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.
