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ste

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those of you who have seen the film
money ball

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or read the book by michael lewis

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will be similar with the story billy
bean

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billy was supposed to be a tremendous
ballplayer all the scouts told them so

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they told his parents that

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they predicted that he was going to be a
star

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what actually happened when he signed
the contract and by the way he didn't

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want to sign a contract we want to go to
college

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which is not my mother who actually does
love me

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that i should do to you and i did

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well he didn't do very well he struggled
mightily

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he got traded a couple times she ended
up in the miners most of his career

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and he actually ended up in management
ended up as a general manager of the

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open dates

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now for many of you in this room ending
up in management which is also what i've

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done

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is seen as a success

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i can assure you that for a kid trying
to make it in the base

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mad going into management and a success
story it's a failure

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and what i want to talk to you that
today and and share with you is that our

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health care system our medical system is
just a is bad at predicting

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what happens to people in it patients
others

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those scouts were at predicting what
would happen to billy being

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everyday

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thousands of people in this country

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art diagnosed

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preconditions

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we share about tree hypertension we care
about tree dementia

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we care about free anxiety and i'm
pretty sure that i'd agnes myself with

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that in the green room

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we also refer to subclinical conditions

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there's subclinical atherosclerosis
subclinical hardening of the arteries

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obviously linked to heart attacks
potentially

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i'm one of my favorites is called
subclinical acne

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if you look up subclinical acne you may
find a website which i did

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which says that this is the easiest type
of acne to treat

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don't have the post rules are the
redness inflammation

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maybe that's because you don't actually
have acted

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i haven't the name for all these
conditions it's another precondition

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i call them preposterous

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in baseball

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the game

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follows the pre-game

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season

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follows the preseason

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with a lot of these conditions that
actually isn't the case releases in the

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case all the time it's as if there's a
rain delay every single time in many

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cases

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we have pre-cancerous lesions

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often don't turn into cancer

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and yet

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if you take for example subclinical
osteoporosis or bone thinning disease

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the precondition

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otherwise known as ours to kenya

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you'd have to treat two hundred seventy
women for three years

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notre prevent one broken bone

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that's an awful lot of women

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when you multiply by the number of women
who were diagnosed

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with this esther pina

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and so is it any wonder

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given all the costs and the side effects

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of the drugs that were using the treat
these preconditions that every year

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we're spending more than two trillion
dollars on health care and yet one

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hundred thousand people a year and
that's conservative estimate are dying

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not because of the conditions they have

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but because of the treatments or giving
them and the complications of those

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treatments

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we've medical as everything

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in this country

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uh... women in the audience site have
some

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pretty bad news you already know

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and that's that every aspect of your
life

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has been medical hottest

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strike one is when you hit puberty

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you'd now have something that happens
you once a month that has been medical

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institute condition

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espy treats right too

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is if you get pregnant

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you half that's been medical arts as
well

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you have to have a high tech experience

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of pregnancy otherwise something might
go wrong

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strike three

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is menopause

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we all know what happened when millions
of women were given hormone replacement

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therapy

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for work for it

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menopausal symptoms

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for decades until all the suddenly
realized because the state came at a big

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one than h funded

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it said

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actually a lot of that commonplace in
therapy may be doing more harm than good

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of those women

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just in case

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i don't want to leave the men out

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i am one after all

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i have really bad news for all of you in
this room

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and for everyone

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listening and watching elsewhere

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you all have

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a universally fatal condition

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just take a moment

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it's called pre death

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every single one of you has it because
you have the risk factor for it

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which is being a lot

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but i have some good news for you
because

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i'm a journalist elected and things and
happy where forward-thinking way

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and that's good news is that if you can
survive to the end of my talk which

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will see if that happens for everyone

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you will be eight revive her

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i made up three deaf

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if i use someone else's freed up by
apologizing

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i think i made it up

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i didn't make a provider

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provider is what a particular cancer
advocacy group would like everyone who

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just has a risk factor

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but hasn't actually had that cancer

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to call themselves

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your eight revival

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is ready to be out here this morning
morning if mark burnett is anyone the

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audience i'd like to suggest

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nellie reality tv show called revival

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if you develop the disease you're off
the island

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the problem is we have a system

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that is completely

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basically promoted this

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we've selected at every point in the
system

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to do what we do and to give everyone a
precondition and then eventually

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condition in some cases

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start with the doctor patient
relationship doctors most of them

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in a few for service system they're
basically incentivize to do more

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procedures tests

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prescribe medication

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patients come to them

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they want to do something where
americans we have to we can't just stand

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there we have to do something and so
they want to be a drug

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they wanted treatment they want to be
told this is what you have this is how

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you treat it let's keep the doctor
doesn't give you that

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you go somewhere else

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that's not very good for doctors
business

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or even worse

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if you are diagnosis something
eventually and the a doctor didn't order

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that test

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you get sued

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we have pharmaceutical companies are
costly trying to expand

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the indications expand the number of
people who are eligible for a given

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treatment

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because that's the help survival
money-back disagreements

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like the one that's come up with
provider

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who want to make more and more people
fill their at her regrets or might have

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a condition

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so that they can raise more funds

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and raise visibility

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etcetera

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this is an actually

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despite what journalist typically do
this is not actually got blaming

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particular players

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we are all responsible

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i'm responsible

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i actually was for the yankees and talk
about

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being sort of rooting for the worst
possible

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offender when it comes to doing
everything you can do

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everyone who's responsible uh... hai

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you know went to medical school

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and high was by didn't have a course
called had i think skeptically or

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how not to order tests

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we have this sort of system

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where you know that's what you do

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and actually took being a journalist

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you know to understand all these
incentives you know economists like to

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say

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down a bit people

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there are just banned sentence

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and that's actually true

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here's what we've created as a sort of
field of dreams when it comes to medical

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technology

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so when you put him another m<u>r</u>i_ in
every corner you put the robot

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in every hospital saying that there's
one has to have robotic surgery

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well we've created system where if you
build it they will come

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but

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you can actually traverse lee

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tell people become tell convince them

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that they have to come

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it was when i became a journalist and i
really realized how i was part of this

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problem

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and how we all or part of this problem

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i was medical ising every risk factor as
writing stories commissioning stories

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everyday

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trying to sort of

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but mr lim people worried though that
was what often happens

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you know there are ways out

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i someone internist last week

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and

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he said to me

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you know and he told me something that

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everyone in this audience could have
told me for free

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but i paid him for the privilege which
is that

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i need to lose some weight

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well he's right i've had
honest-to-goodness high blood pressure

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for a dozen years now stand

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age my father got it

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and it's a real disease it's not pre
hypertension is actual

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hypertension high blood pressure

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well he's right

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and that's but he didn't say to me

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well you have pre-opening city or

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you have pre diabetes or anything like
that he didn't say

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better start taking this step mid to
lower your cholesterol

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they always have gotten some way come
back and sing in a bit

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we're just in a common higher doing

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so that's to me

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you know away for work

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billy being by the way when the same
thing

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he learned

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from watching this kid in the event
rehired who's really successful form

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it wasn't swing for the fences that
wasn't sweeney at every pitch

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like the sluggers do which is what all
the expense of teams like the yankees

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like to

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they like to pick up those guys

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this kid solvent you know you gotta
watch the guys in depth go out and find

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the guys who like to walk

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is getting on this by a walk

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is just as good and in our health care
system

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we need to figure out

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is that really good pitch

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or should we let it go by and not swing
everything