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The most important moment in last night's Democratic debate wasn't a word or a phrase. It was the raising of Elizabeth Warren's hand. When moderators asked who on stage would be willing to abolish the health insurance industry and enact Medicare for All her hand shot up, with only Bill de Blasio joining her.
This was not a guaranteed activity. Of the many plans Warren has issued during the campaign, Medicare for All is not one of them, likely because she's been a co-sponsor of Bernie Sanders's bill in the Senate since 2017 (she’s also offered support for a state-level single-payer push in Massachusetts). But progressive critics—mostly Sanders supporters—have lobbed criticism at her for a few town hall moments where she has expressed that there are “many paths” to universal health care. This was not her stance tonight.
When given the chance to elaborate, Warren locked arms with her main rival for votes on the left, Bernie Sanders, though her articulation of why we need Medicare for All was pitched a little differently. “I spent a big chunk of my life studying why families go broke,” Warren said, noting that medical bills were a major factor in bankruptcy cases, whether victims had insurance or not. It's an idea that resonates with anyone who sees an endless parade of GoFundMe pages begging to raise money for prescriptions or a surgical procedure. It resonates with those who know of families choosing between seeing a doctor and paying utility bills.
Warren blamed the business model of the insurance companies, when in truth the medical providers and their high prices are as big a problem in health care, if not bigger. Medicare for All is an overhaul of the insurance system, granted, and so depicting the insurance company villain is relatively appropriate, though the hospital villains will have to be identified and confronted if you ever want to pass the policy.
But Warren's best moment put the entire issue of health coverage for all Americans in context. “There are a lot of politicians who say, oh, it's just not possible, we just can't do it, have a lot of political reasons for this,” Warren said. “What they're really telling you is they just won't fight for it. Well, health care is a basic human right, and I will fight for basic human rights.” This was a mirror of Warren's speech at the California Democratic Party convention, urging voters to judge candidates’ values by how often they caution to slow down, dream small, and wait for Republicans to come around.
You almost didn't need the words, however. The outstretched hand, four-square for Medicare for All, was enough of a signal. It expressed whose side Warren throws her lot in with, not just on this but all policy debates, something she articulated right out of the gate on Wednesday night when she asked “Who is this economy really working for?” This is the lens through which she sees the entire landscape of America, not only economically but socially. It feeds into her assessment of a corrupt political system that has been gamed by elites through wealth and privilege.
In the health care context, Warren expressed solidarity with the people over the powerful. And And as Jeet Heer pointed out, not a single candidate challenged Warren’s frame on how Washington works, despite being given many opportunities, from Amy Klobuchar to Beto O’Rourke to Cory Booker. The logic of Warren’s theory of politics inexorably moves her to Medicare for All, because it’s the side she must align with, against giant corporations acting in their own interest.
Warren also clarified a position where she was not necessarily that forthright in prior moments. She did not offer support for a variety of plans, or say that an incremental approach was warranted. This was a vulnerability for Warren on the left, and her campaign can point to this moment—as they did with an email blast minutes after her answer—to say that everyone should know where the candidate stands.
That will likely endure well beyond anything else in the debate last night, because it will be referred back to over and over. Senator Warren solidified her position on Medicare for All, and healthcare activists will remember.
