Al Borealis, Universal Health Care Trap? |478|

Silence: Are you being serious? You expect me to devote my life to account for everything under the sun about this issue in this forum for the next weeks?

Tell you what, if you pay me 50 dollar per post (I think that's a fair price), I promise to spend on each one an hour of research and authoring follow ups with details, evidence, subtantiations, references, etc. I'll even proof-read my letters so that the grammar is correct with no typos. It will be a professional standard, honestly.

Otherwise, I think I have contributed sufficient arguments for anyone on the fence to explore further to find out for themselves. I'm not here to tell people what they should believe or what values they should have, neither am I paid by the industry like Eric with due incentive to fight for their cause (you say "expert", I say compromised).

So either pay me, or avoid resorting to bad faith statements like: "What then happens is what we're seeing here. Faced with having to support a position they've stated in absolute terms while being challenged by expertise, they typically try to push back (often from an emotional base) and ultimately exit the conversation.".

Certainly you cannot think people in here are suggestable fools falling for such a manipualtive & distortive conclusion?

I think this may just be another rub.



That's what I thought you'd say.

Lots of things look simple and easy from "the big picture view". As they say, the devil is in the details.

Even socialism looks great from the big picture. Every time it's played out in the real world, though, it's resulted in massive human tragedy.

Insurance companies are not rigged to keep you sick. Quite the opposite. We want you to be healthy so we don't have pay claims. So we can compete on premium cost against other companies that don't do as good a job as gatekeepers. We deny big Pharma all of the time. They have to prove to us that a drug works before we will cover. Ditto medical procedures. Your paranoid corporate conspiracy theory has no basis in reality. OTOH, your paranoia about government does have some basis in reality. So, I'm with Alex. Why on earth would you want to give the govt more info and more power?

Stick to what you know. I actually agree with your assessment of the covid situation and how the government/power seekers use perceived crises to expand their power.
That's the rub, isn't it? The intellectual rigor actually required to wrestle a complicated issue like healthcare to the ground is immense. Similar to many societal issues without obvious, consensus solutions. If they were easy, there would be easy and obvious solutions. But just because some are complex doesn't immediately mean there is an evil cabal behind the disfunction (e.g., "insurance vultures"). It gets quite tiring to watch this thought process.

So what happens in communities like this? Too many allow their predispositions to dominate their thinking. Instead of attempting to discuss and learn; they want to proselytize; they want to lecture. Maybe they've done a surface amount of research or perhaps they haven't researched at all. Doesn't matter: they present their positions as statements as opposed to questions or queries.

Sometimes, when we're lucky, there is someone in the community that actually IS an informed expert on a topic. (In this case its Eric.) What then happens is what we're seeing here. Faced with having to support a position they've stated in absolute terms while being challenged by expertise, they typically try to push back (often from an emotional base) and ultimately exit the conversation.

It serves them no good as they've failed to learn anything. Instead, if really interested, they could ask the person with expertise for more source data/evidence/reading and go through the rigor of actually educating themselves.

Certainly I'm no saint in this regard as I'm guilty of all this myself. The old saying about being unable to learn while your lips are moving seems to apply to fingers typing as well. ;)
 
Shane: My interpreation (opinion, not a fact) is that Affordable Care Act ("Obama Care") made the current system even shittier.

Although it did expand medicare to some poor people (an alibi to do implement the reforms) - not only did it throw the carcass to the insurance vultures to feast on, and you'll be hard pressed to loosen it from the grip of their claws, but it still didn't offer universal coverage - in other words you would had been better off with the original faulty system and think of another way to expand coverage (like public option - which the corporations hate because although they can stay in the game and loot it, the greedy bastards realize that the public option will be a powerful player pressing prices down, which will reduce their profit margins slightly - so they fight even that, not giving an inch, just to keep absolute control).

In my conversation with Robert Bonomo (called the Money Game) he explain how USA got that weird health system to begin with. He explains why its tied to jobs and why it was implemented in the first place. And all of it made kinda sense back in the day, when everyone was employed and the markeds were free and the living standard was booming. Whoever few wasnt covered, could get their due from charities, voluntaires, and other marginale options. Everyone also got the health care they were entitled to, to begin with.

But thats generations ago and what kinda worked then doesnt work anymore. You're not the same country anymore. And your system has been coopted by the globalist corporations, who are now coming for the rest of us. This is the selfish reason why we care about you and want you to stop it.

Yes sir, Obama Care absolutely made the current situation shittier and I am living with the effects of the "affordable steal from the public act" to this day. Furthermore, you are absolutely right, you would have been better off with the original faulty system! This was absolutely a numbers scam made to rape a great deal of American struggling to survive already. Any lickspittle fool, who is profiting as a member of these scams, can spew out a litany of so called "numbers and facts" regarding how this idiotic system was supposed to benefit us. The truth is that they might not be the blood sucking vampire at the top of the pyramid, but one of the countless mosquitos enjoying the voluptuous, all too many pints, pouring off of the asshole's gallivanting at the pinnacle.

The facts are quite simple: the fucking government told everybody millions were required to sign up for health insurance, and they could not afford to do so. Next, the fucking government penalized the hell out of struggling Americans for not doing so, then taxed this shit out of us. Don't let some asshole spin this truth. This is exactly what happened.
 
Silence: Are you being serious? You expect me to devote my life to account for everything under the sun about this issue in this forum for the next weeks?

Tell you what, if you pay me 50 dollar per post (I think that's a fair price), I promise to spend on each one an hour of research and authoring follow ups with details, evidence, subtantiations, references, etc. I'll even proof-read my letters so that the grammar is correct with no typos. It will be a professional standard, honestly.

Otherwise, I think I have contributed sufficient arguments for anyone on the fence to explore further to find out for themselves. I'm not here to tell people what they should believe or what values they should have, neither am I paid by the industry like Eric with due incentive to fight for their cause (you say "expert", I say compromised).

So either pay me, or avoid resorting to bad faith statements like: "What then happens is what we're seeing here. Faced with having to support a position they've stated in absolute terms while being challenged by expertise, they typically try to push back (often from an emotional base) and ultimately exit the conversation.".

Certainly you cannot think people in here are suggestable fools falling for such a manipualtive & distortive conclusion?

I

Brilliantly written and absolutely true!
 
Silence: Are you being serious? You expect me to devote my life to account for everything under the sun about this issue in this forum for the next weeks?

"Silence" is a well-known troll on the Skepitko Forum. He doesn't actually care. His only goal is to waste as much of your time as possible.

That's all he does.

Click here to be rid of him: http://www.skeptiko-forum.com/members/silence.3487/ignore
 
"Silence" is a well-known troll on the Skepitko Forum. He doesn't actually care. His only goal is to waste as much of your time as possible.

That's all he does.

Click here to be rid of him: http://www.skeptiko-forum.com/members/silence.3487/ignore

Charlie, my brother, I know that Silence is not golden, in this sense. However, we are brothers in a war of attrition. If we block or ignore the voice of the enemy, we only muzzle our own bite. Thanks for looking out, brother, but we need these jaded assholes to speak out. If you cannot hear the voice of the asshole, you only end up smelling the stench. We need to let these assholes speak out. I never block or ignore anybody.
 
Oh OK. This is where the $20K to have a baby came from; from a Canadian, of course.

To start with, it doesn't cost $20K for an uncomplicated labor and delivery in the US. It's going to be more in he range of $4.5K to $10K, despite a Canadian's assertion of what "Superstore" the comedy says (really? That the source of this "understanding"?).


What the person having the baby actually pays would range from $0 to $3,500, depending on their insurance plan. Insurance would cover the balance. That's just a fact that is easily verified. I happen to know for sure what it costs, but you can simply Google it and get some more or less accurate figures. For example; https://smartasset.com/financial-advisor/cost-of-having-a-baby

But hey, if you don't want insurance and you don't want to pay anything, you can have some midwife work for barter - maybe a basket of eggs from your chicken coup - and have the baby on your living room sofa. If that's how much you care about yourself, your baby or your loved one, go for it. OTOH, if you really care and you want all of the best in case something goes wrong, you pay for insurance that pays the hospital room with all of the machines and staff and the doctors that have the latest greatest tech and training to handle any emergency. Or if you can't pay for regular employer group insurance, you seek an ACA plan or apply for Medicaid. This is not rocket science.

Now, is it seriously being proposed that in Canada doctors and nurses receive $0 salary? Hospitals just magically appear full of equipment and cost $0? Facilities just maintain themselves via little elves the appear in the middle of the night to do the work with magic pixie dust?

Come on man. Of course the cost in Canada isn't $0. People paid for your brother in-law's care through taxes. The entire Canadian medical system is maintained through taxes - except all the people that bought private insurance (rhetorical question - why would they do that?!!!?).

In the US, some of the system is paid for by taxes and a lot is paid by private citizens and corporations. Instead of paying for it through taxes they pay for it through insurance companies and sometimes directly to the care providers.

It doesn't matter what system you're working in, private or socialized, a lot of relatively healthy people are paying in money they won't personally see a return on to care for a few very sick people. It's called a "risk pool". At least in private systems, you can pick and choose which mix of level of benefits you want at what price. In socialized, you have no choice. It's one size fits all.

Now, you might ask why the middle man of insurance would be desired in the US. Don't they make a profit? Wouldn't removing that profit be a savings to "the people"?

The short answer is "no" - but, since no one on this site, given the lack of knowledge and some of the anarchist/socialist leanings, is going to believe that or take it on faith because I said so, allow me to explain.

Before we address the cost impact of profit, let's look at overhead. Both the government and insurance companies have overhead. Some say the government does it cheaper. That is a fallacy. The often quoted Medicare overhead statistic is misleading. It is calculated on the the wrong variables. They use overhead divided by cost of services provided to arrive at a % overhead (aka admin cost) that is lower than private insurance. The problem is that that Medicare members cost 4 times what under 65 costs. So that calculation dilutes the % admin cost by a factor of four. The correct calculation is admin cost per member. On that appropriate metric, Medicare is no cheaper than private insurance and, in some instances, more expensive than private insurance. In fact, the federal govt (CMS) worked with private insurance to create Medicare Advantage plans. This is Medicare that is sold and managed by private insurance - about 35% (and growing) of Medicare is Medicare Advantage plans. The govt did that because they recognized they could not manage as well as private insurance (look it up if you don't believe me). Also, many CMS administration costs are hidden in other budgets. Those costs are not in the erroneous, albeit often cited, metric I mentioned.

Profits - insurance makes profits on volume. So low margins/high volume. If you removed profits, you would need a sharp pencil to find the savings in premiums - also, much private insurance is through not-for-profit companies, like some Blue Cross/Blue shield plans. Their premiums are no more affordable than the big for profits' offerings. But that's not all. The for profits are able to make profits because they compete in the market and people buy a well managed company's products on price and quality. Competition keeps price low as possible. Insurance must implement cost savings measures and the cost savings outweighs the profits. So save $10 and keep $1 as profit. The other $9 gets passed on to the consumer (you).

How do they save money? Regional based carefully tailored contracting with care providers. Fraud detection programs (there are $billions in fraud every year perpetrated by care providers). Dropping of contracts with providers that deliver poor care. Utilization management (e.g. pre-auth checks won't authorize medically unnecessary procedures, drugs and technologies), care management programs that ensure that the chronically ill are maintaining treatment and not decompensating (e.g. one on one calls to members/patients and connecting with care providers to alert them to gaps in medically approved protocols - all through data analytics). Also, performance based contracting with care providers. There's much more. That's just a few examples to illustrate. Again. Medicare/CMS/Federal govt found it could not do these things well.

No one ever talks about any of this. They just want to gripe about their low grade poor reality non-correlations.
thx for this info. looked at yr link:
https://smartasset.com/financial-advisor/cost-of-having-a-baby

kinda cuts both ways :) looks like it can cost $20K... and if you run into complications a lot more. I'm not sure I can wrap my head around people going broke because they want to have a baby.

I believe socialism is fundamentally evil and soul-crushing... so I'm just trying to balance that with the other evil soul-crushing forces in our culture :)
 
You don't have to opt for the socialist version (NHS). you can go for the centrist or right wing version. Point is they are all Univversal Health cares. Its not more "socialist" to have that, than to have a universal fire department. Also, these are not theoretical ideas or experiments, they've been around in the world fora century now. There's no surprises, we know how it works.

And yes, in the pandemic the entire society is being transformed, including the health care system - and so far not to the better. But that transformation occurs in all sectors of society no matter how we finance health.

You will have the same hospitals and doctors and nurses with UHC, there wont come marching in an army of soviet or nazi docs. Only difference is hospitals will no longer focus on profit but on treatment, and doctors will no longer focus on bureauchratic work, but on their job. But the pandemic may take over their focus in all systems, no matter how it is financed.

Sweden has same system as us and did not go for lockdown. They went for herd immunity - under a socialist government. We went for lockdown under a conservative government. Result in Sweden: More deaths but no industry killed. In norway: Less deaths, yet some industry killed (but no folks going bankrupt because everyone got their salary subsidized by government who also subsided industries so as to avoid whats going on in USA)
thx. I get yr point... I'm starting to think UHC maybe the lesser of two evils. I'm for it as long as rich people can bypass the system and do what they want.
 
thx for this info. looked at yr link:
https://smartasset.com/financial-advisor/cost-of-having-a-baby

kinda cuts both ways :) looks like it can cost $20K... and if you run into complications a lot more. I'm not sure I can wrap my head around people going broke because they want to have a baby.

I believe socialism is fundamentally evil and soul-crushing... so I'm just trying to balance that with the other evil soul-crushing forces in our culture :)


Alex, why are repeating that canard?

No one is going broke to have a baby because there is no one who should be without insurance. If you have insurance you are not paying $10K, or $20K or more if something goes wrong.

Once again - Medicaid is free for the poor an has no co-pays or deductibles. So poor people can have a baby for free, 100% free. The ACA/Obamacare is for people above the poverty line as defined by the 50 states. It has a sliding scale subsidy for premium based on income. There is up to 100% subsidy. The least rich benefit plan ("Bronze") would result in a max out of pocket of $3,500. Even if something goes wrong and the the cost is $100K, the mom would only owe, max $3,500; less if she has one of the more robust plans (silver, gold, platinum). The there is employer based insurance. The benefit level are varied. My plan has a $3,500 annual out of pocket max. When I worked elsewhere in the private sector, it $1,500. When I worked for Uncle Sam, I think it was a mere $750.

How many people are walking around with $2,000 cell phones and paying an extra $250 a month for entertainment an other services on it that then complain they can't afford a couple thousand out of pocket to have a baby? Or a couple hundred a month for their portion of a subsidized ACA policy?

It's on you to support the wild ass assertion that people are going broke to have a baby.

Is there someone somewhere claiming they went broke? Probably. Anecdotes can prove anything. Is it a real trend? Absolutely not.

And once again I'm going to state that hospitals are expensive. That is because of all of the top notch leading edge special technology in every room. Doctors are expensive because of their training and knowledge. Ditto nurses. If you want to be a lucite that doesn't believe any of that makes a difference in outcomes, then have a midwife deliver the baby in your living room. That's how they did it for much of human history. Deaths of mom and baby in delivery were very common.

Also, what hospitals bill is not what they get paid. They can bill $20K all day long, but they only get paid $10K because the contracted amount.

AB has no clue what labor and delivery cost in his country. He appears ignorant enough to think that it costs $0 - like I said, it's magical thinking. Pixies and sorcery make hospitals and technology and staff jus appear. Yeah, right.
 
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Eric, Silence,

I'd you to look at this website which lists all the fines imposed on Big Pharma. Doesn't that list make you think?

https://projects.propublica.org/graphics/bigpharma

David
David,
I don't understand your point.

Is it that pharmaceuticals are bad? Fine, Don't take them.

Most people are not absolutist purists; i.e don't agree with the idea that if an industry or a person has done anything wrong, then delete them because they are 100% evil.

Your approach is kind of like the defund the police movement. A bad cop here or there means all police are bad and should be deleted.

I know of many industry sectors that have incurred class action law suits. Let's get rid of them all! No more automobiles! No more electricity (power companies have been successfully sued after all)! No more restaurants!

Do you know how many doctors get sued? Medical errors and malpractice kill 330K Americans every year. No more doctors! Hey that solves the whole issue. People that can't afford healthcare are actually better off because they avoid evil doctors! They should be thanking the evil 1% who get all healthcare.

I know....let's have the government take over...because evil CORPORATIONS! but wait! Government officials get accused of corruption and malfeasance and are sometimes convicted. This is the same government that some people here think blew up buildings and killed Americans on 9-11. How can we let them be in charge of our healthcare. Ahhhhhhh....head exploding. The world is too big confusing and sinister! There must be some kind of way out of here! I'd love to change the world but I don't know what to do! Ahhhhhhhhhh!

Most people - sane people - weigh the good, the benefits, against the bad. Most people recognize that most pharmaceutical are incredibly beneficial.

The list of lawsuits in your link represents a minuscule proportion of the business. Perspective is important.
 
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David,
I don't understand your point.

Is it that pharmaceuticals are bad? Fine, Don't take them.

Most people are not absolutist purists; i.e don't agree with the idea that if an industry or a person has done anything wrong, then delete them because they are 100% evil.

Your approach is kind of like the defund the police movement. A bad cop here or there means all police are bad an should be deleted.

I know of many industry sectors that have incurred law suits. Let's get rid of them all. No more automobiles! No more electricity (power companies have been successfully sued after all)! No more restaurants!

Do you know how many doctors get sued? Medical errors kill 330K Americans every year. No more doctors! Hey that solves the whole issue. People that can't afford healthcare are better off because they avoid evil doctors!

Most people weigh the good, the benefits, against the bad.

The list of lawsuits in your link represents a minuscule proportion of the business. Perspective is important.
My point is that it is obvious that they did some pretty bad stuff to be fined on that scale - you don't need to pick through the details.

David
 
My point is that it is obvious that they did some pretty bad stuff to be fined on that scale - you don't need to pick through the details.

David
don't let all the 0s convince you.

I'm used to seeing lots of 0s and I don't think those fines are very much. Also, those judgments usually get lowered on appeal. There are always ShaneThe Stinkers on juries who want to stick it to big corporations and they level crazy judgments that don't stand legal scrutiny and are reduced.

And you know who always want to use drugs for unproven off-label uses? Doctors. The previous insurance company I worked got sued because we wouldn't approve an expensive relatively new drug, off-label, for treating pancreatic cancer. The doctors and families initiated the suit. My team the research. The drug extended life by three months, though it was small sample size and the results were impacted by that. At any rate, all of the parents died as expected. The pharmaceutical company did not promote the drug for pancreatic cancer.

Medicine is as much art as it is science in many cases. When I look at your list of lawsuits, I see some that were reasonable efforts to provide helpful medication. I guess you think Big Legal is a virtuous bunch that would never start lawsuits just to make money. Where did that image of the ambulance chaser ever come from? Hmmmmmmmm.

Sorry to be a smart ass, but I just couldn't resist. I know you are one of those that think statins are dangerous and don't help; which is against the real evidence. We recommend and pay for their use where medically required. I suspect you and Alex both think that many other drugs are in the same class; useless at best, potentially dangerous, expensive, etc. I think that is not generally true. Any drug can be abused. Any drug can result in a bad reaction. Good health practices are always better than medical/pharma intervention, but people don't practice good health and, even those few that do, get sick and, mostly, benefit from medical/pharma intervention. That includes statins and their proven efficacy on average. You don't make policy for everyone based on anecdotes and outliers.
 
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My point is that it is obvious that they did some pretty bad stuff to be fined on that scale - you don't need to pick through the details.

David
Can you find an industry, ANY industry, that hasn't been fined? Do you have evidence to show big pharma is disproportionately guilty of fines? I'm with Eric: What's your point?
 
Can you find an industry, ANY industry, that hasn't been fined? Do you have evidence to show big pharma is disproportionately guilty of fines? I'm with Eric: What's your point?
I guess I'm probably a troll too now that you and I have agreed more than once and are bucking the paranoid, uninformed mono-voice here.

Oh no...that's right, I'm a 1%er and a paid shill for BIG CORPORATIONS!

Such a catch 22 - if you work in the field and therefore know something about it, you're a mole a troll and paid shill. If you're just some hack doing "internet research" you're the real deal revealing real truth; even though you get material details wrong. But who cares? It's all about the big picture!
That, right there, is how conspiracy theories begin and thrive. Know nothings convincing other know nothings that those who know are lying. Sheesh. Ignorance is knowledge!
 
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paid shill for BIG CORPORATIONS!
Then there's this from the site David provided that could influence what SmartAsset presents as "data":

How we do it
Our free tools, calculators and advice are objective and based on data. We use patent-pending Automated Financial Modeling (AFM) technology to help people make confident decisions that impact their finances and financial goals, such as saving for a home or retirement. In some cases, companies compensate us with a referral fee if a user clicks on or is approved for a financial product through our site. This compensation does not influence our recommendations or advice. We maintain editorial integrity when evaluating products and clearly label any partner and sponsored or advertising content.

https://smartasset.com/about

There are conflicts of interest in any/every commercial venture or transaction. Pharma's not immune anymore than any free market enterprise. Let's also not forget that conflicts of interest are often a much bigger problem in government controlled activities. There's no panacea. I think this applies to any system of healthcare.

My pushback was just against this notion that big pharma is "evil". Big pharma, and the U.S. healthcare system at large, may be flawed but there's a reason why so many come here to get important medical work done.
 
Silence is not an Enemy. He is a troll
He does not actually care about persuading you. His only goal is to irritate you and waste your time.

Legitimate disagreements with an opponent and Trolling are two very different things.

You may be right. I represented what I think about the idiotic healthcare system here pretty thoroughly, and it is based on negative experiences in real life. A couple of idiots might talk about how they are "experts" in the field because they are profiting off of other people's misfortune, but I know what the hell is really going on. I guess there will be trolls under a bridge wherever one travels.

In other good news, watching the UFC, brother! Yeah, it is only the prelims from last Saturday, BUT I LOVE THAT STUFF! I remember, you are a Jujitsu guy, right? Masterful art! I love Jujitsu!
 
Alex, why are repeating that canard?

No one is going broke to have a baby because there is no one who should be without insurance. If you have insurance you are not paying $10K, or $20K or more if something goes wrong.

Once again - Medicaid is free for the poor an has no co-pays or deductibles. So poor people can have a baby for free, 100% free. The ACA/Obamacare is for people above the poverty line as defined by the 50 states. It has a sliding scale subsidy for premium based on income. There is up to 100% subsidy. The least rich benefit plan ("Bronze") would result in a max out of pocket of $3,500. Even if something goes wrong and the the cost is $100K, the mom would only owe, max $3,500; less if she has one of the more robust plans (silver, gold, platinum). The there is employer based insurance. The benefit level are varied. My plan has a $3,500 annual out of pocket max. When I worked elsewhere in the private sector, it $1,500. When I worked for Uncle Sam, I think it was a mere $750.

How many people are walking around with $2,000 cell phones and paying an extra $250 a month for entertainment an other services on it that then complain they can't afford a couple thousand out of pocket to have a baby? Or a couple hundred a month for their portion of a subsidized ACA policy?

It's on you to support the wild ass assertion that people are going broke to have a baby.

Is there someone somewhere claiming they went broke? Probably. Anecdotes can prove anything. Is it a real trend? Absolutely not.

And once again I'm going to state that hospitals are expensive. That is because of all of the top notch leading edge special technology in every room. Doctors are expensive because of their training and knowledge. Ditto nurses. If you want to be a lucite that doesn't believe any of that makes a difference in outcomes, then have a midwife deliver the baby in your living room. That's how they did it for much of human history. Deaths of mom and baby in delivery were very common.

Also, what hospitals bill is not what they get paid. They can bill $20K all day long, but they only get paid $10K because the contracted amount.

AB has no clue what labor and delivery cost in his country. He appears ignorant enough to think that it costs $0 - like I said, it's magical thinking. Pixies and sorcery make hospitals and technology and staff jus appear. Yeah, right.

You are too jaded to understand that people are going broke everyday due to ridiculous hospital bills. Also, many people are living without healthcare simply because it is unaffordable for them. Of course, in blind faith for the profession that is filling your pocket, you might say something moronic like "you paid for your $2,000 cell phone instead of funding the thieves that pay my salary, so that is on you!"

Of course, you would have to be absolutely honest with yourself to say that, but I don't think that is going to happen. Furthermore, do you realize how many people do not pay for a fucking $2,000 cell phone and still can't afford health insurance? You are incapable of seeing that you are working for a den of thieves because you are being paid by a den of thieves.
 
I remember, you are a Jujitsu guy, right? Masterful art! I love Jujitsu!

Thank you. Yes, I was a professional MMA Fighter back in the late 90's, and have taught Brazilian Jiu-Jitsu for three decades.

I also helped develop the professional fighter licensing scheme used by the Texas Dept. of Licensing and Regulation Combative Sports Division...

https://www.tdlr.texas.gov/sports/sports.htm

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