Senior Citizens Shorted on Health Care

Published January 1, 2003

Congressional scandals come in two varieties. One involves criminality, malfeasance, dark and secret things. The other involves what they do legally–right out in the open–not caring much who notices or complains.

It’s time to notice the scandal of congressional health insurance–the kind they provide for themselves and almost 9 million active and retired federal employees. And it’s time to complain. Not because theirs is too good: We certainly don’t begrudge them that. The scandal is that they’re unwilling to let senior Americans enjoy the same level of choice and care.

A recent national poll by McLaughlin & Associates for the United Seniors Association, released on September 25, 2002, reveals a large discrepancy between the Medicare medical coverage Congress legislates for seniors and what members of Congress provide for themselves and other federal government employees.

If medical care were food, Congress would be offering seniors a no-choice fast-food snack. Seniors say they want a variety of healthy meals. Meanwhile, federal employees mandate a gourmet selection for themselves.

The McLaughlin survey polled 800 likely voters over the age of 50 on September 4-8, 2002. The accuracy is within +/- 3.5 percent at a 95 percent confidence interval. The results are clear. Senior voters want:

  • voluntary–not mandatory–choice of health and prescription drug programs;
  • voluntary and affordable access to safe, quality medicines;
  • their own doctors–not the government’s–deciding what’s important for seniors’ health;
  • minimal bureaucracy and government intervention.

What seniors don’t want is also clear. They don’t want:

  • to be forced to leave their current prescription plan and enter a government program;
  • one-size-fits-all, government-run health care;
  • government bureaucrats controlling what medicines they can get;
  • government interfering in their relationship with their own doctors.

Put differently, seniors want what retired federal government employees already have: choices.

Under the Federal Employees Health Benefits Program (FEHBP), insurance companies design health plans to appeal to federal government employees and retirees in different circumstances and in different parts of the country.

For 2003 these private health plans are competing to enroll federal employees in one of 188–yes, 188–different health insurance plans. Each person has the opportunity to choose the option best suited to that person’s medical wants and desires.

As Robert Moffit, Ph.D., director of domestic policy at The Heritage Foundation and former assistant director of the United States Office of Personnel Management, recently wrote: “Unlike many retirees in the private employer-based health insurance system, federal retirees enrolled in the FEHBP have routine access to the full range of health benefits available to active federal employees and are not burdened by extraordinary rate increases or cutbacks in benefits or coverage.”

This year, the American Postal Workers Union, a large postal employees’ union, will offer federal employees (not just postal service employees) a health care spending account worth $1,000 per person or $2,000 per family. Employees will be able to draw on this account to pay directly for routine medical expenses, and any money left over in the account will accumulate and be available in following years, similar to a Medical Savings Account plan.

Moffit writes, “FEHBP enrollees will be able to have access to Flexible Spending Accounts, a tax-free health-care account now available to millions of workers in many private corporations for out-of-pocket payments for medical services.” This option “would allow federal workers to deposit up to $3,000 a year in an account tax free to pay for out-of-pocket expenses and up to $5,000 a year tax free for child care and the care of aged parents.”

The federal government’s “Do as we say, not as we do” phenomenon is no new thing. It didn’t surprise us when the rhetoric of the Clinton health plan of the early ’90s–supposedly “good for all Americans”–wasn’t good enough for Congress. Members of Congress sought to exempt themselves and other federal employees from the plan. They and the government employees’ unions pushed to continue the multiple choices available in their own FEHBP instead of the Clinton proposal for a government-run monopoly.

However, when it comes to choices in medical care, “Do as we say” is not acceptable. Congress should be “doing unto us what they do for themselves.” All voters want is the freedom to choose the quality of care they want, at least as good as the choices members of Congress give themselves and almost 9 million other federal employees.

Michael Arnold Glueck, M.D., is an award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a former president of the Association of American Physicians and Surgeons.