Federal workers who never marry, or have children, who don’t get sick, never fall down the stairs or off a horse, avoid being struck by lightning or buses, who don’t engage in risky or dangerous practices, who abstain from booze, tobacco and fatty foods and who never age should get a big break on their health insurance premiums.

But they don’t. (…distant sound of violins)

They don’t because the FEHBP is what is known as a group plan. Nearly 9 million folks who range from tri-atheletes to people who are totally paralyzed.

The question is why people who never (or seldom) use their health insurance should subsidize those who are heavy-users.

In a sense young healthy people “subsidize” older workers and retirees who on average cost 60 percent more in doctor and hospital bills and prescriptions. By the same token healthy seniors “subsidize” younger people who have or adopt lots of children. Both groups “subsidize” people — young or old — who have chronic illnesses or disabilities that make them heavy-users of medical services.

I mention this because I have gone from an immortal and invincible young man, to divorced father of four middle-age children. I was always very healthy and the kids were too. For 25 years I “wasted” thousands of dollars paying for health coverage that I mostly didn’t need. Then 10 years ago, in one procedure, I got it all back. In spades. Most of my doctor and hospital bills were covered by my health plan. A group plan.

I also mention this because each year, just prior to open season, those of us covering the government beat get emails (formerly letters) from people who want to know why they should pay premiums for other peoples problems. They want to know why the government doesn’t set up special categories of insurance. In effect a tailored-for-one plan but taking advantage of group rates.

Example:

• ” I guess you would call us DINKS (for double income no kids). It is just my husband and myself. We are both federal government employees. We rarely eat meat, have never smoked, don’t take or need drugs of any kind. In addition we are serious runners. He has a 26.2 sticker on the car. I am more modest but I recently did the Army 10-Miler. We do not plan to have children and wonder why the federal government requires us to pay a “family” premium when our “family” consists of of only two very healthy people. We each have people in (our offices) with many children, with many medical issues. When some of the older workers line up their prescription drugs it looks a small pharmacy. Any chance things will change?” Dianne
• In a recent column on federal health insurance, you made the statement “Retirees get the same benefits and pay the same premiums as younger, healthier workers.” I’m not sure I can agree with that, at least not after you reach the age of 65 and join Medicare.

  Once you are in the automatic Part A Medicare, it seems to me that you have to also enroll in the optional Part B to get the same level of benefits that you do prior to age 65. Of course, that costs an additional monthly premium of over $100. So now you are actually paying more than the active employees. Am I misunderstanding the situation?” T. J. M.

When I responded that retirees pay the same premiums (in the same plans) as a young, healthy 25-year old worker, he replied:

“Yes, I pay the same FEHB premium as a 25-year-old. But to get the same medical benefits as the 25-year-old, I have to pay over $100 a month additional (i.e., Part B Medicare). Or so I have concluded after studying the situation for the last couple of years…”

Trying now to arrange a lunch with Dianne and TJM. Will let you know how that goes!

NEARLY USELESS FACTOID

By Jack Moore

Which country has the highest rate of twin births? The Central African nation of Benin with 27.9 twins born per 1,000 births takes the top spot. Scientists believe a mother’s age, height and number of previous births all influence the instance of fraternal twins, LiveScience reports.

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