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Author Topic: Repeal of the ACA is dead. They should get to work on tax reform now  (Read 1921 times)

Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #60 on: August 03, 2017, 08:23:53 pm »

I don't have a problem with going after bad guys, but this, again, has become an excuse for doing whatever they want.  Worse, the legal entities of the states have been regulated, taken over, and interfered with in the name of "civil rights".  States like the federal money and so give over their rights when there is a threat from the feds to obey or lose funds
Hence the need to repeal the 16th and 17th amendments and require a balanced budget. Think about this 27 states sued the federal government because of Obamacare. If the senators were accountable to the state legislature perhaps many of the trampling of our rights would stop. Eliminating the income tax and forcing a balanced budget would slow down government.
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Offline beecanbee

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #61 on: August 04, 2017, 06:28:17 am »
It would be good if both sides would now sit down to improve the ACA - where common ground can be found, and at the same time agree to rename it - hence `repealing` it thru a renaming.

I don`t see an outcome that deliberately removes healthcare insurance, or weakens it, as being a valid improvement ? but rather would want to see both premiums and co-pay caps reduced, drug costs managed, and numbers of insured increased ? even if that meant higher taxes or a reprioritization of current revenues. 

I`d like to see states require that an insurer cover all counties, or none ? given that insurance commissioners are by state and not county.  I doubt that too many insurance companies would choose to entirely depart a state.

Better yet, IMO, would be single payer, but that seems far off.
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Offline Acebird

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #62 on: August 04, 2017, 10:02:10 am »
It would be good if both sides would now sit down to improve the ACA - where common ground can be found,

Unfortunately if all that gets done is what could be considered common ground the system will still be in trouble.  They need to work together to come up with something sustainable.  Most likely that would be less coverage for most but all would be covered.  Those seeking more coverage could do it privately or just pay out of pocket.  The real nut to crack is the actual costs of drugs and care.  It clearly is inflated.
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Offline Hops Brewster

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #63 on: August 04, 2017, 12:25:35 pm »
It would be good if both sides would now sit down to improve the ACA - where common ground can be found,

Unfortunately if all that gets done is what could be considered common ground the system will still be in trouble.  They need to work together to come up with something sustainable.  Most likely that would be less coverage for most but all would be covered.  Those seeking more coverage could do it privately or just pay out of pocket.  The real nut to crack is the actual costs of drugs and care.  It clearly is inflated.
I recall several Republicons expressing this same view before ACA was hustled through.  Demorats lined up to call them heartless animals and worse, while other Republicons gave them other names.
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Offline kathyp

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #64 on: August 04, 2017, 09:03:11 pm »
Quote
I recall several Republicons expressing this same view before ACA was hustled through.  Demorats lined up to call them heartless animals and worse, while other Republicons gave them other names.

You either have to believe that ACA was designed by complete idiots, or that it was designed to fail.  there is no middle ground on this.  Everything that has gone wrong with it was predicted. 

There is no fixing it.  It is an expensive mess that actually covers fewer people than were covered before because the policies are so expensive and the deductibles so high, the policies are worthless.  The only people who made out in this are the ones on Medicaid and that's a pretty crappy system too.  Most people were either hurt by the cost of policies, or the cost out of pocket before policies kicked in, + the loss of choice in who and where care comes from.

I never see a lot of sympathy from the left for the millions of people hurt, only for the few who might lose coverage....and as the CBO said, most of those would be losses by choice because people would dump those expensive and useless policies.

I have a hard time having sympathy for most people.  They expect that their care should be paid for by someone else.  We have insurance companies because someone else should pay.  We have government subsidies because someone else should pay.  We have massive welfare medicine for both the "poor" and the elderly because someone else should pay.  The more we turn our medicine over to that someone, the less choice and care we will have, but hey....if that's what you want.

Look at what you are subsidizing. 
http://www.financialsamurai.com/subsidy-amounts-by-income-limits-for-the-affordable-care-act-obamacare/

Something to play with

https://www.healthinsurance.org/obamacare/subsidy-calculator/

They are so divorced from their own interests that even when their own security and that of their children is finally compromised, they do not seek to avert the danger themselves but cross their arms and wait for the nation as a whole to come to their aid. Yet as utterly as they sacrifice their own free will, they are no fonder of obedience than anyone else. They submit, it is true, to the whims of a clerk, but no sooner is force removed than they are glad to defy the law as a defeated enemy. Thus one finds them ever wavering between servitude and license.
Alexis de Tocqueville

Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #65 on: August 04, 2017, 10:38:31 pm »
Good post Kathy

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Offline beecanbee

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #66 on: August 05, 2017, 03:35:15 am »
I found that interesting and informative.  (Kathy`s link.) But was somewhat lost when I got to subsidies.  Maybe the topic of subsidies is what spoils the soup.  Instead a simple chart of what one pays for insurance at any given age/income level would be enough ? if it were a single payer system instead of a system that is trying to keep private insurance company investors profitable.
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Offline Acebird

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #67 on: August 05, 2017, 09:10:55 am »
You either have to believe that ACA was designed by complete idiots

You give them too much credit.  Rarely would I use the word "designed" when it comes to Washington.  They are representatives on the take either directly or indirectly disguising what they do to make it look like they are working for the people that voted them in.  I think it is too much to ask them to design anything.  My only hope is that they would put in place something that is good for the majority of citizens without taking too much.
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Offline kathyp

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #68 on: August 05, 2017, 10:56:19 am »
Quote
if it were a single payer system instead of a system that is trying to keep private insurance company investors profitable.

I don't like insurance companies as the go to for health care money.  the only thing I like less than insurance companies as the go to for money, is the government as the go to for money. 

CA has a population of 40 million.  The single payer plan they contemplated was going to cost (now) $400 billion annually.  That cost would only go up.
The country has 350 million people.  20 trillion of debt.  A declining birth rate and aging population. 

Once you give people free stuff you can't take it back Re: Greece.   

It is true that there would be some economic savings to businesses and some consumers by going single payer.  The cost would not be evenly spread though.  there are too many people not contributing.  In the end, the same people paying for everything now would still be paying for everything, but choice and availability of care would be gone. 

With single payer you are basically asking those who are earning and contributing to give up whatever they have so that free stuff can be given to people who are already getting free stuff and not contributing.  Oh, but if those earners want what they had....they can just pay out of pocket for it.  No harm done.
They are so divorced from their own interests that even when their own security and that of their children is finally compromised, they do not seek to avert the danger themselves but cross their arms and wait for the nation as a whole to come to their aid. Yet as utterly as they sacrifice their own free will, they are no fonder of obedience than anyone else. They submit, it is true, to the whims of a clerk, but no sooner is force removed than they are glad to defy the law as a defeated enemy. Thus one finds them ever wavering between servitude and license.
Alexis de Tocqueville

Offline bwallace23350

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #69 on: August 05, 2017, 11:23:36 am »
There is always the possibility of doing a hybrid system. It is not unheard of. You could have basic health insurance and even catastrophic insurance for those that choose to do so and for those than can afford it they can also have health insurance that gets them into private hospitals and such.

Offline Acebird

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #70 on: August 05, 2017, 05:31:02 pm »
Once you give people free stuff you can't take it back Re: Greece.   
That is why it has to be done correctly.  If you worked all your life, paid taxes and got stricken with a heart attack or some life threatening disease like cancer I think you should be entitled to some help.  If the same thing happened and you did not work all your life which means you contributed nothing I don't think you are entitled for help other than basic health care.  Certainly no transplants.  I also think there should be some limits for retirees.  This life of going to one doctor after another or visit after visit once you retire is nuts.  If you need that much medical care it is time to check out.

Quote
With single payer you are basically asking those who are earning and contributing to give up whatever they have so that free stuff can be given to people who are already getting free stuff and not contributing.  Oh, but if those earners want what they had....they can just pay out of pocket for it.

Since about 1972 just about every year I worked and paid taxes health benefits decreased while costs increase.  If I wanted what I had it would cost me more.  It is funny that with every new invention in the world the cost of goods went down but with healthcare every new treatment or breakthrough has caused health care to go up.  Why is that?  I know the answer.
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Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #71 on: August 05, 2017, 06:16:48 pm »


You give them too much credit.  Rarely would I use the word "designed" when it comes to Washington.  They are representatives on the take either directly or indirectly disguising what they do to make it look like they are working for the people that voted them in.  I think it is too much to ask them to design anything.

Hay! We agree on something! As I have said before it is our fault for not voting them out of office. In the words of Jonathan Groober "...call it the stupidity of the American Voter..."

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Offline kathyp

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #72 on: August 05, 2017, 06:54:20 pm »
Quote
This life of going to one doctor after another or visit after visit once you retire is nuts.  If you need that much medical care it is time to check out.

do you want this to be the decision of the government?

Quote
It is funny that with every new invention in the world the cost of goods went down but with healthcare every new treatment or breakthrough has caused health care to go up.  Why is that?  I know the answer.

1st, your statement about cost is untrue and 2nd, I bet you don't know the answer  :grin:

when new things come out they do tend to be expensive.  Laser eye surgery was very expensive and only people with lots of money could afford it.  before it was approved in the US, my BIL went to Canada and it cost him close to 10,000 per eye.  Since then the cost has come down to a fraction of that, but most insurance does not cover it.  It is a cash deal. 
A couple of things about that.  When new stuff comes out it is the rich paying for it that makes it possible for the thing to become common enough that eventually the rest of us can have it too.  The other thing is, there is no middle man.  The deal you make for your surgery is between you and the doc.

Dentistry is much the same.  Most people don't have dental insurance and pay out of pocket.  You have tons of choices in dental care from very cheap, to very expensive, and clinics will make payment schedules for you.  No middle man. 

The middle man is not the only expense.  Cost to bring tech through the approval process is in the billions.  Same with drugs.  Costs to deal with either the government or the insurance companies is also huge in dollars and in time.  Doctors and hospitals employ people just to deal with the paperwork involved.  Malpractice insurance is huge as is the cost of the stable of lawyers that most hospitals keep. 

Single payer would get rid of the insurance stuff, but not the government stuff.  It would do nothing about tort reform.  It would do nothing about the cost of bringing tech and meds to market. 

If you do not solve the real cost issues you end up with a government run, expensive bureaucracy that does not bring down cost.  Who pays for that?  Assuming you get rid of Medicare, you have a small portion of the population paying for what everyone else is using, and I guarantee abusing, for free. 

If that small portion of the population can't support the cost, who pays?  We already have 20 trillion in debt.

CAs single payer was going to cost 400 billion per year for 40 million people. 

The poor are covered.  The elderly are covered.  No one wants to deal with the real cost drivers, yet they think the government will be a magic pill. 

 

They are so divorced from their own interests that even when their own security and that of their children is finally compromised, they do not seek to avert the danger themselves but cross their arms and wait for the nation as a whole to come to their aid. Yet as utterly as they sacrifice their own free will, they are no fonder of obedience than anyone else. They submit, it is true, to the whims of a clerk, but no sooner is force removed than they are glad to defy the law as a defeated enemy. Thus one finds them ever wavering between servitude and license.
Alexis de Tocqueville

Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #73 on: August 05, 2017, 10:05:56 pm »



That is why it has to be done correctly. 

And what makes you think they are smart enough to do it right? Almost all of them are little more than political hacks no matter what side of the isle they sit. As I also said before it seems like doctors would have the most knowledge on the subject but in the Senate there are only 3 I don't know about the house but my guess is it about the same percentage.

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Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #74 on: August 05, 2017, 10:42:36 pm »
Just a thought... My children are adopted German Shorthair Pointers and feline biological rodentacides. When I take any of them to the doctor it costs roughly $125 Federal Reserve notes. I have no PPI (personal pet insurance). Why does it cost less to go to a DVM than a MD? The schooling for a DVM requires knowledge of many different species. MDs just people...

I think another issue that doesn't get much discussion is "new" diseases. We have a much better infant mortality rate than we had in the past. Many people who would have died at birth 100 or more years ago are living normal lives. Then they have children and they find new and unusual diseases or genetic conditions. My wife had cancer at 29. We are not going to pass on genetics that could cause our offspring to go through that. My wife's step father has a genetic condition that causes nose bleeds. He loses so much blood he regularly has to have blood transfusions, sometimes 2 pints at a time. He has 8 kids. I think everyone that has been tested has tested positive. 5 of his kids have kids of their own... Perpetuating the cycle.

Don't get me wrong if someone wants to have kids with bad genetics, who am I to judge? But when the government is in charge... Who judges then?


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Offline Acebird

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #75 on: August 06, 2017, 09:25:00 am »
Quote
This life of going to one doctor after another or visit after visit once you retire is nuts.  If you need that much medical care it is time to check out.

do you want this to be the decision of the government?
I want the government to control the unnecessary treatments, yes.  The insurance companies don't do it because they have card blanch.  For every dollar they pay they take in ten.  And this is exactly why health care costs escalates.

Quote
when new things come out they do tend to be expensive.

Only because we have a profit based healthcare system.  We sent a man to the moon and it didn't bankrupt the country.  The only need was to beat the Russians to it and we did at a very large cost.  Get rid of the profit based system.
You are all about choices and competition Kathy.  You can't have choices and competition when companies are awarded patents.  This is a huge stumbling block for healthcare.
FYI I manage an apartment complex with an above average number of old people in it.  I know first hand that government is paying for eye surgery and the subsequent 3 months visits for life afterwards.  Almost everyone, if they live long enough will get cataracts.  They take out the cataracts and pop in a lens. 
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Offline Acebird

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #76 on: August 06, 2017, 09:40:54 am »

And what makes you think they are smart enough to do it right?

They don't have to be smart enough and I prefer they don't design the plan.  What they need to do is decide on what direction to go in and then assemble a team of experts to figure out the best way of doing it and staying completely out of that decision making.  Then the plan gets executed for four years.  By the time the four years are up the congress can vote on assembling a new team to change it but not on what to change.  The new team would decide that.  The teams should not be affiliated with any government or political position.  No picking their buddies.
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Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #77 on: August 06, 2017, 12:52:50 pm »

And what makes you think they are smart enough to do it right?

They don't have to be smart enough and I prefer they don't design the plan.  What they need to do is decide on what direction to go in and then assemble a team of experts to figure out the best way of doing it and staying completely out of that decision making.  Then the plan gets executed for four years.  By the time the four years are up the congress can vote on assembling a new team to change it but not on what to change.  The new team would decide that.  The teams should not be affiliated with any government or political position.  No picking their buddies.
You don't think that 323,000,000 Americans have more total knowledge and experience than the "team" Congress can create?

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Offline kathyp

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #78 on: August 06, 2017, 01:17:27 pm »
Quote
Only because we have a profit based healthcare system.  We sent a man to the moon and it didn't bankrupt the country.  The only need was to beat the Russians to it and we did at a very large cost.  Get rid of the profit based system.
You are all about choices and competition Kathy.  You can't have choices and competition when companies are awarded patents.  This is a huge stumbling block for healthcare.
FYI I manage an apartment complex with an above average number of old people in it.  I know first hand that government is paying for eye surgery and the subsequent 3 months visits for life afterwards.  Almost everyone, if they live long enough will get cataracts.  They take out the cataracts and pop in a lens.

what happens when you take profit potential out of something? 

Beating the Russians was a part of the cold war. The space race did produce some fantastic innovations but many of those innovations were developed by private companies under contract with the government.  they were brought to the public by private companies that wanted to make....wait for it......profit!
  I am not sure how it has anything to do with medical care.  That said, the current space race is being won by private companies with a profit motive.

Companies awarded patients...like ACA?  I am talking about people choosing what they want.  I agree that limiting people to only the policies that are offered by the job, or the dictates of the state is a bad thing.  I would like to see people able to buy whatever, wherever, or nothing. I am a fan of HSAs and think more people would use them if they had more choice.  I'd rather see a job contribute to an HSA than choosing a health plan that locks workers into it.   

Eye surgery:  Sorry, I may not have been clear.  I was talking about Lasik type surgery.   Fixing near sightedness is not a medical need, it is a personal desire.  Removing cataracts is a medical need. 
They are so divorced from their own interests that even when their own security and that of their children is finally compromised, they do not seek to avert the danger themselves but cross their arms and wait for the nation as a whole to come to their aid. Yet as utterly as they sacrifice their own free will, they are no fonder of obedience than anyone else. They submit, it is true, to the whims of a clerk, but no sooner is force removed than they are glad to defy the law as a defeated enemy. Thus one finds them ever wavering between servitude and license.
Alexis de Tocqueville

Offline Eric Bosworth

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Re: Repeal of the ACA is dead. They should get to work on tax reform now
« Reply #79 on: August 06, 2017, 04:45:17 pm »
Quote
Only because we have a profit based healthcare system.  We sent a man to the moon and it didn't bankrupt the country.  The only need was to beat the Russians to it and we did at a very large cost.  Get rid of the profit based system.
You are all about choices and competition Kathy.  You can't have choices and competition when companies are awarded patents.  This is a huge stumbling block for healthcare.
FYI I manage an apartment complex with an above average number of old people in it.  I know first hand that government is paying for eye surgery and the subsequent 3 months visits for life afterwards.  Almost everyone, if they live long enough will get cataracts.  They take out the cataracts and pop in a lens.

what happens when you take profit potential out of something? 

Beating the Russians was a part of the cold war. The space race did produce some fantastic innovations but many of those innovations were developed by private companies under contract with the government.  they were brought to the public by private companies that wanted to make....wait for it......profit!
  I am not sure how it has anything to do with medical care.  That said, the current space race is being won by private companies with a profit motive.

Companies awarded patients...like ACA?  I am talking about people choosing what they want.  I agree that limiting people to only the policies that are offered by the job, or the dictates of the state is a bad thing.  I would like to see people able to buy whatever, wherever, or nothing. I am a fan of HSAs and think more people would use them if they had more choice.  I'd rather see a job contribute to an HSA than choosing a health plan that locks workers into it.   

Eye surgery:  Sorry, I may not have been clear.  I was talking about Lasik type surgery.   Fixing near sightedness is not a medical need, it is a personal desire.  Removing cataracts is a medical need.
Kathy I think the bottom line is that acebird does not understand economics. He doesn't understand, or perhaps he does and doesn't want to admit it, that nobody hates capitalism more than a capitalist. By that I mean a true capitalist does not want competition.

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All political power comes from the barrel of a gun. The communist party must command all the guns; that way, no guns can ever be used to command the party. ---Mao Tse Tung

Democracy is two wolves and a lamb voting on what to have for lunch. Liberty is a well-armed lamb contesting the vote. ---Benjamin Franklin