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Illinois Obamacare rates could soar as state submits insurance premium increases to feds

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Illinois consumers are one step closer to facing sky-high increases for individual health insurance plans purchased through the Affordable Care Act's marketplace.

The Illinois Department of Insurance said Wednesday it has submitted rate increases to the federal government that for some types of... Reported by ChicagoTribune 1 hour ago.

Centene files to expand offerings in Arizona

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Centene Corp. has filed with the Arizona Department of Insurance to continue to participate in the state's health insurance marketplace in 2017. Centene plans to offer its Ambetter brand HMO coverage in Maricopa and Pima counties in Arizona. The company is working with the Arizona DOI and the Centers for Medicare and Medicaid Services to receive approval for the offerings. The company estimates that the expansion of Ambetter in Arizona will provide more than $500 million in revenue and have a positive… Reported by bizjournals 18 minutes ago.

Obamacare penalty: Here's what you'll pay for not having health insurance

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The ACA requires everyone in the U.S. to have health insurance, unless you qualify for an exemption. If you didn’t qualify, and went without benefits for more than three months in 2016, you’ll have to pay a penalty on your coming tax return. Reported by Christian Science Monitor 2 minutes ago.

Rose McGowan Slams ‘Truly Vile’ Hollywood in Letter of Support to Shannen Doherty (Photo)

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Rose McGowan Slams ‘Truly Vile’ Hollywood in Letter of Support to Shannen Doherty (Photo) Rose McGowan wrote former “Charmed” star Shannen Doherty a letter of support during her battle with breast cancer, and blamed “truly vile” Hollywood for any rivalry they may have had in the past.

“As young women we were pitted against each other for society’s pleasure,” McGowan wrote in an Instagram post, featuring an illustration of the two actresses. “The rules of Hollywood engagement brainwashed into us were truly vile. The men & brainwashed women in our business made it so we couldn’t be friends, I regret that.”

 

McGowan starred as Paige Matthews in “Charmed” after Doherty’s character left the show in 2001 following alleged on-and-off set tensions with co-star Alyssa Milano. McGowan also addressed Doherty’s “bad girl behavior” in her post, calling out the media for “merciless” shaming.

*Also Read:* Rose McGowan Is Sick to Her Vagina Over Donald Trump and the Media

“The Bad Girl Shaming you received at the hands of the media was merciless,” she added.  “Global media shaming is real AF, as you know. F— them all & their machine, too. You cast a long shadow over my life. We were both cast in a fake real life role, that of the Bad Girl. I had to prove I wasn’t as bad as you or I’d get the axe, too. But we were never the bad ones, it was them., the Beige Brained White Dudes in Charge. Well f— them. Damn them for f—ing with our minds & careers just because their misogynistic belief systems couldn’t sanction two strong females in a traditionally subservient role- actress. I refused to give them the cat fight they so wanted.”

McGowan continued to slam Hollywood in the letter, adding that the industry tried to crush the two actresses because they were “a different breed.” And because they both broke through those barriers, McGowan sent Doherty strength during her battle with cancer.

*Also Read:* Rose McGowan Slams Caitlyn Jenner's Woman of the Year Award

“Two boss young women that scared the ‘faux-liberals in provincial Hollywood, for that sin we got burned at the media stake, egged on by Hollywood who believe the press they start,” she wrote. “There was a strongly inferred threat of me being blacklisted in tv as I’d been in film. Instead of understanding that we were a different breed, they tried to crush us, but they couldn’t. I send you strength.”

Doherty was diagnosed with breast cancer in 2015. Her battle with the disease was made public when she sued her former business management firm after her health insurance lapsed, TMZ reported.

Last month, Doherty admitted the cancer had spread to her lymph nodes, calling for chemo and radiation. At the “Stand Up to Cancer” event last week, Doherty looked healthy and her doctor stated that chemo was “nearly finished.”

See McGowan’s Instagram below.



Dear @theshando Someone made this of us & I wanted to share it with you as it made me reflect. We have a funny history. As young women we were pitted against each other for society's pleasure. The rules of Hollywood engagement brainwashed into us were truly vile. The men & brainwashed women in our business made it so we couldn't be friends, I regret that. We were cast in this weird fake reality show where we were supposed to be enemies. I resented it greatly. I regret not being awake enough to articulate this to you at the time. Fear was drilled into me from day one in this town & you were the barometer by which my behavior was judged. I was under a microscope, one false move and I'd be branded 'difficult' just like you. I think we all know what happens when girls here get out of line. I willfully remained enigmatic & unengaged. The Bad Girl Shaming you received at the hands of the media was merciless. Global media shaming is real AF, as you know. Fuck them all & their machine, too. You cast a long shadow over my life. We were both cast in a fake real life role, that of the Bad Girl. I had to prove I wasn't as bad as you or I'd get the axe, too. But we were never the bad ones, it was them., the Beige Brained White Dudes in Charge. Well fuck them. Damn them for fucking with our minds & careers just because their misogynistic belief systems couldn't sanction two strong females in a traditionally subservient role- actress. I refused to give them the cat fight they so wanted. Shannen, we didn't know it yet, but we were the good ones. Two boss young women that scared the 'faux-liberals in provincial Hollywood, for that sin we got burned at the media stake, egged on by Hollywood who believe the press they start. There was a strongly inferred threat of me being blacklisted in tv as I'd been in film. Instead of understanding that we were a different breed, they tried to crush us, but they couldn't. I send you strength. ⚒????#rosearmy #BRAVE #shannendoherty #typos4life

A photo posted by Rose McGowan (@rosemcgowan) on Sep 13, 2016 at 8:32pm PDT



*Related stories from TheWrap:*

Rose McGowan Says 'Wussy' Agent Fired Her for Criticizing 'Bulls–t' Adam Sandler Movie Role

Rose McGowan on Why Rolling Stone Drove Her From Hollywood, Directorial Debut: I'm Done Selling My Sexuality Reported by The Wrap 19 hours ago.

A 93-year-old drug that some children can't live without tells us everything that's wrong with American healthcare (LLY, NVO, SNY)

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A 93-year-old drug that some children can't live without tells us everything that's wrong with American healthcare (LLY, NVO, SNY) Insulin has been around since 1923, so it came as a surprise in July 2015 when Cole LePere's doctor told his mother, Janine, to prepare to pay a lot at the pharmacy for it.

Cole, who was 10, had just been found to have Type 1 diabetes, which typically strikes in childhood. But even the pharmacist was shocked to see the price.

Over and over, the pharmacist told Janine LePere, "This is really expensive." Each time she would respond, "I know, thanks, but I still need the medicine."

The pharmacist finally gave the LePeres the supplies — and a bill for $1,550.

That was after a $350 coupon.

As lawmakers and the public scrutinize dramatic price increases for other old drugs — most recently with the Mylan-owned EpiPen, which saw its cost go up by 500% in the past nine years — the next flash point may be insulin, a drug both ubiquitous and complicated.

And the story of why the LePeres are now paying as much as their mortgage payment on insulin, even though they have insurance and even though there are competing drugs on the market, is really the story of what has happened to the healthcare industry in America since the start of the century.

*The need for insulin*

The human body produces its own insulin. Some people can't. 

When he got the diagnosis, Cole LePere found himself one of nearly 29.1 million Americans known to have one of the two types of diabetes. Cole's kind, known as Type 1, is an autoimmune disease. His body mistakenly kills so-called beta cells that are supposed to make the body's insulin, a hormone that helps people absorb and process the sugar in food. The roughly 1.25 million people in the US who have Type 1 diabetes need to inject insulin to live. Type 2 diabetes, the more common form, is something that develops either based on genetic or lifestyle choices, and doesn't always require that you need to take insulin.

These days his mother says she spends $1,100 out of her pocket each month on his diabetes supplies. The list price of the drugs he takes, called Humalog and Lantus and made by the drug companies Eli Lilly and Sanofi Aventis, have risen by about 300% over the past decade.

Many patients don't pay anything close to that sticker price. Some families Business Insider spoke with had their insulin mostly or entirely covered by insurance.

But at the same time drug companies were increasing prices for many drugs, insurance plans have been going through their own transformation, leaving more families like the LePeres on the hook for far more of that cost.

In half a dozen conversations with mothers of children with Type 1 diabetes, we heard stories like Janine LaPere's. The anxieties of these families don't just end with their monthly paycheck. Diabetes is a lifelong disease, and they worry too about what their children will do when they no longer have their parents' insurance covering them.

*Now, you pay*

One reason Janine LePere is paying so much for insulin is that the LePere family has a high-deductible health plan. Before the insurance company pays a penny toward drugs, she and her husband have to spend $7,000 each year. To make matters worse, that deductible is increasing to $10,000 in December, she says.

And these plans are rapidly becoming more common. In 2006, only 4% of people who worked were enrolled in a high-deductible health plan. A decade later, that's up to 25%. And the amount that people are paying for deductibles is rising as well. A Kaiser Family Foundation survey found that deductibles had gone up 63% in the past five years, 10 times the rate of inflation.

LePere was a salon manager, but she recently went to school to become a nail technician to earn more money to help pay for Cole's medication.

"This cost problem is yet another headache on top of complicated disease," Dr. Elbert Huang, a primary-care physician who has researched the cost of insulin, told Business Insider.

High prices particularly affect the US, though some other countries have trouble getting access to the medication in the first place, said Sarah Lucas, the CEO of Beyond Type 1, a nonprofit aimed at helping educate young adults living with Type 1 on how to live with their disease.

*What's old is new again*

Given insulin's history, and the fact that more than one company makes it, it might seem odd that prices have been going up so dramatically.

Researchers first figured out how to manufacture insulin in animal pancreases back in the 1920s so that it could be injected into people. The doctor who developed it, Dr. Frederick Banting, won a Nobel Prize for the discovery in 1923.

Since then, there have been some big changes. In the 1970s, scientists figured out how to use recombinant DNA to manufacture real human insulin, so that it no longer had to come from animals. But in drug years, that is old, and those insulins are still in use.

The most prescribed types of insulin are called analogues, which are slight variations of human insulin that aim to help diabetics' bodies function more closely to how they would if they were able to produce the insulin themselves.

This is the kind Cole LePere's doctor prescribed. A 2011 World Health Organization review, however, did not find that analogue insulins had any advantage over human insulins, and at about twice the cost, the WHO said they're not worth the price.

Drug companies have a history of marginally improving drugs and then charging higher prices for the new versions. And doctors, who have little info about how patients pay for drugs, often prescribe what is seen as the latest and greatest, even if the extra benefit is small.

*This is competition?*

In most industries, competition drives down prices. But the market for insulin looks more like airline tickets. When one company raises the price, the others quickly follow. And in some cases the companies even seem to increase prices simultaneously.

Look at this chart featuring two similar short-acting insulins: Eli Lilly and Co.'s Humalog and Novo Nordisk's Novolog. The prices, gathered by Truven Health Analytics, are in such lockstep that you can barely see both trend lines.

It's a similar story with long-acting drugs like Sanofi's Lantus and Novo Nordisk's Levemir.

All these drugs serve similar purposes and have seen similar price hikes.

What's missing in the marketplace — despite insulin's age — is generic competition.

Unlike chemically derived drugs like statins to lower cholesterol, or pain medication like ibuprofen, insulin is made of living cells. The industry calls it a "biologic" product. It's a lot more complicated to manufacture.

A "generic" version of insulin would be something called a biosimilar, which is riskier to make. The drugs might have different reactions in your body.

So that's left the industry to three main players: Eli Lilly and Company, Novo Nordisk, and Sanofi Aventis.

*The big 3*

The companies do have competing drugs. For example, Humalog (Lilly's) and Novolog (Novo Nordisk's) are the two most prescribed short-acting insulins, while both Novo Nordisk and Sanofi make long-acting insulins (Levemir and Lantus).

But instead of driving prices down, the competitors appear to increase prices step-by-step (which is why the charts above look like a staircase), something the industry calls "shadow pricing." It's not just the insulin market that is doing this: The same thing happened with the EpiPen market when a competitor came in around 2013 and with multiple-sclerosis drugs.

Ashleigh Koss, a spokeswoman for Sanofi, told Business Insider that Lantus had not had a price increase since November 2014 in the US. "In fact, because of aggressive discounting and rebates to insurance plans, PBMs, and government programs, the net prices of Lantus over the cumulative period of the last five years actually went down," she said.

When asked about pricing, Sanofi, Lilly and Novo Nordisk all highlighted discounts they provide, and also pointed the finger at health insurers.

"We know that many Americans with diabetes struggle to pay for their healthcare and, in some cases, this includes paying for medicines produced by us," Ken Inchausti, a spokesman for Novo Nordisk, told Business Insider in an email. "High deductible plans are still growing segment of all insurance plans. In addition to the significant rebates we provide insurance plans (including those who offer high deductible plans) to secure formulary positions, we fund co-pay cards and vouchers that commercially-insured patients can use for up to two years to offset those out-of-pocket costs they're incurring."

And while the drugs themselves might not change, the facilities in which they are made and the ways the insulin can be delivered have been upgraded. Gregory Kueterman, a spokesman for Lilly told Business Insider that the company spent billions of dollars on eight facilities that are used to produce and package insulin.

"We're spending a considerable amount of time studying this issue internally and talking to experts externally in this space. ... There are no quick and easy answers, because the system is complex and complicated," Kueterman said. "Even just simply lowering prices, while that seems like an easy answer, it wouldn't necessarily lower the prices of the high-deductible plan. They'd have to keep paying till they hit that deductible."

*Anxiety and answers*

The high prices don't affect all patients. Diabetes tends to be a condition that is well covered by insurers in comparison with other chronic diseases, like for example, hepatitis C. And many of the people living either with diabetes or with kids who have diabetes called themselves "blessed" to be able to manage the cost of care. For some, their copays were only $40 a month, and some kids were even covered under state plans.

But that doesn't keep parents from worrying about what happens once their kids age out of the state programs or out of their parents' insurance. Carole Andrew, a mother whose 18-year-old son learned he had diabetes a year ago, used the financial gravity of how much insulin costs to make sure her son takes his insulin.

"He wasn't as careful until I showed him the prices. It had a real impact," she said. Now that he knows how much it costs, he's been better about managing his blood-sugar levels.

Jessica Parkes, a 29-year-old who learned she had Type 1 diabetes when she was 20, found herself going into credit-card debt to pay for her supply of insulin. She had lost her job, she recalled, and her pharmacy benefit manager asked her to pay $400 in 2013 for a 90-day supply of insulin at a time when she didn't have health insurance. So she put it on her credit card and paid it off when she could. "I need my insulin to work and pay for the things I need," she said. "So I made my own payment plan."

The cost conversation could be entirely different by the time some of these kids have to leave their parents' insurance. Already, a drug called Basaglar is set to launch in the US in December as an alternative to Lantus.

Although we won't know the price until it's announced later this year, it's unlikely to be significantly cheaper.

But in the end, this isn't a disease these kids and young adults will outgrow. There will always be a need to get insulin in their bodies, no matter the method or price.

"What makes me angry is that people are taking advantage," LePere said. "They know that we will do anything, I will do anything, to make sure my son has medicine the rest of his life."

*SEE ALSO: 'People are still getting sick': The lasting health impacts of 9/11, 15 years later*

*DON'T MISS: The EpiPen isn't the only drug that has more than doubled in price*

Join the conversation about this story »

NOW WATCH: Scientists discovered something 'shocking' that could rewrite a key part of human evolution Reported by Business Insider 20 hours ago.

Deconstructing The "Median Income Bullshit"

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Deconstructing The Median Income Bullshit Submitted by Dave Cohen via Decline of the Empire

*Deconstructing Median Income Bullshit*

When I learned yesterday, 55 days before the 2016 election, that the Census Bureau and the White House had announced an historic leap in real (inflation-adjusted) median household income, my bullshit detector went into the red, went right off the scale and then ceased functioning. I'll have to get a new one.

 

Look at that jump! The biggest since 1967 when record keeping began.  How fucking likely is that?

My first clue appeared in the Los Angeles Times.

 

The clue is circled. Redesigned income questions?

And while I'm quoting the Los Angeles Times, there is this—



Obama, stumping for Clinton at a campaign event Tuesday in Philadelphia, *did not pass up the moment to spotlight the census report*. Obama said the uninsured rate was the lowest on record as was the pay gap between men and women.

 

"So, now, let's face it; the Republicans don't like to hear good news right now," Obama said. "But it's important just to understand *this is a big deal*. More Americans are working, more have health insurance, incomes are rising, poverty is falling, and *gas is $2 a gallon*. … Thanks, Obama!"



Keep those gasoline prices in mind. OK, this time I searched for "redesigned income questions" and found exactly one article at the New York Post. That's not the New York *Times*. No, that's the New York *Post*. (I added the links.)



Economic data that come out of Census, including the monthly unemployment report, should be scrutinized more carefully than they are — because they are what hurt Americans the most day to day, ruin dreams of hardworking families and, when the numbers are played with to present a better picture, erode trust in government.

 

Here are some details on just two points.

 

First, the 5.2 percent increase came during 2015 compared with the previous year. The Census Bureau doesn’t have up-to-date numbers.

 

But an outfit called Sentier Research, manned by ex-Census workers, does.

 

*And while Sentier’s numbers confirm the increase in 2015, household income this year has slackened off, they told me Tuesday.*



We'll look at the Sentier data below.



Gordon Green, a partner in Sentier, says median household income declined slightly in the first half of 2016. In both 2015 and the first half of 2016, incomes were boosted by a drop in gasoline prices.

 

“*Oil prices play into this in a very, very big way,*” Green said.



Follow the link to see the swan dive in gasoline prices which began in 2014 and continued into and throughout 2015. Use the 5-year chart. You'll see an insignificant seasonal rise in the summer months in 2015.



The second knock is that *Census moved the goal posts*.



Ah, make the data look better by doing the measurement differently. The usual move.



Starting in 2013 with a partial phase-in, which was fully implemented in 2014, *Census changed the questions and the methods in calculating household income.*

 

For example, Census, starting in 2014, *began to “collect the value of assets that generate income if the respondent is unsure of the income generated.”*

 

Also, *the government started to use “income ranges” as a follow-up for “don’t know” or “refused” answers on income-amount questions.*



Those are the redesigned income questions.



There are plenty of other changes — *but with just these two, income levels reported could be noticeably higher, say 5.2 percent higher, without the actual income being 5.2 percent higher.*

 

In the fine print, Census admits the change. “The data for 2013 and beyond reflect the implementation of the redesigned income questions.”

 

Americans, in their guts, know the 5.2 percent gain in median household incomes isn’t true.



OK, now it was time to check out the Sentier data, which is updated monthly by ex-census employees. Doug Short is the go-to guy for this kind of thing, and I found this July, 2016 update.



Sentier Research, an organization that focuses on income and demographics, offers a more up-to-date glimpse of household incomes by accessing the Census Bureau data and publishing monthly updates. Sentier Research has now released its most recent update, data through November (available here). *The numbers in their report differ from the Census Bureau's in three key respects:*

 

1.  It is a monthly rather than annual series, which gives a more granular view of trends.

 

2.  Their numbers are more current. The Census Bureau's most recent is the 2014 annual data released in September 2015.

 

3.  Sentier Research uses the more familiar Consumer Price Index (CPI) for the inflation adjustment. The Census Bureau uses the little-known CPI-U-RS (RS stands for "research series") as the deflator for their annual data. For more on that topic, see this commentary.



I highly recommend that you read the commentary that last link goes to. It's called Median Household Income Growth: *Deflating the American Dream*. The choice of the inflation-adjustment deflator makes all the difference in these median household income calculations. I will comment on that at the end.

Here's the first chart.

 

Sentier data deflated with the CPI (see above) shows a jump in real median household income in 2015 which Sentier says was due in large part to low gasoline prices. Median household income is still down from its early 2008 peak.

Here's the second chart, with some commentary from Doug Short. Remember, this is the latest data available on real median household income (July, 2016).



The next chart is our *preferred way* to show the nominal and real household income — the percent change over time. Essentially we have taken the monthly series for both the nominal and real household incomes and divided them by their respective values at the beginning of 2000. The advantage to this approach is that it clearly quantifies the changes in both series and avoids a common distraction of using dollar amounts ("How does my household stack up?").

 

The *reality illustrated here* is that the real median household income series spent most of the first nine years of the 21st century *struggling slightly below its purchasing power at the turn of the century*.

 

Real incomes (the blue line) hit an interim peak at a fractional 0.7% in early 2008, far below the nominal illusionary interim peak (as in money illusion) of 27.2% six months later and the latest at 40.3%, fractionally off the 40.4% record high in January of this year. *The real median household income is now at -1.1% from its turn-of-the-century level. In essence, the real recovery from the trough has been frustratingly slow*.



 

 

Summing up, real median household income (blue line just above) adjusted with the CPI is down 1.1% with respect to where it was in the year 2000. And if you follow that "Deflating The American Dream" link above, you will find out that deflating with the CPI-U-RS as the Census Bureau does puts a rosier glow on the historical data than deflating with the CPI does.

So it's all bullshit, isn't it?

And if you do this Google search, you will see all the usual suspects celebrating this nonsense. It's all over NPR this morning. Those assholes can't get enough of this happy bullshit.

I knew it was bullshit the moment I saw it, but thought it worth the time to figure out what was going on. And now we know. Reported by Zero Hedge 21 hours ago.

Employers want workers to cover rising health insurance costs: Is this progress?

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According to a new report by the Kaiser Family Foundation, insurance premiums are rising at 'historically low rates.' Part of the reason for this: Healthcare costs are increasingly shifting to the employee, in the form of higher deductibles. Reported by Christian Science Monitor 19 hours ago.

Americans Without Health Care at Record Low. So What’s the Problem?

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While the number of people without health insurance is at its lowest, thanks largely to Obamacare, continued declines are far from certain. Reported by NYTimes.com 21 hours ago.

Why California wants health insurance for undocumented immigrants

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State lawmakers in California want a waiver on an Obamacare ban that prohibits undocumented immigrants from purchasing care on the exchanges. Reported by Christian Science Monitor 20 hours ago.

Automotive Minute: Online vehicle retailers disrupting dealership practices

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“The only thing worse than shopping for a new car is shopping for health insurance,” a text from my mother read the other day, serving as a gentle reminder how much people hate the traditional dealership focused car buying experience. When my husband and I bought a new car last year, we completed 95 percent of the deal online via the dealership website and a short series of emails back and forth with a sales person. When it came time to take delivery of the vehicle, it was a quick, no-negotiation,… Reported by bizjournals 19 hours ago.

Small Business Survey Trips Economic Alarms

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Small Business Survey Trips Economic Alarms Submitted by Lance Roberts via RealInvestmentAdvice.com,

**NFIB Survey Suggests Weak Economic Prospects**

Earlier this week, the National Federation of Independent Businesses released their monthly Small Business Survey. *While this data is much overlooked by the mainstream media, it really shouldn’t be.* Out of the 26 million businesses registered in the United States, only 6 million have active employment and generate revenue. Of that total, almost 80% have fewer than 5-employees. *Simply, it is small businesses that drive the economy, employment, and wages.* Therefore, what the NFIB says is extremely relevant to what is happening in the actual economy versus the headline economic data from Government sources.

*In August, the survey declined 2-tenths of a point to 94.4. While that may not sound like much, it is where the deterioration occurred that is most important.* Furthermore, despite an improvement from the financial crisis lows, *the current levels are still well below the levels normally witnessed at the late stage of an economic recovery.*

As noted in the chart below, *the surge in optimism has now returned the survey to levels normally associated with the onset of recessions.  *And it only took 8-years to get there, hardly a recovery to “crow” about.

However, the internals of the report were much less exuberant as noted by the NFIB:



“Once again, *the NFIB survey showed no signs of strength in the small business sector. Uncertainty seems to be the major enemy of economic progress and the political climate is a major contributor to the high levels of uncertainty that we’ve seen.* The current economic environment is not a good one for strong or sustained growth.”



This certainly isn’t the message that we are getting from the mainstream media suggesting all is well within the economy. But, here are the interesting highlights:



· The *outlook for business conditions* in the next six months had the most dramatic change,* dropping seven points. *
· Setting an all-time high for the survey, *39 percent of business owners cited the political climate as a reason NOT to expand.  *
· *Uncertainty about the economy and government policy also hit record highs* among small business owners.



The issue, despite all evidence the contrary, remains a prevailing “blindness” to the reality of economic cycles. *Economic recoveries are finite and by all measures the current economic recovery has been very long when considering this is the 4th longest expansion in history with the lowest overall rate of growth. *

While longer periods of economic expansion have certainly existed, the underpinnings of those expansions are substantially different than what exists currently. *The chart of real, inflation-adjusted, final sales exposes this issue.*

During previous expansions, real final sales in the economy ran at 4% annualized growth rates or better. *The current expansion from the 2009 lows only briefly touched 3% despite massive Government and Federal Reserve interventions. *

However, one of the hopes that continues to drive economic expectations is a return of capital spending to supplant the dearth of consumer spending. *The problem is that corporate CapEs, as a percentage of economic growth, is far less than the nearly 70% contribution made up by consumers.* The problem, as shown in the chart below, is despite hopes of a surge in capital spending, plans for such expenditures remains very retarded and at levels, not surprisingly, normally associated with recessionary environments.

Importantly, expectations are very fragile. *Any stumble in the current environment will see those expectations quickly reverse*. The chart above shows expectations of economic improvement (currently at -12%, down from -5% in July) as compared to plans for capital expenditures over the next 3-6 months (currently at 28% which is where it was January of 2015).

If small businesses were convinced that the economy was “actually” improving over the longer term, they would be increasing capital expenditure plans *rather than remaining at the same level they were 20-months ago. *The disparity between improved economic outlook and CapEx plans is *likely a reflection that business owners are hoping for increased economic activity. However, they are not willing to ‘bet’ their capital on it.*

This is easy to see when you compare business owner’s economic outlook as compared to economic growth. *Not surprisingly there is a high correlation between the two given the fact that business owners are the “boots on the ground” for the economy.* Importantly, their current outlook does not support the ideas of stronger economic growth into the end of the year.

Of course, *the Federal Reserve has been absolutely NO help* in instilling confidence in small business owners to deploy capital into the economy. As NFIB’s Chief Economist Bill Dunkleberg stated:



“*The Federal Reserve has started its regular ‘hide the rate hike’ game, sending observers looking under every rock of data to see if there are 25 basis points underneath.* Most of the ‘rocks’ look like pebbles, there’s not a lot of growth in the landscape, and there’s that darn international thing, the value of the dollar (which is officially not the province of the Fed) and all that. The inflation and employment goals are defined ‘downward’ in terms of what the Fed might accept, along with prognostications that assure ‘full’ attainment by 2018.

 

*Comments by Chicago Fed president Charles Evans, in remarks to the Shanghai Advanced Institute of Finance in Beijing, indicate that the Fed thinks it is the determining force shaping interest rates, not markets, a very troubling view.* *He said:*

 

*‘Long-run expectations for policy rates provide an anchor to long-run interest rates. So lower policy rate expectations act as a restraint on how much long-term rates could rise following a surprise over the near-term policy path.’ *

 

*These contortions in policy cannot be maintained. We will regret this arrogance even more over the next decade as our private financial institutions become unable to meet the promises they have made.**”*



* *

**The Real Employment Report**

The divergence between the Fed’s “economic fantasy” and “Main Street reality” can also be seen between expectations to increase employment versus those that actually did.

*Three months ago, the percentage of respondents that were expecting to increase employment over the next quarter, or two, rang in at 11%. Three months later, the percentage of respondents that increased employment was -3%.* This currently is the lowest level of hiring since January of this year and greatly contrasts the stats produced by the BLS showing large month gains every month in employment data. *While “expectations” should be “leading” action, this has not been the case.*

The first chart below shows the raw data of how firms feel “today” about increasing employment over the next three months versus actual increases in employment over the last quarter.

*The divergence between expectations and reality can also be seen in actual sales versus expectations of increased sales.* Employers do not hire just for the sake of hiring. Employees are one of the highest costs associated with any enterprise. *Therefore, hiring takes place when there is an expectation of an increase in demand for a company’s product or services. *

This is also one of the great dichotomies of the employment reports that continues to show strong hiring in retail services despite a weakening outlook for, and actual, retail sales.

Furthermore, despite hopes of continued debt-driven consumption, business owners are still faced with actual sales that are still well below long-term trends. *Since revenue is what ultimately drives expansion, it is not surprising that when asked whether this is a “good time to expand” their operations, the large majority of responses remain negative.* That view has remained unchanged since the depths of the financial crisis.

 

*It’s The Government, Man!*

For small businesses, the overall environment remains very challenging. *The top 3 concerns of small businesses remain government regulations, taxes and poor sales as shown by the composite indicator below.* While improved somewhat from the financial crisis, levels remain well entrenched at levels where recessions are starting, not eight years into an expansion.

*Increased regulations, the onset of the Affordable Care Act (ACA), increased taxes (due to the ACA), and increased costs of compliance keep budgets tight with profitability a primary focus.* Taxes and Government Regulations continued to be at the forefront of the decision-making process by business owners.

With small business optimism waning currently, combined with many broader economic measures, it suggests the risk of a recession has risen in recent months.

As I discussed previously, the gap between incomes and the cost of living is once again being filled by debt. *However, using credit to maintain a standard of living is far different that using debt to increase it.* This is why consumptions expenditures are weak and “final demand” in the economy remains anemic. *In turn, business owners remain on the defensive, reacting to increases in demand caused by population growth rather than building in anticipation of stronger economic activity. *

Lastly, as Bill notes, some of the increases we have seen in spending and wages have come at the expense of economic growth rather than a benefit from it.



“Health insurance costs keep rising, diverting compensation gains into benefits rather than take home pay.* Other regulatory pressures such as a rising minimum wage and mandatory paid leave also put an upward pressure on reports of compensation increases.* Capital spending will remain M.I.A., plans are at the highest level for the recovery, matching the previous peak in 2014, but not typical of an expansion and reports of actual spending have been weakening.”



What this suggests is that the current “struggle through” economy will likely continue until some unexpected exogenous shock tips the proverbial “apple cart.”

*The problem for the Fed is that once again the window for a “rate hike” has likely closed.* Economic uncertainty, deflationary threats, and market volatility will keep them boxed in for now. *Unfortunately, the recent spike in LIBOR has likely already done a bigger job of tightening monetary policy than the Fed actually intended to do.* This could cause problems in the not too distant future.

Just some things I am thinking about.

  Reported by Zero Hedge 19 hours ago.

How Behavioral Science Is Serving the American People

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A year ago, President Obama issued an Executive Order directing Federal agencies to apply behavioral science insights—research insights about how people make decisions and act on them—to the design of Federal policies and programs to better serve the American people.  

So, how is behavioral science helping make the government more effective?

J.D. Wheeler III shared a powerful example. He returned home from prison this year, undergoing a transition that is often filled with great challenges—from obtaining health insurance, to finding housing and employment, to building and rebuilding personal relationships.

Over 2.2 million individuals are in American prisons and jails, and the vast majority of them will return to their communities. Improving education and job opportunities has a recognized effect of reducing crime, making our communities safer and reducing barriers to success. 

To support people like J.D., this past year the Bureau of Prisons (BOP) developed a “re-entry handbook.” The Social and Behavioral Sciences Team (SBST)—a cross-agency group of applied behavioral scientists, program officials, and policy makers—contributed to the content and structure of this report using research insights about the best ways of presenting information to people in order to inspire action.

For example, SBST and BOP developed checklists of discrete steps that individuals can take at three distinct points in time: immediately before release, within one week of returning home, and within one month of returning home. Providing individuals who are re-entering society with the proper timing and sequencing of steps is helpful for preventing setbacks—for example, obtaining a birth certificate prior to release can accelerate applying for work upon release. SBST also recommended that individuals be addressed as “members of their community,” and provided ideas for how to de-stigmatize subjects such as mental health.

After using the handbook, J.D. shared that:

"I did 12 years and two months in prison. Before getting my re-entry handbook, it felt like I was in the Flintstone era. With the handbook, though, it rocketed me into the Jetsons' era. I found that I was able to adapt to this entirely new world—especially given all of the new technology—with more awareness and insights into what I needed to do to become a member of my society.

I was removed from the world for so long, I thought my transition was going to move at a snail's pace. But the handbook’s structure helped move things along at a moderate pace. Every inmate should get a copy of this handbook at least 30-45 days before they leave prison so they can already know what is going on, what to expect, and have time to really dig in and understand what steps they can take before and after release. I am an ambitious person and I want something out of my life, and the handbook gave me the knowledge I needed."


 

JD’s story demonstrates why this work matters, both for him and for the broader community. Designing government programs with people in mind can help to ensure that those programs meet people’s needs, and serve their broader societal goals.

To learn more about this collaboration, and the more than 40 collaborations SBST has had with Federal agencies from the past year, read here. And watch the Summit below.

Read the Report Reported by The White House 15 hours ago.

University teacher lockout ends; contract talks continue

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NEW YORK (AP) — About 400 university faculty members who were locked out for 12 days over a bitterly contested contract went back to teaching on Thursday. The lockout action by Long Island University in Brooklyn that suddenly left professors without health insurance or access to email also deprived about 8,000 students of their teachers. […] Reported by Seattle Times 14 hours ago.

Covered California for Small Business rates to rise

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Covered California, the state's health insurance exchange, announced a 5.9 percent rate increase for its small-business plans. The increase, which is a statewide weighted average, will take effect Jan. 1. It is lower than last year's 7.2 percent increase for plans under the small-business program, known as Covered California for Small Business. The program is available to businesses with up to 100 employees. Covered California's rates for individual coverage also will increase in 2017. Although… Reported by bizjournals 15 hours ago.

Heartland Alliance's Analysis of New Report: Hardship, Inequities, and Income Inequality in Illinois

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New data from the U.S. Census Bureau revealed today that poverty in Illinois decreased from 2014 to 2015, following national trends. Despite this heartening improvement, however, poverty in Illinois remains stubbornly high – 13.6% compared to 11.9% in 2007 before the recession.

Chicago, IL (PRWEB) September 15, 2016

New data from the U.S. Census Bureau revealed today that poverty in Illinois decreased from 2014 to 2015, following national trends. Despite this heartening improvement, however, poverty in Illinois remains stubbornly high – 13.6% compared to 11.9% in 2007 before the recession. Moreover, the new data show a number of trends moving in the wrong direction: Illinois is one of only 8 states in which income inequality grew, and wide racial disparities persist on nearly every measure.

“While we are pleased to see the poverty rate generally moving in the right direction, we can’t lose sight of the fact that a staggering number of Illinoisans are still struggling every day to meet their most basic needs,” said Amy Terpstra, Director of Research at Heartland Alliance. “Over 1.7 million Illinoisans are living in poverty, and about 785,000 of them are living in extreme poverty, which for a family of four means living on less than about $12,000 per year.”

The United States has been in economic recovery for a number of years now, but meaningful improvements for Illinois and the nation have been slow to reach those who need it most.

“The lesson is that our lowest income residents are the first to be impacted by an economic crisis, they experience the most hardship, and they are the last to experience any recovery,” said Sam Tuttle, Director of Policy at Heartland Alliance. “This is precisely why we need to invest in programs and policies that address poverty and inequity: so that regardless of the economic climate, more individuals are able to build and maintain stable lives.”

Illinois has entered its second year without a state budget, and the burden of this falls on the backs of the millions of Illinoisans in poverty. The resulting erosion of services that help connect people to work, ensure low-income workers can access child care, provide MAP grants for students seeking an education, and help survivors of violence recover will make it much more difficult for people to meet their basic needs and move out of poverty.

Today’s release revealed:· Illinois poverty declined from 2014 to 2015 and is now at 13.6%. The poverty rate is still 1.7 percentage points above its pre-recession 2007 level of 11.9%.
· Extreme poverty—having income below half the poverty line—also declined in Illinois and is now at 6.2%. 785,000 Illinoisans are extremely poor.
· Illinois median household income increased to $59,588 in 2015. Income is still 4% below its 2007 level.
· The rate of non-seniors in Illinois who are uninsured fell to 8.1%, a 3 percentage point decline from 2014 and a dramatic decline of 6.1 percentage points from 2008.
· Illinois is one of only 8 states where income inequality worsened from 2014 to 2015. Illinois is one of the most unequal states in the nation.
· While white Illinois households experienced an increase in median household income from 2014 to 2015, black and Latino households in Illinois did not see any increase.
· People of color are disproportionately impacted by poverty: 8.7% of white, non-Latino Illinoisan are poor compared to 28.2% of black Illinoisans and 19.4% of Latino Illinoisans.

“The increase in income inequality and the persistence of racial disparities in 2015 tell us that Illinois is leaving low-income families and communities of color behind,” said Tuttle. “We should be making targeted efforts to dismantle the policies and practices that perpetuate racial inequity and income inequality – not cutting the programs that help address these disparities as has been Illinois’ approach as of late.”

Read the fact sheet on Illinois and Chicago region poverty, income, and health insurance trends based on the newly released data.

Download data books for Chicago Community Areas and for all cities and townships in the 6-county Chicago metropolitan region.

Access the Census Bureau’s local demographic, social, economic, and housing data that were released today for places with populations of 65,000 or more. Contact Heartland Alliance for assistance accessing and interpreting the data.

###

Heartland Alliance for Human Rights & Human Needs – Heartland Alliance, one of the world’s leading anti-poverty organizations, works in communities in the U.S. and abroad to serve those who are homeless, living in poverty, or seeking safety. It provides a comprehensive array of services in the areas of health, housing, jobs, and justice – and leads state and national policy efforts, which target lasting change for individuals and society. For more information visit, http://www.heartlandalliance.org or follow us on Twitter at https://twitter.com/heartlandhelps or like us on Facebook at https://www.facebook.com/heartlandalliance.

Heartland Alliance Research & Policy - Heartland Alliance’s Research & Policy Division focuses on the realization of human rights through ending poverty, racism, and injustice by engaging in research on social issues and solutions, policy and systems change, and field building nationwide. Learn more at https://www.heartlandalliance.org/get-informed/research-policy-landing.

CONTACT: Amber Cason
acason(at)heartlandalliance(dot)org
312.870.4960 Reported by PRWeb 15 hours ago.

Here's More Proof That Donald Trump Wants To Drive Out All Undocumented Immigrants

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Republican presidential nominee Donald Trump skirted a question on “The Dr. Oz Show” show this week about whether he believes the United States has a moral responsibility to help an undocumented immigrant who is dying in the streets.

The reply demonstrated a few things, including Trump’s reticence to giving answers and Dr. Mehmet Oz’s failure to ask follow-up questions. More importantly, it showed that Trump, regardless of his efforts to muddy the waters on his deportation plans, is still arguing for driving all undocumented immigrants out of the country.

“You mentioned you don’t want people dying on the streets,” Oz said during the episode that aired on Thursday, as CBS News’ Sopan Deb pointed out. “What if an undocumented immigrant collapses and needs life-saving therapy? Do we have a moral responsibility, do you believe, to help that person?”

Trump rejected the premise ― under in his plan, he said, there would be no undocumented immigrants to help.

“Well, under my plan the undocumented, or, as you would say, illegal immigrant wouldn’t be in the country,” he said. “They only come in the country legally.”

Oz ― who, in fairness, is not a journalist ― let it go. “We’ll be right back,” he said, introducing a commercial break.

This is a serious issue ― quite literally life and death ― and it’s telling that Trump declined to say whether he thinks there is a moral responsibility to save an undocumented immigrant’s life.

There are an estimated 11 million undocumented immigrants in the country, and some of them need life-saving care. Many do not have health insurance, and they are barred from Obamacare, although California officials are asking the White House for approval to let undocumented immigrants in the state onto its public exchange. Hospitals are required to treat people in urgent need of care even if they don’t have the ability to pay, but the cost of that treatment is typically very high and is only sometimes partially reimbursed by Medicaid.

Trump avoided saying whether he thinks undocumented immigrants should receive emergency care by saying he didn’t think they should be in the country.

This would only be the case if his plan was to deport as many undocumented immigrants as possible and drive out the rest by restricting their ability to work and live ― self-deportation, as 2012 Republican nominee Mitt Romney put it. Trump’s comment indicates he means to drive out all ― not just most ― undocumented immigrants.

Trump made inconsistent statements last month, leading many to believe he was not actually hoping to get every undocumented immigrant out of the country. He delivered a speech in early September reaffirming that it is his goal, but said the next day that “perhaps at a later date” he might do something about undocumented immigrants who weren’t, in his parlance, the “bad ones.”

Some interpreted this to mean that Trump might allow some undocumented immigrants to eventually earn legal status, although he hardly said so explicitly: He said he might consider something, but only if the border was secure and unauthorized immigration had been resolved.

The idea that Trump actually supports legal status for some undocumented immigrants was always far-fetched. But if you want more proof, it’s in the Dr. Oz interview: In his plan, there will be no undocumented immigrants in the country to save.

Editor’s note: Donald Trump regularly incites political violence and is a serial liar, rampant xenophobe, racist, misogynist and birther who has repeatedly pledged to ban all Muslims — 1.6 billion members of an entire religion — from entering the U.S.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 14 hours ago.

Business News Roundup, Sept. 16

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The report concludes that the tepid pace of the recovery increasingly reflects the inability of President Obama and the Republican-led Congress to agree on programs to bolster U.S. competitiveness worldwide. Prosperity has become more concentrated among fewer Americans, and the nation’s competitive edge is slipping as factors that have helped drive growth are viewed as worsening. The political system, tax code, health care system, public schools, regulation and infrastructure are now all viewed as weaknesses for the economy, according to surveys of Harvard Business School alumni, students and the public compiled in the annual report. “We have reached the conclusion that the paralysis in the U.S. political system is one of the gravest threats to our economic competitiveness,” said Jan Rivkin, a professor of business administration and co-author of the report. The report defines competitiveness as being characteristic of an economy that enables companies to succeed in domestic and international markets while raising living standards for average people. Oracle Corp. posted disappointing quarterly profit and revenue Thursday. The Redwood City software company said it earned a profit of $1.83 billion (43 cents per share) in its fiscal first quarter. Earnings, adjusted for amortization costs and stock option expense, were 55 cents per share. The business software maker posted revenue of $8.61 billion in the period, which also fell short of Street forecasts. Small-business employees who get health insurance through the Covered California exchange will see an average price increase of 5.9 percent next year. Reported by SFGate 13 hours ago.

Spot The (Book Review) Difference

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Spot The (Book Review) Difference With health concerns mounting, email leaks hurting, and poll numbers tumbling, Hillary Clinton has had a tough couple weeks (poor thing)... but the news just got a little worse as *Hillary’s newest book, “Stronger Together,”* which provides a policy blueprint for where she hopes to take the country if she is elected president, *sold just 2,912 copies in its first week on sale,* according to Nielsen BookScan.

As The New York Times reports, *both Mrs. Clinton and her running mate, Senator Tim Kaine, have promoted the book on the campaign trail, but the sales figure, which tallies about 80 percent of booksellers nationwide and does not include e-books, firmly makes the book what the publishing industry would consider a flop.*



“Stronger Together,” whose cover shows Mrs. Clinton and Mr. Kaine waving, arrived closer to Election Day than most of these types of books.

 

*Named after the campaign’s slogan, “Stronger Together” *offers readers, according to the book jacket, “specific and practical solutions, while also articulating a bold and expansive vision of change and renewal.”

 

*Its roughly 250 pages intersperse bullet-point policy ideas, like “launch a national initiative for suicide prevention” and “humanely address the Central American migrant crisis,” *with photographs of Mrs. Clinton and Mr. Kaine on the campaign trail, charts in the campaign’s signature chunky font and highlights from Mrs. Clinton’s speeches.



But, it appears, from a cursory glance at Amazon.com, that even the 2912 people that read the book were unimpressed by its contents *(with 83% giving it 1 Star)*... slightly different from Donald Trump's "Great Again" book's reviews...

*Some of the 1-Star reviews...*

As 'UrbanLegend' wrote...



*I have to start by saying I am a registered independent voter, and more importantly, a life-long independent thinker. *I have voted for more D's than R's in my life, as well as several third-party candidates. *This is the lamest, weakest, most politically-absurd book ever written, as far as I know. Save your money for food for your family just in case she is elected.*



As Daniel B noted...



*I was going to read this book.....I really was. But just as I got started, I found myself under sniper fire, passed out, and fell and hit my head. *After that I got double vision and had to wear glasses that were so damn thick I couldn't even see to read. Then I had an allergic reaction to something and started coughing so hard I spit out what looked like a couple of lizard's eyeballs, my limbs locked up, and I passed out and fell down again, waking up only to find out I had been diagnosed with pneumonia 2 days earlier. It's a good thing I was able to make a small fortune making this random small trade in the commodities market (cattle futures or some such thing) and then, miracle of all miracles, a few banks offered me a few million to just talk to their employees for a few minutes - and all that really helped out because I swear I was dead broke and couldn't figure out how I was gonna come up with the 6 bucks to pay for this book, let alone pay the $1,500 for my health insurance this month. *I still want to read it, but, hell, what difference at this point does it make? I hear it sucks anyway.*



Paul A. Bedish's review was short and sweet...



What a horrible book*. I got brain damage after 4 pages and lost my shoe*



And finally "Amazon Customer" concluded...



How are we to believe that the book was written by Mrs. Clinton and Mr. Kaine? They've been a bit busy lately. Obviously ghost-written campaign drivel. *If she really believes we're "stronger together" perhaps she should stop dividing us. Not calling her opponent's supporters "deplorable" might be a good start.*



*There were some 5-Star reviews...*

From Bestatchess...



This is a great book.* The chapters on "How to screw up everything you touch with hubris""How to write the perfect doctor's note" and "D**ing bimbos at home" were worth the price of admission.*



And finally...*"I would give this book 10 stars if I could!"*



Why? Because it's a fantastically well-written, witty, insightful and informative book that was* written by a person who is easily the most important female political leader since Queen Elizabeth I.* And her impact on world history is liable to be much, much greater. Please do yourself, your children, grandchildren and great-grandchildren a favor and beg, borrow, or steal this book, but whatever you do - READ IT!!! In it you will find Hillary's plan for making this world of ours a much better place - more peaceful, more prosperous, more just, more environmentally sustainable. And as an aside, way, way more fun!* This book is in fact so chock full of great ideas that if it contained any more, they would literally leak out the sides! *I always felt that, compared to anyone else on the scene, Hillary Clinton was a modern day Colossus of Rhodes, but now I'm more inclined to think of her as the political equivalent of the Great Pyramid. They just don't come any better! After her eight years in office are finished, I predict the only remaining controversy will be which one of those dead guys immortalized on Mount Rushmore should have his features rearranged in her image. (I vote for Alexander Hamilton - way overrated if you ask me.) But I digress.* In sum, if you don't read this book, you will regret it - maybe not today, but soon, and for the rest of your life. Please, don't make that tragic mistake!*

Reported by Zero Hedge 11 hours ago.

California Aims To Limit Surprise Medical Bills

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[protected-iframe id="98297ababc67c0174cd5d59238b8cfa0-7618883-107024162" info="https://www.npr.org/player/embed/493233748/493491977" width="100%" height="290" frameborder="0" scrolling="no"]When it comes to navigating the intricacies of health insurance, Cassie Ray considers herself a pro. Reported by ajc.com 3 hours ago.

TATA AIG, Paytm to offer health insurance to cab drivers

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Tata AIG General Insurance and mobile payments firm Paytm have entered into an agreement to provide cab and auto drivers health insurance plans. Reported by Zee News 3 hours ago.
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