Does New VA Secretary Have What It Takes?

On Tuesday, the newest VA Secretary was confirmed to lead the country’s second largest federal agency under President Joe Biden.

A nonveteran, Secretary Denis McDonough will now lead the agency responsible for providing benefits and services to over 20 million veterans while managing over 300,000 employees and the nation’s largest socialized healthcare system. The annual budget is well over $200 billion, but the agency has yet to fully resolve many challenges of past administrations.

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Many veterans complain about challenges getting access to both benefits and timely healthcare despite expansion of community care. Agency employees are still fearful to dissent against leadership that encourages groupthink. The electronic health record is still not transitioned from VistA to MHS Genesis. And there are many other issues that remain unresolved from previous administrations.

VA Secretary Denis McDonough is a nonveteran. He lacks a track record of success leading a massive workforce and budget like that of VA.

But are these qualifies that are necessary to successfully lead VA?

Well, so far the former track record of most VA secretaries has not mattered, and failures have been abound.

McDonough did serve as a White House chief of staff, deputy national security advisor and chief of staff of the National Security Counsel during the Obama Administration. He has a bachelor’s degree and master’s degree.

While not a veteran, McDonough is the first VA secretary who is more of a DC insider. The majority of previous secretaries were familiar leading military platoons where soldiers were forced to comply with leadership.

Here, I suspect McDonough will be adept at striking deals given his experience managing the expectations of Congress, union leaders, and military commanders while in the White House.

What does this mean? It means many of the hang-ups we noticed from President Trump’s secretaries may not phase McDonough. I would expect less friction and infighting between the different stakeholder camps. The union and military brass will likely fall in line. Congress may also be more prone to not raising eyebrows at least for the sake of optics for the next year.

Recent comments from a VA spokesperson that I reference below serve as a reminder that the agenda of the federal government is to mold VA into the model of healthcare delivery for the entire US, not just for veterans but for everyone.

But it is not limited to healthcare. It also encompasses population management.

VA’s strategies for population management including healthcare delivery will be rolled out to every corner of the country for civilians and veterans, alike, mark my words. Come hook or crook, that is likely going to be the major push over the next four years.

RELATED: Population Management And Genomics At Core Of VA Data Deal

Some Background

It would appear Secretary McDonough is set to finish the agenda rolling under former Secretary Robert McDonald, from 2014 to 2017.

At the time, McDonald, Army veteran and West Point alumnus, had rounded out his tenure as CEO of Procter & Gamble and implemented the MyVA and I-CARE initiatives as well expanding the agency’s relationships with the private sector including Disney.

RELATED: VA To Tap Disney For ‘Disneyization’ Of Veterans Affairs

Some of you may recall an internal power shift under former President Donald Trump and bad blood between McDonald and Trump ended with David Shulkin taking over the top spot in what was rumored to be a bit of a coup against Shulkin’s then boss.

Prior, Shulkin, a medical doctor and business executive, was brought in to reform the Veterans Health Administration as its Undersecretary. Wikipedia states both McDonald and Shulkin were opposed to privatization of the agency, but ironically both former secretaries presided over its expansion.

Will Privatization Continue?

While it is a popular political football between Democrats and Republicans, both parties have enacted policies to accelerate privatization of the agency. This is in furtherance of the Reinvention of Government initiatives under the Clinton Administration of 1993.

RELATED: VA Uses Clinton Executive Order To Preempt States’ Rights

Since that time, many federal agencies are now dependent on private sector contractors after giving up their legacy positions to various partners like IBM, Xerox, Microsoft, and Amazon. If privatization were suddenly stopped, the agencies could not function. Some might argue this includes our own military and its reliance on companies like Kellogg, Brown & Root to conduct overseas wartime operations.

RELATED: Whistleblower Exposes $7 Billion No-Bid Defense Department Contract

VA is critically reliant on private sector vendors for its payment systems, computer systems, software systems, management functions, construction, you name it. Many people wearing white coats in most VA medical centers are government contractors, not VA employees. Even management of community-based clinics has been outsourced in many locations.

Selection Of Shulkin

The majority of veteran organizations in 2017 were critical of Shulkin’s selection including his lack of military experience. Meanwhile, his supporters cited his business accomplishments and medical training as possible favorable attributes. Eventually, Shulkin was ousted in a bit of a coup to remove him from leadership by Trump loyalists.  Around that time, He reportedly cooled off approving the Cerner deal to convert VA electronic health records into the MHS Genesis system approved by the Department of Defense.

RELATED: Top PR Officials Lobby For Shulkin Termination (USA Today)

Privatization Of VA Electronic Health Records System

Generally, senior leadership that did not support the transition to Genesis from VistA left the agency around that time. The deal to privatize VistA was swiftly inked by former Secretary Robert Wilkie when he served as the acting secretary prior to his confirmation.

Some of you may be unaware that VistA is an open source (free to use by the public) electronic health records system designed by software engineers call the Hard Hats who worked in VA to maintain and develop the software. It became quite popular and even serves as the backbone of many similar systems around the world.

Over a decade ago, challenges arose between the Defense Department and VA to unify their electronic medical records systems.

After spending billions with contractors resulting in no success, the Kansas City based Cerner was awarded the contract by Wilkie in 2018.

It appears the MHS Genesis system will be proprietary meaning VA will likely be dependent on Cerner and other contractors to maintain the system moving forward. Since it failed to support the legacy Hard Hats and similarly situated software engineers.

Presently, the Cerner rollout is in dispute. Some union organizations such as AFGE have indicated the software package is not working as advertised, but the agency under the previous administration disputed the allegation.

VA Is Model For America

Curiously, on VA spokesperson had this to say about an internal memo critical of the transition:

“It addresses data strategy broadly and is focused on positioning VA to lead the future of U.S. health care — ensuring information management capabilities provide a best-in-class veteran and employee experience.”

So, why all the brew-ha about what is happening in VA and why should America care more? It is not just about veterans. Under the previous administrations over THREE DECADES, and I quote, “is focused on positioning VA to lead the future of U.S. health care”.

This is why it matters how the previous administrations responded to the wait time scandal, electronic health records transition future scandal, red flag tribunals, lowering the training requirements for healthcare providers, and various privacy rights violations of veterans.

RELATED: Should VA Destroy Physician-Led Care?

VA is the model for America’s future socialized healthcare delivery system. That is a fact, meaning we need to work hard to resolve some of its more troublesome challenges.

RELATED: Paranoid VA Officials Paint Veterans As Crazed Psychos

The Wait Time Scandal

McDonald had some significant improvements underway in the agency after taking over from Eric Shinseki following the shocking revelations of the Phoenix VAMC wait time scandal the rocked the nation. Veterans died while waiting inappropriate amounts of time for access to healthcare, nationwide.

The scandal served as the springboard to implement seemingly radical changes to the agency including introducing Veterans Choice to ramp up access to non-VA care in the community. It also resulted in McDonald’s implementation of directives to improve customer service quality treating veterans more like customers and stakeholders similar to how private corporations operate.

Some within VA considered the post-2017 era as being chaotic. Though, the agency’s customer service has steadily improved compared to previous decades.

McDonough Confirmation Hearing

During his confirmation hearing, McDonough listed five priorities if he were confirmed: 1) getting veterans through the current pandemic; 2) help expand civilian opportunities to veterans through education to find appropriate jobs; 3) improve inclusion of veterans who are women, minorities, and LGBTQ; 4) reduce homelessness; and, 5) reduce veteran suicide.

These issues are the current smokescreen that mirror the platitudes of the political party in the majority at the moment. Behind the scenes, VA is simply moving forward with the 30 year plan.

What do I think will happen?

We will likely see an expansion of what we saw at the end of the Obama Administration as well as expansion of what we were seeing under the Trump Administration. Many of the senior leaders who left positions in senior leadership within VA are back in either leadership roles or advisory roles likely to conclude some unfinished business from 2017.

What we have seen we will continue to see. VA will expand its control and involvement in civilian healthcare delivery by continuing to train medical doctors, nurses, etc. We will see its population management systems expand. We will see an expansion of the health record exchanges systems that will unify control over civilian, veteran, and military medical records systems and healthcare delivery. We will see more medical journals propagandize the public with articles promoting VA healthcare delivery quality over civilian quality.

Under authority of the current pandemic, we may also see VA facilities open their doors to treat civilians.

RELATED: VA Opens More Beds For Non-Veterans

Below in italics is the Secretary’s message following his confirmation. I wish him the best and hope veterans receive better healthcare and benefits delivery in the future.

Secretary McDonough Message

As I begin my tenure at the Department of Veterans Affairs, I want to take a moment to speak directly to Veterans and other VA stakeholders and share my thoughts on VA’s mission and the road ahead.

It is the honor of my lifetime to join the VA workforce in serving Veterans, their families, caregivers and survivors. We live in peace and security today because of the sacrifices of generations of Veterans. My career has afforded me a privilege available to relatively few Americans: to see up close the excellence of our Armed Forces in the field on my regular visits to Afghanistan and Iraq; to witness the strength and resilience of our wounded warriors at Walter Reed; and to experience the unimaginable grief of military families there at Dover when our fallen heroes come home one final time. From that I have a passion to fight relentlessly every day to ensure that VA serves our Veterans as well as they have served America.

Throughout those experiences I’ve also been deeply impressed by the dedication and excellence of VA employees. I look forward to being a true partner with the men and women of VA – dedicated, highly-skilled professionals, many Veterans themselves – Veterans serving Veterans who deserve our profound respect and support.

At this moment when our country must come together, caring for you – our country’s Veterans and your families – is a mission that can unite us all.

The president has called on every American to embrace our responsibility to support our Veterans and their families. So this administration will work with other federal departments and agencies, with Veterans service organizations, with the National Association of State Directors of Veterans Affairs (NASDVA), and with other state and local organizations, both public and private, who have the best interests of Veterans and their families at heart. We must work together to serve all Veterans.

President Biden has defined our country’s most sacred obligation as preparing and equipping the troops we send into harm’s way and then caring for them and their families when they return. Here’s how we at VA will fulfill our part of that sacred obligation.

Every decision I make will be determined by a simple principle, that it increases Veterans’ access to care and benefits and improves outcomes for them.

Our highest priorities will be VA’s three core responsibilities: providing all our Veterans timely, world-class health care; ensuring they and their families have access to the benefits they’ve earned; and honoring our Veterans with a final resting place that’s a lasting tribute to their service.

In addition, we’ll do everything in our power to help Veterans get through this pandemic; help them build civilian lives through education and jobs worthy of their skills and service; ensure that VA welcomes all Veterans, including women, Veterans of color and LGBTQ Veterans; work to eliminate Veterans’ homelessness and reduce suicide; and keep faith with their families and caregivers.

Assessments of our efforts will be measured by the outcomes we generate for Veterans and by listening to what Veterans have to say about their experiences. We will be strengthened by the advice and support of Veterans service organizations and by hearing from our partners and respected organizations who share our mission of improving Veterans’ lives.

We’re going to focus on living our core VA I-CARE values in all our interactions. Integrity, Commitment, Advocacy, Respect and Excellence – these values will define who we are, our culture, and how we care for Veterans and other VA colleagues.

This means that all VA patients, staff, their families, caregivers, survivors, visitors and advocates must feel safe in a workplace free of harassment and discrimination. I will not accept discrimination, harassment or assault at any level or at any facility within VA. We will provide a safe, inclusive environment for Veterans and VA employees. Simultaneously, in VHA and VBA, we will redouble our efforts to care for Veterans who are survivors of military sexual trauma, ensuring they can all count on VA’s support.

We can achieve our mission only by embracing the incredible diversity that defines our Veteran population and all of America, leveraging everyone’s talents and passions. I commit to these principles, and I will make sure that my senior leadership team reflects and embeds them in everything we do.

We are fortunate to have a strong ally and leader in the White House. President Biden gave me a clear mission – to be a fierce, staunch advocate for Veterans and their families. His marching order to me is clear – fight like hell for Veterans. And we are going to fight like hell to give our Veterans and their families the benefits, services, respect and dignity they deserve.

I fully embrace this mission, and I know the VA workforce does, too.

May God bless our troops, our Veterans, their families, caregivers and survivors – and, as a nation, may we always give them our very best.

What Do You Think?

We are not in Kansas anymore as a nation.

McDonough’s team has promised more transparency with the press than the previous administration, which would be a welcomed improvement.

I personally do not believe being a veteran automatically translates into being a great leader of one of the largest union employers in the country. We have seen many generals and senior officers whiff when trying to implement military management strategies over its civilian, union employees. It just does not work out well for anyone, especially veterans relying on smooth implementation and effective policies when receiving healthcare and benefits.

Over the past 4 years, it certainly seemed like the Trump Administration was at odds with federal leadership and Average Joe union employees. Whistleblowers widely did not report improvements in how the agency handled its investigations. Instead, it became easier to terminate.

On the other hand, veterans’ use of community care expanded. VA accelerated adjudication of benefits claims. Veterans have noticed better customer service.

While not perfect, the agency has improved quite significantly over the past 6 years as if the wait time scandal of 2014 shocked the system back to life.

It will be interesting to see how a DC insider will move the agenda forward.

Will it be like herding cats or lemmings?

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  1. VA model is I don’t care that’s what they told a vet at the DC VA that offed himself. Vet s should get care every 90 days not 1 a year. No accountability. Biden gave us 40 dead vets and cooked books. VA fueled the opiod crisis while the government goes after walmart. Korean war vet waited over 70 years than approved after he died for disability. The entire system is broken. The Social Security system is worse as news out of Northfolk Virgiana a guy with beer and 600 rounds.

  2. Yeah, I’m still alive and still a target for the VA clowns, civilian health care unions/health care “complex/Industry.”

    Any hope? Will things change? NO. We, some, many, are still dealing with vast amounts of unbelievable cover-ups and corruption, bottom to top and everything in between including vet groups to media clowns who fear the systems that be and prefer to “fit in’ rather than support some other vet or civilian dealing with it all.

    Too many scum-bags have been allowed to retire, move, or will remain protected by the establishments and unions.

    “Justice delayed is justice denied.” Too many records have been purged, too much ignored, too many witnesses now dead or running off in fear. Media trash has literally laughed in my face over this stuff and had good belly laughs over local VA issues and the many suicides and reasons why. Yeah, really something to laugh about then smile on TV while refusing to report some facts and truth. Might offend some SJW or union, or politician, state officials and their two-faced lying staff who all refuse to do their jobs. Like those in the judicial systems that refuse to help out in our Kangaroo courts.

    Sue Bozgoz (Youtube) and many others, like me, get nothing but censored, attacked, more threats, totally ignored, etc. While others may claim to get good care, but that is not everyone especially those labeled “whistle blowers” or complained about the wrong persuasion of people or type of staffers. Then we gotta play a Cofeefee bug mind-game and more. Nope, not one damn thing will change. As usual. Nothing like being shunned and ignored by an entire community, state wide, and clear to the corrupt clowns in DC.

    1. Words from government don’t mean any thing any more. He can promise what he wants. Joe let us know what he thinks about us to appoint a non-vet to “lead” the dysfunctional hydra we call the V.A. Not much. It was done purpose to send us message, and intended to insult.

    2. We American citizens are waiting across the board for the federal government to start focusing on why they are there. Please do something positive and constructive to assist many. My point is please let Former President Donald J. Trump go.
      All the federal government has done and mostly referring to politicians and everyone who hated this president is engage in politics to take him down. Investigations run amuck, wasted millions of dollars, wasted time and energy.
      Just think how many veterans and even non veterans could have been landed with a hand up into employment with good salaries and with meeting needs with the amount of money they have used to try to take Former President Trump down. They have hated him because he gets things done that needed to be done. He has exposed what they have been up to and they did not like the American people seeing what they have been truly doing while in their positions. I will say all of this has turn my stomach. However, many Americans were witnessing the situation long before Former President Trump was elected. This is why he was elected to begin with. His election was not about him. His election was about how the federal government was trampling over everybody and everything while selling us out to other countries. So I will say that if this new VA Secretary is really in tune to delivering to veterans, we hope that he follows through.
      Maybe one day they will get beyond hating this past president just because he was trying to deliver to the American people. Current administration needs to get on with the business of the day which is serving the American people. Will they?
      I seriously doubt it. Everyone have a great week. 🇺🇸🗽👍

  3. I don’t know where you guys have been getting your care. But for the last 8 years I have been given the best care and advise from a kind and knowledgeable VA primary care physician. I was a train wreck before I sought VA health care and I was dieing with a ruined liver and bleeding from both ends. The physician that was given to me saved my life in no uncertain terms . I have only high marks for my health care team and would recommend VA to every veteran who is eligible. Don’t be so hard on the whole group because of a few dumbasses. Do your best research and your own legwork. Be proactive. Good luck.

    1. Thank you, Shannon for your positive comment. We all need to hear credible valid humane successes when they do happen because the successes have been few and far between. Though, when socialized medicine is discussed as becoming world class healthcare, this has never been the case in history. Socialism does not deliver LIFE for anyone. I do not care what the powers to be claim. Group think does not allow for innovation and does not deliver success period. I have never been able to understand why the federal government strives so to sabotage people. The federal government does not produce, manufacture, build, or innovate anything. It just gets in the way of those who have tried to accomplish something worthwhile. Now, I am speaking for myself in this case. Over the recent years, the federal government, i.e. the VA has done absolutely nothing in my best interest. I have had to straighten up behind them while they believe they are the only ones who have any know how. The federal government does not seem to allow for any veteran to improve to choose his or her own path. For example, I say 2+2 is 4. They say 2+2 is 5.
      I wish the new VA Secretary luck.

    2. Your anectodal example does not disprove the disaster that is the VA. The fact you are on here browbeating veterans who have suffered poor care at the hands of the VA shows low character and low IQ on your part. Wow, a whole 8 years you have been going there. So that makes you an expert, huh? Not everyone gets great VA healthcare handed to them on a silver platter. You are just another blue falcon. People have been fighting with the VA for decades just to the basics, but you got what you wanted, so to hell with everyone else, right?

  4. Yawn? I really can’t see where or how the Sec VA selection matters. When did it? Granted, I’m a relative newbie to VA Healthcare, ca 2013. In those years, I’ve had four pirmary physicians and a couple of subs. In contrast, in the local private sector, my wife has burned through eight primary care providers, none from her own chosing.

    Can I complain? Not really, if my metrics are compared to the private sector. In the last couple years I’ve had a handful of Choice appointments (or whatever the rebranded name is). Communications with those outside entities is horrible. Getting my tests and reports ported over to the VA primary is a problem. Getting VA test results to outside specialists is a problem. But, these are issues I anticipated (oh me of little faith). I made sure I’d downloaded my reports from the VA’s system and brought them to my outsiders. Likewise, I made sure to get my outsider reports uploaded into my VA files. That bit is not always easy, but it is important.

    Bottom line. There ain’t no cradle to grave for anyone. We often hear our doctors, VA or civilian, tell us to be engaged in our healthcare. Exercizing that bounces from sledge hammer to scalpal techniques. Yes, it could be better. Boyoz, it could be a lot worse. If I can point to one tool that has smoothed my healthcare goals, it’s MyHealthEvet. It’s an outdated platform with a primitive dashboard. But I haven’t had to make a frustrating phone call in the last six or seven years. Everything I ask for, everything I point out, everything is on record. My PCPs nurse usually gets back to me on the same day. My distant specialists (VA) get back to me in 24 to 48 hours. My wife is every envious.

    Or, maybe I’ve so lowered my expectations that I can fabricate success.

    To quote Lili Von Schtupp, “I’m tiwed, so wairwy wairwy tiwed…”

    1. We are the throw away generation. Face it the Left and globalists see us as a waste if time and money. “Fodder to be used on foreign battle fields promoting globalist foreign policy.”

    2. Ben, I make quick judgements on them just like they do regarding non veteran citizens and veteran citizens. I am referring to my previous “NO” comment answer to your question. This is what they do to American citizens without even knowing the truth. They fail to remember the relationships work both ways.

    3. Ben, I make quick judgements on them just like they do regarding non veteran citizens and veteran citizens. I am referring to my previous “NO” comment answer to your question. This is what they do to American citizens without even knowing the truth. They fail to remember the relationships work both ways.

  5. From the Message:
    “Every decision I make will be determined by a simple principle, that it increases Veterans’ access to care and benefits and improves outcomes for them.”

    “providing all our Veterans timely, world-class health care; ”

    “Assessments of our efforts will be measured by the outcomes we generate for Veterans and by listening to what Veterans have to say about their experiences.”

    “We’re going to focus on living our core VA I-CARE values in all our interactions. Integrity, Commitment, Advocacy, Respect and Excellence – these values will define who we are, our culture, and how we care for Veterans and other VA colleagues.”

    “We are fortunate to have a strong ally and leader in the White House. President Biden gave me a clear mission – to be a fierce, staunch advocate for Veterans and their families. His marching order to me is clear – fight like hell for Veterans. And we are going to fight like hell to give our Veterans and their families the benefits, services, respect and dignity they deserve.”

    “and, as a nation, may we always give them our very best.”
    First, I am being denied a second opinion for a very deadly blood disorder.

    Second, the employees are still NOT being the professionals they claim to be.

    Third, when will this (bullshit) be implemented!!!?

    Fourth, how long will this one (secretary) last?

    Here is something I wrote while under severe duress of inadequate healthcare at the v.a. system of crooks who rob us of a decent life by not providing the REQUIRED care, the level and quality of while being amicable. –
    The Military Man’s Request

    The military man said as he was boarding the plane, boat or personnel carrier for war to his family and townsmen and women, “I will put my life on the line for the good of the whole but, you must promise to take good care of me if I return. That is all I ask. I do not want you to kiss my hand, just treat me with respect and give me the dignity I deserve and have earned.”
    © 2017 It was listed in the Library of Congress immediately upon certification of Copyright as a significant entry

    I wrote this while under severe duress from the Veterans Administration’s refusal to provide me decent healthcare for my injuries suffered while active duty military. They have treated me very badly and were emotionally abusive towards me continuously to the present day. They have been ‘bitchy, rude and disrespectful’. They told me they thought I was faking my injuries even after I showed them proof. I have almost been killed several times from their ignorance, incompetence and outright stupidity. When will the madness stop? Shameful is what it really is. It has totally ruined a good quality of life for me.

  6. I am not sure that any leader will be able to improve V.A. healthcare. With all the hype during last administration about choice care etc. it is impossible to get medical attention on a timely basdis. I am over 90 years old and still have not been contacted about Covid 19 inoculation.

    1. Did you contact your local VA Clinic? In my area in OH 90 year old individuals have already been done. They’re vaccinating either 70 or 80 year old individuals now.

  7. VA Health Care is a joke along with Indian Health Care Service. Both socialized medicine. I wish I had the same access to care as my wife with CHAMPVA. Even though CHAMPVA is not perfect it is truly better then the VA. I think the VA should allow us to access more private care. Why not? Why is this scary for so many? If the VA is wonderful more people will keep going to the VA, if priviate insurance like CHAMPVA is better for the veteran they will use that. Choice is what matters. I hope he dose a good job, but I still worry we are going to have many issues.

  8. Just as local politics has a bigger impact on my life than national politics, so does my VA healthcare. If I need someone to go to bat for me, or have my back, whom do I go to at the VA? The patient advocate is a joke. That is the thing, isn’t it? We veterans are almost completely powerless against the VA beuacracy. We just have to shut up and keep eating all the crap sandwiches they give us. I asked for community care, but was told since I live within 60 miles of the VA outpatient clinic, I would be denied care. No matter how much money gets thrown at the VA, as long as you have terrible people within the VA, things will never get better.

    1. Wow everything you said is so so very true. We are not people or even service men and woman, we are just something there to them at the VA. Thank you for your letter

  9. The VA has a person who knows
    nothing about the VA or veterans.
    The learning curve will be years
    as Veterans grow older.
    I am a VISN Director.

    1. Well, Ralph, looks like you hit that nail right on the proverbial head.
      Veterans have never had great healthcare. I’ve seen things at the VA which could be used as a plot for a horror movie.
      I hate it when people inject politics into a subject. Yet, in this case, it’s unavoidable. Biden is putting as many people who served under him as when he was Vice President. Many are going into positions they have no experience in! And this IS the case with this person.
      I’ve got a sneaky suspicion we’re in for a very upsetting future!

    2. Ralph, even if they are not involved in a learning curve, they still sabotage life while knowing exactly what they are doing. The leadership types are just placeholders. Most do not understand why they are truly in those positions. Big Government does not give us Life. I can identify the difference in healthcare in both the private sector and the VA since before the Obama administration and today. Before and after are similar to day and night. SAD in my opinion. God gave us life. Government takes life away. Reduce size of government and power back to the people. Though the people maybe taking back the whole country and are taking it back from what I am seeing. Time reveals all.

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