Behavior and causes providers to provide Higher Quality care and total cost of care. [inaudible] Health Care Costs are down, but i think Something Else that is going within the Medicare Program that we are seeing, fundamentally different patterns and controlling hospital remissions, why we have this tremendous variation and cost around the country they thank you for the opportunity to speak today. It is great to be here. We return to sheila burke, who is on the faculty at harvard university, a big chunk of her working life was right here in the senate vote as chief of staff to senator bob dole, both majority and minority. And the chief minister and officer in this body. I think it is worth noting with todays discussion that she has a degree in nursing and worked as a nurse in her career. So she has been closely involved in Health Care Issues for very long time. We are very pleased to have you with us. Thank you very much. It would be frightening to put me back in award. [laughter] no f