Keeping up with the Jones’ is an American tradition. We covet our neighbors; we imitate them, buy what they buy, and then try to up the ante. We want whatever it is that “she’s having.” But like Harry and Louise, most Americans are drowning in paper; unlike the middle class Harry and Louise of almost 15 years ago, they are also drowning in debt and are too tired and confused to sort out their own realities.

The reality is that we have such an impotent Congress that it can’t manage any modicum of success against a lame duck president with the worst ratings in history. It’s hard to find ourselves wanting what they have; they all seem like the losers on American Idol. Perhaps they are, but until we change horses completely or start a revolution, we are stuck with them. So what is it that they have that we should covet? One thing: their health care plan.

Unless you are a civil service employee who shares in the same pool of benefits or among the very wealthy who comfortably pay large sums of money to insure that you and your family have access to whatever health care is needed, you are among the millions of Americans who worry about health insurance, dreading the day you might succumb to some horrible affliction that will wipe out all of your assets, leaving you dependent on the kindness of strangers.

We should all want what Congress has on the table, and yes, one could even get orgasmic about it. For about 25 percent of the cost of the premiums, our esteemed members of Congress can choose health insurance from among multiple providers who offer plans ranging from HMOs to more comprehensive FFS (fee for service) plans. The cost of these premiums to each Congress member ranges from $84/month for a single person in a FFS plan to $400/month for a family, of which we the taxpayer pick up $252 or $713/month respectively (figures are rounded). And it’s a bit lower if one chooses an HMO rather than a FFS plan. They can even elect to add dental and vision plans, again at low cost.

Presumably, since money is not generally an issue for our elected Congressional delegates, and the plans are cheap in comparison to what  most of us are paying for the same services, choosing the plans that offer extensive coverage and low deductibles is a no-brainer. They are covered from the day they officially begin their elected duties - no medical exams required, no age restrictions, and rejection for pre-existing conditions is not allowed.

So why, we should ask, don’t we the people deserve the same treatment? Why can’t we have what they’re having?

Think about it. Congress and the President (who also gets the same benefits) have just denied health coverage to children whose families can’t afford to pay the inflated price of premiums on the open market. These are working families whose taxes continue to contribute toward paying 75 percent of the cost of coverage for the very people who voted against coverage for their children.  In the S-CHIP program, there is a needs test, a threshold for qualification, and even then, cost is pegged to the family’s income. In the federal health care plan (FEHBP or Federal Employee Health Benefits Plan), premium payments are not based on income or assets or any other measure of ability to pay; the government automatically picks up their share of the tab. It’s just a benefit. How quaint!

The FEHBP is based on choice – you know – the old American theory of competition that results in lowered cost. The system works. The insurance companies compete and the costs are lower. A comparable policy on the open market, even for a small to medium-sized business or organization is usually much higher, and for an individual, if you can get it at all, it’s much higher. And of course, the rest of us are required somehow to manage a lot more than 25% of the real cost of the premiums.

Yes, the choices can be complicated and confusing (though Harry and Louise never agonized over the complexities of that health plan). But even there, Congress has an answer – for themselves at least. Built into the federal insurance system are people at every government agency whose job it is to understand the differences, sort them out, and disseminate information. Just like the benefits managers at large companies. These are the go-to guys for when you have a question or are denied some coverage. They go to bat for you and can win some battles because it is in the interest of the insurance company to play nice when so many customers are at stake. You can be sure that the benefit managers who work for Congress are well-versed in the nuances of the various providers and Congress members are not spending their time sorting through reams of confusing double-speak insurance policy papers to determine what’s covered under each plan.

You can rest assured that Congress members and their families don’t worry about the cost of their care should they get sick or need treatment for some ailment; they get the best possible medical care.  Not that we wish illness on anyone, regardless of political affiliation, but bare in mind that the government insurance plan extends into retirement, so should someone enrolled in the plan retire directly from their current job, they can continue with the same plan and when they reach Medicare age, switch to a plan that supplements Medicare. In case you might ask – yes, the government still picks up their 75 percent of the cost during retirement, unlike workers who leave jobs and have a few months during which they are allowed to pay full fare to continue coverage; after that, they have to fend for themselves.

Oh, and the FEHPB program includes catastrophic coverage – no worry about Congress members bankrupting themselves in the process of dealing with major illness (either their own or someone in their family). The catastrophe is that we the people have no such options.

©2007 Lynne Glasner