It’s not that they don’t want you covered. They just don’t want one “option” shoved down their collective post office boxes.

Senator Tom Harkin (D-Iowa), the venerable leader of the powerful Health, Education, Labor and Pensions Committee, gave small business owners their chance at the mic. Apparently, they had a lot to say at the Harkin-hosted “Increasing Healthcare Costs Facing Small Business” forum. As you might imagine, all the usual debaters for low-cost insurance advocacy were there. Those lobbying for the — dare I write it, Republicans — “Public Option” — were also on the soap box.

Since small businesses have been among the most vulnerable victims of this long, cold economic downturn, health insurance (by virtue of its current cost-model that favors group rates) has gotten really expensive for these folks. The less people you have on payroll, the more you pay for coverage. The more people you have on payroll, the less you pay for coverage, but the more you pay in salaries and overhead. Roll the dice. Either way, small business owners are taking it on the chin.

“Get it off our backs,” small Iowa newspaper editor and publisher Art Cullen, told Senators, “If that means a public option, fine. If that means an insurance exchange of some sort, fine. But give us a way to get out from underneath this albatross. It’s become expected that small businesses will provide insurance, even if they can’t afford it. And we cannot afford it.” I gotta hand it to the Congressman. The audience was appropriate. Since everyone has a stake in affordable healthcare, ears were burning everywhere. But we’re still waiting for something — anything — to change the bleak outlook.

In spite of all the back-and-forth between hecklers and proponents of more affordable healthcare (and I’ll admit, after Wal-Mart kind of took over the small business niche’ years ago) a plethora of insurance plans are still around, alive, well and thriving. Small Businesss can get it done. Care at less cost can happen. It just takes some entrepreneurial spirit to change the debate. Unfortunately, Congress has never been known for their independent streak.

A newly-released survey of human resources professionals suggests that HSAs (or Healthcare Savings Accounts / Flexible Spending Accounts) need a strong legislative antibiotic to ward off a growing epidemic of consumers who are enrolling in higher deductible health care plans in a flat, uncertain economy.

Originally signed into law as a cornerstone of the Medicare Prescription Drug Improvement and Modernization Act of 2003, HSAs were endorsed by then-President George Bush as a compromise between healthcare industry advocates who insisted at the time that higher co-payments for medical coverage are necessary to make a profit and please their shareholders and the American Association of Retired Persons (AARP), who lobbied hard for retirees on fixed incomes to obtain public assistance for medications. When the dust settled, the HSA was supposed to be the panacea for skyrocketing healthcare costs.

Shortly after last year’s health insurance open enrollment season, consulting firm Celent released dismal numbers citing the HSA market’s “disappointing early showing”, and projected 12.5 million accounts by 2012. That’s down about four million people than were originally estimated. Even with the additional tax and so-called “catch up” savings incentives for enrollees over age 55 added in, employees who are eligible for health insurance coverage through their workplaces are coming off of a wave of economic uncertainly and every penny counts. Even leading economists with the Government Accountability Office (GAO, the agency in charge of crunching these kinds of numbers) openly admit that given the slow recovery of the current economic climate, HSA enrollment this year will suffer.

“When you tell a worker in this economy that you’re going to take some money out of their pay check each month and then further squeeze them by earmarking the funds for healthcare expenses with a guaranteed loss at the end of 12 months’ time, it’s healthcare suicide,” says James Lloyd, an analyst for the Southeast region of the GAO. “This year will be especially volatile.”

Budget-Friendly HSA Alternatives:

Employers are streamlining their health insurance plans to cut costs. Whereas just a few years ago, according to the GAO, the average U.S. company with more than 100 employees offered three different health insurance plans; you could pretty much count on a high-deductible PPO, a low-deductible PPO and an HMO to choose from when signing up for benefits. Now, more and more employers are promoting the HSA option and/or eliminating any low-deductible, affordable health insurance plan they may have previously offered. Not only do FSAs cost companies less, but they get to share in tax credits too. The trend, according to the Human Resources Association of America and the U.S. Department of Labor Statistics, will only continue toward workers converting to individual medical policies. At least until open enrollment time rolls around again in 2012.

1) Personal responsibility

This is simply our responsibility to each other to take care of ourselves and our overall health. Yes, eat right, exercise, be smart and have fun, but gauge your risks. This is our health responsibility.

2) Social responsibility

Our society has a responsibility to us for instituting and overseeing quality healthcare in the private sector. Businesses want, to provide and meet our needs, but it is government that acts as an overseer. In a country as rich, beautiful, and bountiful as our is, it is not acceptable that our government cannot implement a better system to encourage more efficient care for all of us.

3) Professional responsibility

This represents the responsibility of our caregivers, the doctors, nurses, surgeons, paramedics, and all others directly involved in providing for our care. They go through countless hours of education and training to do their very best, most actually do every single day; thank you.

While I state the obvious above, it is nevertheless a fact that many of us take our health for granted, do not get health insurance, and put our lives and health at risk without thinking of the repercussions to ourselves and our families.

Just as well, our government hasn’t been able to implement a better system and hinges at times on total failure and a true example of inefficiency. If you are one that thinks the government could do “better” if there was universal care, please look at the facts and inefficiencies in Medicare and any system that the government runs; Yet, they must play their role as overseer of the private sector.

Lastly, there are also practitioners that do not make the cut and lack professional responsibility.

Nothing is perfect, but we must work ever so hard and struggle to always continue to make us better.

You start by providing us with basic information that we use to prepare an estimated quote range from many carriers and plan designs. The next step allows you to review the basic information and gives you the opportunity to speak directly with one of our licensed health insurance agents.

This part of the process is truly unique. Our licensed health insurance agents will listen to your needs and expectations, will ask you a few questions, will qualify you, and then customize several plan options specifically for you and your family.

This will be done from the many health insurance plans and carriers that are available and will be customized through our software for you.

You can then review and compare plans, quotes, and benefits and receive a free expert consultation from our licensed health insurance agents. They will be focused on assisting you and servicing you.

Our goal is to provide you with the information you need and assistance from a qualified licensed health insurance agent that represent you, not any one carrier or plan.

Our unique process is geared towards efficient better service to each individual and family.

Specifically, amongst others, is a plan being promoted by the Commonwealth Fund, which envisions a partnership between government sponsored health plans and private insurers.

They would work in combination to offer consumers more choices, but the plan requires that consumers purchase and/or attain healthcare coverage.

They mention that their plan design would reduce the growth at which healthcare costs are rising from year to year.

Whether accurate or not, I don’t know, especially since the results from the State of Massachusetts are not in.

On the surface though, a combination plan offering between government and private groups seem to make sense in the sense that it appears to promote competition.

The plan also wants to reward efficiencies and penalize waste. This also makes sense on the surface, but the question is how effective would it be?

Look, it appears that we are beyond just repeating that we need a better system and are now prepared to begin to do something about it.

Remember one thing though, our healthcare services professionals are tops. Our commitment to excellence and competition place us higher than all other countries.

We need health insurance for all. We need affordable health insurance for all.

A survey released on January 8, 2008 of preventable deaths in 19 industrialized countries ranked the United States last when it comes to providing health care to its citizens. The survey was conducted by the Commonwealth Fund, a charitable organization created to promote health care in the industrialized parts of the world. Their study, which was called “Measuring the Health of Nations: Updating an Earlier Analysis” and published in the Health Affairs journal this month, examined the death rates for individuals under the age of 75, particularly looking for problems that could have been prevented through more effective health care.

The same study had been conducted twice before: once in 1997/1998 and more recently in 2002/2003. Part of establishing the country rankings involved looking at each country’s improvement as compared to past studies. While all of the other countries saw a decline in preventable deaths by an average of 16 percent, the United States’ rate only decreased by 4%. The U. S. was also ranked last in the 2002/2003 results after placing 15^th in the 1997/1998 results. Had the United States shown similar improvements approximately 100,000 deaths would have been prevented.

The survey’s top five countries included France in first place followed by Japan, Australia, Austria, and Canada. The survey also pointed out the United States spends more on health care than do any of the countries with better results.