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family insurance - does this add up?

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Ohioguy

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Nov 23, 2011, 9:21:29 PM11/23/11
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My wife works as a librarian, and I'm a stay at home Dad who changes
diapers & does the budgeting.

I've watched with chagrin as our family health costs have ballooned
over the past 4 years. 5 years ago, we paid something like $1k taken
off of the paycheck, and probably $500 of $20 copays a year. That's a
grand total of about $1,500 for our health insurance costs.

My wife's wages have actually FALLEN over the past 5 years, adjusted
for inflation. She was given a token 1% raise over the past year.
Meanwhile, groceries have gone up something like 15%.

Guess what has happened to our health costs? They switched over to a
high deductible plan with no copays roughly 3 years ago. A couple of
days ago they released our projected health care changes.

Here are our health related costs:

2009 $0 deductible ~$600 in copays ~$1k from paycheck = $1,600

2010 $2k deductible ~$1,000 from paycheck = $3,000 +87%

2011 $3k deductible ~$1,100 from paycheck = $4,100 +36%

2012 $4k deductible ~$1,200 from paycheck = $5,200 +27%

(I should mention that the library covers the first $1k, then our
deductible kicks in)

I'm fairly decent at budgeting, buying things at thrift stores & yard
sales, etc. to stretch our budget. It is getting tougher and tougher,
though. I guess it is mostly because the state of Ohio has continued to
cut budgets for libraries, and our local library is forced to try to get
cheaper insurance, & pass more of the cost on to us.

We used to have about $7k a year of money left after paying off all
of the absolutely necessary bills. The increases have essentially cut
our "cushion" in half.

The library gave us a sheet showing that we have about $1,200 a year
taken out of paychecks to pay for insurance, while the library pays
about $11k a year for the insurance. I set up an HSA so that we don't
get hit all at once with a huge out of pocket bill.

My wife has a medical condition that pretty much guarantees that we
will pay out the full deductible every year.

I guess my question is this: is the library getting a good deal on
this insurance, if it is truly paying $11k a year for the family
insurance? I found a couple of very similar policies online, with about
a $3,500 deductible, no copay, about $400 a month for a family policy.
That would cost about $4,800 plus the $3,500 deductible, for a total of
about $8,300 a year. That is evidently what we could get by shopping
around for family insurance.

Right now, according to the library, the total cost they can
negotiate for hundreds of employees costs $11k from them, $4k deductible
from us, and $1,200 from our paycheck. That total comes out to about
$16,200. I think it also covers basic vision and dental, too, however.
(we pay 20% of the dental costs) So it is sort of apples and oranges.
I guess I would have to shop around for a basic vision/dental plan, then
add it to compare.

Off the top of my head, though, it just doesn't seem possible that
the best deal the library can negotiate is $8k more. Even if I add $3k
to cover the vision/dental, it seems like it should be about $11,300,
and not $16,200.

What do you think, does it add up, or not?

Thanks!

THE Wise & Wonderful Shawn Hirn

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Nov 23, 2011, 10:17:58 PM11/23/11
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In article <4ecdaa28$0$24037$882e...@usenet-news.net>,
Ohioguy <no...@none.net> wrote:

> My wife works as a librarian, and I'm a stay at home Dad who changes
> diapers & does the budgeting.

Since your wife works as a librarian, she ought to be good at doing
research. Right?

Ohioguy

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Nov 23, 2011, 10:52:43 PM11/23/11
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On 11/23/2011 10:17 PM, THE Wise & Wonderful Shawn Hirn wrote:
> In article<4ecdaa28$0$24037$882e...@usenet-news.net>,
> Ohioguy<no...@none.net> wrote:
>
>> My wife works as a librarian, and I'm a stay at home Dad who changes
>> diapers& does the budgeting.
>
> Since your wife works as a librarian, she ought to be good at doing
> research. Right?

She doesn't have much interest in finances at all, which is why I
take care of most of that. Also, I think it would be sort of like
bringing work home with you. Who likes to do that? I think she likes
to try to forget about work when she gets home. (probably like most folks)

Malcom "Mal" Reynolds

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Nov 24, 2011, 1:13:28 AM11/24/11
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In article <4ecdaa28$0$24037$882e...@usenet-news.net>, Ohioguy <no...@none.net>
wrote:

> My wife works as a librarian, and I'm a stay at home Dad who changes
> diapers & does the budgeting.
>
> I've watched with chagrin as our family health costs have ballooned
> over the past 4 years. 5 years ago, we paid something like $1k taken
> off of the paycheck, and probably $500 of $20 copays a year. That's a
> grand total of about $1,500 for our health insurance costs.

25 copays in a year sounds like you are either an abuser or have chronic
problems that any insurance company would want to charge more for

Rod Speed

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Nov 24, 2011, 1:53:35 PM11/24/11
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THE Wise & Wonderful Shawn Hirn wrote:
Wrong. Few librarians can do that sort of research.


Rod Speed

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Nov 24, 2011, 2:22:48 PM11/24/11
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Ohioguy wrote:

> My wife works as a librarian, and I'm a stay at home Dad who changes
> diapers & does the budgeting.

> I've watched with chagrin as our family health costs have ballooned
> over the past 4 years. 5 years ago, we paid something like $1k taken
> off of the paycheck, and probably $500 of $20 copays a year. That's a
> grand total of about $1,500 for our health insurance costs.

> My wife's wages have actually FALLEN over the past 5 years, adjusted
> for inflation. She was given a token 1% raise over the past year.
> Meanwhile, groceries have gone up something like 15%.

But grocerys arent the only thing you spend her wage on,
and its not clear how much of that increase is due to the
price of the grocerys and how much is due to you buying
more as the kids get older etc.

> Guess what has happened to our health costs? They switched over to
> a high deductible plan with no copays roughly 3 years ago. A couple
> of days ago they released our projected health care changes.

> Here are our health related costs:

> 2009 $0 deductible ~$600 in copays ~$1k from paycheck = $1,600

> 2010 $2k deductible ~$1,000 from paycheck = $3,000 +87%

> 2011 $3k deductible ~$1,100 from paycheck = $4,100 +36%

> 2012 $4k deductible ~$1,200 from paycheck = $5,200 +27%

> (I should mention that the library covers the first $1k, then our
> deductible kicks in)

> I'm fairly decent at budgeting, buying things at thrift stores & yard sales, etc. to stretch our budget.

What percentage of what you buy comes from those ?

> It is getting tougher and tougher, though. I guess it is mostly because the state of Ohio has continued to cut
> budgets for libraries, and our local library is forced to try to get cheaper insurance, & pass more of the cost on to
> us.

And because your country is too stupid to go for a decent
modern health care funding system like every other modern
first and second world country has now.

> We used to have about $7k a year of money left after paying off all
> of the absolutely necessary bills. The increases have essentially cut
> our "cushion" in half.

> The library gave us a sheet showing that we have about $1,200 a year
> taken out of paychecks to pay for insurance, while the library pays
> about $11k a year for the insurance. I set up an HSA so that we don't
> get hit all at once with a huge out of pocket bill.

> My wife has a medical condition that pretty much guarantees that we will pay out the full deductible every year.

And that may well be why you appear to be paying rather more
than the best price you can find elsewhere for medical insurance.

> I guess my question is this: is the library getting a good deal on
> this insurance, if it is truly paying $11k a year for the family
> insurance? I found a couple of very similar policies online, with
> about a $3,500 deductible, no copay, about $400 a month for a family
> policy. That would cost about $4,800 plus the $3,500 deductible, for
> a total of about $8,300 a year. That is evidently what we could get
> by shopping around for family insurance.

> Right now, according to the library, the total cost they can
> negotiate for hundreds of employees costs $11k from them, $4k
> deductible from us, and $1,200 from our paycheck. That total comes
> out to about $16,200. I think it also covers basic vision and
> dental, too, however. (we pay 20% of the dental costs) So it is sort
> of apples and oranges. I guess I would have to shop around for a
> basic vision/dental plan, then add it to compare.
>
> Off the top of my head, though, it just doesn't seem possible that
> the best deal the library can negotiate is $8k more. Even if I add
> $3k to cover the vision/dental, it seems like it should be about
> $11,300, and not $16,200.

> What do you think, does it add up, or not?

Hard to say unless you can provide the figures for other librarians
who dont have serious ongoing medical problems and unless you
spell out exactly what your wife's medical condition is.

25 medical bills a year is a hell of a lot even for something like diabetes.


Malcom "Mal" Reynolds

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Nov 24, 2011, 3:34:56 PM11/24/11
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In article <9j7i5h...@mid.individual.net>,
and your proof of that assertion is...?

Max

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Nov 25, 2011, 10:30:49 AM11/25/11
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Any insurance company is going to lose money on you. It's a bargain to
you that any employer is forced to take on employees with pre-existing
conditions. The library could negotiate a much better deal if they
were not saddled with your burden. The potential carriers are well
aware of the customer base they are being asked to absorb expenses
from. Seems like it should be $20K and not $16.2K.

Ohioguy

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Nov 25, 2011, 11:34:53 PM11/25/11
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> 25 copays in a year sounds like you are either an abuser or have chronic
> problems that any insurance company would want to charge more for

Where did you come up with that? For our family of 5, that is only 5
visits a year to the doctor, per person. Granted, I went to the doctor
about once a year back when I was in my 20's and early 30's, but the
amount has increased as I get close to 40.

Malcom "Mal" Reynolds

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Nov 26, 2011, 12:34:41 AM11/26/11
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In article <4ed06c6d$0$15185$882e...@usenet-news.net>, Ohioguy <no...@none.net>
wrote:
5 visits per year is still quite a bit, even if and especially if all 5 of you
need attention that frequently

Rod Speed

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Nov 26, 2011, 12:52:38 AM11/26/11
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Ohioguy wrote

>> 25 copays in a year sounds like you are either an abuser or have chronic problems that any insurance company would
>> want to charge more for

> Where did you come up with that? For our family of 5, that is only 5 visits a year to the doctor, per person.

Thats still a lot, even for the kids.

> Granted, I went to the doctor about once a year back when I was in my 20's and early 30's, but the amount has
> increased as I get close to 40.

It didnt for me, I only saw the doctor for the annual flying license medical.

Even now that I am much older than that I still only see the doctor a couple
of times a year and thats for the routine check post the heart attack.


h

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Nov 26, 2011, 2:18:27 AM11/26/11
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"THE Wise & Wonderful Shawn Hirn" <sr...@comcast.net> wrote in message
news:srhi-C50BBB.22175823112011@[74.209.136.88.rev.sfr.net]...
Obviously not...she married a whiner who never wants to pay his fair share
of anything. A family of 2 adults and 3 children should be paying AT LEAST
$12k a year just for the coverage. Then add in the co-pays. The OP has NO
IDEA how good he has it. Most of us can't afford health insurance at all.
The best I can find (no pre-existing conditions) is $5k/year (just for me)
and it has a $2k deductible. So...I'd have to be out-of-pocket $7k before
the insurance would pay a single penny. And then there's still the
deductibles. Since I haven't seen a doctor in nearly 20 years I wouldn't
even consider flushing that much money down the tubes for nothing in return.
And yes, I'm aware that if I get cancer or have a serious medical crisis I'm
pretty much out of luck. I accepted that years ago.


Ohioguy

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Nov 26, 2011, 10:10:03 AM11/26/11
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> 5 visits per year is still quite a bit, even if and especially if all 5 of you
> need attention that frequently

That is an average, but I find it shocking that several of you
consider 5 visits a year per person to be on the high end.

Our kids HAVE to have at least an annual checkup, just to participate
in sports and such. I think just about everybody should have an annual
checkup anyway, since it saves lives. That would be one per person.

I also count the dental cleanings as a doctor visit. Those are done
every 6 months, so that counts for 2, bringing each person's total up to
3. That's without being sick or anything - simple preventative maintenance!

As a family with adults who both need glasses, we go to the eye Dr.
roughly every two years because our eyes change and we need new lenses.
All of our kids will probably need glasses as well, since it is
hereditary. Figure 1/2 a Dr. visit per year for this, which takes us up
to 3 and a half annually per person.

That leaves us with 1.5 other Dr. visits per year. Come to think of
it, the average per person annually in our family is probably 6 or 6.5,
not 5. Each of us goes a couple of times a year if we are sick with
something for more than ~4 days. (though I was stubborn the last time,
and was kept up coughing at nights for 3 weeks before going to see him)
This number has increased greatly once my kids got in school, because
they bring more home than just homework. (exposed to just about every
illness going around the schools) My wife sees the doctor about once a
month, which ups the average. It was hard for me to get used to,
because when we got married I was used to going to the doctor about one
time a year, maybe twice. It was especially a game changer to me once
we had kids, and getting used to having to take them in for
measurements, etc., every few months. I hated having to do that. It
also took me a lot of time to get used to my wife having to deal with
side effects from ulcerative colitis. It is not a simple thing where
they can just go in and do an operation, and you're cured. You have to
take about 8 different drugs long term, and they all have side effects.
And guess what? Several of the doctors won't do long term renewals of
their prescriptions, because they want more doctor visits to bill to the
insurance. Hence, she is forced to go several times when she really
shouldn't have to.

Rod Speed

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Nov 26, 2011, 1:49:17 PM11/26/11
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Ohioguy wrote

>> 5 visits per year is still quite a bit, even if and especially if all 5 of you need attention that frequently

> That is an average, but I find it shocking that several of you
> consider 5 visits a year per person to be on the high end.

More fool you.

> Our kids HAVE to have at least an annual checkup, just to participate in sports and such.

No they dont.

> I think just about everybody should have an annual checkup anyway,

More fool you.

> since it saves lives.

Like hell it does. Fuck all in modern first world countrys die
of anything that will be found in an annual checkup anymore.

> That would be one per person.

Stupid waste of money.

> I also count the dental cleanings as a doctor visit.

Another stupid waste of money.

> Those are done every 6 months,

Another stupid waste of money.

> so that counts for 2, bringing each person's total up to 3. That's without being sick or anything - simple
> preventative maintenance!

Stupid waste of money.

> As a family with adults who both need glasses, we go to the eye Dr. roughly every two years because our eyes change
> and we need new lenses.

You dont need an eye doctor for something as basic as that.

And I have worn glasses since highschool and didnt need new lenses at anything like that rate.

> All of our kids will probably need glasses as well, since it is hereditary.

You can check yourself if they need them without bothering
with a doctor and can use an eye doctor the first time etc.

> Figure 1/2 a Dr. visit per year for this,

Another stupid waste of money.

> which takes us up to 3 and a half annually per person.

> That leaves us with 1.5 other Dr. visits per year.

Nope. You're still looking for 5 per year.

> Come to think of it, the average per person annually in our family is probably 6 or 6.5, not 5.

Then you are wasting your money.

> Each of us goes a couple of times a year if we are sick with something for more than ~4 days.

Another stupid waste of money.

Anyone with even half a clue can work out that sometimes
the common cold lasts longer than that and that no doctor
can do anything about that.

> (though I was stubborn the last time, and was kept up coughing at nights for 3 weeks before going to see him) This
> number has increased greatly once my kids got in school,
> because they bring more home than just homework. (exposed to just about every illness going around the schools)

Sure, but they dont need a visit to the doctor.

> My wife sees the doctor about once a month,

Another stupid waste of money.

> which ups the average. It was hard for me to get used to,
> because when we got married I was used to going to the doctor about one time a year, maybe twice.

Another stupid waste of money.

> It was especially a game changer to me once we had kids, and getting used to having to take them in for measurements,
> etc., every few months.

Another stupid waste of money.

> I hated having to do that.

So dont be that stupid.

> It also took me a lot of time to get used to my wife having to deal with side effects from ulcerative colitis. It is
> not a simple thing where
> they can just go in and do an operation, and you're cured. You have
> to take about 8 different drugs long term, and they all have side
> effects. And guess what? Several of the doctors won't do long term
> renewals of their prescriptions, because they want more doctor visits
> to bill to the insurance.

Time to find a doctor that isnt a scam artist.

> Hence, she is forced to go several times when she really shouldn't have to.

Time to find a doctor that isnt a scam artist.


Malcom "Mal" Reynolds

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Nov 26, 2011, 1:50:01 PM11/26/11
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In article <4ed10155$0$667$882e...@usenet-news.net>, Ohioguy <no...@none.net>
wrote:
your numbers don't add up. In any event, your wife alone would skew the numbers.
With all of your medical needs, I think you are getting a terrifice deal

(if you are getting dental cleanings for everyone twice a year you might
consider working out a deal to pay cash and get a cheaper rate...and lower your
insurance. That's what I do)

--

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blandit.

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Mrs Irish Mike

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Nov 26, 2011, 4:18:30 PM11/26/11
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On Nov 26, 7:10 am, Ohioguy <n...@none.net> wrote:

>    That is an average, but I find it shocking that several of you
> consider 5 visits a year per person to be on the high end.
>

Twenty-five visits @ a cost of $100 visit (figuring your 'average'
visit is a typical turn, cough, bendover) is $2,500. You paid
"$4,100", leaving the insurance company $1,600 a year to invest in
your future healthcare. Most people eventually get either cancer or
heart disease, which easily can cost $100,000 to treat. Your wife
would have to work and contribute to the plan for sixty years for the
insurance company to just break even.

The insurance company also charges your employer. The money from your
insurer will make up the money not collect when your wife falls short
of her 60 years of contributions. Any remaining amount of money will
be pure profit! And "pure profit" is divided between the shareholders,
the CEOs, and all the regular employees making $20K/year (and each
paying $4,100/year deductable).

Because of the blacklash against government workers getting
"Cadillac" insurance, you'll be finding yourself paying even more in
the future. The age of employer furnished insurance is going the way
of pensions and jobs for life. Get used to it.

Stop going to doctors. No good can come from it if you are healthy.
And if you are not healthy, it can be a crap-shoot as to whether you
die or get better.

tmclone

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Dec 2, 2011, 2:50:35 AM12/2/11
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On Nov 24, 1:13 am, "Malcom \"Mal\" Reynolds" <atlas-
bug...@invalid.invalid> wrote:
> In article <4ecdaa28$0$24037$882e7...@usenet-news.net>, Ohioguy <n...@none.net>
> wrote:
>
> >    My wife works as a librarian, and I'm a stay at home Dad who changes
> > diapers & does the budgeting.
>
> >    I've watched with chagrin as our family health costs have ballooned
> > over the past 4 years.  5 years ago, we paid something like $1k taken
> > off of the paycheck, and probably $500 of $20 copays a year.  That's a
> > grand total of about $1,500 for our health insurance costs.
>
> 25 copays in a year sounds like you are either an abuser or have chronic
> problems that any insurance company would want to charge more for

Agreed. If there are 5 people in the house that's FIVE visits per year
for each person. That's insane. No one goes to the doctor that much
unless they're being abused or are dying.

h

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Dec 2, 2011, 6:00:30 AM12/2/11
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"tmclone" <tmc...@searchmachine.com> wrote in message
news:9d3afabe-aeed-4a47...@y12g2000vba.googlegroups.com...
And the dental argument (counts as 2 of the 5 visits per person) is bogus as
well. I get my teeth cleaned 3 times a year (Anglo-Saxon teeth!) and I don't
have insurance. They want $275/year for insurance, will only pay 80%, yet my
un-insured bill is only $250 a year. Why have dental insurance? Even with
his bogus dental argument, each person in his family is seeing a doctor
THREE times a year. Srsly? That's nuts. Ok, maybe kids need an exam every
year (they don't, of course, but some parents are paranoid) but explain the
other two visits plus THREE a year for the adults! Srsly?

And...if the OP is truly only paying $1K per YEAR for full health coverage
PLUS dental for FIVE people, yet using it TWENTY-FIVE times in ONE YEAR,
then that's why private, for-profit health care costs so much for the rest
of us. That's just INSANE. He should be paying AT LEAST $10K just for the
insurance, then add in the co-pays. I feel SOOOO sorry for everyone else in
his risk pool. They must be paying through the snout for his family of
chronically ill hypochondriacs!

The OP needs to drink a HUGE cup of STFU!


Bob F

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Dec 11, 2011, 12:54:50 AM12/11/11
to
Does that library system have a lot of older employees?


Bob F

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Dec 11, 2011, 12:56:24 AM12/11/11
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This attitude is pretty good proof of just how screwed up the US health system
is.


Bob F

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Dec 11, 2011, 12:59:19 AM12/11/11
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One injury requiring PT treatment can quickly triple that. Nonsense.


Malcom "Mal" Reynolds

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Dec 11, 2011, 5:33:38 PM12/11/11
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but in this case, that isn't what is happening
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