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> Healthcare and Basic Income would do a lot to encourage entrepreneurship. I have a dream that Healthcare will someday be decoupled from employment. So much w

> Healthcare and Basic Income would do a lot to encourage entrepreneurship. I have a dream that Healthcare will someday be decoupled from employment. So much waste is tolerated simply due to the fact that the majority of the expense is borne by your employer before the number they put on your paycheck. I can live on a part time salary without issue, but health insurance, which is already $200/wk for my family with my employer chipping in, would jump to more like $600/wk, which is just completely untenable. There is no sane reason why health insurance should be my single largest expense each month.

nemo136 6y ago
That is more or less what we have in France, it comes with other issues... like really high taxes. But we have many start-ups, which usually migrate to the US as soon as they grow big.
danilocesar 6y ago
You know that your dream is actually the standard in every developed nation except the US right?
- war1025 6y ago
  That's what makes it seem achievable.
Someone1234 6y ago
They could even do this without too many major changes. Just three in fact: - Increase HSA Contribution Limit - Allow both Traditional & High Deductible insurance premiums to be paid with the HSA - Ban employers from directly providing/choosing insurance (ex. US Military) Essentially everyone goes out onto the open market and buys their insurance using pre-tax HSA contributions (similar to tax benefits to employers now). Employers can continue to "help" be providing dollars to HSA/HSA match, rather than picking your insurance for you. There are more radical and arguably better solutions, but if you want to see a large improvement with minimal changes/the least controversy this is it. Most insurance companies could likely just convert existing employer provided policies into employee direct ones paid via HSA.
- luigibosco 6y ago
  You're assuming people have the money to contribute to an HSA and an employer when many do not.
  - Someone1234 6y ago
    I am talking about a solution to separating employers from your choice of insurance policy, you're talking about an entirely different issue. I said there are other, arguably better, solutions (e.g. universal coverage) whereas this is an attempt to solve a near-term issue of employer provided health insurance. If you can get the political support to pass universal reform to health coverage in the US, then absolutely do that instead. In the current political climate this compromise is still a vast improvement.
- snakeboy 6y ago
  Is there any momentum behind these ideas? I don't have any idea what the state of US healthcare reform is.
  - Someone1234 6y ago
    Nope. The current "war" is between complete re-invention and essentially the status quo. This is neither of those, therefore it upsets both sides, and gets squished by "perfect is the enemy of good."
  - aksss 6y ago
    Yes, at least two big changes were attempted in last administration with 50% success rate. First, loosening restrictions on association health plans which would have allowed diverse groups of small businesses in an area to band together to negotiate lower rates as if a larger organization. This was struck down by the federal court. The second, and successful, move was to allow health reimbursement accounts (HRA) to pay for insurance premiums on the individual market. These plans, an ICHRA, would allow a small business to essentially give pre-tax dollars to the employee for buying health insurance as long as the reimbursements were applied consistently across the employee base. The second was great, but the first would have been even better since it would have lowered group rates. Individual insurance premiums and deductibles (when not subsidized by gov) are often so expensive they are hard to justify. Still ICHRA’s are at least another tool for employers and employees to share the burden.

nemo136 6y ago

That is more or less what we have in France, it comes with other issues... like really high taxes. But we have many start-ups, which usually migrate to the US as soon as they grow big.

danilocesar 6y ago

You know that your dream is actually the standard in every developed nation except the US right?

war1025 6y ago
That's what makes it seem achievable.

Someone1234 6y ago

They could even do this without too many major changes. Just three in fact: - Increase HSA Contribution Limit - Allow both Traditional & High Deductible insurance premiums to be paid with the HSA - Ban employers from directly providing/choosing insurance (ex. US Military) Essentially everyone goes out onto the open market and buys their insurance using pre-tax HSA contributions (similar to tax benefits to employers now). Employers can continue to "help" be providing dollars to HSA/HSA match, rather than picking your insurance for you. There are more radical and arguably better solutions, but if you want to see a large improvement with minimal changes/the least controversy this is it. Most insurance companies could likely just convert existing employer provided policies into employee direct ones paid via HSA.

luigibosco 6y ago
You're assuming people have the money to contribute to an HSA and an employer when many do not.
- Someone1234 6y ago
  I am talking about a solution to separating employers from your choice of insurance policy, you're talking about an entirely different issue. I said there are other, arguably better, solutions (e.g. universal coverage) whereas this is an attempt to solve a near-term issue of employer provided health insurance. If you can get the political support to pass universal reform to health coverage in the US, then absolutely do that instead. In the current political climate this compromise is still a vast improvement.
snakeboy 6y ago
Is there any momentum behind these ideas? I don't have any idea what the state of US healthcare reform is.
- Someone1234 6y ago
  Nope. The current "war" is between complete re-invention and essentially the status quo. This is neither of those, therefore it upsets both sides, and gets squished by "perfect is the enemy of good."
- aksss 6y ago
  Yes, at least two big changes were attempted in last administration with 50% success rate. First, loosening restrictions on association health plans which would have allowed diverse groups of small businesses in an area to band together to negotiate lower rates as if a larger organization. This was struck down by the federal court. The second, and successful, move was to allow health reimbursement accounts (HRA) to pay for insurance premiums on the individual market. These plans, an ICHRA, would allow a small business to essentially give pre-tax dollars to the employee for buying health insurance as long as the reimbursements were applied consistently across the employee base. The second was great, but the first would have been even better since it would have lowered group rates. Individual insurance premiums and deductibles (when not subsidized by gov) are often so expensive they are hard to justify. Still ICHRA’s are at least another tool for employers and employees to share the burden.