Welcome to SrinagarGarwhal.Com Guestbook

This Guestbook belongs to SrinagarGarhwal.Com

 Home| Next Page

 Records: 7198 | Currently: 7198 - 7179New Entry

XRumerTest (yourmail@gmail.com)
Date:Tue 23 Jan 2018 06:14:23 AM EST
Subject:Test, just a test
 Hello. And Bye.

XRumerTest (yourmail@gmail.com)
Date:Mon 22 Jan 2018 08:21:00 PM EST
Subject:Test, just a test
 Hello. And Bye.

Williamviady (yzrx5342@first.baburn.com)
Date:Mon 22 Jan 2018 02:03:02 PM EST
Subject:unparelled movement help make it easier to currently
 http://www.studiovrijgelderland.nl/wp-content/themes/get.php?p=165-Viagra-Voor-Vrouwen-Vloeibaar,Generieke-Viagra-Bestellen,Viagra-Voor-Mannen-Apotheek/]Viagra Voor Vrouwen Vloeibaar To boost search engine visibility for the website, don't underestimate the value of your domain address. Try and choose a label which uses standard spelling, similar to another person keying inside a research bar would use. Have the domain name descriptive of your own business, and the sort of keyword you may use yet again through the web site. http://www.salaslimpas.com.br/wp-content/pear.php?u=115-Viagra-Farmacia-On-Line-Vendita-Viagra-Viagra-Per-Donne-Effetti]Viagra Farmacia On Line When you are considering purchasing a vehicle from a private vendor rather than from your automobile car dealership, make certain that a person promoting the car offers the authority to exchange ownership. When there are strategies for moving acquisition when a car is funded by a third party, this process will commonly add actions to the getting from the vehicle. http://www.vto43.ru/wp-includes/confuse.php?k=75-Comprare-Ormone-Della-Crescita-Gh-Ormone-Della-Crescita-Bodybuilding-Ormone-Della-Crescita-Altezza]Comprare Ormone Della Crescita With a little luck with all the knowledge you received about the stock market, you're beginning to truly feel a little assured about that you plan on investing your hard earned money. Just be sure you always understand what you're stepping into before you begin. Become a tad watchful but simultaneously, don't hesitate for taking a risk. Study from your blunders, simply because it's the only method you'll locate any good results.Some Techniques For Hunting Great In The Future http://www.kurzfilmproduktion.de/wp-includes/open.php?s=86]Cialis Kaufen 10mg

Williamviady (guby88778@first.baburn.com)
Date:Mon 22 Jan 2018 12:14:03 PM EST
Subject:ideas that will assist enhance interior producing
 http://www.vitralis.com.br/cdosys/content.php?name=65]Getropin Dosage When you haven't learned a second language then you are already powering the bend. Most experts exterior of the United States of America have worked on learning at least a 2nd or even third or higher words. This assists to branch out the amount of tasks that you may be qualified to receive. http://www.es-sakh.su/layouts/get.php?y=1-Cialis-10-Mg-Avis-Cialis-20mg-Prix-En-Pharmacie-Cialis-Prix/]Cialis 10 Mg Avis Usually do not believe that there is absolutely nothing to be done for the tinnitus. Should your doctor tells you that you simply will simply have to learn how to tolerate it, it really is time and energy to locate another physician. New research inside the discipline offers the health-related community a greater knowledge of tinnitus and new tips for its treatment method. http://www.npfco.net/director/gilue.php?q=Kamagra-Online-Review-Cheap-Kamagra-Pills-Uk-Kamagra-Jelly-Review-86]Kamagra Online Review Just before paying excessive levels of cash on industrial acne remedies, consider seeking an all-natural choice for example witch hazel. It operates by lowering essential oil that clogs the pores on the skin and contributes to zits. A lot of unpleasant business items strip the skin oils with your epidermis so abruptly your epidermis is in distress and also generates excessive oil to combat the evasion. Clean with witch hazel for any far more delicate strategy. http://www.arnoimoveis.com/access/class.php?pagina=8]buy jintropin online from china

XRumerTest (yourmail@gmail.com)
Date:Mon 22 Jan 2018 04:29:14 AM EST
Subject:Test, just a test
 Hello. And Bye.

CosterPn (coster@mail4coin.com)
Date:Mon 15 Jan 2018 09:51:58 AM EST
Subject:Instruction DJI? Инструкция для коптера DJI?
 Подскажите, где найти интскуцию на коптер DJI,кроме вот этого сайта? - http://24concord.ru/ Tell me where to find instruction on Copter DJI, except here this site?

AllanLem (ekoo28190@first.baburn.com)
Date:Sun 14 Jan 2018 10:14:15 PM EST
Subject:exceptional suggestions for a considerably better brighter smile
 http://www.az-uae.com/images/blue/green.php?catid=41/]Levitra Generika Test Lots of people fear becoming older. In their mind it is a existence filled with creaking your bones and medical professional trips. This could be real, however their lives contain a lot more energy than that. When increasing more aged, anybody can experience adore with a husband or wife maturing even much deeper along with the pleasure of getting together with grandchildren. http://www.addkadikoy.org/footer/tulips.asp?cat=88]levitra generic canada Unless you know a great deal about seo, you must require a type in becoming far more well-informed. Numerous local community colleges now offer sessions that teach what seo is and how companies use it to get more visitors to their internet sites. This is often a good way to actually help your site get visitors. https://www.yerushalayim.org.il/Scripts/get.php?tag=59-Viagra-Comprar-Viagra-100mg-Efeito-Viagra-Generico-Online/]Viagra Comprar An excellent tip for your personal painful hemorrhoids is to try and decline a few pounds. This is certainly important because being obese carries a immediate regards to acquiring piles. The added strain from the stomach region in fact triggers there being greater stress of the blood vessels about your anus. http://www.esermutfakekipmanlari.com/images/state.php?ru=256-Hgh-Uk-Review-Ansomone-2017-Igtropin-Hgh]Hgh Uk Review

XRumerTest (yourmail@gmail.com)
Date:Sun 14 Jan 2018 08:03:17 PM EST
Subject:Test, just a test
 Hello. And Bye.

AllanLem (adit6286@first.baburn.com)
Date:Sun 31 Dec 2017 06:04:48 PM EST
Subject:utilize these kind of suggestions to greater tooth treatments
 http://www.scandiwood.dk/sortiment/skor.php?Sider=122]Køb Cialis I Tyskland Not showering your puppy with plenty of good encouragement when he does excellent, will minimize the potential you possess more than him in instruction. Since puppies really like consideration, providing them plenty of it, provides him with motivator to hear you. If all he actually hears by you is what to refrain from doing, he or she is failing to get any reassurance, only discouragement, so be sure to compensate him with praise frequently. http://www.avakowsar.com/tmp/kontakt.php?p=47-Originele-Levitra-Levitra-5-Mg-Levitra-Prijs-Apotheek.html]Originele Levitra When you are attempting to grow within the network marketing business, you need trustworthy places for good info. Should you waste time on terrible info you can rapidly spiral out of control into decrease and financial debt. There may be a lot to discover. Fortunately, you can find among the best multilevel marketing suggestions below. http://www.leap-now.com/userfiles/images/menu/main.php?id=58.html]Riptropin 100iu Jogging at the relaxation stop, throughout a highway getaway, is a speedy method to get up, ease tightness through your limbs and prepare yourself for the upcoming lower leg of your respective experience. Rather than just walking and maybe coming to the restroom, add a several second run at the sleep cease. Just getting away from the auto might not exactly sufficiently restore a weary car owner, which may depart him or her nevertheless drowsy when on profit. A fast work also can give children an opportunity to release some pent-up electricity. http://www.hvchorst.nl/picture/uply.php?geld=104-Cialis-Pil,Cialis-5-Mg-Best-Price,Cialis-Generico-Contrareembolso]Cialis Pil

Williamhyday (vmjc13137@first.baburn.com)
Date:Sat 30 Dec 2017 09:55:03 PM EST
Subject:pay day loan posts for individuals who want to help save
 http://www.totalimagehackensack.com/Content/book.php?w=104.html]Kamagra Tablets Australia Advertising can be challenging, specifically a smaller enterprise with minimal investment capital. Discover the ropes and get accustomed to finding oneself on the small screen you can get to be the representative for a very successful firm! Maintain the following tips in your mind, get artistic with your technique and have fun by using it!How To Pick The Proper Email Marketing System http://www.ibopcooljc.org/neering/iambi.php?page_id=86-Kamagra-Österreich-Apotheke]Kamagra-Bestellen-Schweiz Several drops of unique sweet almond oil could be a very helpful accessory for your skin care schedule as well as for use within crisis situations. Use it on dry skin to infuse heavy-duty dampness, or put it on for your cuticles so they are noticeably softer well before a manicure or pedicure. http://www.stilvoll-rv.de/wp-includes/aid.php?k=75]Kamagra Hamburg Kaufen Leukotriene inhibitors are an increasingly popular treatment for people with symptoms of asthma. This sort of medication works to stop compound materials that can induce an bronchial asthma strike. It is very important that in case you are suggested these, you make sure to carry it just how your personal doctor informs you to. http://www.hartselspringsranch.com/images/News/class.php?e=78]Cialis Chemist Warehouse

Robertrix (nxcu83867@first.baburn.com)
Date:Tue 26 Dec 2017 12:55:18 PM EST
Subject:crucial home improvement suggestions to improve as well as repair your home
 http://www.eldrieny.com/images/event.php?catTitle=127-Kamagra-Oral-Jelly-Frauen]Kamagra-Online-Apotheke-Erfahrung It's very easy to get great health-related insurance coverage yourself and your family by buying Overall health Routine maintenance Business (HMO) specific insurance. This inexpensive team insurance plan will help groups of individuals like employees or individuals a team or organization get numerous health care providers for excellent rates. When thinking of purchasing HMO insurance policy, there are several points you will need to think about. Continue reading to find out the advantages and disadvantages of HMO. http://www.divinetreefloor.com/image/tomir.php?h=66]Cialis Prisfald Cleanup your credit score report soon after decade. Whenever you file Section 7 individual bankruptcy, it continues to be on your credit track record for ten years. Nonetheless, the credit rating bureaus are not necessary to get rid of the info. To acquire free of the a bankruptcy proceeding record, write a letter for the credit reporting companies, plus a copy of your discharge discover. Stick to this with a phone get in touch with to be sure that they have got taken out the personal bankruptcy report. http://www.sandler.com.br/files/feed.asp?page_id=56]Generic Viagra Online Help save sauces in ice-cubes cube trays. If one makes several food in a 7 days, think about protecting sauces from their store in an ice pack cube trays. This will allow you to include some fascinating assortment to your dishes you might be generating in the future inside the week. It will have the procedure easy. http://www.sportschaplains.org/assets/cache.asp?nid=33-Cialis-5-Mg-Vendita-On-Line,Cialis-5-Mg-Torrinomedica,Cialis-Online-Generico]Cialis 5 Mg Vendita On Line

PatrickDak (ktmu40037@first.baburn.com)
Date:Fri 22 Dec 2017 10:57:48 PM EST
Subject:experiencing depressive disorder how to deal with this
 http://www.ariciogluticaret.com/images/simple.php?sd=128]Kigtropin 2017 Know your caffeine lingo. Understanding the right phrases can mean the real difference among an excellent mug of coffee you prefer, and the sort of "slop" that may be rumored to be provided by your mechanic. Understand the distinction between Arabica and Robusta, as well as a latte and a cappucino, and you'll have the ability to greater choose what you want. http://www.elektrikarizasi.com/wp-content/access.php?xz=40]Jintropin Uk Make sure to timetable regular bronchial asthma verify-ups. This is extremely essential simply because both you and your medical professional need to find out immediately when your situation is getting worse. Even when you are controlling your asthma great and don't have episodes frequently, you should sign in with the family medical professional and ensure everything is effectively. http://www.thelazydeveloper.com.au/wp-admin/includes/table.php?cat=22-Kamagra-100-Opinioni-Comprare-Kamagra-Oral-Jelly-Kamagra-Oral-Jelly-Opinioni.html]Kamagra 100 Opinioni Do not reminisce with others frequently. Get togethers with friends and relations might be enjoyable. Unfortunately, they are able to furthermore have a unfavorable influence on your recollection. Recalling something having a group of people can in fact change your recollection of any celebration a bit. Your memory might conform to what everyone else recalls. http://www.spontanlieferservice.de/box.php?p=89]Cialis Kaufen Berlin

Matthewprory (kajg40644@first.baburn.com)
Date:Fri 22 Dec 2017 10:57:48 PM EST
Subject:discover how an apple iphone may gain advantage you actually
 http://sebasdv-002-site3.htempurl.com/Img/writer.php?valor=119.html]Tadalafil 20mg Uk Price Stay away from alcoholic drinks when starting your life without tobacco. The 2 frequently go palm-in-palm with a emotional foundation, so substitute alcoholic beverages with fresh fruits fruit drinks or smoothies. These will provide you with a feeling of luxury along with a required distraction whilst you give up smoking. Furthermore, drink plenty of water to help you flush smoking from your process. http://www.manioglu.com.tr/css/client.asp?p=76-Kamagra-Oral-Jelly-100mg-Biverkningar-Kamagra-Gel-Pris-Kamagra-Oral-Jelly/]Kamagra Oral Jelly 100mg Biverkningar When you generate figures for on the internet roleplaying games, give some thought to the planet they're expected to inhabit if you brand them. Even though some players don't worry about the titles in the other characters they come across, many will behave badly to out-of-place brands. Not everyone in the middle age fantasy game will likely be happy to lover up with "WeedToka420." http://www.globeriddingimpex.com/webcpn/string.asp?MSecID=193]Viagra Para Jovenes Admit your shortfalls. Don't try to reject your website lacks their own issues, because every site does. Keep in mind when an individual complains for your needs about a problem, acknowledge the trouble and then make methods to fix it. Letting the consumer to know you are aware of them, without having acquiring protective, is a great way to not simply resolve web site issues, but in addition, to achieve site visitor trust. http://www.asmuhendislik.com/images/downloads.php?kombi=155-Viagra-Online-Pharmacy-Buy-Viagra-Online-Safe-Viagra-Online-In-Australia]Viagra Online Pharmacy

WilliamVuche (ujks11274@first.baburn.com)
Date:Sat 16 Dec 2017 06:08:53 AM EST
Subject:remarkable techniques for planning the very best coffee around
 http://www.johann-widmann.at/includes/client.asp?subfolderdir=178-Viagra-Online-Viagra-Barcelona-En-Mano-Viagra-Para-Ellas/]Viagra Online Piles flare high on us by far the most if we have problems transferring a stool. Which means you would be wise to try to have looser feces by way of a feces softener. You can get some terrific over the counter items that will keep points moving together beautifully down there, enabling you to use the washroom perfectly. http://www.lotisdesign.com/assets/listy.php?k=138]Hgh Kur Österreich While you are shopping for medical health insurance, you should keep in mind not only what you will be getting but additionally what you are actually failing to get. It is a popular error for folks to check out an agenda, see every one of the good elements of it, and then agree to it. They may be then set for a big big surprise when an occasion occurs they are not protected for the they thought these folks were included for. Be sure to scrutinize your strategy and study every little thing before agreeing into it. http://www.southmiamitkd.com/Seven/coifude.asp?z=50-Levitra-Generika-Günstig-Kaufen-Levitra-Bestellen-Deutschland-Levitra-Rezeptfrei-Bestellen]Levitra Generika Günstig Kaufen When learning for examinations, make sure you're receiving adequate sleep at night. Receiving a complete night's rest and keeping yourself on a resting plan can help you much more than skipping or reducing your sleep. By obtaining a good amount of rest, you'll become more inform, convey more vitality, and then find out your material easier. http://www.casamaringa.net/images/cache.php?setId=135-hygetropin-green-tops-jintropin-191-amino-acid-riptropin-dosage]hygetropin green tops

WilliamVuche (pibc8916@first.baburn.com)
Date:Sat 16 Dec 2017 04:04:58 AM EST
Subject:utilize these suggestions to search the most effective
 http://www.gninutech.com/Scripts/biller.php?me=102-Levitra-Preise-Deutschland-Levitra-Online-Kaufen-Ohne-Rezept-Original-Levitra-Forum]Levitra Preise Deutschland The important thing to great nourishment could be as straightforward as reading through the brands around the food items which you purchase. Check out the fat and calories contents on foods. Make an effort to only acquire items that have thirty percent or a smaller amount of their calorie consumption, range from overall excess fat content material. http://www.es-sakh.su/images/sheall.php?y=47]Cialis Eller Viagra Once you begin to focus on and think about your ringing in the ears, pinch your upper left arm. It's rather distressing and can create a bad feeling close to considering the appears to be within your ears. Which should convince the brain to lay away as well as prevent thinking about it, that will, subsequently, minimize the degree of your signs and symptoms. http://www.nilmalzeme.com/images/kontakt.php?yu=43]Jintropin Uk Supplier Men and women trying to promote their house, require to understand that their home is not really on them. Beautify home in neutral colors it is therefore simpler for potential customers to picture their selves in your home. Different ways of inviting the creative thinking of other individuals include, retaining only your very best furniture out and taking care of cleaning early. A thoroughly clean, easy home will usually tempt customers to take into account for a few more a few minutes. http://www.usitecequipamentos.com/Scripts/class.php?setId=231]buy real riptropin

Thomashot (kazuyogurley5412q4m40@yahoo.com)
Date:Wed 29 Nov 2017 12:57:58 AM EST
Subject:France - A Dream Home
 Living in France is one thing desired by many individuals. If you want to live in France then you have to get French property. You can read the advertisement section of the newspapers which has the section of houses for sale in France. After making a suitable choice, you should research about the properties for sale in France. French property is now a days very much wanted also. If you want to live in France and spend your life there you should select a proper house. French property is not cheap and you need to make a major investment. You must also know about the properties for sale in France at various locations. The houses for sale in France come in different prices depending on the location

JoshuaGravy (rynnkleemann4r69r21a@yahoo.com)
Date:Wed 22 Nov 2017 06:03:26 AM EST
Subject:Medical Thesis
 Writing a medical thesis or dissertation is a task done by almost all postgraduate and master's medical students. Dissertation is derived from the Latin word disserto which means discuss. It is essential to write successful medical papers such as medicine essays and medical thesis papers. There are several reasons as to why students write medicine essays. One of the reasons is to promote enhancement of critical judgment, research skills as well as analytical skills. Moreover, medicine essay writing produce students with the ability to 4evaluate and analyze data critically. The initial step for writing medicine essays is to choose a topic. A writer should have at least three topics to choose from. The topic has to be interesting, feasible and relevant. It is essential to write quality medicine essay. Hence, students need to have analytical skills and perfect writing skills. The writing skills will enable them write outstanding essay papers that can be highly regarded by instructors and professors. Teachers often require a lot and expect a lot from their students in terms of medicine essay writing. for this reason, students find essay writing to be an extremely difficult task and hence resort to buying custom medicine essays. A custom medicine essay has to be written by professional writers who are qualified in the field of nursing. Moreover, the custom medicine essay has to be original and plagiarism free. This means that it has to be written from scratch by experts with many years experience. The many years experience should enable a writer to write any form of medical paper including medical thesis, medicine essay and even medicine research paper. Moreover, experience will enable a writer to write a medicine essay that can guarantee academic success. Students get custom medicine essays from custom writing company. It is essential to choose the best company so that one can get the best custom medicine essay. The best and the most reliable medicine essay writing company should have some unique characteristics such as affordability and the ability to provide original and superior quality medicine essays. The other quality is that the company has to hire expert writers who can write quality medicine essays and other types of medical papers. The essays should not only be quality but also plagiarism free and free of grammatical and spelling mistakes. A custom medicine essay has a similar structure to any other academic essay assignment. It has an introduction that introduces the topic and tells the reader what the essay is all about. The second section is the body that has many paragraphs supporting the main topic. Finally there is the conclusion that briefly summarizes what has been discussed in the body section of the essay. Students should choose reliable writing companies so that they can get quality custom papers on several fields such as technology, sociology and law in addition to medicine field. Our custom writing company is the best company that all clients should rely on when in need of any given type of medicine paper. We provide quality papers that not only plagiarism free but also original. Moreover, our custom papers are affordable and able to guarantee academic excellence at all times. All our medical papers are reliable and sure of satisfying clients at all times.  

WilliamMed (codydavis3434@yahoo.com)
Date:Tue 14 Nov 2017 08:08:11 PM EST
Subject:Health Care Reform - Why Are People So Worked Up?
 First, let's get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher? To begin, let's turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail's pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time! Let's skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a "wait and see" approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions. This very basic review of American medical history helps us to understand that until quite recently (around the 1950's) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; "nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual. What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today. I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor's offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the "perfect storm" for higher and higher health care costs. And by and large the storm is only intensifying. At this point, let's turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions? The Obama health care plan is complex for sure - I have never seen a health care plan that isn't. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let's look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care. Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance. To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don't comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs. To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans. The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs. The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide "free" (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney's general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision. As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to "give up" something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative. Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don't generally like these ideas as they tend to characterize them as "big government control" of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction. A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to "go to the doctor" when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn't any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems. OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience's attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don't necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary. I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens - health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don't need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition. Let's go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don't exercise but we offer a lot of excuses. We don't eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can't do anything about managing these known to be destructive personal health habits. We don't take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because "health care is there" and somehow we think we have no responsibility for reducing our demand on it. It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame. There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, "Google" "preventive health care strategies", look up your local hospital's web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America's health care system now and into the future. I am anxious to hear from you and until then - take charge and increase your chances for good health while making sure that health care is there when we need it.

ElvaNol (m.o.rr.i.s.onel.v.a.7.54@gmail.com)
Date:Mon 13 Nov 2017 01:22:03 AM EST
 Hey guys!!! designs and builds specialty lines of lead oxide production equipment, material handling systems, battery related process machinery, parts, and accessories for the battery, pigment, glass, and chemical industries. http://techbasys.com offers technical application and engineering services to help the customer acheive maximum benefit from their equipment and manufacturing processes.

NataliRus (natali@mail.ru)
Date:Fri 10 Nov 2017 10:52:04 AM EST
Subject:Russia released their crypto currency to replace bitcoin
 In Russia released the national crypto currency SibCoin (Siberian chervonets) SibCoin can repeat the success of Bitcoin. As a thanks that I informed you please send a money of this crypto currency My SibCoin wallet: SRVJfVgYieAEBWJAsX2okBxrM3knYaYpbh My Bitcoin wallet: 1CmY7pLyDTZPzXr7Uo5yE4RwuG7VrjLWiA Thank you

 Home| Next Page