The Democrats met tonight for their second to last presidential debate before the primary voting starts early next month in Iowa and New Hampshire. They touched on several hot button topics facing Democratic voters – from heath care and Wall Street reform to taxes and gun safety. And the biggest difference between the two frontrunners, Bernie Sanders and Hillary Clinton, was on the direction and speed of change they each embraced. Sanders wanted what he calls a “political revolution;” Clinton more like an evolution building on what Barack Obama has already started and achieved.
The Affordable Care Act best exemplified the difference between their two approaches. Bernie, the Democratic Socialist, naturally wants a socialist solution for health care: single payer health insurance through Medicare for all. This solution, however, stands in stark contrast to what President Obama did to get major health care reform passed. The president made a realistic calculation at the beginning of his first term and decided to co-opt the major stakeholders in the health care industry, including private insurers, to make them a part of the solution. ObamaCare gave private insurance companies more customers by mandating individual coverage, but in exchange, did away with pre-existing conditions as a reason for those insurers to deny anyone coverage or charge them a higher premium.
At the debate, Hillary noted that when Congress took up passage of the ACA, Democrats had a filibuster-proof majority in the Senate and still could not get enough votes for the public option, which would have allowed people to buy into Medicare.
She continued, saying:
“So what I’m saying is really simple, this has been the fight of the Democratic Party for decades. We have the Affordable Care Act. Let’s make it work.”
In other words, Bernie, the revolutionary, wants to wholly reimagine health care and start over; while Hillary, the pragmatist, wants to build on what has already been achieved at great cost as a vehicle to move toward universal coverage. Sander’s position feels better in the abstract, but Clinton’s actually provides coverage for people in the real world.
A nice pivot would have been a contrast with the Republicans. The single biggest impediment at present to near-universal coverage is the maddening refusal of Republican governors to accept Medicaid expansion under the ACA for the benefit of their lower income citizens. I’m sure that was the point Martin O’Malley wanted to make as the moderators cut to a commercial break!
The same dynamic between Sanders and Clinton played out on taxes and Wall Street reform. Bernie wants to break up the big banks and raise taxes, mostly on the rich but also on the middle class, to fund health, education, childcare and infrastructure spending. Hillary would regulate shadow banking and build upon the Dodd-Frank financial regulations signed into law by President Obama. But she channeled her husband’s New Democrat bona fides, in promising no new taxes for middle-income earners. Again, revolutionary versus evolutionary.
The exception was gun safety. It’s the one topic on which Clinton has gotten to Sanders’ left and made him pay. The debate took place in a venue literally down the block from the “Mother” Emanuel AME Church where the shooting massacre of worshipers took place last year. Hillary identified the litany of gun safety reforms against which Bernie voted in Congress, including the Brady Bill and the so-called “Charleston loophole,” which allowed the gunman – who should have been blocked because of his criminal background – to acquire his firearm before a background check could be completed. Sanders really had no good answer. On this issue, Hillary was the revolutionary.
In place of closing statements, moderator. Lester Holt. asked the candidates if there was anything they wanted to add that they hadn’t gotten a chance to say. Sanders reprised his campaign theme of taking the country back from the control of wealthy campaign contributors. Clinton injected a new hot topic: the lead contamination of the drinking water in Flint caused by the malfeasance of the Governor of Michigan looking to save money. She noted that poisoning occurred in a “population which is poor in many ways and majority African American” and wondered whether government action would have come more quickly in a rich suburb. Since the debate was co-sponsored by the Congressional Black Caucus Institute and Clinton needs to keep the Obama coalition together to win, she finished strong – for an incrementalist.