diagnostics where there strange data to demonstrate it is needed and it defensive or a billing uncourageoust. encourages. what about end of life and disease states that are particularly demanding on the how do we form specialized care units around those to do a better job. some things we need to do. >> what about pharmaceuticals. a really big portion but it is driving it. t gross fast are and a lot of other costs. why do drugs cost so much? >> it is complex but overall those products are major that butor to the fact people added 30 to 40 years on ife span and whether cardiovascular disease, longer and ving dying later and finding more cures. majority of those are contributed to pharmaceuticals. cost you look at overall they make up about 14%. consistent the last 20, 10, five years ago. rate of increase it is pretty consistent. oing forward it is an incredibly exciting time because we are moving from just glia active nd pal care. of curing ise something like h.i.v. and eeping that in mind and unfortunately because of our system today sometimes the out portion of the payment patient more abou