Bill Clinton: “One of the things that we don't know is how much extra excess procedures and tests are done as defensive medicine or to…”

“One of the things that we don't know is how much extra excess procedures and tests are done as defensive medicine or to churn the system, to go back to your other question. The economic incentives to churn the system will be dramatically reduced under these kind of payment plans. It will be more like the way the Rochester, New York, system works, the way the Mayo Clinic system works. More and more people will be in a system where they pay up front, and then they take what they need. And the doctors are going to get paid out of that. But the malpractice issue is a problem. We will propose some significant reforms, including limiting the percentage of income lawyers can get in contingency fees in lawsuits. But I have to tell you, what I think the most significant--and alternative dispute resolution mechanisms--but I think the most important one will be permitting the professional associations to draw up medical practice guidelines which, when approved, will protect the doctors to some extent, because if they follow the guidelines in any given case, it will raise a presumption that they weren't negligent. And that will be a real protection against just doing an extra procedure because you're trying to hedge against a lawsuit. The State of Maine pioneered this because they wanted more general practitioners in rural Maine to do more things for people like help deliver babies because they didn't have anybody else to do it. So, the idea of giving people practice guidelines I think is very good. Now, you asked who's going to win and who's going to lose. Can we talk through that?”