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The Democratic presidential candidates’ debate was marked by infighting over the specifics of the candidates’ health insurance proposals. Is “Medicare for All" an impossible pipe dream or an achievable reality? So-called moderates targeted Sen. Bernie Sanders (I-Vt.) and Sen. Elizabeth Warren (D-Mass.) for their support of Medicare for All while blasting other proposed plans such as free college for all Americans and free healthcare for undocumented [illegal] immigrants [aliens]. Even before the questions began, Sanders and Warren drew sharp attacks from the other candidates, both veiled and direct. Delaney slammed “Medicare for All and free everything" in his opening statement - as "bad policies" and "impossible promises." Sen. Kamala Harris (D-Calif.) Harris said her plan would be a “Medicare for All” plan with two types of Medicare options — a public Medicare option and Medicare plans run by private insurers. Biden hit back immediately. "The senator has had several plans so far," he said, adding that Harris's plan would have a 10-year phase-in period. "Any time somebody tells you that you can get something in 10 years, you should wonder why it takes 10 years ... In 10 years her plan will cost $3 trillion and you will lose your employer-based insurance Harris said Biden was "simply inaccurate" and that her plan would bring healthcare to all Americans. "Your plan, by contrast [to mine], leaves out almost 10 million Americans," she said. "You should really think about what you're saying ... The people of America want access to healthcare and don't want cost to be a barrier." She also spoke in support of uncoupling health insurance from employment. "It's time we separate employers from the kind of healthcare people get ... It is misleading to suggest that employees want what their employer is offering only; they want choice and my plan gives that to them." Biden defended his own plan, which builds on the Affordable Care Act (ACA). He noted that his plan would "get back all the things Trump took away" and would add a public option that people could buy into if they were uninsured or were dissatisfied with their current plan; those who couldn't afford to pay the premiums would be enrolled for free. The price of the plan would be $750 billion, he said. "My plan will cover everyone; my plan also calls for controlling drug prices," he added. "We have to have a forum that sits in HHS [the Department of Health and Human Services] and says, 'As you develop a drug, you've got to come to us and decide what you can sell it for.' We will set the price, and secondly, it says you cannot raise that price beyond the [rate] of inflation from this point on." "For these plans that rely on private insurance, I'm sorry -- they're for-profit companies," said Sen. Kirsten Gillibrand (D-N.Y.), a supporter of Medicare for All. “ They have fat in the system that's real and it should be going to healthcare. Biden continued to defend the role of private insurance in his plan, noting that the deductible would be limited to $1,000. "No one has to keep their private insurance, but if they like their insurance, they should be able to keep it." The line was oddly reminiscent of one from Biden's former boss, President Obama, who said that under the ACA, "if you like your healthcare plan, you can keep it" -- a promise that Obama later had to walk back. Julián Castro, former mayor of San Antonio and the Secretary of Housing and Urban Development under Obama, also spoke in favor of a public/private plan. "I believe that if someone has a private health insurance plan ... that they want to hold onto, they should be able to do that," he said, adding that it was important that the profit motive of insurers and pharmaceutical companies "shouldn't determine whether somebody gets healthcare or not." Sen. Cory Booker (D-N.J.) appealed for unity. "Every Democrat should stand for the belief that healthcare ... is a human right and how we get there has to be to end this broken system Throughout the debates, healthcare continued to surface and resurface. When Delaney argued that Democrats can only win the next election by advocating “real solutions” to “kitchen table issues" like growing jobs and lowering drug prices, and "not fairy tale economics." Opponents charged that many hospitals would close their doors and moderators noted that private insurance would be taken away from 150 million people with Medicare for All. Taking private insurance away from 180 million people and promising everyone a government job, as does the “Green New Deal” — a plan proposed by Rep. Alexandria Ocasio-Cortez (D-N.Y.) and supported by Sanders and Warren — would be a "disaster." Hickenlooper said. "Us governors and mayors are the ones who — we have to pick up all the pieces," Hickenlooper continued, speaking faster, growing breathless. "When suddenly the government's supposed to take over all these responsibilities, and there's no preparation, the details aren't worked ... You can’t just spring a plan on the world and expect it to succeed," he said. Medicare which was implemented 54 years ago under President Lyndon Johnson with the support of a Democratic congress. In one year, 19 million people had joined, Sanders said. "Please don't tell me, that in a 4-year period, we cannot go from 65 down to 55, to 45, to 35," referring to the age of eligibility for the program. "This is not radical. This is what virtually every other country on earth does," Sanders said. In another pointed exchange, Tapper noted that if Medicare for All were enacted, 600,000 union members in the debate’s host city would lose their private insurance. Would benefits of Medicare for All plans, Tapper asked, be “as good" as those Detroiters' current coverage? “They will be better, because Medicare for All is comprehensive," Sanders said, noting that senior citizens under his plan would have access to dental insurance, to eyeglasses, and hearing aids. Ryan’s own plan is to lower the eligibility age for Medicare to 50 and allow people to buy in. Another issue featured at the debates was whether to offer insurance to undocumented immigrants. At one of the debates last month, all 10 candidates on stage said their health plans would cover healthcare for undocumented immigrants. When asked whether offering undocumented immigrants free insurance and decriminalizing entry into the U.S., as Warren and Sanders proposed, would encourage more illegal immigration, Ryan (who wasn't part of that earlier debate) argued that it would do just that. Ryan said that people seeking asylum should be welcomed into the country but regarding healthcare, “undocumented people can buy healthcare too." If others are paying for it, then so should undocumented immigrants, he said. Bullock also argued against the idea of free healthcare for immigrants. There's currently 100,000 people at the border. By decriminalizing entry and offering free healthcare to everyone, "we'll have multiples of that." Sanders was unmoved. ”I happen to believe that when I talk about healthcare as a human right, that applies to all people in this country," he said. The opioid epidemic was mentioned directly only once when Klobuchar attacked the drug industry for getting a high school swimmer hooked on the drugs. Gun violence came up, but the candidates largely agreed on the solutions: Universal background checks, an assault weapons ban, and "red flag" laws meant to keep guns away from individuals with a history of domestic violence or mental health issues. A Democratic debate will be held on Sept. 12 and 13 in Houston. Sources: https://www.medpagetoday.com/washington-watch/electioncoverage/81366 https://www.medpagetoday.com/washington-watch/electioncoverage/81331