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InvisiblefeeversM
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Re: Viral outbreak in China [Re: Doc9151] * 1
    #26867199 - 08/06/20 07:57 PM (3 years, 6 months ago)

So it's not like labs get a positive COVID test and all of a sudden the hospital collects $14k. It's more like if they're admitted, what may have been a $5k medicare admission will be 14k or whatever instead following a positive test result, same upcharge idea for the ICU. There's no one set rate. Not 100% sure the reasoning, but probably to help compensate for the specific care and precautions needed with COVID vs a typical admission.

So the only way to really scam the system is to take someone who just happens to get admitted with the symptoms of a pandemic virus while said pandemic virus is raging, but doesn't have the virus, falsify a test result, and ensure that all other billing codes (and therefore treatment) align with COVID protocols. This means the nurses and doctors would have to purposefully treat for something the patient doesn't have, or knowingly lie about the entire course of treatment to benefit only the hospital money makers. This would absolutely explode in the media if even one example got out. There are far less risky ways to commit insurance fraud.


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: feevers]
    #26867241 - 08/06/20 08:13 PM (3 years, 6 months ago)

Excuse me but less ppe and drug availability has nothing to do with their profits.

umm, no it's not false, positive test is the only requirement for government funds

the availability of ppe and drug availability is directly a result of poor planning for mass casualties,  these people were warned by the the u.s. military and the powers that be ignored it, this was before covid19 even hit. once again you are blowing smoke


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


Edited by Doc9151 (08/06/20 08:16 PM)


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: feevers]
    #26867264 - 08/06/20 08:25 PM (3 years, 6 months ago)

Quote:

feevers said:
So it's not like labs get a positive COVID test and all of a sudden the hospital collects $14k. It's more like if they're admitted, what may have been a $5k medicare admission will be 14k or whatever instead following a positive test result, same upcharge idea for the ICU. There's no one set rate. Not 100% sure the reasoning, but probably to help compensate for the specific care and precautions needed with COVID vs a typical admission.

So the only way to really scam the system is to take someone who just happens to get admitted with the symptoms of a pandemic virus while said pandemic virus is raging, but doesn't have the virus, falsify a test result, and ensure that all other billing codes (and therefore treatment) align with COVID protocols. This means the nurses and doctors would have to purposefully treat for something the patient doesn't have, or knowingly lie about the entire course of treatment to benefit only the hospital money makers. This would absolutely explode in the media if even one example got out. There are far less risky ways to commit insurance fraud.



You're funny, it happens every day and has been ever since they were able to bill the state and federal government for health care. it didn't start with covid19,  but this virus is another excuse to rape the system. You obviously don't understand how health care fraud takes place. Try reading some of the cases posted by the agency that investigates Medicare and medicaid fraud and you will see how they are stealing tax payer money every day and only a tiny bit are caught because the system is to big and not enough man power to track every dollar.


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


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Offlinemorrowasted
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Re: Viral outbreak in China [Re: Doc9151]
    #26867265 - 08/06/20 08:25 PM (3 years, 6 months ago)

Forcing employees to reuse inadequate ppe reduces costs

I work for a not for profit. My sister manages a for profit facility. I have a direct line to how business practices are conducted there to compare against practices where i work. Reduced ppe isnt about boosting profits- profiting isnt even in the question right, the best they can do is try to break even- it is about trying to reduce how far into the red they go as a result of having to care for covid patients and not being able to do things like elective surgeries


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: morrowasted]
    #26867275 - 08/06/20 08:30 PM (3 years, 6 months ago)

they don't have proper ppe because there wasn't any to be had, that's why I made the comment about the powers that be werent listening when they were warned this would happen


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


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Invisiblecannabinated
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Registered: 01/03/13
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Re: Viral outbreak in China [Re: Doc9151]
    #26867284 - 08/06/20 08:33 PM (3 years, 6 months ago)

theres infinite ppe

we would have been fine if trump made a few sigs


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Invisiblecannabinated
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Registered: 01/03/13
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Re: Viral outbreak in China [Re: cannabinated]
    #26867285 - 08/06/20 08:33 PM (3 years, 6 months ago)

but nah we gotta get it from uygur slaves when china says so


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InvisiblefeeversM
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Re: Viral outbreak in China [Re: Doc9151] * 1
    #26867294 - 08/06/20 08:37 PM (3 years, 6 months ago)

Quote:

Doc9151 said:

umm, no it's not false, positive test is the only requirement for government funds





Source?

There are close to 5,000,000 positive tests so far in the US. If hospitals got $14k for every positive result, you wouldn't be able to walk 5 feet from your house without a hospital doc trying to shove a qtip up your nose.


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: Doc9151] * 1
    #26867308 - 08/06/20 08:42 PM (3 years, 6 months ago)

You know,  I guess it's not only the thievery that is bothering me with this virus but the way it's being politicized in the U.S. at the moment. This goes way deeper than the everyday physician and other providers, there are medical doctors making decisions that haven't seen a patient sine residency because they choose to be an administrator, those are the main crooks and then you add the politicized bullshit on top of a world pandemic and you have a perfect storm for corruption.  It will be decades before all the figures are finally reviewed and the true toll is revealed. Only someone in the loop can blow the whistle and most of them are getting paid to participate. why would they.

I will bet you are years pay that every single hospital out there has overbilled insurance companies and federal/state governments at some point. whether it's for material that wasn't actually used or medication not given, they all do it.


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: cannabinated] * 1
    #26867323 - 08/06/20 08:51 PM (3 years, 6 months ago)

Quote:

cannabinated said:
theres infinite ppe

we would have been fine if trump made a few sigs



thats bullshit, there never was enough,  not even in the government stock pile and that happened under obama/Biden when a mass casualties advisory board told them we didn't have enough,  so tell me how the current president that wasn't in office during this assessment can be responsible for the actions of the previous administration. Signing a piece of paper wouldn't make ppe magically appear. Why do you think companies rushed to retool to start making this stuff after the virus hit. You haven't a clue how national disasters are handled,  I have first hand experience. I  trained and participated in mass casualties, also helped develope plans in the case of such events. The military is all about large scale preparedness and they didn't even have everything they needed.  You want to blame someone blame Biden and Obama for failing to institute the change they promised and they even controlled the house.

edit: Don't hate on Trump because someone told you too, he's done more to help this country than the previous 5 administrations. At least he is thinking about the whole nation and not trying to sell it out to foreign governments.  To all the non_U.S. citizens bashing the president,  how about you keep out of it until your country stops begging for American money and support.  I don't see anyone bashing your country or its leadership.


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


Edited by Doc9151 (08/06/20 09:01 PM)


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Invisiblecannabinated
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Re: Viral outbreak in China [Re: Doc9151] * 3
    #26867328 - 08/06/20 08:53 PM (3 years, 6 months ago)

lol ur a fuccin retard dude

trump killed 130k

at least 100k of em


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Offlinemorrowasted
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Re: Viral outbreak in China [Re: Doc9151]
    #26867333 - 08/06/20 08:54 PM (3 years, 6 months ago)

Quote:

Only someone in the loop can blow the whistle and most of them are getting paid to participate.




I am in the loop. I meet with case managers in the middle of every shift. The entire unit is charted on the board- including what the what the patient's approved length of stay is and how long they have been there. The length is stay is determined by the insurance company (or medicare) in accordance with the diagnostic related groups (DRGs) reported by the hospital as the reason for admission. The point of this meeting is to discuss what are called barriers to exit- these are the factors that prevent the hospital from being able to discharge the patient. The role of the nurse is to relay the barriers of exit to the case manager so that the case manager can reach out to the social workers, therapists, etc. necessary to provide the necessary services so that the patient can be discharged.

I won't lie, it's mindnumbing that the entire meeting is about trying to get the patients out the door so that the hospital doesn't lose money on them. I'm just telling you that right now, the hospitals are losing money on the average covid patient. They are staying far past their approved length of stay and using massive amounts of resources while they are there.

At the SNF my sister manages, they can't even break even because they only have 3 hallways. Any covid positive patients have to be isolated, so as long as they have any, one of the hallways has to be converted into an isolation unit. That hallway can typically house 24 patients, but she only has 2 covid patients there right now. That means she has 22 empty beds, and she can't admit patients to fill them.


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Invisiblevinsue
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Re: Viral outbreak in China [Re: Doc9151]
    #26867342 - 08/06/20 08:59 PM (3 years, 6 months ago)

:popcorn: . . . :peace:


--------------------

"All mushrooms are edible; but some only once." Croatian proverb. BTW ...
  Have You Rated Ythans Mom Yet ?? ... :taser:  ... HERE'S HOW ... (be nice) .  :mod: ... :peace:


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: vinsue]
    #26867354 - 08/06/20 09:07 PM (3 years, 6 months ago)

yeah your in the loop my ass, you have nothing to do with the institutions financial dealings on the corporate level, i call bull shit.

It was dumbasses like the mayor of New york city and the Governor of New York saying its ok for covid19 patients to go to nursing homes that killed those people  don't blame the president.  The Democrats fought tooth and nail calling the president a zenophobe for wanting to stop immigration from China and other hot spots when the virus appeared,  it's the Democrats that sued to block his orders to protect this country not Republicans,  trying informing yourself and let the tv do it for you

Edit: I will bet money you have absolutely nothing to do with billing and what gets sent out to insurance companies,  I guarantee that you have no understanding how hospitals bill for surgeries or anything else. When a hospital bills an insurance company,  they bill for everything they can,  even for things like disposable instruments, guaze packing, tubing and other stuff that can be used but isn't necessarily used but they still say they used it just to name a few things that I now they do for a fact, even the government knows about it and they do prosecute when they can.  There's no one going back looking to see if so and so use such and such until patients start complaining that their Medicare acct is being billed for services that they didn't receive and it takes many people to complain to start an investigation


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


Edited by Doc9151 (08/06/20 09:16 PM)


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Offlinemorrowasted
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Re: Viral outbreak in China [Re: Doc9151] * 2
    #26867356 - 08/06/20 09:09 PM (3 years, 6 months ago)

Quote:

yeah your in the loop my ass, you have nothing to do with the institutions financial dealings on the corporate level, i call bull shit.


I literally just explained to you in detail how that is, in fact, the case, but by all means, believe whatever conveniences your cynicism.

I don't watch the TV, I don't think along partisan lines, I just work in the field and I'm trying to explain to you how the field actually works.

Quote:

One of the best ways to improve a hospital’s financial margin is to reduce the average patient length of stay. Since hospitals are paid by the “DRG” (diagnosis related group), the hospital is going to get paid the same amount for a patient with say, pneumonia, if that patient spends 4 days in the hospital or spends 8 days in the hospital. Therefore, the quicker the hospital can get a patient discharged from a hospital bed, the sooner the hospital can put a new patient in that bed. If the hospital can get all of their pneumonia patients discharged in 4 days, as opposed to 8 days, then the hospital can admit twice as many patients into that bed over the course of a year and consequently can make almost twice as much money.



https://www.medicare.org/articles/how-does-medicare-pay-hospitals/
Quote:

Medicare payment systems have evolved over the past few decades, but they continue to use a pay-per-service payment model. This is known as the Inpatient Prospective Payment System, or IPPS. This system is based on diagnosis-related groups (DRGs). A DRG assignment is made based on a patient’s primary diagnosis and any secondary diagnoses that they have during a hospital stay. These diagnoses can be added as needed throughout a stay as long as they are appropriate for the care being received.

The DRGs assigned to a specific patient can be affected by up to 25 procedures per hospital visit, and all diagnoses and procedures combine to create a set of DRGs tailored to the specific patient. In addition to medical diagnoses, DRGs are also affected by gender and age. Each year, the list of current DRGs is reviewed to ensure they appropriately reflect the resources that are regularly being used in the hospital.

DRGs are also rated on severity. There are three levels of severity, which are assigned to secondary diagnoses. The highest level of severity is labeled Major Complication or Comorbidity, the next level is known as Complication or Comorbidity, and the lowest severity level is known as Non-Complication. The lowest level has little impact on illness severity and uses minimal hospital resources. On the other hand, Major Complication DRGs often use many resources, may contribute significantly to illness and disease, and often accrue higher costs for appropriate care.




https://www.kpcnews.com/covid-19/article_8ab408ad-8fb0-5f74-8d57-11e586bd8a4f.html
Average COVID-19 hospital stay greater than three weeks


You're welcome


Edited by morrowasted (08/06/20 09:14 PM)


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InvisiblefeeversM
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Re: Viral outbreak in China [Re: Doc9151]
    #26867359 - 08/06/20 09:11 PM (3 years, 6 months ago)

Quote:

Doc9151 said:
Quote:

feevers said:
So it's not like labs get a positive COVID test and all of a sudden the hospital collects $14k. It's more like if they're admitted, what may have been a $5k medicare admission will be 14k or whatever instead following a positive test result, same upcharge idea for the ICU. There's no one set rate. Not 100% sure the reasoning, but probably to help compensate for the specific care and precautions needed with COVID vs a typical admission.

So the only way to really scam the system is to take someone who just happens to get admitted with the symptoms of a pandemic virus while said pandemic virus is raging, but doesn't have the virus, falsify a test result, and ensure that all other billing codes (and therefore treatment) align with COVID protocols. This means the nurses and doctors would have to purposefully treat for something the patient doesn't have, or knowingly lie about the entire course of treatment to benefit only the hospital money makers. This would absolutely explode in the media if even one example got out. There are far less risky ways to commit insurance fraud.



You're funny, it happens every day and has been ever since they were able to bill the state and federal government for health care. it didn't start with covid19,  but this virus is another excuse to rape the system. You obviously don't understand how health care fraud takes place. Try reading some of the cases posted by the agency that investigates Medicare and medicaid fraud and you will see how they are stealing tax payer money every day and only a tiny bit are caught because the system is to big and not enough man power to track every dollar.




I'm very familar with how medical fraud works. As I said I've worked in hospitals as a clinician, my wife is an admin at a hospital, and I've actually studied medical fraud extensively. My doctoral level ethics course was taught by one of the lawyers that audits hospitals for my state's medicaid program, I've probably read every single large scale medical fraud case that's been prosecuted in my state. That's partially why it seems to me like you have no idea what you're talking about. You're talking about large scale collusion between hospital admins, nurses/doctors, the labs running the tests, to create an imaginary diagnosis for a thing that, worldwide, is creating new cases far quicker than we can even count them. There is no incentive to take such a massive risk.


Edited by feevers (08/06/20 09:35 PM)


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: feevers]
    #26867370 - 08/06/20 09:18 PM (3 years, 6 months ago)

Quote:

feevers said:
Quote:

Doc9151 said:
Quote:

feevers said:
So it's not like labs get a positive COVID test and all of a sudden the hospital collects $14k. It's more like if they're admitted, what may have been a $5k medicare admission will be 14k or whatever instead following a positive test result, same upcharge idea for the ICU. There's no one set rate. Not 100% sure the reasoning, but probably to help compensate for the specific care and precautions needed with COVID vs a typical admission.

So the only way to really scam the system is to take someone who just happens to get admitted with the symptoms of a pandemic virus while said pandemic virus is raging, but doesn't have the virus, falsify a test result, and ensure that all other billing codes (and therefore treatment) align with COVID protocols. This means the nurses and doctors would have to purposefully treat for something the patient doesn't have, or knowingly lie about the entire course of treatment to benefit only the hospital money makers. This would absolutely explode in the media if even one example got out. There are far less risky ways to commit insurance fraud.



You're funny, it happens every day and has been ever since they were able to bill the state and federal government for health care. it didn't start with covid19,  but this virus is another excuse to rape the system. You obviously don't understand how health care fraud takes place. Try reading some of the cases posted by the agency that investigates Medicare and medicaid fraud and you will see how they are stealing tax payer money every day and only a tiny bit are caught because the system is to big and not enough man power to track every dollar.




I'm very familar with how medical fraud works. As I said I've worked in hospitals as a clinician, my wife is an admin at a hospital, and I've actually studied medical fraud extensively. My doctoral level ethics course was taught by one of the lawyers that audits hospitals for my state's medicaid program, I've probably read every single large scale medical fraud case that's been prosecuted in my state. That's partially why it seems to me like you have no idea what you're talking about. You're talking about large scale collusion between hospital admins, nurses/doctors, the labs running the tests, to create an imaginary diagnosis for a thing that, worldwide, is creating new cases far quicker than we can even count them.



wasn't 6alking to you. I have to use quotes more I'm arguing with two different


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


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OfflineDoc9151M
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Re: Viral outbreak in China [Re: Doc9151] * 1
    #26867404 - 08/06/20 09:36 PM (3 years, 6 months ago)

feevers, don't know what they are doing in your area but in mine hospitals are responsible for test, not private labs like smit-hklien quest and other private entities,  strictly hospitals and only hospitals are eligible to receive the money and it is not based solely on admission, yes, every admission for covid19 gets $14,000 per patient,  doesn't require anything else, they are also paid thousands each positive test result up to 14k.

Meeting with case managers has nothing to do with finance. keeping people in hospitals longer isn't the way they commit fraud. you speak about it like its just done with everyone willingly being a participant,  when in fact it's part of the billing policy. The surgical nurse and doctors do not tell billing what they used during surgery,  there is a preset list that is billed outright even if something wasn't used, that's why I say you don't have a clue if you can't understand that little fact. it is fraud to knowingly bill for services not provided, but its done everyday because hospitals know that no one will check, it's when they get overly greedy that they get caught.  My whloe point is that it is standard practice for hospitals to blanket bill for services and that includes services that weren't actually provided and that is fraud.

Covid19 is a huge opportunity for fraud amongst medical institutions and if you think anything I said just now is wrong then you haven't been paying attention, don't care or just talking shot. I have been both Patient and provider, the system is corrupt.


--------------------


Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis.
https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593


Edited by Doc9151 (08/06/20 09:36 PM)


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InvisibleThe Blind Ass
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Re: Viral outbreak in China [Re: Doc9151]
    #26867407 - 08/06/20 09:38 PM (3 years, 6 months ago)

So if a person gets the test and is positive but asymptomatic and doesn’t get anything else (ie Treatment) and returns home right afterwards... you’re telling me your hospital gets 14k just for running the test? :confused:


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InvisiblefeeversM
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Re: Viral outbreak in China [Re: The Blind Ass]
    #26867413 - 08/06/20 09:44 PM (3 years, 6 months ago)

.
Quote:

The Blind Ass said:
So if a person gets the test and is positive but asymptomatic and doesn’t get anything else (ie Treatment) and returns home right afterwards... you’re telling me your hospital gets 14k just for running the test? :confused:




With close to 5,000,000 positive cases at 14k each, I entered it into my phone's calculator and it just laughed at me :lol:

Yes not every test is done at a hospital, but hospitals and their affiliated PCP's would not be sending you to rite aid and urgent cares to get tested if they were making thousands per positive when it's done at a hospital. I'm still waiting on his source though, I'm not 100% sure.


Edited by feevers (08/07/20 10:13 AM)


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