They confuse medicine with technology. We have the finest technology. We also have some of the finest institutions in the world. Unfortunately that high quality level is not found across the entire system. We have what I call 'islands of excellence in a sea of mediocrity.' All health care is a pyramid. In any society it looks like a pyramid, where at the base of the pyramid you have good quality care and wellness. You work your way up to the top of the pyramid where you get the most technological applications of health care delivery, heart transplants and MRI's and all the cancer technology that exists today. Every society starts at the base of the pyramid and they work their way up until the money runs out. We start at the top of the pyramid and work our way down until the money runs out. Because we start at the top of the pyramid, we focus on technology. We don't have that base of the pyramid where the most high-value, high-quality care can be actually delivered. So we've got to change our paradigm. We've got to create this bottom up approach to health care like other societies have.