The Democratic presidential debate in Detroit got off to a heated start Tuesday night during discussion of Medicare-for-All.

Sens. Bernie Sanders and Elizabeth Warren – the only two 2020 candidates on stage to support moving the United States to a single-payer health care system – fired back after criticism from the eight other candidates, who argued the proposal was too costly and impractical. And in one exchange, the Vermont senator, who authored and introduced the current Medicare-for-All bill in the Senate, took particular exception at one of his rival’s assertions.

CNN anchor and debate moderator Jake Tapper asked the Vermont senator if he could guarantee local union workers that their benefits under Medicare-for-All would be as good as the ones “their union reps fought hard to negotiate.” Sanders said they would be “better,” because his “comprehensive” bill would include coverage of a wide array of care, including dental and vision.


“You don’t know that, Bernie,” interjected Ohio Rep. Tim Ryan.

“I do know it, and I wrote the damn bill,” Sanders shot back, earning applause from the audience.

“You don’t know that,” Rep. Tim Ryan tells Sen. Bernie Sanders when Sanders says “Medicare For All” will provide union members with better health coverage. Sanders responds: “I do know that — I wrote the damn bill.” https://t.co/tUX8uy6ob0 #DemDebate pic.twitter.com/xQtS7bzIUf — CNN Newsroom (@CNNnewsroom) July 31, 2019

Sanders said that many union members, who currently pay high deductibles and premiums, could earn better wages if the government paid for health care. In his response, Ryan argued Sanders couldn’t possibly know the details of every existing private health insurance plan in order to substantiate the claim that his Medicare-for-All bill would provide “better” coverage.

In addition to primary care and hospital visits, the Medicare-f0r-All plan proposed by Sanders would include coverage for maternity care, prescription drugs, dental care, hearing aids, and eyeglasses — which is “significantly” more generous that the single-payer systems run by the United States’ international peers, according to Vox.

Ryan was hardly the only Democratic candidate skeptical of Medicare-for-All during the debate Tuesday night.

Former Maryland Rep. John Delaney, former Colorado Gov. John Hickenlooper, and Montana Gov. Steve Bullock said that transitioning everyone in the country to a government-funded plan was a bad idea that could throw the election back to President Trump. Sanders responded, simply, that they were “wrong,” pointing to less expensive single-payer systems in countries like Canada.

“You’re wrong”: Sen. Bernie Sanders defends himself against John Delaney’s criticism of “Medicare For All.” https://t.co/tUX8uy6ob0 pic.twitter.com/xSoiGMZmJo — CNN Newsroom (@CNNnewsroom) July 31, 2019


In the first exchange of the debate, Delaney argued that his proposal to create a public health insurance option was superior to Sanders’ option, because it wouldn’t force individuals to give up their private plans.

“We don’t have to go around and be the party of subtraction, and telling half the country, who has private health insurance, that their health insurance is illegal,” he said.

Warren, who seemed eager to interject on the subject, lent her support to Sanders when it was her turn to speak. In the previous debate, the Massachusetts senator was one of two candidates to say they would “abolish” private health insurance in favor of a government-run plan. But she admonished her fellow candidates for suggesting that Democrats were proposing to take away health care.

“We are the Democrats,” Warren said. “We are not about trying to take away health care from anyone. That’s what the Republicans are trying to do. And we should stop using Republican talking points in order to talk with each other about how to best provide that health care.”