If you ask small business owners what is the hardest obstacle they face today, nearly all will say it’s the cost of health insurance. Based on a survey by the National Federation of Independent Business, nothing is even close. Taxes can really beat up a small business owner, but they do not cause nearly the hardship that insurance does. In fact, insurance has become so difficult to obtain that there are now some state and local governments that have tried to provide a partial solution to the health care situation. The real problem is that premium increases are being thrown our way even when no one is getting sick. So, small businesses are coming up with an alternative idea of their own. Small businesses are “self insuring.” Instead of having a health insurance company absorbing the risk of someone getting sick, you are your own insurance. If someone goes to the doctor, you as the business owner pay whatever portion of the cost that you’ve agreed to pay. But if someone gets really sick with cancer, heart problems or other chronic illnesses, you have a catastrophic policy that handles that coverage. So, you pay all of the ordinary expenses. Then you buy a policy to cover outrageous expenses. And, you pay an insurance company to handle all of the paperwork. The Wall Street Journal estimates that a company can save about a third of the cost of what you’re paying for health care. As an employee you need to consider a few things. If your employer goes to a health reimbursement plan, the state has no say-so over what benefits are offered and what claims are denied. So, you better trust the company you work for. But this is something to consider if you own a small business. We may be 10 to 15 years away from figuring out the smart ways to do health care. And the most recent addition is the HSA – or Health Savings Account. It’s a modified method that allows you to pay for most of your health care expenses out of pocket. Then, you have a policy for the bigger expenses.