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									                                                                                                  BOGALUSA MEDICAL CENTER
                                                                                                  EARL K.. LONG MEDICAL CENTER-BATON ROUGE
                                                                                                  HUEY P. LONG MEDICAL CENTER-ALEXANDRIA
                                                                                                  LALLIE KEMP REGIONAL MEDICAL CENTER-INDEPENDENCE
                                                                                                  L. J. CHABERT MEDICAL CENTER-HOUMA
                                                                                                  MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
                                                                                                  UNIVERSITY MEDICAL CENTER-LAFAYETTE
                                                                                                  W. O. MOSS REGIONAL MEDICAL CENTER-LAKE CHARLES


                                                      IN THE NEWS
                                                [ MONDAY, JANUARY 22, 2007 ]

         La. works to build research alliance
         The Advocate | 01.22.07

         Jindal announces he's running for La. governor
         The Associated Press | 01.22.07

         Democrats eye all options for 2008 governor’s race
         New Orleans CityBusiness | 01.22.07

         $300 million OK'd for new Charity
         Times – Picayune | 01.20.07

         Dispute emerges between lawmakers, LRA over charity hospital
         The Associated Press | 01.19.07

         New Orleans of Future May Stay Half Its Old Size
         New York Times | 01.20.07

         Groups Offer Health Plan for Coverage of Uninsured
         New York Times | 01.19.07

         Bipartisan Advocates Push a New Health Care Plan
         National Public Radio [Audio] | 01.18.07

         Health-Insurance Gap Surges as Political Issue
         Wall Street Journal | 01.19.07

         Insurers See a Potential Cure
         Wall Street Journal | 01.19.07

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                                    LSU Health Care Services Division - Page 2 of 22

     La. works to build research alliance
     The Advocate | 01.22.07
     Studies under way to define strategies

     When the prominent Microelectronics and Computer Technology Corporation chose Austin, Texas,
     over Atlanta for its headquarters in the 1980s, Georgia business and government officials decided
     they’d had enough.

     As a result, the business community, then-Gov. Zell Miller and the state’s top research universities —
     public and private — combined to form the Georgia Research Alliance.

     A similar type of alliance is forming in Louisiana, said Joseph Savoie, Louisiana commissioner for
     higher education.

     “I think we’re pretty close to putting together something comparable,” Savoie said. “We have a lot of the
     building blocks in place.”

     Louisiana needs business partnerships and a strategic plan to select focused research areas for
     commercialization, he said.

     Studies — funded by Community Development Block Grants and the Post-Katrina Support Fund
     Initiative — just began to determine exact strategies.

     The Georgia Research Alliance is a private, nonprofit corporation governed by a board of trustees with
     executives from major companies like The Coca-Cola Company and United Parcel Service Inc.

     The alliance pumps millions of dollars annually into focused university research to develop new
     technologies and spinoff companies within the state. Then the universities provide the new companies
     with the trained work force necessary to thrive.

     Since its inception in 1990, GRA programs have brought in more than $2 billion in federal and private
     funds to the economy at a five-to-one return for the public money invested. That includes 125 new
     companies and 5,000 jobs, said Kathleen Robichaud, GRA director of communications.

     Although much planning is still needed, Savoie said, the Louisiana Board of Regents could begin as
     early as May awarding grant funds for collaborative research projects between universities intended to
     create new commercial possibilities.

     Brooks Keel, LSU vice chancellor for research and economic development, said Louisiana would be
     wise to follow in Georgia’s footsteps, and LSU could help a lot.

     Keel is familiar with the GRA, having earned his doctorate from the Medical College of Georgia, one of
     six universities in the alliance.

     “I’m excited about the possibility of a Louisiana Research Alliance,” said Keel, who came to LSU last
     year. “It’s an amazing deal they have there (in Georgia).”

     Some Louisiana universities currently work with business incubators and patented technologies
     developed on campus, but not nearly to the extent of the GRA or with a similar amount of collaboration.

     Many states have tried, Keel said, but none have taken such public-private partnerships as far as

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     Louisiana is in good shape to make a move now, Keel said, because of growing entrepreneurial spirit,
     strong research capabilities at the universities and surplus government funds.

     Louisiana may not have Coca-Cola, Keel said, but there are enough “heavy hitters” and major oil-and-
     gas players in the state to join forces.

     That is why there is no better time than now, he said.

     “I think the planets are ready to align,” Keel said. “Clearly, I think, LSU would be at the forefront.”

     Research institutions like Tulane University, Louisiana Tech University and the University of Louisiana
     at Lafayette could also play key roles, he said.

     Savoie said early indications point to Louisiana specializing in research areas like the biomedical
     sciences, environmental sciences and information technology.

     But much work remains.

     Robichaud noted that forming the GRA required years of effort in Georgia.

     Prior to the GRA, scientists struggled to think of commercial or profit-making ideas for their research,
     she said. Each year there is a continual struggle to prove to new legislators the state money is well
     spent, she said.

     “These universities never collaborated with each other before,” Robichaud said. “The businesses and
     universities and state are very much allied in making these results happen.”

     The GRA, which focuses on the biosciences and advanced communications, funds money to attract
     eminent scholars to Georgia and to create labs, research centers and business and technology
     incubators for commercialization.

     “It’s not a small commitment,” Robichaud said. “It takes real serious commitment, strong business
     support and a lot of patience.”

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     Jindal announces he's running for La. governor
     The Associated Press | 01.22.07

     BATON ROUGE, La. (AP) — U.S. Rep. Bobby Jindal, who lost his bid for governor in 2003, announced
     to supporters Monday that he would seek the job again this fall.

     "Our state, our communities, and our families have been through some very tough times. There is
     clearly a hunger for a new approach to governing," Jindal said in an e-mail to his supporters
     announcing his intentions.

     Jindal, R-Kenner, will try to unseat Democratic Gov. Kathleen Blanco, who has said she is running for
     re-election. Blanco defeated Jindal in 2003, but she has faced criticism since hurricanes Katrina and
     Rita about her leadership abilities and her recovery initiatives.

     Though he has been fundraising for weeks, Jindal said he won't formally kick off his campaign until the
     summer. He said he will wait until lawmakers and Blanco wrap up their work in the regular legislative
     session that begins in April before hitting the campaign trail in earnest.

     "It is my belief that campaigns are too long as they are, and that people grow weary of the barrage of
     charges and counter charges," Jindal said in his e-mail.

     The primary election is Oct. 20, with a runoff scheduled Nov. 17.

     The congressman enters the race with significant support. He is extremely popular in his congressional
     district, a staunchly Republican district that includes many of the suburbs of New Orleans. And a recent
     poll showed Jindal leading Blanco in the race.

     Jindal garnered nearly 59 percent of the vote, compared to Blanco's 35 percent in the survey by
     Southern Media & Opinion Research. Jindal led in each region of the state in the telephone survey of
     600 likely Louisiana voters, which was conducted Jan. 12 through Jan. 14 and a had a margin of error
     of plus or minus 4 percentage points.

     However, the slate of candidates in the race remains unclear. Other possible candidates mentioned
     include Public Service Commissioner Foster Campbell, a Democrat from north Louisiana; state Sen.
     Walter Boasso, a Republican from St. Bernard Parish; U.S. Rep. Charlie Melancon, a Democrat from
     southeastern Louisiana; and Jim Bernhard, a former state Democratic Party chairman and chief
     executive officer of The Shaw Group Inc.

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     Democrats eye all options for 2008 governor’s race
     New Orleans CityBusiness | 01.22.07
     by Jeff Crouere

     Rep. Bobby Jindal, R-Kenner, is far ahead of ov. Kathleen Babineaux Blanco in the race to lead the
     state. The most recent poll conducted by Southern Media and Opinion Research shows Jindal leads
     Blanco 58 percent to 31 percent. Several weeks ago, pollster Verne Kennedy projected the Jindal lead
     at 52 percent to 20 percent for Blanco.

     The Democratic National Committee is working behind the scenes to recruit a more formidable
     candidate than the incumbent governor. Former Sen. John Breaux was an early favorite but he is
     making millions as a lobbyist and seems disinclined to make the race. Former Rep. Chris John has
     been mentioned as has Rep. Charlie Melancon, D-Napoleonville, but neither has shown sincere

     The only Democrat certain to run is Public Service Commissioner Foster Campbell of Bossier City, who
     polled only 6 percent in the Southern Media poll.

     Jim Bernhard, former Louisiana Democratic Party chairman and Shaw Group CEO, has also been
     mentioned as a possible candidate but his ties to the Blanco administration and his company’s
     controversial post-Katrina contracts could be real roadblocks if he decides to run.

     Senate race takes shape

     The new candidate in the fall 2007 race for state Senate District 7 is Latter & Blum commercial real
     estate specialist Paul Richard, a Republican.

     Richard will face at least one prominent announced candidate, Democrat David Heitmeier, brother of
     outgoing state Sen. Francis Heitmeier, D-New Orleans. Other potential candidates include former New
     Orleans City Council candidate Kristin Palmer and former New Orleans Councilman Troy Carter, both
     Democrats. The vast Senate district on the West Bank of New Orleans includes portions of Orleans,
     Jefferson and Plaquemines parishes.

     D.C. hopes

     St. Tammany Parish President Kevin Davis, a Republican, will run for Congress if Jindal is elected
     governor next fall. Davis is riding high in the polls by registering more than 80 percent approval ratings.

     If he runs for Congress, Davis will be a serious candidate as more than half of the voters in the first
     district live on the North Shore and the percentage is growing. Other candidates looking at the race
     include state Rep. Steve Scalise, R-Metairie and Jefferson Parish Councilman-at-large, Republican
     John Young.

     However, if the seat opens up and Davis runs, he will be a strong favorite. Davis has more than
     $300,000 in his campaign war chest.

     Price to lead St. Tammany?

     Mandeville Mayor Eddie Price, a Republican, has served two terms and is up for re-election in spring
     2008. But if certain dominoes fall, such as Jindal and Davis winning, then it Price will attempt to
     succeed Davis as St. Tammany Parish president. Price is close to Davis and will likely be able to line
     up the support from most of his team of volunteers and donors.

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     Watkins seeks second term

     Incumbent Covington Mayor Candace Watkins, the first Republican mayor of the city, is unopposed so
     far in her quest for a second term. Watkins announced her candidacy this week and will conduct a
     door-to-door campaign throughout the city.

     A rival candidate could come forward. Watkins has been embroiled for months in a dispute with St.
     Tammany Parish government over Nord du Lac, a controversial new shopping center development off
     Interstate 12. Watkins has criticized certain aspects of the development and the manner in which the
     parish has handled the project and dealt with Covington. This criticism led Parish President Kevin Davis
     to issue a rare public rebuke of Watkins at a community meeting.

     If Watkins is re-elected March 31, look for her to consider a race for parish president against Davis in
     the fall. Although Davis has high approval ratings, Watkins could be enticed to enter the race if no one
     else appears to challenge Davis.

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     $300 million OK'd for new Charity
     Times – Picayune | 01.20.07
     Legislative panel defies Blanco's LRA
     By Jan Moller

     BATON ROUGE -- Defying Gov. Kathleen Blanco's hand-picked hurricane recovery panel, a legislative
     committee agreed Friday to give Louisiana State University a $300 million down payment on a new
     teaching hospital in downtown New Orleans.

     The move by the Joint Legislative Committee on the Budget is the clearest indication yet that Charity
     Hospital, which was flooded by Hurricane Katrina and damaged beyond repair, will be replaced in the
     coming years by a state-of-the-art facility for training doctors and treating the poor.

     The panel's action also provided a possibly precedent-setting climax to a jurisdictional tug-of-war
     between legislative leaders and the Louisiana Recovery Authority over which body has the ultimate
     power to decide how federal block-grant dollars are spent.

     Friday marked the first time the Legislature made changes to a spending plan developed by the
     recovery panel.

     The Recovery Authority had asked the budget panel to sign off on a plan that gave LSU $74 million to
     buy land and hire architects to design the hospital. Under that plan, the remaining $226 million would
     not become available until university officials produce a detailed business plan showing how the
     hospital would operate in the post-Katrina health care marketplace.

     Before federal block grant dollars can be spent, its use must be spelled out in an "action plan"
     developed by the Recovery Authority, whose members were appointed by Blanco to guide the state's
     rebuilding effort. Until now, the Legislature's role has been limited to approving the action plans in an
     up-or-down vote.

     The law that created the Recovery Authority gives the Legislature the right to "review and approve"
     action plans, but does not specifically say whether lawmakers have the power to make changes to
     those plans.

     LRA executive director Andy Kopplin said the law was never meant to give legislators the right to
     amend an action plan.

     "We are in uncharted territory," Kopplin said after the meeting. He said he would consult with Blanco,
     legislative leaders and Attorney General Charles Foti's office before deciding on the Recovery
     Authority's next move.

     But legislators said they never intended to cede that much power to the Recovery Authority, and argued
     that the full amount should be turned over to LSU without strings attached.

     "Are we just rubber-stamping everything the LRA does?" asked Sen. Cleo Fields, D-Baton Rouge. "It
     doesn't make sense."

     The new hospital would be part of a joint venture with the U.S. Department of Veterans Affairs located
     on a 37-acre parcel near Interstate 10. The VA and LSU would build separate but adjoining hospitals
     that would share functions such as laundry facilities and laboratories. State officials view the project as
     the centerpiece of a rebuilt medical district that was decimated by Hurricane Katrina and the flooding
     that followed.

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     A preliminary business plan prepared by a state consultant estimates that the hospital would have 427
     beds and cost $950 million, with the balance being made up by FEMA dollars and state-issued revenue

     Senate President Donald Hines, D-Bunkie, said it was important to approve the full $300 million as a
     positive signal to the VA that the project is on schedule. "I certainly don't want to see a VA hospital built
     in Gulfport, Miss., or anywhere else," Hines said.

     Congress has already provided about $600 million for the VA's share of the project.

     Sean Reilly, a member of the Recovery Authority, said he didn't think the project would be threatened if
     the Legislature only agreed to the lower amount. His contention is backed up by a Jan. 11 e-mail to
     Miles Bruder, an LRA health policy analyst, in which a VA official says the agency does "not see the
     board's recommendations putting our efforts at risk."

     LSU System spokesman Charles Zewe said the school still plans to present its business plan to the
     Recovery Authority, as it had earlier agreed to do as a condition for receiving the money.

     He said the university took no position on the jurisdictional squabble, but applauded the budget panel
     for taking action. "We think it's important that the commitment of the $300 million sends an
     unmistakable message to the (VA) that Louisiana and LSU are committed to building this project,"
     Zewe said.

     The amended action plan now goes before the full Legislature, and also needs approval from the U.S.
     Department of Housing and Urban Development.

     In other action, the budget panel:

     -- Signed off on a Recovery Authority plan to provide $100 million to local governments for hurricane
     debris removal. The money will cover the 10 percent match that the federal government began
     requiring of local authorities starting Jan. 1.

     -- Agreed to spend $9.8 million from an emergency response fund to improve the ability of first
     responders to communicate in an emergency. Among other things, the money will be used to buy
     mobile radios for local jurisdictions and three new radio towers in south Louisiana.

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     Dispute emerges between lawmakers, LRA over charity hospital
     The Associated Press | 01.19.07

     BATON ROUGE, La. (AP) — An ongoing dispute over the Louisiana Recovery Authority's role in policy-
     making after the 2005 hurricanes became a public battle Friday when a legislative panel reworked the
     LRA's spending plans for a new charity hospital in New Orleans.

     The Legislature's joint budget committee advanced plans that would allocate $300 million in federal
     hurricane recovery cash to LSU to replace the flooded charity hospital facilities in New Orleans with a
     new teaching and research hospital.

     The plans still require approval from the full Legislature and federal officials, but LRA officials don't
     believe the joint budget committee had the authority to make any changes to their recommendation.

     The LRA board wanted to provide $74 million now to LSU to buy land, hire the architects and design
     the hospital. LRA board members said they supported building a new charity hospital in New Orleans
     but wouldn't approve the remaining $226 million until they saw details of LSU's plans, including
     financing plans.

     The disagreement at Friday's joint legislative budget committee meeting centered on whether
     lawmakers can change plans submitted by the LRA for spending federal hurricane recovery cash — or
     just take an up or down vote on them.

     LRA officials believe the Legislature can't make changes to the plan, only approve or reject them. But
     many lawmakers — who created the LRA in state law after it was set up by Gov. Kathleen Blanco —
     said they never planned to create a recovery authority that would strip the Legislature of its ability to
     make policy decisions and to direct spending.

     "Are we just rubber-stamping everything the LRA does? That wouldn't make sense," said Sen. Cleo
     Fields, D-Baton Rouge.

     The spending plans submitted by the LRA to the budget committee would have provided $74 million to
     LSU now for the charity hospital.

     The joint budget committee changed the plans to allocate the full $300 million to LSU for the hospital.
     Senators on the committee voted unanimously to change the plans, while the House members voted
     10-6 for the reworked version.

     A lawyer with Attorney General Charles Foti's office said it didn't appear that the Legislature had the
     authority to amend spending plans submitted by the LRA, but she also said that wasn't a formal opinion
     of the office, just a brief review of the statute.

     It was unclear Friday if the LRA would attempt to challenge the legality of lawmakers' actions. LRA
     Executive Director Andy Kopplin said he would meet with his board members, the attorney general's
     office and legislators to determine how to proceed.

     "We're in uncharted territory," Kopplin said.

     Senate President Don Hines, who pushed for the full $300 million plan, said he was afraid withholding
     some of the money could jeopardize an arrangement with the U.S. Department of Veterans Affairs to
     build the new charity hospital as part of a joint medical complex. The two would build and pay for
     separate hospitals but share some operating costs.

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     LRA members said they believe the joint arrangement between the VA and LSU would not be hindered
     because the university would have the money to purchase the land and start developing the designs for
     its facility. LRA board member Sean Reilly said the board wanted to "stage funding as financially viable
     business models are developed."

     Also Friday, the joint budget committee approved — without changes — plans submitted by the LRA to
     spend other federal hurricane recovery money:

     _$100 million to help parishes pay for their costs of debris removal after hurricanes Katrina and Rita.
     Federal officials are paying 90 percent of the removal cost, but local communities must come up with
     the remaining 10 percent.

     _$40 million for repairs to private schools and universities.

     _$135 million for state building repairs, to increase the total funding set aside for those building repairs
     to $278 million.

     Those proposals go next to the full Legislature for approval and then federal officials.

     The dollars, along with the charity hospital money, comes from a $10.4 billion pool of hurricane
     recovery funds set aside by Congress for Louisiana's recovery from Katrina and Rita. Nearly all the
     money has been allocated for relief programs, the bulk for homeowner grants.

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     New Orleans of Future May Stay Half Its Old Size
     New York Times | 01.20.07

     NEW ORLEANS — The empty streets, deserted avenues and abandoned houses prompt a gnawing
     question, nearly 17 months after Hurricane Katrina: Is this what New Orleans has come to — a city half
     its old size?

     Over and over, the city’s leaders reassure citizens that better days and, above all, more people are in
     the future. Their destiny will not merely be to reside in a smaller city with a few good restaurants and
     curious local customs, the citizens are told.

     But some economists and demographers are beginning to wonder whether New Orleans will top out at
     about half its prestorm population of about 444,000, already in a steep decline from its peak of 627,525
     in the 1960 Census. At the moment, the population is well below half, and future gains are likely to be

     “It will be a trickle based on what we know now,” said Elliott Stonecipher, a consultant and
     demographer based in Shreveport, La. “Low tens of thousands, over three or four or five years,
     something in that range. I would say we could start losing people, especially if the crime problem
     doesn’t get high visibility.”

     The new doubts, surprisingly, are largely not based on the widespread damage caused by the flood.
     Rather, crippling problems that existed long before Hurricane Katrina are mostly being blamed for the
     city’s failure to thrive.

     In this view, the storm was merely a grim exclamation point to conditions decades in the making. Before
     the storm, some economists say, New Orleans may have had more people than its economy could
     support, and the stalled repopulation is merely reflecting that.

     Hurricane Katrina may have brutally recalibrated the city’s demographics, setting New Orleans firmly on
     the path its underlying characteristics had already been leading it down: a city losing people at the rate
     of perhaps 1.5 percent a year before Hurricane Katrina, with a stagnant economy, more than a quarter
     of the population living in poverty, and a staggeringly high rate of unemployment, in which as many as
     one in five were jobless or not seeking work.

     Political leaders, worried about the loss of clout and a Congressional seat, press for people to return,
     but a smaller New Orleans may not be bad, some economists say. Most of those who have not
     returned — 175,000, by Mr. Stonecipher’s count — are very poor, and can be more easily absorbed in
     places with vibrant job markets, they say.

     Large-scale concentrations of deep poverty — as was the case in New Orleans before the storm — are
     inherently harmful to cities. The smaller New Orleans is almost certain to wind up with a far higher
     percentage of its population working than before Hurricane Katrina.

     “Where there are high concentrations of poverty, people can’t see a way out,” said William Oakland, a
     retired economist from Tulane University who has studied the city’s economy for decades. “Maybe the
     diaspora is a blessing.”

     Others, however, worry that permanently losing so many people threatens the city’s culture — its
     unique way of talking, parading and eating.

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     “Culture is people,” said Richard Campanella, a Tulane geographer who has written extensively about
     the city’s neighborhoods. “If half the local people are dispersed and no longer living cohesively in those
     social networks, then half of local culture is gone.”

     The new doubts also take into account the current barriers to repopulation, including the well-
     documented failure of the state’s Road Home aid program for homeowners, the loss of tens of
     thousands of jobs since the storm, the crime problem and delays in rebuilding moderately priced
     housing. Official efforts — local, state and federal — to rebuild the network of hospitals, schools and
     public housing projects that once served the city’s huge poor population have been faltering. But they
     also look at what New Orleans was before the storm.

     The low population figure, 191,000, which was reported by the Louisiana Recovery Authority in
     November last year in the most credible survey to date, was about half the 444,000 count in a Census
     estimate before Hurricane Katrina. The number was surprising, dashing expectations of a “big return,”
     as one economist put it, and was hotly disputed by local officials. Still, upticks, if there are any, are
     imperceptible: the percentage of prehurricane gas and electric users who were getting service, for
     instance, remained the same between April and November 2006, the Brookings Institution reported last

     “Our expectations were just wrong,” said James A. Richardson, an economist who directs the Public
     Administration Institute at Louisiana State University. “I don’t believe it will ever be 450,000 again. I
     think New Orleans did not need 450,000 people to support the economy you had at that time.”

     With no real place for the poorest of the evacuees in the economy before the storm, New Orleans may
     have permanently lost that part of its population. Supporting that notion is an unpublished analysis by
     Mr. Oakland, the former Tulane economist, which shows unusually low rates of participation in the labor
     force before Hurricane Katrina.

     Thus, a frequent impression of prehurricane travelers to New Orleans — that there were “a lot of people
     hanging around, going nowhere,” as the Nobel-winning Columbia University economist Edmund S.
     Phelps, a sometime-visitor, puts it — turns out to have a statistical basis.

     The statistics, which compare the number of people actually working with the total working-age
     population, suggest “there are a lot of people out there not working,” said Mr. Oakland, referring to the
     period before Hurricane Katrina. Or, he said, they were working in an underground economy, not
     measured by statistics. If not actually illegal, he said, it was not very profitable.

     In New Orleans, before the storm, about 4 out of 10 men in the working-age population were out of a
     job or not looking for one, compared with less than 3 in 10 nationally.

     Employment had dropped sharply in the city from 1969 to 1999, Mr. Oakland writes. More than half of
     young black men ages 16 to 24 were not in the labor force. Unemployment rates among young blacks
     were above 25 percent. “The data is showing New Orleans is really a basket case,” Mr. Oakland said.

     In the city’s poorest areas, the numbers were even more discouraging. In places like the Lower Ninth
     Ward or Central City, half of all working-age people were not looking for work, Mr. Oakland wrote. The
     real unemployment rate in these impoverished, high-crime areas, which would include those not looking
     for work, would have been a “whopping” 32 percent, he wrote.

     Compounding the city’s difficulties, and, in effect, helping to stem the population loss, was a secondary
     factor: the direness of the city’s poverty, and its concentration. Those conditions helped make the city’s
     poor population exceptionally immobile. New Orleans was also poor not only in absolute terms, but also
     in relative terms. The poorest 30 percent of households had a lower share of the city’s total income
     than the comparable slice in any other similar Southern city, Mr. Oakland found.

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     “The job mobility was very low among the poor, so they just stay where they are, and the social welfare
     system shored them up,” Mr. Oakland said.

     The city’s population was thus “out of equilibrium, if you would say that,” Mr. Oakland added. “It’s not
     normal to have that level of nonparticipation in the labor force.”

     Haunting the city’s effort to repopulate, too, is the incalculable toll inflicted by ghosts from its past — a
     political legacy of corruption and patronage, and a deep racial division with a far more distressing
     passage toward integration than was experienced, say, in Atlanta.

     Looking to the future, another 50,000 people might eventually be added to the city’s population, Mr.
     Oakland suggested, but there are no guarantees.

     There has been little to no construction of cheap housing that would enable the return of the largest
     category of those still displaced, Mr. Stonecipher noted.

     A second category of people, 50,000 or more who have established themselves elsewhere but who
     could return, may be even harder to recapture, given the combination of past weaknesses and
     continuing present-day hurdles.

     “The longer it lasts, the more likely it is that our population is plateauing, the longer the uncertainty
     continues,” said Janet Speyrer, an economist at the University of New Orleans.

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     Groups Offer Health Plan for Coverage of Uninsured
     New York Times | 01.19.07

     WASHINGTON, Jan. 18 — A broad coalition of business and consumer groups, doctors, hospitals and
     drug companies laid out a major proposal on Thursday to provide health coverage to more than half of
     the nation’s 47 million uninsured by expanding federal benefit programs and offering new tax credits to
     individuals and families.

     “This is a proposal not for mandates but for incentives,” said Dr. Reed V. Tuckson, senior vice president
     of UnitedHealth Group, one of the nation’s largest insurers. “It’s a careful balance of public and private

     The proposal, unveiled Thursday after more than two years of work, was endorsed by 16 groups
     including AARP, the American Hospital Association, the American Medical Association, the Blue Cross
     and Blue Shield Association, Johnson & Johnson, Kaiser Permanente, Pfizer and the Chamber of
     Commerce of the United States.

     Other coalition members endorsing the proposal were Families USA, a liberal-leaning consumer group,
     and America’s Health Insurance Plans, a trade group for insurers.

     The proposal comes at a possible turning point in the debate over national health insurance, which has
     been an elusive goal for Democrats since the New Deal. In the past few years, businesses of all sizes
     have said that health costs are cutting their profits and hurting their ability to compete. Politicians of
     both parties predict that the health care issue will figure prominently in the 2008 presidential campaign.

     Without waiting for Congress, states like Massachusetts and California are expanding coverage, but
     want help from Washington.

     As a first step, the 16-member group, known as the Health Coverage Coalition for the Uninsured, urged
     Congress to put more money into the Children’s Health Insurance Program and create tax breaks for
     the purchase of private insurance covering children. Money for the program is running low, and many
     children are eligible but not enrolled.

     Members of the coalition said their proposal would cost $45 billion in the first five years. They did not
     estimate the cost of insuring millions of adults in later years, nor did they suggest how to pay the costs.
     Dr. Tuckson said that “the cost of inaction is higher than the cost of action.”

     Ronald F. Pollack, the executive director of Families USA, said, “Our agreement transcends political
     and ideological boundaries.”

     But tensions bubbled below the surface, showing how difficult it could be to translate the
     recommendations into law. The A.F.L.-C.I.O., the Service Employees International Union and the
     National Association of Manufacturers participated in the coalition for more than a year but did not
     endorse the final report. The deepest divisions came over how to pay for expanded coverage and who
     should foot the bill.

     Andrew L. Stern, president of the service employees’ union, supports health insurance for all but has
     said that the “employer-based system of health coverage is over” and that it “is collapsing, crushed by
     out-of-control costs.” By contrast, members of the coalition said they wanted to preserve and build on
     that system.

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     E. Neil Trautwein, former assistant vice president of the National Association of Manufacturers, said the
     proposal had “little reference to fiscal realities.”

     JoAnn C. Volk, a policy analyst at the A.F.L.-C.I.O., said she favored expanding government programs.
     “But tax credits would not guarantee access to comprehensive coverage and could leave consumers
     with high out-of-pocket costs,” Ms. Volk said.

     Suzanne DeFrancis, a spokeswoman for the Department of Health and Human Services, said: “We all
     share the goal of helping people get health insurance. The administration believes this can be done
     best by helping people buy their own insurance, rather than creating a new government entitlement to
     health care or raising taxes.”

     More than eight million children are uninsured. At least two-thirds are eligible for Medicaid or the
     Children’s Health Insurance Program. One way to cover these children would be to enroll them
     automatically in Medicaid or the children’s insurance program if they qualified for food stamps or
     reduced-price school lunches, the coalition said.

     In general, Medicaid is available to children under 19 in families with incomes below the poverty level,
     about $16,600 for a family of three. The coalition said Congress should provide tax credits to families
     with incomes from 100 percent to 300 percent of the poverty level, to help them buy coverage for

     The coalition offered longer-term recommendations, saying that states should have the option to
     expand Medicaid to cover all adults with incomes below the poverty level.

     “Day after day, there is debate and discussion,” Dr. Tuckson said. “Day after day, people die. We are
     sick and tired of the debate. We are focusing on what is achievable.”

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     Bipartisan Advocates Push a New Health Care Plan
     National Public Radio [Audio] | 01.18.07
     All Things Considered, January 18, 2007 · A diverse list of groups unveils a proposal to cover many of
     the nation's 47 million uninsured Americans. Supporters range from the liberal Families USA to the
     conservative American Medical Association. It's the third time this week that health care has bridged
     opposite ends of the political spectrum.

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     Health-Insurance Gap Surges as Political Issue
     Wall Street Journal | 01.19.07
     Democrats, Governors, Business Push Change, But Fixes Vary Widely

     Suddenly, the long-festering issue of providing health coverage to the one in six Americans who lack it
     seems to have leapt to the top of the national to-do list.

     On Tuesday, an unlikely coalition of the Business Roundtable, AARP and the Service Employees
     International Union called for "affordable quality health care for all."

     On Wednesday, Pennsylvania's governor became the latest to offer a way to cover the uninsured in his

     Yesterday, another strange-bedfellows coalition, ranging from a health insurers' trade group to a liberal
     advocacy group, unveiled a plan to subsidize health premiums with a mix of tax credits and federal
     spending. And Oregon Sen. Ron Wyden dusted off a plan to make people buy insurance, with
     employers chipping in. On Tuesday, President Bush is expected to talk about his ideas for shrinking the
     ranks of the uninsured.

     Thrusting the long-running issue to the fore are political and economic forces that have been building
     for years but are given new force by political events. Not only have the Democrats taken over
     Congress, but state political leaders, including Republicans such as California Gov. Arnold
     Schwarzenegger, are moving on their own to change the system. And U.S. companies increasingly
     complain that the current employer-paid insurance system puts some of them at a disadvantage --
     either globally or vis-a-vis firms that won't provide insurance. (See related story.2)

     All this increases the chances that Washington will try to tackle at least a piece of a health-care
     problem that has only grown bigger since the Clintons' failure at comprehensive reform back in 1994.
     But it still doesn't necessarily mean anything big will happen, at least nationally, in the next couple of
     years. The primary reason: There's nothing approaching a consensus on what to do.

     There is, for sure, a growing consensus that the rising number of Americans without health coverage is
     a problem, not just for them but also for employers and governments that pay the bills. U.S. auto
     companies "are paying for the emergency-room treatments of people who can't afford it," complains
     Tom Lasorda, chief executive of DaimlerChrysler AG's Chrysler unit. "I'm paying for it because the rates
     go up because I have to cover the cost."

     But there is a splintering of approaches to the problem. Some favor bigger government. Others would
     bolster the decaying system of employer-sponsored insurance. Still others would make health
     insurance more like car insurance and have people buy their own, aided by various subsidies.

     See a list of developments this week related to health-care coverage: Who said what, and when, and
     what it means.Those who are optimistic that the recent talk portends action see a harmonic
     convergence of interests that suggests the latest round of press conferences and plans offered by
     coalitions will produce something tangible. Andrew Stern, president of the Service Employees
     International Union, or SEIU, says that when the Clinton health initiative failed, "business believed that
     they could somehow manage health costs, and the economy was far less global." The world has
     changed. "Having had 13 more years of increasing costs...," he says, "people realize that you can't
     manage this as a company -- we have to manage this as a country."

     The problem has long been apparent and is getting worse. The number of Americans without health
     insurance is growing, and rising premiums have lessened employers' willingness to provide it. Though
     a majority of Americans still get insurance through the workplace -- a practice tracing to the 1940s,
     when businesses offered fringe benefits in lieu of higher wages -- the fraction of employees offered
     coverage at work fell to 77.4% in 2005 from 81.2% in 2001.

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     At last tally, the Census Bureau said 15.9% of Americans, 46.6 million in all, lacked health insurance.
     Government programs -- Medicare, Medicaid and the 10-year-old State Children's Health Insurance
     Program -- pick up the elderly, the disabled and the very poor.

     Nearly 70% of the uninsured are in families with at least one full-time worker. In some cases, the
     employer doesn't provide coverage. In others, the employee can't afford it or doesn't take the coverage
     that employers offer, according to the Kaiser Commission on Medicaid and the Uninsured, a private
     foundation-backed effort.

     So by no means are the uninsured all poor; more than a fifth live in families with incomes above
     $40,000. And it would seem they or their employers can afford to pick up a part of the tab -- an
     important factor in making some of the proposals floating around feasible.

     The heightened political focus on the issue reflects pressure from two sources. One is voters' anxieties,
     both about the cost of care and about the risk of losing insurance for reasons such as changing jobs. "A
     member of Congress goes home and two issues come up every time you get together with folks: One
     of them is Iraq, and one of them is health care," says Sen. Wyden, an Oregon Democrat. "A lot of
     people who have coverage think they're one rate hike away from losing their coverage."

     The other is an ever-louder complaint from U.S. businesses that they can't compete in a global
     economy when companies from other countries don't have to pay for health care. Deere & Co. Chief
     Executive Robert Lane told Congress last year that failure to act could result in a "limiting of covered
     services, loss of employer-provided health care...and even a loss of American jobs, both in the
     manufacturing and service sectors."

     The uninsured, of course, make up only one of the U.S. health-care system's issues, alongside quality
     and, especially, rapid rises in costs. But confronting the uninsured problem is politically appealing and it
     seems not quite as intractable. "Dealing with cost is really hard. It means leveling with the public. It
     means telling people you can't have everything you want or your doctor wants," says Paul Ginsburg,
     president of the Center for Studying Health System Change, a foundation-backed think tank in

     Then there's raw partisan politics. Democrats believe they have the political wind at their backs and that
     one reason they do is public anxiety about health care. Republicans feel a need to respond, and often
     look for approaches that rely less on government and more on market forces.

     At the same time, some proponents of free trade seek ways to ease workers' anxieties about
     globalization so they might be less hostile to it. Recent initiatives at the state level reflect the public
     pressure for some kind of governmental action -- and at the same time increase the pressure for some
     federal action.

     "Legislators and governors are feeling pressure from small businesses," says Katherine Swartz, a
     professor at the Harvard School of Public Health. She has another idea for dealing with the problem:
     government-subsidized reinsurance pools that might make it more affordable for employers to offer

     Ms. Swartz says that "nobody believes anything is going to come out of Washington. States are more
     willing to say let's try something." Flush state budgets help. A survey by the Kaiser Family Foundation
     found that one-third of states, 17 in all, increased access to health coverage in 2006, often to low-
     income children. For the first time in four years, no state restricted income eligibility in Medicaid or in
     the State Children's Health Insurance Program.

     Last year, the then-governor of Massachusetts, Republican Mitt Romney, helped by Democratic Sen.
     Edward Kennedy, cut a deal with Democratic leaders of the state's legislature. It required state
     residents to obtain insurance, created a state-sponsored "connector" where they could go to buy it, and
     required all but the very smallest employers to provide insurance or pay a penalty.

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     Vermont and Maine also have enacted universal-coverage plans. Vermont aims to have 96% of state
     residents insured by 2010 through a mix of subsidies and employer contributions, plus a tobacco tax.
     Maine's program, aimed at insuring all by 2009, is grappling with inadequate funding, fewer people
     enrolling than anticipated and lawsuits from business over the financing mechanism.

     Several other states are mulling ways to increase coverage for their residents. Some mix expanded
     government programs with mandates on individuals to purchase insurance -- along with subsidies for
     low-income people, new insurance pools to share risks, and mandatory employer contributions.

     Last week, California Gov. Schwarzenegger outlined a plan that would make uninsured residents
     purchase insurance, and require businesses with 10 or more employees to either offer insurance or pay
     4% of their payroll into a fund for the uninsured. The plan would levy new taxes on doctors and
     hospitals to help pay for the state's estimated 6.5 million uninsured, a number that includes illegal

     On Wednesday, Pennsylvania's Democratic governor, Edward Rendell, became the latest recruit, with
     a plan to cover his state's nearly one million uninsured. He stopped short of a Massachusetts-style
     mandate, instead proposing to phase in a requirement that those with incomes above 300% of the
     poverty level ($60,000 a year for a family of four) purchase health insurance, along with full-time college
     and graduate students. His proposal would also penalize employers that didn't offer insurance and
     would provide money to help individuals afford it.

     As things stand, Mr. Rendell said, "It is a tremendous deterrent for businesses that are considering
     locating in Pennsylvania to know that in addition to paying for their own employees' health coverage,
     they will be subsidizing the costs of the uninsured" as hospitals charge them more to cover the free
     care the hospitals must give.

     From the perspective of big companies, the mandatory-employer-contribution programs at least level
     the playing field within the U.S., though they don't do much to ease the problem of competing globally.

     In Washington, it's far easier to get agreement on the goal -- "affordable, quality health care for all" is
     the mantra -- than on the way to get there.

     One camp, almost entirely Democrats, sees the current turmoil and dissatisfaction with job-linked
     insurance as hastening a single-payer national system. It's an idea many Democrats have pushed
     since the days of Franklin Roosevelt and Harry Truman.

     Sen. Kennedy, head of the Committee on Health, Education, Labor and Pensions, is proposing to
     expand Medicare beyond the elderly and disabled to all Americans, beginning with children and those
     aged 55 to 64. To many, that still seems politically unrealistic, especially given problems that Canada
     and Britain have run into with their national systems, including long waits and rising costs. But
     expanding the State Children's Health Insurance Program, which was created in 1997 to help states
     provide coverage to more low-income children, strikes some Democrats as a feasible step in this

     Another camp, including some Bush administration officials, sees the turmoil and decay of job-linked
     health insurance as a reason to go in a very different direction. They would let individuals shop for
     health care much as they do for other things. They would use tax breaks and vouchers to help people
     afford insurance, preferably high-deductible policies that prod citizens to make wise choices.

     The government already is taking steps to make Americans better consumers of health care. To
     encourage people to be more cautious in using health care, the Bush administration is seeking ways to
     wean Americans off generous schemes that pay for almost anything. In their place, it favors high-
     deductible policies that cover the big expenses, plus ways to let people pocket the savings if they avoid
     unnecessary treatment or shop for lower-priced care. Health Savings Accounts are a way to do this,
     offering tax breaks to people who take high-deductible policies and allowing them to escape taxes on
     wages set aside for health care, keeping the money if they don't spend it.

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     Mr. Bush is expected to continue pushing in this direction. Among possible proposals: ways to make
     the market for individually purchased insurance more efficient, and encouragement to small businesses
     to help employees buy bare-bones policies. Administration officials argue that current tax law
     imprudently encourages employers to provide unlimited amounts of health care to workers who aren't
     taxed on that as income. One possible change would be to limit that tax break and devote any revenue
     raised by the change to subsidizing coverage for lower-income Americans.

     In a recent op-ed piece in The Wall Street Journal, Mr. Bush listed "affordable health care" among the
     biggest issues facing the American people.

     A third camp, borrowing from what's going on at the state level, essentially would widen existing
     sources of health insurance -- government, employers and individual policies -- so that they cover
     everyone. Such plans sometimes require that everyone get insurance; penalize employers that don't
     offer it; and subsidize coverage for people who can't easily afford it yet don't qualify for programs for the

     Although state experimentation is in favor now, one obstacle to state-by-state reform is a federal law,
     the Employee Retirement Income Security Act, or Erisa, that limits states' maneuvering room. It has
     thwarted an attempt by Maryland to force Wal-Mart Stores Inc. to offer health insurance to employees.
     This week, the Fourth U.S. Circuit Court of Appeals upheld an earlier decision that Maryland had
     violated Erisa. Legal experts said the decision could pose problems for states considering health-care
     changes but suggested that it wouldn't cripple efforts in states like Massachusetts, where the overhaul
     is broad and not targeted at a single employer.

     Some veterans of health-care battles past smile at the enthusiasm for tackling the problem. Recalling
     high-profile press conferences of years past -- and proposals shredded by partisan politics or budget
     realities -- they say the most likely federal action is none of the above. There's also likely to be a big
     debate over health care in the coming presidential campaign.

     But Mr. Stern, the union leader, thinks that view underestimates the current ground swell and unusual
     political opening. "I'm not sure Congress is yet recognizing the tidal wave that is building," he says. "It's
     the perfect time. You have an evenly divided Congress in Democratic control and a presidency in
     Republican control. You have everyone lined up on the side of universal coverage."

     Doing nothing is costly too, says Henry Simmons, president of the National Coalition on Health Care, a
     collection of companies and interest groups that has agitated for major health-care change since 1990.
     "We can afford health-care reform," he says. "What we cannot afford is a continued failure to address
     the crisis in health care."

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     Insurers See a Potential Cure
     Wall Street Journal | 01.19.07
     With Enrollment Lagging, Some Firms Support California Health Plan

             IN SUMMARY

             •   The Issue: Commercial health insurers have voiced qualified support for California Gov.
                 Schwarzenegger's proposal to mandate universal health care.

             •   The Background: Insurers stayed on the sidelines during previous state efforts. Many are
                 now missing their enrollment goals because companies are giving up or reducing employee

             •   The Bottom Line: Many health insurers see the potential for increasing enrollment under
                 California's plan, as well as under similar efforts in other states and potentially on the federal

     When Californians tried, and ultimately failed, to pass a 2004 referendum requiring employers to
     provide health benefits to their workers, the reaction of most of the state's big health insurers ranged
     from skepticism to stony silence.

     But since California Gov. Arnold Schwarzenegger proposed a sweeping plan last week to mandate
     universal health care in the country's most-populous state, the industry has been quick to voice its
     qualified support.

     Despite some "worrisome provisions," executives at WellPoint Inc. said they're willing to work with the
     governor. Speaking to analysts and investors yesterday, UnitedHealth Group Inc.'s chief executive,
     Stephen Hemsley, called the California plan "an interesting set of proposals...that represent real
     opportunities for our business."

     The difference suggests how much the political momentum behind health-care reform efforts has
     intensified in three years -- and how health insurers plan to cope, or even benefit. As the ranks of
     uninsured Americans have swelled to nearly 47 million, a number of states have passed or are drafting
     similarly ambitious plans. Health insurers are wary of appearing obstructionist, especially after several
     years of record profits.

     The latest round of earnings reports suggest another reason for their new attitude: Though profits
     remain robust, health insurers are struggling to expand their traditional business of selling insurance to
     employers. Yesterday, UnitedHealth kicked off the reporting season for fourth-quarter earnings with net
     income of $1.2 billion. That's a 38% increase from what it reported a year earlier, though the company
     has said it may have to restate up to 12 years of previous earnings because of the backdating of stock

     But growth in medical-plan enrollment in 2006 fell far short of UnitedHealth's original forecast of
     between one million and 1.2 million new members. This year the company expects to enroll roughly
     700,000 to 800,000 new members in plans that employers finance themselves and pay UnitedHealth to
     administer. But it expects only 300,000 new employer-financed plan members in the first quarter-
     compared with earlier projections of 450,000.

     UnitedHealth and other insurers have been falling short of their enrollment targets because the overall
     market isn't growing. New areas of businesses, such as the Medicare drug benefit for senior citizens,
     are fueling much of the new profit growth. But as health-care costs continue to soar, more employers,
     particularly small ones, are giving up or reducing benefits, and fewer consumers can afford to buy them
     on their own. Insurers like UnitedHealth, who've been reluctant to sacrifice profits to win new business,
     have lost some accounts to smaller, hungry regional insurers.

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     If successful, the California proposal could expand the industry's market by four million to five million
     currently uninsured Californians -- something health plans have been unable to do despite heavily
     marketing new products to some segments, such as relatively healthy but uninsured twentysomethings.
     Because of its size, California could galvanize universal health coverage initiatives in other states,
     where many in and around health care see such reform experiments playing out.

     At the federal level, the debate over such reform has long been bogged down in political infighting and
     the special interests of various business lobbies. But that could change as state initiatives gather
     steam, particularly ahead of the 2008 presidential election.

     Under Gov. Schwarzenegger's proposal, employers and individuals would be required by law to buy
     coverage. Businesses that opt out would pay 4% of their payrolls into a state insurance fund. Doctors
     and hospitals would contribute 2% to 4% of revenue to subsidize people who can't afford coverage on
     their own and to boost state Medicaid payments to physicians.

     "If we don't seize the opportunity here, it will get worse still," said Bruce Bodaken, chief executive of
     Blue Shield of California, a not-for-profit insurer that competes against WellPoint's Blue Cross,
     UnitedHealth's PacifiCare and other rivals in the state. "There's no question [the plan] broadens the
     opportunity for the industry to provide not only the basic products but others we think can benefit
     consumers and employers."

     Insurers and their investors have had a more mixed reaction to some of the plan's details, including a
     provision that would put a tight leash on health plans' profits and administrative costs by requiring them
     to spend 85 cents of every dollar in premiums on health care. Most health insurers in California already
     spend at least 85% of premiums on medical costs, particularly its not-for-profit and private Medicaid
     plans, according to analyst estimates. But a few, particularly WellPoint, the market leader, spend less
     overall on employer and individual plans. Health insurance companies also wouldn't be able to deny
     people coverage based on their health problems, age or line of work.

     Wellpoint shares fell 3.5% on the day Gov. Schwarzenegger unveiled his proposal, while
     UnitedHealth's shares fell 1.2%.

     While skirting the details of Gov. Schwarzenegger's plan, UnitedHealth's Mr. Hemsley yesterday voiced
     optimism that parts of it were still up for discussion and change. "There may be some elements that go
     forward, and I fully expect some elements will not," he said.

     What's more, some of the proposals' provisions to reduce red tape could lower the insurers'
     administrative costs, making it easier to live with the 85% restriction. Analysts say that traditional,
     Blues-branded plans such as WellPoint's, which already sell heavily to small businesses and
     individuals, stand to gain market share.

     "It's a different skill set not every insurer has. That makes [the plan] an opportunity for them," said Joe
     France, a health insurance industry analyst at Bank of America. Both WellPoint and UnitedHealth's
     shares have rebounded since last week.

     Other insurers caution against the industry trying to change or lobby away too much of the proposal.
     "We believe it should hang together close to its current form," says Mr. Bodaken of Blue Shield, one of
     the few insurers to openly support previous California efforts to mandate universal coverage. "It's
     important going forward politically that there are no freeriders in paying for it. Once you start to
     cherrypick [the plan], it falls apart."

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