if you look at the medicare program, it's in many ways quite out of date as joe was saying and bob galvin. it doesn't do what it should have. one example, not paying for never events was an idea that arose in an oim report in the late 1990s, and throughout the 2000s in the bush administration, the department of health and human services never acted on the recommendation even though they were wasting tens of billions of dollars a year, and if you asked them why they were afraid of congress, they were afraid that congress would yell at them, so there was a determination that having 535 ceos was a bit too many for the insurance plan, so what's interesting is one of the things the affordable care act does is it has a lot of secretaries. everyone heard about the 2000 instances, the secretary show. what those are doing there is saying as congress, this is the way we want the system to go, and you, you single ceo are responsible for carrying it out, and we're not going to try and micromanage it, and so my hope is that what that reform turns into is a system where congress is at a broad level loo

if you look at the medicare program, it's in many ways quite out of date as joe was saying and bob galvin. it doesn't do what it should have. one example, not paying for never events was an idea that arose in an oim report in the late 1990s, and throughout the 2000s in the bush administration, the department of health and human services never acted on the recommendation even though they were wasting tens of billions of dollars a year, and if you asked them why they were afraid of congress, they were afraid that congress would yell at them, so there was a determination that having 535 ceos was a bit too many for the insurance plan, so what's interesting is one of the things the affordable care act does is it has a lot of secretaries. everyone heard about the 2000 instances, the secretary show. what those are doing there is saying as congress, this is the way we want the system to go, and you, you single ceo are responsible for carrying it out, and we're not going to try and micromanage it, and so my hope is that what that reform turns into is a system where congress is at a broad level loo

if you look at the medicare program, it's in many ways quite out of date as joe was saying and bob galvin. it doesn't do what it should have. one example, not paying for never events was an idea that arose in an oim report in the late 1990s, and throughout the 2000s in the bush administration, the department of health and human services never acted on the recommendation even though they were wasting tens of billions of dollars a year, and if you asked them why they were afraid of congress, they were afraid that congress would yell at them, so there was a determination that having 535 ceos was a bit too many for the insurance plan, so what's interesting is one of the things the affordable care act does is it has a lot of secretaries. everyone heard about the 2000 instances, the secretary show. what those are doing there is saying as congress, this is the way we want the system to go, and you, you single ceo are responsible for carrying it out, and we're not going to try and micromanage it, and so my hope is that what that reform turns into is a system where congress is at a broad level loo