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Unfortunately cash is not as efficient in procuring the sorts of services that are normally provided by benefits, due to the advantages of structured negotiatio

Unfortunately cash is not as efficient in procuring the sorts of services that are normally provided by benefits, due to the advantages of structured negotiation. You are unlikely to get as good a deal from health insurance providers as your employer.

acdha 9y ago
Beyond just pricing there’s also a question of availability: prior to the ACA you could easily find former contractors who needed to take a corporate job because they or a family member had some sort of long-term condition or risk factor which meant that insurance plans wouldn’t cover them at less than extortionate rates. Having insurance negotiated by individuals is a huge impediment for entrepreneurship.
- trfergus 9y ago
  This is why a Social Health Care system would be such a boon to entrepreneurship. It would remove one of the biggest worries for people creating their own business.
  - module0000 9y ago
    Yea - we can work and pay taxes to give you a "boon" as you try out your next big idea. Sounds great for you, not so great for me. Hard pass.
    - FireBeyond 9y ago
      You realize that -your- cost of health insurance would go down as a direct benefit of being in a larger, more diverse, pool? Well, apparently not. Apparently to you everyone for socialized medicine is a freeloader who doesn't work or pay taxes. This polarized vision is a large part of what plagues the country.
      - ttoinou 9y ago
        You realize that -your- cost of health insurance would go down as a direct benefit of being in a larger, more diverse, pool? Explain the magic to me
        FireBeyond 9y ago
        Increasing the size of the risk pool, for a genuine pool, and a genuine insurance product, should reduce individual pool member costs. Of course, that word genuine, in both contexts, is abused in US healthcare “insurance”, as I’ve discussed in numerous of my comments (and I work in the industry - it’s an absolute abuse of the definition).
    - acdha 9y ago
      As FireBeyond noted, the system you’re defending takes more of your money: not only are U.S. medical costs substantially higher – on average! It’s even worse for independent buyers — but the layers of inefficiency designed into the system mean that the outcomes are worse. The other side of this is considering what happens if you get sick: should we just let you die and bill your next of kin for the cleanup costs? If you’re not that heartless, all of the alternatives cost more than helping people get medical care. I’d much prefer to pay a little more so people can get treated rather than pay for them to be disabled and out of the workforce, or to spare their families the crippling cost of trying to effectively be an insurance pool with a single-digit number of members.
      - module0000 9y ago
        I'm not trolling you - but yes I am that heartless. This could have a lot to do with upbringing, but mine was full of analogies of humanity to nature. One of those was a firm belief that there is no "safety net" to catch me or my family. If I succeed, they succeed - if I fail, then we all fail. Everyone is responsible for themselves. Everyone's particular set of values will vary, but that is mine.
barrkel 9y ago
It's not just negotiation strength. The theory of the firm gives lots of reasons why employment can afford to reward people better than individual contractors. https://en.wikipedia.org/wiki/Theory_of_the_firm https://en.wikipedia.org/wiki/Theory_of_the_firm Though if you have niche skills or knowledge (and I'd include contacts in that), you can be better off with contracts that leverage your specialisms specifically, and not waste your time with work that can be done cheaper by more freely available labour.

acdha 9y ago

Beyond just pricing there’s also a question of availability: prior to the ACA you could easily find former contractors who needed to take a corporate job because they or a family member had some sort of long-term condition or risk factor which meant that insurance plans wouldn’t cover them at less than extortionate rates. Having insurance negotiated by individuals is a huge impediment for entrepreneurship.

trfergus 9y ago
This is why a Social Health Care system would be such a boon to entrepreneurship. It would remove one of the biggest worries for people creating their own business.
- module0000 9y ago
  Yea - we can work and pay taxes to give you a "boon" as you try out your next big idea. Sounds great for you, not so great for me. Hard pass.
  - FireBeyond 9y ago
    You realize that -your- cost of health insurance would go down as a direct benefit of being in a larger, more diverse, pool? Well, apparently not. Apparently to you everyone for socialized medicine is a freeloader who doesn't work or pay taxes. This polarized vision is a large part of what plagues the country.
    - ttoinou 9y ago
      You realize that -your- cost of health insurance would go down as a direct benefit of being in a larger, more diverse, pool? Explain the magic to me
      - FireBeyond 9y ago
        Increasing the size of the risk pool, for a genuine pool, and a genuine insurance product, should reduce individual pool member costs. Of course, that word genuine, in both contexts, is abused in US healthcare “insurance”, as I’ve discussed in numerous of my comments (and I work in the industry - it’s an absolute abuse of the definition).
  - acdha 9y ago
    As FireBeyond noted, the system you’re defending takes more of your money: not only are U.S. medical costs substantially higher – on average! It’s even worse for independent buyers — but the layers of inefficiency designed into the system mean that the outcomes are worse. The other side of this is considering what happens if you get sick: should we just let you die and bill your next of kin for the cleanup costs? If you’re not that heartless, all of the alternatives cost more than helping people get medical care. I’d much prefer to pay a little more so people can get treated rather than pay for them to be disabled and out of the workforce, or to spare their families the crippling cost of trying to effectively be an insurance pool with a single-digit number of members.
    - module0000 9y ago
      I'm not trolling you - but yes I am that heartless. This could have a lot to do with upbringing, but mine was full of analogies of humanity to nature. One of those was a firm belief that there is no "safety net" to catch me or my family. If I succeed, they succeed - if I fail, then we all fail. Everyone is responsible for themselves. Everyone's particular set of values will vary, but that is mine.

barrkel 9y ago

It's not just negotiation strength. The theory of the firm gives lots of reasons why employment can afford to reward people better than individual contractors. https://en.wikipedia.org/wiki/Theory_of_the_firm https://en.wikipedia.org/wiki/Theory_of_the_firm Though if you have niche skills or knowledge (and I'd include contacts in that), you can be better off with contracts that leverage your specialisms specifically, and not waste your time with work that can be done cheaper by more freely available labour.