Ever since he won his first race for the U.S. House in 1992, Sherrod Brown, an Ohio Democrat, has refused to use the federal government's health insurance program.
Instead, as a protest against the fact many American's don't have health insurance, he's obtained it elsewhere.
Few lawmakers in Congress have been as active in the current debate in the Senate over health reform. He has spent much of his time in recent weeks pushing for the "public option" -- a government-run health insurance plan that would be available to anyone not currently covered by health insurance.
His interest in the issue emerges in all kinds of ways. When a new book on health care reform, T. R. Reid's "The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care," was mentioned, Brown said he already had read it.
He recently agreed to answer questions about the issue.
Q. Is it true that you've refused to accept government health insurance for yourself, even though you qualify, because you're waiting for reform to happen first?
A. Yes, I made a promise in my 1992 campaign that I would pay my own health insurance until everybody in Ohio, everybody in my district in those days, had decent health insurance. For 17 years, since I've been in Congress in '92, I've paid my own ... Now I'm on my wife's plan the last five years and I pay a good bit extra to be on that plan. I'm not complaining. I made that commitment because I think that Congress needs to get more serious than it has over the years.
Q. Why is the public option so important to you? Why are you fighting so hard to get that?
A. In too many places, there is little competition. Private insurance companies, two or three companies in many cases, have cornered the market. And as a result, the quality is lower and the cost is higher. Too many insurance companies have canceled people's insurance because of pre-existing conditions, or have discriminated based on disability or gender or geography. The public option will provide competition for private insurance. It will make private insurance companies more honest, because they can't game the system.
It will provide competition where there isn't much competition in the insurance industry. It will bring prices down, because of competition.
Q. Can you clarify what you mean when you say you want to make the insurance companies more honest? Do you think the health insurance companies are less honest than other industries?
A. The health insurance companies have sometimes said one thing and done another. They say they don't want to discriminate, and then they cut people off their insurance because of some technicality. The insurance business model basically is, we don't want to insure people who are sick, that have a preexisting condition. And the people we do insure, we fight the claim. There's estimates that 25 to 30 percent of all claims are denied on the first round by insurance companies. (With) the public option, you're not going to spend a whole lot of time fighting with the insurance company to get your claims paid for.
Q. Usually the news coverage about the various plans that have been advanced in Congress say something to the effect of, "If this passes, 95 percent of all Americans will be covered." Why not pass a single-payer bill, and make sure that 100 percent of all Americans are going to be covered?
A. Well, I would have supported Medicare for all, but that isn't what the president supports, and it wouldn't have passed the Congress.
Medicare doesn't quite insure everybody. There's 1 percent or something of people that don't have Medicare, that are Medicare eligible. We just want to get up to as close to 100 percent as we can. And that's what we're working on. It wasn't in the cards to do a Medicare for all, single-payer system.
Q. Senator, I kind of came in from the left on you when I asked about single payer. Now I'm going to ask a question sort of from the right. If businesses want to comply with a mandate for health insurance by offering health savings accounts with a high-deductible health insurance plan, would the bills working through Congress allow them to do that? And would you be in favor of allowing them to do that?
A. The bill grandfathers all of them in if they are already doing that ... I don't know what (Senate Majority Leader Harry) Reid has actually written, but I'm virtually certain it grandfathers them in.
Second, I want to do whatever it takes to get people insured in large numbers. If it's a mix of private and public, that's fine. That's the way our system works pretty well over the years.
Q. I'm reading a book on health insurance by a Washington Post reporter, T.R. Reid ("The Healing of America"). He makes two statements in the beginning. He says the United States is the only industrialized country where you can go bankrupt for lack of health coverage. And it's the only industrialized country where thousands and thousands of people die every year because they don't have health coverage.
How confident are you that we are going to fix those two things?
A. I think we are.
To me, this is a moral question and an economic question, both. It's a moral question because Americans die because they don't have insurance. They don't always get to go to the emergency room and get care, in spite of what people think.
It's an economic question because it is so onerous, it's such a heavy burden on business, small business and big business ...
So the answer is, yes, I think we'll pass it.