Small business owners who become scared whenever they develop a cough have the National Association of the Self-Employed on their side. The NASE has asked Congress to think about the healthcare costs micro-businesses can encounter.
"The escalation of health costs is most strongly felt by solo practitioners, who are spending more of their total sales on health insurance compared to three years ago," Michael Beene, the NASE's senior health advisor, argued in front of the House Committee on Small Business. In fact, according to a press release, costs rose 48.6 percent between 2005 and 2008.
So Beene continued, "With such a large percentage of revenues going to health coverage, we can see why this expenditure is one of the first to be decreased or cut when business owners are faced with hard economic times." Which becomes bad for both employees and business owners if anyone gets sick.
Beene made several suggestions that might fix the situation. First, he'd like to see a self-employment tax deduction on health insurance. Health reimbursement arrangements (HRAs) could be handy, too. And health tax credits would be nice to have.
In the meantime - and we're not kidding here - just try to stay warm and drink plenty of orange juice. Even if this won't ward off serious diseases, perhaps you can avoid basic stuff like colds.
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Comments
Health care costs are just too high
Although much is said about the Great American way, fact is many small businesses, especially if it is only the owner doing everything, cannot afford good health coverage.
The small business owners I know can only afford the very limited coverage, upto around may $2,000 or so per year.
As the coverage they have is so small, they are reluctant to use it on anything, in case they need something more improtant later on.
One lady owner I know, had a horrible case of hemorrhoids, but wouldn't even go for a diagnosis, as it would eat up some of her limited coverage.
Particularly in recession times, when everyone is normally finding it a bit harder business wise, to take time for an operation is costly just in lost income, let alone havng to fork out money to rich doctors and surgeons and the like.
So, lets hope something comes from these discussions that will actually help the small business operator.
Insurance doesn't address Health Care Costs
What everyone seems to forget, or ignore, is that health insurance doesn't address the cost of health care. It likely increases it. The cost of health care is spiralled up due to several factors.
1) Technology: Everyone feels that they have to have it, the physicians, and the patients. The reality is that the technology is supposed to confirm the diagnosis, not make it. Our best tool is still a caring, well trained, intellegent physician. A comodity indeed.
2) Entitlement: Yes, patients drive healthcare also. I don't know how many patients I have battled to get them to believe they do not need a prescription or expensive test, but better lifestyle and time. We are a victum of the 'silver bullet' philosophy of the 1940's. People will get sick, and people will die, this is a fact of life, and no amount of money will change this. It is a tought choice, but we would be better served making sure the 25 yo does not end up permanently disabled from a broken leg then giving the 88 year old aricept.
3) Liability: Tort drives costs, it certainly doesn't contain them. I know many physicians who base their treatment decision on whether it will increase their risk of being sued. That means more tests, and hospitalizations, which do not improve outcomes. The evidence is that more does the exact opposite.
4) Risk: We must understand what it is, and what it does. This certainly ties to Liability, but also to Entitlement. Trying to convince someone that a test has risks, and that those may be subtle is difficult at best. But your 'Yearly Physical' with all the labs and ecg's is more likely to find a benign abnormality than a real problem. And when we do something, it has inherent risks. Sometimes less is more. My best example are Stress Tests. Everyone over 50 seems to think they need a stress test to "make sure they don't have heart disease." News for you, you do. 18 year olds have heart disease. But if it isn't symptomatic, then a Stress test is not predictive of problems.
Until we realize some of this, which I don't believe anyone is able to, costs are going to continue to increase, and more insurance is simply going to drive it faster.
Good luck to us all.
MD
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