The fourth Democratic debate in Charleston, S.C., Sunday evening touched on guns, Wall Street and foreign policy. However, since Sen. Bernie Sanders (I-Vt.) released details of his health plan hours before the debate, it focused heavily on healthcare.
Joining Sen. Sanders on the stage was former Secretary of State Hillary Clinton and former Maryland Gov. Martin O'Malley. The debate was hosted by NBC News and YouTube.
Here are four takeaways on healthcare from the debate.
1. Affordable Care Act
All candidates agreed the ACA has brought about positive change in getting more Americans health insurance coverage. However, while Ms. Clinton and Mr. O'Malley agreed the country needs to build and improve on the ACA by decreasing out-of-pocket costs and capping prescription drug costs, Sen. Sanders stressed there is considerably more work to be done, and wants to address it with a slightly different approach through his newly-released universal healthcare plan.
Ms. Clinton accused Sen. Sanders of wanting to "tear up" the ACA. Sen. Sanders responded, "No one is tearing [the ACA] up, we're going to go forward. But what the secretary neglected to mention, not just the 29 million who still have no health insurance, that even more are underinsured with huge copayments and deductibles," he said. "We're not going to tear up the ACA. I helped write it. But we are going to move on top of that to a Medicaid-for- all system."
2. Universal healthcare
All candidates backed the idea of universal healthcare.
"I am absolutely committed to universal healthcare," Ms. Clinton said. "I have worked on this for a long time, people may remember that I took on the health insurance industry back in the '90s, and I didn't quit until we got the Children's Health Insurance Program that insures 8 million kids."
Mr. O'Malley called attention to the all-payer system that has been successful in Maryland. "Instead of attacking one another on healthcare, we should be talking about the things that are actually working. In our state, we have moved to an all-payer system. With the ACA, we now have moved all of our acute care hospitals, that driver of cost at the center, away from fee-for-service...We pay them based on how well they keep patients out of the hospital," he said. "That's the future."
Sen. Sanders said universal healthcare is a main tenet of his campaign. "That's what our campaign is about. It is thinking big. It is understanding that in the wealthiest country in the history of the world, we should have healthcare for every man, woman and child as a right," he said.
3. Prescription drug abuse
Ms. Clinton proposed a comprehensive approach to put about $1 billion annually toward helping states deal with the opioid and heroin epidemic. She also called for allowing police officers, firefighters and others to be able to administer the antidote drug to heroin overdose.
"We have to move away from treating the use of drugs as a crime and instead, move it to where it belongs, as a health issue. And we need to divert more people from the criminal justice system into drug courts, into treatment and recovery," she said.
Sen. Sanders agreed addiction should be treated as a disease and implied mental health and addiction treatment would be part of his universal healthcare plan. He also added, "There is a responsibility on the part of the pharmaceutical industry and the drug companies who are producing all of these drugs and not looking at the consequence of it."
4. Financial influence on healthcare policy
Both Sen. Sanders and Ms. Clinton agreed the campaign finance system needs to be reformed.
"It's because we have a campaign finance system that is corrupt, we have super PACs, we have the pharmaceutical industry pouring hundreds of millions of dollars into campaign contributions and lobbying, and the private insurance companies as well," Sen. Sanders said. "What this is really about is not the rational way to go forward — it's Medicare for all — it is whether we have the guts to stand up to the private insurance companies and all of their money, and the pharmaceutical industry."
Ms. Clinton countered, saying she is also for campaign finance reform, but she believes there are many reasons we have the healthcare system we have today.
"I know how much money influences the political decision-making," she said. "That's why I'm for huge campaign finance reform. However, we started a system that had private health insurance. And even during the ACA debate, there was an opportunity to vote for what was called the public option. In other words, people could buy in to Medicare, and even when the Democrats were in charge of the Congress, we couldn't get the votes for that."
See the full debate here.
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