The Health Care That Members of Congress Get

I think leaving out the gym and other perks understates this.

KT,

My PPO through my non-profit employer actually sounds comparable and my employer pays more (75%) of it than the Federal average.

Of course I'd trade that coverage in a New York minute for free access to Walter Reed and Bethesda. Wonder if that's what they mean when they say we'll get health care that's at least as good as Congress? Somehow I doubt it.....

Would a lawmaker ever be turned down for coverage?
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Would a lawmaker ever experience rescission?
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Would a lawmaker ever declare bankruptcy due to income-disproportionate out-of-pocket expenses deemed uncovered after diagnosis/treatment?

Great question Karen. But besides premiums you should dig into the weeds a bit and ask about out of pocket, deductibles, co-pays and if they have 100% coverage after a certain point.

Our costs are $1200 per month for a family of four. My employer pays 50%. Sounds comparable so far, with our being slightly less generous on the employer side. But we pay the first $1500 of any above and beyond stuff (like husband's CAT scans) and and 20% up to $3000 for for co-pays ($25) and lab work. Then co-pays and lab are paid by insurance at 100%. Drugs are $25 for any regular prescriptions, with some drugs not covered, and other we have to pay a percentage of the cost. (We paid $60 for son's Allegra...so we're now back to generic Clariton).

But we never hit 100% on the stuff related to monitoring his ongoing illness. We always pay 20%. So his first CAT scan this year was the full $1500, the next one will be $300, and any additional work, like surgeries will be billed at 20%.

That's what we've got. The costs have gone up a lot every year, while the benefits get less generous. We also have to worry about remaining employed...lose your job, lose your insurance (yeah, you can buy Cobra, but who can afford it without a job?).

opps, should read $25 for co-pays and 20% for assorted other stuff up to $3000. But even when we hit $3000 there's not 100% coverage on some things (like CT's, surgery).

Tech question: what html do I use to get paragraphs, p-tags down't seem to work...

Can you see Blue Cross kicking Lieberman off their plan because he didn't disclose that he once went in to get treated for whiny, nasally voice? Or keeping him on the phone for 2 hours to get x-rays for a broken ankle approved? I have a feeling that Senators don't put up with any of the crap we are treated to.

Th' cap'n be a federal employee an' we be havin' th' FEP blue cross basic option. It be fine fer' reg'lar maintenance, bu' I've me worries regardin' wha' would 'appen should somethin' more serious occur.

Me experience wi' some ongoin' problems be no so pretty.
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Fer instance, BC decided tha' no matter wha' me doc recommended, they only be payin' fer follow-ups fr'm me retina detachin' (I'll be needin' 'em fer th' rest o' me life) every other year instead o' yearly. So, every other year, we be havin' an' extra several hundred dubloons out o' pocket. An' despite th' fact tha' 3 times now additional surgery were found t' be needed fr'm follow-ups in th' years I were payin fer...surgery tha' would'a been too late had we waited another year t' find th' problem, they continues t' refuse t' pay except on wha' they be decidin' be necessary. It be ri' frustratin'. We be fortunate t' be able t' afford t' pay th' off years on our own.

An' this be considered a "good" plan...
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Arrgh!

Yeah, right, Congress critters are treated just like the rest of us. They get no special treatment at all (except for the best freaking hospitals in the country). They never get turned down for pre-existing conditions, huh? Horsefeathers, KT.

Just out on th' AP:
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http://www.google.com/hostednews/ap/article/ALeqM5j8xlwrrdMmmpRPqNM9_T-D650YDQD9913SJ01
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"To enhance their clout, insurers, drug producers and other parts of the health industry have made over $372 million in campaign contributions to lawmakers since 2000, according to a report released Wednesday by Common Cause, the nonpartisan public interest group. Nearly half the total — $178 million — has gone to members of House and Senate committees that oversee health programs. They have also spent over $3 billion lobbying, with their annual expenditures growing yearly, the study said."
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DUH!
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They were gettin' ready fer this game long b'fore "we" were, an' they be ahead now 'cause o' it.
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YARR!

[...] Go here to see the original: The Health Care That Members of Congress Get (Time Magazine) [...]

Um. How does that "taxpayer subsidized care at Walter Reed and Bethesda" work exactly? I read through my Blue Cross PPO paperwork and it doesn't say anything about me being able to go a top-rated national medical center for free (would that be a public health option that Congress has that they don't want everyone else to have?). Maybe I'm missing how Congress gets the same sort of health care insurance that everyone else gets??

But I'm sure that no Congress person would ever actually choose the public health option they have over their private insurance, right?

So how does that stack up with what you've got?
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I can't really tell...when it comes to insurance coverage, the devil is in the details. What are the federal co-pays for doctor visits and drugs?
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I pay $5K/year for skimpy coverage and high co-pays. Beyond the basics, many things are not covered at all and can get very expensive. For example, I just discovered this morning that the CPAP machine recommended by my doctor will cost me $170. My government-employed friend, who has coverage through the same insurer as I do, paid $35 earlier this year for the same thing through the (there's no charge at all for seniors).
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The current for-profit insurance model is riddled with inequities and in most cases, it's those who pay their own bills who pay more for less.
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As far as I'm concerned, a single-payer system is the only rational way to go. If they can finance single-payer in Europe though employer contributions combined with government and/or individual assessments, why can't we do the same here? Why does everyone talk as though the only choice is a taxpayer funded, UK-like model?

Hahaha how does that stack up. I don't have health care. Whatever it is, I'll take it.

[...] time to come up to speed since she not only has a taxpayer-subsidized health-insurance plan, but access to free care at our nation's top government hospitals.) So here we are, getting a bit of what I think [...]