More Small Firms Drop Health Care

By Dana Mattioli
The Wall Street Journal
May 26, 2009

Accelerating health-care premiums and sharp revenue shortfalls due to the recession are forcing some small companies to choose between dropping health insurance or laying off workers — or staying in business at all.

About 10% of small businesses are considering eliminating coverage over the next year, up from 3% in 2005, according to a recent survey by National Small Business Association.

That follows earlier declines in coverage, with just 38% of small businesses providing health insurance last year compared to 61% in 1993, according to the trade group. A Hewitt Associates survey found that 19% of all companies plan to stop providing health-care benefits in the next three to five years.

Rampant health care cost escalation is a problem for everyone. In bad economic times the problems are compounded, threatening the viability of employer-sponsored coverage. Small businesses that operate on very narrow margins have no choice but to reduce health benefits by either shifting more of the health care costs to their employees, or by eliminating health plans altogether. The fault lies not with the small business owners, but with the flawed U.S. system of financing health care.

The recent Medicare trustees report indicates that Medicare is facing similar economic challenges. But there is a very crucial difference. Everyone recognizes that the high costs of Medicare reflect the excessive rate of increases in total health care spending, and that runaway costs must be harnessed. The stewards of Medicare would never consider reducing legitimate health care benefits, or worse, eliminating many Medicare beneficiaries from coverage.

The point is that the structure of the financing system really matters. We can have a system in which individuals or employers are forced by economic circumstances to reduce or eliminate the financing of essential health care services, or we can have a system in which the government is forced by economic circumstances to demand greater efficiency by the health care delivery system so that everyone can have the health care that they need.

Unfortunately, members of Congress are moving forward with a model that will leave individuals and employers financially vulnerable for our health care needs – a patchwork of private plans and public programs that grow ever less affordable for most of us.

The model that would work is a single payer national health program. But last week, after a recital of several options that are still on the table, Sen. Baucus finally admitted, “Just to be honest, (single payer) is not on the table because it cannot pass.”

Hmmm… bad policies can pass but good policies can’t? Is there something wrong with the way Congress operates?