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Gross, Ronald Ronald.Gross at baystatehealth.org
Sat Aug 1 12:47:22 BST 2009


I can't remember---as things are now, Medicare (y'know, run by the gov't) is supposed to go broke when?  And the gov't's proposed fix is?

-----Original Message-----
From: Robert Smith <rfsmithmd at comcast.net>
Sent: Friday, July 31, 2009 7:25 PM
To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>
Subject: Re:


At a recent town hall meeting, a man stood up and told Representative
Bob Inglis to “keep your government hands off my Medicare.” The
congressman, a Republican from South Carolina, tried to explain that
Medicare is already a government program — but the voter, Mr. Inglis
said, “wasn’t having any of it.”


On Jul 31, 2009, at 2:53 PM, Gross, Ronald wrote:

> Not to add fuel to a fire burning from the left and the right
> towards the middle, but I found this story amusing in light of what
> I had heard earlier.  I had just been listening to CBS News on the
> radio; the reporters were discussing how huge sums of stimulus money
> allocated for infrastructure improvement, specifically bridges, have
> thus far been used on bridges that needed no emergent work while
> others were crumbling, and that the banks that had received billions
> and billions in bail out funds were spending millions and millions
> in bonuses for the same folks that created the mess they were in,
> and that AIG subsidiaries were in such bad shape that in might cost
> many more billions to shore up the AIG conglomerate.
>
> This is the same administration that wants to manage medicine,
> establish a brave new world of universal insurance, eliminate waste
> and fraud in the medical world by dictating how it is that the
> medical world will manage care, etc.
>
> I'm having chest pain.  And I already have a headache.
>
> RIG
>
> House Passes Bill to Prolong 'Cash for Clunkers'
> White House Says Nearly Broke Program Will Continue; Bill Would Add
> $2 Billion
>
> By Ben Pershing and Dana Hedgpeth
> Washington Post Staff Writers
> Friday, July 31, 2009 2:19 PM
>
> The House approved a bill Friday afternoon to provide $2 billion to
> continue the federal government's week-old "cash for clunkers"
> program, which has proven so popular with consumers that it was
> almost out of cash. The 316-109 vote split Republicans but attracted
> the support of nearly every Democrat in the chamber.
>
> The money will come from funds in the already-passed economic
> stimulus package that were intended for energy loan guarantees.
> Congress will seek to replenish the energy program at a later date.
>
> "If you were planning on going to buy a car this weekend, using this
> program, this program continues to run," White House press secretary
> Robert Gibbs said Friday. "If you meet the requirements of the
> program, the certificates will be honored."
>
> Senate leaders hope to bring the bill up next week. Conservatives
> who opposed both the original cash for clunkers program and the
> stimulus package as a whole may seek to slow the process, as might
> liberals who want the program's mileage standards to be revised
> upwards.
>
> Two members of the Michigan congressional delegation said the
> administration had told them it would continue to honor exchanges
> made under the program "until further notice."
>
> Lawmakers also want problems fixed in the way the program has been
> administered and and to ensure auto dealers are being reimbursed in
> a timely fashion. Technical glitches have made it difficult for the
> administration to know exactly how many exchanges have taken place
> and how much money has been paid out to date.
>
> "The question I have is, how do you make sure it's a smooth
> transaction?" said Michigan Rep. Thaddeus McCotter (R). "It's a
> glitch in the electronic record-keeping that's the problem."
>
> As the House debated the hastily-drafted measure, Rep. Jerry Lewis
> (R-Calif.) lamented that there had been "not one hearing on the cash
> for clunkers program on the Appropriations Committee," and no
> consideration by the House of how the program had worked so far or
> how much more money it would need in the future. "Here we are,
> shoveling another $2 billion out the door," he said.
>
> But supporters of the program emphasized that its dire financial
> straits indicated that it was working. "This is the best $1 billion
> of economic stimulus funds that the government has ever spent," said
> Michigan Rep. Candice Miller (R).
>
> Only 40,000 applications for turning in clunkers have been filled
> out, according to a Congressional official. But dealers say they
> have many clunkers sitting on their lots that they have not
> processed and stacks of paperwork they can't get through the
> government's system. Government officials told Congressional leaders
> that 200,000 forms still need to be processed, according to survey
> results done of dealers involved in the program.
>
> Congressional leaders expressed concerns that people's cars will be
> destroyed even before their car has been officially approved for the
> program.
>
> Auto dealers, who have said the program is confusing to execute, are
> following the developments closely. Peter Kitzmiller, president of
> the Maryland Automobile Dealers Association, said Friday that he
> will advise dealers to continue negotiating trade-in deals with
> customers, but to stop delivering cars until the government gets a
> handle on the funding issue.
>
> Greg Lewis, sales manager at Fitzgerald Auto Mall in Gaithersburg,
> said Fitzgerald dealerships have suspended clunker sales -- not only
> because of the funding issue but because of ongoing problems with
> processing transactions through the Web site of the National Highway
> Traffic Safety Administration, which administers the program.
>
> Fitzgerald dealerships are on the hook for nearly $1 million worth
> of deals already made with buyers, Lewis said, and officials are
> believe it would be "a big gamble" to make new deals at this point,
> "It's just constantly crashing," Lewis said of the computerized
> system.
>
> Kitzmiller said that given the processing difficulties, "I have no
> idea how NHTSA knows if they are out of money or not. I'm pretty
> sure they don't know how many deals are in the pipeline."
>
> In New York, Honda dealership general manager Brian Benstock said
> one of his showrooms was full of people Thursday night when
> television news shows reported that the program would be suspended
> at midnight. "We started telling customers 'fish or cut bait,' " he
> said. At 11:55 p.m., Benstock's staff told one hesitant customer
> that "the hour glass is closing," Benstock said. The man gave up his
> 1997 Mitsubishi<http://financial.washingtonpost.com/custom/wpost/html-qcn.asp?dispnav=business&mwpage=qcn&symb=MSBHF&nav=el
> > Diamante and left with a brand new Honda CRV at 1 a.m.
>
> Benstock said he's taken in 60 clunkers since the program started
> but has yet to get paid from the government. "We haven't received a
> dime," Benstock said. "We knew the government program was going to
> end but we had no idea it would happen this fast," Benstock said.
>
> Even if Congress approves the $2 billion extension on the program,
> dealers say the money will only last a week if the interest keeps up
> at current levels. That means the program will again be out of money
> during the August recess of Congress.
>
> Benstock and other dealers say that there's pent up demand. The U.S.
> auto industry had been selling 17 million cars a year, but this year
> they expected to sell 10 million.
>
> "The clunker customers have been hanging on for years and all of a
> sudden someone is giving them an opportunity to get a newer car,"
> Benstock said.
>
> The House bill was drafted after Michigan lawmakers held an
> emergency meeting Friday morning in the office of Sen. Carl Levin (D).
>
> The program, formally known as the Car Allowance Rebate System
> (CARS), gives vouchers worth up to $4,500 to consumers who trade in
> gas-guzzling cars for more fuel-efficient models. The highly
> publicized effort -- passed by Congress in late June to help the
> flagging U.S. auto industry and launched just a week ago with $1
> billion in funds -- was scheduled to run until Nov. 1, or until
> money ran out.
>
> But as tens of thousands of people rushed to trade in their cars,
> sources familiar with the discussions who spoke on condition of
> anonymity said, federal transportation officials worried that the
> program's coffers could be empty by week's end.
>
> Shortly before 1 a.m. Friday, several local dealers said in
> interviews that they would wait to see how the government was going
> to proceed with the program before they accepted any more clunkers.
> Dealers had been expecting an overwhelming response to the program
> to continue through the weekend.
>
> "Clearly, this has been a very stimulative program that's got
> consumers back into the car market. It's our hope that possibly more
> funds can be made available," said Cody Lusk, president of the
> American International Automobile Dealers Association.
>
> Lusk said the group has fielded hundreds of calls from frustrated
> dealers who have had problems entering vehicle data into the
> program's Web site. He said frequent crashes of the site have made
> it harder for car sellers to complete deals.
>
> Jack Fitzgerald, who owns several dealerships in the Washington
> region, said his stores have already taken in about 200 clunkers. He
> said the government hyped the program too much before setting clear
> rules and guidelines on it. He suggested that the government
> consider lowering the dollar amount of the vouchers and extending
> the program for more time.
>
> Tammy Darvish, another major auto dealer in the Washington area,
> said that her more than two dozen dealerships have had lots of
> interest in the program but that its success has left dealers
> strapped for money as they wait for payments from the government.
>
> Under the program, dealers credit the amount of the voucher to
> customers who buy new cars. They then get reimbursed by the
> government.
>
> "There's a whole lot of money out there that dealers haven't
> collected on," said Darvish, who noted that she's taken in about 200
> clunkers. "We've sold the cars and we've processed the paperwork,
> but we haven't been reimbursed. I'm out about $1 million. The
> government is supposed to reimburse me for that."
>
> At a Toyota dealership in Silver Spring Bob Grimm, a 64-year-old
> retired Defense Department worker, came last week to look at buying
> his son a new car. He didn't buy then but went home and researched
> the prices on the Internet. He came back Friday and made the deal.
> He traded in his clunker -- a 1996 Chrysler minivan with 176,000
> miles on it. With the $4,500 voucher he got from the clunker
> program, plus getting rebates and other incentives -- he ended up
> buying a 2010 Toyota Corolla for $11,370. The car's manufactured
> suggested retail price was $18,505.
>
> "That's why I couldn't resist the deal," said Grimm, who drives a
> 2006 Corvette. "It was $4,500 off the $15,870 price."
>
> The Toyota Silver Spring dealership manager Ethan Rossignol said
> Toyota estimated his dealership would sell 200 cars in July. They've
> sold 350 -- 110 of them were consumers buying new cars after trading
> in their clunkers. His back lot, now dubbed "The Clunker Lot" is
> full of gas guzzlers from the 1990s. There is a Mercedes station
> wagon, a 1991 Cadillac Brougham with 130,000 miles on it, Chevy
> Suburbans, Jeep Grand Cherokees, Ford Explorers and Mercury Grand
> Marquis.
>
> "It's nuts," Rossignol said of how busy his dealership has been. "It
> is one of the best things to happen to the automobile industry in a
> decade."
>
> Staff writers Sholnn Freeman, Paul Kane, Tom Heath and Scott Wilson
> contributed to this report.
>
>
> Ronald I. Gross, MD, FACS
> Chief of Trauma & Emergency Surgery Services
> Baystate Medical Center
> Assistant Professor of Surgery
> Tufts University School of Medicine
> 759 Chestnut Street
> Springfield, MA  01199
> 413-794-4022  phone
> 413-794-0142  fax
> ronald
> .gross at baystatehealth.org<mailto:ronald.gross at baystatehealth.org>
>
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