Filed under: Capitalism, Domestic Policy, Economy, Health Care, Politics, Socialism | Tags: Economist Milton Friedman, Simple Common Sense, Socialized Medicine
I love Milton Friedman’s clear explanations of simple economic principles. Do any of those on the Left ever watch any of these? Silly question, of course they don’t. Could we get all of these videos into the schools? Never mind, I’m fantasizing.
Filed under: Freedom, Health Care, Politics, Statism, The United States | Tags: Free-Market Medicine, ObamaCare Lies, Socialized Medicine
We recently demonstrated how free-market medicine works with a post about the Surgery Center of Oklahoma, which is a shining example. ObamaCare, on the other hand, is the left’s attempt to gradually funnel us all into single-payer, government-run health care.
Please note that ObamaCare is not about health, nor is it about medicine. It is about insurance and who pays for what. They tell us that ObamaCare will reduce costs and promise you all sorts of free goodies. Obama partly won the election by promising free contraceptives. (Well, of course they are not free because the rest of us will have to pay for them. I should clarify that: the young women who are getting “free” contraceptives will be paying for the “free contraceptives” of all the women in the country who are using contraceptives. Probably paying more than the $9.00 a month’s supply costs at a discount pharmacy. But I guess that’s how you learn about basic economics.
ObamaCare: think of it this way — draw two stick figures with a space between. Label one ‘patient‘ and the other ‘doctor.’ Between the two stick figures, draw a small box. Label that ‘insurance companies‘. Then above the small box, draw a much bigger box. Label that one, oh, just ‘government’ to represent the over 100 agencies and offices and euphemistically named bureaus that will supervise and control the patients and the doctors, the insurance companies, the pharmacies, the suppliers, the hospitals. All those agencies have who-knows-how-many employees who all have salaries which are excessive, except by DC standards. That little exercise alone should tell you that ObamaCare is going to cost a lot more. Yet ObamaCare is all supposedly about how much it will save you. (Not really, it is really about making you dependent on liberal government, so you will always vote for liberals.)
So, while free-market medicine is about competition and creativity, innovation and plain old American free enterprise, ObamaCare is about folding you into the arms of bureaucracy, where you will forever be dependent on government, until they decide that it costs too much. Medicine becomes not a matter of the care a doctor gives to a patient, but for the physicians, it becomes a matter of trying to get paid enough to cover costs. For hospitals and suppliers, it becomes a matter of trying to cut costs to comply with government budgets. The British NHS provides a running example of what we will become in time. To wit:
A BID to save nearly £3billion by slashing appointments with a doctor and treating patients via computer will put lives at risk, ministers were warned.
Health Secretary Jeremy Hunt is planning a technological revolution that could spell the end of the traditional doctor’s surgery.
A new system of “virtual clinics” is being planned in which GPs connect with patients via iPads and Skype, an idea that NHS bosses are importing from India.
The reforms would save £2.9 billion “almost immediately” and improve the lives of most patients, for example by avoiding the need to find child care during appointments, Health Minister Dr Dan Poulter said last week.
However, critics are concerned the initiative would create a two-tier NHS in which the less technologically able, particularly the elderly, would be left behind….
The ideas, contained in a Health Department report called Digital First, include arming community nurses with iPads in rural areas and making more use of Skype video calling between GPs and patients. There will be more online assessments “augmented” with video calls.
Mobile phone “apps” will be used to access lab reports and health records and negative test results will be sent by text messages rather than delivered in person. Mr Hunt, who made a fortune by creating an internet company, believes that while mobile broadband technology is revolutionising most walks of life, there is a problem once people encounter the relatively antiquated systems of the NHS.
The Government is trying to fill a £20 billion NHS funding gap and health chiefs want to reduce “needless” appointments that clog up staff time.
Well, the NHS has kept patients parked in ambulances outside hospitals because they can have only a specified number of admissions a day, they’ve conveniently offed seniors in their final years with ‘”do not resuscitate ” notes on the charts, cut back on cleaning and linen changing and drinking water and food. The battle has become — how to cut costs, not patient care and saving lives.
The innovation and inventiveness that produce savings are eliminated by the overweening bloated weight of bureaucracy, once established, is always seeking more power and more control, and attempting to reduce the costs that they themselves created with their processes.
Filed under: Capitalism, Democrat Corruption, Economy, Election 2012, Freedom, Politics, Statism | Tags: Food Stamps, Socialized Medicine, The Welfare State
Filed under: Health Care, Intelligence, Law | Tags: Social Justice, Socialized Medicine, The Illusions of ObamaCare
(click to enlarge)
Filed under: Capitalism, Democrat Corruption, Economy, Health Care, Statism | Tags: Obamacare, Socialized Medicine, The U.S. Supreme Court
ObamaCare will be argued next week in the Supreme Court. The justices will be considering the application of the health care law in the light of the United States Constitution. While the justices consider the constitutionality of the law, most of the arguments have to do with the economics of the law.
We were lied to in the first place, directly and purposefully. It was necessary for Democrats to drum up nationalized health care in the back rooms of Congress, because the costs of health care were spiraling out of control, and the only solution was
socialized medicine the Affordable Care Act and Patient Protection something or other. That was not true. Medical costs had been moving downwards towards the normal rate of inflation for a decade. There was NO emergency.
Consider the individual mandate to purchase health insurance. The Obama administration defends the mandate on the ground that a person’s decision to not buy health insurance affects commerce by materially increasing the costs of others’ health insurance. The government adds that health care is unique and therefore can be regulated constitutionally in ways other markets cannot.
The government’s other defense is that the health-care market does not exhibit textbook competition. No market does. The economic features relied upon by the government…are characteristic of many markets.
Health care, Douglas Holtz-Eakin, and Vernon L. Smith point out, is typically consumed locally, and health-insurance markets themselves primarily operate within the states.
The administration’s attempt to fashion a singular, universal solution is not necessary to deal with the variegated issues arising in these markets. States have taken the lead in pas reform efforts. They should be an integral part of improving the functioning of health-care and health-insurance markets.
Mr. Holtz-Eakin is a former director of the Congressional Budget Office, and president of the American Action Forum. Mr. Smith is a professor of economics at Chapman University and the 2002 Noble Laureate in Economics.
Professor Richard Epstein argues that the health law’s expansion of Medicaid is problematical. An expenditure of federal funds is unconstitutional when it coerces states rather than encouraging them to participate in a federal policy. ObamaCare transforms Medicaid from a health-care program for the poor into a mandatory federal entitlement— obligatory on both the states and the beneficiaries alike.
What the Supreme Court will do is completely unknown. Speculation does not help. Kind thoughts, prayer, voodoo dolls and worrying probably won’t help either, but you might try your favorite remedy anyway.
Filed under: Capitalism, Health Care, Politics, Socialism, Taxes | Tags: Independent Pay Advisory Board, Obamacare, Socialized Medicine
Paul Ryan’s “Pathway to Prosperity” shows a way to bring our nation’s deficit and debt under control in a reasonable time frame. Democrats object strenuously. They are not prepared to cut back much on spending, and they would prefer to raise taxes sharply on “the rich” and cut spending on the military. To no one’s surprise, they have declared class warfare, and are busily demonizing “the rich” and pretending that raising taxes on the rich will solve everything. Unfortunately the rich don’t have enough money—even if you strip them of everything they have— it’s not enough.
Obama also demonized the Ryan plan’s approach to Medicare. Obama extolled his own plan for reducing the costs of Medicare. He briefly pointed to the Independent Payment Advisory Board (IPAB) as a way to control costs. Remember that acronym —IPAB.
This is a panel of ‘experts’ to be appointed by the president who will control prices, decide what services can be offered and who can have them. ObamaCare has, from the first, been focused on the fact that the greatest medical expense comes from seniors in their final years, and controlling costs has to deal with that fact.
That doesn’t sound too bad, until you realize that it means rationing, denying service, and cutting back on payments to doctors, hospitals and medical services. The experts cannot by law decide what treatment you can have, but they can decide what they will pay for it. They are charged with bringing costs below the costs of Medicaid. Socialist medicine is uninterested in the individual and excuses that lack of concern by referring to the greater good for the greater numbers. Does this all sound a little familiar? Of course, it’s the death panels! Fifteen bureaucrats get to decide who lives and who dies. You don’t get to question or argue. Their decisions are final, and you can’t get them fired.
Under ObamaCare, IPAB is to hit a target for Medicare’s growth that significantly squeezes the costs of the program beginning in 2014. (In his budget speech, Obama said he wants to ratchet down the cap even further) Congress has very limited options. It can pass the IPAB recommendations, substitute its own version of them, or by a three-fifth’s majority in the Senate vote to waive the requirements. If Congress does none of these things, the Secretary of HHS automatically implements the IPAB plan.
Congress is difficult. Members argue, they disagree. Everything would work so much more smoothly if their key functions were handed off to a panel of experts. If you are deeply impressed with the Obama cabinet and Obama’s appointments, then you might be impressed with his ‘experts.’ I’d rather take a chance on me and my doctor. I don’t believe in ‘experts.”
No one can predict the future, but the Obama administration is so interested in cutting back on payments to doctors and hospitals — and the bills for major life events can be huge — yet they seem not to have considered the consequences on the medical profession. Current Medicaid patients often cannot find doctors who will see them. The IPAB is supposed to reduce Medicare cost below Medicaid cost.
We have a current shortage of primary care physicians. If they cannot receive a fair recompense for their effort, if the government keeps ratcheting up the number of patients they must see in an hour, will there be a flood of new students wanting to become doctors? How long would it be before ObamaCare nationalized the doctors?
All of the bright ideas that Obama and the Democrats have had about government controlled health care— and they have admitted that their goal is single-payer health care—has been tried and failed in England, Europe, Canada. Theodore Dalrymple (the pen name of Anthony Daniels, a British physician) wrote a couple of weeks ago in the Wall Street Journal that Obama’s claims for vast new efficiencies in health care would not produce the savings claimed —the British had been there and done that, and it doesn’t work. The incentives are all wrong. The world is more complex than health-care economists assume.
Remember the acronym—IPAB, Independent Pay Advisory Board. You really don’t want the president’s, any president’s, bureaucratic appointees deciding, by looking at the cost, what medicine you can have, what help you can have when you are ill or if you can have any at all and are just too old or too much of a drag on the system, and have to be unplugged from life support, however many productive years you might have left.
A fairly important reason to repeal ObamaCare — it just might be the death of you.
Filed under: Health Care, Law, Statism, Taxes | Tags: Britain's National Health Service, Bureaucracy, Socialized Medicine
We frequently include stories here about Britain’s National Health Service. Britain has had socialized medicine since just after World War II. Some call them “scare stories” and so they are. Many Britons like their National Health Service, and feel that they get good treatment. The scare stories are compelling. Why do we include them? Britons hate it when we use their NHS as a bad example; and they, in turn, use their idea of American medicine as a bad example.
Much of health care is routine and minor. You can’t judge health care by the occasional broken arm or deep cut. Most anyone can fix it. You have to judge health care by the very sick, the elderly in failing health, the difficult diseases, and the chronic disease. The well don’t need health care. So the real customers for health care are probably in poor health. And the question of quality becomes how do we care for those in poor health?
The goal of socialized medicine is to give good health care to the poor — those who cannot pay the usual cost of good health care. The theory is that they will save enough money elsewhere to afford to give good care to the poor. But are we talking about routine care for healthy poor people, or the care for poor people in poor health?
There is an assumption that “preventative care” will prevent people from getting any condition that is expensive. This is nonsense. Diagnostic medicine is expensive. A single blood draw may result in a whole battery of tests. Machines like MRIs and C–T scanners cost a fortune. A diagnosis usually begins with a symptom and the attempt to discover the cause of the symptom. Running tests on people who have no symptoms is not usually cost-effective.
What about the modern epidemic of obesity? A few years ago, they changed the standards for what was called obesity to include more of those people who had never been called obese before. Voilá, and “epidemic” of obesity. The same thing happened with diabetes. They lowered the standards sharply to include more people, and there was suddenly an “epidemic” of diabetes. The intent was to get more people treated early, but the idea that everybody had better stop eating Big Macs or anything that tasted good was probably misguided.
The Wall Street Journal today has a postcard from the NHS. In 2007, 230 patients died of malnutrition in British hospitals, the latest year for which figures are available. Age UK, a monitoring charity, says “the true figure may be much higher” due to under-reporting. In 2007-2008, 148,946 Britons entered hospitals suffering from malnutrition and 157,175 left in that state, meaning that hospitals released 8,220 people worse-off nutritionally than when they entered. In 2008-2009, that worse-off figure was up to 10,443.
The problem is not insufficient food. It is individualized mealtime assistance. The constant scarcities created by socialized medicine, and the constant drive to cut costs leaves nurses with more responsibilities and less time. It is not, the Journal points out, a Labour problem or a Tory problem. It is a single-payer health-care problem.
It is a problem of bureaucracy. Anyone who has worked in an organization of any size recognizes that the bigger the bureaucracy, the greater the problems. Group think doesn’t work. And the more remote the bureaucrats from the actual sick person, the worse the system will be. Examine this chart (click where noted to enlarge) and note the stubby yellowish star in the lower right-hand corner. That represents you the sick person. All the rest of the bubbles and squares and rectangles represent not individual people, but bureaus, who are making decisions about what treatment you get and whether their decisions will allow you to live or die. Not you. Not your doctor. Hundreds and hundreds of faceless bureaucrats.
Democrats are facing a nationwide backlash. Democratic congressional candidates have a new message for voters. We know you don’t like ObamaCare, so we will fix it. Do not believe them. Endless tinkering does not fix anything. It is a single-payer health-care problem. It does not work. The inevitable result is the NHS — which is what the ObamaCare people want. They have said so.
Filed under: Democrat Corruption, Economy, Health Care, Law | Tags: Corrupt, Out-of-Touch, Socialized Medicine
The White House has posted a description of President Obama’s new improved, bipartisan, same-old health care plan that is more expensive than the Senate bill, does not address concerns about the Senate’s abortion language, maintains the tax-exemption for Democrats’ union friends and retains the idea of paying for half the cost of health reform with $500 billion in benefit cuts for the elderly.
He does not give up the attempt to force employers of low-wage workers to spend more than $14,000 on health insurance — sure to lead to massive layoffs. He does not reject the billions of dollars of hidden taxes on everything from wheelchairs to medicine cabinets.
What is new — is a plan to impose the Medicare payroll tax (2.9%) on interest, dividends, annuities, royalties and rent. And the White House wants a national health insurance price-fixing body to approve rate hikes (despite evidence that state price-fixing leads to more uninsured not less). And the White House wants to criminalize almost every aspect of Medicare!
Keith Hennessey says:
I struggle to understand how the President”s new proposal is relevant to any serious attempts at legislating if he cannot deliver either House of Senate Democrats in support of it. Maybe this is the first part of a well-coordinated strategy in which Pelosi and Reid press their own members to line up behind the President’s proposal. Or they could just be winging it again.
A Fox News/Opinion Dynamics poll shows 23% want to pass the current bill, 47% want Congress to start over, and 23% want to do nothing! (That would be 49%+ 23% +73% opposed). Zogby has 57% who reject the Senate and House bills, and want Congress to start over. CNN/Opinion Research Corp. has 48% who want to start over, and 21% who say just stop. Rasmussen says 61% say Congress should scrap it and start over, and 59% ov voters think that states should have the right to opt out of federal government programs they don’t agree with.
75% of voters, according to Rasmussen, are angry at the government’s current policies. 63% believe it would be better for the country if most incumbents in Congress were defeated this November.
The Declaration of Independence, our founding document, states that “governments derive “their just powers from the consent on the governed.” Today just 21% of voters nationwide believe that the federal government enjoys the consent of the governed.
Is anybody listening?
Filed under: Democrat Corruption, Economy, Health Care, Law | Tags: Health Care Reform, Mammograms, Socialized Medicine
And bless her heart, she is running against Barbara Boxer.
(h/t: The Corner, NRO)
Filed under: Capitalism, Economy, Health Care, Progressivism | Tags: Democrat Demagogues, Obama, Socialized Medicine
President Obama has made the health care debate the hot button topic of the moment. The President wants a bill passed right now — this week — before people have a chance to read the bill, digest what it actually says, question the policies it establishes, debate, stage protests, contact their representatives or discuss it with their neighbors.
This, in itself, is astounding. Here is a bill that changes our entire relationship with the health care industry. It changes where we will get our insurance, what that insurance will cover and what it will not, how we find our doctors and how we relate to them, and puts a vast quantity of Washington bureaucrats and functionaries in charge of our health instead of us. And because it is so important, so life-involving and life-changing there is no time, no time to consider whether it is a good idea or not. Most Americans are beginning to believe that it is not a good idea at all — and that is the reason for the rush.
Most of what is claimed as support for the need for “swift and decisive action” is either untrue or an exaggeration. False statistics are paraded, examples from other universal health care systems are dismissed as “scare stories,” costs as delineated by the Congressional Budget Office are ignored, and those who speak out are attacked, bullied and threatened.
Liberals have good intentions. They want universal health care because they believe that they, as enlightened government functionaries of sterling character, know how to see that their system is more fair and cares for everybody equally in an exceptional way — that is except for themselves, who they excuse from ever participating in such a plan. How do they justify that? Got me! But they justify excusing themselves from most anything that is a little unpleasant for the rest of us. You do know that they give themselves regular cost-of-living pay increases automatically, don’t you? They used to vote themselves increases, and then the voters got all huffy, so they just changed the system so they don’t have to vote. It’s automatic, no matter what the state of the economy.
Liberals (Progressives, whatever) aren’t very interested in statistics or results or consequences. They care deeply about their idealism, their goals and “social justice.” Social justice is a socialist code word for equality of outcome. They have never liked the idea of equality of opportunity, because that does not insist that things be fair. It’s just that trying to make things fair to everyone makes for a whole lot of bad consequences.
There are so many examples of government run health care. Medicare is going broke and the baby boomers will start turning 65 in just a few years. There is Medicaid, and the Indian Health Service. None of these government programs are successful. Massachusetts health care was supposed to show how a government-run plan could succeed and be an example for national health care for the country, and in just 3 years it is a failure. Massachusetts just dropped 30,000 legal immigrants from the program because Massachusetts cannot afford them. We are already subsidizing Massachusetts care for those who cannot afford insurance, with our federal taxpayer dollars, to the tune of $1.35 billion a year.
England, France and Canada have failing systems. Many countries have two layers of care, one for ordinary people and another private care for those who can afford it. James Lewis writes of his experience with Mexican care here, and in the comments others describe their experience abroad.
Democrats in Congress and in the White House are already talking about rationing. They have pointed out that the old folks rack up the most costs in end-of-life care, and that really can be reduced. All of us will, with luck, someday become “old folks.” And they are already planning to deny treatment, operations, new remedies, but sorry, we just don’t have time to discuss it. We have to pass the bill now. Maybe we can fix it later, hmmn?
Filed under: Capitalism, Health Care | Tags: Democrat Demagogues, Medical Care, Socialized Medicine, The Good Life
Nepotism is alive and well in the Obama Administration. One of President Barack Obama’s key advisers on medical policy is the brother of his exceedingly partisan chief of staff Rahm Emanuel, Dr. Ezekiel Emanuel. Dr. Emanuel has written a paper on “The Perfect Storm of Overutilization” which was published in The Journal of the American Medical Association.
Dr. Emanuel thinks we use way too much medical resources. He doesn’t even like fancy waiting rooms, he believes that physicians are too highly paid and he doesn’t like the Hippocratic Oath. He doesn’t like American hospital rooms which offer more comfort, privacy and extra services than hospital rooms in other countries. Back to big wards, I guess.
Dr. Emanuel calls for medical students to be trained “to move toward more socially sustainable, cost-effective care.” In order to reduce spending, doctors will have to be pressured to deny treatment. The Canadians do not allow most cardiac treatment for patients 65 and older. The Hippocratic Oath’s promise “to use my power to help the patient to the best of my ability and judgment” prompts doctors to use too many medical resources.
The legislation for influencing your doctor’s decisions was included in the stimulus package — The American Recovery and Reinvestment Act of 2009. It sets a goal that every individual’s treatment will be recorded by computer, and your doctor will receive electronically delivered protocols on “appropriate” and “cost-effective” care. No individual judgment here, just follow the program. In Britain, they deny treatment for elderly people’s macular degeneration until they have gone blind in one eye.
Dr. David Blumenthal, a Harvard Medical School professor, has been named national coordinator of health information technology. His writings, according to Betsy McCaughey, also favor limiting the amount of health care that patients can get. He agrees that there may be longer waits and reduced availability of newer and more expensive treatments or devices. “If electronic health records are to save money,” he wrote, doctors will have to take “advantage of embedded clinical decision support.” [euphemism alert!] Computers telling doctors what to do.
Age discrimination will be big under Obama Care. We were all young once, so denying care to the elderly in order to give more to the young and fit is the goal. This is a fundamental part of Britain’s National Health Service, and Canada’s Health Service. Watch out if you have a lot of health problems too.
The President spoke last Monday on health care. He was flanked by heads of several of the major health care lobbying groups. He announced, grandly, a “watershed event:”
These groups are coming together to make an unprecedented commitment. Over the next 10 years —from 2010 to 2019 — they are pledging to cut the rate of growth of national health care spending by 1.5 percentage points each year — an amount that’s equal to over $2 trillion.
Uh huh. The president of the American Hospital Association said that a deal with the White House had been “spun way away from the original intent.” They promised to try to reduce spending gradually over 10 years, eventually trying to reach 1.5 percent. The agreement had been misrepresented. There’s “frankly a lot of political spin” he said.
The most ethical Congress ever plans to ram Obama’s Health Care program through without any possibility of filibuster or dissension. No consideration of unintended consequences. No reading the bill. No checking on the rules and regulations. Economist Larry Kudlow says that it will be at least $1.5 trillion to $2 trillion more at least, and will bankrupt the nation. Not that the country is not bankrupt already. Every nationalized health care plan has cost far, far more than estimated.
What do you want to bet that the most ethical Congress ever has no intention of giving up their own very special health care plan to join the rest of the nation in socialized medicine? This is billed as only a way to get those 45 million uninsured covered with health care policies. Except that the 45 million number is a lie, and if the whole deal is to cover the uninsured, why the elaborate plan to force doctors and hospitals under threat of losing their licenses to follow the government’s computerized protocols? Logan’s Run or it’s remake The Island have come to life.
Rasmussen reports that 70 percent of insured Americans rate their health insurance coverage as good or excellent. Only 32 percent would pay higher taxes to provide health insurance for all. 54 percent say they’re not willing to pay more in taxes.
When Canadians or British citizens need medical care that they cannot get in their own system, they come here for the things that their own country denies them. So where do we go when we are denied?
Stay tuned for Part II.
Filed under: Europe, Freedom, Health Care, Politics, Socialism | Tags: Government Health Care, Health Care Costs, Socialized Medicine
Fifty-one percent (51%) of Americans oppose a single-payer national health care system overseen by the federal government according to a new Rasmussen Reports national telephone survey. Only thirty percent (30%) favor a government-run health plan, and 19% are undecided.
Democrats favor such a plan by 45% to 30%. Seventy-four percent of Republicans oppose a plan run by the government. Married voters by double digits are more opposed to a government plan than unmarrieds.
A majority of American voters (58%) oppose any kind of government-controlled health plan if it means they have to change their own insurance coverage.
These are encouraging figures. Democrats have taken the position that Americans really want “universal health care.” You will notice the more careful phrasing. No one says “socialized medicine” though that is in fact what they are proposing. And why are they proposing it? Because the cost of health care is too high for many states and corporations.
And if current health care costs too much, how are those costs to be reduced? They talk about greater computerization of medical records. A Rand study suggests significant savings, but not for 15 years. Other studies do not see significant savings. Proponents insist that if we just turn our health care problem over to the government, it will be much more efficient and much less expensive. If you have ever seen a massive government program that delivers on that kind of promise, please comment.
The only way that government can offer less expensive health care is through rationing. Ration the treatments that people may receive. National Health Insurance in Britain does not allow some of the more expensive drugs for Alzheimers or Macular Degeneration. Sorry, costs too much. Expensive cancer treatments, no, sorry. Hospitals get less money, and cleanliness suffers. Fewer top students choose to go into medicine, and fewer students choose to go into nursing. Wait times to see a physician or a specialist increase from days to months. Fewer of those big expensive diagnostic machines are purchased. It is inevitable. This is the result in countries that have adopted some form of socialized medicine.
Some countries have a two tier system, one for ordinary folks and a better one for those who can pay. British patients who can afford it go to India for surgery in India’s upper tier health care.
American patients who are diagnosed with cancer have a far better survival rate than patients in Europe. The American five-year survival rate for prostate cancer is 99 percent, the European average is 78 percent. American women have a 63 percent chance of living at least five years after a cancer diagnosis compared with 56 percent for European women.
If Congress determines to pass some form of health care plan, we’d better make very, very sure that members of Congress have exactly the same plan that we do.