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Tuesday, August 11, 2009

Health Care Q&As from Congressman Earl Blumenauer's First Telephone Town Hall

Posted by Matt Davis on Tue, Aug 11, 2009 at 7:20 PM

Nobody compared President Obama to Hitler, but tonight marked the first of Oregon Congressman Earl Blumenauer's two telephone health care town halls. Blumenauer's last health care town hall took place at Portland Community College in North Portland back in June. There's a lot of misinformation about health care flying around, so I thought you might find it helpful if I just posted all the Q&As after the jump.

8ecc/1250039250-1244590060-howarddeanfriday.jpg

DEAN (LEFT) AND BLUMENAUER: TOWN HALL IN JUNE...

The idea of doing tonight's telephone town hall, according to Blumenauer's staffers, was to reach out to more Oregonians than he could in a single face-to-face event. Tonight, more than 42,000 people were invited to participate, and to ask a question, they just had to hit "star three" on their telephone. "The equivalent of three Memorial Coliseums" had been invited tonight, said Blumenauer.

There's another one of these on Friday. If you'd like to participate, sign up on the website.

"This is the right time to try to shift through all the static," said Blumenauer, opening the discussion, arguing that Portland's Metro area could avoid 1000 bankruptcies a year by reforming its health care system, and give more than 100,000 people in the state access to health care who can't afford it, currently. Callers were limited to one minute per question, and Blumenauer said he would limit his responses to a minute, too. Spellings of the questioners are approximate and phonetic. Here goes:

"I'm wondering why everybody seems to be ignoring the prediction of how much this is going to cost and where the money is going to come from, which is in the trillions of dollars," said Jenny Brewster, a senior citizen on Medicare, opening the discussion.

"Let's deal with the big piece, in terms of cost," said Blumenauer, who said he appreciated Brewster's question. "The estimates are from the Congressional Budget Office, it's not the politicians or their staff that are doing this. The estimates are that this will cost just over $1 trillion, but the savings are going to be $1.48 trillion. It will generate slightly more revenue than the bill will cost. It is essentially budget neutral."

"I'm happy with what I have now, but I was wondering how if we're having trouble paying for it right now, how are we going to cover a lot more people and it's not going to be a problem?" asked Dixie Brechard.

"Currently we have some problems because there isn't, there hasn't been an increased funding source for Medicare. It's running a deficit," said Blumenauer. "What this bill will do is it will levy a tax on approximately 2 percent of the population, will pay a higher income tax. The second is there will be changes in terms of how the Medicare system itself is administered—including some very aggressive work to deal with some abuses going on."

Check out the rest after the jump.

"We had a coworker at our store who was 59 years old and had liver disease, and he couldn't quit working because he needed health care," said Rita Coots. "He should have been able to quit working and have some peace but he had to keep showing up and suffering."

"Part of what we need to establish is to make the insurance more affordable so that people aren't tied to a job," said Blumenauer. "We find a number of people that are trapped that way. The bill that we are working on would free them from being dependent on a job they don't actually like."

"I would like to know if you have read the bill in its entirety, and if you haven't, why not?" asked Ralph Hatley.

"Not only have I read the bill I've also had the opportunity to write the bill," the congressman responded. "There's been more attention to this bill than I've personally seen in 12 years that I've been in congress."

The next question asked whether seniors with cancer would be given health care, or suggested they have an "end of life" conversation instead.

"I'm really glad that you said that, because nothing could be further from the truth," said Blumenauer. "We are working so that senior citizens and their families get the information they want and need. Right now Medicare will pay for all the tests you need and probe, but it currently doesn't pay for people to have a conversation about their choices. We have hundreds of doctors, the AARP, nurses and people in the faith community who know that seniors need the basic information to think about this."

"The notion that somehow anything in this bill would somehow reduce or deny opportunities is really missing the mark," he continued, citing the Veterans' health care system as an example of successful socialized medicine.

Blumenauer also did a poll: He asked callers to share their stories of having had problems with health coverage—how broad that experience is. "If you or someone you know has had serious problems with getting health insurance," he said, "press one now." People who didn't think there were problems were invited to push two.

"Will Medicare be changed? And who will be included?" asked Judy Chris.

It would stay the same, said Blumeanuer.

"I have Chrones disease and I work for the State of Oregon so I have good insurance, but my insurance has denied my medication four years in a row," said Mara Danielson. "What's going to change?"

"One of the concerns we've heard is that there are these gaps," Blumenauer said. "One of the items that is most important in this legislation is that it would no longer permit insurance to be denied to people because of a pre-existing condition. This is across the board." "I really am sorry to hear of your situation, and that's exactly why we have made efforts to fix it."

"After working for as long as I have in direct patient care, I know that health care reform also includes training," said Patch Thurman. "How will you encourage more people to come into the field of health care?"

"We are facing a crisis right now, there are a bunch of us geezer baby boomers who are moving on career-wise, and we have shortages for a wide variety of medical professionals," Blumenauer responded. "There are efforts to deal with expanding opportunities, it includes physician assistants, the dental work force, and this is one of the few areas where there is bipartisan support."

"Can you guarantee I won't lose my coverage? I'm with Kaiser right now, and I fairly well like it," said the next caller. "Is there a guarantee?"

"Yes, absolutely. First of all let me just say that there is no guarantee now that people who have coverage through their employer are going to have coverage tomorrow," Blumenauer said. "But the bill is predicated on the assumption that people who like the insurance they have now will keep it, and the other options are choices. There is no provision in the bill that forces people to do anything. It is about providing people with more choices."

"In many parts of America right now, Americans don't have any choice," Blumenauer continued. "In 25 states, one company has 50 percent or more, and in the vast majority of states there's no meaningful competition. That's why part of the plan that's being developed is to provide a public health insurance plan to give people more choices."

The congressman also did a second poll, asking how many of the callers supported the creation of a public insurance option.

"Do you think taxes are really the answer because taxes are so high already?" asked Ann Bryant.

"This is an area of controversy as well," said Blumenauer. "Over 95% of the American public actually got a tax reduction in the recovery package that we passed in January. There is no interest in gratuitously increasing taxes, but as a practical matter, if we are going to provide health care for almost 50 million Americans, these things cost money. The proposal in this legislation would increase taxes on approximately two percent of the population. This is a group of taxpayers that have seen dramatic reduction in their tax burden over the years as their income has gone up very high. This would return the tax rates to about what they were in the Clinton administration when the economy was humming along and we created 22 million jobs."

Blumenauer did a third telephone poll, asking people if they supported increasing taxes on people owning more than $350,000 a year, the top 2 percent of earners.

"My understanding is, health care reform will not go into effect until 2013. Why would it take so long?"asked Pam Moser.

"We are talking about making the most fundamental change in health care in history," said Blumenauer. "It is going to take some time and attention, and we want to make sure that it is done right."

He said it would take time to set up a health insurance exchange, financing, and to strengthen Medicare.

"The ones that we can do sooner, we will," Blumenauer said.

"Three questions, I was an emergency room nurse for a number of years. Is this going to help in the emergency rooms in terms of being clogged up for people that are non emergency?" asked Helen Norwood. "Is this going to stop hospitals from competing with each other and wasting money, and are we going to be covering illegal immigrants in this bill, also?"

"First of all, the bill explicitly excludes coverage for illegal immigrants," said Blumenauer. "Second, a lot of people are going to emergency rooms as a last resort. We've got people coming in with things that should be taken care of routinely and in fact if they had insurance they would have seen a doctor. That's not the way it should be—it's expensive, it's inefficient, and it greatly complicates the situation for people who have genuine emergencies. The last problem is that we have hospitals competing with each other—hospitals get a lot more money by running people through and doing things. We have a fee for service system that isn't actually tied to results, and part of what we are working very hard with is to provide incentives for groups of doctors to focus on the quality of care, not just the volume of care." "We're very interested in stopping the readmission of people to the hospital a month after they have been discharged," he continued.

"Why are you in such a hurry to back this bill that is presently going to cost us trillions, instead of backing Ron Wyden's bill where it will keep it in the private sector and the cost to us will be a lot more minimal," asked Linda Seaton.

"I did some work with Ron Wyden in the past, and I actually co-sponsored a version of Ron's bill," said Blumenauer. "This bill is not government providing the services. Government pays for the service, but it is provided through private doctors. The bill that we are working on in the house is the same as what would happen with Senator Wyden's proposal. The difference is that what Senator Wyden is proposing would basically eliminate a lot of employer-provided health insurance. Some people think that's fine—that people will just pay what they are paying now, and people will be responsible for getting their own insurance. There are three reservations I have with that. First of all, lots of employers are going to stop providing insurance. If you take away the tax benefits then employers are going to get out of the health insurance business. Second, we were talking about more competition, giving people choices. People would have to pick between one or two insurance companies and have to pick, without the muscle of the employer negotiating, and they might not get an insurance package that is as desirable. Finally, it's just a practical consideration. If you're going to have a system that is going to take away employer-sponsored health insurance, it's going to get harder to get that passed. I respect Ron, as I say, but I think this is a much better approach for the people I am representing."

"I thought I would just call to lend my support," said 'Taylor'. "I have been wondering why Americans have been so resistant to socialized medicine, I feel like it's more expensive to keep things the way they are. It's just turned into a huge corporation, a money-making machine. Isn't it more expensive how we have it right now? Aren't people going to get better care if it's not a money-making machine, and the third question is are employers going to start cutting back on what they're offering?"

"The Federal government currently pays for two thirds of the health care in the nation for one third of the population," said Blumenauer. "People say keep my government's hands off my Medicare, forgetting that it wouldn't exist if government hadn't passed that law in the mid 1960s. We can do this. It's been tough sledding, it's been one of the most difficult things I've ever worked on, but I'm convinced that together we can refine a program. Will everybody agree? No. There are still some people who think that we didn't actually land on the moon, that that happened in Paramount Studios. I can't help that. We'll continue working with Oregonians in the months ahead to make sure that we're answering your questions."

Update, 7:26:

If all of that was a little too reasoned for you, well, have a little dose of Glenn Beck—who I am starting to think must be getting paid by the left to put out this kind of stuff, for all the good it is going to do his cause...

 

Comments (27) RSS

Oldest First Unregistered On Registered On Add a comment
1
Mr. Davis,

I might make fun of you and call you names...

..but...

... I have to thank you.

You're doing an admirable job of doing local coverage of the health care debate.

I can only hope that we Americans can only get the same level of health care that the average UKian gets.

-Graham.
Posted by Graham on August 11, 2009 at 8:10 PM · Report
2
Thanks Graham. Tell your friends.
Posted by Matt Davis on August 11, 2009 at 9:44 PM · Report
3
Thanks Matt, that cleared up some issues for me!
Posted by Rusty! on August 12, 2009 at 1:58 AM · Report
4
What is Alan Alda doing with Howard Dean?
Posted by CH on August 12, 2009 at 8:48 AM · Report
5
These are, pure and simple, LIES. Through and through. And anyone who has actually been paying attention to the facts knows this.

- The CBO score does NOT say the plan is deficit-neutral or even close. Cost: $1T. Savings: $500B.

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/16/AR2009071602242.html

- You will NOT be able to keep your existing coverage. The practical effect of the creation of exchanges and mandated levels of coverage will be that employers will be forced to change the plans they offer to their employees. As an employee, you have no say in what plans your employer offers.

http://money.cnn.com/2009/07/24/news/economy/health_care_reform_obama.fortune/

- The "end of life" issue is real. From April:

President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.

http://www.bloomberg.com/apps/news?pid=20601070&sid=aGrKbfWkzTqc

So you have Blumenauer's "end of life" panels and this statement by Obama that expensive procedures at the end of someone's life aren't sustainable. Does anyone wonder why people think the government is going to be encouraging old people to just die already instead of using up so much taxpayer money? As reliable liberal Eugene Robinson says:

If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.

- Illegal immigrants ARE covered in the bill. In fact, they are required to be treated on an emergency basis by existing law. And, thanks to pressure from La Raza and others, there is no mechanism to make sure they are not covered.

http://thehill.com/op-eds/healthcare-scheme-would-benefit-illegal-immigrants-2009-08-03.html

I can understand why politicians would lie about this bill. It's what they do, and they can't sell it otherwise, given its unpopularity. What I can't understand is why the media is lapping it up so eagerly. You have a responsibility to the public to seek out lies and expose them. Instead, you're spreading them yourself, and willfully. It is nothing short of disgraceful.
More...
Posted by mr. voluptuous on August 12, 2009 at 9:01 AM · Report
6
I'm probaly going to piss off some people, but I tend to agree with Obama about things like his grandmothers hip replacement. Why spend that kind of money for no good purpose? I'm not being callous, just pragmatic. I had to attend a seat belt course in PDX once, and the presenting nurse was bragging about a patient who had been in an accident with no seat belt usage, He was in a come and most probably would never recover, was paralyzed from the neck down and had to be attended 24/7. Who is going to pay for that, and why not just let him expire? Most likely the Oregon taxpayers were paying for his care. All that money could have been spent on someone else that could have benefited from it. I hope I would never have to make that kind of decision, myself. I have told my sister that I don't want to be kept alive by mechanical means. Also, I fully agree with the right to die laws that Oregon and Washington have.
Posted by ujfoyt on August 12, 2009 at 9:23 AM · Report
7
@Mr.V. You're right that as a journalist I have a responsibility to seek out lies and expose them. So I'm going to start by answering your points.

1.The article you cite on cost is from mid July, quotes a CBO member who doesn't even mention those specific costs. More importantly Blumenauer was speaking a month later, which is a lifetime in the evolution of this reform. His cost estimates are the best we currently have.

2.For the fiftieth time, if you like your current plan, you will be able to keep it. I'm feeling like a broken record. But it's worth mentioning that employees have no choice in the plans offered by their employers, now. I don't see why you say that would be a negative effect of reform?

3.This "end of life issue?" Currently, Medicare does not pay for elderly cancer patients to have a discussion with their doctor about their care options. Instead, Medicare is rigged so that elderly people are given test after test after test and treatment after treatment, even if it all has little chance of improving their chances of survival. The reason for this? To put more money into the hands of hospitals. What's being talked about is allowing patients to be realistic about their chances. If they want treatment, they get it. If they don't, that's okay, too. Nobody's going to kill your grandmother. Although it's hardly surprising that most Americans are terrified to talk about death. And it's hardly surprising that the right is capitalizing on our fear of death to scupper these reforms, either. What IS surprising is that you, who I doubt own shares in any medical providers and therefore don't stand to continue profiting from the inefficiencies in Medicare, are so eager to do the bidding of the corporations.

4.Illegal immigrants are not covered by the reforms. Sorry. Personally I would love it if they were, but I'm aware that it would drive people like you nutty, and so, if that's the price of passing the reform this time around, I'm willing to pay it.

ujfoyt:

Right to die is one thing, but this reform is about giving people options and letting them choose. It's not about deciding the value of one life against another. Doctors won't be revoking their hippocratic oaths.
More...
Posted by Matt Davis on August 12, 2009 at 9:49 AM · Report
8
What the hell is going on when I'm rooting for Matt Davis to take down a troll?

Come on Matt, post some inane article on soccer or puppies in bars or something. This crap where I agree with you is getting on my nerves.
Posted by Graham on August 12, 2009 at 10:12 AM · Report
9
Graham: You can expect normal service to return shortly, I promise. But this health care issue is too important for all of us and I'm glad you're on board. Please talk with your friends and family about the proposed reforms, too!
Posted by Matt Davis on August 12, 2009 at 10:37 AM · Report
10
Matt:

1. Here is the actual language used by the CBO in its final report:

"According to CBO’s and JCT’s assessment, enacting H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period."

http://cboblog.cbo.gov/?p=332

Care to issue a correction now?

2. You say: "For the fiftieth time, if you like your current plan, you will be able to keep it."

This is simply untrue, and ipse dixit assertions, whether by you or by Obama, don't make it true. The effect of the plan will be to move tens, if not hundreds, of millions of Americans off their current plan. It is simply a lie to say that "you will be able to keep your current plan." YOU WON'T. Please address the issue instead of repeating the President's dogma.

3. Thank you for illustrating the problems inherent in Medicare's treatment of the elderly. Now tell me why you want to further expand government interventions in health care and put *all of us* on Medicare. The facts are these:

- Most speakers in support of the bill, including the President, have noted that the majority of a person's lifetime health care expenditures are in the last six months of life;

- A stated goal of the bill (even though logically impossible) is to reduce costs;

- Obama has wondered aloud (on more than one occasion) whether expensive medical treatment for the dying is "sustainable".

Given that, only a fool would not conclude that there is some risk that the government, once in control of health care, will simply say, "We've spent enough on you - now please die." Ignoring this, or trying to explain it away, doesn't reassure people. In fact, it convinces people even more that you are trying to pull the wool over their eyes.

3. Democrats specifically voted down the only enforcement mechanism that would have prevented illegal immigrants from receiving treatment under the bill, as the link I posted earlier shows. Is it your position (and Blumenauer's) that people who have entered the country illegally will refrain from receiving medical treatment under this bill.. because it's illegal?

I actually don't care about the immigrant issue -- but that was simply a falsehood out of the mouth of Blumenauer that needs to be corrected.
More...
Posted by mr. voluptuous on August 12, 2009 at 10:39 AM · Report
11
@Mr.V

I'm not looking for an argument, and stand by what I wrote in my last post. You seem to be the one willfully spreading misinformation.
Posted by Matt Davis on August 12, 2009 at 12:24 PM · Report
12
My main factual take-away from the Blogtown discussion here: Mr. V wants to personally murder 50+ million Americans.

Ick.
Posted by Jack Acid on August 12, 2009 at 12:42 PM · Report
13
I also I didn't expect to be getting a high quality discussion of the health care debate. Well done, sir. Well done.

And thanks for the rough transcription of the Blumenauer call!
Posted by catbot on August 12, 2009 at 12:42 PM · Report
14
As I recall, the context (boo context!) of Obama's statements about his grandmother was that the surgery was both expensive and painful, and afterward she was essentially bedridden. This is a result that many reasonable people would be unsatisfied with.
Posted by atomic on August 12, 2009 at 1:56 PM · Report
15
> You seem to be the one willfully spreading misinformation.

Good response! Guess you don't have an actual substantive retort. This, by the way, was simply a lie on your part:

"His cost estimates are the best we currently have."

The CBO was created to provide objective, nonpartisan budget analyses of pending legislation. That's exactly what it's done, and Obama, Blumenauer, and their lickspittles in the media, including you, are lying when they say the bill will be deficit-neutral. There's no two ways about that question.

If you want to argue that we *should* be spending more money on health care and that deficit spending in order to do that is OK, that is an honest argument. Lying about it is simply shameful. But what else do we expect from Obama's cheer squad?

> Mr. V wants to personally murder 50+ million Americans.

Good one! Keep saying things like that, preferably as loudly as possible. Get a megaphone, in fact. People who want to maintain the current system want to personally murder 50 million Americans. That's sure a convincing argument.
Posted by mr. voluptuous on August 12, 2009 at 2:07 PM · Report
16
Shitty troll is shitty. Was 2/10, now it's 1/10.

Mr. V, please return to your Medical Industrial Complex overlords for your new talking-points. The ones you have are getting rather stale.
Posted by Graham on August 12, 2009 at 2:17 PM · Report
17
See.

Ick.
Posted by Jack Acid on August 12, 2009 at 2:20 PM · Report
18
Does anyone have any actual responses? Anyone want to point out how and/or why the CBO is wrong? Anyone? Bueller?
Posted by mr. voluptuous on August 12, 2009 at 2:53 PM · Report
19
The CBO estiamates are incorrect because they were making their estimates on what is now an out-dated version of the bill.

The bill has changed since they made their initial estimates, so their estimates are no longer valid.

Are you fucking retarded and unable to understand simple timelines and logic? Mr. Matt Davis has already told you this. You are attempting to be willfuly ignorant on this topic. But then... I am responding to a shitty troll, so I guess I'm dumb as well.
Posted by Graham on August 12, 2009 at 3:01 PM · Report
20
> The CBO estiamates are incorrect because they were making their estimates on what is now an out-dated version of the bill.

Wrong. The revenue and spending provisions of the bill have not substantively changed since it was introduced in committee. The CBO's latest letter on the bill sticks to its previous estimate:

http://www.cbo.gov/ftpdocs/104xx/doc10400/07-26-InfoOnTriCommProposal.pdf

Anyone else? Care to point me to the changes that have been made in the bill to make it deficit-neutral?
Posted by mr. voluptuous on August 12, 2009 at 4:02 PM · Report
21
@Mr.V.

What Graham said. See the date on that document: July 26, 2009. Two and a half weeks ago, in a process that has been moving miles by the day.
Posted by Matt Davis on August 12, 2009 at 4:15 PM · Report
22
Mr. V,

I enjoy when you try and link to things are are supposed to bolster your argument, except that they don't. You're not very good at this.

To quote the CBO's paper, "our analysis to date does not represent a formal or complete cost estimate for the draft legislation". So their numbers aren't to be taken as anything other than a back of the napkin calculation.

The CBO's estimates were also made of a July 14th version of the bill. The bill was last amended on July 31st. Therefore, there have been changes made to the bill and their estimates need to be revived.

Get back to me when your arguments can carry some water on their own.
Posted by Graham on August 12, 2009 at 4:21 PM · Report
23
If people would get as pissed off about the price of gas and diesel (and the ungodly amount of profit the oil companies are making), I would be very happy.
Posted by ujfoyt on August 12, 2009 at 8:05 PM · Report
24
> The CBO's estimates were also made of a July 14th version of the bill. The bill was last amended on July 31st.

> Two and a half weeks ago, in a process that has been moving miles by the day.

What has changed in the bill? It's funny that you say that, because no one else out there is saying that the revenue/spending aspects of the bill have been changed. What are the changes? Either you cover fewer people, fewer procedures, or tax more. Which is it? I have yet to see a single news report on these supposed changes, and I've been reading it all. So enlighten me -- what are the changes since the CBO score that have made the bill revenue-neutral? You couldn't just be making it up, could you?
Posted by mr. voluptuous on August 12, 2009 at 11:21 PM · Report
25
Mr. V,

You seem to be laboring under the idea that anyone but you is arguing about the "deficit-neutral-ness" of the bill. what everyone else is saying is that the CBO numbers were an early estimate on a bill that has since been amended and changed and is still be hashed out in committee. Therefore, the CBO's numbers are worth about as much as your continually flawed opinions, fucking nill.
Posted by Graham on August 13, 2009 at 8:49 AM · Report
26
Hmm.. I wonder why the attitude and defensiveness when asked for something as simple as the cost of the bill?

"The Democrats’ health care bills have stirred widespread and deeply felt opposition. While some of the protests are organized, the turnout and strong feeling expressed indicate that we are watching something that is largely spontaneous. Try organizing such a protest when almost no one cares much about your issue: no one will show up. It’s the supporters of the Democrats’ health care bills, not their opponents, who are astroturfing—and spending plenty of moolah on television ads and the like."

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/Democrats-flummoxed-by-health-care-protests-52904087.html

"The Democrats are understandably stunned. They and those sympathetic to them do control everything—the White House, Congress, the mainstream media, the popular culture, and elite education. And they still—despite all that power—can’t get the public to pipe down and go along quietly with their planned takeover of health care. What is wrong with everyone? You can sense the anger, the resentment. And the panic."

http://www.commentarymagazine.com/blogs/index.php/rubin/75912

Game over. You've lost the argument.
Posted by mr. voluptuous on August 13, 2009 at 9:33 AM · Report
27
Mr. V, you should look at the quality of your sources when trying to make any sort of reasoned argument. This is why you are always full of shit.

#1: You're quoting from a blog post from an iffy free daily that is edited by a number of former Fox News employees. That is not a source. That is quoting an opinion piece from a very opinionated shitty paper.

#2: Then you quote from another blog post, but this time it's from a magazine that focuses of Judaic issues. But then when the quote is read in context, you realize that the author is just saying that the sales pitch being used by Democrats needs to change.

Neither of these things backs up anything you say or says anything new. What the fuck is wrong with you? Do you think that using too much block quoting and linking to dumb fucking articles makes a point? Try linking to sources that are relatively unbiased and can pass the basic smell test.

Get thee back to Free Republic and leave our vile den of hipsters and homos alone, douche-munch.

Posted by Graham on August 13, 2009 at 9:44 AM · Report

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