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Zona Iklim Dunia Pernahkah Anda bertanya-tanya mengapa satu kawasan di dunia adalah padang pasir, padang rumput yang lain, dan hutan hujan lainnya Mengapa ada hutan dan padang pasir yang berbeda, dan mengapa ada berbagai jenis kehidupan di setiap wilayahnya Jawabannya adalah iklim. Iklim adalah kondisi karakteristik atmosfer di dekat permukaan bumi di tempat tertentu di bumi. Ini adalah cuaca jangka panjang daerah itu (setidaknya 30 tahun). Ini termasuk daerah pola umum kondisi cuaca, musim dan cuaca yang ekstrem seperti angin topan, kekeringan, atau masa hujan. Dua faktor terpenting yang menentukan iklim daerah adalah suhu dan presipitasi udara. Biomasa dunia dikendalikan oleh iklim. Iklim suatu wilayah akan menentukan tanaman apa yang akan tumbuh di sana, dan hewan apa yang akan menghuniinya. Semua tiga komponen, iklim, tumbuhan dan hewan terjalin untuk menciptakan kain bioma. Beberapa fakta tentang iklim Sinar matahari menerpa khatulistiwa pada sudut langsung antara 23 176 N dan 23 176 LS. Radiasi yang mencapai atmosfer di sini paling kuat. Dalam semua kasus lainnya, sinar tiba pada sudut ke permukaan dan kurang kuat. Semakin dekat tempat ke kutub, semakin kecil sudutnya dan oleh karena itu kurang intens radiasi. Sistem iklim kita didasarkan pada lokasi daerah massa udara panas dan dingin ini dan sirkulasi atmosfir yang diciptakan oleh angin perdagangan dan westeran. Angin kencang bertiup dari arah ekuator dari timur laut. Selatan khatulistiwa, mereka meniup dari tenggara. Angin perdagangan dari dua belahan bumi bertemu di dekat khatulistiwa, menyebabkan udara naik. Seiring meningkatnya udara mendingin, awan dan hujan berkembang. Roket berawan dan cuaca hujan di dekat khatulistiwa menciptakan kondisi tropis. Westerlies bertiup dari barat daya di belahan bumi utara dan dari barat laut di belahan bumi selatan. Westerlies mengarahkan badai dari barat ke timur melintasi garis lintang tengah. Baik angin barat dan angin bertiup dari sabuk lintang 30 176. Di area yang luas yang berpusat di 30 176 garis lintang, angin permukaannya ringan. Udara perlahan turun untuk menggantikan udara yang berhembus. Setiap uap air yang dikandung udara menguap dalam panas yang hebat. Padang pasir tropis, seperti Sahara Afrika dan Sonoran Meksiko, ada di bawah wilayah ini. Bumi berputar mengelilingi porosnya, yang dimiringkan pada 23,5 derajat. Kemiringan dan radiasi matahari ini berakibat pada musim Bumi. Matahari memancarkan sinar yang melanda permukaan bumi pada berbagai sudut. Sinar ini mengirimkan tingkat energi tertinggi saat mereka menyerang bumi pada sudut kanan (90 176). Suhu di daerah ini cenderung menjadi tempat terpanas di bumi. Lokasi lain, dimana sinar matahari melanda pada sudut yang lebih rendah, cenderung lebih dingin. Saat Bumi berputar pada sumbu miring di sekitar matahari, berbagai bagian Bumi menerima tingkat energi pancaran yang lebih tinggi dan lebih rendah. Ini menciptakan musim. Koumlppen Sistem Klasifikasi Iklim Sistem Klasifikasi Iklim Koumlppen paling banyak digunakan untuk mengklasifikasi iklim dunia. Sebagian besar sistem klasifikasi yang digunakan saat ini didasarkan pada yang diperkenalkan pada tahun 1900 oleh klimatolog Rusia-Jerman Wladimir Koumlppen. Koumlppen membagi permukaan bumi menjadi daerah iklim yang umumnya bertepatan dengan pola vegetasi dan tanah dunia. Sistem Koumlppen mengenali lima jenis iklim utama berdasarkan rata-rata suhu dan presipitasi tahunan dan bulanan. Setiap jenis ditunjuk dengan huruf kapital. A - Iklim Tropis Lembut dikenal dengan suhu tinggi sepanjang tahun dan untuk jumlah besar hujan sepanjang tahun. B - Dry Climates ditandai dengan sedikit hujan dan suhu harian yang sangat besar. Dua subkelompok, S - semi kering atau stepa, dan padang pasir atau padang pasir, digunakan dengan iklim B. C - In Humid Middle Latitude Iklim Perbedaan air tanah berperan besar. Iklim ini memiliki musim panas yang hangat dan kering dan musim dingin yang sejuk dan basah. D - Continental Climates dapat ditemukan di daerah pedalaman dari daratan besar. Presipitasi total tidak terlalu tinggi dan suhu musiman sangat bervariasi. E - Cold Climates menggambarkan jenis iklim ini dengan sempurna. Iklim ini adalah bagian dari area dimana es dan tundra permanen selalu ada. Hanya sekitar empat bulan dalam setahun di atas suhu beku. Subkelompok lebih lanjut ditunjuk oleh huruf kecil kedua yang membedakan karakteristik musiman spesifik suhu dan presipitasi. F - Lembab dengan curah hujan yang memadai di semua bulan dan tidak ada musim kemarau. Surat ini biasanya menyertai A. C. Dan iklim D. M - Iklim hutan hujan meskipun musim kemarau pendek dan kering dalam siklus tipe monsun. Surat ini hanya berlaku untuk iklim A. S - Ada musim kemarau di musim panas belahan bumi masing-masing (musim tinggi matahari). W - Ada musim kemarau di musim dingin dari belahan bumi masing-masing (musim rendah matahari). Untuk lebih menunjukkan variasi iklim, huruf ketiga ditambahkan ke kode. A - Musim panas yang panas dimana bulan terpanas di atas 22176C (72176F). Ini bisa ditemukan di iklim C dan D. B - Musim panas yang hangat dengan bulan terpanas di bawah 22176C (72176F). Ini juga bisa ditemukan di iklim C dan D. C - Cool, musim panas pendek dengan kurang dari empat bulan di atas 10176C (50176F) di iklim C dan D. D - Musim dingin yang sangat dingin dengan bulan terdingin di bawah -38176C (-36176F) hanya di iklim D. H - Kering-kering dengan suhu tahunan rata-rata di atas 18176C (64176F) di iklim B saja. K - Kering-dingin dengan suhu tahunan rata-rata di bawah 18176C (64176F) di iklim B saja. Iklim gurun pasir ini ditemukan di dataran rendah lintang sekitar 18176 sampai 28176 di kedua belahan otak. Sabuk lintang ini berpusat di daerah tropis Cancer and Capricorn, yang terletak di utara dan selatan khatulistiwa. Mereka bertepatan dengan tepi sabuk tekanan tinggi subtropis dan angin kencang. Angin ringan, yang memungkinkan penguapan uap air dalam panas yang kencang. Mereka umumnya mengalir ke bawah sehingga daerah ini jarang ditembus oleh massa udara yang menghasilkan hujan. Hal ini membuat panas sangat kering. Gurun kering kering adalah iklim padang pasir yang benar, dan mencakup 12 permukaan tanah di Bumi. Rentang Suhu: 16176 C Presipitasi Tahunan: 0,25 cm (0,1 inci). Semua bulan kurang dari 0,25 cm (0,1 in). Rentang Lintang: 15176 - 25176 Rentang N dan S. Global: barat daya Amerika Serikat dan utara Meksiko Argentina bagian utara Afrika selatan Afrika bagian tengah Australia. Mid-lintang Iklim: Iklim di zona ini dipengaruhi oleh dua massa udara yang berbeda. Massa udara tropis bergerak ke arah kutub dan massa udara polar bergerak ke arah khatulistiwa. Kedua massa udara ini terus-menerus mengalami konflik. Massa udara bisa mendominasi daerah tersebut, namun tidak memiliki kontrol eksklusif. Ditandai dengan padang rumput, ini adalah iklim semi kering. Hal ini dapat ditemukan antara iklim padang pasir (BW) dan iklim lembab yang lebih lembab dari kelompok A, C, dan D. Jika hujan berkurang, padang rumput akan digolongkan sebagai gurun gersang. Dengan lebih banyak hujan, itu akan digolongkan sebagai padang rumput tallgrass. Iklim kering ini ada di daerah pedalaman benua Amerika Utara dan Eurasia. Massa udara laut yang lembab terhalang oleh pegunungan di barat dan selatan. Rentang gunung ini juga menjebak udara polar di musim dingin, membuat musim dingin sangat dingin. Musim panas hangat sampai panas. Rentang Suhu: 24176 C (43176 F). Presipitasi tahunan: kurang dari 10 cm (4 inci) di daerah terkering sampai 50 cm (20 inci) di stepa moister. Garis Lintang: 35176 - 55176 N. Rentang Global: Amerika Utara Barat (Great Basin, Dataran Tinggi Columbia, Great Plains) Interior Eurasia, dari stepa Eropa timur sampai Gurun Gobi dan China Utara. Iklim ini berada di zona depan polar - medan pertempuran massa udara polar dan tropis. Perubahan musiman antara musim panas dan musim dingin sangat besar. Suhu harian juga sering berubah. Curah hujan yang melimpah turun sepanjang tahun. Hal ini meningkat di musim panas dengan menyerang massa udara tropis. Musim dingin yang dingin disebabkan oleh massa kutub dan Arktik yang bergerak ke selatan. Rentang Suhu: 31 176C (56 176 F) Rata-rata Presipitasi Tahunan: 81 cm (32 inci). Rentang Lintang: 30176 - 55176 N dan S (Eropa: 45176 - 60176 N). Posisi Global: bagian timur Amerika Serikat dan Kanada selatan utara China Korea Jepang tengah dan timur Eropa. Iklim lintang tinggi: Massa udara kutub dan arktik mendominasi daerah ini. Kanada dan Siberia adalah dua sumber massa udara yang termasuk dalam kelompok ini. Mitra belahan bumi bagian selatan ke pusat-pusat kontinental ini tidak ada. Massa udara asal Arktik bertemu dengan massa udara kontinental polar sepanjang parade ke-60 dan ke-70. Ini adalah iklim kontinental dengan musim dingin yang panjang dan sangat dingin, dan musim panas yang pendek dan sejuk. Iklim ini ditemukan di wilayah massa udara polar. Massa udara yang sangat dingin dari Arktik sering bergerak masuk. Kisaran suhu lebih besar daripada iklim lainnya. Presipitasi meningkat selama bulan-bulan musim panas, meskipun curah hujan tahunan masih kecil. Sebagian besar iklim hutan boreal dianggap lembab. Namun, wilayah yang luas di Kanada barat dan Siberia menerima sedikit curah hujan dan jatuh ke tipe iklim subhumid atau semi kering. Rentang Suhu: 41 176C (74 176F), titik terendah -25 176C (-14 176F), tinggi 16 176C (60 176F). Rata-rata Presipitasi Tahunan: 31 cm (12 inci). Garis Lintang: 50176 - 70176 N dan S. Posisi Global: pusat dan barat Alaska Kanada, dari Wilayah Yukon sampai Labrador Eurasia, dari Eropa utara melintasi seluruh Siberia sampai Samudra Pasifik. Iklim dataran tinggi sejuk hingga dingin, ditemukan di pegunungan dan dataran tinggi. Iklim berubah dengan cepat di pegunungan, semakin dingin semakin tinggi ketinggiannya. Iklim daerah dataran tinggi sangat erat kaitannya dengan iklim bioma sekitarnya. Dataran tinggi memiliki musim yang sama, periode basah dan kering sebagai bioma mereka. Iklim pegunungan sangat penting bagi biomassa midlatitude. Mereka bekerja sebagai tempat penyimpanan air. Salju terus kembali sampai musim semi dan musim panas saat dilepaskan perlahan seperti air melalui pencairan. Rentang Suhu: -18 176C sampai 10 176C (-2 176F sampai 50176F) Rata-rata Presipitasi Tahunan: 23 cm (9 inci) Rentang Lintang: ditemukan di seluruh dunia Posisi Global: Rentang Pegunungan Rocky di Amerika Utara, pegunungan Andes di Amerika Selatan, Pegunungan Alpen di Eropa, Mt. Kilimanjaro di Afrika, Himalayans di Tibet, Mt. Fuji di Jepang Bibliografi: Strahler, Arthur N. Strahler, Arthur H. Elements dari Geografi Fisik. John Wiley amp Sons, 1984.Setelah Mencabut Obamacare: Berpindah ke Perawatan Kesehatan Berbasis Pasien yang Berpusat pada Pusat Perawatan Setelah Merusak Obamacare: Berpindah ke Perawatan Kesehatan Berbasis Pasien, Di Market-Based Curtis Dubay, diakui sebagai pakar masalah perpajakan terkemuka. , Adalah rekan peneliti dalam kebijakan pajak dan ekonomi. Obamacare memindahkan perawatan kesehatan Amerika ke arah yang salah dengan mengikis hubungan dokter, mengendalikan keteraturan, dan meningkatkan biaya kesehatan. Reformasi perawatan kesehatan sejati akan memberdayakan individu, dengan dokter mereka, untuk membuat keputusan perawatan kesehatan mereka sendiri terlepas dari campur tangan pemerintah. Karena itu, Obamacare harus dihentikan dan dicabut seluruhnya. Kemudian Kongres dan negara bagian harus memberlakukan reformasi berbasis pasar yang berpusat pada konsumen yang lebih baik melayani orang Amerika. Key Takeaways Obamacare memindahkan perawatan kesehatan Amerika ke arah yang salah. Ini merusak hubungan antara pasien dengan dokter, memusatkan keputusan perawatan kesehatan, dan meningkatkan biaya. Obamacare harus dihentikan dan dicabut sepenuhnya. Kongres dan negara bagian harus mengikuti reformasi berbasis pasar yang dipusatkan pada masyarakat, yang mendapatkan reformasi perawatan kesehatan kembali ke jalur semula. Pilih Bagian 1 0 Toggle open close Untuk kehidupan yang lebih baik, orang Amerika memerlukan sistem perawatan kesehatan yang mereka, bukan pemerintah, kendalikan. Konsumen harus memiliki kemampuan untuk memilih bagaimana memenuhi kebutuhan asuransi kesehatan mereka di pasar bebas untuk asuransi. Wajib Pajak harus mendapatkan keuntungan dari sistem yang lebih efisien dan terjangkau untuk membantu mereka yang membutuhkan perawatan kesehatan namun tidak mampu membelinya. Yang terpenting, pasien, dengan dokter mereka, harus membuat keputusan perawatan kesehatan mereka sendiri terlepas dari campur tangan pemerintah. Langkah pertama yang penting adalah mencabut undang-undang Obamacare yang menempatkan pemerintah yang bertanggung jawab atas perawatan kesehatan. Langkah kedua adalah membiarkan negara tersebut beralih ke sistem berbasis pasar yang berpusat pada pasien yang berfokus pada warga negara dan bukan pada pemerintah. Prinsip-prinsip untuk Reformasi Agar orang Amerika dapat merebut kembali kendali atas perawatan kesehatan mereka sendiri dan mendapatkan keuntungan dari persaingan di pasar bebas untuk asuransi dan perawatan kesehatan, Kongres harus mencabut undang-undang Obamacare dan memberlakukan reformasi berbasis pasar yang berbasis pada masyarakat berdasarkan lima prinsip: Pilih , Mengendalikan, dan membawa asuransi kesehatan Anda sendiri Biarkan pasar bebas menyediakan layanan asuransi dan perawatan kesehatan yang diinginkan orang Mendorong pengusaha untuk memberikan manfaat asuransi kesehatan portabel kepada karyawan Membantu mereka yang memerlukan bantuan melalui masyarakat sipil, pasar bebas, dan negara bagian dan Lindungi hak hati nurani dan anak yang belum lahir. Perlindungan Pasien dan Perawatan Terjangkau (Obamacare) memindahkan perawatan kesehatan ke arah yang salah. Ini menempatkan pemerintah, bukan pasien, yang bertanggung jawab atas keputusan perawatan kesehatan individu. Apalagi, gagal memenuhi janji yang dituangkan oleh Presiden Barack Obama. Dengan berlalunya hari, semakin jelas bahwa Obamacare tidak akan mengurangi premi untuk keluarga Amerika rata-rata, membengkokkan kurva biaya dalam belanja perawatan kesehatan, atau menurunkan defisit. Untuk alasan ini, antara lain, Obamacare harus dicabut. Namun, kembali ke status quo sebelum Obamacare bukanlah langkah terakhir. Pembuat kebijakan harus mengupayakan reformasi berdasarkan lima prinsip dasar. Mengadopsi reformasi semacam itu akan mendorong perawatan kesehatan Amerika ke arah yang benar: menuju sistem perawatan kesehatan berbasis pasar yang berpusat pada pasien. Prinsip 1: Memilih, mengendalikan, dan membawa asuransi kesehatan Anda sendiri. Reformasi kesehatan sejati harus mempromosikan kepemilikan pribadi atas asuransi kesehatan. Sementara Obamacare menggunakan pertukaran asuransi yang dikelola pemerintah untuk membatasi pilihan individu, reformasi nyata akan berfokus pada mendorong orang Amerika untuk membeli polis asuransi yang dapat mereka bawa dari pekerjaan ke pekerjaan dan ke masa pensiun di pasar bebas yang kompetitif. Pembuat kebijakan harus memberlakukan beberapa perubahan penting bagi budaya kepemilikan perawatan kesehatan pribadi ini untuk mengakar. Portabilitas. Kebanyakan orang Amerika mendapatkan liputan melalui tempat kerja mereka. Hal ini memungkinkan pengusaha untuk memberikan manfaat kesehatan bebas pajak kepada karyawan mereka, sementara individu yang membeli asuransi kesehatan sendiri harus menggunakan uang setelah pajak. Akibatnya, sebagian besar perorangan dengan asuransi kesehatan swasta mendapatkan liputan dari atasan mereka.1 Daripada mengikuti contoh Obamacares untuk memaksa orang Amerika beralih ke pertukaran asuransi kesehatan yang dijalankan oleh pemerintah, reformasi perawatan kesehatan yang berpusat pada pasien sebenarnya akan membuat asuransi lebih portabel. Individu harus dapat membeli polis asuransi saat mereka masih muda dan membawa kebijakan tersebut sepanjang masa kerja mereka ke masa pensiun. Bantuan Pajak yang Sama. Sementara Obamacare mengubah perlakuan pajak atas asuransi kesehatan, hal itu dilakukan dengan cara meningkatkan beban pembayar pajak. 40 persen pajaknya untuk apa yang disebut rencana asuransi kesehatan Cadillac hanyalah satu dari 18 kenaikan pajak terpisah yang termasuk dalam undang-undang, 2 yang, menurut Kantor Anggaran Kongres dan Komite Bersama untuk Perpajakan, akan meningkatkan pendapatan 771 miliar dari tahun 2013 menjadi 2022.3 Pendekatan yang lebih baik akan menyamakan perlakuan pajak terhadap asuransi kesehatan tanpa meningkatkan pendapatan baru. The Heritage Foundation sebelumnya telah mengusulkan untuk mengganti deduksi yang ada untuk cakupan kesehatan yang diberikan oleh pemberi kerja dengan kredit pajak datar yang dapat digunakan individu untuk membeli polis asuransi kesehatan mereka sendiri.4 Gagasan lain, yang pertama kali diajukan oleh Presiden George W. Bush, Akan memberi semua orang Amerika membeli sampul kesehatan melalui majikan atau mereka sendiri dengan deduksi standar yang sama untuk asuransi kesehatan.5 Kedua proposal tersebut mengasumsikan netralitas pendapatan lebih dari 10 tahun. Tidak seperti Obamacare, mereka tidak mengusulkan menggunakan reformasi untuk meningkatkan penerimaan pajak bersih. Kedua proposal ini akan menyelesaikan dua tujuan penting. Pertama, mereka akan menyamakan perlakuan pajak antara cakupan kesehatan yang diberikan melalui pemberi kerja dan cakupan kesehatan yang dibeli oleh seseorang. Memberikan perlakuan pajak yang sama akan menghilangkan hambatan utama yang membuat individu enggan membeli dan memegang polis asuransi kesehatan mereka selama bertahun-tahun dan menerima liputan dari pekerjaan ke pekerjaan. Ekuitas pajak juga akan mendorong perusahaan untuk memberikan kontribusi langsung terhadap cakupan kesehatan pekerja mereka atau untuk meningkatkan upah sebagai pengganti manfaat kesehatan. Kedua, membatasi jumlah manfaat pajak yang diberikan, baik dengan kredit pajak atau dengan deduksi standar, akan mendorong individu untuk menjadi pembeli asuransi kesehatan yang lebih cerdas. Studi telah menunjukkan bahwa manfaat pajak yang belum dibuka saat ini untuk asuransi kesehatan yang diberikan oleh majikan mendorong perusahaan untuk menawarkan rencana kesehatan yang lebih kaya dan individu untuk mengurangi konsumsi perawatan kesehatan. Menurut Kantor Anggaran Kongres, mereformasi perlakuan pajak terhadap asuransi kesehatan akan memberikan insentif yang lebih kuat bagi para peserta untuk mempertimbangkan manfaat dan biaya yang diharapkan dari kebijakan saat membeli asuransi, sehingga membantu mengurangi biaya.6 Pilihan Penyedia. Melalui sistem kontrol pemerintahannya yang baru, Obamacare membatasi pilihan dan akses bagi banyak pasien. Aktuaris nonpartisan Medicare menyimpulkan bahwa pengurangan penggantian Medicare di Obamacare dapat membuat 40 persen dari semua rumah sakit tidak menguntungkan dalam jangka panjang, sehingga membatasi akses terhadap perawatan penerima.7 Selain itu, laporan awal menunjukkan bahwa pertukaran asuransi Obamacares akan menampilkan jaringan penyedia terbatas dalam upaya Untuk mengurangi kenaikan premi untuk pertukaran pertukaran pembelian individu.8 Unsur terpenting dari sistem perawatan kesehatan adalah hubungan terpercaya antara dokter dan pasien. Setiap sistem perawatan kesehatan yang berpusat pada pasien harus bekerja untuk mempertahankan ikatan penting tersebut dan untuk memperbaiki kerusakan pada obligasi yang disebabkan oleh Obamacare. Mendorong Tabungan Pribadi. Sejak didirikan pada tahun 2004, rekening tabungan kesehatan (HSA) telah menjadi cara yang populer bagi jutaan keluarga untuk membangun tabungan untuk biaya perawatan kesehatan yang dibutuhkan. Rencana HSA menggabungkan opsi asuransi kesehatan yang menampilkan perlindungan bencana deductiblebut yang sedikit lebih tinggi jika terjadi biaya pengobatan yang signifikan dengan rekening tabungan bebas pajak. Sebagai salah satu dari beberapa pilihan kesehatan konsumen baru, HSA mendorong pasien untuk mengendalikan perawatan kesehatan mereka sendiri, memberikan insentif finansial bagi konsumen untuk dijadikan pembeli perawatan kesehatan yang bijaksana. Selama beberapa tahun terakhir, jutaan keluarga telah memanfaatkan alat inovatif yang ditawarkan oleh rencana HSA. Jumlah orang yang terdaftar dalam kebijakan yang memenuhi syarat HSA telah meroket dari 1 juta pada bulan Maret 2005 menjadi 15,5 juta pada bulan Januari 2013.9 Sejumlah penelitian juga menunjukkan bahwa individu dengan rencana HSA telah menggunakan alat yang disediakan oleh perusahaan asuransi kesehatan mereka untuk lebih terlibat dalam perawatan kesehatan mereka. Misalnya, dengan menggunakan alat pendukung online, menanyakan tentang biaya dan kualitas penyedia layanan, dan mencari perawatan preventif.10 Akibatnya, individu telah berhasil menyelamatkan setidaknya 12,4 miliar di HSA mereka pada akhir tahun 2011.11 Namun, pemegang HSA masih menghadapi hambatan untuk membangun Tabungan pribadi Misalnya, berdasarkan undang-undang saat ini, dana yang disumbangkan ke HSA mungkin tidak digunakan untuk membayar premi asuransi, kecuali dalam situasi yang sangat terbatas.12 Mengubah batasan ini dan meningkatkan batas kontribusi HSA akan meningkatkan baik tabungan pribadi dan kepemilikan pribadi atas asuransi kesehatan. Cakupan untuk Kondisi Pra-Ada. Masalah menyediakan akses terhadap individu dengan kondisi yang sudah ada, meski sangat nyata, tidak memerlukan perubahan besar dalam sistem perawatan kesehatan Amerika yang termasuk dalam Obamacare. Pada tahun 2011, Pemerintahan Obama menyarankan bahwa sebanyak 129 juta orang Amerika dengan kondisi yang sudah ada sebelumnya berisiko dan dapat ditolak pertanggungannya tanpa adanya perubahan besar di pasar asuransi Amerika Serikat. 13 Klaim itu sangat tidak benar. Berdasarkan undang-undang sebelumnya, individu dengan cakupan yang disponsori majikan (90 persen pasar swasta) tidak dapat dikenai pengecualian kondisi sebelumnya.14 Sebenarnya, sebelum Obamacare, jumlah individu dengan kondisi yang sudah ada sebelumnya yang benar-benar tidak dapat Mendapatkan cakupan kesehatan jauh lebih kecil, dan masalahnya hanya ada di pasar individu. Oleh karena itu, tidak mengherankan bahwa, menurut data terbaru, hanya diperkirakan 134.708 individu telah mendaftarkan diri dalam program renang berisiko tinggi federal tambahan karena dibuat di bawah Obamacare untuk mencakup individu dengan kondisi yang ada.215 masih kurang dari 200.000 individu Awalnya diproyeksikan untuk mendaftar.16 Negara-negara dapat menggunakan berbagai pendekatan untuk memberikan perlindungan kepada individu-individu yang tidak dapat membeli asuransi. Misalnya, 35 negara bagian telah mengoperasikan kolam berisiko tinggi dengan pendaftaran kolektif saat ini yang mencapai 220.000 individu untuk memastikan akses terhadap cakupan bagi individu dengan kondisi yang ada sebelumnya.17 Sebagai alternatif, negara bagian dapat membentuk mekanisme reasuransi atau mekanisme transfer risiko dimana perusahaan asuransi akan mengganti setiap Lain untuk biaya merawat individu dengan biaya pengobatan tinggi tanpa menambahkan dana dari wajib pajak negara bagian atau federal. Pendekatan apa pun akan jauh lebih baik daripada jumlah besar peraturan, perpajakan, dan pengeluaran pemerintah di bawah Obamacare. Prinsip 2: Biarkan pasar bebas menyediakan layanan asuransi dan perawatan kesehatan yang diinginkan orang. Banyak orang telah mengetahui bahwa, sebagian karena Obamacare, dengan pertukaran kesehatan yang dikelola pemerintah, birokrasi baru, dan bentuk kontrol pemerintah lainnya, mereka tidak dapat mempertahankan asuransi kesehatan mereka saat ini.18 Ada cara yang lebih baik, Dan itu melibatkan pemberian lebih banyak pilihan melalui insentif pasar daripada merongrong pasar melalui birokrasi terpusat. Pembelian Lintas Negara. Saat ini, pasar asuransi negara menderita dua kekurangan: Banyak pasar tidak kompetitif, dengan 70 persen wilayah metropolitan dianggap sangat terkonsentrasi, 19 dan mandat yang menguntungkan mahal meningkatkan premi asuransi kesehatan. Analisis Heritage Foundation sebelumnya menemukan bahwa setiap mandat manfaat menaikkan biaya dengan rata-rata sekitar 0,75 per bulan.20 Studi lain menemukan bahwa negara-negara telah memberlakukan total 2.271 mandat manfaat sekitar 45 per negara.21 Secara keseluruhan, kedua studi ini menunjukkan bahwa Efek kumulatif dari mandat ini bisa menaikkan premi pada 2040 per bulan, atau ratusan dolar per tahun. Kongres dapat membantu mengurangi masalah ini dengan menghapus hambatan federal ke perdagangan antarnegara dalam produk asuransi kesehatan. Individu harus memiliki kemampuan untuk membeli produk asuransi di seluruh lini negara bagian, memilih rencana kesehatan yang paling sesuai dengan kebutuhan mereka terlepas dari lokasi penerbitnya. Mekanisme penyemprotan. Cara lain untuk memperbaiki pilihan pasien dan membuat pasar asuransi lebih kompetitif akan melibatkan pengaturan pembelian baru dan mekanisme penyatuan. Usaha kecil, asosiasi keanggotaan individu, kelompok agama, dan organisasi persaudaraan harus dapat menjual polis asuransi kesehatan melalui pengaturan pembelian kelompok baru. Peran pemerintah federal harus menghapus hambatan dalam pengaturan semacam itu. Dengan memperluas manfaat cakupan kelompok di luar tempat kerja, pengaturan pembelian baru ini juga akan mendorong portabilitas cakupan asuransi kesehatan. Reformasi ini akan memungkinkan individu mendapatkan rencana kesehatan mereka dari sumber terpercaya yang dengannya mereka cenderung memiliki hubungan yang lebih lama daripada yang mereka miliki dengan perusahaan mereka sehingga menciptakan suatu bentuk cakupan kesehatan yang benar-benar dapat dimiliki oleh orang Amerika. Medicare Private Contracting. Lanjut usia juga bisa mendapatkan keuntungan dari reformasi Medicare yang berpusat pada pasien, salah satunya akan membantu mengembalikan hubungan antara para dokter. Kongres harus menghilangkan pembatasan anti-persaingan yang mencegah dokter dan pasien dari kontrak secara pribadi untuk layanan medis di luar Medicare tradisional.22 Kongres juga dapat merestrukturisasi manfaat Medicare, memodernisasi perancangan program yang sebagian besar tidak berubah sejak diciptakan hampir 50 tahun Ago.23 Perubahan ini akan meningkatkan pilihan pasien sambil melestarikan solvabilitas program untuk generasi Amerika masa depan. Reformasi Medicare. Sayangnya, Obamacare memberlakukan banyak dampaknya yang paling berbahaya bagi warga lanjut usia.24 Menurut aktuaris Medicare, pengurangan penggantian Medicare di Obamacare akan membuat 15 persen rumah sakit tidak menguntungkan dalam dekade ini dan 40 persen tidak menguntungkan pada tahun 2050.25 Akibatnya, para manula mungkin menghadapi Hambatan signifikan untuk mendapatkan perawatan kesehatan di masa depan. Ada cara yang lebih baik. Secara khusus, Kongres harus memberi para manula subsidi murah untuk membeli rencana Medicare yang mereka pilih. Orang tua yang memilih rencana biaya lebih rendah dari subsidi akan membayar lebih sedikit, sementara manula yang memilih rencana biaya lebih dari subsidi akan membayar selisih harga.26 Consumer Choice and Competition. Sebagai bagian dari sistem kontrol pemerintahnya, Obamacare menghalangi kemampuan pasien untuk memilih rencana kesehatan mereka sendiri. Satu survei menemukan bahwa mandat dan persyaratan dalam undang-undang tersebut berarti bahwa lebih dari separuh semua polis asuransi yang dibeli secara langsung oleh individu tidak akan memenuhi syarat sebagai persetujuan pemerintah di bawah Obamacare.27 Akibatnya, banyak orang Amerika menemukan bahwa mereka tidak dapat Simpan rencana kesehatan yang mereka miliki dan sukai28 meskipun Presiden Obama berulang kali berjanji.29 Reformasi berpusat pada pasien yang benar akan memperkuat HSA dan produk kesehatan yang diarahkan konsumen lainnya seperti pengaturan penggantian kesehatan dan akun pengeluaran fleksibel yang memiliki kemampuan untuk mengubah perawatan kesehatan Amerika. Sebuah studi yang diterbitkan dalam jurnal bergengsi Health Affairs di tahun 2012 menemukan bahwa memperluas penetrasi pasar terhadap rencana kesehatan berbasis konsumen dari 13 persen menjadi 50 persen dari semua pengusaha dapat mengurangi biaya kesehatan hingga 73,6 miliar per yeara pengurangan pengeluaran kesehatan 9,1 persen .30 Dengan kata lain, memperluas pilihan dan persaingan konsumen dapat mengurangi biaya perawatan kesehatan dan membelanjakan kebalikan dari Obamacare, yang membatasi pilihan konsumen dan meningkatkan biaya dan pengeluaran kesehatan. Prinsip 3: Mendorong pengusaha untuk memberikan manfaat asuransi kesehatan portabel. Karena kebanyakan orang Amerika secara tradisional telah menerima asuransi kesehatan dari majikan mereka, banyak orang memiliki sedikit pilihan jika memilih rencana kesehatan. Menurut survei yang paling luas terhadap rencana perusahaan, hampir sembilan dari 10 perusahaan (87 persen) hanya menawarkan satu jenis rencana, dan hanya 2 persen menawarkan tiga atau lebih jenis rencana.31 Akibatnya, karyawan hanya memiliki kemampuan yang sangat terbatas untuk memilih Rencanakan yang paling sesuai dengan kebutuhan mereka. Iuran pasti Solusi ideal akan mengubah sistem asuransi kesehatan tradisional yang diberikan pemberi kerja dari model manfaat pasti menjadi model kontribusi pasti. Alih-alih memberikan asuransi kesehatan secara langsung, pengusaha malah akan menawarkan kontribusi tunai kepada pekerjanya, yang memungkinkan mereka untuk membeli rencana yang mereka pilih sendiri. Dikombinasikan dengan perubahan dalam perlakuan pajak atas perbaikan asuransi kesehatan dan peraturan untuk meningkatkan portabilitas, beralih ke model kontribusi asuransi kesehatan yang pasti akan memungkinkan para pekerja untuk membeli polis asuransi kesehatan di masa muda mereka dan mengambil kebijakan tersebut dengan mereka dari pekerjaan ke pekerjaan ke masa pensiun. . Perubahan ini juga akan memungkinkan pekerja dan keluarga untuk menegosiasikan kontribusi dari banyak pengusaha daripada hanya memiliki satu kaki majikan tagihan. Prinsip 4: Membantu mereka yang membutuhkan bantuan melalui masyarakat sipil, pasar bebas, dan negara bagian. Sementara beberapa reformasi kesehatan seperti mengubah perlakuan pajak atas asuransi kesehatan dan mereformasi program Medicare yang sepenuhnya berada dalam lingkup pemerintah federal, negara bagian juga memainkan peran penting dalam memberlakukan reformasi yang dapat menurunkan biaya, memperbaiki akses terhadap perawatan, dan memodernisasi program Medicaid negara . Dengan melayani sebagai laboratorium demokrasi, negara bagian dapat memberikan contoh bagi negara-negara lain dan pemerintah federal untuk mengikutinya. Karena banyak reformasi berbasis negara tidak bergantung pada keterlibatan dan persetujuan Washingtons, negara dapat bergerak maju dengan solusi berbasis pasar yang inovatif, bahkan ketika birokrat federal berusaha menerapkan pendekatan sentris pemerintah Obama. Inovasi Negara. Jika diberi ruang dan waktu yang tepat oleh pemerintah federal yang terlalu mengganggu, negara dapat bertindak sendiri untuk membuka pasar asuransi mereka. Beberapa negara telah bertindak untuk membuka pasar asuransi mereka. Pada tahun 2011, Georgia memberlakukan undang-undang yang mengizinkan pembelian asuransi kesehatan antarnegara, dan Maine mengeluarkan undang-undang yang mengizinkan perusahaan penerbangan dari negara bagian New England lainnya untuk menawarkan produk asuransi kepada warganya.32 Sebelum Obamacare diberlakukan pada tahun 2010, Wyoming bertindak untuk mengizinkan out-of-state Perusahaan asuransi untuk menawarkan produk.33 Meskipun mungkin perlu beberapa saat sebelum negara bagian yang kritis menciptakan pasar interstate yang benar untuk asuransi, upaya baru-baru ini ini menunjukkan minat nasional untuk memperluas pilihan dan persaingan asuransi kesehatan. Bantuan Premium Medicaid. Di antara berbagai bentuk cakupan kesehatan, program Medicaid dikenal dengan kualitas dan hasil buruknya bagi pasien. Sejumlah penelitian menemukan bahwa pasien Medicaid mengalami hasil yang lebih buruk daripada pasien lain yang menderita.34 Sebuah studi baru-baru ini dari Oregon menyimpulkan bahwa setelah dua tahun, pasien di Medicaid tidak mencapai manfaat kesehatan terukur dari cakupan asuransi mereka.35 Bahkan, para peserta mengakui bahwa banyak dokter, karena Program dengan tingkat penggantian yang rendah, tidak akan memperlakukan pasien Medicaid yang mengeluh bahwa program tersebut bukan asuransi nyata.36 Obamacare membuat masalah Medicaids semakin buruk, sehingga mengantarkan jutaan orang lagi ke program yang dikelola oleh pemerintah yang buruk ini. Reformasi sejati justru akan mensubsidi asuransi kesehatan swasta untuk penerima manfaat Medicaid berpenghasilan rendah. Yayasan Warisan sebelumnya telah mempromosikan solusi semacam itu sebagai bagian dari reformasi komprehensif program Medicaid.37 Kongres harus mengambil langkah untuk mendorong negara-negara memberikan bantuan premium. Program semacam itu akan mempromosikan kepemilikan perawatan kesehatan dan memberi manfaat bagi para penerima manfaat dengan akses yang lebih baik daripada program Medicaid tradisional. Reformasi Medicaid. Terlepas dari kehadiran Obamacare yang menjulang, negara harus terus sedapat mungkin mencari kesempatan untuk mereformasi program Medicaid mereka, bergerak menuju perawatan yang lebih personal dan termasuk insentif yang kuat untuk tanggung jawab pribadi. Negara juga dapat meminta fleksibilitas tambahan dari Washington untuk memodernisasi perawatan. Banyak gubernur telah mengajukan permintaan semacam itu.38 Kongres juga harus bertindak untuk mereformasi dan memodernisasi Medicaid. Efforts in this vein would include comprehensive reformssuch as a block grant or per capita spending capsthat trade additional flexibility for states in exchange for a fixed spending allotment from Washington.39 Other reforms could incentivize and subsidize Medicaid beneficiaries to move to private insurance policies that they can own and keep. All of these reforms would focus on modernizing Medicaid to provide better quality care, reduce costs, and promote personal responsibility and ownership. Reducing Fraud. Regrettably, many government health programs are riddled with fraud. Some estimates suggest that as much as 60 billion in Medicare spending may involve fraud.40 Similar problems plague many state Medicaid programs. A 2005 New York Times expos on Medicaid fraud quoted James Mehmet, a former chief investigator in New York State, as saying that 10 percent of the states Medicaid spending constituted outright fraud, with another 20 percent to 30 percent comprising unnecessary spending that might not be criminal. Overall, Mehmet estimated that questionable Medicaid spending totaled 18 billion in New York State alone.41 Congress and the states should do more to crack down on the waste, fraud, and abuse that plague Americas health entitlements. Reforms should end the current pay and chase model, under which investigators must attempt to track down fraudulent claims and providers after they have already received reimbursement. Other solutions would enhance penalties for those who engage in fraudulent activityfor instance, buying or selling personal patient information, which is often used to perpetrate fraud schemes. These and other reforms would save taxpayer dollars, helping to preserve Medicare and Medicaid for future generations. Removing Barriers to Care. With studies indicating that America faces a doctor shortage in future years, policymakers should focus on removing barriers that discourage institutions from assisting those who need health care.42 Regrettably, Americas litigious culture has resulted in the widespread practice of defensive medicine by doctors and other health practitioners. In response, some states have changed their medical liability laws to discourage frivolous lawsuits, prompting doctors to move to those states to practice medicine. Were other states to adopt such reforms, this would encourage doctorsa majority of whom believe the practice of medicine is in jeopardy43 to remain in practice and would encourage students to join the profession. In addition, reforms that improve the liability system could reduce the prevalence of defensive medicine practices and thereby help to reduce health costs. One government estimate found that reasonable limits on non-economic damages could reduce total health spending by as much as 126 billion per year by reducing the amount of defensive medicine practiced by physicians.44 More recently, the Congressional Budget Office concluded that enacting comprehensive liability reform would reduce health care spending by tens of billions of dollars per year, reducing the federal budget deficit by tens of billions over the next decade.45 To help to eliminate barriers to care and reduce health costs, states should reform their liability systems, capping non-economic damages and taking other steps to reduce the incidence of frivolous lawsuits and ensure proper legal protections for health care providers.46 However, because liability reform and torts in general are properly a state issue, Congress should not impose liability reforms except where the federal government has a clear, constitutionally based federal interest. Examples might include liability reforms with respect to medical products approved by the federal Food and Drug Administration or when the federal government is a payer of health care services, as it is with Medicare and Medicaid.47 Reforming Scope-of-Practice and Certificate of Need. State governments control the licensure of both medical professionals and medical practices. By removing artificial obstacles that restrict the supply of medical providers, states can expand access to health services across populations while unleashing new competition that can work to reduce costs. States can reform their health care systems by re-examining scope-of-practice laws, which frequently limit the ability of nurse practitioners and other health professionals to care for patients. In 2010, the Institute of Medicine concluded that state regulations often restrict the ability of nurses to provide care legally and that policymakers should remove barriers that limit the ability of nurses to practice to the full extent of their education, training, and competence.48 Many states have begun to reform their scope-of-practice laws to allow physician assistants, nurse practitioners, and others to treat more patients even as entrenched interests have fought to preserve their preferential treatment.49 States should follow the recommendations of the Institute of Medicine in reforming their scope-of-practice laws to allow all medical professionals to practice to the full extent of their training. A total of 36 states also impose certificate-of-need requirements, which impede the introduction of new hospitals and medical facilities. These laws require organizations seeking to build new medical facilities to obtain a certificate from a state board that the facility is needed in a particular area.50 As with scope-of-practice requirements, reforming or eliminating certificate-of-need restrictions would encourage the development of new medical facilities, expanding access to care and giving patients more choices. Principle 5: Protect the right of conscience and unborn children. Government should not compel individuals to undertake actions that violate their deeply held religious beliefs. Regrettably, Obamacare imposes just such a requirement on Americans, forcing many employers to offer, and individuals to purchase, health coverage that violates the core tenets of their faith regarding the protection of life.51 Congress should ensure that individuals never again are required to violate their religious beliefs to meet a government diktat. Rights of Conscience. Congress should protect the rights of consumers, insurers, employers, and medical personnel to refrain from facilitating, participating in, funding, or providing services contrary to their consciences or the tenets of their religious faith. Enacting these protections would prevent Americans from facing the moral dilemma presented by Obamacare, which has forced individuals, employers, and religious organizations to choose between violating the law and violating their faith or consciences. Permanent Prohibition on Taxpayer-Funded Abortion. Congress should make permanent in law the existing annually enacted prohibitions on the use of federal taxpayer funds to finance abortions or health insurance coverage that includes elective abortions. These protections, enacted as the Hyde Amendment every year since 1976, prevent the use of taxpayer dollars to fund elective abortions.52 After nearly 40 years of renewing these protections on an annual basis, Congress should finally make them permanent in law. A New Vision for Health Reform Obamacare moves American health care in the wrong direction. Not only does the law raise health costs rather than lowering them, but it creates new bureaucracies that will erode the doctorpatient relationship.53 The trillions of dollars in new spending for Obamacare will place a massive fiscal burden on future generations of taxpayers.54 For these reasons and more, Congress should repeal the law in its entirety. Once this has been done, policymakers should then advance health reforms that move toward patient-centered, market-based health care. Such reforms would promote personal choice and ownership of health insurance enable the free market to respond to consumer demands encourage portability of coverage for workers help civil society, the free markets, and the states to assist those in need and protect the rights of faith, conscience, and life. 1 According to the most recent census data, 86.2 percent of Americans with private health insurance coverage obtained that coverage through an employer. Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica C. Smith, Income, Poverty, and Health Insurance Coverage in the United States: 2011 . U.S. Census Bureau, September 2012, p. 65, Table C-1, census.govprod2012pubsp60-243.pdf (accessed September 20, 2013). 3 Joint Committee on Taxation, Estimated Revenue Effects of a Proposal to Repeal Certain Tax Provisions Contained in the Affordable Care Act (ACA), June 15, 2012, and Congressional Budget Office, Table 2: CBOs May 2013 Estimate of the Budgetary Effects of the Insurance Coverage Provisions Contained in the Affordable Care Act, cbo.govsitesdefaultfilescbofilesattachments44190EffectsAffordableCareActHealthInsuranceCoverage2.pdf. The total amount of tax revenue collected from the individual mandate, employer mandate, and 40 percent excise tax on high-cost health plans comes from the CBOs May 2013 estimate. For all other taxes, the amount of tax revenue totaled comes from the Joint Committee on Taxations June 2012 estimation. 5 The White House, Affordable, Accessible, and Flexible Health Coverage, 2007, georgewbush-whitehouse.archives.govstateoftheunion2007initiativeshealthcare.html (accessed September 20, 2013). Recently, the House Republican Study Committee included a standard deduction in its proposal for health reform. See U.S. House of Representatives, Republican Study Committee, The American Health Care Reform Act, September 18, 2013, rsc.scalise.house.govsolutionsrsc-betterway.htm (accessed September 25, 2013). 6 Congressional Budget Office, Key Issues in Analyzing Major Health Insurance Proposals . December 2008, pp. 8487, cbo.govsitesdefaultfilescbofilesftpdocs99xxdoc992412-18-keyissues.pdf (accessed September 20, 2013). 7 John D. Shatto and M. Kent Clemens, Projected Medicare Expenditures Under Illustrative Scenarios with Alternative Payment Updates to Medicare Providers, Centers for Medicare and Medicaid Services, Office of the Actuary, May 31, 2013, pp. 810, cms.govResearch-Statistics-Data-and-SystemsStatistics-Trends-and-ReportsReportsTrustFundsDownloads2013TRAlternativeScenario.pdf (accessed September 20, 2013). 8 Anna Wilde Mathews, Many Health Insurers to Limit Choices of Doctors, Hospitals, The Wall Street Journal . August 15, 2013, online.wsjarticleSB10001424127887323446404579010800462478682.html (accessed September 20, 2013 subscription required). 9 Americas Health Insurance Plans, Center for Policy and Research, January 2013 Census Shows 15.5 Million People Covered by Health Savings AccountHigh-Deductible Health Plans (HSAHDHPs), June 2013, ahip.orgHSACensus2013PDF (accessed September 20, 2013). 10 Americas Health Insurance Plans, Center for Policy and Research, Health Savings Accounts and Account-Based Health Plans: Research Highlights, July 2012, ahip.orgHSAHighlightsReport072012 (accessed September 20, 2013). 11 Devenir, Health Savings Accounts Surpass 12.4 Billion in 2011, January 31, 2012, devenir2012devenir2011yearendsurvey (accessed September 20, 2013). 12 For the definition of qualified medical expenses, see 26 U.S. Code 223(d)(2). HSA funds can be used to purchase health insurance only for COBRA continuation health coverage, health insurance purchased during periods of unemployment, Medigap supplemental coverage, or long-term care insurance (within certain limits). 13 U.S. Department of Health and Human Services, Office of Planning and Evaluation, At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans, November 2011, aspe.hhs.govhealthreports2012pre-existingindex.shtml (accessed September 20, 2013). 14 Edmund Haislmaier, HHS Report on Obamacares Preexisting Conditions Impact: Say What. The Heritage Foundation, The Foundry, January 19, 2011, blog.heritage.org20110119hhs-report-on-obamacares-preexisting-conditions-impact-say-what . 15 Centers for Medicare and Medicaid Services, Center for Consumer Information and Insurance Oversight, Covering People with Pre-Existing Conditions: Report on the Implementation and Operation of the Pre-Existing Condition Insurance Plan Program, January 31, 2013, cms.govCCIIOResourcesFilesDownloadspcipannualreport01312013.pdf (accessed September 24, 2013). 17 National Association of State Comprehensive Health Insurance Plans, Pool Membership2011, September 2012, naschip.org2012Quick20ChecksPool20Membership202011.pdf (accessed September 20, 2013). 19 Press release, New AMA Study Finds Anticompetitive Market Conditions Are Common Across Managed Care Plans, American Medical Association, November 28, 2012, ama-assn.orgamapubnewsnews2012-11-28-study-finds-anticompetitive-market-conditions-common.page (accessed September 20, 2013). 21 Council for Affordable Health Insurance, Health Insurance Mandates in the States 2012: Executive Summary, April 9, 2013, cahi.orgcahicontentsresourcespdfMandatesinthestates2012Execsumm.pdf (accessed September 24, 2013). 23 Robert E. Moffit and Rea S. Hederman, Jr. Medicare Savings: Five Steps to a Down Payment on Medicare Reform, Heritage Foundation Issue Brief No. 3908, April 11, 2013, heritage.orgresearchreports201304medicare-savings-5-steps-to-a-downpayment-on-structural-reform . 25 Shatto and Clemens, Projected Medicare Expenditures Under Illustrative Scenarios, pp. 810. 26 Owcharenko, Saving the American Dream: A Blueprint for Putting Patients First. 27 Jon R. Gabel, Ryan Lore, Roland D. McDevitt, Jeremy D. Pickreign, Heidi Whitmore, Michael Slover, and Ethan Levy-Forsythe, More Than Half of Individual Health Plans Offer Coverage That Falls Short of What Can Be Sold Through Exchanges as of 2014, Health Affairs . May 2012, content.healthaffairs.orgcontentearly20120522hlthaff.2011.1082 (accessed September 20, 2013 subscription required). 28 Jacobs, Obamacare: Taking Away Americans Health Coverage. 29 For instance, see a 2008 campaign document answering the question Will I have to change plans under the Obama proposal: No, you will not have to change plans. For those who have insurance now, nothing will change under the Obama planexcept that you will pay less. Obama for America, Background Questions and Answers on Health Care Plan, 2008, scribddoc191306barack-obama-08-healthcare-faq (accessed September 20, 2013). 30 Amelia M. Haviland, M. Susan Marquis, Roland D. McDevitt, and Neeraj Sood, Growth of Consumer-Directed Health Plans to One-Half of All Employer-Sponsored Insurance Could Save 57 Billion Annually, Health Affairs . May 2012, content.healthaffairs.orgcontent3151009.abstract (accessed September 20, 2013 subscription required). 31 Kaiser Family Foundation and Health Research and Educational Trust, Employer Health Benefits: 2013 Annual Survey . August 2013, p. 56, Exhibit 4.1, kaiserfamilyfoundation.files.wordpress2013088465-employer-health-benefits-20131.pdf (accessed September 23, 2013). 32 National Council of State Legislatures, Out-of-State Health InsuranceAllowing the Purchase (State Implementation Report), updated September 2012, ncsl.orgissues-researchhealthout-of-state-health-insurance-purchases.aspx (accessed September 23, 2013). 34 For a summary of many of these studies, see Kevin D. Dayaratna, Studies Show: Medicaid Patients Have Worse Access and Outcomes than the Privately Insured, Heritage Foundation Backgrounde r No. 2740, November 7, 2012, heritage.orgresearchreports201211studies-show-medicaid-patients-have-worse-access-and-outcomes-than-the-privately-insured. See also Scott Gottlieb, Medicaid Is Worse Than No Coverage at All, The Wall Street Journal . March 10, 2011, online.wsjarticleSB10001424052748704758904576188280858303612.html (accessed September 23, 2013). 36 Vanessa Fuhrmans, Note to Medicaid Patients: The Doctor Wont See You, The Wall Street Journal . July 19, 2007, online.wsjarticleSB118480165648770935.html (accessed September 23, 2013 subscription required). 38 Republican Governors Public Policy Committee, Health Care Task Force, A New Medicaid: A Flexible, Innovative, and Accountable Future, August 30, 2011, rga.orghomepagegop-govs-release-medicaid-reform-report (accessed September 23, 2013). 39 Owcharenko, Medicaid Reform: More Than a Block Grant Is Needed. 40 CBS News, Medicare Fraud: A 60 Billion Crime, 60 Minutes . September 5, 2010, cbsnews8301-18560162-5414390.html (accessed September 23, 2013). 41 Clifford Levy and Michael Luo, New York Medicaid Fraud May Reach into Billions, The New York Times . July 18, 2005, nytimes20050718nyregion18medicaid.html (accessed September 23, 2013). 42 Nisha Nathan, Doctor Shortage Could Cause Health Care Crash, ABC News, November 13, 2012, abcnews.goHealthdoctor-shortage-health-care-crashstoryid17708473 (accessed September 23, 2013). 43 Deloitte, Deloitte 2013 Survey of U.S. Physicians: Physician Perspectives About Health Care Reform and the Future of the Medical Profession, 2013, p. 3, deloitteassetsDcom-UnitedStatesLocal20AssetsDocumentsuschs2013SurveyofUSPhysicians031813.pdf (accessed September 23, 2013). 44 U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Addressing the New Health Care Crisis: Reforming the Medical Litigation System to Improve the Quality of Health Care, March 2003, p. 16, aspe.hhs.govdaltcpreportsmedliab.pdf (accessed September 23, 2013). 46 Randolph W. Pate and Derek Hunter, Code Blue: The Case for Serious State Medical Liability Reform, Heritage Foundation Backgrounder No. 1908, January 17, 2006, heritage.orgresearchreports200601code-blue-the-case-for-serious-state-medical-liability-reform . 47 Hans von Spakovsky, Medical Malpractice Reform: States vs. the Federal Government, The Heritage Foundation, The Foundry, March 19, 2012, blog.heritage.org20120319medical-malpractice-reform-states-vs-the-federal-government . 48 Institute of Medicine, The Future of Nursing: Focus on Scope of Practice, Report Brief, October 2010, iom.edu mediaFilesReport20Files2010The-Future-of-NursingNursing20Scope20of20Practice20201020Brief.pdf (accessed September 23, 2013). 49 Melinda Beck, Battles Erupt over Filling Doctors Shoes, The Wall Street Journal . February 5, 2013, online.wsjarticleSB10001424127887323644904578271872578661246.html (accessed September 23, 2013), and Melinda Beck, Nurse Practitioners Seek Right to Treat Patients on Their Own, The Wall Street Journal . August 15, 2013, online.wsjarticleSB10001424127887323455104579013193992224008.html (accessed September 23, 2013 subscription required). 50 National Conference of State Legislatures, Certificate of Need: State Laws and Programs, updated March 2012, ncsl.orgissues-researchhealthcon-certificate-of-need-state-laws.aspx (accessed September 23, 2013).Patterns, Set-ups, Analysis What is the Short Skirt Trade A SHORT SKIRT is a quick scalp trade made in the direction of the short-term trend. The setup occurs after the SampP has made a sharp impulse move. The pattern tends to look like a continuation flag on a 1-minute chart. We call it a Short Skirt because the trade usually lasts between 2 - 10 minutes. The concept is - quick in and quick out without getting caught. We try to look for Short Skirt setups that have the potential for a minimum of three points in the trade. An initial 3-point STOP is placed from the trade entry price. The objective for the trade is a retest of the previous swing high or low, even though the market often makes a new leg up or down. How do you enter Short Skirt Trades We watch for a price retracement of 2 to 4 points from the most recently formed swing high or low. For an untrained eye, it may be useful to watch the 20-period exponential moving average on a 1-minute chart, though the price does not always retrace that far. Sometimes the reactions that go sideways instead of back to the EMA can be the best trades. The initial price retracement lasts about 5 minutes. When the reaction back starts to stall, we usually enter a market order. It is ideal to enter the trade BEFORE the price starts moving back in the direction of the original trend. It is also most efficient to work a bid or offer as the price is correcting back down, but sometimes the type of order used is a matter of personal style. Since the price has already corrected back 2-3 points when a trade is entered, it is rare that the initial 3-point stop is hit. We tighten the stop up after the trade moves off in our favor. After the trade starts to work, immediately pull your stop down to the last swing high or low in case the market does not make a full retest back down. What is a BullBear Flag These patterns are taken directly from classical charting (Schabacker, Edwards amp Magee, etc.) and have withstood the test of time. Flags are a continuation pattern in a trending market. They are found on all time frames, all markets, and offer one of the better risk reward ratios for trade setups. A flag formation should be preceded by a pole or initial momentum move in the direction of the trend. The ensuing consolidation tends to be relatively shallow. Continuation patterns are much shorter than reversal patterns. The longer a flag goes sideways, the greater the odds that it will turn into a reversal pattern as opposed to leading to a new leg in the direction of the trend. What is a Grail Trade The Holy Grail trade was originally described in my Street Smarts book. The setup occurs when the markets trend has been strong enough to cause a 14-period ADX to rise above 30. When the price then retraces back to the 20-period EMA, odds favor a retest of the most recently formed high or low. What is an Anti Setup The Anti looks like a small bull or bear flag pattern that occurs either in the middle of a trading range or just after a market has reversed from a sustained trend move. Classic bull or bear flags are continuation patterns that can only occur in a market that has a well-defined trend. Sometimes an Anti will look like the middle retracement of an A-B-C pattern. Thus, we are able to get a measured move objective that is based off the prior swing. The Anti MUST be preceded by a short-term IMPULSE move. Buy Antis are more frequent than Sell Anti setups. The long trades will have the best odds of success if the prior up leg is GREATER than the previous down leg. Oscillator pattern recognition based on either the 310 oscillator or a 7-period K, 16-period D combination of stochastics can also be used to identify this setup. What is Momentum Pinball Momentum Pinball was originally introduced in the Street Smarts book as setup to indicate a Buy Day or a Sell Short Day ala George Douglas Taylor. Taylor looked to go short after 1-2 days of rally, and cover and go long after 1-2 days of decline. The pinball indicator is calculated by using a 3-period RSI of the daily net change. The Street Smarts book contains a complete and detailed description of this trade. (Momentum Pinball, Anti, Holy Grail, 8020 and 9010 bars, and 2-period ROC signals are some of my ORIGINAL concepts. It is repeatedly brought to my attention that there are individuals on the internet offering newsletters and courses based on my original copy-write protected materials. Please note that I do not have any affiliation or association with these entities.) What is an Oops Trade Oops is an expression originally coined by Larry Williams. The setup occurs when the opening price gaps outside the previous days range. A buy (or sell) stop is placed just inside the previous days range in case the market then closes the gap, indicating a reversal. The trade is best treated as a scalp trade and exited before the close. This pattern has no long term forecasting value. What are the main indicators you use on your charts We use the same indicators on all markets, all time frames. We use a 20-period EMA (exponential moving average), a price oscillator, and a 14-period ADX. The oscillator that we use is the difference between a 3 and 10 period simple moving average, with a 16-period simple moving average of the 310. We also use Keltner Channels based on a 2.5 ATR centered around the 20-period EMA. Keep in mind that indicators are just a crutch to tell you what is already there on bar charts. Many traders do best when they learn to read bar charts without the use of indicators, oscillators, etc. What is the Breakout Mode We use a breakout mode strategy when the market has had some form of range contraction. A trend day, or large range expansion day, often follows periods of range contraction, or small average daily ranges. When we are in breakout mode, we use strategies to enter in the direction the market is moving, instead of waiting for a reaction in the price. How do you measure market breadth, put call ratio, and volume Market breadth is monitored by looking at the number of advancing issues minus the number of declining issues on the NYSE. PutCall data is provided by the individual exchanges. We look at the equity only put call ratios, in addition to the index put call volume ratios. For putcall data updated every half hour, you can use this link to Chicago Board Options Exchange: cboeMktDatadefault.asp We look at the volume on the NYSE and compare it to readings made at the same time on previous days. What time frames do you look at. Our initial nightly analysis is always done off the daily and weekly time frames. During the trading day, we use 15, 30, 60 and 120-minute charts. For the SP futures, 1 and 5 minute charts are also helpful. Most often, though, we tend to watch the last price. A trader, who can monitor the basic support and resistance levels by watching the tape action, will often be one step ahead of the trader using bar charts. It is also easier to monitor multiple markets and market internals simultaneously when looking at a quote board instead of charts. Please define TICK, TIKI, TRIN, and VIX. TICK: This is the net change of all NYSE stocks on an uptick minus all NYSE stocks on a downtick. Plus or minus 1200 tends to be an extreme reading. in a trending market environment extremes in the ticks can be used as a momentum indicator indicating further price movement to come in the direction of the trend. however when the market is in consolidation mode, after it has already had a big move, ticks will mark the ends of the short term swings up and down. TIKI: This is the difference between all DOW stocks on an uptick minus all DOW stocks on a downtick. Plus 24 or minus 24 tend to be extreme readings. TRIN: The TRIN is also known as the ARMS Index after its creator, Dick Arms. It is computed as follows: (Advancing IssuesDeclining Issues) (Up VolumeDown Volume). We watch the direction TRIN is moving to indicate the overall trend of the market. For example, if the TRIN goes from .80 to 1.00, this would indicate selling is coming into the market. VIX: This is the Volatility Index that is based on the implied volatility of the at the money OEX puts and calls Most real time data feeds transmit these indicators. However, different data feeds may use different symbols. If you have any questions regarding symbol code, please contact your data vendor directly. What is a Z Day A Z day is a consolidation day that often follows a trend day. The morning period is characterized by a testing back and forth in the price action. We use a different set of trade strategies on these days than we do on other days. one of our favorite trades is the bollinger band trade. see bollinger band explaination in the FAQ What is an NR7 day An NR7 is a day in which the todays daily range (todays high price minus low price) is narrower than the previous six days. The significance of this pattern is that it represents a marked decline in price volatility. Range expansion and an increase in price volatility tend to follow an NR7 day. An NR4 day is similar to an NR7 day except that it represents a day in which the range is the narrower than the previous three days. Toby Crabel originally presented the concepts of NR4, NR7, WR7 etc. in his Market Analytics Letter written in the 1980s. We give credit to him for initiating research in this area. His original articles were published in the magazine, Technical Analysis of Stocks and Commodities. What is a WR7 day A WR7 is a day in which the todays daily range (todays high price minus low price) is wider than the range of the previous 6 days. The significance of this pattern is that it represents an expansion in price volatility. A trader can often buy or sell a test of the WR7 days high or low, on the following day for a scalp trade. What is the 2-period ROC The 2 period Rate-of-Change is todays close minus the close two days ago. For example, to get Fridays 2-period ROC, you would subtract Wednesdays close from Fridays close. The 2-period ROC is useful in highlighting a two to three day trading cycle as explained in the Taylor Trading Technique. Raw momentum is the only derivative of price that we have found to offer statistically significant results in our quantitative research. Our results with this indicator have proven to be durable and robust across all markets. What is Average True Range (ATR) The Average True Range (ATR) was introduced by Welles Wilder in his book, New Concepts in Technical Trading Systems. ATR is a measure of volatility, and it is a component of the ADX indicator. ATR is calculated by finding the greatest value of: 1. The distance from todays high to todays low. 2. The distance from yesterdays close to todays high. 3. The distance from yesterdays close to todays low. The main difference between ATR and the plain daily range is that ATR takes into account gaps. What is a divergence A divergence occurs when a momentum indicator or other instrument fails to confirm a move in the price action of the market under observation. For instance, if the SP futures makes a new low in price, but the 310 oscillator fails to make a new momentum low, then the SP is said to be diverging from the oscillator. Likewise, if the SP futures make a new low that is not confirmed by new lows in a related market or index (for example the SP versus the Dow Industrials, or the SP versus the TICK), this is also considered a form of divergence. Divergences are useful in that they warn of a loss of momentum and often precede a reversal in price. What are Keltner Channels Keltner Channels are a form of trading bands plotted directly on top of a price chart, as opposed to beneath the price chart as in the case of an oscillator or volume. The bands are based on an ATR function centered around a moving average. We use a value of 2.5 ATRs added to and subtracted from a 20-period exponential moving average to create our bands. What is the difference between Keltner Channels and Bollinger Bands Bollinger Bands are based on a standard deviation function. Very often, you will see times where the market is moving HIGHER but the lower Bollinger band is declining. This does not happen with Keltner channels. Though both are based on a volatility functions, Keltner Channels will maintain a more constant width than Bollinger Bands and thus we find them more pleasing to our eye. We also have had much better success in using range functions in our quantitative modeling as opposed to standard deviation functions, especially when creating short-term timing systems. Bollinger Band trades we use 2.5 standard deviation bands centered around a 20 period moving average to make trades on the day following a trend day. we do these trades in the morning session only. the concept behind this is that a push to the upper or lower band will setup a countertrend trade. the objective is a push back to the moving average. no stops were used in our testing, we just used an exit of whenever the trade hit the moving average or end of day in the worse possible scenario. A-B-C is a term borrowed from Elliot Wave terminology that denotes a three-wave corrective pattern that is often found in the middle of a trend. Waves A, B and C are often of the same magnitude in both price and time, and the pattern tends to have the appearance of a zigzag. What are the parameters for the 310 oscillator To construct this oscillator, first subtract a 10 period simple moving average from a 3 period simple moving average. We often refer to this as the fast line. Next, create a 16-period simple moving average of the fast line - we refer to this line as the slow line. It is also useful to plot a horizontal line at the zero value. We plot all three lines together on our charts beneath the price. For some indicators, such as the 310 oscillator, we provide subscribers with downloadable TradeStation code files. When we refer to the EMA, we will always be referring to a 20-period exponential moving average. This line can be thought of as a proxy for a regression to the mean in a trending market. It has little value in a trading range market. Unlike a simple moving average, which takes the average price of the last X periods, the EMA method takes a weighted average of the most recent price and the average price from the bar before. What size stops do you use In general, we use an initial stop of 5 points in the SP futures unless specified otherwise. For scalp trades in the SPs, we use a 3-point stop. In the domestic futures markets, we use a fixed 500 stop per contract unless specified otherwise. If there is an unusual expansion in volatility, we will use wider stops and lower our leverage. Stops should be tightened up as a market moves off in your favor. In stocks, we recommend using stops to limit losses to no more than 2 of your working capital. How do you enter positions In determining whether to use market, limit or resting stop orders to pull us into a trade, we assess the liquidity conditions and the type of market environment (i.e. trending, choppy, etc.) Each trader must ultimately find their OWN style that works best for them over time. Do you have resting stop orders in the market The great majority of the time we keep our stop orders resting in the market. The exceptions tend to be when a gap opening is expected, in which case we let the market settle in first, and then place our stops just outside of the early morning range. The other exception is when current liquidity conditions are poor and we have a large position on. This has been the case in certain markets such as coffee, where it is preferable to let the broker work an exit order within a fixed time window. How do you place your orders in the SP futures We call most of orders directly to the futures pit. However, over the past few years we have been using the e-minis with electronic order entry as well, especially as liquidity has been shifting to this market. What do you mean when you refer to premium The fair value premium is the theoretical futures price minus the cash index price. Fair value describes how far the futures contract should be trading above or below the cash index given expected dividend income for the stocks in the index, the number of days to expiration for the futures contract and the short-term interest rate. When the SPs are trading at a premium or a discount, we are referring to a situation where the futures are trading above or below their fair value. What is the historical volatility ratio This is the ratio between two different lengths of historical volatility (for example, the ratio between 25-day and 100-day historical volatility). We use this indicator to alert us to times when short-term volatility has declined below longer-term volatility by a certain percentage threshold. These signals are often precursors to increasing volatility. What is the BOBO- on your trade sheet These are the parameters for a proprietary volatility breakout system that we trade during certain periods. A buy is triggered on a break above the upper number and short is triggered on break below the lower number. What is the Golf System Golf is a proprietary system that enters the SP futures on the CLOSE. LBRGroup published this system in an advisory service between 1993 and 1998. We also traded it on a mechanical basis for our managed futures program. We stopped trading it mechanically when the overnight volatility became too great during the Asian crisis, though we still use it as a timing indicator. It is based in part upon the 2-period ROC and bar chart patterns. What is the afternoon 2-point trade The 2-point play is not a chart pattern. It is something that we started doing real time in October 2004. It is not a mechanical system though either, since there is no fixed stop other then a time stop. The time stop is 24 hours. It is a tendency based on pattern recognition (number of days up or down along and degree of trend). It is something that we started doing for ourselves originally, and other members have started using it as well. Trades are initiated on the reopening of the Emini contact after the market closes (i.e. the beginning of the Globex session). Very often the 2 point objective is hit in the Globex session, which is why we do not work these trades for the room, but just put in what they will be for your own knowledge. There have been times where the 2 point objective is not achieved until the day session the next day. Of course there will be a times where the objective is not achieved at all, also. What is the RAT trade The Rat trade is an afternoon breakout trade we make in the SPs on days where there is heavy institutional activity. It is not based on a specific chart formation, and the parameters and filters for this trade are proprietary. What is the Last Call trade This is a trade made in the last hour of the day in the index futures. It is similar to the Push into the Noon Hour time frame that we make in the morning. (Members can reference this in the Trade Library Setup). The Last Call setup is based on a combination of bar chart pattern recognition and market breadth parameters. What is a Pivot Point This can be a previous swing high or low, or visible chart point such as the high or low of a gap area. Globex highs and lows, along with the previous days high and low are all forms of Pivot Points. We do not use Fibonacci numbers or arbitrary calculations. We are interested in levels that ALL market participants are aware of, as would be the case with a key high or low. What are the Red Green Red patterns on the bar charts that you post This color rule is based off an average true range function added or subtracted from the previous swing high or low. It is a variation of the parabolic stop and reverse formula published by Welles Wilder in his book, New Concepts in Technical Trading Systems. We find that it provides useful pattern recognition in highlighting the short-term swings on a bar chart. General Trading Related Questions Tick Charts vs. Time Interval on most software applications a 1600 tick chart of the sps would be equivalent to a 5 minute chart. and a 3600 tick chart is similiar to a 15 min time frame. we prefer to use these type of tick charts in the early morning session since they adjust the globex trading relative to the activity level. day session only charts on a 5 min interval can be too gappy, while 5 min charts on a 24 hours basis tend to be distorted. What is relative strength and relative weakness that we talk about in the online trading rooms Simply put, a stock or sector that exhibits relative strength is performing better than a related index, such as the SP500 or Nasdaq. Relative weakness would be a sector or stock that is under-performing a benchmark index. With commodities, the relative strength leader is the one that is performing the best on the day. The early morning relative strength leaders usually continue to perform the best throughout the day. What are the SPY amp QQQ The SPY and QQQ are Exchange Traded Funds. They represent a basket of stocks mimicking the composition SampP 500 and Nasdaq100 stock indexes. They trade on an exchange just like individual stocks and can be sold short on a downtick. In essence, they allow you to trade the entire stock index much like the SP or Nasdaq futures. However, unlike futures contracts, the QQQ and SPY do not expire and are not leveraged instruments. How do you watch so many markets The majority of the time, we watch a quote board which gives us last price instead of watching charts on each individual market. This way we can monitor numerous price levels in addition to various market indexes and market internals. If we want to look at the charts on a particular market, we pull up a screen that has the 30, 60 and 120-minute time frames. The SPs and occasionally the bonds are usually the only markets where we will look at charts on a shorter time frame. Positions in most other markets are entered with the intent of carrying a winning position over night. Why do you look at so many stocks Stocks that are market leaders can often turn before the stock index futures do. This is particularly true of the high beta momentum stocks. Monitoring individual sectors and relative strength can add valuable information regarding the overall technical condition of the market. We limit our database to only the top 250 trading stocks. What kind of broker should I use Avoid brokers with browser-based order entry systems. Use a broker that offers a fully integrated trading platform (stand alone software) with point and click order routing and execution. You will have to do your own research in deciding which company to do business with. If you are not happy with your current broker, it is very easy to try another. We maintain accounts at multiple firms and feel that it is important to have multiple relationships in case there is ever a problem with one firm or a geographic disruption in one part of the country. What data feed and software programs do you use Real Time Data feeds: How can I see what happened each day in the online trading rooms For LBR Futures Live and LBR Stock Beat, we post transcripts of each days activity on our website. These transcripts are available in the Members Services section of our website. For LBR Currencies we do not archive transcripts. However our Currencies room will be open 48 hours, giving members the ability to easily reference the previous days information. I want to join your service. What do I have to know about the stock market Though prior knowledge and experience are not strictly required, it is important that you understand that trading involves risk. Our online trading service is educational in nature and will be of best value to you if you can monitor the markets real time. I still have another job. Can I trade part time Yes. You decide on the pace of your learning. You might start out part-time and decide later on whether this could be the start of a new career for you. Remember that the time and energy you put into learning will pay off down the road. However, we have yet to come across a trader able to consistently support themselves by trading part time. Ultimately trading is a full time job, and many people new to the business are often surprised by the long hours professional traders devote to their study of the markets. How many trades do we make each day There is no normal day, and the number of trades varies with the volatility of the stocks and futures contracts that we are trading. However, we find it better to be patient and wait for a few well thought out high probability trade setups, than to settle for marginal trades. We find that when traders start overtrading, they get sloppy and make mistakes. I cant be near a computer all day - do you have any other suggestions for me Our Basic Online membership offers set-ups and trading ideas that can be implemented without the need for watching the screen during the day. These trades include option plays and longer-term stock swing trades. How long does it take to learn to trade successfully In our experience, the average length of time it takes for a person to be able to trade with the consistency and confidence necessary to make a decent living is about three years. Some people are never able to do this, as they are unable to master the mental side of the game. A few people have been able to find their niche quickly and show consistent profitability after just 6 months. This is the exception though. What are the most important things a day trader needs to succeed What methods are available for accessing the chat rooms We offer all members two methods for accessing our live chat: 1. Stand-alone software method 2. Browser based method Both methods offer the same connectivity speed and deliver the same information. We find that most people prefer the stand-alone software method for its features, such as multisingle window viewing modes. After you login (click on Futures Live, Stock Beat or Currencies buttons located in the upper left side of our home page ) you will come to a page with complete information for accessing both methods, including instructions for downloading our stand-alone chat software. Note: our live chat system will not permit running both methods simultaneously. Nor can you run our chat system on two separate computers, simultaneously. What is the video feature all about, and how do I access it Begining in June 2006, we upgraded our stand-alone chat software to include a direct video feed into Lindas computer. All members of Futures Live and Stock Beat will have access to this feature, at no additional cost. This feature enables you to see the actual charts and indicators Linda and her staff uses as they set up trades and make calls in the chat rooms. For mor information about this feature, click here. Do I need the latest version of your chat software to access the video feature Where do I download the latest version of your chat software The latest version is available by clicking on either the Futures Live or Stock Beat buttons located in the upper left side of our home page. After you enter you username and password, you will be given an opportunity to download the program file. Can you show me in more detail how to log on to the Browser Based chat system For full instructions, click here. How do I get web links (aka hyperlinks) to work in the chat window I click on them, but nothing happens. When you place your mouse over a link in the chat rooms, the link will not change its appearance like you would normally see on a standard web page. Do not be alarmed, this is normal. You need to place your mouse directly over the link, and then double click. Your Internet Explorer browser should then open. ALSO -- the link must be all on one line in the chat window. If the link is broken up over two lines, then simply re-size your window to get the link back to one line of text. I cant get the chat software to work. If you are using any kind of pop-up blocker or firewall devices on your computer, this may adversely affect and possibly even prevent the chat software from functioning. Check to make sure you have the latest Java Runtime Environment (JRE) installed. The latest version can be found here . Note our minimum system requirments: - High Speed Internet Connection (DSL or Cable modem) suggested - Win98, NT, 2000, XP - Java-enabled Internet browser (may require Microsoft Java Virtual Machine to be updated or installed or the SUN Java Runtime Environment: java.sungetjava) NOTE to System Administrators: Our live chat applications were designed to use direct Internet connection. If you are using NAT andor a firewall system, it should permit outgoing connection to the port 8523 of our server (lbrgroup). Also port-mapping may be used on your Internet gateway. What are Open Forum rooms used for Open Forum rooms are special rooms just for members to talk amongst themselves. These rooms will have a blank text field beneath the window, where you may input your comments. After typing, to send your comments to the room, simply hit your Return or Enter key on your keyboard. How do I send a private message You may send private messages to other members as well as to the room moderators. Simply place your mouse over the name of the person you wish to send a message to, and right click. Then select Private Session. This will open up a new window for you to send and recieve your private message. After typing your message in the text field located at the bottom of the chat window, hit your keyboards return key to send the message. Note that the list of member names and moderator names will only apear in the Open Forum rooms, on the right hand side. How do I adjust the font size Both the stand alone and the browser based chat methods allow you to adjust your font size. Simply place your mouse over any text area within the transcript window, then right click your mouse. You can then select a custom font size from the list. What other user-controlled adjustments can I make on the stand alone software In the stand alone software, place your mouse over the small blue icon located in the upper left hand corner of the chat window. Next, select any of the following controls: - Multi Window mode . changes from single window mode to multi-window mode. - Always on Top . keeps the software from becoming obscured by other software applications running on your computer. - Play Sounds . turns on and off all room audio sounds. - Play EMA . turns on and off the subtle typing sound when messages are being broadcast into the main rooms. How do I enable the copy, cut and paste functions in the chat applications This requires adjusting the security settings on your web browser (Internet Explorer). Please click here to access a PDF file with detailed instructions for changing these settings. File requires Adobe Acrobat viewer. General Website Questions How can I cancel or change my service In the Member Services area of our web page, you will find links to Modify my Profile . How do I ask questions Sending us an email is the easiest way. Please see the Contact Us area of our web site. How do I print text found on your web site pages To print the class transcripts, guest lectures or other text items (without also printing all the formatted headers and other content on the page) heres what you do: 1. Simply select the text with your mouse (i.e. highlight the area you want to print). 2. Right click your mouse and select copy. 3. Open up Microsoft Notepad (look under Start--gtPrograms--gtAccessories--gtNotepad) and then simply paste in the text (right click mouse and select paste). 4. Voila -- you are ready to print the text (make sure youre printer is turned on) 5. For charts simply place your mouse on top of the chart - then right click - and save as to your hard-drive. Go to the saved file, click on the file to open it, and proceed to print. How do I print Charts 1. Right click your mouse on top of the chart you want to save, and select Save Picture As. 2. Save the chart image file to your harddrive. 3. Open chart image file by double clicking on file, then select Print from the Edit menu of you software. Why do charts print with such a dark background color Virtually all charts on this site are created with Aspen Graphics software. We realize that they do not print well with a dark background. We apologize for the inconvenience. The trade off is that we are able to manipulate the color rules and write our own formulas to show you unique and useful trading patterns. Why does it say no gaps on some of your charts in the Daily Educational Charts These charts are generated by Aspen Graphics. No gaps means that the data is compressed to eliminate holidays where the markets are closed. If this function is not turned on, a gap will appear in the data for the holiday session. ADX . Trend strength oscillator originally developed J. Welles Wilder Jr. that fluctuates between 0 and 100. BEAMER . Nickname for IBM BEAR FLAG . Classic bar chart pattern that occurs in a trending market, a bearish continuation pattern. BEAR TRAP . A bear trap occurs when the market breaks below chart support, bringing traders in on the short side, then quickly reverses, trapping traders with losses. BREADTH . The difference between the number of advancing issues and the number of declining issues on the NYSE. BREAKOUT TRADE . A trade that occurs when the market breaks above or below some pre-define range, usually a nearby support or resistance levels such as the previous days high or low, or the last 60 minutes highlow. Breakouts are often associated with low volatility readings. BULL FLAG . Classic bar chart pattern that occurs in a trending market, a bullish continuation pattern. BULL TRAP . A bull trap occurs when the market breaks above chart resistance, bringing traders in on the long side, then quickly reverses, trapping traders with losses. BURNING DOG . This is the phrase used to describe the tendency for the SPs to retrace back into a gap area by N- amount after a gap of N-amount. Though we make trades off this pattern in the futures room in the morning after a gap on certain days, this phrase describes a tendency only, and is not a mechanical trade setup. COMPRESSION METER . LBRGroups proprietary volatility index used to signal potential for longer term breakouts. COWS . Nickname for the Live Cattle futures CREEPER MARKET . A market that slowly creeps higher without a significant retracement. One of the strongest types of trending action that does not catch peoples attention. DISCOUNT (SPs) . When the price of the future is trading lower than fair Value DIVERGENCE . A divergence is indicated when momentum fails to confirm a new low or new high in the price. Divergences usually show up best with oscillators such as the 310 and 535 MACD. EDGE . Term used to describe when a trader has the advantage or a favorable margin. It is even better when this margin can be quantified statistically. EMA . Moving Average eksponensial. We use a 20-period setting EQUILIBRIUM LEVEL . The point at which buyers and sellers are in balance. Coincides with a neutral chart point that is often at the end of a consolidation period. EVENT RISK . The risk that some unexpected event will cause a substantial change in the market value of a security. For example, missed earnings, lawsuits, crop failures, war, etc. FADE . A countertrend trade FAIR VALUE . Fair value reflects the relationship between stock index futures and the indexs current levels. It is a theoretical estimate of where the futures should be trading based on their underlying cash index with short-term interest rates and dividends factored into the calculation. Determining the fair value relationship between the SampP 500 futures contract and the underlying SampP 500 index requires adding the cost of borrowing the money to buy the SampP 500 stocks, while subtracting the gain these stocks pay in dividends. FILL OR KILL . This means do it now if the stock is available in the crowd or from the specialist, otherwise kill the order altogether. GOLF . A mechanical trade that is made in the SP futures that is entered on the close of the day. GRAIL . A trade set-up based on a pullback to the 20 period EMA after the 14 period ADX has risen above 30. Pullback in rallies are bought, and pullbacks in declines are sold short. This pattern was discussed at lenght in Street Smarts. IMPULSE . Increase in the market momentum. Impulse moves tend to happen in the direction of the trend. On a bar chart they have the appearance of a sharp markup or markdown. INSTITUTIONS . Mutual funds, pension funds, banks, and large commercials KELTNER CHANNELS . A trading band indicator that is displayed on top of price charts. Similar to Bollinger Bands but calculated differently, using true-range rather than standard deviation. LAST CALL . Trade that setups up in the last hour of a trend day LOAD THE BOAT . Use full line of leverage MACD . An oscillator based on the difference between two moving averages. We use the difference between a 3 and 10-period simple moving average MARK UP . A Wyckoff term, used to denote the phase of the market where prices rise, from the beginning of a bull market to its top. MARKET LEADERSHIP . Market leadership refers to those sectors and industries that are currently bringing in the best returns. MARKET ORDER . An order to buy or sell a stock immediately at the best available current price. A market order guarantees execution. MIT . Market-if-touched order. An order which becomes a market order if the specified price is reached. MOC . Market-on-close order. A buy or sell order which is to be executed as a market order as close as possible to the end of the day. MOMENTUM . The difference between the last price and the price N-numbers bar. A 2-period Rate of Change (ROC) is the same as a 2-period Momentum. NAZDOG . Nickname for the Nasdaq100 index. NAZDOGGIE . Name of Linda8217s adorable little Pomeranian. See photo gallery . NR7 . The narrowest high-low range of the past seven days. OODA . The OODA Loop, often called Boyd8217s Cycle, is a creation of Col. John Boyd, USAF (Ret.). Col. Boyd was a student of tactical operations and observed a similarity in many battles and campaigns. He noted that in many of the engagements, one side presented the other with a series of unexpected and threatening situations with which they had not been able to keep pace. The slower side was eventually defeated. What Col. Boyd observed was the fact that conflicts are time competitive. According to Boyd8217s theory, conflict can be seen as a series of time-competitive, Observation-Orientation-Decision-Action (OODA) cycles. OOPS TRADE . A term originally coined by Larry Williams which refers to a market that gaps below the previous days low (or above the previous days high) and then quickly reverses its direction. OOZE . Down trending price action that slowly inches down without any upward reactions of any magnitude. One of the strongest forms of trending action. OPENING BULGE . Period after the opening when the public has a tendency to pay too high a price. OPENING PLAY . The markets first tendency of the day OUCH SETUPS . When a market Closes in the upper 75 of its range but then gaps lower the next day around the previous days low (vice versa to the upside). OVERHEAD SUPPLY . Are where the market had found support in the past but the price is currently trading lower. PEA SHOOTER DAY . Our SP brokers affectionate term for when the institutions are absent and the majority of the paper in the SP pit consists of 1s and 2s. PIVOT . A market reference point. Our most frequently used pivots are swing highs and swing lows such as the high and low of a daily bar or the highs and lows of the hourly cycles. POWER BUYSELL . A retracement formation that combines two time frames. For a chart example of this setup, members can reference the trade library setup. PREMIUM (SPs) . When the price of an index future is trading greater than Fair Value. PUSH INTO THE NOON HOUR TIMEFRAME . Trade that setup around 11:00 EST on a trend day RAT TRADE . An afternoon breakout trade that is made in the LBRFutures Room RESISTANCE . Area where Sellers have come in the past. ROBUST . Refers to a method or system that is profitable across a variety of markets, time frames and parameters. It is the opposite curve-fit or optimized. SCALP . A Short-term trade that capitalizes on the markets smaller fluctuations. SHAKEOUT FAKEOUT . A sharp downward move following an area of distribution that quickly reverses itself and comes back up through the distribution area. SHORT SKIRT . The name of a very short term pattern trade taken on a one-minute SampP and Nasdaq futures charts. A form of pullback trade on a very short time frame. SKIDS . Slippage or the difference between the price that a stop order was placed and the actual fill price. SLOP AND CHOP . Action in the market when institutions are absent and liquidity is poor. SMA . Simple Moving Average SPRING . Originally a Wyckoff term, is used to denote an impulsive move often associated with a test of support. See also Upthrust. STOP ORDER . An order that becomes a market order when the price touches that level. SUMTICK . LBRGroups proprietary summation Tick index SUPPORT . Area where buyers have stepped in the past. SWEET STUFF . Nickname for the sugar futures THREE PUSHES . A characteristic pattern that occurs near important turning points. Usually three distinct test of a high or low level, followed by a reversal. 3 OCLOCK JIGGLE . A scalp trade that sets up in the SPs around the time that the bonds close. TICK . Smallest increment that a price can change. 1 tick on an e-mini contract .25 points, which is the equivalent of 12.50. TICKS . The difference between the number of issues on the NYSE that are trading UP from the last trade versus the number of issues that are trading down. TREND DAY . A day where the market opens on one end of its range, closes on the opposite end, shows range expansion and has an increase in volume. TRIGGER . Level at which a trade will be initiated if a market trades to that price. TRIN . The TRIN (also know as the Trading Index and the ARMS Index) was invented by Richard Arms in the 1970s. It is calculated as follows: (Advancing issues Declining issues) divided by (Advancing volume Declining volume). If the index is above one, the average volume of stocks that fell on the NYSE was greater than the average volume of stocks that rose. If the index is below one, then the converse is true. UPTHRUST . Originally a Wyckoff term, is used to denote an impulsive move often associated with a test of resistance. See also Spring. VIX . VIX is a weighted measure of the implied volatility for 8 OEX put and call options. VIX represents the implied volatility for this hypothetical at-the-money OEX option. VOLATILITY . The range of the price action over N -Number of bars. WEDGE . A low volatility point in which a triangle type formation can be drawn on the bar charts. The market can break out in EITHER direction from this formation. WHIPSAW . Is when the market rapidly reverses its direction several times in succession. WIRE . Nickname for the Copper Market Z DAY . A consolidation day that typically follows a trend day.
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