Obamism

We are hearing different reasons why we must pass this health reform bill.  1. There is a crisis and if we don't pass the bill, we will go bankrupt (things are unsustainable). 

There are many hidden aspects to this bill, which is not being discussed in a transparent manner (which our esteemed President assured us.)"that things would be different in D.C. if he were elected"

2. If  the bill is passed costs will go up as well, including increases in premiums of a significant amount to cover the new insured,, who were previously uninsurable, or excluded to due pre-existing conditions.

3. Additional taxes will go into effect several  years before any benefits or changes will be made to coverage.

"Quick, pass the bill before anyone can read it and really understand the profound effect it will have not only on health care, but every business, and person who is insured. "What will be the ripple effect on health care costs, provider availability, and hospital survival? 

What's In A Name

THE PUBLIC OPTION 

Let's think of some titles that will be more acceptable to the approximate 50% of voters who do not want a public option.

1. Alternative integrated universal choice for Health.

2..National Public Health, Inc. (NPH)

3.  United Stated Federal Health Reserve USFR)

4. Federal Health Insurance Bank (FHIB)

5. U.S. Health Stimulus Choice (also known as USHC certified)

6. Federal United Care Combine (also known as FUCC) (sounds like Fuc@)

Or let's allow patients to 'Opt-out of the Public Option. This would be done on a state wide basis rather than as individuals. Depending on which state you live in.  This great idea comes from those two Senators Reid and Pelosi who must smoke something for breakfast that is grown in the fields of either Afghanistan or Northern California.

Plans #1 through #4  could be funded by donations from patients who "care" for only pennies a day.

For those who want the public option....I hope you will like what you get...it won't be pretty.  If you think you can't find swine flu now, when you need it, then consider that this is typical of any government program.  The idea that the federal government is going to contract with private insurers copies what it does in most other areas of defense, manufacturing of medications such as vaccines (CDC), NASA, and others).  They cannot do the job themselves, and contract it out to others who are either not supervised or unable to perform.

Our government easily promises what it cannot or will not deliver. The war on cancer, the war on drugs.

Yes, a a physician I know it is a disgusting fact that there are many uninsured needy patients who don't get health care. I also know that programs such as medicaid will pay for a surgery, but not the necessary post op physical therapy....why? Because the states are fearful that everyone on Medi-caid will run down and sign up for chiro-massage or manipulation. That philosophy runs rampant in most state and/or federal programs.

Government programs are always trying to make a brick float.

GML

Who's in Charge, Anyway??

Physicians no longer feel in charge for many things that occur during their daily clinical work. During our training years we are carefully monitored and have mentors who we can look to for advice, guidance and in some cases, even wisdom...For those in 'private practice' in a solo or small group practice 'autonomy' becomes a real issue, and blending this with the reality of patient care, risk, and medical politics becomes a narrow balance beam for most of us.

Health reform measures are a reflection of a conundrum. Will we be reformed from within, or without??   It is a mess.  Even the informed, educated and well read can make little sense or aggregate the impact of the legislation presently being debated in congress. Driven solely by financial analysis the legislators pretend to develop a 'quality driven, consumer oriented health care policy', a real oxymoron in itself.

Kenneth Fisher, MD in his blog, Health Care Reform in America, states,

Dr Fisher and I are classmates and graudated from George Washington UniversitySchool of Medicine

"Indeed it takes more training to take care of seriously ill patients than to fly a jet liner. Yet it is inconceivable that a jet pilot when facing a problem, instead of using his experience and judgment, would have the passengers vote on what to do. However, unlike the pilot, in today’s medical practice it is common for physicians to place the task of medical judgment on the patient/family frequently resulting in irrational care. This often leads to patient suffering and the wasting of valuable resources.

This exaggerated sense of patient autonomy along with the fear of legal action has augmented medical consumerism. This problem has been enhanced by drug and device advertisements directly to the public and by the medical profession’s undue reliance on the legal system to decide what are, in effect, medical questions. Instead of our various medical societies forming referral mechanisms to help decide difficult issues, hospitals and doctors have abdicated this responsibility to the courts with the result being an ever-present fear of legal action.

It should be noted that till this day our medical societies have not answered this challenge. Again, in May, 1994 (New England Journal of Medicine) while discussing the Baby K court case, an encephalic baby with no chance of recovery, George J. Annas had a similar message. He commented that for medicine to avoid becoming a consumer commodity and thus unbearably expensive requiring control by payers, physicians will have to set standards and follow them. Again organized medicine did not and has not responded

A few weeks ago (November 2009) a talented second year resident told me that, in his opinion, American medicine is no longer about treating patients’ problems. It has become a hospitality industry focused on customer satisfaction regardless of the appropriateness of the medical plan.

For health care reform to be successful we have to insist that our medical societies set up procedures so that patients are treated as individuals, each with unique needs. At the same time mechanisms must be established so that we uniformly practice high quality medicine with evidence-based use of resources. We must have expanded peer review so that difficult situations and overuse can be quickly resolved using medical experts.

Dr Fisher's Interview on National Public Radio

The Real Deal

 

It Is obvious how the world of blogging.has displaced the coffee room and the water cooler as sources of inside information. In fact, blog sources are frequently the first place that relevant information appears.

In addition to classical newspaper and Journal sources these entities have their own blog section. Add to this, facebook, twitter, digg, my space and others yet to be determined the relationships become infinite.

Take for example, this posting on ‘Dr Wes’ blog:

On Dec. 3 the U.S. Senate voted to keep significant Medicare cuts in the health-care overhaul bill despite polls showing seniors are concerned about their benefits. Senators voted 50 to 42 to reject an amendment by Sen. John McCain, R-Ariz. that would have stripped more than $400 billion in Medicare cuts from the health-care bill. The measure would have sent the health-care bill back to the Finance Committee for redo

What this means for our seniors is Medicare benefits will be cut in important health-care programs. In my specialty, cardiology, this will mean draconian cuts to Medicare-dependent seniors in cardiology services.

The real deal is this”

A new survey of U.S. cardiologists indicates the following:

Practice effects

* 94 percent would be forced to reduce paid staff such as nurses and technologists.

* 80 percent would be forced to cut employee benefits.

* 67 percent would elect to retire earlier than planned.

* 59 percent would limit practice hours.

* 56 percent would be forced to sell their practice and merge with a local hospital.

* 45 percent would no longer perform imaging services such as nuclear stress testing or echocardiography.

* 25 percent would be forced to close their practices.

Patient effects

* 97 percent believe that Part B costs to Medicare will increase in their area because patients will have to receive imaging tests in the hospital setting where the Medicare reimbursement rate is significantly higher than under the Medicare Physician Fee Schedule (MPFS) for private practice.

* 92 percent believe patients’ co-pays will increase as much as 20 percent if they are forced to have imaging tests done in the hospital setting.

* 89 percent believe early detection of heart disease will be greatly reduced because of patients’ lack of access to cardiology procedure services.

* 76 percent would refer patients to the nearest hospital for imaging procedures.

* 79 percent believe current Medicare patients will no longer be able to have imaging done at private practice offices and would be forced to have imaging done only at the nearest hospital.

* 45 percent would no longer be able to accept Medicare patients.

With these cuts physicians may not be able to provide the services that patients have come to depend on and in the long run, if the current policies are not changed, cardiologists may be forced to close their doors to their patients.

The law is clear — our seniors will realize these cuts unless Congress acts. We all have seen the response to government studies which want to limit mammograms to women in their 40s. You have seen the outcry to this type of foolish rationing. The Senate just voted to reverse that ruling and provide mammograms through their insurance carriers.

These Medicare cuts are the first step in Medicare rationing of our seniors’ health care. We must stop these cuts to the Medicare system. Our seniors are living longer and in better health because of the Medicare system. We can keep current Medicare benefits if fraud and abuse are eliminated. There are good-practice guidelines which have been enacted by the specialties societies. Let us enforce these practices and let Medicare survive.

On the ‘street’ it looks very different from the view at 40,000 feet.  Its about the same as President Obama receiving the Nobel Peace Prize.

Call and write to your senator today. Let him know how you his constituents feel about these proposed changes in health care.

Bottom line: The only way to get health costs down is when consumers are presented with a range of options in a truly competitive marketplace

*******************************************************

Another Observation:

Grace Marie Turner, The Galen Insitute, "More Nutty Ideas from the Senate," December 8
Two thousand seventy-four pages and trillions of dollars later, this bill doesn’t even meet the basic goal that the American people had in mind and what they thought this debate was all about: to lower costs.

Mitch McConnell, Senate Minority Leader, December 8, on Senate Health Care Bill
It’s beginning to look like health care consumers are going to have to take lowering health care into their own hands since no answers are coming down from above. "

My own thoughts on this matter (Health Train Express)

Add to the cost of insuring additional patients, the cost  of the regulatory mechanism .  We have already witnessed this with HMOs and Medicare Advantage. Add to this the costs of    outcome analysis, preferred payment schedules for EMR usage, health information exchanges, etc and you will see that ‘savings’ are imaginary.  Keep it simple, and accountable on the local level. "

Here are ten tips for lowering your costs.
One, encourage your employer to offer a health savings account with a high deductible. Encourage the employer to pay half the deductible. Your premiums will be much lower, and your employer will save up to 50% over current HMOs and PPOs.
Two, investigate a company called Simplecare. The SimpleCare story has appeared in U.S. News & World Report, in Forbes, and on NBC News. SimpleCare , a fee-for-service organization, accepts money for medical treatment without the bother and hassle of insurance forms, co-payments, and other third-party payment related procedures. SimpleCare has an alliance of doctors offering cash discounts. Itsmembership includes 38,000 patient members working with 1,500 doctors nationwide. Discounts range from 15 percent to 50 percent for patients paying in cash.

Three, ask your doctor if he or she accepts cash only. About 10 percent of doctors accept cash only. The idea is to pay for care at the time and point of care with cash, check, or credit card without the expense or trouble of going through an insurance company. Dealing with third parties creates a 50 percent to 60 percent overhead, and many doctors are finding they can charge less and make just as much or more money without going through a third party. Often the doctor’s fee is negotiable.
Four, find out if your doctor dispenses prescriptions in the office. Prescriptions dispensed in this way average 50 percent less. A company called Physicians Total Care has installed prescription systems in 30 states and is growing by 170 percent a year. For more information, google Physicians Total Care or read a chapter “Physician Office Dispensing Stages Comeback” in my book Innovation-Driven Health Care (Jones and Bartlett, 2007).
Five, fill your prescriptions at Walmart, Target, or discount stores. Walmart has more than 300 generic drugs and 1000 over-the-counter medications it sells at $4 for a 30 day supply and $10 for a 90 day supply. Fifty percent of Americans live within 5 miles of a Walmart or Target.
Six, ask your primary care physician if he or she performs common procedures like skin biopsies, abscess drainage, joint injections in the office. An organization called the National Procedures Institute (www.npinstitute.com) has trained over 15.000 primary care doctors to perform simple office procedures, and these can be done less expensively without waiting than in a surgeon or other specialist’s office.
Seven, consider visiting a retail clinic in drug store or discount outlet for minor ailments or immunizations. Nurse practitioners using protocols and electronic medical records run these clinics, which may have physician or hospital backups. The charges are listed are transparent and predictable. About 2000 of these clinics are now operating, and their locations may be found at conveniencecareassociation.com. The services of these clinics cost about half as much as a visit to a physician’s office but do not have a physician’s expertise and may miss serious underlying conditions.
Eight, if you work for a larger employer, ask executives if they are considering setting up worksite clinics. About half of the nation’s corporations with headquarters employing more than 100 employers on site are organizing these clinics, which offer the services of a primary care physician and staff, which may include a nurse, nutritionist, and other health professionals. Employees can receive free generic drugs and other treatments or advice on site, or may be referred to cost-effective networks of specialists off-site.
Nine, if you are uninsured or underinsured consider visiting a federally-qualified community health clinic. These were launched by President Bush as a Health Centers Initiative in 2002. These clinics, which are present in all 50 states, have 4000 locations and have served 15 million people. They are administered by Health Resources and Service Admistration (HRSA. Services include checkups when well, treatments when sick, complete pregnancy care, immunizations, dental, and mental care. To find a clinic near you, google HRSA – Find a Health Center.
Ten, in general low cost and convenient care is available at a local primary care physician. There is now a shortage of these physicians. Therefore, these physicians are now very busy, and you may have to wait for an appointment. Because of low reimbursements, some no longer accept new Medicare or Medicaid patients.

·

It becomes apparent that we should not expect ‘government ‘ to fix the problem . Initiatives from patients, employers and insurance companies are far better than throwing up our hands and relying on the government(s) to solve a problem that really has nothing to do with governing, or defending our country.  It remains to be seen if patients,and employers can bring pressure to bear on insurers without governmental intervention and/or regulations.

Care for each other, your parents, your brothers and sisters, and relatives to the best of your abilities.

A Fairy Tale

Bricks, Straw, or ?    This is an interesting metaphor, and it may apply well to the  current health debate.

Too big to fail? Health care reform, or Dubai?

Obama's 'glow" is diminishing, even amongst the 'faithful, and gullible.

Matt Holt and THCB quote"

There’s a big to-do about whether there are really any cost-saving measures in the House and Senate bill. Most people say that the answers are “no” and “sort of”.

But let’s not dwell on that. Instead let’s have some fun. Regular THCB readers will know that AHIP’s Karen Ignagni has told half-truth after half-truth after outright lie to protect the position of her members. All the while somehow holding together a coalition that really should have broken apart long ago (and may yet still do that). And she gets paid very well for that role.

But today in the WaPo she told the truth:"

 

Karen Ignagni, president of America's Health Insurance Plans, said the Senate bill includes only "pilot programs and timid steps" to reform the health-care delivery system, "given the scope of the cost challenge the nation faces." Unless lawmakers institute changes across the entire system, Ignagni said in a statement Wednesday, "Health costs will continue to weigh down the economy and place a crushing burden on employers and families."

More Docs4Patient Care

Another rally....get involved, patients and providers alike.

Forward the link- 

Go Viral:

Meaningful Use and Incentive Payments

In one of my previous posts I alluded to this.

 

Read it here first !!

 

RECENT COMMENTS FROM IHEALTHBEAT.

MGMA Letter Details Concerns About Health IT Stimulus Funds

On Sunday, the Medical Group Management Association sent a letter to National Coordinator for Health IT David Blumenthal detailing its concerns about the implementation of the federal economic stimulus package's health IT incentive program, Modern Healthcare reports.

Under the stimulus package, health care providers who demonstrate "meaningful use" of electronic health records will qualify for increased federal incentive payments (Conn, Modern Healthcare, 11/23).

In the letter, MGMA argues that health care providers could miss out on the stimulus funds if the government fails to appropriately define meaningful use and administer the program effectively.

To avoid these pitfalls, MGMA recommended that the federal government:

• Allow for flexibility in approaches to meaningful use;
• Create a pilot program to test the incentive payment initiative;
• Develop a simple process to demonstrate meaningful use;
• Emphasize tested and widespread criteria when defining meaningful use;
• Enable physicians to test their reporting systems prior to full implementation;
• Focus on appropriate and achievable meaningful use criteria;
• Monitor the health IT industry; and
• Simplify data reporting processes.

MGMA also called on the government to encourage the health IT vendor community to develop high-quality and affordable software (Hardy, Healthcare IT News, 11/23).

Docs4Patient Care

I've been gone for a week or so on a trip to the ancestral homeland in California. (ancestral in California means longer than five years ago.)

The Docs4Patient Care movment will be very active on November 21, 2009 with chapters now in many states, including Georgia, California, Texas, as well as many other videos. Here is a 'shout out' for recent activities.

Here is a brief video:

Failed California, Failed State,Failed Health Care Reform

Undoubtedly we will see some form of compromise and legislating 'Health Care Reform".  Whether it will truly be a health care reform will be open to debate. Let's face, it seeking perfection is anathema to seeking improvement. Never let perfection obstruct improvement in the status quo. Charlie Rose interviews Friedman.

 

 

NRO, National Review Online report from Grace-Marie-Turner reflects the following.

Further, endorsements by the AARP and the American Medical Association have been largely discredited as reflecting more the narrow interest of those organizations than the will of their members.

Readers should do their part by contacting the following representatives who are most likely to influence health reform decisions.

Key Senator Contacts for Health Care ‘Reform’ Bill

State Senator D.C. Phone # D.C. Fax # State Office Phone # State Office Fax #

AR Blanche Lincoln (2010) 202 224 4843 202 228 1371 501 375 2993 501 375 7064

PA Arlen Specter (2010) 202 224 4254 202 228 1229 215 597 7200 215 597 0406

IN Evan Bayh (2010) 202 224 5623 202 2281377 317 554 0750 317 554 0760

OR Ron Wyden (2010) 202 224 5244 202 228 2717 503 326 7525 503 326 7528

LA Mary Landrieu 202 224 5824 202 224 9735 504 589 2427 504 589 4023

NE Ben Nelson 202 224 6551 202 228 0012 402 441 4600 402 391 4725, 402 476 8753

ND Kent Conrad 202 224 2043 202 224 7776 701 232 8030 701 232 6449

DE Tom Carper 202 224 2441 202 228 2190 302 573 6291 302 573 6434

CO Michael Bennet (2010) 202 224 5852 202 228 5036 303 455 7600 303 455 8851

CA Barbara Boxer (2010) 202 224 3553 202 224 0454 213 894 5000 202 224 0357

AR Mark Pryor 202 224 2353 202 228 0908 501 324 6336 501 324 5320

CO Mark Udall 202 224 5941 202 224 6471 303 650 7820 303 650 7827

CT Joe Lieberman (Indpndt) 202 224 4041 202 224 9750 860 549 8463 860 549 8477

VA Mark Warner 202 224 2023 202 224 6295 804 775 2314 804 775 2319

VA Jim Webb 202 224 4024 202 228 6363 804 771 2221 804 771 8313

MT Jon Tester 202 224 2644 202 224 8594 406 449 5401 406 449 5462

VE Bernard Sanders (Indpndt)202 224 5141 202 228 0776 800 339 9834 802 860 6370

MO Claire McCaskill 202 224 6154 202 228 6326 314 367 1364 314 361 8649

ME Olympia Snowe (Rep) 202 224 5344 202 224 1946 207 874 0883 207 874 7631

ME Susan Collins (Rep) 202 224 2523 202 224 2693 207 780 3575 207 828 0380

To obtain all the required contact information for these senators, go to www.congressmerge.com/onlinedb/ (put this address in your favorites). When you are on the home page, just click the link Find who represents you in Congress. Go to the state of interest and you quickly get the information on every Representative and Senator by clicking on their respective state. You can copy and paste their office address in Washington, D.C. and their home district or state into your letters (with adjustments in fonts) and obtain or check their email addresses and the phone and fax numbers.

Compose your letters (cutting and pasting, inserting correct addresses, names, etc.) and fax them out! www.myfax.com is a quick, easy and inexpensive service for sending many faxes quickly by email, not fax machine!!!

Sunday Morning Bonus

Corruption in American Health Care

Saving Health Care, Saving America as written  By BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVEN in The Health Care Blog

"So far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives have obligated themselves to their benefactors' interests rather than to those of the American people. More than 3,330 health care lobbyists - six for every member of Congress - contributed more than one-quarter of a billion dollars in the first and second quarters of 2009. A nearly equal amount has been contributed on this issue from non-health care organizations. This exchange of money prompted a Public Citizen lobbyist to comment, "A person can reach no other conclusion than this is a quid pro quo [this for that] activity."

Continue reading "Saving Health Care, Saving America"

It goes further down hill from there.

This article should give every physician a gut wrenching reaction, if not disgust at the corruption which has become rationalzied and rampant in some parts of the country.  It  points out how immorality creeps in slowly and devours a system. I reacted to the article in such a manner. From personal experience in such an environment I can describe how market influences alter perception and actions in order to survive in such a market. The financial imperatives create overwhelming features which can only be avoided if the overall physician community reacts appropriately in unison rather than in self interest.   Beyond this the only moral choice for the individual physician is to leave that community (which in itself strengthens the hand of the 'cartel'.

In a second article on The Health Care Blog  By JEFF GOLDSMITH

Atul Gofigure: Why McAllen Should Have Mattered in the Health Reform Debate

 

Back in June, Atul Gawande, a Harvard trained surgeon, published a riveting article in the New Yorker   about the physician community in McAllen Texas.

del.icio.us Tags: McAllen,Gawande,Brian Klepper,David Kibbe,Robet Laszewski,Alain Enthoven,Health Train Express

The Public Option

The AHIP  Singers

Thanks to The Health Care Blog for publishing this musical dedicated to the public option (not).

 

This is much more fun and better sung than traditional protests!

That is my humor for today. 

The following story is well worth the read

The Mike Gallagher Show....watch out Hannity

I just had to include this as a blog post...

 

Hal Scherz is just one of the many willing to  get down and invest his own capital in growing our grass roots efforts to influence health reform.  This is one of those things our organizations just cannot do as well.  Your interest,contributions and participation are essential.

As Dr Scherz states:

""I know how much everyone enjoys opening my TNTC emails (LOL) and I'm sure that you must have wondered where I disappeared to. I was down most of this week with what I'm convinced was H1N1, although the ER wouldn't test me. (A taste of what we have to look forward to under Obamacare). Now that I'm strong enough to sit up, I can start bothering everyone again. If you had any emails bounce back, please resend them. My box was filled up because I didn't clean it out for 5 days. If you sent me an email in the last few days, I promise that I will read it over the next 48 hours.

There are 2 things that I wanted to address tonight. As I have indicated to everyone, Docs 4 Patient Care will be an embedded sponsor of the Mike Gallagher show.

This is more like a partnership, because he has a strong, personal reason for wanting the doctor-patient relationship to be protected. Please begin to go to Mike's web site (http://www.mikeonline.com/) beginning on Monday and you will see Docs 4 Patient Care featured prominently. The exciting news regarding this, is that Mike is doing a 3 hour healthcare show this Thursday, Oct 29, and his co-host will be Hal Scherz. Yes, you didn't misread this. We will be discussing every aspect of the healthcare debate and we will try to have a guest or 2 to help to clarify the issues. His show is predominantly an audience participation show, so it would be a great opportunity for everyone to try to call in and to say what you would like to his national audience. If you are not familiar with his show, find out online which station his show is broadcast on in your area. It might even be a good idea to put this show on in your office waiting room and see if the hospitals will put this through into the doctors' lounges.

The second other important issue that I wanted to cover has to do fundraising. Please don't stop reading- this is different than usual.

I have received feedback from people that I have known professionally for over 20 years who I have reached out to in different parts of the country. When they heard about what we were putting together and that my practice was so committed, that we were putting up $40,000 in seed money, it was a "no brainer" for them. However, they are trying to convince people that they work with in their communities to dig into their pockets and write big checks. They are a bit reluctant because they don't know us, and they aren't sure where their money is going.

These are fair questions and concerns. First, let me assure everyone, that as a not for profit 527 political corporation, everything that we collect and spend has to be above board and transparent. If any member has any questions, they can contact our treasurer and board member, Joanne Thurston, who is a CPA.

Another question was whether I or any of the other officers have received any compensation. I wish. The truth is that not only do we not receive compensation, but we continue to put up our own money without asking for reimbursement for business related items- business cards, signs, etc. We have been to Washington twice already, and use our own money for these trips. And except for the past 4 days that I have taken off because of illness, I have averaged 5 hours of work daily for the past 5 months without any compensation. Anyone who sees what time the majority of my emails are timed can attest to this.

As to where does the money go? Well, there were start up expenses which we won't go into. But there are ongoing costs every month- mostly web site maintenance and our PR team. There are intermittent costs such as legal, marketing, other consultants.

However, we are now ready for prime time. We either move to the next level or pack up our toys and go home. What this means is that we spend a large amount of money getting out our message on a national platform and on a regular basis. This will open up more doors to us than we can possibly even imagine at this point. We need to hire an executive director, who will help to take the burden off of me. There are still many large initiatives that we need to launch, such as putting together the thousands of newsletter recipients who are not doctors and whose energy and enthusiasm is being wasted. We need to get these people working for us and contributing to our cause. The same for the allied health care professionals. There are thousands of doctors that we could get into Docs 4 Patient Care. We are poised for explosive growth. We need help to make this happen. We would like to at some point hire our own lobbyists and this will be very expensive. And there is so much more than this.

So this is where the money is going. Most of you getting this email don't know me at all, although there are ways to check on people today that didn't exist in the past. However, I think that it is worth taking a flier on this one. Do you want to write a big check in hopes that your money will actually work for you, or do you want to pretend that everything will be ok and hope that if you play nice and don't make too much noise, that you'll be left alone? This is almost too insulting to even ask this question.

Enough tonight. But those who want to contribute but just aren't sure, just do it! ""

All the best

Hal