04/ 02/ 2007
by Shannon McRae
| >The State of Health Care >Sensible Solutions >NFIB Helps You Understand What Government-Run Health Care Means |
Imagine this scenario: Your routine colonoscopy revealed a single polyp. After biopsy results are back, your doctor is concerned about possible cancerous cells and recommends you see a surgeon for an evaluation. The bad news: The surgeon's backlog of patients means you can't get an appointment for four months. "Four months?" you think to yourself. That's 120 nights to lie awake fearing the worst--that you have cancer, and that it could be spreading. A few years ago, you probably could have seen a surgeon within a week or two. That was before the government took control, before waiting lines risked your health, before our country's health-care system started functioning more like the ones in Canada and Great Britain.
These kinds of scenarios are frightening to consider, and while they may seem far-fetched, government-run health care is closer to becoming a reality than you might think. Regardless of which side of the aisle you support, there's one thing we all agree on: Our country's health-care system is in big trouble. Health-insurance premiums have increased 87 percent in the past six years, according to a recent study by the Kaiser Family Foundation and the Health Research and Education Trust. Even more alarming: There's no end in sight to the rising costs, which hit small- and independent-business owners the hardest.
"Forty-six million Americans don't have health insurance, and a large majority of those own or work at a small business," says NFIB President Todd Stottlemyer. "Right now, millions of hardworking independent-business owners without health insurance are worrying about what would happen to them, their families and their employees if they had a serious medical need."
Why are small-business owners and their employees less likely to have insurance than those who work for big corporations and the government? As a business owner, it's no surprise to you that individuals in the nation's smallest firms (those with fewer than 10 workers) pay, on average, 18 percent more in health-insurance premiums for the same benefits than those in the largest firms, according to the Commonwealth Fund, a private nonpartisan foundation that supports research on social and health issues. For some, an 18 percent increase would be a dream. Many NFIB members report much greater premium hikes.
There is no single reason why small businesses face higher costs and less access. Some of the many hurdles faced by small businesses include a lack of negotiating power, higher health-plan administrative costs, a highly regulated market that lacks strong competition, the cost of benefit mandates at the state level and participation levels required by insurers.
Big businesses don't have these challenges. They have employees on staff whose jobs are devoted to negotiating insurance and benefits for employees. Big companies seek bids on plans, and then have their pick of the best coverage--something small businesses can only dream about. Insurance companies are willing to work with big businesses to design plans that fit their needs because of their consistent pool of employees.
Large corporations also don't face the same struggles when it comes to state mandates. One major reason the small-business health-insurance market lacks competition in comparison to big businesses is because of the many limits it faces. A 1976 law (widely known as ERISA) exempts large corporations that self-insure from the more than 1,800 state mandates that exist today. Fewer mandates make big-business plans more affordable. Yet small businesses are required by law to purchase plans that include every mandate in their states, often making it prohibitive to obtain health insurance.
Small businesses also don't have access to the same purchasing power that large companies enjoy. Because small companies can't join together to purchase insurance, they're left to fend for themselves when negotiating with the large insurance companies. For years, NFIB has fought to level the playing field and give business owners more bargaining power by supporting Small-Business Health Plans. (See "Sensible Solutions" for more details.) NFIB believes SBHPs are one solution that would help the working uninsured gain much-needed health-insurance coverage. But legislation has stalled in Congress several times.
"In a country that promotes the rights of individuals to enter a free-market system and make their own way, it's just not fair that we penalize the very people who take risks by denying them access to affordable and equitable health insurance," Stottlemyer says. "Rather than focus on temporary solutions, we need to work toward solutions that include market-based reforms that inject competition into the marketplace and that address the real problem--the ever-increasing cost of health care."
A universal solution
Democrats and Republicans agree that we need to find ways to provide more equitable access to health insurance. As the 2008 presidential race gears up, Americans will be hearing candidates of every stripe decry the fact that the most prosperous country in the world can't provide each of its citizens access to quality health care. The difficulty lies in the various proposed solutions to this very real problem.
Small-business allies in Congress believe market-based solutions provide some of the best tools to fix our broken system. But some lawmakers now point to government-run, single-payer, health care as the best remedy.
"We need to find a solution in this Congress, so that every American has guaranteed access to quality care by the end of the decade," Massachusetts Sen. Ted Kennedy said recently. For years, Kennedy has been one of the strongest proponents of a government-run single-payer system. He supports a Medicare for all, government-run plan. As chairman of the Senate Health, Education, Labor and Pensions Committee, Kennedy now has real power to influence the direction of this debate.
"We're not just crying wolf here," says Dan Danner, NFIBÕs executive vice president. "Our members need to be aware that these conversations are starting to take place in Washington. NFIB was one of the first groups to trumpet the cause of health insurance for small business. Now that the debate is widening, we continue to have a seat at the table for all of the current discussions about how to fix the problem."
The problem is complicated, and the solutions are just as complex. Government-run health care can't be summarized as "free health care for all." Realistically, someone has to pay for it. As with all government programs, that someone is the hardworking taxpayer. NFIB is concerned that small-business owners will be subject to even greater taxes if a single-payer system is enacted.
"Government-run health care would mean higher taxes, longer waiting lines and a lot less innovation in the medical field than Americans have come to expect," Stottlemyer says. "We know our country's health-care system can't sustain itself for much longer as costs continue to escalate--we need a change. But NFIB refuses to let the government saddle small businesses with the exorbitant taxes and fees that would come with a single-payer government-run system."
Weighing the options
rising premiums in recent years have left you struggling to continue offering benefits or have forced you to give them up altogether, you're probably fed up, frustrated and willing to listen to any solution that would give you and your employees affordable medical benefits.
Yet Debbie Wicker is shocked that some of her small-business colleagues think government-run single-payer health care doesn't sound all that bad.
"I'm amazed they think it's a good idea," says Wicker, vice president of operations and strategy for EnterForce (www.enterforce.com). "I have family who lives in Canada--they wait months for service.
"Imagine how much bureaucracy will have to be put in place to get socialized medicine up and running," she says. "Who is going to pay for that? We will spend billions and billions of dollars and be worse off than we are today."
Wicker hears sound bites all the time that point to the number of uninsured children, and she agrees we need to fix the problem. "Of course I want all children to have health care," she says. "But to say that socialized medicine is the way to go--people are kidding themselves. It's very easy to say and very difficult to implement. There are much better ways to address the cost issue other than federalizing everything."
