Determined to have a constructive voice in the growing national dialogue on health reform, the National Federation of Independent Business (NFIB), the nation's largest small business association, launched its new health care campaign—Solutions Start Here: When Healthcare is Fixed for Small Business its Fixed for America.

The most impressive message of the day came from Todd Stottlemyer, President and CEO of NFIB. After recalling NFIB's active opposition to the Clinton health care plan (and its employer mandate), Stottlemyer said, "In 1994 it was good enough to say no...today's situation must be different," and went on to emphasize the importance of a "diverse bipartisan conversation."

While NFIB did not introduce a specific plan, they emphasized the strong support for health care reform in the small business community. According to their recent national poll, 53% of small business voters list health care as the "most important factor" in determining their vote. Their new website, FixedforAmerica.com, did provide 10 principles of health care reform for small businesses and produced a video about the compelling stories and struggles that small-business owners in America have experienced with the rising costs of health care (below).

The employer role in health care (and health care financing) is a pivotal debate within the health reform conversation. In California, NFIB opposed reform efforts, on the basis of "pay or play" fee. Nationally, employers faced with rising health care costs are cutting back on benefits or shifting more of the health care burden onto employees. The employer health care burden is real. It threatens the competitiveness of businesses and the stability of middle class jobs. And employers (large and small) are taking notice. Reducing the health care burden for employers and workers must be central to any health reform proposal.