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Shelly Sun on the Burden of Health Care (Opinion) No matter who wins in November, our next president must work to get small-business health-care costs under control, writes Shelly Sun, co-founder of the BrightStar Care franchise.

By Shelly Sun

Opinions expressed by Entrepreneur contributors are their own.


Leading up to the November election, small-business owners are paying close attention to the presidential candidates' plans to get health-care costs under control.

The escalating expense of health insurance makes it difficult for small-business owners to sustain, much less grow, their business. No matter who wins in November, our next president must work with Congress, insurance companies, health-care organizations and the small-business community to address costly and burdensome problems rampant throughout the current health-care system.

As co-founder and CEO of BrightStar Care, a nationwide homecare franchise with more than 250 independently owned locations across the country, I support any effort that increases access to quality care for individuals and provides accountability among health-care providers. President Barack Obama's Affordable Care Act is designed to achieve this. But I'm also concerned about how the legislation, which requires companies with more than 50 employees to provide health insurance or pay a fine, could impact our locally run businesses.

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Combined, our franchise owners employ 10,000 part- and full-time licensed caregivers who provide medical and non-medical care to clients in their homes. The 200 small-business owners in our franchise system, like any small-business owner, strive to run their businesses efficiently so they can be in a position to grow, hire more caregivers and provide high-quality care to families in their community. That's just what my husband JD and I did when we opened the first BrightStar Care in 2002.

As demand for our services grows, our BrightStar franchisees want to be able to meet that demand by hiring more caregivers. The employee mandate, as written, provides a disincentive for small-business owners to grow their businesses because the costly requirement to provide health insurance once you go over 50 employees would have a negative impact on profit. Support mechanisms must be in place to make sure we don't encourage underemployment and exacerbate an already difficult time for our workforce and our economy.

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Business owners who can afford to offer insurance to their employees, do. Those that can't afford it, don't. We need strategies in place to help those small-business owners who currently can't afford to provide insurance and are now required to do so. Without assistance, these small-business owners will have a difficult time managing the added cost of providing insurance to their employees. This financial burden will compromise their ability to grow and hire more employees and could result in job loss or worse, businesses closing.

Now that the individual and employer mandate are constitutional, the volume of people in the marketplace for insurance should reduce the cost of health care over time. But do the millions of unemployed workers have the time to wait for those costs to come down?

Now more than ever, we need policies and regulations that promote job growth. Our next elected leader – whether that's Barack Obama or Mitt Romney – and Congress, insurance companies and small-business community leaders need to work together to find ways to reduce consumption. They must look for opportunities for price control on the programs and factors that increase the cost of healthcare holistically. Otherwise, the great goal of providing health insurance to all may end up putting small businesses on life support that they - and our economy - can't afford.

Shelly Sun is the co-founder of BrightStar Care, a healthcare staffing franchise that has grown from one corporate-owned location in 2005 to more than 200 locations nationwide. She was featured on the CBS series Undercover Boss and received the International Franchise Association's 2009 Entrepreneur of the Year award.

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