Category Archives: Healthcare

Public Officials sound off as Trump signs order sabotaging ACA and proposing budget that cuts $700 billion from Medicaid

Citizens terrified of the devastating effects of massive cuts to social safety net in lower income communities join panel discussion with national, state and local elected officials

U.S. Rep. Debbie Dingell, state Rep. Ronnie Peterson, Washtenaw County Commissioner Ricky Jefferson, Ypsilanti city council member Peter Murdock, Community Alliance executive director Kathy Grant and former state Rep. John Freeman will discuss the potentially devastating impact of Trump’s proposed budget which seeks to cut $700 Billion from Medicaid in front of an audience of concerned community members and constituents.  The discussion focused on how these cuts will impact vulnerable communities in Washtenaw County, including developmentally disabled adults, seniors in nursing homes, school districts ability to serve special needs children, and low income workers.

Kathy Grant, Executive Director, Community Alliance, provides insight on the need for Medicaid and the effects any cuts would have  “Medicaid is a lifeline for people with disabilities. Sometimes it is the only source of funding for long term supports and services that many people with developmental disabilities rely on to live in the community.  Community Alliance works with nearly 500 people with developmental disabilities to help them to utilize Medicaid funded programs and services to receive the necessary assistance with personal care like eating, bathing, getting dressed and taking medicine.  Cuts to Medicaid turn back the clock to a time when the only option for people with developmental disabilities was institutionalization. “

In addition, former State Rep. John Freeman discussed the poison pill provision that will trigger cancellation of Michigan’s medicaid expansion, which would cause 600,000 Michiganders to lose their health coverage as soon as 2019.  As Freeman wrote in a recent memo:

“If federal funding for Medicaid is dramatically reduced, this will trigger the termination [of the Healthy Michigan Plan]…But even if nothing is changed at the federal level, the Healthy Michigan Program will still likely terminate after fiscal year 2019-20”

Furthermore, this is only one of the many ways Trump is actively undermining the ACA and harming the most vulnerable among us.  The President has just signed an executive order that will allow insurance companies to raise rates for sicker and older people by exempting younger and healthier people from certain essential benefits.   As Karen Pollitz, a senior fellow at the Kaiser Family Foundation has said, “Within a year, this would kill the market.”

Citizens and public officials met to raise their voices and resist these assaults to ordinary Americans’ healthcare.

Michigan Families Will Be Harmed by Senate Budget Resolution Vote.

Healthcare for Michigan Medicaid Enrollees, Medicare Recipients Jeopardized, so that Top 1% Can Get $76,560 Tax Cut. Meanwhile 13% of Middle-Class Michigan Households Will Get a Tax INCREASE.

The U.S. Senate is expected to vote on a budget resolution that will set the framework for how much federal spending and taxes will be cut. The proposal would allow for a $1.5 trillion tax cut mostly benefiting the wealthy and corporations, which is not paid for by closing loopholes, meaning the costs will be added to the deficit.The ballooning of the deficit will jeopardize funding for Social Security, Medicare, Medicaid, education,and other services that America’s families rely on. Meanwhile, many middle-class families will see a tax increase under the plan.

This threat to the basic living standards of America’s working families is not abstract. The Senate budget proposes $5.8 trillion in cuts to federal spending, including nearly $500 billion from Medicare and $1.3 trillion from Medicaid and other healthcare programs. Another $650 billion may be cut from income security programs, such as Supplemental Nutrition Assistance Program (SNAP, or food stamps), Supplemental Security Income (SSI) for disabled individuals, and tax credits for working families. Michigan’s working families and seniors will be particularly harmed, and Senators Peters and Stabenow should vote NO to protect their constituents.

See data below for the effects on Michigan’s families.

A panel of officials and constituents gathered Monday at Community Alliance, a non-profit agency in Ypsilanti, Michigan, to discuss the potential changes to Medicaid.

“Seniors need help sometimes with just making sure they’re eating or getting dressed or bathing. It’s dignity.” said  Rep. Debbie Dingell. “It’s about the dignity of every human being, and as you get older, you can still be a very important contributing member of our community, We need their wisdom, we need their contributions. They need a little help. We shouldn’t destitute somebody because they’re older or not be there for them. We need to understand what Medicaid has become.”

“The Affordable Care Act’s Medicaid expansion helped fund the Healthy Michigan Plan, and if the ACA is replaced, the Healthy Michigan Plan will no longer be sustainable.” said former state Rep. John Freeman. “When you make a significant social change like we did with the ACA, you have to expect backlash, and that’s what’s happened. So if we think that this is important – and we all do – then we have to go out there and protect what we want.”

TAX CUTS FOR THE RICHEST 1% IN MICHIGAN FROM THE TRUMP-GOP TAX PLAN

TAX INCREASES ON THE MIDDLE CLASS IN MICHIGAN FROM THE TRUMP-GOP TAX PLAN

  • 14% of households would get a $1,590 tax increase, on average, in 2018.
  • 13% of households making $42,100 to $67,000 would get a $780 tax increase, on average.
  • 14% of households making $67,000 to $108,300 would get a $1,360 tax increase, on average.

EFFECT ON MICHIGAN OF REPEALING THE STATE AND LOCAL TAX DEDUCTION (SALT)

The Trump-GOP tax plan repeals the SALT deduction. Taxpayers can deduct state and local property taxes, and either income or sales taxes, from their federal taxable income.  SALT helps taxpayers, many of them middle-class, avoid being double taxed at the federal level.

  • For state and county level data on the number of households claiming the SALT deduction, the percentage that are middle-income and the average SALT deduction (see this report from the National Association of Counties http://explorer.naco.org).
  • For congressional district-level data on the percentage of taxpayers claiming the SALT

deduction and the average deduction claimed (see this report from the Government Finance Officers Association).

EFFECT ON MICHIGAN OF REPEALING THE FEDERAL ESTATE TAX

The Trump-GOP tax plan eliminates estate and gift taxes, losing $240 billion over 10 years and boosting the inheritances of the very wealthy. The federal estate tax is paid only by estates worth at least $5.5 million, just 2 out of 1,000 estates, or only 5,500 estates in all of 2017.

MICHIGAN SERVICES & PROGRAMS AT RISK DUE TO TAX CUTS

To pay for massive tax cuts to the wealthy and corporations, President Trump and GOP leaders have proposed deep cuts to services that working families rely on. The Senate budget resolution would cut over 10 years:

  • $1.3 trillion from Medicaid and other health care programs
  • $470 billion from Medicare
  • $650 billion from income security programs, which may include cuts to the Supplemental Nutrition Assistance Program (SNAP, or food stamps), Supplemental Security Income (SSI) for disabled individuals, and tax credits for working families.
  • Also at risk are Pell Grants and other financial aid to help students afford college.

In Michigan:

Medicaid serves:

Representatives, Families, Health Care Providers Speak Out Against Trumpcare Effort

U.S. Congresswoman Debbie Dingell (MI-12) today joined State Representatives, families and health care providers to highlight the devastating local impact of Republicans’ latest “Trumpcare” legislation, which the Senate GOP hopes to rush to a vote next week. Michigan stands to lose nearly $10 billion in federal health care funding by 2027 if the Graham-Cassidy bill is signed into law. According to a new report, premiums for those with pre-existing conditions could skyrocket by as much as tens of thousands of dollars.
 

“The American people have overwhelmingly rejected “Trumpcare”, and the newest Graham-Cassidy bill repackages the same damaging proposals and makes them even worse,” said Rep. Dingell. “The stories shared by families and health care providers today emphasize how much is at stake. Not only does this bill end Medicaid as we know it by cutting and capping the program, it also eliminates Healthy Michigan and completely eviscerates protections for people with pre-existing conditions, including autism, asthma and even pregnancy. This is unacceptable. We should be working together on productive, bipartisan action to stabilize the insurance marketplaces and extend affordable health care coverage to more families, not ramming through devastating proposals that take it away,”

“The effects of Graham-Cassidy would be devastating to our patients,” said Linda Atkins, chief executive officer of Western Wayne Family Health Centers. “Over 50% of our patients would become uninsured. That would cause them to begin using the ER for their healthcare, and those are things that we have been working so hard to turn around.”

“It’s because of days like today why it is so important,” said Alexis Wyatt of Brownstown, who was unable to attend the event because her 10-month-old son Alexander had to be rushed to the hospital. Alexander was born with severe illnesses that are still being diagnosed, and Alexis relies on Medicaid for Alexander’s doctor’s visits, emergency room visits, and other treatments. “Alexander is unpredictable. We have many ER visits, hospital admissions, medicines, and health supplies,” she said. “His month medical supplies are $400, and that’s just for his feeding supplies. Without Medicaid, I could not afford that so then how would he eat or get nutrition? Without his feeding tube or constant care, he would likely die.”

“The Graham-Cassidy bill is simply unacceptable when it comes to protecting the health and well-being of our patients, families and communities,” said Laura Appel, senior vice president and chief innovation officer, Michigan Health & Hospital Association. “Michigan hospitals cannot support legislation that will cost our state billions of dollars and eviscerate healthcare coverage and access to care on such a large scale.”

Kari Snyder of Wyandotte, whose mother’s accounting job was outsourced to another company just as she was undergoing a biopsy for breast cancer, said, “my mom didn’t quit or get fired. She just got outsourced. If we are going to give businesses the flexibility to do that, we need to protect their employees. The Graham-Cassidy bill doesn’t do that. If not for pre-existing coverage, my mom might not be alive today.”

Camilleri headshot“Downriver residents are rightfully concerned about recent healthcare proposals that threaten to cut essential benefits and return lifetime caps on insurance coverage,” said State Representative Darrin Camilleri. “I am committed to fighting for these protections at the state level, and today’s conversation is an important reminder of what’s at stake in the debate about health insurance and prescription drug prices in Lansing and Washington.”

“I have deep concerns about the latest attempt to repeal the Affordable Care Act. Specifically, this will spell the end of Medicaid expansion in Michigan, meaning that about 650,000 of our most vulnerable residents —working families, children and seniors — will lose their health coverage,” said State Representative Erika Geiss. “Beyond that, leaving health care protections up to the states means that the popular and effective provisions of the ACA — such as coverage for pre-existing conditions and allowing young people to stay on their parents’ insurance until age 26, among many others — are at risk.”

Dingell was also joined by State Representative Cara Clemente and Farah Erzouki, public health coordinator at ACCESS, to discuss the impact of the Graham-Cassidy bill on the state of Michigan.

Analysts estimate that by 2027, 32 million Americans could lose their health coverage under the Graham-Cassidy bill. The legislation ends the Affordable Care Act’s Medicaid expansion, which has extended health care to 695,000 Michiganders through the Healthy Michigan program; and ends premium tax credits, and cost-sharing reduction payments, all of which help millions of Americans afford health care. The legislation also permanently cuts and caps the Medicaid program—the largest health insurance program in the nation—which covers more than 74 million Americans, including more than 33 million children.

In Michigan:

  • 695,000 people have gained health coverage since the ACA was implemented.
  • Roughly 1.6 million people in Michigan have pre-existing health conditions, and could have their coverage rescinded if the ACA is repealed.
  • Michigan received $3.08 billion in federal Medicaid dollars to implement the Healthy Michigan plan. This revenue could be lost if the ACA is repealed.
  • A recent University of Michigan study found that Medicaid expansion in Michigan has boosted our economy and our budget and will continue to do so for the next five years. According to the study, the Healthy Michigan plan has generated more than 30,000 new jobs each year – one-third of them being in healthcare and 85 percent in the private sector. These jobs resulted in approximately $2.3 billion more in personal spending power for Michigan residents.

Parents of premature & special needs children speak out against proposed healthcare bill

Repeal of ACA threatens those with pre-existing conditions, reliant on medicaid

Representative Debbie Dingell met with several children born prematurely or with special needs and their parents for a roundtable discussion of how proposed healthcare reform would affect them. Children with special needs like these will find themselves squarely in the crosshairs if the cuts to medicaid and removal of protections under the Affordable Care Act are signed into law.

“As a parent advocate and peer counselor for our hospital’s NICU (Neonatal Intensive Care Unit), I see moms and babies every day that rely on the financial and program resources available through our health care plans.” said Vickie Korsak of  the Michigan March of Dimes  “Lack of access and coverage is nothing less of devastating to the the lives and futures of our sickest and most fragile.  The debate over lifetime limits, the definition of pre-existing conditions and the funding of Medicaid strikes terror in every parent who has had a baby born premature, ill or with a genetic condition.”

The BatesRyan Bates, the director of Michigan United and the father of a child born 14 weeks early, said, “Congress is debating taking health care away from vulnerable children so that the most fortunate among us can have a tax cut. That’s just wrong. This is generous country where we take care of each other.”

The group was joined by David Sanchez and his son Benicio, who gets autism treatment through a Medicaid funded program, and a representative of the Michigan Nurses Association.

Michigan United launches Universal Family Care at Downriver women’s rights event

Michigan Women join thousands across the country to push new economic agenda for all women

Michigan United began to roll out it’s Universal Family Care campaign at the Riverview Public Library Monday night.  US Congresswoman Debbie Dingell (D-MI12) and State Representatives Darrin Camilleri, (D-23 Brownstown) and Cara Clemente (D-14 Lincoln Park) came out to show their support for the plan to help families care for their children, seniors, the disabled, and caregivers.

Terri Voepel-Lewis“A few years ago, mom was diagnosed with cancer and had to move in with me. So that I could keep working, we had to use mom’s savings to pay for in home care.” said Terri Voepel-Lewis, a downriver resident who provided end of life care for her mother. ”That quickly ran low, as the cost of in home care for 8 hrs a day cost thousands over her short illness. Mom died before we had to consider other sources of care. No one should have to worry about how to care for their parents at the end of life”.

Universal Family Care would be very helpful families like the Lewis’. The campaign seeks to provide Universal Home Care for Seniors and People with Disabilities, and would have allowed Terri’s mom to receive the resources from the state to afford the care her mom needed during her illness.

Additional components of Universal Family Care include: Universal Childcare, Support for stay-at-home Parents, Workforce Standards, (those include reimbursement rates to workers set high enough to provide a living wage), and Paid Family Leave. The program covers all types of care, to support families and people of all abilities to work and live well at every stage of life.

Universal Family Care is about being there for loved ones. Care needs to be centered on families that are allowed the ability to make good care choices. Without a program that helps provide clear information about affordable choices, Michigan families cannot get the care they need and want.

The Riverview event was part of the “We Won’t Wait’s” week of action that has spawned similar events across the country. Another event will be held Friday, July 7th at the Oloman Cafe at 10215 Joseph Campau Ave, Hamtramck from 6 PM – 8 PM. Lending their voices to speak up for Michigan families and to join Michigan United as they Launch Universal Family Care in Hamtramck will be the Director of Community Engagement for Council Member At-Large for Janeé Ayers, Justin Johnson and State Representative Stephanie Chang (D-6  Detroit).

Michigan United announces launch of Universal Family Care campaign at Capitol Day

Rep. Jon Hoadley presents Long Term Care Study bill to lay groundwork to support families

With new chapters springing up around the state, Michigan United and the Michigan People’s Campaign welcomed record numbers at their annual Capitol Day Event Tuesday in Lansing. The grassroots organizations scheduled dozens of meetings with state representatives and senators to discuss immigration, the environment and family care.

At a rally held at Central United Methodist Church, they announced plans to work with Caring Across Generations and other coalition partners, holding listening sessions over the summer to build out policy details this fall that will ensure the care of all Michigan family members and to help those who care for them. Benchmarks include:

  • Universal childcare up to age 4
  • Long term in home care for seniors
  • Protections for home care workers
  • A stipend for stay at home family caregivers
  • Paid family leave for workers who need time off to care for loved ones.

Many families are in the “sandwich generation:” providing care for young children at the same time they’re providing care for their parents. Sandwich generation families deal with two unaffordable systems, where the people who require care have significant and rapidly changing needs.

Michelle George, an advanced practice registered nurse is one such person. She has a 97 year old aunt with two broken hips. Although she has good health insurance, she won’t be eligible for a new wheelchair to help her get to much needed appointments. “Many families are stretched thin, have to cut back on work, or quit a job to care for aging family members.” said George. “We need better solutions, and the time is now for us to research and fight for them.

Rep. Jon Hoadley also announced that he would introduce his Long Term Care Study bill later that afternoon as the first step in this campaign.

JOB POSTING: Gender Justice and Family Care Organizer

Gender Justice and Family Care Organizer (2)

Location: Detroit

Salary Range: $33,000 – $36,000

Note: One position is long-term, while the other is currently funded for seven months. We are currently raising the funds to ensure that both positions are long-term.

Deadline: Candidates are encouraged to apply immediately. Applications are due by February 14, 2017.

Michigan United is a statewide coalition of faith, labor, civil rights, business, and social service organizations working together for racial and economic justice through community organizing.

We put everyday people at the center of campaigns that build power to address the root causes of poverty and inequality. We also provide services to help develop the capacity of our members to lead.

Our major campaigns areas include immigrants rights and immigration reform, ending mass incarceration, universal family care and environmental justice.

Michigan United provides extensive training on organizing for change. We are a collaborative work environment where we invest in our team and win powerful campaigns. We provide generous paid time off to promote work/life balance, health benefits for those who qualify, and the opportunity to earn a paid sabbatical.

We value passion for justice and our issues, creativity, and initiative. Expect to work in a fast-paced environment and balance multiple priorities.

Women, people of color, and LGBTQ persons are strongly encouraged to apply.

Michigan United is leading the fight to defend the Affordable Care Act, Medicaid and Medicare.  It’s not enough just to defend the status quo, so we’re also working to win universal affordable child care, elder care, and paid family leave.

The Health Care Organizers will work to recruit and train volunteer teams that lead campaigns to provide affordable care to all. We use direct action, earned media, and power of real people’s stories and leadership.

Prior experience in community or political organizing a plus.

Send resume and cover letter to Meredith@miunited.org, cc: Rebecca@miunited.org  

Subject: Health Care Organizer

Michigander Testifies on Capitol Hill about Impact of Medicaid, Medicare, and the Affordable Care Act

Michigan United member and MS patient Ann Serafin of Ferndale shares her family’s care story

Michigan United member Ann Serafin joined with members of the national coalition “Caring Across Generations” in a special Senate hearing about why proposed changes and cuts to Medicaid, Medicare and the Affordable Care Act would hurt their lives, and the lives of millions of Americans. The forum was organized by U.S. Senator Debbie Stabenow (D-MI), U.S. Senator Elizabeth Warren (D-MA), and U.S. Senator Patty Murray (D-WA).

For many seniors, middle-class families, young adults, and people with disabilities, these three foundational programs are integral to their health care. Even at their current levels, these programs are not strong enough for the growing senior population, or Elder Boom. Now, as Congress threatens to cut these vital lifelines, Caring Across Generations members and many other Americans who benefit from these programs are coming together to urge Congress to make our care system stronger, not weaker.

Ann Serafin, also a member of Michigan United, made the trip from Ferndale, Michigan, to explain how she was able to address her own health needs on top of managing the care of her mother who had dementia. Diagnosed with MS at age 40, Ann lives at home with her husband, who is her primary caregiver.

“Without Medicare or secondary insurance, the medication I take to keep my MS symptoms in check would cost about $75,000 a year,” she says. “Without Medicare, I would have had to decide: do I eat, or do I get my meds?”

Ann and her husband also financially supported Ann’s mother, who relied on Medicaid for her nursing home care until she passed away last year at the age of 98. “I couldn’t care for her complex care needs; I needed help for my own care,” said Ann. “Even a barebones nursing home would have been too much for us at $6,000 a month. It was only because of Medicaid that she was able to get the help she needed at the end of her life.”

Whether provided at home or in an assisted living facility, quality care can break the budgets of American families. The high costs of care, in addition to serious threats to the limited social safety net programs that support care, mean that more than ever, our caregiving families need more support, not less.

Small business owner Holly Jensen, from Cleveland Heights, OH, also understands the importance of these vital programs. She traveled to Washington to speak about how Medicaid saved her life. Untreated anxiety and mental health issues nearly destroyed her ability to run her business, as well as her connections to her family and her community.

“I had to cancel an important work trip at the last minute. I couldn’t do it. My anxiety was getting out of control, and the worse it got, the more out of control my OCD got. It was a downward spiral from there.” It wasn’t just her business that suffered under the weight of her untreated condition. She withdrew from being an active volunteer in the local arts community.

Through Medicaid, Holly was able to rebuild her business, her relationships, and her life. “This care not only saved my life, but it also gave me back my life. Thanks to Medicaid, I am becoming the professional I want to be again – and the person I want to be again. Without it, I know I would have eventually depended on emergency care, taxpayer-funded rehab, and the legal system. I would have cost taxpayers much more than the expense of my basic care now.”

Ann and Holly’s stories reflect the experience of millions of Americans who have benefited from Medicare, Medicaid, and the Affordable Care Act. Protecting and strengthening these programs is bigger than any political fight – it is about people’s lives. We are at a moment in our country where we need to be moving forwards, not backwards. “I hope that Congress hears us, and does what the majority of us actually want them to do. The Caring Majority is greater than any political divide,” said Ms. Jensen.

Michigan Residents Tell Rep. Trott “Don’t Take My Health Care”

Families Protest Plans to Repeal Affordable Care Act, Wreck Medicare and Medicaid

Carrying signs saying “Don’t Take My Health Care”, dozens of Michiganders rallied outside of Rep. David Trott’s office in Troy to protest an expected vote early in January to repeal the Affordable Care Act (ACA), which would take health coverage away from nearly a million Michigan residents.

“I’m asking Rep. Trott not to take away the health care my family relies on every day,” said Karen Houghton of Huntington Woods.  “This isn’t just politics anymore– repealing Obamacare would strip health care away from millions of real people like my son and put us back at the mercy of private insurance corporations.”

“Taking away Obamacare will also jack up the rates of everyone with insurance, and put the insurance companies back in charge of our health care.” said Houghton who once worked as a hospital administrator.

Hear and download audio from the press conference

The demonstration, organized by Michigan United and co-sponsored by MoveOn.org, came to protest plans in Congress to cut $1 trillion from state funding for Medicaid and replace Medicare with a limited voucher for private insurance. Trump’s pick for Secretary of Health and Human Services, Rep. Tom Price (R-GA) has been a leader in the effort to repeal the ACA, slash federal funding to states for Medicaid and privatize Medicare.

“Congress is rushing through a plan that would take away health coverage from 30 million people across the country,” said Julia Galliker of Michigan United. “Repealing the Affordable Care Act is a first step in a campaign to slash state funding for Medicaid and turn Medicare over to Wall Street. Insurance companies would make huge profits while seniors get a skimpy voucher for private health insurance, with huge out-of-pocket costs for seniors and big limits on choice of doctors and hospitals.”

“Without the protections of the ACA, the insurance companies could discriminate against my son and others with pre-existing conditions – denying coverage for any reason and raising rates at will.  Ultimately he could be the unfortunate victim of medical bankruptcy.” Said Houghton, whose son was born with hydrocephalus, a disorder commonly known as “water on the brain”. She credits the protections of the ACA for his progress. “ I am so proud to say that our son has successfully coped with these medical challenges to become a productive member of the workforce and very recently began living independently.”

The protest is one of hundreds being held around the country as members of Congress return from Washington to their districts for the holiday recess.

“This is the beginning of a fight to protect the health care and security of every American family and we are not going to stop as long as politicians like Rep. Trott continue their plan to take away our health care.” said Galliker. “Instead of repealing the ACA, and ruining Medicare and Medicaid, lawmakers should strengthen the Affordable Care Act, Medicare and Medicaid by lowering our deductibles and standing up to the health insurance and drug corporations.”

Doctors, patients speak out to protect the Affordable Care Act

Repeal threatens health care for more than million in Michigan

President-elect Donald Trump has pledged to repeal the Affordable Care Act (ACA), but what will this mean to the more than one million people in Michigan who benefit from the program known as “Obamacare”.  Doctors and patients alike are concerned with the impact of such a precipitous loss of coverage.

“The most important costs that we should consider are human.” said Dr. Anthony Spearman who practices internal medicine at Providence-St. John in Detroit. I am scared because the protections of people with pre-existing conditions could be eliminated, leaving millions of people who need it without insurance.” Rather than jeopardizing the health care program, Spearman believes politicians should take the successful model of the Affordable Care Act and work to address its issues and expand it.

Click here to hear and download audio from the tele-press conference

More than 393,000 people in the state of Michigan are currently enrolled in the individual government-run marketplace. Another 615,462 people are currently enrolled in the Healthy Michigan plan.

One of them is Herman Starks.  He says the uproar around the issue before the President has even been inaugurated is unprecedented but expects public resistance will be too. “I want to reach out to Trump voters. We have a lot to talk about. I’m sure we’ll all be having a robust conversations over the holidays.” said Starks. “We have common ground, and we have to start our fight from that common ground. We will fight tooth and nail, and with all our strength to save access to affordable health care. And we need everyone with us.”