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Time for change's Journal
Posted by Time for change in General Discussion
Mon Sep 14th 2009, 10:01 PM
Providing a windfall for the private insurance industry through a mandate to purchase private health insurance is bad enough. Added to that is the possibility that working and middle class Americans will bear the brunt of the cost, and worse, that th
I see three major potential problems with mandated health insurance. But before I get into those potential problems I first feel the need to talk about what is NOT wrong with mandated health insurance.

Simply put, I see nothing wrong with mandated health insurance in principle. In principle, a government mandate that people buy into a program is very similar to a government tax. Our local, state and federal taxes go towards paying for public schools, safe drinking water, Medicare and Medicaid, public roads, and myriad other things. Our taxes pay for these things whether or not we have children attending public schools, whether we use public drinking water, or whether or not we are enrolled in Medicare or Medicaid.

Yet progressives rarely complain about these things. We recognize that certain government services are necessary to the well-being of our communities and our country, and we rarely complain about the principle of being taxed to pay for them. Republicans whine about it as if government taxes are the work of the devil himself. But we rarely do.

In principle there is a very good reason to have a government mandate (or government tax) to help pay for health care. It is the same reason that we pay taxes for all the other things that we pay taxes for. Paul Krugman explained it as well as anyone I’ve heard during the 2007-8 primary season, when he criticized the Obama health insurance plan for not including a mandate, unlike the Edwards and Clinton plans, which did include a mandate:

Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they’re currently healthy, and in return everyone has insurance coverage if and when they need it.

And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else. Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance – then sign up for it if they developed health problems later… As a result, people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn’t sign up for insurance until or unless they needed medical care.

There has been a lot of criticism on DU lately about President Obama’s recent words in favor of mandated health insurance. I see a lot to criticize about his plan. And indeed (as I discuss below), the decision to make health insurance mandatory could be very problematic – depending upon the details. But I get the sense that much of the criticism of health insurance mandates on DU is directed at the very principle of a mandate. I think that’s wrong, and it echoes Republican talking points. That concerns me because echoing Republican talking points will serve their purpose, not ours, will support them and divide us in our efforts to create a meaningful plan for universal health insurance.


PROBLEMS WITH MANDATED HEALTH INSURANCE

Although there is nothing wrong with government-mandated programs as a general principle, in practice there can be a lot wrong with them. Issues to consider in assessing the appropriateness of a government mandate include the value of the program to the American people and who has to bear the burden of its costs. With these issues in mind, I believe that there are some serious problems or potential problems associated with the pending health care legislation:


Inability of some people to pay for mandated health insurance

Some DUers have expressed the concern that mandated health insurance will prove to be unaffordable to them. Our economy is in a precarious state. There are many millions of Americans who live in poverty or on the brink of poverty. A requirement to spend money every month on health insurance could push them over the edge.

This is a legitimate concern. But we should keep in mind that it is a concern about a potential problem, not necessarily an actual problem.

President Obama said that subsidies will be provided to those who cannot afford health insurance. That’s great. But the question we need to ask is: How much subsidy? It is certainly possible that the subsidies will be sufficient to cover the whole cost of health insurance for all Americans who would otherwise have trouble paying for them. We simply don’t know at this point.

Paul Krugman discussed this issue during the primary season, in the form of combating Republican criticisms of health insurance mandates:

The second false claim is that people won’t be able to afford the insurance they’re required to have – a claim usually supported with data about how expensive insurance is. But all the Democratic plans include subsidies to lower-income families to help them pay for insurance, plus a promise to increase the subsidies if they prove insufficient.

If mandating health insurance proves to be a burden for Americans who cannot comfortably afford it, that will constitute a serious problem. In fact, that will not be acceptable. The major purpose of universal health care is to provide comfort and health to those who are currently on the brink of financial disaster. If the program turns out to make things worse rather than better for them, it should be categorically rejected.


Potentially unfair distribution of the burden of supporting the program

I said above that a mandated government program is similar in principle to a government tax. Then why not accomplish the same thing through taxation? Wouldn’t that be a lot simpler?

Yes indeed, it would be simpler. So perhaps we should be asking why the program should be accomplished by mandating that people buy into the plan, while offsetting the burden on them through government subsidies, rather than through a system of progressive taxation.

I can’t answer that question. Perhaps it has something to do with the fact that presidential candidate Obama promised that he would not raise taxes on anyone who makes under $250,000 annually. If his health care program is paid for through people buying into mandated health insurance programs rather than through taxation, that could allow him to technically claim that he has not raised taxes on those who make under $250,000.

If that is the purpose of mandating health insurance rather than paying for it through progressive taxation, then it is a dishonest ploy. We should not accept that, and we should call President Obama (and our elected representatives who support such a plan) out on that. We should hold him accountable for his campaign promises unless he can show damn good reasons for backing out of them. After all, isn’t it well past time time that the Bush tax cuts for the wealthy be reversed? Barack Obama did promise us that when he ran for president.

Of course we don’t know at this point in time whether or not the plan that Obama has in mind, or the plan that will be passed by Congress, will in fact constitute a tax on people making under $250,000. It could be that the government subsidies that President Obama has promised will offset the financial burden on those people to the extent that it can be argued that the government mandate will not cost them anything and therefore will not constitute a tax. We just don’t know at this time.


Subsidization of private, for-profit health insurance companies

Under Obama’s original health care plan – the one he ran on during the primary season – a public option for government sponsored health care would be offered to ALL Americans. Given all the extraneous costs that private for-profit health insurance plans entail, there is every reason to believe that, over time, the vast majority of Americans would opt for the public option over private health insurance.

Some argued that even if a public option was available to all Americans, such a plan would nevertheless constitute a government subsidy to the private health insurance industry. Those people argued that under such a plan, some currently uninsured people would use their government subsidies to purchase private health insurance. That is undoubtedly true. But I felt that it would nevertheless be misleading to say that such a plan constituted subsidization of the health insurance industry, since the competition provided by the public option would drain far more profits from the health insurance industry than they would gain from the few currently uninsured people who decided to use their government subsidies to purchase private health insurance. Indeed, that is why the health insurance industry is so adamantly against a public option for all Americans.

But in President Obama’s speech to Congress last week, he seemed to be backing away from his original plan BIG TIME:

An additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. (Applause.) Now, let me be clear. Let me be clear. It would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

Oh great! We go from a public option offered to everyone to an estimate that only 5% of Americans would sign up. Those of us who currently purchase private health insurance are penalized by making us ineligible for the public option plan. I’d like to know why. And why is it that only 5% of Americans would sign up? Is it because the public option plan would be so weak that it wouldn’t be able to compete successfully with private insurance plans? Would it be because the vast majority of Americans would be ineligible for it? We don’t know yet, because we don’t have enough details on it.

With a mandate to buy health insurance, and only 5% of Americans using the public option to satisfy their mandate, that means that the good majority of other Americans would be purchasing their health insurance from private for-profit companies. And what kind of competition would be provided by a program that involved only 5% of Americans? It seems to me that this would be a great boon to the insurance industry. It is theoretically possible that government regulation of the insurance industry could offset the additional money flowing into their coffers by virtue of the mandate that all Americans purchase health insurance. But how likely is that?


Conclusion

All in all, I’m disappointed in where we stand now with the possibilities for health care reform. President Obama has gone from a government sponsored health insurance option available to all Americans to one that most Americans are ineligible for, and which only 5% are expected to use. With that, the private insurance industry stands to be rewarded with massive government subsidies via consumers who are mandated to purchase private health insurance.

And what for? Clearly, President Obama feels the need to do everything he can to stifle opposition to his plan from the right. Saying “We believe that less than 5 percent of Americans would sign up (for the public option)” is a major part of his efforts to do that.

But was it really necessary to go that far? The right wing criticism of the public option plan has been hypocritical and phony to the core. It cannot possibly result in the things that they say it will. It involves no death panels, and health care is already extremely rationed in our country by private health insurance companies. The whole campaign against the public option has been a cynical attempt by the health insurance industry and their lackey politicians to maintain their currently obscene profit margins -- at the expense of the health of the American people.

A strong public option to compete with the health insurance industry was our best chance to provide all Americans with decent health care. Rather than dismantle it in response to right wing pressure, why not make a determined effort to explain to the American people why it is their best choice?

Providing a windfall for the private insurance industry through a mandate to purchase private health insurance is bad enough. Added to that is the possibility that working and middle class Americans will bear the brunt of the cost, and worse, that those at the lower end of the income scale will not be able to bear the costs without pushing them over the edge into financial collapse. We don’t know that this will happen. We don’t yet have enough details on the specifics of the plan that will eventually emerge. But we can be sure of one thing – The private health insurance industry will be working very hard to see that as much of the cost as possible will be borne by those least able to afford it.
Discuss (44 comments) | Recommend (+29 votes)
U.S. Democracy in Crisis
Time for change


The Democratic Underground was born on one of the worst days in U.S history – The day that the worst President in U.S. history took office.

Now, here we are 8 years later, and we’ve managed to remove that cancer from our nation and replace it with something much better. Notwithstanding my many ambivalent feelings towards President Obama, I have no doubt that he will be infinitely better for our country than his predecessor.

Yet despite that, our country has been terribly scarred from the events of the past eight years, and it continues to suffer from all of the root problems that brought us the worst President in our history in 2000 and 2004. Therefore, it is worth taking a look at the root problems that brought us to this sorry state of affairs.


MAJOR IMPEDIMENTS TO DEMOCRACY IN THE UNITED STATES

One thing that we must keep in mind when considering our current problems is that they are not new. They were greatly exacerbated by eight years of Bush administration misrule, but they did not start with George W. Bush and Dick Cheney.


Money in politics

All but the most naïve of the American citizenry know that the wealthy and powerful in our country routinely influence our local and national elections through huge campaign contributions. And they also know that they are generally well rewarded for their “contributions”. And they also know that bribery is presumably against the law in our country. Yet, on the rare occasion that our politicians are actually accused of bribery, our news media makes a great big deal over it, as if bribery is actually a rare event in American politics.

The end result is that a great many of our politicians do everything they can to make their wealthiest constituents happy with them, at the expense of everyone else. They do that with the knowledge that the voters they lose in doing so will be more than compensated for by the disinformation that will be paid for by their wealthiest constituents. I discuss this situation in more detail here, here, and here.

There are a few dots to connect here, but any reasonable assessment of American politics tells us that bribery is routinely used to buy and sell elections in our country. So routine is it that it is actually built into our system and legalized. But that fact is never overtly spoken of. To do so would imply that our system of government is as much or more an aristocracy than it is a democracy.

Bill Moyers, in his book “Moyers on Democracy”, explains the situation bluntly:

We have lost the ability to call the most basic transaction by its right name. If a baseball player stepping up to home plate were to lean over and hand the umpire a wad of bills before he called the pitch, we’d call that a bribe. But when a real estate developer buys his way into the White House and gets a favorable government ruling that wouldn’t be available to you or me, what do we call that? A “campaign contribution”.

Let’s call it what it is: a bribe.

The legality of contributing money to political candidates, with the implicit (though not explicit) understanding that that money will buy political favoritism, has been defended by both our courts and our Congress by sanctimoniously pointing to the free speech provisions in the First Amendment to our Constitution and claiming that money is speech. But the absurdity of that contention should be obvious to anyone with some primary school education. Speech is of value from a political standpoint (or any other standpoint) only when it is heard. But if one billionaire has one thousand times as much opportunity to speak through a medium which reaches millions than several thousand other people added together, the speech of that one billionaire will drown out the speech of most other people, thereby interfering with their right to free speech.


Election fraud

Electronic vote switching with DRE (direct-recording electronic) machines poses a great danger to the integrity of our election system – by virtue of its ability to switch a voter’s vote without being noticed by the voter. In other words, someone tries to vote for John Kerry, and the machine registers a vote for George Bush instead. What makes matters worse is that many or most of these machines don’t even produce a piece of paper with the vote on it, which can then later be used for a recount. So, if fraud is suspected there is no recourse. And worse yet is the fact that most of these machines use proprietary (secret) code to determine who the voter voted for.

We know for a fact that vote-switching occurred in the 2004 election. One study, based on voter reports to the national Electronic Incident Reporting System (EIRS), showed that vote switching incidents favored Bush over Kerry by a ratio of 12 to 1 nationally. A similar study showed that these vote switching incidents that favored Bush were 9 times as common in the heavily contested “swing states” than in non-swing states. To make the point that the EIRS reports represent only a small fraction of actual Election Day problems, an investigation by the Washington Post identified about 25 electronic voting machines in Youngstown, Mahoning County, Ohio, that were said to have been switching votes all day long. Yet only eight incidents of this nature from Mahoning County (all in favor of Bush) were reported to EIRS that day.

Clint Curtis, a computer programmer working in Florida prior to the 2004 election, testified before the Democratic staff of the House Judiciary Committee that he was requested in 2000 by his boss (at the request of a high level Republican operative, Tom Feeney) to “develop a prototype of a voting program that could alter the vote tabulation in an election and be undetectable”. Curtis’ testimony was followed by the death of Raymond Lemme, who while investigating Curtis’ allegations was found dead in a Georgia hotel room, just a couple weeks after telling Curtis that he had traced the corruption “all the way to the top”,

Another type of election fraud is the illegal purging of registered voters from the voter rolls. Like vote switching, the increasing computerization of voter registration is no doubt making it much easier to perpetrate this type of fraud on a mass basis.

This article describes a great deal of evidence that voter registration fraud played a major role in the 2004 presidential election, and in fact was probably the deciding factor in Ohio, which gave George Bush his electoral victory. Similarly, although the 2000 presidential election was stolen by a variety of means, voter registration fraud was quantitatively the most important method used. In 2000, the Florida Governor’s office used a computer program to purge tens of thousands of mostly black and Democratic voters.

There are many other means of election fraud that have been used in our country to destabilize our democracy. I discuss this issue in more detail, along with means for preventing election fraud, in this post.


Our corporate news media

If cash donated to their political campaigns is not enough to carry them through to victory, and if election fraud doesn’t happen to play a significant role, the corporate news media serves as another valuable tool for those seeking to sabotage our democracy. This problem overlaps with the role of money in politics, since those who own and control the corporate media are uniformly wealthy, and since it was their money that led to the acts that enabled our corporate media to become what it is today – Ronald Reagan’s veto of Democratic legislation to enforce the Fairness Doctrine in 1987, and the Telecommunications Act of 1996. This legislation allowed the monopoly consolidation of our news media to the point where today it is controlled by a very small number of extremely wealthy individuals.

Several excellent books have been written about the extent to which wealthy corporate interests control our news media today. I would highly recommend “Lapdogs – How the Press rolled Over for Bush”, by Eric Boehlert, “What Liberal Media – The Truth About BIAS and the News”, by Eric Alterman, and “Into the Buzzsaw – The Myth of a Free Press”, edited by Kristina Borjesson. And I have ranted about pseudo-journalists such as Tim Russert, who have made a largely successful, but hypocritical effort to appear unbiased to their viewers.

The bottom line, as Bill Moyers points out, is that the protection offered us by our First Amendment is based on the assumption of a separation of our government and a free press, which is supposed to protect us from government abuses. Moyers wrote this during the Bush administration:

What would happen, however, if the contending giants of big government and big publishing and broadcasting ever joined hands, ever saw eye to eye in putting the public's need for news second to free-market economics? That's exactly what's happening now under the ideological banner of "deregulation". Giant media conglomerates that our founders could not possibly have envisioned are finding common cause with an imperial state in a betrothal certain to produce not the sons and daughters of liberty but the very kind of bastards that issued from the old arranged marriage of church and state.

Consider the situation. Never has there been an administration so disciplined in secrecy, so precisely in lockstep in keeping information from the people at large and -- in defiance of the Constitution -- from their representatives in Congress. Never has the powerful media oligopoly ... been so unabashed in reaching like Caesar for still more wealth and power. Never have hand and glove fitted together so comfortably to manipulate free political debate, sow contempt for the idea of government itself, and trivialize the peoples' need to know.


Secrecy in government

Democracy suffers terribly when a nation’s citizens are uninformed – especially when they are uninformed with respect to the actions and motivations of their own government. If we don’t know what our government is doing, then how can we be expected to vote them out when they do something that we would consider deeply immoral had we known about it?

Consider war for example. If Americans understood the real motivations for its nation’s wars, they would probably be much more likely to strenuously object to those wars. That would make war much less politically feasible, and our country would therefore be led into war much less frequently than it has been in the past.

That is why I so hate the “national security” excuse for withholding information from us, the American people – which has become so routine that it is willingly or passively accepted by the good majority of Americans. I very much doubt that the “national security” excuse for withholding information from the American people has anything to do with national security more than 5% of the time. Rather, the reason for withholding such information from us is almost always something totally different. It is to blind us to the real reasons for war or other nefarious acts, so that we will accept them and willingly support or even risk our lives in their cause.


Rampant U.S. nationalism and the GAME

Two months ago I wrote a DU post that I titled “The GAME”, which I began by discussing “Unmentionable things in U.S. politics” – including such things as the stealing of a U.S. presidential election, calling American military or covert actions immoral rather than merely “misguided”, and imputing bad intentions rather than mere incompetence to a U.S. president.

I find this to be terribly repressive, not because I personally can’t mention these things, but because our elected representatives are under tremendous pressure not to discuss them. We elect them to represent us and our nation, and except for some rare courageous exceptions such as Dennis Kucinich, Cynthia McKinney, and Robert Wexler, they refuse to even talk about some of our very most important issues.

It has occurred to me that this provides the backdrop for a huge GAME that has been foisted upon us. A prerequisite of the GAME is to create an alternate reality that must be believed by a critical mass of people in order for the GAME to proceed. Why is that necessary? I believe it’s necessary because the reality is so terrible that if enough people consciously recognized it they would rise up and simply refuse to play the GAME.

Although the GAME’s masters set the rules, there are two related character traits of many Americans that cause them to play along: Rampant nationalism and a propensity for denial. Rampant nationalism is the attitude that our country is inherently better than any other country – so much so that it can do no wrong. This attitude is drummed into the American people from the time that most of us learn how to talk. We are made to feel that to believe or speak otherwise demonstrates a dangerous lack of “patriotism”, which makes us deserving of being shunned – or worse.

The other character trait that persuades too many Americans to play the GAME is denial. Believing terrible things about one’s country can be very painful. Accepting reality as it is, rather than as one would like it to be, can be very painful. To make this point, in a recent post titled “12 Things that Never Happened in American History”, I discuss the following official stories that we have been told (or not told):

The U.S. is not an imperialist country; FDR’s New Deal was not instrumental in ending the Great Depression; the Cold War was just about fighting totalitarian Communism; JFK was assassinated by a lone gunman; bribery is infrequent in American politics; Iran-Contra was not a criminal abuse of presidential power; U.S. presidential elections cannot be stolen; Bush and Cheney did everything they could to protect us against the 9/11 attacks; the Bush administration’s crimes are not serious enough to warrant impeachment or prosecution; and, we’re barely told about our nation’s killing of more than a million Iraqi civilians, the October Surprise, or Operation Northwoods.


CONSEQUENCES

These impediments to democracy work together to surrender great amounts of power into the hands of a small number of elites, who use that power in the cause of increasing their wealth and power at the expense of everyone else. It is a vicious cycle that is very difficult to break. Here are some of the major tragic consequences.


Rampant militarism and illegal aggression against sovereign nations

We are so often told how good and pure our nation and its people are that only a minority of Americans are aware of the extent of our many illegal and immoral activities. Many or most who aren’t aware of these activities would be shocked to learn about them and quite resistant to accepting that information as the truth.

In myriad instances we have overthrown or assisted in the overthrow of sovereign nations. In the good majority of these instances we have substituted a repressive right wing government for one that was much more responsive to the needs and desires of the nation’s citizenry. Sometimes genocide was used to accomplish our goals. The purpose of these activities has most often been to create a government that is friendlier to the desires of American businesses or corporations – though we always have some sort of rationalization for our actions.

In “Excuses for War” I discuss many of the phony excuses that the United States government has used to lead us into war, including its Indian wars, the Mexican-American War, the Spanish-American War, and the Vietnam War.

In “The Roots and Consequences of U.S. Overseas Imperialism” I note or discuss our covert and overt illegal and immoral overthrowing of the sovereign nations of Hawaii (1893), Cuba (1898), Puerto Rico (1898), the Philippines (1899-1902), Nicaragua (1910), Honduras (1911-1912), Iran (1953), Guatemala (1954), South Vietnam (1963), Chile (1973), Grenada (1983), Panama (1989), Afghanistan (2001), and Iraq (2003).

In “The Meaning of U.S. Imperialism, Genocide and Militarism” I note U.S. perpetrated genocides, as described in “State of Darkness” by David Model, including our atomic bombing of Japan (1945), those perpetrated against Guatemala (1954), Vietnam (1954-73), Indonesia (1965), Cambodia (1970-75), Laos (1969-74), and East Timor (1975), and our two wars against Iraq.

Other atrocities include our invasion of Cuba in 1961; U.S. Marine invasion of the Dominican Republic in 1965 to put down a rebellion against their repressive right wing government; U.S. military support of Haitian tyrant and mass murderer, Francois Duvalier; and numerous brutal interventions in several Latin American and African nations.


Massive Income and wealth inequality

Inequality of wealth in the United States is truly astounding – and it is increasing at a fast rate. In the United States in 2001, 1% of the population controlled 38% of the wealth, whereas the bottom 40% owned just 1%. That means that, on average, individuals in the top 1% owned about 1,500 times more wealth than individuals in the bottom 40%.

The rising level of income inequality in our country recently exceeded the point where it stood just prior to the stock market crash of 1929, which led to the worst depression in U.S. history. There are many who see a connection between the income inequality preceding that depression and our current situation. This graph, which plots income inequality measured as the ratio between the average income of the top 0.01% of U.S. families compared to the bottom 90%, over time, makes that point.

I discuss the subject of income and wealth inequality here, here, and here.


The loss of the rule of law

During the Bush Presidency I often argued that he should be impeached for his many crimes. Now that he can no longer be impeached, I have argued that our Justice Department should prosecute him for those crimes, and if it fails to do so then the International Criminal Court (ICC) should step in.

While Bush was still President, President Obama weighed in against impeachment, saying that impeachment should be reserved for only the most serious crimes. Now that he is President he has thus far given little or no indication that he intends to have his Justice Department prosecute George Bush or any other high level Bush administration official for their crimes. But if widespread torture, an illegal war of aggression, spying on American citizens, suspending of the right of habeas corpus, and numerous other violations of our Constitution don’t constitute serious crimes, then what does?

What would people say if a prosecuting attorney failed to prosecute a rapist and murderer simply because he had high level political connections? Who would accept that? Then why when far more serious crimes are committed by a President of the United States are there so many people who seem to think that it is ok to sit passively by and make no attempt to hold the perpetrators accountable for their crimes?

I’ll tell you why. It’s like I said earlier in this post. Saying that a former U.S. President might be guilty of prosecutable crimes is simply against the rules of the GAME. Given that and the failure to hold the Reagan administration accountable for its Iran-Contra crimes, George Bush and Dick Cheney connected the dots and thought that they might be able to get away with just about anything. Testing that assumption by moving ahead with prosecutions might be politically risky for the Obama administration. The Republican Party would no doubt raise holy hell if there was an attempt to prosecute high level Bush administration officials.

Consequently, we live in country in which, protestations to the contrary notwithstanding, certain people are indeed above the law. That fact, taken together with all of the impediments to democracy discussed in the first part of this post, means that democracy and the rule of law in our country are in grave danger. Indeed, some believe that we narrowly averted a military coup perpetrated by the Bush administration.

The American people and their leaders need to reassess what our country stands for. Is our democracy important enough to take steps to remove the role of money in politics, reform our election system, break up the corporate monopoly on our news media, require government actions to be much more transparent than they now are, and dare to look more objectively at who we are and what we do? Can we give up imperialism and warfare for the sake a world in which nations live and work together to further the cause of peace and justice? Can we make our nation one in which all of its citizens truly have the opportunity for life, liberty and the pursuit of happiness? And do our laws apply to all people, not just to those who lack the political influence to avoid them?

If we think that these things are important we have a great deal of work to do, lest our country sinks into a tyranny from which it may never recover.
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