Small businesses, who see the rising cost of health care as their primary challenge, are ready for change. In fact, a new survey of 400 small businesses (fewer than 50 employees) who currently pay for some portion of their workers' health insurance shows they are open to considering all sorts of different forms of change from left, right, and center.

In fact, 42 percent said “making health care more affordable” should be the issue that Congress and the new president consider first.

More than one-in-three small business owners (36%) said that rising costs are likely to cause them to cut some portion of health insurance benefits for their employees, according to the survey released by the Robert Wood Johnson Foundation and conducted jointly by Public Opinion Strategies and Lake Research Partners.

“Many small business owners have already reduced their health benefits and asked employees to pay a larger share of the premium, and still they struggle with the ever-increasing costs,” said Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, which released the report. “They want health care reform that reduces the burden on their business and where all Americans have affordable health insurance.

Here’s a summary of the findings:

By Deanne Loonin

As most readers of Higher Ed Watch know, current bankruptcy law treats students who face financial distress the same severe way as people who are trying to discharge child support debts, alimony, overdue taxes and criminal fines. It's difficult to separate fact from fiction when trying to understand the logic behind this policy, but one thing is clear -- the restrictions came about without any empirical evidence that students were more likely to "abuse" the bankruptcy system.

Unfortunately, the legislative history of the student loan bankruptcy provision sheds little light.

The bare facts are that in 1976, Congress made student loans generally non-dischargeable except five years after default or if the borrower could prove "undue hardship." Since then, there have been three significant legislative changes. First, in 1990, the five year period was extended to seven years. In 1998, Congress eliminated the seven-year floor primarily as a budget savings gimmick to pay for student loan changes it made when it reauthorized the Higher Education Act that year. Finally, in 2005, lawmakers included private loans in the non-dischargeability category as part of comprehensive bankruptcy amendments (the change primarily affected for-profit lenders because private loans made by nonprofit providers were already exempt). If there were reasons to consider restricting bankruptcy for federal loans, there was absolutely no such basis for extending the policy to high-cost private loans.

Sitting in traffic Sunday with the rest of those migrating Turkey Day pilgrims, we caught a story by Karen Brown on NPR's All Things Considered. It seems long lines aren’t limited to the highways of Pennsylvania, and that many of those 440,000 newly—covered by health insurance in Massachusetts are having trouble getting access to a primary care doctor.

The story should be familiar to those who have followed closely the developments of Massachusetts. We've written in the past about some of the challenges facing the state's reform efforts.Physician shortages are certainly high on the list.

It's official. On Monday the National Bureau of Economic Research confirmed that the U.S. has been in a recession since December 2007. This news came as no surprise to many consumers. They have been feeling the impact of escalating unemployment rates and increasing food and other costs for quite some time. Many people have been struggling to afford basic needs like food, child care, housing, and transportation and this financial stress often spills over into the workplace. Employers are taking notice of the stress and are providing some help.

Last week in an article published by the Wall Street Journal titled "Crisis Help via Work," they reported that more and more workers are feeling stress from job pressures and from the turmoil in the financial markets. To help alleviate this stress, some employers are offering free financial counseling. In the article, the WSJ cited an EAP program that provides assistance with budgeting and debt reduction by certified financial planners, accountants, and attorneys through confidential telephone counseling sessions. This sounds like a win-win solution to help workers deal with stress and to help employers gain more productive employees, but there are some challenges in engaging more employers to adopt this service.

With Thanksgiving behind us, it is officially the start of the gift-giving season. Unfortunately, students at public colleges and universities across the country can already expect an unwanted present from their governors -- tuition and fee increases. At least coal could have been used for heat.

Students are going to face increased tuition burdens, both for next semester and the following academic year, because governors and state legislators often turn to higher education when they need to make budget cuts. But increasing tuition could lead more students to drop out or delay enrollment -- lowering graduation rates and stranding students with debt. To prevent these negative outcomes, we urge states to make a sustained commitment to higher education, while asking schools to reexamine their financial aid and revenue allocation policies.

The coming months are going to be gloomy for higher education funding. Several states have already announced plans for postsecondary education cuts, and many more are sure to follow suit. The governors of New York and California -- the two states with the largest public higher education systems in the country -- recently proposed a new round of budget cuts on top of ones that these colleges endured earlier this year.

It's the most wonderful time of the year—at least for proponents of health reform. While holiday shopping has just begun, it seems the "it" item on Washington wishlists these days is health reform.

For example, today's Los Angeles Times suggests, "a consensus appears to be emerging in Washington about how to achieve the elusive goal of providing medical insurance to all Americans." And while a political and policymaking consensus is forming (around the need for public-private partnership that preserves aspects of the existing system, the Times writes), its opposition seems to be stalling, argues a story in The Politico last week.

Like the first snowfall of winter, it seems the events of the past few months have cast health reform in a new light.

Hillary Clinton is going to add yet another chapter to her incredibly fascinating life -- lawyer, feminist, first lady, health care diva, New York senator, and now Secretary of State at a time when America's foreign policy and national security positions are dramatically eroded.

I think that the Clinton we saw during the campaign will give herself, her views and approach to complex national security challenges a "makeover." She's going to push womens' rights, democracy, human rights, poverty reduction, and the like -- but I think she is going to be party of a realist-tilting, crafty Obama-led, Bob Gates-designed, Clinton-out front process to get a strategic shift in US foreign policy. We applaud that.

James Glassman, her Under Secretary of State for Public Diplomacy, has some ideas on how to move her agenda forward -- and she should consider using a lot of the tools that Glassman and his team are developing.

Let's try to have this blog do some reporting for me. I've been intrigued by ads like this one for signature gatherers that suggest the process is dirty. At the same time, the ad says there's lots of money to be made. (That's a new approach). The ads reference this site, http://www.petitionright.com/, which says its mission to eliminate the "for profit" initiative industry. The site identifies itself as part of a company called Green Economy Associates, with an address of Mesa, Arizona. The site is registered with a Nicholas Guillermo of same address. Mr. Guillermo explains himself a little in this separate blog. I've been hearing from signature gatherers asking, is this guy for real? Anyone know the answer to that question? 

As Americans prepare for the annual gluttony that accompanies Thanksgiving, it's hard to believe that far too many children in this country are going hungry. More than 12 million American children live in low-income families that sometimes can't afford to buy enough food to feed them. That's a grim reality that threatens these children's development, health, learning, and longer term prospects. It's also something that's totally within our power to stop. Federal programs have played an important role in reducing childhood hunger: For example, the federal school lunch programs provide free and reduced-price meals to more than 30 million children annually. The Women, Infants and Children (WIC) program provides free milk, cheese, cereal, and other foods to pregnant women, babies, and toddlers. But both of these programs have their flaws, and fall short of meeting the full need.

During the 2008 campaign, President-elect Obama pledged to end child hunged in the United States by 2015. In a new paper for the Progressive Policy Institute, Joel Berg and Tom Freedman offer the new administration recommendations for how to reach that goal:

The most important public-policy document issued since the election is almost certainly “Call to Action: Health Reform 2009,” released by the Senate Finance Committee Chairman Max Baucus, Democrat of Montana. The full version is an eighty-nine-page outline of what will become a landmark bill to provide health-care insurance to all Americans while at the same time reforming incentives to reduce costs and improve quality across the system. The document is an exceptionally intelligent, comprehensive, well-written and balanced survey, and, with few exceptions, it offers the general reader an accessible portrait of exactly what problems new federal law needs to address and how this might be engineered. The staff conveys in their writing not only a mastery of diverse and complicated policy subjects, but also a transparent respect for the political forces (insurers, physicians, hospitals) that must be coaxed into this reform and prevented from revolting before it is complete. Print the plan out, and take the ninety minutes required to read the full version; this is a document as relevant to the most important social-policy project of our times as, say, the Iraq W.M.D. National Intelligence Estimate was to that war...