Resistant Bacterial Infection Outbreak At California Hospital 132
puddingebola writes From the article: "A potentially deadly "superbug" resistant to antibiotics has infected seven patients, including two who died, and more than 160 others were exposed at Ronald Reagan UCLA Medical Center through contaminated medical instruments, the hospital revealed. The drug-resistant superbug known as CRE was likely transmitted to the Los Angeles patients by contaminated medical scopes during endoscopic procedures that took place between October 2014 and January 2015, a university statement said. " UCLA says the infections occurred via contaminated endoscopes that were sterilized according to the manufacturer's specifications.
(Note: beware autoplaying video ad; adjust your volume accordingly.)
From the grave... (Score:3, Funny)
Ronald Reagan's cold dead hand stretches forth again to wreak havoc across the land!
Re:From the grave... (Score:5, Insightful)
But, in fact, the system works. Nothing is going to be foolproof or fail safe. There will always be screw ups or just procedures that don't fix everything. However, it is telling that the hospital's surveillance systems figured out what the problem was, identified the patients at risk and presumably stopped the 'outbreak'. 32 patients, although it sounds like a lot, is probably just a couple of days worth of scopes at a big institution.
Although not clearly delineated in TFA, it appears that the problematic instruments were endoscopes used in ERCP [wikipedia.org] procedures. These particular devices [endoscoper...essing.com] are at high risk of contamination due to their complex design.
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Contamination isn't shit. If these idiots would learn how to Tyndallize their equipment instead of relying upon shit autoclaves, this wouldn't even be an issue.
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115C? Wrong. 121C, and you only need two atmos of pressure, and it's only a single 15 minute session. Where are you getting this days in a row nonsense?
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This entire thread is wrong from the very beginning, actual Tyndallization is for things that can't be boiled. You heat it to just below 100C for 15 minutes to kill active bacteria, then you store it in a damp environment for a day to encourage the spores that don't die to germinate into active bacteria and start growing again over the next 24 hours. Then you heat it again. You repeat this every day until you feel you have it clean enough. Any spores that didn't de-cloak will still be there and will bec
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Making devices withstand pressure and heat would increase costs quite a bit.
US Healthcare costs are already grossly inflated and the companies charge what they charge because they can get it, not because it's based in reality. I'm trying to find where I read about a medical tool that failed to market because it was priced too cheaply, and was successfully marketed and reintroduced at a higher price point. 2010 cost breakdown [aetna.com] structures and equipment is a fraction of the total expenditure. This is like the drought in California asking residents who use up 14% of the water to conserv
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Its not the regulations killing materials costs. Pharmacy costs are pretty obviously the pharmaceutical companies.
Materials is a self inflicted wound. multiple hospitals tried to get better pricing by forming GPO companies. A good idea, but somewhere down the line the majority of them wound up in just a few dozen GPOs. Many of those merged and talked them in to long term contracts. Like 99 year contracts. In short order, everyone had to buy through a very small number of middlemen because they can control s
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Its not the regulations killing materials costs.
I didn't claim that, my comment about regulations was specific to software. My argument was they charge the prices they do because they can. Costs are passed on. Look at how much insurance charges.
Materials is a self inflicted wound. multiple hospitals tried to get better pricing by forming GPO companies. A good idea, but somewhere down the line the majority of them wound up in just a few dozen GPOs. Many of those merged and talked them in to long term contracts. Like 99 year contracts.
Interesting. Since I'm a cowboy today, why can't these organizations reorg and shirk their contracts? Probably not worth it because the vast majority of overhead typically incurred by an organization is the personnel.
Re:From the grave... (Score:5, Informative)
A flexible endoscope is cleaned in a machine more like a kitchen dishwasher than an autoclave. The scope has internal channels for shooting air and water out of a nozzle on the tip. It has a large channel to pass instruments into the patient (biopsy forceps, cauterizers, even other more narrow endoscopes). An ERCP scope has an additional channel that carries a stiff wire that is used to deflect instruments coming out the end. This channel and wire is a very tight fit, so it is more difficult to clean.
Attachments to the channel ports should circulate the sterilizing fluids through all the channels. It's not difficult to imagine a clog preventing the fluid from circulating. Testing for leaks and clogs is part of the cleaning procedure, but in practice, of course, errors happen often:
Similar story from just last month:
http://www.modernhealthcare.co... [modernhealthcare.com]
A biggy at the VA a few years ago:
http://health.usnews.com/healt... [usnews.com]
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instead of relying upon shit autoclaves, this wouldn't even be an issue.
I doubt if the problem was the autoclave. It is more likely caused by sloppy procedures by a lazy operator, who didn't cook them long enough, didn't swap gloves between putting stuff in and taking stuff out, or some other dumb shortcut.
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UCLA claims they were doing de-con per the manufacturer's recommendations. They've changed it now, which is encouraging. But had they gone off book from the start, they'd be just as liable to infect people for NOT following instructions.
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Had they gone off-book from the start, they might have been liable for problems. Since they can demonstrate problems from going according to the book, they're a lot safer legally in coming up with a new procedure.
Re:From the grave... (Score:4, Funny)
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You're just too young to remember how Eeeeeeeeeevvvvvvviiiiiiillllll that RR was.
And have no sense of humor, either.
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But it us OK because his empire although very evil is just crumbling and unimportant.
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I think you did not read last memo - it is all Putin's.
You're joking, right? Many of the slashdotters who dedicate themselves to blaming everything wrong in the world on Obama barely even know who Putin is. The likelihood that they would blame anything on him is quite nearly zero, especially as the official slashdot narrative remains that Obama is a closet communist/fascist/Islamist/anarchist/socialist/martian/illuminati who is femtoseconds from launching a new plan for world domination.
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Fox does not talk about Putin, so they don't know who he is.
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I thought the main misfortune of Obama is that he was born in Liberia, or was it Haiti?
Or is it simoly that he is black, but not black enough?
Anyway, good that you confirmed he is a martian islamist, he always looked suspicious to me!
Regsrding Putin, that is a russian guy famous for his wrestling with bears! I believe they even have a vodca named after him!
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I thought the main misfortune of Obama is that he was born in Liberia, or was it Haiti?
There is no shortage of birthers out there who are still dedicated to "answering" that question.
However, based on what many slashdot conservatives write, it appears that Obama's biggest failure is in the fact that he has the wrong consonant after his last name. His actual decisions and policies are demonstrably more conservative than their hero Reagan but he happens to be a democrat so he is automatically the antichrist.
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"if discovered"
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flexible endoscopes have been around since the 1960's, and they cannot go through an autoclave. Rigid endoscopes can go through an autoclave, but they are more limited in application.
Maybe a camera endoscope could be designed to last in an autoclave, if you can make one you should patent it and demands the FDA no longer approve older designs as they are difficult to sterilized and have literally killed people already.
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Or get less bent.
Resistance is futile! (Score:1)
Well, actually resistance is surprisingly effective.
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As always, it depends on your point of view. Are you a freedom fighter or a terrorist? A bacterium or some undeveloped, unevolved, barely conscious pond scum that is destroying the planet?
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http://en.wikipedia.org/wiki/Great_Oxygenation_Event
Unpatched bug (Score:3)
From January 9, 2014 ...
This investigation highlights the potential for CRE transmission following ERCP. Health-care facilities with CRE outbreaks should consider the possibility of ERCP-related transmission. If ERCP-related transmission of CRE is suspected, reprocessing and preventative maintenance procedures for ERCP endoscopes should be evaluated in consultation with the manufacturer of the endoscope and automated endoscope reprocessor, if used. In addition, expertise in the evaluation and prevention of CRE transmission are available at CDC and can be accessed via state and local health departments.
http://www.infectioncontroltod... [infectionc...ltoday.com]
So this "bug" went unpatched for at least a year.
To quote Sheldon Cooper. . . (Score:5, Funny)
Sheldon Cooper: To a hospital? Full of sick people? Oh, I don't think so.
Penny: Okay, well, your friend and his mother are there. We're going!
Sheldon Cooper: I can't.
Penny: Oh, don't tell me you're afraid of germs.
Sheldon Cooper: Not all germs. Just the ones that will kill me. The same way I'm not afraid of all steak knives; just the ones that might be plunged in my thorax.
Leonard Hofstadter: Ah-uh, fine, I'll tell Howard you didn't come because you're more concerned about your own well-being than his.
Sheldon Cooper: I would think he would know that.
Penny: Okay, you know what? You are unbelievable. You buy all these superhero T-shirts but when it's time for you to step up and do the right thing, you just hide in the laundry room.
Sheldon Cooper: Fine, I'll go. Just for the record, my Aunt Ruth died in a hospital. She went in to visit my Uncle Roger, caught something, and bit the dust a week later. The two of them now share a coffee can on my mother's mantel.
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It is in large part because the actors add a lot more to the performance than just the recitation of lines. That aside if you can't see the humor in a holier than though know it all being called out on his own personal cowardice then it might follow that you are possesed of the same flaws as Sheldon's character.
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Is it personal cowardice, or pattern recognition?
I've always thought doctor's office waiting rooms were a great way to ensure repeat business.
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Visiting a friend in a hospital though is not like sitting around in a doctor's waiting room. Most of a modern hospital's patients aren't infected with some infectious disease. Patients are typically kept in rooms by themselves or with one other patient. There is also a lot of effort that goes into trying to keep it a relatively sterile environment. The only area of a hospital that you could accurately equate to a waiting room in a doctors office would be the emergency room, which if you are going there to
Oops (Score:5, Insightful)
I'm seriously regretting any anti-bacterial soap I've used over the years right about now.
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It's not normal use that's the issue, it's overuse.
Re:Oops (Score:5, Insightful)
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More like misuse.
Re: Oops (Score:1)
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anti-bacterial (soap) != antibiotics (Score:2, Informative)
Acid, chlorine, etc. all kill bacteria in ways that are unlikely to result in resistant strains.
The compounds in anti-bacterial soap (triclosan for example) are not used to treat internal
infections. Antibiotics are more specalized compounds which target bacteria and are (relatively) harmless to humans.
The problem (if there is one) with anti-bacterial soap seems to be that a certain amount of exposure to
bacteria is apparently good for the human immune system and widespread use of anti-bacterial compounds
work
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I'm seriously regretting any anti-bacterial soap I've used over the years right about now.
I'm regretting the anti-bacterial soap that every moron is using, the evil marketers that tout it as a feature, and the greedy companies that capitalize on people's fear of mostly harmless bacteria.
In case anyone is wondering, one of the best antibacterials is other bacteria, but on the other hand, there are bacteria specialized in surviving in hospital environments including both antibiotics and chemical cleaners. So not only do these soaps train antibiotic resistance in bacteria, but they also clear the w
Re:Oops (Score:4, Informative)
I'm seriously regretting any anti-bacterial soap I've used over the years right about now.
Don't be. We may breed triclosan-resistant bacteria by using antibacterial soap, but that doesn't mean we're breeding carbapenem-resistant bacteria -- the C in CRE -- by using triclosan. There is very little evidence that developed resistance to one type of antibiotic increases resistance to another completely unrelated antibiotic. Triclosan inhibits fatty acid synthesis, carbapenem inhibits synthesis of the peptidoglycans used in bacterial cell walls.
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Wrong. Clearly this isn't your field, so generally speaking, please stop commenting with an authoritative tone on things where you do not have the expertise or the will/ability to think through it.
Increased mutation rates and adaptability of bacteria appear to be significant factors for development of antibiotic resistance and are selected for passage to the next generation through natural selection.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2958.2006.05150.x/pdf
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Not triclosan. You shouldn't buy anti-bacterial soap with triclosan to begin with, it does nothing (probably).
Directly from the Wikipedia page [wikipedia.org]: "Triclosan safety is under review by the FDA[15] and Health Canada.[17]" You can read the page to find out why if you're interested.
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Soap should not be an issue, unless it contains antibiotics, which is hart to believe.
Typical DC Comics (Score:2)
Always doing some new Superman spinoff.
get the lawyers ready (Score:2)
You just said the magic words that summons their lawyers. Law suit time!
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Someone should be answering to a judge over this.
If the DA won't do it then it's up to those "sleazy ambulance chasers".
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On the other side, I'll bet the hospital expects the patients to pay the full bill, including the bill for treatment (successful or not) for the disease the hospital gave them. It's no wonder people are so quick to sue.
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To the tune of "Indo smoke" (Score:2)
Ahh, Endoscope
Pass me the tube so I can take a poke
1 push, 2 push, 3 push, 4 push, 5 I'm feelin deep inside
Leaning to the side in my Ophthalmic ride
With the KY gangsta glide
Woo!, hey now ya know
Inhale, exhale with my flow
Breakaway, come again like this
Hey G promise me use two hands don't miss
Cuz if you do, it break you get broke
Me and Mista G and the endoscope
I'm here all day... (Score:2)
Per Specs (Score:2)
But America, so jack shit will happen.
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The manufacturer is under investigation. [latimes.com] No surprise then that it lead to some illness
Which bacteria? (Score:2)
Look up CRE (Score:4, Interesting)
Current estimates are that 3% of patients in ICU test positive and 1/3 of people in nursing homes.
You read that right, 1/3. Also multiple types of bacteria are CRE. It means they have an enzyme that breaks down a class of antibotics.
This has been sneaking up on us for a while.
I think that the problem is, most bacteria are usually harmless, but these can't be killed easy, and if they ever turn into blood infections the mortality rate seems to be 50%.
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And the final irony? If Ronald Reagan ran for President today, he would be kicked out of the GOP today for being too liberal.
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Tell your brother in law that Obamacare can save him, but only if he repents.
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Most of that is stuff that would have happened regardless of who was President. Reagan (and Bush 1) also ballooned the national debt from about $908 billion in 1980 (32.5% of GDP) to $3,233 in 1990 (54.4% of GDP).
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US were sick when he took office. I am not sure they recovered all that much unless of course yo
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Violating the manufacturers instructions runs the risk of damaging equipment - and - for example - having sharp bits of the broken equipment stab the patient.
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Literally the only reason we are doing this is because the democrats are running out of US citizens that actually want to vote for them. So they're importing voters and pretty much breaking every rule on the books to do it. I'm not saying that if you're a democrat that you're a scummy person. You're probably my neighbor and I'm not mad at you. But the people pushing this at a high level are scummy people. They're used to buying elections and since that isn't working as well as it used to they're importing voters. Its pretty disgraceful.
[facepalm]Oh good God! [/facepalm] If non-citizens are voting in any significant numbers how hard can that be to prove? The Bush II administration made it a point of emphasis with the US Attorneys and they didn't find much. Instead we have Republicans pushing voter ID laws that fall most heavily on low income citizens (legal voters) who otherwise have no need for that kind of ID. They're desperate because they know the demographics are turning against them.
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Voter ID laws are about much more than illegals. In the last presidential contest, Romney get not one vote from 59 voting divisions in Philadelphia. Not one single vote. 19,605 to zero. Same with 9 precincts in Cleveland. Many of these voters are not even literate. This is a statistical impossibility. St. Lucie County in FLA had 141% voter turnout. Without fraud like that, the election might have had a different outcome.
It would help to actually do some research as to how it was probable that Romney would get 0 votes in these 59 districts.
This page: http://hatthief.blogspot.com/2012/11/other-precincts-where-romney-got-0-votes.html [blogspot.com]
Has the best explanation.
I will summarize:
(Obama 4, Romney 0 is hardly statistically significant for
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A quick check with Snopes puts the lie to your claims.
Snopes on 2012 voter fraud. [snopes.com]
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Well, yes but it wasn't some sort of voter fraud conspiracy, it's just what happened given the demographics of the precincts.
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Which Snopes.com disagrees with. I'm going with Snopes.com.
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I await your statistical proof of that statement.
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First, who said they won't be citizens? If you make anyone that crosses the border a citizen then they can vote.
What evidence do you have that is happening? It takes far more than crossing the border to become a citizen of the US (unless you are born here of course).
If the democrats really didn't want illegals to vote then they'd allow for some investigation of the voter roles.
The voter registration lists are a matter of public record. It's not that hard to get them. [google.com] Don't you think that by now if illegals were being allowed to vote someone would have got a list and audited it and blown the lid off that scam?
I think it is you are fooling yourself on this subject.
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As to evidence... I am apparently talking to someone that doesn't read the news.
Type "Obama Amnesty Judge" into your search engine of choice. You'll get a whole page of links referring to Obama's bs being so completely out of control that the US Judiciary is putting the brakes on it. Which is f'ing impressive because they rarely involve themselves in such matters unless the government goes WAY beyond its authority.
As to auditing voter registration lists, they are audited but not by the government. They're a
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As to evidence... I am apparently talking to someone that doesn't read the news.
Type "Obama Amnesty Judge" into your search engine of choice. You'll get a whole page of links referring to Obama's bs being so completely out of control that the US Judiciary is putting the brakes on it. Which is f'ing impressive because they rarely involve themselves in such matters unless the government goes WAY beyond its authority.
Where in all of that do you get that anyone is granting citizenship to any of them? Amnesty from deportation is not tantamount to granting citizenship. In a situation where resources are limited the President has discretion to direct the funds to where he thinks they'll do the most good. Did you know that Obama has deported more people than Bush did before him?
As to auditing voter registration lists, they are audited but not by the government. They're audited by private citizens and they do find fun names on their like "Mickey Mouse" or dead people that have been voting some how for years.
Evidence? Without that you're just making unsubstantiated accusations. I agree that there are dead people on the voter rolls that should be purg
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First, they were talking about granting citizenship to people in mass. Numbers ranged from 200,000 to 5,000,000. That is why the courts put the stop to it. From the perspective of the courts, Obama has the right to not enforce the law which just shows you how flexible the courts are on the matter. However, he was going beyond that to grant citizenship to people in contradiction of the law. Which is why the courts shut it down.
Second, even in the event that citizenship would not be issued, he was talking abo
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Having a social security number has nothing to do with citizenship. Anyone who works legally in the US is eligible for a SSN. All of the non-citizens who are in the country legally working with a green card have SSNs. As an example I specifically know about, Nicolas Batum, a French citizen who plays for the Portland Trailblazers has a social security number. Another example would be a coworker of mine. He is originally from South Africa but found his wife in the US. He became a citizen about 6 years a
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The government has already confirmed that it is possible. You're basically saying the federal government is wrong. And given that the federal government is the last word on that issue... your point is beyond pointless.
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You make the claim yet cite no evidence. Why not link to a federal document that says this?
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You're basically just lying now.
Answer this question NOW with no further evasions.
Why do you think it is appropriate to have more ID checks for someone to buy beer then vote in a national election?
Answer the question. Your political faction has been exploiting weaknesses in our polling system for generations and the evasions at this point are just bred into your bones at this point.
Answer this very simple question or you are admitting I am right.
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I think the proper time to validate whether someone is eligible to vote is when they register to vote. All that should be required on election day is the valid signature of a validly registered voter.
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I win.
You just said it should require a photo ID to buy beer but no such thing required when you vote.
Checkmate. We're done.
*walks off*
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It's been over 30 years since anyone asked me for ID when I buy beer.
I didn't say anything about not requiring some form of ID when you register to vote.
I'll believe that ID should be required to vote when someone demonstrates there is any amount of voter fraud that presenting such an ID prevent. No one has been able to do that even though it was a point of emphasis for the Bush II US Attorneys. So it's the epitome of an unnecessary law to require such an ID for voting.
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I'm asked for ID every time and so is my father. So... no.
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At least around here, we keep public records of who showed up and voted. Somebody could check out anybody thought suspicious, and somebody caught having voted without the legal right would be guilty of a fairly serious crime. There has been some inter-party rancor, and accusations of vote fraud brought up without real evidence. The Franken-Coleman senatorial election was exceedingly close, but all the arguing was about counting the ballots, not vote fraud.
If you want me to support voter ID requirement
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Explain why you're against asking for voter ID at the polling place but think that's okay at a liquor store? Explain why you favor more security to buy booze then to vote in a national election.
I'm sorry. You have no case and your position on this matter is disappointing. You're effectively protecting systemic voter fraud by preventing even rudimentary security.
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If I'm protecting systemic voter fraud, show me the goddam fraud! That's what I'm asking. Show me some significant fraud that ID cards would have prevented, if you want to convince me.
If you can't point to some fraud that ID cards would have prevented, why should I be in favor of voter ID? Not everybody has a driver's license, and getting an ID can be awkward for someone in the wrong neighborhood.
And, again, unless you can show me some fraud, you have no case and your position on this matter is fait
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Show me when a person clearly over 18 can possibly not be entitled to buy alchohol?
Half the reason the evidence is often scanty is that there is no investigation and no mechanism in place to investigate it.
An example of something similar would be that in Japan unsolved murders are often cited as "accidental deaths" even when they were clearly murders. The reason being that it looks better on the crime statistics. It is a big problem in Japan to have unsolved murders. It is also partially why their suicide r
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What facts would you like, mr Anonymous Coward?
And as to facts... what did I lie about? To say I didn't offer supporting evidence is one thing. To charge me with lying is another.
The first does not put any burden on you to provide evidence. The second requires YOU to back up the charge that I lied.
What did I lie about, mr AC? And while you're at it... sign in so I can note the fake name of my accuser. :-)