But to Buttigieg, Warren, and Sanders, the obstacle to reshaping a broken system is not opposition from voters themselves, but the fear of political reprisal. Indeed, Republicans—and, as Sanders pointed out, the insurance industry—have been framing the debate over health care in U.S. politics for a generation or more, ever since the famous “Harry and Louise” ads torpedoed the plan designed by then–first lady Hillary Clinton. When Obama finally achieved a major overhaul of the system, he sold the Affordable Care Act as legislation modeled on a law signed in Massachusetts by a Republican, Mitt Romney.

Warren and Sanders want desperately for Democrats to change the conversation, to stop fearing the big bad Republican wolf. They each begged their fellow Democrats to keep the GOP and its spectral presence out of the party’s internal debate over health care. “Let’s be clear about this: We are the Democrats. We are not about trying to take away health care from anyone. That’s what the Republicans are trying to do,” Warren said early on, in one of the night’s first big applause lines. “And we should stop using Republican talking points in order to talk with each other about how to best provide that health care.”