Bill Clinton: “Well, let me mention--let me talk about this from two or three different points. This is a big issue, and it's an issue…”

“Well, let me mention--let me talk about this from two or three different points. This is a big issue, and it's an issue that I'm very sensitive to now. As you know, I just lost my mother a few months ago. My father-in-law died last year. My family's been through this personally. And I would like to say three or four things about it. First of all, on balance, we like having the best medical technology in the world, and we want to have access to it if we need it. And our plan actually continues a commitment to invest more, for example, in academic medical centers which have this technology and in medical research, generally, and I think we should. On the other hand, we don't want to have a lot of money spent on technology if it's totally useless. Let me just mention three things which the present system does, and he alluded to two of them. One is, a lot of doctors are worried about malpractice claims so they may do tests whether they think the patient needs it or not, just so later on they can say they did it in case they get sued. That costs all of us a lot of money if there's no reason to do it. What's the answer to that? Our plan would require the national professional associations to promulgate medical practice guidelines that then the doctors could use, and if they use these guidelines, those guidelines would, in effect, be a first line of defense in a malpractice case. It would at least raise the presumption that the doctor had not been negligent. Problem number two, hospitals get to competing with one another, and they're afraid--if one has an MRI, the other hospital's afraid it won't get any patients unless it gets an MRI. So a town needs one MRI and winds up with two so everybody can compete with one another. We try to make sure that there's equal access to technology, but that hospitals don't feel like they have to do that, double the cost of technology to everybody, when the facilities could be properly shared. Point number three is the really difficult one, and that is the question of when should people in their last months, or their last year, give up expensive technology? My own view of that is that a lot of people have made that decision for themselves, but they don't formalize it. And so one of the things we're trying to encourage people to do is to make sensible living wills, to make these decisions. I think that's a lot better than having medical professionals try to get between a grief- stricken child and a parent on life support, or sometimes a grief- stricken parent and a child on life support. So I think what we should do is to try to encourage the use of living wills, encourage families to talk about this in honest ways. And I think America will move to this and save the money that can be saved and still keep the benefits of technology. Mr. Anschutz. Thank you, Mr. President. As we told you earlier, we're talking with four communities, not only ours but Tulsa, Topeka, and Omaha. At this point, we're ready to go back to Topeka. Mr. Hipp. Okay, Wendall. Mr. President, this gentleman has lived in the capital of Kansas for 18 years. And Paul doesn't have a lot of faith, frankly, in the Government's ability to administer health care, and he's got a question about that for you, sir. Managing the System”