Quite the scene on television wasn’t it? Doctors picketing in Springfield, angered over skyrocketing malpractice insurance costs. Yet the wrath of their picket signs wasn’t aimed at insurance companies—it was lawyers.

It’s been painfully amusing over the past couple of years: the doctors blame the lawyers, and the lawyers blame the insurance companies. Who knows—or cares—who the insurance companies blame. The problem is that as employers, employees, and Americans, we’re all affected.

Our small business at CIBP felt the impact of all this a couple of months ago, even as Caterpillar was finishing a major restructuring of its retiree health insurance plan. For those of you with a business that falls between the two sizes, if you don’t already have a horror story, you probably soon will. Four straight years of double-digit premium increases isn’t something anyone can hide from.

We as employers, as well as our employees, have no trouble seeing the impact of rising malpractice premiums and legal costs on our respective bottom lines. Yet some economists think the cost of defensive medicine, or too many tests, may be 10 times that. We pay that, too. If you’re fortunate to be in a “Cadillac” group health, just try getting in to see your physician within a couple of days when you know you’re really sick, but refuse to label yourself “emergency.” The nurse will tell you the best way to get any type of test or x-ray is to go to a local emergency room—even when you know the costs will be extraordinary—but you can’t wait. That scenario also contributes to our health care plight.

Just as scary is the not-as-obvious cost we all face from the growing employed, but uninsured, middle class. Statewide, almost 20 percent of full-time workers are uninsured, and that number is expected to increase. Often the reason is not only cost, but a pre-existing condition not readily transferable, creating a gap in coverage.

In other states, medical schools are facing recruiting problems, trauma centers and obstetrics units have closed, doctors are leaving, and businesses are looking at health insurance costs as they make expansion and location decisions. Haven’t heard of those extremes in Illinois, but I shudder to think what impact such events could have on the future of Peoria. Medicine has more than just a passing role in a key vision of the city’s future.

Reams have been and will be written on solutions. Simplicity, common sense, and the common good might dictate something like a special medical tribunal that brings sanity to punitive damages, while at the same time dispensing full, fair, and fast actual damages to the wronged. And if premiums don’t drop, it’s “fire, ready, aim” at the insurance companies.

Writing in the Wall Street Journal, Philip K. Howard, noted that: “Health care is falling apart, like a car wreck in slow motion, because no one is at the wheel.”

And if our health care system were to fall apart, not one person could say: “Boy, I never saw that coming.”

The lawyers argue the threat of lawsuits promotes better care. Doctors here in Illinois suggest patients sign a damage-limiting agreement before receiving services. It’s obvious that leaving a solution to either of these parties is like buying chicken wire from the fox.

Short-term, the use of association health plans, which allow small businesses to pool together and spread their risk across a larger employee base, has shown success in lowering premiums. President Bush noted such associations work “to the benefit not only of the small business owner, but to the benefit of those who work for small businesses.”

But valuable as they are, they treat the symptom, not the cause.

If your organizations aren’t working on this issue, they should be. If you aren’t contributing to that effort, you should be. As businesses, we can’t afford to be spectators. We either keep watching that car wreck, or we take the wheel. IBI