JMS

Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

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as a side note to the thread since no one wants to answer any of points in the quote and would rather attack the (admittidly easy to attack) speaker, i have actually shot and missed a deer 4 consecutive times and hit it on the 5th. it was my first deer and i was so amped up i didn't notice that i had flipped my iron sites down. it wandered around while i was shooting at it and at one point it stood directly under my tree stand and looked up at me.

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after reading those who oppose this doing the rounds today, you can tell how surprised folks are.Their messages on all these shows were so disjointed and convoluted. I just read what Paul Ryan and Jindal's replies and both were shambles. "Bobby" went on about Chevy Volts and Tufu, Ryan said something like putting more money in Medicare takes money from Medicare.

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after reading those who oppose this doing the rounds today, you can tell how surprised folks are.Their messages on all these shows were so disjointed and convoluted. I just read what Paul Ryan and Jindal's replies and both were shambles. "Bobby" went on about Chevy Volts and Tufu, Ryan said something like putting more money in Medicare takes money from Medicare.

Was it perhaps 'putting more money in Medicaid BY taking money from Medicare'?...you know that is what they did

Bobby is simply talking about govt overreaching

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Was it perhaps 'putting more money in Medicaid BY taking money from Medicare'?...you know that is what they did

So, the Democrats cut Medicare, huh?

Guess that means it's time for the Republicans to agree to a tax hike, huh?

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So, the Democrats cut Medicare, huh?

Guess that means it's time for the Republicans to agree to a tax hike, huh?

I'll get back to you when we settle what a tax is ....there seems some confusion

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anyone want to tackle trump's rant

Typical smear job. People will be required to have health insurance - NOT forced to buy some gov't chosen plan - rather, they will purchase whatever plan they chose based on the competitive choices of free markets. The mandate, which was proposed by the conservative Heritage Foundation (not Romney, he was just the only one with the ability to get it passed), was the centerpiece of every single major GOP healthcare proposal that I'm aware of. In other words, it was a revolutionary free market idea...until Obama ran with it....just like Cap and Trade.

One might also point out this hypocrisy between both parties - the Ryan plan, adored by GOPers and loathed by Dems, essentially does the same thing with Medicare. Medicare has been an insurance mandate from the beginning, but the money goes straight to the gov't, and the gov't pays medical providers for services. Under Ryan's plan, seniors will get subsidies to purchase private insurance in place of gov't care in order to use the free market system to control costs....just as Obamacare forces ordinary people to buy their own insurance but provides subsidies for lower income earners to make it affordable.

The major flaw with Obamacare is it will likely prove to be far too expensive in the long run. Though it's projected to save money, nearly every such plan ends up going far beyond CBO estimates. I also don't like the fact that like every other supposed reform, it puts more of the onus on employers to provide insurance, and will likely be a considerable financial burden to small businesses.

Edited by Riggo-toni

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This message is hidden because twa is on your ignore list.

FYI, Pal. Not putting this out there to be a jerk. Just figured you wouldn't waste time replying to folks who put you on ignore....if you knew this was the case.

take it easy.

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The major flaw with Obamacare is it will likely prove to be far too expensive in the long run. Though it's projected to save money, nearly every such plan ends up going far beyond CBO estimates. I also don't like the fact that like every other supposed reform, it puts more of the onus on employers to provide insurance, and will likely be a considerable financial burden to small businesses.

Yeah, I've thought ever sonce this theme came up, that the best health care system would be for the government to run a single national system that covered essentials. Just the minimum level of care that we think that the poorest person in the nation is entitled to. And then allow the free market to compete to offer "medicare supplemental insurance", that covers more things.

But then, I have to reflect that, if we ever passed such a system, then the government would instantly be under pressure to expand the system to include more and more things. And everybody would be wanting the thing to expand. The doctors, the providers, employers, voters, even the insurance companies would want for the government to cover more and more things.

And, it occurs to me, that when all of those groups, and their lobbyists, want the government to expand it's "bare minimum" coverage, then it's going to get expanded.

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Perhaps if it was funded solely with a dedicated tax costs/expanding benefits could be controlled....I too believe a basic minimum should be provided to all

the problem of saying we can no longer give you a higher level of care is not one we embrace,tis easier to rob Peter

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My facts may be out of date, but I think that gov't health care has been rising at about double the rate of private healthcare.

I don't want a single payer, but rather a single set of federal regulations with universal forms for all private insurers. Abolish all state regulations, allow insurers and policies to cross state lines, and replace employer insurance with tax-exempt "benefit dollars" which employees can allocate themselves to any combination of health insurance or retirement savings, with everyone is required to at least have catastrophic coverage. Shop owners or cabinet makers, for example can form guilds and purchase group policies.

Edited by Riggo-toni

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My facts may be out of date, but I think that gov't health care has been rising at about double the rate of private healthcare.

I obviously have no idea what kind of statistics you're referring to. But I will observe that, IMO, it's real tough to compare "government health care" and "private health care", because in many cases, they're covering wildly differing demographics (how many 80 year olds aren't covered by Medicare?), or, if you want to compare the insurance offered to government employees (which, I believe, are all private insurance), then you're looking at employees who generally accept lower salary in exchange for much better coverage.

In short, I would think that it would be really tough to make an apples to apples comparison.

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anyone want to tackle trump's rant:

besides the fact that he is a fan of broader healthcare (from his book in 2000), how about someone break down his little rant.

where's yusurf when i need him?!

Sure. I would love to break it down.

We're going to be "gifted" with a health care plan we are forced to purchase and fined if we don't, which purportedly covers at least ten million more people, without adding a single new doctor but provides for 16,000 new IRS agents,

It is never good to start your rambling argument with a straight up lie. But then again, who gives a **** about the truth anyhow.

http://www.factcheck.org/2010/03/irs-expansion/

...... written by a committee whose chairman says he doesn't understand it, passed by a Congress that didn't read it but exempted themselves from it, and signed by a... President who smokes,

And another lie . . . . . :ols:

http://www.forbes.com/sites/rickungar/2011/12/08/congress-exempted-from-obamacare/

........with funding administered by a treasury chief who didn't pay his taxes, for which we'll be taxed for four years before any benefits take effect,

The tax or fee doesn't start until 2014 (I think) - many of benefits take effect before that, some have already gone into effect, so i don't understand his 4 year number at all. The fee or tax will only effect a tiny portion of the country that can afford health care but choose not to get coverage . . . . until they end up in the hospital, declare bankruptcy and then use my money to bailing themselves out.

........ by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese, and financed by a country that's broke!!!!

Social Security and medicare are not bankrupt. Reforms are needed to avoid problems in the future but to say they are bankrupt is just another lazy lie.

Overall, this paragraph sums up the current conservative movement perfectly. Rambling nonsense filled with lies and distortions. Thank you for posting it.

Edited by Duckus

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Overall, this paragraph sums up the current conservative movement perfectly. Rambling nonsense filled with lies and distortions. Thank you for posting it.

no problem. but when both sides lie about the issue:

http://factcheck.org/2012/06/romney-obama-uphold-health-care-falsehoods/

(a great website by the way)

then the people are left to their own devices and those that speak the loudest.

and not to get too into SS, but they sent me a letter saying that i shouldn't plan on getting even 75% of the money i put into SS back and that's if everything stabilized. it was not a happy statement to say the least.

the one interesting point about the "buy or be taxed" is that there is no enforcement (or so i read somewhere). the only thing the IRS can do to actually enforce this tax is withhold any return money you may get, but they cannot enforce it with liens or anything like that. i'll try to look for the article.

edit;

here you go:

The law prohibits the IRS from seeking to put anybody in jail or seizing their property for simple refusal to pay the tax. The law says specifically that taxpayers “shall not be subject to any criminal prosecution or penalty” for failure to pay, and also that the IRS cannot file a tax lien (a legal claim against such things as homes, cars, wages and bank accounts) or a “levy” (seizure of property or bank accounts).

The law says that the IRS will collect the tax “in the same manner as an assessable penalty under subchapter B of chapter 68” of the tax code. That part of the tax code provides for imposing an additional penalty “equal to the total amount of the tax evaded, or not collected.” It also requires written notices to the taxpayer, and provides for court proceedings.

So it may turn out that the IRS will be suing those who fail to pay the tax for double the amount. But so far, the IRS has not spelled out exactly how it will enforce the new penalty with the limited power the law gives it.

Edited by tiger187126

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I think the primary driver of the difference in health care costs is the independent and fractured way in which pay for, supply, distribute, and even produce health care.

You know fundimentally why, U.S. drug companies sell their goods to Canada at 50% of cost they sell them here domestically? Because it's profitable for them to do so. There is simple no other explaination. There is no force on earth that could get a for profit company to sell goods at a loss. Why do they sell them here so much more expensively... Because they can!. Because it's more profitable for them to do so. Why wouldn't they? In a free market competition would create a downward pressure on raising profit margins. Our system has no competition, the insurance companies are free to charge what they can devoid of their own costs which they don't share with the American consumer.

The way socialized programs deal with our for profit corporations to exact 50% cost on goods is throught consolidated purchasing. That doesn't make our lack of consolidated purchasing the primary driver of our expensive pharmisuticals. The primary reason our goods cost more is our for profit corporations simple charge us more. Our healthcare systems framework was designed in the mid 1940's to work via non profits, devoid of competition. In the 1980's we switched over to primarily for profit system while leaving the anti competition and collusion frameworks in place.... ( McCarran–Ferguson Act )

I think that the "paper work" that is required to keep track of who got where when by whom and who paid how much increases costs significantly over single payer systems like those in Canada.

I think drug companies being one of the most "profitable" stock investments segments of our economy beginning in the 1980's and 1990's is a far greater cause for our higher prices for goods. I don't think book keeping is even a blip on the radar since those costs are primarily absorbed by the retailers and not the pharma's responsible for the cost of the drugs.

I suspect that many of these other countries function like France where things like medical school is paid for (and run) by the government.

Medical schools and doctors costs are not a primary driver of our healthcare costs today as they were back in the 1970's. Today the three trusts which run our healthcare industry are the drug companies, the hospital companies, and the insurance companies.... Cost to physicians is not worth even mentioning when compared to the ever increasing funds being driven by these three blocks of companies.

Edited by JMS

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You know fundimentally why, U.S. drug companies sell their goods to Canada at 50% of cost they sell them here domestically?

No, I don't know that. Do you want to actually post something (note, I'm not claiming that drugs tend to costs more in the US, but I am dubious of your 50% number)?

I do know that generics actually frequently costs more in Canada.

http://www.pdci.on.ca/pdf/Generic%20Pricing%20Study%20Final%20Report.pdf

Of course, most of the generics that are sold in Canada are made in Canada vs. the non-generics tend to be made elsewhere (in the US).

http://www.pharmascience.com/canada/about-generic-drugs/

In other words, Canada is essentially using drug prices to subsidize their own industry.

Because it's profitable for them to do so. There is simple no other explaination. There is no force on earth that could get a for profit company to sell goods at a loss. Why do they sell them here so much more expensively... Because they can!.

With respect to phamaceuticals there are two costs. First, is manufacturing costs- that tend to be cheap. Then there is development costs, which are much less likely to be cheap.

Once a drug is developed, it makes sense for a company to sell a drug if they are reasonably covering their manfacturing costs.

But it doesn't cover the costs of R&D.

Your also acting like every drug in the US ends up gettting sold in Canada. That there are times when the Pharma companies can't come to some sort of agreement w/ the Provinces.

But the fact of the matter is that a large number of drugs approved medically in Canada couldn't be bought in parts of Canada because of lack of agreements in Canada over price.

http://journals.lww.com/lww-medicalcare/Abstract/2001/04000/A_Dog_s_Breakfast___Prescription_Drug_Coverage.3.aspx

I do believe that Canada has actually gone to a national, not province, negotiating system, but that doesn't eliminate the issue in terms of there being a lack of an agreement over price for medically aproved drugs.

In a free market competition would create a downward pressure on raising profit margins. Our system has no competition, the insurance companies are free to charge what they can devoid of their own costs which they don't share with the American consumer.

We (well you) haven't been talking about insurance prices. You've been talking about drug prices.

The drug industry is certinaly open to competition.

I know some argue that patents are too protective, but if you believe that, then you don't have to go to doing what Canada has done. You could simply eliminate or reduce patent times so this part of your comment makes no real sense in the context of the rest of your post.

The way socialized programs deal with our for profit corporations to exact 50% cost on goods is throught consolidated purchasing. That doesn't make our lack of consolidated purchasing the primary driver of our expensive pharmisuticals. The primary reason our goods cost more is our for profit corporations simple charge us more. Our healthcare systems framework was designed in the mid 1940's to work via non profits, devoid of competition. In the 1980's we switched over to primarily for profit system while leaving the anti competition and collusion frameworks in place.... ( McCarran–Ferguson Act )

The Pharma industry was never dominated by non-profits.

Your mixing and matching aruments and industries so that they make no sense.

I think drug companies being one of the most "profitable" stock investments segments of our economy beginning in the 1980's and 1990's is a far greater cause for our higher prices for goods. I don't think book keeping is even a blip on the radar since those costs are primarily absorbed by the retailers and not the pharma's responsible for the cost of the drugs.

I was talking about healthcare costs as whole. Not just drug prices.

Do you have anything that shows something unusual happened with respect to Pharms stocks during the 1980's with respect to other industries and the role of drugs in the US economy?

Medical schools and doctors costs are not a primary driver of our healthcare costs today as they were back in the 1970's. Today the three trusts which run our healthcare industry are the drug companies, the hospital companies, and the insurance companies.... Cost to physicians is not worth even mentioning when compared to the ever increasing funds being driven by these three blocks of companies.

Well, I reject the idea that Pharma represents a trust any more than any other industry that is based on patents.

If we are going to call Pharam a trust, we might as well call the PC and smart phone industries trusts too.

Now that doesn't mean that we can't talk about the effects of patents on various industries and how to maybe adjust those patents if we want to.

Do you have anything that actually shows costs broken down by component?

How much have costs to physicians gone up or not gone up?

**EDIT**

You might find this interesting JMS:

http://www.nejm.org/doi/full/10.1056/NEJMsa022033

"Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)"

"The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system."

And that's just health care directly. That doesn't include the insurance industry, education, or other indirect things like that.

Edited by PeterMP

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No, I don't know that. Do you want to actually post something (note, I'm not claiming that drugs tend to costs more in the US, but I am dubious of your 50% number)?

Now you know.

American brand name drugs sell in Canada for half the price they sell in the United States ON AVERAGE!...

The report says Canadian brand prices are about 50 percent less, which would mean the price for a brand-name drug in the US is about $133.

http://www.pharmalot.com/2010/06/does-the-canadian-system-really-lower-drug-prices/

It is not uncommon for a Canada pharmacy prescription to be 50% cheaper than one purchased in the US, and not unheard of for Canadian prescription drugs to be up to 90% cheaper.

http://www.bigmountaindrugs.com/

I do know that generics actually frequently costs more in Canada

So What? If our discussion is that large pharma companies are rapeing the US consumer, basically because they can.. What does the cost of generics have to do with that discussion?

---------- Post added July-2nd-2012 at 12:44 PM ----------

With respect to phamaceuticals there are two costs. First, is manufacturing costs- that tend to be cheap. Then there is development costs, which are much less likely to be cheap.

With respect pharmaceutical companies have one price. The price to the consumer. There is no force on earth that could get a US pharmaceutical company to sell their product in Canada at a loss. Thus we are forced to acknowledge they are making a profit when they sell their drugs in Canada. They sell them here for 50% more for the last few decades, simple because they make more doing so and their is no protection for US consumers to stop them.

Edited by JMS

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Now you know.

American brand name drugs sell in Canada for half the price they sell in the United States ON AVERAGE!...

So What? If our discussion is that large pharma companies are rapeing the US consumer, basically because they can.. What does the cost of generics have to do with that discussion?

I thought the discussion was health care costs.

Aren't generics part of health care costs? Even now, you've seemed to have gone from drug costs to name brand drug costs.

In how many of these cases is there generic availible and the person want the name brand? If the person is putting a premium on the name brand over the generic, is there a reason the company shouldn't?

From your link:

"Does government intervention help Canadians obtain lower drug prices compared with the free market in the US? Not according to a new report from the Fraser Institute, a libertarian think tank in Calgary, which examined per-capita spending on meds by both Canadians and Americans last year. The results indicate that everyone is spending the same 1.7 percent of their income on a per-capita basis."

And if we combine that with the fact that we take more drugs (see the study I linked before), it seems like we are doing pretty good on that front.

**EDIT**

Think of this way JMS, they are using generic prices to subsidize Canadian industry at the costs of US industry (non-generics).

We are doing the opposite.

In the end, from what you've posted, in terms of costs, it seems to be about a wash.

Would you rather see us adopt the Canadian system and start subsidizing non-US generic industry (where non-generic industry is mostly non-US)?

Edited by PeterMP

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The drug industry is certinaly open to competition.

It's really not. US Drug companies make most of their money from Name brand drugs which are devoid of competition due to intellectual property rights legislation. They control the market by being the only guy offering the given service, they don't compete.

---------- Post added July-2nd-2012 at 01:14 PM ----------

I thought the discussion was health care costs.

Pharma costs are one of the three trusts responsible for out of control Healthcare spending all in the absense of competition.. Pharmaceuticals, Insruance, and healthcare provider companies ( hospitals).

---------- Post added July-2nd-2012 at 01:18 PM ----------

Aren't generics part of health care costs? Even now, you've seemed to have gone from drug costs to name brand drug costs.

You want to argue the exception... I want to argue the rule. If you want to claim large American pharmaceuticals make most of their profits on generic drugs then please do.

But since we both understand well that the vast majority of pharmaceutical profits come from name brand drugs, those are the ones we will discuss when trying to understand the relationship between profits

and high consumer costs for drugs which was already documented in your own sources provided..

Edited by JMS

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It's really not. US Drug companies make most of their money from Name brand drugs which are devoid of competition due to intellectual property rights legislation. They control the market by being the only guy offering the given service, they don't compete.

1. This is true for every patent based industry smart phones, the PC industry, search engines, etc. You don't run around calling those things trust.

2. There is competition, at the level as those other industries, drugs that have the similar or same affects that are not based on the same IP.

You saw this for a while with erectile dysfunction. There were several patent protected ED drugs on the market from different manufacturers (I believe now there are also generics, but there was a time when there were only different name brand options.)

That's the way every IP based industry works in terms of competition.

And again, if you have an issue with the patent system, then why don't we adjust the patent system (e.g. their lenght of time)?

Edited by PeterMP

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Think of this way JMS, they are using generic prices to subsidize Canadian industry at the costs of US industry (non-generics).

That is what the pharmaceutical companies say. They are such nice guys they sell their goods for 50% of the price in Canada and that is basically at the expense of the US consumer.

Which is total bunk... That's not how a market works, even a non free market.

The way a market works is you want to buy my goods, I'll sell them to you at a profit. If I can't get a profit, I don't sell my goods to you. There is no force on earth that can get a US Company to sell their goods on a mass scale to another country at a Loss for decades as the US Pharmaceutical companies are doing.

They just sell them to US consumers for more, because they can. Unlike Canada we have no downward penelty on these companies to keep them honest. No competition, no collective buying, and no set profit margin to ensure consumer fairness.... We, the US tax payer pay for 90% of the research, and then we gift our patents over the the pharma companies, who rape us until the patents run out.... making huge profits and loads of money along the way. Then the drug becomes a generic and they move onto the next one.

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That is what the pharmaceutical companies say. They are such nice guys they sell their goods for 50% of the price in Canada and that is basically at the expense of the US consumer.

Which is total bunk... That's not how a market works, even a non free market.

The way a market works is you want to buy my goods, I'll sell them to you at a profit. If I can't get a profit, I don't sell my goods to you. There is no force on earth that can get a US Company to sell their goods on a mass scale to another country at a Loss for decades as the US Pharmaceutical companies are doing.

They just sell them to US consumers for more, because they can. Unlike Canada we have no downward penelty on these companies to keep them honest. No competition, no collective buying, and no set profit margin to ensure consumer fairness.... We, the US tax payer pay for 90% of the research, and then we gift our patents over the the pharma companies, who rape us until the patents run out.... making huge profits and loads of money along the way. Then the drug becomes a generic and they move onto the next one.

Pharma has never claimed they sell drugs at a loss or that they are doing it to be nice to Canada.

Let me try this for you. Let's say you develop a drug and realistically it costs you $10 million to develop the drug, but it only takes you 0.05 to make the drug per a pill once you developed.

If Canada comes to you and says we'll pay you 0.10 per a pill, are you going to sell it to them?

You've already put the $10 million. Making 0.05 on a pill is still good money, even though at that costs, you might never get back your $10 million.

Now, in terms of the patent issue, we've discussed this before, and I'll make the same two points I always make:

1. It helps subsidize higher education. Much of that money goes to non-profit and public institutions, that then patent their work, and then sell or lease the patents to private industry. They aren't gifts.

2. It helps subsidize well paying jobs here. If you are manufacturing something on a patent from money funded by the US goverment, you are required to have some set of your work force in the country. And so you see companies like Bayer, that aren't US companies, have pretty major facilities in the US.

(Though, I would like to see something saying that we pay 90% research costs related to drug development (not research in total as everybody admits that we do a lot of basic reserach not geared to drug development) and realistically should be spread over the larger US industry (e.g. things like the agricultural industry (I once worked in a plant biology lab and was funded by an NIH grant)).

(Again, I've addressed these issues with you before, which again raises the question, do you actually ever internalize new information into your world view?)

And the fact of the matter is as your own links show the Canadians are over paying for generics. If they simply opened the generic only market up to a non-negotiated price, like the US market, they'd save money.

Why don't you think they do that?

---------- Post added July-2nd-2012 at 01:36 PM ----------

JMS, did you see the posts on administrative costs overhead for health care industry in the US?

You might find this interesting JMS:

http://www.nejm.org/doi/full/10.1056/NEJMsa022033

"Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)"

"The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system."

And that's just health care directly. That doesn't include the insurance industry, education, or other indirect things like that.

Edited by PeterMP

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