user126753332 That's one of the things that is lacking so for is taking this opportunity which is you know quite extraordinary and showing it to actualize reduction of cost of do in the US it doesn’t work well because the doctor gets paid lots of things and they don't want you see things could signal code reimbursed an in Brazil and India and China the singer taken off are at a clip that is you know much more what you would expect when there's no misalignment of over incentives the cost equations really interesting because historically in the US we look at the cost to the payer has really the only thing the counter those paying the bill or not holistically McKenna 316 Alyssa serve I love the cost benefits to all the players into including the patient the patient's family I’ll sir share with you an example in India the three top Tolko carries many announced <a href="http://realxrenewfacts.com/">Real X Renew</a> cell is the wireless companies AT&T's and Verizon’s Armenia now sell physician visits by buy premium phone number so literally you pay for the visit and you get to the physician might dialing the phone number and there's no more discussion about payment credit to step back to dial the phone number you be conducted from your phone doesn’t matter where they have a prepaid phone or postpaid phone you paid for the position visit and the the carriers have teamed up with large physician practice in a tie for this is essentially gone from on-existent service to 50,000 visits a day physician in our most no time at all less than a year.