Sauce for the Gander

In the debate over health care, there's one guaranteed, sure-fire way to give Americans the best plan possible: Require that the government adopt the same plan it imposes on the rest of the nation. Currently Congress exempts itself from any health-insurance bill it passes. And no wonder: The plan Congress enjoys is one of the best out there. Consider some of the provisions of the Federal Employee Health Benefits Program. First, it allows federal employees to choose from among ten to twenty different plans every year-compared to only two or three offered by most employers. This gives federal employees the opportunity to do cost comparisons: to examine the premium prices, out-of-pocket costs, and doctors in each plan. They can then make an informed decision based on their own particular needs. The system offers a strong incentive to select the best value for the money. Active consumer choice leads families to act more economically than they do in most corporate plans. In fact, because of the incentive to economize, over the past 15 years the rate of increase in premium costs paid by federal employees was a third lower than the increase paid by the rest of us in ordinary employer-sponsored plans. One of the best features of the federal plan is that employees keep their coverage as they move from job to job within the government. In the rest of the nation, if you change your job, you lose your insurance. We're constantly told that 37 million Americans have no insurance; but what we're not told is that three-quarters of those people are experiencing a gap in coverage because of a job change. All Americans ought to have the same security enjoyed by federal employees. After all, when we change jobs we keep the same auto insurance, the same life insurance, the same home-owner's policy. Why shouldn't we keep the same health insurance? So as Congress debates the merits of various health-reform plans, our response ought to be simple: Don't give the American people second best. Give them the same choice, the same security, enjoyed by you folks in Washington. Ironically, the plan proposed by President Clinton actually works against choice. It mandates a one-size-fits-all standard-benefits package for everyone. The president wants to include everything from high-ticket items like mental health and nursing-home care to trendy things like "health-education classes," "nutrition counseling," and "stress management"-what Paul Gigot of the Wall Street Journal facetiously calls the "Oprah entitlement." These are things you will be required to pay for, whether you need them or not. There will be little room for family economizing. I still say the best strategy for making sure we all get a good plan is to require that those who frame the law have to live with it. It's a scandal that federal employees have enjoyed a level of choice and security denied to the rest of us. The biblical model of leadership is the servant-leader. There's no place for garnering the best for oneself-while imposing a second-class program on the rest of the nation.

11/15/93