Ken's Project Blog

May 29, 2012

NYT – The Politics of Religion

Filed under: Health Care,In The News,Politics — Ken @ 12:36 am

Over at the New York Times, they posted an Op-Ed concerning the dust-up over religious affiliated groups and the federal government’s requirement that they provide no-cost contraception, including the morning after pill. It is staggering that so many half-truths were crammed in to such a short Op-Ed.

I’ll refer you to the actual Op-Ed for the complete text, but let me point out a few of the more egregious mis-representations:

“Mr. Obama very publicly backed down from his original position and gave those groups a way around the contraception-coverage requirement.”


“After religious groups protested, the administration put the burden on insurance companies to provide free contraceptive coverage to women who work for religiously affiliated employers like hospitals or universities — with no employer involvement.”

This refers to the government deciding that religiously affiliated organizations would not be charged directly for the cost of providing the required contraceptive coverage – hoping people will assume that the insurance companies would reach into their own pocket and pay for the contraceptives from their own profits. Ask yourself this question: Will a religiously affiliated organization see the cost of their health coverage go up, down, or remain the same once this expense is ‘covered’ by the insurance companies? The answer is, the cost will go up – the insurance companies won’t be donating coverage for contraceptives to these organizations (they are not in the business of giving things away) and contraceptives aren’t free… It’s just that there won’t be a line item for the cost on the invoice.

Carefully avoided in this Op-Ed is the impact to those religiously affiliated organizations that choose to self-insure, a common practice among religious hospitals – how does a self-insuring hospital avoid paying for contraceptives?

“The vast majority of Americans do not agree with the Roman Catholic Church’s anti-contraception stance, including most American Catholic women.”

As if that matters. The tenets and beliefs of the Catholic Church are not up for vote based on popular opinion – if the majority of Americans felt it was OK to steal, would the Catholic church find itself left with only nine commandments?

“The real threat to religious liberty comes from the effort to impose one church’s doctrine on everyone.”

This was the final line in the Op-Ed, the author’s attempt at a “coup de grace” – but he falls short: the churches aren’t trying to impose their doctrine “on everyone,” if they were to emerge victorious in this “battle” the only people impacted will be those women that choose to work at religiously affiliated organizations (hospitals, schools, charities, etc.) – they will simply be “forced” to pay full price for contraceptives, and there will be no impact on any other woman covered by employer-subsidised medical insurance.

I find it very telling that the supporters of this contraception regulation feel it is necessary to misrepresent the stakes (“impose doctrine…on everyone“), hold up ludicrous arguments (removing the line-item from the invoice solves the problem), and attempt to convince religious groups that they should let popular opinion polls determine church doctrine…

I agree that someone is trying to impose their doctrine on everyone, but it isn’t the Catholic church.


New York Times: The Politics of Religion


October 17, 2011

Rep. Sheila Jackson Lee and the Protect Life Act

Filed under: Health Care,In The News,Politics — Ken @ 3:18 pm

Representative Sheila Jackson Lee, Let me point out two things – the Hyde Amendment and Executive Order 13535.

The Hyde Amendment prohibits the use of federal funds to pay for abortions under Medicaid, except for some very clearly defined circumstances (rape, incest, protect the life of the mother) and allows states to use their own money to fund abortions if they so choose.

Executive Order 13535 was signed by President Obama in March of 2010 to re-affirm the long-standing position of the Hyde Amendment on the Patient Protection Act (so-called “Obamacare”).


youtube: Rep. Sheila Jackson Lee (D-TX) Speaks Against Pro-Life Act (10.13.11)

wikipedia: Hyde Amendment and Executive Order 13535

August 13, 2011

The Latest Health Care Court Case

Filed under: Health Care,In The News,Politics — Ken @ 9:36 pm

Over at the White House Blog we see Stephanie Cutter insist that the recent court decision that found part of the Affordable Care Act – the so-called individual mandate – to be unconstitutional was wrong. Her counter argument? Well, let me quote her posting:

The individual responsibility provision – the main part of the law at issue in these cases – is constitutional. Those who claim this provision exceeds Congress’ power to regulate interstate commerce are incorrect. Individuals who choose to go without health insurance are making an economic decision that affects all of us – when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab. [emphasis added]

Source: White House Blog

Got that? It is constitutional because uninsured people make health care more expensive for everyone else, so the role of government (according to Ms. Cutter’s implied logic) is that of a volume discount negotiator on behalf of all Americans. I don’t remember reading that in the Constitution…

Ms. Cutter also wrote:

“For the 83% of Americans who have coverage and who are already taking responsibility for their health care, the Affordable Care Act will help insurance premiums to decrease over time. And only those who are able to pay for health insurance will be responsible for obtaining it. The Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016.” [emphasis added]

Source: White House Blog

So every American that the government feels can afford health care coverage will be forced to do so, since not doing so would make health care coverage more expensive for everyone that does buy coverage. (By the way, 1% of all Americans is about 3 million Americans that would be subject to the $750 penalty that is really a tax, wait, I mean a penalty…)

I’m not quite sure where this idea that the role of government is to make things affordable originated, but I don’t think it’s constitutional, despite the White House’s simple insistence that it is – various federal courts are mixed on the issue, and the Supreme Court will weigh in soon, rendering a final decision on the ability of the federal government to require individuals to purchase a commercial product from a private company. If the federal government hopes to win that argument, they’ll have to make a more convincing argument than “it will cost less if everyone gets coverage,” because, as Robert Reich notes:

“The mandate is also particularly vulnerable to legal challenge. So far, two federal judges, one in Virginia and another in Florida, have struck it down. They say the federal government has no more constitutional authority requiring citizens to buy insurance than requiring them to buy and consume broccoli, or asparagus. The Florida judge referred to broccoli; the Virginia judge to asparagus.” [emphasis added]


We can now add the U.S. Appeals Court for the 11th Circuit in Atlanta to that list – they just found the so-called “individual mandate” to be unconstitutional as well. From the 11th Court’s Majority Opinion:

“This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them repurchase that insurance product every month for their entire lives,”


And let’s not forget the severability clause (or lack there of) that could bring the whole house of cards down if the Supreme Court finds the individual mandate unconstitutional…


White House White Board: The Costs of Repealing Health Reform

Heritage Foundation: Obamacare, Save Money? Not Likely.

White House Blog: The Latest Health Care Court Case The Individual Mandate in the Health Care Bill: Why We Should Trade Broccoli and Asparagus for Hot Dogs and Apple Pie Appeals court rules against Obama healthcare mandate Severability Clause at Heart of Judge Vinson’s Ruling That ‘Obamacare’ Is Unconstitutional

TaxProf Blog: WSJ: The ObamaCare Tax Penalty Is Unconstitutional

July 15, 2011

It’s for their own good

Filed under: Health Care,In The News — Ken @ 12:31 pm

Before I go any further – the title of this piece is cynical, it was intended to draw in the reader, OK? Thanks…

A recent study, analyzing mortality rates and causes between prisoners and the general population has found that black males are half as likely to die at any given time than black males outside prison. Specifically, black prison inmates were 30-40 percent less likely to die of heart-related problems or cancer than if they were outside of prison.

Why? As was reported at the cause appears to be related to the availability of health care:

Less than one percent of men died during incarceration, and there was no difference between black and white inmates. But outside prison walls, blacks have a higher rate of death at any given age than whites.

“What’s very sad about this is that if we are able to all of a sudden equalize or diminish these health inequalities that you see by race inside a place like prison, it should also be that in places like a poor neighborhood we should be able to diminish these sort of inequities,” said Evelyn Patterson, who studies correctional facilities at Vanderbilt University in Nashville, Tennessee.

As noted by study author Dr. David Rosen, from the University of North Carolina at Chapel Hill:

“For some populations, being in prison likely provides benefits in regards to access to healthcare and life expectancy”

But before you get too excited, he added this sobering comment on some of the negative aspects of imprisonment in an email to the reporter:

“it’s important to remember that there are many possible negative consequences of imprisonment — for example, broken relationships, loss of employment opportunities, and greater entrenchment in criminal activity — that are not reflected in our study findings but nevertheless have an important influence on prisoners’ lives and their overall health.”

So, in the eyes of Dr. Rosen, apparently being in prison has it’s pros and cons.

Let’s not forget the man who reportedly robbed a bank to get much-needed, potentially life-saving medical attention, yet failed to either steal enough money to secure a felony charge or to go down the street to a free clinic that would have provided him the care he needed at no cost. It seems, Mr. Verone, the first-time bank robber had a plan – after a series of mis-steps he made the calculated decision to rob the bank, go to prison for three years, and then retire in Florida on his social security benefits… He reportedly already went condo shopping before he pulled his big heist.

Unfortunately, his un-armed robbery of exactly one dollar may not provide him all the ‘benefits’ he planned on, since his robbery wasn’t a robbery (in legal terms), but merely larceny – a lesser crime with a much smaller penalty. Mr. Verone has said he would consider being a repeat offender to ensure he gets all the medical treatment he needs.

Sources: Black men survive longer in prison than out: study MSNBC Hypes Story of Man Who Robbed Bank for Prison Health Care, Leaves Out Free Health Clinics in His Backyard Man seeking health care robs bank for $1

March 9, 2011

Yet another reminder…

Filed under: Health Care,In The News,Politics — Ken @ 11:02 am

On the off-chance that anyone still thought the U.K. Healthcare system was worth modeling our own after, I give you this story about Daphne Austin (above), a senior leader of the National Health Service in the U.K. and her thoughts on what should be done with children delivered prematurely in the 22nd or 23rd week – she thinks they should be left to die:

She claimed keeping them alive is only ‘prolonging their agony’, and it would be better to invest the money in care for cancer sufferers or the disabled.


‘For me the big issue is that we’re spending an awful lot of money on treatments that have very marginal benefit.’

‘I would prefer to free up that money to spend on providing support to people who have much more lifelong chronic conditions.’

Source: Mail Online

The money she hopes to save and invest “in care for cancer sufferers or the disabled” amounts to around $16 million U.S. (10 million pounds) – that represents a rounding error on a rounding error in the NHS annual budget of 100 billion pounds ($160 Billion U.S.) 0.01% of their annual budget. I’m sure the parents of a 23 week old prematurely delivered baby will understand the importance of making their contribution to the NHS’s attempts to curb out of control healthcare costs… Right?

Think it can’t happen here? The current U.S. Center for Medicare & Medicaid Services (CMS) Director Donald Berwick has admitted he “loves” NHS:

“Dr. Berwick is a huge fan of … the NHS, a system that relies on rationing health care to hold down costs,” Roberts said. “Dr. Berwick has said, ‘I am a romantic about the NHS; I love it,’ and ‘the NHS is not just a national treasure, it is a global treasure.’”


“The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open”

Source: The Hill

Fearing a hostile reception by Republicans, President Obama choose to install Dr. Berwick in his post via a recess appointment:

The recess appointment was somewhat unusual because the Senate is in recess for less than two weeks and senators were still waiting for Dr. Berwick to submit responses to some of their requests for information. No confirmation hearing has been held or scheduled.

Source: New York Times

Dr. Berwick may have to vacate the position at the end of 2011 – it seems the Democrats, in light of a letter signed by 42 Republican Senators indicating they would not support Dr. Berwick’s formal nomination to his current post, are now working on a Plan B for life after Dr. Berwick leaves.

Some would argue that one way to measure a society is how they treat the weakest among them – I think our weakest deserve better.


Daily Mail: Babies who are born at 23 weeks should be left to die, says NHS chief

March of Dimes: Your Premature Baby

NHS Website: About the NHS: Overview page

The New York Times: Obama to Bypass Senate to Name Health Official

The Hill: GOP senators take aim at CMS nominee

The Weekly Standard: Not NICE Sources: Democrats giving up on Donald Berwick

March 6, 2011

One Thousand and Fifty Waivers

Filed under: Health Care,In The News,Politics — Ken @ 10:13 pm

The Hill reports that Department of Health and Human services have now issued 1,050 waivers for various mini and not-so-mini medical care coverage plans for the year 2011, representing over 2.6 Million Americans who have been explicitly excluded from one of the few benefits of so-called ObamaCare coverage – an increase in the coverage limit.

Do you know why the government is granting the waivers? Because in order for these 1,050 plans to comply with the new coverage limits would cause significant increases in the cost of coverage:

Mini-med plans have lower limits than allowed under the Affordable Care Act. While mini-med plans do not provide security in the event of serious illness or accident, they are unfortunately the only option that some employers offer. In order to protect coverage for these workers, the Affordable Care Act allows these plans to apply for temporary waivers from rules restricting the size of annual limits to some group health plans and health insurance issuers.

Waivers only last for one year and are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage. In addition, enrollees must be informed that their plan does not meet the requirements of the Affordable Care Act. No other provision of the Affordable Care Act is affected by these waivers: they only apply to the annual limit policy. [emphasis added]

But I thought ObamaCare was not going to increase the cost of coverage? In fact, I seem to recall the Secretary of Health and Human Services saying quite explicitly that they refused to accept excessive increases attributed to ObamaCare:

“Simply stated, we will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections,” Sebelius said. She warned that bad actors may be excluded from new health insurance markets that will open in 2014 under the law. They’d lose out on a big pool of customers, as many as 30 million people nationwide.

Source: The Huffington Post/AP

I guess we’ve now got over 1,000 counter-examples that prove that increasing benefits leads to increased coverage costs, contrary to Secretary Sebelius statement back in September, 2010


The Hill: Number of healthcare reform law waivers climbs above 1,000

Department of Health and Human Services: Helping Americans Keep the Coverage They Have and Promoting Transparency

The Huffington Post/AP: Sebelius To Health Insurers: Stop Lying About Your Rate Increases

February 20, 2011

Did She Really Just Say That?

Filed under: Health Care,In The News,Politics — Ken @ 4:43 pm

If you haven’t seen the above video yet, take a moment and watch it now – I want to point out the part of the video many are missing… Go ahead, I’ll wait.

While many focus on Congresswoman Speier’s “admission” that she had an abortion, there is something else in her defense that jumped out at me – he equating Haliburton with Planned Parenthood.

Did she really just say that?

Here’s the quote (1:45 into the above video clip):

There is a vendetta against Planned Parenthood, and it was played out in this room tonight. Planned Parenthood has a right to operate. Planned Parenthood has a right to provide services for family planning. Planned Parenthood has a right to offer abortions – last time you checked, abortions were legal in this country. Now you may not like Planned Parenthood – so be it. There’s many on our side of the aisle that don’t like Haliburton. And Haliburton is responsible for extortion, for bribery, for ten cases of misconduct in the federal database, for a $7 billion dollar sole-source contract. But do you see us over here, filing amendments to wipe out funding for Haliburton? No, because frankly that would be irresponsible.

Where to start?

Wait, I know – let’s start with her simple assertion that the “responsible” thing for Congress to do is to overlook problems with Haliburton – really? And why is that the “responsible” thing to do? Is it because Haliburton provides vital logistical support for our military operations overseas? Is that really equivalent to offering up family planning counseling? I think not.

But, the reall issue is the assertion that Democrats have peacefully “tolerated” Haliburton – please, don’t insult my intelligence.

How could any person pay attention to either of the last two presidential elections (2004 and 2008) and conclude that Democrats are “tolerating” Haliburton?

Finally, there is the “existential” question – denying Planned Parenthood federal funding does not conscript the organization to oblivion. From Wikipedia:

Planned Parenthood receives about a third of its money in government grants and contracts ($349.6 million in the 2008 fiscal year). A coalition of national and local pro-life groups have lobbied the federal government to stop funding Planned Parenthood.[33] Federal legislators have also proposed laws that would ban Planned Parenthood from receiving federal money for any purpose.[34] By law, Planned Parenthood cannot allocate any federal funding for abortions;[33] however, abortion opponents argue that allocating money to Planned Parenthood for the provision of other medical services “frees up” funds for abortion.[34]

Source: Wikipedia Planned Parenthood entry

If three-quarters of their budget/operating expenses comes from the government (as noted above), than eliminating funding for the group may cause them to cease operating their clinics, and doesn’t that strengthen the argument that any money given to Planned Parenthood enabled them to offer abortions, since the lack of funding would cause them to stop offering those services?

Finally, regarding the Congresswoman’s abortion, she posted this on her official government website:

Last night, I spoke on the House floor about a painful time in my life when the pregnancy that my husband and I prayed for was unsuccessful. I had what’s called dilation and evacuation or d & e. The fetus slipped from my uterus into my vagina and could not survive. Today some news reports are implying that I wanted my pregnancy to end, but that is simply not true. I lost my baby.

Source: Congresswoman Speier’s official website

So, got that, at 17 weeks, it’s a baby – so abortions at the 17th week or later are terminating the life of a baby.

Finally, despite her feigned reluctance to speak on this, did anyone else notice that Rep. Speier had a list of offenses Haliburton committed – she refers to the podium between each item she rattles off, “off the top of her head” because she “really planned on speaking about something else.” How lucky for us you happen to have those notes detailing offenses from an organization Democrats are so “tolerant” of…

I’d like to thank House Minority Leader Nancy Pelosi’s office for making this video available on YouTube.


YouTube video: Rep. Jackie Speier (D-CA) In Opposition to the Pence Amendment

Congresswoman Jackie Speier’s official Website
Haliburton Corporate Website

Planned Parenthood Website Haliburton webpage

Wikipedia: Planned Parenthood entry

February 14, 2011

Government Health Care

Filed under: Health Care,In The News,Politics — Ken @ 9:40 am

Once again (still?) we find ourselves debating and disagreeing about the role our federal government should play in our health care system – our current discussion revolves around the recently implemented Health Care Reform law (AKA “ObamaCare”). The current debate revolves around the idea of an all-our repeal of “ObamaCare,” and while the bill to do that passed the House of Representatives recently, the Senate will not vote on the bill, and the President has promised to veto the repeal bill if it came to his desk…

I recently came across an interesting article on developments in the British health care system that got me thinking – how did their system of healthcare come to be like this? Certainly no one in the U.K. decided they wanted to implement a health care system that views having patients sit in idling ambulances for hours waiting to enter the Emergency Room an improvement over waiting hours in the Emergency Room itself, where patients call the switchboard because they can’t get a nurse to come to their aid, or where patients are put in restraints for pleading for their medication that nurses refuse to administer, yet that is where they are today.

Then I started thinking about our neighbors to the north, and their own challenges with securing an adequate number of doctors for their citizens:

Today, five million Canadians are without a family doctor. A 2005 survey found that just 23 per cent of Canadians were able to see a physician the same day they needed one—placing this country last among the six studied, including the U.S., Britain and Australia. Canada’s doctor-patient ratio is among the worst of any industrialized nation: with just 2.2 physicians per thousand people, it ranks 24th out of 28 OECD countries (well below the average of three). And among the G8 countries, Canada ranks dead last when it comes to physician supply.

Source: – Adding fuel to the doctor crisis, January, 2008

Surely, neither nation set out to design and implement health care systems with such problems, but issues like these and others give many a justifiable concern about government-controlled health care. When opponents of “ObamaCare” bring up these and other concerns, supporters argue that “we would never make this or that mistake.” I wonder if they realize their response is both insulting to both the British and Canadian people, and a unparalleled display of arrogance on their part?

It is insulting because it dismisses the problems both health care systems are going through as easily avoidable, and implies that they merely lack either the curiosity or resolve to improve their health care systems. It is a display of arrogance to assume that the half-baked, not-yet implemented “ObamaCare” health care system will never have such issues.

But back to that article I saw the other day – A mother in the UK caused a bit of a sensation when she wrote on a blog that she was forced to put her daughter into long-term care because of government cuts in respite assistance. The daughter has profound, almost unimaginable needs – she is blind, quadriplegic and has cerebral palsy and epilepsy. That a mother was forced to make the difficult decision is not, in and of itself, cause for the level of interest this little story kicked up across the pond. No, the underlying issue is that P.M. Cameron personally met with the mother and reassured her that he’d protect the interests of families like hers. P.M. Cameron knows a little of her struggle, he himself helped care for a child with cerebral palsy until his son died at age six, and I honestly believe he wanted to help her, and would do anything he could to help families in similar situations. Yet his country’s financial situation forced the U.K. to make this decision, and it is reasonable to fear such an outcome here in America.

You may be wondering about the album cover above – it is from something called “Operation Coffee Cup” campaign from 1961, when the Medicare program was being proposed. The costs and burdens of this socialized medical care program for retirement-age citizens are well documented, but by-and-large, most recipients of Medicare are happy with their coverage and their health care providers. That being said, many supporters of “ObamaCare” hold up Medicare as a successful example of government-run health care, though they typically ignore (or dismiss) the reality that Medicare is fraught with waste and that looming reimbursement cuts will drive many practitioners away from Medicare patients, and that some doctors are already refusing to accept new Medicare patients.

Bottom line, when health care funds are co-mingled with general government funds, in times of budget troubles, there is no reason to think that health care funds will be somehow protected.


The Telegraph: NHS Waiting time targets for ambulances and A&E scrapped

Daily Mail: Dying hospital patient phoned switchboard begging for a drink after nurses said ‘No’

Daily Mail: Neglected by ‘lazy’ nurses, man, 22, dying of thirst rang the police to beg for water Adding fuel to the doctor crisis

Operation Coffee Cup Campaign record: “Ronald Reagan speaks out against SOCIALIZED MEDICINE” Ronald Reagan Speaks Out Against Socialized Medicine Social Security and Medicare Projections: 2009 Elderly Say They Are Happy WIth The Way Medicare is Obama: ‘We Are Going After The Waste, Fraud, and Abuse’

The Heritage Foundation: Obamacare and Medicare Provider Cuts: Jeopardizing Seniors’ Access

Houston Chronicle: Texas doctors opting out of Medicare at alarming rate

USA Today: Doctors limit new Medicare patients

February 1, 2011

Citizens United

Filed under: Health Care,In The News,Politics,Uncategorized — Ken @ 2:20 am

The left likes to talk about the corrosive effect money from deep-pocketed corporations will have on future elections, as a result of the recent “Citizens United” case. They argue that elections will be bought by corporations, with politicians catering to the wishes of corporations that donated to their campaign.

In his concurrence to the Majority Opinion, Justice Scalia wrote that:

Stevens dissent was “in splendid isolation from the text of the First Amendment. It never shows why “the freedom of speech” that was the right of Englishmen did not include the freedom to speak in association with other individuals, including association in the corporate form.”

Those on the Left may be correct – there are ample examples of deep-pocketed organizations that use their money to curry favor with the Government, take for example the three SEIU locals that got waivers to exempt their members healthcare plans from the very healthcare reform bill they were so supportive of. In total, SEIU contributed $27 million to the election campaign of Barack Obama, and (it could be argued), as a reward for their support, SEIU was able to deny its members the $750,000 annual coverage limit demanded by healthcare reform, and instead offer them only $50,000 in annual coverage.

But is a labor union the same as a corporation? Pretty much. A labor union typically has, as its primary goal the protection and well-being of its members while a corporation typically has, as one of its goals the protection and well-being of the corporation, and by extension, their employees and shareholders. At the heart of a corporation, be it publicly traded or privately held, are people, with the same rights and responsibilities as an individual – no more, and no less.


Wikipedia: Citizens United v. Federal Election Committee entry Three SEIU Locals–Including Chicago Chapter–Waived From Obamacare Requirement Why the SEIU Wants Health Reform

January 31, 2011

Individual Mandate

Filed under: Health Care,In The News — Ken @ 11:11 pm

In 2008 then-Senator Obama and then-Senator Clinton were battling it out in the Democratic Primary, and one of their main differentiators was their vision for Health Care Reform – Senator Clinton’s plan included an individual mandate requiring everyone to buy healthcare insurance, Senator Obama’s plan did not. Then. almost two years later, now-President Obama signed into law a Health Care Reform bill that had as a key component an individual mandate.

Today, when Federal Court Judge Vinson handed down his ruling that the healthcare reform law was unconstitutional because of the individual mandate he wrote:

“I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that, ‘If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house,’” Judge Vinson wrote in a footnote toward the end of his 78-page ruling Monday.


Washington Times: Judge uses Obama’s words against him

H.R. 3962 – Affordable Health Care Act

Federal Court Judge Vinson’s 78 page decision

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