Twelve Democratic presidential hopefuls met on stage in Ohio to debate the intricacies of Medicare for All and denounce pharma executives’ role in the opioid crisis. Frontrunners Sen. Elizabeth Warren and Sen. Bernie Sanders went on the offensive as other candidates, like former Vice President Joe Biden and Mayor Pete Buttigieg, nitpicked their endorsement of Medicare for All.

The two factions of Democratic candidates – roughly divided into those who want single-payer Medicare For All and those who want an opt-in public option – debated about taxes, private insurance and minimizing healthcare and insurance. Buttigieg, who has released a “Medicare for all who want it” plan, tried to get his rivals to admit that taxes will go up under any Medicare For All scheme.

Warren was cagey about admitting that taxes would go up, only saying that taxes will rise on the wealthy and corporations. Sanders, as he is wont to do, addressed the issue head-on.

“In the Medicare For All bill I wrote, all out-of-pocket expenses are gone,” Sanders said. “The overwhelming majority of people will save money on healthcare bills. It is appropriate to acknowledge that taxes will go up. They will go up significant for the wealthy, but for virtually everybody, the tax increase they pay will be substantially less than what they pay for [insurance] premiums and out-of-pocket expenses.”

Biden went even further than Buttigeig, throwing out specific tax-increase figures for certain annual income ranges. Biden also supports an opt-in public Medicare option through the Affordable Care Act.

“It’s awfully important to be straightforward with [the public],” Biden said. “The plan is going to cost $30 trillion over 10 years, that’s more on a yearly basis than the entire federal budget. We have to talk about how we’re going to pay for it. For people making between $50,000 and $75,000 their taxes will go up about $5,000. For those making $100,000 per year their taxes will go up about $10,000 per year. That’s more than they will save on their healthcare plan.”

Amid the debate, Warren emphasized her support for Medicare For All, calling the opt-in proposals, “Medicare for all who can afford it.” She also shined a light on some insurance practices. “[Patients] all have great health insurance right that the beginning, but when they really needed it, that’s when the cost went up and the insurance company pulled the rug out from under them.” 

Opioid accountability

Tuesday’s debate was held in Westerville, Ohio, the state where a federal judge is presiding over thousands of opioid-related lawsuits. To that end, the candidates took shots at pharma companies over their culpability for the opioid epidemic.

Sen. Kamala Harris, former Housing and Urban Development secretary Julián Castro, former congressman Beto O’Rourke and Sanders agreed that pharma executives should be held accountable for the opioid crisis.

Harris made the strongest point on the issue, characterizing pharma executives as “nothing more than high level dope dealers.” She referenced her work as California’s attorney general, noting that she has “seen what [pharma companies] do. They were marketing, false advertising, opioids. They knew what they were pushing in states like Ohio. I would go after pharma companies for what they’ve been doing.”