Bill Clinton: “In two or three ways. First of all, under our plan those plans will have to offer pap smears, mammograms, and other…”

“In two or three ways. First of all, under our plan those plans will have to offer pap smears, mammograms, and other preventive and primary services. They won't be able to cut them out. Secondly, these companies will be under much more pressure to provide quality service and to siphon less money off to bureaucracy and profits than they are now because they won't be able to make a deal with employers which can then be enforced on employees. Every employee--that is, every patient you see will be able to make a new choice of plan every year. So if they get abused in year one, then in year two, the next year, they'll be able to make the same choice they made last year all over again and choose a different plan or fee-for- service medicine or a group of physicians who are providing health care. So this will fundamentally change the whole incentives of the system. They simply will not be able to use the fact that they have a preexisting relationship with an employer to undermine the delivery of quality of care between the doctor and the patient, because the patient will be making a decision and every year can make another decision. And that will have a profound impact on it. And they will not be able to eliminate primary and preventive services from their package. That has to be involved. So that's going to change it. Then we will make--when we make some of the changes in the antitrust laws, which will make it even easier for physicians to get together and deliver health care directly. So these HMO's are going to be under a whole different kind of competition. It won't be competition from somebody else providing less service at lower costs, it will be competition from somebody else providing more services at higher quality with more choices for the same costs or sometimes less. So I think this will really change things and put you and your patients much more in the driver's seat than you are now. That's perhaps the most critical element of my plan that has not been really noted. We are not restricting choice, we're expanding it. And we're putting the decision--we're moving the decision from the employer to the employee about who makes the choice, which means you're moving it to the patient. And that should be, I think, something that will make a profound difference, particularly after you all get through talking to all of them.”