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the 12 transformational practices of highly effective medical organizations." doc, good to have you. >> nice to be here again. >> let's check the main boxes. the first one, why was the skinny repeal insufficient even for some republican senators to vote for? >> well, it was just bad policy. look at lindsey graham who called it a pig and a poke, a disaster. everyone knew it wasn't policy. it was there as a face saving device to get into negotiations with the house. i think that senator mccain realized that it really was a trap because, if they couldn't come to agreement on a big bill with the house, then the fallback was this terrible pig in a poke bill. >> why terrible -- the operative notion was this, the aca doesn't work, it's too expensive for