Hi, I'm Bill Crystal. Welcome to Conversations. I'm pleased to be joined today by Jim Capretta,

resident fellow at the American Enterprise Institute, served at senior levels of the Office

of Management and Budget of the Bush

administration before that on the hill before that as a career civil servant I

think it's yes I want be which is the best part of the US government I'll say that

on my own ticket I hope that's still true. It was true when I was in government.

I tend to agree. People who know a lot, who care a lot about having programs that work as opposed

to having kind of an investment the way people in the agencies have on it.

So, but you supervise the health programs in the Bush administration, so you had a kind of

comprehensive view of the US government's efforts in health care and you're in health,

you've written it's taught on health health care. So let's talk about health care.

Kind of a big topic, right? Yeah, very big. So what about health care in the US? Is it good? It's terrible. It costs too much. It's destroying the good. It's going to bankrupt us.

What's at a 30,000 foot level? What's the basic? Where do we begin? What's the truth?

Yeah. Well, the US has a mixed public privateprivate system, so it's a complicated system, but I would say that at the very highest level we should be grateful that it is an open adaptive introduction of new therapies new ways of taking care

patients new medical technology in a way that is resisted a little bit more around the

world especially in other high-income countries.

So the US really if you're someone who is in need of significant medical attention

there's no better place in the world to get health care than the United States.

Moreover, through a lot of change and adaptation, most Americans have pretty ready access to that

amazing system, through their employer-based health insurance, where the vast majority

of working age people get their

coverage through Medicare if they're 65 and older or disabled and even through

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