10 NEW LEADERSHIP ON HEALTH CARE
11 A PRESIDENTIAL FORUM
13 COX PAVILION
14 LAS VEGAS, NEVADA
16 Saturday, March 24, 2007
17 9:15 a.m.
25 Reported by: Deborah Ann Hines, CCR #473, RPR
1 VOG: Ladies and gentlemen, please welcome
2 from the University of Nevada, Las Vegas the vice
3 president of planning and diversity and chief of
4 staff, Dr. Juanita Fain.
5 DR. JUANITA FAIN: Good morning. It's great
6 to see you all. On behalf of Dr. David Ashley,
7 president of the University of Nevada, Las Vegas
8 along with the students, faculty and staff of UNLV
9 I'm pleased and excited to welcome you to our campus
10 for the New Leadership on Health Care Presidential
11 Forum. We're glad you're here.
12 I would particularly like to welcome special
13 friends and guests of the university who are here
14 with us today. First, I must introduce U.S.
15 Congresswoman Shelley Berkley. Thank you so much.
16 Appreciate it.
17 Also I'd like to recognize leaders of the
18 state Democratic party who are here. I know Clark
19 County Commissioner Tom Collins is here, who's a
20 state chair. Also I'd like to give a special welcome
21 and thanks to the members of the state of Nevada
22 legislature who are here, members of Clark County,
23 and the City of Las Vegas governmental officials who
24 are here, and also special recognition to the Nevada
25 system of higher education board of regents who are
1 here. I'm know for sure Regent Thalia Dondero is
2 here. I don't know if there are others, but thank
3 you for being here.
4 And also members of our UNLV our Foundation
5 and alumni board are here with us this morning, and
6 of course all of you. I'm so glad you're all here.
7 You know, activities that provide the public
8 with a better understanding of the major issues
9 facing us as a nation are an important aspect of the
10 university mission. By hosting this presidential
11 forum, UNLV is providing an opportunity for the Las
12 Vegas community to hear from many of our presidential
13 candidates about their perspective on health care.
14 We are delighted to collaborate with the
15 Center for American Progress Action Fund and the
16 Service Employees International Union to host this
18 UNLV shares with both of these organizations
19 a commitment to improvement of services and quality
20 of life for all American communities. We thank both
21 of these organizations who are involved in the
22 University of Nevada, Las Vegas to host this
23 presidential forum on the critical topic of health
24 care which impacts all of our lives, and we commend
25 you for your efforts.
1 American university is looking for a unique
2 challenge as they move into the 21st century. Among
3 these challenges are population growth, demographic
4 challenges, economic changes of both global and
5 regional levels. Numerous local challenges that
6 phase today's communities. The University of Nevada,
7 Las Vegas is no exception. In fact, UNLV personifies
8 the new American university. UNLV president David
9 Ashley consistently and frequently says that the
10 University of Nevada, Las Vegas is positioned to
11 build the university of the future. And the
12 university of the future has its roots with its
14 The university strives to demonstrate that
15 traditional higher education value can be adapted to
16 the condition and needs of individuals and
17 communities in the 21st century. Instructional and
18 research programs, student centered and responsive to
19 the needs of local, regional and national and
20 international communities, artistic, cultural and
21 technical resources and opportunities are
22 intentionally offered to the broadest possible
24 In its brief 50 year history, the celebrate
25 our 50th anniversary in 2007/2008. I have to say
1 with some concern that I'm older than the University
2 of Nevada, Las Vegas. We're very proud of our
3 50-year history.
4 UNLV has evolved from a small regional
5 institution with 41 students, three faculty and one
6 building to the state's largest doctoral degree
7 granting institution. Today the university has more
8 than 28,000 students, approximately 3,000 employees
9 and 99 buildings. The main campus, where you are
10 here today, located in southwest Las Vegas,
11 classified now in the category by the Carnegie
12 Foundation for the Advancement of Teaching as a
13 research university, consists of more than 350 acres.
14 As we speak, the campus continues to expand
15 beyond the boundaries of the main campus, the
16 satellite campus is a research park, all the way from
17 southeast Asia for the hotel administration and
18 tourism program to Singapore to the future Harry Reid
19 research and technology park in southwest Las Vegas
20 to the health sciences park at Shadow Lane, located
21 in the city's meadows district.
22 This fast-paced dynamic university
23 environment at UNLV is amplified by its location in a
24 rapidly growing metropolitan area whose population
25 now exceeds 1.8 million. UNLV is an integral part of
1 the Las Vegas community. Stimulated economic
2 development in addressing social and environmental
3 issues are among the far-reaching influences UNLV has
4 to in great Southern Nevada area.
5 UNLV is firmly committed in our role to
6 serve the area. Hosting this health care forum on
7 our campus represents the UNLV community partnership
8 that provides an opportunity for public discourse
9 that benefits our society.
10 On behalf of President Ashley and the entire
11 UNLV community, we enthusiastically open our campus
12 to you, and we hope you find the New Leadership on
13 Health Care a Presidential Forum informative and
15 Welcome again and thanks for being here.
16 Thank you. At this time I would like to
17 invite to the podium John Podesta, president and CEO
18 of the Center for American Progress Action Fund, and
19 Andy Stern, president of the Service Employees
20 International Union.
21 JOHN PODESTA: Thank you, Dr. Fain, and
22 thank you UNLV. What a beautiful day. I don't have
23 time to thank and acknowledge all the people who
24 helped make this event possible and the special
25 guests who are here, but I do want to mention two:
1 Las Vegas' great congresswoman, Shelley Berkley. And
2 Elizabeth Edwards, who won't be with us this morning,
3 whose grace and strength through her own health care
4 battle with cancer is an inspiration to us all. I
5 pray for her success.
6 The Center for American Progress Action Fund
7 is proud to sponsor this event at UNLV with SEIU.
8 This forum is not only the first to focus completely
9 on our nation's health care crisis, but it's the
10 first presidential forum ever to take questions
11 directly from the blogosphere via think progress dot
12 org and courtesy of a wide web cast provided by Real
14 We hope that what happens in Las Vegas today
15 will absolutely leave Las Vegas and set the tone for
16 the entire presidential campaign. It's simply time
17 to make affordable, quality coverage for every
18 American a reality. I need don't to tell Nevadans
19 that our health care system is in desperate need of a
20 fix. More than 430,000 Nevadans, almost one in five,
21 lack health insurance.
22 In terms of health care costs, Nevada had
23 the highest percentage growth and health expenditures
24 of any state over the last 25 years.
25 The situation in Nevada highlights precisely
1 what's wrong with our health care system overall. It
2 costs too much, it covers too few, and it delivers
3 too little in terms of health of our citizens.
4 Today 45 million Americans are uninsured,
5 including 9 million children. Since 2000 health care
6 premiums for workers have increased four times fast
7 than wages. Today the average family insurance
8 policy costs $11,841. That's a thousand dollars more
9 than a full time minimum wage worker makes in a year.
10 What kind of value do we get for all that
11 money we spend on health care in the United States?
12 Not much. The U.S. currently ranks 31st in the world
13 in terms of life expectancy, and 28 on infant
15 You know, I think my grandparents came to
16 the United States from a village in Greece a hundred
17 years ago would actually be shocked to know that
18 people living in that village today have a longer
19 life expectancy than people living in the United
21 And in our globalized economy, American
22 business isn't fairing any better. By 2008 health
23 care costs will exceed profits in Fortune 500
25 Our health care system today violates
1 American's deep commit to human dignity for all and
2 fairness for all, and it hampers our nation's
3 economic competitiveness.
4 The upcoming presidential election presents
5 us with an opportunity. We can't find leaders who
6 are willing to reject the status quo and provide
7 fundamental change. We're pleased to have so many
8 candidates with us today and we're also grateful to
9 have an exceptionally talented and accomplished
10 moderator, Karen Tumulty of Time Magazine, to lead
11 today's discussion.
12 Now let me introduce my good friend and
13 ally, Andy Stern. Andy is an organizer, a visionary
14 and a true champion of workers across the country.
15 Under his leadership SEIU has becomes the fastest
16 growing union in the nation, the largest health care
17 union in the U.S., and one of the most powerful
18 political voices in the country. I'm personally
19 honored to partner with him on this and other efforts
20 so please join me in welcoming Andy Stern.
21 ANDY STERN: Thank you, John and CAP, Vice
22 President Fain and UNLV, and of course the seven
23 candidates, but most importantly the 1.8 million
24 members of SEIU who make this first issue forum of
25 2008 election cycle possible.
1 I'd like to introduce the
2 secretary-treasurer of SEIU, the woman who is the
3 highest ranking person in the American labor movement
4 and the head of Change of Win Federation, Anna
5 Burger. All the members of SEIU, the nurses and
6 public workers, janitors and home care workers who
7 are here with us today.
8 Quality, affordable health care for all
9 Americans is an issue on every American's mind, and
10 we are committed to make sure it's on every
11 candidates agenda. Pat Moore is a nurse. She works
12 at the University Medical Center which cares for half
13 of the uninsured in Southern Nevada. She's just one
14 of the million SEIU health care workers who too often
15 treat the people that the system is failing.
16 Pat talks about a ten-year-old child with
17 diabetes whose family traveled to Nevada simply in
18 search of a good job and a better life. Diabetes is
19 normally on easily treatable disease, unless you
20 cannot afford the regular $40 cost for Insulin
22 Her family tried to get by by stretching the
23 medicine out, but sadly with their son, but that
24 didn't work and he was rushed to the ER in a coma.
25 Thank God after three days of intensive care at the
1 hospital he came out of that coma and he recovered.
2 In the richest country on earth, $40 bottle
3 of Insulin should not mean the difference between a
4 child's life and death.
5 Health care in America is no longer just a
6 moral issue, it's an economic issue as well. America
7 cannot be the only industrialized nation on earth
8 that asks its employers to put the price of health
9 care on the cost of its products when all of its
10 competitors around the world do not. It is not just
11 a moral crisis, it's an economic crisis. An economic
12 plan that will not work in a 21st century global
14 Business knows this, which is why the
15 business round table, Fortune 500 companies, AT&T,
16 Intel, Kelly Services and Wal-Mart will be joined on
17 May 8 by many who work. They're demanding a new
18 health care system. The public now knows this.
19 Polling in the four early primary states shows the
20 cost of health care is the number one pocketbook
21 concern for voters of both parties. And a vast
22 majority of Democrat and Republican voters believe
23 everyone has a right to quality, affordable health
24 care, and they want fundamental, not piecemeal change
1 Governors now know this. Governor
2 Schwarzenegger and Romney, Democrat Rendell and
3 Malloyovich have plans for all their citizens, as do
4 senators like Ron Wyden.
5 Policy leaders now know this. Proof is wide
6 ranging as the Center for American Progress and the
7 insurance industry have proposed plans to coverage
8 for all Americans.
9 So what, what are we missing? Leadership.
10 Leadership in Washington, D.C. And for the next
11 president here's the final point of our pole: Voters
12 are saying they're not hearing from you enough about
13 health care. And in a minute we're going to start
14 solving that problem.
15 But the winds of change of health care are
16 blowing. It's up to us voters, voters to keep the
17 pressure up, to ask questions. But more importantly
18 let's demand detailed answers about what they're
19 going to do.
20 America's future is not a matter of chance,
21 it's a matter of choice. And every four years our
22 choice, voters' choices really do matter.
23 Thank you very much.
24 To guide us through our discussion today is
25 Karen Tumulty, our moderator. She's a national
1 political correspondent for Time Magazine, widely
2 considered one of the best political journalists in
4 Karen has written over 25 cover stories for
5 Time, including this week's. She will manage this
6 forum, take questions from our internet audience, and
7 ask her own questions.
8 We're lucky to have her here today, Karen
9 Tumulty. Thank you.
10 KAREN TUMULTY: Thank you very much. It's
11 really exciting to be here. And once again, I want
12 to thank all of you for spending your Saturday
13 morning with us. I want to thank you on behalf of
14 UNLV, SEIU and the Center for American Progress
15 Action Fund, which is a nonprofit nonpartisan
16 organization. The lawyers wanted to me to say that
18 You're going to see these presidential
19 candidates in the coming months over and over and
20 over again in forums like this. But this one is
21 very, very different, because this morning you are
22 not going to hear anything about who's got the latest
23 video on YouTube or what the latest back and forth
24 has been on the campaign trail, this morning really
25 gives us an opportunity to drill down into a
1 particular issue and one that pole after pole after
2 pole shows hits home in a way no other issue does
3 with voters.
4 Hopefully at the end of this morning you're
5 going to have a better sense of these candidate's
6 priorities as they address the health care issue.
7 You're going to have a sense of who has a plan and
8 who doesn't, and you're going to have a sense too of
9 whose plan is realistic in this political climate in
10 the environment that presumably they're going to
11 confront as they take office in January of 2009.
12 But before we get to these candidates, I
13 would like just to take care of a few housekeeping
14 issues and maybe some questions you might have as to
15 this forum is going to work. First of all, I should
16 note that all the candidates of both parties were
17 invited to this forum. These seven, all Democrats,
18 are the ones who accepted.
19 The order in which they will be speaking
20 this morning is the order in which they accepted the
22 The format is going to go like this: Each
23 candidate is going to have 20 minutes. They're going
24 to have two to three minutes at the beginning to make
25 an opening statement, we'll see how well we can hold
1 politicians to that, and then of the remaining
2 minutes, the remaining 17 to 18 minutes will be
3 divided among questions from myself, questions from
4 this audience, and questions that will be coming in
5 over the internet by e-mail, because this is of
6 course being web cast, now that we're living in the
7 21st century.
8 If any of you decide that you need or want
9 to leave the room during anyone's presentation, you
10 will be allowed to leave but you will not be allowed
11 to come back until the break before the next
13 And I think at this point we are ready to
14 start, so our first candidate, who I believe is now
15 in the building, is the former Senator from North
16 Carolina, John Edwards.
17 JOHN EDWARDS: Thank you. Thank you all
18 very much. It's a great privilege for me to be here.
19 Let me say first a personal thank you to all of you
20 and the people who have been so kind and so generous
21 over the last few days, including, by the way, my
22 fellow candidates who will be here today. I'm very
23 proud to have my wife Elizabeth here with me.
24 I also want to thank CAP and the SEIU for
25 sponsoring this forum and for talking about an issue
1 that's so important to us, to all Americans. And
2 what we have is a dysfunctional health care system in
3 the United States of America. And what we need is a
4 big, bold, dramatic change, not small change. And we
5 do not just fix our health care system, we need to
6 fix our military and veterans' health air system.
7 Let me talk just briefly about my plan for
8 universal health care, and then I'm sure we'll get
9 into more detail as we go through this conversation.
10 Basically what we do is cover all Americans.
11 In my plan there's shared responsibilities. The
12 employers are required to either cover their
13 employees or to pay into a fund that will help pay
14 for coverage for their employees. The government
15 plays an important role. The government will set up
16 health care markets all across America, and in each
17 of those markets if you're the consumer, you can go
18 in and choose what your health care plan would be.
19 Some of the choices are private insurers,
20 and then one choice is a government plan, basically a
21 Medicare Plus plan. And the idea is to determine
22 whether Americans actually want a private insurer or
23 whether they'd rather have government run Medicare
24 Plus kind of single-payer plan. And we'll find out
25 over time which way people go.
1 This health care plan also covers the cracks
2 that exist in our health care system. It's complete
3 mental health care, there's coverage for chronic
4 care, coverage for preventative care, coverage for
5 long-term care. We subsidize health insurance
6 premiums for low income and middle income families.
7 That caps out at about $80,000 of income a year.
8 There are huge cost containment pieces in
9 this health care plan, the requirement of
10 preventative care. We require by competition lower
11 administrative costs. We're spending 30 to 40 cents
12 on each dollar, health care dollar today for
13 administrative costs. We've got to bring those down,
14 bring them down dramatically.
15 We require and demand the use of technology,
16 the use of electronic recordkeeping, both of which
17 are more efficient and help bring down health care
18 costs. And then we're going to the a systematic way
19 to measure what's working, what's the most effective
20 treatment, how do we get the most effective drugs,
21 the least costly drugs.
22 So the idea is cover everybody, bring down
23 health care costs for every single American, which
24 this plan I believe will do, fill in the cracks in
25 our health care system.
1 And the last responsible party besides the
2 employers and the government are individuals.
3 Everyone in America will be required to by law to be
4 covered by this health care plan. And the last thing
5 I'll tell you is the cost is 90 to $120 billion a
6 year. That's the government's cost. And I pay for
7 it by rolling back George Bush's tax cuts. Thank you
8 all very much.
9 KAREN TUMULTY: Thank you, Senator. And
10 especially after the week that you and your family
11 have had, we so appreciate you being here, and of
12 course everyone's best wishes and prayers go to your
13 family in support of Mrs. Edwards.
14 Of all the candidates that we're going to be
15 hearing from today you are the only one who has a
16 detailed specific plan as to how you're going to get
17 the universal coverage. And you have been candid
18 enough to say that it involves tax increases.
19 But one of the reasons you have said that
20 you feel so strongly about being specific on health
21 care, and you were much more cautious when you ran in
22 2004, is the personal experience that your family has
23 been through with Mrs. Edwards' illness.
24 And so you on that score, as you had a big
25 decision to make this week, you made it very quickly,
1 but as people look at the situation you are in, that
2 you and your family are in, the fact that you are
3 trying to do two all consuming things here at once,
4 and that however positive the course of this
5 treatment turns out to be, there are going to be a
6 lot personal ups and downs for you over the next year
7 and a half.
8 How are you going to be able to manage both
9 of those, and what do you say to people who are
10 thinking about supporting you, are thinking about
11 contributing to your campaign that are really worried
12 about your ability to take care of two all consuming
13 things at one time? Will you be in this race for the
15 JOHN EDWARDS: Oh, I'm definitely in the
16 race for the duration. What is shows from our own
17 personal experience, this is not the first challenge
18 like this Elizabeth and I have been through. As many
19 of you know we lost our son about ten, actually about
20 eleven years ago now in 1996. And we've gone through
21 Elizabeth's first round of breast cancer treatment.
22 We went through that together.
23 So we know what it's like to function in a
24 very difficult environment. And there is a focus and
25 a maturity that I think is requires to be able to do
1 that, but I know, because I've done it in the past
2 that we can do it. I know because of the nature of
3 woman I'm married to that she will be there ever
4 single step of the way making sure that we do it.
5 And we take our responsibility to serving
6 this country very seriously. And it is the reason
7 I'm running for president because I love this
8 country. I think we can do so much better than we're
9 doing now. And we want to serve, both of us, which
10 is why we made the decision to go forward.
11 But I want to add one thing, because there's
12 been an awful lot of attention focused on the two of
13 us, and I think we're getting far too much credit.
14 When you look at all the millions of women who had to
15 struggle with the same sort of struggles that
16 Elizabeth has had, and many of them had to struggle
17 without what we have, without great health care
18 coverage, without knowing they're going to be able to
19 get all the medicine and medications that they need.
20 One of the reasons that I want to be President of the
21 United States is to make sure that every woman and
22 every person in America gets the same kinds of things
23 that we have, because it's not right that a woman has
24 to go through, or anybody has to go through this kind
25 of struggle and have to worry about whether they can
1 afford the medicine they need, whether they can get
2 the health care that they need. We don't have to
3 worry about that.
4 And no American should have to worry about
5 that. And as Elizabeth said just a couple of days
6 ago, you know, for us, we can focus on what needs to
7 done for our family and for our country, but a lot of
8 women with exactly the same diagnosis had to get up
9 the next morning and go to work and the next morning
10 and go to work. So before we start giving too much
11 credit to us, let's do what we need to do for all of
13 KAREN TUMULTY: Thank you, Senator. One of
14 the criticisms of your plan has been that it
15 doesn't -- it's not aggressive enough in dealing with
16 health care costs. You talk about saving money
17 through preventative care, through using technology
18 that is available but that really isn't being a lot
19 in the health care industry.
20 But right now I'd like to turn to one of the
21 members of our audience, a Jackie Marco, who is the
22 owner of a small business who wants to know how you
23 are going to -- how are you going to come to grips
24 with the kind of rising health care costs that he has
25 to deal with every day and that threaten his
1 business. And, Jack, are you here?
2 JACK MARCO: Yes, I'm a business that just
3 completed our collective bargaining agreement with
4 our employees. And for the last 20 years we've
5 provided health insurance for them, and every year it
6 becomes more difficult.
7 And because in the process when it came down
8 to talking about wages, we had to offer less and the
9 employees had to accept less than they would like or
10 we would like to give because of the money we had to
11 pay off on health care.
12 At the same time I had to compete in an
13 industry with other people doing the same kind of
14 business I do. So the cost that I have for my 75
15 employees compared to another firm means that I have
16 to pay -- I have to charge higher fees for the
17 services I provide; and likewise, I have to
18 provide -- I can only provide a certain level of
19 wages that perhaps a competitor could provide more
20 because they don't provide health insurance. So my
21 question is as the President what would you do to
22 take care of this competitive problem?
23 JOHN EDWARDS: Did you say you have 75
25 JACK MARCO: Correct.
1 JOHN EDWARDS: 75. Well, first of all, I
2 think that this plan deals directly with the concerns
3 that you have. We have a competitiveness issue not
4 only between you and your competitors here in
5 America, we have a huge competitiveness issue, if I
6 can say the word, between our businesses in America
7 and the rest of the world.
8 We have extraordinary health care costs,
9 which you're dealing with every single year in the
10 operation of your business. Those costs have to come
11 down. But in addition to that, what we want is if we
12 have a truly universal health care plan that covers
13 every single American from the time they're born
14 until the time they die. It makes American business
15 more competitive in the world.
16 We're spending 17, $1800 on health care
17 costs on every car that's manufactured in America,
18 compared to about $250 in Japan. Creates a huge
20 What this plan specifically does for your
21 situation is it gives you market power that you don't
22 have today. I mean, individuals in small businesses
23 have no market power, and as a result you pay
24 extraordinary health care costs.
25 So what we do is we set up these health care
1 markets is we create the same market power for you
2 that exists for the biggest corporations in America.
3 These markets will require competitive bidding to get
4 into the markets, and also these private insurers are
5 going to have to compete with the government plan
6 with extraordinary low administrative costs, two,
7 three percent in all likelihood. So that competition
8 will bring down costs.
9 In addition to that, these things that Karen
10 just made mention of, use of technology, electronic
11 recordkeeping, preventative care, mandatory
12 preventative care so that we are healthier, we are a
13 well people will bring down costs for everybody.
14 So I think sort of the bottom line for you
15 is we will bring down health insurance costs on the
16 whole for what you have to pay. Second, your cost
17 directly will be lower because there will be a level
18 of competition that does not exist today, and you
19 will have the market power that does not exist today.
20 I actually believe that besides the
21 uninsured I think we have a moral obligation to,
22 besides the uninsured the people who benefit the most
23 from this health care plan are individuals and
24 smaller businesses. I think that's the greatest
25 beneficiary of this plan.
1 KAREN TUMULTY: Senator, the health care
2 problem has been with us for a very long time. The
3 last time a significant effort was undertaken to
4 address it it never even got to a vote on the floor
5 of either House of Congress because of so many fronts
6 of opposition. And of those the most important I
7 think the strongest was business.
8 So we have a question coming in over e-mail
9 from Mary in Illinois who wants to know do you have a
10 strategy for engaging American businesses in
11 achieving health care coverage for all Americans?
12 JOHN EDWARDS: Yes, because what we want to
13 do is we want to make American business competitive.
14 We want to bring down the cost of health care, not
15 just for individuals, which we do, but also for
16 American business.
17 And so this plan does all those things. We
18 just talked about it in the context of a small
19 business, but it actually applies to all businesses.
20 What happens is because we're bringing -- there are
21 huge cost containment elements in this plan, which I
22 won't go through again, I've gone through it. And
23 because we are subsidizing health insurance premiums
24 for low income and middle income families this has
25 the effect of bringing down health care costs for all
2 The SEIU and Andy Stern had a press
3 conference a few weeks ago with some very large
4 American businesses who were committed to achieving
5 universal health care, which is a very good thing.
6 And what I believe that actually American businesses
7 have now figured out that something has to be done
8 about our health care system that is making them
9 increasingly uncompetitive with respect to the rest
10 of the world, and that universal health care, done
11 the right way, with the right choices and the right
12 efficiencies, will actually help American businesses
13 not just help the 47 million people who don't have
14 health insurance.
15 KAREN TUMULTY: Well, there are going to be
16 candidates who come out here today who suggest that
17 it's possible to do this, to achieve universal
18 coverage without raising taxes, without new sources
19 of revenue. You have been very up front about the
20 fact that your plan does involve tax increases. Do
21 you think it's possible to get their without them?
22 JOHN EDWARDS: No, I do not. I spent a
23 great deal of time studying this issue, working with
24 health economists around the country. I've spent
25 many months on this. The plan just came out a few
1 weeks ago, my plan just came out a few weeks ago.
2 I've spent a great deal of time working on this
4 I do not believe you can have universal
5 health care without find a source of revenue. There
6 has to be some additional source of revenue. We
7 don't get universal health care for free. You have
8 to cover 47 million people who don't have coverage.
9 There's going to be a cost associated with the
10 transition from the health care system we have today
11 to a truly universal and more efficient health care
13 So, no, I do not believe it can be achieved
14 without finding an additional source of revenue. And
15 the joke I always make about it is that American
16 people have heard so many politicians for so long
17 say, Oh, we're going to have universal health care,
18 we're going to transform the way we use energy in
19 America, we're going to end poverty in America, and
20 in process we're going to eliminate the federal
21 deficit. They probably got a bridge in Brooklyn they
22 want to sell you too.
23 I don't think it could be done. I think
24 it's very important, if I could say one last thing
25 about this, I think it is really important,
1 particularly given what's happened in the last six,
2 seven years in this country, that the President of
3 the United States be honest with the American people.
4 And I also think that honesty starts right here in
5 the campaign.
6 KAREN TUMULTY: And if you were putting
7 together your health care plan, there are people who
8 argue that the whole idea of basing your health
9 coverage on where you work is just an anachronism.
10 It's a historical accident.
11 JOHN EDWARDS: Yes.
12 KAREN TUMULTY: You, however, chose to build
13 on that system. Why is it that you didn't, as some
14 people suggested, why did you reject the idea say of
15 government run Medicare for everybody or some other
16 form of health care that would again get rid of a
17 system that is essentially a historical accident.
18 JOHN EDWARDS: Well, there's a judgment that
19 has to be made on the front end. It is true that
20 single-payer health care systems in the world
21 dramatically reduce costs and significantly reduce
22 administrative costs, particularly compared to
23 private insurers.
24 It's also true that a lot of people who are
25 listening to this forum like the health insurance
1 they have now and would like to keep it. And my
2 judgment is, number one, to get it done so that we
3 don't spend another decade arguing about whether we
4 keep the system we have now or actually have
5 universal health care.
6 I think this is system, my proposal, a truly
7 universal plan, a bold plan, but doesn't go directly
8 to single-payer, can be accomplished. I think it can
9 be accomplished politically. I think we can get
10 support from across the political spectrum and will
11 accomplish a lot of what we want to do.
12 Second, it does give people choice. And I
13 think Americans have become accustomed to having
14 choice, and I think they want to be able to choose
15 what their health care plan is.
16 Now, it may be that that gravitates towards
17 a single-payer plan because they will have the
18 Medicare plus the choices. And if that's the case,
19 then the whole system can go in that direction. But
20 you'll decide that. Consumers will decide that.
21 So I think actually this plan makes sense in
22 terms of moving us forward, getting a universal
23 health care plan in place, giving people the choice
24 of the equivalent of a single-payer plan with
25 Medicare Plus, and then we'll see where it goes from
2 KAREN TUMULTY: I think he have time for one
3 more question from the audience, and this is on a
4 subject that's very near and dear to a lot of SEIU
5 members. Reggie Warner is an RN from UHS Desert
6 Springs Hospital. Are you here?
7 REGGIE WARNER: Hi, I'm Reggie Warner. I'm
8 a new nurse at UHS Desert Springs Hospital. I see
9 what happens to patients every day in the hospitals
10 because of short staffing. And I also see what
11 happens to nurses who leave the hospital because of
12 job burnout and overall dissatisfaction. What do you
13 plan on doing for state staffing and nurse retention?
14 JOHN EDWARDS: Well, we have a huge nursing
15 crisis in America, which obviously you know about
16 firsthand. I think a part of that crisis is dealt
17 with by achieving a truly universal health care
18 system where everyone gets reimbursed at a fair rate
19 for the services they're providing. And in the
20 context of achieving this universal health care
21 system, we can regulate in a way that requires the
22 staffing be adequate.
23 What we're seeing now, as you know, nurses
24 working extraordinary -- nurses, who are the primary
25 caregivers in a hospital, certainly in a hospital
1 setting, they spend a lot more time with the patients
2 than physicians do, and in many cases they're
3 stressed, they're working long hours and they're
4 terrified, as you know, because I hear it every time
5 I talk to a nurse, they're afraid that the results of
6 all this is they're going to make a mistake, and the
7 patient is going to be the one who suffers.
8 So I think we need to, in addition to having
9 a truly universal system, in addition to regulating
10 in a way that keeps staffing at an adequate level,
11 which is much easier to accomplish in the context of
12 a universal health care system.
13 I think in addition to that we, as a nation,
14 need to make a commitment to beef up our availability
15 of nurses, which means more investment, more
16 scholarships in nursing schools. It means providing
17 incentive to get nurses who have graduated to the
18 places where they're needed the most where the
19 nursing shortage is most severe. In other words,
20 incentive pay, some help from the government to help
21 attract nurses to go to the places where they're
22 needed the most. And then create a working
23 environment that allows nurses to be the
24 professionals that is they so desperately want to be.
25 KAREN TUMULTY: That's our time, Senator
1 Edwards. And, again, thank you very much for being
2 here, and best wishes going forward.
3 JOHN EDWARDS: Thank you. Thank you all
4 very much.
5 KAREN TUMULTY: The next candidate that we
6 are about to hear from is a neighbor, Governor Bill
7 Richardson of New Mexico.
8 BILL RICHARDSON: I want to thank SEIU and
9 the Center for America Progress for putting this
10 event together. And my first thoughts and Barbara,
11 my wife's first thoughts today are for Elizabeth
12 Edwards and the Edwards family in this very trying
14 And if there's one message about policy
15 message related to this situation is that as
16 Americans we should spend more, invest more in cancer
17 research and the National Institute of Health and
18 many of our entities that are underfunded and with
19 flat budgets. We should invest more in stem cell
20 research. We should find ways to invest in the
21 diseases in this country.
22 We, as Americans, are in crisis today. As a
23 governor I have to deal with the health care crisis
24 every day. We got a problem with increasing access,
25 coverage and controlling costs. Since the year 2000,
1 health care premiums have increased for American
2 families about 80 percent. 4,000 Americans lose
3 health care coverage every day. We spend $2 trillion
4 on health care. 31 percent of health care costs are
5 spent on bureaucracy and red tape instead of direct
7 It is critically important that we device a
8 strategy, first of all, that doesn't create any more
9 bureaucracy we have enough bureaucracy. As a
10 governor I've been able to control costs. I've even
11 cut taxes for working families and at the same time
12 expended coverage.
13 So what would I do as a President? First,
14 to deal with increasing coverage; number one, all
15 Americans and all businesses should have the same
16 coverage, should be able to purchase coverage as
17 members of Congress and the President of the United
18 States. We need to do that and we need to do that.
19 Number two, I would start something new.
20 Americans 55 and older should be able to purchase
21 coverage through Medicare. Today it's at 65.
22 Number three, a trade. And this is how a
23 governor would operate. The federal government,
24 Medicare goes to treat seniors and the disabled. In
25 exchange for the state dealing and increasing
1 Medicare coverage for children and families.
2 And number four, veterans. We should give
3 our military veterans the access they need anywhere
4 they want, any time they want. And I would have a
5 heroes health card that would enable our veterans
6 when they get out to get coverage choices anywhere
7 they want. They should not have to drive 200 miles
8 to the nearest VA hospital.
9 Now, this is how I would deal with coverage.
10 What about costs? I would have a cooperative plan
11 between the employer, businesses, the state and the
12 federal government. I would propose a refundable tax
13 credit for those Americans that need coverage based
14 on income.
15 Number two, I would clamp down on credit
16 card companies that are covering excessive interest
17 rate costs. I have a health secretary who her
18 brother is paying 18 percent. A lot of Americans pay
19 their health care through credit cards. 18 percent
20 interest rate. I would put a cap on those costs.
21 I would also make sure that we have a
22 prevention strategy, early prevention, kids. As a
23 governor I eliminated junk food in schools. I just
24 signed a statewide smoking ban and I would that as
25 president. I would have a promotion of healthy
1 lifestyles. Gave tax credits to companies that
2 encourage their workers to be healthier, to
4 I would also make sure that we have a
5 strategy to deal with a 31 percent of excessive
6 health care costs and bureaucracy by electronic
7 records. I would also find ways to ensure that we
8 have an answer, how do we pay for this? This is how
9 I would pay for this health care plan.
10 Number one, we reorder priorities in this
11 country. We get out of Iraq and put the $400 billion
12 that we have in Iraq and shift it to human needs.
13 Number two, we spend 2 trillion on health
14 care. We shift and reorder priorities in terms of
15 reducing inefficiencies in our system.
16 And number three, we would offer options for
17 all Americans to get health care coverage. Workers
18 must get health care coverage. But you help them.
19 But you help them if they need it. And businesses.
20 And small businesses have to participate in health
21 care plans for all those employees.
22 That's what I would do as President. This
23 is a plan that would not add bureaucracy. This is a
24 plan that could be paid for without any new taxes.
25 This is a plan I believe that says to the American
1 people, if I have a health care plan and I'm
2 satisfied with it, I could keep it the way it is.
3 I believe also that as Americans we have to
4 ensure prevention. That is so important. Making
5 sure that we start early, making sure that we promote
6 healthy lifestyles. That would be my plan as
8 KAREN TUMULTY: Governor, I'm afraid if
9 you're attacking junk food you've already lost my
10 ten-year-old's vote.
11 So how quickly under your plan do you think
12 you could get to true universal coverage?
13 BILL RICHARDSON: I believe with a
14 Democratic President, a Democratic Congress, a
15 stronger Democratic Congress I believe this plan that
16 I outline, which is basically a plan that is taking
17 new ideas into an existing framework could be
18 achieved my first year as President. I believe it's
20 I believe what you're talking about is a
21 shift in laws, for instance a trading of the federal
22 role in Medicare, the state role in Medicaid for
23 S-chip in children. I believe what we're talking
24 about too is within the cost structure, when you're
25 spending 2 million on health care, remember they are
1 47 million uninsured in this country, and we're
2 already paying for it. It's already being paid for.
3 They're in emergency rooms. We're all paying for
5 So it's a question of shifting priorities.
6 So what we're talking about is I believe a very
7 aggressive plan with new ideas that could be achieved
8 the first year that I'm President.
9 KAREN TUMULTY: You know, as Washington has
10 failed to address this problem you and your fell
11 governors have moved forward and stepped into the
12 breach; however, one of the most controversial
13 aspects of the plan that Governor Schwarzenegger just
14 recently unveiled in California is his proposal that
15 illegal immigrants be covered under his plan. How
16 would you see under your plan bringing in this very,
17 very large segment of the population into the system
18 or not?
19 BILL RICHARDSON: They're children. We
20 should cover children. We should cover children, as
21 long as they pay their fair share with everybody
22 else. An essential component of my plan is that we
23 all pay: Employers, employees, the government. But
24 we help each other pay the fair share.
25 The way you deal with immigration, one, yes
1 we have to secure our borders, no question about it.
2 Not with this stupid wall that is being proposed.
3 But you also set up a legalization plan for the 12
4 million undocumented workers that are in this
5 country. Maybe it's not very popular, but it makes
6 sense based on setting a path to legalization that
7 involves dealing with issues like health care that
8 involves if they learn English, if they pay back
9 taxes, if they pass a background check. They don't
10 get ahead of the line of those that are trying to get
11 her legally. These are children. We should insure
12 all children in this country.
13 KAREN TUMULTY: We have a question from
14 David Slater in our audience, who's taken a look at
15 the kind of health care that Congress gets and wants
16 to know why he can't have it too.
17 DAVID SLATER: The governor brought up, back
18 to my question, all members of Congress, Senators,
19 staff, postal workers are all in a great plan
20 sponsored by the federal government. I was in that
21 plan. I'm a retired postal worker. It's a fabulous
22 plan. Why reinvent the wheel? We already have an
23 existing system that can function. We don't need any
24 more bureaucracy, as you mentioned, just implement
25 that plan to everybody here in this room with
1 everybody a U.S. citizen to have the same plan. As
2 Senator Edwards said, he's comfortable. Every
3 federal worker is very comfortable in that plan.
4 Every postal worker has that plan. They have an
5 option to pick from any insurance company they want.
6 Why not just give it to the United States citizens
7 right now? And the governor says that's something I
8 can't believe can be implemented within one year.
9 BILL RICHARDSON: Well, look, that's the
10 cornerstone of my plan that deals with coverage. In
11 other words, you know, the members of Congress, the
12 President, they get the best plan in the world. They
13 have all kinds of options.
14 What I'm saying is offer that to every
15 American, to every business, to every American Family
16 in that federal health care system. I totally agree
17 with you. It's an excellent question. Thank you.
18 KAREN TUMULTY: We also have a question by
19 e-mail from Ken in Olympia, Washington who wants to
20 know how do you feel your experience as governor of
21 New Mexico has prepared you to find solutions for the
22 rising cost of health care and to achieve the goal of
23 affordable health care for all.
24 And if I can just add on to that, could you
25 talk a little bit about, you know, what you've
1 learned, what parts of the problem, the health care
2 problem in dealing with it in New Mexico turned out
3 to be harder to confront than you thought they were
4 going to be?
5 BILL RICHARDSON: As a CEO of a state
6 governors have to deal with this issue every day.
7 And the most I believe innovative programs in this
8 country are happening in the states in experiments to
9 cover our people, all our people and also control
11 As a governor, my approach has been, and my
12 state is one of the highest uninsured, it's about 20,
13 21 percent. Ten percent of those are Native
14 Americans that are supposed to be covered by a
15 federal health care system, and they're not. But the
16 federal government is abdicating. So we try to help
17 with state programs.
18 What we need to do and is what we do in the
19 state. I started out with a health care plan dealing
20 with this access issue. Number one, we were able to
21 insure all children under five. Now we're trying to
22 cover all working adults. The next phase will be try
23 to cover the chronically unemployed.
24 But we have attacked the prevention issue
25 aggressively, as I mentioned. We cut junk food out
1 of schools. I signed recently last week a statewide
2 smoking ban. We should nationally give incentives to
3 companies that give their health care workers time to
4 exercise or an opportunity to build a healthier
6 We should find ways also that in the
7 American system we encourage the American people to
8 start earlier, early childhood, preschool. This is
9 so important. School based health centers at all our
10 schools. But also recognize that it's going to take
11 research. It's going to take efforts, aggressive
12 efforts to deal with deadly diseases, to deal with
13 malaria, to deal with issues that relate to suicide
14 prevention for children, to deal with issues that
15 relate also for children that have sickle cell anemia
16 or diabetes prevention.
17 We don't focus enough on prevention. And
18 prevention, we spend 75 percent of health care costs
19 on chronic diseases and only five percent on
20 prevention. That should shift.
21 KAREN TUMULTY: We also have a question from
22 another SEIU member in the audience, Tracy Powell,
23 who works for the Department of Family and Services
24 in Clark County and is really on the front lines
25 every day of seeing another aspect of the health care
2 TRACY POWELL: Good morning. I am a social
3 worker for Clark County Department of Family Services
4 and a member of SEIU. On a daily basis we see how
5 mental health services and substance abuse issues
6 impact children and families.
7 Typically there's very limited resources for
8 mental health. How would you address the mental
9 health services and the care provided and coverage
10 provided for mental health services?
11 BILL RICHARDSON: Well, for years mental
12 health has been given lower priority in health care
13 than almost any other problem. One out of five
14 Americans has some kind of mental health problem,
15 including schizophrenia and depression. And for
16 years in terms of insurance and coverage we've
17 neglected mental health.
18 As President I would not do that. What we
19 did in New Mexico is we brought all mental health
20 bureaucracy programs under one roof into what's
21 called a mental health collaborative. And we need
22 aggressive efforts to include mental health in all
23 types of coverage. We need to find ways also that we
24 deal with substance abuse. You mentioned that.
25 In New Mexico and the west, and Nevada right
1 here, meth is the biggest problem, and we don't have
2 answers in terms of how we can best treat it. If
3 you're going to deal with substance abuse, mental
4 health problems, alcoholism, what is critically
5 important not just law enforcement incarceration, but
6 treatment and education, an investment in serious
7 substance abuse programs that can make things better.
8 KAREN TUMULTY: Governor, does that suggest
9 that you support full parody for mental health
10 coverage? Certainty your senior Senator of your
11 state, Pete Domenici, has been very outspoken who's
12 been a national leader on that very subject, but
13 opponents say, look, this is just going to, talk
14 about rising costs, the costs would just explode if,
15 in fact, mental health services were covered the same
16 way as physical health services.
17 BILL RICHARDSON: I would include mental
18 health services. Yes, I would. But, see, everybody
19 is talking about costs. What I'm saying is if we
20 manage our health care system more efficiently,
21 eliminate a lot of the duplication. Just think,
22 31 percent of our health care costs is bureaucracy
23 and red tape, and it's not direct care. If we find
24 ways to make that more efficient, with perhaps
25 electronic records, with, you know, you have 50
1 states managing 50 Medicaid programs. You've got a
2 Medicare system that has hundreds of health care
3 plans administering it. If you're able to find an
4 elimination of that bureaucracy and red tape and make
5 it more efficient, you would have that 31 percent go
6 more to direct care.
7 So those that say you need to increase the
8 tax, you need to find other sources of revenue, I
9 believe we can do it within the existing system and
10 cover all Americans and control costs and be fair.
11 But essential component of the plan that I learned is
12 that we have to be part of it: Employers, employees,
13 state, the federal government. It's a cooperative,
14 collaborative relationship catalyzed by the
15 government. Making health care universal coverage
16 something that we can do I believe, as I said, within
17 a year. I believe it's doable.
18 KAREN TUMULTY: Well, I think we have time
19 for one more question, and that would be so you
20 proposed basically building on the existing system
21 that we have and attacking this problem from a number
22 of different directions. Which one do you do first?
23 BILL RICHARDSON: Well, you have to do them
24 both at the same time. You have to control costs,
25 and you have to expand health care coverage. But I
1 propose, as you said, some new ideas within an
2 existing system. And the new ideas are the trade
3 between Medicare and Medicaid, what the states would
4 do. It has to be an exchange. We have to make sure
5 that the states do spend money on S-chip, on
6 children, on families.
7 And new initiative would be what this
8 gentleman proposed, and that is let all Americans,
9 businesses, families be part of the federal health
10 care system that the Congress enjoys, and with our
11 veterans. I mean, you're talking about a sizable
13 Give them access anywhere they want to go.
14 If it's two blocks from their home, they have to
15 drive miles and miles. This is all new within an
16 existing system. And then finally, just find ways to
17 ensure that the states and the federal government
18 have a cooperative relationship.
19 I'm a governor. It's very hard for us to
20 get waivers to do some of the experiments that are so
21 important to the SEIU, to the American people. The
22 bureaucracy strangles our system so much that a major
23 component has to be a way to tame the bureaucracy so
24 that it to works for people and not against people.
25 KAREN TUMULTY: Well, thank you very much,
1 Governor Richardson.
2 Our next candidate that we are going to hear
3 from this morning is Illinois Senator Barack Obama.
4 BARACK OBAMA: Well, thank you so much,
5 everybody. It is wonderful to be here. Thank you to
6 UNLV for helping to sponsor this event, to CAP for
7 the outstanding work you do, but most of all thanks
8 to SEIU.
9 I've got a history with this union. When I
10 was a young organizer I had just moved to Chicago. I
11 started with working with SEIU Local 880, home health
12 care workers to make sure that they were registered
13 to vote. I had a say in the politics in Illinois.
14 When I went to the state legislature I worked with
15 Tom Balanoff in SEIU to make sure that children who
16 didn't have health care received it. And we made
17 sure that hospitals to report on the quality of care,
18 the staffing ratios that they had set up, and now
19 we're working together at the federal level to make
20 sure that all Americans, not just some Americans, are
21 allowed to prosper.
22 But the thing that I appreciate most about
23 SEIU and Andy Stern and Anna Burger is you guys
24 recognize this world is not standing still. And
25 we've got to take the values that have made America
1 great but we have to adapt them to new times.
2 And we know what those challenges are.
3 Because of globalization, because of automation, what
4 we're seeing is increasingly a situation in which the
5 benefits of this new economy accrued to just some and
6 leave too many behind. Wages, salaries have flat
7 lined and benefits are diminished.
8 And the message that we've heard over the
9 last six years is, You're on your own. The troubles,
10 the difficulties, the burdens of globalization are
11 going to be placed on the backs of workers. But
12 there's always been another vision that says we're in
13 it together and that the burdens and benefits of this
14 new economy have to be spread evenly across the
15 economy, and nowhere do we see that more than in the
16 issue of health care.
17 Everybody here knows the statistics. We as
18 a nation spend $2 trillion every year, more than any
19 nation on earth, and yet we still have 47 million
20 people who are uninsured, 9 million children who are
21 uninsured. We've got families who are being bankrupt
22 as a consequence of rising costs and we've got
23 businesses that are being rendered uncompetitive
24 because of these rising costs.
25 Now, everybody on this stage is going to
1 have a plan to move this health care debate forward.
2 I will be putting out a plan over the next couple of
3 months that details how I would approach the basic
4 principals that by the end of the next President's
5 first term, by the end of my first term, that we're
6 going to have universal health care for every single
7 American in the United States.
8 And there are going to be some basic
9 principals; that coverage has to be universal, that
10 we're going to have to save costs and get more bang
11 for our health care dollar, that employers,
12 government and individuals are all going to have to
13 put up something, and that savings that we obtain
14 from making a more efficient system can be just
15 obtained by hitting front line workers.
16 But in addition to those basic principals I
17 think, what I think is most important is we recognize
18 that every four years we hear somebody has got a
19 health care plan. Every four years somebody trots
20 out a white paper, they post it on the web, but the
21 question we have to challenge ourselves is do we have
22 the political will and the sense of urgency to
23 actually get it done.
24 I want to be held accountable for getting it
25 done. I will judge my first term as President based
1 on the fact on whether we have delivered the kind of
2 health care that every American deserves and that our
3 system can afford. And I'm not going to be able to
4 do in on my own so I hope that the SEIU will partner
5 in that process. Thanks, everybody.
6 KAREN TUMULTY: Thank you, Senator. You
7 gave a speech in January where you said that the time
8 for half steps and the time for half measures and
9 health care is over with.
10 BARACK OBAMA: Right.
11 KAREN TUMULTY: But thus far we haven't seen
12 a plan from you yet and so I'm going to turn my first
13 question over to Morgan Miller who went on your
14 website looking for specific answers and didn't find
15 them, so I'm going to give him a chance to ask you
16 those specific questions now. Morgan?
17 MORGAN MILLER: I like many young Americans
18 went on your website to find some information about
19 you, and all I saw when it came to addressing the
20 health care issue was things like HIV, which is very
21 important, and issues like lead poisoning.
22 And so I was wondering what really are your
23 top issues when you want to talk about health care?
24 Are you going to address the pharmaceutical
25 companies? Are you going to address the insurance
1 companies, because it's not online.
2 BARACK OBAMA: Right. Well, keep in mind
3 that our campaign now is I think a little over eight
4 weeks old. And so we will be putting a very detailed
5 plan on our website.
6 One thing I want to make sure of is that
7 you're going -- I'm not sure whether you're going to
8 the campaign website or my Senate website. So we
9 haven't transitioned all that information from our
10 Senate website over to the campaign website.
11 But, as I indicated before, my commitment is
12 to make sure that we've got universal health care for
13 all Americans by the end of my first term as
14 President. There are some basic principles that this
15 plan will have.
16 Number one, we're going to have to make sure
17 that everybody is in.
18 Number two, we've got to make sure that we
19 apply some principles because I think every expert
20 agrees to in terms of how we save money and get more
21 out of the dollars that we're already spending. For
22 example, we've got to put more money in prevention.
23 It makes no sense for the children to be going to the
24 emergency room for treatable ailments like asthma.
25 And if we are giving them regular checkups with their
1 primary care physician, then we're going to save
2 money in the system.
3 Twenty percent of our patients who have
4 chronic illnesses account for eighty percent of the
5 costs. And so it's absolutely critical that we
6 invest in managing those with chronic illnesses, like
7 diabetes. If we, for example, hire a case manager to
8 work with them to ensure that they're taking the
9 proper treatments, then potentially we're not going
10 to spend $30,000 on a leg amputation if they're
12 Application of medical technology can not
13 only reduce administrative costs but it can also
14 improve quality and reduce medical errors. We're
15 going to have to take those savings and apply them to
16 those persons who can't afford health insurance so
17 that they can buy into the system that we're
18 subsidizing them in some fashion.
19 Another principal is that it's going to have
20 to be some form of pooling of costs of risk. And
21 there are going to be a number of proposals, and
22 they're out. I heard in some of the previous
23 questions that one pool would be the federal pool
24 that already exists for myself and other federal
25 workers. Some states, like California and
1 Massachusetts, already started to set up their pools.
2 Whatever the mechanism, we going to have to
3 have a pooling system so that individuals have the
4 benefits of being part of a larger group.
5 And the final thing that I'll just mention
6 is that we're going to have to do something serious
7 about quality and how we spend our money. Not only
8 do we have to put more money in prevention, but we've
9 also got to make sure that, for example, if a generic
10 works just as well as a brand name drug, that we're
11 not fighting drug companies to dictate what is on the
12 formulary, what drugs are available under a plan but
13 we make sure that the money is spent on the most
14 efficient drug for that particular disease.
15 If we do all those things, I believe there's
16 no reason why we can't end up with the kind of health
17 care system that would ensure that every American has
18 high quality, basic health care. Now, I promise you
19 that this will all be on the website. If we have
20 another forum in a couple of months and it's still
21 not there, I'll be in trouble.
22 KAREN TUMULTY: Senator, on the question
23 that is really the lynchpin of all these other
24 questions, which is coverage, there are only a few
25 ways of getting there. Could you at least give us a
1 sense of where you're thinking is on this? Have you
2 accepted or rejected any of the concepts like an
3 employer mandate or require that employers provide
4 coverage? An individual mandate where people would
5 have to buy into the system they way they do with
6 auto insurance? Are you wedded, for instance, to
7 this idea as the first two candidates were that we
8 basically should stick with this system in which most
9 people get their coverage from their employers or
10 have you found any positives to the idea that's being
11 offered by your colleague, Ron Wyden, to essentially
12 break that system and come up with a new one? Could
13 you at least give us a sense of, you know, which
14 possibilities here intrigue you and which ones that
15 maybe you're dismissing at this point?
16 BARACK OBAMA: Well, we have a plan that we
17 are in the process of unveiling. What we want to do
18 is try to set up a series of round table discussions
19 before we actually announce it. Not just with
20 experts, which we've already done, but rather with
21 frontline workers, with nurses, with doctors, with
22 consumers, which we're going to be scheduling over
23 the next couple of month in terms of rolling it out.
24 But let me just address a couple of points.
25 As I indicated before, I think that we're going to
1 have to some system where people can buy into a
2 larger pool. Right now their pool typically is the
3 employer, but there are other ways of doing it.
4 I would like to -- I would hope that we
5 could set up a system that allows those who can go
6 through their employer to access a federal system or
7 a state pool of some sort. But I don't think we're
8 going to be able to eliminate employer coverage
9 immediately. There's going to be potentially some
10 transition process. I can envision a decade out or
11 15 years out or 20 years out where we've got a much
12 more portable system. Employers still have the
13 option of providing coverage, but many people may
14 find that they get better coverage, or at least
15 coverage that gives them more for health care dollars
16 than they spend outside of their employer. And I
17 think we've got to facilitate that and let
18 individuals make that choice to transition out
19 employer coverage.
20 I do believe that employers are going to
21 have to pay or play. I think that employers either
22 have to provide health care coverage for their
23 employees or they've got to make a decision that
24 they're going to help pay for those who don't have
25 coverage outside the employer system. So I think
1 that's one important principle.
2 And as I said, the second important
3 principle is that we're going to have to put more
4 money into prevention, more money into chronic care
5 management, more money into medical technology,
6 because that is how we're going to accrue the savings
7 that help us provide subsidies to those who don't
8 already have it.
9 KAREN TUMULTY: Now I think I'd like to turn
10 to a question from one of our UNLV students who's
11 here, and I'm not going to make the mistake as I did
12 with Morgan and assuming this is a male. Michael
13 Lyle is a journalism student, and I probably ought to
14 talk to you afterwards about the wisdom of that. Are
15 you here, Michael?
16 MICHAEL LYLE: Yes. Currently there are
17 major disparities in both access to insurance and
18 health care for racial and minorities. How will your
19 plan address this issue?
20 BARACK OBAMA: Well, one of the biggest
21 reasons that there are disparities is that African
22 Americans, Latino Americas are much more likely not
23 to have health insurance. And so if we set up a
24 system in which everybody's got health insurance,
25 some of those disparities are immediately going to be
2 And I'm sure one of the statistics that's
3 already been mentioned is that close to 80 percent of
4 those without health insurance works. They are in
5 some cases actually folks who are working in the
6 health care system but don't have health care
7 benefits. And they're cleaning bed pans and, you
8 know, cleaning floors in hospitals and, you know,
9 unfortunately don't have access to the same system
10 which they're a critical part of. So those groups
11 are disproportionately minority. That would be the
12 first step.
13 There are some particular issues within the
14 minority community that I think we can address in a
15 targeted way. Morgan earlier mentioned the issue of
16 lead paint. Now, that may seem like ancillary issue
17 except for the fact that in cities like Chicago the
18 incidence of lead poisoning among African-American,
19 Latino youths is sky high. It has huge ramifications
20 in terms of their long-term health.
21 Obesity and diabetes in minority communities
22 is more severe. And so I think targeted programs,
23 particularly to children in those communities, to
24 make sure that they've got sound nutrition that they
25 have access to fruits and vegetables and not just
1 Popeye's, that they have decent spaces to play and
2 outdoor activities instead of just being couped up in
3 the house all day.
4 Those are specific areas where I think we
5 can target the minority communities. And we've
6 already mentioned HIV AIDS. The incidents is
7 growing, is much higher in poorer populations, and
8 those tend to be minority populations. And so making
9 sure that we're putting money into HIV and AIDS in
10 those communities I think would make an enormous
12 So there are going to be areas where we
13 target specific problems that plague minority
14 communities in particular. But the most important
15 thing that we can do is make sure that every single
16 person has coverage, every single person has access
17 to basic primary care and preventative care. If
18 we're doing that, we're going to see those
19 disparities close significantly.
20 KAREN TUMULTY: Now we have another question
21 by e-mail from Wendy in Oakview, California. And she
22 wants to know as a single mother who meets the bills
23 but not much more I fall through the cracks making
24 too much for state assistance but not enough to
25 afford health insurance. So what will you do for
1 people like me?
2 BARACK OBAMA: Well, I think that is the
3 group that I just referred to. Working people aren't
4 getting benefits on the job, don't qualify for
5 Medicaid. And we're going to have to provide them a
6 subsidy so that they can access health insurance.
7 It's pretty straightforward. If you're working full
8 time in the economy, there's no reason why you should
9 not be able to access health care.
10 And one thing that I think is important is
11 to recognize that there are a lot of small employers
12 who would like to get health care for their workers
13 but they themselves can't afford it because they
14 don't have access to large enough pools to allow them
15 to save money.
16 That's why I think it's going to be
17 important for us in whatever system that we set up to
18 make sure that in addition to the employer based
19 system that we've got an alternative system that
20 individuals who aren't getting it through the job can
22 Now, I just have to repeat something I said
23 earlier. And I'm absolutely convinced of this. The
24 most important challenge for us is to build a
25 political consensus around the need to solve this
1 problem. There are only a handful of options. You
2 mentioned some of them that are out there.
3 John Edwards has put out a plan which I
4 think is very credible. Hillary Clinton has been
5 working on this for a long time. I was listening to
6 Governor Richardson. He's got some good ideas.
7 Everybody is going to have some good ideas, the
8 question is are we able to bring a majority of people
9 together around the need to solve the problem now.
10 And one thing that makes me feel more
11 optimistic about this than I might have been ten or
12 twelve years ago is the fact that business is feeling
13 the pinch. You know, large corporations recognize
14 that they can't be competitive on the international
15 stage if their health care costs are rising at a
16 constant clip and their competitors don't have to pay
17 any health insurance because it's all covered through
18 a government system.
19 Small businesses know that their employees
20 are not going to as productive if they don't have
21 health insurance. So what I think is an enormous
22 opportunity for the next President is to bring
23 business, labor, consumers, providers together and
24 stay focused on it for a year, two years, however
25 long it takes to make sure it happens.
1 KAREN TUMULTY: Well, and one more question.
2 We have time for one more question, and so I realize
3 that your plan is still a work in progress. We heard
4 some disagreements on this stage already today about
5 whether it is possible to do this without raising
6 more taxes. Have you come into this with a
7 particular perspective on this or are you going to
8 put taxes on the table or take them off now?
9 BARACK OBAMA: I think that we're going to
10 have to put some money on the front end into creating
11 a new system. Let me just take a simple example.
12 If we're going to be serious about using
13 medical technology to cut down on the administrative
14 costs, bureaucracy, make sure that we don't have
15 every signed in triplicate every time you go into a
16 hospital, if doctors and nurses and pharmacists are
17 communicating effectively through PDAs instead of
18 writing scribbled notes that nobody can read, if we
19 do all those things, there are a lot of community
20 hospitals out there that may not afford, may not be
21 able to afford the computerization and the software
22 system to set that up, and we may need to subsidize
24 So we're going to have to put some money in
25 on the front. I think that we can by making the
1 system more efficient get a lot of money out of the
2 system and use that to help subsidize workers who
3 have it and to improve the efficiency of the system.
4 I haven't yet made a decision in terms of
5 how much additional money is going to be needed to
6 meet my goal of ensuring that universal health care
7 exists in this country within six years. I can tell
8 you that I will do whatever it takes, because I think
9 over the long-term it's good for families, it's good
10 for business, it's good for the country.
11 So I have not foreclosed the possibility
12 that we might need additional revenue in order to
13 achieve my goal, but I think we shouldn't
14 underestimate the amount of money that can be saved
15 in the existing system. And I think also it's
16 important to recognize that we may be putting in some
17 front end investments, we may have to spend several
18 extra billion dollars on the front end as we
19 transition to a more intelligent system. We will get
20 those savings on the back end.
21 Although one last point that I would make, I
22 want to make sure that those savings go into the
23 pocket of families and not just insurance companies
24 or drug companies. That I think is very important.
25 So one of my priorities is to create a more
1 efficient system. Whatever the mechanism is, I want
2 to make sure that families are seeing lower premiums,
3 lower co-payments, and also that health care
4 providers are not getting squeezed in this process of
5 making more efficient.
6 I get most disturbed when I start hearing
7 the best way to save the system is basically to cut
8 reimbursements to hospitals or cut reimbursements to
9 doctors or, you know, stop giving raises to nurses or
10 have nurses work 10, 12, 15 patients or 20 patients.
11 That's not really saving the system, all that's doing
12 is just compounding some errors we've already made in
13 the system, okay.
14 KAREN TUMULTY: Thank you very much,
16 BARACK OBAMA: Thank you very much. I
17 appreciate it. Thank you, guys.
18 KAREN TUMULTY: The next candidate that
19 we're going to hear from this morning is Senator
20 Hillary Rodham Clinton.
21 HILLARY CLINTON: Well, hello, everyone. I
22 am so happy to be here and to be part of this today.
23 First I think we all want to make sure to send our
24 thoughts and prayers to Elizabeth and John Edwards.
25 I'm very impressed by Elizabeth's strength and
1 optimism, and I'm looking forward to seeing both
2 Elizabeth and John on the campaign trail going
4 And I want to thank you UNLV for hosting
5 this. It's great to be here and to be in one of
6 early caucus states. And I want to thank CAP, the
7 Center for American Progress, for that CAP is doing
8 to put health care in the agenda for America.
9 And I especially want to thank SEIU. I want
10 to thank you for not just talking about health care
11 but actually representing people who provide health
12 care and take care of all of us across the country.
13 I want to thank Andy Stern for being a leader, a
14 visionary leader on this. And I especially want to
15 thank all of my New York state 1199 SEIU members who
16 I am proud to work with every single day.
17 Now, you know, I feel a little bit like this
18 is deja vu all over again. I mean, I worked with
19 some of you all those years ago when we tried to
20 convince the country and the Congress, we convinced
21 the country but we didn't convince the Congress, that
22 we needed for the sake of our country to move toward
23 and achieve universal health care coverage.
24 Now I am proud we tried. We may not have
25 succeeded but we set the groundwork in place so that
1 now people are saying, boy, we wish we had done that
2 back then. Because costs have continued to increase.
3 Pressures on the system, on our doctors, our nurses,
4 our health care workers have just been so stressful.
5 I meet nurses every day who tell me they're
6 thinking of quitting the profession they love because
7 they are having to work overtime. They now have two
8 nurses covering where four or five used to cover.
9 They're not being given the support they need. And
10 each one of you could tell me a story like that.
11 So what we need to do is to make a
12 commitment. And I'm proud that everyone running on
13 the Democratic side is committed to universal health
14 care coverage.
15 Now, we were only given three minutes. Some
16 of you know I could talk three hours or three days
17 about health care but let me just briefly say, number
18 one, I am in favor of universal health care coverage
19 that brings in the 47 million who are uninsured,
20 which is a disgrace in our country to have millions
21 of people who are left out of the system that begins
22 to guarantee coverage to people who already have
23 insurance, because let's not kid ourselves, there are
24 a lot of people who think they have insurance except
25 when they need it.
1 I met a woman in Austin, Texas last week who
2 said, I'm a teacher, Senator, I make $38,000 and I
3 have insurance through employer, but last year I
4 spent $19,000 out of my pocket, half of her income,
5 because she had a preexisting condition.
6 So we can't get universal health care
7 coverage unless we end insurance discrimination once
8 and for all. Now, I don't want to wait until I'm
9 President to do that. I'm going to introduce
10 legislation while I'm in the Senate to end insurance
11 discrimination. Guaranteed coverage. No more cherry
12 picking. You cannot eliminate people on the basis of
13 preexisting conditions because that's what we need
14 insurance for, and, you know, we've now met the human
15 gene O. We're going to find out we're all
16 susceptible to something. So none of us are going to
17 be insurable if we don't change this system. And I
18 think we need to start now in order to make sense out
19 of it and get people the coverage they deserve to
21 We are also going to make better use of the
22 money we've got in the system. We already spend more
23 money than anybody in the world and we don't get the
24 best results, because we have all these uninsured
25 people and all these underinsured people. And many
1 of you and people just like you all over our country
2 who can't afford your deductibles and your co-pays so
3 you go without care and then the problem gets worse.
4 So we're going to improve quality. We're
5 going to control costs. And we're going to once and
6 for all have a health care system that is worthy of
7 our country.
8 Now, I know probably better than anybody how
9 hard this will be. Yeah, I know. I've got the scars
10 to show for it and I've been through it, but that
11 just makes me more determined but it also makes me
12 understand what we're up against, because we've got
13 to modernize and reform the way we deliver health
14 care, but we have to change the way we finance health
16 And that's going to mean taking money away
17 from people who make out really well right now. So
18 that is going to be a big political battle.
19 What I'm doing in my campaign is talking
20 about health care every chance I get, asking people
21 for you ideas, your suggestions. I was listening to
22 some of the questions that were asked. Great
23 questions, deserve answers. We're doing to have to
24 deal with every single one of them. But if we don't
25 have the support to get a bill through the Congress,
1 we can keep talking about universal health care
2 coverage and the number of the uninsured and the
3 underinsured will keep going up, and we'll keeping
4 spending more money and we won't have very much to
5 show for it.
6 So we don't only need candidates to talk
7 about it, and we don't just need candidates to have a
8 plan. We're all going to have plans, that's not in
9 doubt. We need a movement. We need people to make
10 this the number one voting issue in the '08 election
11 to send a message to the Congress and the special
12 interests, we're serious and we're going to get it
13 done this time.
14 So as I said, Karen, I can keep talking but
15 I'm sure my time for three minutes is up, so let me
16 turn now to the questions.
17 KAREN TUMULTY: Well, thanks a lots. Do you
18 want to have a seat?
19 HILLARY CLINTON: No, I'll stand.
20 KAREN TUMULTY: Okay, terrific.
21 Well, I was intrigued by a comment you just
22 made. You said that we're going to change the way we
23 financing the system by taking money away from people
24 who are doing well now. Who specifically are you
25 talking about?
1 HILLARY CLINTON: Well, let's start with the
2 insurance companies. The insurance companies make
3 money by spending a lot of money and employing a lot
4 of people to try to avoid insuring you, and then if
5 you're insured to try to avoid paying for the health
6 care you received.
7 And I see this all the time. You know, my
8 office spends a lot of effort helping people who have
9 insurance get health care. Two quick examples. A
10 father called me from northern New York, had a son
11 with a very serious ailment. He was well insured.
12 He worked, had worked for a long time for the same
13 employer who gave him a good policy. His son needed
14 a special operation, and the insurance company said
15 no, we're not going to pay for that. There was only
16 one place in the country that really could perform
17 it, and the insurance company said, I'm sorry, that's
18 out of network, you've heard that, we're not going to
19 send you to have that done.
20 So my office intervened, and, you know, we
21 get a little bit of attention when I call, and we
22 said, you know, we don't think this is right. This
23 man has paid his, you know, share of his premium.
24 His employer has bargains for this insurance
1 So make a long story short, we got the
2 operation, but I just don't think that people should
3 have to go to their United States Senator to get
4 their insurance company to pay for what they deserve
5 to have.
6 Second fast story, we are having an epidemic
7 of diabetes. You all know all that. We have young
8 people being diagnosed with adult onset diabetes.
9 I'm talking 12, 13, 15, 16-year olds. We are seeing
10 the cost of diabetes go up exponentially. Well, a
11 lot of insurance companies will not pay for someone
12 who's pre-diabetic or been diagnosed with diabetes to
13 go to a nutritionist to find out how better to feed
14 themselves and their families, to go to a podiatrist
15 to have their feet checked. But they will pay if you
16 have to have your foot amputated. Because the
17 reasoning is, and the insurance companies will tell
18 you this, they don't want to pay for preventive
19 health care because that's like a lost amount of
20 money because they're not sure that the patient or
21 the insured person will still be with them. But if
22 they're confronted with the doctor saying we're going
23 to have to amputate the foot, they're kind of stuck
24 with it.
25 That is upside down and backward. So we
1 could save money if we changed the incentive to
2 require that preventative health care and wellness be
3 covered and incentivized, and we could require that
4 every insurance company had to insure everybody and
5 no exclusions for preexisting conditions, and that
6 would be one thing we could do.
7 KAREN TUMULTY: Speaking of the way it's
8 financed, when you do come up with your plan this
9 time, is it going to once again include what was the
10 most controversial aspect of your plan last time
11 which was this employer mandate the requirement that
12 companies cover their workers, and will it also have
13 in individual mandate the way people have to buy auto
14 insurance and the model that we've seen that was put
15 forward in Massachusetts and California?
16 HILLARY CLINTON: Well, there are only a
17 couple of ways to get universal coverage. And I'm
18 pleased that a lot of the people on the Democratic
19 side both running for President and in the Congress
20 are saying, look, we've got to do one of a couple of
21 things. If we're going to build on these employer
22 based system, no more free riders. No more companies
23 that don't insure everybody and shift their costs
24 onto other companies that do and onto the taxpayer.
25 So every employer is going to have to
1 provide insurance or pay into a pool where that money
2 can be used to help people. And we may have to say,
3 look, it is everybody's responsibility to be insured.
4 You know, sometimes young couple come up to me, and I
5 understand this, I vaguely remember being young one
6 time, and they say things like, you know, I'm
7 healthy, I don't need insurance. I'll say, Well, do
8 you drive in cars? Hey, have you ever drive a
9 motorcycle? Do you walk across the street and
10 sometimes not look at the light? You have no idea
11 what can happen to you.
12 Insurance is supposed to be available to
13 make sure that when something happens to you you'll
14 be taken care of, and frankly it is to protect the
15 rest of us who are taking cake of ourselves. We're
16 being responsible.
17 So I've been impressed that on both ends of
18 our country, in Massachusetts and California, an idea
19 that we first floated back in '93 and '94 which was
20 to say, look, individuals have to be responsible so
21 if your employer doesn't provide it, and if you're
22 not covered by one of the government funded programs
23 then you're going to have to be in the system.
24 Because otherwise if something does happen to you
25 you're going to be the responsibility of everybody
1 else. So the so-called individual mandate is really
2 the individual responsibility policy. I think that
3 has to be looked as well.
4 But we also need to look at how we provide
5 an alternative for businesses that are not going to
6 provide health insurance. And their people are not
7 going to have it and where can they go to get a good
9 Well, we have two really good programs
10 operating right now. Medicare, which takes care of
11 people over 65, has the lowest administrative costs
12 of any insurance program. You know, when you look at
13 how much private insurance charges for administration
14 and overhead and profit of course, you compare with
15 Medicare, there's no comparison. Medicare is like
16 three percent compared to anything from 10 to 35 or
18 And we have something called the Federal
19 Employees Health Benefit Plan, where people like
20 members of Congress and people who work for the
21 federal government, they can go into this pool, it's
22 what it's called, it's a big sharing arrangement, and
23 they can have a lot of different choices and then
24 they can pick what kind of insurance policy.
25 If they're young and they think they only
1 need catastrophic care, because that's all they're
2 worried about, they can get that. If they have kids
3 with some kind of problem, they can get coverage for
5 So we can look at how we provide a backup
6 government sponsored approach to compliment the
7 employer system if we stay with the employer. And
8 the final thing I'd say about that is, you know, one
9 of the things that happened in '93 and '94 is that
10 people thought that, even though this wasn't the
11 case, but we didn't do a good enough job explaining
12 it, we're going to do a better job this time, people
13 thought, well, they're going to be required to change
14 what they had, and a lot of people like what they
16 So we don't want to have people feeling
17 like, oh, my goodness, the government is going to
18 come in and they're going to tell me what I have to
19 do and what doctors I have to go to. That was never
20 ever part of the plan, but some people got worried
21 about that.
22 So building on what we have and having a
23 bridge to make sure everybody is included and at the
24 end of that bridge having an alternative that is a
25 government sponsored alternative gives people choice.
1 So that's what I think we have to look at as
2 a framework, because really every plan you're going
3 to hear about has some combination of those elements.
4 KAREN TUMULTY: Senator, right now I'd like
5 to turn things over to Courtney Erickson, who in her
6 job with the Clark County Housing Authority sees
7 every day a lot of the kind of people you're talking
8 about, people who have coverage but can't afford
9 their health care.
10 Courtney, are you here?
11 COURTNEY ERICKSON: As you know, I'm
12 Courtney Erickson. I'm a proud member of SEIU, and I
13 work for the Clark County Housing Authority.
14 Many of the people that I serve on a
15 day-to-day basis are low income families, seniors and
16 disabled people living on a fixed income. Many of
17 them have health care, but still spend a lot of money
18 out of pocket which obviously they can't afford to
19 do. So how and on what timeline are you going to
20 rein in the health care costs?
21 HILLARY CLINTON: That's a really good
22 question, Courtney, because if we don't get costs
23 under control, you can have a universal health care
24 plan and it will still keep costing more and more
25 money for everybody in it, and then we'll be back to
1 right where we are today.
2 So I want to do several things. Number one,
3 as I said, I want to end insurance discrimination and
4 make it clear that they're going to have to be under
5 some, you know, restrictions about what they can
6 charge people and what they can and cannot do to them
7 when it comes to their insurance.
8 Number two, I had a bill that I worked on
9 for four years in the senate to move us toward
10 electronic medical records. We passed through the
11 senate, we didn't pass the Republican House so we're
12 coming back to make it happen. Why do I mention
13 that? Well, those of you in health care know the
14 answer. You spend so much of your time, you know,
15 doing recordkeeping, trying to read records that are
16 illegible, trying to fax records to people who
17 aren't, you know, right near home and need their
18 records. And you go through all this, misplacing
20 We are drowning and frankly people are
21 suffering because we have a paper system in the
22 health care field. We don't rely on paper in any
23 other big part of our economy anymore. Because we
24 rely on paper we are wasting money. We can save by
25 an independent assessment a hundred billion dollars a
1 year if we move toward electronic medical records.
2 And I want to start requiring that people who do
3 business with the government, namely Medicare,
4 Medicaid, VA, you name it, the Federal Employees
5 Health Benefits Plan, they're going to have to move
6 toward electronic medical records.
7 And I'm willing to put some up front money
8 into that to create a system where all these
9 different health care IT systems can talk to each
10 other, because if you're taking care of somebody here
11 in Las Vegas, they have family say in Arizona or
12 L.A., they go there, they slip and fall, they go to
13 the emergency room, you start with a history. You
14 start with tests that maybe they took two weeks or
15 two months ago.
16 After Hurricane Katrina I went down to
17 Houston to see the people who had been evacuated,
18 most in them from the convention center. The
19 elderly, the frail. People who were very dependent
20 upon health care, their records were gone. Those
21 pieces of paper were destroyed.
22 And a lot of doctors told me their biggest
23 problem was trying to figure out what prescriptions
24 to give to people because you have a lot of elderly
25 folks who knew they were taking bills but didn't know
1 what they were. They said, Look, I take a pink pill
2 in the morning and a blue pill in the afternoon. Had
3 no idea what it was.
4 The only people they could help were the
5 people who had shopped at chain drug stores because
6 they had electronic medical records. If we had that
7 for all of our health care records we'd get costs
8 down and we'd have higher quality health care. So
9 we've got to do all of this at the same time and help
10 get these costs downs and help people.
11 KAREN TUMULTY: Senator, you said that you
12 can do this with no big new taxes. So where does
13 this up front money come from?
14 HILLARY CLINTON: Well, I'm talking for
15 example on the electronic medical records, maybe
16 $200 million to get the architecture of the system
17 put into place, you know, give or take money, but
18 that's what we estimated when we did it originally a
19 couple years ago.
20 And there will be some investments, but when
21 I'm talking about how much money we need to spend,
22 let's look at what we spend nationally. It's not
23 just what the government spends, it's what all of us
24 spend. We already spend more money than everybody
25 else. I cannot see us putting more money as a
1 national expenditure into health care without
2 modernizing the system, without ending insurance
3 discrimination, without beginning to emphasize
4 wellness and prevention.
5 People are going to have to start taking
6 better care of themselves. We cannot afford all the
7 illness that folks are bringing on themselves. There
8 are some things we have no control over. There are
9 some things we do have control over, and we need to
10 start working on that, myself included, everybody
12 But what we really have to look at is how
13 can we save money over the long run. So I'm willing
14 to put in some up front investments to do the right
15 thing. And I think we can then save money as we go
16 forward, but I don't think we should start from the
17 position where we say we're going to increase all of
18 these costs by putting more money into a system that
19 is broken. We have to fix the system so it serves
20 people better. It takes better care of those who
21 take care of us and we take better care of ourselves
22 and that is the way that I'd like to approach this.
23 KAREN TUMULTY: Senator Clinton, we're out
24 of time, but I did want to ask you one last quick
25 question. Several candidates we have heard from
1 today have said that they think they can get to
2 universal coverage in their first term. You have
3 suggested that it could take two terms. It could
4 take eight years. Are they being realistic?
5 HILLARY CLINTON: Well, I think we all area
6 going to try to start as soon as possible. You know,
7 it took three years to implement the Medicare
8 prescription drug benefit. Well, you know what, I
9 didn't vote for it but, you know, and this
10 administrative doesn't exactly have the greatest
11 track record on competence, so I can't judge exactly
12 by that, but it took a while.
13 I think we can move forward quickly, but
14 make no mistake about it, this will be a series of
15 steps. But let me end where I started. We're all
16 for universal health care. You know, we have a big
17 debate about it in '93, '94. That debate is over.
18 The Democrats stand united. We are all for universal
19 health care. What we have to do is persuade the
20 country not only to vote for a Democratic President,
21 we have to help elect a Democratic Congress.
22 Because if you look at the politics of this,
23 and I know that people around are not thinking about
24 politics because that's kind of a downer, but if you
25 look at the politics, we got stopped in the Senate in
1 1994 by a filibuster. You know what that means is
2 unless you get 60 votes, which mean usually unless
3 you've got more than 60 Democrats you've got to get
4 some Republicans.
5 We got stopped because they basically said,
6 we're not going to do it. And we couldn't break it
7 and that was the end. We can't get enough
8 Republicans right now to vote with us to try to begin
9 to end the war in Iraq. We can't. We're trying.
10 Every single week we come up with something else to
11 try to get them to vote with us.
12 But the way the Senate works you've got to
13 get the 60 votes. So that's why I said I sure hope
14 you elect me President, but I want more Democrats in
15 the Senate, and I want a movement to support health
16 care reform, and we're going to need it so let's make
17 sure that's what we do in the next two years. Thank
18 you all very much.
19 KAREN TUMULTY: So our next candidate that
20 we are going to hear from is Senator Christopher Dodd
21 of Connecticut.
22 CHRISTOPHER DODD: Well, good morning,
23 everybody. And thank you very, very much for
24 inviting all of us to come by here this morning to be
25 a part of this program. I thank you, Karen, for
1 acting as the host. The Center for American
2 Progress, I want to thank them as well. SEIU for
3 their wonderful leadership. Andy Stern, I see Andy
4 over here as well.
5 Let me also mention, by the way, I know he's
6 already appeared here, I didn't get a change to see
7 him, but I think all of us across the country have
8 incredible respect for Elizabeth Edwards and for John
9 Edwards and what they're going through here today.
10 So I just want to begin these remarks about health
11 care and not fail to mention them as well.
12 I'm deeply proud of the invitation to be
13 with you today. I'm Proud of my relationship with
14 the SEIU and its work over the eight decades of
15 serving the interests of not own its membership but
16 people across this country who are not members of
17 SEIU who benefitted from your leadership.
18 I've been through eight elections in the
19 state of Connecticut and I'm proud to say that those
20 eight elections I've had the support of SEIU, and I
21 thank you for that support.
22 And for those 32 years that I've been in the
23 Congress of the United States, I'm proud to say I
24 have about a 95 percent voting record with organized
25 labor in this country. I stand with union. I stand
1 with labor, and I thank you as well for that
3 I mention that because I think it's
4 important as we talk about where we want to go from
5 here how we want to lead the country that we also
6 have a good understanding of where you've been. And
7 so over those 32 years of work I've been engaged in
8 on behalf of working people it's something I'm proud
9 of, but it gives you some indication of what kind of
10 leadership I offer as a Democratic nominee for the
11 presidency of the United States and how I'd serve the
13 Again I'm preaching to the choir here in a
14 sense we're talking about health care. We all know
15 it's in a serious crisis. The numbers are startling.
16 It is said that we rank something like 26 in the
17 world in life expectancy, something like 28 in the
18 world in infant mortality rates. We have third and
19 fourth world countries that do far better than we do
20 in protecting our youngest children here in this
22 We rank something like 37th in the world in
23 terms of the overall fairness of our health care
24 system, and we account for more than 50 percent of
25 all the money spent worldwide on health care in the
1 United States.
2 So anyone who tells you the health care
3 system is working, those facts alone ought to be a
4 source of collective shame in this country. The fact
5 that we rank as poorly as we do, this is the United
6 States of America, the most affluent country in the
7 history of mankind, we need to be doing a far better
8 job in serving the American people when it comes to
9 health care. I stand firmly in my efforts to see
10 that happen.
11 Let me say to you here as well what needs to
12 be done. First of all, it's important we talk about
13 health care we don't limit the conversation of what
14 needs to be done within the health care system
15 itself. It was pointed out that in the 20th century
16 we extended life expectancy in this country by 30
17 years. Only 5 of those 30 years can be accountable
18 because of improved health care. About 25 of those
19 years actually come from better nutrition, better
20 housing, better jobs, better incomes for people in
21 this country. That had more to do with increasing
22 life expectancy than actually the health care system
24 The reason I mention that to you is because
25 it's very important as we examine this issue we also
1 look at issues like income and equality, like the
2 ability to have decent retirement, decent wages,
3 decent working conditions. Those elements we know
4 empirically today improve the quality of people's
5 people health.
6 If you're better off financially, if you're
7 better educated, then the likelihood is you're going
8 to be in better health. So we need to understand
9 there is a direct relationship between people and
10 people's ability to have good paying jobs with good
11 retirement and going working conditions if you're
12 truly interested in making a difference on health
13 care in this country. It's very important those
14 concepts and ideas be included in this discussion.
15 As for the health care proposals themselves,
16 let me quickly mention the four principles which I
17 think are absolutely essentially if we're going to
18 deal with the health care system.
19 One is what you've heard already I'm sure
20 from the others as well and that is universality
21 here, that everyone participates, everyone benefits.
22 That all the stakeholders, individuals, employers,
23 the government are involved in coming up with a
24 system here that would make it possible to reduce
25 those numbers of 47 million of our fellow citizens
1 who have no health care to make sure they'll be
3 Second is prevention alone. Minimum we try
4 to do is see to it to reduce the cost by stopping
5 people from getting ill in the first place. Around
6 70 percent of health care costs in this country are
7 associated with chronic illness in America. We need
8 to be doing everything we can to see to it that
9 people get screening, get the proper management care
10 to reduce those kind of problems before they emerge.
11 The health care system today deals with
12 these when you get sick. We ought to be doing a far
13 better job of making it possible for people not to
14 become ill because of the incentives we provide and
15 the alternatives we offer for people.
16 In fact, the Veterans Administrative, of all
17 the problems they have today have been able to
18 reduced hospitalizations by 60 percent in this
19 country because of the work they've done of
20 prescreening and dealing with people before they
21 become ill. So prevention has to be a major part of
23 Thirdly is building upon the good things
24 we've done already: Forty years of Medicaid and
25 Medicare. I would extend Medicaid to poorer
1 families, hundred percent of poverty, the ones with
2 children 300 percent of poverty. Those programs have
3 worked very, very well for people. Expanding them,
4 extending them makes a lot of sense too.
5 And then last is the fourth principle,
6 dealing with technology. I'm sure you've heard of
7 this is well. Some 80 or $90 billion could be saved,
8 not to mention the morbidity rates by doing a far
9 better job and utilizing the technology that exists
10 today to see to that people have an opportunity to
11 improve of their health conditions.
12 Let me tell you what also is important in
13 all of this. We're looking at those of us who seek
14 your support for this nomination. What have you been
15 able to do? During the 26 years I've been in the
16 Senate, I've taken Democratic principles and made
17 them national policies. I spent seven years through
18 two presidential vetoes to pass the Family and
19 Medical Leave Act. It's my piece of legislation. 50
20 million Americans have enjoyed the benefits of that
22 I started the children caucus in the Senate.
23 I authored the legislation here with improved Head
24 Start along with other programs dealing with infant
25 screening, premature births, dealing with
1 prescription drugs for children. In every instance
2 I've done it by reaching out to people on the other
3 side of the political spectrum.
4 Whatever we talk about here today needs to
5 be a plan and a program that can build us and bring
6 us together. We're not going to survive much longer
7 in this country, my friends, divided 51/49. The
8 ability to just do what we want to do is going to be
9 dependent upon whether or not we can reach out off
10 this and bring them to that table and sit down and
11 work out these things together.
12 We can't wait much longer. I've done it on
13 every one of those pieces of legislation. That's
14 what I do as a legislature. That's what I would do
15 as the President of the United States, to bring
16 stakeholders together, work together with a common
17 goal we all have in mind, and that is to see this
18 country have improved health care, improvement
19 economics as well for people in our nation.
20 So I ask you today as we talk about these
21 issues to look not only at what we offer you here ut
22 also the proven ability to bring people together,
23 where we've stood over the years and where we'll lead
24 in the future.
25 I'm the father of two very young children.
1 I have a two-year-old and a five-year-old. In fact,
2 my house right now is sort of like a Petrie dish.
3 I've got a five-year-old and a three-year-old and one
4 has a strep throat and the other has an infection of
5 some kind or other, adenoids. And so dealing with
6 children and their problems, going to school and
7 coming back.
8 In fact, I'm the only candidate that
9 actually gets mail from AARP and diapers services I
10 want you to know. I have a broad reach here as a
11 candidate to talk about the needs of people across
12 the country.
13 But it's important to know what families go
14 through who have young children. I'm a United States
15 Senator. I've got a wonderful health care program.
16 I want every single American in this country to have
17 as good a health care program as every member of the
18 United States Congress. That ought to be something
19 we're going to stand there and fight for.
20 Thank you for listening. I ask for your
21 support on the upcoming nomination process, and I
22 promise as your President we will deal with this
23 health care issue, we'll pull the people together,
24 we'll have a good sound health care program for all
25 Americans. Thank you very, very much.
1 KAREN TUMULTY: Senator, at least one
2 political commenter out here has suggested that you
3 should win the caucus if only because you seem to be
4 the only person in the field who doesn't mispronounce
6 CHRISTOPHER DODD: That's correct. Nevada.
7 You've to pass at least that test it seems to me.
8 KAREN TUMULTY: You were one of the original
9 co-sponsors of Hillary Clinton's health care bill in
10 1993, and it never got so far as a vote on the floor
11 of either House. You suggested there's been a
12 failure of leadership on this issue. But, in fact,
13 you know, all the old opponents are still out there.
14 Is there anything that has changed in the political
15 climate in the, you know, in the nature of the
16 problem that would suggest that things could be
17 accomplished on health care that simply were not
18 possible in 1994?
19 CHRISTOPHER DODD: Yeah, I do. I see a
20 number of things. First of all, just the cost alone.
21 Twelve or fourteen years ago the overall cost was
22 somewhere a little less than a trillion dollars.
23 Today we're looking a cost figure of somewhere in
24 excess of $2 trillion, closer to $2.3 trillion.
25 You're watching business and industry
1 beginning to reduce those health care plans for
2 people. They're not doing it because they're evil in
3 most cases, they're doing because of a cost factor.
4 There's a growing constituency that in the past was
5 hostile to the idea of having a universal health care
6 plan that I think didn't understand the economic
7 impact today better than they did fourteen years ago.
8 So those factors alone I think are making
9 greater and greater possibilities for people to
10 understand that this is hurting. We're consuming now
11 15 percent of our grows domestic product in health
12 care costs. That number could very easily jump to 20
13 or 25 percent very, very quickly. That becomes
14 almost an un-stateable number, not to mention of
15 course the fact that we're leaving people out of the
16 system today with the numbers that are growing.
17 The irony here we've got health care costs
18 that continue to rise and the number of insureds
19 continue to rise. So now we have a million more
20 people than we did six years ago under this
21 administration that have no health care, and that
22 cost continues to go up.
23 I think the climate, Karen, is a lot better
24 for us today, and again it comes back to bringing
25 people together. I'm not engaging in something
1 inconceivable here. On January 21st, the day after I
2 might be inaugurated as President of the United
3 States I could invite Lilly and Chuck Grassley, Ted
4 Kennedy, Max Baucus, Ted Stevens. I'm talking about
5 now people in the Congress who are response before
6 the committee to deal with health care. I've known
7 everyone of them for 30 years. I'm not going to
8 spend a year or two getting to know them. They know
9 me. I know them. We've fought against each other.
10 We've worked together on issues. And I believe by
11 bringing people together you know you've worked with
12 to say let's sit down and get this done. The
13 American people expect nothing less of us. We need
14 to stop talking and achieve results I think we can
16 KAREN TUMULTY: Thank you. Since 1994 when
17 efforts have -- oh, here it is, help with the issues
18 we're having.
19 CHRISTOPHER DODD: I'm fading or something.
20 KAREN TUMULTY: Since 1994 when health care
21 reform crashed and burned Congress has sort of
22 limited itself to incremental steps. And you've been
23 involved in a lot of those.
24 And so right now I would like to call on Pat
25 Moore, who's an RN at UMC, to ask you about an issue
1 that you've been very active in, which is expanding
2 coverage of children.
3 Pat, are you here?
4 PAT MOORE: Hi, I'm Pat Moore. In the state
5 of Nevada we have an exceptionally high number of
6 uninsured children. It's really discouraging to me
7 because I've been a pediatric IC nurse at UMC. It's
8 the only public owned county hospital in Southern
9 Nevada, and I've worked there 25 years.
10 So I see the results of what happens when
11 parents cannot provide or seek ancillary health care
12 assistance for their children until it's too late,
13 and oftentimes the result is the death of a child.
14 So I would ask you what is your proposal,
15 what is your platform for insuring every child in the
16 United States?
17 CHRISTOPHER DODD: Well, first of all, Pat,
18 thank you for what you do as a nurse. And let me
19 take advantage of your question to point out as well
20 that on this Tuesday I'll be introducing something
21 called a spec cap which takes these Kentucky river
22 cases, for those who follow these questions
23 understand them, that NLRB, the National Labor
24 Relations Board last year declared that anyone who
25 was occasionally a supervisory, had a supervisory
1 function as a nurse, would be prohibited from
2 engaging in collective bargaining agreements.
3 My legislation overturned that. I think
4 nurses ought to be organized collectively. And then
5 I want to thank your leadership, Andy Stern, the
6 AFL-CIO and other who are already endorsing the
7 legislation. Senator Kennedy, Senator Derby are
8 already co-sponsors of the bill, but I want you to
9 know the nurse shortage issue, how nurses get
10 treated, health care providers is something that has
11 a direct relationship again with the overall health
12 care system in the country.
13 And again I appreciate your bringing up the
14 children's issue. I mentioned I started the
15 children's caucus in the senate with Arlen Specter
16 some 26 years ago. 12 million of that 47 million of
17 uninsured are children in our country. The S-chip
18 program is something I was a strong backer of,
19 supporter of, early author of that legislation to
20 provide those kind of benefits.
21 I'll be quite honest with you, when that
22 first came up I had some hesitancy, in fact all of us
23 did in talking about those, Karen, because we had the
24 feeling that if we just took care of children that it
25 would make it harder to deal with the broader
2 But frankly things were moving so slowly
3 that we decided we had to do something to directly
4 reach out to see to it that children were getting a
5 far better start in all of this.
6 So in addition to making sure that families
7 with children would get 300 percent. 300 percent of
8 poverty would be included under Medicare. You
9 immediately pick up an awful lot of our kids that
10 you're talking about in your hospital.
11 The Family and Medical Leave Act makes a
12 difference. I don't know if you know, C. Everett
13 Koop -- by the way, I voted against when he was
14 nominated the Attorney General because I disagreed
15 with a lot of his view, and then he turned out to be
16 my best witness when I was trying to pass the Family
17 and Medical Leave Act. That was that radical idea
18 that you ought to able to spend time with your child
19 without having to lose your job.
20 By the way, we're going to introduce in the
21 next couple of weeks we're going to introduce the
22 Family and Medical Leave Act with paid leave for
23 people, by the way, so you don't have to -- but that
24 relationship between parents and children during
25 these period of illness make a huge difference.
1 Again I see you nodding. You understand this better
2 than others as a pediatric nurse.
3 And by the way, I thank pediatric nurses and
4 the American Academy of Pediatrics. They've been
5 fabulous when it comes to dealing with some of these
6 children's issues.
7 And then getting into some of this stuff
8 early on, I want to school-based clinics in our
9 country. I want to see a Head Start program that
10 isn't just a literacy program but deals with the
11 whole child so we end up dealing with proper
12 nutrition, good beginning, food issues, all of these
13 basic things. These are the kind of investments we
14 ought to be making.
15 I'm proud to have been chosen by the Head
16 Start Association as the Senator of the decade when
17 it comes to Head Start issues. I wear that badge
18 very, very proudly. I care deeply about early
19 childhood education, what happens with the Head Start
21 Those are some of the things that we need to
22 be doing. As I mentioned earlier, the infant
23 screening legislation that I've authored, the
24 description drugs for children, to get better testing
25 for them, the premature birth legislation dealing
1 with efforts in that regard. We just did a major
2 bill on autism in the country for children as well.
3 I've spent an awful lot of my time working on these
5 When I got to the senate, I discovered there
6 was a caucus for every imaginable constituency in the
7 country except that one our of four Americans were
8 kids. That's the reason I put so much time on it and
9 I will as President of the United States as well. I
10 care deeply about it.
11 KAREN TUMULTY: Senator, you've talked a lot
12 about in the past about health care involves hard
13 choices. Sara in Minnesota has sent a question in by
14 e-mail saying what do you see as the most serious
15 problem with our health care system: Cost, quality
16 or coverage? And can't say all.
17 CHRISTOPHER DODD: Well, I'll begin with
18 cost, because I think if you can deal with cost then
19 these other matters can be dealt with. And so the
20 cost of it is what stuns me. And out of all the
21 incentives in our health care system today, our
22 incentives driving up cost. We need to reserve this
23 and really turn the whole system on its head.
24 If all we're talking about here is sort of
25 tinkering with the status quo all we're going to do
1 is probably raise cost, maybe marginally deal with
2 some of these questions. But today unless you
3 fundamentally alter how the system is going to work,
4 then I'm fearful we'll be back here again four, eight
5 years from now talking about the same subject all
6 over again.
7 All these incentives today in health care
8 are cost driven. We don't provide the incentives
9 within the system to do just the opposite way, and
10 that is to encourage the incentives to have better
11 lifestyles, to do things that are less harmful to
12 you, to encourage businesses to provide environments
13 for people to stay.
14 I come back to the point I tried to make
15 earlier as well here. The incentive to have a
16 cleaner environment, at better energy policy in the
17 country, seeing to it that we insist on schools, for
18 instance, that you don't have to market fast food or
19 junk food. 49 percent of the schools in the United
20 States of America have contracts with soft drink
21 companies and junk food companies, 49 percent. And
22 then we wonder why kids have obesity problems, then
23 we wonder why they have diabetes problems.
24 So the cost issue, they do that because the
25 money comes into a poor school district. They're
1 struggling to make ends meet so that exclusive
2 contract that allows that soft drink company to have
3 a contract with them is very appealing to them to
4 save some money. We need to deal with those
5 underlying issues in my view as well here. The cost
6 I would think is a major issue.
7 KAREN TUMULTY: And given this problem is
8 what it is and the urgency that people feel about it,
9 what's your sense of what is a realistic time frame
10 for getting to universal coverage? Barack Obama says
11 it's four years. Hillary Clinton says it's eight
13 CHRISTOPHER DODD: Well, you know, I'm
14 impatient. I didn't jump into the presidential
15 politics because I woke up when I was five or ten and
16 decided this is my life's ambition. I've been
17 relatively content and happy working in the United
18 Senate. I've got these two kids. A late bloomer in
19 the father business obviously.
20 KAREN TUMULTY: What were you thinking?
21 CHRISTOPHER DODD: My daughter Grace was
22 born 48 hours after 9/11 in Arlington, Virginia. I'm
23 literally watching the Pentagon burning from the
24 hospital she was born. I could watch her literally
25 being born and see the Pentagon burn.
1 And I thought ever since that moment, as all
2 of you as parents or grandparents have, what kind of
3 life is she going to have growing up watching those
4 events. What kind of world is she going to grow up
6 And so I feel a certain amount of impatience
7 in all of this. I think with the right relationship
8 in the country they insist upon issuing a priority.
9 And I would tell you today I wouldn't put a time
10 frame on it, but I make this the first order of
11 business in a Dodd administration.
12 This goes to the heart of our economics. It
13 goes to the heart of who we are as people. It goes
14 far beyond the issue of sort of one set of issues.
15 The danger in forums like this is because we have a
16 tendency to stovepipe the issue. We're here talking
17 about health care. What I tried to say early on to
18 you is that what happens in the workplace in terms
19 job possibilities, income, salaries, retirement
20 benefits all contribute to the health care issues as
21 well. Energy policy, environmental issues contribute
22 to the health care policy.
23 So when I understand the importance of
24 having this discussion, it's important to realize
25 it's far-reaching in its implications. So to me I
1 would want to see us have a universal program begin,
2 with all due respect, four or eight years.
3 I think with leadership in the country that
4 makes this important, that makes this important. If
5 you can have, if you get rid of these permanent tax
6 cuts to the top one percent of income earners, get
7 the war ended in Iraq that we're spending $2 million
8 a week, $8 million a month, we can provide the
9 resources to really move in this direction. So I
10 would make it a top priority in my administration. I
11 wouldn't want to put a time frame on it because I
12 think it's too important for us to get there as soon
13 as possible.
14 KAREN TUMULTY: Great. Thank you very much.
15 CHRISTOPHER DODD: Thank you all very, very
17 KAREN TUMULTY: Next we're going to hear
18 from Congressman Dennis Kucinich.
19 DENNIS KUCINISH: Good afternoon. Good
20 afternoon. It's wonderful to be here with you. And
21 as I'm listening to this discussion today it reminds
22 me that you are the ones who have to insist that
23 America reconnect with its greatness and its
25 Yesterday in the House of Representatives
1 Americans were told that we can't have peace. We
2 have to keep a war going for another year or two in
3 order to have peace. I voted against that because I
4 believe that we have to take a new direction which
5 says if you want peace, you vote for peace and you
6 have a plan for peace.
7 We're being told in this state and other
8 place that you can't have kindergarten care or
9 universal pre-kindergarten care, and yet when you
10 accept that then you don't get it. Efforts are made
11 to just cut short a movement.
12 Today at this forum the sub-message is that
13 you can't break the hold that the insurance companies
14 have. Not a single candidate up here has challenged
15 the underlying problem with our health care system,
16 and that is insurance companies are holding our
17 health care system hostage and forcing millions of
18 Americans into poverty with unconscionable premiums,
19 co-pays, deductibles.
20 So I ask you is it constant with America's
21 greatness that candidates step away from the one
22 solution that could change it all. A not-for-profit
23 health care system is not only possible, but HR 676,
24 a bill that I introduced, and a number of
25 Congressmen, the Conyers Kucinich bill, actually
1 establishes Medicare for all. A single-payer system
2 and it's a not-for-profit system. It's time we ended
3 this thought that health care is a privilege. It is
4 a basic right, and it's time to end this control that
5 insurance companies have not only over health care
6 but over our political system.
7 Think for a moment if Lincoln had decided,
8 well, you know, there's just too much resistance to
9 this idea of emancipation. Think if the suffragettes
10 had decided, well, you know, we can't take on these
11 men who are determined not to include women in the
12 political process.
13 What if Martin Luther King had said, you
14 know, we can only push so far for civil rights, or
15 Cesar Chavez had said well, you know, no quoly.
16 What if we buy into this logic that says
17 can't have peace. We're being told here today to buy
18 into a view of the world which says that, well, you
19 know, but the insurance companies run the system
20 we'll have people, you know, we'll work out
21 competition between the insurance companies and maybe
22 we'll have government subsidize the insurance
24 Where is our call for greatness? What if
25 FDR said, Well, you know, we can't really do the New
1 Deal. I'm talking about a real deal for the American
2 people, a universal single-payer not-for-profit
3 Medicare for all and it's good to be here with you to
4 talk about it. It's already into legislative form.
5 62 members of Congress have signed onto the bill.
6 Over 14,000 physicians have signed on to the bill.
7 The people of California voted for a plan
8 just like it. The senate of New Hampshire endorsed
9 it the other day. The legislature in Kansas put
10 their name on it and endorsed the idea. We can do
11 this. Yes, we can. Break the hold of the insurance
12 company on our health care system and lift the
13 American people out of poverty. That's what my
14 presidency is going to be about. Thank you. Thank
15 you. Thank you. So let's talk. Let's have a
17 KAREN TUMULTY: Congressman you are the
18 first advocate we've heard today of the single-payer
19 health care system, essential Medicare for everybody.
20 However, the last time, my understanding is,
21 that it was on the ballot was in Oregon, which is,
22 you know, except for Vermont probably, you know, the
23 most liberal state in the country on these issues and
24 it didn't pass. Where do you find the political will
25 for a single-payer system?
1 DENNIS KUCINISH: I traveled this country in
2 the last election, came to an understanding that
3 health care is one issue that unites everyone. Where
4 does the support come for a not-for-profit health
5 care system? It comes from all over the country.
6 But it's waiting for a candidate for President who
7 will lead the way, and I've already done that.
8 The Conner, Kucinish bill, HR 676, is the
9 vehicle. Now, how can you break the hold that
10 insurance companies have? Because, let's face it, in
11 Oregon they pumped millions of dollars into doing
12 everything they could to try to defeat the
14 This is really simple. You need a President
15 who doesn't have strings attached. Someone who is
16 ready to confront these insurance industries.
17 Someone who isn't owned by the interests. Look,
18 right now on Wall Street the hedge funds are coming
19 together to pour millions into campaigns of
20 candidates for President.
21 We're looking at a system that people are
22 telling you the words you want to hear, but when
23 you're looking for specifics in a plan, they're not
24 developing it. Why can I do it and other candidates
25 can't? Because simply I don't have strings attached.
1 I've been politics 40 years. I've been a
2 counselman, a clerk of courts, a mayor, a state
3 Senator, a six term U.S. Congressmen. I'm known form
4 having integrity and the willingness to take a stand
5 and for changing the outcome when others say it can't
6 be done. This is the moment that I call upon you and
7 the SEIU and the American people to say, let's join
8 this movement that already exists, call upon the
9 power of our hearts and our intellect.
10 What are the animating forces? How is this:
11 Half of the bankruptcies in America right now are
12 directly connected to people not being able to pay
13 their hospital bills. And of that amount 75 percent
14 of the people are working, have jobs. People's whole
15 lives are on the line here.
16 So the question is will the American people
17 be given a real choice in this election. You know,
18 this isn't American Idol here, I mean, really, you
19 know. I mean, I could come up here and, you know, do
20 a little dance about, well, you know, we're going to
21 take on those insurance companies. Oh, really? Are
22 you going to take away their profits? Are you going
23 to remove the fact that, you know what, 31 percent of
24 the money that's in the system right now of $2.2
25 trillion a year goes for the activities of the for
1 profit system.
2 If we take that money away from the
3 insurance companies and use it for the American
4 people, well, guess what, we have enough money for
5 vision care, dental care, mental health, prescription
6 drugs and long-term care. I'm going to call on the
7 American people to stand up for their rights. Health
8 care is a right, not as a privilege.
9 KAREN TUMULTY: Congressman, we have an
10 e-mail question from James in Patterson, California
11 who wants to know why are health care costs going up
12 so much and what can we do to stop these increases?
13 And can I just add a question to that,
14 because in the framework of a single-payer system
15 people say the consequence of trying to contain cost
16 in a single-payer system would ultimately be
18 So could you take us through first how a
19 single-payer system would address costs and also what
20 you say about these sorts of concerns that people
21 raise about it?
22 DENNIS KUCINISH: You know, think about it.
23 The insurance companies when they look at a
24 single-payer system, a not-for-profit system, they'll
25 say, my God, you're going to end up with rationing.
1 What do we have now? 46 million Americans don't even
2 have coverage. Talk about rationing. They're not
3 even in the line, okay. Give me my portion. No.
4 Another 50 million people are underinsured
5 and the rest are paying these high premiums, co-pays
6 and deductibles. We've got to break the hold the
7 insurance companies, and their public relations
8 operations would say, well, rationing, the fact of
9 the matter is this plan I'm talking about covers
11 How do you reduce costs? Let's look at the
12 costs that are involved in the system rights now.
13 Corporate profits, stock options, executive salaries,
14 advertising, marketing, the cost of paperwork. All
15 this takes about 31 percent out of the health care
17 Now, what does all that have to do with
18 health care? Zero. Zip. Nada. I'm talking about
19 creating a system which, by the way, is similar to
20 that in every other industrialized nation in the
21 world. We take the profit out of medicine. Health
22 care is a right. It is not a privilege.
23 So how do we control costs? By having
24 everyone in the same pool, everyone. Having everyone
25 covered and having the benefits be available to
1 everyone whatever their income, no means testing, and
2 by creating a movement.
3 I want to add something to an earlier
4 question you raised, and that is that good friend
5 Senator Edwards, who he and I campaigned together
6 four years ago, he raised this question, which is a
7 very, you know, which is the question in Washington.
8 Well, it's just not feasible to take this plan for
9 not for private health care.
10 Senator Clinton, talking about charging the
11 insurance companies but doesn't really get to the
12 ultimate challenge of who controls health care in
13 American. Senator Obama still developing his plan.
14 This plan that I'm talking about, I
15 coauthored this plan. I'm one of the ones that wrote
16 the plan. I know the way the system is set up. The
17 area that I represent, Cleveland, people are losing
18 their homes because they can't pay the doctor bills.
19 And so the question is what it ultimately
20 comes down to is who has the courage and the
21 willingness to take a stand and can reach out to the
22 breadth and depth of the American people and call for
23 that greatest to say we're going to change this.
24 We're not going to be strapped by these insurance
25 companies who give us diminishing returns who insist
1 on higher premiums, co-pays and deductibles.
2 KAREN TUMULTY: Congressman, you're kind of
3 an urban kind of guy. And Ashley Osborn, who is a
4 labor and delivery nurse in Elko, which is a rural
5 county in northern Nevada, has a question for you
6 about how you would address concerns in people who
7 are in her situation.
8 ASHLEY OSBORN: Good morning. As you know
9 my name is Ashley Osborn and I'm a labor nurse in
10 Elko, Nevada, which is a rural area up in
11 northeastern Nevada.
12 And commonly I see mom's come in to my
13 department with pregnancy induced, severe pregnancy
14 induced health care issues that could be eliminated
15 or caught early with fetal care. Unfortunately
16 they're unable to get that. What are your plans on
17 improving health care in the rural area in the U.S.?
18 DENNIS KUCINISH: Well, first of all, this
19 plan covers everyone, rural as well as urban areas
20 alike. Rural areas tend to be underserved. I'm
21 looking also at creating a infrastructure program to
22 create millions of jobs for building America's
23 infrastructure, which would build hospitals in rural
25 And rural people would then have access
1 because access is a huge question in rural areas.
2 And when you talk about women being able to get the
3 care they need, this system, prenatal care, postnatal
4 care, I have a plan for child care. This system of
5 not-for-profit health care doesn't try to stop women
6 from getting the care they need because there's not
7 an insurance agent telling a doctor, you know, OB/GYN
8 doctor that we just can't do this. You're asking for
9 too much.
10 This system will meet the health care needs
11 of the American people. We're being told we just
12 can't have those needs met. We've got to start
13 thinking differently.
14 Does that answer your question? Thank you.
15 KAREN TUMULTY: Thanks. And now I would
16 like to turn to a public health student here at UNLV,
17 Megan McCormick, who raises a pertinent point if
18 there's any place where you're interested in outcomes
19 is in health care.
21 MEGAN MCCORMICK: Hello, I'm Megan McCormick
22 and I'm a junior at UNLV here. We're spending an
23 increasing percentage of our gross domestic product
24 on health care while we continue to have poor
25 outcomes in this countries who are allocating a lower
1 percentage of their GDPs towards their own health
2 care. How does America plan to stay globally
3 competitive with increasing health care costs?
4 DENNIS KUCINISH: You know, that's a key
5 question. I mean, in my own congressional district
6 we have auto plants that have been threatened and
7 others throughout the country have been threatened
8 because the high cost of health care is causing Ford
9 and GM to pay billions of dollars in health care, in
10 health care costs.
11 Now, Canada, on the other hand, has a much
12 stronger industry because they have a health care
13 plan for their people. This plan that I'm talking
14 about is going to help American business. It's going
15 to strengthen the economy. It's going to make it
16 possible for individuals to be able to hold on to
17 more of their money.
18 It's true that many families right now are
19 spending in excess of $10,000 a year for health care.
20 With this plan only a fraction of the money that is
21 being spent right now would have to be part of the
22 financing of the system. I mean, do you know that 60
23 percent right now of the money that's in health care
24 is spent by the government. The government has
25 60 percent of the spending right now.
1 If you eliminate administrative costs, if
2 you purchased bulk purchase of drugs, just the way
3 veterans does, you start to come due, you start to
4 come up with the money that you need to provide
5 coverage for everyone, and that is major help for
6 small businesses and large businesses a like.
7 This patchwork proposal that you've been
8 given here today by other candidates locks us into
9 insurance companies who then take their pound of
10 flesh and generally it keeps people from being to
11 have any control over their own budgets.
12 I want to go back to what most American
13 people are experiencing. Economic uncertainty
14 because the way the health care system is set up.
15 People are aware no matter how much money they have
16 that if they have an illness in the family it could
17 wipe them out.
18 Who isn't going to make the choice to take
19 care of a loved one. You do what you have to. But
20 why I would ask you should someone have to lose their
21 home in order to ensure the health of a loved one.
22 Why should someone not be able to get the long-term
23 care they need for a loved one or have to sign on the
24 dotted line to give away everything, you know, you
25 work for for a lifetime in order to get the long-term
1 care you need.
2 See, what I'm talking about is real
3 transformation. I think the American people are
4 ready for that, but they need someone to be not just
5 a messenger but someone who knows this issue, is
6 ready to stand up and speak out. Yes, we can improve
7 our economy and save our businesses large and small,
8 and I'm dedicated to do that and I'm able to do it
9 too. Thank you.
10 KAREN TUMULTY: Congressman, earlier Senator
11 Edwards pointed out that there is a single-payer
12 Medicare like option built into his plan. And it
13 would be, you know, one of the things that people
14 could consider in making their health care choices.
15 And he raised the possibility that if that were out
16 there as an option and people started choosing it and
17 found out that they really liked it, that the country
18 could almost, you know, evolve towards a single-payer
20 Do you see this as a real scenario, given
21 the other interests that are out there or do you
22 think that, in fact, you know, it's going to have
23 sort of come down in one fell swoop if it's ever
24 going to happen?
25 DENNIS KUCINISH: Well, I think you just
1 answered the question, and that is that if you have
2 competition between insurance companies, everyone
3 knows what happens. That doesn't drive down costs,
4 it drives up profits. That's a fact.
5 If you say, well, you're going to give
6 people a choice, either be on a private plan or be
7 with the government, what happens is that the private
8 companies start cherry picking the best, you know,
9 the people in the best health, and then you end up
10 what what's called adverse selection, those as far as
11 the most medically compromised end up on programs
12 that the government is paying for, and then the
13 government program starts to go down. You end up in
14 an insurance death spiral, which is what it's called
15 in the industry.
16 Now, think about it. Candidates up here
17 advocating that government provide subsidies to the
18 insurance industry. What's that about? I mean,
19 didn't we have enough with subsidizing the
20 pharmaceutical companies with that phoney Medicare D
21 program that President Bush had? How are we any
22 different as Democrats? Think about that.
23 Do you know what, universal health care, oh,
24 everybody is for it. Almost resonant with that
25 fellow in the Music Man who said, There's trouble in
1 River City. Universal health care. You know what,
2 even the insurance companies are for universal health
3 care, especially the insurance companies if the
4 government is subsidizing them. What a deal that is
5 for the insurance companies, but what a rotten deal
6 for the American people.
7 We've got to have not-for-profit health
8 care, get the insurance companies out of the picture.
9 Health care is not a privilege, it is a right and it
10 is as human right.
11 Universal health care, right. I mean, come
12 on. You need a President who didn't fall off the
13 Christmas tree. You need a President who will be
14 involved in straight talk straight from the shoulder,
15 and you need a President who doesn't have a key in
16 the back being wound up by special interests to come
17 before the American people and tell them what the
18 interest want. I'm telling you what the American
19 people want and I'm ready to take that message all
20 across this country and I'd like your help in doing
21 it. Thank you.
22 I have four seconds left. Buzzer shot. You
23 want not-for-profit health care, I'm the candidate
24 who can deliver. Thank you very much.
25 KAREN TUMULTY: Thank you very much. And
1 now we area going to move on to our final candidate
2 of the day, former Alaska Senator Mike Gravel.
3 MIKE GRAVEL: Hi, all. I just want to give
4 my condolences to all of you who realized that
5 something sad happened last night. The Rebels lost
6 by four points. I know what that means to you. I
7 also want to point out that, Andy is sitting over
8 there, Andy, I have to tell you, you speak good
9 English. I don't understand why candidates don't
10 understand you.
11 I want to thank you for getting me here.
12 It's better than what CNN is going to do to me in New
13 Hampshire by censoring my voice. But I also want to
14 thank John Podesta.
15 But let me say that Andy pointed out one
16 thing right in the beginning is that we do have a
17 problem, and I don't want to take your time when you
18 know as well as I do. We've heard a lot anecdotal
19 experiences and deep emotions about the problem.
20 That's not a solution. That's not a solution.
21 What's wrong with health care in this
22 country is that we saddle the business community with
23 carrying it, and the can't do it because it's going
24 to cost you your jobs, it's going to cost -- it's
25 going to damage you internationally. Why -- Karen
1 was alluding to it, historical accident in a second
2 World War when wages were frozen. The only way you
3 could get people to come into your company and work
4 was to give them a lot of health care benefits. The
5 war is over and we don't have this freeze on wages.
6 So we don't need that system to go ahead and carry.
7 And if you heard all of blame, they essentially,
8 they're for Dennis, they were all involving employers
9 and employees. That is a non-starter and it's a
10 Band-Aid that is not going to work.
11 Now, what can we do? Oh, well, real simple.
12 We can turn around and say let's have a health care
13 program that establishes equality. And I'll give you
14 the name of it. It's called the Universal
15 single-payer, by single-payer I mean all Americans
16 pay for it regardless of the system you have now but
17 the system you're going to get, single-payer Health
18 Care Voucher plan.
19 Under the plan we would issue vouchers to
20 every single American. And the vouchers, you don't
21 pay for them, they're issued to you. You sign up
22 every year for them. And the vouchers will have a
23 very modest co-pay, a very modest deductible, but
24 that's it. Everybody gets the same product
25 universally in the United States of America.
1 And then if you want more than the product
2 you got, you pay for it. There's no magic in this
3 whole process. Somebody is going to pay, you know
4 who pays, it's the average American, one way or the
5 other, particular under our present system.
6 And so to want to trash the business
7 community and trash our tax system, which is already
8 corrupt with greater corruption as a way to solve the
9 problem is a non-starter.
10 When they tell you about oh, you know, I've
11 done this, done that, keep in mind Harry Truman was
12 the first to raise this issue with the Democrats, and
13 they didn't do it and he haven't done it since and so
14 it's been a little Band-Aid one on top of the other.
15 Now, with these vouchers you'll be able to
16 have choice, choice of doctors, choice of hospitals,
17 free choice. Now, you'll be able to also have a
18 choice of maybe no more than five or six plans,
19 insurance plans.
20 Now, I have my suspicions with the predator
21 activities under our present mercantile system where
22 you have your lobbyists, 30,000 in Washington, go out
23 and make sure that they take care of their clients.
24 So there's going to be some changes made in the
25 future, depends on how this is enacted into law.
1 And it's not going to be enacted by the
2 Congress. Don't hold your breath on that please.
3 Never will happen. For the very simple reason that
4 there's too many interests, 30,000 lobbyists. Who do
5 you think is funneling all these millions of dollars
6 to the presidential candidates. It isn't coming from
7 the wholly trinity. My God, it's coming from vital
8 special interests, whether they're for Democrats or
9 Republicans, that's what you're faced with.
10 So now you're going to have a voucher. You
11 got the freedom of choice. You got the freedom of
12 choice in plans. Now, you might have a public plan
13 if we don't see the insurance industry and the
14 pharmaceutical industry shaping up. So now you got
15 public assistance. But let's have like publica
16 assistance, let's have a central body called a health
17 care board with regional boards that they would then
18 define what the various vouchers are for.
19 And the vouchers are set up for risk on an
20 individual basis, not on a collective this fits all,
21 because if you're young you probably don't have a
22 cost of more than $3,000. When you're my age it
23 could be 150, $180,000 in one year, which is what I
24 got hit with and I went bankrupt as a result of that.
25 So make no misunderstandings, I know the
1 system. I get my meds from the VA and I get the rest
2 from the Medicare. So I know the system up front and
3 personal, and I don't have to tell you about somebody
4 in Benton, Iowa crying on my shoulder.
5 Let me point out to you so what will happen,
6 when I'm talking individually designed, we're going
7 to have electronic records. Hell, that's nothing.
8 We have to have your entire history computerized, and
9 every penny that's spent on your health care
10 computerized all the time so that when we're really
11 redesigning next year, we're going to turn around and
12 project that oh, you spent 3,000 last year, we're
13 going to give you a voucher for 3,000 the next year.
14 But suppose you've got colon cancer so it costs you
15 $150,000 next year. That's going to be the size of
16 your voucher. You begin to see the dynamics of this.
17 And by putting in, and with only having five
18 or six plans, and the plans would determine and there
19 will be no lemon dropping. There will be no, well,
20 you don't qualify, you get a preexisting condition.
21 That is history under this plan.
22 So this plan can work. All we need to do as
23 they say, oh, you've got to bring the people in. My
24 God, bringing people in. They're not bringing people
25 anywhere. They're just tying to create an attitude
1 of that, my God, we're going to do something great
2 for the people. Hell, the people are not empowered
3 to do anything.
4 In the United States more than half of the
5 American people make laws at a state, local level.
6 Why can't we do that at the federal level. If you
7 did then of course you decide what is the health plan
8 you want to have or if you want to continue to put up
9 with the mandates that we're experiencing.
10 So how are we going to pay for my health
11 care will get done, and I want to thank my advisors,
12 Dr. Fuse and Dr. Politnocoff as both experts in the
13 field that have been advising me. They'd be ashamed
14 the way that I presented it, but I think not. I
15 think not.
16 And so I would just say that if we empower
17 you, then you could make the decision and not try
18 to -- it's what they're saying. They're saying we
19 want you people to use the government for your
20 benefit, okay. Why don't you just -- why do you have
21 to do that? Why can't you do it directly? You
22 can't. There's a way to do it. Go to Gravel OA dot
23 U.S. and you'll see the process to be able to do it.
24 Thank you very much.
25 KAREN TUMULTY: Thank you, Senator. It
1 sounds like the plan that you're describing about
2 your standards right have some of the elements of
3 single-payer but also some of the elements of a
4 medical savings account. It's not a sort of
5 traditional pure single-payer plan. And you
6 described this as something that would never come
7 from Congress. And so can you describe again this
8 process by which -- what kind of process are you
9 talking about here?
10 MIKE GRAVEL: I'm talking about using the
11 national initiative. First for this to happen, and
12 I've got to tell you you're not going to have an
13 alternative because 10 years from now, 15 years from
14 now you're going to have the problem getting worse.
15 You're all right about that. It's getting worse all
16 the time.
17 But don't worry about that. You think that
18 that's going to cause him to solve, the Congress to
19 solve the problem? Look at this country. We're
20 literally bankrupt. We're literally bankrupt and
21 nobody pays any attention to it. We've got these
22 crazy wars. We have a nation that's controlled by
23 the military industrial conflict that dictates what's
24 happening to your lives, and the Americans are just
25 whistling walking through the cemetery. So I don't
1 know if I've answered your question.
2 KAREN TUMULTY: This national initiative,
3 how does that work?
4 MIKE GRAVEL: How does it work?
5 KAREN TUMULTY: In terms of the petition and
6 it starts as what?
7 MIKE GRAVEL: Well, I don't want to take the
8 time to go through this whole process, but understand
9 what I've done is I've copied the procedures that are
10 used in the Congress and every legislative body in
11 the world and I've put them into a law called the
12 National Ballot Initiative. And that is to equip
13 every single American to become lawmakers to come
14 into the operation of government as lawmakers and
15 partners with their elected officials.
16 Now, this is revolutionary. This is out of
17 the box. You know what it means is we trust the
18 American people. Isn't that revolutionary? We trust
19 the people, rather the other politicians trust me,
20 I'll get elected, I'm going to do the job for you.
21 I've got news for you, can't be done that way. And
22 we have historic precedence to show it. And if that
23 doesn't convince you that we're not going in the
24 right direction electing various personalities
25 President and thinking that's going to make the
1 change, I've got to tell you, the change lies with
2 you, not the leadership. The leadership has been
3 screwing up by the numbers for the last 50 years.
4 Have you had enough yet? Please.
5 KAREN TUMULTY: Senator, there was a
6 question that I had in my mind about this, and it's
7 addressed by one of our questioners in the audience,
8 and interestingly enough at this very moment a
9 question over e-mail popped up that addressed the
10 same issue.
11 You described these vouchers as addressing
12 the specific conditions you have. You need a heart
13 bypass, you get a voucher that would cover it. But
14 Michelle in Iowa asked how would you increase the
15 role of prevention in the American health care
16 system. And I'd in fact like to turn to Becky, and I
17 apologize in advance, is it Estraya or Estralla,
18 who's an RN at UHS Valley Hospital.
19 Are you here, Becky?
20 BECKY ESTRAYA: I have been a nurse for
21 37 years and I have seen patients come into the
22 hospital with medical problems that could have been
23 prevented if a doctor had seen this patient early on.
24 As President how will you ensure that more efforts
25 for preventive and wellness care is provided
2 MIKE GRAVEL: First off, there is a role for
3 the President in his leadership capacity, or her
4 leadership capacity. And that is to change the
5 culture, to really energize people to exercise.
6 Now, people say at my age that, you know,
7 I'm a good example. I've had two major operations,
8 several major operations, but I'm in good shape
9 because I exercise. I try to eat the right foods.
10 And so I have a lady on the plane that showed me that
11 she could have got this junk bar for 50 cents but
12 they were asking for a dollar 25 for the apple which
13 she was holding up about to eat. Doesn't that tell
14 you something about the dynamics of what's going on?
15 I mean, we're all patriotic, whether it's in
16 business, whether it's in labor, we're all patriotic.
17 But we need a leadership that sets a tone, that sets
18 a tone to demand from us the best that's in us. We
19 recognize these problems. We know the problem of
20 obesity. I try to diet all the time, sometimes
21 successfully, sometimes not so successfully. But
22 when all you've got in your field of vision is junk
23 food, you got problems.
24 And that's the problem that the President
25 can bully but not giving you. He's going to regulate
1 all this. I got to tell you, look what happened with
2 Katrina. You know, you heard the joke, I'm from the
3 federal government and I'm here to help you. Well,
4 that doesn't work.
5 The government is a tool. The people can
6 use it. But if the people have the direct power to
7 use it, now you get to see government as a real tool,
8 not the tool you have where the special interests
9 determine how the tools of government is handled by
10 the lobbyists and the bundling to pay for the people
11 who pay for their campaign to manipulate you to vote
12 for them. That's the process that we live under and
13 that's process that has to change.
14 KAREN TUMULTY: Next I'd like to turn to
15 Fabiola, is it Pavol? Pavel? Who's a janitor in
16 Clark County. Fabiola, are you here?
17 FABIOLA PAVA: Pava.
18 KAREN TUMULTY: Pava, I apologize. I didn't
19 even come close, but I have a hard time with Tumulty
20 so I understand the issue.
21 FABIOLA PAVA: My name is Fabiola Pava and
22 I'm an SEIU member. I work for Clark County as a
23 janitor. I'm also a primary caregiver for my 78 year
24 old mother.
25 My mother has Medicare and the problem lies
1 in that the providers will not use diagnostic tests
2 and treatments that will diagnose her sooner and
3 treat the problem faster. The question is what is
4 your plan for providing preventative and diagnostic
5 services for health care for our seniors, people with
6 disabilities and all Americans?
7 MIKE GRAVEL: One of the facets of the plan
8 would be to keep in place Medicare and Medicaid and
9 phase them out over time. Because plans to put
10 everybody on Medicare aren't going to fly financially
11 and just can't be met. And so they can tell you they
12 can, but they can't be met.
13 We are in deed economic difficulty and in
14 debt. So when you talk about the seniors, this is
15 where you have these health regional boards where in
16 that region they'll be defining what goes into these
17 various vouchers. And they're change every year
18 depending upon your personal history as you get
20 And we know it costs less for young people
21 and it costs more for old people. That's just the
22 nature of the situation. So I don't have any magic
23 to take care of the seniors. All I can say is I can
24 set up a structure that will have checks and balances
25 where they'll have a better say, they'll have a
1 better say than they have today.
2 77 million people are going to be retiring
3 in the next 25 years. Those are the baby boomers.
4 That's twice the amount of people, the adult, the
5 senior people that exist today. If there's a group
6 that's going to benefit from the National Ballot
7 Initiative it's going to be the seniors because
8 they'll have more clout to be able to vote for
9 programs that they feel will address their particular
11 That's the answer that I would offer to you,
12 not a magic wand from Mike Gravel as President, it's
13 from the people being involved directly with the
14 power to make laws on policy issues that affect your
15 lives. That doesn't exist today, and there's nobody
16 running for President, Democrat or Republican, that's
17 even suggested that. Oh, they talk about big
18 changes. They're cosmetic changes and they're
19 Band-Aids to the problems we face in this country.
20 KAREN TUMULTY: Could I ask a follow-up that
21 I think is to the premise of Fabiola's question, if
22 I'm understanding correctly, which is that, and have
23 you found that in your own experience as a patient
24 and also as a policymaker that elderly patients in
25 particular that the medical system doesn't seem to
1 have the same aggressiveness and the same sort of
2 curiosity? Is that sort of what you were getting at
3 here in terms of diagnostic testing and the kind of
4 treatment that elderly patients receive?
5 MIKE GRAVEL: Maybe I didn't answer her.
6 Doctors do a lot of testing today to cover their
7 backside, you know, because they want to be sued.
8 One of the futures of these regional boards is we're
9 going to do away with what we see that the attorneys
10 love, and that is to go sue doctors or raise the
11 costs where they can't even stay in business. The
12 same thing with nurses. That's got to go.
13 Now, you want to see how much money the
14 trial lawyers are pouring into the presidential
15 campaign? Just as a couple of young people out there
16 doing their blogging and putting that data up, look
17 at that data, that answers the whole question.
18 So we can't have everything. You cannot
19 have everything. And so you can have a basic plan
20 that will cover. And the way the plan is designed,
21 it won't raise costs, because the 30 percent that
22 they're talking about is paper cost. If you took
23 that and put it into some real costs in health care,
24 we'd cover everybody without raising any costs.
25 But you do have to recognize that you can't
1 have everything you want. You can't have a burp and
2 run to the doctor. You got to be responsible as
3 citizens. And that goes back to this whole
4 preventative medicine where we change the culture.
5 That will help to lower the cost, but also until
6 we're totally in a new culture in that regard, we
7 have to have some discipline on what the basic
8 package will be. And that is a decision -- and you
9 want to raise the basic package and you're a
10 lawmaker, put an initial up. Let's say we're going
11 to raise the cost, rather than seven percent for the
12 package, the basic package, we're going to raise it
13 to ten percent. Let the people decide. That's the
14 slogan of my campaign, let the people decide. Why
15 should the politicians be also on the mission in this
16 area and they know it all, when they can't even
17 produce a decent plan. I hope that addresses your
18 follow-up question.
19 KAREN TUMULTY: We have about one minute
20 left, and so I wanted to ask you your slogan, let the
21 people decide, what's your plan from here on out?
22 You come into this race without a lot of name
23 recognition, without a lot of money, without big
24 organizations. Where do you go from here?
25 MIKE GRAVEL: Well, the problem with not a
1 lot of money can be solve by the people who hear my
2 voice. It's not going to be the lobbyists bundling
3 money for me. It's not going to be the corporations
4 that are going to be giving me money through their
5 executives giving me the money. It's going to be if
6 my voice can be heard.
7 And I don't need the 50 million, a hundred
8 million dollars -- or a million dollars that they're
9 going to spend. All I need is a modicum of money,
10 around $10 million and I'll win. I'll win because
11 I'll be able to get to the American people and say
12 the solution is with you. It's not with the leaders.
13 And if I can become President, and lightning
14 would have to strike for that to happen, but, you
15 know something, you know something, lightning has
16 struck all the time in presidential elections, all
17 the time. Anything is possible in politics, and I
18 could be your next President. I could be your next
19 President. And if you're worried about my age,
20 don't. We can get a young man who's vice president.
21 There's a few around. I hope I've answered your
23 KAREN TUMULTY: Thank you very much,
24 Senator. I think anything is possible, and politics
25 is a terrific way to end today.
1 MIKE GRAVEL: Thank you.
2 KAREN TUMULTY: Thank you. Thank you very
3 much. This is the end of our forum, and we want to
4 thank again the University of Nevada, Las Vegas for
5 hosting us. And, Rebels, there's always next year.
7 (Thereupon the proceedings
8 were concluded at 12:09 p.m.)
9 * * * * *
1 CERTIFICATE OF REPORTER
2 STATE OF NEVADA )
4 COUNTY OF CLARK. )
5 I, Deborah Ann Hines, certified shorthand
6 reporter, do hereby certify that I took down in
7 shorthand (Stenotype) all of the proceedings had in
8 the before-entitled matter at the time and place
9 indicated; and that thereafter said shorthand notes
10 were transcribed into typewriting at and under my
11 direction and supervision and the foregoing
12 transcript constitutes a full, true and accurate
13 record of the proceedings had.
14 IN WITNESS WHEREOF, I have hereunto affixed
15 my hand this _____ day of _______________, 2007.
19 Deborah Ann Hines, CCR #473, RPR