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Digging In To Democrats' Health Care Arguments In 1st Night Of Debate


In last night's debate in Detroit, Democratic candidates offered very different visions of the country and also of the campaigns they would run against President Trump. Some spoke of radical change, others of a more moderate middle path, and this came across as the candidates talked about health care and whether to pursue "Medicare for All." Let's talk through some of the moments from last night with NPR political reporter Danielle Kurtzleben, who's in our studios in Washington. Hi, Danielle.


GREENE: All right. So a big question about any big plan, particularly when it comes to health care, is how exactly you pay for it. And CNN's Jake Tapper had a very specific question for Senator Elizabeth Warren.


JAKE TAPPER: Would you raise taxes on the middle class to pay for Medicare for All offset obviously by the elimination of insurance premiums - yes or no?

ELIZABETH WARREN: Costs will go up for billionaires and go up for corporations. For middle-class families, costs - total costs will go down.

GREENE: OK. Yes or no, would you raise taxes? There wasn't really an answer there, it sounds like, so what do we learn from that response from Elizabeth Warren?

KURTZLEBEN: Well, she's getting at a really important distinction on Medicare for All that could be easy to lose with one of those sort of simplistic yes-or-no-when-taxes-go-up questions. What she's trying to say is that even if your taxes did go up under this plan, you still might end up with more money in your pocket than you have now. The way that that works is that - it's true that Bernie Sanders has proposed a bunch of taxes under Medicare for All. As she alluded to there, a lot of those are could be on the wealthy. But there is one in particular that would hit middle-class families. But also under his plan, there would be no premiums, no copays. So the argument she's making here, and that Sanders makes as well, is that altogether you have a lot of people who would on net save money.

Now, I did consult with a couple of health care experts last night, and I asked them, is that plausible? And what they said is, yes, totally plausible that some families would - middle-class families would pay less if the plan works as intended. And, of course, we can't say that across the board for all middle-class families.

GREENE: Sounds like a really central question, though, that if candidates like Sanders or Warren are really going to get traction with even some more moderate voters, that they're going to have to really convince people on the topic.

KURTZLEBEN: Most definitely, yes.

GREENE: Well, a number of the more moderate candidates last night made an argument that I think you hear from a lot of Republicans - right? - I mean, the argument that if you replace private health insurance with a government-run system, it could actually take people's health care away. And I want to hear right now how Bernie Sanders responded to that.


BERNIE SANDERS: The fact of the matter is tens of millions of people lose their health insurance every single year when they change jobs or their employer changes that insurance. If you want stability in the health care system, if you want a system which gives you freedom of choice with regard to doctor or hospital which is a system which will not bankrupt you, the answer is to get rid of the profiteering of the drug companies and the insurance companies, move to Medicare for All.

GREENE: Passionate moment. Did this argument get settled at all last night?

KURTZLEBEN: No, of course not. No. I mean, to be clear, what we're talking about here - so Sanders' Medicare for All plan would largely eliminate private insurance. That's very true. Now, last night, you had Warren and Sanders trying to reframe things, saying, you know, we're not taking people's health care away under this plan. It means giving everyone health care. It just means changing what the insurance looks like. But this question of what would happen to private insurance is one aspect of Medicare for All that really has proven unpopular in polling. So for opponents of the program, that line of attack about you would lose your current private insurance is potentially really potent.

GREENE: I want to turn to the economy and trade specifically. That was a big issue in 2016. It's been central to the Trump administration's economic policy. And things got heated last night. This is former Maryland Congressman John Delaney speaking about a trade policy negotiated by President Obama.


JOHN DELANEY: Most of the folks running for president want to build economic walls to free trade and beat up on President Obama. I'm the only one running for president who actually supports the Trans-Pacific Partnership. President Obama was right about that. We should be getting back in that. Senator Warren just issued a trade plan that would prevent the United States from trading with its allies. We can't go - and we can't isolate ourselves from the world. We have to engage...

TAPPER: Thank you.

DELANEY: ...With fair, rules-based trade.

TAPPER: ...Thank you, Congressman Delaney.

GREENE: OK. Danielle, what did we learn from the whole debate over trade last night?

KURTZLEBEN: We learned that especially on the issue of trade you have some really big divisions, even among Democrats. You have people like John Delaney who support some of those big multilateral deals like the Trans-Pacific Partnership. And then you have people like Bernie Sanders and Elizabeth Warren, both of whom really opposed that deal. By the way, that deal was something that Barack Obama pushed and that - he is, by the way, quite popular among Democrats. So this is definitely a thing that could create a big fissure among Democrats. It's something I'm going to be watching very closely as more debates go on.

GREENE: NPR's Danielle Kurtzleben talking through some of the moments last night. Thanks so much.

KURTZLEBEN: Thank you. Transcript provided by NPR, Copyright NPR.

Danielle Kurtzleben is a political correspondent assigned to NPR's Washington Desk. She appears on NPR shows, writes for the web, and is a regular on The NPR Politics Podcast. She is covering the 2020 presidential election, with particular focuses on on economic policy and gender politics.