How do the major stakeholders feel about employer contributions to health care? At present, one of the major expenses for companies, large and small, is health care for their employees—it is so prohibitively expensive that small business in some cases cannot offer insurance to their employees, putting them at a clear competitive disadvantage in the race for talent. Even large companies take a large hit.

Health insurance reform is goaled to bring down the costs for care, across the board. But how will employers be affected? It depends upon which version of the bill eventually passes. East Coast Health Insurance a national health insurance broker (http://echealthinsurance.com) has been researching both sides of the bill and offers this analysis:

The House: Employers with annual payrolls of over $250,000 would need to contribute 72.5% of premium costs for individuals (65% for families); if they fail to do so, they must contribute 8% of wages in payroll taxes (a smaller percentage for those with lower annual payrolls). There are exemptions for companies with lower payrolls (one committee proposal exempts companies with payrolls under $500,000, for example) and exemptions for employers who can show that providing health insurance at that level would lead to job losses.

The Senate: The Senate's more straightforward options requires employers with more than 25 workers (regardless of payroll) to contribute at least 60% of the premium costs or pay penalties (on a sliding scale dependent on full time or part time workers). Another option that is being discussed would not require employer contributions—but requires subsidies (to cover low-wage workers) from any employer who does not provide coverage.

The President: President Obama's concern is for the crippling effect employer mandates could have on small business—one of his biggest areas of focus. He has advocated exemptions for small businesses as a result.

Interest Groups: The interest group most heavily involved here are the various business lobbies. Wal-Mart (the largest private employer in the country) actually came out in support of the idea of large companies insuring their employers, with the caveat that they should not be forced to pay for the portion of employers health care currently covered by Medicare.

Obviously, businesses large and small will be affected by the new policies; as with the rest of the country, they will benefit from reforms that lower overall costs, as they are most responsible for shouldering those costs.

In the end however health reform may be just the tip of the coming global economic issues that remain unsolved. This is evidenced as many of our national institutions and local government treasuries find themselves facing enormous deficits from underfunded hospitals and medical expenses. Many of our political fixes are seemingly just passed for the sake of passing a bill or to show a political victory in a battle not a war.

If health care care costs continue to escalate at even half of the expected and recent growth trends many more than 50 million Americans will find themselves not only without health insurance but without health care.

Additionally and even more of a concern is the doctors that are avoiding service in primary care and other similar areas of shortage in the medical field.