Paul Kusserow

The other thing is that I think it's very important.

is we are sick in a very different way.

Instead of acutely ill, which is what we were when Medicare and Medicaid started, 90% of all illnesses now are chronic illnesses.

And these are illnesses that people live with for 20 to 25 years.

They generally have their onset in their 60s.

People live into their mid-80s, and therefore they have to live with chronic illness.

The worst thing you can do from an economic perspective is take care of chronic disease in acute situations or in institutions.

We've been able to measure how much of the average American household is contributing towards health care, and it's now up to 32%.

And that is just pulling out wealth and the ability to have discretionary spending throughout the rest of the economy.

And we're starting to see some real plateauing there.

And consumers are getting sick of it.

And now these consumers are saying, am I really getting value here?

And do I really know what I'm buying?

And when they look at the answer, it's not a great answer.

And so clarity, transparency, the fact that they're paying more out of pocket for these services, that's going to result in some real consumerism.

And who are the best consumers?

The people in the United States.

Yeah, I mean, I look at this from an employer's perspective.

You know, I was running a Metasys for 10 years and we have 22,000 employees.

And every year we were paying, we're self-insured.