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Obama, since obama has been in office. As a committee there are particular things. I think that of course the administration gave an adequate support in different times ofti the past two or three years but maybe just put it in contextfo uncomfortable for us and not what we were advocating for with the state department and others in thest United States. But this wasnt fortunately a moment where lives were at stake and as would be seen by the rest of the world as a top issue for American Foreign policy or given all the other things going on. So i agree with you that the sort of language they use...

Perfect, identical rebel. Replica. They want to know that they respect first and foremost that elected official. He or she has a course of principles they wanted to stick with. Secondly, to my larger point, they want to know even if they to people whatn no problem voting for me even though they do not share my belief on that particular issue because that effect that the things i focus in on even on the fiscal issues in my state and that is what they feel they hired me to do. I use example outside of politics. Bei were hiring somebody to the chief executive of a company i had and i said he or s...

Individual patients through 200,000 visits. So also i would be remiss if i didnt say texas as im sure all of you in this room know, this is not Medicaid Expansion state, so, therefore, only children, the elderly and disabled are still eligible for medicaid. We are also a, on the federal run exchange we did not object to a state exchange. Our marketplace and how people are accessing it, they are coming into our clinic, making appointment or walking in. They meet first with a certified application counselor who starts the process by getting them to walk through the consent. This causes a lot of ...

Exchanges and then to make way for new enrollees to i guess i just wanted to your whether or not there are some downside our upside to using that kind of model. And you think other states are going to do the same . So, in terms of medicaid, i would say the wisconsin issues different. Wisconsin, its funny, the wisconsin folks say why do we keep getting labeled as a nonexpansion state . We expanded a decade ago. They already cover all of these people are and so its, i think the wisconsin situation is very, very different. But i think its a very, very silly question to talk about, what does arkan...

And the disabled and the chronic conditions, we have got to do more than just keep them covered, we have got to cover and then at th to the cost curv. David blumenthal at commonwealth has done a famous job explaining this. This is what the states are doing that i think its is reay exciting news. Im going to do another session on this. Reforming the Delivery System and reforming the way that we pay for care in this country. We have to treat Health Care Just like a bunch of economic and the words paying for value that is with medicaid is focused on these days i will stop there and look for quest...