I agree with Warren Buffet who said, “medical costs are the tapeworm of American economic competitiveness.”

I face this daily: First, as the owner of a small business in New York City, and, second, as one of the thousands who deferred healthcare treatment for fear of bankruptcy.

Allow me to explain. In my small business, I see the high costs of insurance stall the mobility of first-class candidates. Those with the best qualifications are often stuck in dead-end jobs because they cannot afford to lose their expensive benefits package by jumping ship to me.

And I am always juggling the costs of growing my business with the costs of providing competitive insurance. Recently, I found a superb candidate from Austria who does not require insurance — so I am relieved of high-cost deductibles and other administrative payroll expenses.

Cash was really scarce when I started my company, so I did not have insurance for two years. Fortunately, I faced no life-threatening conditions. But emergency treatment and 12 stitches for a cut to my forehead caused me to choose between the high costs of seeing a plastic surgeon and no scar — and possible bankruptcy — or living with a permanent scar. That’s a pretty dire consequence for 12-stitches.

Whenever I look in the mirror or a customer looks at me, I remember the dread of not having healthcare.

Read the original letter at This is the Bronx.