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Author Topic: Obamacare implimentaiton  (Read 24774 times)
Bill Peckham
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« on: October 25, 2013, 06:34:30 AM »

Signing up for health insurance through the federal health insurance exchange (healthcare.gov) was nearly impossible at first and now nearly four weeks in has gotten better very slowly. I don't think anyone is happy with how the launch has gone. No one knows if the signup process will be robust enough to meet demand as the coverage deadlines start getting closer or if the problems with signing up will significantly change the mix of people signing up. However, I think this video offers some important perspective on the process.

http://youtu.be/ql9RVy6FWkg

The relevant comparison to getting insurance through Obamacare is not how easy it is to buy a book on Amazon, rather what it is like to apply for health insurance pre Affordable care Act. Has anyone tried to get insured through the federal insurance exchange or one of the state exchanges?
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
Shaks24
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« Reply #1 on: October 25, 2013, 06:47:32 AM »

Great video Bill. Keeps things in perspective.
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Hemodoc
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« Reply #2 on: October 25, 2013, 09:42:41 AM »

Bill, it is all in the details. First, let's talk about this in July of 2014 after the law is in effect and see how accurate the projections are. Secondly, there could be a very logical reason why it may or may not have an impact on part time care. Simply Obama will count the effective hours instead of actual hours even in companies with seasonal employees for only 121 days as a full time year. If they are over for 121 days, it applies to the company for the whole year. The attention is in the details.

http://www.breitbart.com/Big-Government/2013/08/05/Uh-Oh-Small-Businesses-Can-t-Avoid-ObamaCare-By-Switch-To-Part-Time-Workers

So with Obama a full time work week is 30 hours and a full year is 121 days. Go figure. Is there confusion on this issue for employers??? You betcha, just like the ObamaCare website disaster. Funny, no one on IHD is talking about that train wreck already in town right now. How is that ObamaCare working for you already???
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Bill Peckham
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« Reply #3 on: October 26, 2013, 03:44:39 AM »

Bill, it is all in the details. First, let's talk about this in July of 2014 after the law is in effect and see how accurate the projections are. Secondly, there could be a very logical reason why it may or may not have an impact on part time care. Simply Obama will count the effective hours instead of actual hours even in companies with seasonal employees for only 121 days as a full time year. If they are over for 121 days, it applies to the company for the whole year. The attention is in the details.

http://www.breitbart.com/Big-Government/2013/08/05/Uh-Oh-Small-Businesses-Can-t-Avoid-ObamaCare-By-Switch-To-Part-Time-Workers

So with Obama a full time work week is 30 hours and a full year is 121 days. Go figure. Is there confusion on this issue for employers??? You betcha, just like the ObamaCare website disaster. Funny, no one on IHD is talking about that train wreck already in town right now. How is that ObamaCare working for you already???


Did you mean to post this to this thread??  What train wreck isn't being discussed? The federal sign up process is what the republicans in Congress (and no too few democrats) are calling a train wreck but that can't be what you mean ... considering this is a thread I started about the federal website/signup process problems. We'll know how the signup process went by December 15 when those who will have coverage on January 1 will have signed up. The key question is what the mix of people this will be - only old and/or sickest or the young healthy too.
« Last Edit: October 26, 2013, 03:47:04 AM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
nursey66
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« Reply #4 on: October 26, 2013, 05:43:45 AM »

All I have to say is, thank goodness there was not computers when Medicare started up Would of been the same thing !!! Glitch after glitch !!!   I worked in healthcare for 30 years, went through all paper charts to computerized charting, labs, patient contact, etc.  When ever we started a new computer program ,it was the exact same thing . Glitch after glitch. In spite of all the extra training, it was always difficult with lots of problems !!! It does't matter how much time there is to prepare, it was always the same. I can't blame anyone, the President, the Secretary of Human Services, the Progamers, I believe it's just the way it is with computers.  You really don't find the glitches untill it is rolled out.  Just my opinion, from my experience.
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noahvale
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« Reply #5 on: October 29, 2013, 07:06:44 AM »

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Jean
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« Reply #6 on: October 30, 2013, 12:22:17 AM »

I sincerely hope that no one is fined because they could not get online in time to get insurance. That would really be kind of rubbing their noses in it, wouldn't you think???
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Zach
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« Reply #7 on: October 30, 2013, 08:26:17 PM »

Here is an interesting explanation (in 3 PDFs) by The NY Times about the issue of individual policies affected by the ACA.
http://www.nytimes.com/interactive/2013/10/30/us/why-some-people-cant-keep-their-insurance-plans.html
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« Last Edit: October 30, 2013, 09:36:12 PM by Zach » Logged

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Going through life tied to a chair!

« Reply #8 on: October 30, 2013, 09:38:16 PM »

Medicare is my primary so I don't think I have to do anything and my secondary is Federal BlueXblue shield and the rates came out and it only went up $12.  Funny that years ago if it went up $12 we would have had a kaniption but now I'm happy.  So I'll pay $198 a month for secondary insurance.  plus Medicare... hmmmm well it beats $60K that DaVita would charge me a month!

Still the problem is the high cost of health care and congress has decided to settle and just figure out how to pay the high prices.  What we need to do is control the high outrageous prices!
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Jean
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« Reply #9 on: October 31, 2013, 12:49:40 AM »

Rerun I so agree with you. The pharmacy hot shots and the hospital administrators are just crazy when it comes to charging for things. I have no idea how they get away with this.
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MooseMom
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« Reply #10 on: October 31, 2013, 11:54:05 AM »

I am done "debating" on these threads, but reading through this particular discussion about individual plans that are now being cancelled, I just have to ask.  Has anyone here ever bought one of these policies or has known anyone who has?  And if so, what was your/their experience?  Did you/they ever have to make a claim?

When I moved from the UK back to the US, the first thing I did was to buy a private health insurance policy through my family's long time State Farm Insurance agent.  The plan I bought was NOT a State Farm product, and for legal reasons, I cannot name the company or the underwriters.

I needed just an annual policy to tide me over until I married and could then be on my husband's insurance.

A few days before the expiration date, I got sick and ended up in the hospital for 5 days.  During my hospital stay, my policy expired, and through an insurance broker, I had the policy renewed and paid the premium.

I recovered and then set about going through the claims process.  To make a veeeerrrrrryyyyyy long story short, the insurance company denied each and every claim.  Over $20,000 worth of claims they denied for made up reasons like "pre-existing condition" (lie!) and other reasons that some drunk underwriter must have pulled out of his nose.  I went through the appeals process, and nothing.  They wouldn't even speak to me on the phone.  Stonewalled.  Then they retroactively cancelled my policy (which, remember, had already expired, so they cancelled an expired policy).  I finally had to contact the state insurance board which forced the ins co to reinstate my policy, which they did but warned me that that didn't mean they'd pay any of my claims.

Then they actually tried to claim that I had not lived in the US long enough to fulfill their "residency requirement" and demanded to see my green card.  They were trying to prove that I had moved to the US specifically and fraudulently to access medical care, so they had assumed I was not a citizen and tried to base their denial of coverage based on that.

Keep in mind that this company had RENEWED my policy...and had cashed my check.

Now, I worked in London as a reinsurance broker, and my husband is an attorney, so we had a pretty clear idea of what the hell was going on.  This company had taken a calculated risk that I would not fight them and would be too ignorant to see through their tactics. 

In the end I had to sue them, and of course I won.  Their own attorney (who had just lost a similar case) couldn't understand why they wouldn't pay my claims.  So they had to pay all of my claims PLUS the maximum punitive damages allowed by law.  The company in question ended up having to pay out three times as much as they would have had to if they'd only been honest in the first place.

Bottom line is that I have to wonder if these people who are so upset about losing their crap policies have EVER tried to get a claim paid.  The individual insurance market is populated by thieves of the most hideous sort.  If any of you have ever bought one of these individual policies and have had your claims paid, I'd really like to know.

Thank you.   :)
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« Reply #11 on: November 01, 2013, 10:01:59 AM »

My financial adviser called me this morning; he calls me once a month.  He told me that he had held a workshop on Medicare and planning for longterm care, and he also hosted a presentation by one of his clients who is an insurance adviser.  She spoke about the ACA and how it affects different people in different ways.  Several people at the workshop complained about this issue of policy cancellations, but interestingly, none of them had these types of policies.  However, one attendee had had one of these individual policies for 20 years and had never had to make a claim.  In year 21, he was diagnosed with cancer, and his insurance company promptly cancelled his policy.

So my question remains...have any of you ever had one of these policies, or do any of you know anyone who had.  If so, again, have any of these policyholders ever had a claim paid?

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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
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« Reply #12 on: November 03, 2013, 08:53:00 PM »

Looks like the ACA isn't that popular at all:

October 18, 2013
Americans More Likely to Feel Negative Than Positive Toward the Affordable Care Act
Gallup Editor-in-Chief Frank Newport shares that 50% of Americans would like to see Congress scaled back or repeal the Affordable Care Act, compared with 38% that would like to see Congress expand or keep the Affordable Care Act as is.

http://www.gallup.com/video/165482/americans-likely-feel-negative-positive-toward-affordable-care-act.aspx
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
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« Reply #13 on: November 04, 2013, 12:25:05 AM »

One more individual Obamacare nightmare:

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.

What happened to the president's promise, "You can keep your health plan"? Or to the promise that "You can keep your doctor"? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

For a cancer patient, medical coverage is a matter of life and death. Take away people's ability to control their medical-coverage choices and they may die. I guess that's a highly effective way to control medical costs. Perhaps that's the point.


http://online.wsj.com/news/articles/SB10001424052702304527504579171710423780446
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Bill Peckham
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« Reply #14 on: November 05, 2013, 07:52:45 PM »

One more individual Obamacare nightmare:

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.

What happened to the president's promise, "You can keep your health plan"? Or to the promise that "You can keep your doctor"? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

For a cancer patient, medical coverage is a matter of life and death. Take away people's ability to control their medical-coverage choices and they may die. I guess that's a highly effective way to control medical costs. Perhaps that's the point.


http://online.wsj.com/news/articles/SB10001424052702304527504579171710423780446


Should public policy care only about Ms Littlefield or about people with gallbladder cancer generally? How many people die every year of gallbladder cancer because they could not carry insurance? or their insurance dropped them the first time they got sick? or after a year or two or less of treatment their insurance dropped them because they reached a lifetime cap?

It could be but for Obamacare the author would be able to keep seeing every doctor she wanted to keep and receive care at the facility she chooses but it is more likely that but for Obamacare her insurer would have pulled out of the CA market since it has only 8,000 policy holders in an era of medical insurance networks. Aside from that it isn't definitive that she won't be paying less and getting more, she states that "After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed."

Ms Littlefield still has over 6 weeks to figure this out and her WSJ essay will no doubt bring clarity to her options so it will be interesting to see what she finds out over the next month. I wonder if she'll end up like the "obamacare victim" CBS featured - more informed and insured.
« Last Edit: November 05, 2013, 08:10:23 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
Hemodoc
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« Reply #15 on: November 05, 2013, 10:17:12 PM »

One more individual Obamacare nightmare:

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.

What happened to the president's promise, "You can keep your health plan"? Or to the promise that "You can keep your doctor"? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

For a cancer patient, medical coverage is a matter of life and death. Take away people's ability to control their medical-coverage choices and they may die. I guess that's a highly effective way to control medical costs. Perhaps that's the point.


http://online.wsj.com/news/articles/SB10001424052702304527504579171710423780446


Should public policy care only about Ms Littlefield or about people with gallbladder cancer generally? How many people die every year of gallbladder cancer because they could not carry insurance? or their insurance dropped them the first time they got sick? or after a year or two or less of treatment their insurance dropped them because they reached a lifetime cap?

It could be but for Obamacare the author would be able to keep seeing every doctor she wanted to keep and receive care at the facility she chooses but it is more likely that but for Obamacare her insurer would have pulled out of the CA market since it has only 8,000 policy holders in an era of medical insurance networks. Aside from that it isn't definitive that she won't be paying less and getting more, she states that "After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed."

Ms Littlefield still has over 6 weeks to figure this out and her WSJ essay will no doubt bring clarity to her options so it will be interesting to see what she finds out over the next month. I wonder if she'll end up like the "obamacare victim" CBS featured - more informed and insured.

Bill, I am quite surprised you are unaware of how restrictive Obamacare networks are?

http://www.bloomberg.com/news/2013-09-23/turns-out-obamacare-is-going-to-limit-your-choices.html

http://money.cnn.com/2013/10/14/news/economy/obamacare-doctors/

http://www.nytimes.com/2013/09/23/health/lower-health-insurance-premiums-to-come-at-cost-of-fewer-choices.html?_r=0

You are not representing accurately at all the reality of restrictive networks in the exchanges. People in the US enjoy their current plans by a wide margin. The sticker shock that comes with Obamacare is that he lied big time when he stated that you could keep your doctor or your current insurance if they wanted to. That is a just one of many lies associated with this monstrous healthcare disaster. Obamacare is not designed to give affordable care. It is instead designed to destroy employer based health care to lead to single payor.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Shaks24
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« Reply #16 on: November 06, 2013, 09:44:50 AM »

Single payer. Excellent if it in fact does. Welcome to the modern civilized world America. Sure am glad GW never lied to us.   ;)   ;)  WMD's in Iraq my eye.  More like revenge at Saddam for threatening his daddy. How much did that cost in human life, misery and treasury?
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Congestive heart failure 2011
Currently about 19% Kidney Function
September 11, 2013 PD Catheter and Fistula Surgery
September 27, 2013 Started PD
Hemodoc
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« Reply #17 on: November 06, 2013, 11:25:21 AM »

Single payer. Excellent if it in fact does. Welcome to the modern civilized world America. Sure am glad GW never lied to us.   ;)   ;)  WMD's in Iraq my eye.  More like revenge at Saddam for threatening his daddy. How much did that cost in human life, misery and treasury?

Let's have an honest political debate on the issue if that is what folks want. Instead, Obama is deceiving everyone and destroying what we have already. Is that honest? Yes, yes, it must be Bush's fault. BTW, I have never defended Bush as an ideal president.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
noahvale
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« Reply #18 on: November 06, 2013, 11:33:55 AM »

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Shaks24
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« Reply #19 on: November 06, 2013, 11:42:19 AM »

Whats a LOFO? Are you an AH?   :urcrazy;
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Congestive heart failure 2011
Currently about 19% Kidney Function
September 11, 2013 PD Catheter and Fistula Surgery
September 27, 2013 Started PD
Hemodoc
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« Reply #20 on: November 06, 2013, 11:49:20 AM »

Whats a LOFO? Are you an AH?   :urcrazy;

From the venerable urban dictionary:

1. lofo
Low information, most commonly used in the phrase, "low-information voter." Used to describe a person that is manifestly uninformed, ill-informed, brainwashed, unable to think long-term or rationally, etc., and yet insists on screwing up the country by exercising his or her so-called "right to vote."

American pollster and political scientist Samuel Popkin coined the term "low-information" in 1991 when he used the phrase 'low-information signaling" in his book The Reasoning Voter: Communication and Persuasion in Presidential Campaigns.
Sam: Are you going to vote in the election tomorrow?

Harry: No way. What's the point? The polls are going to be swamped by lofos.

Sam: You're right. I guess I'll just watch The Voice. This country has gone to pot.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
noahvale
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« Reply #21 on: November 06, 2013, 12:11:55 PM »

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Shaks24
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« Reply #22 on: November 06, 2013, 12:12:44 PM »

Oh thank you. AH is American Hero.
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Congestive heart failure 2011
Currently about 19% Kidney Function
September 11, 2013 PD Catheter and Fistula Surgery
September 27, 2013 Started PD
noahvale
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« Reply #23 on: November 06, 2013, 03:02:32 PM »

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Shaks24
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« Reply #24 on: November 06, 2013, 04:55:53 PM »

So the Tbagger ran a stupid campaign and lost. Was outsmarted by Dems. Whats new? More to come I hope. Close counts in horse shoes not elections. Get over it. Obama won two elections. The second one was a drubbing.
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Congestive heart failure 2011
Currently about 19% Kidney Function
September 11, 2013 PD Catheter and Fistula Surgery
September 27, 2013 Started PD
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