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U.S. Physicians are paid far more relatively than in any other country.

Discussion in 'Allopathic' started by SchroedingrsCat, May 1, 2012.

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  1. SpecterGT260

    SpecterGT260 Catdoucheus

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    I see nothing to suggest this isnt a result of the american people "getting what they asked for"
  2. SpecterGT260

    SpecterGT260 Catdoucheus

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    Im dumb :(
  3. myhandsarecold

    myhandsarecold

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    Overpaid? More like over utilized. Our current system gives people the freedom to get the care they want, when they want it. Our people are also fat -> more doctor visits, surgery, hospitalizations -> higher salary.

    I make $9.00/hr as an intern.
    Last edited: May 1, 2012
  4. surftheiop

    surftheiop

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    Its true, not sure who sold the poor to middle class republican voting block in the southeast that jesus thinks its a bigger injustice for someone to unnecessarily get a few extra food stamps than its is for hundreds of thousands of people to go bankrupt because they get sick, so they insist on voting for politicians who assure them they won't allow the poor people to get a free ride. I guess I missed all those bible verses where jesus talks about how oppressive poor people are and that you need to protect the rich from their tyranny
  5. SpecterGT260

    SpecterGT260 Catdoucheus

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    :eyebrow:
  6. surftheiop

    surftheiop

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    I know it was a random tangent haha, but it just never made any sense to me. I understand the big city affluent types in the Northeast being conservative (Romney), its better for them financially and they can make decent arguments for it being better for the country economically.

    But religious right down south just makes no sense to me in this regard b/c they are actually the ones who would benefit from a lot of the social programs (just look at schools in the SE) and the obsession with the military and making sure poor people don't freeride seems so contrary to the stuff they believe jesus said.
  7. SpecterGT260

    SpecterGT260 Catdoucheus

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    :eyebrow:
  8. Perrotfish

    Perrotfish Has an MD in Horribleness

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    The belief is not anti-charity,but anti government. Its the belief that federal government programs, even those started with the best of intentions, ultimately become a burden and a roadblock to those they were trying to help, while enriching no one but the massive beurocracies that form around each new program and the industries which can afford to lobby congress on their own behalf. Its a belief that any job that a private citizen can do well for ten dollars the federal government will do poorly for no less than a hundred. Its a belief, a belief which is one of the founding principle of this nation, that everything possible should be left to the individual, that those duties which must be assumed by the government should be dealt with by the county or the state, and only those few services that must absolutely be performed at the national level should be the business of the Federal government.

    Conservatives believe that healthcare was being handeled fairly well, at the state level, when Medicaid and Medicare were created in 1965. They note that since those two giant, ever expanding federal entitlement programs were established we have not greatly improved our national health, but have seen a runaway bubble of government healthcare spending. They would argue that we seem to be giving an ever increasing number of dollars to an organization that has failed at every previous attempt to do its job, but like an alcoholic spouse they want us to trust them yet again because 'this time it will be different'.

    I wasn't a huge fan of Reagan, but I did like some of his one liners. My personal favorite: "What are the nine most terrifying words in the English language? 'I'm from the government, and I'm here to help'".
  9. SpecterGT260

    SpecterGT260 Catdoucheus

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    u had to go and do that didnt you.... I was just going to start adding more :eyebrow: faces to my posts to convey the feeling that more and more people were staring blankly until this just went away.
  10. SteinUmStein

    SteinUmStein

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    What the Bible Belt supports politically has almost no connection to anything in the actual Bible. Religious conservatives are marionettes dancing on corporate strings, and fiscal conservatives will always be the real power players even if they're not front-and-center on Fox News. Romney's the nominee, not Santorum, and it was never really close.

    Edit: a good portion of conservatives on welfare will rail against big government, will complain about government hands on their healthcare, even as they use their food stamps and Medicaid. There have been actual people quoted at rallies saying, "Keep big government away from my Medicare." There's no real logic to their political decisions other than doing what their neighbors are doing and following what the TV says about that evil anti-American Barack Hussein Obama.
    Last edited: May 1, 2012
  11. bajastapler

    bajastapler

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    imo: You should consider/read more health-care papers published by leading sociologists, public health officials, and etc before you make such a bold statement. L:(

    I don't think you're giving a holistic picture as to what's really going on. That exorbitant salary you speak of - particularly for private practices - go towards paying for:
    malpractice insurance, medical school loans and interest, undergraduate loans and interest.

    Also did you consider that your first legitimate paycheck as a physician comes at ~ 30 years of age? So now that you're 30 and got your first paycheck you need to pay for: housing, 401 k, taxes, credit card debt, children, children's college tuition, etc, etc.

    All this said, as someone who's pursuing a physician's license (either the m.d. or the d.o. route) i wouldn't mind a salary cut. BUT this has to be done with a consideration for what a physician's salary is actually going towards.

    tl;dr: I don't mind a paycut, but only if the U.S. healthcare system - as a whole - gets reformed.
  12. surftheiop

    surftheiop

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    But if we want to follow the spirit of the founders we should still have slaves and women shouldn't vote, things inherently change with time.

    And you have places like Germany and Switzerland which pretty much invented capitalism having no trouble adapting to provide for their people who are in need while still keeping a better credit rating than the US.
  13. SpecterGT260

    SpecterGT260 Catdoucheus

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    I dont think this stands as an appropriate counterpoint to "people believe the gov'ment will screw up". If the cited countries are running in a purely capitalistic manner then this is evidence which supports john... er... perrotfish's claim

    I also didnt see anything in his post which led me to believe that he was suggesting we go back to what the "founders" had. as a "government of the people" any viewpoint is valid and when enough of these viewpoints band together it spawns policy. That is all. We need not bring the revolutionaries into this
  14. surftheiop

    surftheiop

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    I wasn't claiming they were purely capitalistic, I was pointing out that Germany/Switzerland are able to maintain extremely powerful market based economies while still having "socialized" policies like making sure everyone has healthcare and protects people from medical bankruptcy.
  15. sanityonleave

    sanityonleave Adrenaline Junkie

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    OP,

    Google physician salaries and the Gini coefficient, compare that data to your current set of graphs, and then troll elsewhere.

    I'm not arguing that your final argument is incorrect -- people in medical school should be prepared for salaries to go down -- because politically, that's likely to happen. But looking at physician salaries relative to income distribution inequalities in the US, they're in line with other professions.
    Last edited: May 1, 2012
  16. Perrotfish

    Perrotfish Has an MD in Horribleness

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    The point is not that we can't provide for out people, the point is that our people can provide for themselves. The federal government has nothing to offer its people that it didn't first take from them, and in the process of transforming it from something they take to something they give they inevitably have managed to spend 90% of it on their own ever expanding bureaucracy. We have seen this time and time again. Germany has the same problem we do with health care: they're bankrupting themselves with it. They're spending one out of every seven dollars on healthcare, and the amount is increasing at several times the rate of inflation every year. They've staved off disaster until now with non-sustainable cuts to healthcare providers (they're famous for nation wide physician strikes) which is why they provide care for so little, but now they're hemhorraging providers and still can't control costs. Their system is like someone who has figured out he can save an enormous amount of money by just not paying his rent. It seems like a great strategy until he gets an eviction notice.

    The way to save healthcare and stop all the bankruptcies is not more federal spending,but less. Right now everything in healthcare costs ten times what it should because the prices are set by federal programs that will pay for any type of care, no matter how ludicrously expensive or marginally effective. People need to be spending their own, limited money on health care. And they need to know, universally, when the money runs out that there is no more, just like any other industry. High costs goods will get driven out of the market entirely, and the healthcare industry will, with deregulation, see their prices collapse just like the airline industry did when we finally deregulated that.

    This is a good article on the healthcare model in Singapore. They manage to get better results than the US, for one tenth the cost,by empowering individuals. On the one hand they have significantly deregulated the supply side of medicine: most drugs are OTC, the training for a medical license is short and cheap. On the other hand they have given every indivdual a healthcare savings account (wth the $ taken from their paychecks),but other than enforcing saving for healthcare they don't provide much in the way of healthcare. The only other major reform is that physicians need to post prices at the door like any other business, rather than generating a bill out of thin air after they provided a service. They rely on individuals to managetheir own finances and their own care with doctors and drugs they buy with their own money.

    The result of empowering individuals is, as I said, a debt free, insanely cheap healthcare system with better results that Europe or the US. Our problem isn't that we need the government to save us from ourselves, its that we need to save ourselves from the government.
    Last edited: May 1, 2012
  17. SpecterGT260

    SpecterGT260 Catdoucheus

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    oh.... ok that does make sense then :thumbup::D
    assuming they are as capitalistic as you suggest.
  18. SpecterGT260

    SpecterGT260 Catdoucheus

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    almost did it again! dude, your avatar looks just like JohnnyDrama's in periphery..... (but apparently your name is actually john? lol)

    acupuncture is covered in some states by insurance. :smack:
  19. Chakrabs

    Chakrabs

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    No one else in this country is precluded from making as much as they damn well can earn. When was the last time you were able to pay a repairman half of what he charged and got away with it? Next time I go to Best Buy I'm going to buy a TV and when they tell me its $300 bucks, I'll give them $100; lets see how far I get out the door. I, like everyone else in this country should be able to make as much money as I can earn, and I resent anyone telling me to "oh, don't be greedy", "you can still be comfortable." Who are you to tell me what I can be comfortable with? If I want to work hard for an apartment on Park Avenue, why should I be precluded from doing so by insurance companies or even better, a government healthcare system actively trying to depress my income? Or even worse, a government trying to tax me me out of half my pay because I actually earn it saving lives, while the financial goons are swindling people out of their money and pay a pittance.
  20. Perrotfish

    Perrotfish Has an MD in Horribleness

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    To be fair, they are the people who are guarenteeing your salary by making it illegal to practice without a medical license. There is no other job in this country where the government actually makes it a crime to sell your services without the appropriate 'union card' from a private organization. In fact in any other industry that would be described as collusion and would make your industry a target for trust busting. You can't artifically limit the number of medical positions in this country with government backed licensing and then act shocked that the public won't let you use your exclusive right to provide medical care to overcharge for your services.
  21. Perrotfish

    Perrotfish Has an MD in Horribleness

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    That clarifies the situation. Thanks.
  22. SpecterGT260

    SpecterGT260 Catdoucheus

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    I am now kicking myself for not playing this out :smuggrin:
  23. Perrotfish

    Perrotfish Has an MD in Horribleness

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    Of course you are... steve.




    (did I get it?)
  24. SchroedingrsCat

    SchroedingrsCat

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    +1. In a true free market there would be no barrier to entry for anyone to practice medicine. The people who don't know what they're doing would (theoretically) get weeded out quickly by their results. On the other hand, the anesthesiology provider who only completed a 1 year course on anesthesiology but has good outcomes also is allowed to compete. PLUS he can charge a ton less because his medical education didn't cost 200 grand. The public wins by being able to afford anesthesiology (even a sub-optimal level of it) unlike the current situation.

    Basically, whining about government affecting your reinbursments (most of which they provide to you) is the same as the "keep your government hands out of my medicare" sentiment.
  25. surftheiop

    surftheiop

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    The ironic thing is that the "socialized" countries do a better job of this than we do. Our goverment spends a greater amount of its tax revenue on healthcare than countries that have UHC.

    US spends 18.5% of government revenue on healthcare, while Germany, Sweden, France, the UK, Australia, Canada, Japan all spend a lower percent of their government revenue on healthcare.

    Additionally our healthcare costs are 16% of our GDP while all those other countries are under 11%.

    For the full comparative chart scroll to the bottom of this
    http://en.wikipedia.org/wiki/Health_care_in_Canada


    There is no way the US political climate is going to let old folks go without healthcare if they haven't saved up, and as soon as we cover old people, its way more efficient to go for full UHC as demonstrated by those stats.
  26. Perrotfish

    Perrotfish Has an MD in Horribleness

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    Did your read the article I linked on Singapore?

    FWIW I think that what the US has proven is that the worst possible system is to be half government insurance, half free market. When the government insures everyone then you cover everyone and healthcare costs way,way too much. In the free market some people don't get covered but the free market makes care affordable for most and sustainable in the long run. When half your population is covered by government insurance the half that is covered is enough to make healthcare cost way, way too much, which puts healthcare out of reach of a lot of the other half. We need less or more government. I vote for less, since I think federal health care is well on its way to bankrupting Europe and the US..
  27. awval999

    awval999 New Member

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    Nice response to be honest.
  28. surftheiop

    surftheiop

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    Not yet, sorry if I find it hard to believe that a military police city-state where chewing gum will result in getting thrashed with a bamboo rod to be the greatest demonstrator of what free society should aspire to.
  29. Perrotfish

    Perrotfish Has an MD in Horribleness

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    Just like the free people of Germany have managed to create one of the most compulsory health care systems on the planet, the military city-state of Singapore has wierdly created on of the freest healthcare systems in the first world. It is what it is.
  30. Chakrabs

    Chakrabs

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    Fair enough, when lawyers (who I believe also obtain their proverbial exclusive licence to practice) have their ability to charge as they please limited, then I'll allow for my own wages to be garnished. Until then, keep your hands off my ability to make as much as I please.
  31. SpecterGT260

    SpecterGT260 Catdoucheus

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    I am not sure on the legality of it all, but I know you can represent yourself in court :thumbup:
    Pretty sure you can have anyone you want represent you.... But there may be issues with advertising as a lawyer without the license. Unless you are getting into bird law.....


    but for serious... You can shop around for a lawyer or (as previously mentioned) represent yourself, you cannot always shop around for a doc. Government reimbursements SHOULD act as an incentive to offset obligatory treatment in some cases. You cannot freely fire patients in most cases especially in emergency settings. However I do not think it actually works this way :laugh: if someone comes in without a means to pay for healthcare 1 of 2 things should happen: either I can tell them I am not interested in pro bono work, or if the government tells me I cannot do that - then they should dish out to cover the expense. I am not saying which way is better... just saying if a policy mandates specific behavior the government should ensure this does not occur at a cost to the individual.
  32. Perrotfish

    Perrotfish Has an MD in Horribleness

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    While there are hundreds of other government issued licenses, they're mostly just standardized tests. Anyone who can pass the bar is a lawyer. Anyone who can pass a prometric test can be a real estate agent, a physical therapist, or whatever. In a few cases you need to apprentice under someone with a license, for example professional engineers. However in all other licenses an essentially infinite number of people can go to a prometric center, pass a test, maybe find someone to apprentice under, and get a license. There is no artifical limit on the supply.

    Only medicine, with its system of residency training, has a private organization decreeing 'this many doctors shall be made this year,and no more'. It's unique, and its the reason that physician salaries are so high when other professionals have salaries that are so low (see lawyers). You can't be in that system and then expect to have a completely unregulated salary.
  33. JackShephard MD

    JackShephard MD

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    :laugh:
  34. badasshairday

    badasshairday Account on Hold

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    I'm new to this forum meme thing, but the OP has been trolling us on multiple threads:

    [​IMG]
    Last edited: May 1, 2012
  35. DrSnips

    DrSnips IM PGY-1

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    Well obviously. The guy comes on to a forum of students and residents, many of whom are in tremendous debt and tells them their profession pays too much. It's not like he's going to provide a link to the trololo video as well.
  36. badasshairday

    badasshairday Account on Hold

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    .
    Last edited: May 1, 2012
  37. badasshairday

    badasshairday Account on Hold

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    dude brah, you are suppose to do the o rly meme or something.

    [​IMG]
  38. JackShephard MD

    JackShephard MD

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    We've been trolled.

    [YOUTUBE]2Z4m4lnjxkY[/YOUTUBE]
  39. investing101

    investing101

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    You can't compare the rest of the world to the U.S. I will tell you why.

    Our economies are different in terms of costs and financial model. I would argue that our system is sorta corrupt in that the cheap money our country prints makes it seem like any doctor should be happier by moving to the United States. My point is that you have to compare salaries to total costs of living where you live and not country to country. General surgeons in New York don't earn the same as in other states. More important just because you earn more than I do doesn't mean you keep more of your earned money than I do.

    So this is a pointless study.
    Last edited: May 1, 2012
  40. SurfingDoctor

    SurfingDoctor

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    Sorry but I don't understand your argument. Infant mortality rates have nothing to do with physician salaries. Infant mortality rates are high compared to most other industrialized countries because we have a high number of premature births. The increased premature birth rate is multifactorial, but is more or less linked to incomplete coverage for the poor (if they can't get insurance, they can't get prenatal care) and high usage of artificial insemination (re: look up the article about the Houston mom with sextuplets). None of this linked to physician salaries, just ethics.
  41. SpecterGT260

    SpecterGT260 Catdoucheus

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    that guys face creeps me out somethin fierce....
  42. QuizzicalApe

    QuizzicalApe

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    if you are so passionate about keeping healthcare costs down, make sure your advance directive says DNR/DNI
  43. plauto

    plauto

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    One more thing for you peeps to think about...has it ever occurred to you that people in many other countries cheat on their taxes? It is an extremely common thing. Not so for physicians in the US. Go to a private doc in several european countries (in most countries hospitals are free, anything else is not). See if he gives you a receipt for the $200 visit he just gave you...

    Doubt anything these articles tell you!
    Last edited: May 4, 2012
  44. badasshairday

    badasshairday Account on Hold

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    US Nurses, Businessmen, Engineers make more relative to their counterparts in any other country!:eek:
  45. Gut Shot

    Gut Shot

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    I agree that Singapore is the most consumer-driven system in the world, but you're underestimating the role of government a bit too much. You say they "don't provide much in the way of healthcare," but 80% of acute care is administered through public hospitals with government-imposed price caps.

    In addition to Medisave (the HSA you mention above), their government also administers Medishield (catastrophic insurance), Medifund (for the poor), Eldershield (self explanatory), and it subsidizes disability and pharmaceuticals.

    Their system is, as they say, both to the right and left of our own.
  46. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    The vast majority of states require you to go to an accredited law school prior to taking the bar.
  47. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    There are many healthcare-related fields (besides docs) in a similar situation.
  48. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    It's not always so easy to find someone to apprentice under... I am thinking specifically of some of the financial careers and qualifying for some of the exams such as the Series 7, etc
  49. Perrotfish

    Perrotfish Has an MD in Horribleness

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    Medishield is a capped catastrophic insurance plan which you can buy from the government, but which competes with private catastrophic insurance plans. Medifund and Eldershield disperse a small payment to the individual who then use that money to pay for their health care and, in the case of Eldershield, their cost of living. This is unlike our systems of Medicaid and Medicare that pay providers directly. Basically its the difference between school vouchers and public schools. Acute care may be managed largely through Public hospitals, but long term management of chronic conditions is still largely privatized (unlike Europe). That doesn't seem to be to the left of us in any way.

    I'm not saying its a government or regulation free system, but I think its a lot closer to American ideals than the European system. Also it's just as effective as the European system while being way cheaper. If we can't accept a system of government free healthcare, it seems like the next best alternative.
  50. Gut Shot

    Gut Shot

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    I am not trying to draw a direct comparison with Medicaid or Medicare (neither of which I mentioned). I was merely pointing out that their consumer-driven system still depends on public programs and government regulations in order to function. The decision to cap prices on inpatient services alone indicates that they are not comfortable letting the market operate unfettered. In many respects it is a public-private partnership rather than the libertarian wet dream that some (not necessarily you) make it out to be.

    Alas, there are some rather tough sticking points. Singapore also has a relatively young population (8.5% over age 65, while we have 12.6% in that range), which gives them a much more favorable ratio of healthy, productive citizens to older, infirm ones. Most of Europe is even older.

    Second, I would like you to close your eyes for a moment and imagine that Obama is announcing the establishment of a 9% compulsory payroll deduction to fund healthcare. One can almost hear the aneurysms that would burst like rotten fruit all across the country.

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