For families, businesses — an option that promotes care and competition

The facts are clear. Our healthcare system is failing too many Americans. The current high costs of healthcare hurt individuals, families, and businesses in every community across the country. Small businesses are forced to shoulder a disproportionate amount of the cost of our disjointed and inefficient system. We cannot continue on the present course, with businesses small and large crumbling under the weight of these costs and more working people are going without care or struggling to pay increased high premiums and deductibles. It is time to overhaul healthcare so that everyone is covered, we reduce costs for families, businesses and government, and we give people the choice they deserve through real competition.

The ongoing decline of our healthcare system is well documented. Approximately 46 million Americans lack health insurance, with an additional 25 million underinsured. Every day, people without adequate healthcare must decide to skip a doctor’s visit and the medication and treatment that they know they need but cannot afford.

Of the uninsured, more than 26 million are small-business owners, employees and their dependents. According to the Urban Institute, an estimated 22,000 uninsured adults between the ages of 25-64 die prematurely each year as a direct result of a lack of access to adequate care. The majority of the uninsured are hardworking Americans, with 8 in 10 uninsured individuals coming from working families.

The impact of our escalating healthcare costs is even more severe for small businesses. Small businesses comprise one-half of the United States’s gross domestic product (GDP), employ half of private-sector employees, and provide two-thirds of all new jobs annually. A recent survey showed that 90 percent of all small businesses employ fewer than 20 people, yet small businesses bear the brunt of our broken healthcare system. The costs for small businesses to provide coverage to the 68 million individuals they insure annually have skyrocketed 129 percent over the last eight years, and premium costs have increased 113 percent since 1999. It is not surprising given these increased costs that the percentage of small businesses offering health coverage dropped 9 percent, according to a 2008 Kaiser Family Foundation survey. The Medical Expenditure Panel Survey (MEPS) also found that small-business employers that offer health insurance coverage pay more in employer contributions than large firms. Only 47 percent of small businesses offer health insurance to their employees, according to the National Association of Insurance Commissioners. Further, the cost is not always monetary; small businesses also pay in time. Small-businesses owners are overwhelmed by shopping for affordable policies and dealing with the administrative juggernaut of a complex system.

In response to high premiums, many small businesses have switched to plans with higher out-of-pocket expenses. Additionally, some small businesses have opted to employ part-time workers instead of full-time employees to avoid the costs of health coverage. Small businesses and their employees suffer from exorbitant and unsustainable health coverage costs. There are many reasons that we need healthcare reform now, and the benefit to small businesses and the individuals they employ is among the most compelling.

Congress must stand behind President Obama’s call to provide high-quality, affordable and accessible healthcare so all Americans can choose the option that best suits their individual needs. In the event that a single-payer plan is not enacted, a robust public plan option, like Medicare, will reduce costs for small businesses and individuals, and retain choice of doctors for consumers, competing alongside private insurers with equally high standards of care.

As Congress continues to work on healthcare reform, a public plan option must: be available to all individuals and employers without limitation or exclusion due to pre-existing conditions; allow patients access to their choice of doctors and other providers; implement payment system reforms that promote quality care, primary care, prevention, chronic care management and good public health; and redress historical disparities in underrepresented communities.

The last two criteria are important especially for a congressional district like mine, where people experience disproportionate rates of chronic disease. The status quo is no longer acceptable. This Congress and president will be judged by our ability to construct a healthcare system that extends care to all Americans, lowers costs for everyone, and provides real and competitive choice for healthcare.