Now, there have been reports just over the last couple of days of insurance companies making record profits — right now. At a time when everybody is getting hammered, they’re making record profits, and premiums are going up. What’s the constraint on that? How can you ensure that those costs aren’t being passed on to employers or passed on to employees, the American people, ordinary middle-class families, in a way that over time is going to make them broke? Well, part of the way is to make sure that there’s some competition out there. So that’s the idea.
Now, to get to your original question, can I guarantee that there are going to be no changes in the health care delivery system? No. The whole point of this is to try to encourage changes that work for the American people and make them healthier. The government already is making some of these decisions. More importantly, insurance companies right now are making those decisions.
And part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works — because that’s not how it’s working right now. That’s not how it’s working right now. Right now doctors a lot of times are forced to make decisions based on the fee payment schedule that’s out there.
So if they’re looking — and you come in and you’ve got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid’s tonsils out. Now that may be the right thing to do, but I’d rather have that doctor making those decisions just based on whether you really need your kid’s tonsils out or whether it might make more sense just to change — maybe they have allergies, maybe they have something else that would make a difference.
So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what’s best for patient care — and that’s the whole idea behind Mayo, that’s the whole idea behind the Cleveland Clinic. I’m going to be visiting your hometown tomorrow to go to the Cleveland Clinic to show — to show why their system works so well. And part of the reason it works well is because they’ve set up a system where patient care is the number-one concern, not bureaucracy, what forms have to be filled out, what do we get reimbursed for. Those are changes that I think the American people want to see.