A wise old Senator who was a veteran of the LAST Great Healthcare Debate once said that the most valuable tool to bring into the debate is a pair of safety glasses, because "with all the finger-pointing going on, you could poke an eye out".
That element of the debate hasn't changed very much. Hospitals and doctors blame government bureaucrats and (worse) insurance companies. Insurers blame hospitals, doctors, pharmacists, and people who don't have health care coverage or live "unhealthy" lifestyles. Big business blames unions.
Everybody's right, of course.
For most small businesspeople, and for their employees and families, the principal way they access the health care system is through their health plans. Those plans are rising rapidly in cost, and business owners are under a lot of pressure, both to keep their companies operating through one of the most brutal periods in recent economic history, and to help protect their employees from the catastrophe which a single illness or serious injury can lead to.
I haven't really heard too much in this round of health care reform debate that would give much comfort to a small business owner, whether struggling to hang on to their health coverage or struggling to obtain it. If there's an improvement in the quality of the discussion at all, it's a shift from blaming small businesses for not providing coverage to their workers to, at least, recognizing that the majority of small business owners are trying to do the right thing.
But most small businesspeople know that smoke and mirrors are smoke and mirrors. And that it's been hard so far to understand how elements of the debate will really affect the prices they pay for health insurance.
And when the President says that Congress has achieved agreement on most things, but there are still details to be worked out, they know that means Our Friends In Government haven't figured out what reform will cost, or how to pay for it. That should make everybody in America, but especially small businesspeople, anxious. Because in their hearts, small businesspeople need to know that whether directly, through premiums, or indirectly through taxes, they're going to end up on the receiving end of the bill for a health care reform plan which probably won't help them very much at all.
And when the President talks about "exempting" small businesses from payroll taxes or mandates, they know that businesses with fewer than 10 employees are the ones who struggle most in the health insurance market; fewer than half of companies with nine or fewer employees provide coverage to their employees. The National Federation of Independent Business estimates that 26 million of the nation's uninsured citizens work in small businesses. So exempting small businesses from penalties doesn't really help them in their struggle to find or maintain access to decent health coverage.
We've been taught that it's not gracious, or impolite, to take political discussion personally, to ask, "What's in this for me?" But that's exactly what's called for in this debate. Small business owners have every right to ask, "How exactly is this reform idea going to help me? How much will it increase or reduce the price my business pays for health coverage?"
It's important that you ask because nobody's at the table looking out for you. And you know the old poker adage: if you can't recognize the sucker at the table, it's probably you."
I have a few ideas about how to reduce and control the cost of small business health care, based on years of experience at actually doing it. And I hope, over the next few weeks, to hear from a bunch of smart people who have ideas of their own.
That element of the debate hasn't changed very much. Hospitals and doctors blame government bureaucrats and (worse) insurance companies. Insurers blame hospitals, doctors, pharmacists, and people who don't have health care coverage or live "unhealthy" lifestyles. Big business blames unions.
Everybody's right, of course.
For most small businesspeople, and for their employees and families, the principal way they access the health care system is through their health plans. Those plans are rising rapidly in cost, and business owners are under a lot of pressure, both to keep their companies operating through one of the most brutal periods in recent economic history, and to help protect their employees from the catastrophe which a single illness or serious injury can lead to.
I haven't really heard too much in this round of health care reform debate that would give much comfort to a small business owner, whether struggling to hang on to their health coverage or struggling to obtain it. If there's an improvement in the quality of the discussion at all, it's a shift from blaming small businesses for not providing coverage to their workers to, at least, recognizing that the majority of small business owners are trying to do the right thing.
But most small businesspeople know that smoke and mirrors are smoke and mirrors. And that it's been hard so far to understand how elements of the debate will really affect the prices they pay for health insurance.
And when the President says that Congress has achieved agreement on most things, but there are still details to be worked out, they know that means Our Friends In Government haven't figured out what reform will cost, or how to pay for it. That should make everybody in America, but especially small businesspeople, anxious. Because in their hearts, small businesspeople need to know that whether directly, through premiums, or indirectly through taxes, they're going to end up on the receiving end of the bill for a health care reform plan which probably won't help them very much at all.
And when the President talks about "exempting" small businesses from payroll taxes or mandates, they know that businesses with fewer than 10 employees are the ones who struggle most in the health insurance market; fewer than half of companies with nine or fewer employees provide coverage to their employees. The National Federation of Independent Business estimates that 26 million of the nation's uninsured citizens work in small businesses. So exempting small businesses from penalties doesn't really help them in their struggle to find or maintain access to decent health coverage.
We've been taught that it's not gracious, or impolite, to take political discussion personally, to ask, "What's in this for me?" But that's exactly what's called for in this debate. Small business owners have every right to ask, "How exactly is this reform idea going to help me? How much will it increase or reduce the price my business pays for health coverage?"
It's important that you ask because nobody's at the table looking out for you. And you know the old poker adage: if you can't recognize the sucker at the table, it's probably you."
I have a few ideas about how to reduce and control the cost of small business health care, based on years of experience at actually doing it. And I hope, over the next few weeks, to hear from a bunch of smart people who have ideas of their own.
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