Hillary Clinton in an interview questioned the single-payer healthcare system that Sen. Bernie Sanders (I., Vt.) and a growing group of Democratic leaders support.
Speaking to Vox’s Ezra Klein, Clinton said she faced the challenges of healthcare policy in the 1990s, and pointed out ways that single-payer could backfire on Sanders and other progressives. She criticized her former rival in the 2016 Democratic presidential primary for proposing single-payer bills in the past without even knowing how much such programs would cost.
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"As you might remember during the campaign, he introduced a single-payer bill every year he was in Congress," Clinton said about Sanders. "And when somebody finally read it, he couldn’t explain it and couldn’t really tell people how much it was going to cost."
Klein pointed out that many senators, including a number of potential 2020 presidential candidates, have signed onto Sanders’ plan. That group includes Sens. Kamala Harris (Calif.), Elizabeth Warren (Mass.), Cory Booker (N.J.), and Kirsten Gillibrand (N.Y.). Clinton said that balancing the different goals of healthcare policy has stymied progressive reforms, such as hers during her husband’s presidential administration.
"I’ve been down this road, this is not the first time we have tried to confront this," she said. "When I was working on healthcare back in ’93 and ‘94, if we could have waved the magic wand and started all over, I’ve said it numerous times, maybe we would have started with something resembling single-payer plus other payers, like some other countries that have universal coverage and are much better at controlling costs than we do, primarily in Europe."
Clinton said that reforming healthcare will have to grapple with people’s fears of government intervention as well as their comfort with the current system.
"We were facing the reality — talk about reality — of not just strong powerful forces, but people’s own fears as well as their appreciation for what they already had," she said.
Clinton said that she is for universal coverage, but has not studied Sanders’ proposal enough to be able to say whether she thinks it would work.
"I haven’t seen whatever it is they’re going to be introducing and signing onto, so I don’t know," she said. "I am for universal healthcare coverage that is high quality and affordable for every American. And I think there's a lot of ways of getting there that I’ve advocated for, to open up Medicare, to open up Medicaid, to you know, do more on prescription drug costs."
She pointed to Sanders’ own state as a place where single-payer proved too difficult to enact because it would upend the insurance market.
"Look at what happened in Vermont: it wasn’t for lack of trying in Vermont," Clinton said. "The Democratic political establishment was behind single-payer, and they worked for years to achieve it."
"It just was so difficult to put the pieces together," she said.
Sanders himself has also said it was difficult, his explanation for deep-blue states like his own not passing single-payer healthcare plans. He also maintained that getting the deal through over political difficulties would ultimately save money.
Sanders’ campaign healthcare plan would have cost $15.3 trillion over ten years, and would have entailed raising the taxes of all Americans, according to the Tax Policy Center.
This is far from the first time Clinton has criticized Sanders. He is one of the targets of her book What Happened that was released Tuesday. In the book, Clinton wrote Sanders' attacks on her political and financial connections paved the way for President Donald Trump's tactics against her.