Hillary Clinton is right about health care.

In Thursday night's Democratic debate, Clinton and her fellow Democratic candidate for president, Vermont Sen. Bernie Sanders, debated several issues, including health care reform. While Sanders has been advocating for a single-payer, Medicare-for-all health care plan, Clinton has been pushing to build upon President Barack Obama's health care law, the Affordable Care Act, to close the remaining gaps in coverage. During the debate, Clinton criticized Sanders' plan, noting "if you're having Medicare for all, single-payer, you need to level with people about what they will have at the end of the process you are proposing. And based on every analysis that I can find by people who are sympathetic to the goal, the numbers don't add up, and many people will actually be worse off than they are right now." She also said, "The last thing we need is to throw our country into a contentious debate about health care again."

Democrats should listen to Clinton on this one. Universal coverage should absolutely be the goal of any health care reform plan that is proposed. But health care proposals should also be realistic and politically pragmatic. Sanders' plan is not.

Medicare for all is not a new idea. A bill that would establish the program is pending in Congress now and has been for many years, but has never advanced. Even in a Sanders presidency, the situation is not likely to differ. A proposal like that would never make it through what is likely going to be a Republican-controlled House, since Republicans generally seek to shrink the role of government, not expand it.

But what if, in a few years, Congress was entirely controlled by Democrats? Consider that when the Democratic-controlled Congress was debating the Affordable Care Act, it couldn't even pass the "public option" – the government-controlled health care plan that was to have been included on the health insurance exchanges – because more conservative members opposed the expansion of government's role as a health care payer. A single-payer plan, like the one Sanders proposes, would include much more government involvement than the public option. The political will to pass his plan into law does not exist.

In addition to the political reality is the policy reality that the country does not need to go through another overhaul of its health care system. The Affordable Care Act is still in its infancy. Although the law passed in 2010, the mandates that are key to its reforms only went into effect within the last two years. It was also severely hampered when the Supreme Court ruled against the mandatory Medicaid expansion in 2012. However, even with all the mistakes the administration committed during the law's implementation and the other setbacks and delays it has faced, it has succeeded in decreasing the numbers of the uninsured. Gaps in coverage remain, but as Clinton suggests, the successes of the law can be built upon to shrink those gaps. There is no need to dismantle what is already working.