On PreK-12 education…The Gates Foundation engages in philanthropy, which is quite different from advising their beneficiaries. However, many basic business constructs are foreign to education leaders, rendering them helplessly and relentlessly trying to solve problems in relative darkness. As you offer support for improving the state of the education delivery system, please continue to engage in inquiry around alignment of people, resources, and information around the mission of educating all children well. About 30 years ago, I experienced the transformation of healthcare finance from a regulated, cost-plus plan to a prospective payment system organized around patient-centered case management. This structural shift unified care around the patient and enabled analysis of outcomes and effectiveness of services. I believe an analogous improvement is crucial to achievement of our mission in education. However, it begins with new funding formulas and a mandate for student-centered data for finance and quality review. This will be a daunting task; however, I remember that the transition in healthcare was well worth the effort despite the short-term pain. In the meantime, I believe that we will continue to sustain the system rather than educate the children as long as the money is doled out for a system.