U.S. Supreme Court upholds Obama healthcare law centerpiece


A sharply divided U.S. Supreme Court on Thursday upheld the centerpiece of President Barack Obama’s signature healthcare overhaul law that requires that most Americans get insurance by 2014 or pay a financial penalty.

“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Chief Justice John Roberts wrote for the court’s majority in the opinion.

“Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness,” he concluded. The vote was 5-4.

In another part of the decision and in a blow to the White House, a different majority on the court struck down the provision of the law that requires the states to dramatically expand the Medicaid health insurance program for the poor.

The upholding of the insurance purchase requirement, known as the “individual mandate,” was a major election-year victory for Obama, a historic ruling on the law that aimed to extend coverage to more than 30 million uninsured Americans.

The 2010 law constituted the $2.6 trillion U.S. healthcare system’s biggest overhaul in nearly 50 years.

Critics of the law had said it meddles too much in the lives of individuals and in the business of the states.

Twenty-six of the 50 U.S. states and a small business trade group challenged the law in court. The Supreme Court in March heard three days of historic arguments over the law’s fate.

The court’s ruling on the law could figure prominently in the run-up to the Nov. 6 election in which Obama seeks a second four-year term against Republican challenger Mitt Romney, who opposed the law.

O.U. formally comments on Obama contraceptive coverage rules


The Orthodox Union formally commented on pending Obama administration regulations mandating employer-sponsored health plans for contraceptives and sterilization.

The comments filed Monday with U.S. Department of Health and Human Services express concerns over the regulations’ exemption of houses of worship, but not other religious entities like schools, hospitals and social welfare program providers.

“If the First Amendment’s pair of clauses guaranteeing the right of ‘free exercise’ and prohibiting ‘establishment’ of religion stand for anything, they stand for the protection of citizens against government compulsion to act contrary to conscience and for prohibiting government officials from parceling out religious protection subjectively,” the comments stated.

In a press release, O.U. executive director for public policy Nathan Diament stated the “deepest concern” is “the notion that the federal government will create two tiers of religious organizations with each receiving different apportionments of religious liberty protection. “

“We fully appreciate that on this issue, President Obama is trying to delicately balance competing concerns, and that he recognizes the importance of religious liberty and further recognizes the crucial role religious institutions play in American society,” Diament said. “But we respectfully disagree with how the President and the Secretary of HHS have decided to strike the balance.  We hope he will change the policy.”

The Orthodox Union raised the matter in a meeting with President Obama on June 5. In that meeting, they made clear that the Orthodox Jewish objection was not to contraceptives coverage, but to government interference in the management of institutions owned by religious groups.

The federal government opens proposed regulations to commentary for a period through publication the Federal Register.

Jews Should Oppose Universal Health Care


In part of an ongoing debate on health care reform, JewishJournal.com is hosting this dialogue on the pros and cons of universal health care.

Related: Why we must support universal health care

From BeliefNet.com:

In the always lively Jewish Journal of Los Angeles, Rabbi Elliot Dorff writes in a cover essay that “support for universal health care is an imperative in Jewish law.” Is it now? On health care reform, Rabbi Dorff has his classical sources all lined up—most having to do with obligations on the community to rescue its needy, the captive, and those otherwise endangered. The communal court system can compel a person to give charity in support of the poor. Proper medical services are a necessity in a Jewish community. And so on. Whether through socialized medicine or government health insurance, something must be done: the fact of there being 40 million uninsured Americans is “intolerable.”

Do you notice how many times the words “community” or “communal” appear in the foregoing paragraph? Rabbi Dorff is chairman of the Committee on Jewish Law and Standards of Conservative (i.e., liberal) Judaism. He knows that Jewish laws of the kind he cites are specifically communal laws. They were never envisioned as applying en masse to a non-Jewish country of 300 million people. Liberal Jewish analysts often lose sight of this simple fact. So too in the abortion debate where, simply put, Jewish law for Jews is more liberal on abortion than Jewish law for Gentiles. We are more protective of the unborn non-Jewish life. In Torah, there are separate legal tracks—the Mosaic and the Noachide, for Jewish and Gentile communities respectively. Yet liberal Jews invariably cite Jewish abortion law, not the Gentile one which makes abortion a death penalty offense. They forget that we live in a non-Jewish country.

Read the full story at BeliefNet.com.

Why We Must Support Universal Health Care


Related: Jews Should Oppose Universal Health Care

Whether or not we are believers in the Obama plan, or any of the particular plans for universal health care currently winding their way through Congress, support for universal health care is an imperative in Jewish law. Although what is available in medicine and its cost have changed radically, particularly over the past century, the fundamental right to receive good care — and to be compensated for giving it — goes very far back in our heritage, though perhaps, ironically, not all the way to the Torah or even the Mishnah.

When physicians could not do much to heal a sick patient, their services were easily attainable, relatively cheap, and, frankly, not much sought after. “The best of physicians should go to hell,” the Mishnah says, reflecting people’s frustration in the second century C.E. with doctors’ inability to cure. 

With the advent of antibiotics in 1938, as well as other new drug therapies, and, especially, new diagnostic and surgical techniques, however, there has been an immense increase in the demand for medical care, precisely as it has become much more expensive. This raises not only the “micro” questions of how physicians should treat a given person’s disease, but also the “macro” questions of how we, as a society, should arrange for medical care to be distributed. It is precisely this argument that is taking place in town halls and in the halls of Congress these days, sometimes in rational arguments but all too often in shouting matches that are clouding the real issues.

Jewish tradition imposes a clear duty to try to heal, and this duty devolves upon both the physician and the society. Jewish sources on distributing and paying for health care are understandably sparse, however, because before the 20th century, medical care was largely ineffective and inexpensive. The classical sources that describe distribution of scarce resources and apportioning the financial burden for communal services deal instead with questions like providing for the needy or rescuing someone from captivity, from highway robbers or from drowning. Still, those discussions raise moral problems and suggest solutions that are often similar to those associated with scarcity and cost in modern medical care. 

One set of issues is this: Who should get what when medical interventions are scarce and/or expensive? The other set of questions is this: Who should pay for health care? I discuss at some length the answers that emerge from the Jewish tradition to both of these questions in Chapter 12 of my book, “Matters of Life and Death: A Jewish Approach to Modern Medical Ethics” (Jewish Publication Society, 1998). I will share here a general sense of how the Jewish tradition responds to these questions, which are at once so ancient and so contemporary. (For specific source references, visit this article at jewishjournal.com.)

The Distribution of Health Care: Five Criteria for Triage

If particular forms of medical treatment are scarce or expensive, who should get them? Although this question of triage is most dramatic when the decision is one of life or death, it affects the quality of people’s lives in less threatening situations as well. Who, for example, should get a hip replacement when society cannot afford to provide one for everyone who needs one? Who should have the benefit of a heart bypass operation or transplant, and who shall be denied that? Which AIDS patients should get the regimen of drugs now available to lengthen their lives, and for whom is that just too expensive? In the High Holy Days liturgy, “who shall live and who shall die” is God’s decision; but with the benefit and responsibility of today’s technology, we find ourselves all too often in the uncomfortable position of having the responsibility to decide that ourselves.

The rabbinic passages that might give us some guidance about triage go in five different directions:

Social hierarchy. One passage in the Mishnah determines priorities on the basis of the victim’s position in the hierarchy of society — with knowledge of Torah trumping all other social stations.

Close relationship. Jewish laws on charity provide a second reservoir of precedents that may guide the provision of health care. In concentric circles, you are most responsible for yourself first, then for those closest in relationship to you, then for the rest of your local Jewish community, then for all other Jews, and then for all other people. 

A hierarchy of social needs. A third set of sources we might use as the basis for a Jewish ethic of the distribution of health care concerns the prioritizing of the community’s duties to fund specific needs. The Shulchan Arukh specifies the order of preferences as follows: “There are those who say that the commandment to [build and support] a synagogue takes precedence over the commandment to give charity [tzedakah, to the poor], but the commandment to give money to the youth to learn Torah or to the sick among the poor takes precedence over the commandment to build and support a synagogue.

One must feed the hungry before one clothes the naked [since starvation is taken to be a more direct threat to the person’s life than exposure]. If a man and a woman came to ask for food, we [Jews acting in accordance with Jewish law] put the woman before the man [because the man can beg with less danger to himself]; similarly, if a man and a woman came to ask for clothing, and similarly, if a male orphan and a female orphan came to ask for funds to be married, we put the woman before the man.

Redeeming captives takes precedence over sustaining the poor and clothing them [since the captive’s life is always in direct and immediate danger], and there is no commandment more important than redeeming captives…. Every moment that one delays redeeming captives where it is possible to do so quickly, one is like a person who sheds blood.”

The Shulchan Arukh recognizes the varying needs of the community — physical, educational, religious and social. Each can be easily justified in terms of broader Jewish commitments to life, human dignity, worship and other religious expression, education, economic solvency and close social ties. Consequently, if one were to create a contemporary list based on these Jewish values for funding communal projects in the United States, it would probably closely resemble the Shulchan Arukh’s list. Saving people who are threatened by human attackers would clearly come first, followed by providing food and clothing to prevent disease, followed by some order of curative health care, defense, education, culture and economic infrastructure.

The Importance of Being Michael


“Why aren’t you talking about Michael Jackson more?”

The question, from a caller to Larry Mantle’s KPCC-Pasadena public radio program “AirTalk,” interrupted a ” title=”study” target=”_blank”>study by the Project on Excellence in Journalism.  At the start of the week, nearly a third of the stories monitored – 58 outlets, covering print, online, network, cable and radio news – were about the protests in Iran.  By the end of the week, the velvet revolution wasn’t the only story that had largely been abandoned by journalism.  The economic crisis, health care reform, the energy and global warming bill: you’d need an FBI investigator to find coverage of them.  Only Governor Mark Sanford’s soap opera could compete, barely, with the death of the King of Pop.

By going all-Michael-all-the-time, cable news wasn’t jamming this story down America’s throat.  Even though nearly two-thirds of Americans said last week that the Jackson story was getting too much coverage, the same HCD Research “>“Planet Money” guys on National Public Radio, you know that credit default swaps and collateralized debt obligations can be as interesting as Natalee Holloway’s disappearance.  When Arnold Schwarzenegger suggests that negotiations on California’s fiscal crisis should be broadcast (“Budget talks as a reality TV show?” was the ” title=”story” target=”_blank”>story about the daily 4 p.m. meeting where the paper’s editors decide what stories warrant front-page treatment.  In The Times’s Page 1 conference room, “the belief remains that editing isn’t tyranny but perhaps a little closer to curating.  Pick whatever metaphor you like: wheat from chaff, signal from noise, gold from dross.  Without that process of selection, one is left to find the news on a Borgesian online map that is as big as the world itself.”

I’m glad that anyone who needs to can Google the meaning of Borgesian.  I’m just a teeny bit less glad that no one on the planet needs to Google Michael Jackson. 

Marty Kaplan is the Norman Lear Professor of entertainment, media and society at the USC Annenberg School for Communication.  Reach him at {encode=”martyk@jewishjournal.com” title=”martyk@jewishjournal.com”}.

Bills Seek to End Israel Travel Penalty


It happens over and over again: A planned trip to Israel induces gasps of worry from friends who have never visited the country. Every suicide bombing or mortar attack on television reinforces the vision of Israel as a vast raging war zone.

Some travelers appreciate the concern; others simply ignore it. But this perception of danger has had serious repercussions for people in California and in other states. For several years at least, life insurance companies doing business in California and elsewhere have been denying coverage or charging increased premiums to individuals who have either recently visited Israel or plan to visit soon. The assumption is that the country is just too dangerous, and that someone foolish enough to risk going to Israel once is likely to do so again.

A bill making its way through the California Legislature would make it illegal to impose such a penalty on travelers to Israel or any other country. Two similar bills are before House of Representatives in Washington, D.C.

“Traveling to Israel is so broad,” said Nancy Appel, Anti-Defamation League regional deputy director, who testified in support of the state legislation, Senate Bill 1105, at a July committee hearing. Compare “traveling to Eilat vs. going to a war-zone area.” For insurance companies to discriminate on the basis of travel anywhere in the country is “like swatting a fly with a sledgehammer,” Appel told The Journal.

Momentum appears to favor her view. The states of Washington, New York and Illinois have recently passed similar legislation, although the latter two only ban discrimination based on past travel, rather than future plans. A House bill by Rep. Rahm Emmanuel (D-Ill.), the Life Insurance Anti-Discrimination in Travel Act, deals specifically with past travel, while a bill by Rep. Debbie Wasserman Schultz (D-Fla.), the Life Insurance Fairness for Travelers Act, bans insurance discrimination based on future plans.

In the Legislature, the bill was quickly introduced in midterm by Sen. Jackie Speier (D-San Francisco), with the support of Attorney General Bill Lockyer, who is running for state treasurer in 2006.

“This bill appeared right in the middle of the session, and we only saw it a week before it was heard in the Assembly Insurance Committee,” said Brad Wenger, president of the Association of California Life and Health Insurance Companies, which represents the insurance industry’s legislative interests in Sacramento.

The association opposed the bill at first, but then Speier’s staff struck a hallway compromise that could prove to be a model in other states or even nationally.

To secure industry support, Speier agreed that a company could deny coverage or charge higher rates if it could justify that decision by citing “sound actuarial principles” or “reasonably expected experience.” After adding that language, the association immediately changed its official position on the bill to “neutral,” making its passage a near certainty.

In plain English, the bill now allows insurers to penalize travelers to Israel only if they have actual evidence that higher risk exists. A similar resolution was reached in the 1980s, after the industry came under pressure for allegedly discriminating against the disabled.

“SB 1105 gives the California Department of Insurance the ability to ask an insurer what they’re basing a [discriminatory] decision on, and they would require a pretty good case to be made,” Wenger said.

Wenger quickly added that the department already can investigate alleged discriminatory practices.

“This just makes it a little more specific,” he said.

“Everybody was comfortable [that] this language would not create a loophole,” Appel added. “If they have hard data backing up their opinion to deny coverage or charge more, they can do that. The problem now is that they deny coverage with no data backing up their reasons.”

Still, the definition of “data” can be vague. Some past coverage denials were ostensibly based on State Department travel warnings, which, though anecdotal, derive from a credible source. Such a warning is currently in effect. The State Department cites recent bombings and notes, “The U.S. government has received information indicating that American interests within Israel could be the focus of terrorist attacks.”

Wenger did not provide specific examples of what would constitute sound actuarial principles in the context of the California legislation.

“It’s a very, very competitive market out there,” he said. “I think you have to have some sympathy for [the insurance company] when there is a place in the world that is either at war or in a very dangerous situation.”

With the insurance industry’s official neutrality, the state legislation without opposition in the California Assembly on Aug. 18. The bill is now headed to the state Senate. If it passes there, as expected, the measure would reach the desk of Gov. Arnold Schwarzenegger, who has not yet taken an official position on the bill.

“It’s just amazing,” Appel said. “Some bills take forever to get written [but] this one happened very fast.”

Whether the bill has the intended effect will take longer to work out.

 

New Year, New Changes


Last week I was driving to a family celebration at Leisure World in Laguna Hills when I noticed something very odd about the weather: Fall was in the air.

It’s a subtle thing in Southern California, but those of us who have lived here long enough recognize the slight change in temperature, the almost imperceptible newness in the air.

For us it also means summer camps and summer trips give way to the High Holidays — Rosh Hashanah and Yom Kippur. And this new year brings new developments here at The Journal.

One should be obvious by now: We’ve changed formats, and changed titles. Last month, The Jewish Journal of Orange County became Jewish Family of Orange County. We’ve changed size, shape and paper. But more importantly, the stories reflect the lives so many of us live — working to bring Jewish values and practice into our homes and communities.

A Jewish publication is a place where all the diverse expressions of Jewish life can find common ground on a regular basis, and we look forward to continuing to provide the kind of award-winning, thoughtful coverage we have in the past.

Of course, this is a community publication, which means we need you to be a part of it. Please send us ideas, suggestions, stories, complaints. Please read us and help us grow.

It’s a New Year, but it wouldn’t be as sweet without you.

Shana tova u’metuka from all of us at Jewish Family of Orange County.

Bill Tackles Life Insurance Blacklist


New York state legislators are trying to prevent insurance companies from blacklisting travelers to Israel so that they cannot obtain life insurance coverage.

Sheldon Silver, speaker of the New York Assembly, and Assemblyman Peter Grannis unveiled a bill Jan. 15 that would bar state insurance firms from denying life insurance to anyone who has traveled to Israel.

"I don’t know what Israel travel means: Is it risky lifestyle?" Silver said. "Does this smack of anti-Semitism? Does it smack of participation in an Arab boycott?"

Their move came in response to a recent Jewish Telegraphic Agency report that several major insurance companies around the country are refusing to issue life insurance policies to applicants who recently have visited Israel or, in some cases, to those who plan to travel to Israel or 27 other nations for which the State Department has issued a travel advisory.

The New York bill is aimed solely at insurers that "discriminate" against those who already have been to Israel, Silver said, in part because he has not heard of policy applications asking about future travel plans.

Several top insurance companies, including Allstate, State Farm and TIAA-CREF, recently said that they won’t underwrite life insurance policies for people planning to visit Israel or other U.S.-designated hot spots, because they consider such travel too high-risk.

Meanwhile, a young public relations professional in Washington reported that Fidelity Investments denied his otherwise trouble-free application for insurance, because he had visited Israel in 2002.

Officials with Jewish organizations said they had heard of similar cases over the past year. They said the story sparked yet more reports of recent rejections of Jews who had gone to Israel.

"After the story broke, other people told us about it, but they’d never talked about it because they were embarrassed," said Malcolm Hoenlein, executive vice chairman of the Conference of Presidents of Major American Jewish Organizations.

Hoenlein could not say how many people complained but said they were all from New York. Silver said he also received three complaints. At a recent news conference, the legislator introduced one such case, that of Dennis Rapps of the Jewish Commission on Law and Public Affairs.

In the wake of the report, Hoenlein approached Silver, who in 1996 had introduced similar legislation when the New York-based Metropolitan Life Insurance Co. denied life insurance to a senior member of the Orthodox Union (OU) who often visited Israel. In that case, Metropolitan scrapped its policy, and the legislation never reached a vote. But Silver and Grannis’ spokesman, Peter Newell, said they expect the current bill to easily win support in the Democratic-controlled Assembly.

Silver also said he would bring the bill to other state insurance commissioners and the National Conference of Insurance Legislators in hopes that the New York bill can serve as a model for other states.

Hoenlein and senior officials of other Jewish groups said they would welcome such national attention, in part because they fear insurance red-lining could threaten U.S. travel to Israel at time when the Jewish State can’t afford a further drop in tourism.

"Our community is committed to tourism to Israel, and no one should have to suffer this kind of discrimination," said Betty Ehrenberg, director of international affairs and communal relations for the OU’s Institute for Public Affairs in Washington.

If such denials "are more widely imposed," Hoenlein said, "people are not going to risk not getting life insurance by going to Israel."

Sarina Roffe, director of communications for the Jewish National Fund, reported that she also was a victim of the boycott on hot spots. Roffe said she recently attempted to switch her life insurance policy with John Hancock Insurance and Financial Services but was rejected, because she had visited Israel within the past two years.

"Within 20 minutes, my agent called and said, ‘You’re out,’" she said. "You just don’t think of Israel as an extreme place. You just don’t think it’s going to affect you."

The agent also told her that "no one" in the insurance industry is "writing policies for anyone who has been to Israel," Roffe said.

Circumcision Lite


An undeniable physical reminder of a man’s connection to Judaism, circumcision has been an important focus of the first days of a boy’s life since before we received the Torah. However, for almost as long, there have been people who question the act of circumcision and those who have rallied for eliminating the practice.

Modern times are no exception. In fact, through televised programs and numerous Web sites, the anti-circumcision movement is gaining increased exposure and coverage.

Though most Jewish families still choose to circumcise their sons, some parents are looking for alternatives to their baby boy’s tearful parting with his foreskin. Often, these parents are torn between sparing their child the pain of circumcision and maintaining a connection with Jewish traditions and commandments.

As central as the mitzvah of circumcision is to Judaism, some parents have created alternative rituals. One such ceremony is called brit shalom, or covenant of wholeness, during which parents might read Bible passages and recite the traditional blessing normally recited at a brit milah, but there is no circumcision performed.

Another procedure called hatafat dam brit is also being used in place of a circumcision. Usually only appropriate in the case of already circumcised converts or adopted babies, or when a baby is mistakenly circumcised at the hospital, hatafat dam brit is a Jewish ritual circumcision performed by drawing a drop of blood from the site of the circumcision.

Dr. Fred Kogan, a prominent mohel in the Los Angeles area, is concerned about the increasing number of requests he is getting for this ritual. “People don’t want to circumcise during this big anti-circumcision movement and are looking for something to take its place,” he says. “People have been calling me now, saying, ‘We think it’s barbaric, horrific, and we don’t want to do this to our child.'” He adds that, on the other hand, parents may want to placate grandparents, and many don’t want to exclude themselves from the Jewish world.

In reality, there is no alternative to circumcision, Kogan maintains. “Circumcision is a cultural, physical sign,” he says. “It’s something you have to go through if you want to be part of the team.”

Rabbi Yehuda Lebovics, a Los Angeles Orthodox mohel, has not received many requests for circumcision alternatives, but he is quick to dismiss the appropriateness of hatafat dam brit. “It is totally invalid, totally meaningless. The only way that the drop of blood is valid is if there is no foreskin.” Otherwise, he says, “It is just a waste of a drop of blood.”

Rabbi Dennis Eisner, L.A. director of the Berit Milah Program (a joint project of the Central Conference of American Rabbis, Hebrew Union College-Jewish Institute of Religion, where he is assistant dean, and the Union of American Hebrew Congregations) is in contact with mohels throughout the world. Regarding invalid applications of hatafat dam brit, he says, “I don’t think it’s very widespread. … There may be people out there who are trying to appease parents, but those people are wrong. They are doing a disservice to the young men who are entering in the community. It is not what we’re about, not what we’re promoting, and not what we’re suggesting.” Though he recognizes that the once-asserted medical benefits of circumcision are now falling into doubt, Eisner does not see this as relevant to the Jewish act of brit milah. “There is some ambivalence about the medical act of circumcision, but we are not about the medical act of circumcision,” he says, but about entering into a covenant with God.

Leaders in the anti-circumcision movement say the number of Jewish parents looking for alternatives to circumcision is rising. Ronald Goldman, author of “Questioning Circumcision — A Jewish Perspective” and director of the Circumcision Resource Center in Boston, Mass., says, “The large majority of Jews are not aware of the religious reasons” for circumcision “and do so for cultural reasons.”

Goldman, who does not see his ideas as a threat to modern Judaism, says his book is not directed at traditional Jews. “We are not here to tell people what to do, but to provide an alternative. We’re here to support Jews who are questioning circumcision, to let them know they are not alone. … We have been contacted by hundreds of Jews who are questioning circumcision. We’re also here to clear up the myths and misunderstandings about circumcision.” Goldman calls into question whether one really needs to be circumcised to be Jewish, suggesting that one only needs to be born to a Jewish mother. He adds that circumcision is in direct violation of the Torah’s prohibition against self-mutilation.

Rabbi Mark Fasman of Temple Sinai in Westwood says, “These points are dealt with extensively by the rabbis.” While there are laws against self-mutilation, circumcision is considered the removal of something that is not necessary, he explains, comparing the foreskin to the unneeded parts of a fruit. “It’s important at one stage, but it is ultimately not part of the fruit, like the stem of an apple.” Fasman says, “Human beings don’t own their bodies; God owns their bodies,” adding that it is God who is commanding us to circumcise.

Fasman sees the modern hesitations about circumcision as partly due to our rights-based society. “Rights is a whole new language, and it is often at direct odds with standard Jewish thought. We are inheritors of the rabbinic tradition, which is [that] we best fulfill our obligations in this world. We best fulfill our obligation through the performance of mitzvot.”

According to Anita Diamant in “The Jewish Baby Book,” the Torah refers to the foreskin as the orlah, which, she says, “means not only foreskin but also any barrier standing in the way of beneficial results. The word orlah is also used as a metaphor for obstructions of the heart that prevent a person from hearing or understanding God. Removing the orlah is interpreted as a permanent, physical sign of dedication to the ongoing task of perfecting the self in order to be closer to the Holy One.”

All parents of Jewish boys feel anxiety about their sons’ discomfort during the bris, but most accept it as part of being Jewish and as something the baby gets through. While Jewish parents seeking alternatives to circumcision are few, Kogan fears it’s a growing trend. “When anything starts, people say, ‘Eh, it’s nothing.’ But if I had three people call me in the past three years, and none in the previous 14 years, there must be a lot more people out there.”

+