The health insurance debate rages on, most recently in the Supreme Court, questioning the legality of mandated coverage, the ways in which universal coverage will impact premiums, and the potential financial burden the new laws may cause businesses. But I don't believe any of these issues are at the real heart of the health care coverage issue in America. 

In politics and in business, the question that people should be asking is why health care, which is clearly something that affects individuals on a very personal level (and has nothing to do with the work they perform), is something that employers should provide. At no point in the health care reform debate has the issue of how Americans access health care coverage been discussed—and as both a business owner and a citizen, this infuriates me.

The current health insurance system in America primarily allows access to health coverage through employment. This means when people are unemployed, they routinely lose coverage. It also means that business owners are responsible for making important decisions that affect individuals' personal lives in ways that we should not be asked to. Just as I would never think to tell my employees how they should treat an illness or an injury, as a business owner, I should not be required to choose my employees' doctors or their coverage for them either.  

Both the Republicans and the Democrats have failed to untether health coverage from employment, which means we, as business owners, must consider how the health care coverage choices we make truly affect our businesses—and not just our bottom lines. As the owner of a small business with 15 employees, I have always believed that health coverage was more than just a nice carrot to entice talented prospects to join my company. Rather, it is an essential tool to keep both my employees and my business healthy. 

Like all owners, I want my business to thrive. The only way that can happen is if my employees are able-bodied and fit to work. Employees who are sick or worried about becoming sick, or who have been treated but are then plagued by how to pay for their treatments, are not able to be productive workers. Their minds are elsewhere than on my business, and while they may try to complete their tasks, their output is often diminished both in terms of quality and quantity.

It is with this single and undisputable fact in mind that we must make our choice as business owners about how we can address the health care crisis in America. For me, it all comes down to dollars and sense.

First, as owners, we need to provide health insurance because our businesses, like our employees, would be sick without it. I do so by providing the best health insurance available in my city to my employees at Metal Mafia. I pay 100% of the health care premium, and every employee is covered. As an expense on the company books, it puts what would be taxable profits to better use than maintaining a government that has forgotten for whom it works.  As an employee benefit, it lets my staff know that I give them the best coverage possible, and so I feel I get the best work from them in return. Choosing to cover and fully fund the coverage is not about altruism—it's about maintaining the strong growth rates we have posted every year since our inception—because my team is always in the best condition to seize opportunities and carry us forward. 

Second, as business owners, we should use our purchasing dollars to make a statement. We may not have the time, the power, or the resources to change the American health care landscape in all the ways we know it needs to be changed, but we can make an impact on policy and on our own economic success in the way we use the system. For this reason, I changed our health insurance policy at Metal Mafia this year to a high-deductible plan with an HSA component. I did not do it so that I could shift the continually growing burden of health insurance premiums onto my employees. I did it as a way to beat a loaded system which somehow allows health insurance companies to do things year after year that no other type of business can do—like increasing prices by as much as 25% while decreasing services, or continually refusing to provide the product its customers have paid for by using loopholes in terminology. I fund the HSA at the maximum allowable amount I can—which leaves $450 of the deductible my employees must pay themselves.  This amount is roughly what they would have spent in a year on copays with the old low-deductible policy, but the advantage for both them and my business, is that now this amount can be paid pre-tax.  

By choosing the HSA system, I am able to keep my company's health care spend the same as last year, without changing how my employees are covered.  The dollars involved in the savings equal roughly $10,000 for the first year alone. The sense of the savings is bigger than that.  My employees, rather than the health insurance company, will get to keep all their unused HSA money if they have a healthy year.  This makes my employees happy, and increases their motivation to work hard for my business. In addition, I get the enormous personal satisfaction of furthering the true spirit of capitalism—because spending my dollars in the HSA system penalizes the health insurance conglomerates for putting profits ahead of delivering a quality product.

Still, I don't believe health insurance should be the responsibility of business owners. Since it is, we have to make it work for us rather than against us. We have seen in many instances that government gets its cues from businesses. By taking strong action on an individual level, we can avoid the cancerous flaws in public policy and keep our businesses healthy.