first, we cannot perpetuate a system in which, as you saw from mcallen purses el paso, we spend twice as much in some areas as others and don't seem to get anything in return. addressing that is going to be difficult, you cannot write down a full list of proposals today that will address it in any kind of definitive way. but we conceptually know based on the work that has been done here at the institute of health and elsewhere, the things that are most auspicious, we are trying to do as much of that as possible and perhaps just as importantly, put in place a change in the process so we can keep up overtime with an e evolving health care market. separate and apart from that, but the health reform that will be adopted at some point this year, working with senator ba h bacchus and others, medicaid savings and additional revenue, we have put on the table $635 billion and scored savings. the president indicated last week that we will be putting $200,000,000,000,000 more on the table in the near future. you can easily do the math to see that your quickly getting into the range of the sorts