In less than two weeks, on February 24, President Obama will address the Congress in what amounts to his first State of the Union. Health care, The Atlantic decided, couldn't wait that long.

Hosting a State of the Union for Health Care on Wednesday, the magazine brought together experts from across the health care spectrum to lay out where we are and where we need to go in the coming year.

In terms of where we are, much should sound familiar to our readers. Health care costs too much. It covers too few, and the care it does provide is too often mediocre.

As David Walker, President & CEO, Peterson Foundation, told the audience, health care is our nation's single largest fiscal challenge, with the potential to bankrupt our government and cripple our competitiveness. The fact that some 46 million are left without health insurance, Walker said, was shinola.

In terms of quality, Mark Chassin, M.D., President, The Joint Commission, noted that each day there are about six wrong-site surgeries in the U.S. "Twenty five years ago, health care was cheap, safe and totally ineffective," Chassin said. "Today, health care is effective, expensive and totally unsafe." It's not surprising then, as Mary Woolley of Research! America told the audience, that more than 70 percent of Americans no longer believe we have the best health care system in the world.

As for fixing that system, Senator Bob Bennettt (R-UT)—in a welcome reminder that there are some who still want to solve the health care crisis on a bipartisan basis—laid things out clearly describing what he called the "big Aha moment" in health reform. "If you have health reform that focuses on quality health care for everyone you save bundles of money," he said. "The secret to cost control in health care is quality. The best health care is the cheapest."

So how do we get to a high-quality, high-value health care system? The event's discussion focused around the concepts: transparency, public reporting, and realigning incentives to drive better outcomes.

As we've said before, you can't manage what you don't measure. Much has been made about the need for more public reporting in health care. The real consumers of this information about outcomes and quality are not patients but providers, argued University of Virginia's Elizabeth Teisberg, Ph.D. As Toby Cosgrove, CEO of the Cleveland Clinic said, "There's no group that's more competitive than doctors. These are people used to being at the head of their class... You put the numbers up, the quality will improve."

In constructing these measures, Teisberg asserted that it was important to distinguish between process measures (did a patient receive this recommended treatment or test) and outcome measures (not just mortality, but readmission rates, length of stay, etc.).

Furthermore, Chassin argued that more attention and effort had to be paid to getting what we know works adopted as a standard of practice. It takes close to 17 years for the introduction of medical innovations to achieve general acceptance in our health care system. Publicly reporting process and outcome measurements can help speed up that process. It can serve as the foundation for the kind of comparative effectiveness research our colleague Joanne Kenen talks about in a post early today. It can help realign incentives so that we're paying for better outcomes and higher value care. And it can happen soon.

Representative Frank Pallone, Jr. (D-NJ) spoke at lunch about trying to move comprehensive health reform legislation this year. Congress, Pallone said, had already laid a strong foundation with SCHIP and the Stimulus bill. He said that leaders in Congress and the administration were committed to moving forward as quickly as possible, and that his committee planned to begin holding health reform hearings after the President's Day break. We hope we here a similar message two weeks from now in the president's address to Congress.