The Democratic primary has morphed into a full-blown fight. As the polls have shown Hillary Clinton’s formidable lead slipping in Iowa, New Hampshire, and nationally, she’s gone on a media blitz to attack Bernie Sanders for his policy proposals, or lack thereof. This portends a more spirited slugfest in the Democratic debate on Sunday than we’ve seen so far. Clinton insists that it’s important for voters to “get real” about policy differences between the two leading Democratic candidates. But the broader challenge for Clinton—both in the primary and, if she prevails, in the general election—will be convincing voters that she has the most compelling vision for the future. And that’s what’s missing from her new offensive on Sanders’s proposal for single-payer health care.

This week, Clinton has gone all out on the issue, trying to undermine Sanders’s proposal without directly attacking the idea of single-payer, which remains extremely popular among Democrats. Her first line of criticism comes from the right, pointing out that the senator from Vermont hasn’t explained how he’ll pay for a plan that would cost trillions of dollars. 

“You know, I’ve been laying out very specific policies for months now, and telling people how I would pay for them. I’m asking that Senator Sanders does the same thing,” Clinton said on Wednesday. The Sanders campaign subsequently admitted that the details might not come out before the Iowa caucuses, and the Clinton campaign pounced immediately. “We think that the caucus goers in Iowa deserve to hear from Senator Sanders about how he will pay for this single proposal,” Clinton spokesman Brian Fallon told reporters.

Clinton hasn’t explained how she’ll pay for all her big domestic priorities, either—namely her proposal for paid family leave. But the underlying political calculation is clear: She wants to highlight the huge price tag for single-payer, raising the specter of potential tax increases under a President Sanders—while leaving out the fact that Americans would no longer have to pay insurance premiums.

The campaign’s other line of attack is more head-scratching: Earlier in the week, Clinton claimed that single-payer would create a national system by turning government programs like Medicare over to the states. Her daughter Chelsea similarly warned that Sanders’s plan “would dismantle Obamacare, dismantle the CHIP program, dismantle Medicare,” and “strip millions and millions and millions of people off their health insurance.” Their underlying message is that Bernie Sanders is going to take away your Medicare—while leaving out the fact that his plan would effectively be Medicare for all. 

Clinton’s offensive did manage to goad the Sanders campaign into returning fire: On Wednesday, it accused the frontrunner of “engaging in false and misleading” attacks. Sanders’s spokesperson pointed out that Clinton had personally praised the senator for his work on health care in 1993, and that she’d criticized then-candidate Barack Obama in 2008 for attacking her on universal health care. Democrats, she said then, should be united on the issue.


The single-payer brouhaha—which is likely to spill into Sunday’s debate—isn’t helping Clinton; in fact, it’s highlighting some of her biggest vulnerabilities. Even if you took the most generous interpretation of Clinton’s remarks—that she truly believes single-payer would be too expensive and too disruptive—there’s a difference between drawing a contrast and going negative. Drawing a contrast would mean offering an alternative to Sanders’s proposal, rather than simply attacking it. But the alternative that Clinton offers is the one that her campaign seems rightfully wary about embracing: the status quo of Obamacare. 

The strongest case that the Clinton campaign has made, so far, is that she’s best suited for the next Democratic president’s most likely job description: playing defense against a Republican-controlled Congress and wresting some incremental victories along the way, as opposed to massive legislative change. 

That’s a hard sell in this year’s political environment, which has bolstered anti-establishment insurgents on the left as well as the right. But the political reality of a divided government does play to the genuine strength that Clinton has to offer: years of trench warfare with political opponents at home and overseas. She is asking voters to face reality, and acknowledge that the biggest problem for the next Democratic president is not going to be whether we pass single-payer or not; it’s going to be protecting the achievements that Democrats have already won.

The Clinton campaign has tried to highlight some of these tactical strengths in recent ads: One described the Republican candidates as “backward, even dangerous,” painting Hillary as “the one candidate who can stop them.” Another played up her ability “to do the toughest job in the world,” given her experience going “toe to toe” with the likes of Vladimir Putin. 

But the case for electing a tough warrior who can stand up for ordinary Americans at home (against Republicans) and abroad (against America’s enemies) also requires a compelling vision of what that warrior is trying to protect. Clinton’s platform has some of the building blocks for the kind of future that she wants for America: a safer, more prosperous country, but one that’s fundamentally committed to (and optimistic about) the achievements of the Obama era. She has unveiled incremental policy proposals to take on laudable causes like curing Alzheimer’s and providing care for ailing family members. 

The seeds of the broader vision are there: Clinton can pitch herself as the candidate who’s prepared to use realpolitik to win actual victories that help real people. But she hasn’t delivered the message about where we need to be headed and why. And that’s why her attacks on single-payer have fallen short. 

The more convincing argument that Clinton could make against single-payer would be that it’s politically more feasible—a better use of political energy and time—to build on what we have already. That would mean openly celebrating the progress made under Obamacare, for instance, and projecting a sense of confidence about the direction in which the country is headed under a Democratic president. As I wrote earlier this week, that’s the message that Obama sent in his final State of the Union address.

Yes, a celebration of the status quo would run against the political tide of both parties right now. But that’s precisely the point: The anti-establishment is on the upswing, and Clinton, for the moment at least, is not. She needs to come up with a better case for building on the status quo, rather than skirting around the question by attacking her opponent.