Blue Cross and Blue Shield has called on Congress to pass a bill to create an independent institute devoted exclusively to developing credible clinical information on the comparative effectiveness of new and existing medical procedures, drugs, devices and biologics. The new institute should be developed based on several core principles. First, it should be an independent entity, nonprofit, and governed by a board of experts representing diverse interests. Second, it should support a broad range of research to evaluate the clinical effectiveness of different procedures, drugs, devices and biologics. Third, the institute should focus on collaboration. They also propose a significant change in the malpractice arena.