America’s healthcare results are lackluster and worsening despite enormous effort and investment over many decades. Spending, affordability, health, coverage, access, quality, and healthcare workforce results are suboptimal or poor. Too many are suffering, and the system is financially unsustainable. We need a new approach, a new way of thinking about healthcare financing and delivery. This thinking requires that professionals have a trusted learning space to consider bold ideas. The opportunity for the actuarial profession is that the public experiences better healthcare over the long term when actuaries remind decision making hierarchies of the foundational actuarial principles necessary for success. Our approach starts with Actuarial Principles and Primary Care Tenets and carefully builds from there using reason and evidence. First Principles Thinking asks us to consider if primary care (low cost, predictable, often scheduled care) is insurable. This process brings our focus to a successful and growing model of primary care delivery, Direct Primary Care (DPC), which shows great promise for improving healthcare results at all levels of care for all types of patients. Actuarial principles such as insurable risk should be taken seriously for health insurance just as they are for life, property-casualty, and other insurance, if we expect a durable, sustaining healthcare system. Attendees will appreciate First Principles Thinking; use DPC as the exemplar of what is possible when Principles are honored; and renew their confidence in Actuarial Principles, training, and leadership to guide America to better healthcare results in the future. They will be given permission to find a trusted learning community to consider bold fixes.