Transcript: Sen. John Edwards
The following is a transcript of Senator John Edwards' speech at the Presidential Forum.
JOHN EDWARDS: Thank you. Thank you all very much. It's a great privilege for me to be here. Let me say first a personal thank you to all of you and the people who have been so kind and so generous over the last few days, including, by the way, my fellow candidates who will be here today. I'm very proud to have my wife Elizabeth here with me. I also want to thank CAP and the SEIU for sponsoring this forum and for talking about an issue that's so important to us, to all Americans. And what we have is a dysfunctional health care system in the United States of America. And what we need is a big, bold, dramatic change, not small change. And we do not just fix our health care system, we need to fix our military and veterans' health care system.
Let me talk just briefly about my plan for universal health care, and then I'm sure we'll get into more detail as we go through this conversation. Basically what we do is cover all Americans. In my plan there's shared responsibilities. The employers are required to either cover their employees or to pay into a fund that will help pay for coverage for their employees. The government plays an important role. The government will set up health care markets all across America, and in each of those markets if you're the consumer, you can go in and choose what your health care plan would be. Some of the choices are private insurers, and then one choice is a government plan, basically a Medicare Plus plan. And the idea is to determine whether Americans actually want a private insurer or whether they'd rather have government run Medicare Plus kind of single-payer plan. And we'll find out over time which way people go.
This health care plan also covers the cracks that exist in our health care system. It's complete mental health care, there's coverage for chronic care, coverage for preventative care, coverage for long-term care. We subsidize health insurance premiums for low income and middle income families. That caps out at about $80,000 of income a year. There are huge cost containment pieces in this health care plan, the requirement of preventative care. We require by competition lower administrative costs.
We're spending 30 to 40 cents on each dollar, health care dollar today for administrative costs. We've got to bring those down, bring them down dramatically. We require and demand the use of technology, the use of electronic recordkeeping, both of which are more efficient and help bring down health care costs. And then we're going to a systematic way to measure what's working, what's the most effective treatment, how do we get the most effective drugs, the least costly drugs.
So the idea is cover everybody, bring down health care costs for every single American, which this plan I believe will do, fill in the cracks in our health care system. And the last responsible party besides the employers and the government are individuals. Everyone in America will be required by law to be covered by this health care plan. And the last thing I'll tell you is the cost is 90 to $120 billion a year. That's the government's cost. And I pay for it by rolling back George Bush's tax cuts. Thank you all very much.
KAREN TUMULTY: Thank you, Senator. And especially after the week that you and your family have had, we so appreciate you being here, and of course everyone's best wishes and prayers go to your family in support of Mrs. Edwards. Of all the candidates that we're going to be hearing from today, you are the only one who has a detailed specific plan as to how you're going to get the universal coverage. And you have been candid enough to say that it involves tax increases.
But one of the reasons you have said that you feel so strongly about being specific on health care, and you were much more cautious when you ran in 2004, is the personal experience that your family has been through with Mrs. Edwards' illness. And so you on that score, as you had a big decision to make this week, you made it very quickly, but as people look at the situation you are in, that you and your family are in, the fact that you are trying to do two all consuming things here at once, and that however positive the course of this treatment turns out to be, there are going to be a lot of personal ups and downs for you over the next year and a half. How are you going to be able to manage bothof those, and what do you say to people who are thinking about supporting you, are thinking about contributing to your campaign that are really worried about your ability to take care of two all consuming things at one time? Will you be in this race for the duration?
JOHN EDWARDS: Oh, I'm definitely in the race for the duration. What it shows from our own personal experience, this is not the first challenge like this Elizabeth and I have been through. As many of you know, we lost our son about ten, actually about eleven years ago now in 1996. And we've gone through Elizabeth's first round of breast cancer treatment. We went through that together. So we know what it's like to function in a very difficult environment. And there is a focus and a maturity that I think is requires to be able to do that, but I know, because I've done it in the past, that we can do it. I know because of the nature of the woman I'm married to that she will be there every single step of the way making sure that we do it. And we take our responsibility to serving this country very seriously. And it is the reason I'm running for president because I love this country.
I think we can do so much better than we're doing now. And we want to serve, both of us, which is why we made the decision to go forward. But I want to add one thing, because there's been an awful lot of attention focused on the two of us, and I think we're getting far too much credit. When you look at all the millions of women who had to struggle with the same sort of struggles that Elizabeth has had, and many of them had to struggle without what we have, without great health care coverage, without knowing they're going to be able to get all the medicine and medications that they need.
One of the reasons that I want to be president of the United States is to make sure that every woman and every person in America gets the same kinds of things that we have. Because it's not right that a woman has to go through, or anybody has to go through this kind of struggle and have to worry about whether they can afford the medicine they need, whether they can get the health care that they need. We don't have to worry about that. And no American should have to worry about that. And as Elizabeth said just a couple of days ago, you know, for us, we can focus on what needs to be done for our family and for our country, but a lot of women with exactly the same diagnosis had to get up the next morning and go to work, and the next morning and go to work. So before we start giving too much credit to us, let's do what we need to do for all of us.
KAREN TUMULTY: Thank you, Senator. One of the criticisms of your plan has been that it doesn't -- it's not aggressive enough in dealing with health care costs. You talk about saving money through preventative care, through using technology that is available but that really isn't being used a lot in the health care industry. But right now I'd like to turn to one of the members of our audience, a Jack Marco, who is the owner of a small business who wants to know how you are going to -- how are you going to come to grips with the kind of rising health care costs that he has to deal with every day and that threaten his business. And, Jack, are you here?
JACK MARCO: Yes. I'm a business that just completed our collective bargaining agreement with our employees. And for the last 20 years we've provided health insurance for them, and every year it becomes more difficult. And because in the process, when it came down to talking about wages, we had to offer less and the employees had to accept less than they would like or we would like to give because of the money we had to pay off on health care. At the same time I had to compete in an industry with other people doing the same kind of business I do.
So the cost that I have for my 75 employees compared to another firm means that I have to pay -- I have to charge higher fees for the services I provide; and likewise, I have to provide -- I can only provide a certain level of wages that perhaps a competitor could provide more because they don't provide health insurance. So my question is as the president what would you do to take care of this competitive problem?
JOHN EDWARDS: Did you say you have 75 employees?
JACK MARCO: Correct.
JOHN EDWARDS: 75. Well, first of all, I think that this plan deals directly with the concerns that you have. We have a competitiveness issue not only between you and your competitors here in America, we have a huge competitiveness issue, if I can say the word, between our businesses in America and the rest of the world. We have extraordinary health care costs, which you're dealing with every single year in the operation of your business. Those costs have to come down. But in addition to that, what we want is if we have a truly universal health care plan that covers every single American from the time they're born until the time they die. It makes American business more competitive in the world. We're spending 17, $1800 on health care costs on every car that's manufactured in America, compared to about $250 in Japan. Creates a huge disadvantage.
What this plan specifically does for your situation is it gives you market power that you don't have today. I mean, individuals in small businesses have no market power, and as a result you pay extraordinary health care costs. So what we do is we set up these health care markets is we create the same market power for you that exists for the biggest corporations in America. These markets will require competitive bidding to get into the markets. And also these private insurers are going to have to compete with the government plan with extraordinary low administrative costs, two, three percent in all likelihood. So that competition will bring down costs.
In addition to that, these things that Karen just made mention of, use of technology, electronic recordkeeping, preventative care, mandatory preventative care so that we are healthier, we are a well people will bring down costs for everybody. So I think sort of the bottom line for you is we will bring down health insurance costs on the whole for what you have to pay. Second, your cost directly will be lower because there will be a level of competition that does not exist today, and you will have the market power that does not exist today. I actually believe that besides the uninsured I think we have a moral obligation too, besides the uninsured the people who benefit the most from this health care plan are individuals and smaller businesses. I think that's the greatest beneficiary of this plan.
KAREN TUMULTY: Senator, the health care problem has been with us for a very long time. The last time a significant effort was undertaken to address it never even got to a vote on the floor of either House of Congress because of so many fronts of opposition. And of those the most important I think the strongest was business. So we have a question coming in over email from Mary in Illinois who wants to know do you have a strategy for engaging American businesses in achieving health care coverage for all Americans?
JOHN EDWARDS: Yes, because what we want to do is we want to make American business competitive. We want to bring down the cost of health care, not just for individuals, which we do, but also for American business. And so this plan does all those things. We just talked about it in the context of a small business, but it actually applies to all businesses. What happens is because we're bringing -- there are huge cost containment elements in this plan, which I won't go through again, I've gone through it. And because we are subsidizing health insurance premiums for low income and middle income families, this has the effect of bringing down health care costs for all businesses.
The SEIU and Andy Stern had a press conference a few weeks ago with some very large American businesses who were committed to achieving universal health care, which is a very good thing. And what I believe that actually American businesses have now figured out is that something has to be done about our health care system that is making them increasingly uncompetitive with respect to the rest of the world. And that universal health care, done the right way, with the right choices and the right efficiencies, will actually help American businesses, not just help the 47 million people who don't have health insurance.
KAREN TUMULTY: Well, there are going to be candidates who come out here today who suggest that it's possible to do this, to achieve universal coverage without raising taxes, without new sources of revenue. You have been very up front about the fact that your plan does involve tax increases. Do you think it's possible to get there without them?
JOHN EDWARDS: No, I do not. I spent a great deal of time studying this issue, working with health economists around the country. I've spent many months on this. The plan just came out a few weeks ago, my plan just came out a few weeks ago. I've spent a great deal of time working on this issue. I do not believe you can have universal health care without finding a source of revenue. There has to be some additional source of revenue.
We don't get universal health care for free. You have to cover 47 million people who don't have coverage. There's going to be a cost associated with the transition from the health care system we have today to a truly universal and more efficient health care system. So, no, I do not believe it can be achieved without finding an additional source of revenue. And the joke I always make about it is that American people have heard so many politicians for so long say, Oh, we're going to have universal health care, we're going to transform the way we use energy in America, we're going to end poverty in America, and in the process we're going to eliminate the federal deficit. They probably got a bridge in Brooklyn they want to sell you too. I don't think it could be done.
I think it's very important, if I could say one last thing about this, I think it is really important, particularly given what's happened in the last six, seven years in this country, that the president of the United States be honest with the American people. And I also think that honesty starts right here in the campaign.
KAREN TUMULTY: And if you were putting together your health care plan, there are people who argue that the whole idea of basing your health coverage on where you work is just an anachronism. It's a historical accident.
JOHN EDWARDS: Yes.
KAREN TUMULTY: You, however, chose to build on that system. Why is it that you didn't, as some people suggested, why did you reject the idea say of government run Medicare for everybody or some other form of health care that would again get rid of a system that is essentially a historical accident?
JOHN EDWARDS: Well, there's a judgment that has to be made on the front end. It is true that single-payer health care systems in the world dramatically reduce costs and significantly reduce administrative costs, particularly compared to private insurers. It's also true that a lot of people who are listening to this forum like the health insurance they have now and would like to keep it.
And my judgment is, number one, to get it done so that we don't spend another decade arguing about whether we keep the system we have now or actually have universal health care. I think this system, my proposal, a truly universal plan, a bold plan, but doesn't go directly to single-payer, can be accomplished. I think it can be accomplished politically. I think we can get support from across the political spectrum and will accomplish a lot of what we want to do.
Second, it does give people choice. And I think Americans have become accustomed to having choice, and I think they want to be able to choose what their health care plan is. Now, it may be that that gravitates towards a single-payer plan because they will have the Medicare plus the choices. And if that's the case, then the whole system can go in that direction. But you'll decide that. Consumers will decide that. So I think actually this plan makes sense in terms of moving us forward, getting a universal health care plan in place, giving people the choice of the equivalent of a single-payer plan with Medicare Plus, and then we'll see where it goes from there.
KAREN TUMULTY: I think he have time for one more question from the audience, and this is on a subject that's very near and dear to a lot of SEIU members. Reggie Warner is an RN from UHS Desert Springs Hospital. Are you here?
REGGIE WARNER: Hi, I'm Reggie Warner. I'm a new nurse at UHS Desert Springs Hospital. I see what happens to patients every day in the hospitals because of short staffing. And I also see what happens to nurses who leave the hospital because of job burnout and overall dissatisfaction. What do you plan on doing for state staffing and nurse retention?
JOHN EDWARDS: Well, we have a huge nursing crisis in America, which obviously you know about firsthand. I think a part of that crisis is dealt with by achieving a truly universal health care system where everyone gets reimbursed at a fair rate for the services they're providing. And in the context of achieving this universal health care system, we can regulate in a way that requires the staffing be adequate.
What we're seeing now, as you know, nurses working extraordinary -- nurses, who are the primary caregivers in a hospital, certainly in a hospital setting, they spend a lot more time with the patients than physicians do, and in many cases they're stressed, they're working long hours and they're terrified, as you know, because I hear it every time I talk to a nurse, they're afraid that the results of all this is they're going to make a mistake, and the patient is going to be the one who suffers.
So I think we need to, in addition to having a truly universal system, in addition to regulating in a way that keeps staffing at an adequate level, which is much easier to accomplish in the context of a universal health care system, I think in addition to that we, as a nation, need to make a commitment to beef up our availability of nurses, which means more investment, more scholarships in nursing schools.
It means providing incentive to get nurses who have graduated to the places where they're needed the most where the nursing shortage is most severe. In other words, incentive pay, some help from the government to help attract nurses to go to the places where they're needed the most. And then create a working environment that allows nurses to be the professionals that they so desperately want to be.
KAREN TUMULTY: That's our time, Senator Edwards. And, again, thank you very much for being here, and best wishes going forward.
JOHN EDWARDS: Thank you. Thank you all very much.