I have profoundly mixed feelings about the Affordable Care Act. What I love about it is its impulse. It attempts to deal with this intractable problem in American health care life, which is that a significant portion of the population does not have access to quality medical care.

When I go to my health club, and it's in the basement, you have to take the elevator down. And this drives me crazy. Why can't there be a stairway? At least make it as easy to exercise as it is to not exercise. It's in society's interest for me to take the stairs.

Part of me thinks that innovation, real innovation in health care delivery, needs to happen from the bottom to the top.

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