Medicaid Archives - Page 7 of 33 - Florida Politics

Sarah Maricle Ayers: Rick Scott should stay out of hospitals’ business

If you believe that smoking cures cancer and rainfall is a fix for flooding, then Gov. Rick Scott has some health care proposals for you.

Scott wants to foist a battery of new regulations onto about 129 hospitals across Florida in 2016 as a means of improving health care. He has proposed requiring them to publicize IRS reports, information regarding pricing and average payments received for products and services, and performance on quality measures, all in accordance with strict deadlines. Additionally, Scott has launched an online forum for patients to directly air complaints about medical bills and hospital experiences, which can, in turn, trigger third-party reviews by the state.

Scott’s official statement delineating these initiatives, released in September and naturally cloaked in populist favorites, like “fairness” and “transparency,” are purportedly aimed at cutting health care costs for consumers. Closer examination, though, reveals that their real consequences will do nothing of the sort, and will even further muddy the health-care waters for patients.

Scott says, “The best way to guard against unfairly high hospital costs being passed on to patients is to require hospitals to be fully transparent with their own costs and patient charges.” However, every minute associated with complying with each of these administrative requirements drives up hospital costs. Scott is essentially seeking to reduce costs with a plan that raises them, and enhance patient care with a plan that burdens staff with extra bureaucratic mandates.

Come again?

His website for medical bill complaints is designed to root out price-gouging, but is similarly ill-conceived. Scott’s news release tells patients they would be able to “refer complaints of price gouging at hospitals and surgical centers to the appropriate law enforcement agency or regulatory authority for investigation and potential prosecution.” However, outside of the 120 percent Medicaid cap, there are no legal price parameters on medical products and services. How can price-gouging be assessed or enforced when it has no definition?

And how can average consumers, reeling from medical emergencies and their accompanying hospital bills, be prepared to evaluate the going rate for liver transplants, spinal fusions, and hip replacements? Displeasure with prices is not the same thing as price-gouging.

In any circumstance, consumers are always inherently motivated to minimize financial obligations as much as possible, whether it’s for a cup of Starbucks or an appendectomy. Self-reporting from patients hardly constitutes a reliable basis for activating the potential legal consequences that Scott is dangling over hospitals.

Should we next ask convicts to weigh in on their own sentencing?

Given the legislative history of the past year, this disappointing attack on hospital business practices seems to be less about saving consumers and more about retaliation over Medicaid expansion differences. When Scott sprang onto Florida’s political scene in 2010, part of his unique appeal was the private sector prowess he possessed, having founded and managed Columbia/HCA, ironically the largest private health care company in the U.S. He represented the antidote to the incoming wave of intrusive Affordable Care Act provisions, and the pragmatism he espoused was a welcome contrast to the empty populist rhetoric of then-incumbent Charlie Crist.

Scott’s war on hospitals just adds to bureaucratic sludge and demonstrates that his steely conservative armor is losing its luster.

In order to genuinely advance consumer interests, Florida’s health care industry should do the opposite of Scott’s proposals and adopt the Direct Primary Care approach. This model consists of simple payment-for-treatment pricing, with zero government and third-party involvement. This is an emerging laissez faire approach that achieves true cost cutting.

For example, when the Surgery Center of Oklahoma adopted Direct Primary Care, the savings enabled by streamlining led to bills that are one-tenth to one-fifth of what competing facilities charge. Owner and anesthesiologist Dr. Keith Smith even posts his prices online, but does so voluntarily and in a spirit of free-market competition, not under the threat of a tax-payer funded, bureaucratic fist.

Transparency in pricing is good for consumers, but gubernatorial power should be used for the good of ensuring freely operating health markets, not imposing regulations. Competition can naturally spur upfront pricing for consumers, and do so without the costly layer of government interference. Scott would be well-advised to remember his hospital CEO perspective and dump these non-solutions.

Sarah Maricle Ayers has bachelor’s degree in economics from Florida State University, and an MBA from FSU. Her op-eds on economic issues have been published in Florida newspapers. 

Sarah Maricle Ayers: Rick Scott should stay out of hospitals’ business

If you believe that smoking cures cancer and rainfall is a fix for flooding, then Gov. Rick Scott has some health care proposals for you.

Scott wants to foist a battery of new regulations onto about 129 hospitals across Florida in 2016 as a means of improving health care. He has proposed requiring them to publicize IRS reports, information regarding pricing and average payments received for products and services, and performance on quality measures, all in accordance with strict deadlines. Additionally, Scott has launched an online forum for patients to directly air complaints about medical bills and hospital experiences, which can, in turn, trigger third-party reviews by the state.

Scott’s official statement delineating these initiatives, released in September and naturally cloaked in populist favorites, like “fairness” and “transparency,” are purportedly aimed at cutting health care costs for consumers. Closer examination, though, reveals that their real consequences will do nothing of the sort, and will even further muddy the health-care waters for patients.

Scott says, “The best way to guard against unfairly high hospital costs being passed on to patients is to require hospitals to be fully transparent with their own costs and patient charges.” However, every minute associated with complying with each of these administrative requirements drives up hospital costs. Scott is essentially seeking to reduce costs with a plan that raises them, and enhance patient care with a plan that burdens staff with extra bureaucratic mandates.

Come again?

His website for medical bill complaints is designed to root out price-gouging, but is similarly ill-conceived. Scott’s news release tells patients they would be able to “refer complaints of price gouging at hospitals and surgical centers to the appropriate law enforcement agency or regulatory authority for investigation and potential prosecution.” However, outside of the 120 percent Medicaid cap, there are no legal price parameters on medical products and services. How can price-gouging be assessed or enforced when it has no definition?

And how can average consumers, reeling from medical emergencies and their accompanying hospital bills, be prepared to evaluate the going rate for liver transplants, spinal fusions, and hip replacements? Displeasure with prices is not the same thing as price-gouging.

In any circumstance, consumers are always inherently motivated to minimize financial obligations as much as possible, whether it’s for a cup of Starbucks or an appendectomy. Self-reporting from patients hardly constitutes a reliable basis for activating the potential legal consequences that Scott is dangling over hospitals.

Should we next ask convicts to weigh in on their own sentencing?

Given the legislative history of the past year, this disappointing attack on hospital business practices seems to be less about saving consumers and more about retaliation over Medicaid expansion differences. When Scott sprang onto Florida’s political scene in 2010, part of his unique appeal was the private sector prowess he possessed, having founded and managed Columbia/HCA, ironically the largest private health care company in the U.S. He represented the antidote to the incoming wave of intrusive Affordable Care Act provisions, and the pragmatism he espoused was a welcome contrast to the empty populist rhetoric of then-incumbent Charlie Crist.

Scott’s war on hospitals just adds to bureaucratic sludge and demonstrates that his steely conservative armor is losing its luster.

In order to genuinely advance consumer interests, Florida’s health care industry should do the opposite of Scott’s proposals and adopt the Direct Primary Care approach. This model consists of simple payment-for-treatment pricing, with zero government and third-party involvement. This is an emerging laissez faire approach that achieves true cost cutting.

For example, when the Surgery Center of Oklahoma adopted Direct Primary Care, the savings enabled by streamlining led to bills that are one-tenth to one-fifth of what competing facilities charge. Owner and anesthesiologist Dr. Keith Smith even posts his prices online, but does so voluntarily and in a spirit of free-market competition, not under the threat of a tax-payer funded, bureaucratic fist.

Transparency in pricing is good for consumers, but gubernatorial power should be used for the good of ensuring freely operating health markets, not imposing regulations. Competition can naturally spur upfront pricing for consumers, and do so without the costly layer of government interference. Scott would be well-advised to remember his hospital CEO perspective and dump these non-solutions.

Sarah Maricle Ayers has bachelor’s degree in economics from Florida State University, and an MBA from FSU. Her op-eds on economic issues have been published in Florida newspapers. Column courtesy of Context Florida.

Steve Crisafulli says it’s amazing “anything” gets passed in GOP-led Legislature

The intense divide between the Florida House and Senate this year was so intense that House Speaker Steve Crisafulli led his members out of the chambers three days prematurely this past April, leading for the first of a series of special sessions in 2015.

Speculation surfaced that the enmity between Crisafulli and Senate President Andy Gardiner was still present, after it was announced that for the first time in recent years, the House Speaker and Senate President  would not meet the press jointly at the AP Florida Legislative Planning session held in the state Capitol Wednesday in Tallahassee, but Crisafulli insisted on Wednesday that nothing should be read into that when meeting with reporters.

“Senator Gardiner and I are good friends,” Crisafulli insisted.

But he then went on to say for various reasons, such as the age of legislators, experience and size of their respective districts, that it’s “extraordinary” that anything gets done in the Capitol.

Left unsaid was that this isn’t a partisan divide between Republicans and Democrats as is the case in Washington – but an internecine battle among Republicans who have controlled the legislative agenda in Tallahassee for well over a decade now.

The 44-year-old House Speaker then weighed in on a variety of issues that he expects to be issues in 2016, without getting too specific about any of them. He said one of his top goals is to help in the passage of legislation for aid to disabled Floridians, a top priority for Gardiner as it was in 2015.

His other top issue is tackling water policy, where he invoked the drought in California as a reason why the Legislature must act this year. When the House broke early from session in April, they failed to pass a water bill, though the Senate companion was approved on a 39-1 vote.

The major divide between the two legislative bodies last regular session was the House’s intense opposition to any form of Medicaid expansion, refusing to look a hybrid plan that required federal approval for a never-before sought waiver under a privately-run health insurance plan called the Florida Health Insurance Exchange, or FHIX.

“We remain steadfastly opposed to any efforts, even those disguised as free-market proposals, to expand Medicaid under Obamacare, ” the House Speaker declared. “Let’s be clear. The House believes the solution to health care is innovation and choice, and not big government entitlement programs.”

Last year, Governor Scott and the House proposed $673 million in tax cuts. Ultimately, that became a $400 million cut that was approved. However,  Scott said again on Wednesday that he’ll propose a similar $673 million in cuts this year, and Crisafulli said on “potentially” the House may do the same. “That conversation will take place,” he promised.

Crisafulli pushed backed that he personally had done anything wrong in the whole congressional redistricting imbroglio, saying that the Supreme Court’s rejection of the legislature’s maps in 2012 preceded him.

Afterwards, the House Speaker said that the odds on passing something on the gambling compact was “good.”

Jac Wilder VerSteeg: Gun foes should “politicize” deaths

A recent Dana Summers political cartoon in the South Florida Sun Sentinel and other Tribune newspapers depicts in its first frame a thoughtful-looking Hillary Clinton and President Barack Obama saying, “In light of the recent shootings, we need to think about guns and ask ourselves the obvious question.”

Then, in the punchline frame, Clinton and Obama, both grinning now, say, “How can we politicize this?”

It’s an intellectually lazy cartoon that does nothing more than repeat the NRA-approved response when any politician dares to notice the massacres taking place across America. When any elected official or advocacy group tries to offer gun laws that might reduce the death toll – and cites the carnage du jour – they are accused of politicizing the deaths.

The accusation implies that politicians such as Clinton and Obama don’t really care about the victims, which is a lie. And it implies that politicizing the deaths cheapens them. In fact, what cheapens the tragic deaths is ignoring them, blaming the victims (for not having guns to shoot back) and, most of all, working to perpetuate the gun culture that costs so many lives.

Plus, as is obvious to all, the NRA and its vast stable of kowtowing politicians also politicize the deaths.

But let’s take a step back and ask, is it wrong and unusual to politicize death?

Of course not. Look at almost any aspect of death – particularly violent or sudden death – and related political activity surrounds it.

You could say that, in Judeo-Christian tradition, God was the first entity to politicize death. A prohibition against homicide is included in the 10 laws He handed down to Moses.

Today, the death penalty is heavily politicized. Should we do it? When should we do it? How should we do it? Are we doing it fairly? It’s an issue in elections and in judicial appointments.

Here’s another example: Death, a major byproduct of war, is heavily politicized. Different politicians have different answers to questions about risking American lives in Iraq, Afghanistan and elsewhere. Not too long ago, a key question was whether withdrawing troops from Iraq would mean that U.S. troops killed there had died in vain. That was a blatant politicization of those deaths. “Boots on the ground” – and therefore deaths on the ground – in Syria and Iraq already are an issue in the 2016 presidential and congressional races.

Terrorism is another arena in which death is politicized. Who has protected us from terrorist deaths and who hasn’t?

Death and disease are at the center of the debate over health care in Florida and in America. Remember, in the attacks on Obamacare, the accusations about death panels? When proponents of expanding Medicaid point out that it would save lives, they are politicizing death. But so are those who turn a blind eye to the deaths that could have been prevented. Not worth the cost, is their political calculation.

Death is a topic of concern to us all, including the emerging public policy issue of doctor-assisted death. Not only is death a proper topic for politicians and politics, it is a traditional topic for politicians and politics. Death and its prevention are appropriate motivators for political action. Why would we want our politicians to ignore a serious and persistent cause of unnatural death? And that’s what guns are.

So I have no problem with politicizing death. And I favor politicians who work to find ways to reduce death, not perpetuate it.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. 

Jac Wilder VerSteeg: Gun foes should “politicize” deaths

A recent Dana Summers political cartoon in the South Florida Sun Sentinel and other Tribune newspapers depicts in its first frame a thoughtful-looking Hillary Clinton and President Barack Obama saying, “In light of the recent shootings, we need to think about guns and ask ourselves the obvious question.”

Then, in the punchline frame, Clinton and Obama, both grinning now, say, “How can we politicize this?”

It’s an intellectually lazy cartoon that does nothing more than repeat the NRA-approved response when any politician dares to notice the massacres taking place across America. When any elected official or advocacy group tries to offer gun laws that might reduce the death toll – and cites the carnage du jour – they are accused of politicizing the deaths.

The accusation implies that politicians such as Clinton and Obama don’t really care about the victims, which is a lie. And it implies that politicizing the deaths cheapens them. In fact, what cheapens the tragic deaths is ignoring them, blaming the victims (for not having guns to shoot back) and, most of all, working to perpetuate the gun culture that costs so many lives.

Plus, as is obvious to all, the NRA and its vast stable of kowtowing politicians also politicize the deaths.

But let’s take a step back and ask, is it wrong and unusual to politicize death?

Of course not. Look at almost any aspect of death – particularly violent or sudden death – and related political activity surrounds it.

You could say that, in Judeo-Christian tradition, God was the first entity to politicize death. A prohibition against homicide is included in the 10 laws He handed down to Moses.

Today, the death penalty is heavily politicized. Should we do it? When should we do it? How should we do it? Are we doing it fairly? It’s an issue in elections and in judicial appointments.

Here’s another example: Death, a major byproduct of war, is heavily politicized. Different politicians have different answers to questions about risking American lives in Iraq, Afghanistan and elsewhere. Not too long ago, a key question was whether withdrawing troops from Iraq would mean that U.S. troops killed there had died in vain. That was a blatant politicization of those deaths. “Boots on the ground” – and therefore deaths on the ground – in Syria and Iraq already are an issue in the 2016 presidential and congressional races.

Terrorism is another arena in which death is politicized. Who has protected us from terrorist deaths and who hasn’t?

Death and disease are at the center of the debate over health care in Florida and in America. Remember, in the attacks on Obamacare, the accusations about death panels? When proponents of expanding Medicaid point out that it would save lives, they are politicizing death. But so are those who turn a blind eye to the deaths that could have been prevented. Not worth the cost, is their political calculation.

Death is a topic of concern to us all, including the emerging public policy issue of doctor-assisted death. Not only is death a proper topic for politicians and politics, it is a traditional topic for politicians and politics. Death and its prevention are appropriate motivators for political action. Why would we want our politicians to ignore a serious and persistent cause of unnatural death? And that’s what guns are.

So I have no problem with politicizing death. And I favor politicians who work to find ways to reduce death, not perpetuate it.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. Column courtesy of Context Florida.

Rate of uninsured drops to 16.6 percent in Florida

The rate of Floridians without health insurance dropped to 16.6 percent this past year.

Figures released Wednesday by the U.S. Census Bureau shows that represents a drop of 3.4 percentage points from a rate of 20 percent in 2013.

Despite the drop, Florida still had the third-highest rate of residents without health insurance. Only Texas and Alaska had higher rates.

The national rate was 10.4 percent.

Officials attribute the decrease in Florida and across the country to passage of the Affordable Care Act, which expanded health insurance to millions of Americans.

The act gave states the option of expanding Medicaid. Some did so, and others like Florida chose not to do so.

Census officials say states that expanded Medicaid had bigger decreases in the uninsured rates than those that didn’t.

Republished with permission of The Associated Press.

Florida gives Medicaid insurers 7.7 percent rate increase

Florida health officials said Wednesday they would give insurers a 7.7 percent rate increase in the fledgling Medicaid managed care program, in what has been a contentious battle among Gov. Rick Scott, the insurers and hospitals.

The Republican governor lobbied hard to get federal approval for the statewide managed care program, which launched last year. He promised it would save money and improve health care for more than 3 million low-income and disabled Floridians. But now that the program seems in desperate need of additional funding, Scott has been blaming the insurance companies and hospitals.

Health insurers have lost $542 million through 2014 and said they can’t afford further losses. They asked for a $400 million raise and a 12 percent rate increase from the state. Scott’s administration had warned that any increase could negate the roughly 5 percent savings the program has generated and had previously countered with a 6.4 percent increase.

The governor strongly opposes pumping any additional state funding into the Medicaid program and wasn’t happy when state lawmakers invested $400 million earlier this year in order to help hospitals that were losing other types of federal aid.

The Agency for Health Care Administration said the 7.7 percent increase takes into account the recent legislative hospital rate increase, pharmacy trends including new drugs now on the market, and other changes. Scott’s office did not immediately comment Wednesday.

As the state and insurers have been locked in rate negotiations, Scott has repeatedly spoken out and taken action against them, including requiring that insurance company and hospitals send their contracts with each other to the states to ensure they are complying with the law. The governor had alleged that the reason the Medicaid program wasn’t saving more money was because insurers were negotiating hospital rates that were too high.

Earlier this week, Scott announced his administration would conduct random audits on hospitals. Scott has been adversarial against hospitals that receive public funds after the federal government announced deep cuts in hospital funding earlier this year. Scott, who formerly ran a chain of for-profit hospitals, has tried to show that the hospitals aren’t as bad off financially as they maintain. He has also created a commission to examine hospitals’ finances.

Insurers say higher than expected usage rates, pent-up demand among Medicaid enrollees and expensive drugs costs contributed to the losses. It’s unclear what effect the lower-than-requested rates will have on the market. It’s unlikely that insurers will drop out as there are stiff penalties for leaving, but experts say it could contribute to more market consolidation.

The Florida Association of Health Plan said the rates are a result of a collaborative dialogue between the health plans and the state.

“This a step in the right direction and the plans look forward to continuing this dialogue with the state to ensure our shared goals of providing quality health care while respecting every dollar of taxpayer funding,” said CEO Audrey Brown.

Officials estimated nearly 4.2 million will be enrolled in the Medicaid program in 2016-2017, about a 4 percent increase from the previous year.

Republished with permission of The Associated Press.

Gov. Rick Scott: Hospitals may be referred for fraud investigations

Gov. Rick Scott gave Attorney General Pam Bondi a heads up on Monday that some of the 129 hospitals being audited for Medicaid fraud or waste could be referred to her office for criminal prosecution.

Scott is on the warpath against hospitals that participate in the statewide Medicaid Managed Care program, concerned that some are over-billing the system.

Medicaid, a joint federal-state program, eats up about a third of the annual state budget.

What’s more: The state will lose about $1 billion because the federal government said it will stop paying into the Low Income Pool, a state-federal pot of money given to many hospitals to help pay for their charity care.

In a letter released to media, Scott said Agency for Health Care Administration Secretary Liz Dudek last month asked all Florida hospitals and insurance plans in the Medicaid Managed Care program to certify what they were charging.

“Unfortunately, some hospitals either completely failed to reply, replied past the deadline, or submitted information that raised additional questions and requires further review to ensure compliance with Florida law,” Scott wrote to Bondi.

Scott said he then told Dudek to start auditing hospitals. He said he plans to make sure they are “compliant with state law and (that) there are no instances of fraud or abuse.”

As a result, 129 hospitals across the state are in the process of being audited, his letter shows, from Pensacola to Miami.

“Hospitals have made a record $3.75 billion in profits according to the most recent available data,” Scott wrote.

He told Bondi that Dudek will forward the names of any facilities “where we find suspicion of fraud or abuse to your office for investigation and potential prosecution.”

“I know that protecting consumers and combating fraudulent activity are top priorities for your office and we welcome (your) assistance … to hold all entities accountable for following the law,” he said.

Who’s to blame for Florida’s rising Medicaid costs?

Florida Gov. Rick Scott is blaming rising Medicaid expanses on President Obama’s health law, even though the state’s top economist said the two are not related.

State economists estimated Tuesday that the Medicaid program will cost $577 million more in 2015-2016. That comes as health insurers are seeking a $400 million raise and a 12 percent rate increase. But The Republican governor strongly opposes pumping additional state funds into Medicaid and was not happy when state lawmakers recently invested $400 million.

In a letter Tuesday, Scott warned that health care costs are spiraling out of control. But state economists Amy Baker and others at Tuesday’s budget meeting said the Affordable Care Act was not related to the issues discussed at the conference.

The Medicaid program is finishing its first year under a new managed care structure that Scott fought vigorously for, arguing it would save the state money. But as the program seems in desperate need of additional funding, Scott is blaming the insurance companies and hospitals.

Republished with permission of the Associated Press.

Corrine Brown, Gwen Graham: On collision course?

North Florida U.S. Reps. Gwen Graham and Corrine Brown represent two distinct wings of the Democratic Party.

For one thing, if you Google “Gwen Graham Moderate,” you’ll find no shortage of results about how she’s the type of Democrat who is willing to buck the left wing of the party, on issues like the budget and the Keystone XL pipeline.

For her, it’s the “North Florida Way.”

“I promised to bring the North Florida Way to Washington — and that means working with both parties to reach common-sense solutions,” Graham told the Tampa Bay Times last year. “Now, I’m following through with that promise and focusing on creating jobs, improving education and ending the gridlock in Congress. Neither party is right 99 percent of the time, so the people of North Florida expect us to work together to get things done.”

Google “Corrine Brown Moderate,” and you find a paucity of results. Missing in them: the word “moderate.”

Representative Brown is entering her third decade in the House. Graham? In her second year now.

Despite those differences, there are some commonalities.

One such: a commitment to commemorating a half century of Medicare and Medicaid.

On Friday, Graham met with Tallahassee area seniors for said commemoration. Cake, constituent services, and quotes were served up.

“When Medicare was signed into law, 50 years ago, more than half of America’s seniors were without health insurance,” Graham said. “We’ve made great progress since then, and today, I heard from North Florida seniors who rely on the program for healthcare. I’m dedicated to protecting Medicare for them and for generations to come.”

On Monday in Jacksonville, Brown will have a Medicaid and Medicare-themed news event at the Mary Singleton Center.

The news release offers details as to the programs’ popularity. A key difference: While the Graham event did not stress Medicaid, the Brown event will, as the news release indicates:

“Many of Medicaid’s more than 71 million enrollees are children from low-income working families.  Historically, pregnant women and children have benefited tremendously from Medicaid coverage. The program covers 45 percent of births nationwide; improving health outcomes for both mother and her baby. Medicaid is also the nation’s largest payer for long-term care services and supports, including home- and community-based care as well as nursing homes,” asserts the release from Brown’s office.

The differences in presentation illustrate the differences between the two political operations. Graham’s is clearly tailored toward winning in a swing district; Brown’s can play more toward the Democratic base. It would not be such a big issue, except that redistricting later this month might cause one or both of these candidates to recalibrate.

The very real possibility that one possible redistricting outcome could put Graham and Brown into the same district bears watching. Would they run against one another? Would one run for U.S. Senate?

The conventional wisdom has suggested that if one were to run for Senate, it would be Graham. But why not Brown, if that were the case?

Much is said about the fluidity in the Republican race. But there would seem to be room to move for Representative Brown, should she want it, on the Democratic side. Neither Patrick Murphy nor Alan Grayson have prohibitive advantages. Brown, meanwhile, has hold cards to play. Presences in multiple metro areas and markers to call in across the state and the country among them.

The bulk of redistricting speculation in Northeast Florida has to do with the congresswoman’s seat. Florida Politics  will ask her about that and her plans at her Medicaid/Medicare news conference later Monday, which promises to be a lively and wide-ranging discussion between the Jacksonville media and the ever-quotable congresswoman.

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