NC Healthcare service costs soar, Hospitals buy out doctors, Medicare rules let hospitals charge more than independent doctors, Indigent care cost shifting

NC Healthcare service costs soar, Hospitals buy out doctors, Medicare rules let hospitals charge more than independent doctors, Indigent care cost shifting

“If you like your health care plan, you can keep your health care plan.”…Barack Obama

“If you’ve got health insurance we’re going to work with you to lower your premiums by $2,500 per family per year.”…Barack Obama

“Can we stop calling ObamaCare the Affordable Care Act now?”…Ron Meyer

From the Raleigh News Observer December 16, 2012.

“Doctors join hospitals, and prices soar”

“North Carolina patients pay more for many tests and procedures if their physician is employed by a hospital, an investigation by The News & Observer and The Charlotte Observer has found.

It’s true whether the health care offered is a heart stress test or a routine visit to a doctor’s office. And it’s part of a national shift that experts say is raising costs but not quality: Hospitals are increasingly buying doctors’ practices, then sending bills for routine services that are significantly higher than those charged by independent doctors.

By one count, the percentage of doctors nationally who are employed by hospitals has doubled over the past decade. No similar statistics are available in North Carolina, but it’s clear that more and more doctors are affiliating with hospitals.

For example, in the Triangle, about 90 percent of cardiologists work for hospitals, which can charge more for procedures than private practices.

As a result, the cost of many routine medical tests and services has soared, according to Medicare data and insurance claims reviewed by the newspapers.

The same service performed in the same location by the same doctor can cost more than double what it did just a few years ago.

“Prices are increasing, often for no other reason than the sign on the door changed,” said Robert Zirkelbach, spokesman for America’s Health Insurance Plans, a trade group representing the insurance industry.

Here’s why: Medicare and private insurers pay more for outpatient care – which includes an allowed facility fee for hospital infrastructure – than for the same procedure in a doctor’s office, which cannot charge a facility fee. A hospital can increase revenue by acquiring a practice and changing the billing to outpatient. Or the hospital can simply convert its doctors’ offices to hospital facilities.

In the Triangle, Duke University Health System has been most aggressive in converting its doctor practices to outpatient entities.

“Outpatient visits (in 2010) increased 12.1 percent over 2009, which was due entirely to converted clinics,” according to a 2011 Duke bond document.

One example: For a common echocardiogram procedure, Duke Hospital submitted 4,879 claims to Medicare in 2010, up 68 percent from the year before. Medicare allows $471 for outpatient echocardiograms, more than twice the $200 allowed for those performed in physician offices.

Hospital officials contend they deserve to be paid more because they have expenses and obligations not shared by independent physicians. They must comply with more regulations, keep many departments staffed at all times and treat all patients, regardless of ability to pay.

Experts agree that hospitals should be reimbursed for the extra services they provide.

But there’s a limit, said Robert Berenson, an analyst at the Urban Institute’s Health Policy Center. For many routine services, Medicare pays hospitals about 80 percent more than it pays independent doctors, he said. But he said the additional expenses for a hospital don’t justify that kind of payment difference.

The newspapers’ latest findings underscore the lessons of the newspapers’ previous investigations, which found that the growing market power of nonprofit hospital systems is one of the factors in the rising cost of health care.

Now some public officials are questioning whether hospital systems have grown too big for the public good. Among them is state Attorney General Roy Cooper, who is examining whether to use antitrust laws or push for new legislation to reduce health care costs.

In the meantime, experts say, it’s likely that hospitals will continue to buy doctors’ practices at a rapid clip.

“It’s only going to grow, and it’s going to grow substantially,” said Paul Ginsburg, president of the Center for Studying Health System Change. “It raises the amount people pay. And I don’t think there’s a redeeming benefit to it.”

Jenny Palmer of Durham had been seeing a Duke neurologist for years for her epilepsy. She was furious when her $50 copay turned into a $425 payment applied to her deductible. The visit was less than 10 minutes, Palmer said, as she told the doctor her health was good and she received a prescription for a year’s worth of medicine.

Her bill made no mention of a facility fee, but Duke confirmed it in a letter after she complained.

“This clinic is now owned by Duke University Hospital (DUH) and in addition to the professional fee, there is also a facility fee charged in conjunction with each visit. Both charges are billed as an outpatient service as opposed to an office visit.”

“It makes no financial sense for me to see Duke doctors now,” Palmer wrote to her neighborhood Listserv. “BUT there aren’t many non-Duke doctors in Durham. ARGH!”

Palmer, 41, an administrator of a nonprofit, eventually found a neurologist in Raleigh.

Duke would not comment on Palmer’s case. It has acknowledged the fees in the past but said they were legitimate because of the increased costs of running the doctors’ practices.

‘I was just shocked’

Gay Miller thought she knew what to expect when she received a heart test earlier this year – until she got the bill.

After a heart valve replacement eight years ago, she has been getting periodic echocardiograms at her cardiologist’s office in Shelby to ensure the valves still work properly. Under her insurance plan, the tests used to cost her a $60 copay.

Not this year. During Miller’s annual checkup at the Sanger Heart & Vascular Institute in February, her doctor told her she would need to go to nearby Cleveland Regional Medical Center for her echocardiogram.

At the hospital, Miller received the usual 30-minute test. And the usual technician conducted it.

But there was nothing typical about the bill: Miller wound up owing $952.

“I was just shocked,” said Miller, 64, who lives in Lincoln County west of Charlotte. “I feel like I got taken advantage of.”

Across North Carolina and the U.S., hospitals are increasingly billing for heart tests like these. Experts say the higher bills for those tests are a telling illustration of a structural shift that is leaving patients with higher bills for identical procedures.

In 2005, doctors with Sanger – Charlotte’s oldest and largest group of cardiologists and heart surgeons – became employees of Carolinas HealthCare System, the hospital system that runs Cleveland Regional.

At the time of the merger, officials said Sanger patients wouldn’t notice any difference. Now, however, some Sanger patients who need echocardiograms are diverted to higher-charging hospitals.

Officials for Carolinas HealthCare did not address questions about the case. But in general, the system said, Sanger has been nationally recognized “for cost effectiveness and delivering the most appropriate care to each patient.”

Flocking to hospitals

Until recently, the large majority of physicians worked in doctor-owned practices. But that’s swiftly changing.

Last year, 47 percent of physicians in the U.S. were employed by hospitals – roughly twice the percentage in 2002, according to surveys by the Medical Group Management Association.

That trend is expected to continue, with one health care recruiting company predicting that hospitals could employ as many as 75 percent of all doctors within two years.

About 35 percent of North Carolina cardiologists work for hospitals – almost three times the percentage who did so five years ago, according to a recent survey by the American College of Cardiology.

The irony, some doctors say, is that federal efforts to reduce health care costs have helped drive the trend.

In 2010, Medicare reduced payments to physicians for various cardiology tests while raising payments to hospitals. That prompted many independent doctors to sell to hospitals, which could collect significantly more for the same tests.

Many doctors, however, have been unhappy about the trend. In a recent Physicians Foundation survey, 75 percent of North Carolina doctors said they disagreed “somewhat” or “mostly” with the premise that hospital employment of physicians is a “positive trend likely to enhance quality of care and decrease cost.”

While money helps explain why many doctors have opted to join hospitals, other factors also play a role. By joining hospital systems, many overworked physicians have been able to shorten their workweeks and share on-call duty. Hospitals also take over the complicated back office functions such as billing, negotiating with insurance companies and managing the expensive transition to electronic medical records.

Hospital systems have plenty to gain as well. Purchasing doctors’ offices helps hospitals enlarge their referral networks and boost profitability. It will also help them become Accountable Care Organizations, networks of doctors and hospitals that the architects of President Barack Obama’s health care plan believe will improve quality and efficiency.

Many experts predict that hospital acquisitions of doctors offices will boost prices still higher.

“This is really a historic change in the practice of medicine in the U.S.,” said Dr. William Zoghbi, president of the American College of Cardiology. “It’s more costly to the whole health care system, including patients.”

Dr. Daniel Wise has been on both sides. He was an independent cardiologist, then an employee of Presbyterian Hospital in Charlotte, and now he’s independent again. He left the hospital because he didn’t agree with its priorities.

But the reduced Medicare reimbursements make him wish he had stayed.

Wise said cardiologists’ incomes have declined by 30 percent to 40 percent in the past three years. “It doesn’t make economic sense anymore to try and do it in the office,” he said.

Two labs, two prices

In late 2011, Bruce Stanley was invited to an open house at WakeMed’s new Brier Creek facility. He nibbled cookies and toured the facility. He liked the convenient location and pleasant staff.

In January, he had two routine blood tests done there. He did them in advance of a physical and wanted to be able to discuss the tests with his doctor.

The results pleased Stanley. The bill did not.

Stanley owed WakeMed $240.82 for two routine blood panels. Three months earlier, he had paid $13.73 for the same tests done at the LabCorp office near Rex Hospital. Stanley didn’t know he would be charged full hospital prices.

“I thought it was a satellite clinic,” said Stanley, 58, a Raleigh businessman.

Debbie Laughery, a WakeMed spokeswoman, said the hospital can’t compete with LabCorp, partly because hospitals have more expensive facilities. Laughery also pointed to the practice of “cost-shifting,” where hospitals pay for charity care for the poor by collecting more from insured patients.

“We have to pay for all of our indigent care somehow,” Laughery said.

Is cost bump justifiable?

For many tests and services, the difference between what hospitals and independent physicians can collect is vast.

Hospitals, for instance, can get about 80 percent more from Medicare than independent physicians for a 15-minute office visit – and more than twice as much for many cardiac tests.

The payments to hospitals are also higher from private insurers. For a common outpatient echocardiogram in 2012, Duke was paid an average of about $1,800 by a private health plan. WakeMed was paid about $1,500; UNC, about $900, according to thousands of private insurance claims reviewed by the newspapers.

The same data showed the average payment to an independent cardiologist for the same test was $480.

Experts say private insurers have little choice but to pay hospitals more. When negotiating contracts with health care providers, insurers can survive without a single doctor’s office in their networks. But they must be able to offer customers access to major hospitals. That gives hospitals power to negotiate higher payment rates.

The employers and workers who share costs for health insurance wind up footing much of the bill. Patients, meanwhile, are left with higher out-of-pocket costs.

Hospital officials say there are valid reasons they can collect more. They say they’re obligated to serve all patients, regardless of ability to pay, while independent doctors can be more selective about which patients they treat.

“Provider-based services are also under state and federal regulatory oversight, while free-standing physicians and clinics are not,” the N.C. Hospital Association said in a written statement.

The association stresses that its members are merely following Medicare rules. Doctors’ offices owned by hospitals are generally allowed to bill Medicare at the higher outpatient rates if they are within 35 miles of the hospital campus and integrate their operations with the hospital.

But some experts and insurers question whether that’s reason enough for patients and taxpayers to pay dramatically higher prices.

Margie Maxwell, president of Aetna’s Southeast market, said: “There is no logic and there is no reason to allow a higher payment because it has now become a hospital billing. … It should not be happening.”

‘Harming consumers’

In a review of Medicare and private health plan data, the newspapers found that North Carolina hospitals are increasingly billing for routine office visits and for echocardiograms.

The number of office visits that North Carolina hospitals billed to Medicare climbed by more than 40 percent from 2007 to 2010, according to data compiled by the American Hospital Directory. And at Duke University Hospital, the number more than tripled.

During the same period, the number of echocardiography claims that North Carolina hospitals billed to Medicare increased more than 20 percent. At Carolinas Medical Center in Charlotte, the number more than quadrupled.

Berenson, of the Urban Institute, sees nothing redeeming in the trend.

“That’s taking advantage of the payers and really harming consumers,” said Berenson, who previously served as a commissioner of MedPAC, which advises Congress on Medicare policy. “It is not promoting more efficient care.”

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49 responses to “NC Healthcare service costs soar, Hospitals buy out doctors, Medicare rules let hospitals charge more than independent doctors, Indigent care cost shifting

  1. OT:
    NYC Mayor Bloomberg On Unarmed Sandy Hook Principal: “I Don’t Know What A Gun Would Have Done”…

    Wait, what? Let’s explain the obvious to Captain Clueless, she was the first person to encounter the gunman, if she shot him then there wouldn’t have been a massacre. Really, he couldn’t figure that out on his own?

  2. Bombshell Obama Vetting: 1979 Newspaper Article By Valerie Jarrett Father-In-Law Reveals Start Of Arab Purchase Of U.S. Presidency

    Why would Muslim oil billionaires finance and develop controlling relationships with black college students? Well, like anyone else, they would do it for self-interest. And what would their self-interest be? We all know the top two answers to that question: 1. a Palestinian state and 2. the advancement of Islam in America. The idea then was to advance blacks who would facilitate these two goals to positions of power in the Federal government, preferably, of course, the Presidency. And why would the Arabs target blacks in particular for this job? Well, for the same reason the early communists chose them as their vanguard for revolution (which literally means “change”) in America. Allow me to quote Trotsky, in 1939: “The American Negroes, for centuries the most oppressed section of American society and the most discriminated against, are potentially the most revolutionary element of the population. They are designated by their historical past to be, under adequate leadership, the very vanguard of the proletarian revolution.” Substitute the word “Islam” for the words “the proletarian revolution,” and you most clearly get the picture, as Islam is a revolutionary movement just like communism is. (Trivia: it is from this very quote that Van Jones takes his name. Van is short for vanguard. He was born “Anthony”). In addition, long before 1979, blacks had become the vanguard of the spread of Islam in America, especially in prisons.

    Interestingly, in context with the fact that this article was written by her father-in-law, Valerie Jarrett has an unusual amount of influence over Obama (along with personal security that may be even better than his, another unusual and intriguing bit of business here). And equally interesting is that Obama, who may have been a beneficiary of this Muslim money, and may now be in this Muslim debt, has aggressively pursued both of the Muslim agendas I cited above. And, also equally interesting, is that Obama has paid a king’s ransom for court ordered seals of any such records of this potential financing of his college education, and perhaps, of other of his expenses.

    Lastly, it’s very important to note that the main source for the article is Khalid Mansour, “the same lawyer who allegedly helped arrange for the entrance of Barack Obama into Harvard Law School in 1988.” (Valerie Jarrett, by the way, was born in Iran. The one country protected by Obama from the sweep of the Arab Spring.) Now all of this may seem sensational, but let’s face facts. What makes it most disturbing is that not only is it all logical, but it suddenly makes a lot of previously confusing things make perfect sense.

  3. Interested Bystander

    Hey All,

    I know this comment isn’t on subject, but here goes:

    I believe that those EXPLOITING the tragedy in Newtown are just as sick as the man who committed the shootings.

    For Obama to swoop in for a “talk” just disgusts me.

    Let these people grieve for goodness sake.

    I’d bet that residence can’t take their trash to the road without having a microphone stuck in their face.

    I believe this incident should be REPORTED, but the continued 24 hour “updates” are just too much in my opinion.

  4. Mr. Bill(ms. helga)

    “Don’t Let a Crisis Go to Waste” – Rahm Emanuel

  5. Interested Bystander | December 17, 2012 at 5:07 pm

    Hey IB,

    You’re 100% correct! Try living in New England; it’s wall-to-wall coverage 24/7 and it’s beyond ridiculous!

    I, for one, have opted to turn off the local talking heads; the TV is turned on lately for traffic and weather only and that’s about it!

    Leave these people alone; they have enough on their plates without worrying about the vultures ready to swoop in and make their lives even more miserable than they already are.

    Have some respect for the families dealing with an unimaginable tragedy.

  6. With judges like this, can Shariah be far away?

    Your boss orders you to attend a religious service at a mosque, but you decline because your Christian faith tells you that would be wrong.

    He then orders you to send one of your subordinates … to something that violates your faith and perhaps the subordinate’s faith.

    Simple First Amendment case, right?

    Wrong. It’s “creeping Shariah” in America’s heartland .

  7. Court terminates parental rights in homeschool case

    The U.S. Supreme Court has written that terminating parental rights is the family-court equivalent of the death penalty.

    This mom and dad would agree. They only chose to homeschool their son, and now he has been taken away because that makes them bad parents.

    It’s an outrage

  8. Mr. Bill(ms. helga)

    Watching MSNBC with Chris Mathews and they YET HAVE TO MENTION THAT ADAM LANZA’S FATHER WORKS FOR General Electric!!!

    I repeat “MSNBC is the rectal thermometer for Potomac Fever and Chris Matthews is the nurse.”

  9. After all the talk about gun control lately, does anyone remember a certain someone saying “If they bring a knife, we’ll bring a gun.”

    Who said that? Gee, I can’t remember. Can anybody help me?

  10. Barry Soetoro

  11. The f…er had to read his script that he wrote hahahahahahahahahahah Could not hold ugly head up and look at his subjects while he spoke from the heart…I forgot the little kenyan fraud does not have a heart let alone a brain.

    Hey, Barry go on to Hawaii and jump in the Ocean and let a shark do us a favor and have you for supper.

    Joking aside I have a question???? Why is it that not one time that I know of has the media ever bashed us for calling that joker in the white house Barry Soetoro? Every site that I go to most people call him Barry. Does the media intend to keep the real legal reason why Barry is not qualified to be president of the United States quiet because it is true? Also his phoney SSI # is never mentioned and we talk about it all the time. hmmmm

    Come on lets boycott the media and the businesses they advertise for.

  12. We got our SSI benefits notice today and got a 1.7 % increase for 2013. Then it was taken away and added on to the cost of our medical insurance. Go figure!

  13. Hopefully when they will inevitably bring some bill to disarm law abiding Americans and not change any of the “rights of the mentally disturbed” that make it nearly impossible to commit them UNTIL they act out in something like this, will anyone yell about the incredible amount of weaponry and ammo that all those articles from not long ago alerted the public to re: govt arming itself? Things will certainly become lopsided on the side of the thugs don’t you think?

  14. If anyone is interested ‘International Fellowship of Christians and Jews’
    needs our help.

  15. I hear that not very many thugs showed up at the NRA headquarters today! Around 200

  16. Ginger | December 17, 2012 at 6:57 pm |

    Joking aside I have a question???? Why is it that not one time that I know of has the media ever bashed us for calling that joker in the white house
    Barry Soetoro?
    Ginger, I have a somewhat humorous story for you. Last July my husband was admitted to the hospital and the doctor in the ER wanted to determine if he was coherent. He said “What is your name?” My husband answered correctly. Then he said “What year is this?” My husband said “2012.” Then the doctor asked “Who is the president?” My husband answered “Barry Soetoro.” The doctor looked quite puzzled but the attending nurse broke out laughing. She got it.

  17. Barry was introduced as Barry on Tim Kaines last radio show.announcer said”Tim you have a surprise guest calling,it’s Barry!
    Showed on Fox this was Kain’s last show when he was Gov.
    I fell off my chair

  18. SueQ…..Truth Now


    It feels real good to be able to laugh. Thank you both. 😀 😀 😀

  19. After this post I will go away.

    I hear that Barry at his ego trip and photo opt yesterday stated that “we have been through this several times before.” Excuse me Idiot you for got the f..n muslim slime who shouted “alla akbar’ while shooting down several of our unarmned HEROS at Fort Brag. It was Fort Brag…right?

    Get loud people and remind them that they murder millions of unborn babies by ABORTION

  20. Ginger,
    You have to laugh sometime or you’ll go crazy. Bless you.

  21. Observer,

    I was reminded today by Rush Limbaugh just how many people were slaughtered by the GOVERNMENT at Waco. My daughter and I watched “in real time” on TV in horror as that happened. That whole compound went up in flames and many many children and adults were incinerated. Many little babes lost their lives at the hands of our own government. OUR OWN GOVERNMENT!

  22. “Arizona Electors Question Obama Birth Certificate During Formal Casting Of Electoral Votes”
    “Arizona Electors Question Barack Obama Birth Certificate
    By John Celock @ The Huffington Post

    The chairman of the Arizona Republican Party and two other Arizona members of the Electoral College on Monday questioned President Barack Obama’s birth certificate during the formal casting of the state’s electoral votes.

    Arizona GOP Chairman Tom Morrissey said during the state’s Electoral College meeting that Obama did not produce a “legitimate” birth certificate, KNAU reports. Morrissey’s comments came as presidential electors nationwide formally elected Obama over Republican Mitt Romney.

    “I’m not satisfied with what I’ve seen,” Morrissey said during the meeting. “I think for somebody in the president’s position to not have produced a document that looks more legitimate, I have a problem with that.”

    Morrissey was joined in doubting Obama’s citizenship by two other Arizona electors, Gila County Republican Party Chairman Don Ascoli and former Graham County Republican Chairman John D. Rhodes, the Associated Press reports. Ascoli questioned whether Obama had been”properly vetted as a legitimate candidate for president.”

    Arizona Gov. Jan Brewer (R), who has vetoed bills to require presidential candidates to show a birth certificate to Arizona’s secretary of state, said she disagreed with the trio’s stance. Secretary of State Ken Bennett (R), the presiding officer of the Arizona Electoral College, also said he disagreed with what the three said.”

  23. Thanks GORDO.

  24. “You can’t fix stupid.”…Ron White

  25. Remembering the Waco disaster leads me to think back to Elian Gonzalas saga. Does anyone remember the photo of Janet Reno’s thug pointing his weapon at a five year old boy hiding in a closet?

  26. I guess both of them would also disagree with the Sheriffs investigation proving the B.C. is a complete and utter fraud.

    Let an illegal Mexican alien produce a fraudulent B.C. for a drivers license and food Stamps, Janet would be all over it.

  27. Frankly, I am very ashamed of both Gov. Brewer and SOS Bennett, although not surprised from what we already know about them. They have both shown themselves to be RINOS once again.

  28. SueQ | December 17, 2012 at 8:54 pm |
    Remembering the Waco disaster leads me to think back to Elian Gonzalas saga. Does anyone remember the photo of Janet Reno’s thug pointing his weapon at a five year old boy hiding in a closet?
    Yes, SueQ, I remember it well and it absolutely broke my heart as did Waco, both happening during Clinton’s administration. That little boy was returned to Cuba, and the last I heard he was sort of a poster boy for Castro. Some people are going to have an awful lot to answer for, and I wouldn’t want to be in their shoes.

  29. Actually I did some research on the AZ electors and am not surprised over the three who raised the eligibility issue, based on some of their past comments. I believe there were 10 AZ electors, so 3 out of 10 isn’t a bad ratio.

  30. Cabby,

    The only difference between the two, (he and Lanza) was one pulled the trigger. The other, I suppose, was ordered not to for Clinton’s sake…. bad press…. can’t have that.

  31. communist obama marxist socialist gay usurper criminal felon

    Pass This Video on to All!

  32. SHOOTINGS: “Sandy Hook” and “Aurora (CO)” Shown in Batman Film …What are The Odds of That?!

  33. William | December 17, 2012 at 8:55 pm —

    “I guess both of them would also disagree with the Sheriffs investigation proving the B.C. is a complete and utter fraud.’
    March 6 & 10, 2012

    “Brewer disagrees with Arpaio findings, believes Obama birth record real”

    “I have every reason to believe that his birth certificate is valid in the state of Hawaii,” the governor said.

    Brewer acknowledged that, unlike the sheriff, she has not done extensive research.

    But the governor said she had spoken several years ago to her Hawaiian counterpart when the issue first arose. And she said Tuesday that he “assured me that everything was in proper order and they stand by their records that he was born in Hawaii.”

    Arpaio sniffed at the governor’s comments.

    “That’s the governor’s opinion,” he said. “And I have my opinion, plus facts.

    Last year she vetoed legislation which would have required candidates to provide proof they were born in this country to get on the Arizona ballot. Brewer said giving the secretary of state authority to decide if a candidate is eligible, as the law would have allowed, “could lead to arbitrary or politically motivated decisions.””
    May 25, 2012

    Jerome Corsi:


    “Zullo told WND that his purpose in requesting the meeting with Bennett was to share with the Arizona secretary of state recent developments in the MCSO law enforcement investigation into Obama’s birth.

    “I was shocked to find out Bennett knew virtually nothing about our investigation – only what he read in the newspapers,” Zullo said.

    He added that Bennett did not appear interested in understanding the serious information the investigation had developed.

    “When I tried to bring him up to speed, it became apparent the 20 minutes remaining in the meeting was not going to be enough time to explain even the key points of the investigation,” Zullo said.

    “I felt Bennett was totally ignorant of what I was talking about, and he really didn’t care.”

    Zullo said he left Bennett’s office fully convinced the secretary of state would capitulate to pressure by Arizona and national Republican Party officials, including Sen. John McCain.”

  34. they are trying to cover the connection between the mass shooter in movie theater and school both fathers were to testify about mo ey bailout and where it went .does any one know the connection between senator lanza of ny and the shooter. Senator is agzinst guns .somthing strange here

  35. GORDO | December 17, 2012 at 10:35 pm
    I wonder if Bennett is one of Soros’s secretary of state, of the Soros SOS project.

    It seems, allowing an ineligible candidate on the ballot is one of their goals.

  36. OK, so the electoral college has voted the illegal bastid in once again. IMO, time to do away with these morons and elect the President by the popular vote.

    I don’t believe I’ll ever see a legitimate election again in my lifetime.

  37. Pray,pray,pray Truth come forth,deception ,lies coverups be exposed and deal with them Oh Lord Please save America ,exposé the evil and you oh Lord deal with them,God you love Truth,we cry out save America from
    The evil that has come upon us Pray God’s word over America ,pray the deception Stop Now,have Mercy upon us oh Lord,America is your land

  38. Please Lord Wake America up from her slumber,Truth come Now,One Nation Under Almighty God!!! Put those evil people under heavy conviction,they can’t rest until Truth come forth

  39. Unbelievable school mentioned in movie.
    Pass on,this is weird

  40. William………….
    Janet Reno was a WELL KNOWN LESBIAN. Sadly she had the intelligence quotient of about 30………if that!. Big Sis puts me in mind of Reno everytime I see a picture of her. Look closely at all of the Lesbians they all have the same STARING,ROUND EYED,VACANT EXPRESSION on their faces 24/7. ALL YOU HAVE TO DO IS …..LOOK CLOSELY! YOU WILL SEE THE SAME nitwit EXPRESSION ON MMMMMSSSSSS Feinstein’s face,and on MMMMSSSSSS.Pelosi’s face,and is exactly the same DUMB EXPRESSION. It is a natural human characteristic for the face to display character,and personality. Lesbians and male faggots HAVE NO CHARACTER,OR PERSONALITY, ………THAT IS THE PRIMARY REASON FOR THE vacant facial appearance. ALL HOMOSEXUAL PERSONS HAVE THE SAME VACANT LOOK UPON THEIR FACES 24/7. Learned this YEARS ago!.

  41. oldsailor,
    Barry has that same hollow look. He also looks “dead”.

  42. Well, I just heard that Boehner and Bummer are supposed to be nearer a decision (giveaway). Boehner has lowered the tax increase now to those making over $400M AND won’t cap the debt ceiling for two years. He is absolutely giving away the store, and he needs to be replaced as soon as possible. This is pathetic and outrageous, imo. With friends like this, who needs enemies?
    If you are on Twitter, go to his Twitter account and tell him how you feel.

  43. Yes, Cabby, I tweeted, as requested. Here’s what I told the jackass:

    ” ‘Negotiating’ with this illegal Thugocracy is a disgrace! You need to be replaced and soon.”

    I think that should get me on some sort of ‘list,’ don’t you?


  44. CabbyAZ…………….
    Exactly, and BTW what was it that Larry Sinclair had to say about Lil Barry? I rest my case!

    I have distrusted Boehner from day one! Unfortunately he has allowed the SLIMEY liberals to BROW BEAT HIM. You are right !…..I GUESS ALL WE CAN HOPE FOR WHERE HE IS CONCERNED IS THAT HE INADVERTENTLY STEPS INTO AN OPEN MAN HOLE.

  45. Good Morning All! All this gun reg hysteria/plotting is just disgusting. Arm the teachers and keep freedom.

  46. Good morning Zach, et al.

  47. Cabby,
    Boehner just met privately with Obamalast week, remember?

    We should always be concerned when someone is invited to a private meeting with Obama. Mysteriously, they come away from the meeting with a different mindset. I don’t know if they are threatened, coerced or hypnotized (NLP) but it’s strange how they are persuaded to concede to Obama’s agenda shortly after meeting privately with him in the White House.

    July 18, 2011, 12:59
    Boehner and Cantor Meet Again With Obama
    …..Mr. Boehner had two previous private meetings with the president, and both of those sessions caused unrest among fellow House Republicans who worried that the speaker was going to strike a compromise that many of them would have trouble supporting.

    Archbishop Dolan ‘a bit more at peace’ after meeting with President Obama
    November 15, 2011
    Archbishop Timothy Dolan of New York, the president of the United States Conference of Catholic Bishops (USCCB), met with President Barack Obama at the White House on November 8.

    Archbishop Dolan said at a November 14 press conference that he left the meeting “a bit more at peace [about religious liberty] than when I entered” and that he believed the president to be “very open to the sensitivities” of Catholics about religious liberty.

    It’s good that Dolan later came to his senses.

  48. Pingback: NC Healthcare service costs soar, Hospitals buy out doctors … | Health Tips - Health Articles - Weight Loss Tips - How to lose weight

  49. Thanks, Jonah, for the reminder. Under the right circumstances, O must display a certain aura which is captivating, at least for the moment, as in the case of Archbishop Dolan. They all seem to wilt in his presence.

    When a person is diabolical and devious, that “fatal attraction” is often part of the evil. What we are really talking about here is masterful DECEPTION by a master deceiver.

    Just awhile ago I saw a news conference with Boehner, Kantor, and another from CA. They all appeared SO spineless and weak. Pansies!! (and not the garden variety) I wouldn’t be surprised if they have all been bought off or threatened. Either that, or they are under a spell.

    This is far from settled. Now we understand why Boehner has been ridding some of the House committees of fiscally conservative members. He is acting like a dictator over the House and wants no interference.

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