Making Medical History: Flat-rate Fees without Insurance

2009 July 9

In Seattle, one group of doctors has decided to move forward with its plans on providing healthcare, regardless of the Obama Admin plan to get everyone universal health coverage.  The Qliance group out of Seattle has been seeing patients under this program designed to offer people affordable healthcare, without having to wait to see what insurance companies will do:

Qliance says it is a private alternative to the failures of insurance, which have made health care President Obama’s top legislative priority in Congress, with a price tag of $1 trillion or more.

Qliance customers pay $99 to join, then a flat monthly rate of $39 to $119, depending on age and level of service. Patients can quit without notice and no one is rejected for pre-existing conditions.

Patients must go to outside brokers and qualify medically to buy catastrophic care. One broker said a 30-year-old could expect to pay $133 per month for such care, and a 60-year-old nearly $400, plus substantial deductibles.

Qliance patients get unrestricted round-the-clock primary care access and 30-minute appointments.

“Why would a doctor not want to see sick people? That doesn’t make sense, unless you’re an insurance company,” Bliss said.

He rejected the idea that unrestricted access causes overuse, calling that “nonsense promoted by insurance companies …. There’s nobody I’ve ever met who gets their pleasure by seeing doctors.”

One of the main arguments for this type of care is that when the insurance companies are taken out of the picture, everyone makes more money (patients, doctors, health care clinics) because one of the top middlemen is pulled out of the funding pool. It’s an interesting trend, and it’s one that I expect to see continue as the pool of people without insurance gets larger every week with lay-offs and financial issues.  There is a huge market for the next group who proves that healthcare doesn’t have to break the checkbook to be effective.  It’s such a large group, in fact, that I am willing to bet retailers like Wal-Mart and Walgreens will expand their health clinic services and expand their discounted health care plans possibly as loss-leaders or just plain money-makers.  Wal-Mart already offers vision services and flu shot clinics, along with a pharmacy and tax preparations, food courts, etc.   If Subway can make money in Wal-Marts by standardizing service with fixed prices, why can’t health care?

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Fired Adjunct Given Job Back: More Problems with Colleges

2009 July 9
Edmonds Community College
Image by djwudi via Flickr

In Washington State, one adjunct found restitution in the courts after she lost her adjunct position just as she became head of the union at Edmonds Community College. The labor board sided with the adjunct when she stated that she lost her job due to her union affiliation, and the college had to give Margaret West her job back, plus refund back pay.  This doesn’t happen often, so it’s worth reporting when it does.

It seems to follow the trend of firing adjuncts or instructors when said employees may pose a perceived threat to the administration.  Here is the updated list of colleges with firing/non-renewal disputes:

  1. Edmonds College
  2. Stillman College
  3. Bowdoin College
  4. Edison College

In the case of the adjunct, Margaret West, the law was on her side, but it seems that for whatever reasons, the college failed to understand this.  I see a trend with small colleges occurring here, which should make other adjuncts leery, but it may just be me.

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Commenting on the Adjunct Plight: Why do the readers of Inside Higher Ed miss the point?

2009 July 8

There is an article published with Inside Higher Ed called Add-junk or Instructor, written by a member of the adjunct teaching community.  As this adjunct has written about his experiences, the number of comments that appeared seemed to center on issues with writing style or personal attacks, not much on the issues themselves that occur with adjuncts working in dismal conditions.  I wrote a response to the article, which I have listed below, and Inside Higher Ed did publish, but I think it would be wise for others to take a look a the article, the commentary and the discussions surrounding adjunct work.

In this age of worsening conditions for all instructors, these are issues important to all of us.  An HR rep felt free to comment that the adjunct was only part-time for years due to  his attitude, which we have no way of knowing about for sure.  Maybe the adjunct taught part-time and worked full-time, but  he wanted to stay in the classroom.  I know lots of adjuncts who teach just because they love it, not for the money.  An English-titled commentator, apparently in the field for 4 years only stated that the adjunct was just bitter.  There was even a comment from an overseas reader who waxed on about the glory of student teaching, all with the idea of a pot of gold teaching position at the end of her rainbow.

I wrote the response below, but I would encourage all of you to take a look at the articles and write your own response.  My advice is Unasked, but yours might be welcome….

Seems that those who comment have taken 1 of 2 roads, those who chastise and nit-pick(from the seat of the full-time employee) and those who address the issue that adjuncts rarely get the respect that full-time professors get.  I understand the whole difference in education and background between adjuncts and professors, but the class warfare going on has nothing to do with the students and everything to do with bias.  It’s strange that a librarian and HR guy pick up the moniker to criticize but don’t look at the fact that perhaps those lower on the hiring scheme don’t want to “be given mandatory materials” to “teach.”  Perhaps the Writer above could look at the journey the course takes rather than pick apart a story description, or take issue with the way Burnt Out describes prose.  Is it really that much of an issue, really?

The real issues at play include the fact that there is class system in place for the adjuncts, and the adjunct roles are not organic pieces of work that grow into security and tenure (check out my posts on the frequent faculty firings lately regarding instructors speaking out).  Realistically, the question is:  how many professionals want to be told what they have to teach and then told that they should like it, especially when they can’t make a living wage?  I think it’s important to note that all the full-time people make their wages as a direct result of those adjuncts who earn more money for the university (rather than themselves) by having to accept a pittance pay and shoddy treatment while moving the students through the classes at the same standard (or higher depending on job security) as professors/the protected.

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Faculty/ Adjunct Firing: Stillman College, Edison Community College, & Bowdoin College seem to try to fire profs to keep them from speaking

2009 July 7

Even though I seem to take a lot of my comments from Inside Higher Ed, they have stopped publishing them, so I choose to print them here.  Check out the local community college, or smaller college trend of firing/censuring instructors for saying things that are unpopular:

It’s a troubling trend, and one that polarizes the commentators who speak up after the articles come out.  Part of the problem with the adjunct dilemma is that for speaking up, they can be fired. (to read about the adjunct drama, check out Burnt Out Adjunct) Part of the frightening aspect of this new trend is that all kinds of instructors are getting censured, for speaking out about issues at their schools.

I find Inside Higher Ed’s choice of commentary suspect, as even they seem to censor quite a bit, but they are a publication and publications run by what seems like conservatives tend to censor.  I expect it.  Colleges aren’t expected to censor their employees to such a degree, and it appears as though the business model of getting rid of employees who don’t agree with you might be employed by the colleges, it may not be legal to do in a publicly funded institution.  (Check out Martha Stewart’s jail time and sentence for a more cautionary tale of using the presidential power under public funding and getting slammed by employees.)  But really, what happens when private institutions accept public funds (like putting a company on the market, getting publicly funded student loans, getting government bail-out loans for automakers and bankers)  to help make their budgets?  Well, those same private companies are now subject to more public rules and regulations.  It seems that CEO’s and small college presidents forget this. Isn’t it time to fire some of the college presidents too?

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Add Eddison Community College in Ohio to the list of openly censoring professors by firing them–as deemed necessary by President Yowell

2009 July 7

Remember when I wrote about Stillman College and some of the others who are focusing on quelling free speech among their profs by firing them? (title and link occur after this article too)Edison Community College and its President Yowell get the Assshole Business Award of the Week for their firing of Professor Stephen D. Marlowe, an English professor who was possibly fired fro criticizing the president of the university, Yowell.  Yowell is running two for two in squelching dissent as he also fired an adjunct who refused to turn off his video camera during a public meeting:

Like Marlowe, Essinger was an outspoken critic of Yowell’s leadership, especially the mass non-renewal notice sent to a number of employees prior to the finalization of Edison’s budget. Still, though Yowell openly admits that he does not like Essinger’s “attitude,” he cited one specific action in his rationale for not bringing back Essinger, an adjunct in his first year who has earned excellent student evaluations and the respect of his supervisors.

Essinger videotaped a contentious Edison board meeting in April, following the faculty’s no-confidence vote in Yowell, so that the many interested faculty members who could not attend the meeting could see the proceedings and hear Yowell’s and the board’s reactions. At the start of the meeting, he was asked by the board chair to shut off the camera, although there are no statutes in Ohio that block the videotaping of public meetings, and many are routinely videotaped by news organizations and other parties. When Essinger declined to shut off the camera, he thought he was doing his colleagues a service, but it may have been his undoing at Edison.

“Mr. Essinger disrespected the board chair in the process,” said Yowell of Essinger’s refusal to shut off the video camera. “He shouldn’t have done that. His bad behavior is being punished. I told [his supervisors] that I did not what him reappointed for that reason. He expressed a bad attitude, and I’m not going to put up with that. “

Thank goodness all professors now understand the equivalent of a preschool rule will determine their professional fate.  I mean, for a while it seemed like Yowell had a personal vendetta against anyone who disagreed with him.

Firing of faculty: How Mc Nealy got it wrong and Stillman College is in for a fight

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Beautiful | Eminem | Props to the Michigan Artists–Unasked Says He’s Alright

2009 July 6
The City of Detroit
Image via Wikipedia

Remember when I said I was worried about Eminem, what happends when his anger is gone? Well, turns out he can still put things out there. From a woman’s perspective, I would say he is looking thin and sad, a bit haunted by everything that’s going on. Living here in MI, I can understand that haunted bit–just ask my moniker. But, still, I am impressed that Eminem is showing a softer side, and it’s good. It’s not overdone. It’s sticking with his honesty, and he is talking about how he doubts himself. Obviously Eminem is sad about Michigan’s troubles. And I love the fact that he is reaching out. Instead of telling us how wonderful he is, he is sharing the fall of his home state. For that, I have to give respect. I have been looking for some depth from Eminem, and I like what I see.

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Good Girls Go Bad | Cobra Starship | Monday Music

2009 July 6
by brokeharvardgrad

While I think it’s every guy’s dream to make a woman do something she wouldn’t normally do just with him, I have to say that the only thing the white glasses on this guy inspire me to do is punch him. I can’t really tell you why, but it might have something to do with his dorky-wannabe type song. If you have to brag about it, you don’t have it. The little back and forth riff reminds me of this “shit is bananas” insertion. Not too bad, but I never wanted to be bad for a guy, so I can’t really relate. I was just bad in general, and if he happened to be there, well he most likely ended up in a fight. Not really the point of the song though… The magic might not be there for me.

The Teenage Pregnancy Equation–from the Mailbag: teenage mothers should not give birth

2009 July 2
Anti-teenage pregnancy III
Image by Polina Sergeeva via Flickr

I recently got a provocative comment in from a reader, whose image I used when I wrote about Candies Anti-Teenage Pregnancy Campaign, and I thought it was worth posting for discussion.  The artist, who took the pictures of sullen looking teenage girls with dolls proclaims that girls are being punished not for their sexuality, but for giving birth to children they can’t care for:

This image you have used is my artwork. It was made AGAINST teenage pregnancy, aka “Babies Having Babies”. Girls are being punished not for getting pregnant, but for carrying out a baby into the world. Bringing a child they have no ability to raise or support. I am pro-choice and that was the idea behind this image.

Thank you for the attention you have given to my artwork, I appreciate your feedback =)

While I understand that the topic of teenage pregnancy ignites a lot discussion, I also adamantly support a woman’s right to give birth or not, as she may choose:

Dear Polina Sergeeva,
I agree that babies having babies does offend some people, and while I agree that every woman has the right to choose her own response to her fertility (abortion or carrying to term), it is a woman’s right to do as she chooses. I don’t think many people are “for” teenage pregnancy, but if teenagers choose to give birth, then they have that right, as well as the right to terminate. Why should girls be punished for bringing a baby into the world when the boys are part of the equation? I, too, support a woman’s right to choose what happens to her body, at any age, but I wouldn’t dream of prescribing to any woman whether or not she should birth a baby. The problem that I see is that boys/men routinely cast blame and share no responsibility.
I do like your artwork, and I think that it’s provocative. I am using the image gleaned from Zemanta to showcase opinions. I think the artwork stands on its own merits.

I’ve posted the image again above, and you can read my post that began this discussion below:  In the teenage pregnancy equation(and the Candies ads): where are the fathers? (unaskedadvice.wordpress.com).

I still think that women shouldn’t be punished for having children, regardless of how they get pregnant, because it takes two to make a baby.  In a further attack on the dignity of women and teenage mothers, a viral video, now pulled from YouTube depicts a teenager giving birth on a field, supposedly with a cell phone video.  It just serves to reinforce that the men (boys running around playing soccer) don’t have anything to do with birth as the spectator sport moves to a teenage actor pretending to give birth on the field.  It disappoints me because birth is then seen as a punishment, much as the comment above seems to feel women/teenagers should be punished for giving birth.  There is no such thing as sexual equality in our culture until the punishment of women for a mutual sexual result ends.  We won’t have true sexual freedom until people stop punishing the pregnant woman.

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50% of Patients Don’t Get the Pain Relief they need after surgery

2009 July 1

As you all know, those of you who follow my blog, I have been investigating health care practices after suffering my own injury in a botched surgery, and I have come across some startling facts regarding how many people suffer unnecessary pain after surgery:

Pain is thought to be inadequately treated in one half of all surgical procedures.1 In addition to immediate unpleasantness, painful experiences can imprint themselves indelibly on the nervous system (Figure 1), amplifying the response to subsequent noxious stimuli (hyperalgesia) and causing typically painless sensations to be experienced as pain (allodynia). A chronic condition sometimes develops that produces continuous pain long after surgery. Prior painful experiences are a known predictor of increased pain and analgesic use in subsequent surgery.2,3

So why do half of the patients who have surgery not get the pain relief they need?  I think this has to do with a bias that doctors have that everyone should just “tough it out.”  I know I suffered with severed nerve pain and was told to take 600mg of ibuprofen.  As you can guess, it didn’t touch the pain.  My family doctor was more helpful, and continued to order tests to help determine the cause of the nerve pain.   Not surprisingly, this link is sponsored by the American Family Physician Group, the same type of doctor who actually believed and treated my pain.

I live with chronic pain every day caused by my surgery, some days feeling like my skin is being burned with a blow torch, and even water or clothing touching it is painful, so I will admit I have stake in putting this information out there about pain relief.  But, I also think is more evidence that we need to hold physicians responsible to the same level of standards that we hold other industries.  The medical industry  needs to be held accountable, and that hasn’t happened much at all lately.

Simply obtaining a medical license does not mean that a person is without fault:  look at all the doctors surrounding celebrities like Anna Nicole, Anna Nicole’s son, Michael Jackson, and Marilyn Monroe, Heath Ledger.  Simply having a medical degree does not prevent someone from engaging in harmful or criminal behavior.  So, why would there be laws to protect a set industry like the medical industry?  We know that pharmaceuticals can kill.  We know that doctors are implicated in lots of deaths through medical errors, and yet we still, as a nation, have no real centralized system of tracking these errors.   If celebrities are routinely injured by medicine, how many others of us are out there who are injured but won’t be heard?

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When I Grow Up | Pussycat Dolls | Stripper Choreography and Justin Timberlake STD style

2009 June 29
LOS ANGELES, CA - SEPTEMBER 07:  Members of Th...
Image by Getty Images via Daylife

Okay does this look like a trashy cross between Justin Timberlake’s alleged infection status and a stripper bar in traffic? yeah, I kind of thought so too. This Monday is starting off kind of weird anyway. I usually start Monday off with music and try to end the week with my Asshole Business Awards, but perhaps I could start the week by featuring the production designer of this video in the Asshole Business Awards of the week category. Talk about making women look harsh, possibly infectious and a little too thin.  After all, everyone knows that the real way to define strong and empowered women is to feature them thrusting their scantily clad breasts at the camera while they glare as though this somehow indicates their true strength and physical abilities, not to mention the enticing aroma of their spiritual state.  I hate it when women attempt to look sexy by posing with a look of killer constipation.  Geez, why not just hit a guy if they’re that pissed off?  Seems to work well for other female artists, but apparently the men were in charge of this objectifying video, because all the women do is posture, stick out their breasts and hips rather convulsively and look like pissed off “professionals”  stuck in a bizarre metro traffic/construction jam.   I like the beat, but I can’t get past the weird stripper look. Yes, I can safely say that I think every girl hopes she too can grow up to be a stripper in mid-town traffic in the music biz. Congrats, Pussycat Dolls–I think you hit on every one of our female fantasies. What does it say though that this is supposedly what you wanted?

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Strip Search of Students Illegal

2009 June 25
U.S. Supreme Court building.
Image via Wikipedia

Remember when I wrote the post about the V.principal Kerry Wilson mandating the strip search of a 13-year old girl for ibuprofen?  Well, the Supreme Court backs the student in this one and says that it’s not okay to have strip search of our students in schools.  Thank goodness someone was paying attention here.  Would we really say that this was allowed in schools and then send our kids there?

I asked, a few weeks ago, whether or not the body of a 13-year old girl belongs to the school which she attends, and thankfully the court says no.  Click here for the full background story:  Does the body of a 13 year old girl belong to the school district?

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GM didn’t follow its own market research and now declares bankruptcy

2009 June 24
WARREN, MI - JULY 18:  General Motors vice cha...
Image by Getty Images via Daylife

GM declared bankruptcy on June 1, 2009, and if all of you think that we in Michigan didn’t see this coming, I am here to set the record straight.  See, here in MI, we have lived with the auto industry, we know it like a partner.  Our friends and family have worked for GM, bought cars for GM, made pieces on the lines, had parents and spouses work in management, and our other friends and family worked for GM suppliers.  We lived in GM neighborhoods, where everyone went to work in the same building, and this is how we knew it was failing 5 years ago.

But wait, GM is saying that they had no idea this was coming?  That’s like your spouse saying that they had no idea they blew all the money in all the accounts on a vacation trip to the Bahamas and nights of drinking and debauchery.  The GM execs were on a wild ride, and it seems destined to failure even now, even after they have come home hung over.  HOw can you get over that kind of betrayal of trust?

Trouble really started brewing about 5 years ago, when the gas prices went up, car quality went down, and people started to get angry about how many imports others were buying.  It used to be that anyone who bought a foreign car was frowned on, shunned in the autospeak of Michigan.  But, then people like us bought new GM vehicles, and our Blazer just missed the test for the Lemon Law because the dealership wouldn’t diagnose the transmission issues.  The transmission went out 6 months later, barely two years old, and we spent thousands putting in a new transmission.  Others had their vehicles fall apart little by little, with the seals breaking so the car leaked through the car wash, with the electrical components shorting out (no air conditioner working, the fans broke, the windows wouldn’t roll down).  Even the cigarette lighter, the biggest proof of America’s encounters with big business (tobacco industry) necessitating an ineffective component for a car, stopped working.  (We can all contemplate how scary it is that we even have cigarette lighters in a vehicle that doesn’t need them to function at a different time.)

So those of us close to GM, who knew its habits, who knew that everyone was staying out too late, breaking things, and having problems, knew that things were growing horribly wrong.  Delphi executives started to get snotty, mandated frequent travel from their managers, 5-0-60 hour work weeks for salaried employees with the constant threat of firing, and more time spent on training as the company tried to limp along their numerous ineffective factories that were rapidly moving to Mexico, being cut off from GM and generally going downhill.

I can remember that I knew it was all over when one of the more senior management staff was proven to be sexually harassing female co-workers and HR simply transferred him to another department to harass more women.   I knew then that if they transferred management like that, with no penalties, under the threats of lawsuits from the other women, with proof galore of this man’s piggery, then the management at GM was too old school, too irrelevant, too cocky, and doomed to failure.  It looked a lot like the old guy with a bad comb over who still wants to be the sexy guy he thinks he is and doesn’t realize his bald spot is burned, his gut hangs over his belly, and he’s going to be fired.  Rick Wagoner anyone?

Well, anyway, those of us Michigan, other women in particular said to some of the engineers at the plants:  we want reliability, not fearing that we will be stranded on the road in the dark with a broken car and at the mercy of whomever stops.  We want to have vehicles that fit us, not monster trucks that cost $60,000 and require a step ladder to get into.  We want to have vehicles that aren’t all blue, red, and silver that get 20 mpg and look like bad 20’s Batman minivans.  But by then, GM wasn’t even looking at its own market research (check out the Grand Rapids Press for that article), and everyone at GM was in top denial, even as they were being rejected one by one.

I consider part of GM’s failure to be a gender war, a war in which the men, the good Old White Man’s Club, surrounds itself with the same type of guys, the same type of attitute, the same type of vehicle, because it makes them feel manly, validated, and bigger than everyone else.  You can bet I wasn’t the only woman who cheered when GM execs scrambled in front of their government investigators.  I cheered when GM declared bankruptcy, and even though cutting off GM is like ending a bad relationship, it was time to go.  GM just wasn’t working for us anymore.  GM just didn’t have the respect, and America lost the love.  GM, if you are looking to rebound, check out foreign markets, because we in MI have already cut our hair, gotten new lipstick and bought a Toyota.

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Chris Brown Strikes A Plea Deal| News Video |

2009 June 23
by brokeharvardgrad

Okay, so I called it when I said Rihanna looks scared in her videos and seems pleading in the sexuality department that something was amiss, but who knew that Chris Brown would actually plead guilty? I can’t comment on the sentencing as I am not familiar with the charges leveled for domestic assault and am usually in the “didn’t punish them enough” club. But, I thought that Chris Brown had a dark side. In fact, after watching Rihanna, I watched some of Chris Brown’s videos to see how he reacted to women and the result: Chris Brown watches women in the videos like they are objects. Rihanna’s videos (which I thought might be due in part to poor production) really reflected a scared element on her part, a reflection of a real-life dilemma. Rihanna didn’t have a healthy adult relationship, much less a healthy sexual relationship with her boyfriend, as evidenced by his guilty plea in the felonious assault charge. Poor Rihanna, and why didn’t someone step in before she got beaten up?

Lucky | Jason Mraz |

2009 June 22
by brokeharvardgrad

La voz…yo te quiero.. y la ritma, y la musica… Suerte: la inspiracion para las lunes

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Michigan Medical Malpractice Laws Violate Constitutional Rights

2009 June 22
"Michigan State Capitol dome interior, La...
Image via Wikipedia

So, I have done some research over the weekend about the consitutional right to have access to the courts.  It may seem like an arbitrary thing to do, but it really bothers me that Michigan, unlike a few other states, would set financial parameters for basic citizens entering courts.

I checked out the prices over the weekend for medical specialists who would need to sign an affidavit of merit, and here is what I found:

  1. Mayo Clinic:  Joanne says that the docs charge $1,000/hour or $6,000/day, but they can’t talk to me, the doctors “don’t get involved in that stuff,” and she hung up on me.
  2. On-line Consulting Group:  says their docs charge $1,000 just to  look at records, and about the same for hourly rate, but they only talk to lawyers
  3. On-line Med Mal referral:  says they charge $1,000/inch of medical records to review, and I couldn’t get a firm quote on an hourly rate

My initial research shows that this type of referral needed to enter the court isn’t anywhere near the average person’s price range, and then we are still in the dilemma of having to pay thousands of dollars to get to see a judge.  It’s been a humiliating experience, and people seem unaccountably angry with me for contacting them.  Mayo Clinic had the rudest staff out of all of them, and they have the most bureaucracy, but they told me that they wouldn’t even respond in writing, because according to Joanne:  “that’s just too much effort for me…”  Yeah, so Mayo may be one of the top clinics, but they sure don’t have top points for polite staff.

I am still finding other laws that support my theory that making a plaintiff (or injured patient) pay up to $10,000 to have someone review records and write a report is unconstitutional.  In fact, when I checked the MI Tort Law Reform book, the one case that they cite occurred in West Virginia, not Michigan.  And now, in MI, judges, who have received thousands of dollars in campaign funds from health care groups, state that injured patients must pay a doctor to say they can go to court.  Now, to find out which states have overturned these rulings… Stay tuned!

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