Health care in this nation is at a critical inflection point. All across the country, people are asking three important questions about their health care and the industry that provides it: Why does it cost so much? Why does the price keep going up so fast? And why haven't we been able to rein in the costs?

These are critical questions, and they also are entirely fair. In fact, 18 percent of all spending in this country goes toward health care -- a level of spending that, despite slowing growth, remains unsustainable.

In my role as CEO of Kaiser Permanente, I have been asked these same questions, pointedly, by some of the largest organizations whose members and employees we serve in California and across the nation. Our customers have looked at the increases in the prices for care and coverage for the upcoming year, and they want the issue of affordability addressed with the same vigor and focus devoted to providing quality care and service. While we don't yet have all the answers, our integrated model of health care provides an effective blueprint for delivering affordable health care, while at the same time improving the quality of care. The industry must redefine affordability in health care so current and future generations can lead happy, healthy and productive lives without worrying about major financial hardship.

While we have much work ahead, at my own organization we are impacting the cost of care while improving quality by:

* Working as a truly coordinated health care team, connected by electronic health records, to provide the best comprehensive care in the most efficient way. Harnessing cutting-edge 21st century technology has proven to enhance both communication and coordination of service and treatment at all levels, and is central to delivering affordable care.

* Using accumulated data from our electronic health records that tracks outcomes over decades helps Kaiser Permanente researchers share intelligence about the most effective and efficient way to treat each patient and disease area.

In addition, we've discovered through data that in caring for diverse members, ethnic backgrounds can impact how we deliver care. Adopting best practices that drive affordability with the highest quality outcomes is a requirement.

* Delivering service to patients in the settings that are most appropriate for the level of care or procedure required. Through our model of coordinated care, we can provide the care delivered in hospitals, medical clinics, home settings and virtually through mobile technology.

* Investing in advanced technology, and stewarding these investments effectively and efficiently so that we can see measureable improvements in patient outcomes as well as processes, service delivery and cost containment and reductions.

* Giving members the ability to manage their health care online. Kaiser Permanente members, for example, can get lab test results, order prescriptions, make appointments and securely email their physicians using mobile technology. Last year we had more than 13 million secure, patient-protected "e-visits," and this year we anticipate 17 million "e-visits" will be conducted using technology.

Our goal as an industry, and my goal at Kaiser Permanente, must go beyond slowing the rise in health care costs. We need to drive costs down. Accomplishing this goal will not only benefit our current and future members, it will also contribute to driving America toward a healthier, more sustainable and more sensible health care delivery system. That's good for the country and for every single American

Bernard J. Tyson is chief executive officer of Kaiser Permanente.