четвртак, 29. април 2021.

[TXT, PDF, PNG (Fra, Eng)] True interview with French socialist Jacques Attali

FALSE QUOTES OF JACQUES ATTALI'S INTERVIEW POLLUTE INTERNET DISABLING US FROM VALID REASONING. YES, WORLD IS FULL OF IMBECILES FROM BOTH SIDES.

THIS IS WHAT HE REALLY SAID.

Michel Salomon's interview with French socialist Jacques Attali, published in the book "L'avenir de la vie" (The Future Of Life) [1981]

https://www.amazon.com/Lavenir-vie-Visages-lavenir-French/dp/222150237X


Original scans of interview in PNG, merged PDF and txt translation from French to English can all be found in this Google Drive folder:


English translation of the interview:
---
“Ein Wunderkind” would say the Germans, a child prodigy. At less than forty years old, Jacques Attali is all at the same time an economist of international reputation, a teacher, a political adviser very listened to the Socialist Party and a versatile writer, author not only of theoretical works on his discipline, but of essays. Noticed in fields as varied as politics, music, and, recently, medicine. The book he published in the fall of 1979, "L'Ordre Cannibale ou Pouvoir et Déclin de la Médecine", revived the debate in France, not only on the validity of the therapeutic act but on all existential problems, from birth to death, which underpin the organization of the healthcare system in the West.

What makes Attali run?

For those who are his friends, so much energy in so many directions baffles them. For those who are his enemies - and he has many, less because of his amiable, endearing personality, than because of his political options - this gifted man is suspect. Rooted in a land of reason, measure, “golden mean” -the middle of what exactly?-, the French establishment has always been wary of intellectuals who trample on its "French" gardens...

Jacques Attali undoubtedly disturbs, with his excesses, his excesses, his constant and feverish questioning. But in these times of crisis, don't we need to be more "worried" than reassured?...
---

Michel Salomon:
Why is an economist so passionately interested in medicine, health...

Jacques Attali:
I have found by studying the general economic problems of Western society that health costs are a major factor in the economic crisis. The production of consumers and their maintenance is expensive, even more expensive than the production of the commodities themselves. People are produced by the services they render to each other, especially in the health sector, the economic productivity of which does not increase very quickly. “The productivity of machine production” is increasing faster than the relative productivity of consumer production. This contradiction will be resolved by transforming the health and education system towards their commodification and industrialization. Anyone who analyzes economic history realizes that our society is increasingly transforming artisanal activities into industrial activities and that an increasing number of services rendered by men to others are increasingly becoming objects that are produced in machines.
The meeting of these two questions leads to the question: can medicine, too, be produced by machines which would replace the activity of the doctor?

M.S.:
This question seems a little academic, theoretical ...

J.A.:
Certainly, but it gives an account of the current crisis. If medicine, like education, were to be mass-produced, the economic crisis would quickly be resolved. It is a bit the point of view of the astronomer who would say: "If my reasoning is correct, there is a star..." If this reasoning is correct and if our society is coherent, logic leads to this: as other functions were eaten up, in the previous phases of the crisis, by the industrial apparatus, medicine becomes an activity produced in series, which leads to the metaphor.

The latter means that the doctor is largely replaced by prostheses whose role is to recover the function of the body, to restore it or to replace it. If the prosthesis tries to do the same thing, it does it like the organs of the body do and therefore becomes a copy of the body's organs or functions of the body. Such objects would therefore be prostheses to be consumed. In economic language the metaphor is clear: it is that of cannibalism. We consume the body.
So from the metaphor (and I always thought it was the source of knowledge) I asked myself two questions:
-Is cannibalism close to therapy?
-Is there a kind of invariant in the different social structures, which would make an axiomatized cannibalism, released from the way it was experienced, and reduced to operators, in the mathematical sense, would be found in the therapeutic process?
First, cannibalism seems to be able to be explained quite broadly as a therapeutic, founding strategy. Secondly, it seems that all the healing strategies, in relation to the disease contain a series of operations carried out by the body itself but also carried out by cannibalism and which we find in all these strategies: selecting signs that 'we will observe, watch them to see if they are doing well or not, denounce what will break the order of these signs, what is called Evil; to negotiate with Evil, to separate Evil. All healing systems have thus employed these same operations: selection of signs, denunciation of evil, surveillance, negotiation, separation. These different operations are also part of a political strategy: select signs to observe, watch them to see if all is well, denounce the evil, the scapegoat, the enemy, and drive him away. There are very deep connections between strategy towards individual evil and strategy towards social evil. This is what made me think, deep down, that the distinction between social evil and individual evil was not a very clear one. These various fundamental operations applied to different historical periods, to different conceptions that one might have of disease, evil, power, death, life, and therefore of the one who must fulfill the function of designation of evil, of separation. In other words, there are the same operations, the same roles, but it is not the same actors who play the roles. And the play is not being played at the same time.

M.S.:
From there to founding a theory on the basis of historical or mythical cannibalism... Your essay has upset and shocked not only doctors but also those patients that we all may be, in short, public opinion...

J.A.:
This essay is a triple attempt:
First, an attempt to tell an economic story of evil, the history of relationships with disease.
Second, to show that there are, in a way, four dominant periods and therefore three major crises between which system shifts are structured and each shift not only affects the healer, but also the very conception of life, death, your illness.
Third, and finally, to show that these shifts concern signs and not strategy, which remains that of cannibalism, and that in fact, we start from cannibalism and come back to it. In short, the whole of industrial history can be interpreted as a machine for translating founding cannibalism, the first relation to evil, where men eat men, into industrial cannibalism, where men become commodities which eat commodities. Industrial society would function like a dictionary with different stages in the translation: there are intermediate languages, in a way, four major languages. There is the fundamental order, the cannibal order. This is where the first gods that appear are cannibals and that in the myths that follow historically cannibal gods eat each other, then it becomes awful for the gods to be cannibals.
In all the myths that I have studied, in different civilizations religion is used in some way to destroy cannibalism. For cannibalism, evil is the souls of the dead. If I want to separate the souls of the dead from the dead, I must eat the bodies. Because the best way to separate the dead from their souls is to eat the bodies. So what is fundamental about cannibalistic consumption is that it is separation. This is where I wanted to come from: consumption is separation. Cannibalism is a formidable therapeutic force of power. So why does cannibalism no longer work? Well, because from the moment (we can clearly see this in the myths, - and here I am giving an interpretation both of Girard's work on violence and of Freud on "Totem and taboo", in which he sees the totem and the totemic meal as founders, and the totemic meal disappearing in sexuality) where I say "eat the dead" allows me to live, so... I will find something to eat. So cannibalism is a healer, but at the same time it is a producer of violence. And that's how I try to interpret the passage to sexual prohibitions, always the same as cannibalistic ones. Because it is obvious that if I kill my father, or my mother, or my children, I will prevent the group from reproducing. And yet they are the easiest to kill since they live next to me. Sexual prohibitions are secondary prohibitions compared to food prohibitions. Then, we ritualize, we stage cannibalism in a religious way. In a way, we delegate, we represent, we stage. Religious civilization is a staging of cannibalism. The signs that we observe are those of the gods. Sickness is possession by the gods. The only diseases that can be observed and cured are those of possession. Healing, finally, is the expulsion of evil, the evil which, in this case, is the Evil One, that is to say the gods. And the main healer is the priest. There are always two healers at all times. There is the Whistleblower of Evil and the Separator, later found under the names of Doctor and Surgeon. The denouncer of evil is the priest, and the separator is the practitioner.
Christian ritualization is fundamentally cannibalistic. The texts of Luke on “the bread and the wine” which are “the Body and the Blood of Christ”, and which if we eat them give life, are cannibalistic texts, therapeutic obviously; there is a medical reading, at the same time cannibalistic, of these books, which is striking.
I try to tell, then, the story of the Church's relationship to healing, and to see little by little, probably around the 12th or 13th century, that a new system of signs appears. We observe not only the diseases coming from the gods, but also the diseases coming from the body of the men. Why? Because the economy is starting to get organized. We are coming out of slavery. The dominant diseases are the epidemics that begin to circulate like people and commodities. The bodies of poor men carry disease and there is a total unity between poverty (which did not exist before because almost everyone was a slave or a lord) and disease. To be poor or sick meant the same from the thirteenth to the nineteenth century. So the strategy towards the poor in politics and that towards the sick are no different. When you are poor, you get sick, when you are sick, you become poor. Disease and poverty do not yet exist. What exists is to be poor and sick, and, the poor or sick being designated, the good strategy consists in separating it, in containing it, not in curing it but in destroying it: this is called, in the French texts, to shut it up - confinement in Foucault's theses. He is locked up in many ways: quarantine, lazaretto, hospital and in England work-houses. Poor law and charity are not ways to help people, but to designate and contain them. Charity is none other than a form of denunciation.

M.S.:
The policeman becomes the therapist instead of the priest.

J.A.:
That's it. Religion withdraws and takes power elsewhere because it cannot take on the healing power any longer. There are, of course, already doctors, but they only play a role of consolation and, proof of this, the political power, very cleverly, does not yet recognize the diplomas of doctors. The political power considers that its main therapist is the policeman and not the doctor. In fact, in Europe at the time there was only one doctor for every 100,000 inhabitants.
But I come to the third period where it is no longer possible to lock up the poor because there are too many of them. On the contrary, they must be nurtured because they become workers. They cease to be bodies and become machines. And the signs that we observe are those of the machines. Illness, evil, constitute the breakdown. Clinical language isolates and further objectifies evil. We point out the evil, we separate it and we expel it.
Throughout the nineteenth century, with the new surveillance which is hygiene, the new repair, the new doctor-surgeon separation, the policeman and the priest are seen to disappear behind the doctor.

M.S.:
And today it's the doctor's turn to fall into the trap ...

J.A.:
Today the crisis is threefold. On the one hand, as in the previous period, the system can no longer operate on its own. Today, in a way, medicine is largely unable to cure all diseases because the costs are getting too high.
On the other hand, there is a loss of credibility of the doctor. We have much more confidence in quantified data than in the doctor.
Finally, diseases or forms of behavior appear which are no longer indebted to classical medicine. These three characteristics lead to a kind of natural continuum which passes from clinical medicine to prosthesis and I have tried to distinguish three phases which are interwoven in this transformation.

In a first phase, the system tries to last by monitoring its financial costs. But this desire leads to the need to monitor behavior and therefore to define standards of health, activities, to which the individual must submit. This is how the notion of a life profile that spares health costs appears.

From then on, we move on to the second phase which is that of self-denunciation of evil through self-control behavior tools. The individual can thus comply with the standard of life profile and become independent from his illness.
The main criterion of behavior was, in the first order, give meaning to death, in the second order, contain death, in the third order, increase life expectancy, in the fourth, the one we live, it is the search for a life profile that spares health costs.

The third phase is constituted by the appearance of prostheses which make it possible to designate evil in an industrial way. Thus, for example, electronic drugs such as the pill coupled to a microcomputer make it possible to release in the body, at regular intervals, substances, elements of regulation.

M.S.:
In short, health, with the appearance of these electronic prostheses, will be the new engine of industrial expansion...

J.A.:
Yes, in conclusion, all traditional concepts disappear: production, consumption disappear, life and death disappear because the prosthesis blurs death for a moment...
I believe that the important thing in life will no longer be to work but to be in a situation of consuming, of being a consumer among other consuming machines. The dominant social science until now has been the science of machines. Marx is a clinician because he designates evil, the capitalist class, and he eliminates it. He holds, in a sense, the same speech as Pasteur. The great dominant social science will be the science of codes, computer science and then genetics. This book is also a book on codes because I am trying to show that there are successive codes: the religious code, the police code, the thermodynamic code and today the informational code and what the 'we call socio-biology.

This theoretical discourse is only useful if the future does not happen: we will only avoid being cannibals by ceasing to be cannibals. I believe that the main thing for a theory to be false is not that it is refutable but refuted. The true is not the refutable, but the refuted.

M.S.:
Does your thesis lead to a concrete reflection on medicine, even in the long term? Are these the beginnings of a concrete reflection by a politician and an economist on the organization of medicine?

J.A.:
I don't know. Right now, I don't want to ask myself that question. I think the first thing I wanted to show, just that, is that healing is a process in full transformation towards an organizational model that has nothing to do with the current one, and that the choice is between three types of attitude: either to keep medicine today as it used to be, or to accept the evolution and make it the best possible, with greater equality of access to prostheses, a third evolution in which the return to evil is thought of in a new way, which is neither that of the past nor that of the future of the cannibal system; it would be an attitude close to the acceptance of death, so as to make people more aware that the urgency is neither to forget, nor to delay, nor to wait for death, but on the contrary to want that life is as free as possible. So I think that, little by little, we will polarize around these three types of solutions and I want to show that in my opinion, the last one is truly human.

M.S.:
It's social utopia; it is sometimes dangerous to be utopian ...

J.A.:
Utopia can have two different characteristics depending on whether we speak of Utopia as an absolute dream, then the dream is a dream of eternity, or whether we refer to the etymology of the word, it that is, to what has never taken place and we then try to see what type of utopia is likely. However, I believe that if we want to understand the health problem, we must realize that there are probable utopias. The future is necessarily a utopia, and it is very important to understand that it is not dangerous since to speak of utopia means to accept the idea that the future has nothing to do with the extensions of current trends.
I would even say all futures are possible except one which would be an extension of the current situation.

M.S.:
The future, is it this particular prosthesis that are all these drugs of the future - and of the present - which help man to better cope with his condition...?

J.A.:
I find this fascination with anti-anxiety drugs scary, anything that can eliminate anxiety, but as a commodity and not as a way of life. We try to provide means to make anxiety tolerable and not to create functions so as not to be anxious anymore.
Then, all the medicines of the future which are related to the control of the behavior can have a major political impact.
It would indeed be possible to reconcile parliamentary democracy with totalitarianism since it would suffice to maintain all the formal rules of parliamentary democracy but at the same time to generalize the use of these products so that totalitarianism is daily.

M.S.:
Does that seem conceivable, an Orwellian "1984" based on a pharmacology of behavior ...

J.A.:
I don't believe in Orwellism, because it is a form of technical totalitarianism with a visible and centralized "Big Brother". I rather believe in an implicit totalitarianism with an invisible and decentralized “Big Brother”. These machines to monitor our health, which we could have for our good, will enslave us for our good. In a way we will undergo a gentle and permanent conditioning ...

M.S.:
How do you see the man of the twenty-first century?

J.A.
I believe that we have to distinguish very clearly between two kinds of man of the twenty-first century, that is to say: the man of the twenty-first century from rich countries and the man of the twenty-first century from poor countries. The first will certainly be a man much more anxious than today but who will find his answer to the pain of living in a passive flight, in pain and anti-anxiety machines, in drugs, and who will try at all costs to live a life. sort of commercial form of conviviality.

But besides that, I am convinced that the vast majority, who will know about these machines and the way of life of the rich but who will not have access to them, will be extraordinarily aggressive and violent. It is from this distortion that the great chaos will be born which could result either in race wars, conquests, or in the immigration under our regions of millions of people who will want to share our way of life.

M.S.:
Do you believe that genetic engineering is one of the keys to our future?

J.A.:
I believe that genetic engineering will be in the twenty years to come such a banal technique, so well known and also present in everyday life as the internal combustion engine is today. In fact, this is the same type of parallel that can be drawn.
With the internal combustion engine, we could make two choices: either favor public transport and make people's lives easier, or produce automobiles, tools of aggression, consumption, individualization, loneliness, storage, desire, rivalry... We chose the second solution. I believe that with genetic engineering we have the same type of choice and I believe that we will also choose, unfortunately, the second solution. In other words, with genetic engineering we could little by little create the conditions of a humanity assuming itself freely, but collectively, or else create the conditions of a new commodity, genetic this time, which would be made of copies of men sold to men, chimeras or hybrids used as slaves, robots, means of work...

M.S.:
Is it possible and desirable to live 120 years ...?

J.A.:
Medically, I don't know. I've always been told it is possible. Is this desirable? I will respond in several stages. First, I believe that in the very logic of the industrial system in which we find ourselves, the lengthening of the lifespan is no longer a goal desired by the logic of power. Why? Because as long as it was a question of extending life expectancy in order to reach the maximum break-even point of the machine, in terms of work, it was perfect.

But as soon as we exceed 60/65 years, man lives longer than he produces and then it costs society dear.

Hence I believe that in the very logic of industrial society, the objective will no longer be to extend life expectancy, but to ensure that within a specific life span, man lives as well as possible but in such a way that health expenses will be as low as possible in terms of costs for the community. Then a new criterion of life expectancy emerges: that of the value of a health system, a function not of the increase in life expectancy but of the number of years without illness and particularly without hospitalization. Indeed from the point of view of society, it is much better for the human machine to stop abruptly rather than to deteriorate gradually.

This is perfectly clear if we remember that two-thirds of health spending is concentrated in the last months of life. Likewise, cynicism aside, health spending would not reach a third of the current level (175 billion francs in 1979) if people all died suddenly in car accidents. So we have to recognize that the logic no longer lies in increasing life expectancy but in increasing disease-free life. However, I think that the increase in lifespan remains a fantasy which corresponds to two objectives: the first is that of men of power. The increasingly totalitarian and directive societies in which we find ourselves tend to be ruled by "old" men, to become gerontocracies. The second reason lies in the possibility for capitalist society to make old age economically profitable simply by making old people solvent. It is currently a "market", but it is not solvent.

This goes very well with the idea that man today is no longer important as a worker but as a consumer (because he is replaced by machines at work). So we could accept the idea of ​​extending life expectancy on condition that we make old people solvent and thus create a market. We can clearly see how the current large pharmaceutical companies behave, in relatively egalitarian countries where at least the method of financing retirement is correct: they favor geriatrics, to the detriment of other fields of research such as tropical diseases.

It is therefore a problem of retirement technology that determines the acceptability of the lifespan.
For my part, as a socialist, I am objectively against extending life because it is a delusion, a false problem. I believe that asking yourself this type of problem avoids more essential questions such as that of the liberation of the time actually lived in the present life. What good is it to live to 100 years, if we gain 20 years of dictatorship.

M.S.:
The world to come, "liberal" or "socialist", will need a "biological" morality, to create an ethics of cloning or euthanasia, for example.

J.A.:
Euthanasia will be one of the essential instruments of our future societies in all cases. In a socialist logic, to begin with, the problem arises as follows: socialist logic is freedom and fundamental freedom is suicide; consequently, the right to direct or indirect suicide is therefore an absolute value in this type of society. In a capitalist society, killing machines, prostheses which will eliminate life when it is too unbearable, or economically too costly, emerge and become commonplace. So I think that euthanasia, whether it be a value of freedom or a commodity, will be one of the rules of a future society.

M.S.:
Won't the men of tomorrow be conditioned for psychotropic drugs and subjected to psyche manipulations? How do you protect yourself from it?

J.A.:
The only precautions one can take are related to knowledge and knowledge. It is essential today to ban a very large number of drugs, to stop the proliferation of conditioning drugs; but maybe the border has already been crossed...
On the other hand, isn't television an excessive drug?
Wasn't alcohol always a heavy drug?
The worst drug is the absence of culture. The individuals want drugs because they don't have a culture. Why are they seeking drug alienation? Because they have become aware of their powerlessness to live and that this powerlessness translates concretely into the total refusal of life.
An optimistic bet on man would be to say that if man had culture, in the sense of the tools of thought, he could escape helpless solutions. So, to take evil at the root is to give men a formidable instrument of subversion and creativity.
I don’t believe that a drug ban would be enough, but if you don’t tackle a problem at its root, you inevitably fall into the cradle of the police and that’s worse.

M.S.:
How are we going to deal with mental illness in the future?

J.A.:
The problem of the evolution of medicine for mental illnesses will be done in two stages. Initially there will be even more drugs, psychotropic drugs, which correspond to real progress, for 30 years, in mental medicine.
It seems to me that, as a second step, and for economic reasons, a certain number of electronic means will be put in place, which will be either pain control methods (bio-feedback, etc.), or a computer system of psychoanalytic dialogues.
The consequence of this development will be to lead to what I call the explicitation of the normal; That is, electronic means will allow us to precisely define the normal and quantify social behavior. The latter will become economically consumable since the means and criteria for compliance with standards will exist. In the long term, when the disease is conquered, there is the temptation to conform to the "biological normal" which conditions the functioning of an absolute social organization.

Medicine is indicative of the evolution of a society which is moving towards decentralized totalitarianism in the future. We already perceive a certain conscious or unconscious desire to conform as much as possible to social norms.

M.S.:
Do you see this forced normalization governing all areas of life, including sexuality, since science today allows the almost total dissociation of sexuality and conception?...

J.A.:
From an economic point of view, there are two reasons that lead me to believe that we will go very far.
The first concerns the fact that men's production is not yet a market like any other. By following the logic of my general reasoning, we do not see why procreation should not become an economic production like the others.
One can perfectly imagine that the family or the woman are only one of the means of production of a particular object, the child.
We can, in a way, imagine "rental matrices" which are already technically possible. This idea fully corresponds to an economic development in the sense that the woman or the couple will be part of the division of labor and general production. Thus it will be possible to buy children as one buys "peanuts" or a television set.

A second important reason and linked to the first could explain this new family order. If economically the child is a commodity like any other, society considers him that way too, but for social reasons. Indeed, the survival of communities depends on sufficient demographics for their survival. If for economic reasons the family does not wish to have more than two children, this attitude is obviously opposed to the interest of the community! There is thus an absolute contradiction between the interests of the family and that of the society. The only way to resolve this contradiction is to imagine that society could buy children from a family who would be paid in return. I am not thinking of family allowances which are weak incentives. A family would accept to see many children if the state guaranteed them on the one hand the payment of substantial progressive allowances and on the other hand full support for the material life of each child. In this scheme, the child will become a kind of bargaining chip in the relationship between the individual and the community.

What I am saying here is not on my part some kind of complacency in the face of what seems inevitable. This is a warning. I believe this world in preparation will be so dreadful that it means the death of man. So you have to be prepared to resist it and it seems to me today that the best way to do it is to understand, to accept the fight, to avoid the worst. This is why I push my reasoning to the end ...

M.S.:
Resist what, since you are announcing an inevitable universe of prostheses?

J.A.:
The prostheses that I see coming are not mechanical but are means of fighting against i bionic affections linked to the phenomenon of tissue degeneration. Cellular engineering, genetic engineering and cloning pave the way for these prostheses which will be regenerated organs replacing the failing organs.

M.S.:
The growing penetration of computers in society invites ethical reflection. Isn't this an underlying threat to human freedom?

J.A.:
It is clear that the discourse on prevention, health economics, good medical practice, will lead to the need for each individual to have a medical file which will be put on a magnetic tape. For epidemiological reasons, all of these files will be centralized on a computer to which doctors will have access. The question arises: will the police be able to access these files? I can honestly see that Sweden today has this kind of sophisticated system and does not have a dictatorship. I would add that some countries do not have these files but do have a dictatorship. We know how to create the bulwark of new procedures against new threats. Democracy has a duty to adapt to technical developments. Old constitutions confronted with new technologies can lead to totalitarian systems.

M.S.:
One of the most common projections for the future is that humans will be able to exert biological control over their own body, among other things, through microprocessors...

J.A.:
This control already exists for the heart through “pacemakers”, and also for the pancreas. It should expand into other areas like pain. Small implants in the body capable of releasing hormones and active substances into target organs are planned. If it is aimed at prolonging life, this progress is inevitable.

M.S.:
It seems that we are leaving the era of physics to enter the era of biology, close to panbiology. Is this your opinion?

J.A.:
I believe that we are moving out of an energy-controlled universe into the information universe. If matter is energy, life is information. That is why the major producer of tomorrow's society will be living matter. Thanks in particular to genetic engineering, it will produce new therapeutic weapons, food and energy.

M.S.:
What is the future of the doctor and the medical power?

J.A.:
In a somewhat brutal way, I would say that just as the washerwomen have disappeared behind the advertising images of washing machines, the doctors integrated into the industrial system will become the foils of the biological prosthesis. The doctor we know will disappear to make way for a new social category living in the prosthesis industry. As with washing machines, there will be creators, sellers, installers and repairers of prostheses. My words may surprise you, but do we know that the main companies that think about prostheses are the big automobile companies such as Régie Renault, General Motors and Ford...

M.S.:
In other words, we will no longer need medical therapists because "normalization" will be carried out by a kind of preventive medicine, self-managed or not, and in any case "controlled". Won't it necessarily be coercive? ...

J.A.:
The appearance on the market of individualized articles self-monitoring and self-control will create the spirit of prevention. People will adapt so as to conform to the criteria of normality; prevention will no longer be coercive because it is wanted by people. But we should not lose sight of the fact that the most important thing is not technological progress but rather the highest form of commerce between people that culture represents. The form of society that the future prepares for us depends on the ability to master technical progress. Will we dominate him or will we be dominated by him? There is the question.

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