THE DOCTOR’S VIEW

By…

Dr. Perry Kalis M.D.

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10.27.2012

DISSEMBLING

 

If you Google the word DISSEMBLING, you will find the definition as follows:

 

1.)    Conceal one’s true motives, feelings or beliefs.

2.)    Disguise or conceal (a feeling or intention).

 

DISSEMBLERS come in all shapes and sizes and no doubt we have all been guilty of this less than flattering behavior now and then.  However, our President has attempted to turn this undesirable behavior into the new norm.  It seems that any situation can be rationalized and explained if you are a gifted DISSEMBLER and, of course, are willing to exploit this skill freely.

 

Witness the confusing picture presented by Mr. Obama and his subordinates regarding the tragic events in Libya where four Americans lost their lives.  The events that led to this tragedy can be argued, disputed and discussed but the President’s responses to the events look and sound like DISSEMBLING.

 

This of course is not the first time we have seen and heard Mr. Obama act this way.  Four years ago he sold himself as the post-partisan President - - the great unifier.  His actions have revealed the opposite.  No tactic is beyond him.  He seems to revel in trying to drive one group of Americans against another.  And, very frankly, it has worked for him - - to a point.  The problem with DISSEMBLING is that it is difficult to keep your stories straight and sooner or later, the sun shines on the true heart and motives of the DISSEMBLER.

 

An example:  Mr. Obama’s presents himself as the friend of working men and women and the unions which represent them.  Until, of course, light is shown on his true priorities.  He presented himself as the champion of coal and gas workers until they did not fit into his green-energy agenda.   It was time to move on; he had bigger fish to fry.

 

Obviously situations change and we must all adapt.  This is difficult enough.  What we do not need is a leader whose chief attribute is DISSEMBLING.  A leader whose prime motivation, even greater than his socialistic agenda, is to propagate himself as leader.  The effect has been corrosive and destructive.

 

It is said that Ohio may be the pivotal state in the election.  Mr. Obama’s strongholds are the metropolitan areas.  However, one vote in Cleveland or Toledo is the same as one vote in Zanesville, St. Clairsville or Cambridge.

 

You must exercise your privilege and vote.  Do no sit on the sidelines.  Do not be disheartened.  Urge like-minded friends to vote.

 

You, and only you can make a difference.  Preserve our precious country for your children and their descendants.

 

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10.18.2012

DERISION

 

In one of Mr. Obama’s early international trips (his apology tour) he lamented that the United States had been guilty of treating European governments in a DERISIVE manner.  The Merriam-Webster dictionary defines DERISION as the use of ridicule or scorn to show contempt.  Whether Mr. Obama was correct or incorrect is not the point of this article.

 

For those of us who learn best by example, the Vice Presidential debate highlighted DERISIVENESS at its best.  Vice-President Biden took every opportunity to demean and insult Mr. Ryan.  But it was not just Mr. Ryan who was being treated DERISIVELY.  It was us.

 

Have you ever been out to dinner with your family and had the misfortune of sitting next to some know-it-all, blowhard who believes that a rude, overbearing, and usually loud manner is the way to direct the thoughts of his dinner companions?  If so, you may have been sitting next to Joe Biden. 

 

Devoid of manners, absent rational thought, Mr. Biden blustered and smirked instead of sharing meaningful ideas with us, his constituents (and employers).

 

In regard to the topic of health care, his comments were particularly not helpful.  Perhaps he did not feel we were sophisticated enough to be able to handle an adult discussion of a difficult topic and thus resorted to behavior and mannerisms more appropriate to a bar on Saturday night.

 

To illustrate the point, I refer to an article in the October 5, 2012 Wall Street Journal entitled “Informed Independents Cool to Obama Care” by Heather Higgins and Hadley Heath.  The goal was to see if providing factual information regarding the more widely recognizable parts of Obama Care to independent voters would sway their opinions and ultimately their vote for Mr. Obama or Mr. Romney.  To quote the authors “the change was startling “ __ __ __ 14% of participants changed their vote from Mr. Obama to Mr. Romney. 

 

What were some of the game changers?

1.)    Americans are aware of the new law’s provisions to allow them to keep their children on their insurance policy up to age 26.  Most of us do not know that these provisions raised yearly premiums from $150 - $450 in 2011, for all families, not just the ones who exercised their option.  Believe it or not Blue Cross, Aetna, etc. did not eat that cost.  We did and we will.

2.)    The average family’s health insurance premiums are already up $1,300.

3.)    Young workers who buy their own insurance will see a 19% - 30% increase in premiums.

 

There are many more examples and the interested reader is referred to HEALTHREFORMQUESTIONS.COM.  However, my point is not that Obama Care is a flawed concept that we will live to regret (it is and we will); my point is that Mr. Biden did not even treat us as adults capable of assimilating data and making decisions.  He treated us with DERISION.  He did so because like the blowhard bully described before, he believes that will work with us.  That is what will succeed.

 

I believe he and his boss are wrong.  Take charge of your future remove Mr. Obama and Mr. Biden from office.

 

Only you can do this.  Go to the polls and vote or obtain an absentee ballot from your election board.  Please do not sit on the sidelines.  Our dear country is at stake.

 

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10.11.2012

NO HORNS

 

After almost four years of Mr. Obama’s Presidency each of us who is interested have formed our opinion, favorable or unfavorable, of this man.  We have done so largely through the reflections of the press.  With exceptions, most of these reflections cast the President in a pleasing light.  Despite our country’s woes, a substantial number of our countrymen have given Mr. Obama a pass regarding his personal responsibilities for our country’s troubles.

 

At least part (in my view, the majority) of this perspective has been a product of the less than critical attitude the majority of reporters choose to adopt in covering Mr. Obama. 

 

In contradistinction to Mr. Obama, we have had only limited opportunities to view Mr. Romney directly.  When we have, our filter, our medium is the same group of journalists who treat Mr. Obama so gingerly.  Seemingly working from Mr. Obama’s attack ads as a base, we have been inundated with reports of his wealth, his ruthlessness and his biases regarding seniors, women, immigrants and every other group that the press can lump together to form a Romney target.

 

But then something odd happened.  Mr. Romney was given an opportunity to present himself to us unfiltered.

 

Guess what - - NO HORNS.  Not only that, but he carried himself as our President should.  As a bonus you could understand most of what he said and some of it actually made sense.

 

Mr. Obama’s supporters have given a dozen reasons why he did not perform well.  The air was too thin in mile-high Denver.  He had Presidential matters of import on his mind and could not concentrate.  He was overconfident.  Poppycock!

 

Some of you will recall early on in Mr. Obama’s term, before Obamacare was passed, Mr. Obama graciously held a “round-table” discussion with members of both parties to discuss the pros and cons of his plan versus other proposals.  Chief among the “other” category was a plan put forth by Mr. Ryan (Mr. Romney’s current vice-presidential running mate).  The substance of the meeting is not pertinent.  The President’s demeanor is.

 

Mr. Ryan presented a fact laden argument largely poking holes in Mr. Obama’s plan.  Mr. Obama’s reaction was revealing. He was thin-skinned and became agitated with Mr. Ryan - - seemingly insulted that he would be second-guessed by a mere Congressman.  He had no answers to Mr. Ryan’s questions or proposals and largely ignored him.  Later in a different setting where Mr. Ryan was present but could not speak, Mr. Obama excoriated him and his proposals.  His utterances range from saying the New Haven, Connecticut police acted stupidly by arresting one of his friends (before he knew the facts) to personally castigating the Supreme Court Justices as they sat at his State of the Union address.

 

My point is this.  Yes Mr. Romney’s performance in the first debate was good.  But maybe Clint Eastwood was right.  Maybe the President’s chair is empty.  Maybe he is a lightweight who cannot hold his own (or ours).  Maybe this explains why our country is on the skids domestically and overseas.

 

Could it be he just is not up to the job?  I believe so.

 

Now that Mr. Romney has shown he has no horns, we should give him a hard look.

 

Remember, only you can make the difference.  Our country is counting on you.    

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10.2.2012

REALLY?

 

It should not matter at this point in time if you are Republican, Democrat or Independent; if you are liberal or conservative; if you are male or female; if you are white, black, or Hispanic; if you are straight or gay; if you are a member of the 1% or 99%; if you are spiritual or you are not; if you are Protestant, Catholic, Mormon or Jewish.  It should not matter.  For every one thing that separates us, there are a thousand that bind us.  Our issues are overlapping; our humanity intertwined. 

 

What should matter is our desire to see the wounds of our dear country bound and healed; our desire to find common ground with our neighbors and countrymen; our desire to provide for ourselves and our children opportunities - - opportunities to prosper emotionally, physically, financially, and spiritually.

 

We all know the ground under us is trembling.  Whether you are now prospering or not, your confidence in the future has been severely shaken.  You feel as if you have lost your mojo.

 

Whatever our creed, most of us agree on the above.  What we disagree on is who caused the problem.  In reality it does not matter.  What matters is finding our way out of this mess.

 

Despite Mr. Obama’s actions, the hole we are in is deeper than it was.  Could we stop digging?  Really?

 

Mr. Obama has no idea how to retrench.  He is devoid of ideas other than his same ideologic musings.

 

This then explains his behavior.  No opportunity is squandered to drive a wedge between us whether it be based on gender, finances, sexual orientation, race or creed.  This is his stock and trade.  He appeals to the worst in each of us, stirring resentments and hatreds that we have spent generations to overcome.

 

We must not allow it.  We must look for our brighter lights as a people and culture.

 

I cannot attest to Mr. Romney’s abilities or what is in his heart of hearts.  But I know this.  Mr. Obama has not the least intention of getting us off the road we are currently on.  If anything his designs are best served by the ground trembling and your confidence in the future dissipating.  He wants to be your mojo.

 

It is not enough to simply vote against this man.  Pledge to help a countryman to vote.  Help financially if you can.  Do not lose heart - - - despite what you hear or read in the press.

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9.28.2012

TOP DOWN VS BOTTOM UP

 

There are many ways to distinguish activist liberals, as represented by Mr. Obama, from conservatives.  Among the most salient is the apparent liberal belief that the role of the Federal government is to pick winners and losers on each playing field and then to provide incentives and disincentives to bring about the appropriate conclusion.  This is obviously not to say that conservatives do not employ the same methods at times but the Messianic zeal that Mr. Obama and his colleagues exhibit is unparalleled.  The preconceived end seems to justify any means.

 

I am not writing however, to debate Mr. Obama’s tactics although they are certainly open to question.  I am writing to demonstrate the fallacies of central planning as exhibited by our leaders in Washington.

 

I certainly have no more than a passing knowledge of the intricacies of for instance, energy policy and how central planning affects it.  I do however, have somewhat of a more in depth understanding regarding medical care.  Let us focus on one small aspect of health care, the electronic medical record (EMR).  This is the new age substitute for what many of us in medicine (especially those who are older) and most patients refer to as “the patient chart”.  It has traditionally been for the most part a paper document existing in your doctor’s office and shared with your permission only with other doctors or those you have designated.

 

A few years ago the Federal government decided that it would be wise to digitize these records.  (For those of you as ignorant as I am about such things, this means putting your medical record in a computer).  Their purported reason was that this would markedly facilitate your care at different doctor’s offices thereby increasing the quality of your care and (as always when discussing computers) lower costs.

 

A recent article in the September 18, 2012 Wall Street Journal by Stephen Soumerai and Ross Koppel shed light on how this has worked out.

 

As part of Mr. Obama’s 2009 stimulus package, rewards and penalties were created to entice and coerce physicians and hospitals to purchase and install expensive EMR systems.  The rewards were actual financial payments to participants (tens of billions of dollars from Medicare and Medicaid); the penalties, reductions in Medicare and Medicaid payments for those who do not comply.

 

Three years into it, how has it worked out?

 

Several points:

 

1.)     These systems are expensive.  “For a major hospital, a full suite of technology products can cost $150 million to $200 million.  Implementation - - linking and integrating systems, training, data entry and the like-can raise the total bill to $1 billion.”

2.)   To quote the authors, “the software is generally clunky, frustrating, user unfriendly and inefficient”.

3.)   There are 6,000 hospitals and over 600,000 doctors in the U.S.  Since 2009 almost a third have installed some form of digitized system.

4.)  Once installed, these systems are part of the equation.  Buyer’s remorse is a wasted emotion.

5.)   The authors claim $1 trillion of our money will be spent implementing these EMR systems.

 

But here is the bottom line:

 

                   The vast preponderance of evidence does NOT support the Federal governments

          assertions that this huge investment either improves health care or reduces cost.

 

My purpose in writing this is really not to discuss the merits or demerits of the EMR.  My purpose is to illustrate that top-down planning is the father of unintended consequences.  In this case, it is your health record, but Mr. Obama has his finger in a 1,000 other projects where he knows better than you what is in your best interest.

 

Top down planning by its nature is BIG; it is EXPENSIVE; and its consequences can be HUGE.

 

We do not need Mr. Obama influencing our every day affairs with his one-size-fits all approaches.

 

Only you can stop him.  To do so, you must vote and urge and encourage others to do the same.

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9.20.2012

THE EMPEROR'S NEW CLOTHES

 

The following is an article taken from Wikipedia regarding the folktale written by Hans Christian Andersen and published in 1837 in Denmark.

 

The plot is as follows:  “A vain Emperor who cares for nothing hires two swindlers that promise him the finest, best suit of clothes from a fabric invisible to anyone who is unfit for his position or “hopelessly stupid”.  The Emperor cannot see the cloth himself, but pretends that he can for fear of appearing unfit for his position; his ministers do the same.  When the swindlers report that the suit is finished, they mime dressing him and the Emperor marches in procession before his subjects, who play along with the pretense, until a child in the crowd, too young to understand the desirability of keeping up the pretense, blurts out that the Emperor is wearing nothing at all and the cry is taken up by others.  The Emperor cringes, suspecting the assertion is true, but continues the procession.”

 

Sound Familiar?

 

To listen to President Obama his “clothes” and ours are resplendent and better than they were four years ago.

 

Consider:

 

1.)     In an editorial in the September 13, 2012 issue of the Columbus Dispatch, the paper reviewed a recent report of the World Economic Forum based in Geneva, Switzerland.  The report ranked the United States seventh overall in the characteristics that define competitiveness.  Switzerland, Singapore, Finland, Sweden, The Netherlands and Germany rank higher than we do.  The report noted that our business leader’s “trust in politicians is not strong”.  Really?

2.)   In the same Dispatch publication in another editorial, the following:

a.     President Obama increased the national debt by $5 trillion dollars in three years and two months, more than twice what George W. Bush did in eight years.  Do we have any “clothes” to show for it?

b.     The Dispatch quotes economists Antony Davies and James R. Harrigan in an article they published for MARKET WATCH.  “The Congressional Budget Office (CBO) 80 percent of the time produces a ridiculously optimistic picture of the future”.  The authors estimate the CBO has low-balled this number by 40 percent over the last fifteen years.  The CBO says their estimate of the federal debt in 2021 (9 years from now) will be $25 trillion dollars.  The author’s apply the forty (40) percent low-ball figure to this number and arrive at a figure of $35 trillion dollars.  

 

Can you understand this?  I cannot.  But I can understand that if they are correct, in 2021 the national debt will be over 200 percent of the entire production of the country in a given year.  That is where the Greeks are now, running hat in hand to everyone and anyone for a handout.

 

You cannot want this for your country, for your children and their children.

 

A child must cry out:  the Emperor is wearing nothing.

 

President Obama and his ministers know their “clothing” is non-existent.

 

This is not a Republican issue, a Democrat issue, a liberal or conservative issue.  It is not an issue for the rich or the poor.  It is an American issue and only Americans can fix it.

 

Mr. Obama had his time at bat.  He has struck out.  Let the next batter in the box.

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9.17.2012

WHY?

Sadly our country is seemingly beset by a multitude of problems; problems that seem so daunting that their solutions seem out of reach. They range from financial issues such as Medicare, Social Security, and the national debt to social issues such as immigration policy and worker's rights. These problems seem so complex, their antagonists and protagonists so shrill and unbending in their comdemnation or support that solutions seem unreachable.

It obviously is not inconsequential as to what our individual views are on each and every issue. It is however, more consequential that we are not capable of reaching answers to these problems.

Enter the role of a leader. A leader would try to bridge the gap between parties with disparate views. He would see the greater good for our dear country being served by some middle path. The disparate parties would see their own interests at least partially served and, on a given issue, would give a little so they could take a little on the next issue. A leader whose motives were driven by a desire for the greater good (of course consistent with his own principles) would lead others to accomplish that greater good. He of course would benefit from the increased prestige and power that would come from brokering such transactions.

It then seems that there would be something in it for everyone involved including oddly enough, the rest of us. Not that mistakes and misjudgments would not be made. But every once in awhile, something might even turn out right.

Why then has this not happened on our current leader's watch? Is it because he is a lightweight with no prior experience at managing anything? Perhaps. Is it because his vaunted intellect has been vastly overplayed and overrated? Perhaps. Is it because his teleprompter eloquence and winning smile have worn thin even with his admirers? Perhaps.

No doubt these traits, characteristics and behaviors have all played a role. But without question, the current mayhem that is our Federal government is serving Mr. Obama's greater goal.

When he first took office he said that he, like Ronald Reagen, wanted to be a transformational president. His main thesis of course was to, one way or another, make all of use dependent upon and beholden to a strong central government. Never mind the Founder’s original intent based on individual rights and responsibilities. Mr. Obama's way was the wave of the transformational future. Rugged individualism and American exceptionalism were to be replaced by statism and dependency.

To serve this ultimate goal, Mr. Obama by folly or design (probably both), has taken advantage of Washington's chaos to rule by fiat and regulation.

This must be stopped now. Mr. Obama and his cronies not only do not deserve to be reelected on the basis of competency; they must be sent home because of their greater designs for America.

Please make sure you vote in this election.

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9.5.2012

Independent Payment Advisory Board

 

The Affordable Care Act (a gross misnomer) or Obama Care is now the law of the land. Its central tenet is that top-down direction is needed to control the cost and quality of medical care in our country.

 

The new law contains a multiplicity of mechanisms to accomplish these ends. These include centralization of all medical records to better facilitate and enforce the one-size-fits-all approach to diagnosing and treating individual patients; patients who are as unique as you and I. Patients whose problems, and their solutions, are particular to them and them alone.

 

Secondly the new law encourages the amalgamation of independent, individual physicians to become part of larger hospital and in some cases, insurance systems. Currently fifty percent of physicians work for some large corporate hospital or insurance entity. These employment arrangements are actively encouraged by Medicare and others by offering higher reimbursement for the same services performed in a “hospital facility” (for instance, a hospital employed physician's office) versus an independent practitioner's office. What is the rationale? What is the aim? It is quite simple. Larger entities are easier to control. Create the correct incentives and disincentives and in one swoop the federal government can control hospital(s) and physicians.

 

In the past these arrangements were felt to be contrary to the care of the patient. An antagonism between hospital administrators, insurers and physicians was felt to be healthy and in the best interest of the patient. Alas, no longer. Willingly compliant corporate entities have deluded themselves. It is only a matter of time until the incentives will be gone. Uncle Sugar will be replaced - - - replaced by the Independent Payment Advisory Board.

The Affordable Care Act provides for the appointment of 15 board members who will virtually control your, the patient’s, health care. They will be appointed by President Obama and the Obama appointed Surgeon General. Their task (as noted in the Review and Outlook section published in the Monday, August 27, 2012 Wall Street Journal) will be to find out what "works" and to apply this "to all U.S. medicine through regulation, without Congressional consent or legal appeal." To quote further, "more amazingly still, only a minority of the board can be directly involved in the provision of health care."

 

So, for example, if the "board" says women with breast cancer can only receive certain “cost-effective chemotherapeutic agents, then that is the way it will be. If the “board” stipulates that coronary artery stenting has not been "cost effective” over the age of 74, then that is the way it will be.

It does not take a rocket scientist or brain surgeon to realize what you need to do if you are sitting on a railroad track and you feel it rumbling. This Obama Care business is just as simple.

 

Do not entrust your family's precious health to Mr. Obama and his vision for America’s healthcare.

We must vote Mr. Obama out. Do not allow him to dictate your care in the future.

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10.17.2010

OCTOBER

Among the most valuable functions of government is the ability of that government to deliver to its citizens a sense of constancy and predictability. Whether it be in foreign or domestic matters, we should be able to count on our citizen representatives to articulate and enact policies that make common sense. Policies that by the manner in which they are crafted are sustainable. Sustainable because a majority of Americans can identify with such policies and are willing, if necessary, to sacrifice to support them.

Allow me to share with you a quote from James Madison writing in Federalist 62 in 1788 as reprinted on the editorial page of the October 12, 2010 Wall Street Journal.

In another point of view, great injury results from an unstable government. The want of confidence in the public councils damps every useful undertaking, the success and profit of which may depend on a continuance of existing arrangements. What prudent merchant will hazard his fortunes in any new branch of commerce when he knows not but that his plans may be rendered unlawful before they can be executed? What farmer or manufacturer will lay himself out for the encouragement given to any particular cultivation or establishment, when he can have no assurance that his preparatory labors and advances will not render him a victim to an inconstant government? In a word, no great improvement or laudable enterprise can go forward which requires the auspices of a steady system of national policy.

No matter what your political views are, no matter what your position is on any given issue, it has become painfully clear that our government at the federal level provides anything but constancy. In the six plus decades I have lived, I have experienced the assassination of a popular president, the execution of a horribly unpopular and divisive war, the fall of the Soviet Union and the attacks of 9-11. Throughout these troubling times, however, there was a sense of abiding steadiness, a sense that Old Glory would continue to fly and would stand in large part for the Founder’s Truths.

Mr. Obama and his colleagues early on recognized that if they were to "transform" America, they must first tear down its foundations. Individualism must be replaced with collectivism. We must view ourselves as citizens of the world first and America second. Big government must direct its people, not the opposite.

In their efforts to "transform" us, they are destroying our sense of constancy.

It is for this reason, that their agenda must be disrupted on November 2nd. Mrs. Pelosi, Mr. Reid, Mr. Space and ultimately, Mr. Obama must be repudiated.

Exercise your voice. VOTE.

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10.10.2010

The Cultural Divide

As we approach November and the mid-term elections, it is crucially important that we keep our minds focused on what our votes mean.

Shortly after Mr. Obama was elected, one of his chief advisors, Mr. Rahm Emmanuel, was heard to say that they (Mr. Obama and his cohorts) should not let a good crisis go to waste. I believe he was referring to the tumultuous financial condition of our country. More pointedly by however, I believe he was referring to the rare opportunities available during such uncertain times. Opportunities for the federal government to impose itself in areas where it had never been before - - the GM takeover for example.

Mr. Obama, Mrs. Pelosi and Mr. Reid believed (and apparently still believe) that if enough of the public’s money was placed in the right hands, the moment would be saved. More importantly, Mr. Obama, Mrs. Pelosi, Mr. Reid and their democratic allies would appear as all-knowing heroes and heroins. And most importantly they would have taken a huge step in transforming America from an institution centered around the individual to an institution centered around the federal government - - the font of all things good and plentiful.

So be mindful of this. Our dear country’s fiscal woes are undeniable. Unemployment is debilitating and demeaning. Indebtedness at the personal and federal level is like a slow growing malignancy. It is only human nature to look to an omnipotent government to end these woes. But at what price? The spending is objectionable but the loss of cultural identity is unacceptable.

Thankfully Mr. Obama and his protégée’s ham-handed methods have failed. The word “thankfully” here is cruel. It is certain that if the massive influx of federal money (our money) had lowered the unemployment rate to say 5%, many would have been spared the financial hardship they are experiencing. But the downside of course would have been the promulgation of the idea that we as individuals should look to government to address our ills. Eventually we would not view individuality as a laudable goal but would replace it with collectivism.

It is for this reason that Mr. Space and his democratic colleagues should not be reelected. I am not sure if the republicans in Congress have the wherewithal to do what needs to be done, but I am sure that Mrs. Pelosi and company have no intention of changing their ways. She must be denied the votes to support Mr. Obama’s agenda.

OUR COUNTRY IS A TERRIBLE THING TO WASTE.

 

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