Live on CNBC: Rising health care costs are biggest economic concern for U.S. businesses

Erin Burnett: New survey out this morning on where the business community stands on health care reform. It is a crucial group of people and according to Business Forward's 2009 Leader Survey, 90% of Business Leaders cite rising health care costs as their single biggest concern. If things don't change, one in three say they will be forced to lay off workers. Joining us with more of the survey results exclusively, Jim Doyle, Executive Director of Business Forward. And, we should note right here that you did respondents that cover 81% of the national payroll. The people that you surveyed really do represent the entire country.

Jim Doyle: We capture small, medium, and large businesses - we cover a variety of sectors and we also did it by region and what you find are that the results are generally uniform across all these different groups.

EB: They want reform and they like the public option?

JD: Right. There is no surprise that health care is the number one concern because all of the previous surveys suggested that. What has really changed this year is that they are facing tougher choices because of the economy. A year ago, less than half of employers expected to cut benefits or increase co-pays, now we are seeing the results in the 80% and 70%. One in three employers are expecting lay-offs in the next five years if we don't solve the problem.

EB: Right now, you are already saying "we're seeing it." Deductibles are going up, co-payments are going up, and they are cutting benefits across the board - today.

JD: It makes sense. For thirty years, health care costs have risen faster than the economy and businesses are seeing in a slowing economy -- the problems getting worse. It is essentially the gap between the growth in health care costs and the growth in economy.

EB: We know that the majority of Americans are employed by small businesses - not big businesses. So this issue of an insurance exchange could be crucial because most small businesses can't afford it. It would go out of business if they provide health care.. Do you get a sense from your survey that people understand what this is and really support it?

JD:  First, just the problem. Small businesses in general pay nearly 20% more for premiums than large businesses.

EB: Why is that? 

JD: .. and among, smaller businesses it could be as high as 27%. They lack economies of scale, they lack bargaining power, and the whole notion of the exchange is to introduce the market into the system more effectively. And, this is critical because our economy is relying more and more on small businesses and our current health care system doesn't serve them well. In our new economy, people switch jobs all the time. So the idea of an exchange or trying to solve the problem of pre-existing conditions is absolutely critical for the new economy.

EB: One other thing we should make clear here is that people stereotypically think that business leaders are Republican. You're saying, "yes they are" and perhaps that means -- especially things like support for a public option -- are even more important from this.

JD:  We found strong support for the insurance exchange and for addressing the pre-existing condition problem. We found majority support for a public option -- and this is among a group that is about one and a half times more likely to be a Republican than the general public.