Bill Clinton: “I'll answer your question, but let me say first of all, you're much more likely to have overutilization and exploding…”

“I'll answer your question, but let me say first of all, you're much more likely to have overutilization and exploding costs if we keep on doing what we're doing than if we adopt our plan. In other words, particularly for smaller employers, costs have been going up on average anywhere from 20 to 50 percent a year. Only the very biggest employers that are able, in effect, to bargain more toughly with their own insurance providers have been able to hold their costs in line, and they've been able to do a little bit better job in the last few years simply because of their size. So under our system you would not only start out with a lower premium than you're paying now so you would get an immediate savings, you'd be part of a big alliance of employers and employees who would have some say over the governing of your big health care group. And if the evidence of every other country is any guide, if the evidence of the places which have started it in this country is any guide, the cost is going to go up much less rapidly under this system than it will if we stay with what we've got. In other words, the worst alternative that we can conceive is to continue to do what we've got for small business. Now, in addition to that, we've proposed to have a backup budget cap so that if by pure competition you can't keep costs as low as we think that--you know, basically to inflation plus the growth in people participating, we'll still have a budget to limit it. So the answer to your question is, there is no conceivable scenario, at least that I can conceive of, where you would wind up paying more under this plan than another. Also there are more incentives in this plan not to overutilize the system, not just for your employees but for the American people as a whole. Under our plan all the employees in the country would have to pay something towards their own health care up to 20 percent, which is something that many don't now. And if they wanted a more generous plan than we cover, which is quite adequate, they would have to pay even more. So there will be a lot of incentives not to overutilize the system and not to run the cost through the roof. Let me also point out that over the next 5 years, since you mentioned the short-term period, that's the period over the next 5 years where we'll be realizing a lot of the administrative savings. Our country stands approximately a dime on the dollar more in paperwork than all of our competitors. That's a bunch of money in an $800 billion health care system. So if--let me just say this--if what we've tried to do in implementing this health care system is to phase it in over a period of years, to build in corrections so if something goes wrong, we will find another way to control the costs, not to increase your costs for this health care. We are spending--let me say--I want to drive this home. Today, America spends 14.2 percent of its gross domestic product on health care. Canada spends 9.4 percent. No other advanced country in the world is over 9. None. Not Germany, not Japan. And in the German system, which is about 8.6, 8.7 percent of their gross domestic product, the benefits are as generous as the best plans, more generous than most, and contain a lot of primary preventive health care. So unless we just all go to sleep at the switch, this is--you know, there is no way that you can't be better off under this new system. But there are protections. The way we've got it written, there are basically opportunities to recalculate, to avoid imposing undue burdens on employers 3 and 4 and 5 years down the road. The way it's written, we'll have to have opportunities to readjust it. The bottom line is, sir, none of us are going to do anything which put more small businesses out of work than are already doing it now, because most of the new jobs in this country are being created in units of under 50. So I wouldn't be doing this if I didn't think it was not only better for the health care of the country but also would tend to stabilize the environment for small business so we could get back to generating new jobs. [Administrator Bowles reaffirmed that the new plan would be beneficial to small businesses. A participant then asked about employees with catastrophic or preexisting illnesses.]”