>> i'm barbara dello, i'm a nurse, i'm a caretaker and parent. and i come here because i find >> the process that states are employing by and large to do that kind of work is far more participatory and collaborative in part because it's not as challenged by the partisan divides that make it almost impossible to have a conversation about many of the other elements of the law. and, in fact, states -- and i don't want to romanticize state government, but i do work with people in it -- it's pretty hard to move these agendas without consensus, and it's often quite difficult to achieve consensus unless you have brought a very large number of people to the table including patients and caregivers who are not quiet about their concerns and hopes for where the health care system is going. and so i view these kinds of discussions that are occurring state and locally about reallocating and redesigning the care delivery system to better meet the needs of patients and to be more affordable to those of us who are paying for it as an opportunity for that engagem

>> i'm barbara dello, i'm a nurse, i'm a caretaker and parent. and i come here because i find people whoyou assure lived with the illnesses that you will act in the interests of patients? it has significant implications for patients and caregivers. second, the process employed by participatory and because it is not as challenged by partisan .ivides that make it impossible most states, i work with people in it and it is hard to move these agendas without consensus and it is difficult to achieve consensus unless you have brought people to the table. view these kinds of discussions that are occurring state and locally about reallocating and redesigning the care delivery system to better meet the needs of patients and to be more affordable to those of us who are paying for it as an opportunity for that engagement. and as i say, i think those engagements are far more genuine than much of the discussion that occurs about the parts that are more politically polarized. >> you know, i talk to direct caregivers all the time, physicians, nurses, nurse pract