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The Great American Health Care Debate

Vermont Senator Bernie Sanders took center stage at Tuesday’s presidential debate as “Medicare for All” became both a rallying cry and a point of contention for the Democratic contenders

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On Tuesday evening, CNN hosted the first 10 candidates in the latest 2020 Democratic presidential primary debates in Detroit. Jake Tapper, Dana Bash, and Don Lemon moderated the proceedings which were dominated, in large part, by a resurgent Bernie Sanders.

In their opening statements, the candidates rallied against President Donald Trump. Once the debate began, they mostly rallied against Sanders, the senator from Vermont. Massachusetts Senator Elizabeth Warren emerged as Sanders’s key ally throughout the 150-minute debate, which amounted to a long and paranoid assessment of Sanders’s signature proposal to reform health care, billed as “Medicare for All.” On stage, the Democratic primary’s most obscure candidates proved to be the proposal’s loudest critics, including Ohio representative Tim Ryan, former Maryland representative John Delaney, Montana Governor Steve Bullock, and former Colorado governor John Hickenlooper, all of whom poll below 1 percent. Sanders and Warren poll in the double digits.

With Sanders and Warren at top billing, Tuesday night turned out to be the Great American Medicare for All Debate. Ryan, Delaney, Bullock, and Hickenlooper rehashed familiar concerns about consumer choice, tax hikes, and reimbursement rates in a government-run health care system. Sanders and Warren once again stressed the rising cost of health care premiums as far more capricious and disastrous for Americans than federal taxes. The candidates discussed health care reform proposals even as the moderators shifted the topic to immigration policy and then climate change legislation. Delaney emerged as the most persistent opponent to Medicare for All, arguing that it would shutter hospitals and annihilate consumer choice. Warren accused Delaney of adopting “Republican talking points” in his opposition to Medicare for All, and Sanders mocked Delaney’s experience as a former health care financier in the 1990s. “I’m starting to think this is not about health care,” Delaney said in response to Sanders. “This is an anti-private-sector strategy.”

Sanders and Warren did not deny the characterization, and even South Bend Mayor Pete Buttigieg—another Medicare for All critic—discounted Delaney’s fear-mongering about socialism. “It’s time to stop worrying about what the Republicans will say,” Buttigieg said. “If we embrace a far-left agenda, they’re going to say we’re a bunch of crazy socialists. If we embrace a conservative agenda, they’re going to say we’re a bunch of crazy socialists.”

Ryan, Delaney, Bullock, and Hickenlooper oppose Medicare for All, but they each touted their own semipublic-semiprivate designs for universal health care. Hickenlooper and Minnesota Senator Amy Klobuchar hoped to revive the Democrats’ Obama-era push for a public option, which the Obama administration abandoned nine years ago while pushing Obamacare through the Senate. In less than a decade, Obamacare has become the outdated, compromised reform that even Obama’s former vice president Joe Biden must pledge to expand despite its pretense of being a universal (sorry, “near-universal” or “comprehensive”) health care law. (Biden will appear in the second night of debates on Wednesday.)

Arguably, the candidates found their most irritating health care reform opponent in Tapper. With a cable news anchor’s “gotcha” persistence, Tapper pressed each candidate to declare—yes or no—whether their respective proposals would require federal tax increases for middle-class Americans. Much as Warren criticized Delaney, Sanders criticized Tapper for deploying “Republican talking points” as loaded questions at a Democratic presidential debate. “And by the way,” Sanders added, “the health care industry will be advertising tonight on this program!” As advertised, PhRMA did indeed advertise. The Democratic National Committee might come to regret the party’s overreliance on CNN and NBC. The two networks have, through elaborate production and candidate lotteries, transformed these civic exercises into a modern televised game show. “It took over 100 people eight days to build the set for CNN’s Democratic debates. Nine 53-foot semitrucks were needed to haul in all the equipment,” CNN media reporter Oliver Darcy tweeted from the scene. The overproduction hasn’t made for great politics or even great television, but the ratings are, presumably, unbeatable.