mr. staffly. if you look at who is insured today. .. you concerned, what would you attribute that to? compared to what is happening around world? >> it is -- the answer to that question is incredibly complex, the extent to which you look at survivability and what percentage is did to earlier detection in some situations and what is due to better treatment. the incidence of cancers incredibly high in this country compared to many other countries and in 7s of breast cancer is incredibly high compared to many other countries. it is an incredibly complicated analysis to tease out what results in mortality benefit or survival benefit. >> the status of california? >> thank you, mr. chairman. i wanted to quickly, i know this would have been a better question for mr. hummer, but i want to focus on the medicaid and medicare issue and the concern that we would need to point some costs savings through that. in california, new york, people get nervous about this, we looked at those costs. could any of you comment on that and whether or not -- she mentioned limiting itemized reductions for medicar