The Democratic US presidential candidate and former Secretary of State Hillary Clinton and rival candidate US Senator Bernie Sanders speak simultaneously at the NBC News - YouTube Democratic presidential candidates debate in Charleston, South Carolina January 17, 2016.
Ms. Clinton, by contrast, urged less sweeping action to build on President Barack Obama's health care plan by reducing out-of-pocket costs and control spending on prescription drugs.
If Democrats couldn't pass single-payer with a Senate supermajority, how would Sanders do it with a Republican House and, at best, a narrow Senate edge?
Their heated rhetoric highlighted the central question fueling the increasingly competitive primary race: Will the Sanders passion beat out the Clinton practicality? He said Clinton had accepted hundreds of thousands of dollars in speaking fees as a former secretary of state from Wall Street backers. Sanders showed no hesitation to hit his opponent for being too cozy with the big banks, and on Monday the progressive superstar said he was not nervous that the battle for the nomination was getting too negative.
On the Democratic side, the Bern, who got into the race only because somebody had to, has somehow morphed from a message candidate into a legitimate - contender candidate, who, Trump-like, is now citing the polls as evidence of his electability.
The ratings were an improvement over the other two Democratic debates on the broadcast networks this election season.
Clinton made her pitch in Toledo, Iowa, imploring voters to pay careful attention to what is possible - and what is not - as they decide whether to support her or Sanders' bid. He has since gained on Clinton in the polls, now trailing her by just a few points in Iowa and leading her in New Hampshire, The New York Times reports. He called the former president's behaviour "deplorable" but said he wants to focus on issues "not Bill Clinton's personal life". And President Obama has led our country out of the Great Recession.
"He didn't like that, his campaign didn't like it either and tonight he's come out with a new healthcare plan", she said.
And she resurrected comments Sanders had made about Obama before his re-election, suggesting the president would have benefited from a primary challenge.
Presenting herself as his heir apparent, Clinton warned that Sanders' universal health care plan threatened to reopen a contentious debate with Republicans that could undermine the so-called "Obamacare" law. "I helped write it. However, we are going to move on top of that to a Medicare for all system", Sanders said. We're not going to tear up the Affordable Care Act.
This overstates Sanders' role in the process, making him sound like more of an insider than he actually was.
When Sanders said he had always supported background checks, Clinton countered that he had "voted for what we call the Charleston loophole", referring to the June killing of nine African-Americans in a Charleston, S.C., church.
He really performed very well, but Hillary Clinton also showed some stamina and attacked her, though she failed to hurt him the way she would have liked to do. "I thought that Bernie was much more prepared", Chris Haigh, 66, said.
The rhetoric was a notable shift from several months ago, when Clinton frequently stressed that she was not running for Obama's third term.
All three are aware that their performance - the final Democratic debate before the Iowa caucuses in two weeks - could have a crucial impact on who wins the state.