Affordable health insurance for all is a must

Boston Business Journal
April 2, 2004
Opinion
Anne Shuhler

I co-own a small retail and commercial printing company with 15 employees. My single biggest nonprinting related cost today is health care. I value my employees and believe that providing the best health coverage I can is an employer's responsibility -- but it's becoming more difficult to meet each year. I would not want to work somewhere that did not provide health care coverage. Would you?
Small business health insurance premiums in Massachusetts have been soaring for years. Policymakers in the commonwealth need to remember that when the average premium hike is 15 percent, they are more like 30 percent for small businesses. Over the past five years my company's health insurance premiums have increased over 60 percent.

In 1999, we paid $185 each month per individual employee and asked them to contribute 25 percent for their coverage. This year, in order to hold insurance costs to $300 per employee, I had to change plans and cut benefits. Switching plans saved me 10 percent, but took 80 hours of talking with brokers and different plans, comparing benefits packages and figuring out how each change would affect my employees' lives. To make it all work, I had to ask my employees to pay a larger share, 30 percent each month. We all have coverage, but we are all, quite literally, paying more and getting less.

I'm not alone. All businesses, particularly small businesses, are faced with harder and harder choices as premiums go up each year. I'm constantly in the position of choosing between investing in the employees who make my business successful today and investing in growing my business so it will continue to be successful in the future. Can I give raises this year? Can I buy new equipment? Can I offer the new services I need to keep my business profitable? The system discriminates against older workers, and older in this case is anyone older than 28! Increasingly, the rising costs of premiums are driving business decisions even when they're not good for business.

Rising premiums and cost shifting also burden my employees -- and it's not a burden they share equally. Not all my employees get the same wage, but they have the same deduction for health care. A plan we did not choose had different deductibles based on where my employees live. Many of my employees live near teaching hospitals and, therefore, would have had to pay higher deductibles to use their "local" hospital or doctors. Other employees would have had lower deductibles because they live in the suburbs.

My new job as their employer is to "educate" them on the proper use of health care resources. I'm not a doctor or a nurse, and I don't have a human resources department to run wellness programs for my staff. All the same, I'm their new gatekeeper to the health care system. If my staff uses the emergency room "too much" or visits the doctor "too often," all our premiums rise the following year.

As an employer, I can't subsidize my lower-income employees without raising my prices for printing and copying -- and I can't raise my prices in this market without losing business. As a small employer, I can't get large group rates. As one employer, I can't control the costs of the entire health care system. I can't even get reliable information to figure out which is the best deal for my employees.

Skyrocketing premiums have caused a lot of debate -- but there hasn't been much action. Although I was relieved to hear my premiums would only go up 30 percent instead of 32 percent because the state caps small-group premium hikes, I still believe we need to do better than that if we want small businesses to grow and create jobs.

It's time for some fundamental reforms to ensure that everyone can get the care they need at a reasonable price. Unless those paying for the insurance costs start screaming that these costs are unacceptable, the rise will never stop. Both employees and employers have an incredible vested interest in affordable health care.

I strongly support the proposed amendment to our state constitution so residents of Massachusetts can get affordable, comprehensive health insurance. We need a catalyst to get everyone to the table to rationalize our health care system so it works for people, for employers and for our economy.

ANNE SHUHLER is co-owner of Classic Copy & Printing in Central Square, Cambridge.

< Return to News Room Index