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Dear Moms,

I wrote the following letter to President Obama the day following my last chemotherapy treatment for breast cancer. He asked for ideas, and I was ready to give them.
I'm not sure the day after chemo or even a week after chemo was the best time to sit down and write a letter to the president; but it's a subject I am passionate about, and I know many of you are too. Maybe I was delirious, but that day I saw a way that all sides could win in the healthcare arena -- the family, the insurance providers, and small business. I welcome your input and your ideas. If I missed something in the letter, please add your constructive ideas.

I surely don't have all the answers, and I probably have some things really wrong in your opinion; but I do know that we need to give our representatives something to work with. We need to speak out to our representatives with real and solid solutions because big business is speaking louder than we are. Business owners with less than five employees and less than a $1m in revenue represent 95% of all businesses in America. From the actions on the Hill, our representatives are not hearing loud enough from us. Let's speak up!

If this letter goes with your line of thinking, then please feel free to send it to your representative, and add your two cents.


Dear President Obama,

I have sent an email regarding healthcare reform, but I thought I would follow it up with a letter.

At the time I wrote the email to you, I was in bed recovering from my last chemotherapy treatment for breast cancer. You had just spoken to the auto industry, I believe, about health care and invited new ideas.

I am writing this letter to you as a mother, as a cancer patient, and as the founder and CEO of The National Association For Moms In Business- the leading association representing entrepreneurial, executive and CEO moms.

As you can imagine, healthcare has always been the number one issue for moms in business. As business owners and decision makers, we are not only directly affected by healthcare within our personal families, but the decisions we make also affect our business "families". Most of our association members are small business owners and the bonds with their employees are very familial. Often times, our business moms struggle with the decisions of how to serve their two families best, and many Mom CEOs are cutting their own salaries to almost nothing in order to keep heath care for their employees and to keep their employees in jobs at all.

Nearly 90% of our self-employed members without employees do not have health insurance for themselves and sometimes not even for their children. It's just not financially possible to earn $40-$60,000 a year in a small or home based business or as an employee and pay for your own insurance and health care costs. I also know of women that spend more for healthcare each month than they do for their mortgage.

In all the work I have been engaged in over the years to lend my support in fixing a broken healthcare system with our partners like Women Impacting Public Policy, MomsRising and The SBE Council, I see a real and deep conflict between consumers and health insurance agents/providers on the issue of healthcare reform simply because agents and providers are afraid they will lose business or be completely out of business. Honestly, they shouldn't be put out of business due to healthcare reform. They've worked hard to build their businesses and are in fear of losing their own means to support their families. However, there are too many millions of people dieing and getting sick from a poor healthcare system. There must be a way for both sides to win.

I don't understand why healthcare reform is so difficult.

I know this sounds like a naive statement, but the solution seems so clear to me. I suppose that the real problem is that the people deciding health care reform are receiving the benefits of federal or corporate insurance benefits. They are completely disconnected from what 85% of American's are facing.

I can't imagine that my ideas are incredibly unique. I would think that these ideas to solve healthcare crisis have already been hashed around the halls of your offices. However, I appreciate your requests for new solutions. It seems to me the following idea would be a "win-win-win-win-win" for everyone involved: for government, for the American people, for small business, for big business and for insurance providers.

Synopsis of my idea: Convert all federal employee, Medicare, Medicaid, Disabled, and Veterans health care insurance to private insurance "contractors". All Americans would purchase their own personal and portable insurance policy through their choice of company/provider. If the insured individual/family cannot pay for all or part of the policy, then the insurance provider receives a payment voucher from the government to cover all or part of the insurance. All policies that qualify for vouchers MUST include coverage for prevention and wellness care, be free of any pre-existing condition clauses, and group discount programs will cease to exist.

More Details:

1. All Federal Employees (that includes Congress and their families) must use the same healthcare options available to the rest of America through private insurance companies. No group of individuals or businesses will have special rates, discounts, or programs. I personally think if Congress had to use the same healthcare insurance the rest of us use - reform would have happened a decade ago.

2. Medicare, Medicaid, Veterans, and Federal Employee healthcare must also go through this private healthcare company system.

3. All health insurance must be portable and individual. All American citizens, no matter what their work status: employed, switched jobs, unemployed, under-employed, stay-at-home moms, union worker, disabled, retired, etc., purchase health insurance policies themselves. There are no more group, union, or employer discount rates. Each person in America chooses and pays for their own healthcare under the same group discount rate plan called..."being an American". There would be no more COBRA nonsense or loss of insurance at the time of changing or losing a job.

4. If an employer would like to pay for their employee’s insurance as a tool to attract better talent or because it’s the right thing to do, they would receive a tax benefit instead of a discount.

5. For individuals/families that cannot afford health insurance (46 million people, 8 million children and 11 million newly unemployed, and veterans, disabled, elderly, etc), an electronic "voucher" will be used to pay for their chosen insurance policy. The idea is that the individual will find the health insurance program that provides the BEST benefits to them and their family with their health conditions. The insurance company they choose will apply for a full or partial government voucher to pay for the insurance policy the individual chooses. The government then pays the health insurance provider the value of those vouchers. Insurance providers that opt to be a contractor or offer contracted products will have to adhere to a strict criteria of quality of service policies.

6. Insurance providers will not be allowed to deny insurance to any American citizen for any reason -- pre-existing conditions, ability to pay, etc., and are not allowed to deny any treatment prescribed by a doctor.

7. All American citizens MUST be insured and if they cannot afford it, all or part of their insurance will be paid through the government voucher. The amount of each insurance voucher is based on insurance policy price and income of the individual/family seeking that insurance policy.

8. Government insurance voucher amounts are based on income, number of insured and possibly pre-existing conditions.

9. Since all people have portable and individual health insurance the issue regarding the inequity of tax relief to people who obtain these benefits at work should be null and void. Although, companies that choose to pay for their employees insurance benefits should receive tax benefits.

10. Since all people have portable and individual health insurance, small and medium size businesses have a more level playing field in competing for top talent. Since 85% of registered businesses are microbusiness or small business (Main St. vs Wall St.) - this should be a winning idea. In Nevada 85% of all employees are employed by small business, and my guess is that other states have similar numbers.

11. Insurance companies must meet a set of qualifications to be a "voucher approved" insurance provider.

12. Every American thus has a choice of plan and insurance provider/broker that meets their needs best which maybe a return of personal service which, quite frankly, the government is not known for providing.

13. A HIPAA standards national electronic medical records system must be put into place.

14. Veterans and Medicare benefits will not change…maybe they will even get better by having more options for care.

15. Dental coverage should be included in the healthcare program.

16. Employed, tax-paying non-citizens and their dependents living in America can also qualify for this voucher program with restrictions and intermittent reviews due to un-employment, etc.

17. This health care program can reduce the budget expenses of each state as they will no longer need to offer state health programs and that can take billions of dollars off states’ already over-burdened budgets.

18. A strong program with elementary, middle, high schools and colleges will need to be implemented immediately to provide scholarships for all those wanting to go into the health care field. Start letting children and parents know from kindergarten that their child will be able to go to college, fully paid for, if they are good students and planning on going into healthcare. With more people insured and more people living longer, we need more qualified medical care providers.

Some ways to help pay for this:

1. Medicare funds, Veterans health funds and other relating government funds would go to pay for this. Medicare and Veterans offices would no longer have to process claims -- just voucher requests. This may reduce the operating dollars of these departments which then can be re-assigned in insurance vouchers.

2. Food tax - All foods that have artificial sugars and preservatives. All foods and drinks that have more than 4 grams of sugar/serving, 4 grams of fats/serving and more than 5% of recommended sodium/serving content would be assessed a very nominal tax upon purchase. Basically, American's who choose to eat un-healthy foods pay more than those who choose to eat a healthier diet. And believe me, McDonald's, Nabisco, Pepsi, etc. will not see a decline in profits from a one or two percent tax (or one-two cent tax), but those who choose to eat a diet of junk food should naturally pay more towards health insurance. It's called, "being accountable for our actions". It's something that moms try to teach their children every day in order to be responsible adults.

All people need to eat, and if all people are getting health insurance they can afford - then a tax should be imposed so we are paying for it equally. For a family paying $800 a month on groceries - a percentage tax is an increase of $8-$16 per month, and most families can easily offset that tax by using manufacturer coupons on some products. If food manufacturers actually believe a 1% increase on their products will decrease sales...or even be noticed by their consumers, they are giving more credit to their customers than their marketing departments do.

Consumers buy what they want to buy, need to buy, and are encouraged to buy in advertisements. If a mom needs to cut her grocery costs, she cuts costs overall - not just on one product that has gone up from $3.50 to $3.53. It's sad, but American's are too addicted to unhealthy and unaware of what healthy food really is to notice a slight tax increase. The only thing that will change the eating habits of the American people is education and subsidizing the fresh produce industry (not wheat, corn and soy). It's already been noted by the American Journal of Public Health that just a one-cent tax per 12-ounce soft drink could generate about $1.5 billion annually and a penny tax per pound of candy, chips and other snack foods, or fats and oils, would raise about $70 million, $54 million, and $190 million, respectively. I'm proposing either a one-cent or a one percent tax on a broader range of foods (even diet industry foods that are typically high in artificial sweeteners and sodium).

The American public may not notice a small one-cent or one-percent tax on their food, but they WILL notice that for the first time in years they can have health insurance and can see a doctor. They WILL notice that insurance premiums have gone down to a more manageable level. They WILL notice that they no longer have to choose between their mortgage payment and food on the table, versus their health insurance payment. They WILL notice that they can take their sick child to a doctor instead of an emergency room.

I do hope there is at least a nugget of an idea you can utilize to bring healthcare reform to our people. I personally lean towards the idea of a nationalized health care plan, but I realize that may not be the best solution either. We are Americans, and that means we are innovators. We should be able to create a plan that appeals to the people’s desire for independent choice as well as their right for health and safety.

All My Best to You.


Gina Robison-Billups

The National Association For Moms In Business -

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