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Improving quality for health care. But to the extent we want it to happened to make sure the incentives are right but for decades they have not been aligned. There is an opportunity here to save Small Businesses a lot of money to grow more rapidly. Just very briefly defied the incentives. For years the primary symptom is that it is such a powerful point if you look at one mans cost or another mans revenues of the cost that you pay if you compare our performance versus other industrialized countries you spend 60 percent more than other countries but you dont see better quality measures or outcome so the incentives the opportunity to modify those incentives by the act and the contract being that it encourages is profound but what you see is hospitalization come down but that means they glad of business and that is a real challenge to say that is not a good thing but it can accommodate the extra volume with those spee mori efficien ....