Are You Ready to be Forced to Provide Health Insurance?

If you run a small business and employ people, under one of the proposals floating around for healthcare reform you’d be required to provide health insurance for employees.

Now, most people would agree that all individuals have a right to healthcare. The problem is one of costs — small businesses often cannot afford to provide health insurance coverage for employees.

Healthcare costs money

One of the latest proposals is for mandating that all employers provide health coverage for employees.

As Washington debates an overhaul of health care, many small businesses are vehemently opposed to the idea of requiring employers to help pay for their workers’ medical coverage.

But at least one small-business group says the proposals now being considered by the Obama administration and Senate leaders could save small companies tens of billions of dollars a year in health care costs — even if there is a mandate for employer coverage.

An analysis by the group, the nonprofit Small Business Majority, to be released Thursday, concludes that the changes would be better for small employers than continuing the current system, which leaves many of those businesses struggling to afford health benefits for their workers. Half of companies with nine or fewer workers do not currently provide employee coverage.

While I appreciate that this group wants to solve a difficult societal problem, the savings they are talking about is unclear. There’s no guarantee that health costs for small businesses would, in fact, be lower — it’s dependent on too many forces that are outside of everyone’s control. Also, they are talking about savings years down the road, not in the here and now.

The current system of healthcare in the United States is ridiculous. It’s shameful that so many people go uncovered in a civilized society.  Something needs to be done — but I don’t think the answer is one of putting the burden on small businesses to provide insurance.

For more, read: The Economic Impact of Healthcare Reform on Small Business (PDF) by the so-called “Small Business Majority.”

For another view on healthcare, read:  Why We Can’t Afford NOT to Reform HealthCare, Even in This Economy.


Anita Campbell Anita Campbell is the Founder, CEO and Publisher of Small Business Trends and has been following trends in small businesses since 2003. She is the owner of BizSugar, a social media site for small businesses.

77 Reactions
  1. Sad that small business owners will face again another problem — cost problems. Is there any other option than this? (still thinking)

  2. now a days there is no security for job thn hw health insurance is possible for small business people

  3. Then its about damn time for small businesses as a group to get out in front and in favor of universal health care. How else will we solve the problem without undue burden on business?

  4. So, when will it be OK to look after the smallest minority, i.e., the individual? I have to write a post on how the majority rule has led to an inefficient and ineffective socialized health care system in Sweden. The public sector is even deciding over the small private sector when it comes to decide if it exist a real “need” for alternatives. My father is an example of this whimsical rule. When he and his business partner decided to enter retirement and end the practice, the public sector decided that it was no “need” for the practice to shift hands and be taken over by some younger dermatologists, so it was closed down once for all. The patients had to find a new place to go to…

  5. Anita — Thanks for this post. Both your post on the Amex site and the SBM pdf were also very helpful. As a solo IT shop with Medicare and retiree benefits from my last employer, I don’t worry about myself. It does concern me if I decide to expand and those costs will factor into my choices. And, yes, I am ready. Gary

  6. If this is passed it is yet another example of the government forcing themselves where they should not.

  7. Right on, Brad. But let me help you with the rhetoric. When people say “universal health care” they point to things like this employer mandate proposal. Hey, it’s universal: everyone gets covered somehow, right?

    I think the term you want is “single payer.” It’s unambiguous, and it means your health care has nothing to do with where you work. That would be a big break for small businesses and the self-employed, and it’s actually good for any company that puts a large percentage of its resources into paying workers.

    Imagine if your kids’ college costs or the cost of maintaining your car were things that your employer normally paid for. People with smart children or fancy cars would have trouble finding work, right? And employers would hesitate to hire anyone who might later reproduce or buy a car, right?

    It’s just like that. When something expensive like health care is tied to your job, it makes it really hard for the employer to start hiring. If we take that cost off the hands of the employer and spread it among all taxpayers… sure, taxes would go up. But the “labor penalty” for businesses would disappear.

    You’ll never have an employer thinking, “Hey, we could really use another line worker but this old guy–or woman of childbearing age–or person with a chronic condition–is going to jack up our insurance.”

    And to Martin, I’d be really interested in a survey that asked Swedes whether they are a) happy with health care now, b) unhappy and want their single-payer system fixed, or c) unhappy and want to go to private-pay. I bet there would be a lot of b) responses, a few a), and very few c). But I could be wrong.

  8. Mark W Schumann,

    You are probably right about this. The Swedish people are not brought up to the notion that health care has a value and worth paying for. We have been indoctrinated that the so called “people’s home” (“folkhemmet” in Swedish) is taking care of our needs and that somebody else should pay for the bill.

    I am all for private pay, but sadly said, we don’t have any strong organization in Sweden that could spread a positive message regarding free choice in medicine, like Americans For Free Choice in Medicine. The thing is that you first have to deregulate the public sector and let private companies compete in a fair way and then in the long run let the market take care of the whole business in a principled way. You also have to reduce the tax burden so you could save for “rainy (sick) days” and invest in a similar program like Health Savings Account. My suggestion is to let the older generation to use the system as is and then inform the younger generations to come that they have to save for the future, combined with a lower tax levels, e.g., reduced income tax (and in the long run, the total termination of taxes in the regular sense).

  9. If you require businesses to provide health care you’ll simply see lower wages and higher unemployment. There’s no such thing as a free lunch!

  10. Robert Brady,

    You are totally right about that. Didn’t Robert Heinlein coin the acronym, TANSTAAFL (There Ain’t No Such Thing As A Free Lunch)?

    So, Robert, when should have lunch together and discuss Dr. Peikoff’s essay, “Health care is not a right”? Are you located in Orem, Utah? What’s your favorite cuisine? 🙂

  11. The USA needs a nationalized (read socialized) health coverage system. You are one of the only modern nations on this planet that doesn’t have this. No where else in the modern world do people go bankrupt because of an illness or medical condition. This just isn’t said, it’s pathetic. I thank the dear Lord every day that we live where we do. If we had lived in the USA and my downsizing had occurred, well, we’d be screwed, to say the least.. We would just be another family of 4 living on the edge.. and one sickness away from bankruptcy.

    This is society’s responsibility, not just small business’s.

  12. It seems that we can never catch a break, can we? This is just one more thing that will discourage new businesses from forming. I know that health care is a problem in this country but I don’t think it should fall on our shoulders either.

  13. This is disgusting.

    “All individuals have a right to healthcare.”

    How do you figure? Where did this right come from? Do you expect magic healthcare pixies to come out of the clouds and heal you when you’re sick? No, you expect someone with years of training and practice to take care of you. What if they don’t want to? What if they value their time at more than you value your health? Then what? Do you expect someone to point a gun at them and demand that they heal you and accept an arbitrary amount of money for the “pleasure” of serving you?

    On the large topic of the post, that of employers being mandated to pay for employees health insurance, this won’t make anything better. In fact, it’s that employers often pay for healthcare costs that has made medical care in the United Sates not only so expensive, but also so full of bureaucratic delays and red tape. When someone with employer-paid health insurance goes to the doctor, they don’t care how much the doctor charges. All they care about is their copay. Because of this, doctors don’t have to compete on price. Since their not competitive on price, there’s no reason to offer any additional benefits or perks (like inviting waiting rooms, cozy exam rooms, house-calls or appointments that doctors aren’t routinely 45 minutes late to) to their costumers.

    Getting rid of all employer-funded healthcare would turn us into a nation of healthcare costumers overnight, instead of just consumers. Doctors that provided warm and quality service for a low price would succeed. Those that don’t, wouldn’t.

  14. Dane,

    Thanks for speaking up!

    I think that you would be interested in reading Dr. Leonard Peikoff’s essay, “Health Care is Not a Right.” You could find it at Freedom and Individual Rights in Medicine’s site. He has a similar story about a “free haircut” that could relate to you pixie character! 😉


    “” This is disgusting. “All individuals have a right to healthcare.” How do you figure? Where did this right come from? “”

    Where?? From the fact that we are a just society that is only truly judged by how we take care of those around us. How we bring the meek up from their squalor of poverty and provide opportunities to create a better existence. We address the route cause instead of treating the disease.

    Judge yourself; NOT from what is in your own garage, house, business, or bank account; but on how you treat the impoverished and less fortunate within your society.

    America needs to find a way to cure it’s ills, putting it on business or small business isn’t intelligent. It is a societal cost to be born across all, as all benefit from this type of investment.

  16. Dr. Leonard Peikoff comes off as a neo-conservative right wing zealot who is truly motivated by self-aggrandizing his own particular point of view without respecting the needs of society as a whole. The hair cut or fairy analogy is a fallacy.

    It wasn’t China, Canada, Asia, Europe, et al who led us to our current economic malaise; it was the great USA and the pursuit of total individualism to the detriment of your greater country’s wealth (re greed and profit at all cost without regard to managed risk) which brought you (USA) to where you are today.

    You have some tough choices, I honestly hope you chose what’s in the best interest of all, not just what’s in ‘your’ best interests.

  17. Martin Lindeskog


    Dr. Leonard Peikoff is not a “neo-conservative right wing zealot.” He is a radical capitalist and Objectivist philosopher. He is the intellectual heir of Ayn Rand’s writings.

    You are right that America has a big part in the “current economic malaise,” but not for the reasons that you are saying. It the lack of freedom that has lead to today’s situation. Another reading tip: The Ominous Parallels by Peikoff.

    America is not perfect and it is going in the wrong direction, e.g., with this suggestion of forced health care insurance. But at the same time, I still see America as the land of opportunity and I look forward to return to the United States of America. For a background, please read my post, Americat Sense Of Life. (Click on “Martin Lindeskog” Says:)

  18. “He is the intellectual heir of Ayn Rand’s writings.”


    So, he inherited a bag of hot air, a badly written story, and a failed economic theory?

    I mean seriously, you need more evidence to understand that those values and human nature don’t mix?!? Wow, just wow!

  19. Oops! I wrote a wrong URL address. Now you click on “Martin Lindeskog” Says: if you are interested in my background and interest in the American sense-of-life, today’s melting pot and future job opportunities. I have received material from the Diversity Immigrant Visa program (a.k.a “green card lottery”).

  20. “Lindeskog”

    Yes.. Objectivism.. “that the proper moral purpose of one’s life is the pursuit of one’s own happiness or rational self-interest..” no, that doesn’t sound like neo-conservative right wing ideologue drivel..

    Not to over-simplify here, but.. according to core of his (your) beliefs ‘I just need to look after myself and that will ensure that society benefit’s overall..’ This hasn’t worked yet and won’t work in the future..

    Good Luck with you beliefs, I just don’t happen to agree with them, and (thank goodness) most others don’t as well.

  21. Brad Nickel,

    Have you read anything by Ayn Rand? What’s your view of the human nature? What are your values? Maybe you could send me a fax with your ideas…

  22. “funk”: Check your premises. Yes, I know that many are not in agreement with my views, but as long as we have freedom of speech, I am happy. I am glad to see that Ayn Rand’s bestseller, Atlas Shrugged, is selling very well nowadays. Maybe some summer reading for you?

  23. Dawn Rivers Baker

    You know, the biggest problem I have with a single payer system is that (a) it takes away my right to decide how to pay for my own medical care and (b) it takes the single worst feature of the system and builds its “reforms” on that feature.

    I’ve written this elsewhere but I have never been able to figure out who’s bright idea it was to use insurance to finance medical care.

    I mean, think about it. Insurance is a product that increases in cost the more you use it. So, for example, your auto insurance premiums go down if you have a car alarm/anti-theft device, if you take safe driving courses, if you don’t drive all that much and if you live in places where there’s not much traffic. And why? Because these are all things that make it less likely that you will need to file a claim and try to get back some of those premiums you’ve been paying.

    Conversely, if you get a passel of speeding tickets or are constantly getting into little fender benders, if you live in a high crime area or a high traffic area (or both), your premiums go up. And, of course, if you actually get into a major accident and have to file a BIG claim, then your premiums really go up.

    Health insurance does the same thing. Premiums go up when policy holders file claims. Unfortunately, in the case of health care, filing claims indicates desirable behavior (i.e., seeking medical care when needed). Is it any wonder health insurance premiums have been behaving the way they have been over the last couple of decades?

    I think insurance needs to come out of the mix. I think people should only finance their medical care if that is necessary and, frankly, well-patient doctor’s office visits should not need to be financed. And I think I don’t want the government forcing me to finance stuff if I don’t need to finance it.

    So, I’m totally against mandates. I’m also against the government arbitrarily enriching any industry sector by forcing me to buy products if I don’t need them. And I think that if we went back to treating health insurance like insurance, maybe premiums would get reasonable again.

    Like I’ve often said, consider how much your auto insurance premiums would be if you could use that insurance to buy gas and get your oil changed …

  24. ‘Atlas Shrugged..’ been, done, don’t plan to visit anymore.. perhaps you should read something a touch more current? Good look with that! Cheers 🙂

  25. I have to agree with Brad here. It’s time for a universal healthcare system. We should be ashamed of ourselves and our treatment of our own people with regards to the healthcare issue that exists. Many are oppossed to universal healthcare and call it socialist in nature. I don’t care what you “label” it – it is what it is and if it works – who cares what you call it?

    Bottom line, America needs healthcare reform and we need it NOW. The answer is NOT to put the burden on small business – the answer is to develop a solution that will work for all Americans and keep them happy and healthy – while NOT taking their homes and life’s possessions for failure to pay for lifesaving surgery.

    In the States, we’ll save your life, but if you can’t pay – we’ll take your home. Huh?????

    It’s a ridiculous shame.

    And Dane, you astound me. All individuals DO have a right to healthcare if it’s out there. Everyone has the right to LIVE. Why should someone be forced to accept death simply because of their status in life? The rich are allowed to live while the poor are left to die???

    “What if they don’t want to? What if they value their time more than you value your health?”

    Are you kidding? I’d say if they don’t want to, they’re in the wrong field. And if they value their time more than your health – why are they a doctor? Strictly for the buck? Isn’t that some sort of personal ethics or moral dilemma?

    It’s arrogant statements like that that make me weep for the future of mankind. Our true purpose here on earth is to love one another, be kind to others and help your fellow man. So simple, yet so many fail to grasp it.

    With an attitude like that, the future of mankind looks grim.

    Funk says it best – “Judge yourself; NOT from what is in your own garage, house, business, or bank account; but on how you treat the impoverished and less fortunate within your society.”

    And Martin, if you plan on returning to the States, you’d better buy some sort of international healthcare insurance – because if you get injured while staying here in the states – we won’t help you unless you can pay for it first.

  26. Martin, if you plan on returning to the States, I’d suggest that you buy some sort of international healthcare insurance first.

    Because if you get injured or sick while you’re here in the States – we won’t help you unless you can pay for it first.

    Funk, I totally agree with your views: Judge yourself; NOT from what is in your own garage, house, business, or bank account; but on how you treat the impoverished and less fortunate within your society.

    It’s arrogant statements like Dane’s that make me weep for the future of mankind.

  27. Chris,

    Thanks for your advice. I appreciate it. We could have a discussion on how to become a “trader in matter & spirit” and how to judge yourself and others. Talk to you later on. Cheerio! 🙂

  28. That babies should be able to see a doctor if their parents are poor is somehow “disgusting”?????

    Gimme a break. This is a civilized society.

  29. In looking at the comments, there seem to be two separate issues:

    1) Should we have universal health care?

    2) If we do have it, what funding mechanism should be used and specifically should small business employers be required to foot the bill.

    I’ll add my two cents on issue #2 – if we have universal health care, should it be forced upon small business employers.

    While I think universal health care ultimately means we all universally pay for it, I think it’s a mistake to tie it to employers – especially the small ones.

    Here’s why.

    When employers are required to pay wildly escalating health care costs, it simply increases the cost of labor.

    Whenever, you increase the cost of something, people tend to “buy” less of it.

    When prices goes from $2/gallon to $4/gallon, people start cutting back.

    By putting the burden of health care on employers, it basically becomes a “job creation penalty”.

    You create a job, you get penalized.

    This is not to say that small businesses shouldn’t contribute a portion of such costs.

    But instead of penalizing job creation (which suppresses economic growth, makes recessions last longer, makes economic booms briefer), it would be better to pay for it out of income taxes.

    While this seems like a subtle shift barely worth discussing, it does change the incentives.

    Here’s why.

    Hiring an employee and creating a job does not directly benefit a business owner. It is a bet on the business owners part that the employee’s contributions will at some point end up being profitable for him or her.

    The easiest way to avoid this job creation tax is to eliminate jobs.

    BUT, if you tax profits instead via an income tax, you tax a known and quantifiable outcome–profits–something that every business owner cares about.

    Taxing profits does not increase the risk placed on a small business. But taxing job creation does.

    I’m all for small businesses paying their share of such a program, but lets avoid penalizing job creation and the risks that small business owners take to grow our businesses.

    If you want to tax us while we’re in the winner’s circle, by all means go for it — we’re in a good mood anyways. But making life harder when we’re risking everything we got, seems counter-productive in the end.

  30. This potential move could change the world of small businesses everywhere. It could be devistating to a lot of businesses.

  31. If that were to pass, I think you would see a lot more temp and contract workers. The temp company could provide the health insurance and then pass it on as another addition to the cost. One thing I have noticed is Canada and Europe have a lot more contract workers then full time employees, just my humble opinion.

  32. Mary Grace Ignacio

    Is this already an approved regulation? Or still a proposal? What about small business owners build a campaign against this? The administration might take it for further consideration.

  33. RedHotFranchises

    This would only mean more unemployment rates and lower wages, bad timing especially when we are suffering an economic crisis that not only affects employee’s but Small Business Owners as well, already having to lay off jobs, this would not help the economy, however Franchises would be able to take full advantage of this opportunity as they continue to do well despite the current economic conditions.
    Most have a proven track-record of success and this takes away a lot of risk. Most Franchises already have Health Insurances included.
    Visit to see many opportunities available from nearly every industry.

  34. Wow. What an amazing set of comments. How about a few facts? Since a choice system is so good, how come I don’t have a lot of choices about whom I see (my insurance co. has a list of approved doctors) what meds are covered (they have a list of approved meds), etc. Some choice.

    Martin, you are thinking of fairy-tale capitalism. First, it was the deregulation of parts of the financial system that led to the crazy speculative binge that led to the current crisis. And, btw, it was Milton Friedman, not Ayn Rand, who came up with TANSTAAFKL.

    Also, if the free market is so good, how come about 25% of insurance premiums go to overhead and marketing and about 2% of medicare goes to overhead. Where’s the efficiency in that?

    And, Martin, since you like the American market system so much, you might consider want to check out statistics like infant mortality rates, life expectancy, etc. etc.. At a cost per capita twice any other industrial county, the US does worse than any other. Gee, that’s a good advertisement.

    And, yes, I read and was captivated by Ayn Rand my sophmore year in college and then I grew up.

    As for Diane, I can only hope you get lost alone in the wilderness for several days and have to rely on some volunteers to pull your cookies out of the fire. You then might learn what a decent society is all about.

    If some of you guys represent the best of small business, I’m ashamed to be one of you.

  35. It has been really interesting reading the comments.

    Although we do not have pefect medical care in Australia and there are a lot of problems anyone who has a medical problem can get care for free. Although for elective surgery you may have a long wait.

    Each taxpayer contributes 1.5% of taxable income to cover Medicare and there are exemptions to this. You can also elect to take out private insurance which means you can get the doctor of your choice to visit or perform surgery etc in a public or private hospital where they operate. You then pay the difference between a scheduled (government covered) and the doctor’s fee which is not much and usually nothing.

    There are more details, but essentially all of us as tax paying citizens contribute to the care of ourselves and others in Australia. If you want choice then you pay.

    Maybe a dumb question, but why should businesses have to shoulder the cost?

  36. Gary Nickerson,

    I didn’t say that Ayn Rand coined the expression TANSTAAFL. See my comment to Robert Brady:

    “You are totally right about that. Didn’t Robert Heinlein coin the acronym, TANSTAAFL (There Ain’t No Such Thing As A Free Lunch)?”

    I must still be “growing” up then. So, what are you reading nowadays?

  37. Single Payer is the simplest plan with the least amount of overhead for small businesses. Would save small businesses in-house admin costs, no more cobra. In this economy, small business doesn’t need additional costs, mandates or added work.

    Why won’t Congress consider this?

  38. Marin —

    Most recently I’ve read Jeffrey Sachs Common Wealth. It’s about practical ways to save the world before we push ourselves totally over the edge. BTW, I do believe that taxing business for social insurance is actually economically quite inefficient. I also think it is simply a left-over from the old days when big business and unions provided social insurance and therefore politically attractive. So, I prefer a single-payer plan. On the other hand, I recognize that’s it’s politically likely not possible. Sigh.

    Beyond Ayn Rand, you might want to do some reading in the areas of externalities and public goods. Economists have long known that there are goods that, when provided by the private sector, are too little and too expensive — like fire fighting. In the US, it was originally provided by private insurance companies. When they arrived at the scene of a fire in a house not insured by their company, the firefighters would let it burn.

    Externalities arise when there is a mismatch between social costs and private costs. A positive externality occurs when apple orchard owners don’t have to pay for the fertility provided by a local beekeepers bees. A negative one is when fisherman are put out of business by the paper mill upriver that uses the river as a sewer.

    These are examples that I used twenty-plus years ago (and every economist uses) when teaching econ 101. Ayn Rand missed that class or was so pissed at the Russian Revolution for disturbing her childhood that she couldn’t hear it.

    And then there’s the issue of social justice, where I am a Rawlsian (rather than a Randian).



  39. Gary,

    Thanks for the book tip. Have you been at the Commonwealth museum in London?

    If you are serious about ideas, I will send you some book tips later on. I will also give you a tip on a documentary on Ayn Rand’s life and her sense-of-life.

    I agree with your following statement:

    “I also think it is simply a left-over from the old days when big business and unions provided social insurance and therefore politically attractive. So, I prefer a single-payer plan.”

    Why don’t you think that “it’s politically likely not possible.”?

  40. David Brooks, the NY Times very good conservative columnist has a really great piece on health care reform, “You Be Obama” ( today. It’s about how sausage is made.

    Martin, we should take any further conversation offline. My email address is With all due respect, I read a lot of Ayn Rand 45 years ago and exhausted my interest and patience with her. I think she would have been much helped by therapy for the PSTD she suffered due to the Bolshevick revolution. And we would have been spared.

    My reading interests these days include economic, social, and environmental policy, biblical scholarship (although I am a non-believe-read atheist), some history (recently Islam and the Rise of Europe and currently Defenders of the Faith).


  41. My rant of the day: I do think there should be a means testing if we are to pay for others’ health care plans. The means test should include 1, if you spend over $200/month at the Quik Trip, 2. if you smoke, 3. if you buy lottery tickets and if your entire family has a cell phone…but you cannot ‘afford’ health care, you don’t get to have me pay for yours.
    Just saying.

  42. Very interesting debate. I find it interesting that three points are accepted in this debate when they are incorrect.

    #1. Our system is actually Insurance based. No it’s a prepaid medical plan. If Medical insurance in the U.S. were actually insurance it would pay for unexpected events. Auto insurance doesn’t pay for oil changes it pays for unexpected events. This substantially raises costs and overhead.

    #2. Insurance is a capitalist idea. Wrong. It’s designed from a very socialist model. It’s a group pooling resources to cover each other. Capitalism means that each person pays their own way.

    #3. Government can somehow make prices lower and be more efficient. Where exactly does this come from? Social Security, Medicare, VA, anything? No.

    “Universal HC” doesn’t lower the cost of HC, it just makes all the taxpayers cover the cost. So, the rich, poor, small biz owners, employees, everyone pays no matter what their condition is. Government manages it with very lousy track record of management.

    I see the argument for and against. I don’t believe govt is the answer.

  43. Hi Susan Oakes,

    Your question is not dumb, it’s a very good one.

    There’s no reason for insurance to be tied to an employer and to one’s work status. So, that means, you lose your job and you lose your insurance. It also means your kids can’t go to the doctor because you can’t afford it, or you have to go bankrupt because you’re hit with $350,000 in hospital and medical bills for little Billie’s cancer surgery, and months of treatment, and risk losing the roof over the head of your other children because you can’t possibly pay everything.

    Rhetorical question: What in the world is right about that?

    Answer: Absolutely nothing.

    — Anita

  44. Hi GL Hoffman,

    I agree with you. You raise a good point about priorities and about people with a sense of entitlement.

    We’re already seeing ridiculous proposals that the taxpayer should pay for insurance coverage for families that make over $100,000 a year. Senator Chris Dodd came up such a proposal — and it’s that kind of selfish, hit-the-jackpot mentality that causes those who scrimp and sacrifice in order to pay for their family’s own insurance coverage, to get so angry and feel taken advantage of.

    But those kinds of abuses are for our Congress to prevent, and for taxpayers to hold their feet to the fire to make sure they do NOT happen.

    I will just use this comment to reiterate that just because some people (including Senators) are greedy and selfish, should not be a reason to let our neighbors and friends suffer or die through lack of medical care.

    Providing medical care for our citizens should be an imperative. I put medical care in a completely different category from nonessential perks and out-of-control pork barrel spending — which I am vehemently against.

    — Anita

  45. Like the Pearl Jam song said ‘Jeremy spoken in class today’, but it didn’t mean that Jeremy is or was right..

    He mentioned “Universal HC” doesn’t lower the cost of HC, it just makes all the taxpayers cover the cost. So, the rich, poor, small biz owners, employees, everyone pays no matter what their condition is. Government manages it with very lousy track record of management.”

    Jeremy might want to check the cost of healthcare provided around the world by various one payer government systems. Then compare it to mortality rates across various countries. Jeremy might find out that he may have misspoken and his premise wasn’t correct..

  46. Anita — You are right on target. I really enjoyed your original post and your additional comments.

    Jeremy —

    Several points. I’m sorry, it is insurance. Just because routine health care is included doesn’t mean it’s not insurance. Health care needs are largely unpredictable. Do you know for sure whether you will or will not get cancer, have a heart attack, etc. Only young people think of health as predictable, so I would guess you are 14. :))

    Second, insurance is a socialist idea? Hmmm, why did the capitalists of the 17th & 18th century create insurance companies to cover losses at seas. Or were they secretly socialists? Please . . .

    I want to remind you of what I said above. Govt. health plans have a very low overhead (low single digits) where insurance companies have about 25 % of revenues going to overhead and marketing. What’s so efficient about that. Also, we have a worse track record than any industrial counties on health issues (infant mortality to longevity) than any industrialized country, pay twice as much per capita, and, to boot, it leaves many people out of the system. And, you think that’s a good health care system?

    I mean, think about these realities instead of sounding of on your ideologies.

  47. Wow, don’t attack the machine… I never said that something didn’t need to be done. Our current system has issues. My point was that there is this belief in this country that the govt can solve all problems and they can’t.

    Instead of reciting rhetoric, answer me how well Social Security has solved the “retirement problem”. Why don’t you tell me how great the care the VAs are providing (and yes I’ve seen them – my father in law was in one for almost 6 months).

    To call our current program insurance is a stretch. Oh and Gary you made my point. Insurance should cover you getting cancer. It shouldn’t cover you getting allergy medicine. If auto insurance had a similar coverage model it would have to handle tire rotation, oil changes, tune-ups, etc. Let’s get back to real insurance where the big things are covered in full and stop paying for the “maintenance” items.

    Not once in my previous comment did I say that I thought the current system didn’t need to be reviewed and reformed. I believe it does. The insurance companies have made the system a disaster. I simply believe that the government will make it an even bigger disaster. The insurance bureaucrats have caused enough havoc, adding political bureaucrats seems like a bad idea.

    My point with the taxation portion is that one way or another we’re all going to pay for the system. If it’s universal health care, taxes will rise. My point was that employers are going to pay for it. You know that politicians love to speak about raising corporate taxes. Either way we go the system will be funded by business owners because in the eyes of the politicians you are rich and you should pay.

    There I painted the bullseye…

  48. I want to draw attention to an article by David Leonhardt, a business columnist for the NY Times, “Healthcare Rationing Rhetoric Overlooks Reality,”

    Jeremy, I’m sorry if I misinterpreted you. But, there is an argument for paying for maintenance: A tiny example: A kids cough untreated turns into asthma, which only gets treated in the emergency room — at much greater expense. And do you really think the poor and near poor can afford to pay for the routine care that will keep them and their kids our of (very expensive) emergency rooms?

    You still haven’t answered the heart of my questions: Why does the US pay so much more for health care and get worse results and lower coverage rates than other industrialized countries. OK, I will agree that the VA may suck — I have no direct experience. (Nor of medicaid). I do have experience with medicare (yes, I’m now that old) and it works well.

    Now, labels. My point is that when you can call something socialist you are just popping out a boo word (stops thinking; generates reacting) — which is what it is, having replaced liberal from the 90’s and conservative from the 70’s — instead of dealing with a range of solutions.

  49. Hmmm. . .seems like a “hot button” issue and frankly, I’m glad to see it.

    Seeing the sincere comments, discussion and debates taking place here makes me wonder why on God’s green earth hasn’t something been done about this yet?

    We’ve been talking about healthcare reform in the States for 20 years now and when one person (Hilary Clinton) took a stance on the matter and tried to initiate change – she was literally railroaded and undermined into submission by the drug manufacturers who literally purchased the support of others.

    And the American people stood by and watched the entire process to initiate some sort of change dissolve.

    NO ONE QUESTIONS things anymore here in the States. Everyone is so distracted by their new forms of technology that they are becoming somewhat “disconnected” from reality – constantly spoon fed and kept fattened up and contented by it that they feel no need to question what they’re being fed and told anymore.

    Everyone’s loosing focus. The secret to life here on earth for mankind is not ME – it’s about WE. It’s about the big picture, not the individual. And to say that the government cannot solve the issue is ridiculous. They seem to be able to “solve” (ah hem) other issues that benefit their instituion, their contributors and themselves at the drop of a hat.

    Besides . . . isn’t it THEIR JOB to solve it? And if it isn’t, what then exactly IS their job?

    They need to remember, “The people shouldn’t fear the government. . . the government should fear the people.”

    Now I ask . . . when are the people themselves going to remember this? Always question everything your being sold. . .

    “Complacency is the enemy of us all” – Barack Obama

  50. Gary, I will agree with you that there are issues that we need to deal with. As far as pricing, I believe many of pricing issues come from the fact that we have placed a middleman (i.e. insurance companies) between the consumer and the provider. We have removed competitive forces from the equation. You are not given the option of finding less expensive “coverage” because it is paid for through your employer. You probably don’t know what procedures cost so you don’t take time to see if there are options. Plus someone else is paying the bill (insurance company) so many don’t even think about it. Of course, until rates rise. Competitive forces need to be allowed back into this market.

    As far as the socialist comment, you are correct it is an emotionally charged phrase I should have chosen differently. Maybe collectivist is a better word. Basically insurance is of the mindset of pooling resources for the needs of all. This is a more collectivist viewpoint. That is all I meant. This is not founded out of a capitalist viewpoint which is very individualistic.

    I will completely agree that something needs to be done. I tend to believe that freer markets and competitive forces can deal with many of the cost issues involved. Bureaucracy tends to increase prices not decrease them. I know that that idea will be attacked as it always is but the markets work. They have throughout our history.

    Now, to the topic of the poor in this country. I agree with you on that. Something needs to be done. Many states have already remedied this problem using state run programs and free health clinics. That is why there are state govts. They are supposed to do things like this if the people of the state feel it’s necessary.

    I will agree that there are problems with the system. We need to take a look at them. The idea of throwing the baby out with the bathwater is a bit extreme. The idea the government somehow can magically run a health care system better than they have done with many other systems is a bit hard to believe.

  51. And since in the U.S. many have a rose colored view of single payor systems, it has many problems as well:

    CBS: Canadian Health Care In Crisis ~

    UK Health Care System In Need of Repair ~

    I don’t believe that other single payor systems are working a whole lot better.

    Basic point: It costs a lot for all of this medical care. Someone has to pay for it. As prices rise it will cost more. No matter whether it’s private pay, single payor, or fully nationalized healthcare it’s the same issue. No one wants to work for free. If you standardize pay and remove the profit motive you create shortage and delays. The other systems show that.

    I wish I had the answer to all the problems with the health care issues in all the Western countries that would be a huge profit motive for me.

  52. Jeremy spoke again.. ‘I don’t believe that other single payor systems are working a whole lot better…’

    I tell ya, Jeremy, I would accept either of those systems over the American system. At least they don’t leave 40 MILLION PLUS uninsured. Check into the mortality rates for UK and Canada, you might be surprised you lives longer and healthier lives (clue: it isn’t the USA citizenry).

    To use your vernacular ‘Basic point: they spend on average 1/2 what the USA spends and their citizens live longer than you do’

    Final issues, your comment ‘I wish I had the answer to all the problems with the health care issues in all the Western countries that would be a huge profit motive for me..’

    So unless there’s a penny in it for you, well, the rest of society can take a flying leap or a long walk off a short bridge. That’s pretty unfortunate, sometimes we need to do things for the betterment of all, not just for the few fortunate who can immediately afford it. Ideologically, that’s just pretty sad.

  53. Boy funk… you are awfully argumentative for someone with no skin in the game because you live in an enlightened country.

    Check the facts that Obama is using of 40 million uninsured it is extremely questionable. Many are not U.S. citizens. Others who are ‘uninsured’ are uninsured by choice. (

    As far as the spending 1/2 as much… would love to see the so called proof that you have. Name that tune…

    And about your criticism of my statement, we have a concept in the U.S. called a joke. At times it is good to laugh… it makes you live longer. 🙂

  54. Jeremy:

    Other countries (% GDP):

    USA (% GDP):

    BTW, I laugh plenty, smiling right now..

    This saddens me though: 50% of all bankrupcties in the USA are medical related.. Even if you think you’re covered adequately, you probably aren’t 🙁

    But the below wouldn’t make me smile too much… Current estimates put U.S. health care spending at approximately 15.2% of GDP, second only to the tiny Marshall Islands among all United Nations member nations.[1] The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017.[19][20]

    The Office of the Actuary (OACT) of the Centers for Medicare and Medicaid Services publishes data on total health care spending in the United States, including both historical levels and future projections.[21] In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person, up from $2.1 trillion, or $7,026 per capita, the previous year.[22] Spending in 2006 represented 16% of GDP, an increase of 6.7% over 2004 spending. Growth in spending is projected to average 6.7% annually over the period 2007 through 2017. Health insurance costs are rising faster than wages or inflation, and medical causes were cited by about half of bankruptcy filers in the United States in 2001.[23] (

  55. Martin Lindeskog

    Gary: Thanks for the link and email address.

    Jeremy: I will send you an email. I think you made some great points in your comment of June 17th, 2009 at 2:57 pm.

  56. Well funk…. good information. I appreciate it and I do find it interesting. I agree that something in has to be done in the country (as my posts have outlined). I find it interesting that many of the countries weren’t socialized medicine and even many weren’t single payor. This is my exact point, something has to be done but we need to really think about what best fits our system. Instead of overreacting and completely throwing away the many benefits that a free market system provides we need to consider how to utilize it’s strengths and minimize it’s weaknesses.

    Some of countries outlined used private systems to deal with care. I think that there are reforms that need to happen to make the system better. Instead of immediately throwing our hands in the air and looking to the glorious govt, let’s see what other options we have.

  57. Jeremy,
    The Health Care Lie you linked to is interesting, but out of touch as well and their numbers, even though they cite much less, are not good numbers either.

    The article states, “But there are millions of people who should be excluded from that tally, including: those who aren’t American citizens, people who can afford their own insurance, and people who already qualify for government coverage but haven’t signed up.”

    I am an American citizen, I cannot afford health insurance (self-employed) and I do not qualify for government coverage.

    (BTW, I can’t afford to pay out-of-pocket for health care either. A recent standard, run of the mill gynecological exam two months ago just yielded two bills – one for $245.87 and another for $685.67. So my yearly standard gynecological visit cost me just short of a $1,000. $931.54 to be exact.)

    “Government statistics also show 45 percent of those without insurance will have insurance again within four months after job transitions.”

    Not in my case.

    “Accounting for all those factors, one prominent study places the total for the long-term uninsured as low as 8.2 million – a very different reality than the media and national health care advocates claim.”

    OH, MY BAD. You’re right 8.2 million people is NOTHING.

    “But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326.”

    I don’t know about you, but the income levels referenced above, while good, are still not a lot of money in today’s world. Especially not when those are gross incomes being listed. So, first – deduct income taxes from those figures. Then, add two or three children into the mix, a mortgage and taxes or rent, high monthly gas, electric and utility bills, a car payment, your clothing, your childrens clothing, groceries, gas to get to work . . . it disappears faster than water in the Sahara.

    “Subtracting non-citizens and those who can afford their own insurance but choose not to purchase it, about 20 million people are left – less than 7 percent of the population.”

    Oh, I see. What’s 20 million people being left to fall through the cracks in America these days?

    Nothing, I guess, right?

    But all in all, I guess we all agree . . . something needs to be done.

  58. Click my username for an interesting article from the WSJ.. ‘The Myth of Prevention’ A doctor explains why it doesn’t pay to stay well. Decoding what works, what falls short in Obama’s plans to reform health care..

  59. For whatever it’s worth, too many people entered this country for the CHANCE to become wealthy, hence the opportunity to acquire good healthcare. Entitlement was never a topic of discussion in the beginning 200 years of our country, and now too many unwilling, system abusing, and sometimes illegal non-contributors are asking the hard-working taxpayors to foot the bill for their healthcare, amongst other items.

    I don’t believe “most people agree that everyone has the ‘right’ to healthcare”. It’s a priveledge, and for those who contribute, then let’s figure out a way for them to have healthcare without supporting the unproductive (those who’ve been living off the system for more than their fair share of thier life in what was once the greatest country in the world).

  60. This is pretty sad..

    ‘….I don’t believe “most people agree that everyone has the ‘right’ to healthcare”. It’s a priveledge, and for those who contribute, then let’s figure out a way for them to have healthcare without supporting the unproductive (those who’ve been living off the system for more than their fair share of thier life in what was once the greatest country in the world)…’

    Maybe you and your ilk (in the pejorative sense) believe that the bad apple rottens-the-whole-bunch, but interpreting or managing a ‘public good’ program from the POV of keeping the bad people out vs letting the good people in definitely won’t enable the future success you still dream about ‘in what was once the greatest country in the world’.

    BTW, there where no public healthcare programs 200 years ago, anywhere in the world. Should that mean that we don’t have them now?

    In the end what exactly are you protecting? Your own pot of gold or pot to piss in? Either way it’s only yours for a given time and then it moves on to someone and somewhere else (i.e. you die), at least try to make the world a better place while you’re around.

    At least that’s what I am trying to do and, while I am far from perfect, it’s the ideology I try to work from.

  61. Okay, Ron, perhaps we can raise the quality of this conversation a little.

    First, it wasnt’ that “too many” came here looking for a chance. Actually, Native Americans and those who were brought here as slaves, EVERYONE came here looking for a chance to do better. Including your forebears.

    Second, and yes, some people need help. There’s fossil evidence that even the Neanderthals didn’t simply discard those who were old and weak. What you derisivelly call an “entitlement” is otherwise known as a social compact. So, for example, our social compact says that everyone is entitled to an education — or perphaps you think that should be restricted as well. David Brooks, the noted conservative columnist, wrote a somewhat-recent article saying he thought we were moving to a new social compact that included a right to heathcare. You might want ot think about that.

    And, then, there’s the Rawlsian notion of justice that says a society’s degree of justice can be judged by how well it cares for its weakest members. [And, btw, that’s not necessarily a call for egalitarianism.]

    Lstly, it’s been noted that the more heterogenous the society, the more they are likely to have a robust safety net. It works among industrial societies and also among states in the US. So, perhaps the “I’m on the boat, kick away the ladder” philosophy simply reflects a bit of bigotry.

    Just a few things to think about.

  62. Oops. In the last paragraph, “heterogenous” should be “homogenous.”

  63. Gary Nickerson

    To Char —

    This is getting tedious. But I will repeat something I said to someone else: I hope you are someday injured in the high wilderness and have to be rescued by volunteers risking their own lives out of only a sense of community. Then you might get it. In the meantime, you might read John Rawls about values.

  64. I think most small businesses will be exempt from these mandates. There will probably be some type of back door clause where they will not have to offer group health insurance. Then most of the employees will sign up for the govt run plan should that legislation also pass.

  65. For now, the idea of forcing small businesses to pay for health care is purely speculation. It all depends on what reform bill passes.
    Health care is LONG overdue for reform though, so the costs that may result are worth it IMO.

  66. The White House Council of Economic Advisers has just released a report on effects of health care reform on small businesses and their employees.

  67. Totally agree with you, but it doesnt have to cost employers any more than at presnet, please have a look at my take on the healthcare debate.—Why-Americans-are-Brainwashed

  68. With these inevitable increases in costs for small biz owners, they MUST begin generating more revenues so that cost increased are a non-factor. With the government in place small biz owners are not going to get many breaks over the next 4 years. Take preventive measures and increase your sales… don’t fall victim to outside circumstances.


  69. I have no health insurance, by choice, and I’m sickened that I’m going to be required to purchase gov’t healthcare, which is atrocious, (I was in the military, gov’t insurance cost me a good credit score by not paying bills, not to mention care was abysmal.)

    Why should I be forced to pay for something I don’t need right now? I’m in good health, and I don’t really feel anyone else should have to help me with my forced health care either. This is atrocious, and un-American. Any congressman/senator that supports this should be assasinated for treason!

  70. Chris, maybe you should look a little bit more into how and why your country was created (e.g. what drove the founding fathers) before you label something “un-American”.

    You pay for medicare, EI, etc.. these are ‘self insurance’ policies for the masses.

    If they let you’all opt out, well, it would truly be a world where Atlas Shrugged..

    Better get that stick o’ butter out and bend over, because if we had it your way we’d all be getting screwed when times got a little to rough in our own world.

    You have freedoms in your world because others, along with yourself, make it so. Aren’t you willing to help them in their times of need as well?

  71. Healthcare provision is definitely every human being’s right. Yet at the same time, burdening small businesses is not the solution. This is a task that the government should take upon to change the face of the nation so no one suffers. Thank you for sharing.

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