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Transcript: Presidential Debate, St. Louis, Mo.


___ Debate Referee ___

Referee Washington Post staff writer Charles Babington makes the calls, examining the candidates' claims and charges. Click on the "referee" icons in the text below to see Babington's analysis. Staff researchers Lynn Davis and Madonna Lebling contributed to this feature.

Partisanship and Patient Rights
Patient Rights Bill in Texas
Health Care: The Uninsured
Health Coverage in Texas
School Vouchers
Bush's Spending Plan
Gore's Spending Plan
Bush's Tax Cuts
Gore's Tax Cuts
Reinventing Government
Estate Taxes
Gore on Social Security
Bush on Social Security

Tuesday, October 17, 2000

Following is the complete transcript of the presidential debate between Vice President Gore (D) and Texas Gov. George W. Bush (R). The moderator of the nationally televised debate was Jim Lehrer of PBS.

First of three pages.

LEHRER: Good evening from the Field House at Washington University in St. Louis. I'm Jim Lehrer of The NewsHour on PBS. And I welcome you to this third and final campaign 2000 debate between the Democratic candidate for president, Vice President Al Gore, and the Republican candidate, Governor George W. Bush of Texas. Let's welcome the candidates now.


Before proceeding tonight, we would like to observe a moment of silence in memory of Governor Mel Carnahan of Missouri, who, along with his son and his former chief of staff, died in a private plane crash last night near St. Louis.


A reminder, as we continue now, that these debates are sponsored by the Commission on Presidential Debates. The formats and the rules were worked out by the commission and the two campaigns. Tonight's questions will be asked by St. Louis area voters who were identified as being uncommitted by the Gallup organization. Earlier today each of them wrote a question on a small card like this. Those cards were collected and then given to me this afternoon. My job, under the rules of the evening, was to decide the order the questions will be asked and to call on the questioners accordingly. I also have the option of asking follow-ups which -- in order to get to more of the panel's questions.

For the record, I plan to do sparingly and mostly for clarifications. The audience participants are bound by the following rule. They shall not ask follow-up questions or otherwise participate in the extended discussion. And the questioner's microphone will be turned off after he or she completes asking the question. Those are the rules. As in Winston-Salem last week, no single answer or response from a candidate can exceed two minutes. There is an audience here in the hall and they have promised to remain absolutely quiet, as did their predecessors this year in Boston, Danville, and Winston-Salem.

Before we begin, a correction from last week's debate. I was wrong when I said Vice President Gore's campaign commercials had called Governor Bush a bumbler. That specific charge was made in a press statement by Gore campaign spokesman Mark Fabiani, not in a TV Guide.

BUSH: I'm glad you clarified that.

LEHRER: Now let's go to the first question. Of over the 130 questions we received from this panel, we will begin with one of the 19 on health issues. And it goes to you, Mr. Vice President, and it will be asked by James Hankins (ph). Mr. Hankins?

QUESTION: How do you feel about HMOs and insurance companies making the critical decisions that affect people's lives instead of the medical professionals? And why are the HMOs and insurance companies not held accountable for their decisions?

GORE: Mr. Hankins (ph), I don't feel good about it, and I think we ought to have a Patients' Bill of Rights to take the medical decisions away from the HMOs and give them back to the doctors and the nurses. I want to come back and tell you why.

But if you will forgive me, I would like to say something right now at the beginning of this debate, following on the moment of silence for Mel Carnahan and Randy Carnahan and Chris Sifford.

Tipper and I were good friends with Mel and Randy. And I know that all of us here want to extend our sympathy and condolences to Jean and the family and to the Sifford family. And I'd just like to say that this debate in a way is a living tribute to Mel Carnahan because he loved the vigorous discussion of ideas in our democracy. He was a fantastic governor of Missouri. This state became one of the top five in the nation for health care coverage for children under his leadership, one of the best in advancing all kinds of benefits for children to grow up healthy and strong.

And, of course, this debate also takes place at a time when the tragedy of the USS Cole is on our minds and hearts.

And insofar as the memorial service is tomorrow, I would like to also extend sympathy to the families of those who have died and those who are still missing and the injured.

Now, Mr. Hankins, I think that the situation that you described has gotten completely out of hand. Doctors are giving prescriptions, they're recommending treatments and then their recommendations are being overruled by HMOs and insurance companies. That is unacceptable.

I support a strong national patients' bill of rights. It is actually a disagreement between us. A national law that is pending on this, the Dingell-Norwood bill, a bipartisan bill, is one that I support...

LEHRER: Times up.

GORE: ... and that the governor does not.

LEHRER: Two minutes' response, Governor Bush.

BUSH: I too want to extend my prayers to the--and blessings, God's blessings on the families whose lives were overturned last night. It was a tragic moment.

Actually, Mr. Vice President, it's not true. I do support a national patients' bill of rights. As a matter of fact, I brought Republicans and Democrats together to do just that in the state of Texas, to get a patients' bill of rights through.

Debate Referee
It requires a different kind of leadership style to do it though. You see, in order to get something done on behalf of the people, you have to put partisanship aside. And that's what we did in my state. We've got one of the most advanced patients' bill of rights.

It says, for example, that a woman can--doesn't have to go through a gatekeeper to go to her gynecologist.

It says that you can't gag a doctor. A doctor can advise you. The HMO, insurance company, can't gag that doctor from giving you full advice. In this particular bill, it allows patients to chose a doctor, their own doctor if they want to.

Debate Referee
But we did something else that was interesting. We're one of the first states that said you can sue an HMO for denying you proper coverage. Now, there's what's called an Independent Review Organization that you have to go through first. It says, if you've got a complaint with your insurance company, you can take your complaint to an objective body. If the objective body rules on your behalf, the insurance company must follow those rules. However, if the insurance company doesn't follow the findings of the IRO, then that becomes a cause of action in a court of law.

It's time for our nation to come together and do what's right for the people. And I think this is right for the people.

You know, I support a national patients' bill of rights, Mr. Vice President. And I want all people covered. I don't want the law to supersede good law like we've got in Texas. I think...

LEHRER: Governor, time is up, sir.

GORE: Jim?

LEHRER: Yes, sir.

GORE: We have a direct disagreement on this.

LEHRER: Just a minute, Mr. Vice President. I wanted to--you know, the way the rules go here, now, two minutes, two minutes, and then I'll decide whether we go on.

GORE: Right.

LEHRER: So what I want to make sure is we understand here is, before we go on to another question in the health area, would you agree that you two agree on a national patients' bill of rights?

GORE: Absolutely--absolutely not. I referred to the Dingell-Norwood bill. It is the bipartisan bill that is now pending in the Congress. The HMOs and the insurance companies support the other bill that's pending, the one that Republican majority has put forward.

They like it because it doesn't accomplish what I think really needs to be accomplished, to give the decisions back to the doctors and nurses and to give a right of appeal to somebody other than the HMO or insurance company, let you go the nearest emergency room without having to call an HMO before you call 911, to let you see a specialist if you need to. And it has strong bipartisan support. It is being blocked by the Republican leadership in the Congress.

And I specifically would like to know whether Governor Bush will support the Dingell-Norwood bill, which is the main one pending.

LEHRER: Governor Bush, you may answer that if you'd like. But also, I'd like to know how you see the differences between the two of you, and we need to move on.

BUSH: Well, the difference is is that I can get it done.


That I can get something positive done on behalf of the people. That's what the question in this campaign is about. It's not only what your philosophy and what your position on issues, but can you get things done.


And I believe I can.

LEHRER: All right...

GORE: What about the Dingell-Norwood bill?

LEHRER: All right, we're going to go now to another...

BUSH: I'm not quite through. Let me finish the...

LEHRER: All right.

BUSH: I talked about the principles and the issues that I think are important in a patients' bill of rights. Now, there's this kind of Washington, D.C., focus, well, it's in this committee or it's got this sponsor. If I'm the president, we're going to have emergency room care, we're going to have to gag orders. Women will have direct access to ob-gyn.

People'll be able to take their HMO insurance company to court. That's what I've done in Texas. And that's the kind of leadership style I'll bring to Washington.

LEHRER: All right another--the next question, also on a health issue, is from--it will be asked by Marie Payne Clappey (ph), and it goes to Governor Bush.

QUESTION: Are either of you concerned with...

BUSH: There you go. I've got...


QUESTION: OK. Are either of you concerned with finding some feasible way to lower the price of pharmaceutical drugs, such as education on minimizing intake, a revamp of the FDA process or streamline the drug companies' procedures instead of just finding more money to pay for them.

BUSH: Well, that's a great question. I think one of the problems we have, particularly for seniors, is there's no prescription drug coverage in Medicare. And, therefore, when they have to try to purchase drugs, they do so on their own. There's no kind of collective bargaining; there's no power of purchasing amongst seniors.

So I think step one to make sure prescription drugs is more affordable for seniors--and those are the folks who really rely upon prescription drugs a lot these days--is to reform the Medicare system, is to have prescription drugs as an integral part of Medicare once and for all.

The problem we have today is that like the Patients' Bill of Rights, particularly with health care, there's a lot of bickering in Washington, D.C. It's kind of like a political issue as opposed to a people issue.

So what I want to do is I want to call upon Republicans and Democrats to forget all the arguing and finger-pointing and come together and take care of our senior prescription drug program that says we'll pay for the poor seniors, we'll help all seniors with prescription drugs.

In the meantime, I think it's important to have what's called Immediate Helping Hand, which is direct money to states so that seniors, poor seniors, don't have to chose between food and medicine as part of an overall overhaul.

The purchasing powers--and I'm again price controls. I think price controls would hurt our ability to continue important research and development. Drug therapies are replacing a lot of medicine as we used to know it.

One of the most important things is to continue the research and development component, and so I'm against price controls.

Expediting drugs through the FDA makes sense, of course. Allowing the new bill that was passed in the Congress made sense to allow for, you know, drugs that were sold overseas to come back, in other countries, to come back into the United States. That makes sense.

But the best thing to do is to reform Medicare.

LEHRER: Vice President Gore, two minutes.

GORE: All right, here we go again. Now look, if you want someone who will spin a lot of words describing a whole convoluted process and then end up supporting legislation that is supported by the big drug companies, this is your man.

If you want someone who will fight for you and who will fight for the middle class families and working men and women, who are sick and tired of having their parents and grandparents pay higher prices for prescription drugs than anybody else, then I want to fight for you.

And you asked the--a great question, because it's not only seniors.

Listen, for 24 years, I have never been afraid to take on the big drug companies. They do some great things. They discovered great new cures, and that's great. We want--we want them to continue that.

But they are now spending more money on advertising and promotion--you see all these ads--than they are on research and development. And they're trying to artificially extend the monopoly patent protection so they can keep charging these very high prices.

I want to streamline the approval of the competing generic drugs and the new kinds of treatments that can compete with them so that we bring the price down for everybody.

Now, briefly, let me tell you how my prescription drug plan works. The governor talked about Medicare. I proposed a real prescription drug benefit under Medicare for all seniors, all seniors. And here's how it works: You pick your own doctor and nobody can take that away from you. The doctor chooses the prescription that you need and nobody can overrule your doctor. You go to your own pharmacy and then Medicare pays half the price. If you're poor, they pay all of it. If you have extraordinarily high costs, then they pay all over $4,000 out of pocket.

And I'll bring new competition to bring the price down. And if you pass the big drug companies' bill, nothing will happen.

LEHRER: All right. Another health question. It comes from Vickie French (ph) and it's for you Vice President Gore.

Vickie French (ph), where are you?

Oh, there she is.

QUESTION: As American people, we spend billions of dollars every year on taxes--or pay billions of dollars in taxes. Would you be open to the ideal of a national health care plan for everybody?

And if not, why? If so, is it something you would try to implement if you're elected into office? And what would you do implement this plan?

GORE: I think that we should move step by step toward universal health coverage. But I am not in favor of government doing it all.

Debate Referee
We've spent 65 years now on the development of a hybrid system--partly private, partly public--and 85 percent of our people have health insurance, 15 percent don't. That adds up to 44 million people; that is a national outrage. We have got to get health coverage for those who do not have it.

And we've got to improve the quality for those who do with a Patients' Bill of Rights that's real and that works--the Dingell-Norwood Bill.

And we have got to fill in the gaps in coverage by finally bringing parity for the treatment of mental illness because that's been left out. We've got to deal with long-term care.

Now, here are the steps that I would take first of all. I will make a commitment to bring health care coverage of high quality that is affordable to every single child in America within four years. And then, we'll fill other gaps by covering the parents of those children when the family is poor or up to two and a half times the poverty rate.

I want to give a tax credit for the purchase of individual health insurance plans. I want to give small business employers a tax credit, 25 percent, to encourage the providing of health insurance for the employees in small businesses. I want to give seniors who are--well, the near-elderly; I don't like that term because I am just about in that category. But those 55 to 65 ought to be able to buy into Medicare for premiums that are reasonable and fair and significantly below what they have to get now.

Debate Referee
Now, we have a big difference on this. And you need to know the record here. Under Governor Bush, Texas has sunk to be 50th out of 50 in health care--in health insurance for their citizens. Last week he said that they were spending $3.7 billion--or $4.7 billion on this.

LEHRER: Mr. Vice President?

GORE: OK, I'll...

LEHRER: Time is up. Governor Bush, two minutes.

BUSH: I'm absolutely opposed to a national health care plan. I don't want the federal government making decisions for consumers or for providers.

I remember what the administration tried to do in 1993. They tried to have a national health care plan, and fortunately it failed. I trust people; I don't trust the federal government. It's going to be one of the themes you'll hear tonight. I don't want the federal government making decisions on behalf of everybody.

There is an issue with the uninsured. There sure is. And we've got uninsured people in my state. Ours is a big state, a fast-growing state. We share a common border with another nation. But we're providing health care for our people.

One thing about insurance, that's a Washington term. The question is, are people getting health care? And we've got a strong safety net.

And there needs to be a safety net in America. There needs to be more community health clinics where the poor can go get health care. We need a program for the uninsured. They've been talking about it in Washington, D.C. The number of uninsured have now gone up for the past seven years.

We need a $2,000 credit, rebate, for people, working people who don't have insurance. They can in the marketplace and start purchasing insurance.

We need to have--allow small businesses to write across--insurance across jurisdictional lines so small business can afford health care, small restaurants can afford health care.

And so health care needs to be affordable and available.

But we got to trust people to make decisions with their lives. In the Medicare reform I talk about, it says if you're a senior, you can stay in Medicare if you like it, and that's fine, but we're going to give you other choices to choose if you want to do so. Just like they do the federal employees, the people who work in Washington, D.C., for the U.S. Congress or the United States Senate, get a variety of choices to make in their lives. And that's what we ought to do for all people in America.

LEHRER: Governor?

BUSH: Yes, sir. I'm sorry.

LEHRER: Governor?

GORE: Could I follow up, Jim?

BUSH: Not paying attention to the lights...

LEHRER: No, not right now. Not right now.

Education. We...

BUSH: Trying to find my light.

LEHRER: These folks submitted 18 questions on education, and the first is--that will be asked on education will go to you, Governor, and will be asked by Angie Pettick (ph).

Angie Pettick (ph), where are you? There she is.

Governor, right there.

BUSH: Oh, thanks. Hi, Angie.

QUESTION: I've heard a lot about education and the need to hold teachers and schools accountable, and I certainly agree with that. But as an individual with an educational background and also a parent, I have seen a lot of instances where the parents are unresponsive to the teachers or flat out uninvolved in their child's education. How do you intend to not only hold the teachers in schools accountable, but also hold parents accountable?

BUSH: Well, you know, it's hard to make people love one another. I wish I knew the law, because I'd darn sure sign it. I wish I knew the law that said all of us should be good parents.

One of the things the next president must do is to remind people that if we're going to have a responsible period in America, that each of us must love our children with all our heart and all our soul.

I happen to believe strong accountability encourages parental involvement, though. I think when you measure and post results on the Internet or in the town newspapers, most parents say, "Wait a minute, my child's school isn't doing what I want it to do," and therefore become involved in education.

I recognize there are some who just don't seem to care. But there are a lot of parents who feel like everything is going well in their child's school and all of a sudden they wake up and realize that, "Wait a minute, standards aren't being met." That's why I'm so strong for accountability.

I believe we ought to measure a lot, three, four, five, six, seven, eighth grade. We do so in my state of Texas. One of the good things we've done in Texas is we've got strong accountability, because you can't cure unless you know. You can't--you can't solve a problem unless you diagnosis it.

I strongly believe that one of the best things to encourage parental involvement also is to know that the classrooms will be safe and secure. That's why I support a teacher liability act at the federal level, that says if a teacher or principal upholds reasonable standards of classroom discipline, they can't be sued. They can't be sued.

I think parents will be more involved with education when they know their children's classrooms are safe and secure as well.

I also believe that we need to say to people that if you cannot meet standards, there has to be a consequence, instead of just the kind of soft bigotry of low expectations, that there has to be a consequence. We can't continue to shuffle children through school. And one of the consequences is we allow parents to have different choices.

LEHRER: Vice President Gore?

GORE: Yes, we have a huge difference between us on this question. I'd like to start by telling you what my vision is. I see a day in the United States of America where all of our public schools are considered excellent, world class; where there are no failing schools; where the classrooms are small enough in size, number of students, so that the teacher can spend enough one-on-one time with each--with each student.

Now, that means recruiting new teachers for the public schools. It means, in my plan, hiring bonuses to get 100,000 new teachers in the public schools within the next four years. It means also helping local school districts, that sometimes find the parents of school-age children out voted on bond issues, to give them some help with interest-free bonding authority, so that we can build new schools and modernize the classrooms.

We need to give teachers the training and professional development that they need to--including paid time off to go visit the classroom of a master teacher and pick up some new skills.

I want to give every middle class family a $10,000 a year tax deduction for college tuition so that--so that middle class families will always be able to send their kids on to college.

I want to work for universal free school, because we know from all the studies that the youngsters learn--kids learn more in the first few years of life than anywhere else.

Now, I said there was a contrast. Governor Bush is for vouchers. And in his plan, he proposes to drain more money, more taxpayer money, out of the public schools for private school vouchers than all of the money that he proposes in his entire budget for public schools themselves. And only one in 20 students would be eligible for these vouchers, and they wouldn't even pay the full tuition to private school.

I think that's a mistake. I don't think we should give up on the private schools and leave kids trapped in failing schools. I think we should make it the number one priority, to make our schools the best in the world, all of them.

LEHRER: Governor, what is your position on that?

BUSH: Yes, I appreciate that. I think any time we end with one of these attacks, it's appropriate to respond. Here's what I think. First of all, vouchers are up to states. If you want to do a voucher program in Missouri, fine. See, I strongly believe in local control of schools. I'm a governor of a state and I don't like it when the federal government tell us what to do. I believe in local control of schools.

But here's what I've said. I've said to the extent we spend federal money on disadvantaged children, we want the schools to show us whether or not the children are learning. What's unreasonable about that? We expect there to be standards met, and we expect there to be measurement. And if we find success, we'll praise it.

But when we find children trapped in schools that will not change and will not teach, instead of saying, "Oh, this is OK in America, just to shuffle poor kids through schools," there has to be a consequence. And the consequence is that federal portion of federal money will go to the parent so the parent can go to a tutoring program or another public school or another private school--or a private school.

You see, there has to be a consequence. We've got a society that says, "Hey, the status quo is fine. Just move them through." And guess who suffers?

LEHRER: What's the harm on--what's the other side on vouchers?

Debate Referee
GORE: Well, the program that he's proposing is not the one that he just described. Under your plan, Governor Bush, states would be required to pay vouchers to students, to match the vouchers that the federal government would put up. Now, here's--and, the way it would happen is that, under his plan, if a school was designated as failing, the kids would be trapped there for another three years, and then some of them would get federal vouchers, and the state would be forced to match that money.

Under my plan, if a school is failing, we work with the states to give them the authority and the resources to close down that school and reopen it right away with a new principal, a new faculty, a turnaround team of specialists who know what they're doing to--it's based on the plan of Governor Jim Hunt in North Carolina, and it works great.

LEHRER: So, no vouchers under--in a Gore administration?

GORE: If I thought that there was no alternative, then I might feel differently. But I have an obligation to fight to make sure that there are no failing schools. We've got to turn around all--most schools are excellent. But we've got to make sure that all of them are.

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