There was nothing approaching such candor last night. In the sixteen-minute segment of the debate that dealt with health care, Clinton and Obama tossed out bits of explanation that, if glued together, might form the nucleus of the syllabus they need to get the public on board. Clinton, for instance, said that unless everyone is in the system, insurance companies will cherry-pick only the healthiest people to insure. She also brought up the hidden tax that everyone pays when people without coverage use hospital emergency rooms. For his part, Obama noted that insurance companies don’t mind that everyone has to purchase insurance, because more people will buy their products. All true, but much more needed to be said; instead, both candidates returned to their familiar quarrel over mandates. And that is what the press picked up. A McClatchy Newspapers story, for example, said that Clinton insisted that she alone would expand insurance to all the uninsured by mandating coverage while Obama countered that Clinton would force people to buy insurance even if they couldn’t afford it.

Clinton argued that FDR did not make Social Security voluntary and Lyndon Johnson did not make Medicare voluntary. Her reference to Medicare reminded me of how Medicare supporters neutralized strong opposition from the American Medical Association and worked to educate the public before the Medicare law was passed. They didn’t do it with sound bites but with hundreds of pieces of literature that gave precise details of how Medicare would work and why it was necessary. A representative of the National Council of Senior Citizens recalled, in One Nation Uninsured by Jill Quadagno, “There was no other bill in history where details were as widely disseminated.”

That’s a history lesson worth remembering.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.