how can that be pitched so people don't perceive these as medicare tcuts? you have to take 25 year time horizons. why do we have the entire economics profession raid against the idea that prevention will pay? >> i want to take on the second one first. the prevention one is a curious discussion, because there are a bunch of things we can do on the prevention side. 99% of the attention to this discussion has been on detecting disease. the primary goal of doing disease detection is not to save money. the primary goal is to intervene earlier to make sure people have healthier lives and hopefully live longer. there are other forms of prevention averting disease in the first place, i talked about this in terms of making sure people who are pre-diabetic don't become diabetic. we have random trials that show that these work. we now do that in community- based settings that show that they save money. those interventions save money and work. there is another type for people with multiple chronic health care conditions to make sure we can manage their conditions so we

how can that be pitched so people don't perceive these as medicare tcuts? you have to take 25 year time horizons. why do we have the entire economics profession raid against the idea that prevention will pay? >> i want to take on the second one first. the prevention one is a curious discussion, because there are a bunch of things we can do on the prevention side. 99% of the attention to this discussion has been on detecting disease. the primary goal of doing disease detection is not to save money. the primary goal is to intervene earlier to make sure people have healthier lives and hopefully live longer. there are other forms of prevention averting disease in the first place, i talked about this in terms of making sure people who are pre-diabetic don't become diabetic. we have random trials that show that these work. we now do that in community- based settings that show that they save money. those interventions save money and work. there is another type for people with multiple chronic health care conditions to make sure we can manage their conditions so we