dr. blinder said.e said the 800 pound gorilla in the room is health care costs. , 18%end roughly 16%, 17% of gdp for healthcare. other industrialized countries in manyght percent and cases get better results. but the 800 pound gorilla in the room is healthcare costs. if we do not get our head around this, we are damped. when it came time to ask questions, the question i asked, i said, what is your device to us? if we do deficit reduction, we know a big pieces health care costs. he thought for a moment come and he said i am not an expert on this matter. he said this would be my advice to you. "find out what works. do that -- do more of that." find out whatas " does not work and do less of that?" answer.that was a great spending more money for healthcare, education, housing, you know it. it is like my guidance counselor. how we might do that, some ways we might, particularly with respect to medicaid and medicare, and ways we do not savage these programs ar old people, but we get better result for the sam

dr. blinder was referring to. places where we have seen this work.here you are structuring payments and incentives around quality care outcomes rather than just paying for an influx of independent outcomes. those are the kinds of potential measures that if we can identify them, we can measure them, we can actually verify that those work, and then we can spread them across the system, that is going to be the way we help to really drive systemic change in the health care system. we have a number of tools out there to help on that front, to try to identify these game changers, as some people refer to them. i think we need to look for additional ways to do that a well. you mentioned outside of the healthcare space, and that is an important component as well. one of the things i know omb has been working on and has confirmed, i would want to learn more about and focus on, the focus on evidence-based investment, evidence-based grantmaking, because there are a number of laces where we can do better, and in fact we can be more effective with the same or fewe