The conversation delves into the concept of Medicine 2.0 and Medicine 3.0, highlighting the U.S. healthcare system's ability to extend life expectancy for seniors through advanced medical technology and infrastructure. However, it questions why this success can't be replicated earlier in life to improve overall health outcomes. The discussion also introduces the idea of choice as a critical factor in healthcare, alongside quality, cost, and access. This American emphasis on choice leads to higher costs, as the system prioritizes maximum quality and access without cost constraints. The dialogue suggests that while other countries cap costs, the U.S. system allows for a broader range of options, which can drive innovation but also leads to higher expenses. The conversation further explores the potential for Medicare to leverage its purchasing power to negotiate better drug prices, akin to large-scale buyers in other industries. This approach could help manage rising pharmaceutical costs without stifling innovation. The discussion acknowledges the complexity of the pharmaceutical ecosystem and the need for a balanced approach that considers the benefits of innovation and the realities of market dynamics. The conversation concludes by emphasizing the importance of addressing healthcare costs while maintaining choice and access, and the potential role of national health goals in guiding these efforts.