Public option or no public option? Employer mandate or no employer mandate? Opt in or opt out? Meaningful health-care overhaul in 2009, or ultimately very little reform?

These are just some of the questions that keep commanding the ever-changing debate over U.S. health-care reform, which nearly all agree is long overdue. Everyone in Congress talks about their desire to make health care more affordable to more Americans and reduce the global competitive loss to businesses saddled with providing increasingly costly coverage for their employees.

But that's where the agreement ends.

Republicans are marching lock-step with their insurance industry allies, firmly opposed to any kind of government-run alternative to private insurance. Democrats, although holding a majority in both houses of Congress, can't seem to find an approach that the whole party - including the so-called "blue dog" conservatives - can agree upon.

And the debate goes on, fueled by distortions of the various proposals put forward. Certainly, there is a need for a degree of financial prudence to be inserted into any proposal. What's the projected cost? Will savings in one area balance new spending in another?

Good questions worthy of fair and open debate.

But most of these projections are pure speculation, based on theoretical arguments and estimates of future economic conditions that may or may not come to pass. And if there's one thing most legislators seem to possess in spades it's the ability to pump out partisan gas about how the other side is going to wreck the country.

And very little skill for the once-noble art of compromise for the good of the nation.

For many, it's not about creating a proposal that all can support, each giving up something and gaining something in the end. Unfortunately, in the last 20 years it's come down to a partisan game of who wins and who loses.



Federal coverage bubble

Five hundred and thirty-six people hold the solution to America's worsening health-care dilemma in their hands - 435 representatives, 100 senators and the president. However, these elected officials exist in a bubble of their own cheap health insurance offered by some of the nation's richest corporations.

Through the Federal Employees Health Benefits Program, U.S. legislators who choose the District of Columbia as their place of residence can select from six different plans from companies like Aetna, CareFirst, UnitedHealthcare and Kaiser.

All of the plans offer rich benefits. It's a system that's been in place for federal employees since it was authorized by Congress five decades ago, when most Americans weren't focused on the discrepancies between what average people paid for health care and what bureaucrats and public "servants" paid. A ripe plum for those lucky enough to be elected or otherwise hired onto the public payroll.

A very generous public payroll, by the way.

Michael Orenstein, a spokesman for the U.S. Office of Personnel Management, said federal employees' health-care premiums are sweetly supported by government subsidies - how socialistic! - of up to three-quarters of their cost.

"On average, the government pays between 70 and 72 percent of the total premium," he said. "It is a good program."

But sometimes it's even higher. For example, for the Aetna HealthFund family coverage plan with a total monthly premium of $1,004.62, the non-postal policyholder pays $251.15 and the government - that's you and I and other taxpayers - picks up the remaining $753.47, or 75 percent of the premium.

And the health benefit package available to everyone from the president on down to your local mail carrier lets legislators choose if they want to be covered under D.C. rates or perhaps cheaper rates in their home state.

Orenstein said these plans also have another great benefit: They aren't subjected to the usual rules of exclusion or modification that most private citizens face when trying to get coverage. Rates are not based on age or gender or physical condition or if the policyholder smokes like a chimney.

"These are fixed rates for both federal employees and retirees," Orenstein said. "The program was structured that way when it was authorized by Congress in the late 1950s."

And here's the kicker for members of Congress: Each rank-and-file U.S. senator and representative now earns $174,000 a year while minority and majority leaders in each body earn $193,400 and the speaker of the house gets $223,500.

Cheap, easy-to-get insurance primarily at public expense for people making about four times what the average Joe and Jane earns - the ones who still have jobs, that is.

Is it any wonder that the people who will ultimately say how health care is reformed - or not - may find it difficult to relate to those of us who aren't on board the insurance coverage gravy train?

 

Steve Porter covers health care for the Northern Colorado Business Report. He can be reached at 970-221-5400, ext. 225, or at sporter@ncbr.com.