here's james mitchell. so, james mitchell, where are you from? >> here's james back here. >> hi, mr. president. >> hey, james. >> i'm james mitchell, born in chicago and raised out here in cupertino, california. i have yet another question for you about the debt and health care. >> go ahead. >> so the biggest threat we have fiscally is the rise in health care costs. unfortunately, a lot of the solutions we hear to medicare and medicaid don't involve actually slowing down the rise in health care costs. instead, they involve shifting costs to beneficiaries and states. so my question is, can you talk a bit more about what provisions of the affordable health care act are designed to slow down the rise of health care costs, and what policies you'd like to see enacted in the future to continue to slow down the rise of health care costs? >> let me give you a couple of examples, because you're exactly right in how you describe it. i don't want to just shift the health care costs on to the american people, i want to actually reduce health care costs. let'

james mitchell. so james mitchell, where are you from? >> here's james back here. >> hi, mr. president. >> hey, james. >> i'm james mitchell. born in chicago and raised here in cupertino, california. i have another question about the debt and health care. >> go ahead. >> so the biggest threat we have fiscally is the rise in health care costs. unfortunately, a lot of the solutions we hear to medicare and medicaid don't involve actually slowing down the rise in health care costs. and instead they involve shifting costs to beneficiaries and states. so my question is, can you talk a bit more about what provisions in the affordable health care act are designed to slow down the rise of health care costs? and what policies you'd like to see enacted in the future to continue to slow down the rise of health care costs? >> let me give you a couple of examples. because you're exactly right in how you described it. i don't want to just shift the health care costs onto the american people. i want to reduce health care costs. let's take the example of health i.t. we're in silicon valley. s

james mitchell. james mitchell, where you from? >> here is james back here. >> hide mr. president. born in chicago and raised in cupertino california. i have yet another question for you about health care. so the biggest threat we have to scully is the in health care costs. unfortunately, a lot of the solutions we hear to medicare and medicaid don't involve actually slowing down the rising health care costs. instead they involve shipping cost to beneficiaries in the state. so my question is can you talk a bit more about what provisions of the affordable health care act are designed to slow down the rise of health care costs and what policies you would like to see enacted in the future to continue to slow down the rise of health care cost? >> let me give you a couple of examples. because you are exactly right in how you describe it. i don't want to just shift the health care costs onto the people. i want to reduce health care costs. let's take the example of health i.t.. we are in silicon valley so we can talk about i.t. staff. i will try to sound like you know what i'm talking abou