Women small business owners really need healthcare reform

August 4, 2009

– Nancy Duff Campbell is a founder and co-president of the National Women’s Law Center, one of the nation’s pre-eminent women’s rights organizations. A recognized expert on women’s law and public policy issues, for over thirty-five years Ms. Campbell has participated in the development and implementation of key legislative initiatives and litigation protecting women’s rights, with a particular emphasis on issues affecting low income women and their families. The views expressed are her own. —

Insurance companies and others who profit from our broken health care system are mobilizing to defeat comprehensive reform by using misinformation and scare tactics. A prime example is the allegation that healthcare legislation – specifically the plan being considered by the House of Representatives – will hurt small businesses.

The fact is that small business owners, especially women, are already hurting under our current healthcare system. Leah Daniels, 29, is the owner of Hill’s Kitchen – a gourmet kitchenware store that opened last May not far from the U.S. Capitol. Daniels can’t afford to offer health insurance to her three employees. She purchased her own bare-bones plan on the individual market for protection “in case I get hit by a car,” but not much else. It costs her just under $200 a month and doesn’t cover such services as routine doctor’s visits or maternity care. Daniels, who often works 7 days a week, says that she is constantly worried about getting sick.

Daniels’ problems are, unfortunately, all too typical. A new report by the Council of Economic Advisers (CEA) found that small businesses pay up to 18 percent more than large firms for the same health insurance policy. These higher costs mean that small businesses are considerably less likely than larger businesses to provide health insurance to their employees, and those that do tend to have less comprehensive plans. And Census data show that women-owned businesses are generally smaller than male-owned businesses.

Small business owners and employees who don’t get coverage at work or through a spouse’s plan may shop for insurance individually. But if they are women – and small businesses that don’t offer health coverage tend to have large proportions of female workers – they are likely to face discrimination in the individual health insurance market. A study by the National Women’s Law Center found that insurance companies routinely charge women higher rates than men for individual policies and offer policies that exclude health needs specific to women, such as maternity care.

Women who own a small business know that the current health care system is failing them. At a meeting of women small business owners in May, Daniels says, “We went around the room and everyone either had health insurance through their spouse or didn’t have coverage at all. Women talked about being afraid to go to the doctor because they didn’t want to find out that they might be sick. It was really striking.”

The healthcare reform plans that have begun moving through Congress would help make it possible for small business owners to offer comprehensive, affordable health insurance. The House plan would make insurance more affordable by prohibiting insurance companies from discriminating on the basis of health status or gender and by allowing small businesses to purchase coverage through a new Health Insurance Exchange. The Exchange would reduce administrative costs and offer a choice of plans meeting minimum benefit standards. New tax credits would be available to help some small businesses pay for employee health coverage; the credit would be worth 50 percent of the cost of qualified health coverage expenses for businesses with 10 or fewer employees and average wages of $20,000 or less. It would gradually be reduced until firms reached 25 or more employees or average wages of $40,000 or more.

If some employers still can’t provide coverage, their employees could purchase insurance directly from the Exchange. Sliding scale subsidies would help make it affordable, and they couldn’t be turned down because of pre-existing conditions or charged more because of their gender or health history. Larger employers who fail to offer health care coverage would be required to pay an additional payroll tax, but under the plan being developed by the House, businesses below a certain size would be exempt. One version would exempt businesses with payrolls of $500,000 or less. Another would set the exemption at $250,000 – but even at this level, 76 percent of all firms would be exempt.

Opponents of healthcare reform have claimed that small businesses would be hurt by another provision: a graduated surcharge on the very wealthy to help finance health care reform. But the surcharge would only apply to households with adjusted gross income above $350,000 ($280,000 for an individual). As a result, only the wealthiest 1.2 percent of taxpayers – and only 4 to 5 percent of all tax payers with business income – would be subject to the surcharge. Women-owned businesses are especially unlikely to be affected by the surcharge. According to the latest Census data, 96.3 percent of women-owned businesses, compared to 88.9 percent of male-owned businesses, had total receipts below $500,000 – meaning that profits would be well below that level.

Those who claim that healthcare reform will hurt small businesses should re-examine their facts – and the rest of us should examine who they’re really speaking for. We can’t afford to wait any longer for meaningful reform that will bring a guarantee of quality, affordable comprehensive health care for us all.

56 comments

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The issue at hand here would appear to be cost; people cannot afford healthcare because it costs too much. The government claims they can provide it cheaper than the private sector, or through some nebulous magic bureaucracy, they can at least provide some “competition” that will lower costs. I would submit that the government has a less than stellar resume when it comes to managing costs. Medicare and Medicaid are certainly pertinent examples, but other more recent programs, such as the “cash for clunkers” are even better. “Cash for Clunkers” was only supposed to cost 1 billion, now it looks like it will cost 3 billion. So just exactly how much more will this healthcare “option” end up costing us in the end? Based on the federal governments past performance in managing costs, it seems fairly certain to well exceed the sticker price.

Posted by Matthew L. | Report as abusive

At what point will local governments stop picking up trash, repairing roads, patroling the streets because the tax revenue must service debt? When will we become a third world country? Jobs are being lost every day… Where does the revenue come from?We can’t sustain. The only alternative will be the nationalization of everything…When will it be too late?

Posted by LCP | Report as abusive

Another progressive who is for health care reform as long as they don’t have to pay for it. If you want health care reform than everyone should have to pay. I wander how many progressive would be for health care reform if they had to pay a 5% surcharge? Put your money where you mouth is.

Posted by rich | Report as abusive

I am a woman small business owner and I disagree with this editorial. I think it is trying very hard to make something that is a BAD bill into sounding as if it is good. Reform doesn’t need to cost taxpayers, take away our freedom to choose or penalize us for not being able to afford something. The credit mentioned “50 percent of the cost of qualified health coverage expenses for businesses with 10 or fewer employees and average wages of $20,000 or less” seems ridiculous. Very few small businesses that employ more than 2 people but under 10 have an average wage of $20,000. Look it up. They can’t afford it now – how will they afford it once the bill is passed? They will terminate staff to afford it, pure and simple.And when you include micro businesses (one or two employers, typically spouses) in your 76% statistic, sure, it sounds like most businesses won’t be impacted, but most small businesses that actually employ other people WILL be impacted and this is a big problem.Reform could involve two simple first steps (ditch the 1,000 other pages of the bill) forcing insurers not to discriminate and forcing pharmaceutical companies to set pricing based on some fair standards which in itself would make a tremendous difference. But that wouldn’t mean more income for the government or more “programs” to hire new czars to run. It also might not please certain campaign contributing lobbyists.

Posted by Kelly | Report as abusive

Higher rates for women do not constitute discrimination given that women are likely to require maternity care. Higher future costs should yield higher premiums. Teens pay higher car insurance rates because they are a higher risk (more likely to cause an insurance payout), why should this change because we are talking about healthcare vs any other type of insurance? Or should we have the taxpayers subsidize 16 year olds car insurance as well?

Posted by Josh | Report as abusive

Oh! I get it. Small business owners are supposed to continue to suffer, only this time under a government run plan, according to Nancy Duff Campbell.Don’t you like how she assumes the outcome of her argument in her opening statement? Its broken, so only government can fix it. Ha! The next thing she will want to tell us is that are taxes are going to go up to pay for it. Only she won’t do that now.Once again, one of the great elites is trying to lecture me, about what they want to do to me, not what they are going to do for me. The fact of the matter is government, if you consider its resume of accomplishments in any variety of programs over the years; (if it was your resume, would not get you hired to do anything) as abject pathological failures and sociopathic as well.One thing that is being ignored in all of the health care reform proposals is how many people are going to lose their jobs in the insurance industry…well how many??? I would tend to believe a lot and at a time when unemployment is already high and showing no signs of slowing down.The Obama led crowd is bent on putting as many people out on the street as unemployed, which is certain to make sure they have no employer health insurance plan or are forced into some COBRA plan that is already so high that only the truly wealth can afford it, but because they are already wealthy elect not to be part of it.When are you people going to get in through your head? Get out of the way and let me, the individual do what I want to do.

Posted by Rick | Report as abusive

I’m afraid this country has more important things to be concerned with right now than health care!

Posted by Mike | Report as abusive

The truth is that government is failing to protect simple conceptions in the economy letting the system burn itself 30 to 50 trillion dollars:Investment = Investment + dividendLess than a trillion dollar cannot cover such missing amount of money that disappeared in a short period of time.Stock exchange is letting fear and greed overcome simple rules of offer and demand.

I just want to make sure I understand this…men don’t matter at all?Last I recalled, men need healthcare too.Men get cancer.Men get colds.Men need dental coverage too.It would be a bigger tragedy if only one gender got health coverage, and not the other.After all…some ethnicities get legal, financial, and employment protection while others don’t. Even when faced with similar circumstances.I think America, in general, is gone. Too late.

Posted by Jeff | Report as abusive

The present proposals, while a patchwork, represent a measure of very real reform with respect to a number of issues.I find it ironic that the insurance industry lobbies on the argument that there must be no government health care option because government is inefficient — but then argues that it would be unfair because they couldn’t possibly expect to compete with it.So the private sector is arguing that it can’t possibly compete with an ‘inefficient’ government option.Hmm . . .

Posted by NotSilentNotBob | Report as abusive

“Nancy Duff Campbell is a founder and co-president of the National Women’s Law Center, one of the nation’s pre-eminent women’s rights organizations.”An activist lawyer talking about health care…how novel!Quit trying to separate us by gender. Its outdated, and hurts the overall process of equality.

Posted by Patrick E. | Report as abusive

The only policies available to me, a male sole proprietor in Hawaii, allow the insurance company to bail out with one month’s notice and no reason whatsoever. I choose to also self-insure, holding back hundreds of thousands of dollars that could have been invested in my business. Others cannot afford to do this, so they go bankrupt when sick.That needs fixing, and the only way to fixit is to mandate (close to) universal coverage, eliminating the adverse selection dilemma that now plaques the insurance business. I wish that Ms. Campbell had focused on this point, rather waving the red flags of affordability and sexual bias.

Posted by Tom Burton | Report as abusive

I’m a small business owner. There are just two of us, both professional. When the recession struck we eventually had to let go of our one employee. Eventually, I also had to give up my health insurance, purchased individually, because I could no longer afford it. It was costing me $1,800 a month. I am 50 and have a pre-existing conditon.Small businesses owners need health care reform. We currently have almost no choices; all are extremely expensive. Private insurance doesn’t want to insure people like me. I do not buy the argument that left to itself, private business will solve the health care problem. It’s just not true. It’s a complete failure as far as I’m concerned.

Posted by Mark | Report as abusive

Health Reform has little to do with medical care. It is about paying for it. One of every 6 Americans has no health insurance.Reformers falsely imply – no insurance – no medical care. All presently get some form of medical care – not all recipients pay. The general public subsidizes those who don’t pay through taxes and charity.Health Reform will insure that all pay – by payroll deduction. It will not provide equal care but basic care for all.Social Security was invented because widows, orphans, elderly could not pay for basic needs. Medicare was invented because many elderly didn’t have insurance. Both are funded by payroll deduction – by almost all who receive a paycheck. Part time & full time. Citizen & non-citizen.Many employers offer medical insurance through payroll deduction. Some small businesses & some agricultural employers don’t. Some big box employers don’t for part time workers. Some companies offer increased pay if no benefits opted.So now is the time to do a repeat of the Social Security program and fund universal medical care – through payroll deduction from all.

Posted by Carl Schroeder Sr | Report as abusive

No thanks, I dont care WHO you get to pay for it. If the feds and wall street controll it, I DONT want it! It will hurt every business in the country right off the bat let alone 10 years down the road as the feds and bankers screw with it more and more. Once you open the door for the feds they never leave. We would all benefit by getting the feds/bankers out of healthcare TOTALLY! Government regulations are the reason it is now so screwed up. Tell your representatives NO !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Wake up people. THis is America!

Posted by jason | Report as abusive

No one, absolutely no one, has addressed the issue of rolling back current costs the way Germany and Japan did as they revamped a system to cater to an aging population, just like ours. Unilt we reduce current costs, we are just throwing money at a problem that can only worsen as our population ages and is burdened by a lack of capable healthcare providers. We can only move forward and distribute healthcare afte we know how much it will cost and how we can curtail future costs. I ahve yet to read any comment about this malaise, other than Mr. Peterson’s comments in his book “Running On Empty”.

Posted by John P. Crowley | Report as abusive

Fellow Comrades: As we all know the Government of the United States of America is perfect. It can do everything for everyone all the time and at no cost to anyone. Please do not look behind the Medicare, Medicad and Social Security screen. Markets with the efficiencies and rationalization brought to bear on conflicting econmic forces are a fallacy perpetrated the running dog american capitalists. Resistance is futile. Give up.

Posted by Bob | Report as abusive

“After all…some ethnicities get legal, financial, and employment protection while others don’t. Even when faced with similar circumstances.” What an arrogant thing to say! And totally untrue! First off all, blacks have been hit harder then whites in this recession; so im not sure who is keeping whose job. Secondly, you assume that every black person that works in a company is at the very bottom of the talent pool. Wow. so all the white people you work with are terrific employees? I work with plenty of white people that have their jobs because of connections. As a black guy, I never had those connections so i had to prove i could do the job better. But i don’t presume to say that every connected white person is undeserving. Keep in mind, that most of the inequalities that still haunt America revolve around situations you just take for granted. The black guy hiring you doesn’t make the same assumptions as you obviously make about black people. You never have to prove that your success was merit based. If your white co-worker fails, your chances don’t suffer. Take your mind set about blacks … now pretend you worked for an Asian company and they assumed the exact same things about you. Hope this helps!

Posted by Juls | Report as abusive

Small businesses will benefit from the current health care reform being proposed. I question the motives of anyone who says otherwise.This is really simple. For a small business to offer the same health care as a large company, they pay more. Period. It is called economy of scale. Large companies can negotiate rates with health insurance companies, because they are huge accounts. Think a small company can negotiate rates? Large companies are less risk for insurance companies, because there are many employees. This means the insurance company can rely on fairly accurate statistics to set rates. The accuracy of statistics go up as you add more people into the pool. Private insurance companies prefer to insure large companies, because there is less risk in doing so.Small businesses have a harder time attracting talent because they are not able to offer benefit packages that compete with large corporations. Health care is an important part of any benefit package. The health care legislation currently being proposed is small business friendly because it levels the playing field by offering an affordable public option able to compete in price with the health insurance plans of large companies. This is, again, a function of economy of scale. A very large amount of people will be in the public option. This is why private insurance hates the public option and spreads misinformation that it will be subsidized. The public option will not be subsidized; it will just be flat out more efficient, thus cheaper, due to economy of scale.

Posted by Kirk | Report as abusive

Get the government out of my life and my pocket! I am so sick of all their lame promises. For every dollar of services they provide, they charge me four!They represent the supreme height of inefficiency and waste, and yet they propose “they” can offer efficiency and competition in health care to rival the private sector? Give me a break. I’m not buying it.Why are my tax dollars buying other people cars? Why are my tax dollars subsidizing other people’s down payments on homes? I have 150,000 miles on my car. Why am I subsidizing a car for someone else??? I coughed up my own down payment for a home on a meager salary by saving. WTH???Obama, get out of the free market and let it run. Let it clear. Let companies like GM and Ford go under. Yes, it’s painful. Yes, it’s sad. Creative destruction will power new business and new ideas. The government prop-ups only suck the life out of the market and economy.Stop taxing the life out of American citizens! Leave me alone!

Posted by L A | Report as abusive

Somebody got it right – it’s the principle of economy of scale. That’s why having a centralized uniform healthcare, paid by uniform percentage of income taxes, is on average cheaper, than what America has now. However, centrilized and uniform is confronting the idea of open market economy, never would a private company run such healthcare system without creating monopoly. thus, the need of governmental involvement. However, I don’t see it possible done soon. Meanwhile, it is going to be really fun to see what 99% of anti-healthcare reform taxpayers, if happen to have no income and getting sick, can do to their 1% wealthy neighbours.

Posted by Ananke | Report as abusive

Let’s assume I make $3000 per month on my job.Let’s say that I pay $700 per month on private healthcare insurance.Then let’s say I’ll be taxed $300 per month to have public healthcare access.The difference is still $400 each month I get to keep if I choose NOT to have private coverage along with the public (total $1000 per month for both) and stick to the public plan.Even if I choose to have both public and private, in the case of an emergency at the ER, should the private insurance decide not to cover me, the public will. If that happens, the private insurance will have to explain to the public WHY. Which is more likely to come to a much better conclusion for me than if I was (able) to fight the private for what they’re denying to provide for whatever lame reason they present, and the hospitals will get their money.Even Bill Gates and his family is entitled to this public plan as a contributor. Their choice for purchasing a private plan won’t be denied.See a problem there? I don’t.It’s not a question of paying other people’s healthcare. It’s a question of others contributing to mine and vice-versa.The details must be very clear or else it won’t work.The rights, benefits and entitlements along with the responsibilities, duties and payments – especially to avoid fraud. There is lots of fraud with the income tax every year, so specific security features will have to NOT include the SSN, if at all possible.Adding self-defeating details to the Health Care Bill presented shows absolute corruption.

Posted by Braod | Report as abusive

The problem with “centralized uniform” healthcare is that it is centralized and uniform.In theory that sounds nice. In practice, it means we all are reduced to least-common-denominator.If you need a medication not approved by the gov’t, you can’t have it. And the current proposal requires one such list for everyone on all plans.If you want to save money by self-insuring part of your costs (with a higher deductible), you can’t do it. The current proposal disallows high deductible plans.If you think it is best to allow copays so users will value the care they receive and not go to the doctor for every little thing… you can’t. The current proposal disallows copays.And on and on. One size does NOT fit all. One size does NOT save money. One size simply reduces the health of the many so that a few more can more easily get free / cheap health care.That woman who owns a business is willing to pay $200 a month. Wow, that’s cheap. We pay $700 a month per person as an employer, and are glad that we have the option to do so. Good health care is expensive folks. If you don’t want to pay that kind of money, you can buy a smaller plan but you will get fewer benefits. That’s how it really works. SOMEBODY has to pay.TANSTAAFL

Posted by MrPete | Report as abusive

MrPete, the problem with non-uniform plans is that they are non-uniform. There is no practical way to compare private health plans with each other in order to determine which is really cheaper – except for heavily regulated Medigap plans. Worse, the fine print for the private plans is so extensive that there is also no practical way to know what is really covered and what isn’t. Those are just the facts.Furthermore, there is no real choice in healthcare today as people are limited by their income and employer as to which plan they get. Employees of companies that don’t offer health insurance typically can’t afford it on the open market. Employees of companies that do offer health insurance still usually can’t afford insurance on the open market nor would it make economic sense for them to refuse their employer provided health insurance in the first place.Yes, somebody does have to pay for health care. All of us have to pay for it. The question is how much? The current proposals reduce the cost and don’t eliminate the non-choice we currently enjoy today.As for the scare tactic regarding non-covered medication: You can have it, you just have to pay for it just as you have to pay for non-covered medication under today’s private plans.

Posted by Kirk | Report as abusive

I could not agree more with the article. I would, however, call the public option an absolute necessity without insurance! The insurance companies are the main problem. At one time a long time ago insurance was a fiduciary but no more. There is clearly an unspoken collision between Insurance companies and providers to charge more so rates will go higher, thus greater revenue for insurance companies. The greatest wind-fall to insurance companies came with the government intervention to pay only a percentage of the bill. The percentages fall way below a simple discount — often below costs. The provider responds with much higher charges in order to break even or much more — since everyone is doing it, why not?The only way to grow a public segment is for logical minds to understand the critical necessity and build completely outside the insurance system. Leave them alone with the system they have, even encourage them. Wealthy consumers, wealthy providers, and wealthy insurance companies will be happy. Meantime do an end run and build an Administration directed State executed Medical School University based public delivery system. The diversity and academics are essential to a scientific cutting edge solution. Insurance can never achieve the required level of excellence and neither can bureaucracy. Excellence in medical care requires academics, research, diversity and selflessness. The American people require enough security in health and environment to be productive. There is far more to gain than to loose even in dollars as if that were the only concern.I am a retired doctor with 30 years general and internal medicine and as it happens an undergrad major in economics. I was a thoughtful physician engaged in local medical society efforts to deal with these problems. In a sense the problems are so big and so embedded as to be insoluble. However, there is an opportunity in today’s crisis to plant the seeds of an excellent public health care system. If we start slow, diversified and non confrontational there is a chance. They did it in Europe and on a plan such as I suggest. People have a choice between public and private. They have the best of both worlds.Despite what you hear in political rhetoric, we are something like 16th in ranking by accepted metrics of public health, right behind Ireland.

I am a small business owner myself and i am quite baffled when some people don’t realize that the insurance policies they have don’t covered much. You will find out when you get really sick. I worked for some of the best companies in the US and after 15 years I was let go by one fortune 50 company. It didn’t matter that I was paying for my insurance for all those years, The day i was let go, they told me about COBRA, which I couldn’t afford. Now I know how it feel when you cannot get your once a day high blood prescritption from the doctor. Now I own a small business. I can’t afford health insurance. I prey to God to keep me in good health and to protect my kids.A reform is wy overdue…

Posted by Don | Report as abusive

Science / Innovation Key To Recovery !1. The pay for ‘Outcome’ pack is most likely to expedite the introduction of Health Care IT SYSTEM so that it can reduce the redundant work burden, focus physician’s effort to patients, and store patients’ informations to skip the repetitive and painful procedures.2. The synergy effect of combined Health Care IT & a pay for ‘Outcome’ SYSTEM may help the clinicians correctly diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the crushing lawsuits and deter the excuse for unnecessary procedures to make fortunes.3. In modern society, ‘medical institute’ and ‘energy sector’ is the only arena that is not retrofitted with ‘a must’ . And what happens if the financial institutes get back to the PRE- IT SYSTEM ? , supposedly the crisis would be comparable to the present health care system. Unlike the numeric errors, medical mistakes, in most cases, is fatal to patients. It is believed that over the duration of two wars, computer IT has not expanded the progress to ‘electronic medical records’ & ‘ smart grid technology’ . With them in place, people all around the globe might have avoided this tragic recession.4. The Mayo Clinic medical practice has embarked on the first widely available e-health information service for patients on Microsoft’s HealthVault service.Through Mayo Clinic’s network, users of its health-care services can keep up with their health information and information for family members, and receive health guidance and recommendations from Mayo that is optimized for each person.The system also allows patients to upload information from home-health devices such as blood glucose monitors and digital scales. Patients can authorize whether they want to share their health information with doctors or other caregivers, and those caregivers can provide health-care and general wellness recommendations based on the information patients provide.Thank You !

Posted by HSR0601 | Report as abusive

All of the excellent health systems seem to have one thing in common, a well-organized preventative program.I think prevention system works as a ‘levee’ built against flood by the government, similarly, it also needs non-profit aid from the government on a large scale.This might offer us the clue of why all of the free states have public insurance policy in place.It won’t be easy to draw some specific numbers on the economic effect of the ‘levee’ , but the flood measure without a stable ‘levee’ would be a house on the sand, as all of us agree.

Posted by HSR0601 | Report as abusive

HEALTHCARE…now brought to you by the makers of FEMA, Social Security and the IRS. Sounds like a winner to me.i think most commenters on this thread fail to see the pattern in our government. commenter LA says it well…you pay 4 dollars for bucks’ worth of service.controlling healthcare is a power grab…nothing more. If YOUR BEST INTEREST were really at heart, we would be talking TORT REFORM, not healthcare reform.the US has the highest life expectancy on earth, and its not a coincidence. switch us over to a single payer system and we can all watch our collective lives end sooner when rations run out or the definition of “necessary procedure” keeps being adjusted to suit an economic need, rather than a personal need.all the liberals will eventually get what they’re asking for…I guess we’re dead set (no pun intended) on learning the hard way

Posted by Zack | Report as abusive

Zack, the United States does not have the highest life expectancy on Earth. Recent statistics from the CIA World Factbook show that U.S. males are expected to live to 75.65 while U.S. females are expected to live to 80.69. In single payer France, the life expectancies are 77.79 and 84.33 respectively.Your statement illustrates the main problem concerning the health care issue: misinformation. I am saddened in this day of easily accessible information that misinformation seems to win out over hard facts. I think it is the responsibility of all Americans to determine what the deciding factors are for them on any particular issue and look up the facts from reputable sources rather than simply accepting boiler-plate statements that fit a preconceived notation.This blog entry was about whether small businesses would benefit from health care reform. The answer is yes, they would be one of the main beneficiaries of the reform currently being proposed by the House of Representatives and the White House. This is primarily due to the scale of economy of a public option which would significantly reduce the cost of health care for small businesses and individuals. Small businesses have never been on a level playing field with large companies as the cost of health insurance for small business is disproportionally higher than the same coverage for large companies. The current proposals fix that issue. That is not boiler-plate. That is fact.

Posted by Kirk | Report as abusive

Dear M/S,Very lengthy article with full of contents.I always admire Americans freedom of expression on many issues.As a common learner with some degree on economics subjects,i am highlighting the basic necessities of new,practical new health care polices for all American citizensHere,small business classes especially from women are badly needed some insurance packages for day today running,growing,conssoldation,staining for day today operations,insurance coverages are basic prererequists for it.After reading of all your real coverages, my few words will suffix for acceptancesgenerally speaking, no democratic thinkers will not willing to pay any moderate premium compulsory payment to her agencies in starting times.Every body knows what is insurance,coverages on any prescribed risks against any untoward accidents,any unforeseen situations,and from sudden sickness,sudden,heavy leave by workers,for medical care to pregnant females hospitaiations are all covered by paying premium by employees by employers are rules and regulations by concerned insurance regulatory authorities with State spupervisions.These are all in force in any developing,devlopedntions.Because of some insurance wrong,unethical persons are misused and wrongly claimed. Thats why,many insurance companies were under loss or became closed down.To sum up,Many small business females will get good protections,safety ,and it will encourage small business women elites from new,modern school of thoughts.

I agree with LA. I do not want the government in my health plan at all! Their “free” health care will cost all of us a fortune and the care will be atrocious.I too am sick and tired of my tax dollars bailing out all of these failing businesses. I agree. Let them go under. There are consequences from actions.And keep Obama out of my life!!! He doesn’t have a clue or even care to have a clue because all he wants is power!!!! How anyone can honestly believe that the govt. can run health care is beyond me. Look at Medicare, Medicaid, SS,the post office and the list goes on and on.They are all an absolute disaster.God help us all until Obama is out of office!

Kirk — You can’t compare countries like France and Canada with the US. Populations in those countries are rather homogeneous. US population is very diversified in terms of ethnicity and culture. Be that as it may, life expectancy, other than in broad terms, is not a good indicator of the quality or success of a healthcare system.Many of the problems mentioned by other commenters could easily be dealt with without completely replacing the current system with a government run system. Here’s a start, all of which could be accomplished at no cost and would not take away a single choice:1. Tort reform.2. Streamline medical record storage and access.3. Allow associations to provide health insurance across state lines.4. Expand HSA type plans so people can pay lower premiums and save the difference in a Health IRA.5. Eliminate all mandates for medical expenses that must be covered.I simply don’t trust the government to handle my healthcare. I am quite capable of doing so myself.One step at a time.

Posted by Pat | Report as abusive

As a seasonal small business owner whose prices are strictly controlled by the government, and whose use is allocated by the national park service, we cannot afford to pay for our employees health insurance. Our payroll is close to or slightly more than the $500,000 mentioned. That is not a very large number though when you have about 25 employees and pay them well. If companys with payrolls were forced to pay for employee health insurance, we would hire fewer employees. Government should not force business to pay for health insurance. In a year like this, we are doing the best we can to stay afloat. It is not the responsibility of business to provide or pay for employee health insurance. That should be an individual responsibility.

Posted by Joy Staveley | Report as abusive

At one time, America had many high paying jobs in manufacturing. But, to please the stockholders, these jobs have gone overseas,as many people know. When these jobs were here, healthcare was not an issue. The workers had insurance, and their payroll taxes funded welfare programs that paid for healthcare to the many who were unable or did not want to work. Immigration was also not much of an issue, since there were plenty of jobs to go around for the immigrants. But as the manufacturing jobs bled overseas, more discourse about the lack of healthcare, and illegal immigrants has increased. End the policies, such as NAFTA, that make it easy for manufactuers to close shop and move overseas, and the healthcare for all debate will once again become moot.

Posted by DKeener | Report as abusive

The deal with immigration was that it was swept under the (media) rug for many decades, only coming out during election season.Private health care and charity are not enough to cover millions of people, lets get that straight. It’s obvious.Manufacturers of health care products can only see an increase in dispensation because more people are able to purchase their products, as a bigger pool of people is dishing out the cash. The amount in bulk purchased by states/federal government will be exponentially larger, involving higher dollar figures, which involves an expansion of factories and hiring workers, preferably locally. There will be less entities involved in the negotiation process, which will streamline the business and cut costs all around.Both generics and brand names will make a killing in profits:Right now there are over 40 million (and perhaps a lot more than that) that can’t afford their medicines, either because they’re uninsured or because their private health insurance plans are insufficient.Why spend millions of dollars dealing with tons of private middle men on top of the research cost AND the cost of aproval by the FDA in order to tap a limited market that, if it’s allowed to continue in the same direction, can only limit further the base customers who need the medicine? Willingly or not, thousands are dropping their plans, which means it will get even more expensive for those who get to keep it, and there is only so many drugs and products each insured individual can absorb.Why haven’t the pharma companies assertively push for a cap on lawyer earnings for each malpractice suit involving their products? The more the lawyer companies feel they stand to make out of a case, the harder they’ll push for an astronomical amount in settlements.And if it applies to pharmaceuticals, it works for hospitals and doctors too.

Posted by Danny | Report as abusive

Pat, I did not bring up the life expectancy issue. That is an issue that Zack brought up. I merely pointed out that he was wrong and was in fact repeating the typical misinformation that is out there regarding healthcare.This blog entry is about the current health care proposals by the House of Representatives and the White House. None of these proposals replace our current healthcare system. They simply reform it.Private insurance will still exist. You will still be able to get it through your employer if they choose to offer it. However, now you will be able to get an affordable public plan on your own if you can’t get insurance from your employer or if private insurance is too expensive for you. And small businesses will be able to offer an affordable public plan or private insurance – but, they don’t have to if they don’t want to. Many small businesses want to offer insurance, but can’t afford it with our current system.The proposals offer more choice to individuals and small businesses, not less. You don’t have to trust the government; you can choose to stick with private insurance under the reforms being proposed.

Posted by Kirk | Report as abusive

Kirk — I don’t think you have read the bill. I own a small business with 30 employees. We provide (and pay for) health insurance through an HSA plan that costs $230 per month per employee. The HSA plan pays all preventive care at no cost. In addition, effectively, it allows employees to deduct the cost of all health care related costs (including glasses, contacts, prescription and non-prescription drugs, etc.) from their income taxes (by allowing them to put money into a Health IRA).The proposed bill would exclude the type of plan we provide and we would have to adopt a “government-approved” plan or quit offering health insurance and pay the 8% penalty.Surely you don’t really believe that once a subsidized government plan was in place that it would not eliminate competing plans. And, saying this so-called “refrom” offers more choice is like saying the IRS offers me more choice in how I spend my paycheck.

Posted by Pat | Report as abusive

President Obama may fail over Health care, because the Democrat leadership of Sen Harry Reid, Speaker Pelosi added these services free-of-charge to the 20 million plus illegal immigrants and their families. The cost is trillions of dollars according to Robert Rector, top analyst of the Heritage Foundation. All these money will be further accentuated by the cornucopia of other welfare entitlements, that will keep attracting millions more illegal aliens. These mandatory federal laws are enforced on taxpayers by the IRS, which has drained state, county treasuries for absolute decades. America cannot have a government run health care system, until restrictions are placed on anybody who are unable to prove their citizenship status or residency. Like Europe, America has been invaded by mass hordes of legal and illegal immigrants, with consequences of a suffering government health care system.

Posted by Brittancus | Report as abusive

Pat, you are confusing HSA with HDHP. However, they are very much linked and it is understandable to interchange the two. HSA is a Health Savings Account. HDHP is a High Deductable Health Plan.At issue is the High Deductable Health Plan. Opponents of health care reform are stretching when they say High Deductable Health Plans will be eliminated. They base this on the minimum coverage standards being proposed. The standards that ultimately pass may require High Deductable Health Plans to offer more coverage than they do now, but I have seen nothing that would eliminate the plans. If you have information from a reputable source, please provide it.I also noticed you misquoted me, but I’m sure that was simply a typo on your part.

Posted by Kirk | Report as abusive

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Please consider this. I own a small business. I have a daughter with a heart defect, so carrying good health coverage has never been optional for us! We pay 100% of full time employee coverage. It costs us roughly 4% of payroll because we negotiate and shop to get the best coverage for our groups’ needs at the best price. (The coverage is through a major carrier.)From what I’ve seen of the proposed bill, my carrier will be required to include coverage at government-defined levels and meet many specifically legislated requirements in order to qualify. These may or may not be benefitial to our groups’ specific needs. In case you haven’t read between the lines, I can expect large increases in premium to meet gov requirements. If I can’t afford that, I will have to pay an 8% payroll tax – doubling my cost. Worse, as I understand it, this will leave my employees and my family needing to purchase coverage. So, our costs will have doubled, but we’ll get nothing.Now, let’s consider the large employer. Most are already paying well over 8% for coverage, so it’s better for them to dump the private coverage and take the difference as profit.No doubt, we need some help controlling skyrocketing health care costs. But, insurance reform does not address the problem. Insurance is not the root cause of skyrocketing costs.

Posted by Kimberley | Report as abusive

Kirk — I’m not sure where I quoted you, unless you are referring to the comment about the proposed plan offering more choice. Your comment (and here I do quote) was: “The proposals offer more choice to individuals and small businesses, not less.”Again, surely you cannot believe this.Now, about HSAs and HDHPs. An HSA IS a High Deductible Healh Plan. That’s the reason premiums are lower. You stated earlier that you own a small business and cannot afford to offer health insurance to your employees. If you don’t mind my asking, can you provide some information about what type of business you own, how long have you been in business, how many employees? It would help me understand where you are coming from in your avid defense of the proposed plans.The reason I am asking is that I don’t know of a single small business owner who supports this bill. I’m not saying there aren’t any, but I would wager those who do have not read the section of the bill titled “Subtitle B – Employer Responsibility” beginning on page 143 and going on for about 50 pages (at least 20 pages of which are devoted to describing penalties for noncompliance). There is no way I could comply with this without hiring an additional administrative person.BTW, I own a software company based in Austin, Texas. We have 30 employees and have been in business since 1991. We switched to an HSA plan when they first came out (MSA at the time).

Posted by Pat | Report as abusive

Just because the plan currently running through congress at the speed of light is the only plan being talked about doesn’t mean we all have to jump on the bandwagon. Healthcare reform does NOT have to mean a government run healthcare plan. Changes in our system can reduce costs and increase the number of insured. There is no need to spend billions of dollars on something so unnecessary. Small businesses are the largest employer base in the United States, and they are also the main reason why people go uninsured. It is almost impossible for a small business to get a reasonably priced health insurance plan for their employees. Federal regulations keep the cost high for these business owners, and at a time like this, we need to be helping out small businesses as much as we can. They should be able to band together across state lines to spread risk and increase bargaining power and purchase individually owned plans, like health savings accounts, for their employees using pre tax dollars. These changes could drastically reduce costs, and are still a viable option for the federal government to pursue. At the NCPA, we are working hard to make sure that the private sector does not get drowned out by government intervention! http://www.familyissues.ncpa.orgCongress and the Obama Administration are pushing for health care reform that will move the US health care system closer to that of Canada or the UK. You can help stop a government takeover of health care from happening. Send a message to the White House and Congress by signing the “Free Our Health Care Now” petition. Go to http://www.freeourhealthcarenow.com and sign the petition today!

Posted by Terry Neese | Report as abusive

Pat, an HSA is not an HDHP. Period. Having an HDHP is a requirement of HSAs, but they are two different, yet related things. You are probably confused because you can have the same company provide your HDHP and administer your HSA. It sounds like that is exactly what you are doing. I do believe that is how most HSA’s are handled.The U.S. Treasury department provides information regarding HSAs, the easiest way to get the information is to Google “All about HSA” go to the first Treasury Department link and read the “All about HSAs” document. The document will state of page 2, “HSAs are used *in conjunction* with a “High Deductible Health Plan” (HDHP).” They are two separate things. The document goes into more detail later.Pat, I have asked you to provide information in regards to your claim that HSAs will be eliminated. That is a claim that you have made. I see nothing that supports this. I am aware that this misinformation is being repeated on sites that are ideologically opposed to health care reform. However, none of the sites I have seen actually provide any basis to their claim. They simply state it. Please provide the basis for the claim from a reputable site. I believe you will not be able to do this, because this is simply more misinformation.You say that I stated earlier that I own a small business. I have not stated that anywhere. My comments are right on this site. Please read them as you are misrepresenting them.Now, the problem with the health care issue is that it is very easy to simply state misinformation. It is a lot of work to state accurate facts and back them up. Look at my comment here. This is a long comment. Too long. That is because I’ve had to back up my facts. I hope that people that read the comments will be wary of very simple statements and will instead use the statements to research the facts. Google is a great tool for this. Don’t trust me or anyone else. Look up the facts for yourself.A case in point is Terry’s comment of a government run health plan. This blog entry is about the current proposals from the House of Representatives and the White House. None of these proposals force anyone into a government run health plan. None of these proposals get rid of private insurance. If you are insured today, you can keep the insurance you have. It’s that simple. If you are not insured, you can choose from private insurance offered on an exchange or a public plan. It’s your choice. You have more choices under the current proposals.You can Google “Health Reform” and look up the information on various government sites to see the facts of what is being proposed. Please do so.

Posted by Kirk | Report as abusive

The health reform being proposed by the White House will provide tax credits to small businesses for providing health insurance. Health insurance will be more affordable for small businesses under the current health reform proposals. Claims to the contrary are almost always based on misinformation.A crucial part of health reform is the public option which will reduce costs through economy of scale. The more people in a plan, the more efficient and cost effective it is. The public option will have many people in it – by choice. This option will be available to everyone including small businesses, but nobody is forced into the public option.This site contains state by state information about the current proposals:http://www.healthreform.gov/Pl ease be aware that there really is a misinformation campaign going on by opponents of health care reform. So, if there is something bothering you about the reform being proposed, you should look it up yourself and verify if it is true.The misinformation is so bad that we have people saying to their representatives, “Keep your government hands off my Medicare.” Google the quote. For anybody who might not know this, Medicare is a government program.Now, that is some effective misinformation out there.

Posted by Kirk | Report as abusive

Costs have nothing to do with “not enough people being insured” which makes the proposed HR 3200 rather silly when it’s main focus is trying to cover more people with mediocre insurance.Rising costs have much more to do with patented pharmaceuticals which are then being widely and carelessly distributed by some doctors(the real war on drugs should begin here), high priced attorneys for medical malpractice suits, lack of personal responsibility by everyone who wants to be “fixed” once they’ve abused their health for 40 or 60 years and lax government enforcement of existing and potential regulations.

Posted by Kelly | Report as abusive

The following link debunks some of the misinformation about health reform:http://www.whitehouse.gov/reality check/Of particular interest is the topic “Reform will benefit small business – not burden it” which talks about tax credits for small businesses, how small businesses are exempt from the “pay for play” rule and some general information about how small businesses are operating today under our current health system.

Posted by Kirk | Report as abusive

We don’t need the government taking over healthcare – PERIOD! Our government is the worst of the worst when it comes to costs. Every business owner knows this. Right now any person ANYWHERE in the world with a serious disease (AIDs, TB, Cancer, In need of Transplant, etc) will be allowed into the US and receive care FREE. All provisions to stop this has been stripped out by the democrats. Using 000-00-0000 for a valid SS number is allowable and will get you free care. Now we have millions with illnesses that cost millions. And to the medical costs – Housing, food, transportation etc and the costs go up even more. Than our wonderful government says that these people can’t be here with family so in comes aunts, uncles, kids, grandkids and more. This is called Chain-Migration. This is why we have so many un-insuranced now. 74% are immigrants both illegal and legal. There is only so much to go around and americans shouldn’t be shoved to the back of the line. This is what will happen with the bill offered from the House. I personally don’t want seniors denied care so ‘others’ get care.

Posted by Lori | Report as abusive

Lori, there is no government takeover of healthcare. Period. If you have private insurance now, you’ll get to keep that insurance after the reform. If you have no insurance, you’ll be able to get affordable insurance after the reform – private or public, it’s your choice.The health insurance reform the White House is proposing should be a non-controversial issue. All sides of the healthcare debate are represented with these proposals.If you hate the government, then you can go with private insurance. The reforms allow this. In fact, it will be easier and cheaper to do this. There will be an exchange to purchase the insurance from.If you hate insurance companies then you can go with a public plan. The reforms allow this too.I mean seriously, what is all this hysteria about? I am absolutely shocked at how easy it is to rile people up with very obvious misinformation.

Posted by Kirk | Report as abusive

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The problem is that many small business with greater than a $500K payroll are operating at near or below breakeven profit…especially in this recession.Tax breaks don’t help if the business is not profitable. The result is that the additional cost burden will cause many of these businesses to fold throwing 30-40 people out of work. I believe that a study of the tax returns of small businesses will confirm my concern.The bottom line is that the business will either have to reduce payroll or cut wages in order to survive.

Posted by Ted Pamperin | Report as abusive

One option you might want to consider is a High Deductible Health Plan, I found some info on the web, Ill share it. Im not very good at posting links as Im not very tech savy….so if the links dont click just copy and paste them into the bar up there at the top. Ill put a couple in here for you though and hopefully it will help.http://www.twitter.com/highdeductib lehttp://highdeductiblehealthplan.blogsp ot.comyoutube.com/user/highdeductiblehea lthalso the website for this one company is http://www.highdeductiblehealthplanstoda y.comtheres plenty of info out there. Good Luck

Posted by Jordan | Report as abusive

Um Ted… Tax credits help even if you have no taxable income. They are credits, not deductions. Please get your facts straight. Health insurance reform would be incredibly good for small businesses under any economic situation.

Posted by Kirk | Report as abusive

I have read a very useful book that helped me acquire Gov’t grants to start my business.

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Posted by zararina | Report as abusive

Smart Lipo

The proposed plan discussed above is a much better solution than penalizing businesses that do not offer insurance. I’m a small company with 10 or less employees. Until 3 years ago I paid 100% health insurance coverage. Then I was forced to cut to to 50%. Last year the prices go so high that my employees nor I could afford the benefits at the 50% and we dropped it altogether and that was going through an employee leasing company and getting big company purchasing power. When we tried to get insurance for just our company all but one of us was denied coverage because of the state of our health. Ironically, the one employee that was able to get coverage had a tragic accident and was in a coma in the hospital for a week before dying and the insurance company had to pay those costs and his $25,000 life insurance policy. Sometimes I guess even a sure bet is not such a good thing. The rest of us without insurance are paying or own way and have not yet spent nearly what we would have on premiums alone.

Posted by Johnyc | Report as abusive

i like ur blog,i already bookmarked it.

Obviously the law has been enacted by now. We’ll see if it changes in the courts or through Congress. We’ve found http://www.ceowomensclub.com/articles/Fe male-Entrepreneurs-Reality that this is an important issue for women business owners. The cost and potential fear of getting sick can impact the most successful woman business owner

Posted by wtarken | Report as abusive