AMA: Employed MD's out Number Owner MD's

[DOctorJay]

Yeah, I meant I was trying to get things back on track.

Thanks for the link!

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Members don't see this ad.

 

[DODOCSS]

market is depressed for bleeding heart liberals, ask lobel

 

[Disciple]

1. they want everyone to have healthcare. that is not currently the case. if that is your concept of socialized medicine, then so be it. but that doesn't mean that it has to be "Socialist" government run health care system
2. no
3. no
4. they advocate for all people to have access to healthcare. whether you get healthcare should not be reliant on your trust fund.
5. no
6. no
7.

So noble and genuine, how can anyone not be a progressive?

 

[Disciple]

that's just ridiculous.

if anything, "leftists" hate insurance, Big Pharma and also hospital systems much more than the right.

since some cannot help but use global fake news comments.... it is the right who embrace exhorbitant inappropriate costs as part of capitalism.

This is America. Leftists cannot take down insurance companies, big pharma or hospital systems.

So, they just negotiate with them and destroy the middle class instead. Which just so happens to be most of the people on this forum.

 

[hyperalgesia]

Leftist: I only vote for politicians who support a federal living minimum wage.
Leftist: buys 90% of products manufactured by ultra low wage people in developing countries because they are a better value. This is essentially a boycott of a living American wage.

Verdict: Leftist is a hypocrite. Supports a living wage only on paper but refuses to effectively pay a living wage when shopping.

 

[Ducttape]

hehe i did try DoctorJay...

 

[deleted131481]

Leftist: I only vote for politicians who support a federal living minimum wage.
Leftist: buys 90% of products manufactured by ultra low wage people in developing countries because they are a better value. This is essentially a boycott of a living American wage.

Verdict: Leftist is a hypocrite. Supports a living wage only on paper but refuses to effectively pay a living wage when shopping.

Nothing hypocritical with that. I'm not going to go out of my way to research the supply chain and find a different shirt or laptop to purchase. I am willing to pay a 10% premium on these if it mean a significantly greater number of people can reach a living wage.

That's like saying all conservatives who accept Medicaid or participate on the Healthcare Exchange are hypocrites. It's simply not practical.

 

[hyperalgesia]

Alright so this is kind of back on the main topic...

If Democrats get elected and get their way and we have Medicare for all, my understanding is their will be "auto-enrollment". So every American will be a Medicare beneficiary. The law currently prohibits a participating doc from charging a patient cash for service for a covered service.

How will any of us be able to "opt-out" if EVERY SINGLE PATIENT is a Medicare beneficiary? We will be self employed in name only...

 

[deleted131481]

Alright so this is kind of back on the main topic...

If Democrats get elected and get their way and we have Medicare for all, my understanding is their will be "auto-enrollment". So every American will be a Medicare beneficiary. The law currently prohibits a participating doc from charging a patient cash for service for a covered service.

How will any of us be able to "opt-out" if EVERY SINGLE PATIENT is a Medicare beneficiary? We will be self employed in name only...

I've heard mentioned on the board of something like the Canadian two-tier system. Basic covers emergency and preventive only, or significant wait for elective care. Anything additional is covered by private insurance/cash pay.

Sounds reasonable but I'll admit I know little about Canadian health care and I'm sure there are problems with it.

 

[drusso]

I'd like to Opt Out.

 

[SSdoc33]

Alright so this is kind of back on the main topic...

If Democrats get elected and get their way and we have Medicare for all, my understanding is their will be "auto-enrollment". So every American will be a Medicare beneficiary. The law currently prohibits a participating doc from charging a patient cash for service for a covered service.

How will any of us be able to "opt-out" if EVERY SINGLE PATIENT is a Medicare beneficiary? We will be self employed in name only...

"democrats" is a broad term. what bernie wants and what biden wants are different (even tho biden hasnt come up with a specific platform yet). even if they get elected, we have all seen that changes in healthcare laws move at a snails pace. for all of the hubbub about the ACA, i dont think it changed things all that much.

i would expect only an incremental change if one of the more progressive democrats gets elected

 

[drusso]

"democrats" is a broad term. what bernie wants and what biden wants are different (even tho biden hasnt come up with a specific platform yet). even if they get elected, we have all seen that changes in healthcare laws move at a snails pace. for all of the hubbub about the ACA, i dont think it changed things all that much.

i would expect only an incremental change if one of the more progressive democrats gets elected

ACA accelerated dysfunctional market forces resulting in the absorption of independent MD's into monopolistic employment models--ie it reduced competition.
ACA created "funny-money" accounting related to hospital community benefit programs that caused charity care to plummet--ie it created a boondoggle for nominally non-profit pseudo-charities.
Hospitals and their employees benefited tremendously from ACA (skyrocketing admin salaries, SOS, and large operating reserves)

 

[SSdoc33]

ACA accelerated dysfunctional market forces resulting in the absorption of independent MD's into monopolistic employment models--ie it reduced competition.
ACA created "funny-money" accounting related to hospital community benefit programs that caused charity care to plummet--ie it created a boondoggle for nominally non-profit pseudo-charities.
Hospitals and their employees benefited tremendously from ACA (skyrocketing admin salaries, SOS, and large operating reserves)

exactly. it didnt do all that much.

private practitioners, who were already getting squeezed, got squeezed a little more. to the average consumer (and most doctors) ACA was not a sea-change like many espouse it to be

 

[drusso]

exactly. it didnt do all that much.

private practitioners, who were already getting squeezed, got squeezed a little more. to the average consumer (and most doctors) ACA was not a sea-change like many espouse it to be

It's not keeping with American values to squeeze entrepreneurs job-creaters.

WSJ: Medicare for All Would Ban Private Practice

How do you like your boiled frog? Rare, medium, or well-done? https://www.wsj.com/articles/dems-new-plan-would-ban-private-medicine-11557688457?shareToken=stcf8cf70482364904b006d240d309726e&reflink=article_email_share "With everyone enrolled in Medicare for America, truly private health care...

forums.studentdoctor.net

 

[SSdoc33]

It's not keeping with American values to squeeze entrepreneurs job-creaters.

WSJ: Medicare for All Would Ban Private Practice

How do you like your boiled frog? Rare, medium, or well-done? https://www.wsj.com/articles/dems-new-plan-would-ban-private-medicine-11557688457?shareToken=stcf8cf70482364904b006d240d309726e&reflink=article_email_share "With everyone enrolled in Medicare for America, truly private health care...

forums.studentdoctor.net

dont move the goal posts. we were talking about the ACA, not "medicare for all"

you cant really predict one particular permutation of "universal health care". i understand that this is your livelihood, and ideally, there will be a space for private practice with some sort of health care reform. doesnt necessarily have to be a negative, despite what the WSJ has to say

 

[lonelobo]

Please point out the hypocritical evangelicals you see in the picture, and provide ANY evidence at all you have against the specific people you see in the picture.

Please point out the hate in the picture. Show me the evidence in the picture.

In short, show us the damning evidence you have on these specific people in the picture. Clearly you have plenty, show us the evidence.

Ya guy I was only referring to folks in this Picture

More proof Republican Voters ars so much better than Democratic ones, lol

College Republican Group Turning Point Has A White Supremacy Problem

A video of a Turning Point USA leader declaring "white power" and flashing a white supremacist sign is just one of many similar incidents for the group.

www.huffpost.com

 

[drusso]

dont move the goal posts. we were talking about the ACA, not "medicare for all"

you cant really predict one particular permutation of "universal health care". i understand that this is your livelihood, and ideally, there will be a space for private practice with some sort of health care reform. doesnt necessarily have to be a negative, despite what the WSJ has to say

I've spent the entire academic year studying the ACA's effects: It has reduced competition, consolidated market power, narrowed patient choice, increased bureaucratic/regulatory interference, and has done nothing to "bend the cost curve." It is collectivist and anti-free market by design. If you disagree with any of those statements, then your point of view is more informed by ideology than facts.

The Affordable Care Act: Lessons learnt and unintended consequences - The BMJ

The Affordable Care Act (ACA), colloquially called “Obamacare,” has drastically changed the American healthcare landscape: providing a safety net to millions of uninsured people, creating more robust mechanisms for improving [...]More...

blogs.bmj.com

"As health policy analysts, our work does not end at the implementation of new policies, but rather involves continually going back and looking for gaps and deficiencies that could not be identified at policy formulation. To deliver high quality, cost effective care, we need to encourage positive market dynamics, not impede them."

 

[SSdoc33]

I've spent the entire academic year studying the ACA's effects: It has reduced competition, consolidated market power, narrowed patient choice, increased bureaucratic/regulatory interference, and has done nothing to "bend the cost curve." It is collectivist and anti-free market by design. If you disagree with any of those statements, then your point of view is more informed by ideology than facts.

The Affordable Care Act: Lessons learnt and unintended consequences - The BMJ

The Affordable Care Act (ACA), colloquially called “Obamacare,” has drastically changed the American healthcare landscape: providing a safety net to millions of uninsured people, creating more robust mechanisms for improving [...]More...

blogs.bmj.com

"As health policy analysts, our work does not end at the implementation of new policies, but rather involves continually going back and looking for gaps and deficiencies that could not be identified at policy formulation. To deliver high quality, cost effective care, we need to encourage positive market dynamics, not impede them."

you have put me in the unenviable position of arguing for the ACA. as i have said before, i am not a big fan of it.

in you fair and balanced pursuit of academic excellence, you seem to have skipped over the fact that the ACA mandates coverage for pre-existing conditions and has provided care to millions who would otherwise be without it.


but the problems you highlighted is exactly why further health care reform is needed. who says you cant have a robust private practice market as well as coverage for everyone? first step is to lower cost of drugs and devices, and cut out the 20-30% going to the middle-man insurance companies

 

[Ligament]

I've spent the entire academic year studying the ACA's effects: It has reduced competition, consolidated market power, narrowed patient choice, increased bureaucratic/regulatory interference, and has done nothing to "bend the cost curve." It is collectivist and anti-free market by design. If you disagree with any of those statements, then your point of view is more informed by ideology than facts.

The Affordable Care Act: Lessons learnt and unintended consequences - The BMJ

The Affordable Care Act (ACA), colloquially called “Obamacare,” has drastically changed the American healthcare landscape: providing a safety net to millions of uninsured people, creating more robust mechanisms for improving [...]More...

blogs.bmj.com

"As health policy analysts, our work does not end at the implementation of new policies, but rather involves continually going back and looking for gaps and deficiencies that could not be identified at policy formulation. To deliver high quality, cost effective care, we need to encourage positive market dynamics, not impede them."

But our socialist brethren feel that monopolistic control of medicine is better. Therefore it is better.

 

[SSdoc33]

But our socialist brethren feel that monopolistic control of medicine is better. Therefore it is better.

you can get your point across without being a patronizing a$$.

 

[Ducttape]

yet more people support Obamacare than oppose... 54% to 42%.

go figure. maybe it is not all about free market economy to benefit rich doctors, but it is about what will benefit the average American...

 

[drusso]

yet more people support Obamacare than oppose... 54% to 42%.

go figure. maybe it is not all about free market economy to benefit rich doctors, but it is about what will benefit the average American...

...or what benefits the hospital lobby. Hospital admin is raking in money off of employed MD's. Their lobby is actively opposing site neutral payment.

 

[Disciple]

yet more people support Obamacare than oppose... 54% to 42%.

go figure. maybe it is not all about free market economy to benefit rich doctors, but it is about what will benefit the average American...

Is moral authority the justification for most of your positions?

 

[hyperalgesia]

yet more people support Obamacare than oppose... 54% to 42%.

go figure. maybe it is not all about free market economy to benefit rich doctors, but it is about what will benefit the average American...

Most people support/oppose what the TV tells them to.

 

[hyperalgesia]

you have put me in the unenviable position of arguing for the ACA. as i have said before, i am not a big fan of it.

in you fair and balanced pursuit of academic excellence, you seem to have skipped over the fact that the ACA mandates coverage for pre-existing conditions and has provided care to millions who would otherwise be without it.


but the problems you highlighted is exactly why further health care reform is needed. who says you cant have a robust private practice market as well as coverage for everyone? first step is to lower cost of drugs and devices, and cut out the 20-30% going to the middle-man insurance companies

I agree that we could have basic care for all and a robust private market.

I would love to see a STATE govt experiment with making healthcare insurance ILLEGAL (like gambling), and be able to use all Medicare/Medicaid revenue to design a healthcare system from the ground up. No RVUs, etc. That system is the "insurance". Everything else is bought with cash and lightly regulated.

I would just do this in a state to contain the potential fallout if some unintended fallout occurs. But I would like to see CMS open to things like this.

 

[drusso]

From a doctor who used to practice in the former USSR, but wishes to remain anonymous:

“Why are you surprised? They have got to have total control, or any socialist proposal will naturally fall through. I hear already “greed” and “ regulations “. No worries. It will be completely regulated. Do you know that in USSR you would be thrown in jail for accepting a fee of any kind from a patient. Both you and the patient. But it was still happening because people were desperate to get any care. No greed, no pay, no care , 0 quality, long waits, equal misery, totally fair. Except for the party leaders and government officials rationing the goodies. They will have Special free clinics. I keep saying all along - they will have to abolish private sector or nobody will be using this proposed useless mid level run joke of medical care. By the way- the big pharmaceutical, hospitals etc are having a field day because free market was regulated out. ( coding, emr, quality measures, billing, etc)”

 

[hyperalgesia]

From a doctor who used to practice in the former USSR, but wishes to remain anonymous:

“Why are you surprised? They have got to have total control, or any socialist proposal will naturally fall through. I hear already “greed” and “ regulations “. No worries. It will be completely regulated. Do you know that in USSR you would be thrown in jail for accepting a fee of any kind from a patient. Both you and the patient. But it was still happening because people were desperate to get any care. No greed, no pay, no care , 0 quality, long waits, equal misery, totally fair. Except for the party leaders and government officials rationing the goodies. They will have Special free clinics. I keep saying all along - they will have to abolish private sector or nobody will be using this proposed useless mid level run joke of medical care. By the way- the big pharmaceutical, hospitals etc are having a field day because free market was regulated out. ( coding, emr, quality measures, billing, etc)”

I guess I'm hoping in vain that we could develop a state-wide system that expressly RELEASES the private sector that is currently under the oppressive regulations you mentioned. I would only support expansion of another system if this principle of a totally separate and protected free-market system is enshrined.

No HIPAA, CPT/EHR/RVU all up to the practice.

But yeah, it'll never happen lol

 

[Ligament]

From a doctor who used to practice in the former USSR, but wishes to remain anonymous:

“Why are you surprised? They have got to have total control, or any socialist proposal will naturally fall through. I hear already “greed” and “ regulations “. No worries. It will be completely regulated. Do you know that in USSR you would be thrown in jail for accepting a fee of any kind from a patient. Both you and the patient. But it was still happening because people were desperate to get any care. No greed, no pay, no care , 0 quality, long waits, equal misery, totally fair. Except for the party leaders and government officials rationing the goodies. They will have Special free clinics. I keep saying all along - they will have to abolish private sector or nobody will be using this proposed useless mid level run joke of medical care. By the way- the big pharmaceutical, hospitals etc are having a field day because free market was regulated out. ( coding, emr, quality measures, billing, etc)”

and....our socialist members will read this and absolutely zero problems with it...

Wonder how they are going to feel in 10 years when they are working in one of these socialist clinics as indentured servants. Wonder if they will realize at any point how they screwed everybody.

 

[Ligament]

Joe Biden and VP runningmate Kamala Harris now support universal healthcare for illegal invaders...yes, American citizens get to pay for healthcare for the entire world. No mention from them how that benefits us, the American citizen.

 

[hyperalgesia]

and....our socialist members will read this and absolutely zero problems with it...

Wonder how they are going to feel in 10 years when they are working in one of these socialist clinics as indentured servants. Wonder if they will realize at any point how they screwed everybody.

Nope, they will never realize it.

If we turned into Venezuela, with people scrounging for food scraps, they will say it is clear evidence that the free market has failed and we need to give the govt more power to fix it. Duh! Stupid Trump supporters!

The liberal mind does not look for facts to interpret. It looks for leaders and consensus to follow. Liberals are controlled by presenting the appearance of overwhelming consensus, prestige, credentials, and authority. CNN does this every day with their panels of handpicked "experts" to simulate those elements.

Maybe someday a leader will emerge who can package reality and feed it to the masses in small doses...

 

[hyperalgesia]

Nothing hypocritical with that. I'm not going to go out of my way to research the supply chain and find a different shirt or laptop to purchase. I am willing to pay a 10% premium on these if it mean a significantly greater number of people can reach a living wage.

With the new tariffs on China, prices will rise to better reflect the cost of the "living wage" you endorse.

 

[Ducttape]

Is moral authority the justification for most of your positions?

no. science first, help our fellow American second.


most people watch Fox. so they are not supporting what they are watching on TV. and at least liberals are not believing Fake News spouted by the #1 liar in the world.


finally, anonymous quotes are great! I heard this one recently: "I went to Norway and their healthcare is terrific, best in the world! its not free, but we all get some and we don't go bankrupt!"

 

[DOctorJay]

I wonder if we had the population/demographics/self-responsibility of Norway where our system would rank.

 

[emd123]

Joe Biden and VP runningmate Kamala Harris now support universal healthcare for illegal invaders...yes, American citizens get to pay for healthcare for the entire world. No mention from them how that benefits us, the American citizen.

Looks like the Democrats found a way to screw 100% of voters to benefit people with 0% right to vote.

 

[Ligament]

I wonder if we had the population/demographics/self-responsibility of Norway where our system would rank.

How dare you talk about self-responsibility!

 

[Ducttape]

I wonder if we had the population/demographics/self-responsibility of Norway where our system would rank.

what if we had a system that helped teach self-responsibility?

wait a minute... that is preventive medicine.


and snap! that's a key part of socialized medicine.......... that's a no no, cant do that!

 

[Ducttape]

and fwiw, Biden is not Medicare for all bandwagon. he supports a public Medicare option that one can buy in to Medicare if they so choose, but can choose commercial insurance if they choose to.

Wary of Medicare for all, Democrats seek easier paths to universal coverage

Wary of the political risks and practical difficulties of Medicare-for-all proposals that would move every American into a government health plan, Democrats increasingly are embracing more modest plans to use Medicare to expand insurance coverage.

www.latimes.com

2020 Candidate Joe Biden Backs Medicare Public Option

Biden's endorsement of a public option comes after Bernie Sanders, another Democratic presidential candidate, reintroduced his Medicare for All plan earlier this month.

www.newsweek.com

 

[nvrsumr]

my understanding of medicare option plan is there is an $8000 penalty to the employer for every employee that opts into medicare. This will drive employer sponsored plans into extinction. Which is the goal

 

[VA Hopeful Dr]

what if we had a system that helped teach self-responsibility?

wait a minute... that is preventive medicine.


and snap! that's a key part of socialized medicine.......... that's a no no, cant do that!

As a guy who spends about 50% of his day doing preventative medicine, its not lack of insurance/cost causing problems. Its the American lifestyle...

 

[Ducttape]

my understanding of medicare option plan is there is an $8000 penalty to the employer for every employee that opts into medicare. This will drive employer sponsored plans into extinction. Which is the goal

please post your sources. otherwise, it is hearsay.

if preventive medicine were part and parcel to how medicine is done, there would be much greater work on societal end towards changing the American lifestyle.

just giving up and saying "its the American lifestyle" is self-defeating, if we are going to try to make America healthier. inroads can be made, even in this current situation - look at smoking. drunk driving, etc.

 

[nvrsumr]

Im sticking with hearsay. There are a number of unpersuadable folks posting on this thread so do not have the inclination to to carry their water.

 

[VA Hopeful Dr]

please post your sources. otherwise, it is hearsay.

if preventive medicine were part and parcel to how medicine is done, there would be much greater work on societal end towards changing the American lifestyle.

just giving up and saying "its the American lifestyle" is self-defeating, if we are going to try to make America healthier. inroads can be made, even in this current situation - look at smoking. drunk driving, etc.

Gee really? Did I say anything about not addressing it and giving up?

No, I didn't. But the problem isn't related to our current health system. In fact by most measures we do better at preventative care than almost everyone else. We fail at basically everything related to obesity, which we don't know how to treat all that well. Much of that needs to happen at a governmental level - stop subsidizing corn and by extension high fructose corn syrup, redo the USDA dietary recommendations (grains shouldn't be equal to fruits and vegetables, or really protein for that matter), find a way to make healthy foods cheaper.

Do all of that and my job gets at least 50% easier.

 

[lonelobo]

Maybe lead by example....

Baylor Lady Bears get fast-food treatment from President Donald Trump at White House to celebrate championship

Apparently this trend isn't going anywhere as another team was given fast food after winning a national title

www.cbssports.com

Trump Administration Rolls Back Obama-Era Rules for School Lunches (Published 2018)

The Department of Agriculture announced its plans to lower nutritional standards for grains, flavored milks and sodium in school cafeterias.

www.nytimes.com

 

[VA Hopeful Dr]

Maybe lead by example....

Baylor Lady Bears get fast-food treatment from President Donald Trump at White House to celebrate championship

Apparently this trend isn't going anywhere as another team was given fast food after winning a national title

www.cbssports.com

Trump Administration Rolls Back Obama-Era Rules for School Lunches (Published 2018)

The Department of Agriculture announced its plans to lower nutritional standards for grains, flavored milks and sodium in school cafeterias.

www.nytimes.com

Problem is the Obama-era nutrition standards weren't actually that good.

Dietary fat isn't bad for you, so we don't need a maximum. Sodium isn't bad for you assuming functioning kidneys and heart, so a maximum isn't needed there either.

Whole grains are still grains, that's where a maximum is needed.

Whole milk is no worse for you than skim, banning it is stupid.

 

[Ducttape]

it all depends on how one decides to make it work.

I looked online, googled, and see nothing about anyone posting specific Medicare option plans, with the exception of Washington state, that just put out a plan. nothing I can find on that plan stated anything about fees for employers. so I call Fake News. unless you post something.


now imagine, a plan where people can opt in, without significant fee, for basic preventive medical care and hospital care. the govt has private insurances manage the plan. it caps payment but guarantees payment to hospitals and other entities, but uses the caps to increase payment on physician fees to entice doctors to continue to be in the plans, and it forces hospitals to be required to accept the plan if their physicians request it.....

 

[Goro]

Gee really? Did I say anything about not addressing it and giving up?

No, I didn't. But the problem isn't related to our current health system. In fact by most measures we do better at preventative care than almost everyone else. We fail at basically everything related to obesity, which we don't know how to treat all that well. Much of that needs to happen at a governmental level - stop subsidizing corn and by extension high fructose corn syrup, redo the USDA dietary recommendations (grains shouldn't be equal to fruits and vegetables, or really protein for that matter), find a way to make healthy foods cheaper.

Do all of that and my job gets at least 50% easier.

The bolded especially. It's no coincidence that the obesity epidemic started to skyrocket after the introduction of New Coke in 1985.

 

[Ducttape]

I'm sorry....

isn't that all part of preventive medicine - eliminating that which is bad for americans ike high fructose corn syrup, setting appropriate dietary priorities, improving access to high quality foods?

and having primary care physicians see patients and encourage following such behaviors?

 

[Ligament]

If parents had the guts to ban the internet and video games from their kids, problem solved. They should be outdoors being physically active and breaking bones, not getting addicted to porn at 10 years old and murdering 100,000's of characters in video games by the same age.

 

[lonelobo]

Problem is the Obama-era nutrition standards weren't actually that good.

Dietary fat isn't bad for you, so we don't need a maximum. Sodium isn't bad for you assuming functioning kidneys and heart, so a maximum isn't needed there either.

Whole grains are still grains, that's where a maximum is needed.

Whole milk is no worse for you than skim, banning it is stupid.

1. It was much better than the existing standard
The regulations prioritized whole grains over more processed grains, an emphasis on whole fruits and vegetables, and a reduction in sodium, full-fat milk, and meat.

2. Really unlimited dietary fat and Sodium not a problem?

Notably, it passed with bipartisan support and was endorsed by the School Nutrition Association, a nonprofit representing student meal providers. But less than a year later, both Republican lawmakers and certain agricultural lobbyists came out in full force against the law, pointing to it as evidence of a left-wing nanny state run amok.

 

[VA Hopeful Dr]

1. It was much better than the existing standard
The regulations prioritized whole grains over more processed grains, an emphasis on whole fruits and vegetables, and a reduction in sodium, full-fat milk, and meat.

2. Really unlimited dietary fat and Sodium not a problem?

Notably, it passed with bipartisan support and was endorsed by the School Nutrition Association, a nonprofit representing student meal providers. But less than a year later, both Republican lawmakers and certain agricultural lobbyists came out in full force against the law, pointing to it as evidence of a left-wing nanny state run amok.

1. Probably, not sure what the previous one was

2. In regular food quantities, no.

If you give a kid 5 pounds of Crisco for lunch with a side of 2 cups of salt, yeah that's a problem. Otherwise, not really.