Though it will be many weeks likely before we hear the U.S. Supreme Court's ruling on whether the health-care reform law is constitutional, business groups are already promoting their favorite alternatives to help cut costs.
NFIB has five health-care initiatives it would like to see:
1. Self-employed people could be allowed to fully deduct their insurance premiums when they buy an individual policy.
2. Business owners could contribute a flat amount to employee accounts, which workers could then spend to purchase their own health plan.
3. Small-business owners could pool funds across state lines to purchase insurance in a market of their choosing.
4. Health-care portability would encourage more startups by allowing entrepreneurs to stay on a former employer's plan.
5. Medical liability (tort) reform to cut back on frivolous malpractice cases.
Of those, the third option is perhaps the biggest long shot. I can hear state insurance regulators screaming from here. And tort reform is something the medical professionals have long agitated for to little effect.
The problem with the second option is having every worker purchase an individual plan results in higher rates, as there's no group discount. Portability is something every consumer would like to see, but another one that's been talked about forever. The full deduction for premiums might be a fairly easy break to achieve -- maybe the best bet on this list.
By contrast, Kauffman's focus is on big changes to health-care infrastructure to create efficiency. Here are four ideas out of a study it commissioned on how to improve health-care efficiency and quality of care:
1. Increased data-sharing between medical researchers, the pharmaceutical industry, insurers and doctors; encourage "a new corps of data entrepreneurs" to better collect and analyze medical data to discover best practices and new therapies.
2. More research funding for larger, more collaborative teams with members from multiple institutions.
3. Streamline new drug approvals and remove "counterproductive" restrictions in health-care coverage, all by medical malpractice reforms.
4. Providing more unbiased information to patients on treatment options and lifestyle changes.
Some of Kauffman's ideas are part of the current health-care reform plan, especially advances in data sharing. And some of it is in line with NFIB's agenda, particularly malpractice reform.
As a solopreneur who has paid a lot for several types of small-business insurance for the past six years, I'm one of many business owners hoping that state discount pools for small businesses planned under health-care reform survive the High Court challenge.
Given all the ideas out there, this option still seems like the most immediate way to reduce small-business owners' health-care costs. Give us access to the kind of discount rates the corporations enjoy. There's no logical reason why we can't have them. Keeping it a state-by-state solution works within the existing order, so it's easier to roll out than allowing cross-state policy purchasing, as NFIB would prefer.
What do you think should be done to cut health-care costs? Leave a comment and let us know.