Tuesday, December 1, 2009


ACTION TIME !

Senate Health Care Debate Kicks-Off
Time For US To Fight !


On Monday, the Senate began debate toward crafting the final health care reform bill. During this process, which is anticipated to take at least a few weeks, Senators will have the opportunity to propose amendments or changes to the House and Senate bill(s) as they currently exist. During this process it is important that We The People stay engaged by speaking out to fight and DEMAND that certain measures are included in the final bill. Most important is the inclusion of a strong, competitive public option which will help drive insurance premium costs down through competition. Another very important element will be the start-up date. In the House version start-up is scheduled for 2013 while the Senate's start-up is one year later 2014. (Read House Bill vs. Senate Bill below for quick summary of each). Also important is the question of whether the public option will contain an opt-out or opt-in clause: allowing each state to deny participation in the public option program. There is also the question of the financial assistance or 'subsidies'-which come in different forms (see link below 'What Are Health Care Subsidies') designed to make insurance premiums more affordable, a very important aspect of the bill considering the mandate or law certain to be included in the bill forcing all Americans to have/purchase health insurance or be penalized.

The Senate debates can be seen LIVE on CSPAN 2 and we recommend watching whenever possible.

ACTION LINKS:
Get your Congressperson/Senator's
CONTACT INFO

Contact Senator Harry Reid


Call the White House Comment Line:
202-456-1111 / 202-456-1112
State that we MUST have a strong Public Option

MUST READ:
Comparing Health Care Bills:
House vs. Senate (a quick summary)

What are health insurance 'subsidies'
(read pdf)

The most important changes in American history occurred, not out of the kindness of our politician's hearts, but due to the mass voices of The People. Civil Rights...Women's Rights...Voter's Rights...Fair Housing Rights...the Right to Freedom...just to name a few. Now, We The People must do everything we can to call...fight...DEMAND the Right to
Quality Health Care for ALL !

Spread the word...Recruit others to
Join The Fight...

Yes We WILL !


B4B

Thursday, November 26, 2009


HAPPY THANKSGIVING !

WATCH:
" On behalf of Sasha and Malia "
President Pardons WH Turkey





Instead of being delicious...
turkey to go to Disney World !

In all we do, we must be thankful that we have the power to help those who don't.
Be Inspired...Be Informed...Be INVOLVED !!!
(Greg Jones)


Visit B4B site if video did not appear through email server


B4B

Tuesday, November 24, 2009

The Obama's Host First
White House State Dinner

Honoring India's Prime Minister Singh

Our 1st Lady looks absolutely Marvelous !

Elegant sleeveless gown by little-known Indian-American designer Naeem Khan, many dignitaries and celebrities, entertainment furnished by composer Marvin Hamlisch, jazz vocalist Kurt Elling, A.R. Rahman, an Indian composer, musician and singer who wrote the "Slumdog Millionaire" score also Chicago born, Jennifer Hudson, winner of the third season of American Idol.

Menu included: Potato and Eggplant Salad
White House Arugula with Onion Seed Vinaigrette
2008 Sauvignon Blanc, Modus Operandi, Napa Valley, California

Red Lentil Soup with Fresh Cheese... See More
2006 Riesling, Brooks "Ara", Wilamette Valley, Oregon

Roasted Potato Dumplings with Tomato Chutney
Chick Peas and Okra
2007 Granache Beckman Vineyards, Santa Ynez, California

Pumpkin pie tart
Pear Tatin
Whipped Cream and Caramel sauce
Sparkling Chardonnay, Thibaut Janisson Brut, Monticello, Virginia

Petits fours and Coffee
Cashew Brittle
Pecan Pralines
Passion fruit and vanilla Gelees
Chocolate dipped fruit...

and SMOKED COLLARD GREENS !
(really)


Yes...It's A New Day !

B4B

Sunday, November 22, 2009

With 60 Vote Win-Senate
Health Care Battle Begins

Going To Be Up To WE THE PEOPLE !


Greg Jones
Blacks4Barack

In a rare Saturday session the Senate voted 60-39 for the Senate health reform bill to proceed to the full Senate floor for debate. At this next stage, which begins after Thanksgiving break, all 100 Senators will have the opportunity to add amendments/changes or take things away from the current version of the bill. There are a number of key components of the bill which are certain to stir much discussion including the mandate (law that everyone must have/buy health insurance), the end of discrimination due to pre-existing health conditions, the barring of federal funds to be used for abortions (which is already in the bill but certain obstructionists want to use this issue to block health reform), anti-trust exceptions which currently allow private insurance companies to continue monopolies in different regions, whether there will be a public option and how strong (competitive) it will be, subsidies and the opt-out clause giving each state the right to NOT offer the public option (more affordable insurance) to residents of their state.

During Saturday's Senate 'discussion' leading up to the vote certain Democratic Senators have already voiced their opposition to a strong public option including Senators Lieberman, Landrieu and Lincoln.

Throughout the upcoming debate, which could take weeks if not longer, it is of vital importance that We The People work diligently contacting all of our Senators to let them know that we MUST have a STRONG public option, the ONLY method that could truly drive unaffordable premium costs down, particularly since there will be the law/mandate forcing everyone to have or buy insurance or be penalized. Considering the current economic conditions, a mandate, combined with high-priced, unaffordable insurance rates would be a true recipe for disastrous results.

We must also contact Senate Majority Leader Harry Reid in mass to let him know that WE KNOW that he CAN use the procedure known as RECONCILIATION to get the bill passed in which only 51 votes are needed for passage instead of 60-making Lieberman, Landrieu, Lincoln, Stupak and a few others irrelevant, and therefore should NOT be catered to.

Now, the true, hard work begins. We are hearing numerous politicians, including former President Bill Clinton say that we 'must pass something'. That is incorrect...fact is if the wrong thing is passed it could actually be worse for millions of Americans than it is now. We must pass something that TRULY creates access to quality health care FOR ALL ! Currently 44,000 Americans are DYING per year due to the lack of health care.

THIS MUST END !
It will be up to We The People to...

Fight...Call...DEMAND...
Quality Health Care For ALL !!!



MUST READ Related Article:
RECONCILIATION ! Should Be A Household Word

B4B

Saturday, November 21, 2009


WATCH:
President Obama's Weekly Address
Traveling Abroad for Our Economy at Home




VISIT B4B SITE if video did not appear through email server.

B4B

Thursday, November 19, 2009


READ COMPLETE
Senate Health Care Bill
(HR 3590)

CLICK HERE To Read Bill (pdf)

Bill now needs 60 votes to proceed into debate, amendments, etc..Three Democratic senators -- Ben Nelson of Nebraska, Mary Landrieu of
Louisiana, and Blanche Lincoln of Arkansas -- have yet to commit to
vote for the motion to proceed.


B4B

Wednesday, November 18, 2009


Scary MUST SEE VIDEO:
Frank Shaefer on Rachel Maddow Show Exposes

" Religious Right " Using Scripture
(Psalm 109:8)
To Call For Holy War

Rhetoric is "...trolling for assassins...
the American version of The Taliban"






Psalm 109:8 Let his days be few
and let another take his office
let his children be fatherless
and his wife a widow


ABSOLUTELY
PATHETIC !


CLICK HERE if video did not appear through email server

****************
B4B Commenter SPOTLIGHT !

Comment from Sheri


Thanks Greg, for getting this out. Frank S is excellent in his assessment of the dangerous rhetoric pressing for harm to the president. It's time the National news paid attention- if they can break away from Palin.. and bowing.. and it's beyond time that republicans and their supporters/religious entitities spoke against it.

I watched the video earlier in a diary at dkos. What is disturbing me more at this point is the comments at dailykos that depict/correlate Frank's suggestion that Obama supporters speak out rather than against him- to their arguments with the administration -as being the issue. They, in general are apparently more deeply concerned with their right to speak against the president than the reality that the religious right is calling out death threats against him. Oddly the loss of this president would be a loss of democracy. I'm not surprised by the right's behavior, I'm not shocked for rallying calls to kill either a democrat nor a black man in America. I'm, however, disturbed by the lackadasical response by some 'progressives'.

It's time for EVERYONE to stand up and speak out.. that we will not tolerate these obscene calls to violence against the President of the United States- by anyone. Those folks doing the calling need to be pointed out and catisgated nation-wide, imo. There needs to be a resounding backlash to this BS.

If more folks had spoken up and out - we might not be fighting two unjustified wars right now.

Sheri

B4B

Tuesday, November 17, 2009


VIDEO:

Keith Olbermann's "Countdown" Producer

Attends Free Health Care Clinic

" It Was Hard To Believe I was In America ! "


Danny Shea(HuffPo)

One of the free health clinics launched due to the generosity of "Countdown" viewers took place over the weekend in New Orleans.

While Keith Olbermann was unable to attend himself due to his father's illness, "Countdown" producer Rich Stockwell — who Olbermann credited on air as the brains behind the drive to raise money for the clinics — did attend, and he wrote an essay for MSNBC.com about his experience.

In the essay, Stockwell relays several stories of patients who came to Saturday's clinic: the 50-year-old woman with stage four breast cancer whose cancer was likely diagnosed so late because she didn't have insurance; the nurse who holds down two part-time jobs but can't work enough hours to qualify for medical benefits; the woman sent to the hospital with a 220/180 blood pressure who didn't know why she wasn't feeling well.

"After watching for hours as the patients moved through the clinic, it was hard to believe that I was in America," Stockwell wrote. "Health reform is not about Democrats or Republicans or who can score political points for the next election, it's about people. It's about fairness and justice in a system that knows none. I'd defy even the most hardened capitalist-loving-conservative to do what I did on Saturday and continue to pretend that the system in place right now is working....There are no words that can accurately describe the quiet desperation on the faces of the patients. Every single one I spoke to, and every one I heard talking with doctors, expressed their gratitude for the event and wished that they were held more often."

Stockwell noted that the last time the media convened in the New Orleans convention center was to cover Hurricane Katrina; this time, however, "we were there to cover a man-made disaster of even larger proportions," he wrote.

Read his full essay at MSNBC.com or watch Olbermann's segment on the New Orleans clinic below:





Click Here if video did not appear through email server

B4B

Monday, November 16, 2009

RECONCILIATION !
Should Be A Household Word

The Way Senate CAN Pass The Health Bill



By Greg Jones
Blacks4Barack

For some reason the media and even our politicians keep pounding the vital importance of the Senate obtaining 60 votes in the Senate to pass the health care reform legislation. There's the non-stop 'what will (Traitor) Joe Lieberman do'...or 'will they get (R) Olympia Snowe'...or 'will Harry Reid get the 60 votes he needs...'? 60...60...60 !!! That's all we hear. I'm not sure if the media is trying to add drama to the health care issue in an attempt to stimulate audience ratings or if it's an orchestrated tactic in hopes of keeping Americans ill-informed through the direction of our great politicians, but the FACT is, Senate Majority Leader Harry Reid DOES NOT need 60 votes to pass the health care bill but in fact ONLY 51- a simple majority, which makes a huge difference-through a procedure commonly used and known as RECONCILIATION.

Reconciliation is " a legislative process of the United States Senate intended to allow a contentious budget bill to be considered without being subject to filibuster (only needing 51 votes to pass). Because reconciliation limits debate and amendment, the process empowers the majority party ". The reconciliation procedure is limited to being used for budget related legislation that costs or raises substantial amounts of money. In the case of the Senate health care bill, that would include the expansion of Medicare or Medicaid, revenue-raising tax provisions, and even the creation of a public health insurance option, depending on how it's written. So the reconciliation procedure CAN be used to pass the health care bill with only 51 VOTES !

The downside of the bill being passed through this procedure is that, due to a ruling known as the Byrd Rule, non-budget legislation designed to regulate the insurance industry could not be included in the bill and would have to be voted on in a separate bill which would need 60 votes to overcome a filibuster. But there is a strategy that can be used to overcome even this obstacle as described by Ryan Grimm of HuffPo:
But there's another alternative, according to Martin Paone. Paone, who served as a Democratic Senate floor staffer for 29 years, has been advising Democrats as they craft their legislative strategy. He proposes that Democrats try to get 60 votes to waive the Byrd Rule -- which would then allow the inclusion of those non-budget-related provision in one bill that would require only 51 votes for final passage.

What's the advantage? And why would any senator who opposes the entire bill vote for such a waiver? The answer can be found in the specific proposals that would be in violation of the Byrd Rule. Mostly, those would include reforms to the way the insurance industry operates -- for example, a ban on using preexisting conditions to deny coverage, or a law that insurance companies can't drop a client just because they get sick.

Those are wildly popular reforms. Getting 60 votes to support those policies is much easier than getting 60 for a public health insurance option, which Republicans and some conservative Democrats oppose.

Conservative senators such as Mary Landrieu (D-La.), Ben Nelson (D-Neb.) or Olympia Snowe (R-Maine) could, in voting for a Byrd Rule waiver, put themselves on the record as being in support of popular insurance industry reforms, while still opposing final passage of the bill -- a political strategy that may be appealing to them.
So, as the media continues their daily rant of how imperative it is that EVERY Democratic Senator vote yes on the health care bill remember one FACT that they seem to want to hide from We The People. There IS a way for the Senate to get the bill passed WITHOUT 60 votes...without Traitor Joe...without Olympia Snowe...without Mary Landrieu...making them absolutely meaningless in the debate.

Now, WE must let Harry Reid know that WE know that this option is in fact available to him. Call...Email...and DEMAND that if he feels he doesn't have the 60 votes needed to block the filibuster, then We The People...


DEMAND
RECONCILIATION !

When they, our great politicians realize that WE KNOW that they have this option...they will be FORCED to use it...even if they had other intentions (like letting the bill stall or even fail). Help the word RECONCILIATION become a household word. Spread the fact that this IS in fact an alternate means of the Senate getting the bill passed. Since day one, President Obama has stated that he would not be able to create Change on his own...that he would need OUR help. Time to do OUR part by DEMANDING that our politicians do EVERYTHING possible, including RECONCILIATION, to stop 44,000 Americans from DYING each year due to the lack of access to quality health care, by passing health care reform-with a strong public option-for all.

Email the media to let them know that WE know
and are DEMANDING that our politicians

Get It Done !

Related Articles:
Gibbs: White House Not Ruling Out Reconciliation
(11/09/09)

Robert Reich Pushes Getting STRONG Public Option
Through RECONCILIATION
(11/13/09)

Also Read: The Rules/History/Process of Reconciliation

FLASH ! MUST READ ARTICLE (Nov. 23, 2009)
Howard Dean Says RECONCILIATION
ONLY Way To Go !


FINAL B4B NOTE:

What the budget reconciliation would do is allow the majority to bypass normal procedures for debate and vote on a bill -– by only having 20 hours of debate and forcing a simple majority vote at the end -– and more effectively implement their agenda. (Matt Zeitlin)

Some say that RECONCILIATION should
not be used or it might make Republicans retaliate
by voting NO on all future Democratic bills.
HUH ?

B4B


Sunday, November 15, 2009

B4B
Photo of the Week

President Obama Visits Asia

CLICK HERE for more photos

B4B

Thursday, November 12, 2009





READ:
The Obama Health Reform Plan

" Stability & Security For All Americans "


From THE WHITE HOUSE

"It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government"

If You Have Health Insurance

More Stability and Security

  • Ends discrimination against people with pre-existing conditions. Over the last three years, 12 million people were denied coverage directly or indirectly through high premiums due to a pre-existing condition. Under the President’s plan, it will be against the law for insurance companies to deny coverage for health reasons or risks.
  • Limits premium discrimination based on gender and age. The President’s plan will end insurers’ practice of charging different premiums or denying coverage based on gender, and will limit premium variation based on age.
  • Prevents insurance companies from dropping coverage when people are sick and need it most. The President’s plan prohibits insurance companies from rescinding coverage that has already been purchased except in cases of fraud. In most states, insurance companies can cancel a policy if any medical condition was not listed on the application – even one not related to a current illness or one the patient didn’t even know about. A recent Congressional investigation found that over five years, three large insurance companies cancelled coverage for 20,000 people, saving them from paying $300 million in medical claims - $300 million that became either an obligation for the patient’s family or bad debt for doctors and hospitals.
  • Caps out-of pocket expenses so people don’t go broke when they get sick. The President’s plan will cap out-of-pocket expenses and will prohibit insurance companies from imposing annual or lifetime caps on benefit payments. A middle-class family purchasing health insurance directly from the individual insurance market today could spend up to 50 percent of household income on health care costs because there is no limit on out-of-pocket expenses.
  • Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. The President’s plan ensures that all Americans have access to free preventive services under their health insurance plans. Too many Americans forgo needed preventive care, in part because of the cost of check-ups and screenings that can identify health problems early when they can be most effectively treated. For example, 24 percent of women age 40 and over have not received a mammogram in the past two years, and 38 percent of adults age 50 and over have never had a colon cancer screening.
  • Protects Medicare for seniors. The President’s plan will extend new protections for Medicare beneficiaries that improve quality, coordinate care and reduce beneficiary and program costs. These protections will extend the life of the Medicare Trust Fund to pay for care for future generations.
  • Eliminates the "donut-hole" gap in coverage for prescription drugs. The President’s plan begins immediately to close the Medicare "donut hole" - a current gap in its drug benefit - by providing a 50 percent discount on brand-name prescription drugs for seniors who fall into it. In 2007, over 8 million seniors hit this coverage gap in the standard Medicare drug benefit. By 2019, the President’s plan will completely close the "donut hole". The average out-of-pocket spending for such beneficiaries who lack another source of insurance is $4,080.

If You Don't Have Insurance

Quality, Affordable Choices for All Americans

  • Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. The President’s plan allows Americans who have health insurance and like it to keep it. But for those who lose their jobs, change jobs or move, new high quality, affordable options will be available in the exchange. Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.
  • Provides new tax credits to help people buy insurance. The President’s plan will provide new tax credits on a sliding scale to individuals and families that will limit how much of their income can be spent on premiums. There will also be greater protection for cost-sharing for out-of-pocket expenses.
  • Provides small businesses tax credits and affordable options for covering employees. The President’s plan will also provide small businesses with tax credits to offset costs of providing coverage for their workers. Small businesses who for too long have faced higher prices than larger businesses, will now be eligible to enter the exchange so that they have lower costs and more choices for covering their workers.
  • Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. The President believes this option will promote competition, hold insurance companies accountable and assure affordable choices. It is completely voluntary. The President believes the public option must operate like any private insurance company – it must be self-sufficient and rely on the premiums it collects.
  • Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

For All Americans

Reins In the Cost of Health Care for Our Families, Our Businesses, and Our Government

  • Won’t add a dime to the deficit and is paid for upfront. The President’s plan will not add one dime to the deficit today or in the future and is paid for in a fiscally responsible way. It begins the process of reforming the health care system so that we can further curb health care cost growth over the long term, and invests in quality improvements, consumer protections, prevention, and premium assistance. The plan fully pays for this investment through health system savings and new revenue including a fee on insurance companies that sell very expensive plans.
  • Requires additional cuts if savings are not realized. Under the plan, if the savings promised at the time of enactment don’t materialize, the President will be required to put forth additional savings to ensure that the plan does not add to the deficit.
  • Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. The President’s plan includes proposals that will improve the way care is delivered to emphasize quality over quantity, including: incentives for hospitals to prevent avoidable readmissions, pilots for new "bundled" payments in Medicare, and support for new models of delivering care through medical homes and accountable care organizations that focus on a coordinated approach to care and outcomes.
  • Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. The President’s plan will create an independent Commission, made up of doctors and medical experts, to make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare. The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care. It will ensure that your tax dollars go directly to caring for seniors.
  • Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine. The President’s plan instructs the Secretary of Health and Human Services to move forward on awarding medical malpractice demonstration grants to states funded by the Agency for Healthcare Research and Quality as soon as possible.
  • Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform. Under the President’s plan, large businesses – those with more than 50 workers – will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families. Individuals who can afford it will have a responsibility to purchase coverage – but there will be a "hardship exemption" for those who cannot.
B4B NOTE: This plan spells out, point-by-point, exactly what President Obama wants in the final health care reform bill. ANY politician who goes against any aspect of this plan is going AGAINST the desires of The President...and should be dealt with accordingly.

B4B

Sunday, November 8, 2009


House Passes Health Bill !
Another Historic Obama Landmark


Following a 14 hour debate, the U.S. House of Representatives passed landmark health care reform legislation, handing President Barack Obama a hard won victory on his signature domestic priority.

Republicans were nearly unanimous in opposing the plan that would expand coverage to tens of millions of Americans who lack it and place tough new restrictions on the insurance industry.

The 220-215 vote late Saturday cleared the way for the Senate to begin a long-delayed debate on the issue that has come to overshadow all others in Congress.

A triumphant Speaker Nancy Pelosi compared the legislation to the passage of Social Security in 1935 and Medicare 30 years later.

Obama, who went to Capitol Hill earlier on Saturday to lobby wavering Democrats, said in a statement after the vote, "I look forward to signing it into law by the end of the year."

The bill drew the votes of 219 Democrats and Rep. Joseph Cao, a first-term Republican who broke from his Party of No to do what is right for Americans and should be commended by all. Opposed were 176 Republicans and 39 Democrats.


From the Senate, Majority Leader Harry Reid of Nevada issued a statement saying, "We realize the strong will for reform that exists, and we are energized that we stand closer than ever to reforming our broken health insurance system". Now, the major need is for Reid to be energized enough to unite the Senate Democrats to pass the Senate version before the end of the year as President Obama has requested.

Although there is still much work ahead in the Senate, the passing of this bill in the House of Representatives is an incredibly historic feat for President Obama in that none of the previous 7 Presidents has gotten this close to achieving much needed health care reform for America. We thank Speaker Nancy Pelosi for her leadership to get this done in the House as we now turn to Senate Majority Leader Harry Reid to do the same. (CLICK HERE to read entire 1990-page health care bill or visit Hear The Bill to listen to audio version. The bill also includes the controversial Stupak Amendment. CLICK HERE to read amendment.)

WATCH:
President Obama Comments on
Congress' Historic Health Care Vote




1 Down...1 To Go !

FIGHT...CALL...DEMAND !
Now, Time For The Senate To
Get It Done !


Related Article: Senate Could Use 51 Vote
Reconciliation To Pass Health Bill...This Fact Needs to Go VIRAL !

CLICK HERE if video did not appear through email server

B4B

Friday, November 6, 2009


America’s Affordable Health Choices Act
Implementation Timeline

Greg Jones' B4B NOTE:
It had been anticipated that Congress would vote on the Democrats' health care legislation on Saturday Nov. 7 at 6pm. We are now hearing that the vote may be postponed until this Sunday while some report that the vote may be held up until the end of next week. Below is the complete time-line of when the various phases of this health reform plan will be implemented. As you see, in this plan their version of public option will begin in 2013.

2010

INSURANCE MARKET REFORMS
ENDS HEALTH INSURANCE RESCISSIONS: Prohibits abusive practices whereby health insurance companies rescind existing health insurance policies when a person gets sick as a way of avoiding covering the costs of enrollees’ health care needs.

NEW LIMITS ON PRE-EXISTING CONDITION EXCLUSIONS: Prior to the bill’s complete prohibition on pre-existing condition exclusions beginning in 2013, reduces the window that plans can look back for pre-existing conditions from 6 months to 30 days and shortens the period that plans may exclude coverage of certain benefits. It also prohibits insurers from limiting or denying coverage based on acts stemming from domestic violence.

BAN ON LIFETIME LIMITS: Prohibits insurance companies from placing lifetime caps on coverage.

IMMEDIATE SUNSHINE AGAINST INSURER PRICE GOUGING (RATE REVIEW): Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases.

ENACTS ADMINISTRATIVE SIMPLIFICATION: Begins adopting and implementing administrative simplification requirements to reduce paperwork, standardize transactions, and greatly diminish the administrative burdens and associated costs in today’s health care system.

ENSURING VALUE (MEDICAL LOSS RATIO): Specifies that health plans spend a minimum of 85 percent of premium dollars on medical care, while making sure that such a change doesn’t further destabilize the current individual health insurance market.

INCREASE DEPENDENT AGE FOR POLICIES THROUGH AGE 26: Allows those through age 26 not otherwise covered to remain on their parents’ policies at their parents’ discretion.
COBRA EXTENSION: Allows individuals to keep their COBRA coverage until the Exchange is up and running. [NOTE: This is separate from the Recovery Act provisions that provide premium assistance for selected groups.]

ENSURING RECONSTRUCTIVE SURGERY FOR CHILDREN: Requires plans to pay for reconstructive surgery for children with deformities.

LIMITATION ON POST-RETIREMENT REDUCTIONS OF RETIREE HEALTH BENEFITS: Prohibits employers from reducing retirees’ health benefits after those retirees have retired, unless the reduction is also made to benefits for active participants.

GRANTS TO STATES FOR IMMEDIATE HEALTH REFORM INITITATIVES: Builds on an existing grant program to enhance incentives for states to move forward with a variety of health reform initiatives prior to 2013.

IMPROVED BENEFITS

CREATES REINSURANCE FOR EARLY RETIREES: Creates a new temporary reinsurance program to help offset the cost of coverage for companies that provide early retiree health benefits for those ages 55-64.

IMMEDIATE HELP FOR THE UNINSURED (INTERIM HIGH-RISK POOL): Creates a $5 billion fund, modeled after the President’s plan, to finance an immediate, temporary insurance program for those who are uninsurable because of pre-existing conditions.

NEW LONG-TERM CARE PROGRAM (CLASS ACT): Creates a new, voluntary, public long-term care insurance program to help purchase services and supports for people who have functional limitations. Benefits are a daily or weekly cash benefit to help people with functional limitations purchase the services and supports needed to maintain personal and financial independence. CLASS would supplement, not supplant, traditional payers of long-term care (e.g. Medicaid and/or private long term care insurance).

ESTABLISHES THE HEALTH BENEFITS ADVISORY COMMITTEE: Establishes within 60 days of enactment the Health Benefits Advisory Committee—led by the Surgeon General and made up of health care experts, health care providers and patients—provides recommendations on the essential benefits package to the Secretary of HHS for approval.

PUBLIC HEALTH IMPROVEMENTS

INCREASES FUNDING FOR COMMUNITY HEALTH CENTERS: Provides increased funding for community health centers that will allow them to double the number of patients served over the next five years.

IMPLEMENTS NEW PREVENTIVE HEALTH SERVICES PROGRAM IN COMMUNITIES: Provides immediate funding for preventive services at the community and local level to address public health problems such as obesity, tobacco use, and diabetes.

EXPANDS PRIMARY CARE, NURSING AND PUBLIC HEALTH WORKFORCE: Increases access to primary care by sustaining the current efforts to increase the size of the National Health Service Corps. Primary care and nurse training programs are also immediately expanded to increase the size of the primary care and nursing workforce. Ensures that public health challenges are adequately addressed.

EMPLOYER WELLNESS PROGRAMS: Establishes a grant program for employers to promote healthy behaviors among their employees.

MEDICARE AND MEDICAID IMPROVEMENTS

BEGINS TO FILL IN THE MEDICARE PART D DRUG DONUT HOLE: Provides for a 50% discount on brand-name drugs in the Part D donut hole, and immediately shrinks the size of the donut hole by $500 in 2010. The donut hole continues to be narrowed over the coming years until it is fully eliminated by 2019.

IMPROVES PREVENTIVE HEALTH COVERAGE IN MEDICARE & MEDICAID: Eliminates cost sharing for preventive services to encourage wider use of preventive care for Medicare beneficiaries. Requires State Medicaid programs to cover preventive services recommended to the Secretary of HHS based on evidence, such as tobacco cessation counseling for pregnant women.

ALLOWS STATES TO COVER LOW-INCOME INDIVIDUALS WITH HIV: Gives States the option of extending Medicaid coverage to HIV-positive individuals and provides enhanced federal matching payments for the costs of care.

INCREASES REIMBURSEMENT FOR PRIMARY CARE IN MEDICAID: Brings reimbursement for primary care services in Medicaid up to Medicare levels with 100% federal funding (phased in over several years).

PROVIDES FOR 12-MONTH CONTINUOUS ELIGIBILITY IN CHIP: Provides continuity of care for children by requiring that states provide 12-month continuous eligibility for children in the CHIP program

CREATES MEDICARE ACCOUNTABLE CARE ORGANIZATIONS AND MEDICAL HOME PILOT PROGRAMS: Requires the Secretary to set specific benchmarks for expansion of these programs and to test them in a variety of settings and geographic regions. If the initial pilots prove successful, the Secretary is directed to continue expanding them on a large-scale basis.

2011
ELIMINATES BARRIERS TO ENROLLMENT IN MEDICARE LOW-INCOME SUBSIDY FOR PART D DRUG PROGRAM: Eases burdens on enrollment so more low-income beneficiaries can get the financial help they need to make health care affordable.

NEW PROTECTIONS IN MEDICARE ADVANTAGE: Limits cost-sharing for services in Medicare Advantage plans to no more than cost-sharing in traditional Medicare, and provides for bonus payments to high-quality plans.

ESSENTIAL BENEFITS: In preparation for reform, the Health Benefits Advisory Committee reports their recommended essential benefits package to the Secretary of HHS for adoption.
Additional federal funds to states with high unemployment. Assists States in maintaining access to
Medicaid services during the recession by extending the current Recovery Act increase in federal Medicaid payments to states with high unemployment rates.

2012
IMPROVES LOW-INCOME PROTECTIONS IN MEDICARE: Increases the assets test limits in the Part D drug program and Medicare Savings Programs to ensure that more low-income beneficiaries get the financial help they need to make their health care affordable.

EXTENDS MONTHS OF COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT PATIENTS: Lifts the current 36-month limitation on Medicare coverage of immunosuppressive drugs for kidney transplant patients who would otherwise lose this coverage on or after January 1, 2012.

2013
HEALTH INSURANCE REFORMS: Implements comprehensive health insurance reforms that prohibit insurance companies from engaging in discriminatory practices that enable them to refuse to sell or renew policies due to an individual’s health status. In addition, insurance companies can no longer exclude coverage for treatments based on pre-existing health conditions. The legislation also limits their ability to charge higher rates due to health status, gender, or other factors, and permits premiums to vary only by age (no more than 2:1), geography and family size.

HEALTH INSURANCE EXCHANGE: Opens the Health Insurance Exchange to individuals without other coverage and to small employers with 25 or fewer employees. This new venue will enable people to comparison shop for standardized health packages. It facilitates enrollment and administers affordability credits so that people of all incomes can obtain affordable coverage.

PUBLIC HEALTH INSURANCE OPTION: Creates a new public health insurance plan option that is available only within the Health Insurance Exchange. It competes on a level playing field against private health plans and will inject competition into the many parts of our country without a competitive health insurance market. Because it doesn’t operate at the behest of investors, it will be able to offer stiff competition to private insurers—forcing them to compete on cost and quality for the first time.

AFFORDABILITY CREDITS: Makes Health Insurance Affordability Credits available through the Exchange to ensure people can obtain affordable coverage. Credits are available for people with incomes above Medicaid eligibility and below 400% of poverty who are not eligible for or offered other acceptable coverage. They apply to both premiums and cost sharing to ensure that no families face bankruptcy due to medical expenses.

INDIVIDUAL RESPONSIBILITY: Requires individuals to obtain acceptable health insurance coverage or pay a penalty of 2.5% of their income that is capped at the cost of the average cost of qualified coverage.

EMPLOYER RESPONSIBILITY: Employers are required to offer coverage to their workers and their workers’ families with minimum contributions and meet standards for that coverage or pay a penalty of 8% of their payroll to help offset the cost of their workers obtaining coverage through the Exchange. Employers have a grace period and are not required to meet the benefit standards until 2018.

PROTECTS SMALL BUSINESS: Small businesses with annual payrolls below $500,000 are exempt from requirements to offer or contribute to coverage, including the 8% payroll contribution for failure to provide health benefits to their workers. The 8% requirement is phased in for small businesses with an annual payroll between $500,000 and $750,000.

SMALL BUSINESS TAX CREDITS: Provides certain lower-wage small businesses that choose to provide health coverage with a new tax credit worth up to 50% of the amount paid by a small employer for employee health coverage. The credits are available on a rolling basis for the first two years that an employer offers qualified coverage.

EXPANDS MEDICAID ELIGIBILITY: Expands Medicaid to 150% of poverty to ensure that people obtain affordable health care in the most efficient and appropriate manner. The expansion is fully federally funded in 2013 and 2014; thereafter states pay 9% and the federal government pays 91%.

PROTECTS THE HEALTH OF NEWBORN BABIES: Provides temporary Medicaid coverage for up to 60 days for babies who are born without proof of other health coverage.

2014
INITIATES AN AFFORDABILITY TEST FOR EMPLOYER-SPONSORED COVERAGE: Opens the Health Insurance Exchange to individuals who have an offer of employer-sponsored coverage, but for whom that coverage would be unaffordable because the premium would absorb more than 12% of their family income. People who meet this test will be able to enter the Exchange and are eligible for affordability credits based on their incomes.

HEALTH INSURANCE EXCHANGE EXPANDS: Opens the Health Insurance Exchange to small businesses with 50 or fewer employees.

ENSURING VALUE IN MEDICARE ADVANTAGE (MEDICAL LOSS RATIO): Requires Medicare Advantage plans to spend a minimum of 85 percent of premium dollars on medical care.

2015
EXPANDS HEALTH INSURANCE EXCHANGE: Opens the Health Insurance Exchange to small businesses with 100 or fewer employees and provides the Health Choices Commissioner the authority, from 2015 forward, to continue expanding the Exchange to larger employers as the system is ready to handle increased capacity.

2018
EMPLOYERS OUTSIDE THE EXCHANGE ARE REQUIRED TO MEET ESSENTIAL BENEFITS PACKAGE: The grace period ends for employer-sponsored plans to meet the health insurance standards. All employer-sponsored coverage and health insurance offered within the Exchange is required to meet benefit and contribution standards.

Prepared by the Committees on Ways & Means, Energy & Commerce, and Education & Labor
October 29, 2009


Knowledge Is POWER...Pass It On !!!

B4B

Thursday, November 5, 2009


WATCH:
President Obama Remarks
On Ft. Hood Rampage





Read More: 12 Dead, 31 Wounded

We Send Our Thoughts and Prayers.

CLICK HERE if video does not appear through email server

B4B



Civil Rights Groups Open

K Street Office

in Final Health Care Push


By Krissah Thompson Washington Post

After some small-scale, disjointed efforts to push for health care reform, civil rights groups are renting temporary office space on K Street and combining their efforts to run an operations center with the sole goal of lobbying on health care policy.

The office will be run by staffers from the National Urban League, the NAACP and the Black Leadership Forum. Over the next two weeks, they will coordinate rallies in 10 cities, run a phone bank where volunteers will pepper members of Congress with calls and keep up with the latest developments in the debate.

The groups are calling the effort a "war room" and plan to staff it long hours each day, creating a central hub for the civil rights groups to share ideas and staff resources. The voices of minorities, who are disproportionately represented among the poor and uninsured and could benefit the most from reform -- and who also are more likely than others to have chronic illnesses such as diabetes -- have been a small part of the contentious health care debate.

Marc Morial, president of the National Urban League, said the groups have been working behind the scenes but are trying to push to the front in the final stretch.
(Read more of article)

The Time is Now...
To Call...Fight...DEMAND
The RIGHT To Health Care for ALL !

B4B

Wednesday, November 4, 2009


Congressional Health Care Bill
All 1990 Pages
READ IT HERE !


By Greg Jones
Blacks4Barack

Last week Speaker Nancy Pelosi released the 1990-page House Democrats' health reform plan. The plan includes a version of the public option; mandates everyone to buy health insurance, bans insurance companies from denying health care coverage to people with pre-existing conditions and more. Make some coffee, sit back and read and read and read....then read a bit more. The first pages are the table of contents so you can start there, find what you're most interested in, then scroll down to those sections. Very much worth the time.

Knowledge is POWER !

Click Here to read entire bill...
then share.

B4B

Monday, November 2, 2009



Congressional Health Care Plan
Could Be
Disastrous
For the 46 Million Uncovered !


By Greg Jones
Blacks4Barack


The primary reason for the need for health care reform was always to furnish access to much needed health care to the 46 million hard working uninsured Americans who currently struggle through life without the basic right to adequate health care. With an average of 44,000 deaths per year due to the lack of health care coverage, the uninsured await in hopeful anticipation that our politicians will do the right thing, enabling the millions to no longer be forced to visit make-shift free clinics originally designed to serve in third world countries (attached pics). Unfortunately though, our politicians are heading down a health reform course which is getting farther and farther away from it's intent.

In fact, a quick review of the Congressional Health Care Bill recently presented exposes the fact that the millions currently in need could actually end up in worse shape than they are now if this bill was to pass. Although the bill does expand the number of individuals eligible for Medicaid to the 150% poverty level -which is approximately $16,200 for a single individual, for all who earn above that dollar limit the plan will force or mandate that every American buys insurance on their own (if it is not furnished by their employer) or be pena
lized. The penalty will be in the form of a tax penalty equal to 2.5% of their annual income. In other words, the very people who health reform is supposed to help will be fined for being too poor to afford this great health care coverage ! It's like a penalty for being poor. And they still won't have coverage.


For months we've been hearing about how health reform will become so 'affordable' through the creation of a strong, robust public option. But now as we review the Congressional Plan we see that they have turned away from the robust plan to a much weaker plan guaranteed to have higher premium costs, some warn even possibly a cost higher than the current private insurers. The 46 million hard working Americans are living without coverage for one basic reason: they can't afford it. If they could they would have it. So now, the bright idea from Congress is to create a new high priced, unaffordable form of coverage, but this time CHARGE people a fine who can't afford to buy it. THIS IS PATHETIC ! Even sadder, the plan as it sits now is actually budgeting or planning on millions of Americans to NOT be able to afford it, resorting to paying the fines/penalties, which is evident by the Congressional Plan already counting on $167 billion dollars being generated IN FINES which they boast when applied to the total 10 year cost of the plan, these fines/penalties will help keep the total costs under $884 Billion.

So our brilliant politicians are banking on generating billions in penalty money from the very millions of people that health reform is supposed to help. Not making sure they are covered and have the right to health care, but using the plan's unaffordability combined with the mandate as a way to make money! What ? So under this brilliant, unaffordable plan we will end up with millions who are still unable to receive needed health care, who will now be considered 'lawbreakers' who will then be forced to pay a penalty that will go toward making coverage more affordable for the more affluent who CAN afford the high premiums. THIS IS PATHET
IC and evident that our politicians are coming up with every scheme possible to serve the insurance cartel while telling the Americans in need to 'kiss off'.


If our politicians were sincere about making health care accessible to all they would first of all, demand a strong, robust public option (actually single-payer is the best as we all know but they'll never do that) so that the rates would TRULY be affordable. Then they would make the rate that the 46 million pay for premiums be on a sliding scale. To say that a person earning $16,200 is in poverty therefore eligible for Medicaid, but a person earning $16,250 CAN afford the high premiums and when they don't we'll penalize/charge them, is absolutely anti-American, asinine and in no way can call itself health care reform. Under this plan it would actually be better if no reform was done at all !

We're hearing in the media about how a surtax will be paid by individuals earning $500,000 per year or 1 million per couple to contribute to this health plan's cost, but it is disgusting how neither the media nor our great politicians are exposing how this plan will actually tax the poor-the very people in need of health care reform-by way of penalties for being too poor to afford the coverage !

While the politicians brag about history in the making, make certain that we all know exactly what they're bragging about. As they say, the devil is in the details. And for those who say things like 'this plan is a step in the right direction' or 'progress takes time'...you obviously HAVE coverage and are NOT one of the 46 million struggling each day to NOT become one of the 44,000 who DIE each year
; the very group that reform is SUPPOSED to be FOR...not PENALIZE !

Please Share The Truth...
Then Fight...Call...DEMAND !!!

TRUE Health Care For ALL !!!

Coming: The Truth About These 'Subsidies'

B4B

Sunday, November 1, 2009


Photos:
Halloween With THE OBAMAS !




Christine Simmons (AP)

WASHINGTON — President Barack Obama and first lady Michelle Obama on Saturday doled out presidential M&Ms and dried fruit mixes to more than 2,000 trick-or-treaters, marking their Halloween at a White House event partly aimed at honoring military families.


Dressed as superheroes, pirates, fairies and skeletons, the kids came in with their parents from Maryland, Virginia and Washington D.C., lining up at the orange lit White House.

The Obamas smiled, chatted and passed out cellophane goody bags that were also filled with a sweet dough butter cookie made by White House pastry chef Bill Yosses and a National Park Foundation Ranger activity book. Mrs. Obama wore furry cat ears and a leopard-patterned top.

It's A New Day !

B4B

Saturday, October 31, 2009


B4B NOTE: Hate to say it but...

The Public Option In Congress is Now

A SHAM !


Article By Miles Mogulescu

HuffPo

The so-called "public option" -- as it remains in the bills being proposed in the House and Senate -- is a fraud and a sham. It bears no resemblance to the "robust" public option originally sold by its supporters as the most pragmatic, "uniquely American" multipayer way of achieving affordable universal health care, instead of importing successful single payer models from other democratic capitalist countries which provide better health to its citizens at considerably lower costs.

The pygmy public option now being proposed in the House and Senate will not be a viable competitor to mandated private insurance.

• It will not put any meaningful pressure on private insurance companies to moderate their premiums.

• It will not have the market power to pay lower fees to doctors and hospitals than private insurance and will thus not be less expensive than private insurance.

• It will not even be available to most Americans.

• Since it will be unable to effectively compete with private insurance, it will end up with few, if any customers.

At this point, it really doesn't matter whether or not a final health reform bill includes this type of public option in name only. The public option, as it's now being proposed in the House and Senate, will have no meaningful impact. If Joe Lieberman or other corporate Democrats kill this meaningless public option, it will make no difference in the lives of most Americans. With or without a fraudulent public option, millions of Americans who will be required to buy insurance or pay a fine will see their premiums skyrocket as there will be no effective limits placed on how much private insurers can charge the customers whom the federal government will make buy their product.

The final nail in the public option's coffin came when House Democrats (with no help from President Obama to twist Blue Dog arms) fell 10 or 12 votes short of including a requirement that the public option pay providers Medicare rates plus 5% and instead will be required to negotiate rates with each doctor and hospital in America. This all but guarantees that the public option will end up paying more to doctors, hospitals and drug companies than private insurance.

It's like a brand new Mom and Pop store trying to compete with WalMart.

Here's why, without a tie to Medicare rates, the public option will end up paying more to providers than private insurance: The largest private insurers in each market already have tens or hundreds of thousands of members. When they negotiate rates with providers, they get volume discounts of as much as 30%-40% off "retail rates," just as WalMart gets volume discounts because of its market clout. (Because of its even greater bargaining power, Medicare often pays providers 15%-20% less than private insurance).

But without the ability to tie pricing to Medicare rates, the public option will have no ability to negotiate volume discounts. It will start out with no subscribers. It will then have to go to each hospital, doctor and drug company to negotiate rates. Without any subscribers at the outset, these providers will have no incentive to give volume discounts to the public option, which will end up paying more than large private insurers. This in turn will make the public option more expensive than private insurance. As a result, it will sign up few subscribers. With few subscribers, it will be continue to be unable to negotiate volume discounts. Even if the public option were allowed to pay Medicare plus 5% rates, unless it already had a large number of subscribers in a particular market, providers would simply refuse to accept public option patients at these reduced rates, prefering to treat patients from higher-paying private insurers. So it's a chicken and egg situation. Few subscribers will lead to higher costs. Higher costs will lead to few subscribers. This is a public option designed to fail.

As a result, when the Congressional Budget Office first evaluated the Senate negotiated-rate public option plan, the CBO concluded that it would end up with no subscribers. Perhaps with a little pressure from Congress, the CBO is now projecting that by 2019, approximately 6 million Americans would be enrolled in the negotiated-rate House public plan. The CBO also projects that "a public plan paying negotiated rates would...typically have premiums that are somewhat higher than the average premiums for private plans." The CBO notes that this public plan would attract a "less healthy pool of enrollees" than private plans. With a less healthy pool of enrolees who require more services than private plans, the cost of the public plan would continue to escalate beyond the cost of private insurance, further reducing the number of people who sign up, and further reducing its negotiating clout, leading to a vicious circle of increasing costs and unaffordability that would do little or nothing to put pressure on private insurers to lower their premiums.

As Kip Sullivan, a long-time fighter of universal health care, has argued articulately, the devolution of the public option from a robust proposal projected to cover over 129 million Americans and lower insurance costs to a sham public option that will at best cover 6 million Americans in 10 years and have no impact on lowering insurance costs is a case of "bait and switch".

The "public option" was initially proposed by Yale political scientist Jacob Hacker and Campaign for America's Future leader Roger Hickey as a more politically "pragmatic" alternative to the long-time progressive goal of establishing universal single payer health care (as though insurance companies and their paid-for Congressional allies wouldn't fight against a robust public option as hard as they would fight against Medicare for All).

Hacker and Hickey laid out 5 criteria that, they argued, were essential to the success of the public option.

1. The PO had to be pre-populated with tens of millions of people by shifting all or most uninsured people, as well as Medicaid and SCHIP enrollees, into the PO, so like Medicare, it would represent a huge pool of enrollees on day one.


2. Only enrollees in the PO, not in private insurance, would be eligible for government subsidies.

3. The PO and its subsidies would be available to all nonelderly Americans (not just the uninsured and employees of small businesses).

4. The PO would pay Medicare reimbursement rates.

5. The insurance industry had to offer the same minimum level of benefits that the PO offered.

If these criteria were met, the Lewin Group (a subsidiary of health insurance giant United Health) projected that the public option would enroll 129 million Americans, have overhead of 3%, pay hospitals 26% less and doctors 17% less than the private insurance industry, and have premiums 23% below the private insurance industry average.

That was the "bait." Now came the "switch." The puny public option proposals that are still on the table in the House and Senate meet only the 5th of the 5 criteria for an effective public option and eliminate the first 4 criteria. They are not pre-populated; subsidies go to both the public option and private insurance; large employers are barred from buying into the public option; and the public option is not allowed to use Medicare rates but must instead negotiate rates on a provider-by-provider basis.

The result is that instead of enrolling 129 million Americans and decreasing insurance premiums, the sham public option being proposed in the House and Senate will enroll between 0 and 6 million Americans and will cost more than private insurance.

It's time that organizations which supported a "robust" public option tell their supporters the truth: that the public option in the House and Senate bills bears no relationship to the public option they have been fighting for. (Instead, the Health Care for American Now blog praises the public option in the House bill as "a strong competitor to private insurance, keeping prices down and attracting customers.") Its time that "progressives" in Congress like Anthony Weiner, Alan Grayson, Jan Schakowsky, Raul Grijalva and Lynn Woolsey admit to their constituents that, with no help from President Obama, they've lost the battle for a "robust" public option. Media figures like Keith Obermann and Rachel Maddow, who've been vocally talking up the public option, should be reporting the truth about the pitiful public option that's left on the table.

As it stands now, the sham public option in the House and Senate bills serves only one purpose. It gives political cover to progressives and liberals in the House and Senate to vote for mandates that will use the power of the federal government to force uninsured individuals to buy inferior and over-priced private insurance or be fined by the IRS by being able to say, "Well, at least the bill contains something called a public option," even if it's a public option in name only. Better that Joe Lieberman's filibuster threat forces Congress to drop this sham public option from the bill. At least, then, progressives and liberals will have to squarely face up to the implications of their vote and decide if this type of "health care reform" is really in the interests of the American people, or indeed, in the interests of the Democratic Party.

As the final bill takes shape, it's going to be a close call whether this type of mandated "health insurance reform" with no price controls on premiums is better than no reform at all. (Thanks HuffPo)


Share The Facts...

Then Fight...Call...DEMAND !

STRONG Public Option ONLY !

B4B