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development you cannot get beyond a certain point. talk about entitlements you cannot have that discussion too long before you say what about health care? you cannot talk about the u.s. budget and the trajectory of spending. you cannot recognize to have three or four diseases to drive spending with diabetes her cardiovascular on the health care side. so i get to hang out with some smart guys with health care reform and whether the things that really need to get done to reform the system? over the next year we will talk more specifically about the policies that we have but i have to say the number one issue, aside from coverage is you have to have more affordable, portable, access ible health care insurance policies. that is a huge problem so few have pharmaceutical costs and insurance costs costs, you have some things that have to be addressed. the biggest challenge of all in health care is the escalating cost. it is unsustainable. what is the biggest expenditure with the dep
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