it is time for america and the doctors use the most of nance science of the most personal health-care decisions are made with access to the best available information. i will let minute, i've experienced going to a doctor, it might not be as much fun as going shopping for a car but was made sure that because we spend one of every $6 in america was made sure is at least as efficient as buying a car or that tv. in that way not only will we get a better experience with a go to the doctor but also get healthier americans. thank you very much merit [applause] >> thank you very much, senator, he has graciously agreed to stay for a few questions so if you can raise your hands we will have microphones are on the run. so hands up of any questions. yes up in front, ellen. the mike is coming. >> thank-you. friends of cancer research. i want to thank you for your work on comparative effectiveness research, it has been appreciated. the senate bell, the funding have clinical effectiveness, and was taken out of the house and perhaps you can address that or address the importance of clinical effectiv