Small businesses, doctors voice concerns about health reform

"Small business is suddenly playing a big role in negotiations over health care," NPR reports. "Supporters and opponents of various plans to overhaul the system are all trying to paint themselves as champions of mom and pop entrepreneurs."

The National Federation of Independent Business is "not happy with the health care bill taking shape in the House this week - especially its requirement for all but the smallest employers to provide health insurance or pay a penalty." Meanwhile, "the Democratic National Committee quickly lined up its own panel of small business owners to defend the House plan."

Big business is also getting in the mix, particularly in regards to the proposed employer mandate. "The nation's biggest - Wal-Mart - surprised fellow retailers a couple of weeks ago when it came out in support of the requirement ... And Wal-Mart is now urging other businesses do the same." But "the National Retail Federation quickly distanced itself from Wal-Mart, urging members to speak out against an employer mandate. Retailers in general provide health insurance for only about 45 percent of their workers, and the federation says in these tough times, they can ill afford to do more" (Horsley, 7/17).

The Jackson Sun leads its small business story with an anecdote "It is costing the owners of King Tire Co. about $30,000 more this year to provide health insurance to its employees. King Tire's 31 employees covered by the company plan also are paying more as the company was forced to pay higher premiums to offset the increased cost of health care. 'The cost went from about $10,500 a month to $13,000,' said Georgann McFarland, bookkeeper for King Tire."

Stephanie Cathcart, spokeswoman for the NFIB, "said her organization wants Congress to enact market reforms that would give small business owners access to more plans and reduce health insurance plan costs. She said those goals could be at least partially reached by allowing small business owners to combine with others, including across state lines, to form larger pools of insured employees when purchasing insurance" (Hunter, 7/19).

In an interview with The Boston Globe, "Dr. Gene Lindsey, president and chief executive of Atrius Health, an alliance of five nonprofit community-based physician groups in Eastern Massachusetts," said that doctors need a bigger role in health reform. Lindsey said, "I believe that as a profession we need to increase our commitment to making it work …. I think we need to change the way we practice. I think we need to find new ways to engage with patients that are more convenient for them, that are less oriented around our needs and more oriented around their needs. I think that we actually need to be much more cognizant of the resources we use and the way in which we use them. I think we need to be more collaborative, both with our patients and with our colleagues" (Weisman, 7/19).

Meanwhile, doctors are exploring new ways to organize their practices. In South Dakota, "following a national trend in health care, primary care physicians in Rapid City increasingly are foregoing their hospital privileges and turning their hospitalized patients over to the care of hospitalists," The Rapid City Journal reports. "A hospitalist is a relatively new medical specialty whose practice is limited to seeing patients in a hospital. By September, Rapid City Regional Hospital expects to employ 12 such specialists, up from the three it started its program with several years ago." Unlike the old model of health care, where doctors might see a patient in the morning and then not again until after office hours had ended, "hospitalists are accessible 24 hours a day, seven days a week and are better trained and equipped to work in a hospital environment." Patients may benefit because "hospitalists help free up more primary care physicians to take on greater clinic patient loads. Fewer medical students are choosing to enter the lower-paid primary care/family medicine specialties, resulting in a shortage of those doctors nationally" (Garrigan, 7/19).