Tonight's Healthcare Debate Is Utterly Worthless

The healthcare discussion in the second night of debates so far has been, to no one’s surprise, extremely bad.

The immediate fracas was between Joe Biden and Kamala Harris over her recently-released healthcare plan, which would allow private companies to keep selling Medicare plans. Biden attacked Harris over the cost of the plan, saying it would cost $3 trillion, and Harris shot back, saying Biden’s plan would leave 10 million uninsured. His campaign’s own summary of his plan admitted this.

Overall, Biden seemed very confused about basic questions of health insurance. He initially claimed his plan would limit co-pays to $1,000, then corrected himself later to say there would be $1,000 deductibles—but then said that Sanders’ plan has “a deductible in the paycheck.” This, for a start, is not a thing—a deductible is the amount of money you have to spend on healthcare before the insurance company will chip in, not something that comes out of your paycheck.

Presumably, he means a premium, but that’s not true, either. Sanders’ plan has no premiums. Some Democrats, like Kamala Harris, have taken to describing Sanders’ plan to implement a progressive tax to pay for the plan as a premium—she says he would “tax households making above $29,000 an additional 4% income-based premium.” Tax them a premium? Yeah, I don’t know either. You could argue this elision is fair, since it doesn’t matter a lot what you call it if you have to pay it, but the key difference is that a premium is something you have to pay in order to receive coverage; if you don’t pay it, you don’t get your coverage. That is not how a tax works.

Either way, it demonstrates that Biden does not have a good grip on how healthcare works, which means he does not understand what Americans are going through right now.

As with last night, one of the primary points of contention was whether the Democrats’ bills would force people to give up their private health insurance. Sen. Michael Bennet played the mewling centrist role that John Delaney filled last night, shouting about how Harris’ plan would make employer-provided insurance “illegal.”

But this time, the defense offered on Medicare for All or Kamala’s privatized version of this plan was weak. There was barely any reference to the fact that the public plan would provide far better coverage. No one has said “dental” at all, which Medicare for All would include. We’re not talking about how Medicare for All would limit drug costs to $200 a year; I didn’t hear Harris mention that her plan would do the same. She talked about how her plan “covers everyone, and gives people choice,” but that message doesn’t address that millions of people with “coverage” are now struggling because that coverage sucks. Even the ones who claim to support Medicare for All on the stage tonight don’t actually understand why it’s good, necessary, or significantly better than a public option; it’s just a cudgel against Biden.

Without Bernie Sanders or Elizabeth Warren there to make a real case for Medicare for All, the debate meanders. No one up there gives a shit about whether Medicare for All happens. Since her mix-up on private insurance earlier this year, I’ve thought that the most likely outcome under a President Kamala Harris would be her getting into office and ending up supporting a public option at best. Tonight’s discussion did nothing to dispel that.