Kindness Deficit

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Kindness Deficit

Postby shostakovich » Sat Nov 06, 2004 10:56 pm

In last week's Newsweek Jane Bryant Quinn wrote an article that started "After the third presidential debate the plight of those without health insurance vanished from political sight. No surprise there. Lack of medical care represents a moral lapse that voters love to tut-tut about but aren't moved to fix. Fixing it might cost money, at which point the moralists usually change the subject to the weather. Besides, the uninsured tend to be powerless people whom America's comfortable middle can ignore."

Later in the article she refers to Medicare and its upcoming sellout to HMOs: "If that money didn't have to be funneled through private insurers, who take 20% or more off the top, we could have universal health care at no increase in cost."

In spite of the administration's claim that privatizing will make Medicare more "efficient", reason tells us otherwise. If Medicare is administered by the (non profit) government, it can NOT be more expensive than if by (for profit) private insurers.

The article concludes with "---the suffering of a few million Americans, while regrettable, is a price well worth paying for the fine coverage for the rest of us. What's really regrettable is that that sounds, to most Americans, OK".

And he got the "morality" vote??
By the way, the article was written before the election.
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Re: Kindness Deficit

Postby barfle » Mon Nov 08, 2004 12:57 pm

I'm curious as to how taxing those who earn money to pay the medical bills of those who don't earn money can be considered "kindness."

When the Founding Fathers did their Founding, they intended the government to have as little intrusion into the lives of ordinary people as they could possibly make it. Paying for someone else's doctor bills simply doesn't fit in with a government like that.

I know we've changed a lot of the government's focus since those days, and I know that the health care system is busted and busted bad. However, I don't believe that having a government bureaucrat running the show will fix anything. More government is not the solution, it's the problem.
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Re: Kindness Deficit

Postby shostakovich » Mon Nov 08, 2004 8:43 pm

I'm curious as to how taxing those who earn money to pay the medical bills of those who don't earn money can be considered "kindness."
---------------------------------------------------------
I'm not at all against socialized medicine. Robin Hood had the right idea as far as I'm concerned. Communism's tenet about taking from the rich to give to the poor was a nice ideal, but the administrators, who did a good job of taking, never let it trickle down.

The problem with doling out what's taxed from the rich is that deadbeats (who shouldn't get) and the needy (who should) are hard to distinguish bureaucratically. For those of us who picture the poor as the needy it's primarily a "kindness". For those of us who picture the poor as deadbeats it's primarily a "waste". I'd like to see an effort made to distinguish between deadbeats and needy, so that the money can be apportioned justly. It won't happen because such an effort would not be cost efficient. I'd still like to see it attempted because it serves justice.

This leads to another whacko idea of mine. This country has become too consumed with money being the single most important motivating factor. Bankruptcy, layoffs, outsourcing are consequences. "It has to be done" and "It's the right thing to do" are poor cousins to maximizing a payoff. However, the above 3 consequences could be avoided with flexible salaries. If a company in trouble had a policy of reducing salaries (big time for the CEOs) when necessary, they and their employees would be better off in many ways.

But, back to the quote at the beginning, the poor get sick. Helping them out is a kindness. Of course it would be so much better if individuals and groups felt compelled to do this without resorting to bureaucratic intervention. That would be ideal. I'm sure many people on the BBB do this automatically. But, for the multitude to whom it wouldn't occur, tax 'em.
Fan of Robin Hood (the fictional, idealized one)
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Re: Kindness Deficit

Postby shostakovich » Mon Nov 08, 2004 8:59 pm

PS: I agree the founding fathers never considered welfare through the government. I don't agree that the health care system is busted --- yet. Bush is flying the rumor that it is, so that he can tamper with it. Then, when he destroys it, he can say "I told you it was busted". The government has borrowed heavily from Social Security because, up to now, it had a surplus. And if it has any fatal flaw that would see it go into the red in 20 years, that can be attended to now if there is any intention to do so. The precious permanent tax cuts would have to go.
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Re: Kindness Deficit

Postby BigJon » Tue Nov 09, 2004 12:20 am

Shos, Ms. Quinn fails to mention how much Medicare takes off the top. Care to guess? It's more than 20%. Then go find out how much Social Security takes off the top. It's scary. The term Bloated Bureaucracy wasn't invented for the private sector.

Then go look up the Fallacy of the Commons and its solutions.

Charity begins at home, not in the House.

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Re: Kindness Deficit

Postby OperaTenor » Tue Nov 09, 2004 12:36 am

I'll try not to beat my own personal dead horse on this....again.

The article Shos cited touched on the core of the problem, yet didn't address what I feel would mandate change: Do the majority of Americans feel that equal access to health care is a right or a priveledge?

If we feel it is a right, universal, government-sponsored health insurance is THE ONLY VIABLE SYSTEM (darn, I hate it when caps lock sticks...).

If we feel it is a priveledge, then the current system will suffice quite nicely and we will continue to have a large bloc of folks AND CHILDREN AND ELDERLY(that darn key....again) who will be forced to go without health care.

For me, dog-eat-dog just doesn't sit right when it comes to health care. I'd be willing to pay a little more in taxes if 1) It helped insure everyone American had access to quality health care - no exceptions, and 2) It put the health insurance industry out of business.

The aforementioned article cited a very conservative figure for the health insurance industry's take - I believe it's more like 40% than 20%. I can't understand why anyone would want a business whose bottom line is making a profit controlling their health care - oh what the hell, let's get melodramatic about it - and therefore their very well-being.

The Founding Fathers had no idea leechcraft would become the costly, highly technical and sophisticated industry it is today. Getting medical attention then was like getting a haircut. I'm sure they(the FF's) never intended for the federal government to fund a space program, either.

Shos, you did this just to get me going[again], didn't you?

End of 1st installment of rant.

PS. When it comes to HMO's taking over Medicare, let's review what I learned in Life & Health Insurance class:

HMO - health care provider paid for number of patients enrolled irregardless of treatment => the less services rendered, the more $$ they make.

PPO - health care provider is paid in direct proportion to services provided.

Summary: HMO's tend to rigorously discourage treatment in order to keep costs down(and therefore profits up).

<small>[ 11-09-2004, 12:46 AM: Message edited by: OperaTenor ]</small>
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Re: Kindness Deficit

Postby barfle » Tue Nov 09, 2004 11:02 am

There are a few issues that have been brought up that are worth discussion. First, you have to understand that Robin Hood was a thief. He may have felt that he was working toward the greater good, but his basic mode of operation was immoral. Simply because the theft would be carried out by appointed officials and called "taxation" wouldn't change its morality. See my posts under "moral values."

Next, whether or not the government was intended to fund a space program or not (although the Americas were discovered under a government grant to Chris Columbus, so there is a precedent) has no bearing on whether or not the government was intended to provide health care for everyone. I wonder where this idea came from, and how far it goes.

To cite a slightly off-topic example, all of us own refrigerators. We consider them a necessity, and we would be hard-pressed to function for very long without one. Does that mean the government should provide refrigerators for those who can't afford them at the expense of those who can afford them? Have I opened up a can of worms with that example?

Shos, the line between the needy and the deadbeats may be nearly as wide as the entire group. Many deadbeats are truly needy, and it's because they simply don't know any better. Multiple generation welfare families are a fact of life, and when your parents, grandparents, and great-grandparents spent their lives on welfare, you really don't know any different, you just know you are miserable and have no examples of how to get out of your misery (other than the friendly corner drug dealer).

And finally, the truly indigent do get medical care, if they bother to ask for it. Very few hospitals turn poor people who are actually sick away. Many charities exist to handle this situation, and they could do even more if they weren't in competition with the government.
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Re: Kindness Deficit

Postby shostakovich » Tue Nov 09, 2004 1:08 pm

Shos, Ms. Quinn fails to mention how much Medicare takes off the top. Care to guess? It's more than 20%. Then go find out how much Social Security takes off the top. It's scary. The term Bloated Bureaucracy wasn't invented for the private sector.

Then go look up the Fallacy of the Commons and its solutions.

Charity begins at home, not in the House.

BigJon
-----------------------------------------------------------
Hi BigJon. If you are saying that Medicare (and SS ?) take 20% "off the top", I assume you mean the amount for administration. If the private sector takes over, there will will be the cost of administration plus the cost for stockholders plus the cost for lobbyists plus the cost for advertising.

The government bureaucracy can always stand some improvement in efficiency. THAT should be worked on, rather than "privatizing" Medicare and SS, which will weaken or destroy them, thereby reducing or eliminating the competition with the "private sector" so that it (private sector) can relax its own efficiency.
--------------------------------------------------------
From Barfle: "There are a few issues that have been brought up that are worth discussion. First, you have to understand that Robin Hood was a thief. He may have felt that he was working toward the greater good, but his basic mode of operation was immoral. Simply because the theft would be carried out by appointed officials and called "taxation" wouldn't change its morality. See my posts under "moral values."

--------------------------------------------------------
:p :p An attack on Robin Hood??? Who's next, King Arthur? Horrors!
Robin Hood's method of taxation was illegal. Today's method is not. They are, as you suggest, ethically equivalent. My issue is what is done with these taxes. Robin had a more charitable disposition of "taxes" than (would be King) George does.

The rest of Barfle's post has many points well taken. I must say, whether I agree with Barfle or not on any of his posts (even more numerous than mine), I always appreciate reading them. They provoke thought.
Shos

PS: "Charity begins at home". No argument, but if it ends there, it's not charity.

<small>[ 11-09-2004, 01:11 PM: Message edited by: shostakovich ]</small>
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Re: Kindness Deficit

Postby barfle » Tue Nov 09, 2004 4:06 pm

You may have noticed that I rather carefully avoided the term "legal" when discussing Robin Hood's methods and the tax collectors' methods.

I like to believe that my definition of morality is quite stable, although others may disagree (and I'm interested in participating in that discussion, should it crop up). Legality, on the other hand, is quite dynamic. It seems we have a fairly large segment of the population vying for the opportunity to change the definition of "legal," while we pay them handsomely for doing so.

As far as what's being done with those taxes (morally collected or not), I'm sure 75% of the money goes into something we disagree with, whether it's defense, medical care, road building, land confiscation, scientific grants, public broadcasting, or the DEA, ATF, FBI, and CIA. Unfortunately, those people we pay so handsomely to redefine "legal" don't seem to want to eliminate any spending programs that might cost them votes.
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Re: Kindness Deficit

Postby EJA » Tue Nov 09, 2004 4:33 pm

I, and apparently at least 51% of other Americans, do not believe that healthcare is a right any more than having food, clothing and shelter is a right. All these are things for which one has to labor. Even if these things are made an entitlement, the fact can't be dodged that the labor must be done to garner the benefits. Is it right to require a man to labor not only for his own food and shelter but also for that of another? Likewise, it is not appropriate to make a man labor not only for his own healthcare, but also for that of another. There are situations in which charity is quite appropriate, but charity imposed by government is not charity but slavery. Charity must be of the givers own free will.

Turning from the philosophical to the practical, in spite of the fact that slimey lawyers, such as John Edwards, and slimey insurance companies have greatly increased the cost of health care in this country in the last 20 years or so, the fact remains that the United States has the best health care in the world--both in quality and accesibility. There is no reason that we should follow, lemming-like, the lead of countries such as Canada and France whose health care is deficient both in quality and availability. What we need to do is to punish insurance fraud in a manner sufficient to deter it, and to enact such tort reform as will curb the exorbitant settlements wrought by such swindlers as the infamous senator from North Carolina.
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Re: Kindness Deficit

Postby RC » Tue Nov 09, 2004 5:03 pm

barfle
I think I hear:
Less government and more individual freedom/responsibility is always better, i.e., capitalist market suits the healthcare industry just fine. That's a bit of an extrapolation but still appropriate I think (?).

I agree (as I've said before blah blah blah).

The problem then is ANY government meddling which interferes in the private market. Then health insurance should be abolished altogether and individuals should make their own arrangements for the cost of health care because insurance companies are both manipulated and pandered to, by the government at all levels. If you think ANY health insurance qualifies as working in a "free market", you are mistaken. I've stated many examples before - if you want some I'll do so again.

Plus, you have to pay the insurance companies overhead, a commission to the insurance agent for their overhead, plus profit etc...

Lets just dump them and have it done with.

Ooops...one little thing...

My second most favorite tirade is the development of income polarization and its effects on our free market economy. You folks really do need to understand this - it ranks right up there with our recent presidential election, global warming and the aids epidemic. Its sneaking up on you and really took off with Clinton.

Problem with health care in a free market US right now is this:
The middle class is dwindling, the lower class and the upper class are growing. (Haggis and Shap, I don't care if you agree or not, just like global warming, it becomes more apparent all the time).
Doctors as businessmen, will naturally choose a field and clients that will provide the biggest bang for their buck. Their primary clientele will become the upper class.
Because the wealthy can afford services and procedures that no one else can afford and they will have become the primary clientele, they would continue to escalate costs. No amount of planning would provide enough cushion for the average american household to pay for regular health care let alone a catasrophe.
Health care in the US isn't expensive because its crap. I think we all agree with that. (maybe).

Right now, we have a dog chasing its tail.
My instincts are free market and libertarianism all the time. This is an exception. I just can't see it working.

Show me how it can and I'll show you how it can't until we come up with a good middle road, we'll send it to Bush and get a big reward...maybe a cabinet seat.
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Re: Kindness Deficit

Postby RC » Tue Nov 09, 2004 5:25 pm

EJA,
"What we need to do is to punish insurance fraud"

I guess I lost you when you said we need to punish insurance fraud and then said we needed to limit exorbitant settlements.

Do you mean to say that INDIVIDUALS are responsible for exorbitant settlements but insurance companies and doctors are devoid of responsibility for exorbitant settlements, lawsuits, & fraud?

Seriously, I don't get the practicality in your practical solution. You're going to have to explain it to this bear of little brain.
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Re: Kindness Deficit

Postby barfle » Tue Nov 09, 2004 6:09 pm

Any insurance is a voluntary shifting of high costs to other volunteers, or at least it should be. By and large, insurance companies make their profits not in the difference between premiums and claims, but by handling the money in the period of time they have it. My wife was a commercial lines underwriting manager, so I think she is reasonably knowledgeable on the topic.

Any government involvement in the insurance industry, like any other industry, should be to prevent abuse in either direction.

I have health insurance, and have lost money on it so far. But I'm not getting any younger, so the likelihood of having a serious claim is increasing. This is a contract between me and my insurer. They are bound by the terms of the contract (policy), and if I end up in a situation where they have agreed to pay, I have confidence that they will.

Any big business attracts the attention of regulators. It's the regulators' nature to want to regulate. Such is life. :( And now the government not only wants to regulate, it wants to compete in the industry. Actually, it wants to take over the industry.

I agree, the middle class is losing both population and clout.

Another aside, one of my co-workers is making just over $100,000 per year (he earns it - I wish I knew what he did), but he thinks he's "a middle class working man."

Again, I'll note that I believe the health care system in the US is busted, and the reason it's busted is due to government interference. A competitive free market would sure be a nice thing to try.
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Re: Kindness Deficit

Postby RC » Tue Nov 09, 2004 6:41 pm

Property and Casualty insurance is quite a bit different than health insurance. It really doesn't (can't in fact) work the same way.

Mostly for a lot of the reasons I already sited but there are other very basic differences including the idea of indemnity, a premise of P&C which can't translate in health insurance. (One of the reasons for "exorbitant" claims). The extremely complicated pooling used in underwriting health & life makes it impossible for the average Joe to shop this type of insurance.

Lets pretend a free market would work. First move is to get rid of health insurance all together and start an experiment from there.
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Re: Kindness Deficit

Postby EJA » Tue Nov 09, 2004 6:54 pm

Originally posted by RC:
EJA,
"What we need to do is to punish insurance fraud"

I guess I lost you when you said we need to punish insurance fraud and then said we needed to limit exorbitant settlements.

Do you mean to say that INDIVIDUALS are responsible for exorbitant settlements but insurance companies and doctors are devoid of responsibility for exorbitant settlements, lawsuits, & fraud?
Heavens no, from one bear to another—based on your statements, I suspect that we are in material agreement on this matter. I was proposing a two-pronged attack to the problem. In my attempt at brevity, I perceive that I may have caused some confusion. I know that the common perception of insurance fraud is that the insured makes a false claim to gain insurance benefits to which he is not entitled. However, I consider that the doctor who prescribes treatment that is unnecessary and/or at an exorbitant cost because he knows that insurance will pay for it is just as guilty of insurance fraud. Moreover, the insurance agent who sells his client the insurance policy that generates the biggest kickback for said agent, rather than the best policy for the customer, is likewise committing insurance fraud. In our country, an unholy trinity has developed among doctors, lawyers, and insurance companies that tends to enrich these at the expense of patients. (Occasionally, it is true, the patients strike back with the customary form of insurance fraud.) This unholy trinity is largely responsible for the somewhat inflated cost of health care. At the moment, the lawyers are making the biggest haul and are greatly risking the death of their golden goose (the doctors), which would be a great tragedy for all of us. This is why I propose the solutions of punishing insurance fraud (in all of its manifestations), and tort reform.

One other observation, while I'm at it, is that one reason our health care is expensive is that it is the best in the world. We really pamper ourselves. If we dislike the expense so much, there is always the budget alternative: death.
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Re: Kindness Deficit

Postby OperaTenor » Tue Nov 09, 2004 7:07 pm

Originally posted by RC:
Property and Casualty insurance is quite a bit different than health insurance. It really doesn't (can't in fact) work the same way.
RC moves to the head of the class.

Ethan, I'm so glad you chimed in(even if you are wrong. ;)

I would like to see a comparison of costs incurred by the health care industry due to "frivolous" lawsuits vs. costs incurred due to the health insurance industry. Heck, even just health insurance industry profits. I'll have to do some research. I have a feeling there won't be a close comparison.

If the majority of Americans believe possession of a refrigerator is a right, then perhaps the government should provide us with refrigerators. I thought I stated very clearly that this should be mandated by the will of the American people, like everything else is supposed to be.

This is the one issue that makes me a bad Libertarian. I feel it's wrong to live in the most prosperous country in history and have a significant portion of the population denied what I would consider a fundamental right: to be able to find relief from physical suffering.

Shame on us for not doing everything we can to take care of each other.

I still have yet to hear from anyone living in a country that has "Socialized medicine" that they would prefer our system, or that a patient has ever suffered because of the system. I've never heard of a case where a Canadian went without an MRI, even though the US outnumbers the Canadians something like 20 to 1, per capita in MRI machines.

Yes, we have the best health care. The best that money can buy.

<small>[ 11-09-2004, 07:12 PM: Message edited by: OperaTenor ]</small>
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Re: Kindness Deficit

Postby RC » Wed Nov 10, 2004 9:12 am

OT says: I would like to see a comparison of costs incurred by the health care industry due to "frivolous" lawsuits vs. costs incurred due to the health insurance industry. Heck, even just health insurance industry profits. I'll have to do some research.
I don't think I'd bother to do the research. My guess is Elliot Spitzer will beat you to the punch (when he's done with P&C), and if we're all paying attention, we will get a real eye opener.

EJA, thanks for clearing that up.
I guess I had the standard knee jerk reaction to capping lawsuits since it just passed in FL. My opinion is that is beating the wrong end of the horse. I agree with your summation of where the brunt of the problem lies and it isn't with the folks Edwards tended to represent AGAINST the industry.
Not saying that he wasn't a greedy attorney. I really have no idea - I am not familiar with his work and didn't pay too much attention to election propoganda.
Just seems like mal-practice lawsuit caps is an upside down place to start.
Industry NEVER works "honestly", it works profitably and is more susceptible to fraudulent behaviour (if it's legal by a margin, it's OK).
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Re: Kindness Deficit

Postby haggis » Wed Nov 10, 2004 2:24 pm

RC,

” The middle class is dwindling, the lower class and the upper class are growing. (Haggis and Shap, I don't care if you agree or not,”

I go away for two days and you think I won’t call you on that? :D

That statement is mostly incorrect, despite what you may think. The movement from the lowest economic classes (mostly immigrants) to higher economic classes in the U.S. has been confirmed almost every year since the government began tracking those statistics.

Furthermore, economic migration from all economic classes (lower income, middle income, etc.) upwards has been consistent since at least 1947.

I do, however, agree with you that "...the upper class are growing." Every year more Americans than the year before move into the top tax brackets based on reported income.

Although I suspect that what you meant to say was that the upper class is getting richer; while true, it still does not preclude the fact that annually more people are meeting the definition of "rich."

If the lowest economic class is, as you claim, growing, that’s a phenomenon more attributable to greater immigration, both legal and illegal, than, as you seem to infer, from people sliding back into poverty.

I don't deny that some people might slide back into lower economic straits, but that's usually temporary (loss of a job, uninsured loss of property etc.)

The greater majority of available evidence demonstrates that upward economic migration in the U.S. is the standard rather than the rule.

Absent any reliable statistical evidence to the contrary that the rich are getting richer and that the poor are getting poorer, then your hunch is that; a hunch.


EJA, Re: Lawsuit caps.

” I consider that the doctor who prescribes treatment that is unnecessary and/or at an exorbitant cost because he knows that insurance will pay for it is just as guilty of insurance fraud.”

Evidence that lawsuit caps produce results;

“HoustonChronicle.com - Sept. 21, 2004: Texas' largest medical liability insurer cuts rates”

“ Drop is second since jury award cap was imposed

Associated Press
AUSTIN - Texas' largest medical liability insurance provider said Monday it will cut its rates by 5 percent starting in January.

The drop by the Texas Medical Liability Trust, or TMLT, comes on top of a 12 percent decrease the company implemented last January, after a new law and state constitutional amendment allowed a cap on jury awards and limited insurance companies' liability.


"If you think about it, that's a 17 percent reduction in rates in just a year, and I think what's more important than that, that's over $34 million of savings to TMLT's Texas physicians in a single year," TMLT president and CEO W. Thomas Cotten said during a Capitol news conference.”


Finally, why is access to free or subsidized health care considered some kind of right?

I pay several hundred dollars every 5-10,000 miles on my 1999 Toyota Avalon for “routine” maintenance.

I don't expect my insurance company to step in and pay 75% of my bill.

Why should we expect to have every doctor’s visit and lab test paid? Why don’t we have health insurance for catastrophic health emergencies and pay the “routine” cost out of our own pockets, the same as we do for our cars, appliances or other “routine” or non-catastrophic medical costs?

And yes, I have had and not had medical insurance; I agree it can be scary when you don't have that "safety net."

And I still don't see the government getting into that business.
Haggis

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Re: Kindness Deficit

Postby EJA » Wed Nov 10, 2004 2:45 pm

[quote]Originally posted by OperaTenor:
[b]Ethan, I'm so glad you chimed in(even if you are wrong. :)
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Re: Kindness Deficit

Postby RC » Wed Nov 10, 2004 2:54 pm

Haggis,
Always welcome!
However, you are completely misinterpreting what is meant by income polarization.

Rather than having me explain it, why don't you google it and see what you come up with.

Also, regarding immigration - I never said WHAT is causing polarization in this particular thread but I'm glad you WERE listening last time I preached on this subject; immigration is very much a factor.
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