The US Institute of Medicine, declares $700 Billion  - one third – of our healthcare expenditures are unnecessary, even harmful.

QuadMed, is an innovative private company that reduces employees' healthcare spending by 25% or more, compared to nationwide trends, without sacrificing care, and with improved employee outcomes.  The Camden Coalition of Healthcare Providers has reduced by 40-50% the hospital costs of the 1% of the population who incur 30% of all healthcare costs in Camden (a proportion that holds, nationally).

The most important strategies that underlie these successes :

1) a greater emphasis on primary care to manage the 5% with chronic conditions, who consume 50% of healthcare costs; and

2) greater price transparency to bring normal consumer market forces to bear on excessive costs.

I want to see the Affordable Care Act incorporate the lessons of successes like these on cost-containment while delivering improved quality and results.

The biggest "government waste?" $700 Billion in unnecessary healthcare spending. That's unacceptable.  Who should lead the charge to fix this?  Those in the HealthCare industry who are willing to acknowledge a fix is needed.

Any other "fix" imposed externally, will meet massive resistance.  We should use the power of shaming, by asking repeatedly and often of the healthcare industry, "Why do we pay 2-5 times more in American for healthcare?" And, then, after the shaming, we should ask the smart and talented Doctors and Nurses and Patients, to help us fix problem. The savings will be measured in the Trillions of Dollars.