The ACA ~~ Obamacare

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Re: The ACA ~~ Obamacare

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Message 1 of 25

@GailL1 wrote:

CNN 10/22/2019 - Obamacare premiums are dropping 4% for 2020 plans  

 

Stabilizing or as a result of some of this Administrations actions - perhaps a bit of both.

 

The average premium for the benchmark plan will drop by 4% next year in the 38 states using the federal Obamacare exchanges -- the second year in a row of lower rates. Six states that use healthcare.gov are seeing double-digit declines, though three are seeing double-digit increase.

 

The Trump administration has approved requests by 12 states to create reinsurance programs, which shield carriers from high-cost patients and help reduce premiums. Officials pointed to this and other measures the administration has taken that have stabilized the individual market.

 

Health care experts, however, say the Obamacare marketplace is stronger because insurers have raised rates high enough in recent years to make selling plans on the exchanges a profitable businesses. This is prompting carriers to re-enter markets they had abandoned in recent years either because of heavy losses or uncertainty about the law's future emanating from Washington DC.

 

Twenty more insurers are joining the federal exchanges, bringing the total to 175 for 2020, up from a low of 132 in 2018. The number of states with only one carrier is dropping to two, down from five this year.

 

. . . . premiums remain high for those who don't qualify for federal subsidies. This assistance is not available to individuals who earn more than $49,960 and families of four who earn more than $103,000 a year for 2020. Some 87% of those buying coverage on the federal exchange this year received subsidies.

 

. . . . an earlier report showing that 2.5 million people who earned too much to receive subsidies left the individual market between 2016 and 2018. 

additional source:  CMS Press Release 10/22/2019 - Premiums for HealthCare.gov Plans are down 4 percent but remain unaff... 

 

If you want to know how it is currently doing - CMS puts out a weekly overview of enrollment - Healthcare.gov and some state exchanges are included.

CMS - 11.13.2019 (most current) - Federal Health Insurance Exchange Weekly Enrollment Snapshot: Week... 

 

As to the Vaping industry and any new limits - Here is some articles as you asked for -

you know, john258, government has to be very careful about pulling a person's business (livlihood) out from under them - and that is what we are talking about here - sole-prop., small shop owners, all over the country. 

 

You do know that not all manufacturers use Vit E Acetate in their products - Vit E Acetate seems to be linked, most notably, to those products containing THC - so these are only available illegally in states where THC is illegal or legally in states that have made THC legal - like your state, New Mexico.

 

States can also pull any products or pass restrictions and some have -

The latest from the CDC:

CDC UPDATED 11/14/2019 - Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, ... 

 

WHATS NEW:

CDC has identified vitamin E acetate as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury (EVALI). Recent CDC laboratory testing of bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs) from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the samples. Vitamin E acetate might be used as an additive, most notably as a thickening agent in THC-containing e-cigarette, or vaping, products.

 

CDC recommends that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers. Until the relationship of vitamin E acetate and lung health is better understood, vitamin E acetate should not be added to e-cigarette, or vaping, products.  In addition, people should not add any substance to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments. CDC will continue to update guidance, as appropriate, as new data become available from this outbreak investigation.

 

 

The landmark health care law has proved remarkably resilient, with sign-ups dropping only 300,000 to 11.4 million for 2019. Still, that's down from a high point of 12.7 million in 2016.
 
(HHS Sec.) Azar also noted that open enrollment will continue and 2020 coverage will not be disrupted if the Fifth Circuit Court of Appeals in Louisiana upholds a district court ruling that found Obamacare to be unconstitutional.
 
How are other countries handling this - are they even seeing it?  Canada is one example - they have a few cases now but their concern seems more about stopping the use by youth and their method is by TAXING it more; not banning, not pulling products from shelves.
 
 
The newest news: 
 
So why is it happening here at a rate much higher than other countries? 
How do you keep kids from beginning to do it since it is available over the internet -
How is New Mexico keeping THC products out of the hands of youth ?  Vaporized or otherwise?
 
Why did your state not just pull it all? 
 
I am sure everybody here can read these links and possibly even find more -  that would lend itself to an intelligent conversation.
I believe you have Trumpitis - maybe you need to see a Trumpologist.
 
 
 

Nice long article but why use it as all it does is fool people into thinking rates will not go up. They will due to what Trump is ending and changing in the ACA. there is a time lag which can be up to about 2 years. Suggest you be a little more careful on  what advice articles you use. The one on E-Cigs is misleading in view of what just came out. Bloomberg reported that the FDA had made no tests on the smoke that came out of the E cig. holder when you use it. A private lab did, and found there were lot of chemicals in the smoke of the off brand that could kill you. They found the smoke from the brand was pretty clean, but if you used the high mode when smoking the same chemicals appeared that could kill you. There answer stop smoking all E Cigs if you want to avoid medical problems. See in a way when you put out bad info like in your article it can increase the cost of health care. Now here is a project for you. Start to get all in your area not to smoke E cigs, and get your State to ban them totally. Then you will have helped reduce health care costs.

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Re: The ACA ~~ Obamacare

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Message 2 of 25

@GailL1 wrote:

@ChasKy53 wrote:


People don't go the emergency room for "convenience", but many do go there because they have no insurance. Posting prices would achieve nothing.

 

Large providers such as hospitals and other health care facilities were not-for-profit prior to Nixon.  It would be Constitutional to pass legislation limiting their profits today.  Large Corporations providing health care actually should have no place on the Stock Exchange.  Stock holders making profits from people getting health care is obscene, IMHO.

 

 


 

Of course many people go to the ER for convenience - the working parent(s) who didn't call their doc during the docs office hours.  Kid develops a fever/cough/upset stomach - things outside of real emergencies.

 

One of the things that is scrutinized in other country's systems is what happens after office hours.  That's why many insurance companies now have a nurse on call to answer questions or make the determination if an ER visit is necessary when it is not VERY apparent that life or limb is in jeopardy.

 

If you think that it is only private hospitals that are expensive - I gotta bridge to sell you, in the desert.  Cost shifting happens at all hospitals - private, non-profit, even public ones.  Public hospitals have to pull in some insurance payers or self-payers just to keep going.  Sure, they could survive off of Medicare/Medicaid/Government coverage of charity care or bad debt but quality of care would suffer.

 

It might be constitutional to pass cost controls on private providers just for the sake of controlling cost and make no other changes but that does not mean that they will stay in business or would not change their business model so that government would not have these controls.   I am betting that many providers would begin ordering all sorts of stuff just to keep an adequate income stream alive.  Happens even now - 

So how would we have adequate care if many of them left whatever system and embarked onto something else? 

So how would you determine if a provider is ordering or performing too much of (whatever)?

 

If government began to dictate that all payers or even a single payer system would only pay Medicare or Medicaid rates - private providers would leave the system.  I don't think non-profit providers could make it either.

 

Look at the VA - they have their own hospitals, their own clinics, their own staff - but yet cannot get an adequate supply of specialist, especially of some varieties -

Same is true in Medicare, Medicaid and private insurance when it come to certain specialist - psychiatrist come to mind - many of them have decided not to accept such payments unless it meets their (desired) amount.

 

Last I looked we are a free country - if we start just free-willy setting cost constraints on providers - including pharma - they may not respond in the way you think they should - now and into the future.

However by cutting cost by developing clinical guidelines and only paying for the best at the best price - we have a negotiating position.

 

I agree, for most people, posting prices means little - cause they don't look, they don't consider it.

They don't know how -

 

 

 


Yep there is "always something", like your long rambling posts saying the same thing over and over in opposition to a Universal Health Care Plan for America.

 

In reality, the only thing that will ever assure all Americans of having quality health care and control the spiraling rise of health care costs in America is to do what all developed nations have done (most all of which have been governing a society multiple times longer than America has) and adopt a health care plan like Medicare For All. Our free wheeling pure capitalist for-profit approach has given us a health care system which causes America to be far behind most developed nations in health statistics, low quality or no health care for millions of citizens, and America spending more per person for health care than do the vast majority of other developed nations

 

Starting with the addition of the Public Option for enhanced Medicare within the ACA would be a fine start.

 

Your long postings will not change any of that


"The only thing man learns from history is man learns nothing from history"
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Re: The ACA ~~ Obamacare

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Message 3 of 25

@GailL1 wrote:

We have our choice - This is very simply put but we have to find a balance all of these things or something is gonna get way out of whack - it is a trade-off.  It does not mean denying care - it means prioritizing it - like trauma care.


Things have already gotten "way out of whack", because Nixon made health care in America a for profit business. Things have gotten "way out of whack" because we rely on a for-profit health care insurance industry in our hodge-podge health care system.

 

A tax based single payer system likened to Medicare For All is the answer.


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Message 4 of 25

@ChasKy53 wrote:


People don't go the emergency room for "convenience", but many do go there because they have no insurance. Posting prices would achieve nothing.

 

Large providers such as hospitals and other health care facilities were not-for-profit prior to Nixon.  It would be Constitutional to pass legislation limiting their profits today.  Large Corporations providing health care actually should have no place on the Stock Exchange.  Stock holders making profits from people getting health care is obscene, IMHO.

 

 


 

Of course many people go to the ER for convenience - the working parent(s) who didn't call their doc during the docs office hours.  Kid develops a fever/cough/upset stomach - things outside of real emergencies.

 

One of the things that is scrutinized in other country's systems is what happens after office hours.  That's why many insurance companies now have a nurse on call to answer questions or make the determination if an ER visit is necessary when it is not VERY apparent that life or limb is in jeopardy.

 

If you think that it is only private hospitals that are expensive - I gotta bridge to sell you, in the desert.  Cost shifting happens at all hospitals - private, non-profit, even public ones.  Public hospitals have to pull in some insurance payers or self-payers just to keep going.  Sure, they could survive off of Medicare/Medicaid/Government coverage of charity care or bad debt but quality of care would suffer.

 

It might be constitutional to pass cost controls on private providers just for the sake of controlling cost and make no other changes but that does not mean that they will stay in business or would not change their business model so that government would not have these controls.   I am betting that many providers would begin ordering all sorts of stuff just to keep an adequate income stream alive.  Happens even now - 

So how would we have adequate care if many of them left whatever system and embarked onto something else? 

So how would you determine if a provider is ordering or performing too much of (whatever)?

 

If government began to dictate that all payers or even a single payer system would only pay Medicare or Medicaid rates - private providers would leave the system.  I don't think non-profit providers could make it either.

 

Look at the VA - they have their own hospitals, their own clinics, their own staff - but yet cannot get an adequate supply of specialist, especially of some varieties -

Same is true in Medicare, Medicaid and private insurance when it come to certain specialist - psychiatrist come to mind - many of them have decided not to accept such payments unless it meets their (desired) amount.

 

Last I looked we are a free country - if we start just free-willy setting cost constraints on providers - including pharma - they may not respond in the way you think they should - now and into the future.

However by cutting cost by developing clinical guidelines and only paying for the best at the best price - we have a negotiating position.

 

I agree, for most people, posting prices means little - cause they don't look, they don't consider it.

They don't know how -

 

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 5 of 25

@ChasKy53 wrote:

Why does no one mention the crappy coverage in three health insurance plans that the ACA offers? Premiums going down 4% hardly offsets that. The bottom two plans can leave a person bankrupt as the result of a serious illness. Medicare itself without a supplement or without an Advantage plan is better, even though it only covers 80%.

 

A public option for an enhanced Medicare would solve many things

 

The Public Option for enhanced Medicare would move us towards a Medicare For All type plan, the answer to America's health care woes. Most Americans want this and once the rest see that overall it would cost them less they will want it also.


THEY pick their plan.  If they do not have the deductible, cannot pay their associated out of pocket cost - they need to buy a better plan.  That's called being UNDERinsured.  It doesn't just happen in health insurance either - happens all the time in auto insurance.  The auto insurance industry in most states give you the option of adding UNinsured / UNDERinsured coverage to your plan.

 

Perhaps it would be beneficial if all health plans were connected to an HSA.

 

Are you telling me that you don't think people should at least plan somewhat for themselves on how they will pay for their OOP cost?????

 

You are right about Medicare - you either have to be poor enough to be dual eligible or received EXTRA HELP or wealthy enough to buy a Medigap plan to cover all the cost of traditional Medicare.

There are some options in cost control since there is an assortment of different Medigap plans.

 

Yes, basically the same with OOP cost on a MA plan but at least here there is a limit to OOP cost on an annual basis.  NOT so with traditional Medicare, no limits - not annually and not lifetime.

 

The answer is how other industrialized countries have had some success (not perfect even there).

It does not matter under what type of system we use as the "payer" - it all comes down to CONTROLS:

  • controls on providers, including meds/therapies/treatments - meaning we only pay for the best thing that works at the cheapest price - that may also mean that government has to pay more for those areas where they do the paying like Medicare and Medicaid to avoid cost shifting.
  • controls on care - meaning we only pay for the best thing that works at the cheapest price
  • controls on budgets and when they began to get out of control, we have ways to limit the results - meaning perhaps slowing down those treatments that can wait - waiting periods.

We have our choice - This is very simply put but we have to find a balance all of these things or something is gonna get way out of whack - it is a trade-off.  It does not mean denying care - it means prioritizing it - like trauma care.

 

 

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 6 of 25

@GailL1 wrote:

@WebWiseWoman wrote:

 

The Affordable Care Act (ACA) some called "obamacare" unfortunately to me was a misnomer; I thought it meant affordable medical care, not "affordable" insurance.

 

Perhaps going forward someone could investigate costs that are out of control and beyond recooperating research costs; e.g., why are MRIs still in the 6 figures? why are ER via ambulance costs in the 4 figures (no wonder some are transporting in personal vehicles).

 

Just asking why isn't health care in the so-called richest nation in the world affordable for all?

 

smh


Medical cost vary by area of the country.  You are either in an area that has competition or you are not.  For those areas that have plenty of (in this case) test providers( MRI) and it is a scheduled test- shop around.  You could find that a free-standing provider (not affiliated with a hospital or perhaps one that is not affiliated with the doc ordering the test) would be cheaper than even using your insurance considering all of your out of pocket cost.  If you live in an area where there is no competition - you are sunk because you have no choice unless you commute to another area.

 

Ambulance services have a cost shift - as a self-payer or even under private/group insurance, you are making up for the loss they incure under the Medicare and Medicaid pay structure.  Think about all the cost associated with this sort of medical transport.

 

NPR UPSHOT 11/15/2019 - Trump Wants Insurers and Hospitals To Show Real Prices To Patients 

Would this work - ????  Probably not, especially when most people in this country don't understand how to keep their health cost down.  I am speaking about things that are not emergencies - but even there, we have people that don't understand what the use of ER are - they use them for everything because it is convenient - scheduled at their convenience.

 


People don't go the emergency room for "convenience", but many do go there because they have no insurance. Posting prices would achieve nothing.

 

Large providers such as hospitals and other health care facilities were not-for-profit prior to Nixon.  It would be Constitutional to pass legislation limiting their profits today.  Large Corporations providing health care actually should have no place on the Stock Exchange.  Stock holders making profits from people getting health care is obscene, IMHO.

 

 


"The only thing man learns from history is man learns nothing from history"
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Message 7 of 25

@WebWiseWoman wrote:

 

The Affordable Care Act (ACA) some called "obamacare" unfortunately to me was a misnomer; I thought it meant affordable medical care, not "affordable" insurance.

 

Perhaps going forward someone could investigate costs that are out of control and beyond recooperating research costs; e.g., why are MRIs still in the 6 figures? why are ER via ambulance costs in the 4 figures (no wonder some are transporting in personal vehicles).

 

Just asking why isn't health care in the so-called richest nation in the world affordable for all?

 

smh


Medical cost vary by area of the country.  You are either in an area that has competition or you are not.  For those areas that have plenty of (in this case) test providers( MRI) and it is a scheduled test- shop around.  You could find that a free-standing provider (not affiliated with a hospital or perhaps one that is not affiliated with the doc ordering the test) would be cheaper than even using your insurance considering all of your out of pocket cost.  If you live in an area where there is no competition - you are sunk because you have no choice unless you commute to another area.

 

Ambulance services have a cost shift - as a self-payer or even under private/group insurance, you are making up for the loss they incure under the Medicare and Medicaid pay structure.  Think about all the cost associated with this sort of medical transport.

 

NPR UPSHOT 11/15/2019 - Trump Wants Insurers and Hospitals To Show Real Prices To Patients 

Would this work - ????  Probably not, especially when most people in this country don't understand how to keep their health cost down.  I am speaking about things that are not emergencies - but even there, we have people that don't understand what the use of ER are - they use them for everything because it is convenient - scheduled at their convenience.

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 8 of 25

Why does no one mention the crappy coverage in three health insurance plans that the ACA offers? Premiums going down 4% hardly offsets that. The bottom two plans can leave a person bankrupt as the result of a serious illness. Medicare itself without a supplement or without an Advantage plan is better, even though it only covers 80%.

 

A public option for an enhanced Medicare would solve many things

 

The Public Option for enhanced Medicare would move us towards a Medicare For All type plan, the answer to America's health care woes. Most Americans want this and once the rest see that overall it would cost them less they will want it also.


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Message 9 of 25

CNN 10/22/2019 - Obamacare premiums are dropping 4% for 2020 plans  

 

Stabilizing or as a result of some of this Administrations actions - perhaps a bit of both.

 

The average premium for the benchmark plan will drop by 4% next year in the 38 states using the federal Obamacare exchanges -- the second year in a row of lower rates. Six states that use healthcare.gov are seeing double-digit declines, though three are seeing double-digit increase.

 

The Trump administration has approved requests by 12 states to create reinsurance programs, which shield carriers from high-cost patients and help reduce premiums. Officials pointed to this and other measures the administration has taken that have stabilized the individual market.

 

Health care experts, however, say the Obamacare marketplace is stronger because insurers have raised rates high enough in recent years to make selling plans on the exchanges a profitable businesses. This is prompting carriers to re-enter markets they had abandoned in recent years either because of heavy losses or uncertainty about the law's future emanating from Washington DC.

 

Twenty more insurers are joining the federal exchanges, bringing the total to 175 for 2020, up from a low of 132 in 2018. The number of states with only one carrier is dropping to two, down from five this year.

 

. . . . premiums remain high for those who don't qualify for federal subsidies. This assistance is not available to individuals who earn more than $49,960 and families of four who earn more than $103,000 a year for 2020. Some 87% of those buying coverage on the federal exchange this year received subsidies.

 

. . . . an earlier report showing that 2.5 million people who earned too much to receive subsidies left the individual market between 2016 and 2018. 

additional source:  CMS Press Release 10/22/2019 - Premiums for HealthCare.gov Plans are down 4 percent but remain unaff... 

 

The landmark health care law has proved remarkably resilient, with sign-ups dropping only 300,000 to 11.4 million for 2019. Still, that's down from a high point of 12.7 million in 2016.
 
(HHS Sec.) Azar also noted that open enrollment will continue and 2020 coverage will not be disrupted if the Fifth Circuit Court of Appeals in Louisiana upholds a district court ruling that found Obamacare to be unconstitutional.

 

If you want to know how it is currently doing - CMS puts out a weekly overview of enrollment - Healthcare.gov and some state exchanges are included.

CMS - 11.13.2019 (most current) - Federal Health Insurance Exchange Weekly Enrollment Snapshot: Week... 

 

As to the Vaping industry and any new limits - Here is some articles as you asked for -

you know, john258, government has to be very careful about pulling a person's business (livlihood) out from under them - and that is what we are talking about here - sole-prop., small shop owners, all over the country. 

 

You do know that not all manufacturers use Vit E Acetate in their products - Vit E Acetate seems to be linked, most notably, to those products containing THC - so these are only available illegally in states where THC is illegal or legally in states that have made THC legal - like your state, New Mexico.

 

States can also pull any products or pass restrictions and some have -

The latest from the CDC:

CDC UPDATED 11/14/2019 - Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, ... 

 

WHATS NEW:

CDC has identified vitamin E acetate as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury (EVALI). Recent CDC laboratory testing of bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs) from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the samples. Vitamin E acetate might be used as an additive, most notably as a thickening agent in THC-containing e-cigarette, or vaping, products.

 

CDC recommends that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers. Until the relationship of vitamin E acetate and lung health is better understood, vitamin E acetate should not be added to e-cigarette, or vaping, products.  In addition, people should not add any substance to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments. CDC will continue to update guidance, as appropriate, as new data become available from this outbreak investigation.

 
 
How are other countries handling this - are they even seeing it?  Canada is one example - they have a few cases now but their concern seems more about stopping the use by youth and their method is by TAXING it more; not banning, not pulling products from shelves.
 
 
The newest news: 
 
So why is it happening here at a rate much higher than other countries? 
How do you keep kids from beginning to do it since it is available over the internet -
How is New Mexico keeping THC products out of the hands of youth ?  Vaporized or otherwise?
 
Why did your state not just pull it all? 
 
I am sure everybody here can read these links and possibly even find more -  that would lend itself to an intelligent conversation.
I believe you have Trumpitis - maybe you need to see a Trumpologist.
 
edited  later to only move a couple of paragraphs back under the correct subject.
 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 10 of 25

The recent GM strike should help cure Americans of their love of EMPLOYER provided health insurance - the GM management simply CANCELLED the striker's health coverage - no reason needed, the courts have long held such action is a MANAGEMENT PEROGATIVE, just like deciding to use employee pension funds, including the employee's contributions, to pay bonuses to senior management just before they declare bankruptcy and move production to Commie slaves in Asia.

 

I personally think a Public Option will create "universal coverage" and reduce costs as private insurerers scramble to meet the cost/benefit advantage the PO will have - BUT the FACT all EMPLOYER provided plans can be cancelled without notice make me see MFA as a much more appealing option. Still, if the MFA is designed to provide BASIC (ACA Silver Plan??) insurance while private insurance remains available for higher levels of coverage would be, IMHO, a more "sell-able" to the public.

 

Why I think this would be better than eliminating private insurerers is as follows: With MFA providing EVERYONE with "basic" insurance, the cost of the ADDITIONAL insurance would be considerably reduce simply because most medical care is "basic" - doctors visits, maternity and well baby clinics, annual check-ups or accidents treated in the ER, so the add-ons would be like current plans with really high "deductable".

 

As for how to pay for it, REPEAL THE REAGAN TAXSCAM! Going back to how things were before 1980 will cut taxes for the 90% while raising them for the top 10% with the greatest increase going to the top 1% who've had a huge windfall for 40 years and can bloody well begin paying their share AGAIN - like their parents and grandparents did WITHOUT MEASURABLE CHANGES IN THEIR LIFESTYLE.

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