Transparency of data is one other issue defining a delivery system. Access to data on circumstances, treatments, high quality, and pricing tremendously impacts the selection by patients/consumers and, subsequently, the incentives of medical professionals. While the US healthcare system has come beneath fireplace for lack of openness, new laws might encourage larger openness. There is a perceived tension between the necessity for transparency on the one hand and such issues as affected person confidentiality and the potential exploitation of data for business gain on the opposite. Since the late 1970s, the federal Healthy People Program has been a visual component of the United States’ strategy to bettering population health. Progress has been limited to many aims, leading to considerations concerning the effectiveness of Healthy People in shaping outcomes within the context of a decentralized and uncoordinated US health system.

• Adam Steventon reflects on what we can learn from the successes