<b>Exclusive:</b> Hillary Clinton Answers Your E-Mails

ByABC News via via logo

&#151; -- ABCNEWS.com readers submitted health care questions for Senator Hillary Clinton, D-N.Y. Here, the White House hopeful and former first lady responds to your videos and e-mails on universal coverage, Head Start, and funding for VA hospitals and services. Between now and Election Day 2008, "Good Morning America" and ABCNEWS.com will host more Town Hall meetings with some of the major candidates running for President.

Tiffany Sumuel, Los Angeles, Calif.: How will we pay for universal coverage? Considering the current financial position of the country and the expected financial impact of the impending rash of baby boomer retirements, I'd like to know how, if elected, you intend to balance the country's current and future obligations in addition to implementing universal health coverage?

Clinton: I'm going to pass universal health care that lowers costs for Americans. Families and businesses are drowning in skyrocketing health care premiums. There's a lot of wasted money in our health care system.

Nationally, we spend $1.9 trillion -- more than any other country in the world -- and in 10 years we are projected to spend almost $4 trillion.

I believe we can spend that money more efficiently and still cover our nation's uninsured. And I believe we can invest more wisely and get better outcomes than we are currently. As the world's highest investor in health care (at nearly 16 percent of our gross domestic product), we can do better than ranking 31st in the world in terms of life expectancy. So, yes, to get to where we need to be, we will need some upfront investments, but I am confident that simplifying our system and making it more accountable will achieve just the type of savings we need to achieve real progress. And if we do, I am absolutely confident we will be able modernize our health system, make it more efficient and responsive to the patient, achieve public and private savings, and cover all Americans.

Kimberly Ochs, Minneapolis, Minn.: In our country, health care is not a right but a privilege. Education, however, is a right, and research has shown a strong correlation between health and educational achievement. Would your plan for reform include cooperation and coordination between health care and education? For example, in some countries, eye exams are part of the public school kindergarten curriculum.

Clinton: I strongly support the idea of better coordination and cooperation between our education and health care systems as a strategy for expanding access to health care for children.

One example where coordination is working well is the Head Start program, which I have long supported and worked to expand.

Head Start provides comprehensive services for low income children and their families. Children enrolled in Head Start receive medical, dental, vision screenings, nutrition and the social-emotional and preliteracy and premathematics lessons that will help them get ready for kindergarten. And we have seen that that array of comprehensive services has a great impact on children.

In addition, legislation I recently introduced to expand health insurance for children encourages states to use schools to reach out to eligible children and enroll them in the State Children's Health Insurance Program. So, I really do support programs that provide incentives to schools and health care providers to make health care services more readily available in schools, and I agree with you that this type of cooperation could make a real difference in improving educational achievement.

Beth Cooper, South Beach, S.C.: I would like to know why Americans can't have a health care plan such as Canada has. And if you become president, could you come up with a better health care plan that is for the lower income people who make too much to qualify for Medicaid (the program for the working poor)?

Clinton: My goal is to have a health care system that provides quality, affordable care to every American. On way to achieve this goal is to have a national health care system where there is only one source of care and the government runs it.

That is what they have in Canada, and it is called a single-payer system. Another way to achieve universal coverage is to build on the employer-based system.

Many people think building on the employer system is the most practical way to achieve universal health care because a lot of people are satisfied with the health care they have, they just don't like the high cost. I think we have to have a uniquely American solution to health care because America is a unique country.

We are bigger and more diverse than other countries. Here, people like to have a choice; they want to know that they can pick their doctor and the hospital they go to. That is why I think we will move toward a system that builds on what we have now, and encourages everyone, including employers, to contribute their fair share, the way Massachusetts does and California is considering. But we're also going to lower the cost of health care. I want to hear from you about your ideas on health care. I want to hear from you who have different perspectives about what you think will work.

Suzanne Klein, Pittsburgh, Pa.:You say universal health care for all and what most Americans hear is access for all to top quality facilities and programs. That doesn't really exist in countries that currently have a national health care system How do you plan to implement and pay for such a program?

Clinton: Maintaining what is good about our health care system -- its focus on innovation and the development of cutting-edge treatments -- is a high priority for me as I work to lead our country to affordable, universal, high-quality care. One of the reasons many propose building on the current system is that it causes less disruption and keeps the best features of our current system. I also want to invite you to go to my Web site, HillaryClinton.com, to see some of the proposals I've made that I think are essential to reducing the cost of health care.

One idea that I have been fighting for since I became a senator is the greater use of information technology so every American can have a privacy-protected electronic medical record.

Think about it -- it is almost a miracle if you go to your doctor or your emergency room and they don't ask you to fill out a form with your medical history. You may have done that a hundred times in your life. And if you go visit your family in New York or Florida and something happens to you, you have to start over again.

If we had electronic medical records for every American, we would save money and time. These records will avoid duplication. One study says electronic medical records that can privately share information would save $100 billion. That is money that could be reinvested into enable every American to access high-quality care. My goal is to develop a better system to take care of you. I have lots of ideas. Go to HillaryClinton.com. You'll see some of those ideas. We'll have universal health care when I'm president. There's no doubt about it. We'll get it done.

Thomas Senecal, Bowie, M.D.: Senator, I support your Children's Health First Act, but I was wondering, why do you support health care that is paid for through deductibles versus single-payer health care, which is working rather well in Canada?

Clinton: I know from my many years of working on this issue that there are different ways to address this problem.

One option is the single-payer system, which they have in Canada. Medicare, which has very high satisfaction rates, is also a single-payer system. Another option is to build on our current employer-based system.

That is what they have done in Massachusetts, what California is considering, and what Sen. Edwards has proposed. I know from the battles over health care that I have been involved in it's going to take more than a plan to achieve universal coverage.

We have to build consensus. We have to build the will. That is why I have not proposed a specific plan and why I am not interested in pushing just my plan.

I want to sign into law our plan -- a truly and uniquely American plan. This is what my conversation with the American people is all about. And I am focusing on three principles: coverage, quality and competitiveness. A plan for universal care must deal with our competitiveness issues -- today our businesses can't compete in the global economy because they are buckling from out of control health care costs. But we're also going to lower the cost of health care. The reason I haven't sent out a plan and said here is exactly what I think we should do, is because during this campaign I want to hear the ideas that people have. I want to hear from you who have different perspectives about what you think will work. I also want to invite you to go to my Web site, HillaryClinton.com to see some of the proposals I've made that I think are essential to get costs down.

Walter Anderson, Gahanna, Ohio: Sen. Clinton, I hear you talk about health care reform being one of your pillars for your campaign for the White House. My question is this: During the first two years that you were in the White House and had control of the Congress what happened to health care reform? I have not seen any bills that you have sponsored nor co-sponsored dealing with health care reform. So why is it a favorite topic of yours now?

Clinton: I have been working on improving our health care system since I came to Washington in 1993. After the Health Security Act, I set to work helping to develop the SCHIP program, which represented the largest expansion of access to health care for children since the 1965, and it has worked, covering more than 6 million children to date. I have never stopped believing in universal coverage, but given the Republican Congress we have had for several years, I've worked for changes we could get passed.

For example, I passed legislation through the Senate to use information technology to reduce health care errors, improve quality and save money. I also enacted legislation to ensure that drugs that are marketed to children have first been tested on children to ensure that they are safe and improve the quality of care. I also created a health care tracking system for veterans to ensure that they receive the quality screenings they need and deserve. And after 9/11, I created a health care tracking system for the first responders to ensure that they receive the health care they need.

I wrote a provision, which became law as part of the Nurse Reinvestment Act, to encourage the recruitment and retention of quality nurses, and I brought $1.4 billion in Medicaid to New York.

I also passed legislation to provide extra funding for the flu vaccine and proposed legislation that would raise public awareness and speed production of the vaccine.

As part of the Older Americans Act, I enacted legislation to assist seniors with their mental health care needs by providing home and community-based delivery of critical mental health services. And I have championed efforts to end discrimination by insurance companies against people with mental health and substance abuse problems. I have proposed legislation to combat diabetes, asthma and HIV/AIDS. I also championed legislation to expand access to treatment, interventions and support services for people with autism, and recently I proposed a dramatic expansion of SCHIP to provide access for children living in households earning up to 400 percent of the poverty limit ($70,000 for a family of three). Please go to my Web site at www.HillaryClinton.com to learn more about what I've done in the past on health care and what I plan to do going forward.

Linden Perkins, Ridgecrest, Calif.: Would national health care apply only to U.S. citizens, or would health care be available to all people in the United States?

Clinton: While I haven't proposed a specific health care plan this early in the campaign I have proposed two pieces of legislation in the Senate that would expand access and care for immigrants. One proposal -- the Immigrant Children's Health Improvement Act -- would allow pregnant women and children who are legal immigrants to access Medicaid and the State Children's Health Insurance Program, or SCHIP. I strongly believe this is the right thing to do. I have also proposed providing targeted funding to hospitals and state and local services that bear the brunt of the costs of our failed immigration system, including health care. These services are being strained because we have left local communities to foot the bill. The bottom line here is that preventive care saves money in the aggregate and improves people's lives. And I will work toward a system that enables everyone to access high quality care.

Richard Szewc, Marion, Iowa: With the rising cost of health care nationwide, what are your plans first and foremost to make health care affordable to all?

Clinton: I'm going to pass universal health care that lowers costs and improves quality for all Americans. Individuals and companies, especially small business, are drowning in skyrocketing health care premiums. Unfortunately, there's a lot of wasted money in our health care system. Nationally, we spend $1.9 trillion on health care -- more than any other country in the world. In 10 years we are projected to spend almost $4 trillion. Do I believe we can spend that money more efficiently and still cover our nation's uninsured? Of course I do. And do I believe we can invest more wisely and get better outcomes than we are? Absolutely. Goodness knows that as the world's highest investor in health care (it's nearly 16 percent of our GDP), we can do better than rating 31st in the world in terms of life expectancy. So, yes, to get to where we need to be, we will need some upfront investments, but I am confident that simplifying our system and making it more accountable will achieve just the type of savings we need to achieve real progress. And if we do, I am absolutely confident we will be able modernize our health system, make it more efficient and responsive to the patient, achieve public and private savings and cover all Americans.

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