Pete Stark, a Democratic congressman from California, asked a good question the other day: “If managed competition-type organizations are the answer to the nation’s health-care problems, why aren’t members of Congress, the president, and his Cabinet in them?”
Because the country’s top public “servants” have a health-care plan that’s much better. A model plan. One that offers wide choice, good care, and reasonable cost. It’s the Federal Employee Health Benefits Plan. It’s the one Stuart Butler at the Heritage Foundation has been touting as a prototype for the whole country. But his proposal has been dismissed with a lick and not even a promise by the Clintons.
Why? Well, it’s not the sort of approach that appeals to social planners. It gives folks too many choices. It opens too many possibilities. It is unspeakably fair, economical and practical. So practical that some 9 million federal employees, retirees and their dependents now find it eminently satisfactory.
The rest of us are supposed to settle for the prescription called Managed Competition, which sounds like an oxymoron plus two aspirin in the morning.
Stark would make the country’s leaders take the medicine they’re prescribing for everybody else. He’s working on a bill that would require members of Congress to enroll in the most basic health-care plan offered in their districts if and when the Clinton Plan is enacted.
If members of Congress knew they would be in the same health-care system in which they propose to enroll everybody else, maybe they would insist on the best possible plan for everybody, not just for themselves and fellow federal employees.
Unlikely. People who know Washington know how high the odds are against Congress agreeing to live under the same laws it passes for the rest of us.
So instead of demanding minimal health care and less insurance coverage for members of Congress and other federal grandees, why not devise a system that brings the rest of us up to their level?
Such an approach to health care is already taking shape on Capitol Hill. The financing varies. Some proposals depend on a mixture of tax credits for the better off and government vouchers for the poor. But all such plans have this much in common: Rich or poor, all Americans would get a choice of insurance plans. And all would be required to buy basic coverage for the most serious and expensive (“catastrophic”) of illnesses.
One alternative to the administration’s confusing proposal is called the Consumer Choice Health Plan, which is sponsored by Sen. Don Nickles (R-Okla.).
Among its more attractive features, Nickles’ bill completely severs the link between health insurance and employment, eliminating joblock. A citizen’s insurance benefits wouldn’t change with every new job, as it might under the Clintons’ plan. Pre-existing conditions would be covered. A tax-exempt medical savings account would be available for those who want to set aside money for medical expenses or to buy additional coverage.
To quote Nickles, his plan “empowers families and individual Americans, not government bureaucrats.” Yes, the bill is based on the Federal Employee Health Benefits Plan.
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Why not offer American families the same sort of system that now covers Congress, the White House and the Cabinet? The result would be a health plan fit for a congressman. Only for everybody.
The country should be looking for ways to bring everybody up instead of just bringing members of Congress down. That’s the American way. Let’s raise everybody’s level up to that of our congressmen, not bring them down to ours.
Getting back to sordid reality, it’s not likely that members of Congress are going to quietly fold their efficient, fair, and workable insurance system into any kind of managed competition plan, with all its limits, complications, and uncertainties.
Back when Russia was the Soviet Union, it used to have an enumerated class of party members, civil officials, military officers, and other muckety-mucks known as the Nomenklatura. In the United States, this class is called Congress. The Constitution outlaws titles of nobility only technically.
The Clinton health plan doubtless will join any number of other federal laws and regulations that our lawmakers have has conveniently exempted themselves from. The list is long and telling; it encompasses at least a dozen laws that Congress has decided are good enough for the rest of us but not for its privileged self, including the Civil Rights Act of 1964, the Americans with Disabilities Act, and of course the Ethics in Government Act.
This isn’t the way it was supposed to be. James Madison, arguing for the adoption of the Constitution in the Federalist Papers, assured Americans of his time that the members of this new federal Congress could “make no law which will not have its full operation on themselves and their friends, as well as on the great mass of society.”
Madison clearly did not foresee today’s Congress.