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to the physician payment reform i think lance for the optimism to my belief that they will be avoided change the way that there going to get in such a way that help to close some of those even as new people become eligible. and, of course, we will also be bring in more people who better coverage throughout the lifetime. i think we have reason to believe that can make a difference and helping us of the people who are becoming eligible for medicare which also has an impact. the ben keating preventive care their entire lives, not even getting access to the kind of care they need to prevent hospitalizations. that will make a difference. we ve also made huge strides in quality of medicare. and the past few years reduce the admissions rate by 10%, reduced hospital record conditions by i think 17%. all of those things make me optimistic that we were able to work together to deal with the next changes are we need to make to accommodate the bulk of the senior to be joining medicare.
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