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The Yuba-Sutter Healthcare Council has adopted a series of principles that we believe should be applied to healthcare, many of which are not in place today. As such, they should be utilized in the ongoing healthcare reform discussion.

The Yuba-Sutter Healthcare Council is dedicated to continuously improving the health of the residents in our region. The Council has identified a collection of basic principles which together serve as a foundation for optimizing the use of healthcare resources in pursuit of continuously improving local healthcare. The Council believes that each principle will be self-evident to rational individuals who identify democracy and capitalism as axiomatic in American society. However, individual principles taken out of the context of the whole, may not adequately represent the view of the Council. As a result, it is the Council's intention that all the principles be considered together as a unit in any healthcare policy discussion.

1. Everyone now living will die someday
   
   
2. Regardless of how much money we spend, we cannot change the first principle
   
   
3. The goals of healthcare should be:
• promote positive lifestyle choices
• prevent preventable illness
• screen for early treatable disease
• promote effective therapy
• provide comfort when treatment is not an option
• allow people to die in a dignified and comfortable manner


4. There is a fixed amount of money that can be spent upon healthcare, even if we choose for it to be 100% of GDP
   
   
5. We must optimize our healthcare budget in support of the goals of healthcare
   
   
6. Money collected for healthcare should maximally be spent on provision of effective healthcare services
   
   
7. Every Californian should be able to access a minimum level of healthcare services
   
   
8. No one should be precluded from paying for healthcare services that they choose to obtain in California
   
   
9. Patients should have some responsibility for their healthcare choices, so long as they are legally competent
   
   
10. Allocation of limited healthcare resources should be done in the most rational fashion that supports our goals
    
    
11. No party may dictate to another party what they may charge for their services
    
    
12. Sellers of services shall be paid by buyers (or payors) at the agreed upon rate or the seller's price when no agreement exists
    
    
13. Buyers (or payors) who were forced to obtain services in an emergency which limited their ability to investigate other options may seek a neutral third party to negotiate a reduction in a seller's price.
    
    
14. Provider pricing should be transparent
    
    
15. In recognition of the critical need for trained healthcare workers, some resources of the healthcare industry (insurers and providers) should be directed to support education and training for the development of the next generation workforce.
    
    
16. To ensure that a healthcare system endures in perpetuity, there must be:
    • adequate financial resources to support education and training of the healthcare workforce
    • enough clinical positions open to enable trainees to complete their practical training
    • strong incentives to encourage those capable of becoming healthcare workers to apply to do so

The purpose of these principles is to find common ground among groups with widely disparate goals. Patients want to receive the best care. Providers want to deliver the best care. Employers want to get the best employees at the lowest possible cost. Insurers want to maximize profit by limiting care in order to minimize their "medical losses".

Even among these four key stakeholder groups with four very different goals, it should be possible to first obtain consensus on the principles. From there, many of the policies which are needed will be more clear and effective and sustainable reform might then be possible.

Please spread the word.