Kevin Drum leaves out the words “single payer”

by on November 10, 2005 at 1:03 pm in Medicine | Permalink

Read him here.  Canada, North Korea, and Cuba have single-payer governmental systems.  If you know of others (I believe there are some), please leave them in the comments.  The successes, or supposed successes, of most West European systems do not constitute evidence that a single payer system is a good idea.  This is one of the most commonly overlooked points in the debate over health care.

1 ralph November 10, 2005 at 1:10 pm

OK, I’ll start it off. What are you saying? I read your post, but I don’t understand it. I’m all cool with having problems about other countries’ single-payer health care. But I **still** don’t know what your problems are. Would you be so kind as to explain how you define the word, “viable”?

2 ralph November 10, 2005 at 1:15 pm

Tyler, did you alter the post to remove the word “viable” from it? I wrote the comment using that word for a reason. Am I mistaken?

3 ralph November 10, 2005 at 1:25 pm

No, that sounds fine — so long as you let us know. 🙂

I had assumed that you were using the word “viable” figuratively — obviously the Soviet Union was viable within some limited time frame. Back to the issue: Can you outline quickly why it’s not a “good idea” when laid against what we have now? I’m fine with your objections, but I want to have a clearer idea what they are. Yes, the free market is in general the best way to go: but health care isn’t a free market. Stipulate that there is a moral value at work that we cannot ignore. In this environment, what major objections do you have to a single-payer plan a la Canada or some other variation? I, in return, stipulate that there ARE benefits that we enjoy in our health-care system here that the single-payer systems don’t seem to.

4 Kevin Drum November 10, 2005 at 1:41 pm

Ah, but you left out the phrase “developed country” from my post, Tyler! I really don’t think Cuba or North Korea prove anything. We should be comparing ourselves to other roughly similar countries, shouldn’t we?

As for Canada, their system isn’t so bad. It’s not the one I’d choose, and it’s certainly true that every country’s system has its own upsides and downsides, but overall, single-payer works well in an awful lot of places. Given that, it seem perverse to suggest that it defies the laws of economics.

5 Peter Clay November 10, 2005 at 2:04 pm

In what way is the UK system not single-payer?

6 wkwillis November 10, 2005 at 2:16 pm

North Korea has a public health system? I thought all the Communist
countries had people pay for their own health care, and that’s why
medical care is so bad in those countries for poor people.

7 Dylan November 10, 2005 at 2:33 pm

I would also question how “single payer” Canada is as a practical matter when the US is a feasible alternative for those with many non-emergency conditions.

8 wsam November 10, 2005 at 2:37 pm

Western European governments, like Germany, would mostly like to move toward a single payer system. This is because single payer represents the best way to keep costs down.

As with the US and Canada, European health care costs are rising at the same time the number of people who are going to want access to that health care is growing. Cost containment is an enormous problem.

That Europe’s governments are finding this shift difficult to manage is no surprise. The same interests which oppose single payer health care in the US exist in Europe.

In Canada single-payer health care destroyed the Canadian health insurance market as the government now provides the service from tax revenue.

9 Johan Richter November 10, 2005 at 2:45 pm

I a am wondering as well what you mean by single-payer. In Sweden, the country I know best, the state(actually subdivisions of the state) pay the overwhelming part of your cost for medical treatment. The small fees that exist are mainly to discourage overconsumption of healthcare more than anything else. The state will pay for your treatment either at a private clinic or a state-owned one.
Buying private medical treatment is perfectly legal though but rare. I am not interpreting Krugman et al. as suggesting outlawing private medical insurance.
As for quality, the opinion you often hear ín Sweden is that the treatment is good once you get it but there are long quees for operations and similar stuff.

10 Stian Haklev November 10, 2005 at 2:46 pm

Norway has a singer-payer system, and I would think all of the Scandinavian countries were the same.

11 sirromdivad November 10, 2005 at 2:58 pm

Ivan,

I believe that what Tyler was saying was that since most Western European countries do not in fact employ single-payer systems, the success or not of those systems is irrelevant to a discussion of the merits or lack thereof of a single-payer system. This isn’t moving the goalposts.

David

12 DON B November 10, 2005 at 3:30 pm

I think it may be time that we stop talking about healthcare as a market in the normal sense of the word. It brings with it an enormous sense of morality and fair play from society that really make its allocation something that just does not fit the usual market mold.

For example, if someone is looking for a car, he may decide he wants a Lexis. But his budget may not allow this. So he will have to consider a new Ford. If he cannot afford this then he can look in the used car market. If he still cannot afford a car then he can use public transport. In short, the budget constraint faced by individuals forces them to substitute certain modes of transportation for another. No one has a real problem with this because it is not a life and death issue and usually does not substantially reduce a person’s material well being. The same could be said for many of our purchases.

But there are no substitutes for a mammogram, cancer surgery, chemotherapy, emergency room services, etc. You either get them and survive, or you do not and you either suffer or die. Now society has to decide whether to ration healthcare resources via price (i.e. let the market sort it out) or by some other means. I believe that society has already made the decision that price rationing should not be the rule. That is why we do not auction off hearts and other organs despite the fact that there are fewer of them than patients who need them. As a result, the classic price-quantity equilibria does not come to be and people are put on waiting lists and often die while waiting for an organ.

So, given that society has already put us in this place where free market economics are not going to differentiate who gets healthcare and who does not (for a fact, even poor people get some healthcare but in the most expensive manner conceivable – the emergency room), what is thee best way to manage this. Interestingly, people point to Canada and Europe for a model when one exists right here at home – the military. I work for a Navy think tank and have looked at the mil healthcare system. I do see some abuse in it (the amount of prescriptions is higher for the average sailor than for the general population because they are free so the docs write prescriptions for everything under the sun including tylenol) but overall it is not bad and the admin costs are very low. A few tweaks here and there and the system would be much better. And it is universal and it is a single payer. If it is good enough for the military then it probably is good enough for the general population as well.

13 Eric Mortensen November 10, 2005 at 4:01 pm

Let’s all agree that health care is a hard problem. The free market makes good health care unaffordable to a lot of people, but a government controlled system forces costs down which stifle innovation. This is no different from any other market, except for the moral dimension. We don’t mind some people buying more expensive computers than others, but we do mind (or at least care) that everyone gets decent health care in some form.

There is no doubt in my mind, however, that a giant, federal single-payer system would be just as full of warts and pimples as the current private insurance market is. You’d get cheaper health care which everyone could afford, but I don’t believe for a second it would you’d get better care. Long term I’d say you get worse, since there would be less innovation.

I’m no expert but I’m willing to predict that a disproportionate share of the technological and pharmaceutical innovation in health care is fostered in the US market precisely because of its system of private system (although not necessarily by US firms).

14 John P. November 10, 2005 at 4:26 pm

Is it really inconceivable that we could let the free market determine how much health care people get? For example, we leave child-rearing up to individuals’ choices, and the market determines how safe the neighborhood is where children grow up, how good the schools are, how well fed they are, etc. (at least in all respects above a pretty low threshold). Why are we so reluctant to let prices allocate health care the same way?

15 blah November 10, 2005 at 5:05 pm

Single-payer avoids the marketing costs which private insurance companies use to attract customers. It also avoids duplicating the administration needed to deliver care. A single-payer system is greatly simplified. Less money is also spent setting up bureaucracies to deny people care, since everybody is entitled to recieve care. It is far from perfect but it is a more efficient system.

The US has one of the world’s highest expenditures while recieving one of the worst results.

American governments would consider single-payer if they were actually interested in the problems that effect Americans, like, say, pushing the country’s infant mortality rate to the level of a second world country.

Though these arguments only make sense if society is considered in its entirity.

16 Marcus November 10, 2005 at 5:08 pm

[Canada’s system is] not the one I’d choose

Please reread that and appreciate the irony.

17 Patrick R. Sullivan November 10, 2005 at 5:55 pm

The economic laws violated start with supply and demand. When the price of using something is zero, you get overconsumption. Witness traffic jams in most metropolitan areas between 7:00 AM- 6:00 PM.

Single payer systems, such as in Canada, are free to the consumer. As a Canadian friend of mine who had to shell out $50,000 to the Mayo Clinic for surgery to save his father’s life (he was on a waiting list in Toronto just for tests) told me; ‘They tell you it’s free. But, you know what, you get what you pay for.’

The most important economic law is that people respond to incentives. Single payer ‘pre-paid health care’ (not to be confused with insurance, which it isn’t) creates perverse incentives. And produces perverse results.

And, btw, France’s system is NOT single payer. About 85% of the French purchase insurance to supplement the government tax supported ‘insurance’. And they pay the physicians themselves, and are reimbursed. So, there are incentives in place to get people to self regulate their use of medical care.

But, they won’t be able to keep up the charade that they have a great system much longer. It’s already bursting at the seams, and the demographics are the destiny. You think they’re revolting now, wait ten years.

18 Anderson November 10, 2005 at 6:04 pm

The economic laws violated start with supply and demand. When the price of using something is zero, you get overconsumption.

Assuming that healthcare is like Scotch, yes. If I could walk into the liquor store & carry off all the Macallan 18 for free, I would. But if healthcare were free, I would not start visiting the doctor daily.

Also, aren’t there opportunity costs to visiting the doctor? Wouldn’t the very fear of having to wait around, deter frivolous visits?

I would also think that medical judgment would play a role in diminishing demand—if the doctor thinks you’re not sick, then you’re not going to get treated. There would be a few cranks, like the people who file endless pro se lawsuits until the courts bar them, but that seems like a minor problem.

19 Patrick R. Sullivan November 10, 2005 at 6:17 pm

I’m glad to see Andrew has recanted a bit on Japan’s system, but it too is headed for crisis. If it isn’t already there thanks to its decade long recession.

But, since Paul Krugman was recently advising, to look east, old man, to Taiwan, here’s a little tidbit of what we fact in the brave new oriental future (if we listen to him):

‘ Visitors to hospitals in Taiwan find a veneer of similarity to hospitals back home. Beneath the surface, however, are big differences. In many hospitals it is expected that the patient’s family will help provide routine hygiene chores frequently taken care of by licensed practical nursing staff in an American hospital. Indeed, many hospitals accommodate and expect at least one family member will sleep in the patient’s room (even semi-private rooms). Some hospitals expect patients to bring their own bath towels, toilet tissue, soap and other toiletries. Often the floors, walls and medical equipment will appear much less clean than a typical American hospital.’

http://www.ait.org.tw/en/uscitizens/HealthCareInTW.asp

20 C&H - PCS November 10, 2005 at 6:29 pm

Also of note are the facts that the US pays more per capita for health care than any other western developed nation, and has higher rates of infant mortality and lower life expectancy.

21 Ben M November 10, 2005 at 6:46 pm

One of the economic laws that single-payer “violates” is the idea that centralized control stifles innovation. Is this true in medicine?

I don’t think of clinical doctors as innovators. Medical innovations are already quite centralized; new ideas come down from above, not via a bureaucrat, but from the non-monetary “market” of large medical research studies. Most of that research is initiated and funded, not by primary-care physicians or hospitals, but by governments, universities, and big pharma. An invididual doctor can do his or her job well or poorly, he can be sloppy/inefficient/sharp/quick compared to his or her colleagues, but he or she cannot sit around the clinic and dream up new and innovative treatments.

Let’s imagine that *all primary-care medicine* (not big pharma) had been socialized, UK style, for the past twenty years. Can you imagine what treatments, cost-saving practices, or medical advances we would have forgone? Let’s see; take away the free-market profit motive, and we might not have chiropractors, vanity MRIs, or a glut of competing heart-surgery megaclinics. I can imagine the rise of LASIK being purely market-driven (anyone know?)—but, inasmuch as it’s done in specialized fee-for-service clinics, a single-payer economy would not have hurt it.

It’s not like socializing the Internet, which would kill the motivation of Silicon Valley investors, and kill the funding for innovative startups, and new ideas would stagnate. We’ve got free-market primary care right now, but the investors, startups, and new ideas *do not exist*. If we switch to single-payer and they continue to not exist, we haven’t lost anything.

22 Constant November 10, 2005 at 6:59 pm

“Health care now is not subject to supply and demand.”

If you believe that, what in the world are you doing reading an economics blog.

23 Slocum November 10, 2005 at 7:07 pm

“‘…you go when you’re sick, you don’t when you’re healthy.'”

“Rather a primitive concept you have of health care. The rage in socialist health care circles is about preventative medicine. I.e., before you even get sick.”

And even with respect to sickness, I know many parents to haul their kids in to see the doctor for *every* cough and sniffle. The doctor, in turn, usually prescribes them a near worthless antibiotic that has nothing to do with the disease and they go away happy. They would not do this (and we’d have fewer resistant strains of bacteria) if it wasn’t ‘free’.

24 Andrew November 10, 2005 at 7:33 pm

Japan’s healthcare is in no crisis. I’ve not heard or read a word about this despite splitting my time between SF and Tokyo for the last 5 years.
Simply saying “japan’s healthcare will be in crisis” doesn’t make it so.

25 vk November 10, 2005 at 8:48 pm

Slocum,
Do you have anything beyond anecdotal evidence to suggest this sort of use of a “free” health care system? Of course, I am also sure that you are a better judge of the kids health than their parents.

I don’t know of anyone who likes to go to a doctor. And this is not for purely financial or economic reasons. If anything , a lot of people tend to avoid going to a doctor even when they ought to.

Health care is very much not a simple question of supply and demand. Care providers do have an upper hand in dealing with sick people, given that sickness does not exactly provide one a choice.

Finally, even if slight excess in the use of a “free” system were to occur, it is still better than having large numbers of people with little or no access to medical help, which is the case now.

26 Matt Tievsky November 10, 2005 at 9:42 pm

One reason “overconsumption” may occur is because people may skimp on all of the other ways to take care of their health, like healthy eating and exercising, or getting enough sleep, or avoiding dangerous behaviors like smoking or unsafe sex, under the expectation that medical care will be freely available when they need it.

But the other half of the equation is “undersupply.” Put the two together and you get shortage, which seems to explain the long waits for necessary surgery in Canada.

27 John Y. November 10, 2005 at 10:28 pm

“If you believe that, what in the world are you doing reading an economics blog.”

Actually, I don’t generally read economics blogs — at least, not this one. I find that the vast majority of economists live in ivory towers and base theory on assumptiosn that bear no relation to the real world: the idea that people are “rational actors” is a good example of this.

There is ample evidence that varying degrees of single payer or near-single payer health care works, and works better than what we have in the U.S. You can pretend it doesn’t, but that doesn’t make it so.

28 John Y. November 11, 2005 at 12:50 am

I’ll fix that for you:

Economists apparantly can’t abstract reasonably, therefore most of their theories don’t work in the real world.

29 Richard November 11, 2005 at 1:09 am

Having lived in Japan for eight years during the 1990s and having had several friends who were doctors, I’d like to make a couple points about the Japanese system.

First, the low prices (the Japanese system requires a 30% co-pay; fees and prices are established largely by the Ministry of Health) do result in overuse, especially by the elderly. A common joke in Japanese hospitals is “Tanaka-san [typically an eighty year old retiree] must be sick today; she’s not out in the waiting room.” While I never experienced Canada-length delays in receiving medical tests, a visit to the doctor generally took up half a day–doctors don’t usually take appointments and the typical family physician will see between 100 and 250 patients per day.

Second, partially because of the large number of patients, but also because of price controls, there’s relatively little reliance on physician consultation. The typical exam is about 3 minutes long, in which time the doctor makes a diagnosis and/or orders tests. Doctors can charge only about $20 for a consultation, but as many have basic testing equipment in their clinics, they can collect higher fees by having their patients undergo a large and intrusive battery of tests. (I’ll never forget the time I went in with what I think was just stress, saw a doctor for three minutes and found myself told to come back for a stomach endoscopy–all because my throat felt constricted; sure was cheap, though.)

Third, further evidence of the distortion caused by price controls is the fact that most Japanese clinics (even one-doctor affairs) contain their own pharmacies. Again, this allows the physician to capture additional revenues that she’s denied for mere consultation. Consequently, Japanese seem to be among the most overprescribed patients on earth. (No proof–just my observation.)

Finally, the physical condition of most hospitals and clinics are far below what anyone would tolerate in this country outside of the most desolate urban hospitals. Run down, quite unsanitary, and depressing–one hospital was enough to make me near suicidal, and I was just visiting a friend recovering from an illness. The typical American would be unwilling to put up with such conditions, but they are, I believe, a natural consequence of government-imposed price controls.

I agree that something needs to be done about health care, but the American people, to make an informed choice, must be shown the realities of national health care; just rattling on about health care for all without presenting them with real-life examples of the distortions nationalized health care would create denies the complexity of the debate.

30 Constant November 11, 2005 at 1:47 am

“Besides, the rational ability to judge what health care is needed, as Ezra pointed out on TAPPED, is what doctors spend years training to learn. It’s not something that every patient can learn to do for him or herself.”

You are only pointing out that doctors have a great degree of specialized knowledge. That applies not just to doctors. There are many fields requiring long study; the customers meanwhile are not specialists. However can the market work? You are in effect arguing that all highly paid professionals in any field whatsoever should be paid for by the government. And yet the market does rather well. Time to re-examine your assumptions.

“The “price” of health care /isn’t just money/.”

Correct. In Canada, part of the price is waiting. This is basic econ: if you artificially keep the price down, queues will form, for simple understandable reasons.

“Actually, waiting times for surgery vary wildly over the country — some doctors have one or two patients in their queues, others have hundreds.”

By itself meaningless data. Maybe the doctors with short queues are incompetent. But another possibility is that the unevenness represents a misallocation of resources. Still, too little info to tell.

“But invasive procedures are an incredible inconvenience even to those people with insurance.”

There is not a set treatment for every affliction. There is often a range of things that can be done. There are also different levels of personal doctors’ attention that can be given, amount of time spent with each patient, number of doctors that could be consulted, and of course, quality of doctor. There is the question of the optimal number of doctors overall and in each place. This number is set in a market through the price mechanism: if there are too few doctors, the price of care goes up and new doctors are attracted. There is the question of the right mix of doctor, nurse, other professional, and home care, and this is also worked out in a market.

And so on and so forth.

31 Freeman November 11, 2005 at 6:01 am

“As a result, she has the most advanced IT setup that money can buy, including a 100 per cent paperless billing operation, fully integrated with her patient records.”

You don’t need single-payer systems to do this. I write software for private GPs in South Africa, and most of our customers have 100% paperless billing fully integrated with patient records. And we typically charge our doctors about $200 US/month for this capability. It’s just not as expensive to do it in the first place as people like to pretend. Markets discover this.

32 Slocum November 11, 2005 at 7:31 am

“Slocum, Do you have anything beyond anecdotal evidence to suggest this sort of use of a “free” health care system? Of course, I am also sure that you are a better judge of the kids health than their parents.”

No, vk, no studies to point to off the top of my head, but if you google “insurance over-use cost” you’ll have plenty to go through. One of the first hits pointed out another aspect of the overuse problem –overuse by physicians because ordering tests or procedures doesn’t cost the patient anything but adds to their income.

As for being a better judge than parents, blah, blah, how about this — my own wife overuses our health care insurance by taking our healthy, school-aged kids in for a yearly checkup–the only result of which is a new data point on a height-weight chart that we could easily have produced ourselves. Such frequent visits are wholly unnecessary, but are covered by our insurance (except for a trivial co-pay). If we were paying for the full cost of the office visits, I’d make a bigger deal of it, but as it is, if it makes her happy…whatever.

“Peter Clay: People object to paying for care for similar reasons to why they object to paying for sex.”

Do they? And do they also object to paying fitness trainers, hair-stylists, masseuses, etc for the same reason? If not, why not? Why are sex and medical care similar but different from all of the above?

33 focus November 11, 2005 at 9:53 am

Richard writes of having lived in Japan for eight years during the 1990s. I have live in Japan for over 40 years so far and am still here (in Japan).

When I need a doctor, I go to one in the neighborhood. There are several. All within minutes of my home. And if I am at the office, there are doctors near there too. When we need more than a doctor, we go to a big hospital. Not the problem Richard depicts.

But don’t believe either of us. Look at average life expectancy, medical care cost per person, the number of people without insurance coverage, and some other statistical comparisons.

34 Mcwop November 11, 2005 at 10:14 am

Given this is an econ blog, could someone show any evidence supporting the claim that the US healthcare is better/more efficient than the Canadian outside of extrrme and rare things like heart transplants?

See Chaoulli v. Quebec. Evidently, getting routine Hip surgery is a rather complex ordeal in Canada. Not so in the states. My Grandma got the surgery in about 5 weeks, and did not get bumped the day of her surgery. I would say the U.S. system has issues, but it seems to have more supply for many procedures.

[Note – I am not opposed to a system similar to France’s, but I do not like Canada’s system]

35 Richard Gabbert November 11, 2005 at 11:44 am

Focus states that my description of Japanese health care is inaccurate because there are several clinics within walking distance of his home, and if he needs additional care, he goes to a larger hospital nearby. I fail to see how this addresses any of the issues that I raised. His experience was mine as well, but the ubiquity of doctor’s clinics says nothing about the distortions of national health care that I presented.

Focus, do you have any evidence to refute any of my specific contentions? I’ll list them out again: (1) overuse, particularly by the elderly; (2) overreliance on tests and underreliance of physician consultations; (3) overprescription due to internal pharmacies; and (4) the generally shoddy quality of the physical infrastructure.

I don’t deny that Japanese are on the whole healthier than we, and though I don’t have spending info, I’m willing to grant that Japan has a lower medical expenditure. However, having lived in Japan for 40 years, you should be the first to recognize that the high level of health and longevity have much more to do with diet and lifestyle choices than with health care. Comparing expenditures and levels of health seem to me particularly unhelpful in this context.

36 Mcwop November 11, 2005 at 2:33 pm

My data for Canada’s GDP health spending is from 2002, so I gues a lot has happened in the past 3 years. Regardless, Canada’s system, which is the envy of many in the U.S., does not appear to be the best among OECD countries with universal access.

http://www.fraserinstitute.ca/admin/books/chapterfiles/Executive%20Summary-pages1-6.pdf#1

http://angrybear.blogspot.com/2005/04/waiting-for-health-care.html

37 ArC November 11, 2005 at 3:13 pm

“The best kind of evidence is behavior, and Canadians regularly come to the US for medical treatment they aren’t getting ‘for free’ in their home country.”

What are the statistics on this? Actually, it’s quite low:

http://content.healthaffairs.org/cgi/content/abstract/21/3/19?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=karen+cardiff&andorexactfulltext=and&searchid=1131739824888_3102&stored_search=&FIRSTINDEX=0&resourcetype=1&journalcode=healthaff

This article says:

“Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home.”

I guess the best kind of evidence really is behaviour!

38 Anand Kumar January 7, 2007 at 11:31 pm

Official Website of Shri Srinivasa Ragavaswamy charitable Trust in South India working towards constructing a temple for Sri Srinivasa Perumal (balaji) with Raja Gopuram which is named as Kovai Thiruppathy.

39 æ°´æ— ç—• July 7, 2007 at 2:26 am

google排名
wow power leveling
wow power leveling
wow powerleveling
wow powerleveling
wow power level
wow power level
hongkong hotel
hongkong hotel
beijing tour
beijing tour
翻译公司
翻译公司
上海翻译公司
上海翻译公司
北京翻译公司
北京翻译公司
门禁
wow gold
wow gold
powerleveling
powerleveling
wow powerleveling
wow powerleveling
wow power leveling
wow power leveling
power leveling
power leveling
wow power level
wow power level
窃听器
福彩3D
搬家公司
香港六合彩

Ddo plat
Ddo plat
FFXI Gil
FFXI Gil
GW Gold
GW Gold
GW Power Leveling
GW Power Leveling
RS Gold
RS Gold
RS Power Leveling
RS Power Leveling
Lotro Gold
Lotro Gold
Lotro Power leveling
Lotro Power leveling
china tour
china tour
猎头
猎头
货架
货架
货架
google排名
google排名
翻译公司
翻译公司
上海翻译公司
上海翻译公司
北京翻译公司
北京翻译公司
仓库
仓库
仓库出租
仓库出租
物流园区
物流园区
监控
监控
激光打标机
软件工程硕士
工程地毯
工程地毯
集团电话
集团电话
激光打标机
激光打标机
打包机
打包机
拓展训练
拓展
拓展培训
香港六合彩
搬家公司
搬家公司
窃听器

40 asdd July 12, 2007 at 1:44 am
41 xdrs July 12, 2007 at 4:05 am

liying 07年7月12日

google排名
google排名
wow gold
wow gold
wow gold
wow gold
powerleveling
powerleveling
wow power leveling
wow power leveling
wow powerleveling
wow powerleveling
world of warcraft powerleveling
world of warcraft powerleveling
world of warcraft power leveling
world of warcraft power leveling
hongkong hotel
hongkong hotel
beijing tour
beijing tour
翻译公司
翻译公司
上海翻译公司
上海翻译公司
门禁
北京翻译公司
北京翻译公司
google排名

集团电话
集团电话
仓库
仓库
仓库出租
仓库出租
物流园区
物流园区
搬家公司
搬家公司
北京搬家公司
搬家
搬家公司
搬家公司
北京搬家公司
北京搬家公司
china tour
china tour
多媒体
货架
货架
货架
光盘刻录
光盘刻录
光盘制作
光盘制作
光盘印刷
光盘印刷

摆闸
痤疮
痤疮
色斑
色斑
黄褐斑
黄褐斑
青春痘
青春痘
口腔医生
口腔医生
口腔
口腔
口腔医院
口腔医院
口腔科
口腔科
三星集团电话机
呼叫中心
电话交换机
交换机
呼叫中心
测厚仪
测温仪
停车场
道闸

42 xdrs July 19, 2007 at 10:41 pm

liying 07年7月20日

google排名
google排名
wow gold
wow gold
wow gold
wow gold
powerleveling
powerleveling
wow power leveling
wow power leveling
wow powerleveling
wow powerleveling
world of warcraft powerleveling
world of warcraft powerleveling
world of warcraft power leveling
world of warcraft power leveling
hong kong hotel
hong kong hotel
beijing tour
beijing tour
rolex replica
rolex replica
翻译公司
翻译公司
上海翻译公司
上海翻译公司
门禁
北京翻译公司
北京翻译公司
google排名

超声波探伤仪
超声波探伤仪
物流园区
物流园区
搬家公司
搬家公司
北京搬家公司
搬家
搬家公司
搬家公司
北京搬家公司
北京搬家公司
beijing
beijing
china tour
china tour
great wall
beijing travel
beijing travel
china tour
china tour
网站设计
多媒体
货架
货架
货架
光盘制作
光盘制作
摆闸
痤疮
痤疮
色斑
色斑
黄褐斑
黄褐斑
青春痘
青春痘
电话交换机
交换机
呼叫中心
测厚仪
测温仪
停车场
道闸

43 Missliang August 14, 2007 at 10:22 pm

houyuping 07年8月15日

wow gold
wow gold
wow power leveling
wow power leveling
wow powerleveling
wow powerleveling
world of warcraft powerleveling
world of warcraft powerleveling
world of warcraft power leveling
world of warcraft power leveling
powerleveling
powerleveling
wow powerleveling
wow powerleveling
wow power leveling
wow power leveling
power leveling
power leveling
wow power level
wow power level
china tour
china tour

翻译公司
翻译公司
上海翻译公司
上海翻译公司
北京翻译公司
北京翻译公司
监控
货架
鼓风机
风机
风机
涂层测厚仪
涂层测厚仪
红外测温仪
红外测温仪
超声波测厚仪
超声波测厚仪
超声波探伤仪
超声波探伤仪
频闪仪
频闪仪
涂层测厚仪
涂层测厚仪
电火花检测仪
电火花检测仪

google排名
门禁
门禁
门禁系统
门禁系统
搬家
搬家公司
北京搬家公司
光盘制作
光盘印刷
光盘印刷
搬家公司
激光打标机
搬家公司
北京搬家公司
hongkong hotel
hongkong hotel
beijing tour
beijing tour
集团电话
集团电话
china tour
china tour
青春痘
青春痘

44 Missliang August 16, 2007 at 2:24 am

houyuping 07年8月16日

wow gold
wow gold
wow power leveling
wow power leveling
wow powerleveling
wow powerleveling
world of warcraft powerleveling
world of warcraft powerleveling
world of warcraft power leveling
world of warcraft power leveling
powerleveling
powerleveling
wow powerleveling
wow powerleveling
wow power leveling
wow power leveling
power leveling
power leveling
wow power level
wow power level
china tour
china tour

翻译公司
翻译公司
上海翻译公司
上海翻译公司
北京翻译公司
北京翻译公司
监控
货架
鼓风机
风机
风机
涂层测厚仪
涂层测厚仪
红外测温仪
红外测温仪
超声波测厚仪
超声波测厚仪
超声波探伤仪
超声波探伤仪
频闪仪
频闪仪
涂层测厚仪
涂层测厚仪
电火花检测仪
电火花检测仪

google排名
门禁
门禁
门禁系统
门禁系统
搬家
搬家公司
北京搬家公司
光盘制作
光盘印刷
光盘印刷
搬家公司
激光打标机
搬家公司
北京搬家公司
hongkong hotel
hongkong hotel
beijing tour
beijing tour
集团电话
集团电话
china tour
china tour
青春痘
青春痘

Comments on this entry are closed.

Previous post:

Next post: