. We just don’t do a good job of keeping up in this area. Everything except for our military establishments are in decay.
- We’re number 37 when it comes to healthcare for its citizens. We are the only industrialized nation that does not provide healthcare for all its citizens. Yes if you have the money, and it takes a lot of money, you can get very high quality care in the country. If you don’t have the resources for a typical 6 figure surgery cost then you are pretty much out of luck.
Maybe I am just a naive soul but I would rather be number one is just about any of the items in the second list as opposed to be number one on all of the first. Until we somehow get our priorities aligned we will continue to slide down the lists of things that are really important.
But what do I know…..
No this post is not about how to gut Medicare as seems to be the topic of today. Instead it is about my personal travels of getting signed up for it. As I announced before I am at the head of the herd of the Baby Boomers so I will be joining Medicare this year. As a result I am starting to try to figure out all the ancillary policies I need to get. The free side of Medicare is really only Part A. (Note: I don’t intend to bore you with what all these letters and things mean so maybe you will be inclined to hang around this post a while longer.) Anyway I have to pay some for Part B and my pension plans says I need to get that so that is a done deal. But then comes the other things. Do I go out on my own and get Part D and a “supplemental” policy or do I continue to stick with the policy that my pension plan offers? That is the primary question I guess I have to cover in the next few months.
I have been on my pension plan for about over ten years now. It has gone from about $40/month when I started to more than ten times that amount this year. I just don’t know how getting on Medicare is going to change their policy coverage and amounts. Since my birthday falls on the same month as the pension plan insurance renewal info is available I guess I will have to make some quick decisions about this change in my life.
Even though she might not like it I have to admit that my wife is older than I am so we have already addressed some of these topics before. For her it was cheaper to drop off the “covered spouse” portion of the policy and go it alone. Given the fact that my pension plan still frequently states that, since I was a management employee and not under a union contract as my hourly friends were, they are under no obligations to continue to provide me with healthcare assistance maybe I should just dump them and get it over with. But since they keep complaining about it maybe they do put in at least a little of their profits into my coverage.
Whoever said living in retirement was a simple life obviously never considered all the complications of senior healthcare. I guess I should be thankful that Medicare will be even there for me. At least I think it will be unless the Republicans try to “fast track” replacing it. I paid into it for over thirty years so I think I should get something for all that money I paid in. I know the politicians borrowed it for other things but how is that so much different from the treasury bills I currently hold in my retirement portfolio? Oh boy, maybe I should be worrying about that too!!
I’m sure my Canadian friends who might be reading this post are getting a laugh out of all of this since they have universal coverage both before and after retirement these types of issues don’t exist for them. Maybe someday the U.S. might actually learn something about this for our northern neighbors. But I kind of doubt it.
And the journey goes on….
Source Article: Businesses turn to private exchange health insurance – USATODAY.com.
This is an interesting article about how some CEOs are giving up trying to figure this health insurance mess out and passing it on to their employees and pensioners. They just give them a set sum of money and basically hand them over to some former insurance executives for advice. In other words they are on their own. Here are people who are supposedly the cream of the crop in the business world who admit they can’t figure this stuff out. So, how are the their worker let alone their pensioners supposed to do that? This healthcare circus is just getting more ridiculous every year.
We in the U.S. take such pride in being the smartest of the smartest in the world. We boast that we are the only true innovators on the planet! But I kind of think we are in a gigantic bubble of illusion here, especially when it comes to healthcare. The rest of the world has long ago figured out that a single payer system, mostly maintained by their governments, is the only way to keep healthcare costs in line. They spend less and actually live longer than we do. There are no other industrialized countries that spend even one-fourth of what we do per person for their citizens’ well being.
Come on guys, lets finally admit it that sometimes others outside the U.S. have it more right than we do. Let’s get on the single payer system and get off this constantly increasing healthcare merry-go-round. The employer based healthcare system is totally out of control; let’s replace it with something the rest of the world knows is better.
But I’m just a simple guy so what do I know….
The Republicans in congress seem hell-bent on eliminating the healthcare bill passed by Congress in 2009. They say they want to start over again but don’t really say just what it is that they hate so much. Is it:
- giving those who can’t afford even basic healthcare a change to get it?
- preventing the insurance companies from declaring “pre-existing conditions” for wherever they don’t want to have to cover?
- requiring everyone to have at least a minimum level of healthcare insurance the same way most States currently require auto insurance?
- requiring that most of the money collected for insurance actually goes to providing healthcare?
The last time the Republicans had any suggestions for healthcare they did not cover any of the above things. Of course the first thing they would do is to consult the insurance companies as to how they would like to make changes. That’s kind of like the fox guarding the hen house. But they have suggested that before for the financial meltdown so I wouldn’t be surprised they did it again for this one.
Take a look at the article referenced by the below link to see where President Obama has invited the States to make improvements to the current legislation in their respective States. It is time for the Republicans to “put up or shut up” about healthcare. Just saying you are against something is not productive.
It depends on who is taking the polls on this topic as what they find. Some say the majority are against the current legislation but some say they are not. I personally am against the legislation because it doesn’t go far enough but I am hoping it can be added to later. I wander how many in the against column are like me? Like all polls it just depends on the question asked. But to me even if the majority is against it it can still be a “Tyranny of the Majority” issue. My moral code is much stronger than any political alignment.
But what do I know….
Dear Mr. President
I know you are pretty busy creating your State of the Union address for next Tuesday so I thought you could use some free advice from someone outside of the beltway. No, I don’t have an MBA degree from Harvard or other Ivy league college although I did manage to graduate from Purdue University about more than forty years ago but that hardly counts now.
Up front I must say I actively supported you in your run for office in 2008 but to my disappointment you seem to have gotten off message quite a bit since then. I can certainly understand that as you are now surrounded by the most powerful political elitists in the world. Maybe they have convinced you that the promises you made to guys like me are just not achievable. But that is another story.
I am offering this advice as just a simple guy who worked as an engineer for more than thirty years and is about to enter into the Medicare system that is so trashed today. I am at the front of the Boomer generation so over the years I paid for my grandfathers and my father’s health care via my Social Security taxes. Every year those taxes seemed to go up a little more but I didn’t complain much as I just assumed that those following me would return the favor. But if things keep going it looks like that may not be the case.
Let’s get on to my advice to you. I know you are looking for places to reduce spending and that is a very noble and necessary duty. The healthcare bill passed last year was a good start but please only consider it a start. The next logical step will be to look around the world to see how to reduce the costs. No, I am not one of those who think that we in the U.S. are the only ones who have a brain between their ears. It seems almost the opposite to me when I look at how much we spend keeping ourselves well compared to them. I know that Washington is a place that particularly likes graphs and such so I am going to include some in this advise.
I know the graph is kind of hard to see but I don’t have the staff of 200 to do it the right way so I will have to explain some of it. It seems to me, being a simple person that I am, that a good way to judge how well your healthcare works is would be to look how long we live. The graph here shows that among all the countries listed that Japanese citizens live the longest; almost ten years more than we do. Japan’s healthcare costs per citizen is a little over $2500/year. Our corresponding costs are shown on the graph. You have to look all the way to the very top to see it. It comes out as about three times what the Japanese pay and Japanese cover a much higher percentage of people!
I admit that I have been a Chevy guy all of my life but it seems that a lot of people in this country think Japanese cars are superior to ours. Having to bail out GM last year seems to reinforce that fact. So, if so many of us think the Japanese are better car builders shouldn’t they be good at other things too? Maybe you can convince us on Tuesday that that we should be looking at how they spend three times less than we do and live a lot longer. Isn’t here something to learn here? If for some reason people won’t look to the Japanese, we did go to war with them just before I was born, maybe you can convince them to look at any of the the other nations who seem to be doing it better then we do. There are scores of them. How about New Zealand? I don’t think we have anything against them?
Isn’t it just possible that we can learn from others on how to control our medical costs? Our current system seems almost unfixable so lets look at how others do it.
That is enough for this idea. I will let you think about it some and tomorrow I will give you a sure fire idea on how to control our runaway deficits. My solution tomorrow really seems to be a no brainer. But what do I know I don’t have that big time college diploma that so many around you have.
(except for the graph from National Geographic this post is totally me so there are no sources here)
Baltimore Sun – January 20, 2011 by Thomas Stitz
With the new U.S Congress looking for ways to cut the deficit, we should demand that they eliminate their own health insurance from their benefits. If Republicans are so hell-bent on repealing the new health care law, they can give up their own health insurance. After all, they are essentially independent contractors, hired on for a two- or six-year stint, and most of them are rich enough to pay for their own insurance. Why should the taxpayer pay? And why do we pay for premium lifetime health benefits after they’ve served only 5 years?
Some members may have trouble getting a policy because of pre-existing conditions like chronically enlarged egos, convenient memory loss and wagging tongue syndrome. Sen. Mitch McConnell has recycled arteries after he got federally-paid-for, triple bypass surgery in 2003. New Rep. Andy Harris of Maryland, a wealthy physician at Johns Hopkins Hospital, had a hissy fit when he learned that his government health policy wouldn’t start until February 1 — forcing him to go a whole month without taxpayer subsidized insurance! Unfortunately, there is no cure for chronic hypocrisy.
Maybe Congressional staff should have to pay for insurance also. Let their bosses go out and find a small group policy. If just one of the brightest, hardworking staff has a pre-existing condition, it would raise the rates for the rest of his staff so much that this ideal employee could not be hired. This very situation happened in 2010 to a friend of mine who owns a 100-person business in Dallas.
This current debate is not about coming up with better health legislation — it’s about defeating President Obama in 2012. He and the last Congress had the foresight, brilliance and determination to make consumer-oriented changes to a health care system controlled by a few large, tyrannical health insurers. The health care sector has spent $1.7 billion lobbying Congress since 2006. Let’s ask the health insurers to take the millions they pour into campaign coffers and, instead, provide free health insurance for this new Congress. With the average family policy costing $13,750, we could cut the deficit by $330 million this year alone and still keep the insurers in most of the back pockets of Congress.
Thanks Thomas for the above article. Will Rogers would have certainly been proud of you for your words. Those words speak for themselves so I don’t have much to add. If the now Republican controlled House is serious about budget reductions and really believe that entitlements in general and single payer health care in particular are an evil then they should vote to remove themselves from the very systems they vilify. Let them go out on the private market and get insurance for their families and staff members. After all what company in the real world covers its short term private contractors! None that I know of. As mentioned this action would be an immediate $0.3 billion reduction of the deficit! If they are really serious about their rhetoric then let their actions speak louder than their words.
Does anyone out there really see this happening???