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Why people are afraid of universal health care

Every time you lecture me about helping the poor, you are falsely and groundlessly insinuating that I need a lecture on helping the poor. Every time you do that I will have good reason to lecture you about improving your reading comprehension.
You made remarks that in the context of what I was reading sounded the way I interpreted them.
That context evidently included a bundle of conceptual baggage you brought to the discussion. Don't lay it at my door.

I understand that you don’t need assistance, and so don’t want it. Fair enough. You don’t need to take it. But would you be willing to contribute to a system where everyone has access to the assistance they need?
Of course! I do contribute to such a system. It's called a safety net. Why so many people apparently take for granted that doing your part to maintain a safety net is supposed to mean you have to be in favor of some one-size-fits-all single-payer system like the British NHS is beyond me, but here we are.

That’s what we do here in Australia.
That's what we do here in the U.S. too! Medicaid for the poor who can't afford to pay for coverage, private health care for those accepted into a covered group (mostly employer-based), and "Obamacare" for those who can afford to pay for coverage but whom private health plans don't offer membership to for whatever reason. We're yet another country among many like Australia, with a complicated, messed-up, cobbled-together hodge-podge of a system. Hardly the best-designed of the bunch, but nothing like the Social Darwinism that partisans of single-payer keep accusing the U.S. of.

Those that need it can access it, and those than can pay, don’t access it. Does that make sense?
Perfectly.
 
I hate to break it to you but unless you are extremely wealthy, if you have a very serious health condition and require expensive treatment, you are not rich enough to afford it on your own. ... I never looked at the statements at for his more recent, unrelated surgeries but they certainly must have been $500K in total. ...
Unless you are extremely wealthy, you are not rich enough to buy a new house if your current house burns down. This is not generally regarded as a good reason to require housing to be supplied to middle-income people at the expense of society as a whole. Instead, such people provide that necessity for themselves, because they can, by renting or by taking out mortgages. And since they are not rich enough to buy a new house if their current house burns down, they provide for themselves by making a deal with someone richer, who will promise to buy them a new house if theirs burns down, in exchange for a payment large enough to make the gamble an actuarially sound business decision for him. Unpredictable high cost low probability scenarios are not an obstacle to people providing necessities for themselves without forcing the cost onto society as a whole, if they can.
Hang about. I want to make sure I have comprehended this remark properly by asking a couple of questions.

Is there social housing in the US that people can access to help them get off the street? If so, who pays for it to be built?
Of course there is. I think it's paid for mostly by the federal government, with some support from local and state government and private charity.

We have a massive homeless issue here that our state government is throwing money at to try and fix.
So I've heard. According to one analysis I've seen, it's because your government is using real estate in a Ponzi scheme.


They have bought snd refurbished abandoned unit blocks, hotels etc and converted them. They have also built apartment buildings… all to provide reasonably priced accommodation for those that need it.

... I grew up in one such house. My parents didn’t have anywhere to take us, so the government helped. When my parents could afford it, they bought said house and are there still.

In your opinion, is the government/society providing housing that taxpayers have paid to be built wrong?
Of course not. You bolded a sentence in my post that concerned you. Did you see it said "middle-income"?
 
I don't get it; Many here seem to love the insurance companies more than their countrymen (and -women)?
With the passage of Obamacare, the insurance companies have essentially been turned into privately owned, publicly regulated utilities.

Their profits are capped - if they fail to pay out in benefits at least 80% (I think it is) of collected premiums the difference is refunded to the policyholders.

I tend to get a check for about a quarter of a month's premium.
 
I was hungry this morning. The cost of providing me breakfast should have been shared by the community.
If you lack the means of feeding yourself, it should be.
But I do not lack the means of feeding myself. Do you have any other grounds to think the cost of providing me breakfast should have been shared by the community?
... this is not a debate about whether the cost of providing health care to poor people who can't afford it should be shared by the community. It's a debate about whether the cost of providing health care to people who can afford it should also be shared by the community anyway even though we're perfectly capable of paying the doctor or a private cost-pooler ourselves. It's a debate about the U.S. model vs. the British model. The U.S. has long socialized the cost of care for the impoverished; it's called "Medicaid". ...
No, I think people should provide for necessities for themselves if they can.
Bingo. That's a perfectly reasonable position to take, and since bilby's meme implies it's wrong on purely metaphysical grounds, bilby's meme is perfectly unreasonable.

I hate to break it to you but unless you are extremely wealthy, if you have a very serious health condition and require expensive treatment, you are not rich enough to afford it on your own. ... I never looked at the statements at for his more recent, unrelated surgeries but they certainly must have been $500K in total. ...
Unless you are extremely wealthy, you are not rich enough to buy a new house if your current house burns down. This is not generally regarded as a good reason to require housing to be supplied to middle-income people at the expense of society as a whole. Instead, such people provide that necessity for themselves, because they can, by renting or by taking out mortgages. And since they are not rich enough to buy a new house if their current house burns down, they provide for themselves by making a deal with someone richer, who will promise to buy them a new house if theirs burns down, in exchange for a payment large enough to make the gamble an actuarially sound business decision for him. Unpredictable high cost low probability scenarios are not an obstacle to people providing necessities for themselves without forcing the cost onto society as a whole, if they can.
We have home owner’s insurance for the full replacement value of our home plus contents. We are not extremely wealthy. We are US middle class, for our state, verging on the low end of upper middle class but not quite there. By world standards, we’re pretty wealthy. By NYC or LA or Chicago or San Francisco standards, we’re…. Middle class, probably re ting and hoping our rent doesn’t go up.

In fact, we might sell our current home in the next few years. Any other home we purchase would almost certainly be smaller and less updated and cost hundreds of thousands more than our current updated home. Old Victorians in our area are relatively cheap, compared with anything built in the last 50-60 years. So we’d either use savings or get another mortgage, depending.

I realize you think that means depending on someone richer ( insurance company) who is not a person but a business
It's called a "metaphor". Look into it. When the insurance business got started it worked exactly like I said -- in the 1600s rich guys would hang out in Edward LLoyd's coffee shop and make bargains with risk-takers over coffee. My point was that the market having become dominated by large groups of shareholders cooperating to act as if they were a single rich guy changed nothing essential about the relationship. It's still a bargain between private parties for mutual benefit: a paid transfer of a risk from someone it's too much for to someone else who's more risk tolerant, not an externalization of cost onto society as a whole.

that we pay annual premiums to, just as we do for our vehicles. But your choice of words is disingenuous. I do not know why you are in such a pissy frame of mind but I see no reason to continue to engage with someone who seems to prefer games rather than have honest discourse.
Is libeling me just your hobby now? You did it repeatedly in the Oprah thread, and now this. I wasn't pissy at you; you were pissy at me, Ms. "I hate to break it to you but". And I wasn't disingenuous; you were:

But go ahead and be as pissy as you’d like. Feeding the hungry who cannot feed themselves is something a civilized society does. No one deserves to be beaten.
If you preferred honest discourse you would be the change you want to see in the world. Just because after I repeatedly corrected her a different poster has finally stopped falsely insinuating that I'm against caring for our society's needy does not justify you taking over. IIDB is not tag-team professional wrestling.
 
I do believe that you would favor caring for society’s needy, @Bomb#20.
I just don’t know how you envision such care being administered, because you seem to find fault with every institution or mechanism that purports to try to do that.

Perhaps clarifying your vision of how caring for society’s needy could/should happen, would silence some of your critics.
 
I don't get it; Many here seem to love the insurance companies more than their countrymen (and -women)?
In case you're talking about me, as I wrote in my first post, "Not commenting on the merits of the NHS model for health care delivery, just pointing out that moral philosophy is an utterly garbage way to decide how to solve the hard technical problems of economics.". I have no love of insurance companies; I just think that whether they're a better way to deliver health care to the majority of a society's people than a single-payer system is an empirical question that needs to be resolved by cost/benefit analysis and by experience with both models*, rather than by believing a popular pro-NHS internet meme engineered to preempt economic reasoning and appeal to unexamined intuition.

If you're talking about someone else who prefers private insurance to single-payer for non-economic reasons, no, it's not because they love insurance companies more than their countrymen. Nobody loves insurance companies. They prefer it because single-payer is coercive and private insurance is non-coercive, and a lot of people have a gut-level problem with coercion.

(* "Experience with both models", by the way, does not mean just comparing the U.S. with Canada. There are better single-payer systems than Canada's; there are better mixed public/private systems than the U.S.'s.)
 
I hate to break it to you but unless you are extremely wealthy, if you have a very serious health condition and require expensive treatment, you are not rich enough to afford it on your own. ... I never looked at the statements at for his more recent, unrelated surgeries but they certainly must have been $500K in total. ...
Unless you are extremely wealthy, you are not rich enough to buy a new house if your current house burns down. This is not generally regarded as a good reason to require housing to be supplied to middle-income people at the expense of society as a whole. Instead, such people provide that necessity for themselves, because they can, by renting or by taking out mortgages. And since they are not rich enough to buy a new house if their current house burns down, they provide for themselves by making a deal with someone richer, who will promise to buy them a new house if theirs burns down, in exchange for a payment large enough to make the gamble an actuarially sound business decision for him. Unpredictable high cost low probability scenarios are not an obstacle to people providing necessities for themselves without forcing the cost onto society as a whole, if they can.
Hang about. I want to make sure I have comprehended this remark properly by asking a couple of questions.

Is there social housing in the US that people can access to help them get off the street? If so, who pays for it to be built?
Of course there is. I think it's paid for mostly by the federal government, with some support from local and state government and private charity.

We have a massive homeless issue here that our state government is throwing money at to try and fix.
So I've heard. According to one analysis I've seen, it's because your government is using real estate in a Ponzi scheme.


They have bought snd refurbished abandoned unit blocks, hotels etc and converted them. They have also built apartment buildings… all to provide reasonably priced accommodation for those that need it.

... I grew up in one such house. My parents didn’t have anywhere to take us, so the government helped. When my parents could afford it, they bought said house and are there still.

In your opinion, is the government/society providing housing that taxpayers have paid to be built wrong?
Of course not. You bolded a sentence in my post that concerned you. Did you see it said "middle-income"?
Yes, Real estate has gone bananas here. And yes, migrants are an issue - simply those moving from southern states (where Real Estate Prices are much higher than those in Queensland) to Queensland. And the move was driven by Covid and how we managed the pandemic. It has caused an issue - A BIG ONE!

However, much like our approach to UHC, we are approaching it on the basis that everyone deserves somewhere to live so lets do something about it.
 
Every time you lecture me about helping the poor, you are falsely and groundlessly insinuating that I need a lecture on helping the poor. Every time you do that I will have good reason to lecture you about improving your reading comprehension.
You made remarks that in the context of what I was reading sounded the way I interpreted them.
That context evidently included a bundle of conceptual baggage you brought to the discussion. Don't lay it at my door.

I understand that you don’t need assistance, and so don’t want it. Fair enough. You don’t need to take it. But would you be willing to contribute to a system where everyone has access to the assistance they need?
Of course! I do contribute to such a system. It's called a safety net. Why so many people apparently take for granted that doing your part to maintain a safety net is supposed to mean you have to be in favor of some one-size-fits-all single-payer system like the British NHS is beyond me, but here we are.

That’s what we do here in Australia.
That's what we do here in the U.S. too! Medicaid for the poor who can't afford to pay for coverage, private health care for those accepted into a covered group (mostly employer-based), and "Obamacare" for those who can afford to pay for coverage but whom private health plans don't offer membership to for whatever reason. We're yet another country among many like Australia, with a complicated, messed-up, cobbled-together hodge-podge of a system. Hardly the best-designed of the bunch, but nothing like the Social Darwinism that partisans of single-payer keep accusing the U.S. of.

Those that need it can access it, and those than can pay, don’t access it. Does that make sense?
Perfectly.
What makes our system a "complicated, messed-up, cobbled-together hodge-podge of a system." If you are sick you go to a doctor. If the doctor demands payment instead of bulk billing, they take care of the claim for you. I walk in to my GP, have an appointment, get my scripts, and walk out. If I need a follow up phone call, he gives me a form, I sign it and he gets payment for my phone call. If I get seriously hurt, I go to hospital, I get sorted - no drama. AND NO BILLS OR COPAY REQUIRED!

The only time I Co-Pay is if I go to a private doctor or hospital and even then, it's a pittance. My Shrink costs me $50 I think.

FFS - Medicare (our UHC) even pays for my annual check up at the optometrist, and up to 5 health care visits per year - physio, dietitian, psychologist... All walk in, do and walk out.

How is that 'complicated..... '
 
It's still a bargain between private parties for mutual benefit: a paid transfer of a risk from someone it's too much for to someone else who's more risk tolerant, not an externalization of cost onto society as a whole.
Which is great, if the risk that's too much for people is a fairly rare thing - something that affects only merchants shipping valuable cargoes, or only middle class men who can afford a nice house, but can't afford for it to be replaced if it burns to the ground.

As any actuary will tell you, insurance works best if the pool is as wide as possible. If lots of people buy insurance, then even large claims can be paid without huge premiums being needed.

And of course, all insurance is externalization of the cost of a future disaster onto a wider society of insured persons.

When the disaster that might befall an individual can affect third parties, it is even commonplace to make the purchase of insurance mandatory - car insurance is mandatory in many jurisdictions to provide this protection for third parties.

So, mandatory insurance being a useful and necessary thing, and a wide pool being highly desirable for effective insurance, it makes perfect sense for health insurance to be mandatory, and to have a single insurer.

But monopolies need controls in addition to the monetary controls that (supposedly) keep non-monoply corporations honest. And the obvious way to provide such controls, is to give the general public a vote, when deciding who is to be in charge of the monopoly. Such elected "monopolies managers" are these days typically known as "governments".
 
I do believe that you would favor caring for society’s needy, @Bomb#20.
I just don’t know how you envision such care being administered, because you seem to find fault with every institution or mechanism that purports to try to do that.

Perhaps clarifying your vision of how caring for society’s needy could/should happen, would silence some of your critics.
My vision doesn't really involve me telling others how to do it -- I'm an electrical engineer, not a health care economist. In my ideal fantasy, American politicians would admit to the public that they aren't health care economists either and aren't competent to design a better health care system, so they're outsourcing it to somebody who's good at it. They'd collect quality-of-results statistics from all the single-payer and mixed public/private systems in other countries, identify who has the top-rated system, and hire that country's experts to rebuild the American system in its image. Based on the WHO's numbers, that means we'd bring in the French.

(But that said, I know my country, so I'm confident that if we actually tried to hire French experts to tell us how to duplicate French health care in America we'd find some way to screw it up. And in any event, the chances of us following their instructions correctly, while low, are quite a bit higher than the chances of our politicians admitting they aren't competent to design a better health care system.)
 
What makes our system a "complicated, messed-up, cobbled-together hodge-podge of a system." If you are sick you go to a doctor. If the doctor demands payment instead of bulk billing, they take care of the claim for you. I walk in to my GP, have an appointment, get my scripts, and walk out. If I need a follow up phone call, he gives me a form, I sign it and he gets payment for my phone call. If I get seriously hurt, I go to hospital, I get sorted - no drama. AND NO BILLS OR COPAY REQUIRED!

The only time I Co-Pay is if I go to a private doctor or hospital and even then, it's a pittance. My Shrink costs me $50 I think.

FFS - Medicare (our UHC) even pays for my annual check up at the optometrist, and up to 5 health care visits per year - physio, dietitian, psychologist... All walk in, do and walk out.

How is that 'complicated..... '
Hey, I'm sure you'd know better than I. All I know is what I read on the internet.


Looks complicated to me.
 
collect quality-of-results statistics from all the single-payer and mixed public/private systems in other countries, identify who has the top-rated system, and hire that country's experts to rebuild the American system in its image.
Sounds reasonable to me. If you put some faces and names to it, it might even be compelling.
I don’t think you need to be a HC professional to understand that our system is not cost effective compared to most UHC Countries’. The first step toward implementation of positive change IMO is to figure out the resistance points. That usually leads to people whose ox would be gored. Such people have thus far had ample oxen (resources) to keep the lobby up. Otherwise we probably would long since invested in collecting quality-of-results statistics from all the single-payer and mixed public/private systems in other countries, identifying who has the top-rated system, and hiring that country's experts to rebuild the American system in its image.

(Vote Blue)
 
I don't get it; Many here seem to love the insurance companies more than their countrymen (and -women)?
In case you're talking about me, as I wrote in my first post, "Not commenting on the merits of the NHS model for health care delivery, just pointing out that moral philosophy is an utterly garbage way to decide how to solve the hard technical problems of economics.". I have no love of insurance companies; I just think that whether they're a better way to deliver health care to the majority of a society's people than a single-payer system is an empirical question that needs to be resolved by cost/benefit analysis and by experience with both models*, rather than by believing a popular pro-NHS internet meme engineered to preempt economic reasoning and appeal to unexamined intuition.

If you're talking about someone else who prefers private insurance to single-payer for non-economic reasons, no, it's not because they love insurance companies more than their countrymen. Nobody loves insurance companies. They prefer it because single-payer is coercive and private insurance is non-coercive, and a lot of people have a gut-level problem with coercion.

(* "Experience with both models", by the way, does not mean just comparing the U.S. with Canada. There are better single-payer systems than Canada's; there are better mixed public/private systems than the U.S.'s.)

No, I did not refer to any person per se.
I mean, why not pay to a pool and then distribute health care to everyone? All countrymen would be secured.

I do not know if the Finnish systems are the best, but thus it goes.
I tell first about the pension funds a little bit simplifyed:
- Every worker gets a salary plus he gets a sum depending on the salary that goes to the pension fund. The employer pays that pension to the fund.
- The pension fund pays a pension to everyone, a minimum of 1000 €uros per month, in average some 2000 €. The fund is now so big, that it covers 2,5 years of income taxes. It is more than 255 billion €uros. They invest all over the globe and the yearly income of the funds is about 7-9% per year. The fond grew 12 billion last year because they got paid interests on the investments.
This means that your pension is a part of your salary. And now when we, the baby boomers are getting pensions there is more than enough money for us and the next generations, as they are now paying to the fond. The fond has been growing every year, except for one year some ten years ago.

The health system is paid for by taxes. Unfortunately, that money does not go to a fund. It would be much better as in that case the money could be invested. And it would grow.
Anyway, you do not need insurance for your family. You need it for your house, car and other possessions you have.

Why not go to the fond system?
 
I was hungry this morning. The cost of providing me breakfast should have been shared by the community.
Sure, why not? Food is cheap and plentiful. We can afford, as a community, to provide food to anyone who wants it.
In the first place, you're reversing burden-of-proof. You're the one who posted the claim that something being neither an indulgence nor an offence but a misfortune is a reason its cost should be shared by the community. Show your work.

In the second place, you appear to be watering down the claim. "Anyone who wants it" is likely to be a much smaller class of recipients than your earlier characterization of the recipient class -- "hungry people" -- especially if the quality of the provided breakfasts is set at a level that discourages use by those with the means to fend for themselves. Your meme was an argument for the NHS -- for making all healthcare free and all doctors government employees -- not an argument for getting free care to a small fraction of the population.

As for positive reasons for "why not?", well, there's the obvious: because the taxpayers don't want to. There's an awful lot of stuff we can afford as a community to provide to anyone who wants it. Skydiving lessons, for instance. If we provided everything we can afford to anyone who wants it we'd find the burden excessive and we'd have to skimp on government expenditures we care about more. What makes free food for people who can afford their own food any different from free skydiving lessons in the unnecessary nice-to-have list?

And then there's an equally obvious (to some of us) reason: if it ain't broke don't fix it. Food is, as you say, "cheap and plentiful". Why would you want to mess with the mechanism that made that happen? People generally paying for their own food is the foundation of the whole massive tower of incentives built on top of other incentives that caused the motivations to develop in countless people's minds that caused them to take the myriad coordinated actions that caused food to become cheap and plentiful. If you get people in the habit of thinking food is something they expect the government to provide for free, the whole incentive structure will change, so why would you expect food to remain cheap and plentiful?

Most communities already do this, although in the US it is typically managed by neglect, and ends up as a quasi-religious thing; You could almost certainly get breakfast free of charge in your home town, with the wider community picking up the tab, as long as you are prepared to sit through a sermon, or otherwise have your ear bent about God.
Indeed so. If you don't incentivize non-reliance by price, then either you need to incentivize non-reliance by some other mechanism, or else you get over-use not driven by genuine need, and then the product ceases to be plentiful. Making the breakfasters sit through a sermon strikes me as an effective way to incentivize non-reliance. A comparable governmental and therefore nonreligious free breakfast program could probably achieve much the same effect by only serving pea soup. But "If it's neither an indulgence nor an offence, but a misfortune then the cost will be shared by the community." does not appear to contain a mechanism to incentivize non-reliance.

As some wag put it, "People respond to incentives. That is the whole of economics -- the rest is commentary."

You can even stay in an expensive hotel where breakfast is included, and the guests who prefer a light breakfast or no breakfast at all are communally subsidising that guy who wants to push the boundaries of "all you can eat".
That does not appear to be the case. It's an expensive hotel. The owners are still making a profit on that guy who wants to push the boundaries of "all you can eat". They're calculating that the reduction in profit from that guy overeating is made up in saving the cost of hiring somebody to operate a cash register. For that guy to be getting a subsidy, the hotel would have to be losing money on him.

Sharing food may or may not be "communism", but if it is, then communism is observably a practically universal human trait.
Sharing food is not communism. Sharing food is a complicated system of kin selection and reciprocal altruism, loaded with neural switches to turn it on and off, that was naturally selected for in chimpanzees under the pressures of our idiosyncratic environment. Communism is expecting it to continue to work when you torpedo all the distinctive chimpanzee psychology underlying it and just order the chimps to become Soviet Men and turn it on all the time because from each according to his ability, to each according to his need.
 
National health care would require a compromise that is near impossible.
That's what the Tories said in the 1930s and early '40s in the UK.

Then in 1948, they did it, and it turned out thst it was (and is) perfectly possible.

Not necessarily easy, but then, what is?
You are making the assumption it works. I started this thread because of an example of it seriously failing and I see most of the UHC proponents don't seem to see the utter failure.
 
National health care would require a compromise that is near impossible.
That's what the Tories said in the 1930s and early '40s in the UK.

Then in 1948, they did it, and it turned out thst it was (and is) perfectly possible.

Not necessarily easy, but then, what is?
You are making the assumption it works. I started this thread because of an example of it seriously failing and I see most of the UHC proponents don't seem to see the utter failure.
You started the thread and then came to a completely stupid justification for your point.
 
Holy mother of god! Where the bejesus do you imagine you saw me say the wealthy shouldn't assist those less fortunate? Where the bejesus do you imagine you saw me say the poor shouldn’t receive assistance? Where the bejesus do you imagine you saw me say the US system doesn't suck? Where the bejesus do you imagine you saw me say health care shouldn't be for everyone? It's like you didn't even bother to read my post before you hit "Reply" and quoted it back to me and then appended a "reply" that had jack squat to do with anything you'd quoted.
Fundamentally, this comes down to people who see an objection to a route to reach X as an objection to X.
 
Under UHC, no provider is out of plan, because there's only one plan, and everyone's in it.
I must be missing the boat somehow. I chose my particular advantage plan because it lets me go virtually anywhere. Sure there are costs and copays but access is certainly not a problem. I'm even covered out of country as should be. Yes, I'm healthy with no family histories of chronic diseases - knock on wood - but I don't get what the complaints are about advantage plans. Maybe the shit will eventually hit the fan but with millions of people using these things they seem to be working. Would I like to see UHC so that all the phony bullshit is gone? Yes. But that's not ever going to happen in the U.S.
I see what happens to my wife on multiple occasions. The insurance company goes with only one provider of a specialty. That means that doctors that would otherwise drive off patients are ensured a supply of ones that don't have a choice.
 
National health care would require a compromise that is near impossible.
That's what the Tories said in the 1930s and early '40s in the UK.

Then in 1948, they did it, and it turned out thst it was (and is) perfectly possible.

Not necessarily easy, but then, what is?
You are making the assumption it works. I started this thread because of an example of it seriously failing
No, you didn't. You started this thread with an example of a failure that could arise in ANY system.
and I see most of the UHC proponents don't seem to see the utter failure.
Because you have yet to demonstrate that there is a failure attributable to UHC.

If your contention is that people should be frightened to drive Japanese cars, and your evidence is an anecdote about a Toyota crashing, you have failed to make your case. To make your case you would need to show that the problem is Japanese cars, and not just cars.

You have done exactly nothing to show that the problem described in the OP could not and does not occur in non-UHC systems; Nor have you shown that such systems do not have worse problems that offset any hypothetical benefit that might have arisen for the person in the OP article, even if the problem were unique to UHC.

If there is an "utter failure" here that justifies fear of UHC, then show it to us.

So far, you have utterly failed to make your case.
 
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