New York, NY – State Bureaucrats Fight Doctor’s $79 Flat Fee for Uninsured


    New York, NY – The state is trying to shut down a New York City doctor’s ambitious plan to treat uninsured patients for around $1,000 a year.

    Dr. John Muney offers his patients everything from mammograms to mole removal at his AMG Medical Group clinics, which operate in all five boroughs.

    “I’m trying to help uninsured people here,” he said.

    His patients agree to pay $79 a month for a year in return for unlimited office visits with a $10 co-pay.

    But his plan landed him in the crosshairs of the state Insurance Department, which ordered him to drop his fixed-rate plan – which it claims is equivalent to an insurance policy.

    Muney insists it is not insurance because it doesn’t cover anything that he can’t do in his offices, like complicated surgery. He points out his offices do not operate 24/7 so they can’t function like emergency rooms.

    “I’m not doing an insurance business,” he said. “I’m just providing my services at my place during certain hours.”

    He says he can afford to charge such a small amount because he doesn’t have to process mountains of paperwork and spend hours on billing.

    “If they leave me alone, I can serve thousands of patients,” he said.

    The state believes his plan runs afoul of the law because it promises to cover unplanned procedures – like treating a sudden ear infection – under a fixed rate. That’s something only a licensed insurance company can do.

    “The law is strict on how insurance is defined,” said an Insurance Department spokesman.

    A possible solution that Muney’s lawyer crafted would force patients to pay more than $10 for unplanned procedures.

    They are waiting to see if the state will accept the compromise. Still, Muney is unhappy because, he said, “I really don’t want to charge more. They’re forcing me.”

    One of his patients, Matthew Robinson, 52, was furious to learn the state was interfering with the plan.

    “The whole point is, he [Muney] found a way of paying his rent, paying his workers, and getting to see patients for the price,” said Robinson.

    “How can the state dictate you’ve got to charge more?”

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    1. For all libs who can’t wait for socialised medicine this is the way govt work red tape everywhere. Now imagine you need an emergency operation you will wait 2 year till the govt gives an ok

      • are you thick? this is why we need socialized medicine or more people like muney. why in our society to the rich get the best health care and the poor the worst? because of capitalism. in canada there is no cpmpetition for the best jobs among doctors so everyone ends up being treated the same. in the us, doctors position and fight and compete for the best jobs in the best facilities. the rich get more than than they need and the poor get nothing.

        • The poor end up waiting longer in places where socialized medicine is practiced.
          And in addition to that doctors have no incentive to be the best unlike were people choose their care.

        • Socialized medicine is not the same thing as more people like Muney. Socialized medicine is controlled by the government with its endless bureaucracy and red tape. Nothing will ever get done that way. More people like Muney means private citizens findng their compassion and sense of community responsibility in place of the greed that makes the world go round today.

          Just look to the countries that already have socialized medicine, where an 8-yr-old with sudden headaches and double vision has to wait 3 weeks! for an appointment to be seen by a neurologist, and see how well that works.

    2. Price controls, long a destroyer of the medical profession, are becomming more popular under Omaba. To put it in lerspective, can you imagine if a plumber could only charge what the govt said they could chagre for a service, what about a lawyer, a sheitel macher. Any if you decided you wanted to set your own rates they go after you.

      • The same was true until the government released control over the airline industry… prices fell, but look where we are now! Some govt control is better than none!

      • Price controls are being enacted by Obama???? HAHAHAHAHA. The entire medical industry in the us runs on price controls, enacted by insurance companies. Insurance companies, hmos, and pharma are the major obstacles in the way of any reform.

    3. To all to you liberals wh can’t wait for socialized medicine, I can’t wait to hear your screams. My cousin in Toronto, had lung cancer and it took 8 weeks to get an appointment for an MRI to diagnose that he had small cell pulmonary carcinoma, by that time it was already too late. And no, he was not a smoker, never! Welcome to socialized medicine, sure it keeps costs down, patients die before they are treated.

    4. To #6 Even socialized medicine has levels. I lived in Canada and have relatives there. If you really need a test right away, you can get it but you have to be willing to pay to get to the top of the list!! 2 different levels!! If you shmear you get!! It also depends who your doctor is and if he/she has connections!! If he is the head of the department you have no problems! You’re in!! No Wait!! When you have an emergency. they will admit you immediately no questrions asked!! I hurt myself last year in Canada, went to the hospital,Emergency Room did not pay a cent, came home to Brooklyn, submitted to my insurance and everything was paid.!! So much for socialized medicine!!!!!!!

    5. He can serve thousands ? WoW !!! I want to be a doc too.
      1,000 Patients X $1,000 = $1,000,000
      This is a great business plan. If he can see 4,000 patients he makes 4 million dollars a year ! Add a few assistants and he is a multi multi millionaire.
      This is not a complaint. It clearly shows where all our insurance money is going. To the insurance companies executives who do nothing but shuffle paper and mail forms ! Very few physicians make even $300,000 anymore. Only the most successful specialists make over $500,000. May this Dr. be blessed with hatzlucha. Then more Drs will do the same and prices will fall due to competition. Good job !

      • the average salary for an internist is slighhtly over 100k. If you break it out on an hourly basis and include the 3 hours average they spend after the last patient going over charts adn calling patients back yuo see they earn less than teachers. This does not include the enoromous liability policies. Higher paid specialists average 250. This also includes many hours of unpaid work. the health system sucks and there is a ton of waste but the only pockets that are being lines are the ones who cheat. The honest MD is no longer a desireable or well paying position. hence the shortage. A podiatirst makes more. A plumber, forgtettabout it!

      • You seem to have never heard of the word T A X A T I O N!
        Hate to burst your bubble but the top NY tax rate is like 38% (accountants correct me if I am wrong) so take 38% right off the top to pay Uncle Sam. That leaves him with $620,000 (for the 1000 patient model). Now take out rent (I’m guessing 5k/month or $60,000.00 per year), salaries (2 nurses @ $60,000 per year each, 1 secretary $25,000 per year), transportation, utilities, payments for medical equipment, oh, and don’t forget malpractice insurance which is roughly $70,000 per year). Are you starting to get the picture? Doctors are not rolling in dough anymore. Also, he is paying back his 7 years of student loans….G-d help him.

      • It’s an awesome business plan and we should be saluting this doctor for using a FREE MARKET approach. My friend told me his parents’ doctor in the Boca area did something like, but for a higher fee. It’s akin to paying an annual retainer in exchange for a certain amount of services. Plus if you take generics, you can get them cheaply through Wal-Mart, Target, Publix, etc.

        However, you must keep in mind that it’s not just the executives at the insurance companies who are bing paid a lot. There are many levels of employees, marketing expenses, liability and legal expenses, etc. Don’t forget, many times the states set the rates.

        I would go further… Certain services do not require a doctor. Meaning, you can use nurses and PAs for certain care too.

      • You are making a big mistake — the insurance premiums go towards insane hospital bills which can run to thousands of Dollars a day, and also since the un-insured, Medicare & Medicaid are charged less, the insured pay for a part of the other lower paying are pretty well run companies.

        • Medicare and medicaid are the problem? Give me a break! People are uninsured because they are uninsurable! They have per-existing conditions that they did not ask for or deserve. Ever know of anyone that deserves CANCER? This keeps them from being able to buy insurance at ANY price. The insurance companies are tightening the guideline for who can be insured based on height, weight, pre-existing. By the way the term at the insurance company is by not insuring high risk people is ” cleaning out the gene pool.” If a person falls outside of these STRICT guidelines they find themselves they become the throngs of un-insured, un-insurable. There are millions of Americans who would love to have insurance but hey if you have not heard, the large companies have learned to mainpulate the system. They hire “temporary” workers so they do NOT have to pay health insurance. Insurance companies are masters of doing this. The agents are employees the agents hire assistants who are Temps who work 40 hours a week and receive NO group or individual insurance. Guess where I work! Day after day people call in wanting insurance and they can Not be helped they are left to their own devices to deal with a corrupt system that will not touch them. Our food is filled with synthetic horomones that fatten our food and guess what, it fattens us too. Then you do not meet the height weight parameters of the insurance company and you are kicked to the curb. Insurance companies and drug companies are in bed together and the corruption is running amuck. I applaude any doctor that even attempts to buck the system and actually be a doctor and get the dollar signs out of his eyes. Way to go Doc, remember there is safety in numbers. If more docs are willing to send up a war cry, sign me up, I’m unisurable!!!
          One further rant, Cover-Me foundation a non-profit organization only links you to more insurance companies that will NOT cover you. Let’s send all our unisurable to a desert island somewhere so we can all die together. It might “decrease the surplus population.” HUMBUG!!

      • I don’t know why I bother to respond to this but I will. The clinic is like any business with revenues and expenses. The $1000/yr/patient goes into the clinic. Out of that revenue expenses are paid such as nursing, medical records and accounting staff wages. Then there are building lease payments, utilities and phones. The physician pays insurance for medical liability coverage, plus workers compensation premiums for his staff. I could go on. Before you project what this doctor’s income is you need a lot more information than simply gross clinic revenue.
        You state you’re not a doc and obviously have never done anything other than work for someone else for your hourly wage. Why make posts if you have no useful information to share?
        I had a career in business and now serve my patients as a physician.
        I am a born and raised Canadian Citizen and Canadian trained physician. I now work in the U.S. because I wanted to provide better patient care. In Canada a Family Physician would schedule two patients in each 15 minute appointment slot. With that schedule I could barely make eye contact with the patient for the few minutes I had to spend with them. Canadian Health care costs are controlled by rationing of services. MRI machines and operating rooms are only funded to operate limited hours per week. Elective surgeries can take months to be received, same as an MRI study.
        The Canadian health care model is not a solution. With all the rationing and restricted access to services, the Canadian Health care system is still one of the most expensive in the world (although less the U.S.), without providing the level of positive health care outcomes obtained in other countries.

    6. To #10 When you are sick do you go to a shoemaker?? Or do you go to the best man who can cure you?? Why waste time?? You need the refuah quickly!!

    7. This man is a clear and present danger to the whole Government medical bureacracy.

      He threatens the livelihoods of tens of thousands of paper-pushing Government employees, and he is waking up the sleeping masses to the Government ripoff scheme.

      He must be stopped by any means available!

      • The problems in the healthcare system are not the government. This physician is not a threat to the “government medical bureaucracy.” He is a threat to the insurance industry (note: it wasn’t the Department of Health that went after him, it was the **INSURANCE** Department).
        Don’t fall for the conservative blather about the evils of socialized medicine (and I’m not suggesting that socialized medicine is the perfect answer!).
        The biggest losers, and the ones funding the attacks on “socialized medicine,” are the same ones who take a HUGE percentage of healthcare dollars but provide no medical care: the insurance industry.

        • It’s a a threat to the goverment that regulates this industry. Weaker industry, weaker regulatory framework, smaller and weaker goverment. And under a socialized medical model this would certainly cause a tremendous backlash if more and more doctors chose this capitalistic approach.

    8. If all doctors would do this, it would be beneficial to everyone (except for the money hungry insurance companies.) 35 years ago I was able to afford a decent insurance plan on a very minimal salary. Now I can’t afford any health insurance and I earn much more.

    9. I place the blame squarely at the feet of the insurance industry. The government shares in that blame because they’ve allowed the insurance companies to dictate policy in these matters. I don’t know why anyone here would defend any of the political parties, be they republican or democrat, conservative or liberal, they’ve all accepted bribes in the form of campaign contributions or humongous fees for speeches at island paradises or [fill in whatever form the bribes take]. They’re all greedy pigs scarfing at the trough of money.

    10. This is not about health care, it is about insurance. States have long regulated insurance, and what this doctor is in fact proposing is a health insurance plan. Insurance companies have to show they have reserves in case they mis-guess their claims load, and furthermore they must contribute to risk pools to cover people who have paid premiums whose insurer has gone out of business (as some have done). This well-intentioned doctor appears to have done none of these things! What will happen to his patients if, chas v’shalom, the doctor dies suddenly or is disabled? . One major reason insurance is so expensive in NY is the mandates for things like assisted reproductive technology that were pushed aggressively by us in the frum community. Does the doctor’s $79/month include ART treatments?

      The attacks on so-called “socialized medicine” are completely off the mark; the state is simply trying to enforce a consumer protection measure

    11. On the topic of socialized medicine there needs to be better discussion. Obviously a moral society should do its best to see that everybody is covered, hence universal healthcare. Obviously government control is the worst type of people you can have in charge see U.K. and Canada for example. In short you need to have a system like the chartered public schools where it is paid by the government and run privately. This will be the most effeciant and moral healthcare system in the world.

    12. “Does the doctor’s $79/month include ART treatments? “

      That’s sort of the point, Charlie. No one expects this to be insurance, and no one expects this ? internist to be doing ART.

      • Outstanding point! This was a way to hedge against needing a doctor for minor stuff because you don’t have insurance. Obviously there are flaws… such as this doens’t protect you from hospitalization – WCBS 2 NY pointed that out this evening. However years ago you used to be able to buy major medical protection for hospital only. It was affordable because statistically you are likely to have more office visits than the hospital. Yes, I know we all know of extreme cases where our neighbor needed 20 surgeries because no one knew why he had so much pain in his left leg.

        Charlie… I know you are so focused on ART. But this because is a low cost way for people to take responsiblity of their own health when they do not have access to coverage. I’m delighted because this is a good step to a free market medical approach. Again if your COBRA ran out and you need coverage, ART is the last thing on most people’s minds.

        I can see more doctors doing this down the road, which takes away the doctor kicking the bucket or becoming disabled.

        But I think it also opens up a good way to start a discussion of why people don’t have insurance. Let’s focus on those who don’t have coverage before we screw around with those who do have coverage.

    13. if socialized medicine was so bad, then why in the world do Canadians now have longer life expectancies and lower infant mortality rates than the USA? Why does the W.H.O now rank the USA 37th world wide in healthcare, below such countries and columbia and costa rica, for example? Try learning some facts before you spew right wing mishegas.

      • OK where do i begin?
        1. The WHO is a radically liberal org. run by the UN – nuff said

        2. The WHO list measures healthcare COVERAGE not QUALITY – that’s why a country like Cuba makes it so high on the list even though people are floating on pieces of wood to get from Havana to Key west.

        3. If you think for a second that US healthcare QUALITY is lower than ANY of those 37 countries on that list – then you obviously haven’t ventured very far out of your native Nebraska. (oh and – in case you’re wondering – yes, I’ve been to 13 countries)

        4. The list takes into account many other factors including life expectancy. but the US has a lower life expectancy due to other factors that have NOTHING to do with healthcare. (e.g. more homicides, more accident etc.)

        5. why would the UN make it look like the US has bad healthcare? hmmm let me think – oh that’s right – because they are LIBERAL COMMUNISTS who want to make it appear as if the US free market healthcare system sucks.

        bottom line: if that list were to rank purely the QUALITY of different countries healthcare – the US would beat any other country by a very, very wide margin. that is a fact.

        I rest my case

      • I was in Canada last weekend and my wife, a family physician, enjoyed a long conversation with a Jewish Canadian family physician. He is able to practice medicine with far LESS constraints that most American physicians. For example, he never has to argue with HMOs, or worry about whether his patients will be able to pay him.

    14. Charlie,

      According to your argument, If I prepay for any service it is a form of insurance and needs regulation;

      My local car service gives a coupon for every local ride and coupons entitles you to a free ride, is that legal?

      I have an anual snow contract to have my parking lot plowed every time it snows (if it snows) and I prepay for the year, is that insurance, is that legal?

      In a democratic society people are allowed to take risks as long as they know what they are getting into and they dont put others in danger or jeopordize other people’s wellbeing or property, It’s none of the governments business.

      BTW in Canada and your above age 52 you can’t get Dialysis treatment due to rationing

    15. For all you lovers of socialized medicine I ask you, is there ANYTHING that the govt does that they could do BETTER than the private sector? I will help you by answering … NO!

      Are you happy with how they have handled Social Security? You know, that would be the 15.5% or so that you pay into what is supposed to be your retirement fund when you need it? Instead its paying for the people who need it now which is why when the Baby Boomers, Gen X, Gen Next, etc., are ready to ready to retire there will be nothing there.

      Do you really want some govt offical deciding for you Mi Yich’ye u’mi yamus? If you are older they can/will decide you arent worth the “risk” of investment (meaning to pay for your surgery, docs visit, medicine, etc) and they will not “authorize” necessary procedures. This means they are telling you to DROP DEAD!

      The facts are that the number of people reported not have health insurance are skewed. A number of those people dont want insurance for whatever reason while most of them are ILLEAGALS. Others are not interested in going on Medicaid.

      Are you interested in paying MORE taxes to cover this mess? Countries with socialized medicine have much higher tax rates than we do. Bad enough most of us pay around 40-45% of our income for assorted taxes (all included), this boondogle of a program will increase it to where it is in other countries — OVER SIXTY FIVE PERCENT! This means if you are making 50k, your “take home” pay would only be 27.5k!

      Don’t get caught up on the Obama line of “rich” people paying for it. The “rich” (even on his language of over 250k) pay most of the tax revenue in the country and there still isnt enough. What Obama will have to do is lower his “rich” to 100k, then 75k. This means the liberals out there are making “class envy” where if you dont fall into that “class” you are jealous to the point where you say “yeah, those money grabbing pigs, tax em! The problem with that is those people are the ones who own small businesses which hire people. If they have to pay more taxes, they wont hire!!

      The govt would save more money by allowing us to deduct the cost of our personal out of pocket health insurance as well as co-pays, deductable, etc., on our taxes. I pay about 10k in health insurance annually before co-pays and deductables. That would be a very nice deduction to come off the top of my taxable income.

      Unlike #32 up there, we on the right believe in the power of the people to take care of themselves with less govt involvment. The govt by the way already has its own healthcare — its called MEDICAID! He also seems to be swallowing the part about people not being able to afford healthcare. The problem with that which once again the folks on the left refuse to say, is that NO ONE is denied medical coverage when showing up to a hospital ER. Anyone who thinks I am not telling the truth should walk into any ER and see for themselves. Listen to how they answer when they are asked if they have insurance! Is anyone turned down if they dont have insurance??? NO!

      Socialized medicine takes away the CHOICE we have of doctors, hospitals, and treatments. Do you want some suit or a computer program that relies on stats making a desicion on your mother’s life, your father, your sister, etc. If you CHV have a Premie they could decide the odds of survival are not good so they wont “cover” certain necessary procedures which Derech Ha’teva means kiss your kid good bye. Obama’s plan wont even allow you the option to deicde to have private health insurance (such as blue cross etc) or have private care. The current administration is the most extreme left wing we have ever seen in this country.

      Please, wake up, shtey oif, this is not a matter of the government. They are taking more and more and we will be left with nothing. We dont want to be “wards of the state” like most Europeans/ Russians were. I would think we had enough of that.

      Remember it was President Reagan who said, “Government is not the solution to our problems, Government IS our problem!” The people are the solution.

    16. Health care should NOT be controlled by profiteers like insurance companies. Not everything needs to be run “like a business”. The government needs to back the people not these greedy bastards.

      • That argument never makes any sense to me. Whenever I hear “how can you make money off of sickness?”, I think to myself how can farmers make money off of hunger, or teachers make money off of ignorance? I could go on all day. People need a service and those who provide that service need money so they can buy other services from other people. It’s called free-market economics.

    17. Dr. Muney,
      I encourage you to continue the good fight and here is food for thought. Look at the INSURANCE wall street created called Credit Default Swaps which is nothing more that insurance that is designed to pay out if people default on their mortgage, which is why so many BIG Wall Street firms and banks need our Tarp money to bail them out now. Take your fight all the way to the Supreme Court declaring you are offering Health Care Swaps just as Wall Street were allowed to sell Credit Default Swaps in the market. Keep up the good fight, We as healthcare professionals know what happens when Government runs anything…just like our coming Depression, we can thank our Government and those regulators who turned their backs and looked the other way while America was getting fleeced. Insurance companies, frivolous lawsuits and fraud in the system is why people can not afford health care. IT IS NOT THE HONEST PROVIDERS.

    18. I pay $ 150.00 to a grocery store a month for food. Is this insurance I will not go hungry? Get real. The reason for all this fuss toward the Doctor is the Insurance company is being cut out of the deal by the doctor offering his service without their being able to control the doctor, patient and perhaps even denial of payment. (This sets a precedence for future litigation (case study) and we can’t have this says the insurance company.) They (the insurance company) want your monthly fee, and they still get to deny payment to the doctor who provided the service if they want to. Wait until the government control’s yr health care! ( There will be a new diagnosis. (You are old, You just die. Claim denied.) Who ever started this insurance companies controling health care is a greedy twit , and the bigger idiots for agreeing are the providers: doctors, hospitals, etc. When the insurance companies want to go to school for 8 years to be able to diagnose you and treat you and write Rx’s for you, then they can collect your money. Until then, they need to BACK OFF !!!!!

    19. Our government no longer serves the people. Politicians do not care about YOU, YOUR FAMILY, or THIS COUNTRY. All they care about is getting rich off the backs of us Schmucks. Just another prime example of this.

    20. I’m Canadian and what Dr. K states is the truth. Canadian healthcare is not all its cracked up to be for many reasons. One affecting my immediate family is the profound doctor shortage, not only is there a shortage of trained physicians, Canadian family doctors,were for many years opposed to helpers. Nurse practitioners are very new to the system. It’s not like if a doctor is not taking new patients that you might be able to at least see the NP. They are still rare (although this is slowly changing

    21. I am so happy doctors are starting to do something about the insurance fraud and pharmaceutical theft against the public going on in this country. The statement above “…doing something only a licensed insurance company can do” just shows how far things have gone, where the people who have gone into medicine to help others are being “run” by businesses and profit crazy investors who car little other than making money. Medicine has devolved into an inverted supply-demand bottleneck where demand is (obviously) high and urgent when necessary, so placing business men and insurance companies into the scheme has really corrupted things. They have us where they want us and can charge anything they wish. I wish more doctors can follow his example, and put the power back where it belongs…in the hands of the physicians. The AMA is no help either…they are in cohoots with these guys and deliberately prevent people from becoming doctors so there is artificially high demand. Doctors need to work ridiculous hours to make large salaries, and are too tired to help patients sometimes. The lucrative salaries of specialist also draws money and power hungry people into medicine rather than doctors who really care about their patients. Companies who have raped the ideas of R&D of university and tax paid scientist, and then after standing on the shoulder fo giants, labeled their own patent on it with their high paid lawyers have also milked the public for anything they could. Now they sit on all their patents thickets and prevent any further developement and innovation with their “trade secrets”. We need major patent reform for medical devices and drugs, medical education reform in this country to fix this mess. Our legistlators have greivously been on the sides of big pharm, medical product companies, and insurance for way too long. Put R&D in the universities where it belongs. Put doctors in the drivers seat where they belong. Put medical patents into the control of their individual creators not their corportate buyers, and make sure that if these any company that is going to make money from this knowledge from the public, had better be willing to divulge this knowledge “to” the public for their perusal (but not profit). This doctor is the first step to at least give simple care which does not require expensive equipment or drugs. They are shameless in going after him and it just goes to show how corrupt or deludedly entitled they are (and they know it too!).

    22. The insurance companies are ticked because he is willing to give REAL medical care at a FAIR price…and he’d probably have full schedules of patients because of it. To the insurance companies that means fewer people they can FLEECE for sub-standard care at high cost! I work in healthcare and I’m telling you…get rid of the INSURANCE companies and Dr’s will have to compete; raising the standard of care and lowering the cost. Win-win for patients and Dr’s…leaving insurance companies out in the cold. Too bad it will NEVER happen, especially now that the Fed is getting involved. Watch for healthcare standards to plummet and costs to skyrocket!

    23. People making com’nts sound like . The state insurance dept. sounds more like ins. companies are running it. This doc’s method might make a good model, but should not stop there perhaps hospital should make fixed rate also. (standard procedures and peripherals 1 pkg.) This would be better than what many doctors are doing. (They are limitng patients to a fixed no., then chrging an amount (ex. $1600.00 & up) for exlusive patient care. That is you get posh waiting rooms with short waiting and you see the doctr. All others (one’s that don’t pay the xtra fee) go to a regular waitng rooms and see a nurse or other medical practitoner and no doctr-even if you have insurance. Also give thought to what the government spokespersons say. They are correct about the uninsured, the rate at which medical costs are rising, the strain placed on the social security system, And they are correct that the current system has not done a thing about self policing. (ex. do you really believe the Amer. Med. Asn. is going to tell doctrs to curb their chrgs? remember doctrs fees are due in part because of their insurance costs.) Be careful of many of the comments made just because it sounds good.

    24. This is a fabulous idea. And here is another reason it is NOT insurance: if I get hurt in some other state and need immediate medical attention, my plan at AMG won’t help. I hope AMG will fight the state’s interference … I am sure he will find he has a groundswell of support.


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