Friday, June 01, 2007

Letter to the AG: Changes in pill appearance pose potential danger for consumers

Mary Woolford to Attorney General Marc Dann, June 1, 2007
Subject: Pharmacy generic drug packaging
Dear Mr. Dann,
I am a retired teacher who uses the mail-order pharmacy system authorized by STRS. At the present time, that company is Caremark.
Yesterday, I received a packaged prescription for a drug I have been taking since 1988 for depression. I take a 10 mg. capsule at noon and a 25 mg. capsule at bedtime. They have differed in color and size for years. Well, yesterdays' refill for the 25 mg. capsule came, and it's the SAME color as the 10 mg. and is SMALLER.
For years, there was no danger of confusing the dosage, due to the different colors and sizes, but now, the larger size is the SMALLER DOSAGE, and the smaller size is the LARGER DOSAGE! And, they are now both the SAME COLOR! Boy, I'll have to watch carefully, or I will mistakenly take too much and that will be a disaster, as this is a psychotic drug that alters the brain chemistry. It's the generic form of Pamelor, which I don't object to using, but I DO object to this new wrinkle and will have to use a magnifying glass to see the numbers 10 or 25 clearly so as not to confuse them.
The size difference is subtle enough that they could be mistakenly considered the same dosage. I don't need more complicated things to figure out with such a serious thing as medicating myself using my doctor- recommended prescription drugs. I am concerned about older retirees who may be less sharp than I am and the danger of putting them in the same predicament with their drugs, which could lead to accidental overdosing. It's scary, and I think it's a concern that needs to be carefully looked at by those who are in a position to require companies to adhere to specific regulations that will prevent seniors from being put in jeopardy with their use of prescribed drug treatment.
I will add that the prescription was accompanied by a letter stating that the appearance of the drug was different from before, but that disclaimer statement doesn't excuse drug companies from the fact that such confusion could easily result in accidental death for some unfortunate retiree.
I appreciate anything that you can do to see that generic drug companies conform to some stiffer regulations that will help the consumer and not further complicate the correct use of medications.
Mary F. Woolford
Delaware, OH

Nancy Hamant to Rep. Michelle Schneider re: HB 151

From Nancy Hamant, June 1, 2007
Subject: HB 151
To: The Honorable Michelle Schneider
From: Nancy B. Hamant
Dear Michelle:
I am again writing to you to vote against HB 151. It unfairly puts the burden of fighting terrorism on only those who hold public pensions. The federal government has not asked Americans to sacrifice in this manner, let alone one portion of its citizens. This is a case of well-meaning intent gone wild with ramifications that will impact public workers who are not known to have high salaries--especially teachers. The impact of this bill on the STRS retirement system will hurt our most elderly members at a time when they are struggling with constantly increasing health care premiums and diminishing health care services.
Please, please stop this bill -- as it unfairly targets only public pension holders! I look forward to your response on this matter.
Nancy B. Hamant
(Address, phone no.)

Shirlee Zerkel and Damon Asbury re: Medicare Advantage Plan

From Shirlee Zerkel, June 1, 2007
Subject: Re: Questions!
Damon, in an email to me earlier in the week, said that Board members would be receiving some information on the Medicare Advantage Plan in June. Now in this email, he says that Knoesel says it won't be until August that it will be released. That does not give board members time to digest the information to see if it is good for STRS and the retirees. Here we go again, Shirlee
Damon Asbury to Shirlee Zerkel, June 1, 2007
Subject: RE: Questions!
I spoke with Sandy Knoesel this morning regarding your question and she indicated that specific information about the potential pilot of an Advantage plan will not be available until the August Board meeting.
From Shirlee Zerkel, May 31, 2007
Subject: Re: Questions!
Dr. Asbury:
Thank you for such a quick response from my last question. Since the board will be given some information in June, when can I expect the Member Benefits Dept to be able to answer at least some of my questions.
Shirlee Zerkel

From STRS: Investment Divestment Bill Affecting STRS Ohio Scheduled for June 5 House Vote

From STRS, June 1, 2007
Subject: [News] Investment Divestment Bill Affecting STRS Ohio Scheduled for June 5 House Vote

Substitute House Bill 151 was voted out of the Ohio House Financial Institutions, Real Estate and Securities Committee on May 30 and is now headed for a vote by the entire House of Representatives on Tuesday, June 5. This bill requires the state's five retirement systems, including STRS Ohio, to divest of investments in foreign companies doing certain types of business (oil production, mineral extraction, power generation or military equipment) in Iran and Sudan. The bill only affects the public employees and retirees in the public pension plans and no other investment funds.
As this bill was discussed in House committee meetings, STRS Ohio's executive director, Damon Asbury, testified in opposition to the bill. The Retirement Board and staff of STRS Ohio understand the important issues this bill is attempting to address. And, like the bill's sponsors, we strongly condemn the acts of the governments of Iran and Sudan in support of international terrorism, nuclear buildup and genocide. STRS Ohio holds nearly $19 billion in global international investments, BUT no direct holdings in the governments of Iran or Sudan or businesses based in those countries.
However, we stand in opposition to this bill as written as it places the Retirement Board's fiduciary duty to its members secondary to the goals of this legislation. The money in the pension trust fund belongs to the members. This divestiture mandate puts a foreign policy objective above the board's fiduciary duty to invest in the sole interest of the membership. In addition, it sets a dangerous precedent of using trust fund money to try to achieve a political or social agenda -- no matter how noble or well intentioned.
We also object because any investment losses we experience as a result of this mandated divestment come out of the pension fund. There are no explicit constitutional guarantees in Ohio requiring the state to make up those losses. Under the provisions of Sub. H.B. 151, it appears that more than 70 international companies may be affected. A preliminary review shows that STRS Ohio has investments in 41 of these companies, with a market value of $1.5 billion. The bill does cap system losses to
0.5%. However, that would translate to a $375 million loss on our current $75 billion investment fund before we could halt divestment activities.
Some proponents point to a fund in Missouri that posted positive returns following divestment. However, this is a $30 million fund, not a $75 billion fund and the results are very short term. We project that our future losses could be up to $75 million annually.
Some proponents of the bill also believe that the pension funds are putting members' money at risk by investing in companies that are doing business in Iran and Sudan. However, investment professionals, such as STRS Ohio's staff, take these issues into consideration when making investment decisions, balancing risk and potential return. Further, the companies on the list are multinational companies (e.g., Royal Dutch Shell) and have investments throughout the globe, which provides overall protection to them -- and to their investors.
STRS Ohio members wishing to voice their opinion about this bill can obtain information via the following link:
Contact information can be found at this site by using representatives' names, district number or ZIP code or by accessing a complete House directory. E-mail or a phone call may be the best form of communication since the vote is currently scheduled for next Tuesday.

Thursday, May 31, 2007

To our next Prez....."Deal With It!" (Health Care Reform)

From Frank Kaiser (Suddenly Senior), May 31, 2007
Subject: Next President Must Be Able To Achieve Compromise on Health Care Reform, Opinion Piece Says
The "similarity of the emerging" health care proposals by presidential candidates shows that "a road forward is being paved and a growing number of people from across the political spectrum are on it," according to New York Times guest columnist Atul Gawande, a surgeon at Brigham and Women's Hospital and a New Yorker staff writer. According to Gawande, the "road ... follows the lead of European countries ... that provide universal coverage (and more doctors, hospitals and access to primary care) through multiple private insurers while spending less money than we do."
Gawande writes, the "proposals all define basic benefits that insurers must offer without penalty for pre-existing conditions" and provide coverage for preventive care and cost-saving programs to help patients manage chronic diseases. The plans also "embrace what's been called shared responsibility" -- requiring that individuals obtain health insurance and that businesses provide health benefits to workers or pay into a subsidy fund, Gawande says. He adds, such a system "seems to be our one politically viable approach."
According to Gawande, "attacks are certain to label this as tax-and-spend liberalism and government-controlled health care." The "crucial matter is our reaction as a country when the attacks come," Gawande writes. "If we as consumers, health professionals and business leaders sit on our hands, unwilling to compromise and defend change, we will be doomed to our sliding global competitiveness and self-defeating system," Gawande says. He concludes, "The ultimate measure of leadership ... is not the plan" but "the capacity to take that plan and persuade people to find common ground on it. The politician who can is the one we want" (Gawande, New York Times, 5/31).

More is less and less is more? Be careful if they switch your pill size and color!

From a retiree, May 31, 2007
I'm glad to read that some finer points dealing with our drug coverage, etc. are being investigated and "someone" will have to give us answers to our questions. Since Medicare deductibles are set by the government, we can't do anything about that, but we do need to keep a sharp eye on the pharmacy STRS chooses for us to use.
Today, I received a prescription for a drug I have been taking since 1988 for depression. I take a 10 mg. capsule at noon and a 25 mg. capsule at bedtime. They have differed in color and size for years. Well, today's refill came and it's the SAME color as the 10 mg. and is SMALLER. For years, there was no danger of confusing the dosage, due to color and size, but now, the larger size is the SMALLER DOSAGE, and the smaller size is the LARGER DOSAGE. And they are now both the SAME COLOR! Boy, I'll have to watch or I will mistakenly take too much and that will be a disaster. It's the generic form of Pamelor, which I don't object to, but I DO object to this new wrinkle and will have to use a magnifying glass to see the numbers 10 or 25 clearly and not confuse them. The size difference is subtle enough that they could be mistakenly considered the same dosage. I don't need things more complicated to figure out. I wonder if some retiree older and less sharp than I am might be in the same predicament with their drugs and could easily overdose. It's scary!
[Note: I have contacted this person and urged her to contact the Attorney General's office about this situation. This is serious. KBB]

STRS Board Minutes: 4/18, 4/19/07: Finance, Investment, HC

FINANCE: Bob Slater
2007-08 budget comprised of 4 components: operating expenditures, capital expenditures, Legacy replacement project and State of Ohio requirements. Total organization budget is made up of 5 major department budgets: Admin., Exec., Finance, Member Benefits and Investments. Each dept. budget was prepared and reviewed by Exec. Direc, Deputy Exec. Direc. and the controller after which, addt'l reductions were made to the total organization budget. ((For ques. on these titles and budgets: ask STRS. Send questions to Joyce Baldwin , email listed above.))
Expenditures in the investment division accounts for 6.4% of the 8.5% overall increase over this year's budget. Also, the staff expects to spend $6.4 million on the Vitech project replacing obsolete Legacy pension management sytem. State of Ohio charges from the Attorney Gen., ORSC and the Treasurer are projected at $437,600.
The operating budget included a 4% inc. in wages and salaries for merit and promotional increases awarded based on indiv. associate's performance. The budget recommends 9 new positions, 6 of them in the Investment Dept., 2 in Members' Benefits and 1 in Internal Audit.
Increases in investment expenditures are due mostly to:
1. change in Retirement Board made to the Investment Performance Incentive Program in 2006 increasing next year's operating budget by $3.85 million. The maximum incentive payments are only awarded when relative performance exceeds market returns.
2. Cost of investment research services. Previosly, a portion of commission dollars (soft dollars) on security transactions were used to pay for some investment research services. Paying for investment services with cash instead of soft dollars is considered a 'best practice' in the investment industry and adds transparency to the cost of investment services. STRS has been transitioning these services to the operating budget over the past several years .
Significant decreases are reflected in non management associate's awards, Retirement Board expenses, other consulting services, supplies, materials, phone and printing.
Childcare: The center will be cost-neutral during the 2007-08 fiscal year.
Staff was asked to consider the Board's summary of requests and make addt'l adjustments to the budget. The proposed budget was sent to the ORSC on 4/23 in accordance with ORC. The Board will be asked to approve the budget in June. (6/14: STRS Board Meeting)
Board's Summary of Requests:
1. Brooks: asks to reduce salary and wages based on positions throughout year. Future discussion on why alternative investments are at 3% vs. higher with other pension plans.
2. Leone: asks staff to provide further info including positions description and salaries for the 9 new positions.
3. Board directed staff to continue to look at areas where the budget could be reduced.
INVESTMENTS: Steve Mitchell
Total fund return for fiscal 2007 year to date is a strong 14.6% with strength being seen in all asset classes. Some pullback is expected from the strong equity returns thus staff has positioned the fund underweighted in overall equities.. In addition, liquidity reserves remain significantly overweighted (to protect funds.)
Board conducted its annual review of the Investment staff's Incentive Performance Based Incentive Program for 2008 with 2 changes:
1. add a purpose to indicate that the total compensation (base salary and incentive bonus) target for Investment Dept. associates needs to remain current with private market levels at the 25th %
2. add job positions to Appendix A to keep the document current
Brooks moved and Meuser seconded a motion to approve the Performance Based Incentive Program for 2008. All approved except Leone and Chapman who voted no.
HEALTH CARE: Greg Nickell , Direc HC services: Comparison of Retiree HC Programs: Included are the 5 Ohio Pension Systems, CA (CalPERS), Colorado PERA, Illinois TRIP, Kentucky TRS, Massachusetts TRS, Texas TRS and Michigan Public SERS.
Ohio Systems: Majority are Medicare enrollees. The 3 largest Ohio systems are collectively engaged in the pharmacy benefit manager request for proposal and represent 92% of the retirees on Ohio Retirement Systems (ORS). The costs of the ORS HC programs are similar: for ex., the average spent on RX drugs in 37% of gross costs.
Medicare Part B in SERS is allocated under pension funding.
HC funding for the ORS plans: STRS is in the best position to create long term funding with its HC legislation initiative. SERS has .03 for every HC dollar needed to fund the benefit and its annual required contribution
(ARC) is nearly 28%. OPERS reported it is funding its HC benefit by only about 17%. OPERS has significantly higher per month costs because its enrollees share less of the cost. SERS costs are much lower because of the large number of Medicare retirees.
Puckett asked if there would be a separate fund for Medicare Part B if HC legislation is passed. Knoesel said that is one option because the $29.90 reimbursement for Part B are required by statute.
Nickell went on stating most of the retirement systems offer Indemnity Plans like STRS Ohio and have 3 tier RX plans to encourage generics. Leone asked why we were at the top of the costs for mail order benfits. Nickell said copays are part of cost sharing. Leone asked why Tier II drugs are so high. Ans: The Board sets the copays. Leone said the Board did not know other systems Tier costs when it sent the copays. Knoesel said RX drug costs are reflected in premiums. If copays are lower, premiums have to be raised. Dr. Leone asked where Caremark is in this. Nickell said staff negotiates with overall costs with Caremark.
Nickell continued saying most states do not have out of pocket maximum protection for RX's. STRS does have maximum out of pocket protection for enrollees as part of the plan design.
Zero premiums in KY and MI : Both states offer a Medicare Advantage program which STRS is investigating. These plans generally have restricted networks and fewer covered drugs.
OPERS is targeting solvency range of 15-25 yrs using a plan design indexing and established an inflation protector provision. When HC inflation exceeds wage inflation, up to 5% of that difference can be passed to enrollees. Worse case scenario is someone could have 100% subsidy today and in 10 yrs have a 50% subsidy.
The Board requested more info:
1. how RX drug copays are set
2. subsidies for premiums provided by other systems'
3. examples of how OPERS subsidies will work in future.
Framework for 2008 HC: Knoesel
1. manage STRS HC keeping in mind the new guiding principle approved in
3/07" Maintain or improve the solvency of the HCSF (Health Care Stabilization Fund) in working toward a 30 yr funding period.
2. consider only plan design enhancements that maintain the annual required contribution at or below 5% (contributions based on HC legis.) for the HC program.
3. continue the 2004 member premium contribution strategy in 2008.
4. facilitate understanding of the legislative initiative by sustaining current plan design while legis. is under way
5. continue current benefit structure until program costs require using principal from the STRS HC Fund projected between 2009 and 2011 if legis. is not successful.
Plan design changes to reduce premiums or deduc. have little impact for retirees. For ex., if deduc. for the Plus Plan increased to $1000 from $500, enrollees would see a $5 reduc. in premiums. per month because many enrolles never reach their deductible.
Johnson asked how negotiations are going for the PBM. Knoesel is optimistic and hopes to have a recommendation to the Board in June.
Options will be voted on by the Board in June which were presented in May. Premiums provided in August for Board's consideration.
Nickell stated the passage of HB272 allows systems to create medical savings programs and 8 core elements are necessary for a program to provide relief of significance to members for future HC costs.:
1. non employer entities such as STRS allowed to administer.
2. accounts avail. to retirees
3. members can participate regardless of employer/employee HC programs
4. participating member contrib. and withdrawals are tax deduc.
5. STRS should offer clear advan. t participating members over current programs avail in marketplace
6. program should gain broad based participation
7. accounts expected to become significant future resource for paying HC costs in retirement
8. clear enabling IRS ruling when required
5 Major Components that allow indiv or employer to fund some type of account:
1. FSA allows employee to defer a portion of salary to be used for qualified medical expenses during a year. If not used, it is lost. ((Add up what you know you will spend in a year for HC, RX. Say it is $3000. STRS would deduct that amount from your ck in 26 equal payments or approx. $116 each ck. If you have surgery and can present bills for your deduc. $500 and your $1500 out of pocket for the year, you can get that amount at any time during the year even if it is in Jan. to pay for these costs. But, the monthly deductions of $116 will continue throughout the year. It is like setting aside an amount for your HC and making payments for a year but you can withdraw any or the entire amount as bills come due. We use this thru John's work to pay for out of pocket costs vs. coming up with the entire amount at once. You should only do this for known costs as if you miscalculate you forfeit the amount. The amount you have withdrawn is NOT taxed and NOT part of your reported taxable salary to the IRS. Just FYI should your spouse have this plan offered at work)).
2. Health Reimbursements Arrangements (HRA) limited to employer contributions and are not portable.
3. Archer Medical Savings Accounts (MSA) tied to high deduc. plans with RX plan. Employer must have 50 or fewer employees.
4. HSA (Health savings Acconts) must be tied to high deduc. plan with RX plan. If STRS would offer this, the RX plan would be subject to a $1500 deduc. BEFORE any copays are offered.
The plan would have to be split between retirees and actives.
5. Retiree Medical (Savings) Accounts (RMA; RMSA) establ thru voluntary employee beneficiary assoc. (VEBA) or a Section 115 trust account. OPERS has set up this account. Indiv. can make contributions but recent IRS rulings suggest they will not be tax deduc.
STRS can only offer HSA or RMA. No recommendation is being made at this time as these plans do not offer all essential elements for success nor broad appeal for widespread enrollment.
Meuser asked about OP&F and DROP plan (Deferred Retirement Option Plan). STRS decided that a Partial Lump Sum Option Plan (PLOP) better suited STRS members and has been implemented at STRS due to structure differences as OP&F has a higher mulitplier at the beginning of the career which benefits their members.
Other issues and speakers were reported after the 4/07 Meeting.

Letter to Senator Goodman re: HB 151

Kathie Bracy to Sen. David Goodman, May 31, 2007
Subject: Please do not support HB 151
Dear Senator Goodman,
For all the reasons listed in the Dispatch editorial below, please do all you can to defeat HB 151. To pass such legislation is irresponsible and would do untold damage to Ohio's pension systems, and subsequently to Ohio's economy.
Thank you.
Kathie Bracy
STRS Retiree
(Address, etc.)

Columbus Dispatch: Ohio pension systems divestment bill a "bad idea!"

A bad idea
House should kill bill forcing pension funds to divest Iran-linked holdings
Columbus Dispatch, May 31, 2007
Although states have substantial powers in many areas of government, the Constitution makes clear that exercising foreign policy is not one of them. U.S. relations with other nations should be directed by the president and Congress, not 50 governors and state legislatures.
That's the principal reason why House Bill 151, which yesterday was passed by an Ohio House committee, is such a bad idea.
The proposal would mandate that Ohio's five public pension systems divest their portfolios of investments linked to Iran.
Federal policy already forbids U.S. companies from doing business in Iran, but a number of U.S. corporations have some commercial link to the Islamic republic because of overseas partners and subsidiaries that do business in Iran.
Stripping Iran-connected companies from investment funds is complicated and senseless. If House Bill 151 were to become law, the systems would be required to review billions of dollars of investments to purge some of their holdings, generating significant transaction costs.
And to what end? Freeing Ohio's pension funds of links to Iran will make proponents feel good, but there's no guarantee it will have any influence on the hard-line Islamists running Iran.
However, there's a real chance this measure could cost the pension systems money by forcing investment decisions that aren't in the best interests of Ohio retirees.
House Bill 151 proponents detailed in committee hearings the wrongdoing by Iran, such as support for terrorists, threats to annihilate Israel and other examples of extremism. But there are a number of rogue nations with lawless leaders and vast human-rights violations. Pension funds should not be expected to manage portfolios based on behavior of foreign governments.
The purpose of pension-plan investments is to generate growth in assets, not to manage foreign policy.

At least they don't have him teaching ethics courses!

Ex-Gov. Taft takes job at University of Dayton

Gov. Taft a
teacher? Why do I feel doubly betrayed? KBB

Thursday, May 31, 2007

By Mark Niquette
The Columbus Dispatch
Former Gov. Bob Taft has a new job.

Taft will launch the Center for Educational Excellence at the University of Dayton to encourage students to study science, technology, engineering and mathematics and to attract research funding on educational policy issues for the center, the university announced today.

He also will serve as a guest lecturer at the university, although those details still are being finalized, university spokeswoman Teri Rizvi said.

It's a two-year appointment starting Aug. 15 with the option of a renewal, the university said. Rizvi declined to disclose Taft's salary, saying the university is a private institution.

Taft, a Cincinnati native, and his wife, former First Lady Hope Taft, will move to the Dayton area this summer, the university said.

''The opportunity to help more students succeed is one of the reasons I ran for governor,'' Taft said in a release. ''It's my passion and was a priority throughout my administration."

Taft, 65, served two terms as governor before leaving office in January. Among the accomplishments he cites are instituting higher education standards and a more rigorous high-school curriculum with more math and science requirements.

"Improving the quality of math and science education is critical to the future of our country," Taft said.

Thomas Lasley, dean of the School of Education and Allied Professions, said in a release, ''As governor, Bob Taft provided significant leadership on education issues and took important strides toward ensuring that Ohio had the conditions necessary for both student and teacher success.

"His initiatives created a solid foundation for much of the very good work that is continuing throughout the state of Ohio under the leadership of Gov. Ted Strickland."

Taft holds a bachelor's degree in English from Yale University, a master's degree in public affairs from Princeton University and a law degree from the University of Cincinnati.

He taught English, math, geography and art to children in Tanzania as a Peace Corps volunteer for two years after graduating from college. He was a Hamilton County commissioner, a state legislator and Ohio secretary of state before being elected governor in 1998.

Wednesday, May 30, 2007

Damon's report to STRS Board re: HB 151

From Damon Asbury, May 30, 2007
Subject: HB 151
Despite extensive opposition testimony from four of the five Ohio pension systems, HB 151 was reported favorably out of the House Financial Institutions, Real Estate and Securities committee this morning. (Ohio Police and Fire has taken a neutral stance from the beginning on this bill). I testified twice on the fiduciary and financial impact issues of the divestment from companies doing business with Iran and also Sudan. The bill was scheduled for action on the House floor tomorrow, but the session was cancelled. At this time, it is not certain if the House will now meet and vote on Friday or hold the vote until next week.
The systems were successful in helping to modify the original bill by limiting the scope to foreign companies doing business in oil production, mineral extraction, power generation or military armaments. The bill sponsors estimate that divestment will involve 20 or fewer companies, but our estimate is that it might affect investments in 70 or more companies. An amendment was approved that caps system losses to 50 bps. However, that would translate to a $350 million loss before we could halt divestment activities.
We will be sending each House member a special communication outlining our concerns tomorrow morning, so that they will have a clear picture of the impact prior to their vote; however, we will now have to turn our attention to the Senate. We will communicate with our members via e-mail alert and the web page so that they can express their opinions to the Senate members.

Shirlee Zerkel to Gary Russell: Questions about new option proposed Advantage plan

From Shirlee Zerkel, May 30, 2007
Subject: Questions about new option proposed Advantage plan
Hello Mr. Russell,
I wrote to Mr. Asbury with some questions about the new optional Advantage Plan and he wrote back saying that he had turned it over to some of the staff.
Can you enlighten me any about how this plan will work?
I am concerned that it could become a financial problem for STRS in the future. I understand that there would be a subsidy for STRS if they would implement this plan.
  1. Would that be a one time subsidy or every year that STRS offers it to their retirees?
  2. Would it be based on just because STRS offers the plan or is the subsidy based on the number of members who sign up for the plan?
  3. I understand the subsidy is 12 to 14%. My question is 12 to 14% of what?
  4. If a member would be unhappy with the plan, would that retiree be able to switch back to traditional Medicare?
  5. What would STRS be responsible for in this plan?
  6. Would the retirees in the plan be restricted to in-network providers?
  7. How would the Medicare B premium payment be handled?
  8. Is it true that only retirees who have both Medicare A and B are eligible for this plan?
Thank you for considering my questions,

You know the healthcare situation is bad in Ohio when ..........

Police: Women Trade Identities For Emergency Health Care
Tuesday, May 29, 2007
By Denise Yost
COLUMBUS, Ohio -- A local woman lent her name and Medicaid card to an uninsured friend for hospital treatment, but it didn't take too much detective work to determine that something wasn't right.
Sabrina Wilson wanted to help a friend with an injured ankle, and according to police, she accompanied that friend to Mount Carmel Hospital's emergency room over the weekend, NBC 4's Patrick Preston reported.
Inside, she reportedly lent her identity and Medicaid insurance card to her friend.
Hospital records indicated that Wilson is black. The friend claiming to be Wilson was white.
According to police, the two women admitted what they had done, but only after the injured friend received treatment, Preston reported.
"People are desperate to get health care and they can't pay for it," said Cathy Levine, of Universal Health care Action Network of Ohio.
Levine said she sees the incident as being indicative of a broader problem, which she summed up by saying that people shouldn't have to commit crimes to get healthcare coverage.
"Ohio has to figure out how we're going to provide health care for the 1.3 million Ohioans who do not have access to affordable health care," Levine said.
Patients aren't the only ones feeling the effects. Hospitals are losing money on insurance fraud and can't deny care to those in need.
The problem doesn't end with the hospitals. Physicians said that switching insurance identities is dangerous because a patient could end up being treated based on their friend's health problems.
"We could pick a wrong medicine," said Dr. Ed Boudreau. "We could pick a wrong treatment regimen."
Police said they have not filed charges in the case.
Ohio hospitals offer free care programs for anyone who is living at or below the poverty level.
The majority of hospitals offer free care or charity care for uninsured or underinsured emergency patients.
If it's not an emergency situation, patients can contact a hospital ahead of time to check.

Tuesday, May 29, 2007

Peter Bronson responds to Tom Curtis re: Competition Makes Better Mouse Trap

From Peter Bronson, May 29, 2007
Thanks for the note. No, I don’t understand public school funding as well as people who work in the system, but I have been covering education in Ohio for 15 years, so I do know something about it, and my commentary is not uninformed, it just presents an opinion contrary to yours, apparently. The motives of people who support choice are not originating from greed or contributions – they believe as I do that it is about time that public schoiols were forced to compete and held to more accountability. Some charter schools have failed – but overall, studies show they do as well or better than public schools at far less cost (70 percent of funding and no capital support from the state). As I said, the competition has been healthy, and it has improved public schools in other places where it has had more time to work.
Best wishes,
Peter Bronson

75,000 Registered Nurses give "thumbs up" to Sicko!

“Sicko” offers“inspiration, vision, and hope and the nurses of CNA/NNOC look forward to working with Moore to bring that promise to all Americans,” DeMoro said.
Source: The California Nurses Association
For Immediate Release May 19, 2007
Nurses Welcome Arrival of "Sicko" - Michael Moore’s Stunning New Film Could Help Reframe the National Healthcare Debate Michael Moore’s tour de force on the U.S. health care crisis – which premiered to overwhelming acclaim today in Cannes – could help “reframe and move the national healthcare toward genuine reform for a more humane healthcare system,” California Nurses Association/National Nurses Organizing Committee Executive Director Rose Ann DeMoro said today.
DeMoro notes she was “privileged to get to be among 50 people” mostly those in the film or who worked on the film who were invited to an intimate special viewing of “Sicko” this week in New York. She called the film both an “indictment of an indefensible healthcare industry in the U.S. and a rejoinder for those who think we can fix the soulless monster by tinkering with an unconscionable system.”
The film, she said, “should bolster the spirits of those dedicated to achieving fundamental reform and embarrass those who promote the lowest common denominator with proposals that reinforce the existing system.”
“Sicko” presents an emotional portrait of an array of people, including volunteer rescue heroes of the September 11 attack, who are denied needed care – despite the fact that most are insured. And it points a finger at the source of the crisis, a profit-driven insurance industry whose “biggest accomplishment is buying our U.S. Congress” to prevent real reform.
The film also presents a solution to the crisis – the type of medical system in place in other industrialized countries, where care “doesn’t depend on your premiums, it depends on your needs.” Such a transformation in the U.S., said DeMoro, “is not just a dream – it’s legislation.” CNA/NNOC is campaigning for HR 676 in Congress and SB 840 in California, both of which would establish a type of an expanded Medicare for all system.
“Michael Moore has demonstrated compassion and courage in a film that, true to his career, doesn’t bend to political expediency,” DeMoro said. “He goes right at the treachery of abandoning people in our country, and contrasts that with other countries where when it comes to the nation’s health, they know the distinction between the ‘we’ and the ‘me’. “Sicko” offers“inspiration, vision, and hope and the nurses of CNA/NNOC look forward to working with Moore to bring that promise to all Americans,” DeMoro said.
The California Nurses Association/National Nurses Organizing Committee represents 75,000 RNs from California to Maine. Learn more at
View original article here

Tom Curtis to Peter Bronson re: Competition Makes A Better Mouse Trap

From Tom Curtis, May 26, 2007
Subject: 052607 Curtis To Bronson, Re Competition Makes A Better Mouse Trap
Mr. Bronson,
After reading your article, it is very apparent that you know little about the past and present operation and spending of public schools, how programs are funded and the rules and regulations public schools must operate within. However, in your defense, unless you have been an educator and experienced first hand how our public schools operate, you could not possibly understand what problems public schools deal with on a daily basis.
Private, charter and magnet schools do not and most have not operated under the same rules as do public schools. So I ask you, where is the comparison? Many charter/magnet schools have not accounted for the money they received from the state, and have failed to provide test results of the students' knowledge gained. Why? You are making an uneducated and unfair comparison in your article.
Further, the reason that charter/magnet schools are so abundant is due to the out of control pay to play system those in our state legislature have set up over the past 16 years.
I will ask you to take a good look at those in the legislature that are the strongest supporters of charter/magnet schools and you will find that those legislators are the ones most often supporting the pay to play system. All they are concerned about is how much they will receive towards campaign donations in return for their support. This type of pandering should be dealt with and eliminated, but our legal system has become a pay to play system as well.
There is hope, though. Our last election eliminated many of those greedy legislators and I am hopeful the next election will eliminate the rest of them. The legislature providing state monies to charter/magnet school programs without providing for the oversight of those funds is irresponsible and crass on their part. Because of such, large sums of money provided to charter/magnet schools have been squandered or out right stolen by those in charge. Is this a good system, I don't think so, despite how you seem to misrepresent it in your article.
Thomas Curtis
Retired Ohio Teacher

A better mousetrap? ....and he STILL misses the point!

Peter Bronson to John Curry, May 29, 2007
Subject: RE: A better mousetrap?

Thanks for the note. You make some good points. Yes, the monopoly is finally getting some competition, and that is a healthy thing, because monopoly thinking persists.
Best wishes,
Peter Bronson
From John Curry, May 26, 2007
Subject: A better mousetrap?
Mr. Bronson,
I find your article below interesting and factual areas such as support for Cincinnati public schools' educators and the need for more magnet schools. We do, however, part when it comes to the concept of public schools and your use of the term "monopoly" when it applies to educating Ohio's youth. In the past, public schools have had a monopoly when it came to educating our youth with the exception of parochial schools.
Recently the concept of charter (community) schools and vouchers came into Ohio's educational picture as well as into the Ohio Revised Code. Charter schools in Ohio and elsewhere have also had a "mixed-bag" experience of success with the majority of them (as opposed to public schools) have been showing miserable results when it comes to proficiency test time -- even then the ODE has uncovered that a significant number of charters failed to adequately test all their students as required by the Ohio Revised Code.
Just recently, a minister and head of a charter school in Cleveland, Rev. Mark Olds, was sentenced to prison by a U.S. District Court for mail fraud, money laundering, and absconding with over 1.4 million dollars of an Ohio charter school's monies. These monies were our monies -- monies of Ohio taxpayers.This was all accomplished and discovered far too late thanks to the lack of accountability that is built into Ohio law when it comes to the lack of transparency that charter schools now enjoy -- all compliments of our Ohio legislature. This same lack of transparency allows charters to operate and elude many aspects of the Ohio Open Records Law that public schools are held accountable to. In addition, many charters are ruled by members of a "school board" who live nowhere in the district in which their students live AND are also members of other charter schools also miles away from their residences. Their title should really read "Board of Directors" rather than that of a school board. Charters are in business primarily to make money for the "company" and secondarily for the purpose of education. Charters are also in the business of political campaign contributions -- something (thank God) public schools are forbidden to do. The largest "chain" of charters in Ohio is headed by a major donor to the Ohio Republican Party, David Brennan of White Hat Managements. A quick visit to the Ohio Secretary of State's website will reveal his campaign donations should you be in doubt.
As for private schools, well.....they are just that. If some parents do want their children to go to private schools then they'd best be willing to pay the tab, the Entire Tab rather than have their desires subsidized by the public dole. Public schools in Cincinnati and many other areas of the state are suffering because too many politicians in this state have pandered to the wishes of a vocal minority who have had their way with their own personal wishes.... all at the expense of public schools.
Competition among all schools will be competition when the playing field is level. If public schools were allowed by law to file Chapter 11, they would have done so long ago which would have forced the Ohio legislature to deal with the educational funding problem far sooner 2007. Your "better (school) mousetrap" has yet to be discovered and won't be until taxpayer monies are totally dedicated to just education, for the sole purpose of education, and not to line the pockets of those who see education as a chance to make a fat profit off an institution that should remain totally and exclusively public. Mr. Strickland understands that, many educators and administrators understand that, and so did many voters who went to the ballot box last November 7, 2006 when they initiated wholesale change in the political landscape of Ohio. "Amalgamated Widgets" belong in the realm of the business world, not the world of education nor in the world of law enforcement, fire departments or other public services whose records and books remain open to the voting public.
John Curry
A retiree of Ohio's public schools
A member of CORE (Concerned Ohio Retired Educators)
Cincinnati Enquirer, May 24, 2007
Competition makes a better mousetrap - so why not schools?
Let's suppose Acme Widget builds a better mousetrap. People beat a path to their door and even sleep in lawn chairs overnight just to get on a waiting list.
Amalgamated Widget, meanwhile, spends millions to build new factories and gives raises to its workers - but they don't build better mousetraps. They tell customers they're stuck with the old ones and raise prices while sales drop 28 percent.
That's not from Bankruptcy for Dummies. Amalgamated Widget is Cincinnati Public Schools.
In April, Chris Kearney of Westwood waited all night to sign his son up for a popular magnet school, Dater Montessori. Kearney was first in a line of 60 parents, but he was told there was no place for his "non-black male" son, the Enquirer reported.
His son eventually got in, but Kearney said, "It makes no sense to ration something that is wildly popular."
Here's something else that makes no sense: While enrollment has dropped 28 percent in the past 10 years, CPS is spending hundreds of millions on new schools and will soon ask for a tax hike for more spending.
Obviously, CPS is not a business or it would be way past Chapter 11, somewhere in Chapter 23 of bankruptcy by now. Public schools were not created to make a profit. They were created to profit society by educating children. There are many dedicated teachers and good schools in CPS.
But Kearney's right: Why not respond to demand for more magnet schools that keep families in CPS and in the city?
Maybe it's because government monopolies don't have to care what customers want. And they don't want competition from vouchers and charter schools that do as well or better at 70 percent of the cost. So Gov. Ted Strickland is trying to give teacher unions what they want: kill vouchers and charters that give choices to poor families.
"I can't think of another government service that costs the same or less, people want it, and we're trying to take it away," said Ohio House Speaker John Husted. "The people who want to stop school choice are very well funded and in control."
Recently, state lawmakers were spammed by thousands of e-mails - all saying exactly the same thing: "I urge you to support Governor Strickland's plan to end Ohio's EdChoice private school voucher program and make sure that public money goes to public schools."
Sen. Gary Cates, R-West Chester, called it "massive intimidation" by state teacher unions.
But he and Husted said they were more impressed by a rally the same week in Columbus by 1,800 parents and children who want to save vouchers and charter schools.
"It's hard to look a child in the face who is succeeding and tell them you're taking that away," Husted said.
Maybe Ohio should borrow an idea from New Zealand: Choice for everyone.
New Zealand schools were failing 30 percent of their students, especially in poor neighborhoods. "We had put more and more money into education for 20 years and achieved worse and worse results," wrote former member of parliament Maurice P. McTigue.
So parents were allowed to choose any school - public or private - and the money would follow each student. "Again, everybody predicted there would be a major exodus of students from public to private schools, because the private schools showed an academic advantage of 14 to 15 percent," McTigue wrote. "It didn't happen."
Instead, public schools caught up academically in two years, because "teachers realized that if they lost their students they would lose their funding (and) their jobs," he wrote.
Enrollment in public schools actually increased, and student performance rose from 15 percent below international averages to 15 percent above.
Ohio is not New Zealand. But the kiwi solution could eliminate property-tax levies that superintendents and teacher unions hate, while giving families the ultimate in local control, equality and accountability.
Failing monopoly schools are mousetraps for students. Competition makes everything else better - why not education?

Some questions from Shirlee re: Medicare Advantage and a response from Damon

Damon Asbury to Shirlee Zerkel, May 29, 2007
Subj: RE: Questions!
The Board will receive additional information in June, but will not be asked to vote on offering the plan until August.
From Shirlee Zerkel, May 26, 2007
Subject: Questions!
Dear Dr. Asbury:
Is the Board going to vote in June on implementing the optional Medicare Advantage Plan? That is what I have heard.
Thank you,
Shirlee Zerkel

Back Home Again in I--....... & who owns the press!

Ah.....that wonderful Jim Neighbor's song! It almost makes you want to listen to the introduction of the Indy 500 again, doesn't it? The article below is from the Pfizer whistleblower, Dr. Peter Rost -
Like Kathie Bracy says, "It's only a blog!" It does make for some very interesting reading AND has led to resignations of some very "big buck" pharmaceutical executives for bilking the government. It might be worthwhile for you to visit when you get some spare time. Then again, it's only a blog. Then also again, he's (Dr. Rost) just a whistleblower......of course..... so was our very own Dennis Leone! Some people have to get hit over the head by a two-by-four to recognize that they have been "taken to the cleaners," don't they?
John [Curry]

Investigator of Medicaid Fraud Calls Question Authority

Dr. Peter Rost

This weekend I received a personal phone call from an investigator of state medicaid fraud. He works in the heartland. Said that the first thing he does every morning is read this blog.
Unfortunately, he said, the government agency he works for blocks web images, so he has to use his computer back home to look at the pictures in the evening.
Interesting thing is, he works in a state where a real big pharma company is very entrenched. They pretty much own that state, he said. So his colleagues aren't always real happy when he does what he's hired to do; which includes scrutinizing that big pharma company.
By now most of you with pharma experience have probably both guessed that state and the powerful drug company that owns everyone, including the press in that state. You guessed it right, the state and the state capitol both start with an I . . . and the drug company with an L . . .
The drug industry is powerful, but in some states it is more than powerful; it owns pretty much everyone. I feel bad for the people in those states.

Monday, May 28, 2007

Molly Janczyk re: STRS/CORE meetings Thursday, June 14, 2007

From Molly Janczyk, May 28, 2007
Subject: Addendum: Position Statement: STRS/CORE Meeting: Thurs. June 14, 2007
Addendum: The following is my position statement and not indicative of anyone else. I am continually saddened by the lack of some to acknowledge our help while welcoming it and soliticing it only to disparage us. I have always said I am reactive and this is my reaction based on many exhanges and lack of substance.
THIS IS NO WAY AFFECTS THAT I WILL CONTINUE TO WORK FOR RETIREES ON HCA LEGIS; IMP BILLS; PROPER FUNDING AS THAT IS FOR RETIREES AND NOT FOR ANY ORGAN. I believe we MUST continue to work on common goals FOR THE SOLE PURPOSE OF BENEFITTING RETIREES regardless of some ideology differences which matter little in their world of need. I am just airing my thoughts as we continue to be extremely unappreciated by those who should be working to befriend us. WE ARE ALL THE ORGANIZATIONS AND WE WILL BECOME THEM ONE DAY as more and more our retirees gain positions in these organ. so that we can open minds and debate to all membership encouraging support and dialogue which is our communication style.
*I am sure we can expect the usual unrelenting praise for all but the dissenting 'problematic' Board Members and any retirees on these issues or any issues for that matter not of common interests to all. While listening to this politely or tuning out, simply remember, who has gotten reductions in nearly every area, removal of those who did not provide oversight and got 'lost in translation' of the ORC, were the only ones with language in SB133 (Leone, Janczyk) and recognition for it with direction at CORE by the Gov. and sponsors at the signing and invited to be the speaker of the day (Curtis). Remember, the 'press' we exherted to remove investment appointees: Fisher and Meyers for their corporate thinking of: "Who does it hurt" regarding doing business with companies convicted of with Ethics Violtions (Fisher) and who responded: "It's the law Judith! If you don't understand that , I can't help you!" (Lazares). Remember who is repsonsible for the new 'John Lazares STRS Ethics Code.' Who is responsible for the new travel policy (Leone); cutbacks in vacation and sick leave payouts (Leone); Response to Geoffrey Meyers: "It's only a few dollars" to Leone explaining to him that they approved a contract (Not Leone and Lazares) hiding items of cost the Board knew nothing about and who stood strong (Lazares and Leone) for 'No document; no sign' for months until it was approved.
Small fish in the big ocean of concerns to some. Every penny counts to others. Johnson came on the Board with these words (paraphrased): "My Mother told me to watch every penny as pennies turn into dollars and are not your own to spend." (Please correct this version if I am not stating it accurately tho I did hear it. But, it was a while back.
Remember all the accomplishements WE along with our elected Board Members have accomplished in spite of months long and difficult and stressful insistance, persistance and integrity on our behalf. Did it take some passion? Yes. Does it leave one with feeling any little item is going to need effort and facing a fight along the way? You bet. But only for those long grown in not watching those dollars not their own and think it's ok to spend any amount not necessary whether pennies or millions without oversight for fear of 'intruding' or 'treading' on staff ground. CORE wants no fear of treading, complete oversight and yes, intrusion when necessary. If a voice needs raising to get this, the tame should leave the room, I guess. If it becomes a matter of expectation by all Board Members, no need to raise a voice!
Does this mean we all have to agree or not debate? Absolutely not, when in good conscience and solely for retirees verified NOT BY GENERAL IDEOLOGY DEFENSIVE STATEMENTS BUT BY GOOD, SOUND FOUNDATION REASONING THAT PROVES BENEFIT TO RETIREES. NO EXCUSES ON PAST BEHAVIORS BUT FIRM SOLID FACT.
*One cannot excuse wrong or less than total integrity saying it is politics. One cannot lie, malign or be less than accurate because it suits them and turn around and say it was politics and expect respect or validation. That was the old dishonest way. We will never tolerate that ever again.
For all issues positively impacting retirees such as HCA legis., changing how educ. if funded, House and Senate Bills affecting educators , CORE stands strong and advocates along with all the organizations. I will always advocate we work for any cause with any organization that brings benefit to retirees.
The next STRS/CORE meeting on Thurs. June 14 promises to be interesting.
1. Concerns on the proposed 13.7% increases in the budget for wages and addt'l staff have been expressed by some Board Members and many, many retirees. This is a topic of ongoing discussion and questioning when retirees are fighting to tread water. Benefits to retirees from these increases needs to be scrutinized and weighed in any decision. Expect heavy debate on this issue from those fighting for complete and very public oversight of our monies.
2. HC will be proposed by staff for 2008. Increases will be heaviest for spouses with no Medicare to help.
We all know it is increasingly difficult now to attend due to gas prices on top of distance, health, etc. If any can carpool, please arrange to do so as this is going to be a month of who stands where for retirees. We realize that 'expertise' together with much 'prudence' needs be exhibited for our public pension system understanding we are not corporate in nature and that all must always remember: "We are only as well off as our neediest retirees," which is CORE President Dave Parshall's: Guiding Principle. Leone and Lazares always ask: "How will this look and how can it be explained to our needy retirees?"
Those points should always be a measure and a goal: Complete transparance as to how this impacts retirees for whom STRS staff exists along with specific explanation on any decisions benefit to retirees.

Sunday, May 27, 2007

Take Fosamax? Big Pharma Targets Women For Drugs They Don't Need -- from Suddenly Senior

Don't Buy The Hype: Big Pharma Targets Women For Drugs They Don't Need

By Judy Norsigian, Women's Media Center
Posted on May 25, 2007, Printed on May 26, 2007

Selling anxiety sells medicine. Drug companies know this and profit by it. But are women benefiting as much as the industry's bottom line?

The pharmaceutical industry spent much of its $4.2 billion direct-to-consumer advertising budget in 2005 on ads targeting healthy upper-income, middle-aged people. A common underlying message was this: you appear to be healthy, but a deadly heart attack, hip fracture, or other medical catastrophe could occur at any time. Therefore, you should take a prescription drug to prevent such problems.

For example, a long-running Merck ad featured an older woman with this message: "See how beautiful 60 can look? See how invisible osteoporosis can be?" and recommended that women ask their doctors about bone density screening. As a result, many women started taking Merck's drug Fosamax, even though the benefit may not outweigh the harm.

With such direct-to-consumer ad campaigns, which highlight risk factors and promote screening tests, drug companies move beyond promoting certain pills for treatment of diagnosed conditions to expanding their use in healthy people. And selling prevention through prescription drugs certainly does fill pharmaceutical industry coffers. Healthy people, preferably in early middle age, who can be persuaded to take a drug daily for the rest of their lives, are clearly the industry's most desirable customer base. But as a category, these people who are at low risk of having the problem the drug is meant to treat may still suffer a serious adverse reaction.

For example, Fosamax cuts the risk of hip fracture from 2 percent to 1 percent, but that small benefit may not be worth the 1.5 percent risk of suffering an esophageal ulcer. In addition, in a small percentage of women using Fosamax over the long term, the jawbone will start to crumble. And some research now suggests that the type of new bone created by Fosamax is more brittle and more prone to fracturing over time.

The over-selling of postmenopausal hormones, supported by the depiction of natural menopause as a hormone deficiency disease, was the forerunner to this type of sales pitch, which now permeates the media. Aging, social anxiety disorder, heartburn, restless leg syndrome, and overactive bladder are all examples of symptoms or normal physiological events that are now presented to consumers as being in need of long-term drug treatment.

Prescription drugs used to be advertised mainly in medical journals aimed at health care providers. But since 1997, when the Food and Drug Administration (FDA) loosened the restrictions on direct-to-consumer advertising, pharmaceutical companies have taken their messages directly to the people. They claim these ads are good for consumers because they educate and encourage individuals to be more involved in their medical choices. But whatever the industry's philanthropic motives, the more direct interest is the bottom line.

As Marcia Angell, a former editor of the New England Journal of Medicine, once put it, "They are no more in the business of educating the public than a beer company is in the business of educating people about alcoholism."

Because of direct-to-consumer advertising, more people request prescription drugs from their doctors, and most doctors comply. Most lay people -- and even many physicians -- are not aware that drug ads are not checked by the FDA for accuracy beforehand, and are pulled only after complaints are made and verified. This usually takes about six months, and the drug company is given a grace period of several additional months, by which time most ads would have been changed anyway. A company is rarely required to run a corrective ad, and there is no other penalty for misleading the public. Thus, while the FDA sends hundreds of letters each year requiring drug companies to retract their ads, most people don't hear about them.

Women need to recognize misleading pharmaceutical marketing practices and base drug treatment decisions on scientifically accurate evidence. Be most skeptical of heavily advertised drugs and those that come with coupons. They are the newest, most expensive drugs with the shortest track records of safety.

The FDA does not require new drugs to be proven better than competing, often cheaper, drugs already on the market. Though many drugs for chronic conditions like arthritis are taken every day for years, pre-approval trials typically last no more than a few months and long-term safety studies are almost never done. Life-threatening effects may come to light only after the drug is approved and used widely.

To reduce unnecessary risk, women should seek independent sources of evidence about medicines, particularly new ones. The FDA's web site offers extensive information about medicines, herbal supplements, and vitamins, including safety alerts about the latest recalls and warnings for specific drugs.

The international nonprofit group Healthy Skepticism counters misleading drug promotion and maintains a regular "AdWatch" section on its website. Consumers should be cautious when looking for information on other websites. Many are substantially sponsored by pharmaceutical companies. Being skeptical about drug ads and promotions is smart: it can protect both our health and our wallets.

Judy Norsigian is the executive director of Our Bodies Ourselves, a nonprofit women's health advocacy organization that also maintains a daily health blog. A co-author of every edition of the book Our Bodies, Ourselves, she is also part of the editorial team that has produced Our Bodies, Ourselves: Menopause (2006) and Our Bodies, Ourselves: Pregnancy and Birth (forthcoming, 2008).
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