Clinton, Obama on health care

SOURCE: CNN TRANSCRIPT

HEALTH CARE, Democratic Debate, 31 January 2008:

JEANNE CUMMINGS, Senior Correspondent, Politico.com: You both mentioned that health care is a priority for your party, but the truth is that most Democrats really do want full coverage, everybody covered.

Now, Senator Obama, this is a question for you. Under your plan, which is voluntary, it creates incentives for people to buy, but still is voluntary. There would be around -- about 15 million people who would still not be covered.

Now, why is your plan superior to hers?

SEN. BARACK OBAMA: Well, understand who we're talking about here. Every expert who looks at it says anybody who wants health care will be able to get health care under my plan. There won't be anybody out there who wants health care who will not be able to get it. That's point number one.

So the estimate is -- this is where the 15 million figure comes in -- is that there are 15 million people who don't want health care. That's the argument.

Now, first of all, I dispute that there are 15 million people out there who don't want it. I believe that there are people who can't afford it, and if we provide them enough subsidies, they will purchase it. Number one.

Number two, I mandate coverage for all children.

Number three, I say that young people, who are the most likely to be healthy but think they are invulnerable -- and decide I don't need health care -- what I'm saying is that insurance companies and my plan as well will allow people up to 25 years old to be covered under their parents' plan.

So, as a consequence, I don't believe that there will be 15 million out there. OBAMA: Now, under any mandate, you are going to have problems with people who don't end up having health coverage. Massachusetts right now embarked on an experiment where they mandated coverage.

And, by the way, I want to congratulate Governor Schwarzenegger and the speaker and others who have been trying to do this in California, but I know that those who have looked at it understand, you can mandate it, but there's still going to be people who can't afford it. And if they cannot afford it, then the question is, what are you going to do about it?

Are you going to fine them? Are you going to garnish their wages?

You know, those are questions that Senator Clinton has not answered with respect to her plan, but I think we can anticipate that there would also be people potentially who are not covered and are actually hurt if they have a mandate imposed on them.

WOLF BLITZER, CNN Anchor: All right.

Senator Clinton, this is a substantive difference on health care between the two of you. Go ahead and respond.

SENATOR HILLARY CLINTON: Well, let me start by saying that this is the passionate cause of my public service.

I started trying to expand health care many years ago, first to children, then to rural areas in Arkansas, and obviously tackled it during my husband's administration. And the reason why I have designed a plan that, number one, tells people, if you have health insurance and you are happy with it, nothing changes, is because we want to maximize choice for people.

So, if you are satisfied, you're not one of the people who will necessarily, at this time, take advantage of what I'm offering. But if you are uninsured or underinsured, we will open the congressional health plan to you.

And contrary to...

(APPLAUSE)

Contrary to the description that Barack just gave, we actually will make it affordable for everyone, because my plan lowers costs aggressively, which is important for us all; improves quality for everyone, which is essential. And the way it covers all of those who wish to participate in the congressional plan is that it will provide subsidies, and it will also cap premiums, something that is really important, because we want to make sure that it is affordable for all.

So, when you draw the distinction that, "Well, it's not affordable, therefore people will have to be made to get it," well, the fact is, it has been designed to be affordable with health care tax credits. And it's also important to recognize that right now, there are people who could afford health care, and they are not all young, they're people who just don't feel they have to accept that responsibility. There are many states which give families the option of keeping children up until 25 on their policies, but their rates of uninsurance are still very high.

We cannot get to universal health care, which I believe is both a core Democratic value and imperative for our country, if we don't do one of three things. Either you can have a single payer system, or -- which, I know, a lot of people favor, but for many reasons, is difficult to achieve. Or, you can mandate employers. Well, that's also very controversial. Or, you can do what I am proposing, which is to have shared responsibility.

Now, in Barack's plan, he very clearly says he will mandate that parents get health insurance for their children. So it's not that he is against mandatory provisions, it's that he doesn't think it would be politically acceptable to require that for everyone.

I just disagree with that. I think we as Democrats have to be willing to fight for universal health care.

(APPLAUSE)

And what I've concluded, when I was looking at this -- because I got the same kind of advice, which was, it's controversial, you'll run into all of this buzz saw, and I said, been there, done that. But if you don't start by saying, you're going to achieve universal health care, you will be nibbled to death.

And I think it's imperative that, as we move forward in this debate and into the campaign, that we recognize what both John Edwards and I did, that you have to bite this bullet. You have to say, yes, we are going to try to get universal health care. What I have designed makes it affordable, provides premium caps so it's never above a small percentage of what individuals are asked to pay.

(APPLAUSE)

BLITZER: Senator Obama, let me just fine-tune the question, because I know you want to respond.

On this issue of mandates, those who don't, whether it's 10 million or 15 million, those who could afford it but don't wind up buying health insurance for one reason or another, they wind up getting sick, they go to an emergency room, all of us wind up paying for their health care. That's the biggest criticism that's been leveled at your plan.

OBAMA: If people are gaming the system, there are ways we can address that. By, for example, making them pay some of the back premiums for not having gotten it in the first place.

But understand that, number one, Hillary says that she's got enough subsidies. Well, we priced out both our plan and Senator Clinton's plan, and some of the subsidies are not going to be sufficient. Point number one.

OBAMA: Point number two is that I am actually not interested in just capping premiums. I want to lower premiums by about an average of $2,500 per family per year, because people right now cannot afford it.

I can't tell you how many folks I meet who have premiums that are so high that essentially they don't have health insurance, they have house insurance. What they do is...

(APPLAUSE)

... they have a $10,000 deductible, or what have you, to try to reduce costs. They never go to a doctor. And that ends up something that we pay for, so I'm trying to reduce premiums for all families.

But the last point I want to make has to do with how we're going to actually get this plan done. You know, Ted Kennedy said that he is confident that we will get universal health care with me as president, and he's been working on it longer than I think about than anybody.

But he's gone through 12 of these plans, and each time they have failed. And part of the reason, I think, that they have failed is we have not been able to bring Democrats, Republicans together to get it done.

(APPLAUSE)

That's what I did in Illinois, to provide insurance for people who did not have it. That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are.

(APPLAUSE)

Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who -- Senator Clinton is right. They will resist anything that we try to do. My plan, her plan, they will try to resist.

And the antidote to that is making sure that the American people understand what is at stake. I am absolutely committed to making sure that anybody in America who needs health care is going to get it.

Read the complete transcript by clicking on the link at the top of this post.