Realistic or not…

Obama should have said to the three main sellers of sickness (Deliverers (hospitals/doctors), insurance companies, Big Pharma/Medical Device Makers):

“The business model you’ve created to sap our country dry for the past 50 years is unsustainable. So your business model has 5 years left. Over the next five years, the US government is offering the largest X-Prize in the history of the world. We’re going to give the companies who can form an innovative alliance and manage the health of a population of 5 million people a total of $500 billion cash. If it’s one company, you keep the total bounty. If it’s a collaboration, the companies and/or individuals involved split the cash according to your agreements. There are five criteria to win the prize:”

• Per capita spending on healthcare should be cut in half to the level of every other country in the world (about $4000).
• Consumer satisfaction scores must be on par with the retail industry.
• Health metrics (like infant mortality, vaccination rate, etc.) must improve by 20% from today’s US values. 
• The business model and processes must be open-sourced and replicable to the other 295 million people in America.
• After the five years is up, growth in cost cannot exceed inflation. Fines will be in place to recoup your prize for any growth over inflation.

Now get to work. Five years isn’t that long.