I was able to catch the last 1.5 hours of streaming video yesterday from President Obama’s healthcare summit with the Republicans. I cannot speak about parts of the summit I missed but I was impressed by the President’s grasp of the issues. He clearly has been centrally engaged in the process and not just an interested bystander.

As a small business owner, I saw my healthcare costs rise 38% several years ago followed by a subsequent 25% increase the following year and nearly double digit increases every other year. In 2002 we were paying about $250 for an individual plan and my business was covering 100% . The same plan now costs nearly $800, but we don’t offer that plan anymore. We offer a more cost effective plan. By “cost effective” I mean that the business still pays the same amount for health insurance but my employees are now paying a 20% contribution, doubled co-pays and  $1000 deductibles. Healthcare rationing is real, folks, and it will only get worse without reform.

At yesterday’s summit, the Republicans seemed to think that Americans have a choice in selecting their health care plans,that we just need to be better shoppers and use health savings accounts and that will drive down costs. You know, the old consumer driven health care argument. Nothing could be further from the truth.  Most Americans are employed by small businesses which have no leverage with the insurers. Every year we faced the same problem of selecting a single plan to offer our employees that balanced the financial needs of the business with the healthcare needs of our staff.  Conflicts of interest aside, the only choice of healthcare plans my employees had was to enroll in the one-size-fits-all plan or go without healthcare.

Being in Massachusetts (the only state to mandate individual health coverage for all its citizens) I have the good fortune to have available the Massachusetts Health Connector (MHC), an exchange similar to those proposed in the President’s healthcare bill. The Connector has solved one major headache for me as a business owner by offering a menu of healthcare plans for my employees to select from.  Instead of locking into a one-size-fits-all solution we choose a “benchmark” plan and then agree to contribute a percentage of that plan cost for each employee. Our employees can select that plan or select from a menu of other plans that might better serve their needs. If the plan is less expensive, the employee’s payroll contribution is reduced, if it’s more expensive, the employee makes a larger contribution.

I will point out that the Connector is a work-in-progress. It has primarily addressed the issue of choice and access to healthcare plans. It has yet to have any impact on reining in healthcare costs but I remain hopeful.

Getting back to yesterday’s summit, I’m perplexed by the Republican refusal to engage in the process. They continually give lip service to small business and how important we are for jobs creation. So how can they be so blind to the importance of the healthcare issue to small businesses and our employees? They can’t possibly be as dumb or clueless as they sounded therefore I conclude that their motivations are purely political.  Perhaps there was something meaningful presented earlier in the day but by the end of the day it was just a series of the same tired old Republican talking points designed to scare the public.

They say they want to tear up the President’s bill and start over, but if there were truly interested in starting over wouldn’t they try to build on the 70% of the bill that the President says they apparently agree on?

My take away from the summit was that the Dems have done their legwork and seem to have a firm grasp of the issues for all stakeholders. The Republicans are taking a 1990s view and proposing simplistic solutions for highly complex and inter-related problems. The challenge for the Dems is that they’ve failed to effectively position the issue with the public and made it easy for the Republicans to lob fear grenades. If the Dems want more public support, they are going to need to reframe the issues in ways that speak to the American people. Yesterday’s summit was the first step.