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One hospital charges $8,000 another, $38,000
Washington Post ^ | May 8, 2013 | Sarah Kliff

Posted on 05/10/2013 9:19:32 AM PDT by JerseyanExile

some_text

Consumers on Wednesday will finally get some answers about one of modern life’s most persistent mysteries: how much medical care actually costs.

For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services.

In the District, George Washington University’s average bill for a patient on a ventilator was $115,000, while Providence Hospital’s average charge for the same service was just under $53,000. For a lower joint replacement, George Washington University charged almost $69,000 compared with Sibley Memorial Hospital’s average of just under $30,000.

Virginia’s highest average rate for a lower limb replacement was at CJW Medical Center in Richmond, more than $117,000, compared with Winchester Medical Center charging $25,600 per procedure. CJW charged more than $38,000 for esophagitis and gastrointestinal conditions, while Carilion Tazewell Community Hospital averaged $8,100 in those cases.

Maryland has a unique system for hospital rate charges, so differences were smaller, and its average rate was lower than that of any other state in the most common procedures reviewed by The Washington Post. The highest average charge for a lower joint replacement was $36,000 by University of Maryland Medical Center in Baltimore, much lower than the highest rates in other states.

Elsewhere, Las Colinas Medical Center just outside Dallas billed Medicare, on average, $160,832 for lower joint replacements.

Five miles away and on the same street, Baylor Medical Center in Irving, Tex., billed the government an average fee of $42,632.

(Excerpt) Read more at washingtonpost.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: healthcare; hospitals; medical

1 posted on 05/10/2013 9:19:32 AM PDT by JerseyanExile
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To: JerseyanExile

These outrageous differences in cost for the same procedures show that some thieves wear surgical masks. And it’s our money they are stealing. When is someone going to jail for this felony theft?


2 posted on 05/10/2013 9:28:27 AM PDT by txrefugee
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To: JerseyanExile
I wonder which hospital deals with more non-paying “customers?”
3 posted on 05/10/2013 9:28:30 AM PDT by The_Victor (If all I want is a warm feeling, I should just wet my pants.)
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To: JerseyanExile

Capitalism and the market in play. Whatever the market will bear given that many hospital markets do not have competition.


4 posted on 05/10/2013 9:28:53 AM PDT by buckalfa (Tilting at Windmills)
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To: JerseyanExile

Federal reimbursements are based on labor costs. Hospitals have little incentive to lower costs.


5 posted on 05/10/2013 9:31:08 AM PDT by Rightwing Conspiratr1
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To: txrefugee

What a hospital bills and what medicare pays are two different things. What Medicare actually pays is usually a fraction of what is billed.

If the billing diagnostic and bill codes are the same Medicare will pay both hospitals the same amount. There is payment modifier between cities, so a hospital in a high cost of living city gets paid more than a rural hospital.

Nevertheless, I’m glad to see the government releasing comparative data. Now if they would just require providers to charge the same amount to all payers including insurance companies, we will be on the road to some sensible healthcare.


6 posted on 05/10/2013 9:35:29 AM PDT by DannyTN
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To: txrefugee

What a hospital bills and what medicare pays are two different things. What Medicare actually pays is usually a fraction of what is billed.

If the billing diagnostic and bill codes are the same Medicare will pay both hospitals the same amount. There is payment modifier between cities, so a hospital in a high cost of living city gets paid more than a rural hospital.

Nevertheless, I’m glad to see the government releasing comparative data. Now if they would just require providers to charge the same amount to all payers including insurance companies, we will be on the road to some sensible healthcare.


7 posted on 05/10/2013 9:35:29 AM PDT by DannyTN
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To: JerseyanExile

Wonder what that hospital Moochelle worked for was charging vs. the ones she was scaring the indigent patients away to?


8 posted on 05/10/2013 9:36:04 AM PDT by Buckeye McFrog
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To: txrefugee

The ajc had a similar article on the cost of hip or knee replacements at different hospitals in the area—ranged from about $29,000 to $91,000. And, yes, the most expensive was the one that handles a ton of non insured/illegals in the areaa.


9 posted on 05/10/2013 9:38:26 AM PDT by freeangel ( (free speech is only good until someone else doesn't like it)
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To: txrefugee
First thing I'd do in this case is confirm who is “in DC” and who is “outside DC”...my guess is the lower price is a DC public hospital or relationship like that and the higher price is where the hospital is not majorly funded by government
10 posted on 05/10/2013 9:40:05 AM PDT by Gaffer
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To: freeangel

So...if you get a knee replacement at the more expensive hospital, SOMEONE should be able to WRITE OFF as a GIFT the difference!


11 posted on 05/10/2013 9:41:22 AM PDT by goodnesswins (R.I.P. Doherty, Smith, Stevens, Woods.)
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To: JerseyanExile

The medical industry is almost the only business where you do not have the opportunity to discover the price you will be charged until after the service is provided. It is somewhat akin to a fast food restaurant refusing to post their prices and presenting you a bill for $2000.00 after you have eaten your hamburger.


12 posted on 05/10/2013 9:46:48 AM PDT by etcb
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To: The_Victor
An excellent question.

I'd also ask abotu differences in care.

For instance, there are hospitals that you seek out, and there are hospitals to avoid.

13 posted on 05/10/2013 9:53:08 AM PDT by wbill
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To: JerseyanExile

The Feds have posted tremendously current data from 2011.

Good job.

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html


14 posted on 05/10/2013 9:54:45 AM PDT by Sequoyah101
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To: JerseyanExile

Wanna really get pissed about medical costs? Get into wholesale medical supplies and medicines. The markups are staggering.


15 posted on 05/10/2013 9:55:04 AM PDT by CodeToad (Liberals are bloodsucking ticks. We need to light the matchstick to burn them off. -786 +969)
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To: JerseyanExile

So the Post is saying Obamacare will fix this?


16 posted on 05/10/2013 10:26:40 AM PDT by albie (s)
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To: JerseyanExile
We recently learned first-hand about the outrageous costs of health care. My son was in an accident and hurt his back. He was transported to hospital and spent the afternoon & evening in the ER room before being discharged. He had a bunch of x-rays, was on a bed in the hall - no room, no meals were offered him. The only medication was (finally) a Tylenol. They gave him an "off the shelf" back support (not customized), and let him go.

There was a parade of doctors who came over and briefly talked with him, some gave him a cursory look over. Now I know why - they all submitted their "consulting fees"

The cost for basically sitting in the ER for the better part of a day? $10,000. And my son doesn't have insurance through his job. Fortunately he also doesn't have any assets so, as they say, "you can only squeeze so much blood from a turnip"

17 posted on 05/10/2013 10:30:20 AM PDT by tjd1454 (`)
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To: txrefugee

So the govt should mandate prices?


18 posted on 05/10/2013 10:30:36 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: buckalfa
Capitalism and the market in play. Whatever the market will bear given that many hospital markets do not have competition.

Hardly capitalism. More like caveat emptor. Capitalism provides for the free flow of information to allow the consumer to make an intelligent choice. This information is kept from the consumer, and they don't even know the price until the bill is sent. This is rip-off, pure and simple.

19 posted on 05/10/2013 10:34:47 AM PDT by 0.E.O
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To: freeangel
And, yes, the most expensive was the one that handles a ton of non insured/illegals in the areaa.

So then it' a good thing that the prices became available so patients could avoid those hospitals that are out to rip them off.

20 posted on 05/10/2013 10:36:31 AM PDT by 0.E.O
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To: driftdiver
So the govt should mandate prices?

No. Just make the hospitals provide information on what they charge so I can make a decision which hospital I want to go to and which one is out to rip me off.

21 posted on 05/10/2013 10:38:20 AM PDT by 0.E.O
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To: JerseyanExile

from the start the article is very biased and the writer is a liar.

Specifically hospitals are prcluded by law from knowing what the other hospitals are charging. Medicare calld it price fixing. If it was ever determince that a hospital had access to anothers chrges or charge structure, people would/could have gone to jail.


22 posted on 05/10/2013 10:52:49 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: 0.E.O

All you have to do is ask.

The trouble is there are a million variables. Its very difficult to compare hospitals and unless you pay cash it mostly doesnt matter.


23 posted on 05/10/2013 10:54:58 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: JerseyanExile

BTW! he is talking about chrages to Mediare. Ask him to find out how much the hospitals were actually PAID for those procedures. Hospitals are mostly paid on a specific rate for a procdure, regardless of how much the hospital charges. Most hospital have a write off of about 65% of total charges due to the very low payment of Federal and State reimbursement rates. The only way a hospital can stay in business is to charge non-government payors much more that the cost of their procedures to make up for how little the government is willing to pay. Usually the govt payment is much less than the actual cost of performing a specific procedure. Those unreimbursed cost must be paid by someone and comes in the way of higher prices.


24 posted on 05/10/2013 11:00:08 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: Gaffer

I live outside DC (Northern VA) and have at least minimal knowledge on the 3 DC hospitals referred to. When I heard GW charges more than Providence I wasn’t surprised and thought ok, I’d pay more to go to GW, too. Sibley was something of a surprise.

Geography within the city probably accounts for some of the discrepancies. Sibley is located in the ‘silk stocking district’ close to the upscale MD suburbs. It’s the type hospital where you’d choose to go for non-emergency care because of its environment. And, I would assume, a disproportionately high number of its patients have insurance and/or can make co-payments. That would not be the case at Providence which is located in a lower income section of the city. GW is in a commercial district with ever-decreasing residential areas taken over by govt/non-profits/NGOs and GW itself, but it’s often the hospital of choice for lower-income and/or uninsured patients to go for treatment.

GW is a teaching/research hospital. And, thanks to Reagan and Cheney family donations (@ $10M between them) among others, GW today is a modern, beautiful facility (when Reagan had his surgery there following the assassination attempt, it was the absolute pits). It also has a Metro stop at its front door so it’s easily accessible from any part of the city.


25 posted on 05/10/2013 11:00:27 AM PDT by EDINVA
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To: tjd1454

Bull


26 posted on 05/10/2013 11:03:52 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: JerseyanExile

It is amazing how little a hospital/doctor will settle for in Medicare.


27 posted on 05/10/2013 11:03:56 AM PDT by Mike Darancette (Plan "B" is now Plan "A")
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To: driftdiver
All you have to do is ask.

Now thanks to a government report I don't have to.

The trouble is there are a million variables. Its very difficult to compare hospitals and unless you pay cash it mostly doesnt matter.

Not always. A pacemaker implant is pretty routine; why should it cost twice as much in one place than in another? Knee replacement is also pretty routine, but one hospital in Dallas charged four times as much as the one across town. The story nailed the real reason; hospitals charge whatever they please because there is no visibility in pricing or comparative shopping. What we need is more visibility into how they price their procedures and not less.

28 posted on 05/10/2013 11:13:36 AM PDT by 0.E.O
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To: 0.E.O

There certainly is the ability to do comparison shopping, as long as you have something routine and not emergency.

Some hospitals are better than others. perhaps you had complications at one vs another.

Insurance company apply standard pricing to all hospitals for the equivalent procedure. You can ask for reasonable and customary and they’ll most likely reduce the rate for you.

They are businesses and want to sell their service, again all you have to do is ask the hospital.


29 posted on 05/10/2013 11:19:17 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: EDINVA

I cede to your superior knowledge of the hospitals and prices there. My conjecture was generic in nature. Cost for services in a competetive environment generally equalize or at least become competitive. Universal. It is only when ‘government’ intercedes with some sort of subsidation, open or not, that this tenet becomes inoperative.


30 posted on 05/10/2013 11:20:04 AM PDT by Gaffer
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To: txrefugee

Having had several surgical procedures, I can state that in every case the surgeon’s bill has been separate from the hospital bill. In fact, you can shop around for a surgeon (whose office personnel will tell you what he charges), but you cannot shop around for a hospital. NO WAY will anyone in hospital admin tell you how much your stay is going to cost.


31 posted on 05/10/2013 11:22:02 AM PDT by GSD Lover
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To: driftdiver
They are businesses and want to sell their service, again all you have to do is ask the hospital.

And now I don't have to ask the hospital. All I have to do is open the spreadsheet and do some comparison shopping on my own. One of the few things I've seen the government do lately that actually improves my life.

32 posted on 05/10/2013 11:27:32 AM PDT by 0.E.O
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To: 0.E.O

And you would rather trust information from the govt than call up someone who actually has the information from the source?


33 posted on 05/10/2013 11:38:55 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: driftdiver
And you would rather trust information from the govt than call up someone who actually has the information from the source?

Yes call up the very people who have been overcharging and ask them. Good plan.

34 posted on 05/10/2013 11:42:58 AM PDT by 0.E.O
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To: 0.E.O

At least the information will be accurate and if you want to request reduced rates you’re already talking to the right person.

Or you could trust the govt who probably collected the data a few years ago and probably got lazy and copied data rather then collect it.

You don’t trust hospitals to give you accurate pricing but trust them to put in a pacemaker?

really?


35 posted on 05/10/2013 11:44:48 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: driftdiver
You don’t trust hospitals to give you accurate pricing but trust them to put in a pacemaker?

I trust them to put in the pacemaker. But apparently I can't trust them not to rob me, or my insurance company, blind while doing it.

36 posted on 05/10/2013 11:48:38 AM PDT by 0.E.O
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To: driftdiver

Why don’t you call a hospital right now and try to get a straight answer on how much they’d charge you for a routine procedure.


37 posted on 05/10/2013 11:55:17 AM PDT by Bubba Ho-Tep ("More weight!"--Giles Corey)
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To: Bubba Ho-Tep

Its easy, pick up the handset, press the buttons and speak to a real live person.

Heck they might even send you a listing of what a procedure will likely cost.


38 posted on 05/10/2013 11:56:52 AM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: driftdiver

Good luck with that.


39 posted on 05/10/2013 12:01:04 PM PDT by Bubba Ho-Tep ("More weight!"--Giles Corey)
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To: tjd1454

A friend was knocked off his bicycle by an automobile. Ambulance took him to the hospital and he racked up a $52000 bill in 2 days.

6 weeks later they sent him a letter knocking it down to$2,500 for services rendered. He thinks this is because he has a nothing-none existent credit score. No credit card and has always paid cash. The guy is not poor owns a house and some more. He says the hospital believes he is indigent


40 posted on 05/10/2013 12:01:05 PM PDT by dennisw (too much of a good thing is a bad thing - Joe Pine)
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To: buckalfa

Assuming the prices are known in advance and some degree of choice in product selection is available.

In this case its anything but that. You couldn’t comparision shop even if you didn’t have a life threatening urgent need.

Goverment forcing the publication of prices for each facility would be a great thing.

Also forcing them to charge the same price for the same service to everyone would be nice too.


41 posted on 05/10/2013 12:01:52 PM PDT by wonkowasright (Wonko from outside the asylum)
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To: freeangel

Exactly! Somebody has to pay for all the “free” (mandated by federal law) medical procedures done on those “poor” unable-to-pay indigent and/or illegal alien patients. (As well as those who choose not to have insurance cause somebody else has to pay for it.) Otherwise those hospitals go broke.


42 posted on 05/10/2013 12:22:15 PM PDT by curious12
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To: dirtymac; All
Bull

I am replying not because I care one whit what a pompous blowhard thinks. However, there may be some who are confused by your wholly uncalled-for comment, imagining (mistakenly) that for once you might know what you are talking about. To those I will be happy to provide bills to back up the truthfulness of my post.

43 posted on 05/10/2013 1:24:23 PM PDT by tjd1454 (`)
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To: txrefugee

I took a fall in the parking lot of Krogers near my home. Broke my patella, and the left side of my body was badly bruised (I am over 70) the hospital did a cat scan because the side of my face was black bruised and my left eye was swollen shut.....cat scan of my head was 5000 dollars. Just being taken into ER by ambulance was 1000 dollars. The Cat scan cost was a great surprise to me...took about 10 minutes....


44 posted on 05/10/2013 1:48:49 PM PDT by goat granny
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To: goat granny

CT scan machines cost a few million and require special training to use. While $5k is too high the system is set up to appease the insurance industry.

The insurance industry marks the $5k down to about $400 depending on the policy. Most plans used to pay that.

A couple years ago I got very sick and spent 8 days in intensive care. The bill was $185,000 and it saved my life.

You could go to Canada where the CT scan is cheap but you wait 18 months for it. Thats always an option.


45 posted on 05/10/2013 2:03:52 PM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: driftdiver

to go to canada I need a passport....use to cross to canada all the time for slots and bingo. Not since the laws were changed.++++++When the bills started coming in you could have a company put them in a binder, it looked like a book with so many pages. But the cat scan proved one thing, I DO have a brain irreguardless of what people say...:O)


46 posted on 05/10/2013 2:11:37 PM PDT by goat granny
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To: driftdiver

It’s all about attributing overhead, and that’s all it’s about.

Look: I live in the woods. If I wake up at 0200 with chest pain, I dial 9-1-1 and within 20 minutes there’s a mobile coronary care unit in my driveway. Inside is a trained PA and an uplink to a heart station. The PA gives me drugs that probably stop me from dying on the spot. They roll.

I arrive at the heart center at 0315 where I’m met by an interventional cardiologist and his team (6 people). I’m on the table at 0340. If the study shows surgery is needed, by 0530 the cardiothoracic team is assembled (15 people) and I’m revascularized before the sun comes up.

Now, if the chest pain was just a bad dream, all those people are still getting paid and all that technology is still being paid for.

Multiply that by 365, spread it out over all the air casts and aspirins, and it really adds up.


47 posted on 05/10/2013 2:13:12 PM PDT by Jim Noble (When strong, avoid them. Attack their weaknesses. Emerge to their surprise.)
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To: Jim Noble

Too many big words


48 posted on 05/10/2013 2:20:09 PM PDT by driftdiver (I could eat it raw, but why do ithat when I have a fire.)
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To: goat granny

Auto insurance is one of the big contributors to excessive hospital costs. In the ‘no fault states’, the insurers just treat whatever the hospitals send as a book entry and mail checks until the policy limit is reached. A recent example in lower Delaware had a hospital charging almost $80,000 for 18 hours of limited care until the patient was moved elsewhere. It seems the bill was rushed to the insurer before anyone else could get their hands on the auto insurance stash. The insurance company wrote the check with a small discount and that was that. An insurer like Medicare or Aetna would have fought those charges down to less than half that, I’m sure.
This comparative study is the first worthwhile thing I’ve seen the government do to sensibly address the cost of medical care in this country.


49 posted on 05/10/2013 2:23:15 PM PDT by Hartlyboy
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To: Hartlyboy

I have had insurances send me a bill and try to by pass medicare and supplemental....Like you say in your answer, I called them and told them to bill medicare and supplemental. I told the gal I will not pay this bill and then in a little while you will bill medicare for the same thing..No problem after that, they went through the right proceedure and like you said, they didn’t get what they wanted me to pay....


50 posted on 05/10/2013 5:19:15 PM PDT by goat granny
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