whereas, if you live in tunica, mississippi, you are worse off than if you were in algeria or bangladesh. why is that? why do we tolerate that? we've got to figure that out. there is not easy answers to that and it's been a problem for decades. we have mechanisms to start addressing this. if we are going to start doing these things, we have to look at these things. we have to think about not just the top small fraction of the most complex cases but the broad routine care that we get day in and day out and geographically distributed. finally, let's talk about price and costs. costs and value are all tied together. value is outcome divided by cost. if we're going to see was variability and outcome and we have variability of prices, it's pretty straightforward to see how we can have huge variations in what we see in our performance and we need to figure out why that's happening and try to reduce it. i was fascinated to see these graphs on the left of the cost spent per hospital day across different countries and across the u.s.. the 25th percentile of the u.s. is not that much more than oth

unfortunate enough to live in mississippi or west virginia, you are worse off than if you were in algeria or bangladesh. why is that lester mark why do we tolerate that? we've got to figure that out. it has been a problem for decades. but we have the eta and and with a national approach to quality care, we have some mechanisms to start to address this. be good anding to understandings, we have to look at those things. that's why i applaud u.s. news for thinking about not just the top small fraction of the most complex cases, but the broad summer routine care we get day in and day out and geographically distributed. finally, let's talk about price and cost. cost and value are all tied together. after all, value is outcome divided by cost. going to see this variability and outcome and prices, it is pretty straightforward to see how we could have huge variations and we need to figure out why that is happening and tried to reproduce it. the costcinated to see spent across different countries and across the u.s.. interestingly, the 25th percentile is not that much more than other advanced countries. is the