How to save in health care without touching upon quality of care? Itinera presents 1800 ideas from the sector. Physicians, directors of hospitals, elderly care,… support progressive steps forwards to implement structural reforms. This is a reflection of the vision, courage en a sense of responsibility of the sector. 283 million euro are within arm’s reach in a relative short term if such initiatives would be launched. The resulting savings will be needed to cover the cost of aging and the necessary growth of care. Policy plans of government also testify of an increasing positive vision on themes of ‘smart care’ such as human resource management and IT. Other domains such as financing of care should be added. Most of all, it is time to abandon the divide between vision and budgetary rounds.