Unfortunately, there are too many examples that show how our system can fail to meet patients' needs. These problems are not a reflection on the many doctors, nurses and other professionals who work tirelessly to deliver the highest quality care they can. Instead, they reflect a delivery system that's not always designed with the patient in mind. Improving care and lowering costs are at the heart of the Affordable Care Act. As a pediatrician, as a patient and now as administrator of the Centers for Medicare & Medicaid Services, I have seen our healthcare system both at its best and at its worst. We know that system that we want -- and with the ACA, we can have it. A patient-centered healthcare system is not just a dream, it's a pressing need. We can see proof of the possibility in examples across the country: physician groups that are effectively coordinating care; hospitals that have eliminated many forms of patient injuries and complications; realignment of financial incentives in Medicare and Medicaid to reward better, more coordinated care -- paying for the quality and results of care, not just the quantity of care.