Since the Senate bill allows individual states to pursue their own single-payer programs, why is he still hellbent on voting against the bill?
Steve Benen at his blog posted a good column from Ezra Klein on this:
http://voices.washingtonpost.com/ezra-klein/2010/03/the_state-based_single_payer_s.htmlhttp://washingtonmonthly.com
The state-based single payer strategy
"Quite frankly," Sen. Bernie Sanders said today, "we don't have the votes for single payer." That's not much of a surprise, but Sanders did outline another strategy for single payer that some liberals might want to think about. "Right now," he explained, "we have language in the bill that says that states that want to go forward with single payer can do that." He's talking about the Waiver for State Innovation, which allows states to go their own way if they have a plan that will achieve the goals of the bill at a lower cost. You could imagine a state -- say, California, where the legislature has passed single-payer bills before only to see them vetoed by the governor -- using that provision to implement a single-payer system.
Sanders thought this the best strategy going forward. "I believe the way we move to single payer in this country is to let one state like California go first," he said. And before some of my conservative readers decide this is a liberal trapdoor in the middle of the bill, the provision could be used to develop a much more conservative approach to universal health care. In fact, it's a legislative expression of the GOP's third plank for health-care reform: "Give states the tools to create their own innovative reforms that lower health-care costs."
The health-care reform bill will create a basic, near-universal system across the country. If individual states think they can do better, they're welcome to try. And if they succeed, you could imagine those reforms spreading quickly to other states, too.