Kitchen-table talk on health care reform

By Frank Knapp, Jr., Rock Hill Herald

March 13, 2010

The popular analysis as to why President Obama and Congressional leaders have been losing the public relations war over health insurance reform involves the kitchen table. You know, the family kitchen table where the middle class husband and wife meet to discuss personal finances.

Apparently, the average couple has health insurance through an employer and they haven’t been convinced that reform legislation in Congress is going to help them. They have heard how it will help the uninsured get coverage but what’s in it for working American’s who already have health insurance.

Well, for all of you sitting around your kitchen table satisfied with your employer-based health insurance, I have some bad news for you. If you work for a small business and are fortunate that your employer offers health insurance (i.e. subsidizes your premiums), the issue isn’t how the uninsured get coverage. The issue is this: What are you going to do when your small employer drops the company’s health insurance plan?

As president and CEO of The South Carolina Small Business Chamber of Commerce, I can tell you that without reform, your health insurance from a small business is going away. Your employer is going to drop your health insurance plan. The only question is how soon.

You see, it is very simple. While you and your spouse sit around the kitchen table talking health insurance and personal finances, the owner of the small business you work for is also sitting at his or her kitchen table.

The small business owner, who has been trying to provide health insurance to employees, is thinking about throwing in the towel. Premiums have continued to go up by double digits for the last decade. To hold down costs to the business, employers have reduced benefits, increased deductibles and shifted more of the premium to the worker.

But that game is about over. The 15-percent, 25-percent, even 50-percent premium increases being reported recently by small businesses nationwide are unsustainable. We all knew the day could come when insurance company greed would push premiums too high for small businesses to afford. But we hoped that Congress would pass health insurance reform before that happened.

Small business owners want to provide employee benefits, but they can no longer allow the financial solvency of their businesses to be destroyed by unrestrained health insurance costs. If reform is not put in place soon, small businesses will see no hope for the future and will universally and quickly abandon group health insurance when they receive the next double-digit premium increase.

The result will be health care chaos across the country. Without the employer subsidizing premiums, most families will not be able to afford individual coverage. Employees with pre-existing conditions that drove up the premiums for the employer will find no insurance company wanting them at any price.

All these new uninsured Americans will join the millions already uninsured. They will delay going to the doctor because of the cost or go to the emergency room where treatment is free. The latter will continue to drive up the cost of health care, which will be passed on to the large employers that still offer insurance. With health care costs going up, the cost to the federal government for Medicaid and Medicare will go up, adding more to the national debt.

This doomsday scenario is coming unless Congress takes action quickly to make health insurance more affordable for small businesses in the future by passing (a) health insurance tax credits for small businesses, (b) creating large pools of individuals and small businesses where carriers will really compete for our enrollment, (c) prohibiting insurance rating based on health status or pre-existing conditions, (d) limiting age rating to a 2-to-1 ratio, (e) allowing small businesses to purchase health insurance across state borders, (f) expanding Medicaid to cover low-income employees, (g) controlling the overall cost of health care, and (h) reining in obscene insurance company profits.

Failure to pass these reforms soon will change the kitchen table talks about health insurance for millions of Americans. That is, if the kitchen table hasn’t been sold to pay medical bills.

Frank Knapp is the president and CEO of The South Carolina Small Business Chamber of Commerce :
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