In thinking about what to preserve, to encourage, to replicate in the current health care system, I kept coming back to the same thought. With a system so fundamentally in need of repair, how is it that we still have outstanding success stories? In a system in which nearly all incentives are misaligned, and the lack of information necessary to make informed decisions is pervasive, how is it that the system works at all?

The answer is that we are a nation of innovative problem solvers, and we have brought that skill to health care. So even in the face of the seemingly intractable problems created by our health care system, problems are solved every day, and solved well. There are many examples – ones that will show up on this blog no doubt – of employers, which continue to cover over 170 million people in this country, successfully implementing changes in benefit design that both improve care and lower costs; of introduction and adoption of new technologies that improve care and decrease costs; of doctors and health care institutions who move beyond the challenges inherent in the fee-for-service environment to provide excellent and efficient care; of systems developed to provide people with full and complete information on cost and quality.

As a provider of technology we see it everyday. We see it in the AT&T Labs where we are working to develop ZigBee networks – named for the zigzagging path data takes to reach its destination like that of a bee zigzagging from flower to flower – to weave together data from short range, low power wireless devices to make independent living a reality. We see it in innovative applications of surprisingly simple technology such as one being developed by our technology partner, Confidant, which uses a teenager’s cellphone to track and improve treatment for Type 1 diabetes. This application wirelessly sends blood sugar readings these teenagers must take multiple times a day to the doctor’s office via a Bluetooth enabled cell phone with a touch of a button. Text message reminders are sent if a reading is missed and encouraging messages sent if readings are regular.

We also see it in the progress that has been made in both the private and public sectors on introducing a continuous stream of new technology based products and developing the standards for interoperability, security and privacy that are necessary for the full scale adoption of information technology in the health sector. And we see it in the resources technology companies like AT&T, with their expansive expertise in building networks, managing information and harnessing the power of computing, have dedicated to development of the necessary standards and products.

We need to encourage this kind of innovative problem-solving in all aspects of the financing and delivery system. We need to recognize that the ability of any and all stakeholders in the ecosystem to develop and implement new ways of doing things will be central to the success of any effort at reform.