National Federation of Independent Business (NFIB)

NFIBsmalltag300x150.gifThe NFIB Research Foundation conducts some of the most comprehensive research of small business issues in the nation.  The National Federation of Independent Business is the nation’s leading small business association.  A nonprofit, nonpartisan organization founded in 1943, NFIB represents the consensus views of its members in Washington and all 50 state capitals. NFIB’s mission is to promote and protect the right of our members to own, operate and grow their businesses. More information is available online at

RISING COSTS FOR HEALTHCARE: Implications for Public Policy

The interconnection between costs, coverage, and quality is the subject of this study commissioned by the NFIB Research Foundation. The study describes ways to balance the desire for freedom of choice with the need to restrain nearly limitless desires for healthcare. It argues that a key element will be controlling the spending increases in Medicare and Medicaid. Additional topics addressed in the study include administrative costs, spending on certain specific illnesses, medical liability, eligibility and enrollment for public programs, disease management, tax rules, end-of-life care, integrated delivery systems, and reimbursement structures. This paper suggests remedies that do not jeopardize the considerable strengths of the American healthcare system.

The Case Against Mandated Employer-Provided Employee Health Insurance

There are three primary arguments against the imposition of mandated employer-paid health insurance: 1. the policy is highly regressive since the uninsured, typically (though not always) low income, eventually pay for their own health insurance through job loss, depressed wages and erosion of other benefits; 2. the policy is inefficient because it is too blunt to distinguish between those needing and those not needing assistance to purchase health insurance; and, 3. it is unfair to small employers and employees because the policy fails to address the real problems of the insurance market for small businesses, while retaining rigidities that injure both, and substituting a hefty, direct penalty on them, i.e., a tax, in large part because they are small and lack market power. Other arguments, such as driving off-budget massive public expenditures by laundering them through the private sector, are also valid, if more abstract, and less interesting to the daily concerns of small employers.