During the second presidential debate, Donald Trump accused Hillary Clinton of supporting single-payer health care.

Fact-Check: MOSTLY TRUE

The recently-leaked transcripts of Hillary Clinton’s paid speeches have her speaking supportively of single-payer systems, although in her public campaign pronouncements, she emphasizes “fixing” the problems with the Affordable Care Act. Some examples:

“If you look at countries that are comparable, like Switzerland or Germany, for example, they have mixed systems. They don’t have just a single-payer system, but they have very clear controls over budgeting and accountability. If you look at the single-payer systems, like Scandinavia, Canada, and elsewhere, they can get costs down because, you know, although their care, according to statistics, overall is as good or better on primary care, in particular, they do impose things like waiting times, you know. It takes longer to get like a hip replacement than it might take here.” (June 2013)

“So we’re in a learning period as we move forward with the implementation of the Affordable Care Act. And I’m hoping that whatever the shortfalls or the glitches have been, which in a big piece of legislation you’re going to have, those will be remedied and we can really take a hard look at what’s succeeding, fix what isn’t, and keep moving forward to get to affordable universal healthcare coverage like you have here in Canada.” (January 2015)

What Clinton says in public is often very different than what she tells her private speaking audiences. For example, she recently said she thought single-payer would “never, ever happen,” but she was making a prediction and saying that ObamaCare repairs couldn’t wait for a single-payer system to be created, not expressing her own policy preference:

“I want you to understand why I am fighting so hard for the Affordable Care Act. I don’t want it repealed, I don’t want us to be thrown back into a terrible, terrible national debate. I don’t want us to end up in gridlock. People can’t wait! People who have health emergencies can’t wait for us to have a theoretical debate about some better idea that will never, ever come to pass.”

During Clinton’s primary run against Bernie Sanders, the New York Times found her moving to the left on health care and saying she was “in favor of what’s called the public option, so that people can buy into Medicare at a certain age.” Sanders was explicitly in favor of single-payer health care… and described it as “Medicare for all.”