But if this bill, regularly reintroduced since 2003, is now to be taken seriously, it needs improvement. Most importantly, the proposed federal board governing both payment and care decisions lacks clinical authority and is too politicized. Instead, doctors must be granted, and must accept, responsibility for a national, private, transparent, interprofessional and data-driven mechanism to define quality options for care choices. This will free us from the snarl of various quality guidelines and protect our patients from irrelevant insurance and government interference while providing authoritative relief from over-utilization. This key improvement in the bill is also needed because coverage decisions must be removed from states, as proven by their politicized Medicaid problems.