To Grow Small Business, We Need Health Insurance Reforms

“We know that real people lost their health insurance coverage. This coverage loss happened at the same time millions of people faced double or even triple digit increases in their premium payments.” – Cynthia Cox, of KFF healthcare research nonprofit 

As a retired corporate senior vice president with a publicly held healthcare corporation, I strongly believe in the benefits of capitalism and mentor over a hundred start-ups every year. I perform these services as an unpaid volunteer with a non-profit organization, SCORE (previously the Service Corps of Retired Executives). Providing free mentoring to thousands of small businesses throughout the nation, including many in Fayette County, it’s a fine program that I would recommend to anyone either starting a small business or expanding an existing one.

Small business is the engine driving job creation in our nation. However, there are many obstacles in starting a new small business, among them health care insurance. If entrepreneurs have families with health issues, they may find themselves in an untenable position without government help such as the ACA/Obamacare.

There are 23 million Americans receiving coverage through these ACA marketplaces. Further, the ACA prohibits excluding coverage due to pre-existing conditions. 

Thus, in the past the ACA has made insurance affordable for many of these entrepreneurs. This is one key reason why the Affordable Care Act (ACA, Obamacare) subsidies, passed 2021 and expiring in 2025, were so important. Congress, encouraged by the Trump administration, let them expire, resulting in 3 million people losing insurance so far, including many small business owners.

For those entrepreneurs not affording health insurance, the choice is a stark one. They can start a business and follow their passion…or they can stay put on their current job, playing it safe and keeping health insurance.

This is not a choice entrepreneurs in other developed nations face. These nations have government provided or mandated health insurance…and it costs less than here. 

The Commonwealth Fund recently did an analysis of healthcare in 10 wealthy nations, all having full coverage except the USA. All were less expensive and had better mortality and morbidity outcomes. For example, the US spends 16.5% of its GDP on healthcare versus other nations which spend 10%-12%. One reason for this is the poor functioning of our administrative system which wastes doctor’s time “dealing with insurance or medical claims issues” and aggravates patients stuck “resolving medical bill disputes and completing paperwork”. Further, based on death rates and preventable deaths, the US has worse outcomes than any other developed nation.

This situation is causing burnout among our MDS and nurses. This situation is further explained in a June column that an Emory Medical School physician and I wrote for a Texas paper.

We can turn things around, getting coverage to all small business owners. We can accomplish this task by examining high performing nations like the Netherlands, New Zealand and Australia for systemic reform, greater coverage, best practices and system efficiencies. What we cannot do is what we have done so far in Georgia – ignore the fact that we have 1.2 million people uninsured (the 3^rd worst in the USA)… while bragging about being the Top State for Business as Governor Kemp has done.