i think we need to find a way to let people who want to turn hospital beds in albuquerque or pickford and come here if those jobs go begging. we don't have a system that allows us to do that today. >> medicare will recrt -- reduce hospital payments by 30% in november. how will patients get to his future excellent treatment? >> this is a fundamentally important question. the question th hangs over our defense hangs over the medicare providers of the other end. we are going to decide how much we'd all you care for those over 65 in such an arbitrary way that we just are going to cut it in a huge and massive weight. my guess is we will have some of it in 2012. what type of services do we want and what are we willing to pay for it? in all honesty, for the past 10 or 20 years, we have not actually had that debate. we have hadlections in debates about what we want your we have not had a debate onow to pay for it. he rightly points out what our bar tab is. we are going to have to have that debate because we cannot have a country where we decide every person gets their taxes cut, and we are go