Performance is called avoidable mortality. That is in a Good Health Care system, women should not die in child birth. People should not die of tuberculosis. People should not die of aschemic Heart Disease. People should not die of cancers that can be cured. And when we look at that, im embarrassed to say that we come out in the United States as 19 and the french come out as number 1, i repeat, number 1. That is a fact that cannot be ignored. It must be addressed. It was written up in health affairs, a reputable journal. It was confirmed with different measures by the oecd, and it has not received in my judgment sufficient discussion. Another indicator of how well a system is doing and a theme of this subcommittee that i know is dear to chairman sanders is access to primary care. You can talk about primary care until youre blue in the face, but lets look at the consequences of whether you receive primary care or not in Different Health care systems. We have a very established measure of