On Tuesday, February 7th, CNN hosted a Town Hall debate between Senators Ted Cruz (R-TX) and Bernie Sanders (I-VT) over the future of the Affordable Care Act (ACA); otherwise known as Obamacare. It basically boiled down to capitalism vs. socialism and the right for the people to have more choices vs. the government making those choices. As one would expect, given the participants. These men hold completely different views on how we should approach the healthcare situation in the United States.
First of all, Ted Cruz and Bernie Sanders both agreed that the ACA is not perfect. However, the approach each of these gentlemen proposed are polar opposites of one another. Cruz points out that the urgency of healthcare reform is understood by people on both sides of the isle. He advocates to repeal “every word” and replace it with something within the next year. Sanders advocates that the ACA is a step in the right direction, but it needs to go further.
In his opening statement, Sanders argues that the United States should guarantee healthcare as a human right, not a privilege. This is the same rhetoric he used on the campaign trail during the primary elections in 2016. One of the policies he’s most known for advocating for over the years, a single payer system, was the most consistent theme given its relation to the ACA. As stated on his campaign website:
“The only long term solution to America’s healthcare crisis is a single payer national healthcare program.”
Cruz, on the other hand, argues against the fact that “Bernie and the Democrats want government to control healthcare.” One fundamental issue his argument relies upon is his position against Barack Obama’s many broken promises. Including the fact that the now former president said “If you like your plan, you can keep your plan” on thirty-seven different occasions. House Speaker, Paul Ryan, rightly pointed out last year that the non-partisan Congressional Budget Office (CBO) predicted in 2009 that millions of people would lose their plans. They were correct. In the debate with Sanders, Cruz stated the following:
“As 6 million people in this country discovered, that [the claim of not losing their plans] was not true. When they had their plans cancelled against their wishes. ‘If you like your doctor, you can keep your doctor.’ Again, millions discovered that that wasn’t true.”
In fact, it was so untrue that it won Politifact’s ‘lie of the year’ award for 2013, because the promise was “impossible to keep” from the get go. While the Democrats want to go a step further to a single payer system, House Republicans have introduced a plan entitled ‘A Better Way’ to tackle this issue. Contrary to what many people may assume, it “protects medicare for today’s seniors and preserves the program for future generations,” would clear out some bureaucracy in order to “accelerate the development of life-saving devices and therapies,” and would allow for more options such as the ability to purchase insurance across state lines.
One area where Sanders was correct is in pointing out the outrageously high costs of healthcare, with relatively poor outcomes. The data from the 2014 edition of the Commonwealth Fund’s Mirror, Mirror on the Wall shows that the U.S. ranks last out of 11 major countries in areas of quality, access, efficiency, equity, and overall healthy lives of the citizens. However, the data also shows that Cruz was correct in highlighting that the health outcomes in some of the countries that Sanders often praises (such as the U.K. and Canada) are overall severely lagging and they have rather lengthy wait times for care.
Regarding efficiency, the Commonwealth Fund highlights the following:
“The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of administrative hassles, avoidable emergency room use, and duplicative medical testing. Sicker survey respondents in the U.K. and France are less likely to visit the emergency room for a condition that could have been treated by a regular doctor, had one been available.”
There are no easy answers in dealing with complex issues like healthcare for a nation of such a large and diverse population such as the U.S. Which is why debates such as these are crucial. Regardless of which approach you would prefer, both Ted Cruz and Bernie Sanders make valid points for their positions. At least we finally got to see a debate where they largely stuck to substance there were few, if any, ad hominem attacks thrown by either participant.