Among the many things we’ve learned so far in the presidential campaign is this: The Democratic candidates are talking more honestly about health care than about immigration. To develop a coherent approach to immigration in an era of rising asylum claims, Democrats need to explain—among other things—whom they would and wouldn’t let in. But Donald Trump has made that discussion extraordinarily difficult. In the shadow of his brutal policies and bigoted appeals, Democrats are wary of spelling out whom they would deport. That has led to a debate that’s evasive and vague.
On health care, by contrast, the Democratic presidential candidates are happier to delve into detail and express diverging views. Consider how the discussion about Medicare for All unfolded at last week’s debates. During the first debate, the moderator Lester Holt asked the candidates who “would abolish their private health insurance in favor of a government-run plan” to raise their hands. Elizabeth Warren and Bill de Blasio put theirs up, and that sparked a discussion that exposed the contrasting ways in which the Democratic contenders see private insurance.
Although they support letting more Americans buy into Medicare, the more moderate candidates in the first debate, including Beto O’Rourke, described private insurance as effective for some Americans. That argument continued into the second debate. Bernie Sanders insisted that Americans “don’t like their private-insurance companies” and promised to end the insurers’ “greed.” By contrast, Joe Biden emphasized the value of allowing people to choose between keeping their current private insurance and buying into a “Medicare-like plan.” Pete Buttigieg noted, “Even in countries that have outright socialized medicine, like England”—the countries whose health-care systems Sanders and Warren admire—“there’s still a private sector.” Viewers could fairly conclude that, among the party’s leading candidates, there are fundamental differences of opinion about how to structure the health-care system.