Health care came up in a variety of ways in Monday’s debate in Tampa, sponsored by NBC, National Journal and the Tampa Bay Times. Mitt Romney accused Newt Gingrich of influence-peddling on Medicare and also defended the Massachusetts health care reform. Rick Santorum tried to distinguish himself from both men, claiming their support of the individual mandate in the past undermines their conservative credentials. And he defended his behavior during the 1995 controversy about Terri Schiavo, who was in the center of a right-to-die dispute.
Here’s a transcript, courtesy The Washington Post:
MITT ROMNEY: We have congressmen who also say that you came and lobbied them in favor…
NEWT GINGRICH: I didn’t lobby them.
MITT ROMNEY: You have congressmen who say…
MITT ROMNEY: … that you came and lobbied them with regards to Medicare Part D, at the same time…
NEWT GINGRICH: Now, wait. Whoa, whoa.
MITT ROMNEY: … your center was taking in contributions…
NEWT GINGRICH: You just jumped a long way over here, friend.
MITT ROMNEY: Well, another — another area of influence-peddling.
NEWT GINGRICH: No, not — now, let me be very clear, because I understand your technique, which you used on McCain, you used on Huckabee, you’ve used consistently, OK? It’s unfortunate, and it’s not going to work very well, because the American people see through it.
I have always publicly favored a stronger Medicare program. I wrote a book in 2002 called “Saving Lives and Saving Money.” I publicly favored Medicare Part D for a practical reason, and that reason is simple. The U.S. government was not prepared to give people anything — insulin, for example — but they would pay for kidney dialysis. They weren’t prepared to give people Lipitor, but they’d pay for open-heart surgery. That is a terrible way to run Medicare.
I am proud of the fact — and I’ll say this in Florida — I’m proud of the fact that I publicly, openly advocated Medicare Part D. It has saved lives. It’s run on a free enterprise model. It also included health savings accounts and it include Medicare alternatives, which gave people choices.
And I did it publicly, and it is not correct, Mitt — I’m just saying this flatly, because you’ve been walking around this state saying things that are untrue — it is not correct to describe public citizenship, having public advocacy as lobbying. Every citizen has the right to do that.
MITT ROMNEY: They sure do.
NEWT GINGRICH: And what I did on behalf of Medicare…
MITT ROMNEY: They sure do.
NEWT GINGRICH: … I did out in the open, publicly, and that is my right as a citizen.
NBC NEWS MODERATOR BRIAN WILLIAMS: Gentlemen…
MITT ROMNEY: Here’s why it’s a problem, Mr. Speaker. Here’s why it’s a problem. And that is, if you’re getting paid by health companies, if your entities are getting paid by health companies that could benefit from a piece of legislation, and you then meet with Republican congressmen and encourage them to support that legislation, you can call it whatever you’d like. I call it influence-peddling.
It is not right. It is not right. You have a conflict. You are — you are being paid by companies at the same time you’re encouraging people to pass legislation which is in their favor.
MITT ROMNEY: This is — you spent now 15 years in Washington on K Street. And — and this is a real problem, if we’re going to nominate someone who not only had a record of — of great distress as the speaker, but that has worked for 15 years lobbying.
TAMPA BAY TIMES MODERATOR ADAM SMITH: Senator Santorum, in 2005, Florida was in the middle of a huge national debate over Terri Schiavo, whether her feeding tube should be removed after the courts had ruled that she had been in a vegetative state for years. You were at the center, at the front of advocating congressional intervention to keep her alive. You even came down here, came to her bedside after a fund-raiser. Why should the government have more say in medical decisions like that than a spouse?
RICK SANTORUM: Well, number one, I didn’t come to her bedside, but I did come down to Tampa. I was scheduled to come down anyway for that event, and it so happened that this situation was going on.
I did not call for congressional intervention. I called for a judicial hearing by an impartial judge at the federal level to review a case in which you had parents and a spouse on different sides of the issue.
And these were constituents of mine. The parents happen to live in Pennsylvania, and they came to me and made a very strong case that they would like to see some other pair of eyes, judicial eyes, look at it. And I agreed to advocate for those constituents because I believe that we should give respect and dignity for all human life, irrespective of their condition.
And if there was someone there that wanted to provide and take care of them, and they were willing to do so, I wanted to make sure that the judicial proceedings worked properly. And that’s what I did, and I would do it again.
SMITH: Do not resuscitate directives; do you think they’re immoral?
RICK SANTORUM: No, I don’t believe they’re immoral. I mean, I think that’s a decision that people should be able to make, and I have supported legislation in the past for them to make it.
SMITH: Speaker Gingrich, in that case the courts had ruled repeatedly. How does that square, the Terri Schiavo, action with your understanding of the Constitution and separation of powers?
GINGRICH: Well, look, I think that we go to extraordinary lengths, for example, for people who are on murderers row. They have extraordinary rights of appeal.
And you have here somebody who was in a coma, who had, on the one hand, her husband saying let her die and her parents saying let her live. Now, it strikes me that having a bias in favor of life, and at least going to a federal hearing, which would be automatic if it was a criminal on death row, that it’s not too much to say in some circumstances your rights as an American citizen ought to be respected. And there ought to be at least a judicial review of whether or not in that circumstance you should be allowed to die, which has nothing to do with whether or not you as a citizen have a right to have your own end-of-life prescription which is totally appropriate for you to do as a matter of your values in consultation with your doctor.
SMITH: Congressman Paul, you’re a doctor. What was your view of the Terri Schiavo case?
RON PAUL: I find it so unfortunate, so unusual, too. That situation doesn’t come up very often. It should teach us all a lesson to have living wills or a good conversation with a spouse. I would want my spouse to make the decision. And — but it’s better to have a living will.
But I don’t like going up the ladder. You know, we go to the federal courts, and the Congress, and on up. Yes, difficult decisions. Will it be perfect for everybody? No. But I would have preferred to see the decision made at the state level.
But I’ve been involved in medicine with things similar, but not quite as difficult as this. But usually, we deferred to the family. And it wasn’t made a big issue like this was. This was way out of proportion to what happens more routinely.
But I think it should urge us all to try to plan for this and make sure either that one individual that’s closest to you makes the decision or you sign a living will. And this would have solved the whole problem.
WILLIAMS: Which, Senator Santorum, gets us back to electability, the gap between the Republican Party and the president. Some of the newspaper headlines about this gathering we were going to have tonight, in Florida, Romney seeks to link Gingrich to foreclosure crisis. And here’s a second one: The verdict is in, Mitt Romney’s Bain Capital problem is real. What’s the net effect of all this, of the tax release tomorrow, of Freddie — the Freddie Mac release tonight on your party, say your candidacy, as you try to go forward?
RICK SANTORUM: Well, I would say that there are more fundamental issues than that, where there’s a gap and a problem with two of the gentlemen who are up here with me. And one is on the biggest issue that they — we have to deal with in this election, that’s — that’s crushing the economy, will crush it even further and crush freedom, and that’s Obamacare.
Governor Romney’s plan in Massachusetts was the basis for Obamacare. Speaker Gingrich for 20 years supported a federal individual mandate, something that Pam Bondi is now going to the Supreme Court saying is unconstitutional. Speaker Gingrich, for 20 years, up until last year supported an individual mandate, which is at the core of Obamacare.
If you look at cap-and-trade, Governor Romney was very proud to say that he was the first state in the country as governor to sign a cap on CO-2 emissions, the first state in the country to put a cap believing in — in global warming and criticized Republicans for not believing in it, as did, by the way, Speaker Gingrich, who was for a cap-and-trade program with incentives, business incentives, but was for the rubric of cap-and-trade, not specifically the cap-and-trade bill that was out there.
Again, huge, huge differences between my position and where President Obama is, but not so on two major issues. You go down and you look at the Wall Street bailouts, I said before, here’s one where you had folks who preach conservativism, private sector, and when push came to shove, they got pushed. They didn’t stand tall for the conservative principles that they argued that they were for. And as a result, we ended up with this bailout that has injected government into business like it had never been done before.
They rejected conservativism when it was hard to stand. It’s going to be hard to stand whoever this president is going to be elected. It’s going to be tough. There is going to be a mountain of problems. It’s going to be easy to be able to bail out and compromise your principles.
We have gentlemen here on the three issues that got the Tea Party started, that are the base of the conservative movement now in the Republican Party. And there is no difference between President Obama and these two gentlemen. And that’s why this election in Florida is so critical, that we have someone that actually can create a contrast between the president and the conservative point of view.
WILLIAMS: Congressmen Paul, are the two men in the middle insufficiently conservative for you?
RON PAUL: Well, I think the problem is, is nobody has defined what being conservative means.
WILLIAMS: Go ahead.
RON PAUL: And I think that is our problem. Conservative means we have a smaller government and more liberty. And yet, if you ask, what have we done? I think we have lost our way.
Our rhetoric is still pretty good, but when we get in charge, we expand the government. You talk about Dodd-Frank, but we gave Sarbanes-Oxley. We gave debts as well, you know, when we’re in charge.
So, if it means limited government, you have to ask the basic question, what should the role of government be? The founders asked that question, had a revolution and wrote a Constitution. And they said the role of government ought to be to protect liberty.
It’s not to run a welfare state and not to be the policemen of the world. And so if you’re a conservative, how can you be conservative and cut food stamps, but you won’t cut spending overseas? There is not a nickel or a penny that anybody will cut on the conservative side, overseas spending. And we don’t have the money.
They are willing to start more wars. So, I say, if you’re conservative, you want small government across the board, especially in personal liberty. What’s wrong with having the government out of our personal lives? So, this is what — we have to decide what conservative means, what limited government means.
And I have a simple suggestion. We have a pretty good guide, and if we follow the Constitution, government would be very small and we would all be devoted conservatives.
WILLIAMS: Governor Romney, again tonight, so called Romneycare and so-called Obamacare have been positioned very closely side by side by your opponent, the senator. And again, you have been called insufficiently conservative.
MITT ROMNEY: You know, I have a record. You can look at my record. I just described what I had accomplished in Massachusetts. It’s a conservative record.
Also, the fun of running against Ted Kennedy. What a great thrill that was. I didn’t beat him, but he had to take a mortgage out on his house to make sure that he could defeat me. I believe that the policies he put in place had hurt America and helped create a permanent underclass in this country.
My health care plan, by the way, is one that under our Constitution we’re allowed to have. The people in our state chose a plan which I think is working for our state.
At the time we crafted it, I was asked time and again, “Is this something that you would have the federal government do?” I said absolutely not.
I do not support a federal mandate. I do not support a federal one-size-fits-all plan. I believe in the Constitution. That’s why the attorney general here is saying absolutely not.
You can’t impose Obamacare on the states. What I will do if I’m president, I will repeal Obamacare and return to the states the authority and the rights the states have to craft their own programs to care for their own poor.