LEHRER: Two minutes -- two minutes is up, sir.
OBAMA: No, I think -- I had five seconds before you interrupted me, was ... (LAUGHTER) ... the irony is that we've seen this model work really well in Massachusetts, because Governor Romney did a good thing, working with Democrats in the state to set up what is essentially the identical model and as a consequence people are covered there. It hasn't destroyed jobs. And as a consequence, we now have a system in which we have the opportunity to start bringing down costs, as opposed to just leaving millions of people out in the cold. LEHRER: Your five seconds went away a long time ago. All right, Governor. Governor, tell -- tell the president directly why you think what he just said is wrong about Obamacare? ROMNEY: Well, I did with my first statement. (CROSSTALK)
ROMNEY: First of all, I like the way we did it in Massachusetts. I like the fact that in my state, we had Republicans and Democrats come together and work together. What you did instead was to push through a plan without a single Republican vote. As a matter of fact, when Massachusetts did something quite extraordinary -- elected a Republican senator to stop Obamacare, you pushed it through anyway. So entirely on a partisan basis, instead of bringing America together and having a discussion on this important topic, you pushed through something that you and Nancy Pelosi and Harry Reid thought was the best answer and drove it through. What we did in a legislature 87 percent Democrat, we worked together; 200 legislators in my legislature, only two voted against the plan by the time we were finished. What were some differences? We didn't raise taxes. You've raised them by $1 trillion under Obamacare. We didn't cut Medicare. Of course, we don't have Medicare, but we didn't cut Medicare by $716 billion.
ROMNEY: We didn't put in place a board that can tell people ultimately what treatments they're going to receive. We didn't also do something that I think a number of people across this country recognize, which is put -- put people in a position where they're going to lose the insurance they had and they wanted. Right now, the CBO says up to 20 million people will lose their insurance as Obamacare goes into effect next year. And likewise, a study by McKinsey and Company of American businesses said 30 percent of them are anticipating dropping people from coverage. So for those reasons, for the tax, for Medicare, for this board, and for people losing their insurance, this is why the American people don't want Medicare -- don't want Obamacare. It's why Republicans said, do not do this, and the Republicans had -- had the plan. They put a plan out. They put out a plan, a bipartisan plan. It was swept aside. I think something this big, this important has to be done on a bipartisan basis. And we have to have a president who can reach across the aisle and fashion important legislation with the input from both parties. OBAMA: Governor Romney said this has to be done on a bipartisan basis. This was a bipartisan idea. In fact, it was a Republican idea. And Governor Romney at the beginning of this debate wrote and said what we did in Massachusetts could be a model for the nation. And I agree that the Democratic legislators in Massachusetts might have given some advice to Republicans in Congress about how to cooperate, but the fact of the matter is, we used the same advisers, and they say it's the same plan. It -- when Governor Romney talks about this board, for example, unelected board that we've created, what this is, is a group of health care experts, doctors, et cetera, to figure out, how can we reduce the cost of care in the system overall? Because there -- there are two ways of dealing with our health care crisis. One is to simply leave a whole bunch of people uninsured and let them fend for themselves, to let businesses figure out how long they can continue to pay premiums until finally they just give up, and their workers are no longer getting insured, and that's been the trend line. Or, alternatively, we can figure out, how do we make the cost of care more effective? And there are ways of doing it. So at Cleveland Clinic, one of the best health care systems in the world, they actually provide great care cheaper than average. And the reason they do is because they do some smart things. They -- they say, if a patient's coming in, let's get all the doctors together at once, do one test instead of having the patient run around with 10 tests. Let's make sure that we're providing preventive care so we're catching the onset of something like diabetes. Let's -- let's pay providers on the basis of performance as opposed to on the basis of how many procedures they've -- they've engaged in. Now, so what this board does is basically identifies best practices and says, let's use the purchasing power of Medicare and Medicaid to help to institutionalize all these good things that we do. And the fact of the matter is that, when Obamacare is fully implemented, we're going to be in a position to show that costs are going down. And over the last two years, health care premiums have gone up -- it's true -- but they've gone up slower than any time in the last 50 years. So we're already beginning to see progress. In the meantime, folks out there with insurance, you're already getting a rebate. Let me make one last point. Governor Romney says, we should replace it, I'm just going to repeal it, but -- but we can replace it with something. But the problem is, he hasn't described what exactly we'd replace it with, other than saying we're going to leave it to the states.
OBAMA: But the fact of the matter is that some of the prescriptions that he's offered, like letting you buy insurance across state lines, there's no indication that that somehow is going to help somebody who's got a pre-existing condition be able to finally buy insurance. In fact, it's estimated that by repealing Obamacare, you're looking at 50 million people losing health insurance...
LEHRER: Let's...
OBAMA: ... at a time when it's vitally important.
LEHRER: Let's let the governor explain what you would do...
ROMNEY: Well...
LEHRER: ... if Obamacare is repealed. How would you replace it? (CROSSTALK)
ROMNEY: Well, actually it's -- it's -- it's a lengthy description. But, number one, preexisting conditions are covered under my plan. Number two, young people are able to stay on their family plan. That's already offered in the private marketplace. You don't have to have the government mandate that for that to occur. But let's come back to something the president and I agree on, which is the key task we have in health care is to get the cost down so it's more affordable for families. And then he has as a model for doing that a board of people at the government, an unelected board, appointed board, who are going to decide what kind of treatment you ought to have. (CROSSTALK)
ROMNEY: In my opinion, the government is not effective in -- in bringing down the cost of almost anything. As a matter of fact, free people and free enterprises trying to find ways to do things better are able to be more effective in bringing down the cost than the government will ever be. Your example of the Cleveland Clinic is my case in point, along with several others I could describe. This is the private market. These are small -- these are enterprises competing with each other, learning how to do better and better jobs. I used to consult to businesses -- excuse me, to hospitals and to health care providers. I was astonished at the creativity and innovation that exists in the American people. In order to bring the cost of health care down, we don't need to have a board of 15 people telling us what kinds of treatments we should have. We instead need to put insurance plans, providers, hospitals, doctors on target such that they have an incentive, as you say, performance pay, for doing an excellent job, for keeping costs down, and that's happening. Innermountain Healthcare does it superbly well, Mayo Clinic is doing it superbly well, Cleveland Clinic, others.
