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Old 06-13-2013, 08:16 AM   #1
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Obamacare to cause rate of insured to drop

I was reading the latest article on crazy Obamacare:
http://finance.yahoo.com/news/obamac...3BtaA--;_ylv=3

Basic silver plan:
"$2,000 deductibles, $45 primary care visit co-pays, and $250 emergency room tabs."
"$321 average monthly premium"
"You must have some form of coverage next year, or you will face annual penalties of $95 or 1% of family income"

This got me thinking about all I learned about insurance pricing when I used to work in the insurance world. If a customer knows they can get insurance at any time regardless of medical history, what will be the hazard that the customer will eat the cost of the penalty and get insurance only when they need it (selection bias)?

Paying cash, you can get a regular primary care visit for a 1-2 hundred dollars, which is less than the co-pay+monthly premium of this basic plan.

One year base cost for $50,000 income household:
With this policy: 321*12= $3,852
Without this policy = 50,000*.01 = $500

Once you factor in deductible and co-pays, you need to have a large amount of medical bills in a year before having insurance is cheaper than not having insurance. Since you can simply buy insurance AFTER you find out you have an expensive medical issue like cancer, pregnant, or car accident, why buy insurance? The number of insured will drop.

Since the much higher costs are causing a lot of employers to drop insurance and send employees to the government market, the number of insured wil drop.

The entire basic idea of insurance is risk pooling. If the pool of insured shrinks, there are less people to share the risk and the price goes up. If those remaining in the pool are riskier people, the cost of sharing that risk goes up.

I think the end result will be doctors and patients, who are both fed up with dealing with insurance companies and the government, will start to go towards a cash only system. I personally know people that have found that offering cash up front to a doctor/dentist radically lowers the cost of what they need done.
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Old 06-13-2013, 09:01 AM   #2
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Originally Posted by benjamen View Post:
...
I think the end result will be doctors and patients, who are both fed up with dealing with insurance companies and the government, will start to go towards a cash only system. ...


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Old 06-13-2013, 09:07 AM   #3
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So far I have only seen very, very fuzzy math and a few poorly constructed arguments for Obamacare. How about a real world example?

Ancona calls Blue Cross of Florida to get quotes for his "group" of employees, 38 in total.

Ancona is told that there is a plan that is "affordable" and it is currently offered to employers with ten or more participants.

"Good" says Ancona, "How much is it"?

The plan has a 2,500 dollar deductible, primary care co-pay of $40.00, prescription costs of $15.00 co-pay for generic and $50.00 co-pay for name-brand and 100% patient pay for a huge list of "specialty drugs" [which by the way includes two of the medicines Mrs. Ancona takes regularly]

They went on to tell me that the direct cost for each policy would be $8,400 per year for non-tobacco users and $11,220.00 per year for smokers.

Folks, this is the group rates, not the individual rate. The rate paid by a regular schmoe before any subsidies or government help for a non-smoker is $14,900 dollars. That is before the two and a half thousand dollar deductible and any co-pays.

Obamacare is going to do to the economy what a nuclear war would do. All other commerce is going to implode and burn. Those who do not buy insurance will have a fine taken from their tax refund, meaning even less cash to spend on flat screen TV sets and X-boxes. This is not good for anyone but the big six insurance companies. The rest of the economy is going to crash and burn. In addition, the only people that will benefit will be the poor that are already eligible for free health care and low income people who will receive massive subsidies. People like myself and Mrs. Ancona will be fucked.

I have yet to see anyone in any media discuss the impact of diverting such an enormous percentage of after tax income from consumption of consumer goods to payment of insurance premiums. How can this possibly benefit anyone???
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Old 06-13-2013, 09:13 AM   #4
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Personally, I've never had insurance and needed it at the same time. Every time I've needed care, it's been out of pocket (I guess that's true either way, but here I mean directly).

I plan to do just as you suggest above, myself. I can add a data point as well - yes, a couple of times I've just offered cash, a medical outfit will reduce the price.

Sometimes I've had to play hardball. Emergency rooms, particularly in Carrillion hospitals really get into "cramming.
Once my wife was taken to one as a result of a car accident. Bruised shoulder was the total harm to her. She was there about 15 min while I dealt with the cops etc, then I got there, and her total stay was about 45 min - no one even came into the room she was in for the 30 min of that I was there. Yet we got bills from the hospital, about 7 doctors, several specialists, and for 10 times the number of X rays she said she got. Good thing there was another witness with me...yes, we offered to take them to court over it - and they folded and then just charged for the one doc and one X ray.

Another, much longer story (too much to type right now) concerned my getting pretty seriously hurt - gun bolt blew through my jaw, shattering it and all my teeth on that side. Since I was dressed as a bum (weekend, and I'm not a clothes horse anyway), they assumed I could not pay, and put me on the "just let them die" ward. For 10 hours they tried to get me to answer questions (hard to talk with only half a face, FWIW) about all this, till a couple employees showed up. I got no treatment at all till then - they pointed out I could buy the wing of the hospital with the content of my wallet, and that they should get moving - 10 hours is far too long to wait, and I still have issues from the nerves that control that side of my face never reconnecting, as they would have if I'd been treated on time.

Well, they treated me after my guys went after them. I get out of surgery, they take me back to the same wing, which is full of very stoned nurses, and screaming other patients (I wasn't in any serious pain - no nerves that still worked). I couldn't sleep due to the others screaming, so one of my guys (a doper) went out on the floor, figured out who the drug dealer was (the only sober nurse) and bought pain meds with my money to give --->the other patients<--- so I could sleep. As luck would have it, he had a cel phone in his shirt pocket that was recording video of all this.
I negotiated with them over the costs. I got the nurse/chair warmer person to admit that insurance only paid about 30% of such a bill. But then I brought up the video...and showed it to them, and gave them my lawyer's business card.

Well then. I wound up paying only for the actual surgeon and gas passer - who did good honest work, just late (my jaw is now titanium, and it works fine). I could have sued them into a hole in the ground, but that's not my style; maybe I should have...this is years later and recovery isn't full due to that lag in treatment - all over money, or more accurately, their concern about my ability to pay.

I pretty much never get sick - the intervals between visits to that system is averaging in the years - I do get myself hurt (trauma once in awhile). Insurance is an incredibly bad deal for me. I plan to do just as you suggest - not get it, pay a minimal fine (or was that tax, the supremes used one for part of the case, and the other for another part - obviously that decision should not stand), and simply pay if I need service (or get insurance then as you suggest). Screw this rippoff law written by guess who? Insurance co lobbyists. Even Feinstein (may she have an incurable painful condition in a Carrillion hospital - for at least a few years, then die in pain) said "pass this to find out what's in it".

Note, not all docs will give you a break for cash. Some do, some don't.

We are lucky here in that there is one who will work for barter. Well, she needs computer upgrades to meet the new requirements, and I'm a computer guy - the deal is, I get treated for life, she gets a working set of systems.

Sadly, that won't count as insurance under the new law....assholes. (pardon my french this is a hot button issue with me, as I've been so mistreated over a lifetime).

The way this slipped in - having insurance is equated with access to med care. To some extent, that's true in our for-profit system, as I found out when I couldn't talk to tell them I had the money. But in general - no, it has nothing whatever to do with it, the insurance doesn't pay the full bill anyway, and they really rip off cash customers to make up their "entitlement" to a ton of money in a secure job where they don't work too hard, with great security.

Perhaps I'd feel better about it had any of the 4-5 people I've known over the years who were getting training to be nurses etc had mentioned their motivation was to heal. Not one - they all mentioned the pay and job security though.

I have met good doctors - and in general, I met them in the "free" clinics setting. Those are the ones who actually care, and they donate their time and the free drug samples they get from big pharma to actually heal people.

The system is sicker than I have ever been.
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Old 06-13-2013, 10:01 AM   #5
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I get the benefit of the National Health Service on demand ..........

And I make fookin sure I never have a need for it or, any of their big pharma products

National illness management service using the most expensive solution that has been approved, would seem a more appropriate description.

There are so many ways to deal with mal and they all ultimately require YOU to fix yourself, including the gov 'cures'

My son has had some pretty harsh injuries at different times, including spinal hyper extention , ruptured spleen and broken back ( cant feel my feet kind of broken !) and while he has done time in various hospitals, ultimately none of em actually did anything, apart from diagnose and monitor ............... the nurses love him though cos he is a minor celeb freestyle MX rider (-;

The power of mind to fix yourself is far greater than most realise.

Having said that, if I am in a bad accident and get some reconstruction from the NHS, I will be grateful. Well I have paid enough for it over the years and had little in return.
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Old 06-13-2013, 10:22 AM   #6
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Originally Posted by benjamen View Post:
I was reading the latest article on crazy Obamacare:
http://finance.yahoo.com/news/obamac...3BtaA--;_ylv=3

Basic silver plan:
"$2,000 deductibles, $45 primary care visit co-pays, and $250 emergency room tabs."
"$321 average monthly premium"
"You must have some form of coverage next year, or you will face annual penalties of $95 or 1% of family income"

This got me thinking about all I learned about insurance pricing when I used to work in the insurance world. If a customer knows they can get insurance at any time regardless of medical history, what will be the hazard that the customer will eat the cost of the penalty and get insurance only when they need it (selection bias)?

Paying cash, you can get a regular primary care visit for a 1-2 hundred dollars, which is less than the co-pay+monthly premium of this basic plan.

One year base cost for $50,000 income household:
With this policy: 321*12= $3,852
Without this policy = 50,000*.01 = $500

Once you factor in deductible and co-pays, you need to have a large amount of medical bills in a year before having insurance is cheaper than not having insurance. Since you can simply buy insurance AFTER you find out you have an expensive medical issue like cancer, pregnant, or car accident, why buy insurance? The number of insured will drop.

Since the much higher costs are causing a lot of employers to drop insurance and send employees to the government market, the number of insured wil drop.

The entire basic idea of insurance is risk pooling. If the pool of insured shrinks, there are less people to share the risk and the price goes up. If those remaining in the pool are riskier people, the cost of sharing that risk goes up.

I think the end result will be doctors and patients, who are both fed up with dealing with insurance companies and the government, will start to go towards a cash only system. I personally know people that have found that offering cash up front to a doctor/dentist radically lowers the cost of what they need done.
my personal doctor, with whom I am actually having a physical today, takes silver or chickens for his services (I kid you not.) Every other doctor in his clinic (Shepard Clinic, Burnet Texas) has quit as they took early retirement since it took several years to get their money from the government and they said it just wasn't worth it anymore.
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Old 06-13-2013, 10:31 AM   #7
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Originally Posted by rblong2us View Post:
I get the benefit of the National Health Service on demand ..........

And I make fookin sure I never have a need for it or, any of their big pharma products

National illness management service using the most expensive solution that has been approved, would seem a more appropriate description.

There are so many ways to deal with mal and they all ultimately require YOU to fix yourself, including the gov 'cures'

My son has had some pretty harsh injuries at different times, including spinal hyper extention , ruptured spleen and broken back ( cant feel my feet kind of broken !) and while he has done time in various hospitals, ultimately none of em actually did anything, apart from diagnose and monitor ............... the nurses love him though cos he is a minor celeb freestyle MX rider (-;

The power of mind to fix yourself is far greater than most realise.

Having said that, if I am in a bad accident and get some reconstruction from the NHS, I will be grateful. Well I have paid enough for it over the years and had little in return.
ten years ago I had a sub-arachinoid aneurysm burst which required brain surgery. I was in a coma for a month, and three months to learn to walk and talk again. (and gain some weight, I went from 165 to 100 pounds). So in that regard I'm kinda glad there are doctors. The sticky wicket is that although I have a familial history of anuerysms, it is a side affect of taking Lipitor 40 for high cholesterol. (which the practicing doctors had put me on at the time). After some further investigation, I discovered that Lecithin is clinically proven to lower your cholesterol 100 points in one week, and you can buy it at Walgreens for 8.00 for 100. So go figure. Now I pretty much avoid doctors. I have to have a physical today for work; every year my "new" doctor tells me he thinks I'm just fine. Last year he told me the only reason I had a pot belly was I was too damn lazy to exercise, so I did something about that. He also told me that he thinks statin drugs kill people and he would never prescribe them.


edited to add; I think Big Pharma makes up the cholesterol numbers anyway.

edited again to add: he thinks I'm just fine.

Last edited by Jay; 06-13-2013 at 03:23 PM.
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Old 07-17-2013, 10:46 AM   #8
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When government gets into healthcare:
http://thenewamerican.com/usnews/hea...odes-that-kill

Good article on the insane system of medical codes and blatantly ignoring new advances in medicine.
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Old 07-17-2013, 06:47 PM   #9
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heres a doomer article if there ever was one...:

snip:
Sunstein is also in favor of various eugenics policies through such unspeakable policies as embracing, as policy, post-birth “abortions” (i.e. murder) of “defective” children up to the age of three.

Even the Nazi’s were not as inhumane as Sunstein. The Nazis were publicly forthcoming for their perceived need to ration healthcare when it came to what they called “useless mouths.” Kissinger used the term “useless eaters” to describe those that should be done away with under this draconian form of Fabian Socialism. Under Hitler, 300,000 people were exterminated in German hospitals through lethal injection. Under Obama’s plan, this number will seem miniscule by comparison.

http://thecommonsenseshow.com/2013/0...in-us-history/
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Old 07-18-2013, 04:08 AM   #10
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A must-read for everyone about how health care got to where it is today:

http://mises.org/daily/4276
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Old 11-01-2013, 08:03 AM   #11
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The numbers for how many people that are actually signing up for Obamacare are finally starting to come out.

http://news.yahoo.com/day-1-of-obama...233817649.html

Number of people signed up for Obamacare on day 1: 6
Number of people signed up for Obamacare on day 2: 248

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Old 11-01-2013, 08:18 AM   #12
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Originally Posted by benjamen View Post:
...
Number of people signed up for Obamacare on day 1: 6
Number of people signed up for Obamacare on day 2: 248
...
What an amazing coincidence. SNL did a skit recently where they opened with someone apologizing for the Obamacare website. One of the jokes in the skit was that the website was only designed to handle 6 users at a time:

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Old 11-01-2013, 08:21 AM   #13
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Benjamen,
This law is having precisely the intended effect. As it turns out, the only people signing up for this abomination are getting in to medicare. Just as was planned. They have no intention of pricing this to help anyone, they have set the system up to fail, and it will fail, massively.

It is about control for the administration, and the ability to decide who gets care and who does not. Imagine if you will the presidential elections two or three administrations from now. These people are the ones responsible for deciding whether or not you get that cancer treatment, or that hip replacement. Suppose they find out you are voting for the "wrong party". Suppose also that someone makes a phone call and directs some low level punch-card employee to put an "X" in the DENY box instead of the APPROVED box. This is what it's all about folks, power and control. Now, they can control whether you live or die, because your records are all ONLINE and "they" can look at them any time they choose to, and from there, determine where your weaknesses or soft spots are.

How many people are going to choose to roll the dice with cancer over their political convictions? This system has way, way too many weaknesses to suit anyone with more than an IQ of 75.

There are some evil bastards out there who have lofty political aspirations and would not hesitate for one minute to pull some sideways bullshit to gather votes, even if it meant screwing with someones health.
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Old 11-01-2013, 08:48 AM   #14
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In addition to the above commentary, it should be noted that they need four healthy people to sign up for each medicare recipient if the system is going to self-fund. I predict that it never happens.
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Old 11-01-2013, 09:13 AM   #15
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Originally Posted by ancona View Post:
Benjamen,
This law is having precisely the intended effect. As it turns out, the only people signing up for this abomination are getting in to medicare. Just as was planned. They have no intention of pricing this to help anyone, they have set the system up to fail, and it will fail, massively.

It is about control for the administration, and the ability to decide who gets care and who does not.

There are some evil bastards out there who have lofty political aspirations and would not hesitate for one minute to pull some sideways bullshit to gather votes, even if it meant screwing with someones health.
I wish I could argue with this, or even come up with a smart ass response. But sadly I think you are right.
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Old 11-01-2013, 12:43 PM   #16
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Originally Posted by ancona View Post:
In addition to the above commentary, it should be noted that they need four healthy people to sign up for each medicare recipient if the system is going to self-fund. I predict that it never happens.
The other elephant in the room is that many doctors are not going to take "Obamacare" insurance patients. I know of some already who said they won't take them. So you buy the insurance, but you can't get in to see a doctor. So then you go to the emergency room and stand in line? How is this supposed to work in real life?
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Old 11-01-2013, 02:36 PM   #17
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I already use concierge medicine because the cost is so much more palatable.
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Old 11-04-2013, 12:00 PM   #18
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Even after subsidies, the average cost of health insurance will go up by 41%.

http://www.forbes.com/sites/theapoth...rtner=yahootix

I am sorry if you wanted a top doctor:
"Importantly, post-Obamacare exchange plans will typically have narrow networks of physicians and hospitals, especially excluding those tied to prestigious medical schools."

I am sorry if you are young:
"...a key feature of Obamacare, insurers are only allowed to charge their oldest customers three times the amount they charge their youngest customers. Because 64-year-olds consume on average six times as much health care as 19-year-olds, this rule has the effect of driving up the cost of insurance for young people."

I am sorry if you are male:
"Men will face steeper increases than women in most states, because women consume more health care than men do, and Obamacare forbids insurers to charge different prices on the basis of gender."
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Old 11-04-2013, 02:29 PM   #19
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Originally Posted by Aubuy View Post:
The other elephant in the room is that many doctors are not going to take "Obamacare" insurance patients. I know of some already who said they won't take them. So you buy the insurance, but you can't get in to see a doctor. So then you go to the emergency room and stand in line? How is this supposed to work in real life?
Aubuy, this is NOT an argument against what you said. Here is a comment from Kunstlers Monday screed:

Well Jim, your thoughts are not my thoughts this morning..I was thinking proctologist…Anyhow, I believe the “badguys” are the paper pushers here, not the Dr’s..Ever see a building in NYC with a big,illuminated umbrella on it? Bet not to many Doc’s have an office like that. I’m a dentist south of you, you know me outside of Annapolis…I agree that costs are out of control, but we the Dr’s are not driving the model..we are at the mercy of the system,not running it..also, all this talk about 44% of New York Dr’s posturing to “not participate” in Obamacare is just that,posturing.It is a consumer driven model here in the USof A, and just where will those Dr’s patients come from? I say ‘bullshit” to them…or they will starve..Wall Street drives it all,and our ball less politicians fall in line also..nothing has been done to fix any of it..The chosen one has “enabled it more”..Wonder what the money to the Muslim Brotherhood would have done to drive done healtcare costs and save a few innocents from breast cancer…?

http://kunstler.com/clusterfuck-nati...tape-politics/
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Old 11-04-2013, 04:01 PM   #20
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When this monstrosity collapses, and I am certain it will, the middle class will be raped to pay for it. The government is not finished strip mining our wallets, of that I am sure.

This will all be blamed on Republicans and most of all, Bush and his policies.
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