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Obamacare Just Saved The U.S. Economy From Contraction

The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.
Unless you have evidence that the US spends more on early detection tests and that does not get appreciably better outcomes, your response is a non-sequitur.
 
I had not considered that. A bunch of people who previously did not have health insurance suddenly have it, so of course they're going to run out to the doctor and get treated for long-standing issues, causing a surge in health care spending.

I don't think the health care spending was on health care. It was the money spend on the insurance that Obamacare required.
You will need to explain to me how and why the health care spending on health care has increased in my household since we have enrolled in a Silver Plan via the AHCA Exchanges. You must have some different explanation than my own conclusions :

1) Was part of the under-insured from 2009 to January 2014.

2) Dependent on a "crumb" Group Plan which could only result in self rationing due to the extremely limited benefits the Group Plan provided.

3) Currently, our Premiums are only 20 dollars more monthly than the Premiums we paid under our Group Plan.

4) Extremely limited benefits which placed us in the situation to not fill scripts either prescribed by my PCP or specialized medicine physicians such as my oncologist. Meaning skipping diagnosing tests, lab work, imaging procedures.

5) Came January 2014 and we caught up with all the indispensable tests designed to monitor the metabolic activity in my lymph nodes. Need I to give you a detail of the cost for all those medically necessary scripts?
You do not seem to realize that all under insured Americans had NO choice but to ration their health care spending. Which means that over the course of several years, early detection designed diagnosing tests were not accessible to them. There is a massive cost difference between treating an early diagnosed condition and one in advanced stages. Let alone the non access to preventative medicine having affected the under insured.

And you somehow *think* that the increase in spending is somehow not on health care?

Anecdotal evidence.
 
Yes, it's kind of idiotic to assume that if people hadn't spent the money on health care they would have flushed it down the toilet. In fact, you could point to any increase in spending and say that that was the reason that the economy grew by .1%.
Are you referring solely to recently released advance estimate of US real GDP growth for the 1st quarter on 2014 which is based on incomplete data and subject to dramatic revision and also ignoring that the real GDP growth is estimated to have grown by 2.6% in the preceding quarter? (source: http://www.bea.gov/newsreleases/national/gdp/gdpnewsrelease.htm)

Of course I am because that's where the health care spending figures were included. So maybe they'll revise the health care figures downward and even that .1% growth will disappear, but I can't know that. After all, the early reporting for the previous quarter was 3.2% growth.
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.

I am not sure why Sabine expects you to explain her narrow and unproven exception to these generalities. First it is not germane - general propositions on spending for insurance and testing is "general", not unconditional or unqualified. Pointing out a specific instance of a kind of test where more spending might 'result in appreciably better outcomes' is a bit of a straw-man.

Second, her loaded exception is speculative and unproven; what evidence is there that more insurance spending on 'early detection tests' appreciably improves outcomes for the population? It' rather like being expected to explain how God could not do good and could not exist, before making a case that God actually exists and actually will do good.

Rhetorical thimble rigging?
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive. This is why Obama sold it as "bending the cost curve down".

But spinners gotta spin.

While I agree there is unnecessary spending that has nothing to do with the surge in spending due to people getting needed care they weren't getting.
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.

But our system gets similar outcomes despite a decent chunk that get basically no care until it's too late. Thus our system must actually be much better than the others.
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.

But our system gets similar outcomes despite a decent chunk that get basically no care until it's too late. Thus our system must actually be much better than the others.

There is nothing "decent" about the disparity in healthcare in this country. It suffers from the same disparity as every other sector of the American economy....too friggin many rent takers. If it were possible someone would like to set up shop renting the air we breathe to us.:rolleyes:

I am not a huge fan of Obamacare. I am still less of a fan of what we had before that. We are a society so deeply engrossed in political rhetoric, we can't see how shabby we have become. The problem is that this plan is loaded with parasitic expenses that are completely unnecessary...just like the old medicine for profit plans.:shrug:
 
The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Anyone who understand anything about US healthcare regardless of ideology knows that the US spends dramatically more than other countries and does not get appreciably better outcomes.

The news that more money will be spent on more insurance and more tests that probably won't result in appreciably better outcomes should not generally be taken as a positive.
Please explain how and why more access to early detection tests "won't result in appreciably better outcomes".

Which aspect do you dispute?

1) The US spends more money.
2) The US does not get appreciably better outcomes.

But our system gets similar outcomes despite a decent chunk that get basically no care until it's too late. Thus our system must actually be much better than the others.

Other than blind faith, upon what basis do you assert this?

Are you aware of the Oregon Medicaid study?
 
But our system gets similar outcomes despite a decent chunk that get basically no care until it's too late. Thus our system must actually be much better than the others.

Other than blind faith, upon what basis do you assert this?

It should be obvious.

Our overall outcome is similar or a bit better. (Beware the faulty judgment based on life expectancy--that far more shows social factors than medical ones.) Yet we have a substantial population that gets little if any care and thus will die at far above normal rates.

Are you aware of the Oregon Medicaid study?

1) We discussed what was wrong with this one on the old board. It hasn't gotten any better since then.

2) It showed spending, not healthcare.

3) The real problem isn't Medicaid patients, but the ones with too much money for Medicaid but not enough for insurance.
 
You will need to explain to me how and why the health care spending on health care has increased in my household since we have enrolled in a Silver Plan via the AHCA Exchanges. You must have some different explanation than my own conclusions :

1) Was part of the under-insured from 2009 to January 2014.

2) Dependent on a "crumb" Group Plan which could only result in self rationing due to the extremely limited benefits the Group Plan provided.

3) Currently, our Premiums are only 20 dollars more monthly than the Premiums we paid under our Group Plan.

4) Extremely limited benefits which placed us in the situation to not fill scripts either prescribed by my PCP or specialized medicine physicians such as my oncologist. Meaning skipping diagnosing tests, lab work, imaging procedures.

5) Came January 2014 and we caught up with all the indispensable tests designed to monitor the metabolic activity in my lymph nodes. Need I to give you a detail of the cost for all those medically necessary scripts?
You do not seem to realize that all under insured Americans had NO choice but to ration their health care spending. Which means that over the course of several years, early detection designed diagnosing tests were not accessible to them. There is a massive cost difference between treating an early diagnosed condition and one in advanced stages. Let alone the non access to preventative medicine having affected the under insured.

And you somehow *think* that the increase in spending is somehow not on health care?

The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Firstly, it depends on who you call conservative and which conservatives you are speaking of. That health care has presented some difficult issues of social concern has not been disputed by the strong majority of informed conservatives. The issues have not been on just the spending of more money (virtually everyone on the right and left think we are spending too much money) but on how to improve access, care, choice, and to reduce costs and spending.

Second, the issue is not just one of "wasting money" went spent, but of who should pay, or if the money spent can more wisely be used, and/or if the results are worth the cost.

Third, the problem may reflect a difference in values. For example, regarding minimal care; that those who contribute little should not be expected to be as treated as well as those who pay a lot. Or, for example, that the young should not be subsidizing the older population or to disproportionately subsidize those with pre-existing conditions.

Finally, many conservatives and classical liberals strongly support health care reform, but the kind which is informed by economic realities, free choice, and the actual causes for perceived high costs (etc.). There is no free lunch, which is as true of health care as it is minimum wage bromides. Milton Friedman, for example, was a free market supporter but acknowledged that under our current social-cultural climate no one would accept a fully free market. None the less, as he pointed out, it was imperative that folks understand what has caused the inflation and the massive expansion of spending in order to understand why 'more spending' and 'more insurance' may be counter-productive to the goals of economy.

His last paper, with his wife Anna Schwartz, presented a conserve-libertarian reform that would provide universal health care while providing incentives to reduce costs. From a libertarian aspect it had some disturbing features (mandatory insurance) but it was elegant, fair, and simple, and worked with (rather than against) market forces - unlike ACA.
 
You will need to explain to me how and why the health care spending on health care has increased in my household since we have enrolled in a Silver Plan via the AHCA Exchanges. You must have some different explanation than my own conclusions :

1) Was part of the under-insured from 2009 to January 2014.

2) Dependent on a "crumb" Group Plan which could only result in self rationing due to the extremely limited benefits the Group Plan provided.

3) Currently, our Premiums are only 20 dollars more monthly than the Premiums we paid under our Group Plan.

4) Extremely limited benefits which placed us in the situation to not fill scripts either prescribed by my PCP or specialized medicine physicians such as my oncologist. Meaning skipping diagnosing tests, lab work, imaging procedures.

5) Came January 2014 and we caught up with all the indispensable tests designed to monitor the metabolic activity in my lymph nodes. Need I to give you a detail of the cost for all those medically necessary scripts?
You do not seem to realize that all under insured Americans had NO choice but to ration their health care spending. Which means that over the course of several years, early detection designed diagnosing tests were not accessible to them. There is a massive cost difference between treating an early diagnosed condition and one in advanced stages. Let alone the non access to preventative medicine having affected the under insured.

And you somehow *think* that the increase in spending is somehow not on health care?

The basic problem here is that the conservatives aren't willing to admit there has been a problem with health care. You had insurance before, you have insurance now. No benefit, any extra spending is pure waste. You are claiming extra medical spending, you must be simply wasting money. Why???

Firstly, it depends on who you call conservative and which conservatives you are speaking of. That health care has presented some difficult issues of social concern has not been disputed by the strong majority of informed conservatives. The issues have not been on just the spending of more money (virtually everyone on the right and left think we are spending too much money) but on how to improve access, care, choice, and to reduce costs and spending.
Firstly, "informed conservatives" is an oxymoron. Just about everything the right wing propaganda machine has said about Obamacare turned out to be a lie.

And how much in denial of reality do you have to be in order to think that saving money would "spend too much money"? The system we are abandoning is famously the most inefficient in the world (in terms of dollars spent versus health gained) so even if you ignored the analysis of the CBO and other groups, almost any change to our fucked up system is going to result in less money spent.
 
Underseer said:
Firstly, it depends on who you call conservative and which conservatives you are speaking of. That health care has presented some difficult issues of social concern has not been disputed by the strong majority of informed conservatives. The issues have not been on just the spending of more money (virtually everyone on the right and left think we are spending too much money) but on how to improve access, care, choice, and to reduce costs and spending.
Firstly, "informed conservatives" is an oxymoron. Just about everything the right wing propaganda machine has said about Obamacare turned out to be a lie.

Unsupported assertion.

And how much in denial of reality do you have to be in order to think that saving money would "spend too much money"? The system we are abandoning is famously the most inefficient in the world (in terms of dollars spent versus health gained) so even if you ignored the analysis of the CBO and other groups, almost any change to our fucked up system is going to result in less money spent.

Unsupported assertion, unproven assumption, irrational and a seeming gambling addiction.
 
Second, the issue is not just one of "wasting money" went spent, but of who should pay, or if the money spent can more wisely be used, and/or if the results are worth the cost.

Third, the problem may reflect a difference in values. For example, regarding minimal care; that those who contribute little should not be expected to be as treated as well as those who pay a lot. Or, for example, that the young should not be subsidizing the older population or to disproportionately subsidize those with pre-existing conditions.

I do agree the young -> old subsidy in the current system is wrong.

Something to understand, though--most of the people with pre-existing condition problems aren't slackers, but victims of circumstance. I paid into the system for 20 years while using almost no healthcare for most of those years. Then my employer collapsed and I've only had odd jobs since (not a great surprise--there is *MAJOR* age discrimination in my area.) Thus Obamacare has been the only way I could get coverage.

Finally, many conservatives and classical liberals strongly support health care reform, but the kind which is informed by economic realities, free choice, and the actual causes for perceived high costs (etc.). There is no free lunch, which is as true of health care as it is minimum wage bromides. Milton Friedman, for example, was a free market supporter but acknowledged that under our current social-cultural climate no one would accept a fully free market. None the less, as he pointed out, it was imperative that folks understand what has caused the inflation and the massive expansion of spending in order to understand why 'more spending' and 'more insurance' may be counter-productive to the goals of economy.

All sorts of excuses for don't pay.

Will you at least provide a painless means of suicide for your victims?
 
I do agree the young -> old subsidy in the current system is wrong.

Something to understand, though--most of the people with pre-existing condition problems aren't slackers, but victims of circumstance. I paid into the system for 20 years while using almost no healthcare for most of those years. Then my employer collapsed and I've only had odd jobs since (not a great surprise--there is *MAJOR* age discrimination in my area.) Thus Obamacare has been the only way I could get coverage.

Finally, many conservatives and classical liberals strongly support health care reform, but the kind which is informed by economic realities, free choice, and the actual causes for perceived high costs (etc.). There is no free lunch, which is as true of health care as it is minimum wage bromides. Milton Friedman, for example, was a free market supporter but acknowledged that under our current social-cultural climate no one would accept a fully free market. None the less, as he pointed out, it was imperative that folks understand what has caused the inflation and the massive expansion of spending in order to understand why 'more spending' and 'more insurance' may be counter-productive to the goals of economy.

All sorts of excuses for don't pay.

Will you at least provide a painless means of suicide for your victims?

Such may serve as excuses for "don't pay" for some, but it is a reality that will always impact a market based insurance system no matter who runs it. And while the prior system provided insurance that most were happy with (according to surveys), there remain(ed) gaps from a patchwork of remedies of many overlapping, localized, and multi-level government and ngo programs. And yes, the availability and ease of many of these supplementary programs (federal clinics, emergency rooms, S-Chip, County and University hospitals, VA access, etc.) has been problematical. How people 'made due' in an environment of medical insecurity is interesting and informative (e.g. the large amount charity work of Kaiser) , but most of us know that even if most of the uninsured could have begged or borrowed for medical care, something had (and has) to be done.

I'd enjoy sharing some of my own personal learning's, but I think the bottom line consensus of just about every reformer is that anyone whose family income and/or pre-existing conditions made health care prohibitively expensive needed to be given a subsidy to make it affordable, in kind or in direct payment to them and/or providers.

And, to my mind, that subsidy should be paid by the income tax (or reduction of the scope government) not by creating 'winners and losers' because of a persons age or gender.
 
Such may serve as excuses for "don't pay" for some, but it is a reality that will always impact a market based insurance system no matter who runs it. And while the prior system provided insurance that most were happy with (according to surveys), there remain(ed) gaps from a patchwork of remedies of many overlapping, localized, and multi-level government and ngo programs. And yes, the availability and ease of many of these supplementary programs (federal clinics, emergency rooms, S-Chip, County and University hospitals, VA access, etc.) has been problematical. How people 'made due' in an environment of medical insecurity is interesting and informative (e.g. the large amount charity work of Kaiser) , but most of us know that even if most of the uninsured could have begged or borrowed for medical care, something had (and has) to be done.

I'd enjoy sharing some of my own personal learning's, but I think the bottom line consensus of just about every reformer is that anyone whose family income and/or pre-existing conditions made health care prohibitively expensive needed to be given a subsidy to make it affordable, in kind or in direct payment to them and/or providers.

And, to my mind, that subsidy should be paid by the income tax (or reduction of the scope government) not by creating 'winners and losers' because of a persons age or gender.

But you keep talking about the cost.

How do you propose to provide the care without spending the money?
 
Such may serve as excuses for "don't pay" for some, but it is a reality that will always impact a market based insurance system no matter who runs it. And while the prior system provided insurance that most were happy with (according to surveys), there remain(ed) gaps from a patchwork of remedies of many overlapping, localized, and multi-level government and ngo programs. And yes, the availability and ease of many of these supplementary programs (federal clinics, emergency rooms, S-Chip, County and University hospitals, VA access, etc.) has been problematical. How people 'made due' in an environment of medical insecurity is interesting and informative (e.g. the large amount charity work of Kaiser) , but most of us know that even if most of the uninsured could have begged or borrowed for medical care, something had (and has) to be done.

I'd enjoy sharing some of my own personal learning's, but I think the bottom line consensus of just about every reformer is that anyone whose family income and/or pre-existing conditions made health care prohibitively expensive needed to be given a subsidy to make it affordable, in kind or in direct payment to them and/or providers.

And, to my mind, that subsidy should be paid by the income tax (or reduction of the scope government) not by creating 'winners and losers' because of a persons age or gender.

But you keep talking about the cost. How do you propose to provide the care without spending the money?
I don't. I propose to provide care by spending money in a more efficient manner that is likely to reduce the rate of medical care inflation.

There are several proposals by others, and I have not studied any of them intensively other than Friedman's. It is one idea that I have always liked and (ironically) can be implemented by vastly simplifying and remaking Obamacare. His proposal had the benefit of working with the marketplace and dealing with some of the drivers of high medical costs (e.g. Medicare and Medicaid, employer tax exemption, etc.) in a slightly modified version, it would be:

1) End both Medicare and Medicaid, at least for new entrants, and replace them by ...
2) Requiring and providing every family in the United States with catastrophic insurance - i.e., a major medical policy with a high deductible.
3) Ending the employer tax exemption.
4) Ending expensive and restrictive policy regulations on state and federal levels.

How every family pays for catastrophic insurance (or if they pay at all) is, of course, a matter of values. Some (such as I) would propose that policies are set by free market price paid by the family, but with a subsidy based on income level and subsidized policy costs for those with pre-existing conditions. For the most poor, most of the policy cost would likely be paid by government.

"This reform would solve the problem of the currently medically uninsured, eliminate most of the bureaucratic structure, free medical practitioners from an increasingly heavy burden of paperwork and regulation, and lead many employers and employees to convert employer-provided medical care into a higher cash wage. The taxpayer would save money because total government costs would plummet. The family would be relieved of one of its major concerns - the possibility of being impoverished by a major medical catastrophe - and most could readily finance the remaining medical costs. Families would once again have an incentive to monitor the providers of medical care and to establish the kind of personal relations with them that were once customary. The demonstrated efficiency of private enterprise would have a chance to improve the quality and lower the cost of medical care. The first question asked of a patient entering a hospital might once again become "What's wrong?" and not "What's your insurance?"

This is far simpler than ACA and its crude attempt to micro regulate employers, policies, exchanges, reinsurance pools, etc. It permits the market to evolve away from employer provided insurance (if economic efficiency pushes it in that direction) and towards individual choice and control by consumers.

http://www.thepublicinterest.com/archives/2001winter/article1.html

Although the charts are 17 years old, the data trends have not changed. It provides some insight into the challenge:

 
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I don't. I propose to provide care by spending money in a more efficient manner that is likely to reduce the rate of medical care inflation.

Your proposal amounts to letting them die.

There are several proposals by others, and I have not studied any of them intensively other than Friedman's. It is one idea that I have always liked and (ironically) can be implemented by vastly simplifying and remaking Obamacare. His proposal had the benefit of working with the marketplace and dealing with some of the drivers of high medical costs (e.g. Medicare and Medicaid, employer tax exemption, etc.) in a slightly modified version, it would be:

Medicare/Medicaid are about people who need care getting it. Thus this is just a version of let-them-die.

1) End both Medicare and Medicaid, at least for new entrants, and replace them by ...
2) Requiring and providing every family in the United States with catastrophic insurance - i.e., a major medical policy with a high deductible.

If you need Medicaid a catastrophic policy might help the docs when you end up in the ER but it won't do you any good. A typical senior citizen won't be able to afford it, either.

3) Ending the employer tax exemption.

I can't see how this is supposed to reduce medical spending.

4) Ending expensive and restrictive policy regulations on state and federal levels.

You mean the rules that keep companies from offering Swiss cheese coverage? The mandates are because the the patients were getting screwed.

How every family pays for catastrophic insurance (or if they pay at all) is, of course, a matter of values. Some (such as I) would propose that policies are set by free market price paid by the family, but with a subsidy based on income level and subsidized policy costs for those with pre-existing conditions. For the most poor, most of the policy cost would likely be paid by government.

But the poor can't pay the deductible. The policy is useless.

This is far simpler than ACA and its crude attempt to micro regulate employers, policies, exchanges, reinsurance pools, etc. It permits the market to evolve away from employer provided insurance (if economic efficiency pushes it in that direction) and towards individual choice and control by consumers.

There are two primary things the ACA does:

1) Close loopholes.

2) Make coverage available for those who can't afford it.

Your approach does nothing about the former and will simply transfer the costs of the latter to the government. The only way you're saving money is by denying care.

http://www.thepublicinterest.com/archives/2001winter/article1.html

Although the charts are 17 years old, the data trends have not changed. It provides some insight into the challenge:

Of course you spend more when you actually provide coverage rather than let people die.
 
I do agree the young -> old subsidy in the current system is wrong.

Do you guys understand how insurance works?

The whole thing is predicated on someone subsidizing someone else.

But it's reasonable to charge the premium that corresponds to the risk pool you're in.

The current system makes insurance a bad deal for the young, is it any wonder they're reluctant to sign up??
 
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