Small- and midsize-business owners do not like the current healthcare system. Just ask Dylan Dusseault, executive director of the Business Initiative for Health Policy (BIHP), in Washington, D.C.

"Business owners want out of providing healthcare,” he said via email to MultiBriefs. “The employer-sponsored system isn't working for them or their workers, but they're all being held hostage by rising premiums and out-of-pocket costs. BIHP was created to advocate for what business owners actually need: A Medicare for All healthcare system."

Medicare, established in 1966, provided healthcare to 56 million Americans in 2017. Medicare recipients are age 65 and up, along with those younger who have some disability status, and people with end-stage renal disease and amyotrophic lateral sclerosis.

Kristine Grow is the senior vice president of communications for America’s Health Insurance Plans. She disputes the notion that Medicare, a national health insurance program, will cure what ails the system if provided universally.

"Today, health insurance providers deliver coverage that is working for hundreds of millions of Americans — including 180 million Americans who are covered through their jobs," Grow said in an email, "22 million covered through Medicare Advantage, 55 million covered through Medicaid managed care, and 20 million who buy their own coverage. The vast majority of Americans are satisfied with the coverage they have today. They have choice and control over their coverage, options, and treatment."

Dusseault disagrees with Grow’s perspective on consumer satisfaction. "I've yet to meet a business owner who is happy with what they currently spend on health insurance," he said.

For Grow, a Medicare for All system will worsen and not improve the current healthcare system.

"Americans want to improve what’s working for them and fix what’s broken," she said. "Medicare for All, single-payer, buy-in, or a public option will have the same consequences: Americans will pay more, to wait longer, for worse care. Let’s focus on real solutions that deliver real results, not a one-size-fits-all government system."

Adam Temple, national media communications director for the National Federation of Independent Business, added, "Whenever new policies are proposed, the effects on the small business half of the economy must be taken into account. If it won't work for small businesses, it won't work for the economy. NFIB members have consistently stated they're skeptical of increased federal involvement in private health insurance, and they oppose significant increases in payroll taxes to fund a Medicare for All system."

Richard Master is the CEO of MCS Industries and founder of the BIHP. In Medicare for All, he sees predictability and not inefficiency.

"As the founder and CEO of a business that has always provided health care for our employees, MCS Industries," he writes in Fortune, "I’d rather pay a predictable, manageable payroll tax to finance health care than pay impossibly high and unpredictable premiums."

The BIHP has grown to 260 businesses backing its Medicare for All advocacy from a handful in late 2017, according to Dusseault.

"I think that the core concept is something a lot of business owners already agree with, and we speak to them on their terms," he said. "They all want their employees to have healthcare, and a healthy workforce is better for their businesses."

Dollars matter when it comes to employers paying for employees’ healthcare. "Some small businesses can't afford it," according to Dusseault. "Others can scrape the money together but it's a huge sacrifice. Even for midsized or much larger businesses it's a strain on their bottom line."

"All of them would prefer to spend that money on raising wages, entering new markets or creating new products, creating jobs, or keeping their prices competitive internationally. Instead, they're paying an insurance company to act as a middleman between their employees and the actual providers of care, and it turns out they're a pretty ineffective and inefficient middleman."