People were so intent on the delivery of high tech and high touch medicine that they weren't looking at the negative consequences to that.

Thank you very much, Senator Harkin, for convening this really important hearing, and what I think is one of the most important issues on how we can save lives and save money, which is our emphasis on practical health quality endeavors.

I think it is a national disgrace that when we are talking about how to have a more frugal government, how to get our budget costs under control, healthcare costs being No. 1, how we are about to devolve Medicare, we don't have the head of CMS.

Thank you, Chairman Harkin and Ranking Member Enzi, for calling this hearing to discuss implementation of health reform's quality provisions.

The Patient Protection and Affordable Care Act had important quality provisions. It had four guiding principles, and I think it would go very much to some of the points made by Senator Enzi.

This isn't the malpractice issue. This is a systemic failure to identify with these practices.

We find we spend a lot of money, but we rank 37th nationally in health outcomes.

Your practices came out of our quality initiatives and our national health effort through the Patient Protection and Affordable Patient Care Act.

But isn't one of the failures to comply a lack of information and lack of follow through, and a lack of actual news that you could use, tips for the practical thing, and the failure--it is usually around the taking of their drugs and their pharmaceutical regime?

I find it a bit thin.

I think it is a national waste that we don't have this man confirmed.

One of the big things we want to improve is health outcomes for patients. That is our large, bipartisan, public policy goal.

While you got high tech and high touch, you didn't get a lot of information when you were ready to leave about what you needed to do to comply with the medical regime.

I know my time is up, but to my colleagues, Senator Harkin and Enzi, and others, if you live in Baltimore, you have Hopkins, you have University of Maryland.

In your quest to be the very best and to improve the methodologies of quality, was the government of any help to you?

I think we need to confirm Dr. Berwick and stop fooling around here because under his leadership, the most important healthcare finance officers in America work.

I think that is an excellent point.

We have a responsibility to the taxpayers of this country. We have to make some tough decisions in our budget.