Sanders, Warren, moderates clash over 'Medicare for All'

DETROIT -- Liberal firebrands Bernie Sanders and Elizabeth Warren slapped back against moderate rivals who ridiculed "Medicare for All" during a fierce Democratic presidential debate Tuesday night in which lesser-known pragmatists warned "wish-list economics" would jeopardize the presidency.

The tug-of-war over the future of the party early in the 2020 season pits voters' hearts against their heads as they balance their desperate desire to find an electable candidate to take on President Donald Trump with their strong preference for dramatic change. Over and over, Sanders and Warren insisted their plans to transform the nation's economy and health care system make up the core of a winning message.

"I don't understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can't do and shouldn't fight for," said Warren, a Massachusetts senator, decrying Democratic "spinelessness."

Standing at Warren's side at center stage, Sanders, a Vermont senator, agreed: "I get a little bit tired of Democrats afraid of big ideas."

The fight with the political left was the dominant subplot on the first night of the second round of Democratic debates.

Twenty candidates are spread evenly over two nights Tuesday and today. The second night features early front-runner Joe Biden, the former vice president, as well as Kamala Harris, a California senator.

While much of the debate was dominated by attacks on the preferred liberal health care policy, the issue of race emerged in the second hour. The candidates were unified in turning their anger toward Trump for using race as a central theme in his re-election campaign. Sanders said Trump exploited racism, and others said the president's rhetoric revived memories of the worst in the country's history, including slavery.

"The legacy of slavery and segregation and Jim Crow and suppression is alive and well in every aspect of the economy and the country today," said former Texas Rep. Beto O'Rourke, adding he supported the creation of a panel to examine reparations for the descendants of slaves.

Tuesday's debate was notable for its friction and substance. And in many respects, it is only beginning. The Democratic nomination won't be secured until the party's national convention next July in Wisconsin.

Despite the long road ahead, there is an increasing sense of urgency for many candidates who are fighting for survival.

More than a dozen could be blocked from the next round of debates altogether -- and effectively pushed out of the race -- if they fail to reach new polling and fundraising thresholds implemented by the Democratic National Committee.

Minnesota Sen. Amy Klobuchar, who is working to keep her campaign alive, aligned herself with the struggling pragmatic wing Tuesday night: "We are more worried about winning an argument than winning an election."

Montana Gov. Steve Bullock, in his first debate appearance, took a swipe at Sanders: Working people "can't wait for a revolution," he charged. "Their problems are here and now."

While he avoided any direct confrontations with his more liberal rivals, Pete Buttigieg tried several times to present himself as the more sober alternative in the race. Substantive and composed, he rejected extreme positions, quoted scripture and abstained from calling out his opponents.

The 37-year-old mayor of South Bend, Indiana, also subtly emphasized the generational difference between himself and Sanders and Warren, two candidates in their 70s.

Perhaps no issue illustrates the evolving divide within the Democratic Party more than health care.

Sanders' plan to create a free universal health care system, known as Medicare for All, has become a litmus test for liberal candidates, who have embraced the plan to transform the current health care system despite the political and practical risks. Medicare for All would abandon the private insurance market completely in favor of a taxpayer-funded system covering all Americans.

In targeting Medicare for All, the more moderate candidates consistently sought to undermine the signature domestic policy proposal of the top two progressives on the stage. They variously derided Medicare for All as too costly, ineffective and a near-certain way to give Republicans the evidence they need Democrats support socialism.

"They're running on telling half the country that their health care is illegal," former Maryland Rep. John Delaney said.

"We have a choice: We can go down the road that Sen. Sanders and Sen. Warren want to take us, which is with bad policies like Medicare for All, free everything and impossible promises," he continued. "It will turn off independent voters and get Trump re-elected."

A new set of candidates, none with more to lose than Biden, will face off today.

There, Biden will fight to prove that his underwhelming performance during last month's opening debate was little more than an aberration.

It won't be easy.

The 76-year-old Democrat is expected to face new and dangerous questions regarding his past policies and statements about women and minorities.