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The relevant literature from low- and middle-income economies points out how interventions focused more on the detection and treatment of alcohol dependence rather than on harmful alcohol use, which is responsible for more alcohol-related harm, lead to delayed identification and care for harmful and hazardous drinkers [72]

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The ACA included a variety of these countervailing measures, with both carrots (e.g., premium tax credits and cost-sharing reductions) and sticks (e.g., the individual mandate penalty and limited enrollment opportunities) to encourage healthy as well as sick people to enroll in health insurance coverage

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