In his speech to Congress on Wednesday night, President Obama touched on the urgency of fixing health care for America's small businesses. The President highlighted how rising costs are forcing business owners to scale back or drop coverage and how concentrated health insurance markets give insurance companies free reign to overcharge small businesses who have no leverage.
As people concerned with small business issues -- a local Chamber director and a small business operations manager -- we have a major stake in the success of health care reform. Our current health care system has failed small businesses famously. It has failed to control costs. It has failed to give small businesses real choices. It has failed to offer true financial security or peace of mind. As such, it threatens the very viability of small businesses across America.
Starting a small business that creates jobs and serves the needs of a community is part of the narrative of the American Dream. Yet small business owners who are doing exactly what that narrative says to do are facing a real nightmare when it comes to health care. Small businesses that do offer health coverage pay 18 percent more than larger businesses for the same coverage, are vulnerable to steep annual rate hikes with no recourse, and watch health care costs eat deeper and deeper into the bottom line every year. Businesses that can't afford it are left without any financial security and struggle to recruit and retain good employees against bigger competitors that can afford to offer benefits.
Small business owners are fundamentally problem solvers and pragmatists: we seek solutions to everyday problems, and we're interested in what works for business, our employees and our customers. We've grown accustomed, though, to the name of small business being borrowed - without permission - to justify conservative ideological positions. So we have pretty good radar for that sort of thing... and the alarms are going off right now in health care debate as conservative lobby groups try to paint health care reform as bad for small businesses.
The fact is, small businesses have as much to gain as anyone from real health reform that stops insurance companies from denying coverage, increases our bargaining power, offers us more choices, and drives down costs. There are four core components to the President's plan that will help small businesses afford quality health coverage:
- A health insurance exchange will promote transparency and new choices.
- A competitive public health insurance option will give small businesses new leverage, drive down costs, and force insurers to compete around cost and quality.
- Insurance market reforms will prohibit pre-existing condition exclusions and end discrimination against small groups based on health status and gender.
- Affordability measures, including tax credits for small businesses and subsidies for our workers, will make health coverage affordable for smaller businesses and our employees.
These elements are essential to make health care work for Main Street. Yet, despite these benefits, the name of small business has been invoked more often than not to justify opposition to reform.
For example, the health care surcharge proposed for the highest income earners to help make coverage affordable for everyone in the House bill, HR 3200, has been attacked as a "tax on small business" despite the fact that 96 percent of small businesses would be unaffected by the original proposal (the original proposal would begin assessing the surcharge on families earning over $350,000; it appears likely the threshold will be raised as high as $1 million). The overwhelming majority of enterprises you would think of as small businesses - your auto mechanic, the neighborhood florist, your favorite corner bakery or café - won't come close to being touched by this surcharge. Most small business owners will tell you they can only dream of taking home that much in profits... many will add that even if they did, they'd be happy to pay a little more to put an end to their constant health care headaches.
The President's call that everyone must take responsibility for meeting the challenges of health care -- including employers and individuals as well as government and insurers - has also been criticized in the name of small businesses, even though the proposed plans would provide an exemption for the vast majority of small businesses (as many as 95 percent) from the employer contribution requirement. The real point here though is that small business owners share a sense of responsibility to do right by their employees and want to offer health coverage. We need reform that makes it possible for small businesses to opt in on health care, not opt out - and that's what the insurance exchange, public plan, market reforms and affordability measures will do.
Small businesses can't afford to see costs double over the next ten years. They can't operate if forced to continue paying twice as much in administrative costs as larger groups. They can't continue to absorb the rate hikes that follow after an employee faces illness or injury, or go without coverage after being "purged" by an insurance company.
Without real reform, small businesses could be forced to cut coverage, lay off workers and shut their doors. We risk losing the critical foundation that small businesses provide for the economy and for communities. We can't afford the cost of doing nothing.
So why are some groups working so hard, against the facts, to make reform sound bad for small businesses? Because they know that speaking in the name of small business carries real currency in the American political debate. Now is the time for small business owners to speak for themselves and stand up for what we really need: real health care reform, and fast.
Susan Davis is the Executive Director of the Rainier Valley Chamber of Commerce in Seattle, WA. ReShonda Young is Operations Manager of Alpha Express, Inc, a family-owned transportation and contracting business in Waterloo, IA and an Executive Committee member of the Main Street Alliance (www.mainstreetalliance.org).
1. Regulate our food supply and stop allowing corporations to push their GMO's and chemical additives
2. Make quality nutritious foods more accessible and affordable
3. Teach children about nutrition -- ie. you are what you eat
4. Tax fast and junk foods the same as tobacco and alcohol
5. Ensure all have access to safe drinking water
6. Require companies to respect the 9-5 work day and provide adequate (no, 2 weeks if that is not adequate) vacation time for employees to take care of themselves and their families. Who has the time to maintain physical, emotional and spiritual health on a 60-hour work week?
This is important: the government is supporting a very profitable enterprise. The entrenched structure of health care makes it hard to understand and hard to change.
I’d like to see clear presentations with nice graphs showing the costs of health care, the source of the money, the direct and indirect subsidies, including research grants.
Employers need a vehicle for speaking out: even with the tax deduction, the costs are rising too quickly to be manageable.
Former small business owner....
If the President would allow what he calls “governments’ unfair advantages†to be used:
Everyone selecting public care would receive all care and medications free, no restrictions, no insurance and no co pays.
Businesses which select public care for their employees would have no further involvement to either pay anything for care or be involved in anyway with health care.
Using a national sales tax to pay for the public option would be a fairer way to spread risks and much less expensive than mandatory insurance, and care would be paid for when it is used without increasing our national debt.
All government funded costs could be reduced by hundreds of billions annually from the $2.6trillion spent last year if distributed only through civilian VA government hospitals.
America’s Veteran Administration is the largest, lowest cost; best outcome producing at any cost, health care delivery system in the US, it uses the world’s best medical software, and it has been controlling the problems with access, cost, quality, and malpractice successfully for years.
see Phillip Longman’s book Best Care Anywhere, Why VA Health Care Is Better Than Yours.
Going back and forth between free public, and user purchased private care, would allow unlimited choices, ultimate freedom, and always free public care would be available when it is needed.
To me the Public Option is a DEFENSIVE MOVE for the Americans People.
If more individuals were buying health insurance and less companies were, the price would definitely go down to meet what individuals can pay, not companies. AND, if they allowed people to shop for insurance across state lines there would be more competition. All the public option will do is lead to NO competition as small businesses will drop the healthcare they pay for.
I don't agree with you about the price going down if more individuals bought health insurance. In the beginning it would be so expensive no one could afford it because the insurance pool would be too small. That's the problem now. No one can afford quality health care for their families out of their pocket.
Who would we buy insurance from across state lines when most insurance companies have monopolies on health care insurance all across America? Blue Cross/ Blue Shield and Wellpoint have 69% of the health insurance business in Illinois. That's the way it is in most states . Large conglomerates own health insurance companies all over the U.S. and they would be able to charge whatever they wanted as they do now. With the status quo, in ten years only the very wealthy will be able to afford health care.
I am small business.
The Public Option allows any employees I might have to get care for any serious illness that my insurance (if I could afford any at all) might not cover. Small biz cannot afford those fancy plans large corporations can. Anything we could afford would only cover things like work related injury. It would not cover health maintenance for my employees which is even more important.
The PO creates competition that drives my cost of coverage down so I can try to provide more for my employees. At present, with premiums rising out of control, all small biz will have to abandon insurance. If there's a PO we can keep it. It's that simple.
There is nothing negative that can come from a choice in coverage.
Maybe if people would do more to stop getting sick in the first place, and stop calling obesity, baldness and ED medical conditions that need to be treated immediately, maybe small businesses would have to spend less money that they could save for the people who really need them, the critically and chronically disabled.
That is, of course, assuming you're one of the one in one billion small companies that even hires the disabled, and doesn't consider us "medical liabilities" as I've been called so many times
Obesity, however, leads to the critical and chonic illnesses that you DO make a valid point about.
1. Regulate our food supply and stop allowing corporations to push their GMO's and chemical additives
2. Make quality nutritious foods more accessible and affordable
3. Teach children about nutrition -- ie. you are what you eat
4. Tax fast and junk foods the same as tobacco and alcohol
5. Ensure all have access to safe drinking water
6. Require companies to respect the 9-5 work day and provide adequate (no, 2 weeks if that is not adequate) vacation time for employees to take care of themselves and their families. Who has the time to maintain physical, emotional and spiritual health on a 60-hour work week?