MONTPELIER — U.S. Sen. Bernard Sanders will likely make history this year when — for the first time ever — he brings a bill creating a national single-payer health care system to the floor of the Senate for a vote.
As a compromise on a public-option plan that would allow states to opt out gains steam in the U.S. Senate, Sanders, a Vermont independent, continues to focus his attention on a single-payer bill, although he acknowledges that there are not enough votes to pass it.
"That bill will lose," Sanders said Wednesday morning during a telephone interview. "The question, however, will be how much support it will get."
Introduced in the early spring, Sanders' American Health Security Act of 2009 would eliminate the role of private insurance companies in health care and create a public fund that would insure all residents of the United States.
Sanders said his bill would insure the 46 million Americans without coverage and could save upwards of $400 million annually by eliminating insurance overhead and medical bureaucracy.
The system would be paid for through existing sources of government health care spending along with some tax increases, which advocates say would be less than what people pay now in co-pays or out-of-pocket expenses.
Sanders' bill has received little attention in Washington political circles as this summer's health-care debate focused more on discredited fears of government death panels and the cost of a public health insurance option, which President Obama favors.
There has never been a vote on a single-payer health care system in either the U.S. Senate or the House, according to Mark Almberg, communications director for the organization Physicians for a National Health Program, a national advocacy organization that supports a single-payer system.
"We do believe that this could be the first time a single-payer bill gets a vote in Congress," said Almberg, whose organization supports Sanders' bill.
Almberg agreed that single-payer does not have the votes to pass the U.S. Congress. He said there are about 80 co-sponsors of a similar House bill, but would not hazard a guess as to how many votes for such a plan there are in the Senate.
Knowing that his single-payer bill is likely to fail, Sanders said he also plans to try including a provision in the final health-care bill that would allow states such as Vermont to experiment with a single-payer system on a state level.
If that legislation is approved, it would be welcomed by some lawmakers in Vermont. Sen. Doug Racine, D-Chittenden, a candidate for governor in 2010, said he plans to kick off hearings at the Statehouse in January on exactly what a single-payer system in the Green Mountain State would look like.
Racine said Vermont would need certain waivers from the federal government to conduct a single-payer health care system here – exactly the type of clearance that Sanders' proposed provision would allow.
"There are lots of different questions that need to be answered," Racine said. "I think we need to move past the question of whether or not a single-payer system would be good for Vermont and begin looking at how it would work."
Sanders was hesitant to make predictions of where health care reform will end up in the Senate – his staff has yet to see a final version of the bill and a date for a vote has not been scheduled.
But his expectation is that the final bill will have the required 60 votes to overcome a Republican filibuster to bring it to a final vote, which only requires more than 50 votes to pass.
"I think that, once we get closer to a vote, the American people will look closely at what is in the Senate bill and what is in the House bill," Sanders said. "I hope that we will see a groundswell of support for health care reform that will force some members to take a stand and allow for a vote."
Still, Sanders is not too enthusiastic about the public-option opt-out plan pushed by Senate Majority Leader Harry Reid, a Nevada Democrat, this week.
"All the American people should be given the option of a public health insurance plan that competes on the market with the private insurance companies," he said.