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One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance

One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance for myself and my family. It's not just plain $$$ and career risk, it's the "suppose you will go bankrupt and your family has permanent medical issues now" risk. That game is for the wealthy or healthy single people In addition, each insurance plan has slightly different doctors that sign on, so when there are changes, you might wind up needing to use different doctors or worse, health systems. It'd be much better for me, personally, to require providers to all accept some US Public Single Payer plan (or whatever you call it) as part of opening a practice and seeing patients. (I don't speak in any sense for my employer, who is in the health care space: this is just an engineer's personal musings)

toast0 8y ago
When I worked for a startup, they were affiliated with a "professional employer organization", which allowed access to major PPO and HMO insurance plans, and also handled some of the payroll obligations.
henrikschroder 8y ago
> One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance for myself and my family. I joined a startup once, but it was in Europe, so these issues weren't even on my radar or the company's radar. With government healthcare and government unemployment insurance, it's a no-brainer. The only risk is to your lifetime earning potential. Stay at a solid job with a solid salary, or take a shot at the startup lottery. Your health or your family or your home are just never on the line by taking that risk. The amount of time and worry you have to spend on healthcare for yourself and your family in the US is absolutely off the charts, and this cost is completely hidden! Time that companies have to spend on acquiring healthcare insurance for their employees is wasted time. Time that employees have to spend on researching the insurance options their company is offering them is wasted time. Time that you spend dealing with healthcare providers to ensure that you're covered by your insurance is wasted time. In Europe the time spent on this is, for the most part, 0. Companies don't spend time on this. Employees don't spend time on this. But noone in the US seems to regard this waste, this cost, as something fixable. Noone seems to think of the competitive edge this gives EU companies, or want to have the same competitive edge. Why? Why are US companies and US employees just completely resigned to the thought that healthcare just is a massive necessary headache for everyone?
- tanzbaer 8y ago
  And yet the US is still way more entrepreneurial.
dudul 8y ago
This is also the reason why I've never looked seriously into starting a company. I wonder how many jobs would almost instantly be created in the US if this factor of uncertainty was lifted.
- jdhn 8y ago
  I think you'd see a bump upwards, followed by a slow fall downwards as people realize that there's a hell of a lot more to running a small business than just healthcare costs.
  - pnutjam 8y ago
    There's no shortage of morons staring businesses doomed to fail in our current system. This would just put self employment in reach for millions.
helen___keller 8y ago
When I was young, my dad started a small business around the same time my mom stopped being a stay at home mom and finished her education at the local community college to pursue a nursing career. I learned later one of the main motivations for her career was that it allowed my parents to have a good healthcare plan for the family under her employer.

toast0 8y ago

When I worked for a startup, they were affiliated with a "professional employer organization", which allowed access to major PPO and HMO insurance plans, and also handled some of the payroll obligations.

henrikschroder 8y ago

> One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance for myself and my family. I joined a startup once, but it was in Europe, so these issues weren't even on my radar or the company's radar. With government healthcare and government unemployment insurance, it's a no-brainer. The only risk is to your lifetime earning potential. Stay at a solid job with a solid salary, or take a shot at the startup lottery. Your health or your family or your home are just never on the line by taking that risk. The amount of time and worry you have to spend on healthcare for yourself and your family in the US is absolutely off the charts, and this cost is completely hidden! Time that companies have to spend on acquiring healthcare insurance for their employees is wasted time. Time that employees have to spend on researching the insurance options their company is offering them is wasted time. Time that you spend dealing with healthcare providers to ensure that you're covered by your insurance is wasted time. In Europe the time spent on this is, for the most part, 0. Companies don't spend time on this. Employees don't spend time on this. But noone in the US seems to regard this waste, this cost, as something fixable. Noone seems to think of the competitive edge this gives EU companies, or want to have the same competitive edge. Why? Why are US companies and US employees just completely resigned to the thought that healthcare just is a massive necessary headache for everyone?

tanzbaer 8y ago
And yet the US is still way more entrepreneurial.

dudul 8y ago

This is also the reason why I've never looked seriously into starting a company. I wonder how many jobs would almost instantly be created in the US if this factor of uncertainty was lifted.

jdhn 8y ago
I think you'd see a bump upwards, followed by a slow fall downwards as people realize that there's a hell of a lot more to running a small business than just healthcare costs.
- pnutjam 8y ago
  There's no shortage of morons staring businesses doomed to fail in our current system. This would just put self employment in reach for millions.

helen___keller 8y ago

When I was young, my dad started a small business around the same time my mom stopped being a stay at home mom and finished her education at the local community college to pursue a nursing career. I learned later one of the main motivations for her career was that it allowed my parents to have a good healthcare plan for the family under her employer.