En español | Health care issues dominated a second Democratic presidential debate in Detroit Wednesday with 10 more candidates sparring over whether private health insurance would have a place in the American system if they were leading the United States.
Former Vice President Joe Biden and California Sen. Kamala Harris argued over whether the best way to cover all Americans is through Biden's plan to add a public option to the existing Affordable Care Act (ACA) or through Harris’ new proposal that would eventually eliminate job-based health insurance.
"Under my Medicare for All plan, yes, employers are not going to be able to dictate the kind of health care that their employees get,” Harris said. “It's misleading to suggest that employees want what their employer is offering only. They want choice and my plan gives that to them."
Biden defended the Affordable Care Act and said his plan would cover more people more quickly than Harris’ would. “No one has to keep their private insurance. But if they like their insurance they should be able to keep it,” Biden said. Several of the other 10 presidential hopefuls agreed with Biden that Americans should have the choice between their current employer-based coverage and buying into a public plan. They included Sen. Michael Bennett of Colorado and former Housing and Urban Development Secretary Julian Castro.
"It doesn't make sense for us to take away insurance from half the people in this room,” said Bennett, adding the American people should be trusted “to make the right decision and have universal health care in this country.” Castro said he wants to “strengthen Medicare for the people who are on it and then expand it to anybody who wants it. I also believe that if somebody has a private insurance plan that is strong, that they want to hold on to, that they should be able to do that."
At the other end of the ideological spectrum, several of the potential Democratic nominees urged their fellow candidates to jettison private coverage.
"There's tens of millions of Americans who don't even have health insurance, tens of millions more who have health insurance they can barely make work because of copays, the deductibles, the premiums, the out-of-pocket expenses,” said New York City Mayor Bill de Blasio. “There's this mythology that somehow all of these folks are in love with their insurance in America."
New York Sen. Kirsten Gillibrand, who is a cosponsor of Vermont Sen. Bernie Sanders’ Medicare for All bill, also lashed out at insurers. “They're for-profit companies,” she said. “They have an obligation to their shareholders. They pay their CEO millions of dollars."
Andrew Yang, a tech entrepreneur, agreed with Harris that it would be best to sever the link between health insurance and employment. “I can tell you flat out our current health care system makes it harder to hire, it makes it harder to treat people well and give them benefits,” Yang said, “We're going to get health care off the backs of businesses and families, then watch American entrepreneurship recover and bloom."
The candidates also took aim at pharmaceutical companies and promised to take action to lower prescription drug costs.
"We spend more than every other nation, on everything from MRIs to insulin drugs, multiples more than other countries,” said New Jersey Sen. Cory Booker. “I'm going to work to get us to a point where we have Medicare for All – where everyone is covered."
Rep. Tulsi Gabbard of Hawaii said that the “core of this problem is the fact that big insurance companies and big pharmaceutical companies have been profiting off the backs of sick people.” Gabbard said America has a “sick care system, and there are far too many people in this country who are sick and unable to get the care that they need because they cannot afford it."
The one governor on Wednesday's debate stage, Jay Inslee of Washington, said “It is time to give people adequate mental health care in this country. There's no reason we should distinguish between your physiological and your mental health.” Inslee said his state was the first to offer “publicly sanctioned offer of health care to our citizens."