Give Congress a taste of our medicine

Here's my suggestion for solving the nation's healthcare crisis — the one that I would propose at one of those town-meeting shoutfests if I could get in a word edgewise: Make sure that members of Congress are living with the same health benefits that the rest of us are.

As reported recently by the Los Angeles Times, you see, senators and members of the House of Representatives enjoy a health insurance program that insulates them from the costs, problems and worries suffered by millions of uninsured and underinsured Americans. Like other government workers, they have their choice of ten different health plans, while 85% of companies offering a health plan to their employees offer a single option. They pay a modest $300 a month for family coverage, according to the Times. And — in stark contrast to the difficulties faced by cancer survivors or diabetes sufferers who try to get health insurance on the individual market — they don't have to worry that pre-existing medical conditions will prevent them from getting coverage or sorely limit their coverage if they do manage to get a policy.

With such cushy benefits, it's easy for members of Congress to get all passionate about the theoretical issues surrounding health care funding and the social safety net, while ignoring the practical realities what it's like to go broke paying for catastrophic or chronic medical expenses. So let's help them focus their minds and best intentions on the problem at hand.

What we'll do is randomly select senators and representatives to live with a particular quality of health care in the same proportion as the rest of Americans. Forty-six million Americans — 18% of the non-elderly population (in other words, too young to qualify for Medicare) — don't have health insurance at any one time, according to the U.S. Census. So 18% of members of Congress — 18 senators and 78 representatives — will start walking around uninsured. Very quickly, one supposes, they'll be a lot more nervous crossing the street and a lot more worried when a family member starts running a temperature during flu season.

But that wouldn't give Congress a complete taste of the anxiety that Americans feel about their health care — the knowledge that even if you do have affordable health insurance, you could lose it at any moment. All it takes is a job loss or an employer who decides it's just too expensive to provide insurance as a benefit. So, because by one estimate one-third of the non-elderly went without health insurance over 2007 and 2008, we'll make sure that 33 senators and 145 representatives randomly lose their health coverage for a time over each two-year session of Congress. That averages out to roughly a year without health insurance for all those lucky congressmen and congresswomen and their families. Again, let's hope for their sake that they don't choose that year to come down with an expensive medical condition.

Finally, let's make sure that an appropriate number of congressmen feel the financial pain felt by those for whom having health insurance doesn't protect them from financial pain. Seventeen percent of employees with coverage through their employer (see page 7) ended up paying more than 10% of their after-tax income on health expenses such as premiums, co-pays and co-insurance. A whopping 53% of people purchasing non-group private insurance paid more than 10% of their income on health care. So, with the number of people getting health insurance through their employer declining on a regular basis, let's split the difference and dock 10% of the after-tax pay of 35% of congressmen — 35 senators and 152 representatives — and call it a day.

What do we end up with? Two-thirds of elected officials in the legislative branch who either have no health insurance or have reason to be unhappy about it. As the Samuel Johnson quote goes, "(W)hen a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully." If congressmen knew that their own physical and financial health were at stake, I'm sure they'd solve the health care problem faster than you can say, "Tea party."