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Healthcare in Democratic debate: Clinton defends Obamacare, Sanders pitches single-payer

Sanders said his plan is to get private insurance out of healthcare, which would lower the cost for middle class families by $5,000 a year.

Susan Morse, Executive Editor

Screenshot via YouTube.

In a contentious debate in Charleston, South Carolina Sunday night, the three challengers for the Democratic nomination tried to distinguish their views on healthcare and the effects and future of the Affordable Care Act.

While Vermont Senator Bernie Sanders -- who is nearly even in the polls with Hillary Clinton in Iowa and New Hampshire -- pushed his plan for "Medicare for all" and a universal health system, he said he would not dismantle Obamacare, which he helped to create and for which he voted.

"I'm not going to tear it up, I helped write it," Sanders said. "We are going to move on top of that."

Clinton also defended the ACA, saying, "We've seen 19 million Americans get insurance."

Clinton said she is also "absolutely committed to universal health care" and respects Sanders' intentions, but said similar legislative proposals made in the past could not get an affirmative vote even through a Democratic-controlled Congress.

"The Democratic party in the United States worked since Harry Truman to get Affordable Care Act passed," Clinton said. "We finally have a path to universal healthcare. We've accomplished so much already I do not want to see the Republicans repeal it and I don't want to see us start over again with a contentious debate. I want us to defend and build on the ACA and improve it."

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Former Baltimore Mayor and Maryland Governor Martin O'Malley said healthcare is becoming more affordable as the model moves away from fee for service to one based on how well health systems keep patients out of the hospital.

"That's the future," said O'Malley, who often had trouble getting his voice heard in arguments that went back and forth between front-runners Clinton and Sanders.

Clinton responded to O'Malley's value-based comment.

"That's exactly what we're able to do based on the foundation of the Affordable Care Act, what Governor O'Malley said," Clinton said. "The Republicans just voted last week to repeal the Affordable Care Act and thank goodness President Obama vetoed it and saved Obamacare for the American people."

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Polls show Sanders and Clinton running even in Iowa and Sanders pulling ahead of Clinton in New Hampshire. The Iowa Caucus is February 1 and the New Hampshire Primary is February 9.

Sanders put the blame of the high cost of healthcare and drugs on the pharmaceutical industry, the health insurance companies, and the Super Pacs and campaign contributions that he indicated fuel both.

"It's because we have a campaign finance system that's corrupt, Super Pacs, pharmaceutical industry pouring hundreds of millions into campaign contributions into lobbying, and private insurance companies as well. … The debate should be about whether we have the guts to stand up to health insurance industry, pharmaceutical companies."

Clinton responded, "I have stood up."

Sanders said his plan is to get private insurance out of healthcare, which would lower the cost for middle class families by $5,000 a year.

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"Right now what we have to deal with is 29 million people who still have no health insurance," Sanders said. "We are paying the highest prices in the world for prescription drugs, getting ripped off.

Sanders and Clinton put healthcare in their top priorities in their first 100 days in office.

"I would also be presenting my plans to build on the Affordable Care Act, decreasing out of pocket costs, putting a cap on prescription drugs, a way to put prescription drug business and the health insurance company business on a more stable platform that doesn't take too much money out of the pockets of hardworking Americans," Clinton said.

Twitter: @SusanJMorse