Time to adopt reform in order to cure the ills of health care system.

A MAZON.COM opened its virtual doors for business 10 years ago. By using the latest information technology, this start-up company .rapidly created an entire consumer experience It is a quick and efficient system that has brought more choice and lower prices to millions of shoppers.

Unfortunately, health care in America is not delivered as efficiently as our books. No other country spends as much on health care as the United States, but 23 other nations enjoy longer life expectancies and 41 others have lower infant mortality rates than we do.

Instead of an integrated system in which all the different parts communicate between and among themselves in a language understood by all, we have a patchwork of overlapping parts--doctors, hospitals, pharmaceutical companies, insurers, and policymakers--each trying to do what is, from their point of view, in the best interest of the consumer. Meanwhile, each division of this collective cottage industry is unable to see the big picture.

As a result, there's a huge disconnect between what we know works and what we actually do. In fact, a recent Rand Corp. study found that patients are getting the recommended, evidence-based care only 55 percent of the time. This inability to deploy the knowledge we have exacts a staggering toll: $300 billion in unneeded and redundant medical care; and--more alarmingly--195,000 deaths each year due to preventable medical errors and as many as 79,000 deaths a year because of the inability to get the appropriate care for common conditions.

We can improve the quality and affordability of care if we can build a true health care system that can get the right information to the right people at the right time. The formula is simple: better knowledge drives better and more affordable health care for consumers.

We need to engage and empower consumers so they can make more knowledgeable health care choices for themselves and their families. The more consumers take charge, the healthier they'll be and the less likely they are to need expensive care down the road.

To make knowledge-based health care work, we must collaborate with doctors and hospitals to boost quality and rein in costs. In particular, we need to support efforts to implement proven best practices and standards of care--and make sure that they are being met. Used in conjunction with quality incentive plans, this would help ensure that doctors and hospitals are being rewarded for delivering quality care, not just quantity of care.

We need to improve operational efficiency within the health care industry. Right now, the health care sector is investing less in information technology than any other part of our economy except low-tech fields like construction, education, and mining. A recent study found that the 100 most-wired hospitals have a risk-adjusted mortality rate that is, on average, 7.2 percent lower than other hospitals.

Finally, all of us must work with policymakers at all levels of government to improve access to health care. There are many reasons why people go without health insurance. But whatever the cause, the strain it places on society affects each and every one of us. When people don't get preventive health care, they show up sicker in the ER, and the costs skyrocket from there. There is no one-size-fits-all answer to this problem, but there are tailored, practical solutions--such as medical malpractice reform and tax credits to help small businesses provide coverage to their employees--that can have a real and immediate impact.

Scott P. Serota is president and chief executive of the Blue Cross and Blue Shield Association. He spoke on this topic recently at the Jonathan Club in Los Angeles.