While the comments on the effect of rising health care costs on small business and their employees is important, we must look beyond simply making health care delivery more efficient and of higher quality. All businesses with employees must offer workers' compensation coverage in most states in the United States. Efforts to integrate health and workers' compensation benefits, however, generally fail due to application of ERISA. Furthermore, from a productivity standpoint, we must focus not just on health care but also disability management. Were we to start a dialogue on these issues and recognize the important role disability resources have in the overall health care debate, we could at least begin the process of developing a conceptual framework of not only better treatment of injuries and illnesses, but also better accommodation of the consequences of those injuries and illnesses.