Opening up Federal Employees' health program sounds great. But it's a point where good health politics meets bad health policy.
By Joshua Holland, AlterNet
Posted on December 11, 2009, Printed on December 14, 2009
http://www.alternet.org/bloggers/www.alternet.org/144518/
I'm not going to write a big wonky post about the Senate health-care compromise today. I just want to highlight a small point: the idea of having the Office of Personnel Management -- the federal government's HR department -- administer the program is really smart politics, but a pretty bizarre policy when you stop to think about it.
The Dems' health care plans are roughly modeled on the benefits program federal employees, including members of Congress, enjoy. There's a government-run exchange. Private insurers sell policies within that exchange, and they have to conform to certain rules and offer a set of minimum benefits. After that, they compete -- federal employees choose from a variety of plans. If the "public option" existed, it would just be one among several different insurance plans in the exchanges.
During this summer of brain-dead right-populism over health-care, folks at Town Halls would berate their representatives for not signing themselves up for the program they were creating.
The reason they didn't, of course, was that in order to assuage those same idiots' irrational fears of a socialist take-over of the U.S. health-care system, lawmakers had specifically excluded those who currently have decent insurance through their employers from participating. And federal employees already have decent insurance through their employers.
Of course, the rage at those town-halls was the definition of "inchoate," and not exactly inspired by wonky white papers on health-care policy. So surely part of the motivation for this new approach is that it allows Blue Dogs Dems to go back to their districts and say, 'I only voted to give you the same health-care as I get as United States Senator.'
And that's incredibly powerful politically. 'If it's good enough for me and my staff, it's good enough for you!' is a winner.
But as far as policy goes, it's rather bizarre. The Office of Personnel Management, which administers the Federal Employees Health Benefit Program, isn't set up to handle this kind of plan, and is not known to drive a hard bargain with providers. Federal employees unions are coming our against the idea, fearing that it would screw up their benefits program.
And I think as far as the policy goes, Margaret Baptiste, president of the National Active and Retired Federal Employees Association, has it about right. She told the WaPo, that a program modeled on FEHBP should be operated by the Department of Health and Human Services, since "one of their fundamental responsibilities is to administer large health care systems for diverse communities of coverage."
And what does "a program modeled on the FEHBP" but run by HHS look like? The Dems' health-care reform scheme with a public option.
It's pretty amazing when one considers all the knots these folks are willing to twist themselves to avoid challenging the insurance industry too directly.
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