When thinking about doing things differently in the transaction and identity space its hard to go past the health care industry. There are an awful lot of health care transactions and with the right system in place we might be able to learn how to improve health care in general.

I know President Obama's heart is in the right place with health care - he has a fight on his hands and I can't help but be a little more pragmatic and look to where he can win without a fight. It's not like things are any different elsewhere, as we all have issues with the cost of health care.

I look to see where health-care can be improved. After all it is just a process, albeit hopefully a very human oriented one. Parts of health care like billing and record-keeping don't really rest in the realm of medical treatment - it isn't the role of medical staff. We need to make sure they aren't doing anything except practicing medicine and providing care to  patients.

The first place  to start is work out who is getting medical treatment. That means we have to identify the patients. Identity is the cornerstone to good healthcare. The days of having the same doctor treat you all your life are long gone. People aren't static. They travel, especially as they get older and they can require medical treatment anywhere. We need to know who they are so we can match the patient to their records - with life saving accuracy.

Matching records to patients means better treatment because we can make sure all the patient's information is at hand - anywhere the patient requires treatment.

Identifying the patient ensures that payment comes from the right place and goes to the right recipient. Fraud must be prevented.

Reliability is key. Lives are at stake.

Patients also have a right to privacy. By default. We can only protect a patient's privacy if we control who is accessing their records. This means identifying all the participants in the medical care system. The bonus for them is that at least we know who should be being paid for medical care.

Another area we need to take great care with is pharmaceuticals. When a doctor prescribes drugs to treat a patient it is preferable for the patient to get the right drug, and could be fatal to get the wrong one. While some of us have uncommon names in our neighborhood, in places like China there are millions of people with very similar or the same names. We need to be able to provide for them when they travel, don't we? We need to be able to reliably access any patient record anywhere. Language differences complicate matters further.

How do we identify the patient? We use their mobile phone. If anyone thinks that a card based system could work then have a little think about this first. Does every country use the same card? Do ER and Ambulance crews have to carry a card reader connected to every healthcare system in the world? I don't think you'd ever get them all to agree. Look at the trouble President Obama is having trying to improve care in one country with a majority government.

We are a long way away from one giant global patient health records database covering the planet accessible from anywhere. So, like some of the things Obama is attempting, it may take a little time.

I come back to a solution which can fit into and interface with any health-care database in the world in a safe and private manner, without a single new piece of infrastructure.

What might be the most beneficial advantage of what I propose for health care would be the foundation of anonymity that the system is built on and really no identity data is put at risk. Opening up the general data like prescription drug dispensing, disease patterns, treatment statistics vs outcomes and an endless array of anonymous information which medical researcher could use to rapidly improve health care outcomes.

The US spend is about $2.26 trillion on health care and the right foundation would save more than $100 billion dollars a year without a single practitioner, pharmacist, drug company or medical manufacturer suffering any loss of income.

That foundation is identity, the place to start patient care and the tool which enables every process supporting health-care to to be streamlined and made safer and more efficient. The bonus with mobile as identity is that it can integrate with an easy and reliable transaction system to ensure that every participant gets to optimize their cash-flow and help to provide the best possible standard of care. No matter where you are.

The good thing is that it makes so much sense that no-one can argue about it, let alone overlook saving $100 billion to provide more care for more people. It is 100 billion reasons to start right now.