Why is it bad to be sick? Is it a tough theoretical question?
How does being chronically ill affect your family? Your quality of life? Your job?
How does being sick affect your finances?
Are these difficult questions?
Are you taking medications? It seems it is becoming a norm to take medications after a certain age.
Why? Why is that a rule rather than an exception?
Why are we becoming a society of sick people? Why are we getting used to the fact that a half of our population is sick?!
WHAT IS WRONG WITH US?
WHAT IS WRONG WITH OUR “HEALTH CARE”
Some more “questions” to my fellow Americans: would you prefer to stay healthy or to be sick?
Fat or trim
To go fishing or to go to the doctor
To pay the doctor or to go on vacation
Socialized Government care
Would you prefer:
To be insured by the private firefighter company or to have “Government firefighters” that you know will be there if your house catches fire.
Do you want USPS service to mail your letter or do you want private companies like UPS only?
Do you want a “social” government army or a Blackwater type army?
Do you need to be an economist or a politician to understand the benefits of basic health care for ALL?
Health care issues in our country are long-term problems and require long term solutions.
It starts with going back to basics.
Time Magazine June 29 2009
No. 1 killer of Americans (as it has been for all but a few years since 1900), our collective waistline continues to bulge, diabetes rates march ever higher, and after steadily declining in recent decades, the smoking rate among high schoolers is leveling off. The U.S. boasts the best cutting-edge medicine in the world, yet 75% of our health-care costs are attributable to chronic, preventable diseases. In all, about 40% of premature deaths in the U.S. are caused by lifestyle choices — smoking, poor eating and inactivity
Did you notice” the best cutting-edge medicine in the world”-not the best healthcare system in the world. Do you understand the difference?
Your car: Do you change the oil regularly or do you wait until you need to replace the engine?
Do you check the brakes from time to time or do you replace the whole mechanism after it falls apart?
In short, do you prefer to do preventative maintenance for your car?
If yes – why?
Is that because you may get killed on the road or you know that you will need to spend money on a new car if you don’t take care of it?
However you treat your car, do you treat your body the same way?
If you do not do preventative care of your body – why?
Is it because it is cheaper to replace parts of your body than parts of your car?
Or is it easier to get a new body than a new car?
Do you need to be an economist to understand the benefits of preventative care?
Ours is a system that rewards pills and procedures and nurtures a clinical culture in which the goal is primarily to fix what goes wrong. "I never saw a well patient in my life," says a doctor of the years he spent as a heart surgeon. "They were all sick. We are in the sickness business. We need to get into the health business."
Do you need to read statistics to know that “health” care in our country is in crisis taken hostage by drug and insurance conglomerates?
Conglomerates whose ONLY concern is profit not your health.
In order to make more money, the goal of insurance companies is NOT to treat you.
The goal of drug companies is to help your symptoms a little so you will keep buying their products-drugs. In other words – to keep you sick.
And doctors are forced to do a lot of unnecessary procedures because of the pay structure and liability concerns.
“ The U.S. spends more on health care than any other country does, and studies have suggested that as much as 30% of it — perhaps $700 billion a year — may be wasted on unneeded care, mostly routine CT scans and MRIs, office visits, minor procedures and brand-name prescriptions that are requested by patients and ordered by doctors every day.
For example, chronically ill patients in Los Angeles visited doctors an average of 59.2 times in the last six months of their life, vs. only 14.5 times in Ogden, Utah; they still ended up just as dead.
Patients in higher-spending regions get more tests, more procedures, more referrals to specialists and more time in the hospital and ICU, but the Dartmouth research has found that if anything, their outcomes are slightly worse. "We're flying blind," says Dartmouth's Dr. Elliott Fisher. "We're getting quantity, not quality."
My fellow Americans
Look around when you are in public places. Look around at people.
Do you see overweight and sick people around? According to Chicago Tribune average American carries an extra 23 pounds and the nation, collectively, is about 4.6 billion pounds overweight.
Reactioners insist that ours is the “Best Health Care in the world”
Really? How come we have more sick people in our country than any other industrialized nation??
The direct medical costs of obesity total about $147 billion annually -- almost twice the amount since CDC first considered costs in 1998, and more than $50 billion more than is spent fighting cancer each year -- according to a study funded by the CDC Foundation and released Monday.
Do you have to be a doctor or a statistician to see the picture?
Or do you just need to open your eyes and to pay attention?
Do you know that insurance companies tell doctors how much time they are allowed to spend with each patient? (15 minutes)
Here is this scary word, “SOCIALIZED” health care that reactionaries are trying to scare you with.
Can you explain what “socialized” means?
Do you like socialized Army, or do you prefer Blackwater type armed forces?
Firefighters, Post Office, Veterans affairs, and numerous other government services?
There is a role for the government in human societies. That is why governments are as old as human civilization.
It is just that the government should be kept in check, under control, just as private corporations should be.
In the near future, I believe that patients won’t have to wait until they’re ill in order to feel comfortable going to the doctor. Health care should be able to prevent that from happening.
Optimizing overall health is no longer a choice, it’s a responsibility.
You owe it to yourself and your family to be well enough to dance at your daughter’s wedding someday spend an amorous weekend with your spouse or hike with your grandchildren. The last 20 years of your life, you are either going to spend well or ill. There is no real in-between.
“People under financial stress don’t take care of themselves as well,” says Dr. Timothy Gardner, a cardiac surgeon and president of the AHA. “If they end up neglecting medication or skipping dental cleanings, they’re adding to their health risks.”
Pressure on families’ medical budgets has been building for decades. In 1970, U.S. spending on health care amounted to 7% of national output. By last year, it was 17%. In fact, 2008’s health outlays of $2.4 trillion exceeded our spending on housing or food.
A large proportion of the total reflects our frequent use of advanced specialty care, in which American medicine leads the world. But according to the World Health Organization, our country ranks behind 30 others in promoting the simple preventive care, good nutrition, and exercise that enable people to live longer. Average life expectancy in the United States is about 78 years, according to the National Center for Health Statistics. In Japan, it is 83 years; even Costa Rica does slightly better.
Some more statistics
• One American dies every 33 seconds from Cardio Vascular Disease (CVD)
• AHA (American Heart Assoc.) estimates for the year 2005 are that 80,700,000 people in the United States have one or more forms of cardiovascular disease (CVD):
High Blood Pressure
Coronary Heart Disease
Health costs are bankrupting small businesses and even conglomerates like General Motors as well as millions of families. And it's awful for the country. Medicare is on track to go broke by 2017, and our long-term budget problems are primarily health-cost problems. At current growth rates, health spending by the Federal Government alone would increase from 5% to 20% of the economy by 2050; Social Security, by contrast, would increase only from 5% to 6%.
One Dartmouth study found that if nationwide spending had mirrored the modest rate of that in Rochester, Minn. — where care is dominated by the renowned Mayo Clinic — Medicare would have reduced its costs for chronically ill patients by $50 billion from 2001 to 2005. As the old inflation-adjusted saying goes, pretty soon you're talking about real money.
Health Care Revolution
There is a wellness revolution under way, where people are looking to take a more proactive approach to their own health care. An emphasis on health and wellness that focuses on the prevention rather than the mere treatment of disease is the future of healthcare.
Prevention Must Be a Priority
U.S. health care needs to shift its focus away from treating illnesses and problems and move toward prevention instead, declares Kathleen Sebelius, Secretary of Health and Human Services. “We cannot achieve our ultimate goal—a healthier nation—unless we shift away from a sick-care system,” she said at a Senate hearing earlier this spring. “We pay for emergencies, not the care that prevents them, with little emphasis on the responsibility each of us has in keeping ourselves and our families well.”
Some smart employers, health plans, and medical providers are experimenting with ways to save people’s health dollars or use them more effectively. Their goal is to make it easier, even in a recession, for families to receive the care they need.
"I spend 40 percent of my time away from my patients doing paperwork and getting prior authorizations," said Jim King, MD, a family physician in Selmer, Tenn. "We need to start taking the barriers that are between me and my patients away."
The U.S. has a catastrophically fragmented system that provides incentives for sick care instead of prevention. The system is in dire need of reform - reform to save lives, to save families and to save money for both patients and the American health care system.
It's time to put our health back where it belongs, out of greedy insurance companies' grasp and back into you and your doctor's hands. It's time to stand with more than 450,000 doctors who support health care reform.
As we are trying desperately to break away from the “Wild West” medieval past in America - the reactionary forces are still powerful. The self preservation instinct takes over and the reactionaries are fighting for survival. They want the “Good Old Times”, the past to become the Present again.
Don’t kid yourselves. It is not about health care for them - it is self preservation, it is limbic brain in action.
My fellow Americans. Do not let them scare you into inaction!
Look around! You do not have to be a professional to see sick people around you. Open your eyes!
Do not allow yourself to get used to what you see.
The definition of insanity is when you keep doing the same thing and expect different results.
Fire your elected officials who do not want change.
No nation can be called civilized if millions of its citizens are denied basic health care.
My last question to my fellow Americans: do we want to become a civilized nation?
At times, I feel that we approach life from the wrong direction.
A few examples:
Climate is changing
1. Global warming, or perhaps global cooling, let's just call it climate change. Is this really occurring beyond a reasonable doubt? Before we do anything to reduce pollution, should we not wait for incontrovertible proof of its existence? But, why wait? What could be bad about cleaning up our planet? Must we have hard facts indicating that current energy resources will be depleted before practicing energy conservation? Just what could be the downside in developing green energy sources?
Usually the counterargument states that these efforts “will hurt the economy." It is my understanding that people create economies. Economies are created by people in order to make life better, in other words, in the pursuit of happiness.
Does dirty air, water and a toxic laden environment make us happier let alone healthier? Does the chronic worry about toxins everywhere make us healthier and happier? It seems to me that the only entities which become happier and benefit from our current situations are multinational corporations.
2. Now about health care. First, people need to be educated on how to stay healthy. We all know that our country's people are not getting healthier; cancer will soon surpass heart diseases as the main cause of death, and rates of CVD (cardio vascular disease) are skyrocketing. Diabetes has reached epidemic proportions, especially in children. I see this as the unintended result of our Western economic model spiraling out of control. The economy appears to be feeding on itself for the sake of the economy. There is a movement in this country and in the rest of the world to encourage people to take personal control of their health by educating themselves about adopting a healthy diet and a healthy lifestyle. Will we need affordable healthcare for all?
Absolutely! It is the only ethical choice.
Again, I think we are approaching the issue from the wrong side. The state of our current economy is itself very stressful, and what creates most of the stress? Money! In our country, a disproportionate amount of our people's income is spent on medical bills.
So, people get sicker due to technology, the industrialization of their food supply and chemicals in our environment. Making it even worse, people are further stressed because of the money needed for “health care.” And this just makes them sicker. It seems obvious that it would be sensible, moral and prudent to remove these stress factors. As our economy grows, trying to solve problems, it appears to be creating new ones. In short, the current economic model is not sustainable.
So, what would be the right approach? Again, what is wrong with staying healthy? We need to educate ourselves, and use technology wisely, for our sake, not for the sake of the “economy”. Do the right thing and the economy should follow. After all, the economy is supposed to function for our benefit, not the other way around. There was a saying in the USSR "we create problems and successfully overcome them." Are we are following in their footsteps?
3. It seems to me that a significant portion of our planet’s resources is being wasted. Our economy is a consumption-based economy. We consume stuff; our economy produces more stuff to consume so we can generate income to enable us to purchase and consume more stuff. While admittedly not an economist, I can state that in the long run this continual spiral of production and consumption is unsustainable. It is just a giant Ponzi scheme. Our planet’s resources are limited. The planet’s population is growing exponentially. If we continue on a current path, we are heading toward a cliff.
Our planet’s capacity to feed its growing population is diminishing. In order to keep up with the demand, farms become technological factories overusing chemicals, utilizing genetic engineering and adopting mono-culture-based farming (corn, soy beans) . These practices create tremendous health problems for our population. Pharmaceutical companies come up with more and more drugs to deal with health issues. The use of these drugs then cause side effects creating the need for more drugs. The spiral continues.
All of the above issues are interconnected. We must understand how all these problems affect each other and how these interconnections exacerbate our problems. To keep up with growing demand, the industrial nations need more and more energy. More energy allows us to make stuff for us to consume; so we get sick; so pharmaceuticals make more drugs for us to deal with that sickness, and we just get sicker. In order to afford “healthcare” we need to consume more stuff to support the economy, and this way we just continue to poison our environment and create energy crises and an unhealthy planet
And all this is supposed to make our lives better? Because, remember, we created this economy for our benefit. So, maybe we should do things that will benefit us and “the economy” will follow. For example, our approach to healthcare and medical education should be changed from "cure" to prevention.
The Russian scientist and dissident Andrei Sakharov stated, “At the end, the moral choice, is the most pragmatic choice.”
We must do the moral thing and the economy will adopt, follow and support ethical practices.
In my opinion, if we do not change our approach to the “economy” there will be no economy.
The debate is raging on how to help sick people. I do not hear a lot about how to help people not to get sick.
In the long run this is the way to cut cost.
About health care…. again. And about personal responsibility.
Here is the plan.
Get educated in what you eat, when to eat and how often you eat. Watch what you drink.
Information is available - watch the movies: Sicko, Food. Inc, Sweet Misery, World according to Monsanto, Eating.
Exercise regularly. Why do some people take pills every day but neglect to exercise?
I would ban the escalators in the USA for the first three floors. Use your legs. You legs are designed for it.
I have noticed that when I go to the gym, people go up the escalator, work out and go down the escalator.
Only in America.
Caring, well-meaning parents
People drive their kids a half a block to the school bus stop, kids sit in the bus, sit in school, go back home sitting on a bus, and their caring parents drive them to the TV or computer.
Bus exhaust pollutes the air we breathe. We can stop buying Arab oil if we just use common sense and use our body’s abilities to move by itself. And we would save a bunch on health care because, if we would not be so lazy, we would have health not sickness. And because we would get healthier, we will not be stressed out so much about health insurance cost.
Trust yourself more then your doctor. I meet my doctor in the gym. Every time he seems to be surprised that I am in a better shape then he is. Why is he surprised? Have you seen doctors that look worse then their patients? Next appointment, pay attention to what shape your doctor is. Does your doctor look healthy? If not – change your doctor.
How can doctors help others if they cannot help themselves?
Eat in moderation
Do not “pig out”. You are supposed to enjoy your meal, not destroy it. Do not worry - you will have food to eat when you will get hungry.
Vote with your wallet. Do not buy junk, especially for kids. Sugar drives them crazy. It is not ADD or ADHD. It is sugar and lifestyle. Kids need to exercise. They need to use their energy. It is OK if they get a few bumps and bruises. Our kids get sick all the time by being around other kids – colds, ear infections, pink eye, etc. We understand the dangers and are used to it.
But why are we afraid of bumps and bruises? Bumps and bruises do not create chronic diseases, constant colds and infections do.
Take control of your life and your health. Do not count on doctors, government and insurance companies to do it for you.
Because if we do, we are not any better then chickens in one of the industrialized farms.
The difference is, we have a choice.
Some thoughts about current affairs:
- We as a country are falling behind in every way.
- Healthcare- are we healthy as a nation?
- Wealth – we live on borrowed money
- Military – cannot have strong military without money, health and education.
- A little bit more about military: there is no use for conventional military with tanks, fighter jets and bombers against new enemy. That is unless you want to occupy every country that hides terrorists.
How did it happen that from liberators we became occupiers and world’s policeman? Because that is how we are perceived in occupied countries and in the rest of the world.
So, what are we doing in Iraq and Afghanistan? Are we protecting our interests? What interests? Oil? We all know that oil is the past, not the future.
Are we protecting freedom? Whose freedom? Do we have more freedom since we invaded Iraq and Afghanistan? Financial freedom? Freedom to be happy? According to statistics, we are not much happier then people of Sudan.
Also, if history teaches us something, occupiers never win.
A little bit about militant Islam.
Just like western doctors, we fight with symptoms, not the cause of militant Islam. We are supporting the oppressive regimes around the globe, which are “friendly” to us. Why we are supporting these regimes? That support creates the impression that America is the oppressor, so the local population becomes radicalized and hates their own rulers and their supporter – the US.
If we would know the natural laws that govern development of the society, we would be able to use these laws to our advantage, instead of installing “democracies” western style in tribal societies.
Some thoughts about our President.
President Obama is too pragmatic and too practical to be a great president, he did not have the courage to end the wars in Iraq and Afghanistan. Because he added troops in Afghanistan, it is his war now.
Exports from America and China
The fall of the Empire.
If you studied the history of the Roman Empire, you would see the similarities between the last years of the Roman Empire and the current situation in US.
Is the end inevitable? I do not know.
There is a crisis growing in our country. The conflict between the progressive forces trying to advance the country and the reactionaries trying to hold us back, to keep us in old and comfortable for them society.
Many people are not comfortable, unhappy, in this fast changing dynamic society. They long for “good old” simpler, happier times.
New skills are needed to succeed in today’s advanced technological civilization. And the majority does not have those skills. The reactionaries are using these anxieties to advance their own agenda.
Their public agenda – back to good old simpler times. The real agenda – they are just puppets of multinational corporations. And also, I suspect that many of their followers are just confused and scared to death of this new world.
Another note – during the crises extreme elements are more visible, more vocal. It is like you steer standing water, all the crap comes up to the surface. So, if not Limbaugh, Cheney, Hennity some other crap would flow there.
In light of what is going on right now.
We are at a very dangerous crossroads. The rise of mediocrity and cheap populism in these troubling times is similar to the times of the rise of the Third Reich.
This situation brings the opportunists that use uninformed and confused populous to their advantage.
I would argue that whether we like the President and the Democrats is not as important right now. We have to realize that the alternative is much worse:
- the rise of storm troupers
- the rise of mediocrity
- the suspicion towards intellectuals
- the threat of violence
We know it happened before. Please do not let it happen again.
Please don't be the “silent majority” While you are still a majority.
Speck up. The tea baggers are the loud minority.
History tends to repeat itself if people don't know history.
Do not let mediocrity win in this great country.
Are we a country whose democracy is active, or are we at a point where our democracy is approaching a state of inaction?
Regardless of personal political viewpoint, many of our citizens believe the United States is at a crossroads.
Will we, or should we, remain a superpower?
What is our economic future?
How do we meet our citizens' basic human needs?
Will our population have access to affordable healthcare?
Will our environment be clean and healthful?
What will insure our citizens have freedom to choose their leaders and have their voices heard?
How do we function in a world economy demanding increased consumer consumption while our planet requires conservation?
How will we provide our children with the necessary skills and education to thrive in an increasingly complex world?
Clearly no one has answers to all the above questions; it is doubtful any of us has a workable solution to any single major problem. But we all have ideas. The purpose of this blog is to provide a forum where creative ideas may be shared, discussed and debated.
The truth is incontrovertible,
malice may attack it,
ignorance may deride it,
but in the end; there it is.
Work. Home. Kids. Parents. TV. Games. Social Events.
I wish there would be a mandatory time-out – one hour every day for all the adults.
No TV. No work. No driving. – just stop, think.
What is it all about?
What are you doing in life?
What is really important?
What would you really like to do with your life?
Think about the future, the present, the past.
Where are we going as a Nation? As Humanity?
Stop pretending that everything around you will be just fine. The world around us is always in motion, always changing. Regardless whether we admit it or not.
What is really important?
What do we need to do to make it a better world for us and our children?
We need to understand that if we stay busy with our daily little routine the world is still changing and one day you will face the changed world that may not be friendly to you.
People sometimes remind me of the ant's colony – every ant is very busy doing what it has been doing for the whole life, no ant has time to look up to see the coming tsunami.
My dear Ants.
We are at the cross roads of history. The silent busy majority please look up, the tsunami is coming.
It may not be too late. Please find time to act.
If you are disappointed in Democrats – fine, please vote not for but against:
Against the hate, intolerance and bigotry.
Against stupidity, grid, homophobia and xenophobia.
Against mediocrity and incompetence.
Against complacency and inaction.
Vote against plutocracy.
Vote against the global grid of corporations
Against demagogues who incite mass hysteria.
Please find time to build the future for your kids.
The future is not cast in stone, the future is to be built by you.
Here are some opinions about parenting.
I will publish my thoughts shortly.
Mariette Ulrich | 20 Jan 2011
Tiger Mother parenting ignores dignity and heart of the child.
I’m sure that all parents, to some degree, sympathise with this attitude. What mother doesn’t bask in the glow of a child’s success? But there has to be more to life than this, especially for the child, because sooner or later, he or she can’t be “number one.” Fostering an unyielding (and unrealistic) attitude of “failure is not an option” is no way to prepare a child for setbacks in life. If the adventure of parenting is in any way an ego trip for the parent, it’s often the child who ends up falling under the bus.
"I see (and concur with) Ms. Chua’s point about some Western parents being overly concerned about damaging their children’s fragile psyches, to the point where they offer no guidance or correction whatever. Yet at the same time, children have souls, unique personalities, and human dignity. They are not, and should not be expected to perform as, machines. The goal of education is surely not to produce success-at-any-cost “winners”, but to expand the mind, heart, and soul of a human being.
The bigger consequence is that I find I'm socially awkward and simply do not fit into most people's perceptions of family. Living in the western world people are used to family dinners and time-outs or groundings not being called names and being on the other end of a belt lashing. My self-esteem is on a constant roller-coaster ride and my confidence is arguably below average."
I don't know if Amy's daughters will eventually rise up against her but it may just happen that one day they get as little freedom and realize the emotional prison their mother had them caged into. Nevertheless, this is how it is for Chinese families and us children of this system find it acceptable when we're younger because it's what we've come to know as a child. It's not until we become older and see other things that e realize how flawed the system we grew up really is.
I hope for Amy's sake that her kids don't turn out like me and my father but it wouldn't surprise me if their relationship begins strain at some point.
Are there any parenting lessons to be learned from tiger mother Amy Chua?
There are certainly elements in what she is espousing that have scientific evidence that they constitute good parenting. Kids need limits and structure, and it's good for parents to have high expectations for them—and if you want your kids to do well in school, you want to do things like getting involved in their schooling, having expectations of success and praising them when they do well.
On the other hand, the downside to what she is advocating, if I understand her correctly, is that if parenting becomes too authoritarian—and by that I mean overly restrictive, overly punitive, squelching any attempt by the child at independence or autonomy—those parenting practices have been shown to be related to elevated anxiety, depression and psychosomatic problems. Kids raised in those circumstances are less self-assured and socially poised, and more compliant.
In other words, on the one hand Amy states that children are fully capable, while on the other hand she controls them to such an extent that one might question whether she truly believes in them. How can we believe a child is “great” on one level, then treat them as if they are incapable of wisdom in practice? The approach screams of parental insecurity, not security.
A parent who is secure in themselves has no fear of their child’s imperfections and mistakes, but trusts that children are innately capable of finding themselves. Indeed, the struggle to identify their authentic voice is far more important than the perfect regurgitation of someone else's dream of who they are.
Just a child
Any extreme is bad. Overly Nice or Overly Strict, You Created the Monster
There exists in the cosmos a great measuring scale that balances out good parents with good children. If the parents stray either way from too light parenting to too strict parenting, the result at the other end of the scale is the same, a rebellious monster the rest of us will eventually have to deal with.
Who we are and what we do. Are you happy?
Are you happy?
To my fellow Americans and to the rest members of our “advanced” civilization
We drive our cars to work. We work a lot doing important things, like designing new line of clothing or new cereal. Our industries are furiously producing more stuff that is absolutely needed to produce even more stuff. We are flying all over the planet to important meetings, deciding how to make more stuff.
We are busy in this life, very busy.
Trying to accomplish what?
Can we pause for a moment, and try to feel what we really want?
Are we happy?
We work to “make a living”. What living?
Are we happy?
Do we live to work? Why do most of us separate life and work? What is “working”? Is working – life? Is that what life meant to be?
Are we happy?
Our beautiful planet. Our only home. We are busy destroying it. Why?
Will we ever learn to live? To live and let live?
We enjoy our only home, the nature 2 -4 weeks a year. So we work 50 weeks on destroying our planet and for 2 weeks are enjoying what we did not destroy yet.
Are we happy?
I saw the movie Avatar. What a great fantasy! A non-technological civilization, intelligent creatures that live in harmony with nature. No, they are nature, inseparable from the planet, part of the living planet.
Are they happy?
Do we know more about life then they do?
I wonder what would happen to American Indians, to their civilization, if we would not destroy them and their world.
What would happen to African civilization if Europeans never invaded?
Why are we so bent on destruction?
Why are we so sure that our way of life is the only way of life?
How are we learning about the world around us?
We came from animals, we are on the top of the food chain. We are superior to any other creature on this planet. Right? The planet is ours to destroy!
So why don't we feel the coming tsunami or the earth quake like animals do?
A good part of our knowledge, of out technology is applied toward the better way to kill each other. Does that seems natural?
Are we happy?
I do not have all the answers, I just have questions. May be it is a good start.