Americans spend more than $265 billion a year out of pocket on healthcare and pile up medical debt, but now Haddam, CT-based Criterion Ventures is creating a new approach to dealing with world of deductibles, co-pays and care for the uninsured. Criterion's idea is to weave together private and public sources of payment, negotiate discounts on hospital and doctor care, community by community, and load it all onto a hybrid debit-credit card. The card is aimed at insured as well as uninsured consumers.