It was a fitting and succinct synopsis of the health care debate taking place among the crowded field of Democratic presidential candidates.
Bernie Sanders, Pete Buttigieg and Steve Bullock — just three of the roughly two dozen candidates seeking their party’s nomination for president — on Saturday in Council Bluffs participated in the fifth and final forum hosted this week by the AARP and Des Moines Register.
Health care has been a hot debate topic on the presidential campaign trail this week in Iowa, in no small part thanks to the series of forums, which were held across the state.
Saturday’s discussion in Council Bluffs encapsulated that debate, with Sanders touting his Medicare-for-all proposal, Buttigieg calling for a public option that could eventually lead to Medicare-for-all, and Bullock proposing just the public option.
Pick any of the roughly two dozen candidates in the field, and each will have a health care policy proposal that matches or comes very close to one of those three proposals.
“It is time now to complete what they began in 1965 (when Medicare was created),” Sanders said. “Medicare is a strong program. Let’s expand it to every man, woman and child in this country.”
Sanders’ plan is to overhaul the current U.S. health care system by, over a four-year span, moving all Americans onto Medicare, the government-run and funded health care plan. Sanders would incrementally lower the Medicare eligibility age until all Americans were in the program.
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Buttigieg’s proposal, which he calls “Medicare for all who want it,” is to introduce a Medicare-like plan on the current Affordable Care Act marketplace, giving individuals a public option to buy into. He said his expectation would be that most Americans would find that public option superior, which would put the system on a path to Medicare for all.
“It is a chance to demonstrate that that public option will provide the kind of efficiencies that we were just talking about. It’s also one last dare, though, to the corporate world to come up with something better than they have. If they do, great. I’m not counting on it,” Buttigieg said. “So I think what will happen over time is that this will become a very natural glide path toward a Medicare-for-all environment. Not by flipping a switch and banishing the private sector, but just by putting something better on the table and letting people figure it out for themselves.”
Bullock stressed his preference for a Medicare-like public option, and said he does not think Medicare for all is the best approach.
“While there’s differences in approach, I just don’t think the best way to get to universal (health care) is to disrupt 70 percent of the people (who currently have private insurance),” Bullock said.
Bullock also said states should be free to determine their laws regarding recreational and medical marijuana, and that the federal government should not be a threat to interfere.
“I don’t think the federal government should be prosecuting medical marijuana,” Bullock said. “I think the federal government should get out of the way and this is a state-by-state decision.”
Each of the three candidates agreed on raising the cap at which income is taxed to fund Social Security.
Sanders said he would prefer to “scrap the cap,” so that high-income earners would pay more into the system.
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“The result of that is we expand benefits for seniors, especially lower-income seniors, people trying to get by on $11,000, $12,000, $13,000 a year,” Sanders said. “Equally important, we expand the life of Social Security for 52 years.”
Buttigieg offered some advice for Democrats who may be worried about Republicans’ attempts to paint Democratic policy proposals as socialist.
“If we adopt a platform that’s way out to the left, they’re going to say we’re socialists. If we adopt a more moderate or conservative platform, they’re going to say we’re socialists,” Buttigieg said. “So we might as well just do what we think is right, make the case for it and then let them do what they want.”