Transcript: Gov. Bill Richardson
The following is a transcript of Governor Bill Richardson's speech at the Presidential Forum.
KAREN TUMULTY: The next candidate that we are about to hear from is a neighbor, Governor Bill Richardson of New Mexico.
BILL RICHARDSON: I want to thank SEIU and the Center for America Progress for putting this event together. And my first thoughts, and Barbara, my wife's first thoughts today are for Elizabeth Edwards and the Edwards family in this very trying time. And if there's one message about policy message related to this situation is that as Americans we should spend more, invest more in cancer research and the National Institute of Health and many of our entities that are underfunded and with flat budgets. We should invest more in stem cell research. We should find ways to invest in the diseases in this country.
We, as Americans, are in crisis today. As a governor I have to deal with the health care crisis every day. We got a problem with increasing access, coverage and controlling costs. Since the year 2000, health care premiums have increased for American families about 80 percent. 4,000 Americans lose health care coverage every day. We spend $2 trillion on health care. 31 percent of health care costs are spent on bureaucracy and red tape instead of direct care. It is critically important that we device a strategy, first of all, that doesn't create any more bureaucracy. We have enough bureaucracy. As a governor I've been able to control costs. I've even cut taxes for working families and at the same time extended coverage.
So what would I do as a president? First, to deal with increasing coverage; number one, all Americans and all businesses should have the same coverage, should be able to purchase coverage as members of Congress and the president of the United States. We need to do that and we need to do that.
Number two, I would start something new. Americans 55 and older should be able to purchase coverage through Medicare. Today it's at 65. Number three, a trade. And this is how a governor would operate. The federal government, Medicare goes to treat seniors and the disabled in exchange for the state dealing and increasing Medicare coverage for children and families. And number four, veterans. We should give our military veterans the access they need anywhere they want, any time they want. And I would have a hero's health card that would enable our veterans when they get out to get coverage choices anywhere they want. They should not have to drive 200 miles to the nearest VA hospital.
Now, this is how I would deal with coverage. What about costs? I would have a cooperative plan between the employer, businesses, the state and the federal government. I would propose a refundable tax credit for those Americans that need coverage based on income. Number two, I would clamp down on credit card companies that are covering excessive interest rate costs. I have a health secretary who her brother is paying 18 percent. A lot of Americans pay their health care through credit cards. 18 percent interest rate. I would put a cap on those costs. I would also make sure that we have a prevention strategy, early prevention, kids. As a governor I eliminated junk food in schools.
I just signed a statewide smoking ban and I would do that as president. I would have a promotion of healthy lifestyles. Give tax credits to companies that encourage their workers to be healthier, to exercises. I would also make sure that we have a strategy to deal with a 31 percent of excessive health care costs and bureaucracy by electronic records. I would also find ways to ensure that we have an answer, how do we pay for this?
This is how I would pay for this health care plan. Number one, we reorder priorities in this country. We get out of Iraq and put the $400 billion that we have in Iraq and shift it to human needs. Number two, we spend 2 trillion on health care. We shift and reorder priorities in terms of reducing inefficiencies in our system. And number three, we would offer options for all Americans to get health care coverage.
Workers must get health care coverage. But you help them. But you help them if they need it. And businesses. And small businesses have to participate in health care plans for all those employees. That's what I would do as president. This is a plan that would not add bureaucracy. This is a plan that could be paid for without any new taxes. This is a plan I believe that says to the American people, if I have a health care plan and I'm satisfied with it, I could keep it the way it is. I believe also that as Americans we have to ensure prevention. That is so important. Making sure that we start early, making sure that we promote healthy lifestyles. That would be my plan as president.
KAREN TUMULTY: Governor, I'm afraid if you're attacking junk food you've already lost my ten-year-old's vote. So how quickly under your plan do you think you could get to true universal coverage?
BILL RICHARDSON: I believe with a Democratic president, a Democratic Congress, a stronger Democratic Congress I believe this plan that I outlined, which is basically a plan that is taking new ideas into an existing framework, could be achieved my first year as president. I believe it's doable. I believe what you're talking about is a shift in laws, for instance a trading of the federal role in Medicare, the state role in Medicaid for SCHIP in children. I believe what we're talking about too is within the cost structure, when you're spending 2 trillion on health care, remember there are 47 million uninsured in this country, and we're already paying for it. It's already being paid for. They're in emergency rooms. We're all paying for this. So it's a question of shifting priorities. So what we're talking about is I believe a very aggressive plan with new ideas that could be achieved the first year that I'm president.
KAREN TUMULTY: You know, as Washington has failed to address this problem, you and your fellow governors have moved forward and stepped into the breach; however, one of the most controversial aspects of the plan that Governor Schwarzenegger just recently unveiled in California is his proposal that illegal immigrants be covered under his plan. How would you see under your plan bringing in this very, very large segment of the population into the system or not?
BILL RICHARDSON: They're children. We should cover children. We should cover children, as long as they pay their fair share with everybody else. An essential component of my plan is that we all pay: Employers, employees, the government. But we help each other pay the fair share. The way you deal with immigration, one, yes we have to secure our borders, no question about it. Not with this stupid wall that is being proposed. But you also set up a legalization plan for the 12 million undocumented workers that are in this country. Maybe it's not very popular, but it makes sense based on setting a path to legalization that involves dealing with issues like health care that involves if they learn English, if they pay back taxes, if they pass a background check. They don't get ahead of the line of those that are trying to get here legally. These are children. We should insure all children in this country.
KAREN TUMULTY: We have a question from David Slater in our audience, who's taken a look at the kind of health care that Congress gets and wants to know why he can't have it too.
DAVID SLATER: The governor brought up, back to my question, all members of Congress, Senators, staff, postal workers are all in a great plan sponsored by the federal government. I was in that plan. I'm a retired postal worker. It's a fabulous plan. Why reinvent the wheel? We already have an existing system that can function. We don't need any more bureaucracy, as you mentioned. Just implement that plan to everybody here in this room with everybody a U.S. citizen to have the same plan. As Senator Edwards said, he's comfortable. Every federal worker is very comfortable in that plan. Every postal worker has that plan. They have an option to pick from any insurance company they want. Why not just give it to the United States citizens right now? And the governor says that's something I can't believe can be implemented within one year.
BILL RICHARDSON: Well, look, that's the cornerstone of my plan that deals with coverage. In other words, you know, the members of Congress, the president, they get the best plan in the world. They have all kinds of options. What I'm saying is offer that to every American, to every business, to every American family in that federal health care system. I totally agree with you. It's an excellent question. Thank you.
KAREN TUMULTY: We also have a question by email from Ken in Olympia, Washington who wants to know how do you feel your experience as governor of New Mexico has prepared you to find solutions for the rising cost of health care and to achieve the goal of affordable health care for all? And if I can just add on to that, could you talk a little bit about, you know, what you've learned, what parts of the problem, the health care problem in dealing with it in New Mexico turned out to be harder to confront than you thought they were going to be?
BILL RICHARDSON: As a CEO of a state, governors have to deal with this issue every day. And the most I believe innovative programs in this country are happening in the states in experiments to cover our people, all our people and also control costs. As a governor, my approach has been, and my state is one of the highest uninsured, it's about 20, 21 percent. Ten percent of those are Native Americans that are supposed to be covered by a federal health care system, and they're not.
But the federal government is abdicating. So we try to help with state programs. What we need to do is what we do in the state. I started out with a health care plan dealing with this access issue. Number one, we were able to insure all children under five. Now we're trying to cover all working adults. The next phase will be try to cover the chronically unemployed. But we have attacked the prevention issue aggressively, as I mentioned. We cut junk food out of schools. I signed recently last week a statewide smoking ban. We should nationally give incentives to companies that give their health care workers time to exercise or an opportunity to build a healthier lifestyle. We should find ways also that in the American system we encourage the American people to start earlier, early childhood, preschool.
This is so important. School based health centers at all our schools. But also recognize that it's going to take research. It's going to take efforts, aggressive efforts to deal with deadly diseases, to deal with malaria, to deal with issues that relate to suicide prevention for children, to deal with issues that relate also for children that have sickle cell anemia or diabetes prevention. We don't focus enough on prevention. And prevention, we spend 75 percent of health care costs on chronic diseases and only five percent on prevention. That should shift.
KAREN TUMULTY: We also have a question from another SEIU member in the audience, Tracy Powell, who works for the Department of Family Services in Clark County and is really on the front lines every day of seeing another aspect of the health care crisis.
TRACY POWELL: Good morning. I am a social worker for Clark County Department of Family Services and a member of SEIU. On a daily basis we see how mental health services and substance abuse issues impact children and families. Typically there's very limited resources for mental health. How would you address the mental health services and the care provided and coverage provided for mental health services?
BILL RICHARDSON: Well, for years mental health has been given lower priority in health care than almost any other problem. One out of five Americans has some kind of mental health problem, including schizophrenia and depression. And for years in terms of insurance and coverage we've neglected mental health. As president I would not do that. What we did in New Mexico is we brought all mental health bureaucracy programs under one roof into what's called a mental health collaborative. And we need aggressive efforts to include mental health in all types of coverage.
We need to find ways also that we deal with substance abuse. You mentioned that. In New Mexico and the west, and Nevada right here, meth is the biggest problem, and we don't have answers in terms of how we can best treat it. If you're going to deal with substance abuse, mental health problems, alcoholism, what is critically important, not just law enforcement, incarceration, but treatment and education, an investment in serious substance abuse programs that can make things better.
KAREN TUMULTY: Governor, does that suggest that you support full parody for mental health coverage? Certainty your senior senator of your state, Pete Domenici, has been very outspoken who's been a national leader on that very subject, but opponents say, look, this is just going to, talk about rising costs, the costs would just explode if, in fact, mental health services were covered the same way as physical health services.
BILL RICHARDSON: I would include mental health services. Yes, I would. But, see, everybody is talking about costs. What I'm saying is if we manage our health care system more efficiently, eliminate a lot of the duplication. Just think, 31 percent of our health care costs is bureaucracy and red tape, and it's not direct care. If we find ways to make that more efficient, with perhaps electronic records, with, you know, you have 50 states managing 50 Medicaid programs. You've got a Medicare system that has hundreds of health care plans administering it.
If you're able to find an elimination of that bureaucracy and red tape and make it more efficient, you would have that 31 percent go more to direct care. So those that say you need to increase the tax, you need to find other sources of revenue, I believe we can do it within the existing system and cover all Americans and control costs and be fair. But an essential component of the plan that I learned is that we have to be part of it: Employers, employees, state, the federal government. It's a cooperative, collaborative relationship catalyzed by the government, making health care universal coverage something that we can do, I believe, as I said, within a year. I believe it's doable.
KAREN TUMULTY: Well, I think we have time for one more question, and that would be so you proposed basically building on the existing system that we have and attacking this problem from a number of different directions. Which one do you do first?
BILL RICHARDSON: Well, you have to do them both at the same time. You have to control costs, and you have to expand health care coverage. But I propose, as you said, some new ideas within an existing system. And the new ideas are the trade between Medicare and Medicaid, what the states would do. It has to be an exchange. We have to make sure that the states do spend money on SCHIP, on children, on families. And the new initiative would be what this gentleman proposed, and that is let all Americans, businesses, families be part of the federal health care system that the Congress enjoys, and with our veterans.
I mean, you're talking about a sizable population. Give them access anywhere they want to go. If it's two blocks from their home, they have to drive miles and miles. This is all new within an existing system. And then finally, just find ways to ensure that the states and the federal government have a cooperative relationship. I'm a governor. It's very hard for us to get waivers to do some of the experiments that are so important to the SEIU, to the American people. The bureaucracy strangles our system so much that a major component has to be a way to tame the bureaucracy so that it works for people and not against people.