Democratic presidential candidate Pete Buttigieg doubled down on his calls for a more pragmatic approach to health care policy in an interview with the Review-Journal.

Pete Buttigieg talks health care and how he fares as a candidate in 2020 (Angus Kelly and Reed Redmond/Las Vegas Review-Journal)

South Bend, Indiana Mayor Pete Buttigieg was campaigning for the 2020 presidential election in Las Vegas on Tuesday, Oct. 22, 2019. (Ellen Schmidt/Las Vegas Review-Journal)

Pete Buttigieg, mayor of South Bend, Indiana, and 2020 presidential candidate, takes questions from the crowd at a campaign rally on Tuesday, Oct. 22, 2019, in Las Vegas. (Ellen Schmidt/Las Vegas Review-Journal)

Presidential candidate Pete Buttigieg speaks with the Las Vegas Review-Journal at his campaign headquarters in Las Vegas on Tuesday, Oct. 22, 2019 before a rally at the East Las Vegas Community Center. (Ellen Schmidt/Las Vegas Review-Journal)

One week after criticizing fellow presidential candidates’ plans for health care reform, Pete Buttigieg doubled down on his calls for a more pragmatic approach to policy among the Democratic field during a campaign visit to Las Vegas.

“Being bold doesn’t have to be divisive,” Buttigieg said in an interview with the Review-Journal just before his rally in east Las Vegas. “There is a new American majority on issues from gun law to immigration. Where Democrats used to be on defense, now most Americans agree with us on the big questions.”

Buttigieg stressed that the next president will have to fill two key roles: bringing a divided nation together after a rough four years, and implementing real-world solutions to the many problems that existed long before President Donald Trump.

He believes trying to force a single-payer, “Medicare for All” system championed by those directly above him in the polls — Sens. Elizabeth Warren and Bernie Sanders — would not accomplish either. Before the debate last week in Ohio, he released a one-minute ad contending Medicare for All would deprive Americans of their right to choose between a health plan they may have worked hard for and government-sponsored health care.

The South Bend, Indiana, mayor has been especially critical of Warren, who he said has refused to explain to the American public how she would pay for a health policy that probably would cost trillions of dollars. Buttigieg, a self-identified millennial at 37, said his generation would be caught paying the bill on such a plan.

“What most Americans aren’t so sure about is the idea of being kicked off their private plan in four years or less,” Buttigieg said Tuesday. “I just think it’s a mistake. Never mind the politics of it. I just don’t think it’s the right policy. I think a better policy is to make sure everybody gets coverage in a way that honors individuals’ chance to have the freedom of choice.”

Buttigieg said his plan would strengthen Medicare and offer it as a low-cost option to Americans and undocumented immigrants. Those in need of government aid would get it, and anyone paying more than 8.5 percent of their income could qualify for subsidies.

He would pay for this by rolling back Republican changes to the tax code, which would revert taxes on the wealthy and corporations to a higher rate, Buttigieg said.

The remaining $100 billion needed would come from negotiating better prices with prescription drug companies and other crackdowns on the pharmaceutical industry, he said.

Buttigieg mentioned Nevada’s large and powerful Culinary union in reference to his health care plans, saying its members negotiated hard for the plans they have and may not be willing to give them up. He and former Vice President Joe Biden, who appear to be the field’s leading centrists, have pushed this rhetoric hard in recent campaign stops as organized labor has shown some apprehension over Medicare for All.

But critics say that Buttigieg, as recently as earlier this year, has expressed support for Medicare for All.

In a statement sent Tuesday, the Trump campaign accused him of “jumping from one hot-button issue to the next in an attempt to stay relevant.”

Supporters of Sanders and Warren have questioned his progressive credentials because of his stance on health care and willingness to accept corporate donations. Buttigieg pushed back, saying his policy proposals would make him “the most progressive president in our lifetime.”

In response to Buttigieg’s criticism of Medicare for All, Sanders’ Nevada campaign noted the Silver State has a high uninsured rate.

“Rather than fighting to preserve a system that leaves millions uninsured and causes hundreds of thousands of Americans to go bankrupt, we need a president who has the guts to stand up to the health insurance and pharmaceutical industry by implementing universal health care under Medicare for All,” Sanders’ senior state adviser Peter Koltak said.

Speaking on the criticism, Buttigieg said: “When you start to do better, some of your competitors start to get a little more negative. But that’s just politics.”

Buttigieg acknowledged his prior support for Medicare for All but said that anyone who makes such a grand promise has a responsibility to show the American people how they plan to get there. His system, he added, would allow for a much smoother transition into such a system if the American people want it.

“I still think the public alternative we create will be the best one, which means people will gradually choose it until it’s the only game in town,” Buttigieg said. “But if for some reason, at least for some Americans, it’s better to stay with a different plan, then we’re going to be really glad we didn’t force everybody over.”

Buttigieg said the Democratic field has “a golden opportunity” to make real change on health care, climate change, gun control and immigration if it remains focused on real solutions and not lofty goals.

“I get frustrated sometimes when the talk accelerates without much of a sense of how it’s going to happen,” Buttigieg said.

Buttigieg said his approach has helped win over some Republicans and conservatives who are “disgusted in their own party.” He said he welcomes them and knows such moderate support would be instrumental in defeating Trump should he make it to the November general election.

“I am not going to pretend to be more conservative than I am, but I am going to offer a plan for America that’s rooted in values that we all ought to be able to share and make sure it’s clear how the policies I am putting forward are going to make Americans’ lives better,” Buttigieg said. “I think that’s a winning message in the primary, (and) I think that’s a winning message against Donald Trump in the general.”

Contact Rory Appleton at RAppleton@reviewjournal.com or 702-383-0276. Follow @RoryDoesPhonics on Twitter.