And too much health care is misused: 7 percent of hospital patients experience a serious medication error;(12) 1 of every 1,000 health system encounters is fatal—more than in driving or flying;(13) poor care accounts for 30 percent of all health care costs.(14)

The data confirm what patients already know—that few important things in their lives seem to go so wrong so often as health care. I see it at the clinic in New Brunswick where our patients are as worried about what the system is going to do to them as what it is going to do for them.

Independent national public opinion polls show the rest of the country shares their concerns. For the first time in more than a decade a majority of Americans question the system’s overall quality.(15) The numbers who believe the health system is meeting their needs declined 28 percent over the past five years.(16) In 2004 nearly 60 percent questioned if their hospital would do the right thing for patients. Just as many said they worry that if admitted to the hospital they will receive the wrong treatment or get a serious infection.(17)

HERE IS WHAT ALL THIS SUGGESTS TO ME: The public is worried about the true value of health care and whether the system that delivers it reflects their personal values. In the patient’s world, quality is not a policy or a product but an individual and social value. We agree.

Our own research makes it clear that people want the peace of mind that comes from knowing that they and their loved ones are well cared for. They want a sense of confidence in their own financial security and that they have some control over how health care affects their lives. They want evidence that those making health care decisions know what they are doing. And they want to see the people running the system working tenaciously for good outcomes that serve the health and well-being of all of us.

Americans clearly expect to be served by an interdependent health care system that connects all of us through shared values—equality, compassion, shared obligations, social responsibility and accountability. This potent mix of common sense interdependence and shared values is the glue the public expects to be used to bind the system together. This is where we come in.