Health policy discussions in the second Democratic presidential debate Saturday night illuminated differences in how former Secretary of State Hillary Clinton and Vermont Sen. Bernie Sanders would continue the aims of the Affordable Care Act.
The debate at Drake University in Des Moines, Iowa, came a day after terrorist attacks on Paris killed more than 120 people. The discussion focused heavily on foreign policy and combating terrorism. Candidates also were eager to discuss healthcare. It received more relative time as a general topic than it has in Republican debates so far.
Clinton said Sanders' plan eliminates the ACA and establishes a single-payer system that is administered by the states. She would be worried that Republican statehouse leaders would not faithfully administer such a program.
Sanders said the ACA is a step forward, and “I think we all support it,” but said it doesn't go far enough. He called for a single-payer system like Medicare for all.
After a question about the feasibility of taking on the insurance industry, Sanders said it would not happen overnight and would need to be implemented alongside campaign finance reform.
“But when millions of people stand up and are prepared to take on the insurance companies and the drug companies, it will happen, and I will lead the effort,” he said.
Prescription drug costs were also a key topic Saturday.
Clinton said she would establish a $250 cap on individual out-of-pocket expenses for prescription drugs and would also tackle drug company pricing practices.
“So there's more to my plan than just the cap,” she said. “We have to go after price-gouging and monopolistic practices and get Medicare the authority to negotiate."
Sander reiterated his support for prescription drugs to be imported from Canada and other countries and said Americans are “ripped off by the drug companies who can charge us any prices they want.”
Former Maryland Gov. Martin O'Malley tried to get a word in during both major healthcare exchanges but a moderatorsaid they had to move on to other topics.
O'Malley has advocated for the ACA and said Maryland's implementation, which included medical cost caps, should be a model for the nation.
Sanders brought up veterans' healthcare during foreign policy and military discussions, saying soldiers returning home with post-traumatic stress disorder and traumatic brain injury were an important long-term consequence of war.
