Some insurers are coming around to see the big picture. One example in which I have first hand knowledge is we have a couple contracts that pay 2k more per IVF cycle. The stipulation is twin rates less than low single digits. They’ve realized that they can recoup the extra up front by lowering obstetric and more importantly neonatal costs related to twins. The costs of obesity are less immediate and this could be unrealistic under our current system but if we could realize the bigger picture then perhaps it’s in the realm of possibility