By  JoLinda Ruth Cogen

“A disproportionately large share of U.S companies’ health care costs stem from the treatment of a small group of employees and dependents who have chronic or catastrophic illnesses, according to an analysis by consultancy Watson Wyatt Worldwide – April 26, 2006.”

Yet, healthcare in America as we know it is poised for a radical and comprehensive changed that Americans neither fully understand nor can imagine the consequences. The U.S. Congress has let Americans down in this area and both Republican and Democrats must share the blame. The House has passed legislation for the past 10 years to assist uninsured Americans; especially those who own and work for small businesses. The Senate each year has failed to pass legislation once the House sent it to them.

The last time we were real close to legislation was when Sen. Bill Frist (R. TN), was the Senate Majority Leader in 2006. He is a heart and lung transplant surgeon. Who better to champion a health care bill to help Americans have access to affordable health care? But NO! The know it all, left liberal Sen. Ted Kennedy (D. MA) opposed the legislation and championed Sen. Durbin’s (D. IL) bill. Sen. Durbin is one of Sen. Obama’s main advisors. That bill was to offer National Government fully paid healthcare like what the Congress enjoys – sounds familiar?

The Small Business Fairness Act of 2006, or H.R. 525, was passed by a vote of 263-165. The act allowed small businesses to pool their resources into a group health plan and purchase health insurance collectively, crossing state-lines to bargain for lower rates from national insurers. When this House bill got to the Senate, Sen. Mike Enzi (R-Wyo.) sponsored it. Some claimed that if this bill did not pass it would be years before another bill surfaces and here we are two months from 2009, no bill and people getting sick and dying needlessly.

This is a personal issue for me since I was uninsured after being insured for over 20 years via my employer and becoming seriously ill and hospitalized. According to the doctors, whom I became friendly with, I should have been dead because I walked around for two weeks with a heart rate of 318! The normal heart rate is between 70 and 100! Well, I guess God wanted me here to tell this story!

My experience of hospitalization and subsequent clinic visits without healthcare insurance when previously I had insurance was demoralizing, eye opening and obviously anti-American and anti-Middle class. I can safely say that illegal aliens demand and receive FREE and better health care on the American taxpayer dime than Americans.

I was fuming when I realized that healthcare is dispensed on a first come first serve basis without any deference to Americans. Yep, you stand in line and wait behind illegal aliens, immigrants and whoever knows the system and got there before you.

I can also say that you either have to be insured, broke or rich to receive proper healthcare. The incentive is to cheat rather than be honest on both the provider and receiver end. Those of us who wish to pay “something” or “what one can afford” are turned away for those who can pay everything or have a “free ride” on the tax payer dime. This tells me the healthcare conversation and focus needs to be changed.

According to the U.S. Chamber of Commerce there are 45.7 million uninsured persons in America.

• More than 9 million of the uninsured earn more than $75,000 a year, and over 17 million make more than $50,000. Why are they choosing to opt out and risk not having some level of coverage?

• Almost 10 million are not citizens and would not even qualify for a federal program under current law.
• Approximately 5.4 million children are uninsured and eligible for Medicaid or SCHIP at any given point in time, according to a letter from the Congressional Budget Office last year.
• Another 6 million or so are eligible for Medicaid and other government public insurance programs, but don’t take advantage of it according to a July 2008 report by the National Institute for Health Care Management Foundation.
• Millions more are eligible for healthcare through their employer or a family member’s employer, but do not enroll.

Thus, the real number of uninsured is 10 million to 15 million people and we need to address this problem separately than those who chose not to take advantage of available insurance.

Now within these numbers there are different problems with different groups and they must be addressed according to the issue not with a general broad brush. There is no magic wand that can comprehensively solve the problem like universal coverage, single payer system or an employer mandate ala Hillary Clinton. Therefore, step by step vs. comprehensive is the way to go in solving this major problem.

Why am I focusing on the small business owner? The number one employer of Americans is government the second largest employer in America is the small business. This is where most Americans are employed and that includes African-Americans. The small business is also the dream that many African-Americans have since we have been the leader in starting small businesses. Moreover, in a tough economy when people find themselves without a job they often start small businesses. Lastly, it is the small business which is most vulnerable to government paid universal health care to be saddled to pay the bill via mandated policies and draconian taxes. This action unilaterally will destroy America as we know it. Thus, the focus in healthcare reform has to be at the small business level along with an individual market that is robust, affordable and portable.

It was reported this week that Senator Kennedy was returning to the Senate from his sick bed to insure that a government paid health plan be introduced first thing in the 111^th Congress, January 2009 even though the Canadian system is tanking. Maybe the Veterans should tell the new Congress how they like their version of universal healthcare? Prayfully, Senator Michael B. Enzi will be able to introduce his new bill with his “Ten Steps to Transform Health Care in America” and that Americans will stand up and shout what we want!

Hon. JoLinda Ruth Cogen is a motivational speaker and community advocate in New York City. She is the former Female Republican District Leader in Central Harlem.