By: Brady Bizarro, Esq. The fourth Democratic debate featured the largest crowd of candidates yet (twelve) debating everything from healthcare to billionaires to automation. On healthcare in particular, though, this debate sharpened distinctions between the Democratic candidates. The moderate candidates wasted no time in launching their most aggressive and detailed attacks on Medicare for All, the signature policy of the progressive wing of the Democratic Party. Senators Elizabeth Warren (D-MA) and Bernie Sanders (D-VT), the staunchest defenders of Medicare for All, found themselves repeatedly on the defensive, defending the proposal’s multi-trillion dollar price tag and its eventual abolition of the employer-sponsored health insurance. Clearly, for some lower-tier candidates, they felt this moment could be their last, best attempt to make their case to the American public that their healthcare plan was better than mandatory single-payer coverage. In what some progressives have labelled a “Republican talking point,” Senator Amy Klobuchar (D-MN) remarked that Warren’s plan was a “pipe dream.” Mayor Pete Buttigieg, among others, repeatedly tried to cajole Warren into admitting that in order to pay for Medicare for All, she would raise taxes on the middle class. For her part, and unlike Sanders, Warren has adopted the political strategy of dodging this question. Fearful of a soundbite in which she would admit that taxes would go up, she has instead decided to focus on her claim that overall costs would go down for the public. These two rebukes from the party’s moderate wing: over tax increases and the elimination of private insurance, represent the gravest political threats to Medicare for All. Taken together, they explain why Medicare for All, in its current form, is extraordinarily unlikely to become law. The proposal is simply too radical a solution for the electorate. There are approximately 159 million Americans who receive their health insurance through their employer. Many of those individuals like their coverage and would oppose efforts to forcibly move them onto new Medicare for All plans. We in the self-funded space understand that our healthcare system is in dire need of repair. From exploding drug costs to surprise bills to ever-increasing premiums and deductibles, many working people and employers are fed up. Senator Warren rightly pointed out that many individuals who face severe economic hardship, sometimes including bankruptcy, over their healthcare expenses have health insurance. It’s just that in many cases they cannot afford to use it. When the national conversation refocuses on the more immediate problems plaguing our healthcare system, employers, their employees, and other interested parties in the self-funded space will benefit.