Hillary Clinton is not only saying that Bernie Sanders vision of a single-payer health care system is unrealistic, but that it, if implemented, would be a disaster for those it intends to help.

At the last debate between the two candidates for the Democratic nomination, Clinton, who has lost six consecutive primaries to her opponent, sought to portray Sanders’ policies not only as unachievable, but fundamentally flawed.

Clinton referenced a recent column in the Washington Post, by Max Ehrenfreund, which argued that Sanders’ health plan would cost more for low-income Americans than the status quo. Millions who are currently enrolled in Medicaid already pay very little for care, Ehrenfreund pointed out, but they would end up paying more in payroll taxes to finance Sanders' single-payer system.

“The Washington Post called it a ‘train wreck for the poor,’” said Clinton during the debate.

She further chided Sanders for not being upfront about the costs of his ambitious overhauls of public services, including health care and higher education.

“I do think when you make proposals and you’re running for president, you should be held accountable for whether or not the numbers add up, and whether or not the plans are actually going to work,” she said.

In past encounters, Clinton has suggested that Sanders’ plan to put in place an entirely new health care system would endanger the progress made towards universal coverage through the Patient Protection and Affordable Care Act (PPACA). He has called the criticism absurd, saying that there would be no scenario in which the PPACA would be scrapped if he cannot achieve his “Medicare-for-all” vision.

As he has in past debates, Sanders highlighted the fact that governments in other western countries guarantee coverage to their citizens, while spending far less on health care overall. He suggested that reluctance to embrace a single-payer system was due to fear of taking on the insurance industry.

“What Secretary Clinton is saying is that we are not a country that has the courage to stand up to big money and do what has to be done for the working families of this country,” he said.

Despite the string of recent defeats, Clinton remains the clear frontrunner for the Democratic nomination, with a sizeable lead among delegates.

Unlike the race for the Republican nomination, which has included a number of “winner-take-all” contests, every Democratic primary and caucus has awarded delegates to the candidates based on the proportion of the vote they receive. As a result, Clinton has still picked up a fair share of the delegates even in the states she has lost. Polls also suggest she will win the upcoming primary in New York by a comfortable margin.

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Hillary Clinton calls Bernie Sanders health plan &quot;train wreck&quot;

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Hillary Clinton calls Bernie Sanders health plan "train wreck"