yesterday, i was speaking to someone -- they have an hsa. they said that their doctor prescribed them $150 a pump inhibitor. they went to them and say listen, we're paying for this out of our hsa and they asked for a substitute and they got a $20 generic substitute. that's because the patient had her healthcare was not subsidized. i don't see much innovative to drive down costs and presumably shifted over to the degree. how do we effectively make the patient central as opposed to the payment mechanism and the government bureaucracy which must administer this program? >> well, thank you very much for your question and thanks for the compliment, i think. at this particular moment i don't think i want to be considered the author of this proposal. >> i wouldn't either, but that's okay. >> so i want to -- i want to address each of your questions in turn. with regard to the question of whether or not this is an innovative approach, i think it's very important to emphasize as i have and as is emphasized in the legislation that the idea would not be

age as a --hsa they got a $20 substitute. the patient initiated and her health care was not compromised. a couple questions. i don't see much innovative beyond using monopoly power to drive down costs and presumably shifting whatever degree you shift. how do we effectively make the patient central as opposed to the payment mechanisms or government bureaucracy which must administer the program? >> thanks for the compliment, i think. i am not sure i want to be considered the author of this proposal. >> of what d there, but that is okay. >> i want to address each of your questions in turn. with regard to the question of whether or not this is an innovative approach, it is very important to emphasize, as i have, in the legislation, the idea would not be to replicate the medicare program but create a new program that had a broader set of benefits, different risk. >> you were explicit that you are using the same way to control costs as medicare which is through monopsony power and your bargaining power to lower rates. >> i said it