With Election Day edging closer, President Donald Trump and Democratic challenger Joe Biden have sharply contrasting views about the current severity of the COVID-19 pandemic and how they would shape health care over the next four years if elected.

Those differences were on display during their final face-to-face debate on Thursday, which covered little new ground but presented their positions more clearly than their first debate, where substance was lost amid constant interruptions and attacks.

With coronavirus cases spiking all over the country, Trump maintained that the country is “rounding the corner” and didn’t suggest any change to his administration’s current approach. He called for lifting restrictions meant to reduce virus spread, and said a vaccine would be ready “within weeks” — though when asked if that was a guarantee, he said it was not.

“It will go away,” Trump said. Even though death rates have fallen, the national daily case count exceeded 76,000 on Thursday, a level that hasn’t been seen since peaks during the summer.

Biden argued that continuing Trump’s approach could result in another 200,000 deaths in the United States and a “dark winter.” He said that schools and businesses should reopen but need to be given the resources to do it safely. He said restrictions would be appropriate in cases when the virus is spreading rapidly, but emphasized that it wasn’t an all-or-nothing choice between slowing spread of the virus and keeping the economy open. “I’m going to shut down the virus, not the country,” Biden said.

“You need standards,” he added. “The standard is if you have a reproduction rate in a community that’s above a certain level, everybody says slow up; more social distancing, do not open bars and do not open gymnasiums, do not open until you get this under control.”

Trump and Biden also showed their competing views on public health when the topic turned to energy and the environment. When asked about the adverse effects on people’s health when they live in proximity to entities like oil producers and refiners, Trump justified his administration’s lowering of regulatory standards with economic reasons: “They are employed heavily and they are making more money than they have ever made.”

Biden, who grew up in the refinery-heavy state of Delaware, offered empathy for people sickened by polluters and argued in favor of regulations and transitioning away from fossil fuels. “It matters how you keep them safe, what you do, and you impose restrictions on the pollution,” he said.

Trump argued that the rest of the 2010 health care law needs to be thrown out, but argued that he’s done a better job managing it than the Obama administration. Rather than elaborate on his vision for improving health insurance coverage, Trump attacked Biden’s plans as socialized medicine that would result in the privately insured losing their coverage.

Biden pointedly distinguished himself from other Democrats who support a single insurance option in “Medicare-for-all” and said he supports private insurance. He argued that his “Bidencare” plan, which would offer a government-insurance option, would not crowd out the private insurance market.

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