PRESIDENTIAL DEBATEOctober 16, 1996
JIM LEHRER: The next question is for Senator Dole and it's from this section. Yes, ma'am? Yes?
VERDA STRATIGUS: Senator Dole, I am Verda Stratigus and I work in health care. And it's truly an honor to be here tonight to address both of you.
MR. DOLE: Thank you.
VERDA STRATIGUS: Being in health care, we have talked a little bit about health care tonight, but mainly MediCal and Medicare have been mentioned, but the private sector is a problem. Managed care is taking over, especially in California, and because of that, the quality of care is going downhill. There are many, many people who cannot get the tests that they need when they need them. And because of that, they are dying needlessly. There are many, many more lawsuits being presented against the managed care industry because of this. And I think it's a real problem that needs to be addressed. What would you do if you were president?
MR. DOLE: Well, one thing I did was to oppose the government takeover of health care that President Clinton offered in 1993, which created 17 new taxes and 50 new bureaucracies and price controls, because we were afraid the very thing you mentioned would have happened. Everybody would have been forced into managed care. You couldn't have chosen your own doctor. And that would have been the end.
And I think right now we've got to go back - I know they've appointed a commission to take a look at managed care. Maybe that's part of the answer. But it seems to me, if we start to take choices away from people and if we drive them into one type care, if we eliminate fee-for-service altogether or eliminate the fact you can go to your own doctor, you've got to go somewhere else, then I think we've taken a giant step backward in the United States of America.
We have the best health care delivery system in the world, and we want to keep it that way. That's why we opposed the government take-over health care plan that President Clinton tried and tried and tried to get through Congress.
Didn't get it done. When it ended up we had more votes than he had, then they decided to pull the plug. It was a big, big mistake. Now, whether or not he'll do that again, I've heard some of the people say "Well, that's the model we ought to use." And if he's reelected, maybe he'll come back and try it again. I hope not. I hope not in both cases. But it does seem to me that you've raised a very important point that needs to be addressed. We're going to have watch it, going take a look at all the managed care going on in California, or we're going to end up losing our best care that we have in the world.
PRESIDENT CLINTON: I'm just curious. How many of you are under managed care plans? Raise your hand if you're in managed care.
MR. DOLE: Probably the young people here.
PRESIDENT CLINTON: How many of you like it? Well -
MR. DOLE: Two.
PRESIDENT CLINTON: - one of the things that I tried to do was to make sure that everybody in the country who was under a managed care plan should at least have three choices of plans and would have the right to get out without penalty every year. Now that's not a government takeover, that's like the Family and Medical Leave law. It just tries to set the rules of the game.
I'm strongly in favor of a federal bill to repeal the - any gag rules on providers. In other words, I believe that doctors should not be able to be kicked out of managed care plans just because they tell the patients what they need and what more expensive care options might be.
If we're saving money and managing resources better, that's a good thing. If we're saving money and depriving people of care, that's a bad thing. A good place to start is to say no managed care provider can gag a doctor and kick the doctor out of the managed care plan for the doctor telling the patient, "You need a more expensive test, you need a more expensive procedure. Your health requires it."
JIM LEHRER: Senator Dole?
MR. DOLE: Well, I don't have any quarrel with that. I think that would help. But I think what we want to avoid is falling back into this nationalized health care system that President Clinton wanted to give us in 1993.
If that isn't a liberal idea, I've never heard one. Seventeen new taxes; price controls; 50 new bureaucracies. We'd have that trouble all over America. We need to deal with managed care. It not only happened in California, it's happening in other states that we visit too. It's a national problem, not just a state problem.