I am an Internist, ID specialist, and managing partner in a multi-specialty practice in a suburb of NYC. I am disturbed about the high cost and low overall quality of our healthcare system. My own experiences in the exam room are what motivate me to find solutions to our healthcare morass. The focus of reform is to eliminate "fee for service" as if that is the underlying problem in our healthcare system. In my view, the complete lack of transparency about cost and quality are the fundamental deficiencies, particularly since, until recently, healthcare consumers did no care about prices. Now with high deductibles, the consumer cares and has a right to know the facts. Providers also need to know the costs of their care and how it compares to their peers. Such information has been nonexistant outside of an ACO. Medicare started giving out this information to all practices in 2014. Private insurance companies need to do the same. Informed and engaged healthcare consumers will drive the system to higher value. Without transparency, it is not likely we will change the path of the US healthcare system.