Most coverage of last night’s debate is understandably focused on which of the two candidates performed better and what that means for a potential Donald Trump second term or Joe Biden presidency. It’s also worth dwelling on the prospects for another main character in American politics: Medicare for All, or a single-payer health care system, popularized by Bernie Sanders in his first and second presidential campaigns.

Polling from last week shows that a majority of Americans want Medicare for All — little wonder, since the pandemic has also been accompanied by mass unemployment, causing millions to lose employer-sponsored private health care coverage in the middle of a public health emergency and underscoring the dysfunctionality of the system — but you wouldn’t know it from last night’s debate. Trump scaremongered about socialized medicine, but there was nothing like socialized medicine on the table.

When the conversation turned to health care, Trump alleged on five occasions that Biden wanted to enact socialized medicine. At times, he seemed to accuse Biden of covertly supporting Medicare for All, while at other times, he seemed to suggest that Biden’s moderate plan to expand on the Affordable Care Act (ACA) was itself socialist in nature. In both cases, the message was the same: if Biden wins, he will socialize the American health care system, “and this whole country will come down.”