Will Single-Payer Supporters Have A Voice? An Interview With Senator Bernie Sanders

by Ezra Klein

I fear very much that much of the talk of health-care reform is not getting to the root cause of why we have 46 million uninsured and, at the same time, we pay more for health care per person than any industrialized country on earth. And the reason the discussion is not getting to the root cause of the problem is that the discussion is unwilling to take on the role of private insurance companies that are precisely the reason our system is so wasteful, inefficient and bureaucratic. And not to take on that fact is to ignore the reason we are where we are.

For all the talk of the Congressional Budget Office lately, I haven't seen the CBO taking on your legislation or Rep. Conyer's. Have you submitted it to be scored?

We have not submitted it to be scored. If we can we surely will. It's not clear they would score it.

Why wouldn't they?

These studies don't take five minutes. If I were the chairman of the HELP Committee they'd score it.

Re Single Payer not being part of the Senate Finance Commitee Hearings:

I think the importance of the hearing is not that it will change minds but that the American people -- and Congress -- should hear the facts about the enormous waste and bureaucracy and profiteering associated with private health insurance. Not to deal with that is mind-blowing.

You've implied here that single payer may be the long-term goal. In the shorter-term, what should single payer advocates be looking to get out of the health care process Baucus is running? Are there any concessions that could make that a win?

I am sure that there are some single payer advocates who think the only thing worth fighting for is single payer. What I have also introduced, which we will be fighting for, is a five-state option. That would mean five states would have the option of running pilot programs in universal health care but one would have to be single payer.

I think it's possible this will never happen in DC, but that this country will join the rest of the industrialized world when a state, maybe like Vermont, implements single payer and does it well. And then New Hampshire will be looking over our shoulders, and they will adopt that, and so on through the country. That's in fact how national health care came to Canada, it started in the Saskatchewan province.

The second area of less importance, but important nonetheless, is the fight for a strong public option. In my view, if you had a level playing field and a pubic program and a private insurance program providing the same level of benefits, people would come into the public program because the public program would be substantially more efficient. I think we can make that case, and I will advocate for it in the legislation.

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