Bill Clinton: “Let me try to restate what I said before. I believe that the micromanagement of medicine by insurance companies has…”

“Let me try to restate what I said before. I believe that the micromanagement of medicine by insurance companies has reached an excessive point. And what we have tried to do to reduce it, since we can't--you don't want the Federal Government exactly passing laws saying what decisions can or cannot be made by physicians and others working with them. What we've tried to do is to change the whole system so that it would be much less likely. And I will mention two things again. Number one, we make it easier for people like you to join with like-minded physicians in providing services directly or to join together and to tell people if you're going to work with them, you don't want those kinds of utilization reviews. And we require the insurance companies to disclose their utilization review protocols in advance. And they will be under much more pressure than they are now because now they won't have the same shot at business X, Y, or Z's employees because the employees themselves will be deciding whether they want an HMO, do they want a PPO, do they want some other kind of organization, or do they want to have fee-for-service medicine. Under each case the employer's responsibility is the same. So I think that we are changing the environment in ways that will really permit you to cut down, working with your fellow physicians and your patients, to cut down dramatically on the number of these abuses. I also want to point out that if there is a single card, which we envision, which entitles a person to health care and which enables them to hook into a computer which says that they are covered and all of that, and if there is a single form related to the comprehensive benefit package which can be filled out in every doctor's office and hospital in the country and then processed by every insurance company in the country, then that is going to dramatically reduce the paperwork burden, too. I have many, many doctors complain to me that the time they have to spend and the money they have to spend in their clinics on post facto paperwork has exploded in recent years. And I think that is also very important, cutting down on that burden, not only the time but the money, is critically important. So I believe that we will make it better. If you have further suggestions, I'd be glad to hear them. But this is an area in which it is difficult to legislate directly and in which many physicians are reluctant to have us legislate directly. It seems to me if you change the economics and change the distribution of the power of decisionmaking in this whole process, giving more to the doctors and to patients through the workplace and less to the insurance companies, that those practices will inevitably change because the shift of decisionmaking has occurred.”