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I can't tell you how disheartened I was to read last night that President Obama was willing to put any part of Tricare on the table of cuts. The title of this piece is taken directly from Bob Woodward's description of a grand bargain between the White House and Speaker Boehner. But Bob Woodward doesn't understand that military folks gave up a long time ago on any of their benefits being sacred.

Over 20 years ago, I watched my Dad lose free health care for both him and my mom. I saw military retirees angry with the government, especially at Congress, for making promises they had no intent to keep. I watched as a court case determined that Congress actually didn't make a promise, that recruiters lied and mislead, and that retirees were shit out of luck. Sacred went out the window and it did so under a Democratic President. Is history about to repeat itself?

I've heard fellow Americans say it's no big deal. The increased costs to retirees were minor back then, especially when you see how much other Americans pay to get their health coverage today, if they can afford to pay at all. It's a divide and conquer system where Congress uses the anger of those living without as a wedge to make incremental changes to systems that essentially can work but are tied by excess regulation and are run by people who essentially want government to fail at their job. Instead of truly fixing the system, they would prefer to see it limp along poorly so that more Americans learn that government can't manage and would be better off out of the health care business.

Below the fold, I'm going to introduce you to TRICARE and tell you how important it really is. But before I do that, I need you to know one thing. Our Government can fix all health care problems once and for all by tackling the issue at hand - health care costs are driven by a broken system and the system itself needs fixing. Not part of it but all of it. Until that time, tinkering with pieces and parts only enables a broken system to survive but never allows it to thrive. In the words of one of my military doctors, "We just need to simply put all government health care under one chain of command. The VA, Medicare, and Tricare should all be one program. We could save millions." I will take her idea one step further - let's just get all health care under one plan and start saving those millions, possibly trillions, today. Then we won't need to talk about screwing our military retirees at all.

Looks like my husband and I get to repeat the retiree scare of the 1990's. When he joined the Air Force over 22 years ago, we were under the expectation that part of his retirement package would include free health care for himself and for me. As 20 somethings, this wasn't a big deal but it certainly was a part of the big picture, especially for me. My husband is driven by his desire to serve the public, like almost every military service member. If he was asked to give up something for his country, his answer would most likely be yes. Even his health care. That is why it is so important that spouses like myself speak up. We're often a little more practical about the day to day living. We manage the money, especially when our active duty members are deployed or just too damn busy at work to make it home. We fret about not putting savings into a home or, if we're fortunate enough to live in a place long enough to own a home, we fret about our ability to sell it or rent it when it's time to leave. We worry about the rising cost of college and wonder if that GI Bill split between the two kids will be enough to see us through their combined 8 years of university education. We spouses know that health care is expensive and we believed that a part of putting up with military was paid back in the benefit of having a free system we could rely on. Then, we felt lucky we could rely on a system that was affordable. Today, I don't feel lucky. I feel scared.

At 45 years old I recently had the biggest scare of my health care life. This last summer I suffered a bout of something called optic neuritis. I thought I was going blind in one eye. And then I found out that it is increased my risk of being diagnosed with MS. So far, I've been clear of that diagnosis and we hope that the tests continue to show a healthy woman who just had a case of ideopathic optic neuritis (basically a case that has no explanation). I won't go into all the details but I will tell you that the care I have received in our military system has been fantastic. Being stationed near Washington DC has made such a difference as I have had access to a top notch Opthamologist and Neurologist as well as a great Primary Care Physician, all military doctors. My care is paid for 100%. That will change the day my husband retires. Currently, we can turn to Tricare For Life, the plan for retirees that allows them to continue using the military health care system. But it increasingly looks like that plan is going to be taken away by the Obama Administration. Part of it will happen without any help from Congress. Retirees using Tricare for Life Tricare Prime will be transferred to a program called Tricare Standard. While it allows its enrollees to use any doctor, it also charges co-pays for each and every visit. For someone like me, seeing multiple doctors of multiple specialities, those visits are going to add up. Add in the MRI's, the CT scans, and possibly the costs of medications (currently I am medication free, thank goodness), and it won't be cheap. Basically, the Administration will just transfer the cost of health care from the government to the military retiree or spouse.

Then we have a greater fear - what happens when Congress sits down with an Administration that is already willing to make these cuts? We know when Democrats sit down at the bargaining table with a stance that has already moved to the right that it is impossible to move to the left. It does not happen. And Bob Woodward released documents on Meet the Press yesterday that list both TRICARE for Life and and TRICARE drug copayments as areas worthy of cutting in a grand bargain between the White House and our Republican House of Representatives. We can hope that making cuts to TRICARE Prime, the program used by the vast majority of active duty families, is not on the chopping board at all but there are no guarantees.

This topic needs to be discussed far and wide and not just among military community members. If we as a nation cannot live up to the promises we have made the men and women in uniform, what does that say about us as a nation? Let's move this attempt to save money to the arena where it belongs - in the broader conversation about health care in the entire United States and quit trying to fix the broken system on the backs of those who served. Please talk about this with your friends, family, and neighbors. Please call your Congressman and let them know this is untenable. Please write or call President Obama and remind him that making these kind of austerity cuts are the wrong way to ultimately fix our broken economy.

Please, just call.

Originally posted to Military Community Members of Daily Kos on Tue Nov 13, 2012 at 06:53 AM PST.

Also republished by DKos Military Veterans.

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Comment Preferences

  •  Much simpler, much cheaper...... (17+ / 0-)
    "We just need to simply put all government health care under one chain of command. The VA, Medicare, and Tricare should all be one program. We could save millions." I will take her idea one step further - let's just get all health care under one plan and start saving those millions, possibly trillions, today. Then we won't need to talk about screwing our military retirees at all.
  •  Well, if it's a choice (5+ / 0-)

         between Tricare and, say, the F-35, which do expect they'll cut ?

    The free market is not the solution, the free market is the problem.

    by Azazello on Tue Nov 13, 2012 at 07:00:30 AM PST

  •  This truly takes a grassroots action (13+ / 0-)

    I have been on Tricare Standard since I retired. It has a $250 deductible- then you pay 20% of what Tricare determines as the cost.
    At least to this point- I haven't been made to pay any co-pays. I give them my ID card and am told there is no co-pay.
    As for Tricare for life- that doesn't kick in until you are Medicare eligible.
    But- there has always been a drive to cut retiree medical benefits- it's sooo easy to do. There really aren't alot of us,compared to the general population.
    And divide and conquer is the strategy.
    You can bet that not only will I write my Senators and Congressman- we also need to activate All the Veterans organizations.
    So- what are we waiting for?

    Intolerance betrays want of faith in one's cause. Mohandas Gandhi

    by onceasgt on Tue Nov 13, 2012 at 07:23:01 AM PST

    •  So your doctors aren't asking for the co-pay (3+ / 0-)
      Recommended by:
      ccasas, llbear, DaNang65

      or Tricare isn't asking for the co-pay? That's interesting. I know some military families that have chosen Standard and they all pay co-pays. Most of them use specialists and they want to be able to continue specialist care at each new location without having to go through the referral process all over again. Another example of over regulation on the Tricare Prime side costing us too much taxpayer money, IMO.

      •  I've never been asked for a co -pay (3+ / 0-)
        Recommended by:
        angelajean, llbear, DaNang65

        Even when seeing a specialist. As for prescriptions, they don't even ask for the $3 for generics. I do have to pay full cost up to $250 for everything but preventive care (mammogram,etc.)which is new because of the ACA.

        Intolerance betrays want of faith in one's cause. Mohandas Gandhi

        by onceasgt on Tue Nov 13, 2012 at 08:05:43 AM PST

        [ Parent ]

    •  I've always had to pay a prescription drug co-pay. (2+ / 0-)
      Recommended by:
      llbear, VeloVixen

      And I have been on TriCare since 1986.

      I think it is important to understand what the proposal involves. It only involves the co-pay for prescription drugs and no other benefit under TriCare.  At present, the co-pay only kicks in if a beneficiary chooses to get prescriptions filled at a retail pharmacy. If you take the prescription to the nearest military facility and get the prescription filled there, there is no co-pay. I am not sure if this "free on base" benefit will change under the proposal. If it will change, I will be angry.

      If the goal is to reduce spending on prescription drugs for TriCare beneficiaries, it probably means that the co-pay will most likely increase. But remember, paying a co-pay is really a matter of choice right now.

       Currently, the monthly co-pay is $12.00 per prescription for formulary (usually generic or patent expired) drugs and up to $25.00 per prescription for non-formulary (usually brand name drugs) for a one month supply if you get your prescriptions filled at a retail pharmacy. If you get them filled through the TriCare ExpressScripts system by mail, you pay one month's co-pay for a three month supply. This is pretty much the same under Medicare Part D and virtually all prescription supplemental plans.

      So in the final analysis, right now, the co-pay only kicks in on TriCare beneficiaries if they choose to NOT have their prescriptions filled at a military facility where the costs of drugs are better controlled by the Pentagon's ability to negotiate prices. If they choose to go to retail pharmacies, the co-pays are not too unreasonable, and TriCare itself offers a plan to reduce the costs by
      two-thirds.

      I am currently spending about $110.00 every three months for 7 prescriptions that I take for various chronic conditions. If I drove down to Camp Pendleton, I would spend about $20.00 in gas and 3 hours. For me, it really is a matter of convenience, and my retirement pay from the military more than covers my prescription drug costs.

      Bottomline: The proposal is NOT suggesting in anyway that TriCare or TriCare for Life be taken away from beneficiaries. It is only the prescriptions costs that are being looked at. And these are optional under current law - one can avoid them by simply going on base.

      So while I will continually monitor my benefits, I don't know if I can get too excited about the "grand bargain" proposal as it currently seems to be. I'm willing to do my part to help out, just as I was willing to serve for 22 years. Just so long as it is fair. Now, if it were to be unfair, that's a different story.

      The foolish and the dead alone never change their opinions. James Russell Lowell

      by Serendipity on Tue Nov 13, 2012 at 08:20:59 AM PST

      [ Parent ]

  •  Please Rec this diary-We need you Kossacks! (6+ / 0-)

    Intolerance betrays want of faith in one's cause. Mohandas Gandhi

    by onceasgt on Tue Nov 13, 2012 at 07:23:57 AM PST

  •  Truly an abomination... (5+ / 0-)

    Young men and women, coming home from war in droves with broken bodies and minds. The absolute LEAST out country can do is honor the sacrifice by providing Healthcare to its wounded and retirees.  I fear these cuts are a shiny object meant to preserve the unwarranted military industrial contracts which the military does not need and has not ask for.  

    “Too often we honor swagger and bluster and wielders of force; too often we excuse those who are willing to build their own lives on the shattered dreams of others.” ― Robert F. Kennedy

    by docreed2003 on Tue Nov 13, 2012 at 07:28:26 AM PST

  •  Husband is retired Army (4+ / 0-)

    I'm on Prime, he's on Standard. He has more medical issues than I do, he's a paraplegic caused by a bicycle accident. He was on Medicare for a while and was sent to some wonderful specialists. They're not on Prime, so he's on Standard. The big problem we have with Standard is the major costs if you are admitted to a hospital.
    They keep braking their promises to us.

  •  There is a annual expenditure cap on Tricare (4+ / 0-)
    Recommended by:
    angelajean, llbear, DaNang65, Lily O Lady

    Standard once a family hits it you have no further out of pocket costs.  This saved me from bankruptcy while discovering and treating the Chronic Lyme disease.

    I was greatly disturbed to hear about this memo.  Time for letters to both Obamas, the Bidens, and all my congress critters.  I did wonder, since it was from last year, if now that he won an election, he would take it back "off the table".  I certainly hope so.

    You can't make the speech he made Sunday and then cut Tricare.  It is hypocritical and wrong.

  •  There is an answer but the administration (3+ / 0-)
    Recommended by:
    angelajean, llbear, DaNang65

    would not like it I am afraid.   Disabled veterans and their familes are not entitled to Tricare.  Only retirees and active military.  The veterans and thier families if 100 percent total and permanent and only those deemed total and permanent are awarded Champ VA.
    The Champ VA program does NOT give access to the veteran as he or she is the sponsor.  Absolutely no shared prescription cost for the veteran. This health care is  Strictly for the family.

      It offers no dental, little mental health and a 30 percent out of pocket cost to the patient.  It is supposed to be a sister health plan to medicare but not all providers will take Champ VA...based out of Colorado.

    The vision is not covered but in some instances they will cover some vision problems.  Now get this, the only way you can get dental work is if your jaw is broken or you are in an accident of sorts.  No dental, limited mental access and no vision.  The whole thing is basic medical for serious illness and the deductible is 100.00 per year  with a 30 percent co pay.  There you have it.  It beats nothing but it is good for catastrophic costs.  it caps out.

    My answer is to put all total and permanent and retirees under  Tri Care and eliminate the other program.  One can get meds by mail by champ va but the monies they would get from deductibles and co pays from the disabled community who do have to switch to medicare part b at age 65....or flat medicare for all.  I am not pleased to hear about the potential cuts in tricare and it looks like you are heading to Champ VA type coverage which just is not that good.

    We the People have to make a difference and the Change.....Just do it ! Be part of helping us build a veteran community online. United Veterans of America

    by Vetwife on Tue Nov 13, 2012 at 07:54:28 AM PST

  •  While I agree with the intent of this (2+ / 1-)
    Recommended by:
    Carol in San Antonio, llbear
    Hidden by:
    onceasgt

    Here's the way I see it.  

    The military is rife with Republicans, TPers and Libertarians who think government should be smaller, tax less, and get out of their business.  That includes retirees and other former military members.  And yet they don't see an issue with themselves personally taking advantage of government provided services, like health care because "they earned it."  

    Never mind that everyone who has paid into the system has earned it as well.  They think they are special and others are the freeloaders.  They are makers while others are takers.

    Never mind that because they didn't fight for the rights of those coming behind them that the promise of free health care for veterans for life wasn't even something that recent veterans were tempted with, because it didn't exist.  

    There are retirees who spent their entire 20 years in the military as file clerks in the Cold War, who claim to have "earned" their TriCare, while recent veterans like myself who served in Iraq or Afghanistan and know what war really is, don't get the same benefits if we chose to leave the service.  (I could get health care through the VA system, but since I have employer sponsored health plan and make above the poverty level in annual income, it really doesn't apply.)

    I'm not saying that your situation is a reflection of any of this, but that's the way it is currently.

    But my point is, let TriCare be on the table.  Let the military to argue that it should be untouched.  See how many would rather try their luck in the open market.  Get all of these conservative, TP loving, Oathkeepers out in the open of supporting government run health care and we'll expose them for the selfish, me first, assholes that we know they are.  

    And right now it's just a proposal, a bargaining chip.  (And don't forget that through Medicare and Obamacare these retirees will still be covered, just under a different umbrella) Let's see if the Republicans accept it, then they can also be exposed for their false support of the troops, when really what they care about is defense contractors not personnel.  After all it was Bush-era appointee David Chu, that said that veteran's benefits "have gotten to the point where they are hurtful. They are taking away from the nation's ability to defend itself."  
    WSJ

    Look, as a nation we broke our "sacred bond" to veterans a long time ago, all the way back to the Bonus Army  and even before that.  The difference was that then, those veterans were not career military, they were regular citizens that answered the call when needed - something that I hold in higher regard than some of our professional military, especially those who served their careers in staff and noncombat positions and never got their boots sullied by foreign soil.  Now we have a military, where a large majority hold themselves above the rest simply for putting on the uniform and at the same time are protesting against the rest of the country receiving the same kind of benefits from the government which they currently enjoy.  Doesn't sound very patriotic to me.  
     

    •  I was arguing this with a military friend of mine (3+ / 0-)
      Recommended by:
      angelajean, gooderservice, llbear

      the other day. I say anyone who serves gets health care for life (hell, congress does.) My friend, who was a Black Hawk pilot in the army for 20 years argues that file clerks don't deserve it.

      But as we've seen file clerks get sent to the front line and even if they didn't they joined up so they deserve our unwavering gratitude for life.

      Well, as long as we have standing armies. I could argue that we could phaze out Tri Care by disbanding our military and using all the money to pay for the ex soilders  until there are no more ex soilders  to pay for. Then maybe we could feed and clothe the poor.

      Tracy B Ann - technically that is my signature.

      by ZenTrainer on Tue Nov 13, 2012 at 08:42:12 AM PST

      [ Parent ]

      •  Pilots don't fly unless file clerks do their jobs. (3+ / 0-)
        Recommended by:
        ZenTrainer, gooderservice, llbear

        And I don't think there are many file clerks anymore anyway... those kinds of jobs have been privatized or we hire civilians.

        •  In case it got lost in what I wrote, (3+ / 0-)
          Recommended by:
          angelajean, llbear, ZenTrainer

          I am a veteran of OIF who left the military before being eligible for retirement.  So at present, I get nothing in terms of health care from the military (though if I was at the poverty level I could seek care through the VA).  And I think the government's track record of breaking promises is a tragedy and a scandal.  I cited the Bonus Army of 1932 and acknowledged that it went further back than that.  We talk a lot about supporting the troops when they are fighting, but turn our backs on them when they come home.

          File clerk is a generic I used to describe a non-combat service member of which there is a 3-to-1 ratio in the military.

          Last I checked, there were still plenty of admin, logistics, and other support personnel in the military.  

          There are combat arms, combat support, and combat service support personnel in the military.  You're right none can do their jobs without the other.  

          But my point was not to denigrate file clerks and other non-combat arms personnel in the military (I was in a combat support role, but that didn't mean much when I was ambushed during convoys in Iraq)

          My point is that I think everyone in the military has right to health care, in fact every citizen does.  (From a program standpoint, there could be differences in levels of coverage, facilities available, and payment requirements for military vs. non-military to recognize their service and sacrifice)

          Further, knowing the percentage of the military who support the Republican, Libertarian, Tea Party, and Oathkeeper position I would like to see them stand up and defend Tricare and admit that government programs can be good and worth supporting.  Maybe then they'd see the illogical nature of their political position.

  •  FYI this is from last year... (3+ / 0-)

    The "Grand Bargain" memo from Woodward is from the talks that occurred last summer when Obama made irresponsible concessions to the Tea Party crazies. Also note that Woodward is not totally impartial: his book on the debt ceiling talks was significantly slanted against Obama.

    But your concerns are absolutely well-founded. However, a lot of guys whose analysis I respect (Jonathan Chait among them) are saying Obama is going to press a much harder line than before.

  •  In the words of President Teddy Roosevelt (2+ / 0-)
    Recommended by:
    angelajean, Lily O Lady

    "A man who is good enough to shed his blood for his country is good enough to be given a square deal afterwards. More than that no man is entitled, and less than that no man shall have."
    Speech to veterans, Springfield, IL, July 4, 1903

    "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

    by FloridaSNMOM on Tue Nov 13, 2012 at 10:45:54 AM PST

  •  Military Spouses could be the most effective (1+ / 0-)
    Recommended by:
    angelajean

    organizers of a comprehensive health care system [ OneCare is a good sounding name ] that  covers ALL miliary - both past and present.

    Before making any decisions defining your mission, you should start developing a list including every spouse who regularly ontacts either the White House or Congress for veterans, retirees, active duty, and reserve.

    Here's where I suggest you start:
    1. The White House. Meet with staff people explaining what you are interested in doing. Find out from those  staff people dealing with health care and with the military [two different groups, my guess] who contacts them most frequently and most effectively. Do the same, if possible with the First Lady's staff [this will be key for my grand plan].

    2. Congress LegisStorm can  save you a lot of time. but costs $90 a month or $600 a year.
    a. The House of Representitves.
    (1) The House Committee on Veterans Affairs Subcommittee on Health
    (2) The House Armed Services Subcommittee on Military Personnel
    (3) The House Appropriations Subcommittee on Health Care, District of Columbia, Census and the National Archives
    b. The Senate
    (1) The Senate Committee on Veterans Affairs
    (a) Majority - (202) 224-9126
    (b) Minority - (202) 224-2074
    (2) Senate Committee on Appropriations Subcomittee on Labor, Health and Human Services, Education, and Related Agencies
    (3) The Senate Committee on Health, Education, Labor, and Pensions
    (4) The Senate Special Committee on Aging

    The llbear grand plan:
    In your meeting with the FLOTUS staff, explore their feeling about making your project an official project of the FLOTUS. Tell them about needing to locate all of the potential players in reforming and consolidating all of the health care systems.

    If you are really interested, this project will take at least 3 years just to launch and will require your presence in Washington long beyond your scheduled assignment. However, if you decide to tackle the issue as only you can, his next assignment could be changed.

    I know that you can do this and I really hope you do. It may look daunting but it really isn't. It is do-able in the right hands - and, angelajean, you have the right hands and heart to do it.

    Thank you for the update on your health. We've been on pins and needles since Spring about how you are.

    Those who fought the war in Afghanistan won it. Get them out of Afghanistan NOW . . . It's long past time. Those who want to wage the next war in Afghanistan are condemned to lose it.

    by llbear on Tue Nov 13, 2012 at 11:59:44 AM PST

  •  Very informative diary. (0+ / 0-)

    I certainly agree that our active duty and retired military are entitled to quality healthcare.  However, reviewing your link to Bob Woodward's released documents, it appears that the proposed cuts are TriCare For Life's drug copayments program, not to gut program itself, and are 16 billion over a 10 year period, which amounts to 1.6 billion per year.  The DoD budget is annually roughly 524 billion.

    There's an excellent article on the National Military Family Associate website that explains the Obama administration's 2013 proposed budget:

    The budget proposals that will cause most concern to military families, especially retirees, are those related to new and increased TRICARE fees. DoD officials cite both the overall increase in health care costs and the decreased share of costs paid by beneficiaries as the reasons increased fees are necessary. Costs for prescriptions filled outside of a Military Treatment Facility (MTF) will increase as well. However, increases would not apply to active duty service members.

    DoD is proposing higher annual increases in TRICARE Prime fees for retirees under age 65 and their families, but the increases will not be the same for all. DoD is adopting the recommendation of the 2007 Task Force on the Future of Military Health Care that recommended a tiered pricing structure based on retired pay. Last year, the Prime enrollment fee for a family for all under age 65 retirees was set at $520 per year. If the budget proposal is adopted, annual Prime family enrollment fees will range between $600 and $820 beginning October 1, 2012. By 2016, these fees will jump to a range of $850 to 1,950.

    Surviving spouses of service members who died on active duty and service members who were medically-retired and their families would be exempt from the increases in TRICARE Prime enrollment fees. In a big change, the enrollment fee will no longer count toward the catastrophic cap, meaning beneficiaries would have to meet the cap with actual health care costs. The catastrophic cap is the maximum amount beneficiaries must pay in a year before the government picks up all costs for care. Active duty families in Prime will still not have to pay an enrollment fee or co-pay when seeking care in the civilian sector.

    In addition to the increased Prime enrollment fees for retirees, DoD proposes instituting a first-ever enrollment fee for retirees and families using TRICARE Standard/Extra. These fees would not be tiered, but would be set at $70 for an individual in FY2013 and $140 for a family. TRICARE Standard deductibles would also increase from the current level of $300 for a retiree family and $150 for an individual to $320 and $160.

    Retirees and spouses over the age of 65 are eligible for TRICARE for Life, in which TRICARE covers the costs, usually 20%, not paid by Medicare. The cost of that benefit since it was created in 2001 was enrollment in Medicare Part B. Using the same tiered structure being proposed for Under Age 65 retirees in Prime, DoD proposes to implement an annual TRICARE for Life fee on top of the Medicare Part B premiums of $99 and up. The annual fee for each beneficiary beginning in FY13 would range from $35 to $115 with planned annual increases.

    Know what you believe, why you believe it, who believes with you, and how it matters. Stand for what you believe, believe what you stand for.

    by VeloVixen on Tue Nov 13, 2012 at 08:05:17 PM PST

  •  California is poised, (1+ / 0-)
    Recommended by:
    angelajean

    since the election results, to revist "Medicare for All"  which has been passed twice by the legislature only to be vetoed by Republican Governors.

    But I'll be sure to talk up the incorporation of all health care, VA and Tricare, etc., when it comes up again.  TY.

    "Truth and love will overcome lies and hatred.” Vaclav Havel

    by dharmasyd on Tue Nov 13, 2012 at 08:35:15 PM PST

  •  I love my Tricare. (0+ / 0-)

    I really hope they don't gut it.  I'm getting out in a few months and keeping Tricare is one reason I'm planning on joining the reserves to finish my twenty.

    "If Mitt takes office, sooner or later, the Zomnies will come for all of us." -Joss Whedon

    by quillsinister on Sun Nov 18, 2012 at 11:53:46 PM PST

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