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University of Denver
Denver, Colorado
THE PRESIDENT: I suspect that on Social Security we’ve got a somewhat similar position. Social Security is structurally sound. It’s going to have to be tweaked the way it was by Ronald Reagan and Democratic Speaker Tip O’Neill. But the basic structure is sound. But I want to talk about the values behind Social Security and Medicare, and then talk about Medicare because that’s the big driver of our deficits right now.My grandmother, some of you know, helped to raise me -- my grandparents did. My grandfather died a while back. My grandmother died three days before I was elected President. And she was fiercely independent. She worked her way up -- only had a high school education, started as a secretary, ended up being the vice president of a local bank. And she ended up living alone by choice. And the reason she could be independent was because of Social Security and Medicare.She had worked all her life, put in this money, and understood that there was a basic guarantee, a floor under which she could not go. And that’s the perspective I bring when I think about what’s called entitlements. The name itself implies some sense of dependency on the part of these folks. These are folks who've worked hard, like my grandmother, and there are millions of people out there who are counting on this. So my approach is to say, how do we strengthen the system over the long term. And in Medicare, what we did was we said we are going to have to bring down the costs if we’re going to deal with our long-term deficits, but to do that let’s look where some of the money is going -- $716 billion we were able to save from the Medicare program by no longer overpaying insurance companies, by making sure that we weren’t overpaying providers, and using that money we were actually able to lower prescription drug costs for seniors by an average of $600, and we were also able to make a significant dent in providing them the kind of preventive care that will ultimately save money throughout the system.So the way for us to deal with Medicare in particular is to lower health care costs. When it comes to Social Security, as I said, you don’t need a major structural change in order to make sure that Social Security is there for the future.MR. LEHRER: We’ll follow up on this. First, Governor Romney, you have two minutes on Social Security and entitlements.GOVERNOR ROMNEY: Well, Jim, our seniors depend on these programs, and I know any time we talk about entitlements people become concerned that something is going to happen that’s going to change their life for the worse. And the answer is, neither the President, nor I are proposing any changes for any current retirees or near-retirees, either to Social Security or Medicare. So if you’re 60 or around 60 or older, you don’t need to listen any further. But for younger people we need to talk about what changes are going to be occurring -- oh, I just thought about one, and that is in fact I was wrong when I said the President isn’t proposing any changes for current retirees. In fact, he is on Medicare. On Social Security he’s not. But on Medicare, for current retirees, he’s cutting $716 billion from the program -- now, he says by not overpaying hospitals and providers, actually, just going to them and saying we’re going to reduce the rates you get paid across the board, everybody is going to get a lower rate. That saying we're cutting the rates. Some 15 percent of hospitals and nursing homes say they won't take any more Medicare patients under that scenario. We also have 50 percent of doctors who say they won't take more Medicare patients. We have 4 million people on Medicare Advantage that will lose Medicare Advantage because of those $716 billion in cuts. I can't understand how you can cut Medicare $716 billion for current recipients in Medicare. Now, you point out, well, we're putting some back, we're going to give a better prescription program. That's $1 for every $15 you've cut. They're smart enough to know that's not a good trade.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.With regards to young people coming along, I've got proposals to make sure Medicare and Social Security are there for them without any question. MR. LEHRER: Mr. President.THE PRESIDENT: First of all, I think it's important for Governor Romney to present this plan that he says will only affect folks in the future. And the essence of the plan is that you would turn Medicare into a voucher program. It's called Premium Support, but it's understood to be a voucher program.MR. LEHRER: And you don't support that?THE PRESIDENT: I don't. And let me explain why.GOVERNOR ROMNEY: Again, that's for future people --THE PRESIDENT: I understand.GOVERNOR ROMNEY: -- not for current retirees.THE PRESIDENT: So if you're 54 or 55, you might want to listen, because this will affect you. The idea, which was originally presented by Congressman Ryan, your running mate, is that we would give a voucher to seniors and they could go out in the private marketplace and buy their own health insurance. The problem is that because the voucher wouldn't necessarily keep up with health care inflation, it was estimated that this would cost the average senior about $6,000 a year.Now, in fairness, what Governor Romney has now said is he'll maintain traditional Medicare alongside it. But there's still a problem, because what happens is those insurance companies are pretty clever at figuring out who are the younger and healthier seniors. They recruit them, leaving the older, sicker seniors in Medicare, and every health care economist who looks at it says over time what will happen is the traditional Medicare system will collapse. And then what you've got is folks like my grandmother at the mercy of the private insurance system precisely at the time when they are most in need of decent health care.So I don't think vouchers are the right way to go. And this is not my -- only my opinion. AARP thinks that the savings that we obtained from Medicare bolstered the system, lengthened the Medicare trust fund by eight 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 co-pays for basic checkups that can keep them healthier. And the primary beneficiary of that repeal are insurance companies that are estimated to gain billions of dollars back when they aren’t making seniors any healthier. And I don't think that's the right approach when it comes to making sure that Medicare is stronger over the long term.MR. LEHRER: We'll talk about -- specifically about health care in a moment. But do you support the voucher system, Governor?GOVERNOR ROMNEY: What I support is no change for current retirees and near-retirees to Medicare. And the President supports taking $716 billion out of that program. MR. LEHRER: What about the voucher --GOVERNOR ROMNEY: So that's number one. Number two is, for people coming along that are young, what I'd do to make sure that we can keep Medicare in place for them is to allow them either to choose the current Medicare program or a private plan -- their choice. They get to -- and they'll have at least two plans that will be entirely at no cost to them. So they don't have to pay additional money, no additional $6,000 -- that's not going to happen. They'll have at least two plans.And by the way, if the government can be as efficient as the private sector and offer premiums that are as low as the private sector, people will be happy to get traditional Medicare. Or they'll be able to get a private plan. I know my own view is I'd rather have a private plan. I know I’d just as soon not have the government telling me what kind of health care I get. I’d rather be able to have an insurance company. If I don't like them, I can get rid of them and find a different insurance company. Let people make their own choice.The other thing we have to do to save Medicare, we have to have the benefits high for those that are low-income. But for higher-income people, we’re going to have to lower some of the benefits. We have to make sure this program is there for the long term. That's the plan that I put forward. And by the way, the idea came not even from Paul Ryan or Senator Wyden, who is a co-author of the bill with Paul Ryan in the Senate, but also it came from Bill Clinton’s Chief of Staff. This is an idea that's been around a long time, which is saying, hey, let’s see if we can't get competition into the Medicare world so that people can get the choice of different plans at lower cost, better quality. I believe in competition.MR. LEHRER: Okay.THE PRESIDENT: Jim, if I can just respond very quickly. First of all, every study has shown that Medicare has lower administrative costs than private insurance does, which is why seniors are generally pretty happy with it. And private insurers have to make a profit. Nothing wrong with that, that's what they do. And so you’ve got higher administrative costs, plus profit on top of that, and if you are going to save any money through what Governor Romney is proposing, what has to happen is, is that the money has to come from somewhere. And when you move to a voucher system, you are putting seniors at the mercy of those insurance companies. And over time, if traditional Medicare has decayed or fallen apart, then they're stuck. And this is the reason why AARP has said that your plan would weaken Medicare substantially. And that's why they were supportive of the approach that we took.One last point I want to make: We do have to lower the cost of health care, not just in Medicare, but --MR. LEHRER: We'll talk about that in a minute.THE PRESIDENT: -- but overall.MR. LEHRER: Okay.THE PRESIDENT: And so --GOVERNOR ROMNEY: That's a big topic. Can we stay on Medicare?THE PRESIDENT: Is that a separate topic?MR. LEHRER: Yes, we’re going to -- yes, I want to get to it.THE PRESIDENT: I’m sorry.MR. LEHRER: But all I want to do is very quickly before we leave the economy --GOVERNOR ROMNEY: Let’s get back to Medicare. Let’s get back to Medicare. MR. LEHRER: Governor --GOVERNOR ROMNEY: The President said that the government can provide the service at lower cost and without a profit.MR. LEHRER: All right.GOVERNOR ROMNEY: If that's the case, then it will always be the best product that people can purchase.MR. LEHRER: Wait a minute, Governor. Wait a minute.GOVERNOR ROMNEY: But my experience -- my experience is the private sector typically is able to provide a better product at a lower cost.MR. LEHRER: Can we -- can the two of you agree that the voters have a choice, a clear choice between the two of you on Medicare?GOVERNOR ROMNEY: Absolutely.THE PRESIDENT: Yes.GOVERNOR ROMNEY: Absolutely.MR. LEHRER: All right. So, to finish quickly, briefly on the economy, what is your view about the level of federal regulation of the economy right now? Is there too much? And in your case, Mr. President, is there -- should there be more? Beginning with you -- this is not a new two-minute segment. Just start, and we’ll go for a few minutes, and then we’re going to go to health care, okay?GOVERNOR ROMNEY: Regulation is essential. You can't have a free market work if you don't have regulation. As a businessperson, I had to have -- I needed to know the regulations. I needed them there. You could have people opening up banks in their garage and making loans. You have to have regulations so that you can have an economy work. Every free economy has good regulation. At the same time, regulation can become excessive.MR. LEHRER: Is it excessive now, do you think?GOVERNOR ROMNEY: In some places, yes. MR. LEHRER: Like where? Let me know.GOVERNOR ROMNEY: Other places no. It can become out of date. And what’s happened with some of the legislation that's been passed during the President’s term, you’ve seen regulation become excessive and it’s hurt the -- it’s hurt the economy.Let me give you an example. Dodd-Frank was passed, and it includes within it a number of provisions that I think has some unintended consequences that are harmful to the economy. One is it designates a number of banks as "too big to fail," and they're effectively guaranteed by the federal government. This is the biggest kiss that's been given to New York banks I’ve ever seen. This is an enormous boon for them. There have been -- 122 community and small banks have closed since Dodd-Frank. So there’s one example.Here’s another. In Dodd-Frank, it says if --MR. LEHRER: You want to repeal Dodd-Frank?GOVERNOR ROMNEY: Well, I would repeal it and replace it. We’re not going to get rid of all regulation. You have to have regulation, and there are some parts of Dodd-Frank that make all the sense in the world. You need transparency. You need to have leverage limits for institutional --MR. LEHRER: Well, there’s a specific --GOVERNOR ROMNEY: But let’s -- but let’s mention --MR. LEHRER: Excuse me --GOVERNOR ROMNEY: Let me mention the other one. Let’s talk the other big one.MR. LEHRER: No, let’s not. GOVERNOR ROMNEY: Okay.MR. LEHRER: Let’s let him respond -- let’s let him respond to this specific on Dodd-Frank and what the Governor just said.
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