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Elizabeth Warren's new standing as a leading contender for the Democratic nomination for president placed her in the crosshairs of her rivals during Tuesday's primary debate. The most pointed criticism — lobbed most aggressively by Joe Biden, Pete Buttigieg and Amy Klobuchar — was aimed at her health care plan.
Warren is a proponent of Medicare for All, a position she shares with her chief progressive competitor in the race, Bernie Sanders, who famously "wrote the damn bill." Medicare for All is a sweeping restructuring of the health care system that would create a single, government-run plan covering the medical needs of all Americans. The proposal has become a key part of the platform promoted by a wave of young progressive Democrats such as Rep. Alexandria Ocasio-Cortez.
Other candidates in the Democratic primary support plans that would create a less-sweeping version of government-run health care, such as a public option or systems to allow people to choose between Medicare and private insurance.
Medicare for All is reminiscent of state-run health care systems found in most European countries, although it is in some ways more generous than those plans because it covers vision, dental and prescription drugs.
Why there's debate:
For critics on the right, Medicare for All is the embodiment of Democratic overreach and big-government spending. But the idea also faces criticism from Democrats, despite broad agreement within the party that significant change is needed in the health care system.
Critiques commonly focus on two perceived problems with the plan: cost and political feasibility. If enacted, Medicare for All would cost an estimated $32 trillion over a 10-year span, according to a recent study.
Moderate Democrats question whether voters would be turned off by a plan that includes tax increases and would force 150 million people with employer-provided plans to change their coverage. There is also skepticism that the proposal would have any chance of making it through Congress, even in the most optimistic 2020 scenarios for Democrats. Klobuchar called the plan a "pipe dream."
Sanders and Warren defend Medicare for All, citing studies that predict total health care costs would actually go down, both for the country and for most Americans. The extra money in taxes the average citizen pays would be less than they pay in health care costs under the current system. Medicare for All would also eliminate the risk of unexpected medical expenses that lead to 500,000 bankruptcies a year, Sanders said.
Others argue that the bold plan provides room for compromise if concessions are needed to get enough votes in Congress. Even if parts of the proposal are lost through political maneuvering, a bill that gets through would still be a major reform of the health care system.
With Warren and Sanders toward the front of the pack in the Democratic race, Medicare for All will likely be a major point of debate throughout the primaries. Support for the idea has dipped slightly in recent months, although it is still quite popular among Democrats, according to a recent survey. Regardless of who wins the nomination, and what their plan is, health care is projected to be a winning issue for Democrats in the general election. Trust in the president's ability to deliver on the issue is low, polling suggests.
The plan is feasible
Medicare for All would be cheaper than the current system
"We pay more now than we would under Medicare for All. Not only can we afford it, we can't afford anything else. Our current system is unsustainable.' — Marcia Angell, USA Today
A bold proposal serves as a strong starting point for negotiations
"To transform what’s wrong, and achieve conditions in which people are no longer suffering and dying, we cannot bargain against ourselves. We have to come to the table with the strongest possible legislation — not a half measure." — National Nurses United executive director Bonnie Castillo, The Hill
It's worth advocating for the idea, even if it's unlikely to be achieved in the near future
"Debating it now doesn't do nothing. Politicians like Sanders and Warren may recognize that even if their policies don't pass in their respective (hypothetical) presidencies, talking about the policy now could lay the groundwork for Medicare for All in the future." — Danielle Kurtzleben, NPR
Medicare for All would save money by driving down costs
"Medicare for All would empower the federal government to use the collective bargaining power of 330 million Americans to reduce the cost of health care, something that commercial insurers have been unable to do." — Diane Archer, Washington Post
Less ambitious plans will face the exact same resistance in Congress
"It’s fair to say that the progressive policies are hard to implement, but so are the moderate policies. Solutions are not magically made easier to pass because they are smaller or less comprehensive." — Elie Mystal, the Nation
It's irrelevant whether taxes would go up if overall costs go down
"What really matters here is that, while Medicare-for-all would require some additional taxes on the middle class, those increases would be more than compensated for by zeroing out premiums, co-pays, and deductibles." — Ryan Cooper, the Week
The plan's large price tag has nothing to do with socialism
"The eye-popping price tag of Bernie Sanders’s Medicare for All plan does not reflect the steep price of socialized medicine, per se. Rather, it reflects the fact that America’s aberrant refusal to impose price controls on its health-care industry has enabled the sector to extract an ever-higher share of national income." — Eric Levitz, New York
It is unrealistic
The plan would lead to lost jobs and shuttered hospitals
"If Medicare for all abolished private insurance and reduced rates to Medicare levels — at least 40 percent lower, by one estimate — there would most likely be significant changes throughout the health care industry, which makes up 18 percent of the nation’s economy and is one of the nation’s largest employers. Some hospitals, especially struggling rural centers, would close virtually overnight, according to policy experts." — Reed Abelson, New York Times
Medicare for All is more generous than any other country's system
"The 'Medicare for All' plan advocated by leading 2020 Democrats appears more lavish than what’s offered in other advanced countries, compounding the cost but also potentially broadening its popular appeal." — Ricardo Alonso-Zaldivar, Associated Press
The more people understand Medicare for All, the less they like it
"The phrase ‘Medicare for All’ tended to poll well early on, but its popularity tended to drop once respondents were told it would require them to give up their private insurance." — Jordan Weissman, Slate
Medicare for All would be more expensive
"Instead of bending the cost curve downward for the public and private entities and individuals who finance healthcare, Medicare for All would increase healthcare costs over what is currently projected." — Editorial, Washington Examiner
It's possible to improve health care with less extreme policies
"All Americans deserve access to healthcare equal or superior to that of other advanced nations. However, this does not require massively disrupting an industry that accounts for one-fifth of the U.S. economy, or legislation that has no realistic chance of passage, or a wildly extravagant increase in the federal budget." — Peter D. Salins, Los Angeles Times
Voters don't like socialism
"The thought of making our system into a socialized one is still scary. The idea of having to give up their current plan is one that most Americans just aren’t going to support — and Democrats would be wise to take this into account when drafting their policy proposals for 2020. If they don’t do this, if they do give in to the temptation to go too far to the left, then that could easily be what hands the next election to the incumbent." — Katherine Timpf, National Review
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Cover thumbnail photo illustration: Yahoo News; photos: AP, Getty Images