As an uninsured small-business owner, I can speak to this fact first hand. I co-own a small coffee shop in Vancouver. Small businesses like ours form the backbone of our state’s economy. But, as a small independent shop, we have been unable to afford the high cost of health care for our employees, or even for myself as an owner.

There are more than 40,000 other uninsured people in Clark County, just over 10 percent of our population. More than 70 percent of the uninsured are members of working families, like mine. Two in three uninsured workers are employed in a small business. 

More than 1 million people in Washington are in families that will spend more than 10 percent of their income on health care this year. Four out of five of these families have health insurance. 

These sobering statistics call for urgent attention on the part of policymakers to enact solutions that guarantee quality, affordable health care for every Washington resident.

A coalition of more than 65 organizations statewide, including consumer advocates, nurses, physicians, hospitals, labor unions, and businesses, is building momentum for comprehensive health care reform. The Healthy Washington Coalition is urging lawmakers to take action this year to address immediate needs while at the same time building a road map to a secure health care system that’s there for all of us when we need it. 

Here are five concrete ways lawmakers, this year, can chart a course for health care reform:

• The Health Insurance Partnership, a program envisioned by lawmakers to help small businesses afford quality coverage for their workers, has been designed but still needs to be implemented. The program would make quality coverage affordable by providing premium assistance to low-wage, small-business employees and allowing businesses and employees to pay their premiums with pre-tax dollars.
• While opponents of reform argue that the only way to make health care affordable for small businesses is to strip down the quality of coverage and offer more bare-bones plans, the Health Insurance Partnership represents a departure from that sort of pessimistic thinking. Small businesses deserve the same high-quality health care choices that our lawmakers enjoy. 
• Many self-employed people and others who purchase health insurance as individuals will find much-needed relief in legislation to increase public oversight of health-insurance rates. This past year, the wealthiest health insurer in Washington, Regence BlueShield, raised individual rates as much as 40 percent without public scrutiny. Government can be a stronger watchdog to protect individuals from unfair and excessive rate-hikes. 
• An effort to protect doctor-patient privacy and control prescription drug costs would prohibit pharmaceutical companies from buying physicians’ prescribing records for marketing purposes. 
• We can address the shortage of primary care providers in many parts of our state by expanding the scholarship and loan repayment program for doctors entering the field. 

While each of these measures is necessary, by themselves they are not sufficient to fully address the health care crisis. Lawmakers should not lose sight of the goal of ensuring that all Washington families have the peace of mind that a medical emergency will not force them into bankruptcy. 

To reach this goal, legislation has been introduced to create a Health Care Working Group that would analyze concrete health care reform options, engage the public in evaluating the benefits of each proposal for average Washington residents and provide recommendations to the 2009 Legislature. 

This is the kind of concrete road map we need to set the stage for lasting health care reform.