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Would a completely free market healthcare system with zero government involvement and no subsidies for anyone work better in the long run?

I see a lot of answers here that seem to be leaving out a lot of relevant information. I’ll do my best to address this as clearly as I can, and I’ll update this if discussion in the comments shows a need to.First, I would say, yes, I believe it would be better.Many of the other answers pointed out that if someone needs emergency medical attention, they’re just going to get it no matter the cost. They deem health care to not fit into the free market system because the consumers of health care aren’t able to make rational market-based decisions. It sometimes comes down to life or death, and so they take what they can get. The argument then goes to say that this means there is no incentive for health care companies to provide treatment at a reasonable cost. Their incentive would be to drive up the costs as high as possible since people will pay anything to save their own life.This is all true and fair, only if there was only one health care provider with no competitors and the only time you can make decisions about your own health care is at the time of an emergency.Multiple health care providersIf there are multiple health care companies offering the exact same service in every relevant way, a company wanting to compete must increase the value of their work, either by improving the service, or decreasing the price. Both of these have limits. For instance, if all these companies are providing the best quality care possible, then the only thing that could be done to compete would be to reduce the price. What the consumer is willing to pay is simply one of many variables that go into setting the price of a service.The lack of competition is a huge incentive for high prices. If you can keep competition out of your industry, you will have a monopoly. We actually see this in effect quite often. For instance, you’ve probably read in the news last year about EpiPen’s cost skyrocketing[1]. The natural reaction is to get mad at the drug companies, but why would they care if you’re mad. They’re protected by the government that you believe is protecting you. Thanks to patents, they don’t have to worry about competitors. If you want the drug they invented to save your life, then yes, you have no choice but to pay them whatever they ask. In a truly free market, competition of all kind is allowed. Patents and copyrights only serve to create these types of dangerous monopolies.I mean, what an amazing opportunity this would have been for a competitor in a free market! EpiPen prices shoot up and any entrepreneur with any business sense at all would see that and have dollar signs flash in their eyes. They see that a company has created a huge opening for someone else to do the same thing they’re doing, but cheaper. It’s the easiest business model there is. The cost of producing the drug is very low so the quality wouldn’t even suffer. In fact, coming into the market at precisely that time would provide it’s own marketing benefits. They’d be immediately seen as heroes by the general public. It’s a formula that just couldn’t fail.In a truly free market, it is possible that some prices will be higher, but it is likely that most prices will be lower when you actually take into account all incentives a business owner faces. The overhead of business taxes and government licensing fees also go a long way to increasing the price of the services. I’m not saying some form of oversight is bad. I’m saying government oversight is bad. BBB, Trust-Guard, Consumer Reports are all examples of non-government services that will verify the integrity of the businesses on which they report. I would much sooner trust business like these. A government can “make mistakes” all they want, and will never be held accountable. In the free market bad decisions result in the business failing. In government, you just get a new manager.In some countries (like Canada) you have no say in who treats you whether you can afford better or not. You get who you’re assigned. If you end up with someone fresh out of med school with zero experience and a drinking problem, then that’s just how it goes. Even if you have the time and money to put towards a skilled doctor with years of proven experience, it doesn’t matter. In Canada, you aren’t a consumer of health care. You’re a child being nursed.Shared CostsHere’s a little secret about me. I’m broke! If I had to pay out of pocket for some emergency health care costs, I could probably afford a Band-Aid and a hug, but only if the hug was free. Even in a free market, there’d be no reason for me to need to do pay out of pocket for medical costs.What is it about the government running health care that is so appealing? It’s still being paid for by you. It’s just spread out. It’s literally just mandatory health insurance, but you no longer have a say. Again, in a truly free market, health insurance agencies would be quite competitive. You could choose exactly the right agency for you based on costs and services. Now, instead of paying out of pocket for your emergency costs, they come out of the pool provided by the insurance company. It’s the same as the government doing it, except the one with the power to make the decisions is you.You could even have it worked out beforehand that, should you need certain emergency treatment at a time when you’re unable to voice an opinion for whatever reason, what your preferred facilities/doctors/level of care/etc would be.But what about those who can’t pay anything? This is the realm of charitable work, which is something governments are notoriously terrible at. Imagine that instead of your tax dollars being taken forcefully by the government and used for whatever they deemed appropriate, you could decide where it went and how it was spent. You decide that you’re going to donate a portion of that money to charities that help those who can’t afford health care. One of the options sees to it that 30% of the donated funds are used by those who need it, and 70% are given to the administrators[2]. The other option gives 82% to the cause, and only 18% is used to pay administration.[3] You’d obviously opt for the second option. The first option is actually the current situation with government spending on welfare related systems. The second option shows the far better spending by private charities.Consider that math! You could give half of what you are currently giving to the government to charity and the amount of money actually being put to use would still be more!To me, it seems very obvious that state should stay out of all industries, including health care.For further reading on this subject, consider checking out Steve Day's answer to What is your review of Anarchism?Footnotes[1] Rising cost of potentially life-saving EpiPen puts pinch on families[2] Welfare Reform[3] Financial Score Conversions and Tables : Charity Navigator

What are your thoughts on the Japanese concept of 'Ikigai'?

It’s absolutely beautiful.And a powerful yet simple way to always strive for improvement.As a kid, you start off by finding “what you love”. These are your hobbies and dreams, you enjoy doing them.Slowly, you drop some of them off. “You are no good at XYZ”, you are told. And you believe it and try and find things you are good at. After all, most people’s childhood is just a never-ending comparison with others who are “better at this” and “excellent at that”. Your hobbies get stowed in a corner and you try and discover “what you are good at”, aka your talents.Later, when you are about to graduate, you realize that a lot of your skills aren’t marketable. You might be good at painting, but you realize that it is a very idiosyncratic market where the chances of success are infinitesimally small. So you once more filter your skills and try and find something that will help you earn a living wage, something “you can be paid for”, or skills.As you grow older, you read news about people who are changing the world. The teenager who just received a Nobel Peace Prize, or the billionaire building floating extraterrestrial cities. You feel unfulfilled, not knowing what your true calling is. You can’t provide anything “the world needs”.But in all of this, you never realize that you can have it all.Yes, it will take a long time. And unwavering persistence. Lots of failures and dejection. And periods of utter misery.But you can have it all.I love writing. It is something that I discovered about a decade ago. I worked on it for years to the point where I am now good at it. Voila!, I have discovered my passion. I also have other skills that I am really good at — crunching numbers, analyzing data, creating novel solutions. And I utilize them at my job. I am good at what I do and I get paid for it, so I have my profession too.But honestly, I have no idea how to combine the two of them as of yet. I have a few thoughts but there isn’t much progress there. Despite what I preach to others here, I too fall in the trap of lethargy frequently, making excuses for not working to convert my passion into a full-time profession.Once (hopefully) when I have that, I will try and find my true calling. To see how I can take the intersection of these three things and use it to make the world a better place. The pursuit of my Ikigai will be a long one, but I am going to persist.And I believe that all of us should do the same (see, more preaching!).Take the example of Bill Watterson, one of the most famous cartoonists on the planet.Bill had found his passion at a young age. He loved drawing and aspired to be a cartoonist, much like the people he idolized, foremost of them being the creator of Peanuts, Charles Schulz.He pursued his passion and created his own profession. After a couple of other stints, he finally struck gold when he created his magnum opus, Calvin and Hobbes. He could now make a living utilizing what he was good at and what he loved to do.And then slowly, he developed his calling too. Watterson’s stubborn denial to merchandize CnH was a testament to his beliefs against diluting something good just for more money.Some very good strips have been cheapened by licensing. Licensed products, of course, are incapable of capturing the subtleties of the original strip, and the merchandise can alter the public perception of the strip, especially when the merchandise is aimed at a younger audience than the strip is. The deeper concerns of some strips are ignored or condensed to fit the simple gag requirements of mugs and T-shirts. In addition, no one cartoonist has the time to write and draw a daily strip and do all the work of a licensing program. Inevitably, extra assistants and business people are required, and having so many cooks in the kitchen usually encourages a blandness to suit all tastes. Strips that once had integrity and heart become simply cute as the business moguls cash in. Once a lot of money and jobs are riding on the status quo, it gets harder to push the experiments and new directions that keep a strip vital. Characters lose their believability as they start endorsing major companies and lend their faces to bedsheets and boxer shorts. The appealing innocence and sincerity of cartoon characters is corrupted when they use those qualities to peddle products. One starts to question whether characters say things because they mean it or because their sentiments sell T-shirts and greeting cards. Licensing has made some cartoonists extremely wealthy, but at a considerable loss to the precious little world they created. I don't buy the argument that licensing can go at full throttle without affecting the strip. Licensing has become a monster. Cartoonists have not been very good at recognizing it, and the syndicates don't care.And more than two and a half decades after the comic ceased to be published, its legacy lives on.It is one of the most beloved comic strips of all time, packed with precious life lessons — The Impact of Calvin and Hobbes.Watterson would often load his comic strips with some subtle satire or critique about the educational system, public polls, or just life in general. The comic captivated children, but for the adults reading them, they would have their perspective changed. Upon re-reading them you’d learn something new every time making this series truly everlasting. Often times the true beauty of Calvin and Hobbes would be the conversations Calvin would have with his stuffed tiger. Ethically baffling questions were proposed, with the answers and meanings to others discerned through the dialogue they would have. Often times this would be had while they traversed the woods on their way to the Yukon, camping out in their backyard, simply trying to go to sleep at night while thinking about friendship (perhaps as a distraction to ward away the terrors of the night). It’s these things that go on in a young child’s mind that often goes unsaid because it never really needed to be brought up by a six year old. Watterson expertly crafted such short little stories that chronicled hundreds of memories in the life of one fictional boy and his tiger; which then impacted tens of thousands of readers across the entire world. All because Watterson was willing to ask meaningful questions through an art form.It is then no surprise that Mr. Watterson had a fulfilling life. And that is something we all can, and should, aspire for.

Are China and the United States of America moving toward a new kind of cold war?

Short answer: No and it’s complicated.Long answer:We should first clarify what we mean here. “Cold War” is a very specific historical term that has been conscripted as an analogy to describe what’s going on between the US and China.And it should not be. Chinese academics themselves don’t use “Cold War” to describe their current rivalry with the US. They use the term “Competitive Co-Existence”. This is a far less hawkish term than what the Americans are using. And it’s a correct term.What the US and China have is a rivalry. This is INCREDIBLY different from what a cold war is. The Cold War in the US meant an overall foreign policy that was Zero Sum. There was no space for co-existence with the USSR. It was an entity that was considered (at least initially) as weak and destined to be destroyed overtime by the US, if the US pursued certain policy actions such an “containment”.Rivals however, compete with each other, they don’t try to destroy each other.The use of the term “Cold War” as an analogy to describe the state of US and China relationships comes specifically from policy making think tanks in the US. Even US historians reject using it as either an analogy or a framework for defining the US-China relationship.These US policymakers are holdovers from the Cold War era who seek to beef up their profile and maintain relevance in the 21st century by drawing parallels between the US and USSR cold war and the current US-China relations (perhaps hoping for renewals of their tenure). Kissinger, the current war criminal in US hire, is one of the biggest proponents of using “Cold War” to describe US-China relations (“We are in the foothills of a new cold war” is what he said).If the US chooses to let these holdovers define US policy towards China today, then it won’t be any surprise if the US creates a self-fulfilling prophecy and drags the US into an unnecessary confrontation with a rival that never needed to turn into an escalated frozen conflict.The other major error of using the Cold War as an analogy for the current US-China relations is because the context of the Cold War was so astronomically different from what you have today that it’s lazy and criminally irresponsible to apply this analogy to US-China rivalry unless you are Bolton and WANT a war.1. The Cold war occurred in the aftermath of nearly 30 years of 2 major global conflicts and a great depression. Current US-China relations are in the aftermath of 30 years of peace under the declining US Hegemony.2. The Cold war was in the aftermath of 30 years of rising tariffs and closed economic systems. Currently, we are seeing a downward trends on tariffs overall and open economic integration.3. The Cold war was in the aftermath of 30 years of USSR economic isolation. Currently, the US-China rivalry is under the shadow of 30 years of Chinese economic systems in the global economy.4. The Cold War was in the aftermath of vast destruction across Europe and Asia with Germany and Japan completely decimated and occupied. China was in a civil war. Huge vacuums of power surrounded the Soviet Union. And in these vacuums of power, massive revolutionary and de-colonization movements were emerging that were ridding the old powers of their holdings in the soon to be ex-colonies.Today, China is surrounded by a resurgent Japan, a major regional power in the form of India, an assertive Russia and a wealthy, industrialized South Korea.5. The Cold War came when capitalism was in disrepute as it was blamed for 2 world wars and a great depression. French and Italian communist parties were on the verge of winning elections in their respective countries. Marxist Leninist ideas and central planning that led to rapid economic growth and industrialization were immensely popular as ideas in revolutionary movements sweeping across Asia and Africa. The Cold War was under the shadow of socialism’s mass appeal. The Labor party was voted into power in the UK as it called for the nationalization of major industries and implementation of social welfare programs. The USSR had vast ideological appeal as an entity promoting social justice and equality.This is not what is the case today. China does not offer ideological appeal of the same kind and it’s message is one of nationalist, not Globalist, ethos: “Socialism with Chinese characteristics”.6. The Geo strategic threat today is completely different. Back during the cold war the key policy message was the following: The US must not allow an adversary to gain power in Europe and Asia. This is because during WW2, Germany and Japan’s conquest of vast land holdings in Europe and Asia allowed them to amass enormous resources and industrial material and human labor that allowed them to wage an effective war against the US. The USSR after WW2 appeared to be able to present the same threat as it’s ideological appeal in vast power vacuums, its military strength and (then) impending US withdrawal from Germany and China appeared to give it a close chance of gaining control of similar vast economic resources.This is not China. It is nowhere the same geostrategic threat of the USSR during the 40s and 50s. The South China sea islands are not the same as the USSR’s contest for power in Poland and Romania. The Spratly island dispute is not the same as the tense movements to control Germany.7. The risks taken during the cold war were much larger due to the higher stakes (control of Europe and Asia) at play. Containment of the USSR as a policy was pursued due to the belief that the USSR was making major inroads across the world especially when China fell to the Reds after the Chinese civil war ended.This is not what China is doing today, nor can it do this today.8. The Cold War, being a rivalry of political and economic systems, also resulted in the US and USSR competing to form systems that improved the quality of life for their citizens so they could show case the ideological appeal of their citizens over the others. Kennen himself stressed that the US needs to demonstrate, at a time when democratic capitalism was considered weaker to communism and central planning, that Japan, Germany, the US and the UK could establish democratic capitalism and improve the lives of their citizens immensely. The USSR was doing the same with Communism and Central Planning.The US has not responded to the rise of China by somehow trying to adopt policies that improve the lives of their citizens at a time when their political institutions are faltering, mostly because they don’t see China’s system as having vast appeal beyond their borders.The two axioms of the cold war that drove containment policy of the US towards the USSR were:The US and USSR were such ideological opponents that there could be no co-existence between them. Both believed the other was out to destroy their way of life.George Kennen believed that the USSR was fundamentally a weaker entity that would back down in the face of strong US resolve and containment.Neither of these are true today. China is not seeking to destroy the US way of life. Nor is it weak as an entity the way the USSR was (at least that’s what Kennen believed based on his observations of the inner workings of the USSR economy and political system).The Cold War was also something that integrated ideology-geopolitics-economics into one over arching struggle between the USSR and US. The USSR was also feared as a threat by the US because it was able to create massive geopolitical opportunities due to it’s immense ideological appeal (you don’t have to take my word for it, this is what US leaders believed and documented in various public sayings in the 1940s and 50s). And the USSR had intentions to exploit those geopolitical opportunities.To think that China has similar ideological appeal across the Globe that can be exploited as geopolitical opportunities is almost delusional.Similarly, Kennen believed that the US could push ahead with major risks like the Berlin Airlift and containment because 1) He believed the USSR was much weaker 2) the US had a nuclear monopoly 3) There were no economic interconnections between the US and USSR.While China’s military still lags behind the US to an extent, all 3 of the above are not true today. And to base US risk taking off of them with respect to China is a major disaster waiting to happen. Instead of realizing the fundamental common interests between the US and China on preventing pandemics, preventing the spread of nuclear weapons, preventing a conflict in Korea or South Asia and preventing Climate change, this Cold War analogy sets both up for an unnecessary conflict.To double down on the above points about how the Cold War analogy is so false, I think we need to acknowledge that the period of the Cold war was the tail end of a period of time when the world was gripped by major insecurities due to scarcity.We seem to have forgotten about Malthusian ideas that the world population was growing so rapidly and so out of pace with agricultural output that we would soon face global starvation on an unprecedented scale.There were massive wars of conquest over land and resources during this period of time, with ideology serving as the mobilizing basis for such conflicts, all the way from the French Revolution to the 1960s and 70s.As Dr. Francis Gavin puts it, this period of scarcity and crises has been replaced since then by a period where the problem is a problem of plenty. We have too much now. Whether it’s the climate change crises (rooted in too much industrialization and consumption), the obesity crises, the opioid crises.So the institutional framework or the political institutions that were developed during the cold war or that rely on the cold war as an analogy will look at the world through the lenses of great power conflicts that were fueled by scarcity.Which is not the nature of our world today and the nature of the US-China rivalry. Why wouldn’t you use political institutions here to resolve these issues that are geared to deal with the problem of too much consumption, too much information, too much free flow of money, too much trade and so on.I might be beating a dead horse at this point but I just want to give an example of how dangerous it can be and how badly the US can get it wrong if they frame China of today with the same cold war lens as the 1945–1991 period.For this example, lets take Hong Kong.If it was the 1950s and the Chinese wanted to take Hong Kong, they probably would have just invaded and taken over. They had the military muscle and proximity for it.So why doesn’t modern day China do that as well?Hong Kong is one of the 3 primary capital markets in the world today besides NY and London. Its the go-to place in the world when you want to raise significant capital.The primary power of Hong Kong is the trillions of dollars in capital that the Hong Kong Banks sit on and it’s draw as a financial center in the world. Its the fact that Goldman Sachs is there. Its the fact that if you’re a exec in the financial world, you would probably chose to live in Hong Kong and raise a family there cause its a great city and it has a powerful, well integrated financial system there.Invading Hong Kong means Goldman Sachs leaves. It means capital flight. It means no more fancy bankers choosing to live there.The CPC knows this which is why all of it’s political moves towards Hong Kong are carefully calibrated to ensure Hong Kong’s capital stays put and it remains a financial center. Because the CPC is under no delusions that if that money leaves, its gonna come to Shanghai. It wont, It’s gonna go to London or NYC. Which the CPC wants to avoid at all costs.Think of this for a minute and understand how differently the CPC is acting here compared to the CPC that was dealing with Taiwan during the island crises of the 1950s which I also wrote an answer about:Usama Ahmad's answer to What is the most ridiculous war ever fought in our history?If you were still stuck on the cold war analogy, you would be advising the US president a few years ago or back in the 90s that the Chinese were going to invade Hong Kong by force to retake it.And you would have been completely off the mark in your advice because that never happened. Because the CPC of today is not the CPC of the Cold War and using the Cold War analogy to understand China today and think of it as a USSR substitute for the modern day is a recipe for disastrous foreign policy mistakes.There was a time for International Relations when they could be shaped by John Mearsheimer and Kenneth Waltz who defined ways of thinking in IR under the framework of scarcity. But that time is long gone and we live in a new age now.We cannot define US-China relations through outdated Great Power competition frameworks that were beginning to get out dated even in the 1970s as they were defined by the US-USSR and old European power rivalry.We need to define US-China relations in the new age of plenty, where we have Climate Change, free flows of information (to an extent), massive movements of people and financial flows.The Cold War analogy is primarily used in the US by hawks who are interested in turning China from a rival to an enemy, mostly because it would reinforce the systems of US militarization that provide them with their domestic economic clout.A bit of a segue, but to be honest, even the definition of what the “Cold War” was is a bit murky and people who have studied it in depth have vastly different time frames for when the Cold War actually began and ended, timeframes that vary significantly from the standard 1946–1991 timeline. There are academics who have posted detailed thesis framing the cold war as starting much eelier (1917 or even the late 1800s). Others have pushed the date forward and consider the Cold War to begin more around the time of the 1949–1950 timeline when you had a series of crises such as the detonation of the USSR’s nuclear weapon, the Korean war and the Chinese intervention in it.History itself is a pretty complex subject and as people in the present, we have retrospective bias when looking at the past. What that means is that when we look back at the Cold War, we tend to project our bias on what living through it must have been like based on how we know things turned out in the end.But for the people who actually lived and died through the Cold War, the experience would have been very different.A good example is how we in the present think of the Cold War as a continuous historical episode. But for people living through it, it would have been more like periods of intense crises islanded between business as usual.The 1949–1953 and 1958–1962 periods of intense crises. 1953–1958 was pretty relaxed even as the McCarthyism period gripped America. 1963 to the 1970s was characterized by close cooperation on nuclear issues.There is a lot of interesting uncertainty when discussing the Cold war and to be honest, the more confident I hear someone talking about the Cold War in the present the more I suspect that they only have a surface level understanding of it.Seasoned Historians have different answers as to why the Cold War lasted so long when most of the Geo Political issues were somewhat settled by the 1960s. They also have different answers on why and how a Hot War was avoided if the Cold war was so bad in the first place. And more importantly: Was the Cold War inevitable.We don’t even have definitive answers around why the Cold War ended. Was it the driving of the USSR bankrupt through US actions under the Carter-Reagan administration? Or was it the internal contradictions of the USSR’s political and economic system itself?I love Dr. Francis’s analogy on the circular nature of how our view of history can be shaped by the present and how our present can be shaped by our view of history in some ways.Imagine you had to write a text book about international politics from 1945 to 1990. And you had to update the edition every 10 years. So your first edition would be in 1990, next in 2000, next in 2010 and next in 2020 and so on. And you only had 300 pages.Historians know that that volume would look different every 10 years.That 1990 volume would have maybe 2 pages on China at most.The 2020 one would have a 100 pages on China.The 2040 one might not even mention China but talk about how much GDP the US lost when Florida went below sea level and California turned into a desolate, burned out desert thanks to Climate Change.The Global Forces that drive world politics often look different in retrospect than in real time.And this analogy is extremely important for us to understand because it leads us to the next question:Was the Cold war even the most important global force driving world politics between 1945–1991? Or do we think this way because of a centralization of history around the US first and Europe second?There were other seismic events that shaped the world that do not get as much attention but might actually rival the Cold war in terms of importance if not exceed it clearly.The European Integration project for one. Tony Judt has work written around how he believes that the most important event after 1945 was the resolution of European tensions and the creation of the European integration project.Then we have decolonization: The vast majority of the Earth’s population experienced that period not as a rivalry or conflict between the US and USSR, but as the creation of new national identities in South Asia, Africa, East Asia, South East Asia.Similarly, post 1945 can also be regarded as the history of the Nuclear Age rather than the cold war (oh yea, they are both distinct and separate from each other).Alternatively, we could say that the beginning of Globalization in the 1960s and 70s, its acceleration in the 1990s and it’s intersection with the rise of China could be the deciding global force shaping world politics.Of course, it could also be that all these historical threads intersected in complex ways to shape the history of the world during this period of time.This was a bit of a long segue bit it was important for a core reason: The struggle to understand and answer these questions, the struggle to understand the nature of history gives you far more insight into the present and positions you better to understand and act in the present.And allows you to avoid these lazy, false narratives of there being a “Cold War” between the US and China that are being pushed by Kissinger himself or Kissinger wannabes who want to get appointments or tenure in DoD or Pentagon positions because a war between US and China is good for their pockets.The Chinese have acted smart so far and understood that in this day and age, what they have with the US is “competitive co-existence” and not a Cold War. And have quietly continued to build on their economic strengths by investing in AI, human resources, infrastructure, education, healthcare and so on. Because these are the foundational pools of power in the 21st century.The US cold-war analogy pushers have been most frustrated perhaps by the Chinese refusal to accept the Cold War as an analogy and invest in nuclear weapons, command and control systems, hard military assets the way the Americans do in order to trigger an arms race that diverts China away from the economic well being of her citizens.To conclude: No, I do not think there is a cold war between the US and China and I understand that this is an anaology pushed by policymakers, not historians, in the US who are either trained in outdated IR techniques that do not apply to the modern world (ignorance) or because they want there to be intense tensions and near conflict between the US and China because it serves their domestic interests (malice).We are in a different age now, and need to understand history better if for no other reason than to understand our present better. Our present circumstances call for new political and IR ideas that are based around the issues we face today because those issues will reveal a far more common stance between the US and China on the major crises facing the world today (Climate Change, Pandemics, Unstable regions). And puts them both on the path to cooperation rather than conflict.Academic sources: Emma Bates, Dr. Francis Gavin , Dr. Melvyn Leffler

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