joining me from the mayo clinic is dr. john noseworthy and from the cleveland clinic, dr. toby cosgrove. dr. cosgrove, let me start with you. what is the impact of obamacare in 2014? >> this started out to do three things. it started out to increase access. i think when it's fully developed, we will see increased access. it started out to improve quality of care, which is very variable across the country, and i think with the transparency that it brings around quality, we'll see quality going up across the country. the real question is cost. and we really don't have the answer to that yet. we're going to have to see how this plays out over time. >> i see it the same way. i think what it basically has done is expand insurance coverage, and what we need to do now is modernize the health care system to deliver care at lower cost. and sustainability of medical care in the long term is