we heard from jim fasules about the beneficial aspects of a lot of the technology that we have adopted. with respect to cardiovascular disease, particularly as evident in the 30% reduction in mortality. from cardiovascular disease just in the last decade. nonetheless, as he pointed out there are things going on in ca cardiovascular care that shouldn't be done and then there's the five interventions not to allow your physician to suggest that you have. and as he noted, that coupled with a lot of quality improvement, efforts underway at various institutions we're improving the cardiovascular care and perhaps reducing some of the unnecessary care driven by certain technologies. we heard from diane roland about the very important fact that the high spenders in the medicare program are different from the medicaid program. which is a recipe for us to developing a much more nuanced understanding about how to restrain excess cost in those two pockets of the population. we heard from bruce chernof again much on that same theme that half of the medicare enrollee with chronic conditions have func

we're going to move now to jim fasules, and this is your chance to explain why all this spending on cardiovascular disease interventions has been entirely worth it. >> i hope so. i want to thank ed and i want to thank mary ellen because you're probably as much responsible for me being here as anybody else. i don't know if that's good until after the comments, okay, mary ellen. i guess we picked cardiovascular disease as the example or the model of chronic disease here. let me just say that i would also going to go into that, go into the data and take the opportunity to say what a disease-specific association can do that's actionable in what we have been talking about. right off the bat, one thing we haven't talked about, cardiovascular disease also has an effect on the economy. a net loss to productivity of anywhere from 300 to $400 billion a year in lost productivity. also though, dr. newhouse's slides, the last decade we have had a 30% reduction in mortality from cardiovascular disease. probably from the treatment. i'm going to say in the data aspects we have to kind of be careful what we pick.

we're going to move now to jim fasules of the american college of cardiology. jim, your chance to explain to us why all of this spending on cardiovascular disease inventions has been entirely worth it. >> i hope so. i want to thank ed and i want to thank mary ella, you're probably as much responsible for me being here as anybody else. i'm not sure that's good until after the comments, okay? i guess we picked cardiovascular disease as the example or the model of chronic disease here. let's me gijust say that i'll g into that but go into the data and take the opportunity to say what a disease-specific association can do that's actionable in what we've been talking. right off the bat, one thing we haven't talked about cardiovascular disease also has an effect on the economy. a net loss to productivity of anywhere from $300 billion to $400 billion a year in lost productivity. also, though, what dr dr. newhouse's slide the last decade a 30% reduction in rtality from cardiovascular disease, probably from the treatment. i'm going to just say, inhe data aspect, we have