It has tackled costs by shrinking the work force 19% since 2001.
One way of tackling cost of living issues is to bear down on prices.
By tackling cost at the same time as access, they have made their political challenge more difficult.
Damm explained that the idea is to rethink how the space industry thinks about sharing information and technological developments, as well as tackling cost and building a solid tech foundation.
China has been in a right direction in reforming provider payment methods to tackle cost escalation of health care in recent years.
For instance, Massachusetts is trying to achieve universal coverage first before tackling costs.
"I think most of them know they have to tackle costs," he said.
After all, many economists argue that national health reforms must tackle costs hand-in-hand with coverage or else be deemed reckless.
Last month the White House proposed the creation of an Independent Medicare Advisory Council (IMAC) to tackle costs and improve quality in Medicare, the government health scheme for the aged.
Such changes sweetened by a colossal increase in spending, of 7% a year in real terms were designed to increase capacity and efficiency, not tackle costs.
