In education, I think we have the makings of a great system. At the higher education level, we have real distinction at Carnegie Mellon, UPMC and the University of Pittsburgh. Many of the programs are really first rate. I think we are not as great at the elementary levels.

In the health and medical area, we have many elements of greatness but we are not truly great. I believe it is possible for us to do some things that would be good for the whole community and that would demonstrate to the whole nation that there is a different way to think about the problems in health and medical care -- by focusing on being a place of best practices.

According to the best national studies, there are 185,000 human beings in the United States killed every year by medical mistakes. To put that in context, that’s two Egyptian airliners every day going down. Because it only happens to one individual at a time, we don’t pay a lot of attention to it, and we don’t really see it. But that study said 185,000 -- that’s a lot.

The error rate in the best studies is one in 2,000. Think about that. Some of you would know about the idea of six sigma. There are a lot of industries that say, "We are in a six sigma industry." That means you are only permitted to make 3.4 errors per million exposures. One in 2,000 is 500 per million. It’s no sigma.

I think in Pittsburgh we can create a community resolve to be a learning laboratory for the nation. And we can make it a matter of community purpose to say that we are going to demonstrate that we can eliminate medication errors in all of southwestern Pennsylvania. And we can eliminate staph infections. Those infections are a serious cause of extended and more costly hospital stays for patients who contract an infection through no fault of their own, but because of the way medicine is practiced.

Maybe we can add to that that we are going to eliminate accidents that happen to medical staff. One of the routine ones is for people to stick themselves with a hypodermic needle and get an infection.

We can do this, and it will require a very substantial change in the system of delivery of medical care. It will require using electronic technology to the level that we already use it in banks. Believe it or not, we could use it in medical care. So that you could capture data about a patient’s radiology and admission and all the rest just by effectively using your plastic card to download data to any doctor you want to.

We already have the capability to do all of these things. My notion is that we can get the community leaders, in a very broad-based sense, to agree that we will be a learning laboratory and that we can be on our way to achieving what I think is possible for the country -- an improvement in the value equation of heath and medical care of something between 35 and 50 percent. That means either twice as much care available or half the current costs.

Those are doable things, and if we together don’t do something in that direction, we are going to continue to be the victim of well-intentioned, fiddling-with-reimbursement formulas that don’t accomplish anything except drive the provider community crazy and interfere in decisions that ought to be made by people with professional training.

We’re not too far away from having an agreement that we are going to try to do this. That we can do something in Pittsburgh that will show the rest of the nation how we can do a job that is worthy of an intelligent society, instead of continually arguing and debating issues that go nowhere.