Summary
On October 15, 2019, candidates convened yet again for the fourth 2020 Democratic Presidential primary debate. Twelve candidates met in Westerville, Ohio and discussed a range of issues, including the current impeachment inquiry, the potential addition of a wealth tax, foreign policy, and how to handle the emergence of monopolies in big tech.
On health care specifically, candidates again discussed Medicare For All, the opioid epidemic, and women’s reproductive health. Of note, candidates also touched heavily on gun violence, which is often thought of as a critical public health issue.
Note that candidates needed to have 130,000 unique donors and have secured at least two percent in four polls to participate in the debate. The event was moderated by CNN’s Anderson Cooper and Erin Burnett, as well as the New York Times editor Mark Lacey.
Key remarks pertaining to health care follow:
- Medicare For All/Public Option –Moderators quickly zeroed in on the issue of Medicare For All’s projected costs, asking Massachusetts Senator Elizabeth Warren (background and polling) whether the U.S. could afford such a plan. She replied that costs will go up for the wealthy and corporations, and that they will go down for middle class families. She also stated that Americans should not have to worry about how they will pay for their health care, noting that private insurers often “pull the rug out from under” those who get sick.
Moderators then plainly asked if, under Sen. Warren’s plan, taxes would increase on the middle class, citing that Vermont Senator Bernie Sanders (background and polling) has been upfront in communicating that there would be tax increases. Sen. Warren maintained her statement that overall costs would go down for the middle class, but not explicitly address the question of taxes. South Bend Mayor Peter Buttigieg (background and polling) accused Sen. Warren of “evading the answer to the question” and used this as a reason for backing his universal coverage alternative, “Medicare For All Who Want It.” As a public option-based plan, Mayor Buttigieg stated this plan trusts Americans to make the right health care decisions for them and their families. He maintained that his plan would be affordable for all Americans through the use of subsidies, despite Sen. Warren’s claims that not all would be able to afford a public option plan.
Stepping into the debate, Sen. Sanders clarified that, under Medicare For All, consumers would no longer pay premiums, co-pays, deductibles, and all other out of pocket expenses. While this would lead to tax increases, he said, these tax increases will be less than what Americans pay in health care costs. Minnesota Senator Amy Klobuchar (background and polling) disagreed and invoked President Obama’s legacy, insisting instead to build on “what Obama wanted to do from the beginning and have a public option” instead of “kicking 149 million people off their private insurance in four years.” She also brought up the need to “take on pharma” and increase access to long term care policies. Former Vice President Joe Biden (background and polling) agreed, and also emphasized the need to be transparent with Americans about how much a broader Medicare For All plan would cost them. Specifically, he cited research suggesting that a family making $100,000 a year would see annual tax increases of $10,000, and alleged this would be more than they would save on health care costs.
- Gun Violence – Moderators asked Former Texas Congressman Beto O’Rourke (background and polling) how he would implement and enforce a mandatory buyback program for assault weapons. Rep. O’Rourke replied that it would be the general expectation for Americans to abide by the law and turn in their weapons, and that his administration would “find” those who do not and that their weapons would be “taken from them.” Mayor Buttigieg was quick to then point out that Rep. O’Rourke did not “know how this will take weapons off the street,” and insisted instead that the U.S. should move forward with policies that can work in the near term. He cited specific policy measures such as banning the sale of new assault weapons, universal background checks, and red flag laws. He also highlighted the need to “take the fight to the National Rifle Association and their supporters in Congress.” Rep. O’Rourke insisted that the policy prescriptions Mayor Buttigieg outlined were not mutually exclusive from a buyback program, and maintained his support for such an initiative. California Senator Kamala Harris (background and polling) threw in her support for a mandatory buyback program, citing that there are five million assault weapons on the street today.
Sen. Klobuchar expressed her support for a voluntary buyback program, stating she did not want to support anything that could get in the way of getting something done in the near-term. Sen. Warren expressed similar sentiments. She also highlighted what the federal government did to get machine guns “off the streets” and the importance of having these weapons registered. Former Vice President Biden agreed, and also noted how he is the only candidate who has “taken on and beaten the NRA twice.” He then added that gun manufacturers should be liable for being sued for the prevalence of gun violence.
- Opioid Epidemic – Moderators asked Sen. Klobuchar how she would address the opioid epidemic. She replied that such an epidemic “never should have happened to begin with,” and pointed to drug manufacturers as the cause. She said she would make these opioid manufacturers pay for the treatment of those who are now addicted to and recovering from opioid use. Sen. Harris agreed and added that the executives involved in opioid manufacturing should go to jail, stating that “this is a matter of justice” and that “they knew what they were doing.”
Former Tech Executive Andrew Yang (background and polling) stated that having a small amount of opiates for personal use should be decriminalized, as this would make it more likely for users to seek treatment for addiction. Rep. O’Rourke agreed.
- Women’s Reproductive Health – Moderators asked what Sen. Harris do to stop states who restrict access to abortion. She stated that her Department of Justice would review any state law that bans abortion to see if it is in violation of the Constitution and Roe v. Wade, and, if it is, would not allow that law to go into effect. Sen. Klobuchar added that she would codify Roe v. Wade and make it the law of the land. Sen. Warren agreed.
Several candidates then discussed the merits of adding additional justices to the Supreme Court in the context of abortion rights. Former Vice President Biden stated that, if Roe v. Wade were overturned, he would refrain from adding additional justices to the court to avoid setting such a dangerous precedent. However, Mayor Buttigieg stated he would consider creating a 15-justice court, where five justices could be appointed only at the unanimous consent of the other ten. He stated this would ensure not everyone is appointed to the court on a partisan basis. He also referenced other measures to improve how justices are appointed, including term limits and rotating justices from the appellate courts.
A total of six debates are slated for this year, followed by at least six more in 2020 (tentative schedule).