For the first time Thursday, frontrunner Joe Biden faced his two leading left-leaning competitors on the debate stage: Sen. Elizabeth Warren (D-MA) and Sen. Bernie Sanders (I-VT).
The argument between the former vice president and his two main competitors went quickly towards their competing health care policy proposals, after an opening question from the moderator that all-but invited Biden to ask how Warren and Sanders would pay for universal coverage.
Biden did ask, and Warren and Sanders replied, initially leading the discussion into the weeds of how the government could finance public health care – be it increased payroll taxes or savings from squeezing rent-seeking health care providers.
Another exchange between Biden and Sanders brought the discussion to the ongoing toll of health care costs in the U.S., with the senator from Vermont citing a statistic that 500,000 Americans declare bankruptcy each year because of medical costs, bringing up cancer while making the point.
Biden, whose son died of cancer, replied that he “knows a lot about cancer.” Biden suggested that because his plan requires less of a fundamental shift in health care policy, it could be implemented faster than the years it would take to switch to a full Medicare for All system.
For a few moments, the candidates meandered towards a more revealing discussion that went to the intersection of the values that motivate each politician’s policy choice and how they want to expand coverage.
South Bend Mayor Pete Buttigieg, for example, plugged his own Medicare buy-in proposal while lambasting the left alternative as “my way or the highway.” Sen. Kamala Harris (D-CA) attacked President Trump and the GOP for repeatedly trying to reduce coverage, while plugging her own version of Medicare For All, which would offer a choice between private insurance and a public option.
But overall, the discussion stayed in trench warfare.
Entrepreneur Andrew Yang made a proposal that sounded like paying doctors a flat rate per patient, though the specifics were unclear. Former Rep. Beto O’Rourke (D-TX) endorsed a Medicare buy-in, without picking up any flack from his competitors.
Sen. Cory Booker (D-NJ) closed out the discussion by saying “we cannot sacrifice progress on the altar of purity.” He did not endorse any single plan.