There is a lot of contributing factors to the forced growth in medical travel. The aging population, the fact that people are living longer as they age, that is when they become particularly dependent on the health care system.
The staff shortages when we have the high turnover rate and the recruitment and retention problems that we have been challenged with in the last couple of years. The confidence quite often at the community-regional level is not there to diagnosis and treat patients. So there is more medical travel associated with that. They may not know the medical history or be as comfortable with the medical history of the patients. Also, the increasing airfares that is being contributed and driven by the rising costs of fuel. All of these things together are causing quite a bit of forced growth in the medical travel.
As to what we are trying to do to address that, Members are aware of our efforts and some of our results under recruitment and retention, there is not much that we can do about the cost of air travel. However, we are trying to keep these costs under control. Thank you.