please welcome to the stage john figueroa cochair of the health care symposium committee and ceo of genoa health care. [applause] >> what an incredible morning. the insight that doctoring emanuel regarded the results in the future the affordable parents as well as integrated care and power industries moving to a value-based system was fascinating. equally as intriguing was the description of our complex and ever-changing health care system by our esteemed panel of doctors and health care administrator's. i trust that their years of practical experience and i trust that they have certainly confirmed the complexity of our health care system and the speed in which it's changing in america. i'm going to take a little bit of a different view on this some of his comments consistent with some of the complexity issues of the day, consistent with things that we need to do to change the system to make it better but a slight difference in quality perspective. today as the indicated health care represents approximately 18% of our countries gdp. i think it is safe to say that the health care industry