Entries Tagged as 'Politics'

Mythbusting Canadian Health Care

This is from an article by Sara Robinson published on Campaign for America’s Future.

1. Canada’s health care system is “socialized medicine.”
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is “single-payer insurance.” In talking to Americans about it, the better phrase is “Medicare for all.”

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don’t have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don’t have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid — quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren’t interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don’t realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don’t operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor’s debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family’s major expenses, expectations tend to run very high. A doctor’s mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it’s no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they’re not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don’t have to include coverage for future medical costs, which reduces the insurance company’s liability.

3. Wait times in Canada are horrendous.
True and False again — it depends on which province you live in, and what’s wrong with you. Canada’s health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don’t plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country’s health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland’s grandfather.). In spite of that, though, grousing about health care is still unofficially Canada’s third national sport after curling and hockey.

And for the country’s newspapers, it’s a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it’s on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it’s certainly one of the things that keeps the quality high. But it also makes people think it’s far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I’m finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It’s the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don’t have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that’s just as true in the U.S. — and in America, the government won’t cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

5. You don’t get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don’t get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country’s top specialists that rich ones do.

6. Canada’s care plan only covers the basics.
You’re still on your own for any extras, including prescription drugs. And you still have to pay for it.
True — but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees’ premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

“The basics” covered by this plan include 100% of all doctor’s fees, ambulance fares, tests, and everything that happens in a hospital — in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn’t include “extras” like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you’d pay for a room in a middling hotel). That other stuff does add up; but it’s far easier to afford if you’re not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren’t nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country’s remaining private health insurers. Since they’re off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month — about $300 for a family of four — if you’re stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America’s largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they’re actually likely to be safer.

Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It’s amazing.

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they’re getting a constant level of care that ensures small things get treated before they become big problems.

The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren’t working 60-hour weeks trying to hold onto a job that gives them insurance.

9. People won’t be responsible for their own health if they’re not being forced to pay for the consequences.
False. The philosophical basis of America’s privatized health care system might best be characterized as medical Calvinism. It’s fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one’s own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One’s Own Health.

They’ll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you’ll never get sick. (Like all good theologies, there’s even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it’s a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can’t complain. It was their own damned fault; and it’s not our responsibility to pay for their sins. In fact, it’s recently been suggested that they be shunned, lest they lead the virtuous into sin.

Of course, this is bad theology whether you’re applying it to the state of one’s soul or one’s arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us — even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it’s built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians tend to think of tending to one’s health as one of your duties as a citizen. You do what’s right because you don’t want to take up space in the system, or put that burden on your fellow taxpayers. Second, “taking care of yourself” has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you’re contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they’re still small and cheap to fix.

Third, there’s a somewhat larger awareness that stress leads to big-ticket illnesses — and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there’s a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

10. This all sounds great — but the taxes to cover it are just unaffordable. And besides, isn’t the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we’re not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we’re actually money ahead. When you factor in the greatly increased social stability that follows when everybody’s getting their necessary health care, the impact on our quality of life becomes even more signficant.

And True — but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There’s always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

But, as many of us know all too well, there’s also constant tension between what patients want and what private insurers are willing to pay. At least when it’s in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

It is true that Canada’s system is not the same as the U.S. system. It’s designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It’ll be a good day when when Americans can hold their heads high and proudly make that same declaration.

You can read the complete article and more of what Sara Robinson has to say on OurFuture.org.

Originally posted 2010-03-12 02:00:29.

BP Profits

Byron Grove, BP’s chief financial officer said a week after the Deepwater Horizon drilling rig explosion that it was too early to talk about how much BP would be spending on the cleanup.

2010 First Quarter financial statements for BP show profits double the same period last year at $6.08 billion.

Over the past few years BP has been fined for workplace safety violations… but apparently the company hasn’t had a problem staying in business and making record amounts of money.

The oil spill cleanup is after all, just a cost of doing business for BP; and perhaps it’s time to crank up that cost with hefty fines for each and every day it continues.

The Secretary of the Interior, Ken Salazar has threatened BP with a government take over of the clean up… but last I check the government was already involved.  And US Coast Guard Admiral Thad W Allen has been clear that their is little more that they can do… mainly because there isn’t a contingency plan for this type of spill — by any government agency.

In 1989 Exxon was hit hard by a consumer boycott when they dragged their feet in the clean up of the Valdez spill; but so far there’s no sign that consumers are slowing their purchases at BP — the largest oil and gas producer in North American, and one of the largest in the United States (selling under the retail labels of BP and Arco).

Maybe when the news media starts providing images of animals and habitat that’s devastated by the oil spill consumers might wake up — but there are actually live feeds of the oil spewing from the damaged rig that show oil-soaked birds and now there’s plenty of footage of landfall of the spill in Louisiana… so maybe not.

The oil and gas industries are the 14th largest contributors to congress — almost $7 billion per year ( http://politics.usnews.com/congress/industries — don’t be shocked by how many times Harry Reid is the #1 recipient of that money — and by all means use this list to know who to vote out of office) — so it’s understandable why the federal government is slow is really punish BP; after all, we know that our elected official look out for their interests first (which involves looking out for the interests of those who give you money — over those who you consider sheep who’ll just continue to vote for you).

FINES FINES and MORE FINES — if BP is making money hand over foot, let’s make sure that they bare the full cost of this cleanup and the costs of un-doing the damage that they’ve caused…  I’m thinking $50 million per day would be just about right to force BP to take real action.

Originally posted 2010-05-28 02:00:19.

Gas Prices

So have you filled up your tank lately?

Gas is now less than two dollars a gallon in much of the country again; including California and the Northeast (NY/CT).

Less two months ago gas had hit five dollars a gallon, and had taken three years to rise to that price from it’s current level.  Actually it took one year to go up a dollar, and then the next year it went up two (and most of that in just a few months).

Why?

How?

Oh… right — who was in charge of the US Petroleum Reserves… and who are his friends and business associates?

My feeling is this begs for a congressional investigation and some punitive action against those responsible.

My rational is simple.  Many American’s that were hardest hit this Summer by gasoline prices had their budgets totally destroyed by the price gouging… and some of them likely lost their houses or had to dip into their retirement saving because of it.  So once again, the middle class Americans pay for big business (read that as big oil) to make even more money.

Greed… pure adulterated greed!

I certainly have no issues with capitalism and fair market economies; but we don’t have a totally open economy, the government exercises control over many facets of it, and that requires that the government keep a watchful eye over all of it.

Originally posted 2008-11-17 12:00:11.

Religious Intolerance or Insensitivity?

One has to ask the question, why would a US Congressman choose to use a facility with a religious affiliation when a public facility is only a few blocks from the chosen site and many public facilities exist within a short distance from the chosen structure?

While this is not a violation of the US Constitution (Establishment Clause of the First Amendment or Article VI) it is an extremely poor choice and one can only conclude that the intent is for it to be a public endorsement of a single religious belief and a rejection of the beliefs of those whose are different.  My guess is the congressman would never ask a christian to step foot into a mosque (there is a mosque not far from the church that was chosen — perhaps he might decide to hold another meeting there soon).

It’s easy to see how hate is promoted in American society when elected official either actively feed it or are just insensitive to the differences that once made this country strong…

I object to any pandering of intolerance.


Congressman Miller Townhall Meeting
Tuesday, August 16
7:00 p.m. CT

Marcus Pointe Baptist Church
Main Worship Center
6205 North W Street
Pensacola, FL 32505

 

Original Link: http://jeffmiller.house.gov/news/email/show.aspx?ID=KV2BK2PRUC2HK6XTHVVK6ONOY4

Originally posted 2011-08-12 02:00:36.

The Incredible Shrinking State

Rising Temperatures, Disappearing Coastlines
December 8, 2009

Greenland and Antarctica hold the world’s largest reservoirs of fresh water, locked in their giant ice sheets. Global warming may cause large parts of these ices sheets to melt within centuries — changing the shape of coastlines around the world.

See the entire article on NPR.

Originally posted 2010-04-14 02:00:12.

Boehner makes sense

House Minority Leader John Boehner (Republican) stated that he would support President Barack Obama’s proposal to renew the expiring Bush tax cuts only for those making less than $250,000 if it were his only option.

The Republicans in both the House and Senate were quick to add fuel to the fire and turn up the volume on the rhetoric about fiscal responsibility, watching out for the little guy, etc, etc, etc — and saying that they believe the tax cuts should be extended for all Americans.

Do people making over $250,000 really need a tax cut?

Seems to me that they’re doing OK; much better than the average American is fairing in this economic crisis (I won’t call it a recession because it certainly seems much more like a depression — so we’ll leave it a crisis).

The bottom line is we have to pay our bills — and as the Republicans are complaining about the government has been spending out of control… but what they don’t remind you is that George W Bush is responsible for the out of control spending; Barrack Obama and his administration haven’t spent anywhere near as much as George W Bush — and a large amount of what is being spent now is being spent on a war that George W Bush threw this country into (and lied to get the support for it).

I’m well aware that it’s a tenant of Socialism that we take more from those who can afford it, and give it to those who need it…

From each according to his ability, to each according to his need
· Karl Marx, 1875 Critique of the Gotha Program

But in point of fact the American income tax structure has always been based on a progressive tax (those who earn more, pay more); except what happens now is that those who earn enough can avoid taxes by taking advantage of the loop holes the complex laws afford them.

We really need to rework the tax system so that it’s more equitable across the board; and those who benefit greatly from society pay their fair share of the costs of supporting society… but until then, I think getting $700B from those who earn more than a quarter million dollars per year is a necessary step to putting this country back on the road to stability.

Originally posted 2010-09-15 02:00:52.

Political Change

I’ve seen a few articles about voters sending a signal of change this last Tuesday with an “anti-establishment” vote… the headlines sound great (along the lines of my “no incumbent” philosophy), but looking at the primary results makes me feel like the declaration of change is more comparable to ice melting in Antarctica in the Spring than anything truly significant…

Real change requires that Americans understand that we are where we are because of the short sightedness and the self-servings of  those we elect — though that said, each and ever American needs to shoulder responsibility for supporting our political leaders and our frenzied consumerism.

Simply put, there’s no such thing as a free lunch — and along with that, you can’t have everything right now.

If we American are to effect real political change, and put this country back on a track that insures our children a safe and prosperous future we need to commit to begin making changes now and pass on to each generation the responsibility and understanding of living in the present while planning for the future.

It’s not going to be an easy path, and we Americans will likely continue to have to address social ills and internal and external detractors; but we must move forward with our economy, society, and environment in a sustainable way with open hands and hearts to help the rest of the world do the same.

Originally posted 2010-05-21 02:00:42.

Boeing

I’ve seen a number of initiatives from Boeing that are targeted at trying to get a US DOD contract for supplying tankers to the US Air Force.

I don’t think there’s anything wrong with Boeing as a potential supplier for tankers (though I would like everyone to review why we need to build tankers period); but Boeing seems to be forgetting that with government contracts, it’s the lowest bidder who wins.

Boeing talks about American jobs, know-how, unfair competition from Air Bus (well, Boeing probably thinks any competition is unfair)… but they don’t highlight the fact that they simply aren’t competitive.

Welfare capitalism to large is just another form of socialism — and part of the “trickle down” philosophy (the question is how much get’s skimmed of with huge executive bonuses and how much really does trickle down).

We need to think global; and keep moving forward to creating a global economy and global society rather than trying to make sure the grass in our own yard stays the greenest (of course we can talk about this on a state-by-state basis just as easily as a nation-by-nation basis).

I say, the the low bidder win; and let’s make sure that the defense budget is treated with the same scrutiny and cuts that other budgets are — waste is waste, and “saving” our troops (who were put in danger by a lie by George W) just isn’t a reasonable excuse to keep spending on destruction.

Originally posted 2010-04-29 02:00:45.

Separation of Church and State

The First Amendment to the United States Constitution guarantees the separation of church and state.

The phase “separation of church and state” comes from a letter written in 1802 by President Thomas Jefferson to the Baptists from Danbury [Connecticut]; but the concept pre-dates the Constitution and Bill of Rights, and was largely championed in it’s adopted form by James Madison (the principal drafter of the United States Bill of Rights).

The ideological basis of the separation of church and state are often credited to English philosopher John Locke and his principle of social contract.  It can also be seen implicitly in the flight of Roger Williams from Massachusetts to Rhode Island.

Many in the religious right argue that our founding fathers did not intend fro the First Amendment to create a godless country; and they continue to argue that the United States is a Christian nation, and Christian beliefs are centric to the nation and the Constitution.  However, that argument is not supported by the verbiage of the Treaty of Tripoli.

The Treaty of Tripoli, (unanimously) ratified by the US Senate and signed by President John Adams (one of the founding fathers) in 1797 contains in Article 11 the following:

Art. 11. As the Government of the United States of America is not, in any sense, founded on the Christian religion,—as it has in itself no character of enmity against the laws, religion, or tranquility, of Mussulmen,—and as the said States never entered into any war or act of hostility against any Mahometan nation, it is declared by the parties that no pretext arising from religious opinions shall ever produce an interruption of the harmony existing between the two countries.

It seems clear that it isn’t necessary to dig into the Federalist Papers, the Declaration of Independence, or read in depth biographies of the founding fathers to understand that they never intended religion to be a central pillar of United States and that it was in fact their intent to prevent religion (particularly organized religion) from exerting control on the government and it’s policies.

Why then, two hundred years later do Christians seems to have carte blance to have the precepts of their religion imposed on the country as law and policy?

One place you can clearly see the Christians exercising control is state and local mandated ordinances forbidding retail operations on Sunday (particularly as it relates to alcohol sales).  While perhaps not as flagrant as it was fifty years ago, it’s is still clearly an affront to the religious freedom and separation guarantied by the US Constitution and a fundamental founding principal of this county.

To [mis]quote Lewis Carrol … the time has come the walrus said to speak of many things …

My personal belief is that each and every time any governmental unit attempts to impose the will of an organized religion there should be quick and severe recourse.

Religious invocations should be forbidden in any governmental sponsored event (that includes public school events, local governmental meetings, etc); civil oaths should be the default in any judicial or administrative hearing; and laws which are based solely on religious fundamentals stricken down.

Christians now account for less than 75% of the adult US population, and that number has been decreasing at an increasing rate over the past two decades with non-religious individuals the fastest growing segment (currently over 15% of the adult US population).

The United States was founded on the principles of freedom of religion (including freedom from religion), it’s time we honor the core values of those who built the framework that has endured the tests of time by ending religious persecution once and for all.

Originally posted 2010-08-30 02:00:51.

50 Years of US Peace Corp

Today marks the fiftieth anniversary of John F Kennedy’s founding of the US Peace Corps (1-March-1961)… originally just a pilot program, but approved and funded by congress now as an American fixture.

The Peace Corps traces its roots and mission to 1960, when then Senator John F. Kennedy challenged students at the University of Michigan to serve their country in the cause of peace by living and working in developing countries. From that inspiration grew an agency of the federal government devoted to world peace and friendship.

Since that time, 200,000+ Peace Corps Volunteers have served in 139 host countries to work on issues ranging from AIDS education to information technology and environmental preservation.

Today’s Peace Corps is more vital than ever, working in emerging and essential areas such as information technology and business development, and contributing to the President’s Emergency Plan for AIDS Relief. Peace Corps Volunteers continue to help countless individuals who want to build a better life for themselves, their children, and their communities.

President John F. Kennedy established the Peace Corps to promote world peace and friendship.

The Peace Corps’ mission has three simple goals:

  1. Helping the people of interested countries in meeting their need for trained men and women.
  2. Helping promote a better understanding of Americans on the part of the peoples served.
  3. Helping promote a better understanding of other peoples on the part of Americans.

http://www.peacecorps.gov/

Originally posted 2011-03-01 02:00:46.