The California trade group, Bay Area Council, recently published the report, “Roadmap to a High-Value Health System: Addressing California’s Healthcare Affordability Crisis,” to address the skyrocketing health care costs in California. The report suggests ways in which employers, insurers, and health care providers can help build a more affordable, higher-quality health care system, without Washington’s help. According to the paper, the overwhelming majority of health care costs stem from emergencies. Thus, the council urges insurers and self-insured businesses to reward doctors and hospitals for keeping their patients healthy, rather than treating those who are sick. On the consumer side, the council suggests that members of health plans be encouraged to avoid chronic disease through lower premiums or cash incentives for meeting fitness goals. As for state policy makers, the council calls for them to support nascent private sector models. Additionally, the paper highlights a particularly critical task as setting up a successful California Health Benefit Exchange.