Medical and financial outcomes in health care derive from choices made by three decision-making components of the system: medicine, management and regulation. Because they are judged by three different sets of rules, this is a triple standard. Medicine is expected to be evidence-based and to have effective feedback mechanisms. Management is becoming evidence-based but has little effective feedback. Regulation lacks both an obligation to evidence and effective feedback mechanisms. The triple standard is part of why healthcare outcomes consistently disappoint. The solution is to create one set of standards for all decision-makers within healthcare. Implementation of the Figure-of-Eight Learning Loop can help.