"[C]hange will require new structures and institutions, not tweaks to the current system. That's the only way to disrupt the wasteful habits of the status quo. [The author offers] two specific proposals for new frameworks. The first ["Create Special Heath Care Courts"] is now broadly accepted by health care thought and political leaders of both sides ... but has been stymied so far by a powerful special interest. The second [" Replace Public Health Care with Comprehensive Providers"] is radical, and would be considered politically suicidal. It would also solve much of the problem of misaligned incentives."