Senator Clinton devoted much of a speech here in Ankeny, IA, to blasting her chief rival Barack Obama for failing to cover every American under his health care plan. In her harshest criticism yet, Clinton said Obama was betraying Democratic principles by leaving 15 million uncovered, adding “just because it’s controversial or ambitious, doesn’t mean we shouldn’t do it. The time is now.”

“If we don’t move toward universal health care coverage now, if we don’t have an election about it where I stand against whoever the Republicans nominate and let them answer the questions about why they won’t take care of covering every single American, why they want to still be in bed with the health insurance companies, that is an election we will win,” she said. “

But we’ve got to put up a candidate that’s willing to stand for it and fight for it

.”

Responding to Hillary’s attacks, Obama spokesman Bill Burton released a statement saying, “Another day, another desperate attack.”

“Demonizing anyone who doesn’t share her exact plans on health care is exactly why Hillary Clinton flunked the opportunity she had to pass universal health care in 1993. The truth is, Barack Obama’s universal health care plan makes coverage affordable for every single American, he just doesn’t agree with Hillary’s plan to start by forcing everyone to buy insurance they can’t afford,” he said.

What follows is a “greatest hits” compilation from the event, including her comparison of the fight for universal health care to FDR and LBJ’s battles for Social Security and Medicare — in which she plays the role of the strong, principled president, and Obama is (by implication) not up to the same level. The entire Obama-related portion of her speech is after the jump.

“More than anybody else in this race, I have a plan to reduce the cost of health care by $120 billion a year. And I think its important that we understand the differences among us who have plans.

You know, among the Democrats, all of us except Senator Obama have universal health care, they have put forth a plan. Senator (sic) Richardson, Senator Edwards, Senator Dodd. We’ve put forth universal health care plans, because we know if we don’t cover everybody, we’re going to leave millions and millions of people out. Its a substantive and important difference. Because if you don’t start with the goal of covering every American, you will never get there.

Here’s how my plan works: if you already have private insurance and you’re happy with it, nothing changes. You keep that insurance. But if you don’t have health insurance or you don’t like he insurance you have, you can choose from a wide variety of options that are available to members of congress.

All Americans will have a responsibility to get and keep health insurance. I believe if we make this the law of the land, Americans will follow it and will purchase health insurance far more than if we don’t have that requirement.

We’ll provide tax credits to ensure that people can afford it, and we’ll give tax credits to small businesses so that they can cover more of their employees. If you want to cover everybody you have to make health care a shared responsibility.

I know you need to have the willingness to stand up to the insurance companies and the drug companies and demand universal coverage.

And that’s why I don’t understand why we have this difference on the Democratic side, because if anything, democrats should stand for universal health care. That distinguishes us from the Republicans. The Republicans don’t believe in it. Democrats do. And we’ll fight for it.

It will be a president with the experience and strength to make that happen, otherwise we’ll be right back here in another ten or twelve or fourteen years, and we’ll still have tens of millions of people uninsured and in fact our problems will be even worse and we will have lost more jobs because employers won’t be willing to provide insurance. They’ll move jobs off shore because they don’t want to have those benefits. And we will not be either competitive or living up to our ideals.

It is impossible to get to universal health care if you don’t have a mandate. That is a key difference between my plan and Senator Obama’s plan.

Now when Senator Obama was a state senator in Illinois, he helped to create a health care task force that looked into how best to cover everybody in Illinois with health insurance.

 They released their report earlier this year – and they made it very clear, if you want to cover everyone you need to require people to get health insurance. Otherwise you will fail to cover 60-90% of the uninsured.

Now, there are a number of ways of doing this. one sensible step would be to use what’s called default enrollment. If you don’t make a choice, well we set up a system where people are automatically enrolled when they come into contact with the health care system or with schools or colleges. We could also work with employers so they automatically enroll people. The Congress has ideas about this, it will work to make sure that these mandates are enforceable.

But what’s strange is that Senator Obama’s plan actually does have a mandate, but only for children. No requirement for adults. Now I’ve worked on this issue a very long time.

 And if you believe you can enforce a mandate on children, that means you enforce the mandate on the parents of the children to enroll the children?

Why would you leave out the parents of the children? 

Because what happens when you leave out the parents is that they’re less likely to get health care for their own children. See, this is all connected.

And I’m proud that Senator Edwards agrees with me, Senator Dodd agrees with me, Governor Richardson agrees with me. Congressman Kucinich has a different approach, but he gets everyone covered to have universal health care.

If we don’t have universal health care, then we will be betraying the Democratic party’s principles. And it’s important that those who will caucus on January 3rd understand this difference. Senator Obama’s plan does not and cannot cover all Americans.

He’s called his plan universal, then he called it virtually universal, but it is not either. When it comes to truth in labeling, it simply flunks the test.

He’s been saying there’s no difference between our plans, but his plan would Leave at least 15 million Americans uninsured, including more than 100,000 people right here in Iowa.

So why don’t we just say everybody against the wall, you don’t get insurance. We’re very sorry, but we’re just not going to have a plan that covers you. Who’s going to choose who doesn’t get covered? Who’s going to leave out 15 million people, or 100,000 people in Iowa? That’s more than half the population of Des Moines. That’s a huge difference for those who get left out, like the daughter of the woman I met from Greenville.

And its a huge difference to me, to leave 15 million people virtually invisible, because that is what we would do.

 Well when I’m president, there will be no invisible Americans, and there will be no Americans without health care. That is one of my highest priorities.

And I know its going to be a tough fight. But I have been fighting the republicans and the special interests for 15 years.

I have to admit I get amused when any of my opponents try to claim they’ve fought more fights than I’ve fought. Well I don’t remember them being with me in 1993 and 1994, to tell you the truth.

So I don’t mind standing up and fighting. That’s what I want to do for all of you.

And I know that you are not going to get the health insurance companies to say, oh ok, we’re going to cover everybody, and therefore its going to be hard for us to make money because we’ll to have to do it the old fashioned way.

 Instead of eliminating people from coverage and refusing to pay doctors bills and hospital bills, we’re just going to eliminate you in the first instance, or deny coverage for you and refuse to pay your bills. I know they’re not going to like my plan. That’s not the point.

Just because it’s controversial or ambitious, doesn’t mean we shouldn’t do it. The time is now. If we don’t move toward universal health care coverage now, if we don’t have an election about it where I stand against whoever the Republicans nominate and let them answer the questions about why they won’t take care of covering every single American, why they want to still be in bed with the health insurance companies, that is an election we will win. 

But we’ve got to put up a candidate that’s willing to stand for it and fight for it

.

Imagine if President Roosevelt had said, ‘well, lets have Social Security, but lets start by leaving out millions of our seniors.’ Or suppose President Johnson, fighting the fights over Medicare

, said, ‘you know, lets just cover some of our seniors with Medicare. Eventually the others will catch up.’ That is not the way it works.

They knew what it took to make big, important changes in our country. They also knew that if you aim too low, if you give up before the fight has started, then you have no chance of making it to the finish line. And I intend to not only make it to the finish line, but to be there with all of you. Because we’re going to do this together.

Those that don’t have insurance, they don’t just struggle with costs themselves, they impose costs on everyone else. When you leave 15 million Americans uninsured, the result is a hidden tax on every other American. What do I mean by that? Well when someone is finally forced to go to the emergency room because they can’t afford a doctor’s appointment, we all pay the bill. When they can’t pay their medical bills, insurance companies just raise the rates on everybody else.

And when you leave 15 million uninsured, insurance companies will just continue to cherry pick the healthiest people and discriminate against the sickest. Those that need the coverage the most.

We’re going to eliminate health care discrimination. Were going to require insurance companies to insure everyone, including preexisting conditions. You will not any longer be denied insurance, you will be entitled to insurance. And as long as you pay your share of the costs, no one can take it away from you

And that will also be a cardinal principle when it comes to how we’re going to make it absolutely clear to people that having insurance is a shared responsibility. Everybody’s got to pitch in. No more hidden taxes. No more insurance company cherry picking.

I know we can do this, and even the Republicans, at least some of them, do. That’s why Governor Schwarzenegger has a mandate

 in his proposal. No one who looks seriously about how we get to universal health care can come to any other conclusion

.

So this is a fight worth taking on. I’ve never shied away from tough challenges., and neither has America. You know, we’re the nation that split the atom, that sent a man to the moon, that mapped the human genome. We’ve got the best doctors and nurses and health care professionals in the world. We’ve got the most exciting research, the most promising treatment and cures. And it’s long past time

 that all of our people benefited from that.”