The field of 2020 presidential candidates with health care overhaul plans is crowded, and Pete Buttigieg, mayor of South Bend, Ind., is drawing lines of distinction between his proposal and his competitors' plans.
"I mean, the reality is, all these beautiful proposals we all put forward, their impact is kind of multiplied by zero if you can't actually get it through Congress, and it's one of the reasons why I do favor the approach that I have," he said.
Buttigieg would offer public health insurance to those who want it while also keeping private health care plans available. Other candidates' proposals, including "Medicare for All" — backed by Sens. Bernie Sanders and Elizabeth Warren — would replace the current system with a single-payer, government-run program and eliminate private insurance altogether.
Buttigieg spoke to two undecided Indiana voters and NPR host Scott Simon as part of the Off Script series of interviews with 2020 presidential candidates.
"We make sure that everybody can afford [public health insurance], but we don't require you to take it. And partly I think that's just the right policy, because I think people should be able to choose," he said. "But it's also really important that that's a policy that commands the support of most Americans. ... We have a moment where we can get something that big done and most Americans want it done. That's not true of some of the other ideas out there, which would make it much harder to actually achieve them no matter how good they sound in campaign season."
The voters — Michael Logan, a 54-year-old retired Michigan State Police detective sergeant, and Jacque Stahl, 37, who works with a health care group in South Bend — pressed Buttigieg on his plan.
Stahl's 5-year-old son has a condition that requires treatment that if uninsured would cost her family $35,000 a month. She said the health care system can be confusing even for those in the industry, and Americans who do their best to stay in-network can be faced with large surprise medical bills.
Buttigieg told her he's proposing to end surprise billing.
"We would set 200% of Medicare, would be the highest that even an out-of-network therapy could cost when you have a hospitalization or something like that," he said. "Because some of this is also the responsibility of hospitals and health care providers. This can't just be handled on the insurance side."
Buttigieg is polling second in Iowa according to a Quinnipiac University poll released Wednesday. The poll shows Buttigieg polling at 19%, trailing Warren, who is receiving 20%. Iowa holds the first-in-the-nation caucuses on Feb. 3.
Off Script is edited and produced for broadcast by Ashley Brown and Bridget De Chagas. Eric Marrapodi is Off Script's supervising editor.
RACHEL MARTIN, HOST:
What questions do voters have for the 2020 presidential candidates? South Bend, Ind., Mayor Pete Buttigieg sat down this week with NPR host Scott Simon and two undecided voters for Off Script. It's our series of conversations with presidential candidates. They all met at a South Bend restaurant called Pegs. Voter Michael Logan, a retired police detective sergeant, started with a timely question.
MICHAEL LOGAN: What's your favorite sport and why?
PETE BUTTIGIEG: It's football 'cause I grew up going to games with my dad. And, you know, I mean when you're in South Bend, I think you're either a football fan, or you're a contrarian.
MARTIN: So that existential question being settled, the conversation went on to cover a wide range of topics. The most pressing for voter Jacque Stahl was health care, given her son's medical bills.
JACQUE STAHL: Personally, my son has a condition where his medication costs up to $35,000 a month.
MARTIN: Stahl works in the health care industry as a marketing director. She pressed Mayor Buttigieg edge on his plan, which he calls Medicare for all who want it. Stahl wanted to know how it would make health care more affordable and less complicated.
STAHL: My CEO and I were joking because we work in health care, yet it's so difficult to navigate health care. And we're in it. You know, so many times, we see patients that do the right steps to make sure that they're in network and that everything is covered by their insurance, but yet they have a surprise bill of $300 or thousands of dollars. That has to stop. How do we get that to stop?
BUTTIGIEG: Well, and another thing we're proposing is to end surprise billing. So we would set - 200% of Medicare would be the highest that even an out-of-network therapy could cost when you have a hospitalization or something like that because, you know, some of this is also the responsibility of hospitals and health care providers. This can't just be handled on the insurance side. Now, we want hospitals to grow, and we want, you know, providers to do well. And we can do that in a way that also manages these costs.
But it sure will help, I think, if we can take steps like what I'm proposing with Medicare for all who want it to make sure everybody's covered, and no one's falling through the cracks because then we're more likely to see an evening out of the radically different prices that can be attached to the same procedure or the same bit of medication depending where you are in our current patchwork of coverage.
SCOTT SIMON, BYLINE: Let me ask a question, Mr. Mayor, to follow up. There are lots of ambitious health care plans that have been proposed in this campaign alone. Can you get yours passed? 'Cause that's kind of the acid test, isn't it?
BUTTIGIEG: It is. I mean, the reality is all these beautiful proposals we all put forward - their impact is kind of multiplied by zero if you can't actually get it through Congress. And it's one of the reasons why I do favor the approach that I have - what we call Medicare for all who want it. We create a public plan, Medicare-type plan for every American. But - and we make sure that everybody can afford it, but we don't require you to take it. And partly, I think that's just the right policy because I think people should be able to choose.
But it's also really important that that's a policy that commands the support of most Americans, which, by the way, is a big deal because this would be the biggest innovation, the biggest move forward in health care in about 50 years. But we have a moment where we can get something that big done, and most Americans want it done. That's not true of some of the other ideas out there, which would make it much harder to actually achieve them, no matter how good they sound in campaign season.
SIMON: May I try another question? You are married to a real social media celebrity.
SIMON: Your husband, Chasten, has really taken off. But I have to raise a question with you - 'cause I was hoping not to ask anything about orientation. But as you know, there's some information recently reported by The New York Times that says the fact that you're a man married to another man might be causing some reservations and misgivings specifically among African American voters in South Carolina. I wonder what you would say to voters who have that reservation.
BUTTIGIEG: Well, I think that that perspective - it's so simplifying and, I think, not fair to a diversity of views among African Americans and among a lot of people who are Democrats who may have come up in a socially conservative background but are also on a journey, as the country is. I think the question that voters are asking is, how's my life going to be different if you're president? And in order to earn votes, my job is to go out there and answer that question. And I think a lot of the other stuff falls away if and only if you have a good answer to that question.
MARTIN: We should note The New York Times reports that information came from an internal Buttigieg campaign memo on focus groups it held that included two dozen uncommitted black voters. You'll hear more of Pete Buttigieg's conversation with Weekend Edition host Scott Simon and undecided voters across NPR today and tomorrow. And you can watch video of the conversation with Buttigieg and other presidential candidates at npr.org/offscript.
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