Healthcare costs are in the news most every day now. In the United States, especially, political debate is focused on the question of whether and how healthcare should be provided to the estimated 50 million Americans currently living without health insurance.

We’re raising the issue on Found|READ because when (not if) reform takes place in this country, the brunt of the financial burden for delivering health insurance to those uninsured folks , estimated at $110 billion, will fall on small- and -medium-sized companies. That includes startups. Why? Because ours is the demographic that currently shoulders the smallest portion of health care costs in this country. <!—more—>

According to a study published in the journal Health Affairs:

the biggest portion of the $1.9 trillion in total health care expenditures in 2005 (the most recent year for which data are available) went to pay for “private health insurance premiums” totaling $694 billion. [Private means non-government-sponored insurance. Think Blue Cross, not Medicare.] Employers paid for two-thirds of these premiums, or $463 billion. The rest was paid by employees through cost-sharing and co-pays, or by self-employed workers who finance their own insurance.

And according to Helen Darling, President of the National Business Group on Health, a Washington, DC-based nonprofit that researches healthcare economics for the private sector, the lion’s share of these costs are shouldered by large employers—those with more than 500 workers—that must provide health insurance because of collective bargaining agreements, etc.

“Large employers’ [costs] will go up some with universal coverage, but not much,” says Ms. Darling. “The real pain will be felt by smaller companies, those that don’t currently provide health insurance to their workers at all.”

Small companies and startups aren’t typically obligated to offer health insurance for their workers. So many of us don’t. But we’re going to have to figure out how to do it. In this economy, all founders recognize that taking care of our talent is a top priority. So now that the issue of “universal coverage” is out there, you can’t be surprised if your workers ask for health benefits.

And some kind of reform — if not “universal coverage” — is practically a fait accompli. Worse, that $110 billion estimate is “not even close to accurate. It’s way low,” says Ted Nussbaum, director of the healthcare practice at consulting firm, Watson Wyatt, which serves Fortune 500 companies.

Based on his clients’ experience, Nussbaum puts the average annual cost of providing health insurance to an individual worker at $5,000. Families cost between $12,000 and $13,000 a year. This means the $110 billion estimate for giving “universal coverage” to those 47 million uninsured Americans that keeps popping up in political stump speeches is off by a factor of 2, at least. (It is only $2,340 per person).

So, dear founders, our healthcare burden is guaranteed to increase, by a lot.

In anticipation of this future headache one concerned Found|READer prompted us to post these Questions of the Day:

How do you cover your employees’ healthcare costs now?

How will you afford $5,000 (per worker), or as much as $13,000 (per family) in new healthcare costs?

Do you already have a good plan/strategy?

If so, what tips can you share with other founders — especially those who have little extra cash!— for how to cover such healthcare costs?