Tailor federal health plan, young, healthy, childless say

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By Mike Causey

Everybody out of the pool. Or, almost everybody.

Imagine if your city, county or neighborhood swimming pool decided to ban children, people older than 60, smokers, the overweight or anyone with a serious or potentially serious medical condition or handicap. Or if it charged them a lot more for the privilege of sharing the pool with you. Or tossed them in another pool.

For the young (but not too young), hale, hearty and slender person that might sound like the perfect swimming hole.

Now, dry off and apply that same principle to the world's largest company-sponsored health plan. The federal health plan, or FEHBP, for short. It covers 9 million people, including three of the four people now running for president or vice president.

The FEHBP also pays the medical bills for virtually every active and retired federal civil servant. And their families, and in many cases ex-spouses (who never worked for the government), and in a growing number of instances, the grandchildren of retired feds or their surviving spouses.

Many people - both members and outsiders - consider the FEHBP the best health program in the nation, if not the world. The government, as employer, picks up the bulk of the total premium (an average of 72 percent for most civil servants, and even more for unionized postal workers).

The FEHBP offers any eligible person the choice of more than a dozen nationwide plans, and hundreds of local HMOs, or health maintenance organizations. Anyone who is eligible for the program can change plans during the annual open season (this year it is Nov. 10 to Dec. 8). The elderly and ailing pay the same premiums as young healthy workers in the same plans.

Premiums come in two flavors: Single or family. In each plan, the family premium (roughly double the single premium) is the same whether the family is you and your spouse or whether yours is the Brady Bunch.

It's the ultimate group plan.

But some people don't like groupies. They want Uncle Sam to carve up the program so that a family of 10 would pay a higher premium than a family of two. Or they would like older people (whose health costs are usually significantly higher) either to pay more or have their own health plan. Others would financially penalize people who smoke, drink too much or who have never seen a super- giant cheeseburger with bacon that they didn't like.

The idea, of those proposing customized health plans, is that people who are young, healthy and who prefer children in small doses would pay less. Because they cost less to cover. (Unless of course, they have a stroke or get hit by a bus.)

The problem with that is that even those who never marry and never have children will (if they are lucky) someday be old - and living on pensions that are generally much smaller than their salaries.

Some young feds have proposed a plan exclusively for the young and healthy. Some older feds complain (now that their kids are no longer kids) that they are literally sick of subsidizing people whose homes or apartments resound with the pitter-patter of lots of little feet.

Here's some mail on the subject for people who like the group rates as well as from folks who want plans to reflect the risks of those who are covered:

• "My wife and I made a decision not to have children. We are both reasonably healthy. Yet we (she is the federal worker) are required to pay the same premiums as a family that keeps popping out kids. Those families are, usually, a bigger drain on the system than a twosome like us." - Ken in Frederick

• "Tell those snivelers to be glad the federal government discriminates in their favor. I would gladly pay family rates to be able to get my domestic partner on my FEHB plan - my HMO would allow it, but I can't do it because the federal government discriminates against same-sex couples. Instead, we pay high premiums with an enormous deductible just to get her basic health coverage in case of catastrophic illness or accident. The result is that her 'plan' costs a fortune but actually pays for very little until you cross the high deductible limit."- KT in San Diego

• "As a retired federal employee, I agree ... it would be nice if the premiums could include rates for self plus one (or two single rate) instead of the self and family rate. While this would save me money, I think it would save the government money since the government's share of a self and family rate is more than the government's share of for two single rates." - Jeffrey N.

Mike Causey, senior editor at Federal News Radio AM 1050, can be reached at 202/895-5132 or mcausey@federalnewsradio.com.