"We're going to have universal health care when I'm president — there's no doubt about that. We're going to get it done," the New York senator and front-runner for the 2008 nomination said.
Clinton focused on health care issues during an appearance on ABC's "Good Morning America" broadcast from the state where precinct caucuses will launch the presidential nominating season.
Asked how she could improve on her failed effort to reform health care during her husband's presidency, Clinton said pressure for change has built in the last decade and that would make tackling the issue easier.
"I believe the American people are going to make this an issue," said Clinton. "I believe we're in a better position today to do that than we were in '93 and '94. ... It's one of the reasons I'm running for president."
After the televised meeting, Clinton headed to a Des Moines elementary school to receive the endorsement of former Gov. Tom Vilsack and his wife, Christie.
"Hillary Clinton has been tried and tested like no other candidate for president," Tom Vilsack said.
His wife added, "To me, this is not just an endorsement but a commitment."
Clinton said her relationship with the Vilsacks dates to her work in the 1970s with Christie Vilsack's late brother, lawyer Tom Bell.
"We will be crisscrossing Iowa and crisscrossing America," Clinton said.
In her earlier appearance, Clinton argued that health coverage has deteriorated over the last decade, and that's increased public pressure to act.
"The number of uninsured has grown," said Clinton. "It's hard to ignore the fact that nearly 47 million people don't have health insurance, but also because so many people with insurance have found it's difficult to get health care because the insurance companies deny you what you need."
Clinton opened her latest campaign swing with a live broadcast from the Science Center of Iowa, where she spoke to more than 200 activists at a town meeting about health care issues. It's an issue with which she is very familiar. After her husband won the White House in 1992, she headed an effort to put a universal health care system in place. That effort eventually collapsed under pressure in part from the insurance industry.
However, while Clinton said the issue continues to be a high priority for her, she has not offered up a specific plan. One questioner at the town hall meeting held up a copy of a DVD containing a detailed description of Democratic rival John Edwards' plan for universal health care, asking Clinton if she will also offer specifics.
The reason she hasn't "set out a plan and said here's exactly what I will do," Clinton said, is that she wants to hear from voters what kind of plan they would favor.
"I want the ideas that people have," said Clinton. She said any health care plan must deal with the reality that there's a unique climate in the country.
"We are bigger and more diverse and people like their choice," said Clinton.
Edwards, a former North Carolina senator and 2004 Democratic runningmate, has said it's inevitable that taxes would have to go up to finance an expensive health care plan. Clinton disagreed.
"We've got to get the costs under control," said Clinton. "Why would we put more money into a dysfunctional system?"
Clinton sidestepped a question on whether she'd consider Vilsack as a potential running mate should she win the nomination.
"I am a very big fan of Governor Vilsack," Clinton said, adding that he has "the kind of practical but visionary leadership we need in our country."
Vilsack was the first Democrat to formally enter the 2008 presidential race in November, but he dropped out last month citing the difficulty in raising the tens of millions of dollars necessary to mount a credible bid.