Fifth Freedom News Alerts
A special visitor came by Fifth Freedom’s office this morning
August 26th, 2010
ADA 20th Anniversary Events & Activities
July 13th, 2010
An informational alert prepared by Fifth Freedom
Information courtesy of the organizations listed below
ADA 20th Anniversary Events & Activities
The 20th Anniversary of the Americans with Disabilities Act is July 26, and organizations around the country are getting ready to celebrate! Here are some of the events in Indiana happening this month:
Tuesday, July 20
2:00 pm to 3:30 pm
ADA-Indiana audio conference on the ADA anniversary, including enforcement efforts
More information, including registration and locations
Thursday, July 22
Thursday, July 22nd
9:00 am to 5:00 pm
ADA Summit – Panel of experts will identify barriers to ADA implementation and make recommendations for improvement, focusing on employment; hospitality and entertainment; retail accessibility; cities and towns; parks, recreation, and temporary events; and voting
Government Center South Auditorium
Indiana Government Center
302 West Washington Street
Indianapolis
More information: email adainfo@indiana.edu
Friday, July 23
Starts 11:30 am
Mayor’s Advisory Council on Disability annual Access and Inclusion Awards Ceremony
Indianapolis Artsgarden
110 West Washington Street
Indianapolis
Monday, July 26
Starts 10:00 am
Northeast Indiana Disability Advocacy Coalition presents the Northeast Indiana ADA Report Card
The steps of the Federal Building
1300 South Harrison Street
Fort Wayne
More information: email info@fifthfreedom.org
Thursday, July 29
Starts 6:00 pm
Council for Community Accessibility Celebration of the 20th Anniversary of the ADA
Fountain Square Ballroom
Third floor of Fountain Square Mall
101 W Kirkwood Ave
Bloomington
Thursday, July 29
Starts 7:00 pm
The Disability Awareness Work Group will celebrate the ADA’s anniversary with a ball game with the Terre Haute Rex
Bob Warn Field
931 North First Street
Terre Haute
Any time:
Watch the video of the original signing of the ADA in 1990 (Scroll to the bottom of the page.)
Any time:
ADA-Indiana collection of YouTube videos related to the anniversary
Doug Schmidt
Act Team Coordinator
The Fifth Freedom Network
New housing locator service IndianaHousingNow.org
July 7th, 2010
An informational alert prepared by Fifth Freedom
Information courtesy of Disability.gov and the Indiana Housing and Community Development Authority
New housing locator service IndianaHousingNow.org
Looking for a new place to call home? IndianaHousingNow.org is a free housing locator service. Sponsored by the Indiana Housing and Community Development Authority (IHCDA), this Web site can help you find rental housing in your area that best fits your needs. Search by location, rent amount, accessibility features, Section 8, and more. The site also provides links to useful tools for renters like an affordability calculator, rental checklist, and information about renter’s rights.
Please note that this service is designed to help locate housing, not to help you apply for Section 8 or other housing assistance. For information on applying for housing assistance, contact your local Public Housing Authority office. Contact information is available here: http://fifthfreedom.org/u/s . Also see this page at the IHCDA Web site: http://fifthfreedom.org/u/t .
Doug Schmidt
Act Team Coordinator
The Fifth Freedom Network
3-26-10 Reconciliation is over – Now what?
June 29th, 2010
Earlier this week, the House passed two bills: the Senate’s health care bill, and a reconciliation bill that included around 150 pages of changes. The reconciliation bill bounced from the House to the Senate and back to the House, finally passing and heading to President Obama’s desk. Mr. Obama is expected to sign it sometime next week.
So what happens now? The bill’s various provisions take effect during different years, and won’t entirely take effect until 2020. Here is a timeline of some of the provisions that will directly affect patients.
**********
What Takes Effect When?
2010
Later this year, insurance companies will no longer be allowed to cut off customers’ coverage when they become ill. Insurers also will not be allowed to establish lifetime coverage limits.
Insurers will no longer be able to exclude children with preexisting conditions. Adults with preexisting conditions who have not had insurance for six months will be able to get subsidized coverage in a “high-risk” pool through a program that expires in 2014. Children of insured individuals will be able to stay on their parents’ plans until they turn 26.
In about three months, a temporary “reinsurance” program begins to help employers maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.
Medicare drug recipients in the “coverage gap” will get a $250 rebate.
A new appeals process begins to help customers appeal decisions made by their insurance companies.
New private plans will be required to provide preventative care at no direct cost to patients.
2011
Medicare will provide recipients some preventative care at no direct cost. This will include a once-a-year “wellness visit” and an individualized prevention plan. New Medicare plans will offer preventative services with no direct cost to patients.
Medicare drug recipients in the “coverage gap” will get a 50% discount on prescription drugs.
The fine for withdrawing money from a medical savings account for nonmedical expenses will double, from 5 percent to 10 percent.
2012
The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.
2013
Insurers will raise premiums on male customers to help female customers pay for their unique healthcare needs.
2014
Low-income adults without children will now be eligible for Medicaid. From 2014 o 2016, the federal government will pay states 100 percent of the cost of expanded Medicaid coverage.
State Health Insurance Exchanges for small businesses & individuals open.
Individuals will be required to have health insurance coverage or pay a fine. This fine begins at $95.00 per individual.
People making up to 400 percent of the federal poverty level will be eligible for tax credits to help them buy coverage on the Health Insurance Exchanges.
Health plans will no longer be able to exclude people due to pre-existing conditions.
2015
Medicare will begin a new payment program for physicians designed to reward quality of care rather than the amount of services rendered.
The fine for not having health insurance increases to $325 per individual.
2016
The fine for not having health insurance increases to $695 per individual. After 2016, fines will increase at the general rate of inflation.
2018
The “Cadillac Tax” on high cost, employer-provided plans begins. Every dollar beyond the first $27,500 of a family plan or $10,200 for an individual plan is taxed at 40 percent. This tax rate is tied to the rate of inflation. If medical costs continue to increase faster than the rate of general inflation, this tax will impact increasingly cheaper plans.
2020
The federal government cuts payments to states for the cost of expanded Medicaid coverage by 10 percent.
**********
This timeline only reflects the bill as it stands today. A bill with as far-reaching effects as this one, stretching across as many years as this one, is almost guaranteed to be changed, especially considering that there will be major elections before the major changes begin in 2014. Legislation is like the weather – the farther out you look, the harder it is to predict.
Sources and More Information:
HealthReform.Gov
http://www.healthreform.gov
The White House Blog – What’s in the Health Care Bill? http://www.whitehouse.gov/blog/2010/03/23/whats-health-care-bill
OpenCongress - It’s Over! House Gives Final Approval to Health Care Reform
OpenCongress - House Gives Final Approval to Historic Health Care Bill
Reuters - FACTBOX-US healthcare bill would provide immediate benefits
http://www.reuters.com/article/idUSN1914020220100319
CNN - House passes Senate’s health care ‘fixes’ bill
http://www.cnn.com/2010/POLITICS/03/25/health.care.main/index.html?hpt=T1
CNN – Timeline: When health care reform will affect you
http://www.cnn.com/2010/POLITICS/03/23/health.care.timeline/index.html
3-22-10 Health Care Reconciliation Package Passes House
June 29th, 2010
As you have undoubtedly heard by now, the House passed the health care reconciliation package on Sunday. The reconciliation bill passed 219 to 212. Indiana’s Representatives voted along party lines – the five Democrats voted in favor of the reconciliation bill, and the four Republicans voted against it.
Despite the big vote in the House, Congress still has some work to do. There were two bills passed on Sunday: the Senate’s health care reform bill, and the House’s package of changes to the Senate bill. The Senate reform bill will go immediately to President Obama to be signed into law, and the House’s reconciliation package will still have to be voted on by the Senate.
President Obama will likely sign the Senate health care reform bill tomorrow, March 23. The Senate is also expected to begin debate on the House’s reconciliation package the same day. While the House reconciliation bill is about 2,300 pages long, it only contains around 150 pages of changes to the Senate bill. Theoretically, the reconciliation package could be passed on Wednesday, March 24, but debate is likely to continue for some time, pushing a final vote to later in the week.
The reconciliation bill will require a simple majority - 51 votes - to pass. Senate Majority Leader Harry Reid has stated publically that he has promises of votes from 51 Senators.
Some notable changes in the reconciliation bill:
- The Congressional Budget Office estimates the reconciliation bill would cost roughly $938 billion over the next decade, about $63 billion more than the Senate bill.
- It removes Nebraska’s exemption to paying for its share of increased Medicaid costs. This provision would be replaced by special treatment for several other states: Tennessee hospitals would be given almost $100 million in extra funding, and Arizona, Delaware, Hawaii, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Vermont, Washington State and Washington, D.C., and Wisconsin would split $8.5 billion in extra Medicaid funding.
- It also includes the Student Aid and Fiscal Responsibility Act, which would move student loans from private banks to a government-run program. The Congressional Budget Office (CBO) has estimated this would create $67 billion in direct savings over the next decade, which would be used to expand federal student loan programs and the Pell grant program. (The estimated savings assumes that the number of people defaulting on their student loans will not increase. As it is, CBO estimates about $30 billion in default risk, which would take the savings down to $37 billion.)
- Effectively changes the eligibility for Medicaid from 133 percent of the federal poverty level to 138 percent, which CBO estimates would result in 16 million added to Medicaid. This is about 1 million more than under the Senate bill.
- Both the Senate and House reconciliation bills would tax insurance companies 40% on every dollar they spend on a plan above $27,500 a year. The tax would be passed along to consumers. The Senate bill increases this dollar amount by the rate of inflation plus one percentage point. The House reconciliation bill only increases it by the rate of inflation. As health care costs increase faster than general inflation, over time, this tax will include more and more plans, eventually impacting the middleclass.
- Average subsidies for lower-income people (24 million Americans) to purchase health insurance are higher, $6,000/year instead of $5,800/year under Senate bill.
- 32 million more people would have access to health insurance, or about an 11 percent increase. This is 1 million more than under the Senate bill. 23 million left uninsured.
However, CBO also points out that there are several provisions in the bill that may be difficult to maintain over the next few years. These changes could drive the price of the bill up significantly. For example, the bill would maintain or create some deep cuts to Medicare payments to healthcare providers. CBO notes that it is unclear if these payment cuts would result in healthcare providers becoming more efficient, or if the cuts would result in less access to or lower quality of healthcare. If these cuts were not made, the price of the bill would increase. CBO has estimated in an analysis of another bill that not cutting Medicare payments to physicians would cost roughly $200 billion over the next decade.
In an article in the New York Times, former CBO Director Douglas Holtz-Eakin expresses some doubts about the CBO’s health care reform math.
- The bill’s new taxes and fees start immediately, but benefits are not fully enacted for four years. That is, it uses ten years of taxes to pay for six years of benefits.
- Discretionary spending is left out of the analysis entirely. For example, the Internal Revenue Service would have to hire thousands of new workers for the new tax work created by the bill, but this expense is not counted.
- The long-term care insurance program (CLASS Act) created by the bill will collect billions of dollars in premiums during the first decade but not pay out much in benefits during that time.
Holtz-Eakin estimates that these and other “accounting sleight of hand” maneuvers are hiding an additional $562 billion in deficit spending. Of course, this is assuming that Congress does not fix these budget shortfalls as they arise.
Sources & More Information:
Congressional Budget Office – Letter to Representative Nancy Pilosi
http://cbo.gov/ftpdocs/113xx/doc11379/Manager%27sAmendmenttoReconciliationProposal.pdf
Congressional Budget Office – Letter to Representative Paul Ryan
http://www.cbo.gov/ftpdocs/113xx/doc11376/RyanLtrhr4872.pdf
Congressional Budget Office – Letter to Senator Judd Gregg
http://www.cbo.gov/ftpdocs/102xx/doc10295/Gregg_StudentLoans__09-07-27.pdf
ABC News - Health Care Bill: House Passes $938 Billion Bill, Sweeping Legislation on Its Way to Become Law
CNN - Health care reform now faces Senate challenge
http://www.cnn.com/2010/POLITICS/03/22/senate.health.care.ahead/
The Washington Post - Cornhusker Kickback gets the boot in health bill
http://www.washingtonpost.com/wp-dyn/content/article/2010/03/18/AR2010031803914.html
Washington Post - The five most promising cost controls in the health-care bill
http://voices.washingtonpost.com/ezra-klein/2010/03/the_five_most_promising_cost_c.html
Reuters - FACTBOX-US healthcare bill would provide immediate benefits
http://www.reuters.com/article/idUSN1914020220100319
NY Times - The Real Arithmetic of Health Care Reform
http://www.nytimes.com/2010/03/21/opinion/21holtz-eakin.html
2-25-10 House passes bill that would end health insurance antitrust exemption
June 29th, 2010
Yesterday, the House passed a bill that would end the antitrust exemption for health insurance companies. The “Health Insurance Industry Fair Competition Act” (HR 4246) would repeal the exemption to antitrust laws that health insurance companies have had since 1945, making it possible for the government to pursue legal action against these companies for price fixing.
However, the Congressional Budget Office (CBO) completed a cost estimate of a previous version of this legislation ( http://2.gp/jtf ). CBO stated that the actual effect on premiums would likely be small, as many of the activities that would be banned under federal law are already banned under various state laws. The biggest effect would likely be the government getting additional revenue from fining insurance companies that violated the new law.
Also, if the legislation becomes law, it may prevent insurers from sharing the data they use to set rates. As smaller insurance companies have fewer resources to get data on their own, they would be hurt the most.
Read the full text of HR 2426 here (http://www.opencongress.org/bill/111-h4626/text ).
Sources and more information:
Congressional Budget Office - Health Insurance Industry Antitrust Enforcement Act of 2009
http://www.cbo.gov/ftpdocs/106xx/doc10673/hr3596.pdf
OpenCongress - House Votes to End Antitrust Protections for Health Insurers
1-27-10 Harry Reid on Healthcare Reform: “There’s no rush”
June 29th, 2010
Now that President Obama has given his State of the Union Address, the Democrats in Congress have missed their self-imposed deadline for passing health care reform. If recent statements by Senate Majority Leader Harry Reid are any indication, it appears that they will not be setting another deadline. At a press conference earlier this week, Reid said “there is no rush” on the health care bill and that Congress was “not on health care now.”
Although they are not in a hurry, Democrats are still making plans on how to pass the health care bill. After losing the election in Massachusetts, the Democrats lost their supermajority in the Senate and, with it, their ability to pass legislation without a possible Republican filibuster. In the House, Speaker Nancy Pelosi has stated that she does not have the votes to pass the Senate bill as-is. However, Pelosi and other House Democrats are considering making an attempt to pass the bill anyway, as long as some changes were made.
Some House Democrats are proposing that Democrats in the Senate change the Senate bill through a process called “budget reconciliation”. Unlike ordinary votes, the budget reconciliation process only requires a simple majority to pass changes, and debate is limited to 20 hours, with no filibusters allowed.
Some of the possible changes being promoted by the House Democrats include:
- Removing the new tax on high-end “Cadillac” insurance plans
- Higher subsidies to help low- and moderate-income Americans buy health insurance
- Additional funding to help states expand Medicaid
The budget reconciliation process would only require 51 of the 59 Democrats in the Senate to approve changes. This would mean that the demands of Senators like Joe Lieberman and Bill Nelson could potentially be ignored.
However, some Senate Democrats have already expressed their opposition to the proposed changes, as they could add over $300 billion to the cost of the bill. Also, some Senate Democrats are opposed to the use of the budget reconciliation process entirely, as it could effectively shut the Republicans out of the negotiation process. At a recent press conference, Indiana Senator Evan Bayh said that he was concerned “reconciliation… will really destroy any prospect for bipartisan cooperation on anything else for the remainder of this year.”
Sources and More Information:
Kaiser Health News - How The Budget Reconciliation Process Works
http://www.kaiserhealthnews.org/Stories/2010/January/21/budget-reconciliation-health-reform.aspx
NY Times - Democrats Put Lower Priority on Health Bill
http://www.nytimes.com/2010/01/27/health/policy/27health.html
NY Times - House Could Pass a Revised Senate Bill, Pelosi Says
LA Times - Pelosi suggests maneuver to pass healthcare overhaul
http://www.latimes.com/news/nation-and-world/la-na-health-pelosi28-2010jan28,0,2042091.story
Politico - Dem impasse on health bill continues
1-5-10 Congress to play “ping-pong” with health care bill
June 29th, 2010
While the Fifth Freedom offices were closed for the holidays, the Senate passed its health care bill, just barely. The bill passed with 60 votes, just enough to avoid a possible Republican filibuster. Many Republicans are alleging that some Senators votes were “purchased” with special favors for their states:
- Senator Mary Landrieu of Louisiana was reportedly given $300 million in extra assistance for Medicaid recipients in her state. According to CBS News, it was originally reported that the deal was only $100 million, but Landrieu “bragged” that it was actually $300 million.
- Senator Bill Nelson added an amendment to the bill that would exclude Medicare Advantage members in Florida from future cuts, which some sources estimate at $5 billion for his state.
- The final holdout, Senator Ben Nelson, allegedly made a deal with Democratic leadership specifying that, in exchange for his vote, Medicaid expansion in Nebraska would be paid for entirely with federal funds, instead of a combination of state and federal funding, as in the rest of the country.
Of course, allegations of “pork” in congressional bills are common, and GOP leadership has also been accused of “buying” votes. In 2004, then-Republican Majority Leader Tom Delay was formerly admonished by Congress for offering to endorse retiring Representative Nick Smith’s son in his bid for his father’s seat, in exchange for his vote on the Republican Medicare bill.
Now that both houses have passed a bill, what happens next?
The Senate and the House have to reconcile the differences between the two bills, and pass a “merged” version to send on to President Obama’s desk. These differences could be negotiated through formal conferences, but this process would require multiple procedural votes, making it a lengthy process. Instead, Democrats are much more likely to ping-pong the bill. “Ping-pong” is the informal name for sending a bill back and forth between both chambers of Congress, where differences between the House and Senate bills are worked out in informal, closed-door meetings.
Why ping-pong? The answer depends upon who you ask.
Opponents of the health care bill are likely to view it as an attempt to shut Republicans out of the debate, and to prevent the general public from observing the end of the legislative process, as the bill continues to be changed and amended.
Proponents of the bill are likely to view it as simply an attempt to speed things along, avoiding legislative hurdles that would further delay what has already been a lengthy legislative process, and to avoid filibusters or other procedural problems from Republicans like Minority Leader Mitch McConnell, who has already vowed to continue the “fight… to stop this bill from becoming law.”
The Democrats are hoping to finish their game of ping-pong and have a bill on President Obama’s desk before his State of the Union address in early February.
Sources & More Information:
Slate – The Tom Delay Scandals
http://www.slate.com/id/2116392/
Politico - Payoffs for States Get Harry Reid 60 Votes
http://www.politico.com/news/stories/1209/30815.html
CBS News – Tallying the Health Care Bill’s Giveaways
http://www.cbsnews.com/blogs/2009/12/21/politics/politicalhotsheet/entry6006838.shtml
CBS News – Senate Deal: Compromise or Corruption?
http://www.cbsnews.com/stories/2009/12/21/eveningnews/main6007678.shtml
CBS News – Senate Health Bill Faces Constitutional Criticism
http://www.cbsnews.com/blogs/2010/01/05/taking_liberties/entry6056342.shtml
The Hill – House Democrats Posed to Pass on Formal Conference
http://thehill.com/blogs/blog-briefing-room/news/74217-house-dems-poised-to-eschew-formal-conference
Talking Points Memo - Ping Pong: The House Prepares To Take Up The Senate Health Care Bill
The New Republic - EXCLUSIVE: Dems ‘Almost Certain’ to Bypass Conference
http://www.tnr.com/blog/the-treatment/exclusive-dems-almost-certain-bypass-conference
NY Times - Democrats Likely to Dispense With Conference Committee
12-16-09 Senate amendment to import prescription drugs fails
June 29th, 2010
Yesterday, the Senate failed to pass an amendment to the health care bill that would have legalized importing prescription drugs from Canada, Australia, Japan, and Europe. Due to price controls and government-negotiated rates, these countries all pay lower prices for prescription drugs than residents of the United States. The Senate voted in favor of the amendment 51 to 48, but it would have required 60 votes to pass. Both of Indiana’s Senators and Senator Joe Lieberman were among those who voted against the amendment.
The amendment was sponsored by Senator Byron Dorgan (D-ND). According to the Congressional Budget Office, the amendment would have saved the government around $19 billion over the next decade, and consumers around $80 billion. According to Dougan, a Nexium prescription costs $424 in the U.S., but only $36 in Spain.
Drug manufacturers and the head of the Food and Drug Administration (FDA) criticized the measure, saying that it would be difficult to guarantee that the imported drugs were safe. However, a bigger reason for the amendment’s failure may be a deal made between the White House and the drug industry. Earlier this year, drug manufacturers pledged to contribute $80 billion over the next decade to help reduce the Medicare coverage gap. (The gap or “doughnut hole” occurs when people have drug costs between $2,700 and $6,100, when Medicare coverage can stop.) According to internal memos, the White House agreed to oppose drug importation in exchange for the $80 billion drug deal.
This is not the first attempt to pass this amendment. Dorgan has been trying to pass essentially the same legislation for over a decade. In 2004, drug makers said that they would reduce shipments to countries that exported drugs to the U.S. An analysis by the New York Times concluded that Canada and other countries would “clamp down” on shipments to the United States to avoid the threat of a drug shortage in their own countries.
Sources & More Information
NY Times - White House Affirms Deal on Drug Cost
http://www.nytimes.com/2009/08/06/health/policy/06insure.html?_r=1
LA Times - Obama gives powerful drug lobby a seat at healthcare table
http://www.latimes.com/features/health/la-na-healthcare-pharma4-2009aug04,0,3660985.story
Washington Post - Obama Announces Agreement With Drug Companies
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/22/AR2009062200349.html
The Washington Independent - Senate Dems Protect Big Pharma
http://washingtonindependent.com/71047/senate-dems-protect-big-pharma
Wall Street Journal - Measure to Allow Drug Imports Fails
http://online.wsj.com/article/SB126093494955393151.html
NY Times - Importing Less Expensive Drugs Not Seen as Cure for U.S. Woes
http://www.nytimes.com/2004/10/16/business/16drug.html?pagewanted=print&position=
12-15-09 Democrats quickly abandon Medicare buy-in
June 29th, 2010
Senate Democrats have apparently bowed to the demands of Senators Joe Lieberman and Ben Nelson, and given up the idea of expanding Medicare. The proposal introduced just last week would have expanded Medicare to people age 55 to 64, but the two men objected. The proposal appears to have been abandoned just last night over fears that not winning their support for the legislation would leave it with fewer than the 60 votes needed to bypass a Republican filibuster.
Shortly after the Medicare buy-in was proposed, Nelson voiced his concerns that it would lead to a single-payer healthcare system. Lieberman objected, saying that the idea was fiscally unsound. While he had supported similar ideas in the past, this time around was different, because the health care bill contained “duplicate” supports for seniors. A spokesperson for Lieberman, Erika Masonhall, said that the bill already included “extensive affordability credits that would benefit this specific group of individuals. …Any inclusion of a Medicare buy-in for that same age group would be duplicative of what is already in the bill, would put the government on the hook for billions of additional dollars, and would potentially threaten the solvency of Medicare, which is already in a perilous state.”
Lieberman himself had this to say about the proposal being dropped: “I don’t feel like a spoiler. I feel like somebody who has wanted to be for health care reform. We have within reach — the core parts of this bill are a historic accomplishment. I mean, think about it, 30 million people who can’t afford health insurance in our country today are going to get it under this bill. The cost curve is going to be bent down.”
Other Senators appeared to be positive, taking the view that the bill sans Medicare expansion was better than nothing. Senator John D. Rockefeller said, “We’re not going to get all that we want, but we’re going to get so much more than we have.”
Sources & More Information:
Wall Street Journal - Democrats Drop Plan to Expand Medicare
http://online.wsj.com/article/SB126083637029991305.html?mod=WSJ_hp_mostpop_read
Wall Street Journal - The Choice Facing Democrats
http://online.wsj.com/article/SB126081598065990829.html?mod=article-outset-box
Connecticut Post - Lieberman recants support for Medicare expansion
http://www.connpost.com/ci_13996897?source=most_emailed
NY Times – Lieberman: The Fallout
http://prescriptions.blogs.nytimes.com/2009/12/15/lieberman-the-fallout/
Washington Post - Senate health bill unlikely to include Medicare buy-in
http://www.washingtonpost.com/wp-dyn/content/article/2009/12/14/AR2009121401580_pf.html
