uncovered How America's Health Care System Fails Young People

Transcription

1 uncovered! How America's Health Care System Fails Young People

2 uncovered! How America's Health Care System Fails Young People Saffron Zomer and Michael Russo U.S. Public Interest Research Group November 2009

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

4 Table of Contents 9-')(5&2'.(-$ $ $$ $ $ $ $ O F(&-A$%-5$6-.-*&)#5$ $ $ $ $ K$!"#$94,%2'$(1$Y#%/'"$C%)#$C(*'*$ $ $ R 7'&5#-'$Y#%/'"$8/%-*B$6-)#/.%+/#$8)('#2'.(-$ R 8)(*,#2'*$1()$:#1()4$ $ $ $ $ Z [-5-('#*$$ $ $ $ $ $ $ ON

5 Introduction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`5#+'G$.-%+./.'0$'($%22#**$)#^&.)#5$2%)#G$5.1a2&/'.#*$2(4,/#'.-A$*'&5.#*$()$a-5.-A$=()H`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

6 Young And Uninsured :.*.-A$"#%/'"$2%)#$2(*'*$"%<#$,&'$^&%/.'0$2(<#)%A#$(&'$(1$'"#$)#%2"$(1$'(($4%-0$T4#).2%-*3$b<#)$'"#$,%*'$'#-$0#%)*G$.-*&)%-2#$,)#4.&4*$"%<#$5(&+/#53 O $T+*#-'$*')(-A$)#1()4*$'($+#-5$'"#$2(*'?A)(='"$2&)<#G$'"#$)%'#$(1$A)(='"$=.//$.-2)#%*#G$=.'"$'"#$-#>'$5(&+/.-A$(1$,)#4.&4*$"%,,#-.-A$.-$(-/0$#.A"'$0#%)*3 K $!"#$2(-*#^&#-2#*$(1$'".*$&-*&*'%.-? %+/#$).*#$%)#$,)#5.2'%+/#G$%*$4()#$%-5$4()#$T4#).2%-*$a-5$'"#4*#/<#*$&-%+/#$'($%11()5$"#%/'"$.-*&)%-2#$2(<#)%A#3 T-5$-(="#)#$.*$'".*$')#-5$4()#$=.5#*,)#%5$'"%-$="#-$.'$2(4#*$'($0(&-A$,#(,/#3$T4#).2%-*$%A#5$Oc?KR$%)#$'"#$ 4(*'$/.H#/0$5#4(A)%,".2$.-$'"#$2(&-')0$'($/%2H$"#%/'"$.-*&)%-2#B$(1$'"(*#$%A#5$Oc?KRG$%$1&//$Kd$,#)2#-'$%)#$&-.-*&)#5G$ 2(4,%)#5$'($%-$&-.-*&)#5$)%'#$(1$Oe$,#)2#-'$1()$%//$%5&/'*3 f $!"#$1%2'$'"%'$-#%)/0$%$'".)5$(1$0(&-A$T4#).2%-*$/%2H$%$ "#%/'"$.-*&)%-2#$2%)5$4#%-*$'"%'$'"#0$"%<#$*&+*'%-'.%/$5.1a2&/'0$%22#**.-AG$4&2"$/#**$%11()5.-AG$-##5#5$"#%/'"$2%)#3!"#$,)(+/#4$.*$-('$2(-a-#5$(-/0$'($'"(*#$="($#-'#)$'"#$=()H1()2#$0(&-A$)%'"#)$'"%-$a-.*".-A$'"#.)$*'&5.#*3$C(/? /#A#$*'&5#-'*$5($1%)#$*(4#="%'$+#''#)$'"%-$0(&-A$,#(,/#$%*$%$="(/#G$+&'$%)#$*'.//$*.A-.a2%-'/0$/#**$/.H#/0$'($"%<#$ 2(<#)%A#$'"%-$'"#$A#-#)%/$,(,&/%'.(-G$=.'"$%$KNNZ$;(<#)-4#-'$T22(&-'%+./?.'0$b1a2#$*'&50$a-5.-A$'"%'$KN$,#)2#-'$(1$2(//#A#$*'&5#-'*$%A#5$Oc?Kf$=#)#$ I currently don't really have much of any kind of healthcare; I go to the emergency room and can't really afford to pay for most of the stuff. All I have is a temporary ER insurance thing due to my financial situation, and I was lucky to get that. I'm working and going to school in hopes of making enough money to pay for and ensure my good health because I know from experience if you haven't got care that's too bad. Talor Williams Santa Monica College &-.-*&)#53 L $T-5$(-2#$%$*'&5#-'$A)%5&%'#*G$&-.-*&)%-2#$)%'#*$*,.H#B$%4(-A$ '"#$-#=$A)%5&%'#$5#4(A)%,".2G$'"(*#$%A#5$Kf$'($KRG$%-$#0#?,(,,.-A$fc$,#)2#-'$%)#$&-.-*&)#53 Z $!"#)#$%)#$'=($H#0$1%2'()*$*,#2.a2$'($0(&-A$,#(,/#$'"%'$2(-').+&'#$'($'"#.)$ /(=$.-*&)%-2#$ )%'#*B$ g%a.-a$ (&'\$ (1$ #/.A.+./.'0$ 1()$,%)#-'%/$,/%-*G$ %-5$ '"#$ 5.1a2&/'0$0(&-A$=()H#)*$1%2#$A#''.-A$.-*&)%-2#$'")(&A"$'"#.)$#4,/(0#)*3 T$ /%)A#$,)(,()'.(-$ (1$ 0(&-A$ %5&/'*$ ="($ 5($ "%<#$ 2(<#)%A#$ )#2#.<#$.'$ %*$ 5#,#-5#-'*$&-5#)$'"#.)$,%)#-'*\$,/%-*`%*$4%-0$%*$Ze$,#)2#-'$(1$2(//#A#$ *'&5#-'*G$%22()5.-A$'($'"#$;Tb3 e $F(&-A$,#(,/#$2%-$(-/0$)#/0$(-$'"#.)$,%)? #-'*\$,/%-*$1()$*($/(-AG$"(=#<#)B$4(*'$.-*&)%-2#$,(/.2.#*G$%-5$*(4#$,&+/.2$,)(A)%4*G$=.//$5)(,$0(&-A$,#(,/#$1)(4$'"#.)$,%)#-'*\$.-*&)%-2#$="#-$'"#0$ '&)-$Od3 c $b1'#-g$.-*&)#)*$=.//$#>'#-5$'"%'$5#%5/.-#$1()$1&//?'.4#$*'&5#-'*g$+&'$ '".*$A)%2#$,#).(5$2(4#*$'($%-$#-5$="#-$'"#0$/#%<#$*2"((/G$4#%-.-A$'"%'$1()$ 4%-0$2(//#A#$*'&5#-'*G$A)%5&%'.(-$5%0$%/*($=#/2(4#*$'"#4$'($'"#$)%-H*$(1$ '"#$&-.-*&)#53 d 9-$*(4#$*'%'#*G$/%=4%H#)*$"%<#$"#/,#5$0(&-A$,#(,/#$H##,$'"#.)$2(<#)%A#$ +0$%//(=.-A$'"#4$'($*'%0$(-$'"#.)$,/%-*$&-'./$'"#0$)#%2"$*(4#$(/5#)$%A#G$ *&2"$%*$KZ3 ON $]&'$KR$*'%'#*$"%<#$0#'$'($5($*(G$4#%-.-A$'"%'$="#-$4%-0$0(&-A$ T4#).2%-*$#-'#)$'"#$=()H1()2#G$="#'"#)$'"#0$=#-'$'($2(//#A#$()$-('G$'"#0$=.//$ /%2H$A((5$1%//+%2H$(,'.(-*$1()$2(<#)%A#$.1$'"#.)$#4,/(0#)$5(#*$-('$(11#)$.'3 6-1()'&-%'#/0$ 1()$ '"#4G$ '"#$ *.'&%'.(-$ 1%2.-A$ 0(&-A$ #4,/(0##*$.*$ +/#%HG$ %*$ '"#)#$ %)#$ *.A-.a2%-'$ (+*'%2/#*$ '"%'$,)#<#-'$ '"#4$ 1)(4$ A#''.-A$ ^&%/.'0$ 2(<#)%A#3$T$KNNe$C(44(-=#%/'"$I&-5$*'&50$1(&-5$'"%'$(-/0$Lf$,#)2#-'$(1$ Od?'(?Kd?0#%)?(/5*$=#)#$#/.A.+/#$1()$2(<#)%A#$'")(&A"$'"#.)$#4,/(0#)*3$!".*$ -&4+#)$.*$*.A-.a2%-'/0$/(=#)$'"%-$'"#$eR$,#)2#-'$(1$fN?'(?ZR?0#%)?(/5*$="($%)#$(11#)#5$2(<#)%A#G$%-5$%*$%$)#*&/'G$ _&*'$(-#?'".)5$(1$0(&-A$=()H#)*$%)#$2(<#)#5$+0$'"#.)$#4,/(0#)\*$,/%-3 OO $7(4#$%)#$%+/#$'($+&0$,/%-*$(-$'"#.)$(=-G$ +&'$%$1&//$Kc$,#)2#-'$(1$=()H#)*$.-$'".*$%A#$A)(&,$=#)#$&-.-*&)#5G$').,/#$'"#$&-.-*&)%-2#$)%'#$1()$('"#)$=()H#)*3 OK $ 2

7 7(4#$0(&-A$,#(,/#$%)#$%+/#$'($(+'%.-$2(<#)%A#$'")(&A"$'"#$.-5.<.5&%/$4%)H#'`'"(&A"$'".*$4#%-*$,%0.-A$1%)$4()#$ 1()$.-*&)%-2#$'"%'\*$4&2"$/#**$/.H#/0$'($(11#)$%5#^&%'#$2(<#)%A#3 Of $I()$4%-0$0(&-A$,#(,/#$#-'#).-A$'"#$/%+()$4%)H#'$ ()$1&//?$()$,%)'?'.4#$*'&5#-'*G$"(=#<#)G$#<#-$'".*$(,'.(-$.*$1()#2/(*#5G$%*$/(=$,%0.-A$%-5$,%)'$'.4#$()$'#4,()%)0$ =()H$.*$(1'#-$%//$'"#0$2%-$A#'$'($+#A.-$=.'"3$h('$(-/0$5($'"#*#$_(+*$)%)#/0$,)(<.5#$"#%/'"$.-*&)%-2#$+#-#a'*G$'"#0$ %/*($1)#^&#-'/0$5($-('$,%0$#-(&A"$'($%//(=$#4,/(0##*$'($%11()5$2(<#)%A#3$b<#)$%$'".)5$(1$=()H#)*$%A#5$Od?Kd$#%)-$ /#**$'"%-$ion$,#)$"(&)g$%-5$&-*&),).*.-a/0$rn$,#)2#-'$(1$*&2"$/(=?=%a#$=()h#)*$"%<#$-($4#5.2%/$.-*&)%-2#3 OR $ T-5$(-2#$0(&-A$,#(,/#$(+'%.-$2(<#)%A#G$'"#)#$%)#$1#=$A&%)%-'##*$'"#0\//$+#$%+/#$'($H##,$.'3$!"#0$1%2#$'"#$2"%//#-A#*$ (1$'#4,()%)0$_(+*G$".A"$_(+$'&)-(<#)G$%-5$,#).(5*$(1$&-#4,/(04#-'$'"%'$%'$+#*'$/#%5$'($%$5.*)&,'.(-$(1$2(<#)%A#G$ %-5$%'$=()*'$/#%5$'($+#.-A$&-.-*&)#53$T*$%$2(-*#^&#-2#G$%'$/#%*'$(-#$'".)5$(1$2(//#A#$A)%5&%'#*$2%-$#>,#2'$'($*,#-5$ *(4#$'.4#$&-.-*&)#5$.-$'"#.)$a)*'$0#%)$%1'#)$A)%5&%'.(-3 OL $T-5$%//$(1$'"#*#$#11#2'*$%)#$#>%2#)+%'#5$+0$2&))#-'$".A"$ &-#4,/(04#-'$/#<#/*B$OL$,#)2#-'$(1$KN?KR$0#%)$(/5*$=#)#$&-#4,/(0#5$.-$W&-#$KNNdG$%$*&+*'%-'.%/$.-2)#%*#$1)(4$'"#$ ON$,#)2#-'$&-#4,/(04#-'$)%'#$1()$'"#$*%4#$5#4(A)%,".2$.-$W&-#$(1$KNNc3 OZ $!%H#-$'(A#'"#)G$'"#*#$*'%'.*'.2*$5($-('$,%.-'$%$)#%**&).-A$,.2'&)#3$C(4,%)#5$'($#<#)0$('"#)$%A#$A)(&,G$0(&-A$,#(,/#$ %)#$4()#$/.H#/0$'($+#$&-.-*&)#5$%-5$/#**$/.H#/0$'($=()H$1()$%-$#4,/(0#)$="($(11#)*$2(<#)%A#3$I()$2(//#A#$*'&5#-'*$ %*$=#//$%*$'"(*#$="($A($*')%.A"'$.-'($'"#$=()H1()2#G$#11()'*$'($*'%)'$(&'$.-$'"#$=()/5$'(($(1'#-$/#%<#$'"#4$&-2#)'%.-$ %+(&'$="%'$=.//$"%,,#-$.1$'"#0\)#$&-1()'&-%'#$#-(&A"$'($A#'$*.2H3 The Impact of Health Care Costs 9'$.*$#%*0$'($5.*4.**$'"#$"#%/'"$2%)#$2(-2#)-*$(1$0(&-A$,#(,/#3$T1'#)$%//G$.'$.*$%$2(44(-$%**&4,'.(-$.*$'"%'$'"#0$%)#$ F(&-A$,#(,/#$%)#$*.A-.a2%-'/0$4()#$/.H#/0$'($/%2H$"#%/'"$.-*&)%-2#$2(<#)%A#$'"%-$%-0$('"#)$5#4(A)%,".23 R $ Percent Uninsured, By Age % uninsured under age 3

8 (<#)%//$%$"#%/'"0$A)(&,G$=.'"$/.''/#$-##5$1()$4#5.2%/$2%)#3$]&'$/%2H$(1$"#%/'"$.-*&)%-2#$"%*$*#).(&*$-#A%'.<#$2(-*#? ^&#-2#*$1()$0(&-A$,#(,/#G$="($*&11#)$2")(-.2$.//-#**G$-##5$,)#<#-'%'.<#$2%)#G$%-5$%)#$*&+_#2'$'($%22.5#-'*$_&*'$/.H#$ %-0(-#$#/*#3$ 9-5##5G$="./#$.'$.*$')&#$'"%'$0(&-A$,#(,/#$%)#$.-$A#-#)%/$1%.)/0$"#%/'"0G$0(&'"$.*$%2'&%//0$2(-*.5#)#5$%$,#).(5$(1$ ".A"$).*H$+0$'"#$4#5.2%/$,)(1#**.(-3 Oe $!"#.)$A#-#)%/$/#<#/$(1$A((5$"#%/'"$4%*H*$*'%)H$5.11#)#-2#*$.-$4#5.2%/$-##5*B$ %$*.A-.a2%-'$4.-().'0$(1$0(&-A$,#(,/#$"%<#$2")(-.2$.//-#**#*$*&2"$%*$%)'").'.*$()$5.%+#'#*G$4%-0$0(&-A$=(4#-$(1$ '".*$%A#$-##5$,)#?$%-5$,(*'?-%'%/$2%)#G$%-5$4#4+#)*$(1$'".*$%A#$A)(&,$4%H#$&,$%$*.A-.a2%-'$-&4+#)$(1$#4#)A#-20$ )((4$<.*.'*3$ T-5$_&*'$%*$=.'"$(/5#)$T4#).2%-*G$'"#.)$-##5*$4#%-$'"%'$/%2H$(1$%22#**$'($%11()5%+/#$2(<#)%A#$/#%5*$'($%-$.-%+./.'0$'($)#? 2#.<#$-#2#**%)0$2%)#3$!=($'".)5*$(1$0(&-A$,#(,/#$=.'"(&'$2(<#)%A#$)#,()'#5$1()A(.-A$-##5#5$4#5.2%/$2%)#$*&2"$%*$ a//.-a$%$,)#*2).,'.(-g$*h.,,.-a$%$)#2(44#-5#5$'#*'$()$*##.-a$%$5(2'()$="#-$*.2hg$+#2%&*#$(1$2(*'3$i()$.-*&)#5$0(&-a$,#(,/#g$"%/1$%*$4%-0`(-/0$(-#$'".)5`)#,()'#5$'"#*#$,)(+/#4*3 Oc $ ;.<#-$'"#.)$/%2H$(1$^&%/.'0$2(<#)%A#$%-5$A#-#)%//0$/(=$#%)-.-A$,(=#)G$.'$.*$-($*&),).*#$'"%'$="#-$0(&-A$,#(,/#$5($ 1%2#$4#5.2%/$2(*'*G$'"#0$.-2&)$4#5.2%/$5#+'3$V%2H.-A$%22#**$'($+#''#)$*(&)2#*$(1$2)#5.'G$4%-0$0(&-A$,#(,/#$=.-5$&,$ 4%>.-A$(&'$'"#.)$2)#5.'$2%)5*3$T22()5.-A$'($%$U#4(*$)#,()'G$0(&-A$,#(,/#$%A#5$Oc?fR$="($"%5$+())(=#5$'($2(<#)$ 4#5.2%/$2%)#$"%5$%<#)%A#$&-,%.5$2)#5.'$2%)5$+%/%-2#*$(1$iOfGfNf3NN3 Od $7&2"$%$".A"$+&)5#-$(1$5#+'$4%H#*$.'$#<#-$ "%)5#)$1()$0(&-A$,#(,/#$'($4%H#$#-5*$4##'3$ T-5$.-5##5G$*'&5#-'$5#+'G$.-2/&5.-A$2)#5.'$2%)5$5#+'G$,(*#*$%$".A"$).*H$'($*&22#**1&//0$2(4,/#'.-A$%$,)(A)%4$(1$ *'&503$I%2.-A$&-,%.5$4#5.2%/$2(*'*G$*'&5#-'*$4%0$%'$+#*'$"%<#$'($*'&50$,%)'$'.4#$()$=()H$4()#$"(&)*$'($2(<#)$ It was mid-july when I experienced the most severe pain in my abdomen that I had ever experienced. I told my father about the pain, and he told me that I would go to the doctor when I got back to Iowa and was with my mom again and with her insurance. Only I didn t get to go to the doctor when I got home. Shortly after my return, my mother was laid off from her job as an editor in a publishing company. This meant that we had only the income that the government gave us and no insurance until she could find another job. It took long enough for the symptoms I was experiencing to go from extreme stomach pain to having heartburn, having bowel issues, extreme gas buildup, loss of appetite, and the occasional non-digested food. When my mother had secured a new job. I received insurance, though it was not great insurance, and I went to the doctor. After about a year of tests they discovered that I have a form of a rare motility disorder, which means that my intestines don t have cleansing waves. My doctor told me that, had I come in a year earlier (when I didn t have insurance), I could have saved myself a year of pain, several panic attacks, and the agony of not knowing what was wrong with me. Adam Helgeson Rutgers University, NJ 4

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bG$-%'.(-=.5#$&-.-*&)#5$*'&5#-'*$.-2&))#5$+#'=##-$iOKN$4.//.(-$%-5$ ikll$4.//.(-$.-$&-2(4,#-*%'#5$2%)#$1()$-(-?.-_&)0?)#/%'#5$4#5.2%/$#<#-'*$.-$knnl`%-$#*'.4%'#$.-2/&5.-a$%//$4#5.2%/$')#%'4#-'g$%-5$&-5#).-*&)#5$%*$ =#//$%*$&-.-*&)#5$*'&5#-'*G$=(&/5$+#$".A"#)3 KO $ Student Health Plans: Unreliable Protection X%-0$ &-.<#)*.'.#*G$.-2/&5.-A$ '"#$ 6-.<#)*.'0$ (1$ C%/.1()-.%$ *0*'#4G$ "%<#$ -('.2#5$'"#$,)(+/#4*$1%2.-A$*'&5#-'*$="($/%2H$2(<#)%A#$%-5$"%<#$)#^&.)#5$ 1&//?'.4#$*'&5#-'*$'($"%<#$.-*&)%-2#$2(<#)%A#$%*$%$2(-5.'.(-$(1$#-)(//4#-'3 KK $ I()$'"(*#$*'&5#-'*$="($2%-$)#/0$(-$'"#.)$,%)#-'*\$2(<#)%A#$&-'./$A)%5&%? '.(-G$'".*$.*$%$*4%//$+&)5#-G$+&'$1()$('"#)*G$a-5.-A$2(<#)%A#$.*$4()#$5.1a? 2&/'3$8%)'/0$.-$)#*,(-*#G$%-$.-2)#%*.-A$-&4+#)$(1$&-.<#)*.'.#*$`Le$,#)2#-'$ -%'.(-=.5#`(11#)$'"#.)$(=-$*'&5#-'$"#%/'"$,/%-*3 Kf $T/'"(&A"$%22()5.-A$'($ '"#$;TbG$(-/0$e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a2#`+&'$%-0$ *'&5#-'$="($5(#*$*&11#)$1)(4$2%'%*')(,".2$.//-#**$()$.-_&)0$=.//$+#$#>,(*#5$ '($"&A#$/.%+./.'.#*3$ T$;Tb$)#,()'$1(&-5$'"%'$,/%-*$*#'$2%,*$%*$/(=$%*$iKGLNNG$4#%-.-A$'"%'$.1$%$*'&5#-'$2(4#*$5(=-$=.'"$%-$.//-#**$ '"%'$)#^&.)#*$*&)A#)0$()$)#,#%'#5$"(*,.'%/$<.*.'*G$%//$#>,#-*#*$(<#)$iKGLNN$=(&/5$2(4#$*')%.A"'$(&'$(1$'"#.)$,(2H#'3$ T-5$('"#)$,/%-*$(11#)$+#-#a'*$'"%'$%)#$(-/0$*(4#="%'$4()#$2(4,)#"#-*.<#3$b<#)$"%/1$(1$'"#$,/%-*$)#<.#=#5$+0$'"#$ ;Tb$"%5$%$,#)?.//-#**$2%,$(1$/#**$'"%-$ifNGNNNG$*'.//$1%)$/#**$'"%-$'"#$#>,#2'#5$2(*'$(1$')#%'4#-'$1()$%$*.2H$*'&5#-'3 KZ $ M"./#$.'$.*$%$,(*.'.<#$5#<#/(,4#-'$'"%'$*2"((/*$%)#$%''#4,'.-A$'($,)(<.5#$%$+%2H*'(,$/#<#/$(1$2(<#)%A#$1()$*'&5#-'*$ ="($/%2H$('"#)$(,'.(-*$'($(+'%.-$2(<#)%A#G$'(($(1'#-G$'"#*#$*'&5#-'$"#%/'"$,/%-*$,)(<.5#$(-/0$'"#$.//&*.(-$(1$2(<#)? %A#3$7H.4,.-A$(-$+#-#a'*$4%0$%//(=$&-.<#)*.'.#*$'($H##,$'"#$(<#)%//$,).2#$(1$2(<#)%A#$/(=`+&'$%*$%$2(-*#^&#-2#G$ '"#$)#*&/'$.*$%$,(/.20$'"%'$,)(<.5#*$-($"#/,$'($%$*.2H$*'&5#-'$_&*'$="#-$"#$()$*"#$-##5*$.'$4(*'3 Prospects for Reform I got injured while skateboarding and cut my leg above my knee. My friend drove me to the hospital and I got 3 stitches in the ER. Because I am uninsured I was later billed $300 for the visit. The friendly nurse also told me I was lucky my friend drove me, because if I had called an ambulance it would have cost me an additional $400, which I certainly could not afford. Courtney Shackelford Santa Monica College I()'&-%'#/0G$'"#)#$%)#$%$<%).#'0$(1$*.4,/#G$2(44(-$*#-*#$,(/.2.#*$'"%'$2(&/5$+#$%5(,'#5$.-$()5#)$'($"#/,$2(//#A#$ *'&5#-'*$%-5$%//$0(&-A$,#(,/#$"%<#$+#''#)$%22#**$'($^&%/.'0G$%11()5%+/#$2(<#)%A#B j$ T//(=$5#,#-5#-'*$'($*'%0$(-$'"#.)$,%)#-'*\$"#%/'"$2%)#$,/%-*$&-'./$'"#0$%)#$KZ3$]0$%//(=.-A$1%4./.#*$'"#$(,'.(-$ 5

10 (1$2(<#).-A$'"#.)$2"./5)#-$&-'./$'"#0$"%<#$%$2"%-2#$'($#-'#)$'"#$=()H1()2#G$0(&-A$T4#).2%-*$=.//$-($/(-A#)$ -##5$'($1#%)$+#.-A$4%5#$&-.-*&)#5$(-$'"#.)$Od'"$+.)'"5%0$()$A)%5&%'.(-$5%03 j$ C)#%'#$#>2"%-A#*$'($%//(=$.-5.<.5&%/*$'($,((/$'"#.)$+%)A%.-.-A$,(=#)$'($,&)2"%*#$.-*&)%-2#3$!".*$=.//$"#/,$ 0(&-A$T4#).2%-*$="($%)#$-('$(11#)#5$#4,/(0#)?*,(-*()#5$2(<#)%A#$'($A#'$%$+#''#)$5#%/`%*$=#//$%*$,)(<.5?.-A$2(<#)%A#$'"%'$2%-$1(//(=$'"#4$1)(4$_(+$'($_(+3 j$ b11#)$%$,&+/.2$"#%/'"$.-*&)%-2#$(,'.(-$'($a.<#$0(&-a$,#(,/#$'"#$2"(.2#$(1$+&0.-a$%$".a"?^&%/.'0g$/(=?2(*'$,/%-g$%-5$,)(<.5#$2(4,#'.'.(-$'($h##,$%//$.-*&)#)*$"(-#*'3 j$ [-5$,)#?#>.*'.-A$2(-5.'.(-$5#-.%/*$%-5$,)#<#-'$.-*&)#)*$1)(4$5.*2).4.-%'.-A$%A%.-*'$'"#$*.2HG$'($#-*&)#$'"%'$ 0(&-A$,#(,/#G$"#%/'"0$%-5$*.2HG$2%-$+&0$2(<#)%A#$%'$'"#$*%4#G$1%.)$)%'#3$ j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a2%-'$.//-#**$()$.-_&)03$]0$ %5(,'.-A$'"#*#$)#1()4*G$T4#).2%\*$)#,)#*#-'%'.<#*$2%-$#-*&)#$'"%'$0(&-A$,#(,/#$=.//$%'$/%*'$"%<#$2(<#)%A#$'"%'$4##'*$ '"#.)$-##5*G$'"%'$'"#0$2%-$)#/0$(-G$%-5$'"%'$=.//$%//(=$'"#4$'($'%H#$'"#.)$,/%2#$.-$*(2.#'0$%*$"#%/'"0G$*#2&)#$%5&/'*3$ 6

11 Endnotes O3$k%.*#)$I%4./0$I(&-5%'.(-3$!"#$%&''()'*$+,(-'.'/+01(2334(56""*7&(%8(9:.;:.<03$"'',BJJ#"+*3H113()AJ.4%A#*J%+? *')%2'JeedO3,513 K3$h#=$T4#).2%$I(&-5%'.(-G$!"#$C(*'$(1$U(.-A$h('".-AG$h(<3$OfG$KNNcG$*=*:$*>$'(*+("'',BJJ===3-#=%4#).2%3-#'J,&+/.2%'.(-*J,(/.20J2(*'l5(.-Al-('".-A3$ *=*:$*>$'(*+$"'',BJJ===3%4%?%**-3()AJ%4%OJ,&+J&,/(%5J44JfeKJ%Ne24*R3,513$ 6,5%'#G$T&A&*'$ZG$KNNdG$*=*:$*>$'(*+$"'',BJJ===32(44(-=#%/'"1&-53()AJC(-'#-'J8&+/.2%'.(-*J9**&#?]).#1*JKNNdJ T&AJ:.'#?(1?8%**%A#?M"0?F(&-A?T5&/'*?]#2(4#?6-.-*&)#5?%-5?Y(=?h#=?8(/.2.#*?C%-?Y#/,?KNNd?6,5%'#3%*,>3 L3$;(<#)-4#-'$T22(&-'%+./.'0$b1a2#G$J%0+(A%$$'<'(5+6;'.+0(K7'(A%='7';(L,7%6<,(!"#$%&'7(5#%.0%7';(C$*.0M(*.;(5%"'( ;Tb?Nc?fcd$m"#)#.-%1'#)$D;Tb$:#,()'En3$ e3$;tb$:#,()'3 c3$b:+'(%8(c*00*<'3 d3$?;o ON3$?;O OO3$?;O OK3$?;O Of3$C%/.1()-.%$Y#%/'"$C%)#$I(&-5%'.(-G$7-%,*"('B$Y#%/'"$9-*&)%-2#B$A*.(A*$:8%7.:*.0(K88%7;(?+D(233P(!;:+:%.G$W&-#$ KNNeG$*=*:$*>$'(*+$"'',BJJ===32"213()AJ'(,.2*J"#%/'".-*&)%-2#J.-5#>3214o.'#49UpOfffOf3 OR3$B:+'(%8(C*00*<'3 7

12 OL3$?;O OZ3$?;O Oc3$?;O "'',BJJ===35#4(*3()AJ,&+*J"#%/'"0l=#+3,513$ *=*:$*>$'(*+$"'',BJJ===3&-.<#)*.'0+&*.-#**32(4J<.#=%)'.2/#3%*,>o%)'.2/#.5pfNNq,1pO3$ KO3$;Tb$:#,()'3 *>$'(*+$"'',BJJ===3&-.<#)*.'0(12%/.1()-.%3#5&J-#=*J%)'.2/#JOdeNc3$ Kf3$;Tb$:#,()'3 KR3$?;O$T/*(G$*2"((/*$(1'#-$/.4.'$#/.A.+./.'0$1()$'"#.)$"#%/'"$,/%-*$+0$*#''.-A$%$4.-.4&4$-&4+#)$(1$2)#5.'*$'%H#-$+0$ '"#$*'&5#-'G$#>2/&5.-A$%$/%)A#$,%)'$(1$'"#$*'&5#-'$+(503 KL3$?;O KZ3$?;O 8