Do Small Business Owners Misunderstand Single-Payer Healthcare?


This election year will offer plenty of discussions about health insurance. Even as the candidates stake out their respective positions, the U.S. Supreme Court looks poised to take a new case that could ultimately rule the Affordable Care Act (ACA) unconstitutional. Meanwhile, small business owners are coming out in support of a single-payer healthcare system.

According to data cited by Forbes contributor Sally Pipes, some 58% of all small business owners are in favour of a single-payer system operated by Medicare. This leads to the inevitable question of whether or not small business owners truly understand how such a system would work. Based on their motivations for supporting single-payer, it is quite possible they don’t realize what Medicare for All would mean from a practical standpoint.

The Money Issue

It is understandable that small business owners would favour a single-payer healthcare system in light of how much it now costs them to provide health insurance. In their eyes, Medicare for All stands to save them a ton of money. But will it?

The Commonwealth Fund says that employers can spend up to 10% of their total payroll costs on employee health insurance. Yet Medicare for All will not be free. Such a system will have to be funded, and that funding will come through additional payroll taxes.

Pipes reminds her readers that Sen. Bernie Sanders is in favour of an additional 7.5% payroll tax on employers and a new tax of up to 4% on households to pay for Medicare for All. It’s highly unlikely those numbers would remain static for very long. That 7.5% could easily eclipse 10% in a matter of years. Thus, employers probably wouldn’t save any money under a single-payer system.

The Paperwork Issue

Another reason small business owners favour single-payer healthcare is the elimination of complicated paperwork. As things currently stand, the amount of paperwork and administrative effort required to manage even a moderately sized health insurance plan is daunting.

Dallas-based BenefitMall explains that some companies have a team of HR and payroll experts whose primary task is to manage the company’s health insurance program. Going to a single-payer system would eliminate almost all health insurance tasks and free up those staff members to do other things.

As Pipes points out, however, that doesn’t mean the administrative burden disappears. It does not. Rather, the burden is shifted to consumers who must now deal directly with the federal government. Anyone who’s ever filed a tax return knows how well that goes. Small business owners wouldn’t be excluded, by the way. They would have to deal with Medicare for their health insurance coverage as well.

Employees Still Want Benefits

One final thing for small business owners to consider is that employees still want benefits. That won’t change even if a single-payer health insurance system becomes the law of the land. What employers save on health insurance through Medicare for All would be spent on other benefits instead.

According to BenefitMall, student loan assistance is an emerging benefit younger employees are looking for. It could very well become the next big thing if our healthcare system ever transitions to single-payer. Employers hoping to compete for top talent will find themselves helping employees pay off their student loans in order to keep them from looking for work elsewhere.

Single-payer might be a better way to go for health insurance. Then again, it might not be. The one thing we can say for sure is that it is not a cure for what ails our current system. Medicare for All will not be any less expensive or complicated than the current system.

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