If Senators Lived Like Us

BOSTON — Boston -- Over the years, the U.S. Congress has developed a nasty habit of passing laws that apply to everyone except the people who pass them.

To this day, our legislators uphold a double standard that frees them from their own laws about workplace safety and discrimination. And this summer, if no one notices, they may devise a health-care policy that leaves them equally untouched. Someone has to tell these folks that what's good for the governed is good for the governors. Allow me to present a modest proposal.


The biggest difference in the health-care debate is between those who want to cover every American sooner and those who want to cover most Americans sooner or later. In the Senate especially, this has become a struggle between "universalists" and "incrementalists." Right now, senators who favor covering about 95 percent of us have won the coveted political title of "moderate."

The Five Percent Difference sounds like a small compromise. It sounds smaller, for example, than the number it represents: 15 million Americans. None of these people, of course, are senators.


Members of Congress already have universal health coverage. One hundred percent of the 100 Senators are eligible to join the federal health-care alliance which allows them to choose between plans and doctors, with no exclusion for pre-existing conditions. Only one reform proposal -- Sen. Ted Kennedy's -- offers Congress' plan as one of our choices.

Under my proposal, however, senators who are willing to settle for the 95 percent solution for us must also apply it to themselves. Before voting against a universal plan, they will be required to present the names of five colleagues -- exactly 5 percent -- who will immediately lose coverage.

Consider the health-care profile of the Senate. If this High-Risk Hundred were looking for an insurer of their own, they'd be rejected faster than the American Bungee-Jumping Association. These are 94 men and 6 women with an average age of 58. Most are lawyers by training who lead a sedentary work life punctuated by months spent in the ultimate Type A activity: running for office.

There are enough pre-existing conditions among this cohort group to to fill a medical text. We don't know how many are staying in their jobs because they don't want to lose their health insurance.

Faced with the requirement of naming names, senators could eliminate their colleagues by age. They could write off the five oldest members of the Senate beginning with the 91-year-old Strom Thurmond and the quartet -- Howell Heflin, William Roth, James Exon, Jesse Helms -- born in 1921.

The senators could also exclude cohorts by disease. They could go over the quota by choosing senators with a history of heart ailments. Or they could disqualify the quintet -- including the leader of the opposition, Bob Dole -- whose "pre-exist- ing condition" is prostate cancer.

The Senate, like the country, has its share of families that would be virtually uninsurable. Florida's Connie Mack runs down his family's history this way: He's had skin cancer, his daughter's had cervical cancer, his wife and mother have both had breast cancer. Is there a senator who is willing to cut the Macks off the rolls?

There are other candidates. Delaware's Joe Biden had an aneurysm. Pennsylvania's Arlen Specter had an awfully pricey brain tumor. Maybe it's easier to triage by lifestyle. Kentucky's Wendell Ford smokes. Ohio's John Glenn flies small planes. Oregon's Bob Packwood -- no, lunging at women (lunge-itis?) is not a pre-existing condition -- admitted a problem with alcohol.


Those are the easy calls.

If this proposal sounds much too personal, that's the point. A senator who can't cut five colleagues face-to-face shouldn't be cutting 15 million constituents anonymously. Health care is about real people.

The Five Percent Difference isn't going to come from the rich -- surely not the Senate millionaire's club -- or from the poor or very old. It will come from the working class and those who are or could be between jobs. Over a lifetime a whole lot of Americans will pass through that tiny percentage.

The truth is that we'll either get universal coverage or universal insecurity. This is the time when the fully covered Congress with its cushy health plan paid largely by its employers -- us -- should consider the Golden Rule of Re-election.

Do unto others -- all others -- as you have already done unto yourselves.

8, Ellen Goodman is a syndicated columnist.