Detroit

The second round of Democratic presidential debates opened with an actual debate, and the winner was Medicare for All.

The win came because Senators Elizabeth Warren (D-MA) and Bernie Sanders (I-VT)—working together not as rivals but as a progressive tag team—dared to call out more conservative Democratic candidates and debate moderators for peddling “Republican talking points” in their objections to replacing private insurance with a program that guarantees health care as a human right. The progressive contenders bluntly labeled compromises on health care as “wrong.”

For supporters of single-payer health care, which rarely gets a fair hearing in media coverage, Tuesday night’s debate was an epic moment. And Warren and Sanders seized it to directly challenge the hostility that political and media elites hold not just for this reform but for the idea that Democrats should again be the party of what Warren described as “big structural change.”

In doing so, they also challenged the race’s centrist front-runner, former vice president Joe Biden, who will debate nine other candidates on Wednesday night. The CNN moderators and the Democratic moderates—who were given plenty of time to serve as first-night surrogates for Biden—tried to trip up Warren and Sanders with arguments that those big structural changes, such as a Medicare for All health care reform, would be too much for November 2020 voters. But it didn’t work. In fact, the progressives got a chance to make the case that going big is the way to win.

Warren framed the fighting astutely when she introduced herself with an observation that, though she plans to work her heart out to beat the president in 2020, “Our problems did not start with Donald Trump. Donald Trump is part of a corrupt, rigged system that has helped the wealthy and the well connected and kicked dirt in the faces of everyone else.”

That system has kicked working Americans hard. And the cruelest kicks have targeted ailing children, women, and men who need health care—not insurance company runarounds, skyrocketing drug prices, and personal bankruptcy. The system’s key components are not popular; a 2017 Bloomberg survey found that Wall Street was very unpopular and Congress even more unpopular, but the most unpopular institutions in America were insurers and drug companies. In contrast, a Reuters/Ipsos poll from last year found that 70 percent of Americans favor Medicare for All, including 85 percent of Democrats and 52 percent of Republicans.

On the streets of Detroit on Tuesday, the rallies and marches organized by local and national groups did not call for maintaining the status quo or adding a public option. The signs read “Medicare for All!” And as the debate played out, policy analysts like Michael Lighty ridiculed the notion that “a policy that has 70 percent support is unpopular.”

Yet the questioning on Tuesday night began with an inquiry from CNN’s Jake Tapper that seemed to suggest that supporting guaranteed health care for all is politically dangerous. Sanders called Tapper out. “Jake,” he said, “your question is a Republican talking point…. And by the way…the health care industry will be advertising tonight on this program.”

Warren had already pushed back against the candidates who were trashing Medicare for All as a threat to those supposedly popular private insurance plans—primarily former Maryland representative John Delaney and former Colorado governor John Hickenlooper. “Let’s be clear about this,” she announced. “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.”

Later, after Delaney said, “I think Democrats win when we run on real solutions, not impossible promises, when we run on things that are workable, not fairy tale economics,” Warren pounced. “You know,” she said, “I don’t understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can’t do and shouldn’t fight for.”

The applause was thunderous.

Her rejoinder challenged the media fantasy that caution and compromise are the only way forward. But the most critical exchanges were the moments when Sanders and Warren were afforded the time to explain how a single-payer system would work.

This is important because, while Medicare for All polls well, it is under attack. Those attacks are best countered with details and analysis. Warren provided those when she shredded arguments for working with private insurance companies to achieve reforms. Noting past attempts, she asked, “What have the private insurance companies done? They’ve sucked billions of dollars out of our health care system. They’ve made everybody fill out dozens and dozens of forms. Why? Not because they’re trying to track your health care. They just want one more excuse to say no. Insurance companies do not have a God-given right to suck money out of our health care system.”

Sanders was just as aggressive in defending Medicare for All. At one point, Tapper noted that Delaney had referred to the idea as “political suicide that will just get President Trump reelected” and asked, “What do you say to Congressman Delaney?” Sanders replied, “You’re wrong.”

When Tapper asked if Sanders could guarantee that benefits under a Medicare for All system would be as good as those enjoyed by union members with private insurance, Sanders said, “They will be better because Medicare for All is comprehensive. It covers all health care needs. For senior citizens, it will finally include dental care, hearing aids, and eyeglasses.” Ohio Representative Tim Ryan said, “You don’t know that, Bernie.” Sanders responded, “I do know it. I wrote the damn bill.”

He did write the damn bill. And on Tuesday night he made the case for it.

“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,” Sanders thundered. “Five minutes away from [the debate stage] is a country. It’s called Canada. They guarantee health care to every man, woman, and child as a human right. They spend half of what we spend. And by the way, when you end up in a hospital in Canada, you come out with no bill at all. Health care is a human right, not a privilege. I believe that. I will fight for that.”