Bernie Sanders is an independent Senator who is to the left of the Democratic Party as a democratic socialist. He advocates the rights of the bottom 90% of the population, specifically a right to public health care.
Rand Paul is a right wing Tea Party Republican who is to the right of a good part of the Republican Party. He denies that a society has any obligation to the bottom 90% of the population. As a libertarian, he advocates a society with no social obligations, only "contracts", and he wants to shrink the US government so that it can be "strangled in a bathtub".
In the real world most people find themselves somewhere in the middle of this debate. To say that you have a "unrestricted right" to medical care and to take the view that each life has "infinite value" implies that you should bankrupt a society in order to provide "medical care" to a hopelessly ill patient with no "quality of life" and no hope of recovery. This viewpoint effectively says that one person's "right" trumps all others. But this is self-contradictory. Those being bankrupted have a "right" to medical care. So you can't simply give all resources to one person. There needs to be compromise!
The Rand Paul position is just as nutty. He argues that nobody has any obligation to the broader society. He views any effort to get him to contribute to society (act as a doctor under the Hypocratic oath, pay taxes, serve on a jury, etc.) all all just forms of "slavery". The only motivator for him is money. He wants you to bargain with him and come up with a contract and money before he will act. But this is ridiculous because no parent negotiates with a child or vice-versa. In a family there are rights and responsibilities. In a society there are rights and responsibilities. Money is not the be all and end all to everything.
This "debate" was polite, but it exhibits the insanity that has infected the American body politic. Neither side attempted to negotiate a compromise, a pragmatic workable compromise.
What is silly about this "debate" is that the US already has working examples of an effective public health care with reasonable limits on "rights" and a well defined commitment by the state to provide social services to give a reasonable meaning to a social right to health care. These two debate at the extremes and ignore the fact that there already are working examples of appropriate compromise solutions already in place and effectively providing public health care!
Here is a Paul Krugman comment on the insanity of the current politics in the US. This deals with the argument over raising the debt ceiling, but like the above, it shows that at least one side, the Republicans, have gone completely nuts:
...failure to raise the debt limit could act as a terrible signal about the US political system.
When you look at the US fiscal position in terms of what we’re capable of as a nation, it’s not a big problem. Never mind those big numbers you hear about implicit liabilities; we have a big economy, too. So modest tax increases and reasonable efforts to limit health care costs could bring our long-run finances into line.
But all this depends on our having the political will and cohesion to do what’s necessary. What if it turns out that we’re a banana republic, with crazy extremists having so much blocking power that we can’t get our house in order?
And failing to raise the debt limit could be widely read as a signal that we are, in fact, a banana republic.
In that case, however, what should Obama do? My answer is that despite all that, he must not let himself be blackmailed.
Partly that’s because once he gives in the first time, the blackmail will never stop. Once the crazies know that they can get whatever they want by threatening to blow up the economy, they’ll just keep demanding more and more. Obama just can’t let that dynamic get started without setting up an even worse crash down the road.