As President Barack Obama pushes Congress to pass a healthcare reform package in the next two weeks, South Florida employers have two main messages to the nation’s top policymakers: Reduce costs and don’t mess up small businesses.

Some Congressional leaders say Obama’s timetable won’t be met, but much of the nation is watching carefully. Doctors, hospitals and pharmaceutical companies all have huge stakes in the outcome, as do the estimated 50 million uninsured.

But so does a group that has been fairly quiet until now — the nation’s employers.

“There’s change that’s needed, but there are moving parts that need to be examined,” said Publix spokeswoman Maria Brous. “We want to make sure we are doing things that are well thought-out.”
Publix and many other companies say that whatever is done to extend coverage to the uninsured, the government needs to cut healthcare costs.

“Get the costs down!” pleads Marlene Bernard, co-owner of Apricot Office Supplies in Miami Gardens. She recently paid $300 out of pocket for lab tests. “Who can keep affording this?”
Larger employers are generally able to continue to provide quality health plans even in a recession, and the bills aren’t likely to affect them, but for small employers, it’s another story. Many can’t afford to pay for insurance now, and they fear the consequences of some proposals, such as the one that would add an 8 percent payroll tax to companies with payrolls of more than $250,000 a year that don’t provide insurance.

“Oh my Lord! We couldn’t survive,” said Miriam Vilariño when she heard that proposal. Her family owns 14 restaurants, most called Las Vegas Cuban, in Broward and Miami-Dade counties. “The only thing we could do is hike our prices and our customers are already suffering to the max. We are a very budget-priced family enterprise.”

A study this month by the U.S. Public Interest Research Groups found that 76 percent of small businesses surveyed said their interests are not being recognized in the healthcare debate.
The study reported: “Small businesses who do not currently offer coverage would overwhelmingly like to, but are stymied by high costs, complications and red tape.”

Some proposals would provide tax credits to employers of fewer than 25 full-time workers (House of Representatives) or 50 (Senate) to help them buy insurance, but that wouldn’t help Las Vegas Cuban, which has more than 250 low-paid employees.

Steven Ullmann, who directs health policy programs at the University of Miami, said the details about how to reward or punish small businesses are still being hammered out in the halls of Congress.
A critical issue is what happens to those businesses on the edge of any new healthcare law, said Ullmann. If a firm’s payroll or number of employees meant it might required to provide insurance or be taxed, the easy solution would be to lay off people to get below the threshold. “The consequences of these things can get complicated,” said Ullmann.

One example: The payroll tax proposal was intended to encourage companies to provide insurance, but the co-owners of Apricot Office Supplies found themselves wondering if the tax wouldn’t be cheaper than offering employees insurance — the opposite of what policymakers had planned.
For a small-business owner like Vincent T. Brown of Grace Funeral Home in Miami, the view can be simpler.

Brown offers health insurance to his four employees, paying 70 percent of the premium, because “it’s the right thing to do.”

But he knows that there are many self-employed or small-firm workers who have no insurance, and a major illness could be catastrophic for them. “It’s critical this country find a way to protect them.”
What follows are snapshots of a survey of South Florida employers’ healthcare situation and their views about what Washington should be doing to improve the situation.

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When you are not well or healthy, you should seek healthcare advices from health experts or doctors. Taking preemptive action is better option than to go to see a doctor or health experts. Do your homework by identifying different types of health-care services, how to get health insurance to help pay for health care. This will help you financially and mentally as well.

If you are feeling not well you should go to see a doctor or health experts. Going to see a doctor is not going to assurance that you will get well. You must to know what to ask and follow the directions and prescription the doctor gives you. In addition, you required good amount of money to pay for these services. It is very difficult to pay for good healthcare coverage from your pocket. That is the main purpose for the discussion on health insurance.

Try to understand the importance of seeking healthcare advices when needed. Many people do not go to the doctor or health experts because of difficulty, money, and panic. These are all justifiable reasons for avoiding a doctor’s clinic. Putting of seeing a doctor can cause superior difficulty, money, and panic.

Search available healthcare options in your area. Most insurance companies want that people see a primary care physician before going to an expert any time they want, but they will most likely have to pay for the appointment themselves. Search on internet or ask your friends or go through the yellow pages and look up different types of healthcare providers. You can find a list of physicians by specialty in your area or nearby. Most people will go to an internal medicine doctor or family practice doctor for basic healthcare such as colds, flu, cough, cuts, etc. again, people who have health insurance would pick their doctor from a list that the insurance companies provide.

Search various healthcare options available in your area. The clinic where your doctor sits is where you go for basic medical checkups. Search whether there are free medical checkups available in the hospital and where it is located. Most people get health insurance through their company. A person who is not entitled for health insurance from any of these sources can pay for health insurance independently through an insurance company. Depending on the medical coverage, you may have to pay a certain percentage of the total medical expenses, a flat fee for each visit to the doctor or hospitals, or may pay nothing.

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Polls indicate that most Americans are satisfied with their coverage. But the White House and other advocates of overhauling healthcare say people are probably paying more for insurance each year. Premiums for employer-provided plans have risen four times faster than wages, and are now double their cost nine years ago. Deductibles are rising as well. Supporters of the legislation contend that healthcare costs are a drag on the economy.

How many proposals are there?

The Senate’s Health, Education, Labor and Pensions Committee has passed its plan on a party-line vote. A competing plan from the Senate Finance Committee — which has the task of figuring out how to pay for the overhaul — is expected within two weeks. Then the two proposals will be merged by Senate leaders.

In the House, three committees have signed off on an overhaul bill, but the Energy and Commerce Committee has yet to produce its version, which is likely to feature some significant changes. House leaders would like the chamber to vote on a final bill before the House leaves for its August recess.

Which bill does President Obama support?

Here are some key questions regarding the effort to overhaul the nation’s healthcare system:
I have health insurance and I’m happy with it. Why does the nation need to overhaul healthcare?
The president hasn’t endorsed any of them. The White House has preferred to detail what it considers to be the necessary elements in any package and let the legislative process fill in the blanks. But expect the administration to be heavily involved as the House and Senate bills are refined.

What do the plans working through Congress have in common?

There is consensus that more money needs to be invested in preventive medicine, while creating incentives for doctors and hospitals to provide quality care. There is also a strong push to create a more competitive marketplace for health insurance, either through the creation of cooperatives, state-supported “gateways,” or a federal government “public option” that would compete with private insurers. Supporters say competition would drive prices down.

I don’t have health insurance. Would I be forced to buy it?

A requirement to have health insurance is likely to be part of a final bill, similar to the way many states require auto insurance. Today, an estimated 47 million people are without insurance and millions more are considered to be underinsured. Democrats in Congress argue that people with insurance are in effect subsidizing those without, because their premiums are higher than they would be otherwise.

What if I can’t afford health insurance?

* People who work for companies that do not provide insurance.
* People who cannot afford the insurance offered by their employers.
* People who work for small businesses that elect to make the government plan available to their employees.

* People making up to four times the federal poverty rate — that is, $43,320 for an individual or $88,200 for a family of four — could be eligible for assistance to help pay the plan’s premiums.
House leaders originally proposed limiting eligibility to businesses with fewer than 10 workers in the first year of the program and to 20 in the second. The Senate health committee has proposed limiting eligibility to businesses with 50 employees or fewer. The Senate Finance Committee is still working on a proposal that may not even include a government plan.
Couldn’t businesses just dump the coverage they provide now and then their employees would sign up for government insurance?

They could, but they might get hit with a penalty. There is debate about whether some businesses would drop coverage because paying the penalty would still be cheaper.

Small employers would be exempt from this penalty.

So, with all the restrictions, how many people would be eligible for the government plan?
By 2019, the Congressional Budget Office estimates as many as 36 million people will be eligible. But the CBO also thinks only 11 million Americans will sign up, while 160 million will have private insurance.

Why is that?

The government plan will be able to offer lower premiums than private plans, but people often look at factors beyond the cost of premiums, including the cost of co-payments, deductibles and the size of the network of providers. For example, many federal employees can choose among more than a dozen health plans, but not all of them have chosen the cheapest one.

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