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Rob Horowitz: Obamacare: Hold the Shovels

Tuesday, December 03, 2013

 

The goals of the Affordable Care Act remain important and essential and it will be ultimately judged by how well it meets them over the long-term—not on its admittedly shaky beginning, believes Rob Horowitz.

The self-inflicted wound of the botched October launch of Healthcare.gov—the national web site designed for individuals and small businesses to purchase insurance under Obamacare—has done far more political damage than years of loud and insistent Republican attacks. National polls record a significant decline in support for the landmark law, which was not popular in the first place, along with a significant drop in President Obama’s over-all approval rating with specific measures of trust in President Obama moving below 50% for the first time in his Presidency. The widespread operational difficulties are also making it much harder to meet the goal of 7 million new people signed up for health insurance by the March 31, 2014 deadline for purchasing it.

State exchanges

But people who are dancing on the grave of Obamacare, otherwise known as the Affordable Care Act, are doing so prematurely. While as the insurance companies are accurately pointing out there are still major backend difficulties to surmount, it appears that the White House met its self-imposed deadline of November 30 for fixing most of the access problems for consumers. Further, by and large, states that built their own exchanges, the preferred method for individuals purchasing new insurance policies as outlined in the new law, are signing up people at a good pace. Kentucky, California and Rhode Island are examples of state health care exchanges that are working particularly well. Also, data now available from some of the state exchanges show that a sufficient percentage of young healthy people are enrolling. This is a critical component to keeping the price of new insurance policies with-in bounds.

Giving credit where credit is due

Lost in the understandable focus on the problems with the website, is the fact that it is just one aspect of a sweeping comprehensive and needed reform of our broken health care system. Among other important features, Obamcare prevents insurance companies from denying insurance to people with pre-conditions; offers strong incentives for stepped-up primary care and preventive medicine; puts in place needed cost-containment measures and for participating states expands the amount of people eligible for health care coverage under Medicaid.

Premature celebration

Obama is also lucky in his ‘just say no’ opponents. Congressional Republicans do not help their cause by doing flamboyant end zone dances over the problems with the web site. Further, they continue to fail to offer any real substantive alternatives. As a result, they look as if the pre-Obamacare status quo, including unsustainable rising costs and 48 million people without health insurance is just fine with them.

Growing pains

While the jury is certainly out about how well Obamacare will end up working, it is still very much alive and kicking. The history of sweeping policy reforms are that they usually require some adjustments during the implementation phase and it is clear already that this law will be no exception. The goals of the Act remain important and essential and it will be ultimately judged by how well it meets them over the long-term—not on its admittedly shaky beginning.

 

Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.

 

Related Slideshow: Check Out The Grades: Massachusetts Hospitals Report Card

A recent survey released by The Leapfrog Group assigns a Hospital Safety Score, using the report card system of A to F to each of the hospitals in Rhode Island. These grades are based on expert analysis of injuries, infections and errors that cause harm or death during a hospital stay.

Let's see how each of Massachusetts' hospitals were graded from highest to lowest:

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Addison Gilbert Hospital

Gloucester, MA

 

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Anna Jaques Hospital

Newburyport, RI

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Baystate Franklin Medical Center

Greenfield, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Baystate Medical Center

Springfield, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

 

(Photo: John Phelan, Wikimedia)

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Berkshire Medical Center

Pittsfield, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Beth Israel Deaconess Hospital Milton

Milton, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Beth Israel Deaconess Medical Center

Boston, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Beverly Hospital

Beverly, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Boston Medical Center

Boston, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Brigham and Women's Hospital

Boston, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Brigham and Women's Faulkner Hospital

Boston, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Cambridge Health Alliance: Cambridge

Cambridge, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Cambridge Health Alliance: Whidden

Everett, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Cape Cod Hospital 

Hyannis, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

(Photo: Davee, Flickr)

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Carney Hospital

Dorchester, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Charlton Memorial Hospital: Southcoast Hospitals Group

Fall River, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Emerson Hospital

Concord, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Hallmark Health System: Lawrence Memorial Hospital of Medford

Medford, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Hallmark Health System: Melrose-Wakefield Hospital

Melrose, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Harrington Memorial Hospital

Southbridge, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Holy Family Hospital

Methuen, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Jordan Hospital

Plymouth, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: C

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Lahey Hospital and Medical Center

Burlington, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Leonard Morse Hospital

Natick, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Lowell General Hospital

Lowell, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Marlborough Hospital

Marlborough, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Mercy Medical Center of Springfield

Springfield, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: C

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Merrimack Valley Hospital

Haverhill, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: C

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Framingham Union Hospital

Framingham, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Milford Regional Medical Center

Milford, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Morton Hospital

Taunton, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Mount Auburn Hospital

Cambridge, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Nashoba Valley Medical Center: A Steward Family Hospital

Ayer, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Newton-Wellesley Hospital

Newton, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Noble Hospital

Westfield, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

Prev Next

North Shore Medical Center - Union Hospital

Lynn, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Quincy Medical Center

Quincy, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Signature Healthcare Brockton Hospital

Brockton, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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South Shore Hospital

South Weymouth, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Steward Good Samaritan Medical Center, Inc. 

Brockton, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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St. Luke's Hospital: Southeast Hospitals Group

New Bedford, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: B

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Steward Norword Hospital

Norwood, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Steward St. Anne's Hospital

Fall River, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Steward St. Elizabeth's Medical Center

Boston, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Sturdy Memorial Hospital

Attleboro, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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The Cooley Dickinson Hospital

Northampton, MA

 

Fall 2013 Grade: 

Spring 2013 Grade: 

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Tobey Hospital: Southcoast Hospitals Group

Wareham, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Wing Memorial Hospital & Medical Centers

Palmer, MA

 

Fall 2013 Grade: A

Spring 2013 Grade: A

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Beth Israel Deaconess Hospital: Needham

Needham, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: A

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Falmouth Hospital

Falmouth, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: C

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Holyoke Medical Center

Holyoke, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: A

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Lawrence General Hospital

Lawrence, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: B

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Massachusetts General Hospital

Boston, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: B

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North Shore Medical Center: Salem Hospital

Salem, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: B

Prev Next

Saints Medical Center

Lowell, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: B

Prev Next

St. Vincent at Worcester Medical Center

Worcester, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: A

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Tufts Medical Center

Boston, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: A

Prev Next

Winchester Hospital

Winchester, MA

 

Fall 2013 Grade: B

Spring 2013 Grade: B

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HealthAlliance Hospital

Leominster, MA

 

Fall 2013 Grade: C

Spring 2013 Grade: B

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North Adams Regional Hospital

North Adams, MA

 

Fall 2013 Grade: C

Spring 2013 Grade: A

Prev Next

U Mass Memorial Medical Center

Worcester, MA

 

Fall 2013 Grade: C

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

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U Mass Memorial Medical Center: Memorial Campus

Worcester, MA

 

Fall 2013 Grade: C

Spring 2013 Grade: C

Prev Next

Athol Memorial Hospital

Athol, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Baystate Mary Lane Hospital

Ware, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Boston Children's Hospital

Boston, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Clinton Hospital

Clinton, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Dana-Farber Cancer Institute

Boston, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded due to lack of publicly available data

Prev Next

Fairview Hospital

Great Barrington, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Martha's Vineyard Hospital

Oak Bluffs, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Massachusetts Eye And Ear

Boston, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

Nantucket Cottage Hospital

Nantucket,  MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

Prev Next

New England Baptist Hospital

Boston, MA

 

Fall 2013 Grade: Not Graded*

Spring 2013 Grade: Not Graded*

 

*Not graded because the hospital did not respond to Leapfrog's voluntary survey

 
 

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Comments:

Iron Mike Farquhar

The Obama-Soros Cartel is America's self-inflected wound, - and our Young Republic may well die of it!

Sandy Williamson

Rob,

If you are just going to regurgitate the WH fabulist points, why waste time writing (or is it cutting and pasting) your “Mindsetter” piece.

You reference “successful” state exchanges. Where is the data to support the contention?

You refer to a “broken” healthcare system. “Broken” by who’s definition. Prior to ObamaCare, most legitimate estimates said that 85% of Americans were satisfied with their healthcare. Did we really need legislation to affect those people? That’s right, “If you like your healthcare/doctor, you can keep it.” Right? Well, maybe not.

And you trot out that old progressive lie: “Republicans have offered no alternative.” Really? Have you researched this? Let me provide a set for you to review that starts before Obama was elected:
- Ten Steps to Transform Health Care in America Act (S. 1783) introduced by Senator Mike Enzi (R-WY) July 12, 2007.
- Every American Insured Health Act introduced by Senators Richard Burr (R-NC) and Bob Corker (R-TN) with co-sponsors Tom Coburn (R-OK), Mel Martinez (formerly R-FL) and Elizabeth Dole (formerly R-NC) on July 26, 2007.
- Senators Bob Bennett (R-UT) and Ron Wyden (D-OR) introduced the Healthy Americans Act on January 18, 2007 and re-introduced the same bill on February 5, 2009.
- Patients’ Choice Act of 2009 introduced by Senators Tom Coburn (R-OK) and Richard Burr (R-NC) and Rep. Paul Ryan (R-WI) and Devin Nunes (R-CA) on May 20, 2009.
- H.R. 2300, Empowering Patients First Act introduced July 30, 2009 by Rep. Tom Price (R-GA).

And, there are more. But, I’m not going to do your job for you. Of course, we would have known more of this if the debate pre-dating ObamaCare had been broadcast on CSPAN as was repeatedly promised by our Fabulist-in-Chief.

Perhaps you’d like to review the article below from the WSJ. The sub-title says it all.
*********************************************************************************************************

http://online.wsj.com/news/articles/SB10001424052702304854804579232213683736826?mod=WSJ_Opinion_LEADTop

REVIEW & OUTLOOK
ObamaCare Mission Accomplished
The system isn't working and the website isn't fixed.

Dec. 1, 2013 6:40 p.m. ET
Great news: The White House says that Healthcare.gov and the 36 federally run insurance exchanges are finally good to go. The only thing missing from Sunday's relentlessly upbeat progress report was President Obama in front of a "Mission Accomplished" banner.

Sunday's eight-page report was intended to meet Mr. Obama's deadline for fixing the site after its October 1 debut was a calamity. But the more important goal was political—namely, claiming enough progress to prevent Democrats on Capitol Hill from joining the GOP demand for delaying the individual mandate to buy insurance or even the entire program.

Most Democrats are eager to believe any good news, which may explain why the Sunday report is so short on basic information. The eight pages are heavy on charts with unverifiable claims—more than 400 "cumulative software fixes"!—and the Health and Human Services Department declares that "we believe we have met the goal of having a system that will work smoothly for the vast majority of users.”

This weekend miracle defies other evidence, such as the recent admission by an HHS official that 30% to 40% of the exchanges are still unfinished. Much of this involves the "back end" of the exchange operation that provides information to insurers but that consumers don't see. In a pre-Thanksgiving news dump, HHS even gave up on the federal exchanges for small business and delayed those for a year.

The truth is that the White House is defining as a "success" however well or poorly the website actually works so it can declare political victory. The millions of people who've had their old coverage cancelled must re-enroll by December 23 to avoid gaps in coverage by the New Year. So like the Keynesian multiplier for stimulus spending, the White House is revising its goals along the way and claiming success based on nonfalsifiable standards.

For instance, the progress report reveals that the website is functioning more than 90% of the time—excluding periods when it is shut down for maintenance. HHS won't say how often that is or for how long. Why not simply proclaim that it works 100% of the time, as long as you don't count the times when it doesn't?

HHS touts other measures of progress—four times as much of this, doubled capacity of that—without revealing the original base. They've fixed those 400 bugs but won't say what they are or how many there are in total. Such statistical ploys are like a business claiming its revenues are twice as high as the last quarter's, in order to avoid saying if it's profitable.
Our favorite line in the report is the HHS boast that "the team is operating with private sector velocity and effectiveness." That sure is a remarkable two-month turnaround for the same team that took three and half years to botch the initial launch at a cost of more than $1 billion, according to an analysis by Bloomberg Government.

If this miracle fix is real, the White House will open the ObamaCare black box to an independent audit, or maybe start by answering questions honestly. But on a conference call with reporters Sunday, HHS refused to say how much progress the team had made on technical problems that are seeding insurance companies with bad information about who is signing up and for what products. It knows the insurers will keep quiet lest they make themselves political targets.

The mission accomplished pose is another attempt to power through a political deadline. Americans who have now discovered the Administration's other false claims—you can keep your old plan and your doctor, and the new plans are better—can be forgiven for waiting to see the actual results.

Sandy Williamson

A survey of 1,000 Likely Voters was conducted on December 1, 2013 by Rasmussen Reports. The following headline introduces the report:

-- 81% Favor Repealing or Changing Health Care Law--

A summary of the findings follows:

Tuesday, December 03, 2013

Voters overwhelmingly want to change or repeal the new national health care law. One-out-of-two want to scrap it completely and start over again.

Given the problems associated with the law, a new Rasmussen Reports national telephone survey finds that 50% of Likely U.S. Voters believe Congress and the president should repeal it and start again from the beginning. That’s up from 43% support in late October. Another 31% think Congress and the president should go through the law piece by piece to improve it.

Just 16% want to leave the law the way it is, down slightly from 18% four weeks ago. (To see survey question wording, click here.)

The survey of 1,000 Likely Voters was conducted on December 1, 2013 by Rasmussen Reports. The margin of sampling error is +/- 3 percentage points with a 95% level of confidence. Field work for all Rasmussen Reports surveys is conducted by Pulse Opinion Research, LLC.




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