Jump Starting the Health Care Debate

Jump Starting the Health Care Debate

- in Progressive Voices

By Adam Searing, NC Health Access Coalition

I was in REI the other day replacing a broken pair of cycling sunglasses and came across a new and irresistible product. One of the energy bar makers is branching out into candy.  And not just any candy – each one of these small grape-flavored gummy squares contains “essential nutrients” and, incidentally, about the same amount of caffeine as in a can of Mountain Dew. Eat two or three and it’s “watch out Lance Armstrong.”

My first thought was to take a few packs over to our General Assembly and see if they could help jumpstart some real debate that the standard meeting-room coffee hasn’t been able to touch. One great idea where this supercharged candy might help would be making a real try at helping small businesses afford health insurance. The small business lobby in North Carolina sees this as its number one issue, but has no affirmative ideas at all as to how to reduce premiums for their members. 

Instead, the lobby’s two major issues are defeating mental health parity and defeating a high risk pool for health coverage where insurance companies contribute to costs along with everyone else.  Neither of these ideas would do much to raise health insurance premiums given the positive experience of the North Carolina’s state employee health plan with mental health parity and similar mental health requirements and high risk pools in other states. In fact more than 30 states already have both of these conservative, common-sense health efforts on the books.

Rather than just shouting “no” all the time, the small business lobby might want to consider pushing for a positive solution for their members. One, already proposed by the NC Institute of Medicine last year, is a deep discount health insurance plan for small businesses that would reduce premiums an average of 30%. That’s right – while the small business lobby wastes enormous amounts of energy trying to defeat two modest health proposals there is a fully-formed plan that could be enacted right now to immediately reduce many of their member’s premiums by almost one-third.

Not only is this plan a product of months of thought and research, but a similar version is already up and running in New York where it is drastically reducing premiums for small businesses.  The way the plan works is for taxpayers to fund an account that would pay for a certain portion of health claims made by employees who buy the Healthy North Carolina policies.  If an employee’s health claim was $1,000 or $1,000,000, then it would be paid for out of premiums.  If it fell in a certain range, say between $20,000 and $100,000, then the costs would be paid for out of the state account.  Healthy North Carolina would be sold by ordinary insurance agents and would otherwise work just like any other insurance offered by employers. 

Like any realistic health care reform that actually reduces costs, there has to be a clear way to finance the plan. For Healthy North Carolina, estimates of the annual cost range from about $26 to $53 million. A great deal of the cost could easily be covered simply by maintaining North Carolina’s highest tax bracket (which is scheduled to be reduced) or even limiting it to households with incomes of more than $1 million a year. 

To solve our health insurance crisis, people all over North Carolina are going to have to come together and agree on solutions. That includes small business owners who employ millions of North Carolinians, are hugely important in communities across the state, and provide needed growth for our economy. 

Whether or not everyone is getting too much caffeine, it’s always much easier to try and block something you don’t like in our legislature than it is to actually get something done.  However, too many people are losing their health insurance or can no longer afford coverage for us to have the luxury of simply sitting on the sidelines and tripping up the good ideas and they zoom by in front of us. 

It might be more expedient for the small business lobby – which always seem to be for lower taxes at any cost – to not advocate for a program that would tax millionaires to provide a deep discount health plan for small business workers.  It just wouldn’t be in the best interests of small businesses in North Carolina.

Adam Searing is the Director of the N.C. Health Access Coalition

About the author

Chris Fitzsimon, Founder and Executive Director of N.C. Policy Watch, writes the Fitzsimon File, delivers a radio commentary broadcast on WRAL-FM and hosts "News and Views," a weekly radio news magazine that airs on multiple stations across North Carolina.
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