Health Care Crisis: Pricing Out Small Business

As executive director of the Albuquerque Independent Business Alliance, Rebecca Dakota communicates regularly with the owners of about 175 small businesses in the city.

Dakota’s members tell her they know that keeping their employees healthy is good for their businesses as well as for each employee and their family.

“The bottom line is that when employees are healthy, they do a better job, they are more productive and they show up at work more often. So it’s a good thing for the employer,” says Dakota.

Ideally, an employer also wants to be able to insure the employee’s family, too, because if a child is sick, it affects the employee’s work, she said.

But increasingly, the cost of making sure that employees are insured is out of reach, says Dakota.

“For small business owners, the number one obstacle to providing decent health care is the cost of getting a decent policy,” said Dakota. “And even then, sometimes the employee can’t afford the matching part. And that’s a big issue, because 40 percent of families in New Mexico are considered low-income families.’

Dakota says she’s not sure what the solution is, but she knows the current system isn’t working.

Tying health insurance to people’s jobs is an idea that emerged after World War II, when people typically stayed at one job throughout their lives. That rarely happens anymore. Plus, the job-based model leaves out so many people and pushes the cost for those who do have insurance ever higher, she says.

“Small businesses are the backbone of the American economy…and yet this backbone is being crushed by the high cost of decent insurance and…by the fact that too many people are left out of the system,” she says.

Dakota says many AIBA members share her frustration with the outmoded healthcare system and are keenly interested in helping find an alternate method.

AIBA’s members range from very small businesses with just one employee to larger ones with one hundred employees or more.

Member Martha Doster operated the popular Nob Hill lingere shop Martha’s Body Bueno for 32 years before closing it two years ago.

Doster, who now sells her popular massage oils and body care products online, said she always considered her shop a “micro-business,” because she only employed a handful of workers.

Typically, the smaller the company, the higher the cost per person for health insurance, Doster says.

Most of the time, the cost of insurance was so high that Doster wasn’t even able to afford any coverage to her workers. Or if she did, the co-payment was so high her workers declined it, she says.

Doster said it broke her heart to see her workers suffer through everything from abcessed teeth to cancer, all with limited or no health insurance.

Now in business for herself as a licensed massage therapist, Doster said she barters with her doctor, dentist and chiropractor for the health care she need.

Doster says she is working closely with Dakota to activate other AIBA members and learn more about different health care models, with an eye toward actually changing health care policy at the state level.

“Within AIBA, we want to educate our members so they are aware there is a dialogue going on and that they can have their voices heard. Typically, insurance companies and health care providers have been involved, but not small businesspeople,” says Dakota.

“We want to make sure our members are able to talk with their legislators, to tell their legislators about their concerns and what they think is really important.”

The goal is not just to take the burden of providing healthcare off of small businesspeople – it’s to improve the affordability and accessibility of healthcare to all, says Dakota.


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