How to Save American Business

And they do listen. I was in a restaurant the other day, and one of the hospital's leading surgeons came over to my table. "I want you to know that we've heard what you're saying about keeping our costs in line with inflation, and we're working on it," he said. That's what I like to hear. Because of the hospital's efforts, it costs our company about $90 a month to provide a single employee with health care coverage, compared with a national average of $308 a month, according to the Kaiser Family Foundation. As President, you might be able to bring that average down if you can get other boards of health care providers to listen to the business owners who are footing the bill.

Please understand, I'm not saying you should drop your own ideas for addressing the health care situation. Most of them we support. Health savings accounts certainly have the potential to help small businesses like mine. Because employees would be using their own pretax dollars to pay for medical expenses, they would no doubt become smarter consumers of health care services, which is good for everyone.

Most of us in small business are also behind your effort to curb medical malpractice suits through tort reform. It's just not enough. The $24 billion that the health care industry doled out in malpractice awards in 2002 represented less than 2% of its total costs for the year, according to the Congressional Budget Office. Measures like capping attorneys' fees and limiting awards will help reduce health care costs in some areas, but we need to do more.

As for allowing small businesses to band together in associations that would let them qualify for discounted health benefits, it sounds like a good idea, but be careful. There's a danger that associations would favor companies with a young work force and reject those with older employees -- with the result that some people who have coverage now might lose it. And before you spend a lot of your political capital on getting a bill for association plans through Congress, you might want to check out how many additional people would actually be covered. I understand that's a matter of some debate.