Republican presidential candidate Mitt Romney and his running mate, Rep. Paul Ryan, order food at a Wendy's restuarant in Richmond Heights, Ohio, on Tuesday.
Editor's note: Nancy Pelosi, the first woman Speaker of the House, is the House Democratic Leader.
(CNN) -- The first presidential debate highlighted a clear choice on Medicare: President Obama's vision, guaranteeing the fundamental promise of Medicare for seniors today and into the future, versus Mitt Romney's blueprint for the eventual destruction of Medicare as we know it.
Ahead of the next presidential debate tomorrow in New York, it is important to make clear that either the Republican nominee does not know the facts or was willing to deceive the American people with false claims. Romney repeated the standard Republican falsehood that the Affordable Care Act cut $716 billion for Medicare beneficiaries. That is not true, and they know it.
Here are the facts, supported by independent critics, and they are indisputable:
The Affordable Care Act extends the life of Medicare by nearly a decade by reducing the rate of increase in payments to health care providers, by reducing costly taxpayer subsidies to insurance companies, and by reducing waste, fraud and abuse. The law requires hospitals to improve their quality of care, reduce infections and re-admissions, and increase efficiency. It places a premium on value, not volume, in medical procedures.
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The Affordable Care Act does not cut a single benefit or add a single penny to the cost of insurance for any Medicare beneficiary. Even before the law fully takes effect, seniors are experiencing the benefits. The gap in prescription drug coverage -- the so-called "doughnut hole"-- is starting to close, and more than 5.5 million seniors have saved an average of more than $600 each year on prescription drugs. All 49 million Medicare enrollees now have access to free wellness visits, checkups without a co-pay, and free preventive care services like mammograms and other cancer screenings.
Romney claims that if you're 60 or older, "you don't need to listen any further." Actually, seniors need to listen carefully -- very carefully -- because Medicare will be bankrupt by 2016 under the Romney-Ryan plan.
According to a report last month from the Center for American Progress Action Fund and co-authored by Harvard economist David Cutler, the Romney blueprint would cost today's senior more than $11,000 during retirement and force them to pay more for prescriptions and premiums, while cutting off access to critical services and benefits.
Republican Newt Gingrich has said that Medicare will "wither on the vine." Republicans have been developing and pursuing this agenda for two decades -- an effort to take our country back to the era before Medicare, when tens of millions of seniors were impoverished by health costs.
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It's not just today's seniors who should listen carefully to Romney's plan. For those under age 55, the Republican proposal is a voucher plan that ends the Medicare guarantee.
As the AARP made clear, the Republican proposal risks "simply increasing costs for beneficiaries while removing Medicare's promise of secure health coverage -- a guarantee that future seniors have contributed to through a lifetime of hard work."
AARP's words echo those of President Lyndon Johnson's on the day he signed the Medicare bill: "No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts. And no longer will this nation refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country."
That's what President Obama and Democrats are fighting to preserve: the American Dream that says, if you work hard, play by the rules, and take responsibility, anyone can succeed, support his or her family, and look forward to a secure retirement. Voters, be aware this year: Medicare is on the ballot, and its future is in jeopardy. Democrats created Medicare and will always fight to strengthen it for our seniors and for their families. And under President Obama's leadership we are moving forward.
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The opinions expressed in this commentary are solely those of Nancy Pelosi.
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Romney boards his campaign plane in Bedford, Massachusetts. The Romney camp has decided to continue campaigning on Election Day.
President Barack Obama gets emotional at his final campaign rally in Des Moines, Iowa, on Monday, November 5, on the eve of the U.S. presidential election. Obama's speech included references to his 2008 campaign and his victory in the Iowa caucuses, which helped catapult his political career.
The president and first lady Michelle Obama embrace Monday in Des Moines at his last campaign rally before the election.
A young supporter listens to Obama at Monday's rally in Des Moines.
Romney and his wife, Ann, greet supporters at a rally late Monday in Manchester, New Hampshire.
Ann Romney wipes away tears during her husband's campaign rally Monday in Manchester.
Romney reaches out to supporters Monday in Columbus, Ohio.
A Romney fan shows her support at Monday's rally in Columbus.
Obama, lower left, speaks during a campaign rally Monday in Madison, Wisconsin.
Workers put up signs Monday for Romney's election night event in Boston.
Obama is greeted by former President Bill Clinton during a campaign rally in Concord, New Hampshire, on Sunday, November 4. Obama and Romney darted from swing state to swing state, trying to fire up enthusiasm among supporters and win over any last wavering voters before Election Day.
Romney meets some young supporters during a campaign rally at the Hy-Vee Center in Des Moines, Iowa, on Sunday.
Romney arrives at Sunday's rally in Des Moines.
Obama arrives at a campaign rally in Dubuque, Iowa, on Saturday, November 3.
Romney supporters attend a rally in Englewood, Colorado, on Saturday.
Obama arrives at Cleveland Burke Lakefront Airport before an event in Mentor, Ohio, on Saturday.
President Barack Obama departs aboard Marine One for travel to campaign events in Ohio, Wisconsin, Iowa and Virginia from the south lawn of the White House on Saturday.
Ann Romney offers pastries to journalists aboard GOP presidential candidate Mitt Romney's campaign plane at Portsmouth International Airport in Newington, New Hampshire, on Saturday.
Supporters look on as Romney speaks during a campaign rally in Newington, New Hampshire, on Saturday.
President Barack Obama embraces Judith Kamalay after she introduced him during a campaign rally Friday, November 2, in Hilliard, Ohio.
Republican presidential candidate Mitt Romney works aboard his campaign plane before takeoff Friday in Norfolk, Virginia.
Romney gets ready to step off his campaign bus during an event Thursday, November 1, in Doswell, Virginia.
Obama addresses a campaign rally Thursday at Austin Straubel International Airport in Green Bay, Wisconsin.
U.S. Republican Presidential candidate Mitt Romney greets policemen who were part of his motorcade as he prepares to board his campaign plane in Roanoke, Virginia on Thursday.
Supporters wait to hear President Obama during a campaign rally at Austin Straubel International Airport on Thursday.
Mitt Romney holds a baby during a campaign event at Meadow Event Park on Thursday.
President Obama speaks during a campaign rally at Austin Straubel International Airport.
A Mitt Romney supporter holds an American flag during a campaign event at Meadow Event Park.
President Barack Obama greets and comforts victims of Hurricane Sandy at a shelter in Brigantine, New Jersey, on Wednesday, October 31.
Republican presidential candidate Mitt Romney holds a campaign rally on Halloween at Metropolitan Park in Jacksonville, Florida, on Wednesday, October 31.
President Barack Obama speaks about the federal government's response to Superstorm Sandy at the headquarters of the Red Cross in Washington on Tuesday, October 30.
Republican presidential candidate Mitt Romney accepts a food donation for storm victims at an event in Kettering, Ohio, on Tuesday.
Supporters listen as Romney speaks at an event to collect food and supply donations for storm victims in Kettering, Ohio, Tuesday.
Romney talks with advisers on his campaign bus while en route to a rally at Avon Lake High School on Monday, October 29, in Avon Lake, Ohio.
Obama makes a statement in the White House briefing room following a briefing on Hurricane Sandy on Monday in Washington. Obama returned early from a campaign trip to Florida and has canceled several other campaign events to monitor the storm.
Former President Bill Clinton speaks during a campaign rally with Vice President Joe Biden on Monday in Youngstown, Ohio. Obama had planned to attend the event but canceled to monitor Hurricane Sandy.
Obama steps off Air Force One on Monday upon arrival at Andrews Air Force Base in Maryland.
People line up in the rain for a campaign rally with Clinton and Biden on Monday in Youngstown, Ohio.
Democratic supporters listen during a campaign rally Monday with Clinton and Biden.
Romney greets supporters during a campaign rally at Avon Lake High School on Monday in Avon Lake, Ohio. Romney canceled other campaign events planned for Monday and Tuesday due to Hurricane Sandy.
A young girl looks on during a campaign rally for Romney at Avon Lake High School on Monday.
Romney speaks during a campaign rally at Seven Cities Sod on Monday in Davenport, Iowa.
Romney gets into his SUV after landing Monday in Vandalia, Ohio.
Romney holds a giant cinnamon roll on Monday en route to Dayton, Ohio.
A supporter of Mitt Romney and Paul Ryan wears a campaign sticker on his shoe during a campaign rally at the Celina Fieldhouse in Celina, Ohio, on Sunday, October 28.
Obama delivers remarks during a campaign rally at Elm Street Middle School in Nashua, New Hampshire on Saturday, October 27. With 10 days to go before the presidential election, Obama and his opponent, former Massachusetts Gov. Mitt Romney, are criss-crossing the country from one swing state to the next in an attempt to sway voters.
A young Romney supporter holds a homemade sign during a campaign rally at Ranger Jet Center on Saturday in Kissimmee, Florida.
Obama speaks at a campaign rally in Nashua, New Hampshire, on Saturday.
Romney emerges from his SUV at Akron-Canton Regional Airport on Saturday in Canton, Ohio.
Romney and his running mate, Rep. Paul Ryan, hold a campaign rally at Canton Hoover High School in North Canton, Ohio, on Friday, October 26.
Obama chats with firefighters after dropping off doughnuts for them at a fire station in Tampa, Florida, on Thursday, October 25.
Romney, center, poses for a photo with workers at First Watch Cafe on Thursday.
Volunteers make phone calls seeking support for Romney at his Arlington Victory Center in Virginia.
Obama kisses a baby during a campaign rally at Byrd Park in Richmond, Virginia, on Thursday.
Supporters take photos of Obama during a campaign rally at Ybor City Museum State Park in Tampa on Thursday.
Supporters look on as Romney speaks during a campaign rally at Jet Machine in Cincinnati.
Romney says goodbye to Ryan at Denver International airport on Wednesday, October 24.
Supporters cheer as Obama speaks during a campaign event at Mississippi Valley Fairgrounds in Davenport, Iowa, Wednesday.
The president speaks with residents during a lunch with a group of Obama for America volunteers at an unanounced stop at Antonella's Pizzeria in Davenport, Iowa, on Wednesday.
Romney holds a campaign rally at the Reno Event Center in Nevada on Wednesday.
Obama greets people at Buckley Air Force Base in Aurora, Colorado, Wednesday.
Romney gestures to the crowd during a campaign event at the Reno Event Center in Reno, Nevada on Wednesday.
Romney talks with his running mate Rep. Paul Ryan of Wisconsin aboard their campaign plane on Tuesday, October 23, en route to Denver. A day after the final presidential debate, Romney is campaigning in Nevada and Colorado.
Obama and Romney hug their wives on stage after finishing their third and final presidential debate at Lynn University in Boca Raton, Florida, on Monday, October 22.
Romney and his wife, Ann, try to relax backstage with members of their family before the start of Monday's debate.
Obama reads briefing material while meeting with advisers inside his cabin on Sunday, October 21, at Camp David, Maryland.
Republican candidate Mitt Romney plays with his grandson while having dinner on Sunday in Delray Beach, Florida.
Bartek Wawruch stands between cardboard cutouts of Obama and Romney at Lynn University in Boca Raton, Florida, on Saturday, October 20, as the campus prepares for Monday's presidential debate.
Romney boards his campaign plane at Newark Liberty International Airport on Friday, October 19.
Romney speaks with campaign staff on board his campaign plane at Washington Dulles International Airport in Chantilly, Virginia, on Thursday, October 18.
Obama speaks during a rally at Veterans Memorial Park in Manchester, New Hampshire, on Thursday.
Jack Bunn, 51, and Jane Cookson, 57, cast their votes at the Board of Elections early voting station in Wilson, North Carolina, on Thursday.
Barack Obama and Jon Stewart speak during a break in the live taping of Comedy Central's "The Daily Show with Jon Stewart" on Thursday.
Supporters of Mitt Romney attend a campaign rally in Chesapeake, Virginia, on Wednesday, October 17.
Mitt Romney is seen backstage through a campaign flag as he waits to take the stage at a rally in Chesapeake, Virginia, on Wednesday.
Supporters of Obama listen to him speak during a rally at Cornell College in Mt. Vernon, Iowa, on Wednesday.
President Barack Obama arrives at Rickenbacker International Airport in Columbus, Ohio, for a campaign rally Wednesday.
A group of men watch the presidential debate on television screens at an electronics store in Miami on Tuesday, October 16.
Republican presidential candidate Mitt Romney talks with aides aboard his campaign plane en route to Ronkonkoma, New York, on Tuesday.
A worker cleans a sign for the Commission on Presidential Debates before the second presidential debate in Hempstead, New York, on Tuesday.
Members of the production crew ready final preparations for the second presidential debate between President Barack Obama and Republican nominee Mitt Romney on Tuesday.
First lady Michelle Obama greets supporters during a campaign rally at Ohio Wesleyan University in Delaware, Ohio, on Monday, October 15.
Supporters of President Barack Obama cheer during the campaign rally at Ohio Wesleyan on Monday.
Obama jokes about a telephone with campaign volunteers Alexa Kissinger, left, and Suzanne Stern as he makes calls from a campaign office in Williamsburg, Virginia, on Sunday, October 14.
Dolls depicting Obama and Mitt Romney are on display at a gift shop at Baltimore/Washington International Thurgood Marshall Airport in Maryland on Sunday.
Romney holds up a baby as he works the rope line after delivering remarks at a rally in Lebanon, Ohio, on Saturday, October 13.
A supporter holds an American flag in front of the Ohio logo on his shirt as he stands with a crowd at Shawnee State University to hear Romney speak on Saturday.
Mario Orosa, left, and Ron Cathey, right, chat with Obama during dinner at Smith Commons restaurant in Washington on Friday, October 12. Obama had dinner with contest winners who contributed to his re-election campaign.
Romney, right, and GOP vice-presidential candidate Paul Ryan greet supporters as they arrive at a rally in Lancaster, Ohio, on Friday.
Students walk past a political mural near Centre College in downtown Danville, Kentucky, where Vice President Joe Biden and Republican vice-presidential nominee Rep. Paul Ryan faced off Thursday, October 11.
Ryan greets his son Sam after the debate in Danville, Kentucky, on Thursday.
Romney, left, speaks with the Rev. Billy Graham during a visit to the Graham cabin in Montreat, North Carolina, on Thursday.
Obama greets supporters at a campaign rally at the University of Miami on Thursday.
Romney and New Jersey Gov. Chris Christie talk with supporters at Buns Bakery and Restaurant in Delaware, Ohio, on Wednesday, October 10. Romney is campaigning in Ohio with less than a month to go before the general election.
Christie, left, and Romney walk up to the stage at Ariel Corporation in Mount Vernon, Ohio, on Wednesday.
Centre College students Ben Boone, left, a stand-in for U.S. Vice President Joe Biden, and Tommy Munoz, a stand-in for Republican Vice Presidential candidate Paul Ryan, wave during a rehearsal for the vice presidential debate in Danville, Kentucky, on Wednesday.
Members of the media watch as President Barack Obama arrives aboard Marine One on the South Lawn of the White House on Tuesday, October 9, in Washington. The president was returning from a two-day campaign trip to California and Ohio.
Obama addresses supporters during a campaign event at The Ohio State University on Tuesday.
Two Obama supporters, one holding a Big Bird book and the other clutching a picture of the president, listen while he speaks at a rally at Ohio State on Tuesday.
Republican presidential candidate Mitt Romney departs a Wendy's restaurant with his dinner order in Cuyahoga Falls, Ohio, on Tuesday.
Supporters cheer as Romney delivers remarks on the James Koch Farm in Van Meter, Iowa, on Tuesday.
Allan Banojakedjian, left, and Jesus Romero fill out their voter registration forms at the Miami-Dade Elections Department on the final day of registration for the upcoming presidential election.
Rain doesn't keep Romney from campaigning in Newport News, Virginia, on Monday, October 8.
Obama holds a campaign event Monday at the Bill Graham Civic Auditorium in San Francisco.
Obama takes the stage at a campaign concert at the Nokia Theatre in Los Angeles on Sunday, October 7. The president has been on a three-day trip to California and Ohio.
Air Force One leaves a shadow as it passes over the Forum on approach to Los Angeles International Airport on Sunday.
Obama leaves the White House on Sunday to board Air Force One.
Republican presidential candidate Mitt Romney and his wife, Ann, greet workers at the Tin Fish restaurant following a rally Sunday in Port St. Lucie, Florida.
Romney casts a shadow on a banner as he speaks during a campaign event in Apopka, Florida, on Saturday, October 6.
A supporter holds a photograph of Romney in Apopka on Saturday.
Jon Bon Jovi performs at an Obama for America event at the House of Blues in Las Vegas on Saturday. It was the last day people in Nevada could register to vote in the upcoming presidential election.
Romney speaks during a campaign event in St. Petersburg, Florida, on Friday, October 5.
Romney supporters listen during Friday's campaign event in St. Petersburg.
Obama smiles as he speaks during a campaign rally in Fairfax, Virginia on Friday.
Obama is assisted with putting on a raincoat onstage during a campaign rally at Cleveland State University on Friday.
Romney speaks in Fishersville, Virginia, as Secret Service members keep guard on Thursday, October 4. A day after the first presidential debate in Denver, Romney headed to Virginia to continue campaigning.
Romney supporters bow their heads in prayer during Thursday's event at the Augusta Expoland in Fishersville, Viriginia.
Obama addresses the crowd at the University of Wisconsin in Madison on Thursday.
Romney greets police officers before boarding his campaign plane in Denver on Thursday.
Obama speaks at a campaign rally in Denver on Thursday. He accused his Republican challenger of dishonesty over tax policy and other issues brought up in Wednesday night's presidential debate.
Audience members cheer as Obama makes his way onto the stage at Sloan's Lake Park in Denver on Thursday.
Reporters watch the final minutes of the debate between Romney and Obama in Denver on Wednesday, October 3. The first of four debates for the 2012 election -- three presidential and one vice-presidential -- was moderated by Jim Lehrer of PBS.
A member of the U.S. Secret Service keeps watch from the top of a building as Obama takes part in a debate walk-through at the University of Denver on Wednesday.
A seat is assigned to first lady Michelle Obama prior to Wednesday's debate.
Obama stands at the podium as he speaks during the debate on Wednesday.
Michelle and Barack Obama, left, join Mitt Romney and his family at the conclusion of the first presidential debate.
University of Denver student Sam Garry sits at the moderator's desk before a presidential debate dress rehearsal at the University of Denver on Tuesday, October 2.
Volunteers sit in for on-air television reporters on Tuesday in preparation for the first presidential debate in the Ritchie Center at the University of Denver.
Romney greets a father and his daughter after having lunch Tuesday at a restaurant in Denver.
Obama stares at the Hoover Dam in Nevada during a visit Tuesday.
Romney boards his campaign plane in Bedford, Massachusetts, on Monday, October 1. The Republican candidate was heading to Denver for the first presidential debate on Wednesday.
Obama hugs Chasstiry Vazquez after she indroduced him at a campaign event at Desert Pines High School in Las Vegas on Sunday, September 30.
Obama supporters cheer during Sunday's event in Las Vegas.
Romney leaves his campaign headquarters in Boston on Sunday.
A boy reaches out to shake hands with Obama on Sunday in Las Vegas. The president was in Nevada ahead of Wednesday's presidential debate in Denver.
Romney arrives at the Church of Jesus Christ of Latter-day Saints in Belmont to attend Sunday services.
Obama talks on the phone with Prime Minister Benjamin Netanyahu of Israel in the Oval Office on Friday, September 28.
Romney speaks during a rally at Valley Forge Military Academy and College in Pennsylvania on Friday.
Romney talks to journalists aboard his campaign plane about his phone call with Netanyahu on Friday.
Cadets listen to Romney speak at a campaign rally Friday at the Valley Forge Military Academy and College in Wayne, Pennsylvania.
Romney addresses Friday's rally at the Valley Forge Military Academy and College.
Vice President Joe Biden hugs U.S. Rep. Debbie Wasserman Schultz, chairwoman of the Democratic National Committee, as he arrives for a campaign event Friday in Boca Raton, Florida.
Romney speaks at a Veterans for Romney campaign event in Springfield, Virginia, on Thursday, September 27.
Obama supporters cheer at a campaign rally Thursday in Virginia Beach, Virginia.
Veterans at the American Legion Post 176 pray before Romney speaks Thursday in Springfield.
People listen to Obama speak at the Farm Bureau Live arena in Virginia Beach on Thursday.
Obama delivers remarks Thursday in Virginia Beach.
Supporters cheer as Romney speaks at SeaGate Convention Centre in Toledo, Ohio, on Wednesday, September 26.
Romney speaks during a roundtable discussion on manufacturing at American Spring Wire in Bedford Heights, Ohio, on Wednesday.
Supporters wait to see Obama on Wednesday at Toledo Express Airport in Bowling Green, Ohio. Air For One aborted an initial landing attempt in Ohio due to weather conditions.
Obama addresses supporters at Bowling Green State University on Wednesday.
Romney delivers remarks during a campaign rally Wednesday at Westerville South High School in Westerville, Ohio.
Former President Bill Clinton introduces Obama during the Clinton Global Initiative annual meeting in New York on Tuesday, September 25.
Supporters cheer during a Republican campaign rally Tuesday with Romney and his running mate, Paul Ryan, at Dayton International Airport in Vandalia, Ohio.
Ryan speaks Tuesday in Vandalia as Sen. Rand Paul, from left, Sen. Rob Portman and Romney listen.
Former Florida Gov. Jeb Bush hugs a waitress as they wait for Ryan's arrival during a campaign stop at a restaurant in Miami's Little Havana neighborhood on Saturday, September 22.
Supporters cheer as they listen to Romney speak during a Juntos Con Romney Rally at the Darwin Fuchs Pavilion on Wednesday, September 19, in Miami.
Romney shakes hands with supporters during the Juntos Con Romney Rally in Miami on Wednesday.
Obama and David Letterman speak during a break in the taping of the "Late Show with David Letterman" on Tuesday, September 18, at the Ed Sullivan Theater in New York.
A crew member opens the door to Air Force One after the jet arrived at John F. Kennedy Airport in New York on Tuesday.
From left to right: Romney, his wife Ann, and son Tagg watch one of Tagg's sons play soccer in Belmont, Massachusetts, on Saturday, September 15.
Ryan arrives onstage to address the Family Research Council Action Values Voter Summit on Friday, September 14.
Supporters wait for Romney to speak at a campaign rally at Lake Erie College in Painesville, Ohio, on Friday, September 14.
Obama arrives at Andrews Air Force Base in Maryland on Thursday, September 13. Obama returned to Washington after a two-day campaign trip with events in Nevada and Colorado.
Supporters cheer as Romney speaks at a campaign rally in Fairfax, Virginia, on Thursday.
An Obama supporter attends a rally in Las Vegas on Wednesday, September 12. Obama focused on economic policies during his two days of campaigning in Nevada and Colorado.
Former President Bill Clinton speaks in support of Obama during a campaign stop in Miami on Tuesday, September 11.
Obama is lifted up by Scott Van Duzer, owner of Big Apple Pizza and Pasta Italian Restaurant, during a visit to the restaurant in Fort Pierce, Florida, on Sunday, September 9. Obama was on a two-day bus tour across the state.
President Obama greets supporters during a campaign stop at the Palm Beach County Convention Center in West Palm Beach, Florida, on Sunday.
Mitt Romney walks through the garage area during a rain delay before the start of the NASCAR Sprint Cup Series Federated Auto Parts 400 at Richmond International Raceway on Saturday, September 8, in Richmond, Virginia.
Ann Romney, wife of Republican presidential candidate Mitt Romney, waves to the crowd before speaking at a rally in Leesburg, Virginia, on Friday, September 7.
Supporters try to stay dry in between rain showers while waiting for President Obama to speak at the University of Iowa on Friday. It was Obama's first day of campaigning after accepting the presidential nomination at the Democratic National Convention in Charlotte, North Carolina.
A girl listens to President Obama speak at the University of Iowa on Friday.
Vice President Joe Biden, first lady Michelle Obama, President Obama and Biden's wife, Jill, wave after Friday's campaign event at the University of Iowa.
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