and we, this goes partly to joe antos' talk, we thought that accounted for 29% to 43% of the change in growth. and we thought that interacted with technology, again, to go to joe antos' point about interaction was another 27% to 49%. the insurance changes mattered less. i do think there's some in our data. we're looking now across the oacd and the demographic changes matter just a little bit. so, it -- and now chronic diseases, to go to ken's point, are also increasing, i think, throughout the developed world. certainly diabetes is increasing throughout so that in, i think, going forward, that's also going to be driving cost, as i said. but again i think all of these things are different aspects of the same reality. and i do think there is a mechanism that's driving the growth rates. >> i think dallas had a hand up. >> testing. quick follow-on on that set of points is, in work that paul has been doing with the database that we now have that has seven years of data pre-and post-design change by a major employ employer, this goes both to joe's point that it makes sense, and jo antos' poi

changes over time, which are certainly common across the developed countries, and this goes partly to joe antos talk. we thought that accounted for 29-43% of the change in growth, and we thought that interacted with technology, again goes to joe's point come at an auction passionate interaction was another 29-49%. the insurance changes mattered less. i do think there's some, and our data, we are looking out across the oecd and the demographic changes mattered just a little bit. so chronic diseases, to go to ken sport, are also increasing i think throughout the developed, certainly diabetes is increasing throughout. so that i think going forward, that's also going to be driving cost, as he said. but again, i think all of these things are different aspects of the same reality. but i do think there is a mechanism that is driving the growth rates. >> i think dallas had a hand up. >> just a quick follow on on that set of points is, in work that paul has been doing with the database that we now have, that has seven years of data pre and post design change, by a major employer. this goes both to joe's

to get us started, we're delighted to have two speakers, joe antos from american enterprise institute and ken thorp from emory to expect about the roles of technology and chronic conditions. and joe, we're very happy to have joe here with us today. he decided to have an authentic health care experience over the weekend in order to have a legitimate grip on his subject, but joe managed to come back from a case of sciatica and be with us today. joe, thank you so much for being here. we know it was only with considerable effort that you were able to join us and we appreciate that. so, joe, we're going to start with you. joe has a presentation and then we'll move directly in to ken's presentation. joe, all yours. >> thank you. what do we aim at? okay. all right. there we are. so i promise to stay on the subject for whole minutes at a time, technology, and of course you saw the picture of marcus welby. you know, if you got up this morning and took a pill, you used medical technology. that's probably what almost everybody in this room did. i took quite a few pills. they didn't do much good.

to get us started, we're delighted to have two speakers, joe antos from american enterprise institute and ken thorp from emory to expect about the roles of technology and chronic conditions. and joe, we're very happy to have joe here with us today. he decided to have an authentic health care experience over the weekend in order to have a legitimate grip on his subject, but joe managed to come back from a case of sciatica and be with us today. joe, thank you so much for being here. we know it was only with considerable effort that you were able to join us and we appreciate that. so, joe, we're going to start with you. joe has a presentation and then we'll move directly in to ken's presentation. joe, all yours. >> thank you. what do we aim at? okay. all right. there we are. so i promise to stay on the subject for whole minutes at a time, technology, and of course you saw the picture of marcus welby. you know, if you got up this morning and took a pill, you used medical technology. that's probably what almost everybody in this room did. i took quite a few pills. they didn't do much good.