getting its moneys worth out of health care. >> let me broach one topic, which is a tough one to explain. there is the criticisms that you hear are often centered around rationing. will there be rationing of care? the term that makes people's eyes glaze over is comparative effectively. you figure out what works and pay for those things or reimburse for those things. things that don't work, you don't necessarily pay for those things. or it is not as easy for those particular treatments or procedures. is that a type of rationing? given your background, how much of medicine is an art versus a science? >> with regard to comparative effectiveness, what that really means is if i were sick and i were a patient and let's say i had high blood pressure an given my circumstance, maybe my genes, my family history, there might be two or three drugs that are