Amazon.com Widgets

As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Monday, October 26, 2009

You Don't Think They'll Just Give Up, Do You?

(I'm a blogger fellow for Brave New Films and their Sick For Profit campaign)

After today's announcement from Harry Reid, adding a public option to the Senate health care bill, some might think that a great victory has been achieved. And it's a significant accomplishment to this point. But we're at the beginning of the end, not the end. And now that this public option, with a state opt-out, represents the lower bound of health care reform, you can bet that the insurance industry will redouble their efforts to kill the bill and retain the status quo. In fact, they've already started. Blue Cross/Blue Shield of North Carolina has begun to lobby their customers to work against the bill, asking them to contact Senator Kay Hagan (D-NC). Not a front group, or some ad hoc organization funded by BC/BS. No, just the company itself.

(The mailer) reads:

Public option?
Government Cooperatives?
Community plan?
Single payer?
No matter what you call it, if the federal government intervenes in the private health insurance market, it's a slippery slope to a single payer system.

Who wants that?


The enclosed postcard to Hagan reads:

Senator Hagan,
Please oppose government-run health insurance. We can meet our health care challenges without the government unfairly competing with the private sector. Tell Senate leaders that North Carolina doesn't need government-run insurance.


They've also deployed lobbyists and shills to Capitol Hill to make completely dubious arguments. At a hearing about the insurance industry's anti-trust exemption, this amazing exchange occurred:

University of Arkansas business professor Lawrence Powell, who testified on behalf of the medical malpractice insurance industry.

"The best possible outcome from repealing McCarran is continuation of the status quo," he said. "However, it is also likely that repealing McCarran would have negative consequences for consumers, by decreasing competition and accuracy in insurance pricing."

Rhode Island Democrat Sheldon Whitehouse pointed out that the professor was relying on outdated information.

"You cite for the proposition that insurance markets are highly competitive an article by Paul Joskow. Do I have the date of that article correct, it's 1973?" he asked Powell. "I believe so," came the answer.


And, they've started to push their message out to media, getting an AP reporter to buy the canard that poor, henpecked insurance companies just don't make a lot of money.

WASHINGTON – Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They're all more profitable than the health insurance industry.


The missing ingredient here is scale. Tupperware is more profitable than health insurance on a percentage basis, but 1/6 of the US economy doesn't go through Tupperware. In real dollars, the insurance industry makes a mint. And remember, "profit" doesn't count salaries, not even what's given to CEOs.

The truth is that, even with this public option, insurers will do just fine in the health care bill. They get millions of new customers, with competition that is limited (not everyone can get the public plan, under even the most expansive version). But it's just not good enough for them. The notion that they might have to offer coverage with actual benefits, and not cherry-pick the healthy to pay their premiums, which would cut into those profits, is just distasteful to them. So they will fight. And we will be ready.

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Friday, September 25, 2009

"They aren't friends to consumers."



Harry Reid doesn't appear to be receptive to canceling the insurance industry's anti-trust exemption:

Reid (D-Nev.), who will play a key role crafting the final Senate healthcare overhaul in the next few weeks, is excluding a proposal to repeal a loophole that exempts health insurance companies from federal antitrust laws.

Although the proposal is very popular with Democrats and liberal groups, Reid has concerns that attaching it to the healthcare legislation risks damaging prospects for an effort already facing significant hurdles.

Republicans say Reid is being calculated in a different manner, dangling the standalone bill as a way of intimidating the companies into making concessions on Obama’s broader healthcare objective. But they will have to overcome recent testimony from former Senate Republican Leader Trent Lott, who backed a broader effort to lift the exemption for the entire industry.


Many Republicans actually support the end of the anti-trust exemption because they believe it would be a vehicle to expand interstate sale of insurance and essentially deregulate the industry, which would not be to the benefit of the consumer. And Reid himself has backed a repeal of the McCarran-Ferguson Act, which gave the industry the exemption, for many years. So if he's brandishing it as a club, he doesn't appear to be doing much of a job of it.

Unfortunately, there are too many people in the halls of Congress willing to give the industry exactly what it wants - a forced market without competition from a public option. Future Congressman John Garamendi, who for eight years was California's Insurance Commissioner, explains why that is a disastrous outcome.

Some in Washington are seriously considering penalizing Americans for being unable to afford care in a marketplace that doesn't control costs. If voters in the 10th Congressional District choose me to be their representative in Congress, let me be clear. I will not vote for any bill that includes the individual mandate unless I am confident that bill offers generous subsidies for Americans struggling to make ends meet and unless that bill includes the public option to provide real competition in the health care marketplace. I regulated the insurance companies for eight years as California's State insurance Commissioner, and I know those companies well enough to know that we can trust them to put profits before people. They aren't friends to consumers.

In California in the first half of this year, according to data provided by the insurance companies to state regulators, PacifiCare denied 39.6 percent of all claims, Cigna 33 percent, Anthem Blue Cross 28 percent and Kaiser 28 percent. 45,000 people died last year in the United States because of a lack of health care coverage. These are not statistics you see in the rest of the industrialized world. Profits ahead of people, greed ahead of the general good is no way to run a health care system.


The Democrats had better figure this one out. If the public gets the sense that their representatives are being run by the insurance companies, they will take their frustrations out in next year's elections.

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Thursday, September 17, 2009

Hitting The Insurance Industry Where It Hurts

John Conyers and some allies on the House Judiciary Committee have come up with a fabulous way to get the insurance industry in line - by threatening to remove their anti-trust exemption.

Many people don't know that the insurance industry, under the McCarran-Ferguson Act of 1945, has a broad anti-trust exemption that facilitates regional monopolies. The Act allows states to regulate the insurance business instead of the federal government, but also allows that, as long as the state regulates the industry, federal anti-trust laws would not apply.

As a result of this exemption, states have seen markets for health insurance where one or two companies predominate. In the state of Maine, Wellpoint controls 71% of the market. In North Dakota, Blue Cross controls 90%. Using the Herfindahl/Hirschman Index, a metric for market concentration, a 2007 study by the AMA found almost every health insurance market in the United States is highly concentrated.

This edition of the study analyzed 313 MSAs. This compares with 292 metropolitan areas in the 2005 study, 84 in the 2003 study, 70 in the 2002 study, and 40 in the 2001 study.

In terms of market concentration (HHI), the study found the following:

In the combined HMO/PPO product market, 96 percent (299) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.
In the HMO product market, 99 percent (309) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.
In the PPO product market, 100 percent (313) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.


Here's the AMA study. Paul Rosenberg has a lot more on this.

The point is that the concentration of the health insurance market among regional monopolies leads to higher costs for consumers, almost by definition. What the legislation by Conyers (D-MI), Hank Johnson (D-GA) and Diana DeGette (D-CO) would do is end that anti-trust exemption for health insurers, allowing for enforcement in all of these highly concentrated markets. The Senate has companion legislation:

“This legislation would specifically prohibit price fixing, bid rigging, and market allocation in the health insurance industry,” said Conyers. “These pernicious practices are detrimental to competition and result in higher prices for consumers. Conduct that is unlawful throughout the country should not be allowed for insurance companies under antitrust exemption. The House Judiciary Committee held extensive hearings on the effects of the insurance industry’s antitrust exemption throughout the 1980s and early 1990s. It became clear then that policyholders and the economy in general would benefit from eliminating this exemption.

“The legislation we introduced today is intended to root out unlawful activity in an industry grown complacent by decades of protection from antitrust oversight. In doing so, we aim to make health insurance more affordable to more Americans. I want to thank my friend Senator Leahy for his leadership on the bill and for working with the House on this joint introduction.”


Many of the actions taken by the insurance industry over the years simply violate federal law. Repealing their anti-trust exemption would force the industry to end their criminal ways or face punishment. As a companion to insurance regulations designed to lower prices for consumers, but perhaps without the kind of enforcement necessary to maintain it, I couldn't think of anything better. And if nothing else, this legislation is a powerful whip to keep the industry in line as they try to extract more perks from the health care bill. Combine this with the multiple investigations into industry practices from Dennis Kucinich, Henry Waxman and others, and you have real pressure on the industry for the first time in a while.

Good for John Conyers.

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Friday, August 28, 2009

Reid On Board With Public Option

Strong words from Harry Reid on the public option.

Reid opened a private meeting of health care providers in Las Vegas on Tuesday by saying, according to one attendee who took notes: “We have a problem in America and it’s called the private insurance industry.”

Reid went on to express support for a public option, the proposed government-run insurance plan that he compared to Medicare, saying any meaningful reform legislation would have to include a public component.

Nevada’s main progressive group said the majority leader’s comments during Tuesday’s meeting of about 20 hospital CEOs, doctors and other health care providers was among the most significant statements they have heard on his thinking.

“We’re energized and we’re also confident that Sen. Reid is on the right side on this issue,” said Michael Ginsburg, a community organizer at the Progressive Leadership Alliance of Nevada, who attended the meeting. “That’s something we can take to our supporters and reassure them.”


Couple things here. First of all, Reid is up for re-election and it's going to be a dogfight, with Reid already behind in the polls. Because of his leadership position, he is caricatured by the right as a liberal ideologue, and members of his own party find him not able to compete procedurally in the Senate and get the Democratic agenda passed. But Reid has always been solid on fighting the insurance industry, which he once called the enemy of most everything we do today. And that principle has held up, despite his re-election battle. Surely Reid knows that Democrats must pass a bill if they have any hope of a decent showing in the 2010 midterms.

Second thing is that this offers good evidence that Reid may split the bill, getting the public option and other budget-related measures through on reconciliation, with the non-budget items coming in a second bill under regular rules with 60 votes. The second bill could wait until a successor is elected for Sen. Kennedy, by January 26 at the latest, if not earlier if the law is changed. Anthony Wright has a good piece about bill-splitting examples in the states when it comes to health care reform. Policy should trump process in this case.

Third thing is that Reid should threaten to repeal the McCarran-Ferguson Act that gave the insurance industry an anti-trust exemption. This has allowed the insurance industry to highly concentrate in almost every state market and has offered precious little choice. Just the buzz of repealing McCarran-Ferguson will send the insurance industry into battle mode, and the public option would be seen as practically benign by comparison.

...or, maybe, not at all.

During a tele-townhall with constituents today, Senate Majority Leader Harry Reid said he supports a public option...but then he added an extremely important caveat. Reid said he doesn't think the public option ought to be a government run program like Medicare, but instead favors a "private entity that has direction from the federal government so people that don't fall within the parameters of being able to get insurance from their employers, they would have a place to go."

That sounds suspiciously like Reid would prefer a so-called co-op system, which almost all reformers regard with suspicion, and many regard as a non-starter.

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Tuesday, May 12, 2009

Bring On Johnny Law And Break Up The Banks

Many of us have been insistent on the message that, when it comes to the banking industry, if it's too big to fail, it's too big to exist. Yesterday, the Obama Administration at least hinted at using antitrust law to ensure such a scenario will not happen again.

President Obama’s top antitrust official this week plans to restore an aggressive enforcement policy against corporations that use their market dominance to elbow out competitors or to keep them from gaining market share.

The new enforcement policy would reverse the Bush administration’s approach, which strongly favored defendants against antitrust claims. It would restore a policy that led to the landmark antitrust lawsuits against Microsoft and Intel in the 1990s [...]

Ms. Varney is expected to say that the administration rejects the impulse to go easy on antitrust enforcement during weak economic times.

She will assert instead that severe recessions can provide dangerous incentives for large and dominating companies to engage in predatory behavior that harms consumers and weakens competition. The announcement is aimed at making sure that no court or party to a lawsuit can cite the Bush administration policy as the government’s official view in any pending cases [...]

Ms. Varney is expected to say that the Obama administration will be guided by the view that it was a major mistake during the outset of the Great Depression to relax antitrust enforcement, only to try to catch up and become more vigorous later. She will say the mistake enabled many large companies to engage in pricing, wage and collusive practices that harmed consumers and took years to reverse.

While Ms. Varney is not expected to mention any specific companies or industries vulnerable under the new policy, those who have talked to her about the speech say she is aiming at agriculture, energy, health care, technology and telecommunications companies. She may also be reviewing the conduct of some in the financial services industry, which is now undergoing a wave of consolidation as a result of the financial crisis.


Those last two grafs are the key ones, although I would welcome a return to Clinton-era antitrust enforcement in all aspects of business - the Bush Administration's Justice Department did not file a single case using anti-monopoly statutes.

Simon Johnson, who has long advocated for using antitrust law to break up the banks, sees hope in this new outlook. Since the beginning of the financial meltdown, the industry has consolidated massively, often at the request of the federal government. As a result, consumers are seeing higher charges in bank fees, and considering that banks need profit to negate their capital shortfalls, I expect that to only grow. Antitrust law has a role to play here, though obviously they will run into tension from the Treasury Department. Not to mention wealthy Obama donors, who have brought their opinions to bear on a separate debate, the proposed closure of offshore tax havens:

A report by the General Accounting Office found that 83 of the largest 100 publicly traded US companies had subsidiaries in tax havens or "financial privacy" jurisdictions, as do 63 of the largest US federal contractors (PDF).

Joe Conason wrote earlier this year about the tax havens of bailed out banks around the world. "Don't expect to find out from Fox News Channel or the New York Post, because News Corp. has its own constellation of strange subsidiaries, including 33 in the Caymans alone," he notes.

But back to the class war business. Who is the anonymous "hedge fund" manager sending ominous warnings to Obama in the press? It seems to be the all the rage among rich donors these days -- Orin Kramer has certainly done it before, as has Pimco's Bill Gross, and of course poor little rich girl Penny Pritzker.

Nobody should really be surprised that rich people don't want to pay their taxes. I guess the bigger question is: why aren't there more cosponsors in the House and Senate?


We have very powerful interests, both rich individuals and corporations, asserting their right to break the law, and imploring the Obama Administration to allow them to continue to do so. We'll see where they come down.

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Friday, April 17, 2009

Making Money Coming And Going

You'll lack surprise when you discover that Edward Liddy, the head of AIG installed after the company imploded, owns a large stake in Goldman Sachs, which has been bailed out by AIG counter-party payments.

Edward M. Liddy, the dollar-a-year chief executive leading the American International Group since its bailout last fall, still owns a significant stake in Goldman Sachs, one of the insurer’s trading partners that was made whole by the government bailout of A.I.G.

Mr. Liddy earned most of his holdings in Goldman, worth more than $3 million total, as compensation for serving on the bank’s board and its audit committee until he stepped down in September to take the job at A.I.G. He moved to A.I.G. at the request of Henry M. Paulson Jr., then the Treasury secretary and a former Goldman director.


I think this has to be the end of Mr. Liddy. When your alibi is that the $3 million is “a small percentage of his total net worth,” you're really grasping at straws. No really, that's his alibi, check the link.

The 100% pass-through of AIG counter-party payments to Goldman and other banks is absolutely insidious, maybe the worst part of this whole thing. This is why Goldman and these other banks can self-righteously claim to be renouncing government help while accepting it through pass-throughs and separate federal aid programs. They'd rather get their payoffs in black bags than in public, that's all they're whining about.

I don't necessarily think that Liddy is only making Goldman whole because of his financial stake; it's more that he's a bankster helping out his other bankster pals. It's the culture of coziness between elites that must be stopped.

Have we completely lost of sense of what is and is not a conflict of interest? Have we really built a system in which greed fully overshadows responsibility? Is it not time for a complete rethink of what constitutes acceptable executive behavior?

One of our country’s leading corporate attorneys made a telling point to me on Wednesday night, “the only way to control executive behavior is to criminalize it,” i.e., civil penalties do not change behavior - the prospect of jail time has to be on the table. His broader point was that antitrust action can make a difference in today’s world, but only if this includes potential criminal charges [...]

Let me be very clear on my position vis-a-vis AIG-Goldman and the broader Washington-Wall Street Corridor. I’m not saying that anyone has broken any laws, but rather that laws need to be changed. I’m not even saying that there have been transgressions against the prevailing code of ethics for executives and politicians - although surely we agree that this code needs to be dragged, kicking and screaming, into the 21st century.

I’m just saying that we have a problem - ultimately, with the belief system that underpins how big finance behaves - and we need to fix it.


...more AIG hilarity: Jake DeSantis, who "resigned" in a letter picked up by the New York Times, still works for the company. What a bunch of WATBs who want to rule the universe in secret like the good old days instead of under public scrutiny.

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Thursday, March 26, 2009

If You Read One Article About The Economic Crisis....

Make it this one.

Increasingly over the past several weeks, my favorite blog has become Baseline Scenario, written by Simon Johnson and James Kwak. Johnson was the chief economist at the IMF and now teaches at MIT, while Kwak is a student at the Yale Law School. And throughout this crisis, the two have consistently offered the best explanation of the financial crisis, how we got here and what we must do to get out. Many writers of this stripe argue on the basis of policy and which resolution is most likely to be the most cost-effective and successful. What sets Johnson and Kwak apart has been their ability to properly contextualize the crisis as a failure of elites, who grew too rich and too powerful and must be made to take losses, as a necessary component, indeed the only component, to revitalizing the American economy. Johnson has now put those thoughts into The Atlantic, in something of a long summary of the work of Baseline Scenario over the past few months, a description of how the financial industry took over the government, much like in most banana republics, and how the only way to properly wind this down is to shrink the power and influence of the industry, as would be done in any other emerging country when the bankers grow too big and the elites start stealing everything. This is must reading.

Kwak sets it up on his site.

From 1945 until around 1980, the financial sector was one industry among many in the United States. Then something happened.

People in finance started making more money, jobs in finance became more desirable, financial institutions became more influential, and the linkages between the financial sector and the political establishment became stronger. At the same time that our financial sector became more leveraged and more risky, it also became more powerful. The result was a confluence of interests between Wall Street and Washington - one more normally found behind the scenes of emerging market crises, the kind the IMF is called on to resolve.




The chart shows that pay in the financial sector has risen to 181% of the average for all domestic private industries. They didn't just get too big to fail, they got way too big.

This is a familiar story to those who have been paying attention, but I've never seen it captured better. As the elite financiers grew richer and concentrated their wealth, they became more embedded with the government, not just with campaign contributions but through a shared belief system which made an unlimited virtue out of the unfettered free market. Certainly there has been a revolving door between Washington and Wall Street (and also at the top levels of academia, with econ professors shuttling in and out of financial institutions), but concurrent with that has been this image of Wall Street as a bunch of virtuous benefactors of their will, of the Masters of the Universe who can do no wrong.

Once, perhaps, what was good for General Motors was good for the country. Over the past decade, the attitude took hold that what was good for Wall Street was good for the country. The banking-and-securities industry has become one of the top contributors to political campaigns, but at the peak of its influence, it did not have to buy favors the way, for example, the tobacco companies or military contractors might have to. Instead, it benefited from the fact that Washington insiders already believed that large financial institutions and free-flowing capital markets were crucial to America’s position in the world [...]

Wall Street is a very seductive place, imbued with an air of power. Its executives truly believe that they control the levers that make the world go round. A civil servant from Washington invited into their conference rooms, even if just for a meeting, could be forgiven for falling under their sway. Throughout my time at the IMF, I was struck by the easy access of leading financiers to the highest U.S. government officials, and the interweaving of the two career tracks. I vividly remember a meeting in early 2008—attended by top policy makers from a handful of rich countries—at which the chair casually proclaimed, to the room’s general approval, that the best preparation for becoming a central-bank governor was to work first as an investment banker.

A whole generation of policy makers has been mesmerized by Wall Street, always and utterly convinced that whatever the banks said was true. Alan Greenspan’s pronouncements in favor of unregulated financial markets are well known. Yet Greenspan was hardly alone. This is what Ben Bernanke, the man who succeeded him, said in 2006: “The management of market risk and credit risk has become increasingly sophisticated. … Banking organizations of all sizes have made substantial strides over the past two decades in their ability to measure and manage risks.”


Over the past several decades and thanks to this shared ideology, finance has been massively deregulated, what regulations remained in place were never followed, institutions were allowed to grow in an almost unlimited fashion, leverage themselves tremendously, and "innovate" with exotic instruments that nobody truly understood. Every policy, seemingly, benefited the financial sector to an outsized degree. And every policy that would have limited the sector was quietly set aside.

Of course, what's best for the financial titans has never been what's best for the country, and this is true for any nation on Earth, many with which Johnson has real-world experience. The key to every financial crisis lies in that moment when the need for solutions runs up against a politics that practically exists to protect and defend elites.

Typically, these countries are in a desperate economic situation for one simple reason—the powerful elites within them overreached in good times and took too many risks. Emerging-market governments and their private-sector allies commonly form a tight-knit—and, most of the time, genteel—oligarchy, running the country rather like a profit-seeking company in which they are the controlling shareholders. When a country like Indonesia or South Korea or Russia grows, so do the ambitions of its captains of industry. As masters of their mini-universe, these people make some investments that clearly benefit the broader economy, but they also start making bigger and riskier bets. They reckon—correctly, in most cases—that their political connections will allow them to push onto the government any substantial problems that arise [....]

Squeezing the oligarchs, though, is seldom the strategy of choice among emerging-market governments. Quite the contrary: at the outset of the crisis, the oligarchs are usually among the first to get extra help from the government, such as preferential access to foreign currency, or maybe a nice tax break, or—here’s a classic Kremlin bailout technique—the assumption of private debt obligations by the government. Under duress, generosity toward old friends takes many innovative forms. Meanwhile, needing to squeeze someone, most emerging-market governments look first to ordinary working folk—at least until the riots grow too large [...]

From long years of experience, the IMF staff knows its program will succeed—stabilizing the economy and enabling growth—only if at least some of the powerful oligarchs who did so much to create the underlying problems take a hit. This is the problem of all emerging markets.


We have a far more developed country than those the IMF typically counsels, in some respects. Yet with the rise of an unaccountable and impenetrable oligarchy of elites, with a political class unwilling to do anything that would upset them, America resembles very closely the developing nations in banana republics. This continued fealty to the banks represent the leading threat to economic recovery. Whether through stoking fear of their failure or outright intimidation of the policymakers or something in between, the banksters own the country.

Johnson has his own prescriptions for the way forward: nationalizing the insolvent banks (which won't be cheap, but neither will any alternative), resolving the assets and returning them to private hands, increased regulation, etc. But none of that will work without the total and utter breakup of the oligarchy at the heart of the crisis.

Oversize institutions disproportionately influence public policy; the major banks we have today draw much of their power from being too big to fail. Nationalization and re-privatization would not change that; while the replacement of the bank executives who got us into this crisis would be just and sensible, ultimately, the swapping-out of one set of powerful managers for another would change only the names of the oligarchs.

Ideally, big banks should be sold in medium-size pieces, divided regionally or by type of business. Where this proves impractical—since we’ll want to sell the banks quickly—they could be sold whole, but with the requirement of being broken up within a short time. Banks that remain in private hands should also be subject to size limitations.

This may seem like a crude and arbitrary step, but it is the best way to limit the power of individual institutions in a sector that is essential to the economy as a whole. Of course, some people will complain about the “efficiency costs” of a more fragmented banking system, and these costs are real. But so are the costs when a bank that is too big to fail—a financial weapon of mass self-destruction—explodes. Anything that is too big to fail is too big to exist.


Johnson argues, compellingly, that President Obama is taking after the wrong Roosevelt, and what we need right now are the trust-busting policies of Teddy in addition to the New Deal policies of Franklin. But he ends on a downbeat note, mindful that the American oligarchy is much stronger, and the nation much less desperate, to expect the breaking of their money train to happen quickly or easily. It may take the threat of a real global collapse to shake us into action and away from this continued death-dance with the elites.

Anyway, read this and commit it to memory. To the extent that our political leaders listen at all anymore, they must understand how essentially untenable this economic power structure has become. I leave you with this quote from Mr. Johnson:

To paraphrase Joseph Schumpeter, the early-20th-century economist, everyone has elites; the important thing is to change them from time to time.

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