Snelling Center for Government

In January 2005, twenty-four diverse interest groups representing a broad array of business, health care, consumer and other professional concerns achieved a consensus that Vermont will be well served by using the following principles to guide health care reform.

Principle I:
It is the policy of the State of Vermont to ensure universal access to and coverage for essential health care services for all Vermonters.

Universal access means the absence of barriers to essential health care services. Access needs to be equitable. Vermonters will have coverage for essential services that are delivered in the same high quality manner regardless of economic or geographic situations.

It is a critical social policy goal that all Vermonters have health coverage and that all Vermonters actively participate in the health system.

Principle II:
Health care coverage needs to be comprehensive and continuous.

Coverage for essential health services needs to follow the individual from birth to death, and be responsive and seamless through employment and life changes. Vermonters will have access to high quality care throughout their lives.

Principle III:
Vermont's health delivery system will model continuous improvement of health care quality and safety.

Continuous improvement in health care quality and safety will be integrated into the operation of the health care system, drawing on and promoting evidence-based and best practices, striving for optimal outcomes for the resources expended. It is essential that wellness and public health initiatives that promote healthy lifestyles and preventive care be the foundation of the health system. The health care system will promote care that is safe, timely, effective, patient-centered, efficient and equitable.[1]

[1] Institute of Medicine, Crossing the Quality Chasm, 2001: 39-40.
Six Aims for Health Care Improvement
· Safe - avoiding injuries to patients from the care that is intended to help them.
· Effective - providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding under use and overuse, respectively).
· Patient-centered - providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
· Timely - reducing waits and sometimes harmful delays for both those who receive and those who give care.
· Efficient - avoiding waste, in particular waste of equipment, supplies, ideas, and energy.
· Equitable - providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

Principle IV:The financing of health care in Vermont will be sufficient, equitable, fair and sustainable.

Universal access to a continuous and comprehensive package of essential high quality health care is a public good. The financing mechanism for attaining a workable, affordable, and sustainable health care system needs to be adequately and fairly financed and operated in a manner that ensures both high quality of care and efficient use of resources.

Principle V:
Built-in accountability for quality, cost, access and participation will be the hallmarks of Vermont's health care system.

The health system will be accountable to the people it serves in respect to the quality of care and the management of costs.

Principle VI:
Vermonters will be engaged, to the best of their ability, to pursue healthy lifestyles, to focus on preventive care and wellness efforts, and make informed use of all health care services throughout their lives.

These six principles are essential for the successful transformation of the health care system. Coalition 21 is committed to identifying and advancing changes in the system that over time will achieve these goals.