Download a PDF version of the Principles with accompanying backgrounders.

1. Access is not enough. Health insurance must be accessible and affordable for all Americans not only because it is socially just but also because it will help our country achieve a system that is effective and efficient. Insurance for all is essential so that more care is provided at earlier stages when it is most effective and least costly. But we can't stop there. Access alone will not drive the improvements needed to increase safety, reduce waste, enable coordination and promote quality. Consider, too, that in recent years nearly 40 percent of insured Americans reported having trouble getting the care they needed. Providing access to all without a greater focus on prevention and significant improvements in the delivery and value of care is simply not affordable or sustainable. Read more.
2. I am in charge of my health. Health is not just an issue of access to care. It is also an issue of access to information and to the ability and resources needed to act upon it. Individually and collectively, we are the stewards of our own health. Reclaiming this power is essential. All Americans should know that, ultimately, they are their own best health care providers. Going forward, we cannot ignore the personal and political health choices we make. If we as individuals made healthier choices and our leaders enacted policies that supported the promotion of health and the prevention of disease, we could reduce our current rates of illness and disability by as much as 40 percent. As a nation, we should treat our health and health care dollars like gold, conserving and protecting them. We should each have more control over our own health care and more rewards for being good stewards of our health.
3. Value and quality in care are paramount. For any solution to have lasting impact, it must drive dramatic improvements in health care and health outcomes while increasing efficiency. The point is not to reduce costs at the expense of health. We need to enable innovations that drive up value to have the best health outcomes for our investment, and that should be our primary measure of value. We must reduce overuse and inappropriate care and deepen investments that truly make a difference to health. The United States already spends more per capita than any other nation ? more than we need to ? on health care. With proper redesign, we can have better health outcomes, better health for the population as a whole and improved efficiency at the same time. Fundamental improvements in value will be accelerated when doctors, nurses, insurers, researchers, communities and individuals ? in a word, everyone ? works toward these aims. The goal of improving value aligns everyone’s interests. Read more.
4. Focus on cultural change. We haven’t paid enough attention to cultural barriers within the health care system to achieving our health care goals. Meaningful reform must address more than the symptoms of a broken system. We must surmount the culture of the current health system that protects the status quo and empower all quarters of our community to produce real change. Health care delivery must be reorganized to suit patients, not the industry. Care should be well coordinated and easy to navigate. Health plans must be refocused on enabling health rather than limiting care. Employers and communities must redirect their efforts toward supporting health. These changes are essential to enable health stewardship and needed improvements in health and health care. Read more.
5. Health span, not life span. Life span is how long we live. Health span is how long we live with the best possible health. Our goal is better health, not more treatment. That said, health care should focus more on early health and less on late disease. To achieve that goal, we will need a much greater focus on prevention, and this must be brought to bear everywhere: at work, at school and at home. Incentives must be changed to support and encourage people to stay healthy. We must move to a system that prevents illness and protects health for as long as possible and for as many as possible. This should be accomplished through better coordination of care so even individuals with chronic illnesses stay healthier longer and have fewer complications. This alone should decrease health care spending while providing a national health benefit in the form of increased productivity. Read more.
6. Turn information into insight. Information technology and biomedical research form the backbone of our health care system. We must minimize barriers to innovation and use information more effectively to better understand disease and therefore better treat it. The time has come to use information technology across the entire health care spectrum and to introduce tools that will protect privacy while driving efficiency and improving health outcomes. If we want better health, we must define it. To define it, we must gain insight by measuring outcomes and identifying what works. And once better health is measured, we should reward those who are achieving it best. Better information will help us meet our objectives. Read more.
7. An effective health care system is a transparent one. Stewardship and individual health empowerment require the right information and tools. Health information should be timely, accessible and user-friendly, particularly to individuals. It must be available to us at the right place and at the right time to make the right decisions for our health. This information must enable individuals and clinicians to consider and compare the full spectrum of care, not just isolated procedures. Individuals must have the right to any data on their health that exist electronically at no charge or nominal cost. Such transparency needs to extend to health costs and quality as well. Insurers, hospitals, doctors ? all health care stakeholders ? should share their performance and health outcome information so that they can improve and individuals can make well-informed decisions regarding their health care choices, especially when it comes to early health, wellness and prevention. Read more.
8. Equity in health, not just in health insurance. From heart disease and diabetes to cancer and childhood diseases, Americans face crippling disparities in both the occurrence of disease and their successful recovery from it. Better stewardship should include pathways to reducing these financially unsustainable health differences based on ethnicity, gender, income, region and language. Transparency is critical. When outcomes are measured and discussed, disparities in care will be unmasked and intolerable. Read more.
9. We shouldn’t have to tell our children that they won’t live as long as we will. It is almost unfathomable that with our nation’s wealth and technological prowess, our children face shorter life spans than we do. But that is what current trends predict. Rising rates of obesity and diabetes are just part of the brick wall being placed in the path of longevity for future generations of Americans. We must reverse this trend. Our policies must take into account the overall health of our people as well as the health of each individual. Read more.
10. Health in all policies. Health is fundamental to every sector of our economy. Recent research has shown that many factors outside of health care have a huge impact on health. From agriculture policy that influences the food on our dinner table to national environmental decisions that put us at risk for disease, every choice we make brings us closer to, or moves us further from, our national health goals. Therefore, every policy, large and small, and every decision, personal and political, should take into consideration its impact on health. No compromise should be reached without analyzing its health footprint. From transportation and education to energy and trade, every political decision has a health cost or benefit ? and these costs and benefits should be weighed in every decision. Considered wisely, health could be a powerful economic driver. Our leaders should lead by example, and health is a great place to start. Read more.