Republican Presidential Candidates On Health Care: Transcript

During the June 13 CNN Republican presidential debate, candidates discussed health care issues three times. They attacked President Barack Obama and the health law, they discussed controversial plans to overhaul Medicare and they addressed abortion.

The participants included: Former Sen. Rick Santorum, Former House Speaker Newt Gingrich, former Mass. Gov. Mitt Romney, former Minn. Gov. Tim Pawlenty, Rep. Ron Paul, R-Texas, Rep. Michele Bachmann, R-Minn., and former CEO of Godfather’s Pizza Herman Cain.

THE HEALTH LAW

TOM FAHEY, New Hampshire Union Leader: I’m here with Sylvia Smith. She’s from Littleton. And she is a freelance journalist who’s written about the health care industry. She has a question about health care.

SMITH: Yes. As a journalist who’s written frequently about health care and medicine for both newspapers and for corporate publications, I’m very concerned about the overreach of the massive health care legislation that was passed last year. My question is, what would each candidate do? What three steps would they take to de- fund Obamacare and repeal it as soon as possible? Thank you.

JOHN KING, CNN: Congresswoman Bachmann, let’s start with you on that.

BACHMANN: Thank you, John. Sylvia, thank you for that great question. I was the very first member of Congress to introduce the full-scale repeal of Obamacare. And I want to make a promise to everyone watching tonight: As president of the United States, I will not rest until I repeal Obamacare. It’s a promise. Take it to the bank, cash the check. I’ll make sure that that happens.

This is the symbol and the signature issue of President Obama during his entire tenure. And this is a job-killer, Sylvia. The CBO, the Congressional Budget Office has said that Obamacare will kill 800,000 jobs. What could the president be thinking by passing a bill like this, knowing full well it will kill 800,000 jobs?

Senior citizens get this more than any other segment of our population, because they know in Obamacare, the president of the United States took away $500 billion, a half-trillion dollars out of Medicare, shifted it to Obamacare to pay for younger people, and it’s senior citizens who have the most to lose in Obamacare.

KING: Governor Romney, just yesterday, Governor Pawlenty, who is to your left on the stage tonight, called your Massachusetts plan, which you know has become a focal point of the criticism in this campaign from your friends here, Obamneycare, Obamneycare. Is that a fair comparison?

ROMNEY: You know, let me say a couple things. First, if I’m elected president, I will repeal Obamacare, just as Michelle indicated. And also, on my first day in office, if I’m lucky enough to have that office, I will grant a waiver to all 50 states from Obamacare.
Now, there’s some similarities and there are some big differences. Obamacare spends a trillion dollars. If it were perfect — and it’s not perfect, it’s terrible — we can’t afford more federal spending.

Secondly, it raises $500 billion in taxes. We didn’t raise taxes in Massachusetts.

Third, Obamacare takes $500 billion out of Medicare and funds Obamacare. We, of course, didn’t do that.

And, finally, ours was a state plan, a state solution, and if people don’t like it in our state, they can change it. That’s the nature of why states are the right place for this type of responsibility. And that’s why I introduced a plan to repeal Obamacare and replace it with a state-centric program.

KING: Governor, you just heard the governor rebut your characterization, Obamneycare. Why?

PAWLENTY: Well, let me first say to Sylvia, she has put her finger on one of the most important issues facing the country, which is President Obama stood before the nation in 2008 and said he promised to do health care reform focused on cost containment, along with Republicans, he’d do it on a bipartisan basis…

KING: The question — the question, Governor, was, why Obamneycare?

PAWLENTY: That’s right. Well, I’m going to get to that, John.

KING: You have 30 seconds, Governor.

PAWLENTY: Yeah, so we — this is another example of him breaking his promise, and he has to be held accountable. And in order to prosecute the case against President Obama, you have to be able to show that you’ve got a better plan and a different plan. We took a different approach in Minnesota. We didn’t use top-down government mandates and individual requirements from government. We created market alternatives and empowered consumers. I think that’s the way to fix health care in the United States of America.

KING: And you don’t want to address why you called Governor Romney’s Obamneycare?

PAWLENTY: Well, the issue that was raised in a question from a reporter was, what are the similarities between the two? And I just cited President Obama’s own words that he looked to Massachusetts as a blueprint or a guide when he designed Obamacare.

KING: But you chose — you say you were asked a question, which is fair enough, but you chose those words. And so one of my questions is, why would you chose those — choose those words maybe in the comfort of a Sunday show studio? Your rival is standing right there. If it was Obamneycare on “Fox News Sunday,” why isn’t it not Obamneycare standing here with the governor right there?

PAWLENTY: It — President Obama is — is the person who I quoted in saying he looked to Massachusetts for designing his program. He’s the one who said it’s a blueprint and that he merged the two programs. And so using the term “Obamneycare” was a reflection of the president’s comments that he designed Obamacare on the Massachusetts health care plan.

KING: All right. Governor, you want to respond to that at all?

ROMNEY: No, just — just to say this, which is my guess is the president is going to eat those words and wish he hasn’t — hadn’t put them out there. And I can’t wait to debate him and say, Mr. President, if, in fact, you did look at what we did in Massachusetts, why didn’t you give me a call and ask what worked and what didn’t? And I would have told you, Mr. President, that what you’re doing will not work.

It’s a huge power grab by the federal government. It’s going to be massively expensive, raising taxes, cutting Medicare. It’s wrong for America. And that’s why there’s an outpouring across the nation to say no to Obamacare. And I’m delighted to be able to debate him on that.

KING: OK. Mr. Speaker… (CROSSTALK)

KING: … you have a — I’ll let you — Mr. Speaker, you have at times said, you know, maybe you do have to consider a mandate. You’ve been very open to the individual mandate. It has become, it seems, at least at the moment, a litmus test in this Republican primary. Should it be?

GINGRICH: Yes, it should be. If you — if you explore the mandate, which even the Heritage Foundation at one time looked at, the fact is, when you get into a mandate, it ultimately ends up with unconstitutional powers. It allows the government to define virtually everything. And if you can do it for health care, you can do it for everything in your life, and, therefore, we should not have a mandate.

But I want to answer Sylvia at a different level. This campaign cannot be only about the presidency. We need to pick up at least 12 seats in the U.S. Senate and 30 or 40 more seats in the House, because if you are serious about repealing Obamacare, you have to be serious about building a big enough majority in the legislative branch that you could actually in the first 90 days pass the legislation.

So I just think it’s very important to understand, it’s not about what one person in America does. It’s about what the American people do. And that requires a senatorial majority, as well as a presidency.

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MEDICARE

KING: All right. We’re going to continue our conversation now. We want to bring up a very important issue I know all of you will want to weigh in on, and that is the debate about entitlements — Mr. Cain mentioned those — and specifically — specifically Medicare. Right now, I want to go down to our audience. We’ve got Josh McElveen with a question. 

JOSH MCELVEEN, WMUR-TV: Thanks very much, John. And I have Dr. Paul Collins who — you’ve been running a family practice in Manchester for how long?

DR. PAUL COLLINS: Twenty-seven years.

MCELVEEN: Nice work. So not surprising your question is related to health care. What’s your question, sir?

COLLINS: Yes, sir. As a member of the Baby Boomer generation, I’ve been contributing to Medicare through payroll taxes for over 30 years. How do you propose to keep Medicare financially solvent for the next 50 years and beyond?

KING: Let’s start with Dr. Paul on this one.

PAUL: Well, under these conditions, it’s not solvent and won’t be solvent. You know, if you’re — if you’re an average couple and you paid your entire amount into — into Medicare, you would have put $140,000 into it. And in your lifetime, you will take out more than three times that much.

So a little bit of arithmetic tells you it’s not solvent, so we’re up against the wall on that, so it can’t be made solvent. It has to change. We have to have more competition in medicine.

And I would think that if we don’t want to cut any of the medical benefits for children or the elderly, because we have drawn so many in and got them so dependent on the government, if you want to work a transition, you have to cut a lot of money.

And that’s why I argue the case that this money ought to be cut out of foreign welfare, and foreign militarism, and corporate welfare, and the military industrial complex. Then we might have enough money to tide people over.

But some revamping has to occur. What we need is competition. We need to get a chance for the people to opt out of the system. Just — you talk about opting out of Obamacare? Why can’t we opt out of the whole system and take care of ourselves? (APPLAUSE)

KING: All right, let’s — let’s continue the conversation. Governor Pawlenty, Congressman Paul says opt out. Congressman Ryan says squeeze a lot of savings across the federal budget, including a lot out of Medicare to turn it into a — he doesn’t like this word — but turn it essentially into a voucher program. Instead of having the federal program, the government would give you some money and you’d go out in the marketplace and shop for it. Is that the right way to do it?

PAWLENTY: Let me first address the doctor. Doctor, you said in your question that you’ve paid in your whole life, and we respect that. People have made plans, particularly people who are on the program now or close to eligibility. We should keep our word to people that we’ve made promises to.

So under my proposal, if you’re on the program or near the program, we’ll keep our word. But we also have to recognize what Congressman Paul just said. There was a recent report out that the premiums for Medicare and the payroll withholdings are only paying about half the program. So it is not financially solvent. We have to fix it; we have to reform it.

I’m going to have my own plan, John, that will feature some differences from Congressman Ryan’s plan. It will feature performance pay rather than just volume pay to hospitals and clinics and providers. It will allow Medicare to continue as an option, but it’ll be priced against various other options that we’re going to offer people, as well, and some other things.

And I also said, if it was a choice between Barack Obama’s plan and doing nothing, we have a president of the United States got one of the worst crises financially in the history of the country, and you can’t find him on these issues. He’s missing. I’ll lead on this issue.

KING: All right, Governor. Mr. Speaker, I want to bring you into this conversation, because I’m looking down — I want to get the words just right — your initial reaction to the Ryan plan? It’s radical right-wing social engineering. Then you backtracked. Why?

GINGRICH: Well, first of all, it was a very narrow question, which said, should Republicans impose an unpopular bill on the American people? Now, I supported the Ryan budget as a general proposal. I actually wrote a newsletter supporting the Ryan budget. And those words were taken totally out of context.

I’m happy to repeat them. If you’re dealing with something as big as Medicare and you can’t have a conversation with the country where the country thinks what you’re doing is the right thing, you better slow down.

Remember, we all got mad at Obama because he ran over us when we said don’t do it. Well, the Republicans ought to follow the same ground rule. If you can’t convince the American people it’s a good idea, maybe it’s not a good idea. So let me start there.
Second, there are certain things I would do different than Paul Ryan on Medicare. I agree strongly with him on Medicaid, and I think it could be done. But let me just say two quick things.

KING: Quickly.

GINGRICH: Congressman Tom Price has a very good bill in that would allow private contracting so those people who want to voluntarily could contract with their doctor or their hospital in addition to Medicare, and it would be outside the current system and it would relieve the pricing pressure on the current system. We did a study called “Stop Paying the Crooks.” We think you can save $70 billion to $120 billion in Medicare and Medicaid annually by not paying crooks…

KING: All right. We have to — we have to save time.

GINGRICH: … two examples.

KING: We have to save time. Let me start with the senator first. Should the Republicans slow down?

SANTORUM: No. We have a $1.4 trillion deficit, and it isn’t getting any better anytime soon. We have to deal with this problem now. And what Paul Ryan has suggested, which I wholeheartedly support, is to use a program that is identical to what seniors already have. It’s called Medicare Part D.

They have a program right now which seniors like. It is a program that’s called a premium support program. We give seniors — depending on income — a certain amount of money so they can go out and they can purchase health care that they want that helps them — and this is the key, John — we need to include seniors in controlling costs.

What President Obama — let me finish, please — what President Obama has done is he put in, in the Obamacare bill, the Independent Payment Advisory Board. Ladies and gentlemen, seniors, Medicare is going to be cut, starting in 2014, by the federal government, and it’s going to be rationing of care from the top down.

What Paul Ryan and Rick Santorum want to do, which is not radical, which is take a program, Medicare prescription drugs, that is 41 percent under budget, because seniors are involved in controlling costs, and apply it all to Medicare. It is the right approach for Medicare.

KING: The speaker’s point — the speaker’s point, Mr. Cain, was that if you’ve lost the American people, if they’re not following you, you have to slow down until you can get them with you. Is that a fair point?

CAIN: We don’t need to slow down. I hate to tell you — I hate to be the one to give you the bad news, Doctor. You’re not going to get most of the money you put into Medicare if we don’t restructure it.

The reason we’re in the situation we are today with Medicare and Social Security is because the problem hasn’t been solved. We can no longer rearrange it. We’ve got to restructure those programs. And the Paul Ryan approach I totally support.

And he has been very courageous in taking the lead on this.

CAIN: And you know that commercial where they have demagogued the whole thing with medi-scare and having grandma tossed off the bridge? If we don’t fix this problem, it’s going to be our grandkids in that wheelchair that they are going to be throwing off the bridge. We have got to fix the problem.

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ABORTION

JENNIFER VAUGHN: Senator Santorum, staying with you for a moment, if I may, you are staunchly pro-life. Governor Romney used to support abortion rights until he changed his position on this a few years ago. This has been thoroughly discussed. But do you believe he genuinely changed his mind, or was that a political calculation? Should this be an issue in this primary campaign?

SANTORUM: I think — I think an issue should be — in looking at any candidate is looking at the authenticity of that candidate and looking at their — at their record over time and what they fought for. And I think that’s — that a factor that — that should be determined.

You can look at my record. Not only have I been consistently pro-life, but I’ve taken the — you know, I’ve not just taken the pledge, I’ve taken the bullets to go out there and fight for this and lead on those issues. And I think that’s a factor that people should consider when you — when you look, well, what is this president going to do when he comes to office?

A lot of folks run for president as pro-life and then that issue gets shoved to the back burner. I will tell you that the issue of pro-life, the sanctity and dignity of every human life, not just at birth, not just on the issue of abortion, but with respect to the entire life, which I mentioned welfare reform and — and the dignity of people at the end of life, those issues will be top priority issues for me to make sure that all life is respected and held with dignity. (APPLAUSE)

KING: Governor Romney, let me give you — take — take 20 or 30 seconds, if there’s a Republican out there for whom this important, who questions your authenticity on the issue?

ROMNEY: People have had a chance to look at my record and look what I’ve said as — as I’ve been through that last campaign. I believe people understand that I’m firmly pro-life. I will support justices who believe in following the Constitution and not legislating from the bench. And I believe in the sanctity of life from the very beginning until the very end.

KING: Is there anybody here who believes that that’s an issue in the campaign, or is it case closed?

(UNKNOWN) Case closed.

KING: Case closed it is. All right. Let’s move on with the questions. Tom Foreman is standing by up in Rochester.

FOREMAN: Hi, John. Representative Bachmann, I have a question for you. Governor Pawlenty says he opposes abortion rights except in cases of rape, incest, or when the mother’s life is at stake. Do you have any problem with that position? And if so, why?

BACHMANN: I am 100 percent pro-life. I’ve given birth to five babies, and I’ve taken 23 foster children into my home. I believe in the dignity of life from conception until natural death. I believe in the sanctity of human life.

And I think the most eloquent words ever written were those in our Declaration of Independence that said it’s a creator who endowed us with inalienable rights given to us from God, not from government. And the beauty of that is that government cannot take those rights away. Only God can give, and only God can take.

And the first of those rights is life. And I stand for that right. I stand for the right to life. The very few cases that deal with those exceptions are the very tiniest of fraction of cases, and yet they get all the attention. Where all of the firepower is and where the real battle is, is on the general — genuine issue of taking an innocent human life. I stand for life from conception until natural death. (APPLAUSE)

KING: Governor Pawlenty, it was your position that was brought into the question. We’ll give you a few seconds.

PAWLENTY: Well, this is a great example where we can look at our records. The National Review Online, which is a conservative publication, said based on results — not just based on words — I was probably the most pro-life candidate in this race.

As governor of the state of Minnesota, I appointed to the Supreme Court a conservative court for the first time in the modern history of my state. We passed the most pro-life legislation anytime in the modern history of the state, which I proposed and signed, including women’s right to know, including positive alternatives to abortion legislation, and many others.

I’m solidly pro-life. The main pro-life organization in Minnesota gives me very, very high marks. And I haven’t just talked about these things; I’ve done it.