4 ms·

When I had a small business in the US, my biggest concern was figuring out medical insurance and retirement. Since I had no clue one what to choose from the myr

by dalke 10y ago

When I had a small business in the US, my biggest concern was figuring out medical insurance and retirement. Since I had no clue one what to choose from the myriad of options. I wanted more government control - single payer health care and decent Social Security coverage. I didn't feel overtaxed either. I still feel that unions are far more over-regulated than businesses. I think many of the employee laws the article mentions are in place because collective bargaining has been so nerfed that the only remedy to bad but common management abuses (eg, wage theft) is through the legal system.

beached_whale 10y ago
I think of a single payer system as infrastructure like roads, electrical supply, water... It collectively takes the risk from the individual and provides for everyone. A business no long gets distracted with pension, drug, medical... and focuses on the business of making money. They pay tax and that is it. In an ideal world.
- throwaway_xx9 10y ago
  > In an ideal world. You mean, every other country in the Western world, except the USA.
- crazy1van 10y ago
  >A business no long gets distracted with pension, drug, medical Unless that business was in the pension, drug, or medical industries. My point is that it's not super clear where to draw the line between common public services and businesses, and people's perspective is usually determined by the nature of their own business. For example, provide gov't healthcare and pensions so my smartphone company can focus on making great devices instead of worrying about health care. Or... provide gov't smartphones so my social media app company can focus on making great apps rather than worrying about what mobile OS to support. Or... provide gov't social media apps so my independent media company can focus on generating content rather than worrying about distributing it across many social media platforms.
  - dalke 10y ago
    There are still companies involved with "roads, electrical supply, water", even when they are part of the public infrastructure. It's not like there are no drug or medical companies in Switzerland. The evidence doesn't need to be "super clear." The numbers are pretty solid that universal healthcare is more efficient than the current system the US has. That is, the US government spending alone, on a per capita and GDP basis, is higher than the combined public+private spending in most countries with universal health care. Yet the public+private funding in the US doesn't result in a higher quality of health care, by most measures. Even sticking to the US, we can get an idea from Medicare and the VA system of the advantages to single payer systems. Those comparison numbers don't exist for the proposals you mentioned, and there is no reason or experience to suggest they make sense in the current market. (But, consider France's Minitel in the 1980s, when it did make sense.) Also, the failure costs in health care are much higher than the failure costs in choosing the wrong mobile OS. The worst case for the former is an nation-wide epidemic. The worst case for your company is ... you run out of money and need to get a job.
- jomamaxx 10y ago
  Health Care is not like building roads. I live in Quebec, Canada and the healthcare here is among the worst in the civilized world. Also - it's illegal to pay a doctor to fix you. Canada is the only place in the world where it's illegal to pay someone to cure you of something. It's basically communist. The American system is untenable, but 'single payer' is not the solution. Successful countries that do it are tiny. Sweden is smaller than Los Angeles. Swtizerland does it at the cantonal level, which on average is 800 000 citizens. Can you imagine your entire hospital and insurance system being in blocks of 800 000? Maybe at the state level, subsidies, regulating drug prices etc. etc. - but full-on national level 'single payer' would be a huge disaster, beyond contemplation. Also in many single payer systems - the guy who snuck across the border illegally gets the exact same healthcare as you, working professional, paid a million in taxes, dutiful citizen etc.. I think there should be coverage for everyone, but single-payer is not the path.
  - icebraining 10y ago
    Not a word about the UK's NHS?
  - jomamaxx 10y ago
    You can vote me down if you want, but I live in a system where I cannot get a doctor. And it's illegal to pay for one. I' forced by the government, to use local clinics where they don't have my records, I don't have a relationship with the doctor, they can't make longer term prognosis, and frankly, the care is sub-par. I once had an ailment that was difficult to diagnose, the doctors at the clinics, used to seeing people for coughs and colds could give a shit. I ended up having to pay a few grand for an American entity operating barely within the bounds of legality in Canada (the Cleveland Clinic). I can assure you that it's a pretty desperate feeling when you are locked out of the system. Notre Dame Hospital in Montreal is lined with people in beds in the hallways, broken chairs, broken, leaking water fountains in the waiting room, broken / discarded beds in the waiting room - I thought I was in Cuba. The doctor was actually nice but the facilities were crazy. A well run McDonald's has more visible operating efficiency. It's far from optimal.
    - 10y ago
NotSammyHagar 10y ago
Yes, thank you for posting this. It's exactly the case that if one were to start a small company, the more govt services that automatically take care of things like ins and retirement, the easier it is to focus on your business.
- orangecat 10y ago
  This seems like a false dilemma. Housing, food, clothing, and most other things are not directly provided by either employers or governments, and yet people are able to acquire them.
  - dalke 10y ago
    I started learning about housing, food, and clothing from my parents, when I was a toddler. They taught the basics, including how to cook, how to buy groceries, how to maintain a house, etc.. I had over a decade of practice under their watchful eyes before doing it on my own. Then in school we learned more about food during health class. Those who wanted to learn more could take home economics. Also, many people purchased magazines to help understand and select clothing styles, participated in discussions on the topic, and spent a lot of time at stores evaluating the different options (i.e, "hanging out at the mall"). Even for housing, I did it in steps, with college dorm, then shared apartments, to shared houses, to my own apartment, to my own house. By comparison, when I started my company, I had no corresponding practice or experience in selecting health care or retirement options. Just like I had no practice in reading NDAs and consulting contracts, or setting up a company. But those are remarkably stable. A NoLo book on consulting and the advice of a friend who started a company a couple of years previous was enough. Then hire a CPA who has a legal obligation to work in my best interests. An insurance agent does not have the same obligation. I also don't have the experience to judge between the offerings from the different companies, nor experience in the local hospitals or clinics to know who is in which system or what I should be watching out for. That's straight 'paradox of choice', making it all the more difficult to figure out what to do. It didn't help that every few months I would get a message that the health insurance rates were increasing, making my wonder if I had made a mistake and was being screwed over by the insurance company, who knows that most small business owners really don't want to deal with re-evaluating the insurance market all the time.

by dalke 10y ago

beached_whale 10y ago

I think of a single payer system as infrastructure like roads, electrical supply, water... It collectively takes the risk from the individual and provides for everyone. A business no long gets distracted with pension, drug, medical... and focuses on the business of making money. They pay tax and that is it. In an ideal world.

throwaway_xx9 10y ago
> In an ideal world. You mean, every other country in the Western world, except the USA.
crazy1van 10y ago
>A business no long gets distracted with pension, drug, medical Unless that business was in the pension, drug, or medical industries. My point is that it's not super clear where to draw the line between common public services and businesses, and people's perspective is usually determined by the nature of their own business. For example, provide gov't healthcare and pensions so my smartphone company can focus on making great devices instead of worrying about health care. Or... provide gov't smartphones so my social media app company can focus on making great apps rather than worrying about what mobile OS to support. Or... provide gov't social media apps so my independent media company can focus on generating content rather than worrying about distributing it across many social media platforms.
- dalke 10y ago
  There are still companies involved with "roads, electrical supply, water", even when they are part of the public infrastructure. It's not like there are no drug or medical companies in Switzerland. The evidence doesn't need to be "super clear." The numbers are pretty solid that universal healthcare is more efficient than the current system the US has. That is, the US government spending alone, on a per capita and GDP basis, is higher than the combined public+private spending in most countries with universal health care. Yet the public+private funding in the US doesn't result in a higher quality of health care, by most measures. Even sticking to the US, we can get an idea from Medicare and the VA system of the advantages to single payer systems. Those comparison numbers don't exist for the proposals you mentioned, and there is no reason or experience to suggest they make sense in the current market. (But, consider France's Minitel in the 1980s, when it did make sense.) Also, the failure costs in health care are much higher than the failure costs in choosing the wrong mobile OS. The worst case for the former is an nation-wide epidemic. The worst case for your company is ... you run out of money and need to get a job.
jomamaxx 10y ago
Health Care is not like building roads. I live in Quebec, Canada and the healthcare here is among the worst in the civilized world. Also - it's illegal to pay a doctor to fix you. Canada is the only place in the world where it's illegal to pay someone to cure you of something. It's basically communist. The American system is untenable, but 'single payer' is not the solution. Successful countries that do it are tiny. Sweden is smaller than Los Angeles. Swtizerland does it at the cantonal level, which on average is 800 000 citizens. Can you imagine your entire hospital and insurance system being in blocks of 800 000? Maybe at the state level, subsidies, regulating drug prices etc. etc. - but full-on national level 'single payer' would be a huge disaster, beyond contemplation. Also in many single payer systems - the guy who snuck across the border illegally gets the exact same healthcare as you, working professional, paid a million in taxes, dutiful citizen etc.. I think there should be coverage for everyone, but single-payer is not the path.
- icebraining 10y ago
  Not a word about the UK's NHS?
- jomamaxx 10y ago
  You can vote me down if you want, but I live in a system where I cannot get a doctor. And it's illegal to pay for one. I' forced by the government, to use local clinics where they don't have my records, I don't have a relationship with the doctor, they can't make longer term prognosis, and frankly, the care is sub-par. I once had an ailment that was difficult to diagnose, the doctors at the clinics, used to seeing people for coughs and colds could give a shit. I ended up having to pay a few grand for an American entity operating barely within the bounds of legality in Canada (the Cleveland Clinic). I can assure you that it's a pretty desperate feeling when you are locked out of the system. Notre Dame Hospital in Montreal is lined with people in beds in the hallways, broken chairs, broken, leaking water fountains in the waiting room, broken / discarded beds in the waiting room - I thought I was in Cuba. The doctor was actually nice but the facilities were crazy. A well run McDonald's has more visible operating efficiency. It's far from optimal.
  - 10y ago

NotSammyHagar 10y ago

Yes, thank you for posting this. It's exactly the case that if one were to start a small company, the more govt services that automatically take care of things like ins and retirement, the easier it is to focus on your business.

orangecat 10y ago
This seems like a false dilemma. Housing, food, clothing, and most other things are not directly provided by either employers or governments, and yet people are able to acquire them.
- dalke 10y ago
  I started learning about housing, food, and clothing from my parents, when I was a toddler. They taught the basics, including how to cook, how to buy groceries, how to maintain a house, etc.. I had over a decade of practice under their watchful eyes before doing it on my own. Then in school we learned more about food during health class. Those who wanted to learn more could take home economics. Also, many people purchased magazines to help understand and select clothing styles, participated in discussions on the topic, and spent a lot of time at stores evaluating the different options (i.e, "hanging out at the mall"). Even for housing, I did it in steps, with college dorm, then shared apartments, to shared houses, to my own apartment, to my own house. By comparison, when I started my company, I had no corresponding practice or experience in selecting health care or retirement options. Just like I had no practice in reading NDAs and consulting contracts, or setting up a company. But those are remarkably stable. A NoLo book on consulting and the advice of a friend who started a company a couple of years previous was enough. Then hire a CPA who has a legal obligation to work in my best interests. An insurance agent does not have the same obligation. I also don't have the experience to judge between the offerings from the different companies, nor experience in the local hospitals or clinics to know who is in which system or what I should be watching out for. That's straight 'paradox of choice', making it all the more difficult to figure out what to do. It didn't help that every few months I would get a message that the health insurance rates were increasing, making my wonder if I had made a mistake and was being screwed over by the insurance company, who knows that most small business owners really don't want to deal with re-evaluating the insurance market all the time.