With the three top contenders on the same stage for the first time, rifts in the Democratic Party over health care came into sharper focus at the primary debate in Houston on Thursday night.
The third Democratic debate began with ABC News and Univision moderators setting up a heated discussion between former Vice President Joe Biden, who has proposed a public option that would expand the Affordable Care Act, and Sen. Bernie Sanders, who is pushing a single-payer Medicare for All plan, which has also been endorsed by Sen. Elizabeth Warren.
“I know that the senator says she's for Bernie, well, I'm for Barack,” Biden responded. “I think the Obamacare worked. I think the way we add to it, replace everything that has been cut, add a public option, guarantee that everyone will be able to have affordable insurance, number one.”
Biden criticized Sanders’s plan as too expensive, costing $32 trillion over 10 years. But Sanders said that’s less than the current health care system would cost over the same period.
“In the United States of America, we are spending twice as much per capita on health care as the Canadians or any other major country on Earth,” said Sanders.
“This is America,” interjected Biden.
“Yeah, but Americans don’t want to pay twice as much as other countries and they guarantee health care to all people,” Sanders shot back.
“You’ve got to defend the fact that today not only do we have 87 million people uninsured and underinsured, you’ve got to defend the fact that 500,000 Americans are going bankrupt,” said Sanders. “Do you know why they’re going bankrupt? Because they suffered a terrible disease, cancer or heart disease. Under my legislation, people will not go into financial ruin because they suffered with a diagnosis of cancer.”
“I know a lot about cancer. Let me tell you something, it’s personal to me,” said Biden, whose son Beau died of cancer in 2015. He said cancer patients would be covered under his plan.
Warren, who has been supportive of the Sanders plan and introduced her own version of it on Thursday, said Medicare for All, by cutting profits from the health insurance industry and eliminating the bureaucracy of health care billing, would be an efficient way to cut costs for Americans.
“Doctors won’t have to hire people to fill out crazy forms,” said Warren. “They won’t have to spend time on the phone arguing with insurance companies. People who have sick family members won’t have to get into these battles. What this is about is making sure that we have the most efficient way to pay for health for everyone. Insurance companies last year sucked $23 billion in profits out of the system. How did they make that money? Every one of those $23 billion was made by an insurance company saying no to your health care coverage.”
Pete Buttigieg said the problem with the Sanders bill is that it doesn’t trust the American people to make their own choices, recommending his own plan, which he calls Medicare for All Who Want It, a form of Obamacare with the public option President Obama sought. Sen. Kamala Harris credited both Obama and Sanders for their work on health care but said her own version, which phases in a public option over 10 years, was better.
The Partnership for America’s Health Care Future, a lobbying group for pharmaceutical companies, hospital groups and the health insurance industry, has come out against both the Harris and Biden plans in addition to Medicare for All. The American health care system is among the most expensive in the world, and also has some of the highest prescription drug costs. At the same time, 28 million people are without health coverage and 79 million have medical debt, and crowdfunding sites to help cover medical expenses are proliferating.
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