You’ve heard the buzzwords during this presidential campaign year — universal health care, individual mandate, the uninsured, the underinsured, and so on. As candidates draw up their plans and big businesses lobby to lower their costs, small business owners are struggling to keep their employees insured and their doors open.
“Small businesses have seen a staggering 70 percent cost increase in health insurance in the last five years, making it unaffordable for more than half of small businesses with 10 or fewer employees,” says Steve Millard, president and executive director of the Council of Smaller Enterprises (COSE).
“The cost of health insurance is threatening the very existence of small business,” adds Millard. “In an economy that depends on small business to create all new jobs, the current state is simply not sustainable.”
But, there is hope — scenario planning, a new approach that could serve as the launch pad for a more informed national debate.
Smart Business learned more from Millard about COSE’s health care scenario planning effort and the changes that must happen regarding health care and small businesses.
In a nutshell, what led us to the current state of the health care system?
For the last 60 years, the system has developed expectations of unlimited care and boutique services primarily on the tab of employers or government. Putting people in charge of making decisions for which they reap benefits or accept consequences is key to reducing costs — and long overdue. After all, as consumers, we don’t let other people make decisions for us about buying a house or a car. Why should we let someone else make a decision regarding our health and our health care?
Today, the health care system is fundamentally broken, and we’ve concluded that no less than a complete overhaul will suffice.
What specific changes to the health care system should be pushed?
We’ve concluded that change must occur in two major areas no matter what political party wins the presidency or whose plan takes center stage. The first is the health care marketplace itself. We need vast improvements in the way the health care marketplace operates; for example, the development of an IT infrastructure that can make information about provider quality readily available to consumers. Availability and transparency of data can lead to improvement in care, reduction of waste and inefficiencies, improved prescription accuracy and service/cost transparency to consumers.
Secondly, the consumer mindset must change. We must take charge of our own health, starting with avoiding to the extent possible the three biggest cost drivers — obesity, smoking and depression. We must also take an active role in making the system work through responsible use of health care. By making better decisions, such as not using emergency rooms for primary care and avoiding lifestyle prescription drugs, we as consumers can make a significant impact.
What is ‘scenario planning’?
Scenario planning is the process of bringing together experts and stake-holders, identifying large uncertainties, and envisioning potential scenarios or futures that can play out down the road.
Rather than advocating for a specific solution, we engaged some of the best minds in the country and took this new approach to look at the issue in a comprehensive way. Our experts included representatives from national and regional organizations like The Leapfrog Group, The Cleveland Clinic, University Hospitals, Michigan and California small business groups, big insurers, academics, big businesses, former government policy makers and small business owners. Our goal is to envision potential futures in health care in 2015.
What conclusions or solutions have come from this process?
This process did not result in any one specific solution — rather, it provides a glimpse at the various issues that must be considered in any effort to reform the health care system, and one thing is clear: comprehensive reform of the U.S. health care system is no longer optional. The hemorrhaging has gone on far too long for an incremental, or band-aid, approach to be sufficient or acceptable.
STEVE MILLARD is the president and executive director of the Council of Smaller Enterprises (COSE), one of Ohio’s largest small business support organizations. Comprised of more than 17,000 members, COSE strives to help small businesses grow and maintain their independence. COSE has a long history of fighting for the rights of all small business owners, whether it’s through group purchasing programs for health care, workers’ compensation or energy, advocating for specific changes in legislation or regulation to benefit small business, or providing a forum and resource for small businesses to connect with and learn from each other.