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Aside from the health care system, it arguably makes the general job market less efficient, by tying people more strongly to jobs that provide good health insur

• inthewoods 8y ago
  This. I'm amazed that no one the liberal side of single payer has made this argument: single payer would help create more small businesses.
  • luckydata 8y ago
    The argument has been made countless times, the press just doesn't seem to want to talk about it.
  • downrightmike 8y ago
    Which is what we need, because medium to large businesses are cutting head count and offshoring.
  • akhilcacharya 8y ago
    They do, even Bernie says it. http://fortune.com/2017/08/21/bernie-sanders-medicare-for-all-bill-health-care-insurance/ http://fortune.com/2017/08/21/bernie-sanders-medicare-for-al...
  • bwanab 8y ago
    This argument has been made before e.g.: http://harvardpolitics.com/united-states/the-pro-business-argument-for-single-payer-healthcare/ http://harvardpolitics.com/united-states/the-pro-business-ar...
  • whamlastxmas 8y ago
    It's too easy to find facts and figures to support either side of the argument and I think the left finds a better argument in it simply being a human right and the moral thing to do, neither of which are easily refuted.
    • weberc2 8y ago
      > neither of which are easily refuted. I don't agree or disagree with the claims, but they're not easily refuted because they're not falsifiable. They amount to "we should do this because I think it's better". It's not persuasive. A better argument would be, "We all want to take care of poor people and improve our economy--we can do both and here is the data". Of course there will still be lots of friction and lobbying and so on, but at least it's a compelling argument.
      • toiletfuneral 8y ago
        Sorry but can you clarify; are you saying there does not exist a moral argument for changing our healthcare systems unless it also benefits capital? Or are you saying your observations of this country's value system leads you to believe that only economic arguments would be effective?
    • galaxyLogic 8y ago
      > It's too easy to find facts and figures to support either side of the argument I don't think it is too easy, to find such facts and figures. Can you give us some links to them?
  • rossdavidh 8y ago
    1) it has been made, but.. 2) it doesn't naturally appeal to most people on the left, and everyone else knows it, so it comes off as unmotivating to the left and insincere to everyone else. None of which means it isn't true (it is), or that it isn't important (it is), but that's why it doesn't get used as an argument very much.
    • galaxyLogic 8y ago
      Makes me think that the "right" is insincere, they say they are "pro-business" but really they are only "pro BIG business". How can we know? Because if they were pro small business they would be pro universal healthcare, so that it would be easy to start your own business.
      • fwip 8y ago
        Going even further: if you want to support small businesses, let's establish UBI.
        • rossdavidh 8y ago
          I know a lot of small business owners who were only able to strike out "on their own"...because their spouse worked for a large corporation (or the government). They could afford to spend a few years getting it off the ground, supported by the family's other income (and health insurance). So, I suspect you're correct on this.
      • TeMPOraL 8y ago
        The only thing this demonstrates is the sheer idiocy of dividing ideas by "sides" or party lines. Real life has complex interactions that don't get captured by this. I suspect the "right" is actually sincere. But it so happens that ideas giving more power to private businesses tend to disproportionally benefit larger businesses over the smaller ones (this is a natural advantage of having scale and capital). The ideas surgically targeted to benefit smaller businesses? The "targeted" aspect tends to pattern-match to the "left", so they get rejected. The end result looks like the "right" was dishonest, but IMO it's just the ass-backwards stupid fixation on ideology over problem solving that causes this. And the same thing applies to the "left".
  • scarejunba 8y ago
    Democrat voters don't care about that. Edit: it's true. If you are a democrat candidate and this is the angle you push, it's not going to work. But you already know that.
  • arcticbull 8y ago
    I've been working in my little corner of the world to re-frame the conversation. Socializing medicine isn't about restricting your freedom to choose your physician, it's the freedom from. Freedom from fear of losing your job, freedom from fear of having to change your doctor if you do, freedom to pick any doctor (they're all in-network), freedom from fear of starting a new business, freedom from fear of death and bankruptcy if anything goes wrong -- and it does, to all of us, eventually. Socialized medicine is freedom, and private medicine just isn't.
    • sologoub 8y ago
      This. Especially - freedom to pick any doctor as they are all in-network. Family had experience with California PCIP insurance (bridge for pre-existing condition after ACA was voted in, but before it took effect). The PCIP was amazing - PPO-like benefits, using MediCare network (close to 100% doctors take it) and quality services. Of course, unfortunately, the ACA/exchange provided policies are nowhere close to how good PCIP was. If we could get the PCIP-like option, it would truly change lives for the better.
      • mises 8y ago
        > freedom to pick any doctor Any doctor? Doctors can take so many patients. Though it may benefit a large number of people, some may end up worse. Those who have the best doctors currently (because they can pay) may no longer be able to have those doctors.
        • beat 8y ago
          You realize that's a terrible argument, right?
          • mises 8y ago
            Ok, why? I'm more than open to being convinced otherwise; I'd love to think no one would be harmed.
  • dorchadas 8y ago
    I've personally been trying to push this for years. About how much freedom would be had if we weren't basically in slavery to our job-granted insurance. I've found the right-wing people in my family don't like to hear it...
  • SubiculumCode 8y ago
    They are so focused on helping those without they forget the powerful argument that small business has to do part time shennanigans to avoid paying healthcare costs
  • beat 8y ago
    As a liberal, this sort of thing drives me nuts. It's like my side has completely ceded the ground of both economic liberty and economic opportunity to conservatives, because neoliberalism has made "capitalism" such a dirty word on the left. As liberals, we should own the conversation about small business. Sigh. Being trapped as the vassal of a giant corporation just to not-die is in direct opposition to the very concept of liberty. Being able to quit your job and create your own business is an essential freedom. But liberal politicians are unwilling to market that way, and so the neoliberal political class gets to argue for the preservation of a system that benefits the wealthy and the corporate at the expense of the liberty (and wallets!) of ordinary people as the "free market". Feh.
    • jwbwater 8y ago
      Stop being so rational and go yell at some conservatives.
  • gamblor956 8y ago
    I'm amazed that no one the liberal side of single payer has made this argument: single payer would help create more small businesses. This argument has in fact been made by a great many liberals and moderates, many times, going back to Clinton's (failed) attempt to pass a single-payer health system.
  • jwbwater 8y ago
    How about someone on the conservative, rah rah free-markets will solve all our problems, side? Oh yeah, they're getting campaign contributions from big business.
• bwanab 8y ago
  Not to mention that it makes it prohibitive to start a new business for anybody with dependents.
• tdb7893 8y ago
  Anecdotally I know people who were running a small business and moved to Canada partially because how much of their revenue was going towards insurance. I think they pay more in taxes now but it still is a lot less than they were paying in insurance.
  • Scoundreller 8y ago
    It’s not as good as it used to be, but Canada lets business owners do a lot of income splitting with family members across different share classes. Particularly if you have children >18. And if they’re under 18, just make them directors and pay them $100 for attending each monthly board meeting.
    • andechs 8y ago
      > But Canada lets business owners do a lot of income splitting with family members across different share classes. Particularly if you have children >18. Thankfully, they're finally closing the loophole. Many doctors with private practices were reducing their tax burdens significantly by stating that their 14 year children were "medical receptionists". It's ridiculous to grant further tax avoidance loopholes to the already wealthy.
  • theturtletalks 8y ago
    And big corporations are getting a discount on health insurance due to the volume of employees. Tell me why I can't find 100 more relatively healthy people and have our own "insurance" where we pitch into a account and do payouts. Oh yeah, the high barrier of entry these insuracne companies created and we would have to pay the Obamacare penalty for "not having insurance."
    • speeder390 8y ago
      Yes fresh faced 20 somethings that all look, act the same who have this weird problem almost sick obsession with (EQ). Being a nice person who is a hard worker no longer good enough in today's New economy. I am over 40,unemployable because I needed to take some time off. Self studying front and back end development, having an accounting degree means nothing because I am an introvert and act nervous etc.. So don't interview well
• sgt101 8y ago
  US employers also seem to have a strong preference for young single employees - my theory is that this is because older employees with families are much more expensive to employ due to insurance.
  • brycesbeard 8y ago
    Plus you get people are less interested in “work life balance”, and generally don’t have as high of salary expectations. I’ve been involved in hiring decisions where HR brought up the healthcare costs to complain, then stated clearly we can’t use that as a criteria for hiring. I have doubts that human brains can separate out that kind of statement from our actions.
  • speeder390 8y ago
    Yes under 30 white with great social skills also known as good fit. Come to the Boston area, everyone looks the same and self segregates based on race outside of the office
  • gowld 8y ago
    I think working longer hours with less distractions for less pay is more of a reason.
  • oldandboring 8y ago
    This is true only if the company's health insurance is group-rated rather than community-rated. Large employers who self-insure (the employer is actually paying the claims; the insurance company is just providing administration and financing) have premiums set based on the cost of caring for their group of employees and will see their costs go up (and their employees' premiums likely go up too) if their employees are collectively sicker. Under the ACA, small businesses all end up lumped together in the same state-wide risk pool, so if my small business hires old or sick people it's very unlikely to affect our premiums. In most places this risk pool is larger and somewhat less morbid than the individual market.
• dahfizz 8y ago
  I'm not sure how health insurance is different than any other benefit a job offers when analyzing market efficiency. It's not hard to put a dollar amount on the value of employer provided health insurance, and then use that when calculating your total compensation at one job versus another. Functionally I don't see how it's any different than your employer paying you the amount you would need to buy insurance. Could you expand on what makes health insurance special in this regard?
  • guelo 8y ago
    If you get a chronic disease it is not possible to buy health insurance so you have to stay with your current health insurance.
  • danans 8y ago
    Under the current system, you can't get the same insurance costs vs benefits as an individual or small business, even through the Obamacare exchanges, that you can get from a large, stable employer that has leverage to negotiate with insurance companies and health providers. In turn, that is an incredible amount of leverage that big employers have over certain employees who need to be part of a shared insurance negotiating pool. This is obviously not as relevant when comparing jobs at Google, Apple, or Microsoft, who all have equivalent health benefits, but it definitely matters when considering jobs at startups, nonprofits, or for being self-employed.
    • usaar333 8y ago
      Is there solid data out here that this is true? My COBRA premiums last year were quoted at a bit over $1700; a Gold PPO (a slightly better plan) on Covered CA goes for $1900. This is in the range of "not that different". What is a bit annoying for start-up founders is that health insurance premiums are only tax deductible/paid with pre-tax money if the plan is offered by your employer (may be you).
• everdev 8y ago
  > it arguably makes the general job market less efficient I didn't understand this until I started my own business. I was desperately trying to find a job during the '08 crash to get health insurance for my family but was unable to find one. As a last resort I started my own consultancy which turned out to be a fantastic opportunity. Self paying for health care was a massive barrier to starting my own business. Once I hired people health care benefits were frequently top of their list in interview questions.
• jwbwater 8y ago
  Not arguably, it definitely makes the "free market" for labor less free when workers have to think about possible gaps in coverage before changing jobs. And prior to Obamacare the first year(s) of self-employment were a huge risk.