Is health insurance a right or a responsibility? That’s a question many of our national and state leaders are asking these days.

With the spiraling cost of health insurance causing many employers to pass premium increases onto their employees or eliminating coverage altogether, some are worried that employer-provided health insurance may go to way of traditional pensions and disappear. While traditionally most people have gotten their health insurance through their employers, the number of companies offering health insurance benefits is decreasing.

In fact, in 2000 the percentage of all employers offering health insurance stood at 69 percent while today that percentage has decreased to 60 ercent. More alarming is the decrease in small businesses (three to nine workers) that are offering health insurance to their employees, falling from 58 percent to 45 percent.

As a result of the decreasing number of employers offering health insurance, the number of uninsured U.S. workers has risen to almost 19 million or 17 percent of all employees.

Nationally, every presidential candidate has offered their own proposal to address this pressing issue. Most proposals fall in either the category of universal coverage subsidized by employers and the government or market-based coverage made affordable through tax deductions.  

In Georgia, at least two plans that seek to address the issue of providing coverage for the growing number of uninsured will be debated during the next legislative session.

In early August, Gov. Sonny Perdue announced the Health Insurance Partnership for Georgia plan aimed at subsidizing health insurance for small businesses and their employees earning 300 percent or less of the federal poverty level.

Those eligible would be sole proprietors and those who work for small businesses of 50 employees or less. They must work at least 20 hours per week and make less than $62,000 a year for a family of four or $30,600 a year for a single adult.  

The plan would be paid for by state and federal funds as well as employers with employees paying premiums based on the plan chosen. The government portion would be made up of $30 million in federal matching funds leveraged by committing $20 million of state funds.  

It is expected that about 30,000 of the 1.7 million Georgians currently without health insurance would be eligible for this plan.

Supporters of the plan say that it would make it easier for Georgians to buy private insurance and cost taxpayers less that they pay now to cover the costs of the uninsured who seek care in emergency rooms.  

Meanwhile, critics of the plan say that it is nothing more that another entitlement that would increase in cost each year. They point to the SCHIP funding debate currently being waged in Washington as an example of a similar program that started out with a specific audience only to grow uncontrollably.  

They also claim that it will lead to “crowd out” other insurance companies who might otherwise offer similar coverage for small businesses. Instead they suggest tax incentives to encourage Georgians to buy their own health coverage.

Another proposal to lessen the impact of the uninsured on the state’s emergency rooms has come from Lt. Gov. Casey Cagle who has proposed to create a series of health clinics for the working poor and a Web site to shop for health insurance plans.   

Called the Georgia Health Marketplace, the Web site would help the uninsured sort through their health insurance options. The proposed clinics for the uninsured would build on the existing network of free clinics and would be public-private partnerships paid for by state dollars, charitable donations and donated physician services.

While both the governor and lieutenant governor are to be commended for their attempts to address the growing problem of the uninsured, ultimately the decision must be made as to whether health insurance is a right or a responsibility.