To the editor:

Do Americans deserve the same insurance options as their employees in the U.S. Congress?

Quoting Sen. Nick Kristof, "It may be that the lulling effect of having very fine health insurance leaves members of Congress insensitive to the dysfunction of our existing insurance system." So what better way to attune our leaders to the needs of their constituents than to put them in the same position?

House and Senate members are allowed to purchase private health insurance offered through the Federal Employees Health Benefits Program, covering more than 8 million other federal employees, retirees and their families. It's not a "single-payer" system where government acts as the only health insurance company. It's not a centralized, government-run health care program. It has been praised by both conservatives and liberals.

Per Congressional Research Service, the FEHBP offers about 300 different private health care plans, including five government-wide, fee-for-service plans and many regional health maintenance organization (HMO) plans, plus high-deductible, tax-advantaged plans. All plans cover hospital, surgical and physician services, and mental health services, prescription drugs and "catastrophic" coverage against large medical expenses. There are no waiting periods for coverage of new employees, no exclusions for preexisting conditions. The FEHBP negotiates contracts annually with all insurance companies who participate. Competition is high since FEHP is the largest employer-sponsored health plan in America.

Coverage may be switched to another plan during a yearly "open season" period. "Satisfaction surveys" of each plan with more than 500 members are published annually. The government (that's us) pays a large share of the cost of coverage. On average, we pay 72 percent of the premiums up to a maximum of 75 percent depending on the chosen policy. Example: One family plan's premium is $1,120.47 per month. The beneficiary pays $356.59. An HMO option family plan's premium is

$629.46 per month and the employee pays only $157.36. Doing the math of costs to the government (again, that's us) for members of Congress, their families, plus more than eight million other employees, retireees and their families, is staggering.

Members of Congress also qualify for medical benefits that ordinary federal workers do not. They (but not their families) are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, for an annual fee of $491 (in 2007). House and Senate members (but not their families) also are eligible to receive care at military hospitals. For outpatient care, there is no charge at the Washington, D.C. area hospitals (Walter Reed Army Medical Center and National Naval Medical Center). Inpatient care is billed at rates set by the Department of Defense.

How is it that these elites in Congress can cut care for Medicaid and Medicare patients, force others to buy inferior insurance, while enjoying their Cadillac plans? A good question to ask your representatives and senators. If we all must sacrifice, why not those whose salaries we pay?

(Information gathered from FactCheck.org and their listed sources, August 25, 2009).

Charlotte Koewler

Newburgh