Monday night’s CNN/Tea Party Express debate among the Republican presidential candidates included discussion of Medicare, the health law, costs, the individual mandate and vaccines. Texas Gov. Rick Perry, former Mass. Gov. Mitt Romney, Rep. Michele Bachmann, Rep. Ron Paul, businessman Herman Cain, former Utah Gov. Jon Huntsman, former Speaker of the House Newt Gingrich and former Sen. Rick Santorum all believe that the health law should be repealed, but they did not agree on other issues.
Watch video excerpts of the debate
Here is an edited transcript of the health care sections of the debate:
CNN’S WOLF BLITZER, MODERATOR: We have a question now from the audience.
DR. BRIDGET MELSON, PLEASANTON TEA PARTY: My question for you is, what is your plan to balance the budget and get this spending under control so that my children’s share of the debt is erased without compromising my retired mother’s already tenuous financial future?
BLITZER: Good question. Let me ask Speaker Gingrich to respond, and I’ll sort of paraphrase it.
How do you do that? How do you protected seniors, balance the budget? So much of the budget goes to defense and entitlements like Social Security, Medicare.
GINGRICH: But that’s just a Washington mythology. And anybody who knows anything about the federal government knows that there’s such an enormous volume of waste, that if you simply had a serious all-out effort to modernize the federal government, you would have hundreds of billions of dollars of savings falling off.
Let me say, I helped balance the budget for four straight years. This is not a theory. Rick and I were working together on this. This is not a theory. You voted for it. So we can balance the federal budget.
But let me start with — all of you should go to Strong America Now, which is a group that believes if you modernize the federal government, you save $500 billion a year. Now, check and see whether the super committee of 12 in their august power is willing to sit down with that group and actually learn how to be smart rather than cheap, and actually modernize the federal government.
One example, the federal government is such a bad manager of money, that somewhere between $70 billion and $120 billion a year in Medicare and Medicaid is paid to crooks. We wrote a book several years ago called “Stop Paying the Crooks.” I thought it was pretty obvious even for Washington. So I would start to balance the budget by stop paying the crooks, not by cheating honest Americans.
BLITZER: Sen. Santorum, staying on the issue of spending, budget deficits, you voted for the prescription drug benefits for seniors when you were in the United States Senate costing about $1 trillion. If you had to do it over again, you wouldn’t vote for that, but if you were president of the United States, would you repeal prescription drug benefits for seniors under Medicare?
SANTORUM: I think we have to keep a prescription drug component, but we have to pay for it. In other words, we have to have a program that is funded.
Now, the reason that that program has actually worked well is it’s come in 40 percent under budget because it’s a program that uses private sector insurance, not government-run, one-size-fits-all health care. If we do that for the rest of Medicare, which is what the Ryan proposal suggests, and something that I proposed, again, years ago, had the courage to go out and lead on this issue, then we would be able to have a prescription drug program and we’d be able to have Medicare that you choose.
The idea that unless we have a government-run, one-size-fits-all Medicare program, that that’s throwing grandma off a cliff, is Washington think — is people who think in Washington this president, who believes that they know better than you how to run your life and how to purchase your health care. I trust you, I trust the American people. That is the greatness of our country.
BLITZER: Thank you, Senator. Gov. Perry, it was President Bush who pushed for prescription drug benefits for senior, not President Obama. It was President Bush who pushed for prescription drug benefits for seniors. The question to you: If you were president — it’s not a difficult question — would you vote to eliminate, to repeal those prescription drug benefits for seniors under Medicare?
PERRY: No. It’s a $17 trillion hole that we have in our budget we’ve got to deal with. And I think that’s the issue of, how do you find the savings and still deliver the services?
For instance, in the state of Texas, we combined a substantial amount of our health and human services from 10 down to five agencies. We put an Office of Inspector General into place, and we saved over $5.3 billion, Newt, just by finding the waste and the fraud in Texas state government. I’m thinking there might be more waste and fraud in the federal government than even there is in the Texas government.
BLITZER: Gov. Romney, what about you?
ROMNEY: I wouldn’t repeal it. I’d reform Medicare and reform Medicaid and reform Social Security to get them on a sustainable basis, not for current retirees, but for those in their 20s and 30s and early 50s.
But the key to balancing the budget — and we talk about all the waste in government and the inefficiency. And having spent 25 years in business, I know something about taking waste out of enterprises. I’d love to do that to the federal government. And there is massive waste.
But we’re not going to balance the budget just by pretending that all — all we have to do is take out the waste. We’re going to have to cut spending. And I’m in favor of cutting spending, capping federal spending as a percentage of GDP, at 20 percent or less, and having a balanced budget amendment. That’s essential to rein in the scale of the federal government. … The right answer for America is to stop the growth of the federal government and to start the growth of the private sector.
BLITZER: Congressman Paul, what about you? Would you repeal it?
PAUL: Well, we shouldn’t have never started it. I voted against it. But that sure wouldn’t be on my high list. I would find a lot of cuts a lot of other places. As a matter of fact, on Social Security, it is already being reformed, because the cost of living increases aren’t there, so the value is going down.
BLITZER: Gov. Perry, as you well know, you signed an executive order requiring little girls 11 and 12-year-old girls to get a vaccine to deal with a sexually transmitted disease that could lead to cervical cancer. Was that a mistake?
PERRY: It was. And indeed, if I had it to do over again, I would have done it differently. I would have gone to the legislature, worked with them. But what was driving me was, obviously, making a difference about young people’s lives.
Cervical cancer is a horrible way to die. And I happen to think that what we were trying to do was to clearly send a message that we’re going to give moms and dads the opportunity to make that decision with parental opt-out.
Parental rights are very important in state of Texas. We do it on a long list of vaccines that are made, but on that particular issue, I will tell you that I made a mistake by not going to the legislature first.
Let me address Ron Paul just a minute by saying I will use an executive order to get rid of as much of Obamacare as I can on day one.
BLITZER: Congresswoman Bachmann, do you have anything to say about what Governor Perry just said? You’re a mom.
BACHMANN: I’m a mom. And I’m a mom of three children. And to have innocent little 12-year-old girls be forced to have a government injection through an executive order is just flat out wrong. That should never be done. It’s a violation of a liberty interest.
That’s — little girls who have a negative reaction to this potentially dangerous drug don’t get a mulligan. They don’t get a do-over. The parents don’t get a do-over. That’s why I fought so hard in Washington, D.C., against President Obama and Obamacare.
President Obama in a stunning, shocking level of power now just recently told all private insurance companies, you must offer the morning-after abortion pill, because I said so. And it must be free of charge. That same level coming through executive orders and through government dictates is wrong. And that’s why again we have to have someone who is absolutely committed to the repeal of Obamacare and I am. I won’t rest until it’s appealed.
BLITZER: Let’s let Gov. Perry respond. Was what you signed into law, that vaccine for 11 and 12-year-old girls, was that, as some of your critics have suggested, a mandate?
PERRY: No, sir it wasn’t. It was very clear. It had an opt-out. And at the end of the day, this was about trying to stop a cancer and giving the parental option to opt out of that. And at the end of the day, you may criticize me about the way that I went about it, but at the end of the day, I am always going to err on the side of life. And that’s what this was really all about for me.
BLITZER: Sen. Santorum — go ahead.
BACHMANN: Can I add to that, Wolf? Can I add to that?
BLITZER: Hold on a second. First Congresswoman Bachmann, then Sen. Santorum.
BACHMANN: I just wanted to add that we cannot forget that in the midst of this executive order there is a big drug company that made millions of dollars because of this mandate. We can’t deny that…
BLITZER: What are you suggesting?
BACHMANN: What I’m saying is that it’s wrong for a drug company, because the governor’s former chief of staff was the chief lobbyist for this drug company. The drug company gave thousands of dollars in political donations to the governor, and this is just flat-out wrong. The question is, is it about life, or was it about millions of dollars and potentially billions for a drug company?
BLITZER: All right. I’ll let Sen. Santorum hold off for a second.
You’ve got to respond to that.
PERRY: Yes, sir. The company was Merck, and it was a $5,000 contribution that I had received from them. I raise about $30 million. And if you’re saying that I can be bought for $5,000, I’m offended.
BACHMANN: Well, I’m offended for all the little girls and the parents that didn’t have a choice. That’s what I’m offended for.
SANTORUM: I think we need to hear what Gov. Perry’s saying. He’s saying that his policy was right. He believes that what he did was right. He thinks he went about it the wrong way.
I believe your policy is wrong. Why — ladies and gentlemen, why do we inoculate people with vaccines in public schools? Because we’re afraid of those diseases being communicable between people at school. And therefore, to protect the rest of the people at school, we have vaccinations to protect those children.
Unless Texas has a very progressive way of communicating diseases in their school by way of their curriculum, then there is no government purpose served for having little girls inoculated at the force and compulsion of the government. This is big government run amok. It is bad policy, and it should not have been done.
BLITZER: I’m going to move on, Gov. Perry, unless you want to say anything else.
PERRY: Look, I think we made decisions in Texas. We put a $3 billion effort in to find the cure for cancer. There are a lot of different cancers out there. Texas, I think, day in and day out, is a place that protects life.
I passed parental notification piece of legislation. I’ve been the most pro-life governor in the state of Texas. And what we were all about was trying to save young people’s lives in Texas.
SANTORUM: Then give the parents the opt-in, as opposed to — teach them, let them opt in, but do not force them to have this inoculation.
BLITZER: All right. Let’s take a question from the audience. Give us your name please.
CAROLINE TAYLOR, ORANGE PARK FLORIDA, PEOPLES TEA PARTY: My question is, health insurance is expensive because health care is expensive. What is your plan to reduce the cost of health care so that our insurance premiums and other related costs can also be reduced?
BLITZER: All right. Mr. Cain?
CAIN: First, repeal Obamacare in its entirety.
CAIN: Secondly, pass market-driven, patient-centered reforms such as, under the current code, deductibility of health insurance premiums regardless of who pays for it. But as you know, I want to throw that out and put in my 999 plan. Secondly, the other thing that we can do in order to help bring down the costs is pass loser pay laws. Doctors will tell you that one of their biggest expenses is medical liability insurance because of frivolous lawsuits.
Secondly, restructure Medicare, another big cost that’s passed on to us as consumers related to all the bureaucracy associated with that.
Another market-driven idea, allow association health plans. When I ran the National Restaurant Association, which today has 14 million employees, we wanted to design a system for health insurance that was going to be customized for our industry. We could not do that. We need to be allowed to do that, and so should other organizations and other associations.
BLITZER: Thank you, Mr. Cain. Governor Romney, a lot of the Tea Party supporters here and around the country have a real serious problem with the health care mandate that you got through in Massachusetts. Is there anything you want to say to them to revise or amend? Do you stand by what you did?
ROMNEY: Absolutely. And let me come back and just mention something that — Herman Cain is right, and let’s get back to getting the cost of health care down. I happen to think that’s an enormous issue.
And I agree with almost everything you said, Herman, but the reason health care is so expensive, I think you hit the nail on head. You said it’s not just because of insurance, it’s because of the cost of providing care. And one reason for that is the person who receives care in America generally doesn’t care how much it costs, because once they’ve paid their deductible, it’s free. And the provider, the more they do, the more they get paid.
We have something that’s not working like a market. It’s working like a government utility. And so what we have to do is make sure that individuals have a concern and care about how much something costs. And for that to happen, health savings accounts. Give people a stake in what the cost of insurance is going to be, what the cost of it is going to be. Co-insurance, where people pay a share of the bill, that makes a difference.
And with regards to Massachusetts care, I’m not running for governor. I’m running for president. And if I’m president, on day one I’ll direct the secretary of Health and Human Services to grant a waiver from Obamacare to all 50 states.
It’s a problem that’s bad law, it’s not constitutional. I’ll get rid of it. (APPLAUSE)
BLITZER: Gov. Perry, you’re a firm believer in states’ rights. Can a state like Massachusetts go ahead and pass health care reform, including mandates? Is that a good idea, if Massachusetts wants to do it?
PERRY: Well, that’s what Gov. Romney wanted to do, so that’s fine. But the fact of the matter is, that was the plan that President Obama has said himself was the model for Obamacare. And I think any of us who know that that piece of legislation will draw a line between the doctor/patient relationship, that will cost untold billions of dollars, is not right for this country. And frankly, I don’t think it was right for Massachusetts when you look at what it’s costing the people of Massachusetts today. But at the end of the day, that was their call.
So, from a just purely states get to decide what they want to do, I agree with that. And in the state of Texas, we don’t think that’s the way we want to go.
BLITZER: All right.
BACHMANN: Wolf, can I —
BLITZER: I’m going to let you respond, but I want Governor Romney to respond first.
ROMNEY: First, I’d be careful about trusting what President Obama says as to what the source was of his plan, number one. But number two, if you think what we did in Massachusetts and what President Obama did are the same, boy, take a closer look, because, number one, he raised taxes $500 billion, and helped slow down the U.S. economy by doing it. We didn’t raise taxes.
He cut Medicare by $500 billion. This is a Democrat president. The liberal, so to speak, cut Medicare. Not Republicans, the Democrat.
We dealt with the people in our state that were uninsured, some nine percent. His bill deals with 100 percent of the people. He puts in place a panel that ultimately is going to tell people what kind of care they’re going to have. We didn’t do anything like that.
What the president did was simply wrong. It is the wrong course for America. It is not what we did in Massachusetts. The people of Massachusetts favored our plan by three to one. And states can make their own choices. I’m happy to stand up for what he did. But I’ll tell you one thing, what he did is wrong for America, and I’ll stop it.
BLITZER: Thank you, Governor. Before I get to Michele Bachmann, I want to just — you’re a physician, Ron Paul, so you’re a doctor. You know something about this subject. Let me ask you this hypothetical question.
A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it.
Who’s going to pay if he goes into a coma, for example? Who pays for that?
PAUL: Well, in a society that you accept welfarism and socialism, he expects the government to take care of him.
BLITZER: Well, what do you want?
PAUL: But what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would have a major medical policy, but not be forced —
BLITZER: But he doesn’t have that. He doesn’t have it, and he needs intensive care for six months. Who pays?
PAUL: That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody —
BLITZER: But Congressman, are you saying that society should just let him die?
PAUL: No. I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio, and the churches took care of them. We never turned anybody away from the hospitals.
PAUL: And we’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. This whole idea, that’s the reason the cost is so high.
The cost is so high because they dump it on the government, it becomes a bureaucracy. It becomes special interests. It kowtows to the insurance companies and the drug companies, and then on top of that, you have the inflation. The inflation devalues the dollar, we have lack of competition.
There’s no competition in medicine. Everybody is protected by licensing. And we should actually legalize alternative health care, allow people to practice what they want.
BLITZER: Congresswoman Bachmann, go ahead and weigh in on this hypothetical 30-year-old who needs six months of intensive care, has no insurance.
BACHMANN: Well, first of all, what I want to say, with all due respect to the governors, I’ve read this health care bill, I’ve been fighting this fight the last couple of years.
BLITZER: Which health care bill?
BACHMANN: President Obama’s Obamacare bill. And waivers and executive orders won’t cut it. If you could solve Obamacare with an executive order, any president could do it and any president could undo it. That’s not — not how it can be done.
Plus, no state has the constitutional right to force a person as a condition of citizenship to buy a product or service against their will. It’s unconstitutional…
… whether it’s the state government or whether it’s the federal government. The only way to eradicate Obamacare is to pull it out by the root and branch to fully repeal it. It’s the only way we’re going to get rid of it.
And this is why I’m running for the presidency of the United States, because 2012 is it. This is the election that’s going to decide if we have socialized medicine in this country or not. This is it.
Why? I just have to say this. It’s because President Obama embedded $105,464,000,000 in Obamacare in post-dated checks to implement this bill. We are never going to get rid of it unless we have a president committed to getting rid of it. And if you believe that states can have it and that it’s constitutional, you’re not committed. If you’ve implemented this in your state, you’re not committed. I’m committed to repealing Obamacare.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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