Warren and Sanders both defended Medicare-for-all — in very different ways

Onstage at the first night of the second Democratic debate, Sens. Bernie Sanders (I-VT) and Elizabeth Warren (D-MA) teamed up to defend Medicare-for-all with a one-two punch.

Sanders and Warren, the two progressives in a sea of more moderate Democratic candidates, from Sen. Amy Klobuchar (D-MN) to Rep. Tim Ryan (D-OH) and former Rep. John Delaney (D-MD), came up against familiar attacks on a single-payer health care proposal: Candidates claimed their plan would “take away” people’s health insurance, that it would worsen care for union workers who had negotiated strong plans. The debate moderators tried to push them on how taxes would increase for middle-class Americans.

In hitting back, Sanders and Warren showed a united front on policy. But the exchanges revealed the rhetorical divide that’s come to define their competing campaigns. Sanders was on the attack. He blasted the moderators for asking the wrong questions and swore at his fellow Democratic candidates.

“I wrote the damn bill,” Sanders told Ryan when the Ohio Congress member alleged Sanders didn’t know what the health insurance plan would look like.

Brendan Smialowski/AFP/Getty Images

Warren took a different approach. She reframed the debate altogether, making the case that moderate Democrats were echoing Republican talking points, at a grave human cost. When asked if she would raise taxes on the middle class to pay for Medicare-for-all, she simply replied, “Costs will go up for billionaires and go up for corporations; for middle-class families, costs total costs will go down.”

She invoked activist Ady Barkan, who has Lou Gehrig’s disease and early this year moved Democratic lawmakers to tears using a computer system to deliver a testimony in defense of Sanders’s bill.

Together, Warren and Sanders showed themselves as two candidates who have largely similar platforms and are on the same team — but with two very different political styles.

“I wrote the damn bill”: Bernie Sanders was on the attack

The first thing Sanders said in defense of his health care plan at the debate: “You’re wrong.” That was directed at Delaney, who called Medicare-for-all “bad policy.”

Over the course of the debate, Sanders made the case he has made all along: that corporate greed has overtaken the American health care system.

“Right now we have a dysfunctional health care system: 87 million uninsured or underinsured, 500,000 Americans every year going bankrupt because of medical bills, 30,000 people dying while the health care industry makes tens of billions of dollars in profit,” he said. “Health care is a human right, not a privilege. I believe that. I will fight for that.”

But Sanders went off his talking points several times Tuesday night to go on the attack. Take this exchange with Ryan, who questioned whether the benefits in Sanders’s plan would be as good as the plans negotiated by strong unions:

SANDERS: Two things. They will be better because Medicare-for-all is comprehensive and covers all health care needs ... it will finally include dental care, hearing aids, and eyeglasses. Second of all —

RYAN: You don’t know that, Bernie.

SANDERS: I do, I wrote the damn bill. Second of all, many of our union brothers and sisters — nobody more pro-union than me up here — are now paying high deductibles and copayments, and when we do Medicare-for-all, instead of having the company putting money into health care, they can get decent wage increases, which they are not getting today.

Or the time he took he attacked Delaney for his career as a health care finance executive.

SANDERS: Under Medicare-for-all, the hospitals will save substantial sums of money because they won’t be spending a fortune doing billing and the other bureaucratic things they have to do today.

DELANEY: I’ve done the math —

SANDERS: Maybe you did that and made money off health care, but our job is to run a nonprofit health care system.

He even turned the heat on Jake Tapper, one of CNN’s moderators, and the network for asking whether Medicare-for-all would increase middle-class taxes.

“Jake, your question is a Republican talking point at the end of the day, and by the way, the health care industry will be advertising tonight on this program,” Sanders said.

Warren’s defense of Medicare-for-all was different in style

Warren took a noticeably different tack defending Medicare. Right away, she reframed moderate Democrats’ argument that single-payer’s elimination of private insurance would “take away” health care. She said her fellow Democrats onstage were acting like Republicans.

“Let’s be clear about this,” Warren said. “We are the Democrats. We are not about trying to take away health care from anyone. That’s what the Republicans are trying to do. And we should stop using Republican talking points in order to talk with each other about how to best provide that health care.”

Similarly, she refused to engage with Tapper’s question about raising middle-class taxes in order to pay for single-payer health care. Instead, she talked about health care costs in total, making the case that while taxes would go up, primarily for the wealthiest Americans, out-of-pocket costs at time of service would be eliminated.

Finally, she then put a human face on the debate. She told the story of Ady Barkan, an activist with ALS who has become a central figure in the fight for Medicare-for-all:

I want to have a chance to tell the story about my friend Ady. He is 35 years old. He has a wife, Rachel, and a cute little boy named Carl. He also has ALS, and it’s killing him, and he has health insurance, good health insurance ... this is somebody who has health insurance and is dying. Every month he has about $9,000 in medical bills that his insurance company won’t cover. His wife, Rachel, is on the phone for hours and hours and hours begging the insurance company please cover what the doctors say he needs. He talks about what it’s like to go online with thousands of other people to beg friends, family, and strangers for money so he can cover his medical expenses. The basic profit model of an insurance company is taking as much money as you can in premiums and pay out as little as possible in health care coverage.

Warren herself wasn’t shying away from the attacks.

“I don’t understand why anybody goes to all the trouble of running for president of the United States to talk about what we really can’t do and shouldn’t fight for,” she said at one point, in a remark directed at Delaney. “I don’t get it.”

In all, Warren and Sanders were a team Tuesday night. But between the two of them, they showed voters two very different styles of defending a bold progressive agenda.

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