those suffering from some of the diseases that christine beasley and others have spoken about are dis pro portionately effected by their pain. we need a different way to distribute. we need primary care physicians working together with on the front lines health care providers that can work together, to create new partnerships between them and we need to pay for those services in a different way. right now, disincentive, who does not allow enough time for nurses and doctors to spend with the patients to develop a plan that will be meaningful for them. that is another area that we need to think about. we need to think about how the payment system is restructured so we are not just paying for expensive services but paying for those that fit the patient. the realty is that there's therapies that are available today, and not one particular one is best for all patients and not all are good for any one patient. need to look at the right match. between them. i would say that we certainly have innovations and interventions that have available today, but we have a need for defining more. there'