"The dayhas got to come, and I will bring that day about, when we finallysay to the drug companies and the insurance companies, the functionof health care is to provide it for all people in an effectiveway," Sen. Bernie Sanders said in the last debate.

In the end, literally, the candidates returned to healthcare.

The sixth Democratic presidential debate on Thursday is likelyto be best remembered for its sharp exchanges over campaign financeand aglistening fundraiser in a Napa Valley wine cave. But justbefore their closing statements, after lengthy discussions ofimpeachment, climate change and human rights in China, the sevencandidates who qualified for the last debate of 2019 talked aboutthe practicality of sweeping health care reform — specifically,"Medicare for All."

Related: Which candidates' health care strategy will winover voters?

In light of the Obama administration's challenges passing theAffordable Care Act nearly a decade ago, former Vice President JoeBiden was asked about the likelihood of being able to replace thenation's existing health care with a single-payer system.

"I don't think it is realistic," he replied.

Biden noted that Americans are already paying taxes for arelatively small portion of the population to be covered byMedicare, suggesting taxes would skyrocket under a single-payersystem.

Yes, Sen. Bernie Sanders of Vermont replied, taxes would go upunder his Medicare for All plan. But premiums, deductibles andout-of-pocket expenses would disappear, he said, and there would bean annual cap on prescription drug costs.

"The day has got to come, and I will bring that day about, whenwe finally say to the drug companies and the insurance companies,the function of health care is to provide it for all people in aneffective way," Sanders said, "not to make profits for the drugcompanies and the insurance companies."

Sen. Amy Klobuchar of Minnesota, who, like Biden, has proposedadding a public option to the existing system, took a folksierapproach to criticizing Medicare for All.

"If you want to cross a river over some troubled waters, youbuild a bridge," she said. "You don't blow one up."

It was an encore of an argument over health care reform that hasbecome familiar to anyone who watched, well, any of the previous five debates.

But with six Democratic debates to go in the primary season, thecandidates also waded into topics that focused more on care: thestartling racial disparities in maternal mortality rates and the treatment of those withdisabilities.

Andrew Yang, a businessman who is mostly running on his proposalto institute a universal basic income of $1,000 a month, noted thatblack women are 320% more likely to die in childbirth.

That disparity has prompted calls to extend Medicaid coverage, ensuring manynew moms are not kicked off their health care shortly after givingbirth.

And speaking as the parent of a child with special needs, Yangnoted his universal basic income plan could help shift more of theresponsibility for caring for those with disabilities away fromcash-strapped local governments.

"We're going to take this burden off of the communities and offof the schools who do not have the resources to support kids likemy son, and make it a federal priority, not a local one, so they'renot robbing Peter to pay Paul," he said.

Sen. Elizabeth Warren of Massachusetts, who taught children withspecial needs, vowed to fully fund the Individuals withDisabilities Education Act, a law passed in 1975 that was intended to provide free,specialized education to those with disabilities.

She added that she would also focus on supporting those withdisabilities in housing and the workplace.

"You've got to go at it at every part of what we do," Warrensaid. "Because as a nation, this is truly a measure of who weare."

The seventh debate is scheduled for Jan. 14, with three more tofollow in February and another two yet to be announced.

KaiserHealth News is a nonprofit news service coveringhealth issues. It is an editorially independent program of theKaiser Family Foundation, which is not affiliated with KaiserPermanente.

Read more: 

• House Democrat offers state-based Medicare for Allbill
• Middle class the winners in Warren's Medicare forAll plan
• 9 ways to finance Medicare for All, none of whichlook that great