Increasing numbers of small businesses conclude that they cannot continue to offer insurance to their employees and keep their workforce at the current level. Health insurance premiums have been growing steadily since the early 1980s at annual rates that dramatically exceed both workers' earnings and overall inflation. Except for a brief respite in the mid-1990s, the annual rate of increase in health insurance premiums has ranged between 5.8 percent and 18 percent as compared with annual increases in workers' earnings and overall inflation rates, which have generally remained within the 2 percent to 4.5 percent range. Between 2000 and 2006, health insurance premiums for a family of four increased 87 percent, while workers' wages and general inflation increased at rates hovering around 19 percent