Former Secretary of State Hillary Rodham Clinton and Sen. Bernie Sanders of Vermont clashed Thursday night over the future of federal health care policy and the federal tax code, taking starkly different positions that may eventually prove pivotal in the selection of the 2016 Democratic presidential nominee.
Sanders, the “revolutionary” socialist insisted his multi-trillion-dollar national health care plan funded by major tax hikes was both feasible and necessary, while the more pragmatic Clinton dismissed it as “wishful thinking” and vowed to build on the existing Affordable Care Act.
Related: Sanders’ Single-Payer Plan Would Add Up to $14 Trillion to the Debt
In one heated exchange, Clinton accused Sanders of trying to plunge the nation and Congress back into another prolonged and likely futile battle over health care coverage that would jeopardize the future of Obamacare and the millions of Americans currently enrolled in the program. “I don’t want to rip away the security that people finally have,” she said.
Sanders strongly denied that he would stand by and allow Obamacare to be dismantled by the Republicans while seeking support for his far more ambitious plan for a national health program to replace current government programs and private insurance coverage.
“Every major country on earth, whether it’s the [United Kingdom] whether it’s France, whether it’s Canada, has managed to provide health care to all people as a right, and they are spending significantly less per capita on health care than we are, he said. “So I do not accept the belief that the United States of America can’t do that.”
Sanders did not acknowledge that health care in Britain is rationed as it is in other developed countries, and that not everyone is eligible for the services that Medicare provides in the U.S.
While the two remaining opponents in the Democratic presidential campaign agreed that the ultimate goal was to extend health care insurance to the 29 million Americans currently uninsured by Obamacare, their approaches are radically different and go to the essential difference between the two veteran politicians’ strategies:
Clinton believes Sanders’ health care and tax proposals are utopian and will never pass in a Congress likely to be controlled by the Republicans for years to come. Sanders insists voters are hungry for visionary ideas that will shatter traditional thinking by the political establishment.
Sanders, 74, who is from neighboring Vermont, is leading Clinton in the latest NBC News/Marist poll by 20 points and is favored to win next Tuesday’s New Hampshire Democratic primary. Clinton, 68, beat Sanders by a fraction of a percentage point in Monday’s Iowa caucuses. Now she is trying to make a strong second-place finish in New Hampshire, a state she carried in her unsuccessful bid for the 2008 Democratic nomination.
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Health care reform takes a back seat to concerns about the heroin epidemic in New Hampshire, but it has far more saliency among voters nationally. The high cost of health care and insurance ranks third in the concern of voters across the country, just behind terrorism and the economy, according to a recent survey by the Kaiser Family Foundation.
Sanders favors replacing current federal health care programs, including Obamacare, with a government funded “Medicare for all” program that would include the 29 million Americans currently uncovered by Obamacare, who include illegal immigrants. The plan would echo national health care programs in Canada, Europe and Scandinavia.
Sanders says his plan would provide full medical and prescription drug coverage and reduce the annual cost to consumers by eliminating the need to purchase private health insurance policies with ever-mounting premiums and co-payments. The new program would also crack down on the pharmaceutical industry and bring down soaring drug costs.
Related: Democratic hopefuls Sanders and Clinton spar over 'progressive' credentials
He claims his “single-payer” program would cost the government an additional $1.4 trillion a year – or $14 trillion over the coming decade. He would offset the cost by raising revenues from a combination of taxes on average workers, employers, investors, estates and the wealthiest earners.
While that would mean higher taxes on middle-income and even some lower income Americans, Sanders argues that the net effect of those taxes on many would be negligible, because they no longer would have to pay premiums and copayments on private health insurance under Obamacare.
“If you are paying $10,000 a year to a private health insurance company, and I say to you, hypothetically, that you are going to pay $5,000 more a year in taxes…but you’re not going to pay any more private health insurance, are you going to be complaining about the fact that I’ve saved you $5,000 in your total bills?” he said recently.
Clinton dismisses Sanders’ proposal as unworkable, and vows to work to preserve and expand Obamacare if she is elected president. “I’m not making promises I can’t keep,” she said repeatedly.
Moreover, she questions key elements of Sanders’ proposals and insists, “The numbers just don’t add up from what Sen. Sanders has been proposing. That’s why all the independent experts, all the editorial boards that have better both of us have concluded that it is just not achievable,” she said of Sanders’ health care initiatives.
Related: How Hillary Clinton and Bernie Sanders Both Won the Iowa Caucuses
“There is no disagreement between us on universal coverage for health care,” Clinton said. “The disagreement is where do we start from and where do we end up?”
