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There is a moment in the "ABC Health Care Town Hall" where President Obama gets in a nice little jab at former Aetna CEO Ron Williams. After Ron cries a little freaking river about the potential for a public option, Obama reminds Ron "Millionaire on the Backs of Denied Claims" Williams that even with a public option Aetna shareholders will do great.

Well, it appears that without the threat of a public option, Aetna is just doing fan-freaking-tastic.

Aetna Inc. (AET) posted a 30% increase in fourth-quarter profit, offered a far better-than-expected 2011 forecast and significantly raised its dividend as the health insurer benefited from people's lighter-than-usual use of medical services and new pricing on its health plans.

Please excuse me while I take a moment for a bit of cathartic Will Ferrell-esque unadulterated RAGE.

Ron Williams has the nerve the complain last year about a "level playing field," but at the same time his company actively stacks the deck against policyholders by raising premiums and pushing more and more individuals into junk plans with deductibles ranging from $1,000 to $10,000 (or higher). There's your "lighter-than-usual use of medical services" -- when everyone in America is losing his or her job or failing to get wage increases, but their bastard insurance company pushes them into a plan where they need to spend thousands they don't have to get any covered medical care, of course people are going to use less care.

Ron, if one of those individuals using less care is foregoing a cancer screening, you have their damn blood on your hands as you enjoy your American public-financed retirement.

Ron, if one of those individuals using less care is foregoing a heart screening, you have their damn blood on your hands.

Indeed, all of the executives at Aetna who persist in acquiring massive amounts of "economic rent" by virtue of grossly inflated salaries, have blood on their hands if their efforts to raise premiums and make their insurance policies even "junkier" than they already are leads to an individual not seeking the care he or she needs.

Aetna (and CIGNA and Humana and United Healthcare) is exactly the reason why we must keep fighting on the state level for single-payer schemes and robust public options. A good place to start is by joining the fight at Physicians for a National Health Program.

While it would be horrible to repeal the Affordable Care Act, the reality is that the Affordable Care Act does nothing more than try to jerry-rig a horrid, immoral and unethical private insurance model into a kind of pseudo-social insurance. Unfortunately, it does so at immense cost to the American public and its government -- forcing government to subsidize private insurance premiums that are not capped (or even regulated), and still leaving tens of millions un- or underinsured.

If we had a Medicare-for-all, single-payer system, Aetna could still realize profit gains of 30 percent (or more) selling junk insurance to those who want private hospital beds or gold-plated care that Medicare should not have to provide, but at least the broader public would not be collectively subsidizing these unlimited profits through the lack of a public alternative to "corporate care."

UPDATE: Fans of corporate care should not be worried if they love Aetna or CIGNA as much as they do Trader Joe's or Starbucks (respectable corporate citizens). Big-profit insurers are looking abroad to sell their policies in Europe and Asia to individuals who want a little more "gold" on their government plans. That is the proper place for private health insurance -- supplementing government-provided, basic benefits that you can never lose.

UPDATE II: Just got off the phone with my uncle suffering from major heart issues who has a small-business plan with Aetna. Almost every hospital bill was initially denied, and then he had to call to have bills dealt with by Aetna. Aetna claims they will fix problem, but then they never do. Another phone call. Repeat. I'm not sure Aetna is intentionally denying claims, but the for-profit, employer-based "non-system" of health care in this country seems so damn broken that even the insurance companies themselves can't operate within its confines. Why do we punish ourselves like this day  in and day out? The system isn't working for anyone...and I'm upset that Aetna is causing my uncle further heart troubles dealing with their horrible non-governmental bureaucracy.

Originally posted to james321 on Sat Feb 05, 2011 at 12:20 PM PST.

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Comment Preferences

    •  Every CEO of a health insurance company should be (5+ / 0-)
      Recommended by:
      Kitsap River, Uberbah, pyegar, GeeBee, james321

      tattooed on their forhead that states, they kill people knowingly. What is going to happen when only the 1% can afford premimums? Where will their profits come from?

    •  The logic that supports.... (5+ / 0-)

      single payer, universal health care is overwhelming in favor of social well-being.  What I can't ever get my head around is the consequences of an uninsured populace in an ever more expensive health care environment.

      Uninsured people who get very sick can't pay for their medical coverage AND their home.  Something has to go.  We have seen that the banks are flooded with repossessions with no market for them.  Uh. Oh.  Furthermore, a sick work force is NOT a productive workforce.  A non-productive workforce doesn't add as much to the GDP and therefore doesn't pay as many taxes to support all the other things our government does.

      So why in the world, other than complete, abject greed would we the people not want universal, government sponsored health care?  The government, as witnessed by the hugely successful Medicare and VA care, doesn't interfere with doctors' decisions like the cost accountants at insurance companies do.

      Is this our DUH! moment to go along with everything else that needs to be pulled out of the shit from 8 years of Bush?

      "Have a beginner's mind at all times, for a beginner knows nothing and learns all while a sophisticate knows all and learns nothing." - Suzuki

      by dolfin66 on Sat Feb 05, 2011 at 01:52:15 PM PST

      [ Parent ]

      •  Great argument - we have sick people... (5+ / 0-)

        serving us food at McDonalds, sick people washing the dishes at fancy restaurants, sick people cleaning offices, sick people manning the cash registers at Wal-Mart. All these grossly sick people in our economy getting everyone else sick because they don't have the ability to see a doctor.

        Let's also not forget that the USA is the only developed country on the face of the Earth that does not require employees to provide SICK DAYS...the USA is a PUBLIC HEALTH DISASTER unseen anywhere outside of the third world.

        •  I think you mean.... (2+ / 0-)
          Recommended by:
          Kitsap River, james321

          employers providing sick days.

          But, you're right about everything else.  Money and greed overrule everything else including the citizens' health.  This dark side of capitalism is perhaps the darkest of all.

          "Have a beginner's mind at all times, for a beginner knows nothing and learns all while a sophisticate knows all and learns nothing." - Suzuki

          by dolfin66 on Sat Feb 05, 2011 at 02:22:18 PM PST

          [ Parent ]

    •  Thanks for the tips, guys! (1+ / 0-)
      Recommended by:
      Kitsap River

      How can the big-profit insurers whine and moan about essential benefits and the MLR ratio when they are making record profits?

      These people -- cue the cliche -- have no shame.

  •  Your last paragraph sums up (4+ / 0-)

    most succinctly why single payer would work for everyone.

    I just got an Aetna policy this week through my employer, for what appears to be a reasonable rate, but when I get a chance, I'm going to delve into the fine print to see what kind of junk I'm actually paying for.

    •  Thanks so much for the compliment! (4+ / 0-)
      Recommended by:
      Kitsap River, Thestral, priceman, mideedah

      I agree -- what the "corporate care fans" don't realize is that under single-payer care, they would pay less in tax than they are currently paying now for basic care, and could STILL spend all the money they want on letting Aetna or CIGNA sell them a junk policy for their private bed. Indeed, that's what CIGNA says its market strategy is moving forward -- supplementing government plans in Asia and Europe.

      They just don't want us to have a government plan in the US, because they want to keep us totally hostage...forever.

      •  They are not holding us hostage (2+ / 0-)
        Recommended by:
        priceman, james321

        Nor do they determine if we have a government sponsored system. They do of course lobby heavily, as is their right, but the lack of single payer falls squarely on the shoulders of our elected officials. In particular, the Democratic majorities we elected along with Obama.

        •  Yup, I agree with YOU! (1+ / 0-)
          Recommended by:

          I like to get upset with big-profits insurance for lobbying against government care, but then I think how cowardly the Democratic Party was not to be able to stand up to these hostage takers...

          You can bomb other countries without thinking twice about it, but just creating a little public option to provide some health security for your own people is too fucking much?!

          Again, I agree.

        •  Obama never promsied single payer (0+ / 0-)

          I know he took it off the table when perhaps it shouldn't have been, but it's not like he broke a promise.

          Single payer would mean that all domestic insurance companies would likely go out of business. Which means all the people there will lose their jobs, from the top people to the bottom people.

          I support single payer, but it's far too big a step to do nationally at this point.

          People panic too much on this site.

          by thematt523 on Sat Feb 05, 2011 at 01:31:42 PM PST

          [ Parent ]

          •  Two points... (4+ / 0-)

            1.) Single-payer would mean that the corporate insurance companies would have to downsize, but they would still stay in business selling supplemental policies and policies to other countries (i.e. China). In Australia, the wealthy are required to purchase private policies to take pressure off the public system, or they pay a higher amount of tax. Also, most single-payer bills account for this and include funds for retraining laid off insurance company workers. Change is hard and change hurts sometimes.

            2.) He did promise us a public option -- which would have made ACA much more tolerable.

            I think, even if we had single-payer, private insurers could still play a role in the regional administration of the scheme.

            Just my two cents, but I agree with you that he never promised single-payer. You're right, and you're also right that national single-payer probably won't come anytime soon -- all the more reason why we need a robust public option.

            •  We have to think big again... (0+ / 0-)

              in America. The same arguments against single-payer could have been made against abruptly ending slavery, but I think we can all agree that an abrupt and immediate end to a morally abhorrent policy -- at any cost -- is better than keeping business as usual and suffering through a long period of incrementalism. Life is too short to keep suffering with these big-profit bastards at Aetna, CIGNA, etc.

  •  Great Diary! (3+ / 0-)
    Recommended by:
    Kitsap River, evangeline135, james321

    As usual I don't have much to add, I'm all talked out and mentally exhausted.

    My only hope in the reform bll was the preexisting condition plan and I can't even afford that.

    See my sig-

    I had cancer, I can't get insurance, if my cancer comes back? The Plan: Walk It Off!

    by ArtemisBSG on Sat Feb 05, 2011 at 03:23:56 PM PST

    •  Sorry to hear of your cancer... (1+ / 0-)
      Recommended by:
      Kitsap River

      My mom was just in tears today b/c she got a letter regarding life insurance, and some insurance bureaucrat wanted her to pay to turn over all her medical records to them b/c she had stage I breast cancer five years ago.

      I hate how the pre-existing condition plans are so expensive, and that you have to go six months without coverage first. That's like the government encouraging you to make bad decisions!

      I'm sorry for your struggle -- health insurance will never be easy until we get single-payer in America.

      Just this week I read a study saying how much of a pain it will be for people going in and out of Medicaid eligibility, and how they will lose coverage for weeks, months at a time as they deal with finding new coverage (which the big-profit companies won't make easy).

  •  Misdirected anger (0+ / 0-)

    The purpose of a for-profit corporation is to make profits -- as much profit as they can without actually breaking the law.  The game is to make enough of a return on investment so that you stock value goes up and you are a more attractive investment than other for-profit corporations.  That's what for-profit corporations do.  If the officers and directors of a for-profit corporation don't do everything they legally can to make profits, they can (and often are) sued by their shareholders for violation of their duty to the corporation.  

    It is amazing to me when people who should realize this -- like elected officials -- act shocked, surprised, or outraged when a for-profit corporation does everything it legally can to increase its profits.  Um, Duh?  Why do people expect that they will do anything else?  That's what they are SUPPOSED to do.

    For-profit corporations are going to put profits first.  That's as basic as the sun coming up tomorrow.  Legislation has to be written with that as a given.  

    If you don't want the focus to be on increasing profitability, you have to change the system so that you aren't dealing with a for-profit corporation.  Or, do like regulated utilities -- give them a monopoly and, in exchange, limit the profits they can earn.  There are areas where we have decided that we do not want the for-profit system operating.  When we do that, of course, THEN we can expect that something other than increasing profits will be the first priority.    

    But really, setting up -- or allowing -- a system where a for-profit corporation operates in a particular area and then suddenly saying, "They are doing everything they can to make profits!!! I'm shocked, SHOCKED!!" is just disingenuous.  That's what for-profit corporations DO.  Profits ARE their first priority.  Legally, we've set it up so that profits HAVE TO be their first priority.  

    Anybody in a position of power or authority who doesn't understand that doesn't belong in that position.  Anybody who legislates without understanding that basic fact doesn't deserve to be in office.  

    •  Perfect argument ditching for-profit basic care (2+ / 0-)
      Recommended by:
      Kitsap River, Danali

      You make a great argument above for why we need single-payer care in America. The most ardent advocates -- and I count myself among them -- will all agree that for-profit insurance companies aren't charities, they have the fiduciary responsibility to make profits. And, that's exactly why they shouldn't be in the position of having to grapple with providing basic health care insurance to an entire population as a result.

      •  You have one of three choices when dealing (0+ / 0-)

        with any industry.  

        1.  Have a for-profit system with the expectation that profits are going to drive the industry, and legislate so that the profit motive creates benefits such as increased innovation and competitiveness.
        1.  Have a monopoly/utility model where you legislate the product or service that is provided, the charge for that product/service, and allow profits, although you limit the product.  
        1.  Have a system removed completely from the profit motive and run entirely through an entity like a government entity.

        Each of the three models has benefits and drawbacks, and the benefits and drawbacks have to be weighed in the context of your particular goals.  

        However, it seems nonsensical to me to have system 1 in place in a particular industry and then to say, "they're trying to increase profits!  I'm horrified!"

        •  I'm sorry, but our anger is also justified... (1+ / 0-)
          Recommended by:

          when these for-profit companies a significant amount of their resources (our premium dollars) to lobby against a saner non-profit health insurance system (like Medicare for all) for our country.

          We have a right to be angry when these for-profit corporations engage in unethical and dirty behavior -- like that detailed in Wendell Potter's Deadly Spin.

          •  You have a right to be angry if they (0+ / 0-)

            violate the law, of course. I would completely agree there.  Law-breakers should be prosecuted.  Including corporate officers who violate the law.  They should be prosecuted.  

            But a for-profit corporation legally has to do everything reasonably possible within the bounds of the law to increase value for its shareholders.  That's the legal duty of its directors and officers.  Those who write the laws have to expect corporations to do that.  That's just reality.

            If legislators don't want them to do certain things in their quest for profits, legislators have to write laws to that effect.  That's where the blame lies. If there are LEGAL things a for-profit entity can do to increase its profits, those who make the laws have to expect that the for-profit entity will do those things.  A for-profit corporation has to, or it violates its legal duty to its shareholders.    

    •  We have every right to be angry at for-profit (2+ / 0-)
      Recommended by:
      Danali, james321

      businesses. It's not disingenuous to be angry that these people are destroying lives with their greed - you may as well say that anger at sweatshops is "misdirected", because the system should not allow the sweatshops to exist in the first place.

      Here's to our last drink of fossil fuels - may we vow to get off of this sauce. Shoo away the swarms of commuter planes...and find that train ticket we lost.

      by terra on Sat Feb 05, 2011 at 03:46:17 PM PST

      [ Parent ]

      •  That's why laws were passed limiting (0+ / 0-)

        things employers can do, of course.  

        If you perceive an injustice, it makes sense to direct your anger at people who can do something to prevent that injustice.

        A for-profit corporation has a legal obligation to do everything within the boundaries of the law to increase shareholder value.  That's the system that we (i.e., through our elected representatives) have set up.  Google "shareholder derivative suits."  Thus, the CEO of a for-profit corporation has a fiduciary and legal obligation to do everything he can within the bounds of the law to increase shareholder value.  If he doesn't, he can be sued by the shareholders.  That's the legal system we have set up.  Because of that system, it is absurd to think that a CEO is going to do anything OTHER THAN do everything he can, within the bounds of the law, to increase shareholder value.  Legally, that's what he HAS to do.  

        That's the system "we" (in the collective sense) set up. (There are some benefits in some contexts to that system and some detriments.)  It is ridiculous to set up that system and then to expect that the system will not operate in the way we set it up to do.

        If we DON'T want a CEO to do everything he can within the bounds of the law to increase shareholder value, we need to change the system within which that CEO operates.  If you don't like the system, the anger needs to be directed to those who set up the system, not so much at those who are playing by the rules of the system.  (Again, I do not include in that anyone who breaks the law.  Breaking the law should be prosecuted.  Absolutely.)    

        •  Fair points, but it's also perfectly reasonable (0+ / 0-)

          to express anger towards for-profit corporations that spend customer money lobbying so that it is extremely difficult -- in the context of our current socio-political climate -- to switch from a for-profit system to a regulated utility or government-run system.

          You're right that politicians are ultimately responsible for the nature of our laws and our business operating environment, but we can also express extreme anger at the companies that we are stuck with in the present doing everything that they can to avoid the system changing.

          Unfortunately, we have no other choice except to play hard ball with the insurance companies when they try to play hard ball with our lives.

          •  Again, our system says that lobbying is legal (0+ / 0-)

            I don't know why anyone would expect that the oil industry, the farm industry, the rubber industry, the steel industry, the plastic industry, the coal industry, and every other industry we have to lobby, but the insurance industry won't?  Of course they will.  The anger you express about lobbying is, in my view, again misdirected.  It seems to me that your underlying problem is that (1) lobbying is legal; and (2) lobbying is effective at getting things for industries that lobby.  Both of those are reasons to expect that every industry will do it, and both of those are reasons that any problem people have with the system where lobbying pays off needs to be directed to the people who can change that -- the legislature.  Again, as long as lobbying is (1) legal and (2) effective at helping an industry become more profitable, why on earth would anyone expect that people who have a legal obligation to do anything they legally can to increase profits would NOT lobby?

            I'm not saying that the profit motive is moral or immoral.  It is neither.  It just is, and many industries are based on it.  It has some benefits, and some detriments.  But when the collective "we" sets up a system where the officers and directors have a legal obligation to do everything they legally can to increase shareholder profits, it is just silly to be angry at them when they do just that.  That is what the collective "we" have told them they MUST do.  

            I'm not saying the anger is unjustified.  Just that it is misdirected.  

    •  Your premise is out of a right wing fairy tale. (3+ / 0-)
      Recommended by:
      SingleVoter, Danali, james321

      You fundamentally start with a right wing myth about corporations--"the honest drive toward profits is the sole concern of corporate officers".
      Total fairyland understanding of how corporations actually work--sorry.

      The first task of most corporate officers is to maximize and rig the system of corporate goverance toward their personal wealth and bonuses.  The ideal is that as they increase value, they in turn get more money.  But this is also fairyland thinking.  As the book In Search of Excess had shown, corporate execs rig the system so they become rich regardless of company results.

      As a result, their behavior and goverance is driven by personal greed, not serving some mythical capitalist creature call the "shareholder".  And from there both unethical and illegal behavior starts to ripple through a company.  

      Give the right wing propaganda about the mythical shareholder, any action is then valid and excused, as this mythical creature must have his profits.  

      You assume that corporate execs act according to the rules of corporate competition--they don't.  You have fallen fundamentally for right wing propaganda about the workings of corporations.

      Now  you solution your alternatives are of course good, but sorry, too much naiveness about the inheratnt corruption of corporations and their execs.

      •  Thank you - good response! (2+ / 0-)
        Recommended by:
        MrWebster, Danali

        Those who perpetuate a broken system for their own advantage are just as guilty as those creating and sustaining the system.

        •  And they broke the system (2+ / 0-)
          Recommended by:
          Danali, james321

          I re-read coffetalk's points and it fundamentally is an apologist argument for illegal and immoral corporate behavior.  They after all, are just doing what we  in essence told them  to do.  Sorta like blaming the victim of a robbery for the robbery because we created the system of streets they used  to escape capture.

          The point is that corporations are not simply some neutral, unblamed actor which the poster wants us to believe following the fairytale rules of competitive engagement.  

          They are in effect the causative agent of the corruption.  We didn't give them permission to deny legit claims, which I suppose coffee in the end would deny as bad behavior because we didn't have a particular law or system in place--we just told them to make a profit.  It is our fault, not the person who just may have killed a relative for the sake of profit.

          •  No, denying legit claims that they (1+ / 0-)
            Recommended by:

            contracted to cover is not within the bounds of what I call "legal" behavior.  

            A company that knowingly and intentionally breaches a contract that causes that kind of harm ought to be sued into oblivion.  

      •  Corporate officers who enrich themselves (0+ / 0-)

        at the expense of shareholder value are not acting within the bounds of the law.  

        That's why shareholder derivative suits were invented.

        And, if corporate officers enrich themselves at the expense of shareholder value, that's when they should be used.  

  •  Aetna denied my Tegaderm (3+ / 0-)
    Recommended by:
    denise b, evangeline135, james321

    I need Tegaderm to cover up my catheter exit site; it's necessary to keep me free of infection. Since the catheter goes straight into my jugular vein, which in turn goes straight to my heart, this is a major issue.

    I needed Tegaderm when I had a peritoneal catheter, too, so my physician prescribed it for me. Aetna promptly denied it, saying it was an adhesive. It is not. It is a wound dressing, not an adhesive. The fact that it has adhesive on it should be secondary; it does not replace tape.

    In fact, I am allergic to all tape, bandaids, etc. I can use non-adhesive "tapes" like Coban, or I can use Tegaderm where Coban is not applicable, such as around my abdomen or my neck. My physician spent over 3 hours that he could have spent with patients on the phone with Aetna trying to get this approved, but they continued to deny it. I wound up purchasing it out of pocket and it is very expensive.

    To this day, we have to purchase my Tegaderm out of pocket. We are now with Blue Cross. I do not currently have a prescription for Tegaderm; instead, my nephrologist's nurse just mails me some from the hospital. That is probably more expensive to the insurance company than my going to the specialty pharmacy and purchasing it with a prescription. It makes no sense.

    They don't cover the barrier film I need on my skin before any adhesive (Tegaderm included) is placed on me; if I don't use that, I get a rash with weeping sores, which is extremely dangerous if it's in an area where I am accessing a vein.

    Living kidney donor needed; type B, O, or incompatible (with paired donation). Drop me a note (see profile).

    by Kitsap River on Sat Feb 05, 2011 at 03:38:04 PM PST

    •  All this time on the phone... (2+ / 0-)
      Recommended by:
      Kitsap River, mrsgoo

      Sorry to hear about your Aetna troubles -- common sense is not common to these bastards. Flu shot? NO! ICU for swine flu? YES! Malaria meds for that trip to Ecuador? NO! Malaria treatment when you get back and wind up on death bed? YES!

      I've spent hours and hours and hours on the phone arguing with Aetna over things as small as 30 dollar bills - clearly, the time we're spending arguing is worth more than them paying the bill, but they don't care. It's insane -- and that's why doctors are charging us so much.

      Aetna's CEO says we need to reduce health care costs as part of real reform! I agree -- and Aetna needs to start by firing itself! B/c a major cost of health care in America is doctors and hospitals having to hire hundreds and hundreds of medical billers to spend hours on the phone haggling over 50 dollar insurance claims. Aetna and the big-profit insurance corps ARE THE reason why health care costs so damn much.

    •  prices from Canada (1+ / 0-)
      Recommended by:

      6 cm x 7 cm - 1 each  -  $2.99  
      6 cm x 7 cm - 6 each  -  $7.49  
      6 cm x 7 cm - 100 each  -  $39.99
      10 cm x 12 cm - 50 each  -  $85.49
      15 cm x 20 cm - 10 each  -  $46.99
      20 cm x 30 cm - 10 each  -  $59.99

      I'm not sure if these are of the right type or are cheaper.

  •  I prefer Nicolas Cage rage (1+ / 0-)
    Recommended by:

    No, seriously...I feel just like this video right now.

    Here's to our last drink of fossil fuels - may we vow to get off of this sauce. Shoo away the swarms of commuter planes...and find that train ticket we lost.

    by terra on Sat Feb 05, 2011 at 03:42:02 PM PST

    •  Oh NO! Dealing with a big-profit insurance corp? (0+ / 0-)

      Do you have insurance company rage?!

      It's a real problem - it's called PIISD. ;)

      •  "Feelings of alienation from and abandonment (1+ / 0-)
        Recommended by:

        by one’s countrymen"...sums it up! I think half the country gets it. A quarter are confused. And the remaining quarter doesn't give one shit what others are going through as long as they are personally comfortable for the time being.

        Here's to our last drink of fossil fuels - may we vow to get off of this sauce. Shoo away the swarms of commuter planes...and find that train ticket we lost.

        by terra on Sat Feb 05, 2011 at 03:48:02 PM PST

        [ Parent ]

        •  Honestly, I didn't "get it" until after college.. (1+ / 0-)
          Recommended by:

          It wasn't until well after college that I realized other countries didn't "do" health insurance like America does...and I went to a great school and have traveled to 26 countries.

          Unfortunately, like the old Soviet Union or North Korea, a lot of people in America just don't know that there are better ways to do things outside of our borders. This is the result of both American tendencies to be very insular, and American exceptionalism.

          Most people in America just don't get or know that there is a better system in place in almost every other developed country...we don't need to keep punishing ourselves with Aetna or CIGNA's greedy, evil behavior.

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