Helping make health a priority

Some folks may scoff, and say it just doesn't amount to much. But in a symbolic sense, we think the state's fledgling program for small business health insurance surely does make a difference.

It's a start in addressing a problem that simply can't be ignored - particularly in a state like Montana, where small entrepreneurial businesses are driving growth in the state's economy.

House Bill 667, passed by the state Legislature earlier this year, extends tax credits and premium payments to qualified small businesses that otherwise could not afford health insurance for their employees in the current market.

State Auditor John Morrison, the program's leading advocate, said Montana is estimated to have 170,000 people without insurance, and a large share of those people are working for small businesses.

Morrison's main argument in support of the program is that many uninsured workers and their employers have long been willing to pay a certain amount of money for health insurance. But it's just not enough to afford available insurance plans.

As a result, the money that could be mustered toward health-care coverage is left on the table. When an uninsured worker gets sick, he's more likely to avoid medical care until absolutely necessary, until he must seek it at greater cost. That expense often translates to "bad debt" for health-care providers who are ethically obliged to provide treatment. In the end, bad debt results in substantial "cost shifting" to those who do have insurance.

Bottom line: The uninsured drive up the cost of health care for everyone.

So the state's new program attempts to take a bite out of the problem at a fairly small scale. At its peak, the first-come-first-served program will be extended to only 8,000 Montanans. And it will only be available to businesses with two-to-five employees who make no more than $75,000 annually.

The limited nature of the program arguably reflects the conservative values of many Montanans, particularly those here in the Flathead Valley. Rather than being an expansive state-run health-care program, it is a strategically targeted program that is appropriately limited in size for experimental purposes. It is not an entitlement, where this year's participants can expect to be on the gravy train for years to come. Instead, they have to requalify every year. It is not tapping property or income tax revenue. Instead, the program's costs are being "backfilled" with tobacco tax revenue - an appropriate source, considering the links between tobacco use and health-care costs.

But the best aspect is that this program will put to use private-sector contributions towards health care that have for years been left on the table. Small business wants to do its part to help out employees. This program will provide the chance.