The Republican candidates for president spent their latest debate Tuesday night criticizing features of the health care law, including the IPAB. Newt Gingrich brought up “death panels” and Gov. Rick Perry faced questions about Medicaid and the uninsured in Texas.
Here is a transcript of the sections of the debate concerning health care:
KAREN TUMULTY, The Washington Post: Speaker Gingrich, Medicare is going broke. Consider the fact that half of all Medicare spending is done in the last two years of life, and research that has been done right here at Dartmouth by “The Dartmouth Atlas” would suggest that much of this money is going to treatments and interventions that do nothing to prolong life or to improve it. In fact, some of it does the opposite. Do you consider this wasteful spending? And, if so, should the government do anything about it?
NEWT GINGRICH: I am really glad you asked that, because I was just swapping e-mails today with Andy von Eschenbach, who was the head of the National Cancer Institute, the head of the Food & Drug Administration. But before that, he was the provost M.D. Anderson, the largest cancer treatment center in the world. And he wrote me to point out that the most recent U.S. government intervention on whether or not to have prostate testing is basically going to kill people.
So, if you ask me, do I want some Washington bureaucrat to create a class action decision which affects every American’s last two years of life, not ever. I think it is a disaster. I think, candidly, Governor Palin got attacked unfairly for describing what would, in effect, be death panels.
And what von Eschenbach will tell you if you call him is, the decision to suggest that we not test men with PSA will mean that a number of people who do not have — who are susceptible to a very rapid prostate cancer will die unnecessarily. And there was not a single urologist, not a single specialist on the board that looked at it. So, I am opposed to class intervention for these things.
TUMULTY: Well, Congresswoman Bachmann, of course no one wants the government to come between a doctor and a patient. But do you think that Americans are getting the most for their money in Medicare spending? And how can we make sure that the money that is being spent is being spent on the treatments and the preventive treatments that do the most?
Rep. MICHELE BACHMANN: We have a big problem today when it comes to Medicare, because we know that nine years from now, the Medicare hospital Part B trust fund is going to be dead-flat broke, so we’ve got to deal with this issue. I was in the White House with President Obama this summer. We asked him not once, but three times, “President Obama, what is your plan to save Medicare?”
And the president mumbled and he didn’t give an answer the first time, the second time. And the third time the president said something very interesting, Karen. He said Obamacare. I think that senior citizens across the country have no idea that President Obama plans for Medicare to collapse, and instead everyone will be pushed into Obamacare.
And just like Newt Gingrich said, the way that Obamacare runs, there’s a board called IPAB. It’s made up of 15 political appointees. These 15 political appointees will make all the major health care decisions for over 300 million Americans. I don’t want 15 political appointees to make a health care decision for a beautiful, fragile 85- year-old woman who should be making her own decision.
RICK SANTORUM: We need to repeal Obamacare. That’s the first thing we need to do. You want to create jobs? I went to Ossipee [N.H.] yesterday and I talked to a small businessman there, and he said, “I will not hire anybody, I will not make a move until I find out what is going to happen with this health care bill and how it’s going to crush me.”
And so, repealing Obamacare, and we can do it, not by waivers. That’s the wrong idea, Mitt. The reason it’s the wrong idea, because you get a waiver, California going to waive that? No. New York going to waive it? No. All of these states, many of them, liberal states are going to continue on, and then states like New Hampshire that will waive it will end up subsidizing California. (CROSSTALK)
SANTORUM: We need to repeal it…
CHARLIE ROSE, Moderator: All right. But the time…
SANTORUM: I know. (CROSSTALK)
ROSE: You see the red light, time.
SANTORUM: We need to repeal it by doing it through a reconciliation process. And since I have experience and know how to do that, we’ll take care of it…
MITT ROMNEY: Rick, you’re absolutely right. On day one, granting a waiver for all 50 states doesn’t stop in its tracks entirely Obamacare. That’s why I also say we have to repeal Obamacare, and I will do that on day two, with the reconciliation bill, because as you know, it was passed by reconciliation, 51 votes.
ROSE: All right. We can get rid of it with 51 votes. We have to get rid of Obamacare and return to the states the responsibility… (CROSSTALK)
ROMNEY: No, not if you get rid of it. And particularly — by the way, the Supreme — the Supreme Court may get rid of it. (CROSSTALK)
ROMNEY: Let me finish. Let me finish.
ROSE: OK, let’s — then we’ll go to Huntsman, then we’ll go to the break, and then when we come back, each of you can question each other.
ROMNEY: Let me just — let me just say this, which is we all agree about repeal and replace. And I’m proud of the fact that I’ve put together a plan that says what I’m going to replace it with. And I think it’s incumbent on everybody around this table to put together a plan that says this is what I’ll replace it with, because the American people are not satisfied with the status quo. They want us to solve the problem of health care, to get it to work like a market, and that’s what has to happen.
ROSE: All right. Governor Huntsman, then we go.
JON HUNTSMAN: It’s disingenuous to — to just say that you can — you can waive it all away. The mandate will be in place. The IRS is already planning on 19,500 new employees to administer that mandate. That will stay, and that’s the ruinous part of — of Obamacare. And that — Mitt, your plan is not going to do anything.
ROMNEY: I said we had to repeal it. Did you miss that?
HUNTSMAN: No. It doesn’t — it doesn’t repeal the mandate.
ROMNEY: No, no, I said I’m going to repeal it through reconciliation.
SANTORUM: Through reconciliation, you can repeal the taxes, you can repeal the spending, and therefore, the mandate has no teeth, because there’s no tax penalty if you don’t enforce it.
Gov. RICK PERRY: Governor Romney, your chief economic adviser, Glenn Hubbard, who you know well, he said that Romneycare was Obamacare. And Romneycare has driven the cost of small-business insurance premiums up by 14 percent over the national average in Massachusetts. So my question for you would be: How would you respond to his criticism of your signature legislative achievement?
ROMNEY: You know, the — the great thing about running for president is to get the chance also to talk about your experience as a governor. And I’m proud of the fact that we took on a major problem in my state. And the problem was that we had a lot of kids without insurance, a lot of adults without insurance, but it added up to about 8 percent of our population. And we said, you know what, we want to find a way to get those folks insured, but we don’t want to change anything for the 92 percent of the people that already have insurance. And so our plan dealt with those 8 percent, not the 92 percent.
One of the problems with Obamacare is he doesn’t just deal with the people without insurance. He takes over health care for everyone. Then he does something else that Chris Christie said today. He said the problem with Obamacare is he spends an extra trillion dollars and raises taxes. And raising taxes is one of the big problems, something we didn’t do in Massachusetts. He also cuts Medicare. Only — but people out there are talking about cutting Medicare, it’s President Obama that did that.
And I’m proud of what we are able to accomplish. I’ll tell you this, though. We have the lowest number of kids as a percentage uninsured of any state in America. You have the highest. You… (CROSSTALK)
ROMNEY: I’m still speaking. We — we have — we have less than 1 percent of our kids that are uninsured. You have a million kids uninsured in Texas. A million kids. Under President Bush, the percentage uninsured went down. Under your leadership, it’s gone up.
I care about people. Now, our plan isn’t perfect. Glenn Hubbard is a fine fellow. Take a look at his quote. Some people say that. Just because some people say something doesn’t mean it’s true. The truth is, our plan is different, and the people of Massachusetts, if they don’t like it, they can get rid of it. Right now, they favor it 3 to 1.
But I’m not running for governor of Massachusetts. I’m running for president of the United States. And as president, I will repeal Obamacare, I’ll grant a waiver on day one to get that started, and I’ll make sure that we return to the states what we had when I was governor, the right to care for our poor in the way we thought best for our respective states.
ROSE: I want to go to Governor Perry. Explain to me what you think the difference is about your health care ideas and Governor Romney’s health care ideas, and how you see mandates and how he sees mandates and the Constitution, because not only has there been some exchange here, Governor Christie got involved today.
PERRY: Well, certainly the issue of health care is probably one of the biggest ones that’s facing us. I mean, there are a lot of Americans sitting out there today, and getting those people back to work is the most important thing that we do as a country so that they can have the opportunity to purchase health care. … in the state of Texas, from the standpoint of what we have done to make access of health care better, we passed the most sweeping tort reform in the nation in 2003. We also passed Healthy Texas, which expands the private sector insurance. And we have driven down the cost of insurance by 30 percent.
So, those are some of the ways that the states — but the real issue for us is Medicaid and how to get the flexibility on Medicaid so that the innovators can occur in the states. I can promise you, whether it’s Governor Jindal or myself or Susana Martinez over in New Mexico, that’s where you will find the real innovation in health care. The way to deliver health care more efficiently, more effectively is to block-grant those dollars back to the state and keep this federal government that has this one-size-fits-all mentality from driving the thought process that we have seen destroy health care in this country today.
TUMULTY: But, Governor Perry, Texas as “The Washington Post” fact-checker noted, Texas has had 16 waivers for Medicaid. So how can you say that the problem is that the federal government has not given Texas enough flexibility?
PERRY: They haven’t anywhere near given the states — I think what you should see is the block-granting, not having to go to Washington, D.C., and ask them, mother, may I every time you come up with a concept or an idea. Block-granting back to the states, I’ll guarantee you, the governors and their innovators in their states will come up with ways to better deliver health care more efficiently, more effectively, more cost-efficiently, and that’s what this country is looking for, is a president who understands that we have these 50 laboratories of innovation, free up these states from Washington, D.C.’s one size fits all.