South Carolina Democratic debate transcript

Williams: Senator, thank you.

Senator Obama, how would you pay for your plan?

Obama: Well, first of all, let me tell you what I would do.

Number one, I think we should have a national pool that people can buy into if they don't have health insurance, similar to the ones that most of us who are in Congress enjoy right now.

It doesn't make sense to me that my bosses, the taxpayers, may not have health insurance that I enjoy.

Obama: And we can provide subsidies for those who can't afford the group rates that are available.

The second thing I think that we're going to have to do is make sure that we control costs. We spend $2 trillion on health care in this country every year, 50 percent more than other industrialized nations. And yet, we don't have, necessarily, better outcomes.

This week, we saw a story that showed that black infant mortality in this country is actually going up in some states, which is shameful and makes no sense.

And if we make sure that we provide preventive care and medical technology that can eliminate bureaucracy and paperwork, that makes a big difference.

The third thing is catastrophic insurance to help businesses and families avoid the bankruptcies that we're experiencing all across the country and reduced premiums for families.

That's the kind of plan that I think we can accomplish, as long as we build the movements to actually make that change happen.

Williams: Senator, thank you.

Senator Clinton, you're perhaps more closely associated with this issue than anyone on this stage.

How would you pay for your plan?

Clinton: Well, let me start by saying that all of the ideas that you're going to hear about in this campaign are very important to get out to the public so that people can actually think about them, examine how they would affect their lives because I do have the experience of having put forth a plan, with many of the features that John and Barack just mentioned.

And people were enthusiastic about it initially, but then after the insurance companies and the pharmaceutical companies got finished working on it, everybody got nervous and so politically we were not successful.

Well, I'm ready to try again, and there's three things we've got to do. We've got to control and decrease costs for everyone. This is not just about the uninsured.

Yes, we have nearly 47 million, but we've got many millions more who have an insurance policy that they can barely afford and that they can't get the treatments they need under it. We have to cover everybody but we've got to improve quality.

We can save money within the existing system. I am not ready to put new money into a system that doesn't work until we've tried to figure out how to get the best outcomes from the money we already have.

Williams: Thank you, Senator.

Governor Richardson, you are perhaps the most strident on the position against raising taxes to pay for this.

But how could it possibly be the domestic Marshall Plan some people say it must be without that kind of revenue?

Richardson: Well, as Democrats, I just hope that we always don't think of new taxes to pay for programs.

This is what I would do -- and I'm a governor; I deal with this issue every day. I deal with the issue of guns every day. I deal with almost everything you asked, as a chief executive.

This is what I would do. I would have the following principles. In our health care plan, my new health care plan, no new bureaucracy. Every American shares, along with businesses, the state and the federal government. I would focus on prevention.

I would also ensure that the first thing we do is deal with the bureaucracy and inefficiencies in our health care system. Thirty-one percent of our health care goes to inefficiencies and bureaucracy.

If we had a health information system where doctors and nurses could share information about health care, we would save billions of dollars.

I would also make sure that we would re-establish the doctor- patient relationship, eliminate those in the middle, like HMOs and others.

But my plan, I believe, would focus on prevention. We need to focus more on deterring these diseases, like...

Williams: Thank you.

Richardson: ... like diabetes, that is 30 percent of our Medicare costs.

Williams: Thank you, Governor. Time has expired.

At this point, we're going to go to my colleague, Dave Stanton, in the audience, who has another round of questions via e-mail.

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