BHAGs for aligning incentives and building a learning system to improve total population health

Neither care delivery nor public health systems have grappled with widening disparities as life expectancy gaps increase in the US. Reimagining health care and public health requires aligned incentives including attention to vulnerable populations, financial incentives to improve total population health, effective deployment of community assets, and adoption of a continuous learning system. We argue that Big Hairy Audacious Goals-targets for a Health GDP (similar to the economy's gross domestic product [GDP]), Life Expectancy, Safe and Sound Children, One Earth Policy, Social Spending, and Political Healing-can focus our attention and propel needed action.