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This Element is an excerpt from Overhauling America's Healthcare Machine: Stop the Bleeding and Save Trillions (9780132173254) by Douglas A. Perednia. Available in print and digital formats. Starting with the end in mind: a set of common sense, achievable goals for truly reforming the U.S. healthcare system. Our American healthcare machine was never planned with a specific result in mind: it evolved through tradition, politics, regulation, and rational responses to (sometimes perverse) incentives. So, if we're really going to "reform" healthcare, we'd better decide what we'd like it to do. Here is a relatively short list of goals based upon common sense and the public good....