Word: systemically
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...grandmother was generally very happy with her care, and if we could actually get our health-care system across the board to hit the efficiency levels of a Kaiser Permanente or a Cleveland Clinic or a Mayo or a Geisinger, we actually would have solved our problems...
Although you didn't define what a public option really is. I would say, Karen, actually we defined it fairly clearly in terms of what we thought would work best. What I said was, is that it shouldn't be something that's simply a taxpayer-subsidized system that wasn't accountable, but rather had to be self-sustaining through premiums and that had to compete with private insurers...
...your earlier question, I guess - and I also said at the beginning that it was very important for us to alter delivery systems so that we could reduce costs. And as the process has moved forward, we have further refined those aspects of the system that can be changed to deliver more bang for the buck...
...that was always going to be a wrestling match because even if these are benign changes - changes in how the delivery system works, reimbursing doctors for quality as opposed to quantity, trying to reduce the number of tests, trying to discourage hospitals from readmitting patients, or at least providing them bonuses for getting it right the first time - all those things mean that people are going to have to change their practices...
...when you have a system this large, with this many players involved, it was inevitable that not only would that be contentious but that, again, the public would be suspicious of the possibilities that, well, somehow this means that my doctor is not going to be able to give me what he or she thinks I need...