I am a new NFIB member and not at all happy with the presentation of their stance on Health Care reform.

I find it appalling that the articles are filled with opinions and inflammatory comments but no references to the actual sections of the bill. I did not join NFIB for them to think for me or tell me what my opinion is. I want them to show me portions of legislation they are referring to and give me the pros and cons so that I can make up my own mind.

Gerri – thanks so much for joining NFIB and for taking the time to get involved! Being a member-driven organization, NFIB is unique among business associations. We ballot our members on policy positions and regularly poll our members through our Research Foundation. On health care, we’ve found that there are some specific things our members want us to support and others they want us to oppose.

A majority of our members have indicated they need health care reform to address costs, and that part of that involves reforming the small group and individual insurance markets. We support eliminating the use of health status as a rating tool, as that can severely drive up premiums for our members. Also, we are urging Congress to allow small business owners to pool at the state and federal level so that they can enjoy the same economies of scale as large corporations and labor unions. And, we would like to see tax credits made available for small business owners (including the self-employed) so that they can better afford health insurance for themselves and their employees.

Our members have been equally clear on what they oppose, and of great concern is an employer mandate. Our economic data shows that an employer mandate will be a job killer, costing over 1 million small business jobs alone. Also, the House legislation couples an employer mandate with up to an 8% payroll tax (for firms with a payroll of $500k or more). Also, our members don’t want to be told what kind of health insurance they have to buy, how much of the premium they have to cover, and are not supportive of the creation of a public health insurance plan. All of these provisions are included in the legislation being considered in the House, and because they would be so devastating to many of our members, we want to be crystal clear to legislators and the media why we oppose the House legislation.

Per your request to see actual legislative language, the link below contains bill language followed by comments. Please note there are three versions of House language and they have yet to be merged. Regardless, most of the provisions in all three contain similiar content, i.e. employer responsibility, medical advisory council.

Copy and past in your browser to view:
http://www.nfib.com/Portals/0/PDF/AllUsers/IssuesElections/FINAL%20NFIB%20Comments%20Tri%20Com%20Report.pdf

Well stated, Amanda. Gerri, you will find that NFIB presents a lot of information for you to review, which allows you to form an educated decision how you can stand on issues that are critical for small business. They have the tools to help us, when we don't have the time to do all of the research, as we are busy trying to keep our businesses viable in these difficult times.

It seems to me that the legislators are making the health care proposals far too complicated.

My recommendation is simply that they provide a government funded catastrophic health care program that covers all AMERICANS with medical expenses over $250,000 (or some number) per year and then let the existing insurance providers cover the day-to-day health care costs.

The benefit will be that the insurance companies will be able to reduce insurance premiums dramatically because they will not have the burden of having to set aside funds for those insured clients that find themselves with catastrophic health care claims.

Doctors and Hospitals will have fewer credit losses when people are not able to pay huge medical bills. This will allow them to reduce fees required to cover those losses.
With these reduced premiums more AMERICANS will be able to afford insurance. The government will only have to be involved when the patient is burdened with an accumulation of medical bills.

No public option, no restructuring of the current health care system, only a simple cushion for all AMERICANS. This would be a Win-Win-Win for everyone.

Why does it have to be so difficult?

Dave, I'm a member of our health care and lobby team here at NFIB. Thanks much for your message and for engaging in the health care debate. Meaningful reform depends upon activisim such as yours. Your recommendation is certainly a viable one and deserves consideration. As you know, Washington is very good at making issues complicated and is doing a good job of it now with the current thousand plus page bills being considered. Please stay engaged and thanks so much for your message.

Any small business owner who has reviewed the House health reform bill (HR3200) and isn't frightened should take another look -- especially at the sections that discuss employer responsibilities. The words tax and penalty appear 328 times in the 1,000+ pages.

My initial impression is that we will have two choices:

1. Hire a full time person to ensure that we comply with the complexities without incurring severe penalties.

2. Drop our insurance and pay the 8% payroll tax.

I suspect the bill is written to encourage option 2 in order to move people to the so-called public option.

Pat,

You are absolutely correct in stating that any small business owner should be concerned about the punitive nature of H.R. 3200. I would encourage you and any employer worried about keeping their doors open and employees on payroll to contact Congress and tell your elected official to opppose the bill.

NFIB provides an easy method to do so by visiting the following online action alert:

http://capwiz.com/nfib/callalert/index.tt?alertid=13802326

(Simply cut and paste the URL into your web browser)

Thank you for your thoughtful comments.

Andrew Fimka
NFIB.com/Issues

While I agree that small business' do not need another thing we MUST pay for, if we do not get a public option, why would the large insurers lower their rates, which most agree are way to high? Currently, most states have maybe 1-2 healthcare providers. This does not breed competition in any way. Insured are locked into just a couple of choices.

And I read many believe our healthcare is one of the best. Where do they get this information? That is like Boehner's statement that we will all will be forced to give up their existing plan to sign up for a public one. Balderdash.

If we do not get complete facts, we cannot possibly make a good decision. And a health plan without a public option is not a healthplan I will support. We simply must lower healthcare costs and insure the 40+ million without coverage. Let's look at what is working in other countries and model our plan after this.

The last thing we need is the government offering "health insurance." One of the reasons health insurance premiums keep going up is that the government keeps adding requirements to what must be covered.

We offer coverage through an HSA. It costs us about $230 per employee per month and covers most preventive care with no co-pay. Routine doctors visits are not covered, but most doctors discount (my doctor discounts $20). I also pay for the visit out of my HSA account which, in effect, is tax deductible -- so that knocks off another $20 or so. In addition, I can pay for things like glasses, prescription and non-prescription drugs, and other health related items out of my HSA account. My biggest worry -- that I will have a catastrophic event like cancer or a heart attack -- is covered.

I would bet that if coverage of things like accupuncture, chiropractic care, psychiatry, and counseling were not mandated to be included in our policy, the premiums would go down significantly.

Doug, Rates are too high for small business and there are too few insurers to choose from. State laws lock small-businesses into small, fragmented risk pools that can’t extend beyond the boundaries of a single state. Many states require every small-business policy to cover an excessive range of medical treatments. Small businesses also have shop for insurance in slow, cumbersome markets. Big businesses don’t face any of these limits. They can pool across state lines and have very few mandated benefits. NFIB believes lower costs require more efficient markets (exchanges), fewer mandated benefits, and interstate pooling. Small businesses need to be able to group together into large, efficient pools.

NFIB does not favor a public option. We do not believe a government-run plan would lower costs, and we do believe that evidence shows that a government-run plan would drive many private insurers out of business. In the past decade or so, several states have experimented with public options, and they have been disasters. Probably the three most visible cases have been TennCare (Tennessee), MaineDirigo (Maine) and Keiki Care (Hawaii). Let’s look at Keiki Care. In 2008, Hawaii established universal coverage for children with an optional public plan to cover the previously uninsured. As soon as Keiki Care opened, Hawaiians began flooding out of private insurance plans and into Keiki Care. Within seven months, Keiki Care was blasting such a wide hole in the state budget that the whole program was scrapped. People who had signed up with the public option were sent scurrying for private coverage. Let’s look at America’s biggest public option: Medicare. In 1965, President Johnson predicted Medicare would cost $500 Million per year ($3.5 billion in 2009 dollars), and he considered that amount "a train wreck." This year, Medicare will actually spend over $500 Billion – 143 times as large as LBJ's prediction. (It'll double again in around 10 years.) Medicare’s $30 to $60 trillion long-term funding gap is on course to consume the entire federal budget by mid-century. Some estimates place fraud at 12% of Medicare payments.

As for other countries – I can go on all day about the weaknesses in the Canadian, British, French, and other systems. Yes, we can learn some things from those countries, but none of their systems would work here or even work all that well over there.

Bob Graboyes (NFIB Senior Healthcare Advisor)

The Health Care Reform is quite simple...America, just sit back and think about a few things. One for example.. when you drive into any city and see all of these large buildings or skyscrapers, have you ever wondered who owns them ?? Take a guess.... it's most likely the insurance companies. Hmmmm and where did the insurance companies get all this money ??? Hmmm could it be from ripping off the insured with high premiums over years and years ????

I live in a small town in southern Alabama and while driving around the small towns/cities close to me, I've noticed that the ONLY new construction or buildings going up in the last year have been BANKS or CREDIT UNIONS !!! Imagine that.... who got the stimulus money ??? It sure wasn't me... who is trying to expand my small business. Hmmm could it be the BANKS or FINANCE COMPANIES getting all the low interest loans to themselves ????

WAKE UP AMERICA !!!! INSURANCE COMPANIES and THE BANKS are out to make as much money as they can....stock holders DEMAND this. Sure insurance companies do not want the general public to think that a Public Option is good....sure insurance companies are going to use every tactic they can to scare or persuade you into thinking the govenment can't run and insurance program...they want TOTAL CONTROL of the industry. MEDICARE IS A GOVERMENT OPERATED INSURANCE COMPANY !!! I don't see it being any problem to add on the rest of Americans under 65 to a program.

Has anyone had surgery in the last couple years ??? I have and I have received NUMBEROUS Bills from Doctors, Hospitals, Specialist, it goes on and on. Why can't we just get ONE itemized bill encompassing the surgery. I don't know who to pay, who not to pay, what insurance was suppose to pay. etc.... etc.. etc... WE NEED REFORM !

WAKE UP AMERICA... what happens when "We the People" do not REGULATE the BANKS or FINANCIAL COMPANIES....Hmmm interest rates skyrocket for loans and drop down to near zero for the majority of Americans who have little savings in the bank. Their profits go throught the roof and nobody is heald responsible. what happens when "We the People" do not regulate the Insurance Companies....

Dave Pfau:

For me, given the choice of being controlled by insurance companies versus by government, I'll take the insurance companies every time. Insurance companies can't arrest me and I can always cancel my policy or refuse to do business with them. Try avoiding doing business with the government by canceling your income tax or payroll tax payments and I'll see you in jail.

But that's not the issue. Indeed, insurance companies, banks, and other financial institutions are the major investors in most commercial (and residential, for that matter) real estate either through mortgages or by direct investments with developers. Insurance companies sell insurance to you and to me and hope that they bring in more than they pay out. Nothing wrong with that. That's the same way I run my business and, I assume, the way you run yours.

Would it surprise you to know that most insurance company profits don't come from keeping more in premiums than they pay out? As premiums comes in, they use that money to invest in the office buildings you mention. I don't know if insurance companies make too much money. My guess is it is a fairly competitive industry and they pretty much make what the market allows them to make. Just like me in my business and probably just like you in your business.

One point upon which I totally agree with you is about the "bailouts." But, of course, that was the government. And the last thing we need in this country is more government!

ATTENTION: Small Business Opposses H.R. 3962

All small business owners and their employees should be aware that the U.S. House of Representatives is rushing to vote on a healthcare bill that is 1,990 pages long, measures nearly 9 inches tall and weighs in at 19 pounds.

The America's Affordable Healthcare Act is a deeply flawed bill. It does not address the core challenge facing small businesses - rising healthcare costs.

In fact, this bill will actually harm small business owners with its expensive employer mandates, punitive payroll taxes and new government-run programs – all of which will only result in more money coming out of small business owners’ pockets.

We all agree that something needs to be done to improve the system. Unfortunately, this bill with a price tag of $1.05 trillion dollars doesn’t fix what’s wrong with our current healthcare system and instead, penalizes small business owners to the tune of $167 billion in new costs.

Go to NFIB.com and select Issues & Elections to take action and help oppose H.R. 3962. The most important action we can all take is to call our representatives in Congress and urge them to vote "NO" on the bill.

Respectfully,
Andrew Fimka
NFIB.com/Issues