The sharply contrasting plans the Democratic presidential candidates have proposed for repairing the nation’s healthcare system created a clash on the debate stage Thursday, as they argued the merits of vastly expanding government health care.

After Vermont Sen. Bernie Sanders laid out his case for transitioning to government-run healthcare under a “Medicare for all” system in which existing private insurance would be eliminated, former Vice President Joe Biden attacked Sanders’ blueprint as unrealistic and unworkable.

“I don’t think it is realistic,” Biden said. He warned that ending private insurance could upend the lives of millions of Americans who have negotiated their healthcare costs with their employers, and he advocated instead for a “public option” that would allow those who want to buy into a Medicare-like system to do so.


“You shouldn’t have Washington dictating to you that you can not keep the plan you have,” Biden said.

Sanders was eager to retort.

“Under Joe’s plan we retain the status quo,” Sanders said.

“That’s not true,” Biden said.


“It is true,” Sanders said. He argued that the average family with an income of $60,000 is currently paying 20% of it — $12,000 a year — on healthcare costs. He vowed that under his Medicare-for-all plan, their healthcare costs would be almost entirely erased while their taxes would go up only $1,200. He promised to dismantle a “byzantine and complex” healthcare system that is designed to generate billions of dollars in profits for medical corporations at the expense of consumers.

Biden challenged the Vermont senator’s math.

“I am going to interrupt now,” he said. “It costs $30 trillion. Lets get that straight: $30 trillion over 10 years. The idea that you are going to save that person making $60,000 per year on Medicare for all is absolutely preposterous.”


Sanders did not back down, arguing that the end of a profit-driven medical care system would lead to the savings he promises.

Massachusetts Sen. Elizabeth Warren pitched her own plan to move Americans to a Medicare-for-all system, which includes transitional steps under which she vowed millions would be covered but private insurance would not immediately be eliminated.

An opponent of Medicare for all, Minnesota Sen. Amy Klobuchar, pointed out that the vitriol with which the Democratic candidates are attacking each other on healthcare could ultimately harm efforts to get more Americans covered. She noted that there is limited appetite in Congress, including among Democrats, for the plan Sanders champions.

“This fight you guys are having is not real. Your fight, Bernie, is not with me or Vice President Biden,” Klobuchar said, noting the resistance Sanders would face in his own party on Medicare for all should he be elected president. She argued that a consensus approach to expanding health coverage would help a lot more Americans. “If you want to cross a river over troubled water, you build a bridge, you don’t blow one up,” Klobuchar said.