Aetna CEO Mark T. Bertolini believes that when times are tough, people want to hear the truth. In his Monday morning opening keynote here at HIMSS14, Bertolini was prepared to speak the unvarnished truth.

By his estimate the healthcare system as we know it today wastes $800 billion a year – more than enough money to pay back the nation's debt over 10 years.

"This should be the focus of our policy decisions, our solutions and our IT."

The giant health insurer's revenue and stock price are at an all-time high, Bertolini told the audience. So, when he advocates for sweeping changes not only for healthcare, but also for how the health insurer does business, it causes people to ask, 'why change now?'"

 "It's the perfect time to change," Bertolini said, "because the solution we need is not found in how Aetna does; it's in whether or not we meet that goal of healthier individuals, who are more productive, more economically viable and more satisfied." When that's accomplished for individuals, he said, it spreads to communities, then the world.

"Until that's done, no matter how well we do, or any of you do, it just doesn't matter."

Bertolini sees the country's "wellness" journey as lengthy – 25 to 30 years long, but healthcare needs to be solved now. 

"We need to solve (healthcare) today," he told the HIMSS14 audience, noting that healthcare premiums are growing at four times the rate of inflation and that most people are paying 41 percent for healthcare through premium sharing and benefit cost – a situation he called "unsustainable."

His three prescriptions? Investing in wellness, taking care of the chronically ill and aligning incentives. 

Aligning incentives to Bertolini means payment reform. "More" should not mean more revenue, but rather "more" should mean "'I have to think more about how I take care of these patients.'"

Patients need to be connected through technology, and the healthcare industry and the country has to move care far away from the highest cost, he said. 

"It doesn't matter who's paying for it: government, employers or individuals. It doesn't matter. It's breaking the bank."