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Doctors back Medicaid Expansion

A

Anonymous

Guest
Doctors back Medicaid expansion in talks with Bullock
15 hours ago • By Tom Lutey


Billings-area residents living at or near the poverty level desperately need the improved medical access offered by Medicaid expansion, RiverStone Health officials told Montana’s governor Thursday.

Doctors say it has become increasingly frustrating to watch from the sidelines as Medicaid expansion bills founder in Republican-controlled committees.

Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.

Afterward, the federal government would reduce its support to 90 percent by the end of the decade. Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.

RiverStone sees a lot of working people who lack health insurance and don’t qualify for Medicaid, said Dr. Megan Littlefield, RiverStone medical director. Those patients often put off medical care because they can’t afford it and end up in worse health and needing more care.


“I was seeing patients this morning, and 50 percent of the patients I saw were uninsured. All of them were employed. And instead of being able to just make medical decisions based on the judgment they have, it becomes a negotiation,” Littlefield said.

“I recommend A. They can’t possibly afford A. So we have to think about well, can we do B? ‘No, we’re not sure if we can afford B right now. I’m saving up money. Maybe I’ll be able to in a couple months.'

“Their medical decision is truly not a medical decision. It becomes a decision about what a patient is able to afford, and it’s not providing the highest-quality care I could deliver. It’s frustrating.”

Bullock met with medical providers at Beartooth Billings Clinic in Red Lodge, RiverStone and St. Vincent Healthcare in Billings. The governor said he needs patients and health care providers to contact their Republican legislators and advocate for Medicaid expansion. Several key Republican lawmakers on the Medicaid issue come from Billings and Red Lodge.

Rep. Cary Smith, R-Billings, is vice-chairman of the House Human Services Committee, which will take up Medicaid expansion when it hears House Bill 590 on Monday. Smith strongly opposes the federal Affordable Care Act, which makes the Medicaid expansion possible. Billings Republican Dennis Lenz also sits on the committee.

Sen. Jason Priest, R-Red Lodge, is chairman of the Senate Public Health Committee. He also has been an outspoken critic of the Affordable Care Act, which Republicans call Obamacare.

Republicans ran campaigns on opposing the Affordable Care Act in 2010 as successful Tea Party candidates gave Republicans strong majorities in the House and Senate. They rallied in 2012 around national candidates like Republicans Mitt Romney and Paul Ryan, who advocated scrapping the Affordable Care Act.

However, Republicans in other states have done an about-face when it comes to securing Medicaid dollars that if rejected will be spent in other states.

For governors like "Jan Brewer in Arizona, opposing the Affordable Care Act is part of who she is. For Rick Scott in Florida. For John Kasich in Ohio. I mean, that was at their core and by and large what they were running campaigns on,” Bullock said. “Now, faced with the choice of covering their citizens and creating jobs, it’s become more sensible.”

It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years. Roughly 5,000 new jobs in health care related fields would also be created.


Those new jobs could bring needed general practitioners to Montana counties that have none, said Dr. Zach Meyers, RiverStone’s Montana Family Medicine Residency faculty physician. In Montana, 45 of 56 counties are underserved by doctors, Meyers said. Roughly half of those underserved counties have no doctor.


Read more: http://billingsgazette.com/news/local/doctors-back-medicaid-expansion-in-talks-with-bullock/article_34cb5521-5553-558b-8e3d-e281760984fb.html#ixzz2OHuUiEUv
 

Mike

Well-known member
It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years.

This why many states are rejecting the expansion. These large sums to the state's aren't sustainable.

Someone has to step up and take the high road.
 
A

Anonymous

Guest
Mike said:
It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years.

This why many states are rejecting the expansion. These large sums to the state's aren't sustainable.

Someone has to step up and take the high road.

Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.

Afterward, the federal government would reduce its support to 90 percent by the end of the decade.
Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.

I would just as soon have the money going to help 70,000 Montanans get coverage than have it all go to New Yorkers and Californians... If Alabamy doesn't want it fine with me-- the more that turn it down- the more that's available for the states that take it... Even 90% 10 years from now will help a lot of our folks out... Several MT counties average income is not too much higher than $15,400- with several of the neighboring counties being $22,000- and Montana as a whole's average per capita income only being $24,600...
 

Whitewing

Well-known member
Trust me, in that entire story, this was the only sentence that really interested OldI'mReallyQuiteConservativeYouKnow:

Doctors say it has become increasingly frustrating to watch from the sidelines as Medicaid expansion bills founder in Republican-controlled committees.
 

Whitewing

Well-known member
Oldtimer said:
Mike said:
It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years.

This why many states are rejecting the expansion. These large sums to the state's aren't sustainable.

Someone has to step up and take the high road.

Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.

Afterward, the federal government would reduce its support to 90 percent by the end of the decade.
Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.

I would just as soon have the money going to help 70,000 Montanans get coverage than have it all go to New Yorkers and Californians... If Alabamy doesn't want it fine with me-- the more that turn it down- the more that's available for the states that take it... Even 90% 10 years from now will help a lot of our folks out... Several MT counties average income is not too much higher than $15,400- with several of the neighboring counties being $22,000- and Montana as a whole's average per capita income only being $24,600...

One day it's a BOOMING economy in Montana, the next day they're eating dirt. :roll: :roll: :roll:
 

Mike

Well-known member
Whitewing said:
Oldtimer said:
Mike said:
This why many states are rejecting the expansion. These large sums to the state's aren't sustainable.

Someone has to step up and take the high road.

Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.

Afterward, the federal government would reduce its support to 90 percent by the end of the decade.
Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.

I would just as soon have the money going to help 70,000 Montanans get coverage than have it all go to New Yorkers and Californians... If Alabamy doesn't want it fine with me-- the more that turn it down- the more that's available for the states that take it... Even 90% 10 years from now will help a lot of our folks out... Several MT counties average income is not too much higher than $15,400- with several of the neighboring counties being $22,000- and Montana as a whole's average per capita income only being $24,600...

One day it's a BOOMING economy in Montana, the next day they're eating dirt. :roll: :roll: :roll:

Yep, those biatching about the spending in D.C. want all they can get for free. Do they not realize that nothing is free? :roll:
 

okfarmer

Well-known member
Guess my wife's obstetrician didn't get your memo. She was there this morning and he thinks health care under the dems is in SERIOUS trouble. Said teachers insurance in the state is going to be worthless. Those are his words.

Maybe they can qualify for medicare also?

Glad this obamacare is working out so swell. :roll:



I think OT is a good example of what the progressives are trying to create in our schools. Someone who can read and parrot the "message" but has no critical thinking skills for themselves. I guess the bright side is that at least they won't know it could actually be better.
 

Tam

Well-known member
The Next Exodus: Primary-Care Physicians and Medicare

by David Hogberg

In late 2009 the highly respected Mayo Clinic grabbed national headlines when it announced that one of its primary-care centers was no longer accepting Medicare. Henceforth, Medicare patients visiting its family clinic in Glendale, Arizona would have to pay cash. In 2008 Mayo lost $120 million on Medicare patients at all of its Arizona facilities. At the Glendale clinic, Medicare had covered only about half of the clinic's expenses for treating the elderly.1

When physicians limit their exposure to Medicare by either dropping out of the program or restricting the number of Medicare patients they treat, it seldom receives any press coverage beyond local media, if it receives any coverage at all. Nevertheless, physicians' growing reluctance to accept Medicare patients is becoming a serious problem. If this budding crisis has an epicenter, it appears to be Texas. "Texas Doctors Fleeing Medicare in Droves," blared a Houston Chronicle headline. Data compiled by the newspaper found that Texas physicians were dumping Medicare at a rate of about 100 to 200 per year.2 In 2010 a Texas Medical Association survey found that 18 percent of the state's physicians were restricting the number of Medicare patients they treated, while 16 percent were no longer seeing new Medicare patients.3

Nationally, the number of physicians who still participate in Medicare is unclear. As of 2008 only 58 percent of physicians were willing to see all new Medicare patients, while fully 13.7 percent were no longer willing to see any new Medicare patients, a survey by the Center for Studying Health System Change survey found.4 Both a 2010 American Medical Association (AMA) survey and the 2011 National Ambulatory Medical Care Survey found that about 17 percent of physicians were restricting the number of Medicare patients they treat.5

The evidence suggests the primary reason why physicians are fleeing Medicare is that it doesn't pay enough. Over one-third of physicians surveyed by the Physicians' Foundation in 2008 said Medicare payments did not cover costs.6 Another 2010 AMA survey found that 85 percent of physicians capping the number of Medicare patients they treated cited Medicare's stingy payments as a reason.7 According to the Center for Studying Health System Change, about 62 percent of physicians cited inadequate Medicare reimbursements as either a very important or a moderately important reason why they refused to accept new Medicare patients.8

Yet Medicare's inadequate payment structure does not repel all physicians equally. Among primary-care physicians, who tend to be the physicians who have first contact with a patient, the trend is considerably worse. The AMA survey that found 17 percent of all physicians were limiting the number of Medicare patients they saw also found that 31 percent of primary-care physicians were doing so.9 Because Medicare tends to compensate "specialists" —physicians who focus on one area of medicine— better than primary-care physicians, it is no surprise that specialists aren't limiting their exposure to Medicare to the same extent as primary-care physicians. According to the Center for Studying Health Change, the percentage of primary-care physicians who were no longer seeing Medicare patients was about double that of specialists.10

Texas showed the same pattern. In 2011, the Texas Medical Association found that only about five percent of specialists had stopped taking Medicare as a form of payment, while over 13 percent of primary-care physicians had stopped.11

Survey: 83% of Doctors Considered Quitting Over Obamacare
Monday, 09 Jul 2012 07:44 PM

By Todd Beamon

Eighty-three percent of American physicians have considered leaving the profession over President Barack Obama’s healthcare reform law – and 63 percent have called for repealing all or part of it, according to a survey by the Doctor Patient Medical Association.

The results from the non-partisan association of doctors and patients, founded last fall and headquartered in Alexandria, Va., is based on a national survey of 699 physicians, the Daily Caller reports.

By 2020, the U.S. is expected to face a shortage of at least 90,000 doctors. Because the new healthcare law expands insurance coverage, it will increase physician demand.

“Hands down, doctors blame government involvement for the current problems in medicine, and are not shy to say they want it out,” the association says in a report on the survey findings.

“The reasons cited range from the deluge of regulatory compliance that siphons time away from patient care, to de facto rationing achieved through complex payment schemes, to cushy relationships that favor corporations and special interests in medicine.”

The organization found that many doctors don't believe the legislation will give more Americans quality care, association co-founder Kathryn Serkes said.

“Doctors clearly understand what Washington does not — that a piece of paper that says you are ‘covered’ by insurance or ‘enrolled’ in Medicare or Medicaid does not translate to actual medical care when doctors can’t afford to see patients at the lowball payments, and patients have to jump through government and insurance company bureaucratic hoops,” she said

As for Obamacare specifically, the association said: “Doctors say that a key government provision in the Affordable Care Act, the huge expansion of Medicaid enrollees, is likely to backfire, as 49 percent say they will stop accepting Medicaid payments.”

Washington and Govenor BS I mean SB needs to look north to see the Doctors are RIGHT saying you have healthcare coverage doesn't mean a thing if your doctor is to busy to see you. And Oldtimer if you make one crack about me wanting a doc at my beck and call you will wish you hadn't. :x
 

Tam

Well-known member
Oldtimer said:
Mike said:
It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years.

This why many states are rejecting the expansion. These large sums to the state's aren't sustainable.

Someone has to step up and take the high road.

Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.

Afterward, the federal government would reduce its support to 90 percent by the end of the decade.
Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.

I would just as soon have the money going to help 70,000 Montanans get coverage than have it all go to New Yorkers and Californians... If Alabamy doesn't want it fine with me-- the more that turn it down- the more that's available for the states that take it... Even 90% 10 years from now will help a lot of our folks out... Several MT counties average income is not too much higher than $15,400- with several of the neighboring counties being $22,000- and Montana as a whole's average per capita income only being $24,600...

Typical Liberal if we don't take the money somebody else will get it. :roll:

Tell us you idiot where does the Federal Government get their money? Do they pull it out of their azzes? No, THEY TAX PEOPLE and the more they tax the less you have to pay your bills. :roll: If Obama can't find enough "RICH" guys to pay for all your freebies and medicaid expansion who do you think he will be coming after next? Gawd I hate stupid people and anyone that thinks they are going to get something for NOTHING is on the top of my hate list. :x
 

TexasBred

Well-known member
Montana Gov. Steve Bullock visited a local health center on Wednesday to make the case that Medicaid expansion is good for the state’s economy.

According to the chief executive, “[t]he estimate is 5,000 new jobs in Montana next year alone.” Democrats across the country have claimed that Medicaid expansion will create jobs, with mainstream media outlets backing them up. But is the claim true?

Supporters of the expansion claim that new government spending will create jobs in the healthcare sector. Additional spill-over effects will boost related sectors as well. But this simplistic thinking is looking only at the seen benefits while ignoring the unseen costs.

Cato’s Daniel J. Mitchell explains:

The theory of government-instigated job creation overlooks the loss of resources available to the productive sector of the economy. Frederic Bastiat, the great French economist (yes, there were admirable French economists, albeit all of them lived in the 1800s), is well known for many reasons, including his explanation of the “seen” and the “unseen.” If the government decides to build a “Bridge to Nowhere,” it is very easy to see the workers who are employed on that project. This is the “seen.” But what is less obvious is that the resources to build that bridge are taken from the private sector and thus are no longer available for other uses. This is the “unseen.”

The money for new Medicaid recipients has to come from somewhere. That somewhere is the private economy. By “creating” jobs, the government must destroy them elsewhere. The 21 tax hikes in ObamaCare destroy private wealth by redistributing it through the inefficient bureaucracy of the federal government.

In addition to those 21 national tax hikes, Montana will have to raise taxes to pay for the expansion. Here’s how the expanded Medicaid program is funded:

Obamacare provides additional federal funding to the states for this new expansion population. Starting in 2014, the federal government would pick up 100 percent of the benefit costs for the newly eligible population for three years. Thereafter, this enhanced federal funding would gradually decline to 90 percent in 2020.


Click to view larger

The Heritage Foundation estimates that Medicaid expansion will cost the state $138 million through 2022. After three years of money from the feds, the state will need to find alternative sources of revenue to make up for reduced federal funding.



That means tax increases or budget cuts to other areas of the state government. Either way, that’s money being shifted away from one area and into another. In the process, jobs will be destroyed and jobs will be created. But what would the net effect be? After all, maybe the Governor is right, and 5,000 jobs will be created in one year that are directly attributable to an expanded Medicaid program. But if a higher number of jobs are eliminated in the process, that job “creation” is actually job destruction!

According to Forbes contributor Chris Conover, we could see significant job destruction on the national level as a result of expanding Medicaid:

Based on dozens of studies of this so-called “deadweight loss” or “excess burden” that inevitably accompanies higher taxes, I have calculated that currently every added dollar of federal taxes essentially shrinks the economy by 44 cents. Thus, if we convert this to jobs, we will lose 144 jobs for every 100 health sector-related jobs that are induced by expansion.

Technically, it’s worse than this. On average, health sector jobs pay more than other jobs in the rest of the economy. Thus, we will lose even more than 144 jobs for each 100 health-sector-related jobs.

That’s on the national level overall. On the state level, the situation is a little more complicated. It ultimately depends on how many new people will be enrolled. However, there are a few statistics that could apply to every state:

For the average state, failure to account for the exchange subsidies means that estimated job gains from Medicaid expansion are overstated by approximately 25 percent. Failure to account for job losses associated with taxes required to cover state matching funds for the expansion means that job gains are overstated by another 14 percent.

This policy stuff can get pretty complicated. But basically, even in states that could see a net jobs benefit, it will be significantly lower than projected. In a number of states, including Montana, the analysis has been weak at best. In South Carolina, a state with a similar poverty rate and rate of uninsured, a study claimed that the economic benefits of Medicaid expansion were “unambiguous.”

But an analysis of the study, conducted by the South Carolina Policy Council, points out a number of issues with the “job creation” claims. Taking information from a South Carolina Department of Health and Human Services (DHHS) addendum, the SCPC points out the following:
 

Tam

Well-known member
And when the government needs money to cover the Medicaid expansion down the road they will be coming back to the liberal bias media to push the fact if they don't raise taxes kids will go uneducated, crimes will not be investigated and houses will burn as they are going to have to cut jobs to TEACHERS, POLICE and FIREFIGHTERS to cover their commitments.
 
A

Anonymous

Guest
Montana Chamber endorses Bullock's medicaid expansion plan

Posted: Mar 29, 2013 6:41 PM by Q2 News


HELENA - Governor Steve Bullock's plan to expand Medicaid in Montana, which appeared to be on life support earlier this week, has gained a big endorsement from the Montana Chamber of Commerce.

Earlier this week, republican House members tabled Bullock's Access Health Montana bill, siting concerns over it's long term cost.

But Thursday, the Montana Chamber of Commerce Board of Directors offered its endorsement of the Governor''s proposal.

Gov. Bullock has pushed his plan as a jobs bill, in that expanding Medicaid to thousands of low-income Montanans would create thousands of jobs.

In response to the Chamber Board''s endorsement, Bullock issued this statement Friday.

"We have the incredible opportunity to create nearly 13,000 jobs while providing access to affordable health care for 70,000 Montanans," said Bullock.

"I'm glad the Chamber is joining us in making this a reality and I'm pleased that they recognize that implementing Access Health Montana will control the cost of health care and be an economic boom for the state."

On Wednesday of this week, the House Human Services Committee tabled the governor's bill, and then also defeated two other similar medicaid expansion proposals.

It remains to be seen if the Chamber's endorsement will be enough to change some votes in favor of the Gov. Bullock's plan.


Interesting that the business community- the folks that understand where the "real" longterm increasing cost will come from are supporting the Obamacare Medicaid expansion....

Not surprisingly- it was also the Chamber that supported the Obamacare type mandate for health care- when it was a Republican/conservative idea/plan... :wink:
 

hopalong

Well-known member
are you aware oldtimer, that not one person here believes the crap you post????

You do more to hurt the the cause you CLAIM to support than any other one thing!!!BUT your wet depends have fogged your brain,,what little of it is left that has not been destroyed by the booze :wink:
 

Tam

Well-known member
WASHINGTON (Reuters) - Eight months before President Barack Obama's health care law goes prime time, a confederation of industry and business groups is ramping up its lobbying apparatus for an 11th-hour assault on the web of new taxes and regulations.

Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.

The campaign is backed by two of the business world's lobbying powerhouses: the U.S. Chamber of Commerce and the National Federation of Independent Business, or NFIB. The latter had a leading role in 2012's failed attempt to overturn the Patient Protection and Affordable Care Act in the Supreme Court.

Seems Montana's Chamber might just be going up against the National Chamber Oldtimer. :wink:
 

Tam

Well-known member
The time bomb in Obamacare?
By George F. Will,
Jan 19, 2013 01:18 AM EST

The Washington Post Published: January 18
A willow, not an oak. So said conservatives of Chief Justice John Roberts when he rescued the Affordable Care Act (ACA) — a.k.a. Obamacare — from being found unconstitutional.

But the manner in which he did this may have made the ACA unworkable, thereby putting it on a path to ultimate extinction.

This plausible judgment comes from professor Thomas A. Lambert of the University of Missouri Law School, writing in Regulation, a quarterly publication of the libertarian Cato Institute.

The crucial decision, he says, was four liberal justices joining Roberts’s opinion declaring that the ACA’s penalty for not complying with the mandate to purchase health insurance is actually a tax on not purchasing it. With this reasoning, the court severely limited the ability of the new health-care regime to cope with its own predictable consequences.

What was supposed to be, constitutionally, the dispositive question turned out not to be. Conservatives said that the mandate — the requirement that people engage in commerce by purchasing health insurance — exceeded Congress’s enumerated power to regulate interstate commerce. Liberals ridiculed this argument, noting that since the judicial revolution wrought during the New Deal, courts have given vast deference to Congress regarding that power. The ridicule stopped when five justices, including Roberts, agreed with the conservative argument.

This did not, however, doom the ACA because Roberts invoked what Lambert calls “a longstanding interpretive canon that calls for the court, if possible, to interpret statutes in a way that preserves their constitutionality.” Roberts did this by ruling that what Congress called a “penalty” for not obeying the mandate was really a tax on noncompliance.

This must, Lambert thinks, have momentous — and deleterious — implications for the functioning of the ACA. The problems arise from the interplay of two ACA provisions — “guaranteed issue” and “community rating.”

The former forbids insurance companies from denying coverage because of a person’s preexisting health condition. The latter, says Lambert, requires insurers to price premiums “solely on the basis of age, smoker status, and geographic area, without charging higher premiums to sick people or those susceptible to sickness.”

The point of the penalty to enforce the mandate was to prevent healthy people — particularly healthy young people — from declining to purchase insurance, or dropping their insurance, which would leave an insured pool of mostly old and infirm people. This would cause the cost of insurance premiums to soar, making it more and more sensible for the healthy to pay the ACA tax, which is much less than the price of insurance.

Roberts noted that a person earning $35,000 a year would pay a $60 monthly tax and someone earning $100,000 would pay $200. But the cost of a qualifying insurance policy is projected to be $400 a month. Clearly, it would be sensible to pay $60 or $200 rather than $400, because if one becomes ill, “guaranteed issue” assures coverage and “community rating” means that one’s illness will not result in higher insurance rates.

So, Lambert says, the ACA’s penalties are too low to prod the healthy to purchase insurance, even given ACA’s subsidies for purchasers. The ACA’s authors probably understood this perverse incentive and assumed that once Congress passed the ACA with penalties low enough to be politically palatable, Congress could increase them.

But Roberts’s decision limits Congress’s latitude by holding that the small size of the penalty is part of the reason it is, for constitutional purposes, a tax. It is not a “financial punishment” because it is not so steep that it effectively prohibits the choice of paying it. And, Roberts noted, “by statute, it can never be more.”As Lambert says, the penalty for refusing to purchase insurance counts as a tax only if it remains so small as to be largely ineffective.

Unable to increase penalties substantially, Congress, in the context of “guaranteed issue” and “community rating,” has only one way to induce healthy people to purchase insurance. This is by the hugely expensive process of increasing premium subsidies enough to make negligible the difference between the cost of insurance to purchasers and the penalty for not purchasing. Republicans will ferociously resist exacerbating the nation’s financial crisis in order to rescue the ACA.

Because the penalties are constitutionally limited by the reasoning whereby Roberts declared them taxes, he may have saved the ACA’s constitutionality by sacrificing its feasibility. So as the president begins his second term, the signature achievement of his first term looks remarkably rickety.

The SCOTUS made it so Obama can't raise the tax/fine on those not buying him crap and the Democrat Controlled Senate just voted to repeal the Medical Device tax so What is Obama going to do to fund this horrid mess Oldtimer He promised he would pay for 100% until 2016 and 90% after that. Where will the money come from?
 
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