Health care

CNN SUZANNE MALVEAUX: It was last June, Senator Clinton. It was the PBS forum at Howard University where you said if HIV/AIDS was the leading cause of death among white women ages 25 to 34, there would be a national outcry. Obviously, you're calling attention to the need, specific need for African-American women and their health concerns.

Why is it that African-American women would be better off in your health care program?

CLINTON: Well, first of all, my health care program will cover everyone. I don't leave anybody out. It is a universal system.

It will build on the congressional plan that provides health care for members of Congress, their staffs, government employees, and therefore it is not a new system.

CLINTON: It is not government-run. It has the advantage of being proven, so that we can withstand what will be obviously the attacks coming from the Republicans, and the right, and the drug companies, and the health insurance companies.

It also will give comprehensive health care to everyone. It's especially important we do that with chronic diseases.

And, thankfully (sic) HIV/AIDS has become a chronic disease. We're able to keep people alive in the United States. We don't do enough around the world. And we don't do enough yet to get the services as quickly as necessary to a lot of our people who are not given the kind of immediate help that they deserve.

But we need a universal health care system where we manage chronic diseases, where we get prices down because we can bargain with the drug companies, where we say to the health insurance companies that they must cover everyone, they have to do it at an affordable rate.

And for people who might have some financial challenges, I am proposing health care tax credits that will make health care for everyone affordable.

And I think that that is the right way to go, because if we don't have everybody in the system, we know what will happen. We will begin to have more and more people who are uninsured.

The health care companies will continue to cherry pick. The hidden tax that comes when someone does finally show up at the emergency room will be passed onto everyone else.

Clinton includes everybody in universal health care

So I am adamantly in favor of universal health care. And that means everybody is covered. And we will have a system to make it affordable, but it will be required, as part of shared responsibility, under a new way of making sure that we don't leave anybody out and provide quality, affordable health care for everyone.

Obama does not include migrants in universal heath care

JOHNS: Senator Obama, we all know what universal health care is, as Senator Clinton just said, sort of the idea that everybody deserves health care. And I have not been able to sort of zero in on your position on this one question: Does your plan cover the estimated 12 million or so illegal immigrants in the country?

OBAMA: It does not.

JOHNS: Why not?

OBAMA: Well, because I think we've got limited resources. And it is important for us that, when we've got millions of U.S. citizens that aren't yet covered, it's important for us to make sure that they are provided coverage.

I do think that we have an obligation to make sure that children are covered. And we want to make sure that they are not sick in the emergency room.

But the critical issue on these various plans is, how are we going to actually get it done?

Because, you know, I respect the fact that Senator Clinton and President Clinton attempted in '93 to get health care reform passed. But I do think that they did it in the wrong way, because it was behind closed doors, and we did not enlist the American people in the process.

The only way we're going to be able to overcome the insurance companies, and the drug companies, and the HMOs who are profiting from the current system is if we are having all these negotiations in a public setting, we are very clear about who's carrying water for the drug companies and the insurance companies, and who is looking out for the families who, day to day, are struggling.

All of us, all three of us have met people every day in our travels across the country who, even if they have health care, are looking at such high premiums that effectively it's not really health insurance, it's house insurance.

They're paying premiums, in case they get hit by a car, they don't lose their home. But they never go to a doctor.

And we've got to put responsibility not just on the next president, but also on Congress to make sure it happens. And that means that we've got to have the American people clear about the choices that we face.

BLITZER: Senator Edwards, would your plan include the 12 million illegal immigrants? And if not, what happens if they get sick and they wind up in emergency rooms? Who's going to pay for that?

EDWARDS: Well, it's a good question. I think, honestly, none of our three plans cover them.

But what I have done is strengthen the safety net of the public health system so that our public health clinics, our public hospitals will always be available.

And if that is married to comprehensive immigration reform, so that people who are living here undocumented actually have a chance to become American citizens, then I think they've got the opportunity to become part of the plan.

There are a couple things I want to say, though. Senator Obama spoke — and he's right about this — about the importance of us being straightforward and being honest during the campaign.

The truth is that there are three health care plans represented on this stage. Two are universal; one is not. His is not. Senator Clinton's is, and mine is.

EDWARDS: In order for the plan to be universal, it has to mandate coverage for everybody. And when we talk about getting it done — and Barack just spoke, as he does often, eloquently, about taking on the drug companies, the insurance companies, I also think it's important to recognize that Senator Obama has taken more money from the drug companies than anybody. Senator Clinton has taken more money from the insurance companies than anybody.

I have not. And I am ready to take these people on.

OBAMA: Well, a couple of points.

OBAMA: A couple of points. John, I think, is aware I don't take PAC money. I don't take money from federal lobbyists. I'm not taking money from their companies.

It is true that there are employees of all sorts of companies that have given to my campaign because, frankly, I've raised a lot of money, and sometimes in $25, $50, $100 donations.

But that does mean that I've gotten a bunch of money from drug lobbyists. And I think it's important to make that distinction, John.

EDWARDS: That's fair.

OBAMA: Point number two. With respect to universal coverage, understand what this debate is about. And this is a legitimate policy debate. And I respect the positions that John and Hillary have taken.

They have decided that we should mandate coverage for all adults. I believe that the problem — and understand what that means. A mandate means that, in some fashion, everybody will be forced to buy health insurance.

Now, John has been honest that that may mean taking money out of people's paychecks in order to make sure that they're covered. Senator Clinton has not been clear about how that mandate would be enforced.

But I believe the problem is not that folks are trying to avoid getting health care; the problem is they can't afford it.

And that's why my plan emphasizes lowering costs, not only setting up a government plan so that people who don't have health insurance can buy into it and will get subsidized, but also making sure that those who have health insurance — because, keep in mind, we've got millions of Americans all across the country who have health insurance, but are struggling with rising co-payments, deductibles, premiums.

Under George Bush, families are paying 78 percent more on health care than they were previously — let me just finish, because this is an important policy point. We put in a catastrophic re-insurance plan that will help reduce those premiums for families by an average of about $2,500 per year.

But the last point that I think is worth making, every expert that's looked at this has said there is not a single person out there who's going to want health care who will not get it under my plan.

And it's true that some people could game the system by just waiting until they get sick and then they show up. But keep in mind that my plan also says children will be able to stay on the parents' plan up until the age of 25.

And so I don't believe that there are a whole bunch of folks out there that will not get coverage.

And, John, both you and Hillary have a hardship exemption, where, if people can't afford to buy health care, you exempt them, so that you sort of don't count them.

EDWARDS: But we would cover them. We cover them, Barack.

OBAMA: But you don't cover them.

EDWARDS: Yes, we do.

CLINTON: Yes, we do.

EDWARDS: Yes, we do. It's not true, Barack.

CLINTON: That is not true.

EDWARDS: No, no. Here's the problem. The problem with this argument is you can make exactly the same argument about Social Security.

I mean, you think about the analogy. What George Bush says is he wants people to be able to get out of the Social Security system, choose, elect to get out of the Social Security system. Well, that's exactly what this argument is.

OBAMA: No.

EDWARDS: This argument is you shouldn't have to have health care. If you choose not to have health care, you shouldn't have to have it.

And that is a threshold question. It is a judgment. It's a fair policy debate.

EDWARDS: There's nothing wrong with us arguing about this, but I believe that there is not a single man, woman, and child in America who's not worthy of health care. Everybody should get health care.

CLINTON: Well, first of all, if you don't start out trying to get universal health care, we know — and our members of Congress know — you'll never get there.

If a Democrat doesn't stand for universal health care that includes every single American, you can see the consequences of what that will mean. I think it is imperative that we have plans, as both John and I do, that from the very beginning say, "You know what? Everybody has got to be covered."

There's only three ways of doing it. You can have a single-payer system, you can require employers, or you can have individual responsibility. My plan combines employers and individual responsibility, while maintaining Medicare and Medicaid.

I think that the whole idea of universal health care is such a core Democratic principle that I am willing to go to the mat for it. I've been there before. I will be there again. I am not giving in; I am not giving up; and I'm not going to start out leaving 15 million Americans out of health care.

Secondly, we have seen once again a kind of evolution here. When Senator Obama ran for the Senate, he was for single-payer and said he was for single-payer if we could get a Democratic president and Democratic Congress. As time went on, the last four or so years...

CLINTON: As time went on, the last four or so years, he said he was for single payer in principle, then he was for universal health care. And then his policy is not, it is not universal. And this is kind of like the present vote thing, because the Chicago Tribune, his hometown paper, said that all of those present votes was taking a pass. It was for political reasons.

Well, when you come up with a universal health care plan and you don't have any wiggle room left, you know that you're going to draw a lot of political heat. I am not running for president to put Band- Aids on our problems. I want to get to universal health care for every single American.

OBAMA: Here's the policy question: if, in fact, we are not making it affordable enough, which is what's happening right now, and you mandate on families to buy health insurance that they can't afford and if they don't buy it you fine them or in some other way take money for them — this is what's happening...

EDWARDS: But, Barack, you're ignoring that we subsidize...

OBAMA: John, I haven't finished. John, let me finish.

EDWARDS: OK, all right, go ahead.

OBAMA: Now, what is happening in Massachusetts right now — there are articles being written about it — which is that folks are having to pay fines and they don't have health care. They'd rather go ahead and take the fine because they can't afford the coverage.

My core belief is that people desperately want coverage. They desperately want it, and my plan provides those same subsidies. And if they are provided those subsidies and they have good, quality care that's available, then they will purchase it. That is my belief.

Now, it's fine for us to have a debate about how the best way to get there is, but to suggest somehow that I'm not interested in having anybody covered, or to suggest, as Hillary just did, that I was in favor of single payer — I never said that we should try to go ahead and get single payer. What I said was that if I were starting from scratch, if we didn't have a system in which employers had typically provided health care, I would probably go with a single-payer system.