What are you seeing as the drivers of those diseconomies of scale? That might help me better answer the question. Again, though, I think it’s an error to treat

What are you seeing as the drivers of those diseconomies of scale? That might help me better answer the question. Again, though, I think it’s an error to treat each country as if it’s interchangeable. In other words, we need to understand the systemic causes of those costs to understand the impact as it relates to other nations. In the above example with Medicare, the cause is due to negotiating power through volume. So it’s pretty clear that scale matters there.