To the Editor:
To the people who shovel out their cars and then put a trash can or lawn chair in the spot to prevent people from parking, there a couple of salient points:
1) The street in front of your house is public property where all people have the right to park. You don’t own the spot in front of your house despite the presence of your crappy lawn furniture.
2) There is no Constitutional right to park in front of your house. (I know this will surprise some people — probably the same people who think there is a Constitutional right to smoke.)
3) The fact you broke your back shoveling out your car entitles you to be able to move your car out in to the street — and nothing else. Give yourself some credit for the elbow grease. Don’t ruin it by being a shmuck.
4) The person who might park in the spot you shoveled also shoveled out his/her car and probably couldn’t park in that spot because someone else parked there.
5) If you have a parking spot in your rear driveway and you put a chair in front of your house to preserve that spot, you are officially an idiot.
6) If you don’t want someone to park in front of your house, then don’t move your car and take the bus or train for a change. It’s cheap and you don’t have to pay for parking.
7) People have been shot over parking spots after snowstorms. Putting out a chair tempts many unbalanced people into a confrontation with you. Think about that when you put a chair out.
On a serious note, there are many examples of neighbors helping neighbors in a snowstorm by shoveling out their neighbor’s car or helping the elderly get to doctor’s appointment, etc. Let’s follow their example instead.
To the Editor:
On Christmas morning, the neighbors of the Moyamensing Avenue-Bigler Street area woke up to slashed tires. Then it happened again the day after Christmas.
I want to thank those wonderful children and their parents for such a lovely gift! I wonder if they would like to pay for all the damage done.
Article:
Change in scenery
Article:
The night Izzie died
Article:
South Philly landmarks
Article:
The corner hangers’ club
Article:
Cheers to The Capistrano
Article:
Prize-worthy pupils
Article:
Just sayin’
Article:
Mother’s Day 2012
1. Gloria Endres said... on Dec 31, 2009 at 11:40AM
“Kudos to "Sarge" the brave rescued pit bull who is a true profile in courage. He has every right to hate and despise humans for his horrible treatment at their hands, and yet he can show love and compassion for people in need.
I hope all the children who are visited by this wonderful dog can write a letter to the Eagles to express their disappointment at the awarding of Block to Vick.
”
2. chaloots said... on Dec 31, 2009 at 10:23PM
“Here we go again with Mr. Essex's reasoning. This time Mr. Essex reasons that our present President , Barrack Obama's vision was fulfilling the goals of Bin Laden. Mr. Essex forgets that George Bush was on duty when Bin Laden's cohorts attacked America. He forgets that Bush did absolutely nothing to capture the masterminds of 9/11. The efficient HealthCare, that Mr.Esses talks about is for the priviledged only. There are hard working people who work two and three jobs at below poverty level wages with no health care or inadequate health care. Yet Mr. Essex and the Conservatives have no solution for these proud working Americans.And the phrase redistritribution of wealth is the priveldged's nongreedy way of saying that we should not help and care about the poor and less fortunate. But go to war with a defenseless country, under false pretense is ok. Maybe Mr. Essex could find in God's word somewhere, that says he can shoot the sick who have no insurance, fixing the healthcare problem.”
3. Bob said... on Jan 2, 2010 at 02:18AM
“Actually Chaloots, we did capture Khalid Sheikh Mohammed, one of the masterminds of 9/11. As for the healthcare system we do have the best system in the world but because of the government's interference and the lack of market mechanisms costs are and will continue to rise. The government pays about 60 percent of all the costs of healthcare with CHIP, Medicare, Medicaid, Indian Health Services and Veteran's care. All of these programs are either deeply flawed, going broke or not sufficent enough. I don't think more government is the solution. What is needed is competition and less government. Before we got medicare/medicaid in the 60s the poor and rich actually did get treated about the same so we shouldnt look to the government to fix the problem it should be the market. Hopefully the Congress decides to trash this disgraceful bill that will do nothing for the people who truly do need help and start over but I won't hold my breath.”
4. Gloria Endres said... on Jan 2, 2010 at 11:46AM
“Hi, Bob. Chaloots of course meant the failure to capture the chief 9/11 mastermind "Osama bin Forgotten," but you knew that.
We may have the best health care system in the world, but access to it is not universally available. The unemployed, the elderly, and the disabled are stuck and those programs you list and decry are essential safety nets. Only fully employed, healthy, young individuals can be cavalier about denying health insurance to those who do not qualify. The ER is not a satisfactory solution to primary care, no matter what Bush told you.
You are a solid advocate of the free market model, but only because it has not bitten you on your Astor Bar. History teaches that underregulated markets tend to balloon and then fail. There is room for competition but we have an obligation to take care of the weak.
It is called being a just society.”
5. chaloots said... on Jan 2, 2010 at 12:19PM
“Actually Bob, here you go again with your Conservative facts, which aren't facts but fiction. America does not have the greatest healthcare in the world. America is 37th in healthcare, according to World Health Organization's ranking of the world's health systems. And you say that Congress should trash the HealthBill, but you and the Conservatives have no solution for the working poor only using your Conservative facts (fiction in reality) that the poor are treated about the same as the rich. Bob if you are going to use Carl Rove truths do me the favor and save it for the Conservative sheep and the gullible, because they don't work for me and those who know reality from fiction.”
6. Gloria Endres said... on Jan 2, 2010 at 12:40PM
“I did some of my own research into health care systems and found this ranking of 14 selected countries according to the percentage of preventable deaths through health care in the year ending 2008. The United States ranked dead last. France is seems has the best health care system in the world and the fewest number of preventable deaths.
http://www.allcountries.org/ranks/preventable_deaths_country_ranks_1997-1998_2002-2003_2008.html
If anyone wants to argue that we have the best health delivery system in the world, you have to find some sources that prove that. If you want a perfect example of how a poor person can be a victim of this neglected system, just ask the family of the heart attack victim who died in the ER waiting room and was not discovered for more than an hour.
Our system is too bloated, too expensive and too inefficient. Something has to be done to reform it. I am not swearing that the plans nowbefore congress will do that, but doing nothing is not an option.”
7. Anonymous said... on Jan 2, 2010 at 03:00PM
“1113”
8. Bob said... on Jan 2, 2010 at 03:19PM
“Gloria, I didn't know what Chaloots meant that is why I pointed to the fact that we did capture one of the masterminds of 9/11...KSM. She had already mentioned bin laden.
Chaloots as for the WHO study. Their own people discredited the study when they said the study was "hampered by the weakness of routine information systems and insufficent attention to research."
I think both of you are missing my point. We already have the government involved and its only made things worse. I don't want to put words in your mouths but I am assuming you are both advocating for more government. You know its actually medicare who denies the highest percentage of claims, not an insurance company so I think the goverment healthcare has big problems it needs to deal with.
Gloria as for the link, if your implying France has the best healthcare, they pay 19 percent of their income for insurance and still 90 percent buy private insurance so thats really twice as bad.”
9. Bob said... on Jan 2, 2010 at 03:28PM
“Gloria, I didn't know what Chaloots meant otherwise I wouldn't of pointed out we capture KSM. Bin Laden was already mentioned.
Chaloots, as for the WHO study, their own people discredited that study when they said the study was "hampered by the weakness of routine infromation systems and insufficent attention to research."
I think both of you guys are missing my point. The goverment has had a big hand in the healthcare already, its only gotten worse. Im not sure if your advocating more goverment but I think that would be worse. Did you know medicare actually denies more claims as a percentage than insurance companies, so they have big problems they need to fix.
Gloria, as for your link I am not sure if you are implying France is the best healthcare but they pay about 19 percent of their income in taxes for health insurance and still 90 percent purchase private insurance, so goverment insurace must not be adequate. (http://www.cato.org/pub_display.php?pub_id=9272)”
10. chaloots said... on Jan 2, 2010 at 03:28PM
“Bob, you are missing the point. How are the Conservatives going to help the working poor who have inadequate or no insurance?
And I don't care who supplies healthcare for the working poor, the government, insurance companies, or hospitals. I want Health Care for ALL AMERICANS, not just the privledged! THAT IS MY POINT! Without the fiction that you proclaim.”
11. Bob said... on Jan 2, 2010 at 03:41PM
“Health savings accounts, tax credits for people who cant afford insurance, tort reform, allowing people to buy across state lines, electronic medical records, making medicare and medicaid more efficent. All of these things will lower the cost of insurance and of medical care in general. Plus the poor has medicaid and CHIP plus there are different companies that specialize in providing low cost coverage. Like ehealthinsurance I believe is one of the websites that helps low income families.
By the way Chaloots I don't know what motive you think I have to outright lie to you and make fictious claims, but its insulting. I am not here to get over on anyone and I am not rich and I have had problems with my health insurance so I understand. I am trying to have a conversating and offer an opinion. I promise I am not from an insurance company figuring out a way to increase the bottom line.”
12. chaloots said... on Jan 2, 2010 at 04:08PM
“Bob you consistently present Conservative facts and think that those who know differently with proven facts, e.g. "America has the best health care system in the world". There are many more examples, and times you have been debunked.
I don't care about the politics of healthcare, I am outraged that 47,000 Americans died last year because they fell through the safety net that you imagine to be in place for Americans. 120 Americans will die today because they don't have health insurance, there is my point and, OUTRAGE! I welcome your opinion, just don't mix fiction with reality, and not expect to be called to task.”
13. Bob said... on Jan 2, 2010 at 04:43PM
“Sorry if you don't like my "conservative facts" but thats the way it is. You aren't the arbiter of what is fiction and reality. I haven't heard any solutions from you, just attacking me as someone who provides a fiction accout of the world.”
14. chaloots said... on Jan 2, 2010 at 06:02PM
“Bob, my solution is for free Universal Health Care for ALL Americans. To me people are more important than profit.”
15. Bob said... on Jan 2, 2010 at 08:15PM
“Well I disagree. Medicare curently has a unfunded liability of 74 billion dollars, (usdebtclock.org) its unsustainable. I just don't have any confidence that another government program is the answer when the government can't run the programs we have now. We'll agree to disagree I guess.”
16. Gloria Endres said... on Jan 2, 2010 at 11:05PM
“Bob said, “Health savings accounts, tax credits for people who cant afford insurance, tort reform, allowing people to buy across state lines, electronic medical records, making medicare and medicaid more efficent. All of these things will lower the cost of insurance and of medical care in general."
Bob, of your list, at least three of your suggestions depend on being full time employed. I:nsurance tied to employment is haphazard and precarious. Many people cannot find full employment in any one place and do not qualify for group insurance, but make too much money to qualify for Medicaid. Going across state lines would wipe out any incentive for regulating insurance to protect consumers. Tort reform also depends on who is being protected. And exactly how would you make Medicare and Medicaid more "efficient."?
”
17. Bob said... on Jan 2, 2010 at 11:37PM
“Gloria, the nice thing about health savings accounts is that if you do have a job you can contribute to the account and if you lose your job you still have that extra money to use for insurance. If you don't have a job the government could provide a tax credit for you and let you purchase healthcare yourself. Safety nets also depend on other people having jobs so they can contribute to the pool for medicare or medicaid. So your right we need pro job growth policies. As for the insurance companies, I believe they are heavily regulated already. Right now if you live in Penn. you can only buy policies in Penn. What kind of free market is that? Its special interests lining the pockets of those companies and not allowing competition. Im not sure but I believe COBRA is a system that allows the unemployed to have health insurance. For medicare and medicaid, there are billions of dollars of fraud, waste and abuse that need to be cut.”
18. Gloria Endres said... on Jan 2, 2010 at 11:44PM
“As for France spending so much of their tax money on a single payer system, so what? Compare your income taxes to your insurance premiums, especially if you are not fully employed. I thought it was a good idea to expand Medicare to younger people. And if you use income tax credits to pay for insurance, isn't that the same thing as paying for your insurance with taxes?
Let's face it, Bob, the real reason so many working class people resist a single payer system is because they resent having any of their taxes going to help someone who is not fully employed. They are particularly resentful if the person is an immigrant, or of a minority race. They are paranoid that the government will "distribute" their hard earned money to anyone else. They do not realize that our present system is oligarchic or concentrates too much wealth in the hands of too few.
I”
19. Gloria Endres said... on Jan 3, 2010 at 10:17AM
“Bob says: "Right now if you live in Penn. you can only buy policies in Penn. What kind of free market is that?" That is the point, Bob. Insurance should not be totally in a "fee market" model, but regulated so that it cannot deprive consumers of critcal support during their health crises. If consumers are allowed to shop around, they will find other states where such protective rules do not apply and think they are getting a better deal....until the company weasels out of covering a claim.
You are right that Medicare and Medicaid depend on working people. It is a pay as you go system like social security. I paid social security taxes for 40 years. And guess what? I still have to pay income tax on my benefits. I also have to pay a sum from my SS check for Medicare, so it is not only the younger working people who are supporting the system. And since Medicare does not pay more than 80% of the bill, I also have to buy supplemental insurance.”
20. Bob said... on Jan 3, 2010 at 09:55PM
“Gloria I in no way want to imply anything about you. But, in you 1st response you said people don't want a single payer because they don't want their money to go to the minority community? So I believe your implying they are racist or prejudice. I find that hard to believe. The real reason people don't want a single payer system is because the goverment can't run the post office. They can't run the programs they have now. As for France, my point was that it just proves that the French people are paying both a portion of their income forcibly and they have to buy extra insurance, that is absurd. Single payer is suppose to cover everyone, and it clearly doesn't in France. As for the income tax credits, in France the government is telling you that you need to pay for this single payer system. At least with the income tax credits, people have more freedom to shop around and buy the policies they want instead of just one blanket plan provided by the government, single payer destroys freedom”
21. Bob said... on Jan 3, 2010 at 10:00PM
“Gloria, the fact that the health insurance companies have only limited competition in each state causes the rise in insurance prices. So by not allowing people to buy anywhere in the US, the prices stay artificially high and it hurts middle and low income families. Also the government in each state tells the insurance companies which policies they can offer, that is absurd as well. People should be able to pick and choose what they want to pay for and not have government mandated options for private insurers, that regulation also hurts people. However, I am totally on board with stoping insurance companies from dropping people who paid into the insurance pool, then don't get the care they need. That isn't acceptable.”
22. mary ann vita said... on Jan 4, 2010 at 03:12PM
“All this healthcare talk back and forth is scary to me. For those for the Gov't run health care...I am asuming you are for Obama who is destroying this country. That is sad so please see what you are fighting for you will be shocked on what you get. NO JOBS FOR INSURANCE, GOV'T TELLING YOU WHAT YOU CAN SAY, DO, not BEING ABLE TO GO ON THE INTERNET TO VOICE YOUR OPION. I CAN GO ON AND ON. There are others plans but the dems do not want to hear them. They are determined to make this Fabulous Country a socialistic country...do as we say or else. Why won't the congress use this Obama health plan for themselves and families, WHY!!!!”
23. Sick of Vick said... on Jan 4, 2010 at 03:27PM
“Sarge the Pitbull is infinitely more courageous than Michael Vick.
From their website: "The Ed Block Courage Award Foundation is dedicated to ending this vicious cycle of pain and despair [of child abuse]."
To me, an animal's innocence is JUST as fragile and important as a child's. Giving Vick this award would be like giving it to a Hollywood star who molested children, went to jail and then went back to work in movies after "serving his time". I don't CARE if you agree with me or not.
It is ludicrous and I am appalled that the Ed Block Courage Award Association is even allowing it.
Sarge the Pitbull is the one who deserves the award here in Philadelphia...along with all of the other INNOCENT animals who are trying to cope with life after the violence.”
24. chaloots said... on Jan 4, 2010 at 04:17PM
“It is all about greed! It is the privledged not wanting the less forturnate to get decent healthcare. They use all kinds of scare tactics to make you think that the poor and less fortunate getting decent healthcare is going to destroy America. And they have no solutions for the 120 people who will die today because they live in America and are not entitled to basic healthcare.
But when it came to a trillion dollar war that was unjust and unfunded the Conservatives did not worry about money then.
For some people this or any healthcare is better than none and would be gladly accepted.”
25. Gloria Endres said... on Jan 5, 2010 at 02:44PM
“Bob, you cannot say that the government cannot run the post office and cannot be trusted with running a health care plan. Here is a really scary story. I know someone with a chronic debilitating condition that can only be treated with a very expensive drug. Her employer provided insurance plan will not pay for it because they call the drug "experimental". Ever hear of such a term. It is the insurance company's way of denying claims for chronic and expensive maintenance. Meanwhile the same exact drug is covered under Medicare, the government run program.
OK, imagine this. This young person does not qualify for Medicare. She would have to be totally disabled to get any kind of government plan. But her group insurance plan is worthless to her and she cannot afford either the treatment or private insurance.
If the Medicare plan were extended to her (as a single payer) she would not have this issue. And yes, her life is in danger because of this.”
26. chaloots said... on Jan 5, 2010 at 02:51PM
“This is the reality of the Health Care System that I've experienced;
Seeing a neighbor come home from work collapse on the sidewalk. Helping her and begging to take her to the hospital, her refusing to go because she didn't have health care insurance with the job she had. Upon the next day, being awoken by her daughter to come and see what is wrong with her mom. Only to find her dead in bed. Or like today hearing of another neighbor, who had back and chest pains for two years, but couldn't get it checked until it was unbearable, now finding that he stage 4 cancer.120 a day!
The Democrats, Republicans and Independents should be working together so that this sort of thing doesn't take place. But there are some out there calling themselves Conservatives, TeaBaggers, haters of the poor, minorities and gays, that don't want a United America, they'd rather follow the what Rush and Glen Beck say. These two men preach hatred of fellow Americans and in no way help America's woes”
27. Bob said... on Jan 5, 2010 at 08:56PM
“Gloria, I support reform, but I don't support more government run healthcare. Its just not the post office Gloria, its everything they run. As for medicare, they deny more claims than any insurance company, thats a statistic from the national healthcare exchange. So, having a single payer is not a fix. I truly don't understand why you have faith in the goverment to run healthcare. The closest to a single payer system is medicare and it has 73 trillion dollars in unfunded liabilities, imagine what would happen on a larger scale.”
28. Bob said... on Jan 5, 2010 at 09:04PM
“Chaloots, Republicans were kept out of the debate when Reid added his "manager's amendment" to the bill. Now that both bills have passed, the Dems may skip the conference comittee. I remember when Obama said these issues will be debated out in the open, now we have backroom deals going on. Most people who oppose reform which is about 60 percent of the country don't hate the poor, black or gays. People have seen government healthcare and everything else in action, they don't want it.”
29. chaloots said... on Jan 5, 2010 at 09:32PM
“There is an entity that killed 47,000 people in America last year, 120 a day! The entity is the current Healthcare System in America. Those who want to keep the status quo and do nothing are facilitating the death of these people. When I first started conveying my outrage on this subject the amount of people who died each day was 60, it has now doubled to 120. I like to see those who want the status quo, tell the family of my neighbor who is about to die that this is the best healthcare system in the world. There are 119 other families who just had the same thing happen to them today, I bet those families don't think this is the best health care system in the world, try telling them that it is.”
30. Bob said... on Jan 5, 2010 at 10:05PM
“I haven't heard any conservative commentators or republican office holders who are satisfied with the status quo. Compared to the other nations in the world we do have the best healthcare system in the world, but nothing Congress can pass will ever be perfect especially this bill trying to be shoved through right now.”
31. chaloots said... on Jan 5, 2010 at 11:00PM
“Bob, I already debunked your assertion that this is the Best Health System in the World. But you continue to try and say that it is. Like I said the 120 people's families that will face the death of their loved one today, would beg to differ. Bob there are Republicans out there saying that a new health care plan is a worse enemy to America, than an Al Quida terrorist attack. Imagine that reasoning if you can, helping those who are less fortunate and without healthcare is worse than an Al Quida terrorist attack.Face it Bob the Conservatives are the party of division and the party of NO, who can't stand to have their tax dollars go to the less fortunate.”
32. Gloria Endres said... on Jan 5, 2010 at 11:29PM
“Bob, I never claimed that the government is perfect, but the current system is far from perfect either. It is not just about paying premiums. I gave you one very clear example of an employer sponsored health care plan that is worthless to a very sick young woman. She found out that only if she ceases to be a productive citizen can she obtain care. At the rate she is going she will never live to receive Medicare coverage.
What you suggest is not applicable to her or thousands like her.Under the present system, she is basically UNINSURABLE. That is the basic problem and all the fancy competition in the world does not fix that.
Insurance companies must not be for profit organizations because that makes them dangerous. I choose the government because the government is WE THE PEOPLE, and we can demand what we want from it. We can demand full coverage for life-saving treatments. Will it cost us? Of course it will, but what is the price of a life, Bob?”
33. Bob said... on Jan 5, 2010 at 11:30PM
“You didn't debunk anything, you cited a discredited World Health Organization study whose own researchers said the study was "hampered by the weakness of routine infromation systems and insufficent attention to research." Nothing was debunked. Im sorry if you believe that conservatives hate the poor, I guess thats why your not a conservative but that isn't the case. And by the way its Conservatives who have been found to donate more to charities not liberals. Also, The Republicans have offered numerous alternatives to the Dems healthcare plans so they AREN'T just voting no. An one idiot Republican said liberals are more dangerous than Al-Qaeda, he clearly doesn't speak for all of us.
”
34. Bob said... on Jan 6, 2010 at 12:36AM
“Gloria taling the profit margin away from insurance companies isn't going to do much. Healthcare profits were about 13 billion in 2008 which was six-tenths of 1 percent of the total healthcare spending, and it hasn't gone up much in 2009. So that six tenths of 1 percent or so of profit isn't going to fix the system. If you demand from our government that all people have full coverage for life saving treatments our country will plunge even deeper in debt and lead to our ultimate demise, and then we really will have a terrible healthcare system since we won't have money to pay for it. I refuse to allow the goverment to take over 1/6th of the economy when their track record is awful and they haven't shown any competence in dealing with the healthcare sector. As for we the people, its obvious that the politicians don't care what we want as evidence of them shoving this bill down our throats.”
35. Gloria Endres said... on Jan 6, 2010 at 10:39AM
“Bob says: " If you demand from our government that all people have full coverage for life saving treatments our country will plunge even deeper in debt and lead to our ultimate demise..." I cannot believe you just wrote this!
How much are we paying for two or maybe more useless wars of choice? And how many multimillionaires are paying NO TAXES due to creative accounting? It is not that we do not have the money. It is how the money is being collected and distributed. The big argument today is all about that distribution of our considerable wealth. So far the money seems to be going in only one direction....into the hands of fewer people and to hell with everyone else. It is hemorraghing into nation building in other countries while our nation is going to the dogs.
Bob this is how revolutions start.”
36. Bob said... on Jan 6, 2010 at 02:24PM
“Afghanistan wasn't a useless war of choice. And the top 1 percent pay 40 percent of the taxes in this country. The bottom 50 percent pay less than 1 percent. Gloria you could take all the money the fortune five hundred companies made last year and it still wouldn't pay the interest, just the interest on our debt. Please don't make this about wars or a few people not pay taxes, we are in much deeper trouble. The fact is that no matter how much extra money we have to put into healthcare, the goverment will continue to waste it, mismangage it and we will be worse off. Having the government's hand on more of the taxpayer's money isn't a solution its a problem.”
37. chaloots said... on Jan 6, 2010 at 02:36PM
“W.W.J.D?”
38. Bob said... on Jan 6, 2010 at 09:26PM
“I think He would want everyone to have access to healthcare, but I know that the government isn't capable of being the institution to make that happen.”
39. Gloria Endres said... on Jan 6, 2010 at 10:40PM
“Bob, for 2010 it is expected that filers making more than $1 million will enjoy a 7.7% average BOOSTin their after-tax income relative to what they would have if the present tax cuts weren't in place, according to the Tax Policy Center. Middle-income households, by comparison, will see an average boost of 2.6%.
The fact is that private insurance companies without regulation will do much worse than mismanage money. They will DENY life saving coverage to people who do not meet their strict criteria. That is a fact of life that is endangering the lives of tens of thousands of our fellow citizens.
How would you solve the problem of people declared UNINSURABLE by all major insurance companies? What alternative do you offer them? My solution is a guaranteed coverage by the government, the same as congress, veterans, and Medicare patients get.
And do not be disingenuous about the wars in the Middle East. You know very well that I am referring to Iraq and now even Afghanistan.”
40. Bob said... on Jan 7, 2010 at 03:03PM
“Gloria I think your missing my point, having people covered by the government will not solve the problem. Please go to this website. Medicare denies MORE claims as a percentage than private insurers. Government healthcare is not a fix. http://www.johnnyproctor.com/amy/Medicare_Denials_Large.jpg
Also go to usdebtclock.org, medicare is in the hole some 74 trillion dollars, you can't pile more people onto the rolls of the government. Taxing the rich for this is not going to solve the problem. Neither is pulling out of Iraq or Afghanistan. There needs to be a fundamental change to the already heavily regulated, semi goverment run healthcare system.”