No, I didn’t watch it. Rather, I wait till transcript is posted about an hour after the debate is over. Here it is.
First, in response to a question about what programs he would cut, Romney mentioned Obamacare by name.
What things would I cut from spending? Well, first of all, I will eliminate all programs by this test — if they don’t pass it: Is the program so critical it’s worth borrowing money from China to pay for it? And if not, I’ll get rid of it. “Obamacare” is on my list. I apologize, Mr. President. I use that term with all respect.
PRESIDENT OBAMA: I like it.
MR. ROMNEY: Good. OK, good. (Laughter.) So I’ll get rid of that.
Second, in response to a question about entitlements:
I want to take that $716 billion you’ve cut and put it back into Medicare. By the way, we can include a prescription program if we need to improve it, but the idea of cutting $716 billion from Medicare to be able to balance the additional cost of “Obamacare” is, in my opinion, a mistake.
Third, Obama was not fond to repealing his eponymous law:
So I don’t think vouchers are the right way to go. And this is not my own — only my opinion. AARP thinks that the — the savings that we obtained from Medicare bolster the system, lengthen the Medicare trust fund by 8 years. Benefits were not affected at all and ironically if you repeal “Obamacare” — and I have become fond of this term, “Obamacare” — (laughter) — if you repeal it, what happens is those seniors right away are going to be paying $600 more in prescription care. They’re now going to have to be paying copays for basic check-ups that can keep them healthier.
Fourth, Lehrer asks both candidates to speak for two minutes each about the Affordable Care Act:
MR. LEHRER: All right, I think we have another clear difference between the two of you. Now let’s move to health care, where I know there is a clear difference — (laughter) — and that has to do with the Affordable Care Act, “Obamacare.”
And it’s a two-minute new segment, and it’s — that means two minutes each. And you go first, Governor Romney. You wanted repeal. You want the Affordable Care Act repealed. Why?
MR. ROMNEY: I sure do. Well, in part, it comes, again, from my experience. 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 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. It 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 spent 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.
MR. LEHRER: Mr. President, the argument against repeal.
PRESIDENT 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 take over. 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 till you’re 26 years old. And it also says that they’re — 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 —
MR. LEHRER: Two minutes —
PRESIDENT OBAMA: — before —
MR. LEHRER: Two minutes is up, sir.
PRESIDENT OBAMA: No, I — I think I’ve — I had five seconds before you interrupted me — was — (laughter) — that 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 cost, as opposed to just —
MR. LEHRER: Your five —
PRESIDENT OBAMA: — leaving millions of people out in the cold.
MR. LEHRER: Your five seconds went away a long time ago. (Laughter.)
PRESIDENT OBAMA: That —
MR. LEHRER: All right, Governor. Governor, tell the — tell the president directly why you think what he just said is wrong about “Obamacare.”
MR. ROMNEY: Well, I did with my first statement.
PRESIDENT OBAMA: You did.
MR. ROMNEY: But I’ll go on.
PRESIDENT OBAMA: Please elaborate.
MR. ROMNEY: I’ll elaborate.
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. Two hundred 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 a trillion dollars under “Obamacare.” We didn’t cut Medicare. Of course, we don’t have Medicare, but we didn’t cut Medicare by $716 billion. We didn’t put in place a board that can tell people ultimately what treatments they’re going to receive.
We didn’t — 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 & 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 — don’t want “Obamacare.” It’s why Republicans said, do not do this.
And the Republicans had a — had a 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 in 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.
PRESIDENT 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. 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 the — 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 at — at Cleveland Clinic, one of the best health care systems in the world, they actually provide great care cheaper than average. And the reason they do is because they do some smart things. They — they say, if a patient’s coming in, let’s get all the doctors together at once, do one test instead of having the patient run around with 10 tests. Let’s make sure that we’re providing preventive care so we’re catching the onset of something like diabetes. Let’s — let’s pay providers on the basis of performance as opposed to on the basis of how many procedures they’ve — they’ve engaged in. Now, so what this board does is basically identifies best practices and says, let’s use the purchasing power of Medicare and Medicaid to help to institutionalize all these good things that we do.
And the fact of the matter is that when “Obamacare” is fully implemented, we’re going to be in a position to show that costs are going down. And over the last two years, health care premiums have gone up, it’s true, but they’ve gone up slower than any time in the last 50 years. So we’re already beginning to see progress. In the meantime, folks out there with insurance, you’re already getting a rebate.
Let me make one last point. Governor Romney says we should replace it. I’m just going to repeal it, 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 the fact of the matter is that some of the prescriptions that he’s offered, like letting you buy insurance across state lines, there’s no indication that that somehow is going to help somebody who’s got a pre-existing condition be able to finally buy insurance. In fact, it’s estimated that by repealing “Obamacare,” you’re looking at 50 million people losing health insurance at a time when it’s vitally important.
MR. LEHRER: Let’s let the governor explain what you would do if “Obamacare” is repealed. How would you replace it? What do you have in mind?
MR. ROMNEY: Let — well, actually — actually it’s — it’s — it’s a lengthy description, but number one, pre-existing 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 — have the government mandate that for that to occur.
But let’s come back to something the president — I agree on, which is the — the key task we have in health care is to get the costs down so it’s more affordable for families, and — 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.
PRESIDENT OBAMA: No, it isn’t.
MR. 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 costs 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 — an — 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 targets such that they have an incentive, as you say, performance pay, for doing an excellent job, for keeping costs down, and that’s happening.
Intermountain Health Care does it superbly well.
PRESIDENT OBAMA: They do.
MR. ROMNEY: Mayo Clinic is doing it superbly well, Cleveland Clinic, others. 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.
PRESIDENT OBAMA: Let me just point out, first of all, this board that we’re talking about can’t make decisions about what treatments are given. That’s explicitly prohibited in the law.
But let’s go back to what Governor Romney indicated, that under his plan he would be able to cover people with pre-existing conditions. Well, actually, Governor, that isn’t what your plan does. What your plan does is to duplicate what’s already the law, which says if you are out of health insurance for three months then you can end up getting continuous coverage and an insurance company can’t deny you if you’ve — if it’s been under 90 days.
But that’s already the law. And that doesn’t help the millions of people out there with pre-existing conditions. 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. 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 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 is because there isn’t a better way of dealing with the pre-existing conditions problem, it — 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 hes going to replace “Obamacare” and assure 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 — is it because that somehow middle-class families are going to benefit too much from them? No, the — the reason is because when we reform Wall Street, when we tackle the problem of pre-existing conditions, then, you know, these are tough problems, and we’ve got to make choices. And the choices we’ve made have been ones that ultimately are benefiting middle-class families all across the country.
What word was mentioned nowhere in that colloquy….Constitution!
All of Romneys objections focus on cost, not the Constitution.
If the president’s re-elected, “Obamacare” will be fully installed. In my view, that’s going to mean a whole different way of life for people who counted on the insurance plan they had in the past. Many will lose it. You’re going to see health premiums go up by some $2,500 per — per family. If I’m elected, we won’t have “Obamacare.” We’ll put in place the kind of principles that I put in place in my own state and allow each state to craft their own programs to get people insured. And we’ll focus on getting the cost of health care down.
I wonder how this debate would have gone differently if the Court struck down the ACA?
Oh, there was one mention to the Constitution and the Declaration by Romney.
The role of government — look behind us: the Constitution and the Declaration of Independence.
The role of government is to promote and protect the principles of those documents. First, life and liberty. We have a responsibility to protect the lives and liberties of our people, and that means the military, second to none. I do not believe in cutting our military. I believe in maintaining the strength of America’s military.
Second, in that line that says, we are endowed by our Creator with our rights — I believe we must maintain our commitment to religious tolerance and freedom in this country. That statement also says that we are endowed by our Creator with the right to pursue happiness as we choose. I interpret that as, one, making sure that those people who are less fortunate and can’t care for themselves are cared by — by one another.
We’re a nation that believes we’re all children of the same God. And we care for those that have difficulties — those that are elderly and have problems and challenges, those that disabled, we care for them. And we look for discovery and innovation, all these thing desired out of the American heart to provide the pursuit of happiness for our citizens.
But we also believe in maintaining for individuals the right to pursue their dreams, and not to have the government substitute itself for the rights of free individuals. And what we’re seeing right now is, in my view, a — a trickle-down government approach which has government thinking it can do a better job than free people pursuing their dreams. And it’s not working.
Later, Obama noted that repealing Obamacare will be quite unpopular.
PRESIDENT OBAMA: Well, first of all, I think Governor Romney’s going to have a busy first day, because he’s also going to repeal “Obamacare,” which will not be very popular among Democrats as you’re sitting down with them.
Second, although Romney predictably spent a lot of time attacking Obamacare, he said absolutely nothing about the individual health insurance mandate, which remains hugely unpopular – far more so than any other part of the law. Even when Obama waxed eloquent about the evils of insurance companies, Romney didn’t play the obvious gambit of pointing out that the President is the one who passed a law that forces millions of people to buy insurance company products that they don’t want, after saying in 2008 that “[f]orcing people to buy health insurance [in order to provide them with health care] is like forcing the homeless to buy a house to eliminate homelessness.”
Why did Romney let this obvious opportunity slip by? The answer is obvious. If he had attacked the individual mandate, Obama could have countered by noting that Romney’s own Massachusetts health care plan also includes an individual mandate, and Obamacare was modeled on Romneycare. Even as it stood, Obama was able to point out (correctly) that his health care plan was modeled on Romney’s and designed by some of the same advisers.