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The Whiteboard: The health care debate needs business voices

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It's time for the business community to get engaged in the health insurance debate.

The insurance system set up under the Affordable Care Act, aka Obamacare, is going to be upended one way or another. Business owners have the choice of being spectators or participants. You have to believe it will be better to be participants.

If you’ve paid attention over the last few years, the fact that something has to give should be obvious. Too few young, healthy people are buying insurance to subsidize the premiums of older people more likely to need health care. Premiums have been going up rapidly. As premiums go up, the incentives for young, healthy people to buy insurance go down. The Obamacare penalties for not buying insurance are less than the premiums.

Working with small businesses, I’ve had direct experience with Obamacare. Annual premium increases far outpace the rate of business growth and the inflation rate. I’ve seen an HR manager delighted to receive a premium increase of “only” 7.5 percent after a couple of years in the double digits. Many businesses have had to change plans every year in an effort to keep premiums affordable. Small-business owners who truly care about their employees’ families, and who have traditionally covered the lion’s share of premiums, are stretched to the limit.

I’ve seen employee deductibles go from several hundred to several thousands of dollars, severely warping the concept of insurance coverage. Having a card in your wallet is not coverage if you can’t afford the deductibles. Something has to give.

Richard Randall
Richard Randall - ()

A Republican bill to repeal and replace the Affordable Care Act has passed the House of Representatives. Now the Senate will craft its version of the bill. We are probably months away from a final bill. But already the usual suspects are out in force resisting change. Over 50 national organizations are actively opposed.

The list includes prominent organizations that are typically against anything that isn’t directly to their benefit. AARP, the guardian of seniors (including yours truly) is already proclaiming the end of the world. Unions have naturally joined in, including the AFL-CIO, American Federation of Teachers, National Education Association, and the American Federation of State, County and Municipal Employees.

Doctors and hospitals fear change as much as anyone, so the American Medical Association, American Hospital Association and the Federation of American Hospitals have all joined the opposition. Of course, when medical lobbyists oppose legislation, they give the opposition the imprimatur of deep concern for patients, never mind that there is also a deep concern for profits.

Democrats, who seem to have recently extracted their heads from the sand, are now vocally blaming Republicans for the unraveling that has been happening for years. They want to “fix” Obamacare. Fix means provide more taxpayer money for more subsidies for insurers. That is a rabbit hole that will only get deeper.

The business community needs to wake up and get in the debate. A tepid position statement from the US Chamber of Commerce is not going to make a difference.

People, regardless of their income, need access to affordable health care. People with preexisting conditions need access to affordable health care. The system we have now is not meeting those goals. Pouring more taxpayer money down the rabbit hole is not the answer. Maybe the Republican bill isn’t the answer. But it is time for the business community, the source of all the wealth that can be spent on health care, to demand an answer that works. It is time for the business community to find its voice and make it a loud one.

Richard Randall is founder and president of management-consulting firm New Level Advisors in Springettsbury Township, York County. Email him at

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