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Health insurance has become a leading obstacle to small business and family farm prosperity. Small business and family farm entrepreneurship are the most promising approaches for creating an economic future in rural communities. But we must overcome the health insurance obstacle.

Toward that end, the Center for Rural Affairs signed on to a set of principles for federal health reform developed by a coalition called Health Care for America Now. The principles stress three points:

Quality affordable health care for all Americans – The current system is not working for many hard working people who struggle to make ends meet. The problem is particularly severe in rural America, where the self employed and those who work in small business are often uninsured, underinsured, or at risk of being priced out of coverage.

Reform should ensure that the smallest businesses and their employees have access to the competitive rates charged the largest businesses, through either private plans or a public plan. Some still won’t be able to afford the full cost, and a system should be devised to assist with a portion of the premiums according to need.

Finally, reform should ensure no one is denied or priced out of coverage by preexisting conditions. The very concept of insurance is that we each pay something to ensure that none of us is financially destroyed or worse due to catastrophic circumstances.

Choice, Competition, and Quality – The best way to protect the quality of health care is to preserve choice and competition. That is the American way. And it is the only practical approach. Americans well served by their current insurance should not be forced to change coverage.

Preventative Care and Personal Responsibility – The best care is that which keeps us healthy. We will never keep the cost of health care within reason unless we do a better job of preventing sickness.

The current system is often counterproductive in that regard. Those who cannot afford health care often avoid preventive care and checkups for fear of the cost. But when they get really sick, they seek treatment in the one place available to those who cannot pay – the emergency room. That is the most expensive place for care, and we all end up paying through higher medical bills and insurance premiums. The better approach would be to pay up front to prevent sickness.

Equally important, we should do more to encourage and promote healthy behaviors that prevent sickness. And more health research should be focused on how to stay healthy – instead of focusing the lion’s share of medical research on developing treatments.

Fixing the broken health insurance system is the right thing to do. People should not die because they cannot afford reasonable care.

We believe the principles above provide the guidelines to develop practical reform that preserve the current system where it is working, while offering additional choices for instances in which it is not working.

Agree or disagree? Send your opinions to Chuck Hassebrook, chuckh@cfra.org or 402.687.2103 x 1018.