Share the health - Congressmen's medical benefits and perks

Washington Monthly, Oct, 1992 by Stephanie Mencimr

Why hasn't the Washington establishment done anything about the health care crisis? Follow us inside the comfy world of presidential and congressional health care....

Until recently, when you thought of Oregonians you probably envisioned Birkenstock-shod tree huggers earnestly sorting plastic from paper in the nation's recycling capital. But if you've tuned in to the nightly news lately, you may have a slightly different image--one of hospitals and doctors and sick people. Legions of reporters have besieged Oregon in the past few months trying to get a look at one of the country's first broad-based efforts to resuscitate an ailing health care delivery system.

For the past five years, as Congress and the White House noodled around on health care reform, Oregon grappled with all the tough issues--cost, access, quality--and came up with a plan to make primary health care available to all the state's residents, regardless of income. Other state legislatures, from Hawaii to Florida to Minnesota, have made moves as well, providing subsidized and even free health care to the working poor. And with all the heat they're now taking from the Bush administration and health care industry representatives, you'd be excused for forgetting that they're an exceptional breed of politicians: ones getting knocked for actually doing something about health care.

So how is it that a few states have the guts to tackle the issue while the Bush administration ducks and Congress covers? Is it Oregon's bracing air? Minnesota's clear water? Or is it that the politicians who make up those legislatures are still real people--people who don't

V have to read policy tomes to see that America's health care system is in crisis.

Oregon's legislators, for instance, meet once every two years; they're police officers, farmers, electricians, housewives, union bosses, small business owners, real estate agents, and professors who spend the majority of their time in their own communities working regular jobs with regular people. Unlike Bush and members of Congress, who enjoy an extensive network of low-cost medical benefits and perks, Oregon legislators don't need Pennsylvania Senator Harris Wofford to tell them that people are worried sick about health care. Most of the year, they see it firsthand.

Maybe it's asking too much to wish that every U.S. congressman could experience America's health crisis as directly as the average electricians sees it. But a trek through the cushy health care empire of Washington politicians should chill the average Joe's ticker. Few lines, minimal costs, a galaxy of options, and guaranteed coverage make the federal government and Capitol Hill just about the only places in America where health care isn't in crisis. And it also makes one wonder whether the real explanation behind Washington's failure to act on health care isn't a matter of insurance industry PACs or pleas from small business or the other usual suspects, but a product of plain old insulation. Of course, the point isn't that congressmen and other officials should be denied adequate health care. It's that the rest of America should be afforded it, too.

Executive privilege

Even the plushest hospital couldn't be mistaken for a Ritz-Carlton with catheters; hospitals can be miserable places. But some are less miserable than others, especially when you're North Carolina Rep. Bill Hefner. Last June, when Hefner arrived at Walter Reed Army Medical Center for bypass surgery, there were no suspicious inspections of his insurance card, no long waits in cold rooms full of screaming kids. Instead, he was greeted by an orderly who helped him check in and then escorted him to the Eisenhower Executive Nursing unit. This is a high-security, extra-private VIP wing that sports a stereo (circa 1956) compliments of John Foster Dulles and is decorated with artwork donated by Jackie Onassis and the Eisenhowers. Hefner spent nearly a week and a half being tended by Walter Reed's elite cadre of cardiologists before going under the knife. After surgery, he was afforded eight days to recuperate.

Had Hefner been a private citizen and undergone the same surgery at George Washington University med center, a private hospital a few miles away, the charges would have mounted fast. The actual surgery would have been $8,000, and he would have been charged $2,789 for each day he spent in intensive care and $1,000 a day for a regular room, for a grand total of about $40,000. But as a member of Congress, Hefner paid nothing for his medical care. The only bill he received for his stay was for the room and food (at a relatively cheap $701 daily rate)--the entire sum of which was promptly picked up by his Blue Cross health insurance, provided through the federal government.

Granted, most people with decent health insurance would probably have their bypasses at least partially covered, too. But then again, they might not. Medical costs have risen so steeply that insurance companies now resort to all sorts of creative ways to pinch pennies, such as delaying claim payments, limiting the amounts they pay for some treatments, and subjecting consumers to long waiting periods before they are eligible for coverage. Excluding preexisting conditions from coverage is almost standard. So it should come as little surprise that, according to a recent study, almost half the patients who were unable to pay their hospital bills actually had insurance but their policies simply wouldn't cover their treatments.