But he was not about to turn down the opportunity.

Parsons, one of five people invited to a "conversation" with the president about health care, told Bush that the chamber saw its $2,400-a-month premiums drop when it went from insuring two workers to insuring five. If small organizations like his could band together across state lines to pool the risk, insurance premiums would drop, he argued.

Bush agreed with Parsons' call for such association health plans, one of several healthcare reform measures the president touted Wednesday to an auditorium packed with several hundred NIH workers.

"I think a restaurateur in Maryland ought to be able to combine in the same insurance plan as a restaurateur in Texas," Bush said.

"And so I look forward to working with Congress to get an association health plan out, a bill out that will allow for pooling of risk for small business owners across jurisdictional boundaries," he said, as well as benefiting non-profits like Parsons'.

After opening the hour-long event with comments on topics that ranged from Iraq to the deficit, Bush asked Parsons and the others on the stage to share their stories or concerns.

The panelists included a roofer from Atlanta who solved his company's insurance problems through health savings accounts, individual tax-exempt accounts that are used to pay health plan deductibles. Panelists also included a woman who does healthcare outreach among the poor and working poor in Louisiana and the owner of an Iowa insurance agency.

Bush questioned the speakers in turn and seized on their stories to pitch his initiatives.

"Imagine someone living in Maryland getting on the Internet and being able to shop nationwide for an insurance plan that meets his or her specific needs," he said.

Parsons said that increasing the level of competition among insurance companies "is critical" to making coverage more affordable and accessible. Consolidating policies through association health plans would not threaten the providers, he said.

He told Bush that "the lack of choice" in health insurance in Maryland "doesn't affect just consumers, but small business owners in particular, and small non-profits, like ours."

"We have a very small range of choices that we can select from when we go to do what we all want to do -- which is provide our employees with good coverage at good prices," Parsons said.

One problem is the high number of mandated healthcare benefits in Maryland, Parsons said, which drives up premiums. According to the Maryland Health Care Commission, Maryland has 40 mandated healthcare benefits, as opposed to 15 in Pennsylvania and 11 in Washington, D.C.

Parsons thinks mandatory benefits, such as hair plug implants and in vitro fertilization, may go unused while jacking up prices for everyone.

Parsons said that even though Maryland "is one of the leading biotech and medical innovations centers of the world today, we have about . . . four companies that will even write policies for small businesses in the state. And we've got to expand choices."

Bush said, "That's common sense, isn't it?"

Copyright © 2005 University of Maryland Philip Merrill College of Journalism