Today 1 out of 6 Americans lacks access to basic health care coverage, and the number of uninsured citizens continues to grow. Aside from the fact that this is a national disgrace, employers should be seriously concerned about the uninsured for very pragmatic business reasons.

First of all, the problem of the uninsured, both adults and children, is largely one of small business and individuals lacking access to affordable coverage. 80% of the nearly 44 million uninsured Americans live in families with an employed worker. Three out of five of these workers are either self-employed or employees of firms with less than 100 workers. Over 80% of uninsured children are in families with at least one working parent.

Current demographic and industry trends indicate that most of the future job growth will be in small business, the service sector, and industries employing non-traditional workers. These are the employers who are least likely to be able to offer affordable insurance in today's environment.

Second, in today's tight labor market, health insurance is an important recruiting tool. Currently US employers provide health insurance to over 150 million employees and dependents. But rising costs and concerns about potential liability are forcing many businesses to take unpopular steps to hold costs down, through cost-shifting to employees, eliminating benefits for dependents or dropping coverage altogether. Yet, in total numbers, more employers than ever are offering health insurance to employees.

Third, there is another way lack of access raises costs and impacts employer purchasers. The rising number of uninsured citizens is compounding already serious cost-shifting, risk selection, and quality problems in the health system. The uninsured do get care in this country. But frequently not until health problems are more advanced and expensive to treat. And usually treatment is administered in higher cost settings, like emergency rooms. Someone pays these bills--usually through cost shifting to the private sector.

Few understand the impact of the problem of the uninsured better than corporate benefits managers, the private payers who foot the bill for uncompensated care through higher charges.

Business owners also feel the effects when uninsured workers are sick more often, absent longer and miss work to care for their uninsured children. The bottom line is that lack of proper and timely health care services means higher costs and lower productivity. Employers want to ensure their employees have access to the right care at the right time in the right setting!

Therefore, it should be apparent that controlling healthcare costs and optimizing workforce productivity require that we find politically acceptable ways to expand access to basic healthcare coverage to all Americans. The relationship between affordability and accessibility is a vicious cycle--one that can only be broken by systematically addressing the root causes of the problem.

To promote fairness, we need to level the playing field for individuals and small business by providing the same tax advantages to them as those enjoyed by employees of large business. With certain tax code changes, coverage options would open up that would make at least some health insurance within reach of nearly every American.

Tax credits, which would be refundable for lower-income people, give everyone a basic level of resources to buy a health plan and move the nation toward universal coverage through incentive, not mandate.

And small employers need to be able to pool together their resources, minimize variances in risk, and share fixed overhead costs. Tax and regulatory barriers that prevent the creation of competitive private health care purchasing groups should be eliminated.

Employers who understand the impact of 44 million uninsured Americans on their bottom line will readily agree that the issue of access to necessary healthcare related services is one that is too important to be politicized. We need to work collaboratively to promote a bipartisan approach!

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