Rep. Richard Gephardt (D-Mo.) says it is silly to assume that federal employes would get caught with their benefits down if the government shifted to a voucher-type health insurance program.
Currently, federal employes pay anywhere from $300 to $1,400 a year for health insurance. The government, under a complicated formula, pays between 40 percent and 75 percent of the premium, depending on the kind of coverage the worker or retiree selects.
Reagan administration officials want Congress to go to a voucher system, whereby employes and retirees would get a voucher annually. The officials maintain that it would be enough to cover the full cost of a basic-benefits health plan. Workers who wanted more expensive plans with better benefits would pay the difference.
The argument in favor of the voucher system is that it would encourage insurance plans to design packages that employes could buy with their vouchers. And it would also encourage employes who thought they could get by with basic insurance to buy those plans, rather than the high-option plans that cost workers and the government more money.
Opponents of the voucher plan see it as an administration ploy to remove controls from the health care industry and save the government money by encouraging employes to buy the lowest-priced plans.
Several weeks ago Edwin C. Hustead, formerly the Office of Personnel Management's chief actuary, warned that the voucher system could lure employes into selecting plans based strictly on price, rather than on the coverage they provided.
Gephardt, who has been working on health care cost containment plans in Congress, says feds are fully capable of picking the best health plan, and to suggest otherwise is "insulting."
"These are people," Gephardt said, "who are better educated than the American population generally, who make basic decisions personally about home and family and who also make the policy decisions that have some impact on the lives of all of us."
Hustead's argument--that, given the opportunity to shop for health insurance, feds would be "little more than lambs waiting to be fleeced"--is "balderdash," Gephardt maintains.
"To change the argument slightly, think of what would happen if we let these people buy any car they want," he continued. "The experts know that safety, durability and fuel economy are important issues.
"But people might be impressed by flash and dash and low price. They might be tempted to buy a car that had lots of glitter, a very low price and a mechanical and electricial system guaranteed to fall apart within six months, or 6,000 miles, whichever came first. Wouldn't there be a danger that they'd made a bad decision and not realize it until it was too late, say at mile 6,001?
"Yet we let them do it," Gephardt observed. "We have some minimum safety standards to prevent them from buying cars that would be little more than rolling bombs. We'd have similar standards for health insurance. We could easily, for instance, insist that catastrophic coverage be included in any package offered. Obviously, we'd have to insist on some proof of financial viability so the firm offering the plan couldn't quietly go out of business."
Feds have had lots of practice shopping for health insurance and, Gephardt said, the record shows "that they are quite rational."
Gephardt said "I really consider it a quiet insult, though, to suggest that thousands of federal employes are unable to make a competent decision about health insurance. In fact, I'd argue that their success in choosing so far is a recommendation for the change under consideration."
The OPM voucher plan is still awaiting clearance from the Office of Management and Budget. If OMB okays the plan, and the White House Cabinet Council agrees, OPM will ask Congress to set up the voucher insurance plan, which could begin as early as 1985.