jobs with single payer healthcare.


http://www.valleyadvocate.com/article.cfm?aid=13331

Quote :

" single-payer system could save the state at least $580 million yearly, or $1.2 billion by 2019, and create 4,000 jobs because the burden of rising healthcare costs would be lifted from businesses. On February 24, the Republican mayor of Rutland, Christopher Louras, urged the state to adopt the single-payer legislation, noting that more than a third of the city's $7 million annual payroll is consumed by healthcare costs. "The only way to fix the problem is to blow it up and start over," Louras said."

Socialism works, promotes business and is fiscally responsible.

3/31/2011 9:28:31 PM

YEH, SOCIALISM!

3/31/2011 9:37:05 PM

the only way to conquer failed socialism at the city level is by expanding it to the state level. this could never fail.

3/31/2011 9:46:46 PM

The beauty of the separation of the states that we have is that every state can do things differently. Hopefully, for their sake, it works out better than Massachusetts' plan did. I guess we'll know in about a year or two if we start seeing reports of how Vermont has a 4 month long list of IOUs for their health care workers, a doubling of healthcare costs in 2 years, rate increases that rival the private insurance industry and no change in the number of people using the ER for their medical care.

3/31/2011 10:24:19 PM

Quote :

"Socialism works, promotes business and is fiscally responsible."

according to the promoter of those plans, before they have been put into effect.

4/1/2011 4:02:03 AM

Quote :

"I guess we'll know in about a year or two if we start seeing reports of how Vermont has a 4 month long list of IOUs for their health care workers, a doubling of healthcare costs in 2 years, rate increases that rival the private insurance industry and no change in the number of people using the ER for their medical care."

I take it this is the Mass. experience?

4/1/2011 6:50:24 AM

Yes. At lease it was during the HC Bill debates. I haven't looked recently at it.

4/1/2011 7:54:18 AM

Socialism works, promotes business and is fiscally responsible in the health care field in which every person's life should be valued more than a money and receive equal treatment

4/1/2011 9:53:27 AM

I heard medicare is spending $93,000 for a treatment that extends the life of patients UP TO four months.







Worth it?

4/1/2011 9:55:37 AM

Probably not.

4/1/2011 10:23:14 AM

and in the long term, we will all eventually suffer from horrible health care service... I believe there are a few foreign countries that are great examples of this.

GREAT short term benefit. Horrible long. Good job looking out for the future America.

[Edited on April 1, 2011 at 10:27 AM. Reason : .]

4/1/2011 10:26:48 AM

singlepayer healthcare system + medical marijuana laws = FREE POT FOR EVERYONE!!!!

4/1/2011 10:52:18 AM

Aww man, I haven't read the Valley Advocate for nearly ten years. Takes me back to my days living amongst the bluest of blues.

As for the issue at hand, maybe you don't need to centralize it, but at very least they need to crack down and make health care into a regulated commodity like electricity. The fact is that with all the consolidation over the last couple of decades, you only have a small number of both insurance companies and health care providers remaining (kinda like how Moses Cone pretty much owns the entire medical system in Greensboro/High Point).

4/1/2011 12:59:01 PM

^there was a great article in Smart Money or Kiplinger's explaining why that is. You see medicare reimburses a certain amount for a code/procedure performed. However, medicare also allows for a hospital or hospital affliate to bill an additional facilities fee. So our great governments loop hole is paying these groups more for the same services as the private practice doctor. So the private docs feel the reimbursement cuts more, thus they are selling out to these bigger groups. Which not only get paid more for the same services but can negociate with private insurance companies better than private docs.

So now you are seeing less private practice docs and more of these big hospital related offices which charge and get higher prices. Thus you have another reason why health care costs are rising.

http://www.nytimes.com/2010/03/26/health/policy/26docs.html?pagewanted=1&_r=1

That isnt the article that I read. The one article talked about how he closed the office on friday and on monday he was owned by the hospital. The only difference was the cost was now 30% higher to his patients. It was a great article.

Just another example of govt shifting the market and it causing a shit storm which they will then blame on the free market. haha

4/1/2011 9:55:47 PM

ah, found it. Enjoy

Quote :

"Now that the acquisition spree is in full swing, some experts worry that price increases could become the dominant narrative for patients. When hospitals run medical practices, federal law allows them to add substantial "facility fees" to patients' bills to cover overhead expenses. "

http://www.smartmoney.com/personal-finance/health-care/farewell-to-the-family-doctor-1298917784955/

4/1/2011 10:01:56 PM

cheap, fast, quality - pick 2

4/1/2011 11:18:54 PM

what makes you think you get two? you don't have to provide a product that's good, fast, or cheap when there's no competition.

4/1/2011 11:49:06 PM

Man, reading shit like this makes my head assplode

Quote :

"But hospital executives also believe that buying doctors' practices could yield a big payday, thanks to a different provision in the health care law. The law will encourage doctors and hospitals to share some payments when treating each patient; as collaborative teams, they could earn bonuses for holding down costs and meeting quality markers. "The real question for everyone is how that pie—that money—is going to get split up," Goertz says; hospitals think they'll have the upper hand if they employ the doctors that they're sharing their banana crème with. And that's touched off a flurry of mergers everywhere—from Seattle to Roanoke, Va. "

and, before I got to this point in the story, I knew that this is what it is all about

Quote :

"That's because when hospitals sit down at the bargaining table with insurers, they're almost always able to negotiate higher payment rates for their big groups of doctors than a lone physician with little bargaining power. "

Can the libertarians and anti-regulators please tell me how this isn't anti-competitive?

[Edited on April 2, 2011 at 10:52 AM. Reason : .]

4/2/2011 10:43:58 AM

Why are people assuming that small private practices are better? Doctors are frequently dumbasses when it comes to running businesses. Consolidation also has benefits such as economies of scale and, hopefully, standardization of administration.

I don't know how many of you have been to the doctor recently, but it's one of the worst bureaucracies that could possibly exist. Getting 2 different medical offices to deal with each other takes a fucking miracle. Getting private insurance to pay for anything but the most routine things is a bitch (Come to think of it, getting any kind of insurance company to pay out anything is a chore). The military might be the only thing that is worse.


[Edited on April 2, 2011 at 11:15 AM. Reason : .]

4/2/2011 11:10:05 AM

The shortage of doctor idea is bullshit. Every kid wants to be a doctor. If anything, it would simply become easier to get into med school and you would weed out the people who were only in it for the money. Good things.

4/2/2011 11:32:17 AM

Quote :

"Why are people assuming that small private practices are better?"

Because they are?

Quote :

" DoctorsPeople are frequently dumbasses when it comes to running businesses."

FTFY

Quote :

"Consolidation also has benefits such as economies of scale and, hopefully, standardization of administration"

I don't think anyone would have a problem with an entrepreneur finding savings in the system if it means paying the same or less and getting the same amount of service while he keeps all the profits from the savings he found. Good for him. But...that likely isn't happening and won't happen any time soon with health care. I quoted the key points. Hospitals are scooping up doctors so they have bargaining power against insurers. Weird, when individuals do this people talk about how evil unions are.

Quote :

"I don't know how many of you have been to the doctor recently, but it's one of the worst bureaucracies that could possibly exist."

Over the past several years, the only negative impressions I've had of the system is this:

Quote :

"Getting private insurance to pay for anything but the most routine things is a bitch (Come to think of it, getting any kind of insurance company to pay out anything is a chore)."

I see the doctors somewhat as pawns in a game being played at a level greater than them. And as always, in some way the consumers get fucked while some execs get paid.

4/2/2011 11:42:37 AM

Quote :

"create 4,000 jobs because the burden of rising healthcare costs would be lifted from businesses"

In theory, I'd agree, but only if any eventual law does, in fact, forbid all private medical insurance. I can be convinced that there are employers who want to hire and for whom the cost of hiring a new employee would be decreased from an otherwise unaffordable level.

Quote :

"single-payer system could save the state at least $580 million yearly"

This is a much tougher sell, and the article provided no explanation or evidence. How does a state take on the responsibility for paying for the medical care of a greater number of people, yet spend significantly less money? The only rational answer is limiting care, limiting payment for care, or a combination of both. If providers had no choice but to accept lower rates from a single payer, some would quit, but many would have no choice but to continue to work at lower rates. The problem is providers do have a choice, in the form of 49 other states.

4/2/2011 11:43:10 AM

Quote :

"Why are people assuming that small private practices are better?"

Because as far as treatment goes, in my experience, they are. In the past 3 years, my wife and I have been to 3 different neurologists for her. Two of them were hospital employees. One of the them wasn't interested in the history of her condition, and wanted to start at the beginning of the usual treatment course. The other was more interested in trying to get her to become a test subject for some research he was interested in doing. The independent neurologist we went to however, was a completely different kettle of fish. First, even though we were told our initial appointment wouldn't be for 3 weeks, we got a call 2 days later stating they had had a cancelation and letting us know we could come in the next day instead if we would like. Then the doctor actually got her full history, was actually interested in treating her like a real person, and never once made us feel like he was a busy man and we needed to wrap things up so he could get to his next patient. Simple customer service skills, but something apparently no one who works for a hospital seems to be able to do.

Same story with our PCPs, every time we've been to a hospital owned PCP, getting in to see them has been a nightmare, they never really know who you are, god help you if you ask for a referral that's outside the hospital system because you've already dealt with the specialist in the system and didn't like them.

And when the wife broke her ankle and needed PT? The independent shop we found was in the middle of negotiating their insurance contract with her insurance company and didn't know if they would be able to accept her insurance. However, the shop told us that if the contract didn't go through, they'd just charge us about $10 more than our co-pay would have been anyway. Oh, and did I mention that since the office was only open during the hours when i wasn't around to get her to PT, that the therapist personally came to pick my wife up and drop her back off? Try getting that out of a hospital office.

I know these are all anecdotes, but it really has been my experience that independent offices are far and away superior when it comes to providing actual care.

4/2/2011 11:58:44 AM

^ That is is because when a hospital owns a doctor, they can overburden the physician with patients because they pay him on a salary basis with small incentives for additional patients. At first it seems like a great deal to the physician because they get their overhead paid for and don't have to deal with insurance companies. But then, however, the hospital tacks on 40+ pts a day. So if he works a 8 hr day, 8 am - 4pm w/o lunch he would have to see 5 an hr or 1 every 10 or so minutes. Most private practices top out at 23-26 or so patients a day.

If you let a physician practice the way he/she was taught instead of ct / mri/ expensive lab test everything you can save lots of money but unfortunately malpractice lobbying groups have both sides in their pockets. Also, the american public is not willing to accept the fact that physicians are human too and that they deserve 7-9 million dollars a settlement.

4/2/2011 3:58:38 PM

^ I would dispute the part of being overburdened: most of the primary care physicians I know become hospitalists because the private practice route is too hard. The hours are terrible, the insurance companies are a pain to work with, the respect is low, and the pay is the worst amongst the specialty fields.

However, I think the weakness of hospitalists is that unlike traditional small practices, the doctor is likely to not be familiar with your medical history; you're not building the long-term relationship with them but are instead being diagnosed by someone who doesn't know anything about you and is relying upon incomplete medical records to figure out your background.

You can think of it as the increasing institutionalization of what was one of the last holdouts of the old-school relational service. That personal knowledge is fading for a more industrialized system where the doctors are simply replaceable cogs in a machine.

From the article:

Quote :

"For older doctors, the change away from private practice can be wrenching, and they are often puzzled by younger doctors’ embrace of salaried positions. “When I was young, you didn’t blink an eye at being on call all the time, going to the hospital, being up all night,” said Dr. Gordon Hughes, chairman of the board of trustees for the Indiana State Medical Association. “But the young people coming out of training now don’t want to do much call and don’t want the risk of buying into a practice, but they still want a good lifestyle and a big salary. You can’t have it both ways.” "

4/2/2011 5:20:58 PM

Quote :

"But the young people coming out of training now don’t want to do much call and don’t want the risk of buying into a practice, but they still want a good lifestyle and a big salary. You can’t have it both ways."

This simplistic, disingenuous comparison is all too common among the older generation of physicians. Dr. Hughes is conveniently ignoring major differences in the career of a physician who graduates in 2011 versus 1971 - namely relatively inflated tuition costs and deflated earnings potential, hugely increased overhead and paperwork burden due to increased reliance on insurance and increased regulation, greater malpractice exposure, and decreased standing within the community.

The fact is these issues makes primary care medicine a la 40 years ago almost an impossibility. Whether in a hospitalist or private practice role, ^ is correct that medicine is becoming more "institutionalized" and ^^ is correct that physician's are increasingly not able to practice "the way he/she was taught".

There was an interesting article in the New York Times today which touched on these generational differences.

http://www.nytimes.com/2011/04/02/health/02resident.html?_r=1&ref=health

4/2/2011 5:42:48 PM

Quote :

"The Case For Single Payer, Universal Health Care For The United States Why doesn’t the United States have universal health care as a right of citizenship? The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship. 28 industrialized nations have single payer universal health care systems, while 1 (Germany) has a multipayer universal health care system like President Clinton proposed for the United States. Myth One: The United States has the best health care system in the world. Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990 Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960 Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960. Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations. Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation Myth Two: Universal Health Care Would Be Too Expensive Fact One: The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care Fact Two: Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits. Fact Three: State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits Fact Four: The costs of health care in Canada as a % of GNP, which were identical to the United States when Canada changed to a single payer, universal health care system in 1971, have increased at a rate much lower than the United States, despite the US economy being much stronger than Canada’s. Conclusion: Single payer universal health care costs would be lower than the current US system due to lower administrative costs. The United States spends 50 to 100% more on administration than single payer systems. By lowering these administrative costs the United States would have the ability to provide universal health care, without managed care, increase benefits and still save money "

http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm

4/2/2011 7:24:51 PM

Quote :

"Can the libertarians and anti-regulators please tell me how this isn't anti-competitive? "

it may be, thus the reason we should get away from the insurance model for routine healthcare

4/2/2011 7:26:08 PM

You're advocating people pay out of pocket for their health care?

4/2/2011 7:46:08 PM

Quote :

"State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits"

Reality on the other hand shows continued spiraling costs, budget shortfalls and failures on the part of the state to meet its obligations.

Quote :

"You're advocating people pay out of pocket for their health care? "

For routine services why not? It would vastly reduce the costs of care. See LASIK costs vs broken arm costs over the last 20 years.

4/2/2011 9:15:52 PM

Quote :

"Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990"

Better fact. The US also counts its infant mortality rate differently than many other nations, thus leading to a higher recorded rate. It includes premature babies in those numbers, while other nations do not.

Quote :

"Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960 Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960. "

Better fact. We're ridiculously in bad health due to smoking, not exercising, and being fatasses. I can't imagine that makes a difference in life expectancy, can you?

Quote :

"Fact One: The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care "

Better fact. All the other nations just send their people here to get healthcare, so we end up subsidizing their medical systems. Is it any wonder that our costs are higher? We do the research, we do the testing. They pay nothing.

Quote :

"Fact Four: The costs of health care in Canada as a % of GNP, which were identical to the United States when Canada changed to a single payer, universal health care system in 1971, have increased at a rate much lower than the United States, despite the US economy being much stronger than Canada’s."

Better fact. Canada has long lines for procedures that are routine here. And guess what else they do? Their people come here when they REALLY need health care. Yeah, that's a model to follow

4/2/2011 10:07:24 PM

Quote :

"For routine services why not? It would vastly reduce the costs of care. See LASIK costs vs broken arm costs over the last 20 years. "

And the solution for really expensive health issues...?

4/2/2011 10:24:25 PM

Quote :

"Better fact. All the other nations just send their people here to get healthcare, so we end up subsidizing their medical systems. Is it any wonder that our costs are higher?"

What a crock of shit ... our healthcare system is expensive, and sucks ...

4/2/2011 11:24:58 PM

Quote :

"And the solution for really expensive health issues...? "

Is health insurance. Just like your car insurance, it really isnt difficult to understand.


Great point about Lasik btw. That uncovered service is usually paid in cash, people shop around and has only gotten better and cheaper over time. success

4/2/2011 11:28:39 PM

aaronburro just makes shit up.

4/2/2011 11:42:02 PM

riiiiiiiight. all of that shit is common knowledge, dude.

4/3/2011 1:35:50 AM

Quote :

"common knowledge"

Another phrase for "pulling stuff out of your ass" ....

4/3/2011 7:39:29 AM

Quote :

"Is health insurance. Just like your car insurance, it really isnt difficult to understand. "

The fuck? Go back and read my last three posts with the people replying to them.

4/3/2011 9:01:22 AM

Quote :

"The fuck? Go back and read my last three posts with the people replying to them."

What's so confusing? Insurance (real insurance, not group savings) is the answer for major medical issues. Insurance increases the cost of care like any other third party in a transaction does. So the less you use it, the cheaper the costs will be overall. You use insurance to pay for the unexpected, and the rare things you can't afford. You don't use insurance to pay for things you know are going to happen.

4/3/2011 9:57:53 AM

But I thought it was these expensive end of life care with new-fangled technology that is driving the cost of health care up?

What percentage of the "inflated" costs is coming from using it for everyday care and using it for expensive procedures?

4/3/2011 10:46:01 AM

You tell me. Look at the last EOB you got for your last general checkup. Would you pay your doctor $200 for a 10 minute visit if you were paying in cash?

4/3/2011 10:51:41 AM

D0120 - Periodic Oral Evaluation - $42
D1110 - Prophylaxis Adult Cleaning - $77
D1204 Topical Ap. of Flouride - $32
D1330 - Oral Hygiene Instruction - $0
D0431 - Veloscop Screening - $25

$176 total is what the OOP would be for hr worth of attention. That isn't bad. And for whatever reason I actually HAVE dental insurance that I think I pay like $23/month for my wife and I that covered $88.

I can't imagine these costs being less if I didn't have insurance. That isn't a ton of money for healthy teeth.

4/3/2011 12:12:48 PM

You'll notice that dental coverage is almost nothing like most people's medical coverage. Mine (and likely yours) spits out the benefits something like 80% for routine, 60% for minor surgical and 50% (or less) for major surgical, and usually all benefits are capped at $1000 / year. As a result, dental costs typically reflect the fact that patients are paying at least 20% for all their services, and as the services get more expensive, paying even more.

Same with vision insurance, most cover very little, usually at some percentage. As a result, vision care is also generally affordable and hasn't seen the year over year cost increases that routine medical has.

By comparison, doctors office procedures reflect the fact that patients are usually paying some flat co-pay and only when they get to an emergency room do we start seeing co-insurance. In this case, doctors are incentivized to continue to raise their prices because the patient will not be paying more (at least not until their premiums increase) and the doctor gets paid based on usual and customary rates, so the higher his rate, the higher the UCR.

4/3/2011 12:42:19 PM

Quote :

"As a result, vision care is also generally affordable"

You're not really showing causation, merely correlation. Could it be that there is something else at work for dental and vision that has prices (relatively) lower?

Quote :

"In this case, doctors are incentivized to continue to raise their prices"

It seems like they weren't able to actually do this until they joined a union that got them higher prices.

And again, this doesn't say anything about where the costs are coming from. Is it death by a thousand cuts with these increased costs at the non major level or is it paying for end of life care that is driving it up for everyone?

4/3/2011 2:26:24 PM

Quote :

"You're not really showing causation, merely correlation. Could it be that there is something else at work for dental and vision that has prices (relatively) lower? "

Sure, there could be plenty of other things at work too. But it's awful telling that pretty much the only prices that keep going up are the ones that are covered by insurance. Every elective procedure that isn't covered by insurance always manages to fall down into affordable ranges. Again the most obvious example is LASIK which continues to fall in price.

Quote :

"It seems like they weren't able to actually do this until they joined a union that got them higher prices. "

Yes and no. A doctor can bill whatever the hell they want, the insurance company will pay what they contract to pay based on UCR. If I'm one doctor in a sea of a thousand independents, I could push my cash billing to $10,000 procedure. I'll still get paid the same from the insurance company, and I'm not going to move the UCR needle much.

On the other hand, if I band together with the other thousand doctors, and we decide we're all going to use a standard cost schedule, and we bump up even $20 or $50 a procedure, now we've moved the UCR.

Quote :

"And again, this doesn't say anything about where the costs are coming from. Is it death by a thousand cuts with these increased costs at the non major level or is it paying for end of life care that is driving it up for everyone?"

A little from column A and a little from column B. And both are really examples of the same thing: using insurance to pay for expected costs.

4/3/2011 3:16:51 PM

What I don't like is the fact that OOP payees are often penalized by the current health care system due to the insurance companies. With no major leverage individual OOP payees end up making up for the subsidization the insurance companies receive due to strong-arming health care providers.

4/5/2011 8:09:07 PM

^most of the time private practices and hospitals give cash payers discounts. This is directly bc you are only allowed to charge ONE fee per code, per medicare guidlines. So you actually set your fee a little over your highest reimbursement rate.

However, some people look at it like this. Those cash payers also saved a ton of money by NOT buying insurance per month and thus should pay more when the gamble loses.

The general rule of a free market is the more choices and consumer control the better the market can respond with a drive to provide the best quality at the cheapest price.

Funny thing about dentists, as the only health care profession to avoid medicare they can actually go after the patient for the difference in reimbursement and fee. (not with SOME dental insurances though) That is why you have seen dentists maintain a high salary, even higher than ER docs... sad huh. Although people will gladly pay 400 for some white teeth, but ask them to pay 20 bucks from some blood pressure meds and they lose thier mind. If they need it it should be free, my money is for my wants...type attitude.

4/5/2011 9:39:12 PM

^ I'm glad I'm not the only one who sees the dichotomy in the way dentists and physicians are viewed by the general public. The average dentist certainly earns more per hour than the average primary care physician, and I'd wager more than quite a few specialists too. When is the last time you heard someone vilified as a "rich dentist"?

On the contrary, I think dentists are more likely to be viewed in a positive light, analogous to a small business owner. The fact that dentists are more likely to be in a small or single-professional practice and dentists deal with insurance and government meddling that is orders of magnitude away from those experienced by physicians can't be overlooked in explaining this difference.

4/5/2011 10:09:47 PM

Yet I would note that there is still a fundamental difference in perception between a doctor and a dentist. While good dental care is an important part of proper health, very few would view it as a sort of "life or death" type of care. About 99% of all procedures are comparatively simple "outpatient" type of matters, and the overall range of tools isn't nearly as large.

However, doctors conduct a range of procedures far beyond what dentists do using equipment and facilities far beyond what even a large dental practice would require including procedures that require hospitalization. You can't compare the extraction of wisdom teeth to say open heart surgery or even an appendectomy.

There is also a significant difference in the amount of risk that a dentist faces versus a doctor. While I'm sure that a botched dental job can lead to some lawsuits, I don't think those lawsuits would be equivalent to say something that an Ob/Gyn would face. Also, dentists are rarely facing life and death situations and thus patients can look at it a little more rationally, doctors however are dealing with patients who are probably less worried about the economics of the situation with death facing them down.

Maybe doctors are making the field overly complex and going overboard with tests and equipment, but it's hard to compare the economics between the two.

4/6/2011 5:56:41 PM

actually, lawsuits are making doctors go overboard on tests and equipment. you've probably done a good job of explaining some of the differences in price, as a result

[Edited on April 6, 2011 at 6:06 PM. Reason : ]

4/6/2011 6:06:09 PM