We want Cadillac care and we do have amazing high tech care, really the state of the art, but we don't really want to pay for it. In other countries, there are delays if you need hip elective, hip surgery, knee replacement. So I think we need to shift expectations and really say without rationing care per se, can we change our expectations? We certainly want high quality care. But if we give high quality care to everybody all the time without any competition or cost market forces, we're in trouble with higher percent of our budget.

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