We all know about the Medicare "doughnut hole," but there is another "doughnut hole" in our health care system that is possibly more important.
Who in this country has health insurance they can count on? Generally, people who work for larger companies, for government, for large institutions etc. People over 65 have Medicare. Very low income people ($10,000 and less) have Medicaid. So who is left?
Well, unemployed people of course, but also people who work for, own, or are a small business. It is well known that small business provides 50% of the employment in this country (small business defined as 500 employees or less). Roughly 36% work for businesses with less than 100 employees. Many are self employed. This group is in some ways the most vulnerable in our economy on the issue of health care, but they in some ways are also the most important.
It is a fundamental tenant of the idea of a free market economy that it's the entrepreneurial spirit that continually refreshes the economy with new ideas, new products, new ways of doing things. Its new businesses that often provide the key to the future. And as a progressive, I do subscribe to that idea in many ways. But, one of the greatest deterrents to anyone thinking of starting a new business venture in this country right now is the cost and availability of health insurance.
How many people with a small business right now are slow to hire for that reason? How many are laying off for that reason? How many people who might have a good idea and might try to run with it don't because they can't afford or can't get health insurance. How many people operating as sole proprietors over the last 10 years gave up and signed on with some large company for that same exact reason. How many people stay in a "safe" job for that reason, when otherwise they might try something else in the pursuit of a good idea?
Fixing health care can be framed as a key to unlocking the very thing that can help pull us out of recession and provide for this country's future economic prosperity. There is an economic cost, shall we say an opportunity cost, derived from what is NOT happening as a result of our health care system's problems. What the free market people so loudly tout as our economic savior is in fact being stifled right now by our health care system. By addressing the health care problem we could free the ingenuity of Americans to go back to pursuing good ideas.
People shouldn't have to be making key decisions that dominate the shape of their lives sometimes for decades purely on the basis of health insurance.
We should turn this argument back on the conservatives. There has been some talk about the problems of small businesses and health insurance. But there has been very little talk about the economic potential that could be unleashed by solving this problem. Make it a positive argument, not a negative one. People respond to that better (especially in the political middle).
Our arguments need to appeal to the lives of real people, not just to political theater and theory. There are a tremendous number of people out there who fit into these categories, who are scared right now and can be appealed to, if done in the right way. Even some Republicans.
This is a part of the argument I think has been overlooked. This should be a huge constituency that favors health care reform if it is presented to them in the right way.
NOTE: I posted a version of this late Tuesday night and it disappeared without a trace, but I think its an important point, so I've revised, expanded and reposted.