This article discusses the principles that guide healthcare delivery reform in the United States, the sustainability of healthcare systems, and recommendations for improvement. The principles include continuous, affordable, and transportable healthcare coverage, restructuring the healthcare delivery system to promote health and prevent diseases, equitable and sustainable healthcare mechanisms, maintaining existing programs until superior alternatives can replace them, adequate healthcare practitioner supply, and stable support for the inherent cost in health research, development in technology, and the provision of required specialized services to the broader society. The article also highlights the challenges of healthcare systems, including the aging population, increased chronic disease, ever-increasing costs of technology, and the demand on the entire healthcare system. Finally, the article provides recommendations for addressing these challenges and improving the sustainability of healthcare systems.