奥巴马罗姆尼辩论会：2012美国总统大选首场电视辩论视频及文(16)

PRESIDENT OBAMA: No, it isn't.

MR. 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 costs 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 — an — 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 targets such that they have an incentive, as you say, performance pay, for doing an excellent job, for keeping costs down, and that's happening.

Intermountain Health Care does it superbly well.

PRESIDENT OBAMA: They do.

MR. ROMNEY: Mayo Clinic is doing it superbly well, Cleveland Clinic, others. But the right answer is not to have the federal government take over health care and start mandating to the providers across America, telling a patient and a doctor what kind of treatment they can have. That's the wrong way to go. The private market and individual responsibility always work best.

PRESIDENT OBAMA: Let me just point out, first of all, this board that we're talking about can't make decisions about what treatments are given. That's explicitly prohibited in the law.

But let's go back to what Governor Romney indicated, that under his plan he would be able to cover people with pre-existing conditions. Well, actually, Governor, that isn't what your plan does. What your plan does is to duplicate what's already the law, which says if you are out of health insurance for three months then you can end up getting continuous coverage and an insurance company can't deny you if you've — if it's been under 90 days.

But that's already the law. And that doesn't help the millions of people out there with pre-existing conditions. There's a reason why Governor Romney set up the plan that he did in Massachusetts. It wasn't a government takeover of health care. It was the largest expansion of private insurance. But what it does say is that insurers, you've got to take everybody. Now, that also means that you've got more customers.

But when Governor Romney says that he'll replace it with something but can't detail how it will be in fact replaced, and the reason he set up the system he did in Massachusetts is because there isn't a better way of dealing with the pre-existing conditions problem, it — it just reminds me of — you know, he says that he's going to close deductions and loopholes for his tax plan.

That's how it's going to be paid for. But we don't know the details. He says that he's going to replace Dodd-Frank, Wall Street reform. But we don't know exactly which ones. He won't tell us. He now says he's going to replace "Obamacare" and assure that all the good things that are in it are going to be in there and you don't have to worry.

And at some point, I think the American people have to ask themselves, is the reason that Governor Romney is keeping all these plans to replace secret because they're too good? Is — is it because that somehow middle-class families are going to benefit too much from them? No, the — the reason is because when we reform Wall Street, when we tackle the problem of pre-existing conditions, then, you know, these are tough problems, and we've got to make choices. And the choices we've made have been ones that ultimately are benefiting middle-class families all across the country.

MR. LEHRER: All right, we're going to move to a —

MR. ROMNEY: No, I — I have to respond to that —

MR. LEHRER: No, but —

MR. ROMNEY: — which is — which is my experience as a governor is if I come in and — and lay down a piece of legislation and say it's my way or the highway, I don't get a lot done. What I do is the same way that Tip O'Neill and Ronald Reagan worked together some years ago. When Ronald Reagan ran for office, he laid out the principles that he was going to foster. He said he was going to lower tax rates. He said he was going to broaden the base. You've said the same thing: You're going to simplify the tax code, broaden the base. Those are my principles.

I want to bring down the tax burden on middle-income families. And I'm going to work together with Congress to say, OK, what are the various ways we could bring down deductions, for instance? One way, for instance, would be to have a single number. Make up a number — 25,000 (dollars), $50,000. Anybody can have deductions up to that amount. And then that number disappears for high-income people. That's one way one could do it. One could follow Bowles-Simpson as a model and take deduction by deduction and make differences that way.