kirks5oh

Dat extended warranty

Fuck that. I don't want people farting in the seats before I get a chance to. Cross me off the list of potential buyers. Lol I need a fast winter car that seats 5

jeeps were cool in high school. cruising at the beach with the doors off, top off, etc. if you're not going to do that, or not going to off-road it, then they are just plain garbage. we had one for 60k miles, bought brand new, all the options, etc etc---it was the biggest piece of shit i've ever driven. i murdered a brz on the freeway in my cts the other week---he was driving like a jackass cutting everyone off, and he shot me a stink eye as he passed me and cut the guy off in front of me (we were passing a line of cars). once the car in front of me got over, i nailed it. this guy was probably 200ft ahead of me, still WOT, and i passed him like he was standing still at a very high rate of speed--probably 15mph faster than him at least. he was topped out---lol. i slowed down and he still couldn't catch me. fun times. carry on

Yeah, he even looks like a dumbass. Sounds like he may be headed to a whole different kind of strip club

very cool. you make it sound easy enough, but i have to imagine there's some reasonable fabrication to getting the turbo piping, mounts, electrical, trans fitment, etc etc. almost sounds easy enough for me to consider attempting a project like this. subscribed.

Get one of the small six volt ones. Batteries are available on ebay. Get a good charger as mentioned above. My kids have had three 6 volt ones, and have four 12 volt ones. Barbie jeep, mustang, Toyota SUV, and my boy has a raptor. They can be easily modded too. Just use sealed batteries, that won't leak acid if they fall out.

You are the exception and not the rule. The reason I enjoy working at a non-profit hospital. When someone like you is in need of an elective surgery, I push to make it happen. Our hospital has a system (community care) where they pick up the whole cost for an elective surgery. Regardless, if someone with nothing comes in with a broken arm, appendicitis, etc, they get taken care of. Sure, they might get a bill. Where do you mail a bill when the patient has no ID, claims their name is Phil mccraken, and gives you a non-existent address. Unfortunately, for every hard working American like you, who deserves affordable healthcare, there are literally 100, who come into the er 10 times a year at $2k per visit with bullshit complaints. These people have no job, no ambition, and suck the system dry. They will be the death of this country if we don't start holding them accountable for their own needs. And as far as people using the new system appropriately for preventive care? Never going to happen. A dirtbag drug addict with free healthcare is still a dirtbag drug addict. The only way to change people is to take shit away from them, and make them work for it. It's never going to happen. When was the last time you saw some toothless fat pig in the checkout of Walmart telling her baby-daddy that she really needs to work on lowering her LDL cholesterol?

"What in gods holy name are you blathering about?" -Jeffrey lebowski The big lebowski

Srsly? You started this thread, have you not been following it? Early in the thread I commented on how the Cleveland clinic (Cleveland's largest employer) was cutting over 1000 jobs and 30-ish million dollars to prepare for Obamacare Our hospital is the largest employer in our county, and administration is letting people go to prepare. Hospitals are going to lose money in terms of reimbursement. It's spelled out clearly in the new law. Hospitals are a huge source of jobs in every single city in this country. The law hurts every single hospital in the country. Honestly, it's pointless to argue with you. Some of your posts are so incoherently written, it's as if you're under the influence of something when you type them. Why would I assume you've remembered anything that was posted one page ago, let alone at the beginning of this thread.

the plan does not hold americans accountable for their laziness, and general poor habits, which leads to poor health. again, we are the unhealthiest society BY FAR. the only society, as mentioned, where the poorest, least intelligent people are the FATTEST. how does that happen?? how does someone who cannot afford shelter, clothes, etc, become an absolute 400lb slob??

someone post up a picture of the timing chain on that v8. they sound amazing, but are a bit slow if you're used to 400hp cars. awd, so you can drive it in the weather and be fine. my buddy owned one. i would have bought it for a fun winter daily, if not for the carbon build up issue

Again, payment is highly variable on location and practice type. University docs are typically paid a flat salary per year. There's no incentive to work harder. I have a base salary, but can get much more than that once I cover that base salary. The more I produce, the less overhead I pay. That's why I bust ass, and take a modest amount of vacation. If I take a week off, I need to fight the urge to think of it as lost money. Our family physicians earn roughly $150k. They have 8-4 office, no weekends, no call, etc. they can earn more by doing procedures like injections. In big cities a pediatrician might make $100k. That's sad considering most are $200k+ in debt right out of school.

Everything is based off Medicare rates, which are set by the govt. so when obamacare says they will cut Medicare reimbursement by 5% over the next five years! that means we get paid 5% less. Private insurance companies pay a percentage of Medicare. Like I said I live in a good area to practice. Some private companies will pay 300% of Medicare (very few do this). That is obviously awesome. Most of my patients are over 65 and have Medicare. Most private insurance companies will pay just above Medicare rates, but this is HIGHLY variable based on location. When I was in Florida some of the insurance companies paid as low as 80% Medicare. It was eye-opening. After taxes, that knee would pay less than $400. Guys just didn't give a shit about quality---some days we did 15-16 joint replacements. It was nuts. Docs will scrub out during long surgeries to piss. I've never had to do it as a surgeon but have when I was in training. Not to sound overly dramatic but I'm usually so focused during a surgery I just don't get hungry, don't have to piss or shit.

i'm not complaining. i love the surgery i do. i do two of the most successful surgeries that can be done in all of medicine, and there's an endless supply of people who need knees and hips. i practice medicine in a state with great insurance reimbursement for now, and my med school loans are almost gone, house paid off, etc etc.. i'm pretty good at what i do, but people still have complications--that's why i don't sleep a ton, and have bad heartburn. the income i earn is significantly more than 90% of other physicians because of the volume of surgery i do, the fact that i practice surgery (and not general medicine), and the location in which i practice. people look at the cars i own, and tell me i'm lucky. sure, some luck is important--plenty of things could have gone the other way in my life. but its not like i won the lottery, and i'm not ashamed to buy nice shit and enjoy spending money. most of what could be called 'complaining' on my part is for my colleagues who work their ass off and don't get paid shit, for the time they work, and the investment they've made to get them where they are.

some re-do hip or knee replacements take 4 hours to do the surgery, need to be seen much more often, and i get paid 130% over a standard procedure. the surgery is much more stressful, and the results are not as good. think of that as tuning someone else's 3000gt where the previous tuner fucked everything up, and the car has 100k+ miles on it. and you have to do all the repairs with the car still running. and you can't really stop in the middle of the job to take a lunch break. if the surgery takes longer than normal, if the patient is much larger than normal, we don't get paid more. i can tell you its much harder to do a hip replacement on a 400lb guy compared to a 120lb female--you get paid the same. i don't see very many people who weigh 120lbs here in wisconsin. i don't even comment anymore when we see a 300 pounder.

i hear you, and agree. the implant itself can cost upwards of $10k!!! i've done replacements where we've replaced half of the femur and the whole knee joint. that device cost $27k. i know, because our hospital administrator let me hear about it. out of the whole hospital bill, the only thing that you're getting a deal on is the amount the surgeon gets paid. again, i have zero input on this. i replaced my surgical assistant's husband's hip---she gave me some of the breakdown on the individual costs and i was shocked. again, i didn't go into this job to set prices, and shit like that. its the part of the job i like the least is sitting in meetings and crap like that. and to answer bill's question before, the total time i might have invested in the knee replacement might be 4+ hours, give or take. but keep in mind for every surgical patient in my office there are more patients that don't end up getting surgery, and i only operate twice a week, sometimes three times a week. the only reason my office does reasonable and turns a profit is because i end up doing a lot of injections---sometimes 30 a day, on a busy day. otherwise, the office simply sustains itself.

doctors are normal human beings. some are simply book-smart--and that is how they got into medical school in the first place. they should be doing research somewhere in a dark lab, but they chose patient care for some reason. you talk to them and come away with the thought that they are complete tools/douchebags. they use jargon that you don't understand and assume you will know what they are talking about. some are not book smart at all, they have no logic, and somehow eeked into medical school by interviewing well, and having the minimal mental requirements. you'd be surprised at how successful these people are as physicians. its a 'practice', and most people can learn on the job with time. if you have the people skills, and your patients like you, then you will be infinitely more successful than the guy who is mentally/technically gifted, but an asshole to talk to, with no personal skills. i hate computerized medicine as much as the next person. hate paperwork, hate meetings, hate the fact that i have a foot high stack of papers to sign each week. my perfect day is operating all day, or seeing 50-60 people in the office without all the bullshit. it isn't that way, and will never be that way again.

more. but i do 300-400 joint replacements

dr's are in and out in 10 seconds because they have that many more patients to see. my average tuesday office is 60 patients. most of the time, i don't even get a chance to piss until lunch. and my lunch is usually between patients. its crazy, but that's how it is. there is simply not enough time in the day. in order for most dr's offices to be profitable, they have to see more patients as reimbursement goes down, and fixed costs (overhead, malpractice) go up. it is simply not possible for female family doctors to work part time--this used to be common practice, but it is no longer feasible. they simply can't make a profit. family physicians used to deliver babies. because they don't do surgery, and don't do it enough, the malpractice insurance has risen to the point where they cannot do this any longer. when someone comes into my office and has no money, yet is deserving, i might give them a cortisone shot in the knee for free--no charge, no bill, no nothing. this is not exactly legal---it could be considered fraud, but in certain circumstances it is the right thing to do, and maybe worth it (from a moral standpoint). like i said, i don't set the charges, have no control over them, and am just as likely to get in trouble if i omit charges or add charges that were not done.

the total bill for a knee replacement could be upwards of $50k. i get $1250. again, that's what i get for the preop visit, the surgery, the hospital rounding, and the three months of postoperative visits. out of that $1250, i have to pay between 30-40% for overhead---that is for malpractice insurance, to pay for the office, the supplies, the nursing staff, etc. so the number becomes less than $800. after i pay taxes on that money, my actual net payment from this surgery is just north of $500. people think we get paid $10k to do this surgery.

what the hospital/clinic bills, and what they receive from the insurance company are two completely different things. back up a couple pages and read my question about knee replacement surgery. what do you think i get paid as a surgeon to replace a knee or a hip, keeping in mind the cost covers the 40 minute preop visit in my office, the 1.5 hour surgery, seeing the patient each day while they are in the hospital (dressing changes, etc), and seeing them several times in the office for the 3 month recovery. what do you think the surgeon "makes" for something like that?

obviously you have some kind of chip on your shoulder about the situation. when a patient asks me how much a procedure is going to cost i refer them to our billing department, and they are able to quote a price, and how much is covered by insurance, etc, etc. the patient knows well in advance of surgery how much will be covered, and what the costs are. the truth is that i have no fucking clue what the patient is billed for the procedure in most cases, and its not my job to determine that--i can't simply set my prices---the price is dictated by a multitude of factors over which i have ZERO FUCKING CONTROL. would your rather have your doctor be an expert at billing, etc., or an expert at fixing your health problem?

Not sure if serious? Our medications have been getting better and better. Diagnostic equipment has improved. Implants for my surgery have improved dramatically. It costs money to develop that technology. And that cost is passed to the consumer. A typical hip reacement is made of titanium, and plastic. Those materials don't cost $10k, but that's what they cost because you pay for the technology that goes into r&d. I agree with you. All routine care in the future will be computerized:dumb: Good call. Let me guess, when you go to the dr, you try to tell them what they should do based on a quick google search you performed right before the visit?

Bingo!! It's the American lottery. In the wild, he would be consumed by a stronger predator and prevented from reproducing and thus passing his weaker traits down to offspring.

I'm a hospital employee, and our hospital is a non-profit org. We cannot turn people away who need care. The elbow had to be fixed. We have programs for people who have zero insurance to get elective surgery such as a knee replacement. I pick these patients carefully--if I can do 3 of these a year they are deserving people just down on their luck. Honestly, the people on Medicaid and 48 year old on Medicare disability because of back pain are similar, only they essentially have insurance. Needless to say, this guy got enough pain medication to initially recover and nothing thereafter. He never once questioned about his elbow function or whether there would be any permanent limitations. Just "where's my pain meds". The average hard working, insured American would be shocked to follow an inner city er nurse, or doctor around. Shocked. Most health care workers have just become numb to it