Affordable health care. It's a small business issue, a big business issue, a political issue, a moral issue. The writer Malcolm Gladwell, in the March issue of Fast Company, sees it as one of the things that has been "relegated to ideology," when it is actually one of the "matters of fundamental international competitiveness" for the U.S. "The simple fact is that GM and Ford and Chrysler cannot compete in the world market if they're asked to bear the pension and health-care costs of their retirees. Can't be done. It's that simple."

Simple, but not easy. I'm more and more convinced that every one of us will need to be engaged in this debate over the next few years. Small business owners, solo entrepreneurs and employees alike will need to take responsibility for understanding the issues and dynamics driving this most urgent problem. Once we begin to understand the implications of different options (such as uniform health insurance, Health Savings Accounts, and the like) we will be in a better position to voice our political will.

There is no shortage of opinions on the subject of health care in the U.S. (See Barbara Ehrenreich's blog post and the trail of comments it spawned, for example.) But it surely isn't easy to get facts. It is such a charged issue, both politically and emotionally. I'm going to try to learn as much as I can about it, as an American citizen and business person, because I want to see this great country of ours remain a leader for business innovation and creativity. I just don't think we'll be able to do that without dealing with health care.

If you'd like to read more, there is an insightful article about the assumptions underlying personal health care savings account in Malcolm Gladwell's New Yorker article "The Moral Hazard Myth: The Bad Idea Behind Our Failed Health Care System."