Halforums Fixes the World: US Healthcare Edition

[Dave]

In this series of threads, we will attempt to fix various and sundry problems plaguing the world, the United States or other issues nobody can quite figure out.

This thread will attempt to fix the United States Healthcare System.

Note that the following must be followed:

1. We are not beholden to any lobbyists and thus can act with impunity and without fear of repercussion.
2. We are not running for office so we don't have to pander to any singular group.
3. YOU MUST SAY HOW WE WILL PAY FOR THIS!
4. If you have concrete views on something (public option, abortion, etc) please state this and why.

I'm interested to see what we come up with or if anyone even bothers to try.

 

[GasBandit]

First, in order to reintroduce competition to the system, we allow medical insurance to be sold across state lines, which is currently prohibited. We also repeal any state mandates on health care coverage that artificially inflate premiums, such as Connecticut's requirement that any medical insurance coverage plan cover hair plugs.

Then we start moving toward a system where health insurance is no longer coupled to your job, and you shop for it just like you'd shop for and compare car insurance. Health insurance premiums will be made tax deductible (currently they are only tax deductible for employers, not employees or other individuals). Set up other special incentives to encourage people to create and contribute to medical savings plans.

The next step will be to reintroduce familiarity with the cost of health care to the patient. Currently, the mind of the patient with insurance is "disconnected," they don't care how much something costs because in their mind, they pay their premiums so somebody else has to pay the bill, so to them it's as good as free... which lets medical providers raise prices like crazy. This perhaps gets them shopping around for lower cost providers, encouraging health care providers to once again get leaner and meaner instead of fatter and costlier.

Competition makes providers AND insurance companies get cheaper for the consumer while retaining, if not improving, quality. Fat gets trimmed. Waste gets eliminated. Fraud gets rooted out because now everybody knows it's THEIR money and there's multiple people looking at it instead of being controlled by one central entity (government, a-la medicare). Medical costs go down, quality of care remains high. And since it is all done largely in the private sector, cost to the taxpayer will be minimal... just the usual salary of the legislators who need to change the laws.

 

[Chazwozel]

In this series of threads, we will attempt to fix various and sundry problems plaguing the world, the United States or other issues nobody can quite figure out.

This thread will attempt to fix the United States Healthcare System.

Note that the following must be followed:

1. We are not beholden to any lobbyists and thus can act with impunity and without fear of repercussion.
2. We are not running for office so we don't have to pander to any singular group.
3. YOU MUST SAY HOW WE WILL PAY FOR THIS!
4. If you have concrete views on something (public option, abortion, etc) please state this and why.

I'm interested to see what we come up with or if anyone even bothers to try.

You need another bulletpoint. 'why your plan will never work'

This reminds me of my virology final.

Create the deadliest most contagious virus ever known by combining infectivity, insertion, genetic traits of existing viruses and explain why it's impossible for this virus to exist in nature.

 

[MindDetective]

Fellow Half-forumites. I propose several targeted actions to help alleviate some of the health-care woes. These are preliminary suggestions that are open to change and elaboration upon by my colleagues in the House of Halforums.

1.) Unionize patients - This may require very little in the form of legislation. The goal will be to allow patients to buy healthcare and health insurance in bulk. It also will allow for competitive membership into groups that can bargain for better premiums and better coverage.
2.) Protect doctors - If we can refine the laws that define and describe medical negligence, we will be able to protect doctors and hospitals from unnecessary and vindictive legal action. Honest, capable doctors need a reasonable amount of security when practicing medicine.
3.) Increase capability of doctors - Raise the bar on requirements for becoming a medical doctor
4.) Increase the capabilities of medical technicians and nurse practicioners - Allow non-medical doctors with sufficient, rigorous medical training to be a first line of defense in health care that can allow patients with smaller healthcare issues to be treated at lower cost. This will also require the ability of nurses and med techs to recognize when doctors are needed and/or require annual doctor visits to review treatment by non-doctor medical personnel
5.) Nationalize chronic care for certain disorders - We do not, as a nation, need to account for the health of all our citizens but we can ease the burden on insurance companies by taking over the medical costs for certain chronic disorders, like alzheimer's disease and multiple sclerosis (just to name two). This will ease the financial risk for health coverage companies and provide security for those with constant health problems, even if they lack insurance.

As always, I anticipate a vigorous debate from my fellow legislators of the House of Halforums but I hope we can find a resolution to this all important issue with grace and statesmanship.

 

[Charlie Don't Surf]

comedy answer: the exact opposite of everything GasBandit says


serious, succinct answer: full single-payer

 

[Dave]

serious, succinct answer: full single-payer

And how are we going to pay for it?

 

[Charlie Don't Surf]

serious, succinct answer: full single-payer

And how are we going to pay for it?[/QUOTE]

If it doesn't pay for itself in driving down costs, raise the fuck out of taxes.

 

[WolfOfOdin]

Comedy answer: Enslave the poor and institute a breeding program so that all menial labor is done for free, removing a vast chunk of people who would otherwise need healthcare.

 

[Charlie Don't Surf]

Comedy answer: Enslave the poor and institute a breeding program so that all menial labor is done for free, removing a vast chunk of people who would otherwise need healthcare.

this is already pretty much done unofficially in the United States. Capitalism beat you to it.

 

[GasBandit]

serious, succinct answer: full single-payer

And how are we going to pay for it?[/QUOTE]

If it doesn't pay for itself in driving down costs, raise the fuck out of taxes.[/QUOTE]

And what do you do when the producers have had enough of carrying the parasites on their shoulders and move out of reach of the plunderer's ability to tax them? The "Tax the fuck out of the rich" mentality is why california and new york's state budgets are going down in flames.

I did forget one important facet in my first post however, that Mind Detective touched upon: Tort Reform. A great deal of the cost of health care can be attributed to the titanic cost of malpractice insurance, which can be attributed to patients suing doctors when the risks from risky procedures manifest themselves.

 

[Covar]

Comedy answer: Enslave the poor and institute a breeding program so that all menial labor is done for free, removing a vast chunk of people who would otherwise need healthcare.

this is already pretty much done unofficially in the United States. Capitalism beat you to it.[/QUOTE]

I'm glad I don't live in your world. It sounds like such a sad, depressing place.

---------- Post added at 02:08 PM ---------- Previous post was at 02:04 PM ----------

Gas and MindDetective pretty much hit my points. The real solution is to identify the high cost areas of insurance and find ways to ease them. Tort reform would help to streamline treatment as the doctors will be able to stop worrying about covering every single base, and instead being able to focus on getting the patient the treatment needed faster. Opening up competition will better allow the laws of supply and demand to keep the costs at their natural levels.

 

[Krisken]

I think I'll sit this one out and watch the armchair experts take it on.

 

[Rob King]

I'm actually genuinely interested to see where this goes. I am Canadian, and I'm glad and greatful for the healthcare system that is in place. But I might not mind living in Gasbandit/Mind Detective's worlds.

 

[Chazwozel]

3.) Increase capability of doctors - Raise the bar on requirements for becoming a medical doctor

One of the single biggest problems with training doctors is med school. Med school is hard as hell to get into. Now I'm not saying it's a cake walk after that, but it's really, really hard to completely flunk out of med school once you're in. I think med school needs to have the same qualification and standards to get in, however, I think that med students should be paid a stipend (don't ask me where the money would come from) instead of paying tuition. This eliminates the 'need' for medical programs to bump mediocre students along in order to keep funds going. That way, like grad school, if you're a hopeless case, they pat you on the head and you get booted if you can't keep a 3.0.

 

[Dave]

I agree, Chaz. Also, because of the way that the system is set up currently there is an economic incentive to stay as far away from the General Practice as you can.

There's no money in it.

 

[@Li3n]

The real solution is to identify the high cost areas of insurance and find ways to ease them. Tort reform would help to streamline treatment as the doctors will be able to stop worrying about covering every single base, and instead being able to focus on getting the patient the treatment needed faster.

Or you can go crazy and do both...

Opening up competition will better allow the laws of supply and demand to keep the costs at their natural levels.

Even Adam Smith, first guy that talked about the invisible hand said that it only work if everyone is honest... instead companies do this: http://www.thedailyshow.com/watch/thu-march-11-2010/eamon-javers

 

[GasBandit]

Even Adam Smith, first guy that talked about the invisible hand said that it only work if everyone is honest... instead companies do this: http://www.thedailyshow.com/watch/thu-march-11-2010/eamon-javers

The inherent flaw, however, is that one assumes that corruption is less of a factor in centralized (socialist) systems. The difference between centralized and decentralized systems is that in a decentralized system, corruption happens on a case by case basis, and corruption of many working in concert becomes easy to find and thus to stomp on. However, in a centralized system, all the records you have to fudge and people you have to bribe are in one convenient location. Corruption harms any system, be it capitalist or socialist. However, capitalism makes it less difficult to bust the corrupt businessman because he's not in charge of government... whereas under socialism the corrupt businessman IS the government, and you're screwed with no options outside of revolt.

 

[Chibibar]

3.) Increase capability of doctors - Raise the bar on requirements for becoming a medical doctor

One of the single biggest problems with training doctors is med school. Med school is hard as hell to get into. Now I'm not saying it's a cake walk after that, but it's really, really hard to completely flunk out of med school once you're in. I think med school needs to have the same qualification and standards to get in, however, I think that med students should be paid a stipend (don't ask me where the money would come from) instead of paying tuition. This eliminates the 'need' for medical programs to bump mediocre students along in order to keep funds going. That way, like grad school, if you're a hopeless case, they pat you on the head and you get booted if you can't keep a 3.0.[/QUOTE]

Wow. I didn't know about the 2nd part (i.e. hard to flunk out) I did flunk out of college (CS degree) back in the early days, but I did finally return and finish my degree. Good to know.

@Dave
How to fix it? I believe some of the other poster have already stated that we really need to fix the tort portion. The lawsuits are in the millions now and that can't be good for hospitals and insurance company.
I believe opening insurance across state line would be good competition. I don't know why this isn't the case in the first place. Of course this would be ALL medical procedure (cost wise) would have to be same across the board or at least similar for pay out purpose, but that should even out if a person can shop around for insurance.

I do believe that people should get a tax break when they are paying THEIR portion of the insurance.

@krisken - hehe armchair expert. Well, I don't know about you, but I have my share of medical expenses (not as high as some) but some of these charges are ridiculous in my book. I mean when I got the hospital (not emergency room) I get all kinds of charges by all kinds of doctor and at most I see the nurse. I never once get "Hi, I'm Doctor Jones." and yet I get charge by the doctor. What is up with that? Is him giving advice without seeing me really worth 800$?

 

[Dave]

So here's what I'm hearing so far (tell me if I'm incorrect):

1. Malpractice is a huge problem and needs to be addressed. It drives up costs unnecessarily. Yes, risk is inherent in all medical procedures. But when a doctor fucks up negligently we need to keep open some form of recourse for the patients.
2. Insurance needs to be able to cross state lines. Currently each state makes their own laws regarding health insurance and the lack of portability causes prices to go up. But if we allow carriers to cross state lines, we'd run into the problem that some states already have which is monopolization and lack of choices for consumers. I know that allowing the state line crossing will help a little, but the Blue Crosses will just get bigger and make it that much harder to break into the market.
3. Reeducate consumers on the cost of health care. I agree that our current system fosters a disconnect between imagined and real costs, but I'm wondering how we would achieve this education. Really the only way would be to bill the customer first and then send it to whichever insurance, but some would not be able to pay anything and it would add a HUGE backlog into the system as people ignored the bill. So how would you propose this education gets done?
4. The cost of medical school is too high. This is already being addressed privately. I can't remember where it's at, but a hospital is allowing a certain number of people to go through their medical school for free but are then obligated to stay at that facility for a period of time once they graduate. This has worked out very well for them and it could be rolled out on a larger scale or we could include the subsidization of medical school. The only problem that I can see with subsidization is that it starts a huge ball rolling for the argument of subsidizing other degrees also and is not really fair to those going to school for other professions. I would state that becoming a nuclear physicist would be pretty hard to go through, also.

One thing that I've noticed is that we already have a breakdown in that one person wants a single-payer system and one person wants to stay away from that. Charlie wants to raise taxes to pay for it all. While we pay a lot less than most countries that would be a hard sell.

Here's a few idea that I have:

1. No matter what we use - single payer or private options - preventive care should be unable to be charged. One of the reasons things are so bad is that people wait as long as they can before going in. Once they do it is more expensive and costs us all much more.
2. Take employers out of the insurance game. Make people go shopping for their own insurance. I think this is what Gas is talking about above, come to think of it. Right now one of the biggest drains on US industry is the rising health care costs. Put it back into the hands of the people.
3. Allow for cheaper pharmaceuticals, whether this is by changing the laws regarding generics or by shopping in other countries. I don't mind a company making money, but some of the unscrupulous things pharmaceutical companies do is helping drive costs up for everyone.

 

[Krisken]

3.) Increase capability of doctors - Raise the bar on requirements for becoming a medical doctor

One of the single biggest problems with training doctors is med school. Med school is hard as hell to get into. Now I'm not saying it's a cake walk after that, but it's really, really hard to completely flunk out of med school once you're in. I think med school needs to have the same qualification and standards to get in, however, I think that med students should be paid a stipend (don't ask me where the money would come from) instead of paying tuition. This eliminates the 'need' for medical programs to bump mediocre students along in order to keep funds going. That way, like grad school, if you're a hopeless case, they pat you on the head and you get booted if you can't keep a 3.0.[/QUOTE]

Wow. I didn't know about the 2nd part (i.e. hard to flunk out) I did flunk out of college (CS degree) back in the early days, but I did finally return and finish my degree. Good to know.

@Dave
How to fix it? I believe some of the other poster have already stated that we really need to fix the tort portion. The lawsuits are in the millions now and that can't be good for hospitals and insurance company.
I believe opening insurance across state line would be good competition. I don't know why this isn't the case in the first place. Of course this would be ALL medical procedure (cost wise) would have to be same across the board or at least similar for pay out purpose, but that should even out if a person can shop around for insurance.

I do believe that people should get a tax break when they are paying THEIR portion of the insurance.

@krisken - hehe armchair expert. Well, I don't know about you, but I have my share of medical expenses (not as high as some) but some of these charges are ridiculous in my book. I mean when I got the hospital (not emergency room) I get all kinds of charges by all kinds of doctor and at most I see the nurse. I never once get "Hi, I'm Doctor Jones." and yet I get charge by the doctor. What is up with that? Is him giving advice without seeing me really worth 800$?[/QUOTE]
The charge isn't by visit, necessarily, or just a doctor charge. Is this an inpatient or outpatient facility? What is the MRG (Medicare Reiumbursement Rate (don't ask me why it isn't MRR)), what was the condition? What was the procedure performed? Were there co morbid conditions? Something like being a long time smoker gets coded as an addiction.

It's really easy to say "Shit, my bill was high and they barely did anything!", but another entirely to know why the bills are as high as they are.

Oh, and insurance companies shouldn't be for profit. It creates a conflict of loyalty for the company. The loyalty isn't to the customer, but to the share holders.

 

[GasBandit]

[*]Insurance needs to be able to cross state lines. Currently each state makes their own laws regarding health insurance and the lack of portability causes prices to go up. But if we allow carriers to cross state lines, we'd run into the problem that some states already have which is monopolization and lack of choices for consumers. I know that allowing the state line crossing will help a little, but the Blue Crosses will just get bigger and make it that much harder to break into the market.

There are hundreds of medical insurance companies already existing, so "breaking into the market" won't be as much of a factor. However, you have a good point in that we need to make sure companies like Blue Cross don't consolidate and form an ubercorp like pre-baby-bell AT&Ts that can drive others out of business simply by sheer mass. The aim here is to increase competition. It may, sometimes, become necessary to break big companies into multiple smaller companies, which is (in my libertarian fantasy world) the only true and valid use of government intrusion into the private sector.

 

[Krisken]

The problem with allowing insurance companies to sell across state lines is insurance regulation is controlled by state laws. In Alabama, for instance, the laws are fairly lenient. In California, they are more strict. Companies would move to Alabama to sell insurance in this example because they would have more freedom and would have to follow Alabama laws, not California laws, even if the buyer is in California.

Just an FYI on why they can't sell across state lines right now.

 

[GasBandit]

Oh, and insurance companies shouldn't be for profit. It creates a conflict of loyalty for the company. The loyalty isn't to the customer, but to the share holders.

Without profit incentive, there's very little drive to expand or innovate. The much-maligned profit motive is what made our country the consumer's paradise that it is. The trick is, you have to get the profiteers to have no choice but to shave their own profits and/or find cost-saving methods. You do this through ensuring competition - that they have competitors also trying to give as-good-or-better service for incrementally lower prices. Sort of like how Cable companies enjoyed a monopoly until satellite TV came along, and now the two hold each other in check, keeping prices going down and service going up outside of a few notable exceptions.


After all, if your service costs 10% more than the other guy, and the consumer can't tell the difference between your product and his, they are going to go to him... unless you also trim your price.

 

[Charlie Don't Surf]

The problem with allowing insurance companies to sell across state lines is insurance regulation is controlled by state laws. In Alabama, for instance, the laws are fairly lenient. In California, they are more strict. Companies would move to Alabama to sell insurance in this example because they would have more freedom and would have to follow Alabama laws, not California laws, even if the buyer is in California.

Just an FYI on why they can't sell across state lines right now.

It'll be like when all the corporations skirt paying taxes by being in Delaware. And why Credit Card companies can get away with doing heinous shit because they're in South Dakota.

 

[Dave]

Right, which is why we need a FEDERAL set of insurance guidelines.

 

[Chibibar]

Oh, and insurance companies shouldn't be for profit. It creates a conflict of loyalty for the company. The loyalty isn't to the customer, but to the share holders.

I had a really bad cough that causing to barely breath (not sure what caused it) so I was checked in. A nurse took my temp, blood pressure, and give me some Oxygen (help with breathing). After like 2 hours, the nurse check up on me and I was release. I don't have the bill with me since it was like 4 years ago, but I remember paying (since I paid it) over 2000$

I was charge for oxygen, nurse seeing me, a person help escort me to the room (since I can barely walk myself), paid for some test done on me (no blood drawn, just check up) and FOUR DOCTORS under examination but I only met the nurse and never lost conciousness.

 

[Krisken]

Right, which is why we need a FEDERAL set of insurance guidelines.

We have that. That is what HIPAA legislation is. However, it creates a minimum requirement which is often expanded upon by each state.

 

[Dave]

Blue Cross Blue Shield is already not for profit. Trust me. I worked there for a LONG time.

---------- Post added at 03:23 PM ---------- Previous post was at 03:22 PM ----------

Right, which is why we need a FEDERAL set of insurance guidelines.

We have that. That is what HIPAA legislation is. However, it creates a minimum requirement which is often expanded upon by each state.[/QUOTE]

HIPAA is a failed bad idea that has NEVER been prosecuted. All HIPAA did was create the CCC (certificates of creditable coverage) which does work...and everything else that doesn't.

 

[GasBandit]

I also want to come back to the topic of medical savings accounts. A lot of people confuse having medical insurance with having "everything paid for so long as I keep paying my premiums." We need to get back to having people treat medical insurance like insurance. Thus, a policy with a very high deductible can be had for very inexpensive premiums that will keep you covered in case of catastrophic injury or illness, and you can pay for the little stuff out of medical savings plans. Since you are paying with YOUR MONEY the consumer gets a cold splash of reality back in the face and now starts shopping for medical providers that aren't still in the "gouge the insurance as much as possible" mode (many providers already give big discounts if you pay in cash instead of using your insurance).

For instance, recraft the laws in such a way that rather than providing insurance to you, your employer matches your contributions to your MSA, much like a 401k. To encourage this setup, make it tax deductible for both you and your employer, but the money follows YOU and is not tied to you keeping your job. That way when the kid gets the flu or you break your arm, you pay out of your MSA... but if you need expensive surgery or cancer treatment or some such, you still have your high-deductible insurance policy to cover the stuff that's tens to hundreds of thousands of dollars.

 

[Krisken]

Oh, and insurance companies shouldn't be for profit. It creates a conflict of loyalty for the company. The loyalty isn't to the customer, but to the share holders.

I had a really bad cough that causing to barely breath (not sure what caused it) so I was checked in. A nurse took my temp, blood pressure, and give me some Oxygen (help with breathing). After like 2 hours, the nurse check up on me and I was release. I don't have the bill with me since it was like 4 years ago, but I remember paying (since I paid it) over 2000$

I was charge for oxygen, nurse seeing me, a person help escort me to the room (since I can barely walk myself), paid for some test done on me (no blood drawn, just check up) and FOUR DOCTORS under examination but I only met the nurse and never lost conciousness.[/QUOTE]
That is a bit strange. I know that I would be coding that for Breathlessness (786.09), and probably Weakness (780.79), but it sounds like they didn't properly bundle the codes for the procedures.

 

[Chibibar]

Oh, and insurance companies shouldn't be for profit. It creates a conflict of loyalty for the company. The loyalty isn't to the customer, but to the share holders.

I had a really bad cough that causing to barely breath (not sure what caused it) so I was checked in. A nurse took my temp, blood pressure, and give me some Oxygen (help with breathing). After like 2 hours, the nurse check up on me and I was release. I don't have the bill with me since it was like 4 years ago, but I remember paying (since I paid it) over 2000$

I was charge for oxygen, nurse seeing me, a person help escort me to the room (since I can barely walk myself), paid for some test done on me (no blood drawn, just check up) and FOUR DOCTORS under examination but I only met the nurse and never lost conciousness.[/QUOTE]
That is a bit strange. I know that I would be coding that for Breathlessness (786.09), and probably Weakness (780.79), but it sounds like they didn't properly bundle the codes for the procedures.[/QUOTE]

yea well. Being a good boy, I paid my bills and be done with it. I was not happy about it.

that is my little bit of derail (sorry Dave!)

 

[Krisken]

Blue Cross Blue Shield is already not for profit. Trust me. I worked there for a LONG time.

---------- Post added at 03:23 PM ---------- Previous post was at 03:22 PM ----------

Right, which is why we need a FEDERAL set of insurance guidelines.

We have that. That is what HIPAA legislation is. However, it creates a minimum requirement which is often expanded upon by each state.

HIPAA is a failed bad idea that has NEVER been prosecuted. All HIPAA did was create the CCC (certificates of creditable coverage) which does work...and everything else that doesn't.[/QUOTE]
No, most Blue Cross/Blue Shield is non profit. About 30% has moved on to for profit since they were allowed to.

I disagree about the Health Information Portability and Accountability Act being a failed bad idea. There is a lot more in it than what you are stating. Privacy rules, Electronic healthcare transfer from paper, Coding standards (like dentists all use the same set of codes), etc. Without it our healthcare system would be worse than it already is.

But seriously, I didn't want to get into all that. I am happy watching you guys throw around stuff.

 

[Dave]

Krisken, I say that HIPAA is flawed because even though privacy is included, it has never been prosecuted! Never. Not once. People have been fired for violating HIPAA, but that's just through the company for which they worked. The electronic transfer from paper has a whole SLOUGH of things wrong with it and has unreasonable and impossible demands (I was part of the team who helped set some of this up when HIPAA first came into being) and the coding standards were already industry-wide with the ICD-9 & CPT coding systems. NOTHING HIPAA did except for the CCC portability has worked and costs the health care system billions.

 

[Chibibar]

Krisken: You seems to be knowledgable in this area. Maybe first we should break down what are required to make this thing to run. (needs and cost)

People
Want low insurance premium
low deductable
able to cover variety of medical procedures
coverage for existing issues

hospital
Getting paid (this is a touchy part - this mean do they have to treat non insurance?)
making a profit
admin overhead cost (paying the admin staff to run the place)
medical overhead cost (paying for the equipment)
medical staff overhead cost (paying the doctors)

Insurance company
Profit - high premium and low payout (insurance dream)
staff overhead cost
low payout

I think that is the rough rough version. I am probably missing a lot of legit and "illegal" stuff

 

[Krisken]

Krisken, I say that HIPAA is flawed because even though privacy is included, it has never been prosecuted! Never. Not once. People have been fired for violating HIPAA, but that's just through the company for which they worked. The electronic transfer from paper has a whole SLOUGH of things wrong with it and has unreasonable and impossible demands (I was part of the team who helped set some of this up when HIPAA first came into being) and the coding standards were already industry-wide with the ICD-9 & CPT coding systems. NOTHING HIPAA did except for the CCC portability has worked and costs the health care system billions.

Yeah, a lot has changed since 1996. Never mind disaster contingency plans, designated record sets, clear rules for individual rights and access to health information, and uses and disclosures for health information. You do realize that there are constantly changes to these things, right? Coding standards were observed... mostly. Hospital admission forms and data requirements were... mostly observed. That kind of thing right there is why it's important to require it.

Edit: Gah! I'm getting sucked in! I really would love to add more, but I have a Health Information floor plan and explanation due Saturday night and Healthcare Reimbursement assignments I have to get done. I'll try to give more input if I get some time.