OK

Debate re-write with extra zing!

This edition:
"The Affordable Care Act"

"The Affordable Care Act"

ROMNEY: I want it repealed. I sure do. Well, in part, it comes, again, from my experience. You know, I was in New Hampshire. A woman came to me and she said, look, I can't afford insurance for myself or my son. I met a couple in Appleton, Wisconsin, and they said, we're thinking of dropping our insurance, we can't afford it.

And the number of small businesses I've gone to that are saying they're dropping insurance because they can't afford it, the cost of health care is just prohibitive. And -- and we've got to deal with cost.

And, unfortunately, when -- when -- when you look at Obamacare, the Congressional Budget Office has said it will cost $2,500 a year more than traditional insurance. So it's adding to cost. And as a matter of fact, when the president ran for office, he said that, by this year, he would have brought down the cost of insurance for each family by $2,500 a family. Instead, it's gone up by that amount. So it's expensive. Expensive things hurt families. So that's one reason I don't want it.

Second reason, it cuts $716 billion from Medicare to pay for it. I want to put that money back in Medicare for our seniors.

Number three, it puts in place an unelected board that's going to tell people ultimately what kind of treatments they can have. I don't like that idea.

Fourth, there was a survey done of small businesses across the country, said, what's been the effect of Obamacare on your hiring plans? And three-quarters of them said it makes us less likely to hire people. I just don't know how the president could have come into office, facing 23 million people out of work, rising unemployment, an economic crisis at the -- at the kitchen table, and spend his energy and passion for two years fighting for Obamacare instead of fighting for jobs for the American people. It has killed jobs.

And the best course for health care is to do what we did in my state: craft a plan at the state level that fits the needs of the state. And then let's focus on getting the costs down for people, rather than raising it with the $2,500 additional premium.

LEHRER: Mr. President, the argument against repeal?
OBAMA: Well, four years ago, when I was running for office, I was traveling around and having those same conversations that Governor Romney talks about. And it wasn't just that small businesses were seeing costs skyrocket and they couldn't get affordable coverage even if they wanted to provide it to their employees. It wasn't just that this was the biggest driver of our federal deficit, our overall health care costs, but it was families who were worried about going bankrupt if they got sick, millions of families, all across the country.

If they had a pre-existing condition, they might not be able to get coverage at all. If they did have coverage, insurance companies might impose an arbitrary limit. And so as a consequence, they're paying their premiums, somebody gets really sick, lo and behold, they don't have enough money to pay the bills, because the insurance companies say that they've hit the limit.

So we did work on this, alongside working on jobs, because this is part of making sure that middle-class families are secure in this country.

And let me tell you exactly what Obamacare did. Number one, if you've got health insurance, it doesn't mean a government takeover. You keep your own insurance. You keep your own doctor. But it does say insurance companies can't jerk you around. They can't impose arbitrary lifetime limits. They have to let you keep your kid on their insurance -- your insurance plan until you're 26 years old. And it also says that you're going to have to get rebates if insurance companies are spending more on administrative costs and profits than they are on actual care.

Number two, if you don't have health insurance, we're essentially setting up a group plan that allows you to benefit from group rates that are typically 18 percent lower than if you're out there trying to get insurance on the individual market.

Now, the last point I'd make before...

LEHRER: Two minutes -- two minutes is up, sir.
OBAMA: No, I think -- I had five seconds before you interrupted me, was ...

(LAUGHTER)

... the irony is that we've seen this model work really well in Massachusetts, because Governor Romney did a good thing, working with Democrats in the state to set up what is essentially the identical model and as a consequence people are covered there. It hasn't destroyed jobs. And as a consequence, we now have a system in which we have the opportunity to start bringing down costs, as opposed to just leaving millions of people out in the cold.

LEHRER: Your five seconds went away a long time ago.

All right, Governor. Governor, tell -- tell the president directly why you think what he just said is wrong about Obamacare?

ROMNEY: Well, I did with my first statement.

(CROSSTALK)

ROMNEY: First of all, I like the way we did it in Massachusetts. I like the fact that in my state, we had Republicans and Democrats come together and work together. What you did instead was to push through a plan without a single Republican vote. As a matter of fact, when Massachusetts did something quite extraordinary -- elected a Republican senator to stop Obamacare, you pushed it through anyway.
So entirely on a partisan basis, instead of bringing America together and having a discussion on this important topic, you pushed through something that you and Nancy Pelosi and Harry Reid thought was the best answer and drove it through.

What we did in a legislature 87 percent Democrat, we worked together; 200 legislators in my legislature, only two voted against the plan by the time we were finished. What were some differences? We didn't raise taxes. You've raised them by $1 trillion under Obamacare. We didn't cut Medicare. Of course, we don't have Medicare, but we didn't cut Medicare by $716 billion.

ROMNEY: We didn't put in place a board that can tell people ultimately what treatments they're going to receive. We didn't also do something that I think a number of people across this country recognize, which is put -- put people in a position where they're going to lose the insurance they had and they wanted.

Right now, the CBO says up to 20 million people will lose their insurance as Obamacare goes into effect next year. And likewise, a study by McKinsey and Company of American businesses said 30 percent of them are anticipating dropping people from coverage.

So for those reasons, for the tax, for Medicare, for this board, and for people losing their insurance, this is why the American people don't want Medicare -- don't want Obamacare. It's why Republicans said, do not do this, and the Republicans had -- had the plan. They put a plan out. They put out a plan, a bipartisan plan. It was swept aside.

I think something this big, this important has to be done on a bipartisan basis. And we have to have a president who can reach across the aisle and fashion important legislation with the input from both parties.

OBAMA: Governor Romney said this has to be done on a bipartisan basis. This was a bipartisan idea. In fact, it was a Republican idea. And Governor Romney at the beginning of this debate wrote and said what we did in Massachusetts could be a model for the nation.

Of course, that was before today, and with the Governor we only can go on what he's saying right now. Now, he's against his idea. We thought it was a good idea, it was shown to work at the state level, so we took it national. That's a sensible approach to creating policy, and one that both Democrats and Republicans generally get behind.

And I agree that the Democratic legislators in Massachusetts might have given some advice to Republicans in Congress about how to cooperate, but the fact of the matter is, we used the same advisers, and they say it's the same plan.

It -- when Governor Romney talks about this board, for example, unelected board that we've created, what this is, is a group of health care experts, doctors, et cetera, to figure out, how can we reduce the cost of care in the system overall?

Because there -- there are two ways of dealing with our health care crisis. One is to simply leave a whole bunch of people uninsured and let them fend for themselves, to let businesses figure out how long they can continue to pay premiums until finally they just give up, and their workers are no longer getting insured, and that's been the trend line.

Or, alternatively, we can figure out, how do we make the cost of care more effective? And there are ways of doing it.

So we took 716 billion in waste out of the system. We put in state exchanges. We did these things so we could do things like eliminate pre-existing conditions and recission and lifetime caps on benefits. The governor knows all this, but I guess he spent too much time memorizing zingers and not enough time remembering what worked in Massachusetts.

Let me make one last point. Governor Romney says, we should replace it, I'm just going to repeal it, but -- but we can replace it with something. But the problem is, he hasn't described what exactly we'd replace it with, other than saying we're going to leave it to the states, but not his old state, and not his plan. Maybe we should ask him again tomorrow.

LEHRER: Let's let the governor explain what you would do...
ROMNEY: Well...
LEHRER: ... if Obamacare is repealed. How would you replace it?
(CROSSTALK)

ROMNEY: Well, actually it's -- it's -- it's a lengthy description. But, number one, preexisting conditions are covered under my plan. Number two, young people are able to stay on their family plan. That's already offered in the private marketplace. You don't have to have the government mandate that for that to occur.

But let's come back to something the president and I agree on, which is the key task we have in health care is to get the cost down so it's more affordable for families. And then he has as a model for doing that a board of people at the government, an unelected board, appointed board, who are going to decide what kind of treatment you ought to have.

(CROSSTALK)

ROMNEY: In my opinion, the government is not effective in -- in bringing down the cost of almost anything. As a matter of fact, free people and free enterprises trying to find ways to do things better are able to be more effective in bringing down the cost than the government will ever be.
Your example of the Cleveland Clinic is my case in point, along with several others I could describe.

This is the private market. These are small -- these are enterprises competing with each other, learning how to do better and better jobs. I used to consult to businesses -- excuse me, to hospitals and to health care providers. I was astonished at the creativity and innovation that exists in the American people.

In order to bring the cost of health care down, we don't need to have a board of 15 people telling us what kinds of treatments we should have. We instead need to put insurance plans, providers, hospitals, doctors on target such that they have an incentive, as you say, performance pay, for doing an excellent job, for keeping costs down, and that's happening. Innermountain Healthcare does it superbly well, Mayo Clinic is doing it superbly well, Cleveland Clinic, others.

ROMNEY: But the right answer is not to have the federal government take over health care and start mandating to the providers across America, telling a patient and a doctor what kind of treatment they can have.
That's the wrong way to go. The private market and individual responsibility always work best.

OBAMA: It is a lengthy description, Governor. Your running mate didn't have time to do the math on your tax plan, and now your replacement plan is too lenthy as well. There are no panels rationing care. There are people, trained medical professionals, not politicians, trying to reign in costs. I'm not sure if Governor Romney wants to allow pre-existing conditions to lose you your insurance, or if he wants the fraud and waste back in the system. I think mostly he just wants to jab at me personally, because the plan he's attacking is something he was passionately in support of right until it got my name put on it.

The law as it was didn't help the millions of people out there with preexisting conditions. It didn't put people together to look at costs. There's a reason why Governor Romney set up the plan that he did in Massachusetts. It wasn't a government takeover of health care. It was the largest expansion of private insurance in history. But what it does say is that "insurers, you've got to take everybody."

Now, that also means that you've got more customers. But when -- when Governor Romney says that he'll replace it with something, but can't detail how it will be in fact replaced and the reason he set up the system he did in Massachusetts was because there isn't a better way of dealing with the preexisting conditions problem.

OBAMA: It just reminds me of, you know, he says that he's going to close deductions and loopholes for his tax plan. That's how it's going to be paid for, but we don't know the details. He says that he's going to replace Dodd-Frank, Wall Street reform, but we don't know exactly which ones. He won't tell us. He now says he's going to replace Obamacare and ensure that all the good things that are in it are going to be in there and you don't have to worry.

And at some point, I think the American people have to ask themselves, is the reason that Governor Romney is keeping all these plans to replace secret because they're too good? Is it -- is it because that somehow middle-class families are going to benefit too much from them?

No. The reason is, is because, it's easier to attack me on old problems than to look at the solutions we've put in play. I don't think that's what America wants. We needed solutions, and we found them.

LEHRER: We're going to move to...
ROMNEY: No. I -- I have to respond to that.
LEHRER: No, but...
ROMNEY: Which is -- which is my experience as a governor is if I come in and -- and lay down a piece of legislation and say, "It's my way or the highway," I don't get a lot done. What I do is the same way that Tip O'Neill and Ronald Reagan worked together some years ago. When Ronald Reagan ran for office, he laid out the principles that he was going to foster. He said he was going to lower tax rates. He said he was going to broaden the base. You've said the same thing, you're going to simplify the tax code, broaden the base.

Those are my principles. I want to bring down the tax burden on middle-income families. And I'm going to work together with Congress to say, OK, what -- what are the various ways we could bring down deductions, for instance? One way, for instance, would be to have a single number. Make up a number, $25,000, $50,000. Anybody can have deductions up to that amount. And then that number disappears for high-income people. That's one way one could do it. One could follow Bowles-Simpson as a model and take deduction by deduction and make differences that way. There are alternatives to accomplish the objective I have, which is to bring down rates, broaden the base, simplify the code, and create incentives for growth. And with regards to health care, you had remarkable details with regards to my pre-existing condition plan. You obviously studied up on -- on my plan. In fact, I do have a plan that deals with people with pre-existing conditions. That's part of my health care plan. And what we did in Massachusetts is a model for the nation state by state. And I said that at that time.

The federal government taking over health care for the entire nation and whisking aside the 10th Amendment, which gives states the rights for these kinds of things, is not the course for America to have a stronger, more vibrant economy.

LEHRER: That is a terrific segue to our next segment, and is the role of government. And -- and let's see. Role of government. And it is -- you are first on this, Mr. President. And the question is this. Do you believe, both of you -- but you had the first two minutes on this, Mr. President -- do you believe there's a fundamental difference between the two of you as to how you view the mission of the federal government?

OBAMA: Well, I definitely think there are differences. Mr. Romney's state-wide Romneycare plan covered abortions, for instance. My national plan found compromise there. My tax plan also doesn't rely on spit-balling a made-up deduction number at this late stage of the election.

12:46 PM PT: FINAL PART:
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