Micro-Debate: Clinton and Obama on Health Care

Micro-Debate: Clinton and Obama on Health Care

The following is the health care portion of last night's debate, exerpted from the transcript provided by the New York Times.

MR. WILLIAMS: A lot has been said since we last gathered in this forum, certainly since -- in the few days since you two last debated. Senator Clinton, in your comments especially, the difference has been striking. And let's begin by taking a look.

SEN. CLINTON: (From videotape.) You know, no matter what happens in this contest -- and I am honored, I am honored to be here with Barack Obama. I am absolutely honored. (Cheers, applause.)

(From videotape.) So shame on you, Barack Obama. It is time you ran a campaign consistent with your messages in public. That's what I expect from you. Meet me in Ohio. Let's have a debate about your tactics and your -- (cheers, applause).

MR. WILLIAMS: Senator Clinton, we're here in Ohio. Senator Obama is here. This is the debate. You would agree the difference in tone over just those 48 hours was striking.

SEN. CLINTON: Well, this is a contested campaign. And as I have said many times, I have a great deal of respect for Senator Obama, but we have differences. And in the last several days, some of those differences in tactics and the choices that Senator Obama's campaign has made regarding flyers and mailers and other information that has been put out about my health care plan and my position on NAFTA have been very disturbing to me.

And therefore, I think it's important that you stand up for yourself and you point out these differences so that voters can have the information they need to make a decision.

You know, for example, it's been unfortunate that Senator Obama has consistently said that I would force people to have health care whether they could afford it or not. You know, health care reform and achieving universal health care is a passion of mine. It is something I believe in with all my heart. And every day that I'm campaigning, and certainly here throughout Ohio, I've met so many families -- happened again this morning in Lorain -- who are just devastated because they don't get the health care they deserve to have. And unfortunately it's a debate we should have that is accurate and is based in facts about my plan and Senator Obama's plan, because my plan will cover everyone and it will be affordable. And on many occasions, independent experts have concluded exactly that.

And Senator Obama's plan does not cover everyone. It would leave, give or take, 15 million people out. So we should have a good debate that uses accurate information, not false, misleading, and discredited information, especially on something as important as whether or not we will achieve quality, affordable health care for everyone. That's my goal. That's what I'm fighting for, and I'm going to stand up for that.

MR. WILLIAMS: On the topic of accurate information, and to that end, one of the things that has happened over the past 36 hours -- a photo went out the website The Drudge Report, showing Senator Obama in the native garb of a nation he was visiting, as you have done in a host country on a trip overseas.

Matt Drudge on his website said it came from a source inside the Clinton campaign. Can you say unequivocally here tonight it did not?

SEN. CLINTON: Well, so far as I know, it did not. And I certainly know nothing about it and have made clear that that's not the kind of behavior that I condone or expect from the people working in my campaign. But we have no evidence where it came from.

So I think that it's clear what I would do if it were someone in my campaign, as I have in the past: asking people to leave my campaign if they do things that I disagree with.

MR. WILLIAMS: Senator Obama, your response.

SEN. OBAMA: Well, first of all, I take Senator Clinton at her word that she knew nothing about the photo. So I think that's something that we can set aside.

I do want to focus on the issue of health care because Senator Clinton has suggested that the flyer that we put out, the mailing that we put out, was inaccurate. Now, keep in mind that I have consistently said that Senator Clinton's got a good health care plan. I think I have a good health care plan. I think mine is better, but I have said that 95 percent of our health care plan is similar.

I have endured over the course of this campaign repeatedly negative mailing from Senator Clinton in Iowa, in Nevada and other places suggesting that I want to leave 15 million people out.

According to Senator Clinton, that is accurate. I dispute it, and I think it is inaccurate. On the other hand, I don't fault Senator Clinton for wanting to point out what she thinks is an advantage to her plan.

The reason she thinks that there are more people covered under her plan than mine is because of a mandate. That is not a mandate for the government to provide coverage to everybody; it is a mandate that every individual purchase health care.

And the mailing that we put out accurately indicates that the main difference between Senator Clinton's plan and mine is the fact that she would force in some fashion individuals to purchase health care.

If it was not affordable, she would still presumably force them to have it, unless there is a hardship exemption as they've done in Massachusetts, which leaves 20 percent of the uninsured out. And if that's the case, then, in fact, her claim that she covers everybody is not accurate.

Now, Senator Clinton has not indicated how she would enforce this mandate. She hasn't indicated what level of subsidy she would provide to assure that it was, in fact, affordable. And so it is entirely legitimate for us to point out these differences.

But I think it's very important to understand the context of this, and that is that Senator Clinton has -- her campaign, at least -- has constantly sent out negative attacks on us, e-mail, robocalls, flyers, television ads, radio calls.

And, you know, we haven't whined about it because I understand that's the nature of these campaigns, but to suggest somehow that our mailing is somehow different from the kinds of approaches that Senator Clinton has taken throughout this campaign I think is simply not accurate.

MR. WILLIAMS: And Senator Clinton, on this subject --

SEN. CLINTON: But I have to -- I have to respond to that because this is not just any issue, and certainly we've had a vigorous back and forth on both sides of our campaign. But this is an issue that goes to the heart of whether or not this country will finally do what is right, and that is to provide quality affordable health care to every single person.

Senator Obama has a mandate in his plan. It's a mandate on parents to provide health insurance for their children. That's about 150 million people who would be required to do that. The difference between Senator Obama and myself is that I know, from the work I've done on health care for many years, that if everyone's not in the system we will continue to let the insurance companies do what's called cherry picking -- pick those who get insurance and leave others out.

We will continue to have a hidden tax, so that when someone goes to the emergency room without insurance -- 15 million or however many -- that amount of money that will be used to take care of that person will be then spread among all the rest of us.

And most importantly, you know, the kind of attack on my health care plan, which the University of Pennsylvania and others have said is misleading -- that attack goes right to the heart of whether or not we will be able to achieve universal health care. That's a core Democratic Party value. It's something that ever since Harry Truman we have stood for.

And what I find regrettable is that in Senator Obama's mailing that he has sent out across Ohio, it is almost as though the health insurance companies and the Republicans wrote it, because in my plan there is enough money, according to the independent experts who've evaluated it, to provide the kind of subsidies so that everyone would be able to afford it. It is not the same as a single state trying to do this, because the federal government has many more resources at its disposal.

SEN. OBAMA (?): (Inaudible.)

SEN. CLINTON: So I think it's imperative that we stand as Democrats for universal health care. I've staked out a claim for that. Senator Edwards did. Others have. But Senator Obama has not.

MR. WILLIAMS: Senator Obama, a quick response.

SEN. OBAMA: Well, look, I believe in universal health care, as does Senator Clinton. And this is -- this is, I think, the point of the debate, is that Senator Clinton repeatedly claims that I don't stand for universal health care. And, you know, for Senator Clinton to say that, I think, is simply not accurate.

Every expert has said that anybody who wants health care under my plan will be able to obtain it. President Clinton's own secretary of Labor has said that my plan does more to reduce costs and as a consequence makes sure that the people who need health care right now all across Ohio, all across Texas, Rhode Island, Vermont, all across America, will be able to obtain it. And we do more to reduce costs than any other plan that's been out there.

Now, I have no objection to Senator Clinton thinking that her approach is superior, but the fact of the matter is, is that if, as we've heard tonight, we still don't know how Senator Clinton intends to enforce a mandate, and if we don't know the level of subsidies that she's going to provide, then you can have a situation, which we are seeing right now in the state of Massachusetts, where people are being fined for not having purchased health care but choose to accept the fine because they still can't afford it, even with the subsidies.

And they are then worse off. They then have no health care and are paying a fine above and beyond that.

MR. WILLIAMS: Thank you.

SEN. OBAMA: That is a genuine difference between myself and Senator Clinton.

And the last point I would make is, the insurance companies actually are happy to have a mandate. The insurance companies don't mind making sure that everybody has to purchase their product. That's not something they're objecting to. The question is, are we going to make sure that it is affordable for everybody? And that's my goal when I'm president of the United States.

MR. WILLIAMS: Senator, as you two --

SEN. CLINTON: You know, Brian -- Brian, wait a minute. I've got -- this is too important.

You know, Senator Obama has a mandate. He would enforce the mandate by requiring parents to buy insurance for their children.

SEN. OBAMA: This is true.

SEN. CLINTON: That is the case.

If you have a mandate, it has to be enforceable. So there's no difference here.

SEN. OBAMA: No, there is a difference.

SEN. CLINTON: It's just that I know that parents who get sick have terrible consequences for their children. So you can insure the children, and then you've got the bread-winner who can't afford health insurance or doesn't have it for him or herself.

And in fact, it would be as though Franklin Roosevelt said let's make Social Security voluntary -- that's -- you know, that's -- let's let everybody get in it if they can afford it -- or if President Johnson said let's make Medicare voluntary.

SEN. OBAMA: Well, let me --

SEN. CLINTON: What we have said is that at the point of employment, at the point of contact with various government agencies, we would have people signed up. It's like when you get a 401(k), it's your employer. The employer automatically enrolls you. You would be enrolled.

And under my plan, it is affordable because, number one, we have enough money in our plan. A comparison of the plans like the ones we're proposing found that actually I would cover nearly everybody at a much lower cost than Senator Obama's plan because we would not only provide these health care tax credits, but I would limit the amount of money that anyone ever has to pay for a premium to a low percentage of your income. So it will be affordable.

Now, if you want to say that we shouldn't try to get everyone into health insurance, that's a big difference, because I believe if we don't have universal health care, we will never provide prevention.

I have the most aggressive measures to reduce costs and improve quality. And time and time again, people who have compared our two approaches have concluded that.

SEN. OBAMA: Brian, I'm sorry.

SEN. CLINTON: So let's -- let's have a debate about the facts.

SEN. OBAMA: I'm going to get filibuttered -- I'm getting filibustered a little bit here.

MR. WILLIAMS: The last answer on this topic.

SEN. OBAMA: I mean, it is just not accurate to say that Senator Clinton does more to control costs than mine. That is not the case. There are many experts who have concluded that she does not.

I do provide a mandate for children, because, number one, we have created a number of programs in which we can have greater assurance that those children will be covered at an affordable price. On the -- on the point of many adults, we don't want to put in a situation in which, on the front end, we are mandating them, we are forcing them to purchase insurance, and if the subsidies are inadequate, the burden is on them, and they will be penalized. And that is what Senator Clinton's plan does.

Now, I am -- I am happy to have a discussion with Senator Clinton about how we can both achieve the goal of universal health care. What I do not accept -- and which is what Senator Clinton has consistently done and in fact the same experts she cites basically say there's no real difference between our plans, that are -- that they are not substantial.

But it has to do with how we are going to achieve universal health care. That is an area where I believe that if we make it affordable, people will purchase it. In fact, Medicare Part B is not mandated, it is voluntary. And yet people over 65 choose to purchase it, Hillary, and the reason they choose to purchase it is because it's a good deal. And if people in Cleveland or anywhere in Ohio end up seeing a plan that is affordable for them, I promise you they are snatching it up because they are desperate to get health care. And that's what I intend to provide as president of the United States.

MR. WILLIAMS: Senator, I'm going to change the subject.

SEN. CLINTON: About 20 percent of -- about 20 percent of the people who are uninsured have the means to buy insurance. They're often young people --

MR. WILLIAMS: Senator --

SEN. CLINTON: -- who think they're immortal --

SEN. OBAMA: Which is why I cover them.

SEN. CLINTON: -- except when the illness or the accident strikes. And what Senator Obama has said, that then, once you get to the hospital, you'll be forced to buy insurance, I don't think that's a good idea. We ought to plan for it --

SEN. OBAMA: With respect --

SEN. CLINTON: -- and we ought to make sure we cover everyone.

That is the only way to get to universal health care coverage.

SEN. OBAMA: With respect --

SEN. CLINTON: That is what I've worked for for 15 years --

SEN. OBAMA: With respect --

SEN. CLINTON: -- and I believe that we can achieve it. But if we don't even have a plan to get there, and we start out by leaving people, you'll never ever control costs, improve quality, and cover everyone.

SEN. OBAMA: With respect to the young people, my plan specifically says that up until the age of 25 you will be able to be covered under your parents' insurance plan, so that cohort that

Senator Clinton is talking about will, in fact, have coverage.

MR. WILLIAMS: Well, a 16-minute discussion on health care is certainly a start. (Laughter.) I'd like to change up --

SEN. CLINTON: Well, there's hardly anything be more important? I think it would be good to talk about health care and how we're we going get to universal health care.

MR. WILLIAMS: I -- well, here's another important topic, and that's NAFTA, especially where we're sitting here tonight.

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