Tuesday’s Democratic presidential gabfest wasn’t so much a debate as it was an ever-so-mild mugging, with top-tier lefties Bernie Sanders and Elizabeth Warren the targets of a group attack.
Having cornered them in the narrow alley of public-policy reality, the more moderate liberals and liberal moderates went after the duo with all the weapons at their disposal: spaghetti balloons, foam-rubber swords, feather pillows, cat-toy lasers, and the like.
It would be nice to report that Senators Sanders and Warren gave as good as they got. But that wouldn’t be true. Sanders’ primary mode of rebuttal seemed to be to shake his head dismissively at the incoming arguments, and to yell ever more loudly, perhaps in the hope of driving those with acute hearing from the stage. Or even from Detroit’s storied Fox Theatre itself.
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Let’s stick with health care, since it’s such a pivotal issue.
Sanders’ defense of single-payer comes not from a true mastery of the policy details but rather from a deep conviction that it can be done here because it has been done in other places. He’s convinced he’s right because he believes it so fervently.
Warren let Sanders take the lead in defending single-payer. Result: She didn’t seem quite as zealous as he, but neither, under fire, did she live up to her reputation for substance. Seemingly surprised to find herself on the defensive, she returned time and again to the notion that insurance companies had sucked billions from the system.
That’s her way of making the insurance industry’s profit of about 3.3 percent seem like greed of the highest order. For Warren, such a profit is apparently one of the big factors justifying an end-it-rather-than-mend-it approach to the Affordable Care Act. For many others, disrupting the private health care arrangements for some 165 million people seems like an abridgement too far.
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Many were the crafted-for-the-recap-reel moments. But former Representative John Delaney of Maryland dug deeper, showing a real knowledge of health care policy. He noted that one big flaw with Sanders’ proposal is that its payment rates would be based on current Medicare, and that those rates didn’t reflect the real cost of health care. Currently, the difference tends to be made up for by private health insurance payments. But if Medicare governs all payments, financially shaky hospitals will face real problems. That’s a problem the single-payer supporters largely ignore, except to say that hospitals will save by having less paperwork.
The other candidates highlighted the political perils attached to single-payer. With the debate taking place in Detroit, the symbolic capital of the unionized auto industry, Representative Tim Ryan of Ohio pointed out that the Sanders-Warren approach would mean the end of the generous health insurance that unions had won at the bargaining table.
Montana Governor Steve Bullock reminded viewers of what a long, tough struggle it had taken to pass Obamacare, saying the better way forward was to build on that success with a public option. Former Colorado Governor John Hickenlooper noted that the way the Democrats had retaken the House was by flipping purple seats with moderate candidates, and asserted that “not one of those 40 Democrats supported the policies of our front-runners at center stage.” That is, Sanders and Warren.
Minnesota Senator Amy Klobuchar asserted that she too had bold plans, but hers were grounded in reality, and reminded everyone that adding a public option to the Affordable Care Act was the approach President Obama had preferred.
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Even Marianne Williamson, author and spiritual-awakening activist, chipped in to say that though she was usually with Sanders and Warren, she too worried that running on a health care proposal that would strip away private insurance would make it harder for Democrats to win. Suffice it to say when Williamson thinks you are out in left field, you are probably some miles removed from the ballpark of reality.
Warren fought back by accusing critics of echoing Republican talking points and expressing her surprise that so many on the stage were talking about what can’t be done.
That substance-free rallying cry may warm the hearts of the lefties, but little she said will allay the concerns of pragmatists.
This debate mirrors one that has run through the Democratic Party for almost a half-century: Do you win by going further left or by tempering your ideas with realism?
The harder lefties say if only Hillary Clinton had been bolder she would have prevailed in the 2016 race. But the moderates note, absent hypotheticals, that the harder-left prescription didn’t work with George McGovern or Walter Mondale, while a center-left approach propelled Bill Clinton and Barack Obama into office.
As Tuesday’s debate demonstrated, that schism will be even more pronounced this time around.
As for the best performers, Bullock, relatively new to the race, will create some buzz with his forceful, confident showing. South Bend, Ind., Mayor Pete Buttigieg turned in another thoughtful performance. Delaney showed himself a smart, knowledgable moderate. Klobuchar made a decent case for her Midwestern electability.
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But the real takeaway here was the deep divide between the moderates and the lefties. The way it played out should give thoughtful Democrats serious pause about the harder lefties’ Medicare for All project.
Scot Lehigh can be reached at lehigh@globe.com. Follow him on Twitter @GlobeScotLehigh.