Democrats Spar Over Private Health Insurance At Presidential Debate

Leading Democratic presidential candidates sought to differentiate themselves on health care at a Houston debate Thursday by vying to find out what scares voters more: the potential for higher taxes or to continue to be subject to the whims of the private health insurance system.

Once again, questioning from debate moderators focused heavily on the need for tax increases to finance large-scale programs like “Medicare for All,” a line echoed by former Vice President Joe Biden and other relatively moderate candidates. Biden also hammered away at his theme that his health care platform wouldn’t disrupt the coverage for the many millions of Americans who currently have health benefits provided by their employers.

“The 160 million people who like their health care now, they can keep it. If they don’t like it, they can leave,” Biden said.

Among the 10 contenders on the stage at Texas Southern University, Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) are the lone remaining full-throated supporters of erecting a single-payer “Medicare for All” health care system that would replace a system that mixes private coverage for most working-age adults with public programs for the elderly and the poor.

Sanders and Warren emphasized the ways health insurance companies deny care to policyholders and vowed that middle-class people who see lower costs under a single-payer program, even if the money they spend will be in the form of taxes rather than insurance premiums. Sanders authored the legislation to create Medicare for All, which Warren has endorsed during the campaign.

“I’ve actually never met anybody who likes their health insurance company,” Warren said. “I’ve met people who like their doctors. I’ve met people who like their nurses. I’ve met people who like their pharmacists. I’ve met people who like their physical therapists. What they want is access to health care.”

Biden, the front-runner in the campaign for the Democratic Party nomination so far, is among those candidates who have backed a smaller but still substantial increase in the federal government’s role in providing health care to Americans. Among other things, Biden has proposed creating a government-run public option program people could choose as an alternative to private insurance.

As it has from the beginning of this election cycle, the finer points of these two approaches were mostly overshadowed by a dispute over whether to build on private health insurance, as transformed already by the Affordable Care Act, to make coverage more affordable and fair or whether the solution to high costs and poor benefits is to follow the rest of the developed world’s lead and establish a single program for everyone.

Biden and other candidates, including Sens. Kamala Harris (Calif.) and Amy Klobuchar (Minn.), have based their case largely on limiting costs preserving choice and allowing Americans to decide whether to select private insurance or the public option.

“How are we going to pay for it? I want to hear tonight how that’s happening,” Biden said.

For Sanders and Warren, the principles of guaranteeing lifelong access to stable, government-provided health benefits trump the notion of choice.

“Instead of paying premiums into insurance companies and then having insurance companies build their profits by saying no to coverage, we’re going to do this by saying everyone is covered by Medicare for All,” Warren said. “The only question here in terms of difference is where to send the bill.”

These two candidates also see higher taxes on wealthy households and businesses as a principle of their own and a means to reduce inequality while also financing medical care. Sanders in particular has long held that profit motives in the health care industry pervert the system by prioritizing financial considerations over providing care.

“We need a health care system that guarantees health care to all people, as every other major country does, not a system which provides $100 billion a year in profit to the drug companies and the insurance companies,” Sanders said.

Polling suggests that Democratic voters and Democratic-leaning independents are open to Medicare for All, but more of them support the incremental approach favored by Biden and the other candidates.

According to Henry J. Kaiser Family Foundation survey results published Thursday, given a choice between building on the Affordable Care Act and replacing the private insurance system, 55% of those voters support the more incremental approach and 40% support the more sweeping plan.

But these voters also appear open to supporting either of these approaches, according to the poll, which was conducted last week. Among Democrats, 87% support a public option, while 77% support Medicare for All. Notably, 41% of Republicans also expressed support for a public option and 20% favored Medicare for All.

Also on HuffPost

Elizabeth Warren

Democratic challenger Elizabeth Warren gestures during her debate against Republican U.S. Sen. Scott Brown, sponsored by the Boston Herald, at the University of Massachusetts in Lowell, Mass., Monday, Oct. 1, 2012. (AP Photo/The Boston Herald, Matt Stone, Pool)
Democratic challenger Elizabeth Warren gestures during her debate against Republican U.S. Sen. Scott Brown, sponsored by the Boston Herald, at the University of Massachusetts in Lowell, Mass., Monday, Oct. 1, 2012. (AP Photo/The Boston Herald, Matt Stone, Pool)

Elizabeth Warren

Democratic candidate for U.S. Senate Elizabeth Warren speaks during a campaign rally at the Reggie Lewis Center in Boston, Saturday, Nov. 3, 2012. (AP Photo/Michael Dwyer)
Democratic candidate for U.S. Senate Elizabeth Warren speaks during a campaign rally at the Reggie Lewis Center in Boston, Saturday, Nov. 3, 2012. (AP Photo/Michael Dwyer)

Elizabeth Warren

Senate candidate from Massachusetts Elizabeth Warren addresses the Democratic National Convention in Charlotte, N.C., on Wednesday, Sept. 5, 2012. (AP Photo/J. Scott Applewhite)
Senate candidate from Massachusetts Elizabeth Warren addresses the Democratic National Convention in Charlotte, N.C., on Wednesday, Sept. 5, 2012. (AP Photo/J. Scott Applewhite)

Elizabeth Warren

Senate Banking Committee member Sen. Elizabeth Warren, D-Mass. listens on Capitol Hill, in Washington, Tuesday, May 21, 2013, as Treasury Secretary Jacob Lew testifies before the committee. (AP Photo/Evan Vucci)
Senate Banking Committee member Sen. Elizabeth Warren, D-Mass. listens on Capitol Hill, in Washington, Tuesday, May 21, 2013, as Treasury Secretary Jacob Lew testifies before the committee. (AP Photo/Evan Vucci)

Elizabeth Warren

Sen. Elizabeth Warren, D-Mass., questions a witness at Senate Banking Committee hearing on anti-money laundering on Capitol Hill in Washington, Thursday, March 7, 2013.  (AP Photo/Cliff Owen)
Sen. Elizabeth Warren, D-Mass., questions a witness at Senate Banking Committee hearing on anti-money laundering on Capitol Hill in Washington, Thursday, March 7, 2013. (AP Photo/Cliff Owen)

Elizabeth Warren

Democratic candidate for the U.S. Senate Elizabeth Warren addresses a crowd during a campaign stop in the Dorchester neighborhood of Boston Monday, Nov. 5, 2012. (AP Photo/Steven Senne)
Democratic candidate for the U.S. Senate Elizabeth Warren addresses a crowd during a campaign stop in the Dorchester neighborhood of Boston Monday, Nov. 5, 2012. (AP Photo/Steven Senne)

Elizabeth Warren

Democratic candidate for the U.S. Senate, Elizabeth Warren addresses an audience during a campaign rally at a high school in Braintree, Mass., Sunday, Nov. 4, 2012. (AP Photo/Steven Senne)
Democratic candidate for the U.S. Senate, Elizabeth Warren addresses an audience during a campaign rally at a high school in Braintree, Mass., Sunday, Nov. 4, 2012. (AP Photo/Steven Senne)

Elizabeth Warren, Barbara Mikulski

Democratic U.S. Senate candidate Elizabeth Warren, left, applauds as U.S. Sen. Barbara Mikulski, D-Md., gestures during a campaign event at University of Massachusetts-Boston, Friday, Oct. 26, 2012. (AP Photo/Elise Amendola)
Democratic U.S. Senate candidate Elizabeth Warren, left, applauds as U.S. Sen. Barbara Mikulski, D-Md., gestures during a campaign event at University of Massachusetts-Boston, Friday, Oct. 26, 2012. (AP Photo/Elise Amendola)

Elizabeth Warren

Democratic candidate for the U.S. Senate Elizabeth Warren greets people during a campaign stop at Doyle's Cafe, in Boston, Tuesday, Oct. 23, 2012. (AP Photo/Steven Senne)
Democratic candidate for the U.S. Senate Elizabeth Warren greets people during a campaign stop at Doyle's Cafe, in Boston, Tuesday, Oct. 23, 2012. (AP Photo/Steven Senne)

Elizabeth Warren

Democratic candidate for the U.S. Senate Elizabeth Warren speaks with reporters during a campaign stop at the Puerto Rico Bakery, in Springfield, Mass., Monday, Oct. 22, 2012. (AP Photo/Steven Senne)
Democratic candidate for the U.S. Senate Elizabeth Warren speaks with reporters during a campaign stop at the Puerto Rico Bakery, in Springfield, Mass., Monday, Oct. 22, 2012. (AP Photo/Steven Senne)

Elizabeth Warren, Al Franken

Massachusetts Democratic candidate for Senate Elizabeth Warren speaks during a campaign rally in Worcester, Mass., Friday, Oct. 19, 2012. At right is Sen. Al Franken, D-Minn. (AP Photo/Charles Krupa)
Massachusetts Democratic candidate for Senate Elizabeth Warren speaks during a campaign rally in Worcester, Mass., Friday, Oct. 19, 2012. At right is Sen. Al Franken, D-Minn. (AP Photo/Charles Krupa)

Elizabeth Warren

Democrat Elizabeth Warren gestures as she campaigns for the U.S. Senate at a senior housing complex in Quincy, Mass., Tuesday Oct. 16, 2012. Warren is running against incumbent U.S. Sen. Scott Brown, R-Mass. (AP Photo/Charles Krupa)
Democrat Elizabeth Warren gestures as she campaigns for the U.S. Senate at a senior housing complex in Quincy, Mass., Tuesday Oct. 16, 2012. Warren is running against incumbent U.S. Sen. Scott Brown, R-Mass. (AP Photo/Charles Krupa)

Elizabeth Warren

Democratic challenger Elizabeth Warren speaks during a debate with Republican Sen. Scott Brown in Springfield, Mass., Wednesday Oct. 10, 2012. (AP Photo/Elise Amendola)
Democratic challenger Elizabeth Warren speaks during a debate with Republican Sen. Scott Brown in Springfield, Mass., Wednesday Oct. 10, 2012. (AP Photo/Elise Amendola)

Elizabeth Warren

Massachusetts Senate candidate Elizabeth Warren, a Democrat, speaks during a campaign rally, Saturday, Sept. 15, 2012, at Boston University in Boston. (AP Photo/Bizuayehu Tesfaye)
Massachusetts Senate candidate Elizabeth Warren, a Democrat, speaks during a campaign rally, Saturday, Sept. 15, 2012, at Boston University in Boston. (AP Photo/Bizuayehu Tesfaye)

Elizabeth Warren

Senate candidate from Massachusetts Elizabeth Warren looks over the podium during a sound check at the Democratic National Convention in Charlotte, N.C., on Tuesday, Sept. 4, 2012. (AP Photo/J. Scott Applewhite)
Senate candidate from Massachusetts Elizabeth Warren looks over the podium during a sound check at the Democratic National Convention in Charlotte, N.C., on Tuesday, Sept. 4, 2012. (AP Photo/J. Scott Applewhite)

Elizabeth Warren

Senate candidate from Massachusetts Elizabeth Warren addresses the Democratic National Convention in Charlotte, N.C., on Wednesday, Sept. 5, 2012. (AP Photo/J. Scott Applewhite)
Senate candidate from Massachusetts Elizabeth Warren addresses the Democratic National Convention in Charlotte, N.C., on Wednesday, Sept. 5, 2012. (AP Photo/J. Scott Applewhite)

Elizabeth Warren

FILE - In this June 2, 2012 file photo, Massachusetts Democratic Senate candidate Elizabeth Warren speaks in Springfield, Mass.  (AP Photo/Michael Dwyer, File)
FILE - In this June 2, 2012 file photo, Massachusetts Democratic Senate candidate Elizabeth Warren speaks in Springfield, Mass. (AP Photo/Michael Dwyer, File)

Elizabeth Warren

FILE - In this July 21, 2010, file photo, Elizabeth Warren, head of the Congressional Oversight Panel, testifies before a Senate Finance Committee hearing to examine the Troubled Asset Relief Program in Washington. U.S. Sen. Scott Brown, R-Mass., who filled Senator Edward M. Kennedy's Senate seat following a special election, is invoking the legacy of the late senator as he seeks a full six-year term. (AP Photo/Manuel Balce Ceneta, File)

Elizabeth Warren

Elizabeth Warren speaks in Lowell, Mass. Tuesday, Oct. 4, 2011 during a debate between six Massachusetts Democratic candidates for the U.S. Senate seat held by Republican Scott Brown. (AP Photo/Elise Amendola)
Elizabeth Warren speaks in Lowell, Mass. Tuesday, Oct. 4, 2011 during a debate between six Massachusetts Democratic candidates for the U.S. Senate seat held by Republican Scott Brown. (AP Photo/Elise Amendola)

Elizabeth Warren

In this July 21, 2010 file photo Elizabeth Warren, head of the Congressional Oversight Panel, testifies before a Senate Finance Committee hearing to examine the Troubled Asset Relief Program (TARP) on Capitol Hill in Washington. (AP Photo/Manuel Balce Ceneta)
In this July 21, 2010 file photo Elizabeth Warren, head of the Congressional Oversight Panel, testifies before a Senate Finance Committee hearing to examine the Troubled Asset Relief Program (TARP) on Capitol Hill in Washington. (AP Photo/Manuel Balce Ceneta)

Love HuffPost? Become a founding member of HuffPost Plus today.

This article originally appeared on HuffPost.