8 ms·

The thing holding many people back from doing this is health care - Americans predominantly get their health care through their employer and the options on Obam

The thing holding many people back from doing this is health care - Americans predominantly get their health care through their employer and the options on Obamacare are not cheap. Another reason socialized health care would benefit this country - it would boost the number of entrepreneurs and small businesses. Socialized health care desperately needs a rebranding - instead of "Socialized Health Care" or "Medicare for All", it should be called "Entrepreneur Focused Health Care" or simply "Freedom Care".

PragmaticPulp 5y ago
Having done this myself, I don't really see it. Yes, health insurance is expensive, but I can also bill substantially more than my non-US counterparts can in their respective countries. Even with paying for health insurance myself, I don't see how I'd come out ahead in any other country right now unless I relocated and kept my working hours / client base in the US.
- macNchz 5y ago
  Sure once you have solid revenue and a repeatable business model, but it certainly costs enough to have an impact on people just starting out. When I quit my job to work for myself in 2019 I was choosing between $600/mo COBRA or nominally cheaper marketplace plans with absolutely terrible coverage, just for myself. I had plenty of runway and software development is in demand so it wasn’t a huge burden, but with a family it could easily have cost $2k+/mo. I’m sure that’s enough to dissuade people from trying new things, especially in niches where it takes longer to get to profitability.
hsn915 5y ago
Health Freedom "Freedom Care" sounds like an oxymoron. If you need "care" you are not "free". It's not about "care", it's about risk mitigation. You are not sick now, but you have no idea when you or one of your dependents might become sick and need $$$.
- deleted 5y ago
  [deleted]
- mcv 5y ago
  The care frees you from the burden of illness.
belval 5y ago
That does not seem to pass the smell test for me. Do we see a greater percentage of entrepreneurs from Canada or Europe than from the US? I didn't look up hard numbers but I doubt it.
- newshorts 5y ago
  Anecdotally, healthcare benefits did factor in to my decision making when I thought about opening my own shop. I have two small kids and decided at this point in my life I’m going to stay put instead of starting something.
- zz865 5y ago
  Agreed it seems a paradox. Maybe it really is socialism kills entrepreneurial spirit. If you can be an artist or a 35hr/wk public servant and live well, why bother being an entrepreneur?
  - mcv 5y ago
    > If you can be an artist or a 35hr/wk public servant and live well, why bother being an entrepreneur? Maybe because I don't want to be a public servant? I mean, it's important work that needs to be done, but the impression I get from my wife is that it involves a lot of bureaucracy. If we had a basic income or something like that, it would be much easier to take the risk to become an entrepreneur.
  - belval 5y ago
    My take is that there is a whole culture side of things to consider. Some cultures will have a higher general opinion of entrepreneurs than others. In Quebec, Canada you still see a lot of that mindset where a successful entrepreneur is more associated with a slimy businessman than a smart person. It's slowly changing however.
    - 908B64B197 5y ago
      > In Quebec, Canada you still see a lot of that mindset where a successful entrepreneur is more associated with a slimy businessman than a smart person. Historically, didn't the employees speak French and the bosses English? From what I understood, there was very much a glass ceiling and discrimination, similar to what was going on here in the south. Capital wouldn't be loaned across ethnic lines for instance. That might contribute to the perception of entrepreneurs being shady: they historically were there to fleece the locals, not build and prosper.
deleted 5y ago
[deleted]
_9hey 5y ago
You have to correct the pharmaceutical industry for that to be effective. Capitalism works but we need to discover the rules at scale, similar to Physics. Seems like everyone agrees that the rules we know tend to break at scale.
- _9hey 5y ago
  [flagged]
b9a2cab5 5y ago
Socialized healthcare might be much more amenable if it were single-payer but without subsidies. You pay for insurance just like you do now, except there's only 1 provider and it's the government. The primary benefit most M4A people tout is that costs would be lower under a single payer system. This makes that happen without the welfare leeching. I and I'm sure many others are opposed to subsidizing people who decided to play video games and smoke weed all day with our tax dollars. If you're an entrepreneur, you're not harmed by this, you can afford to pay for it. If you're a small business owner, this should save you money. If you're disabled or old, you already get subsidized and would continue to get subsidized. Everyone else - pay for the services you receive.
- katbyte 5y ago
  so what about people who just cannot afford it? homeless, addicts, single mothers raising kids, collage kids, kids kicked out of home because of religious/abortions/pregnancy/LGBTQ/ect? do they just not get healthcare?
  - b9a2cab5 5y ago
    Last 3 categories can afford it if they get a job. Single payer proponents claim on the order of 10x cost savings compared to the status quo. Presumably insurance costs wouldn't exceed $200/mo under single payer. Amazon pays $15/h minimum nationally. That's a day and a half of work for health insurance for the month. The first 2 categories need better help than healthcare insurance. I think it's plainly obvious after SF spending $50k/homeless person that more money isn't going to help them.
    - InvertedRhodium 5y ago
      So they just don't get healthcare? Or are you suggesting an additional welfare system to cater to those subsets specifically?
      - shukantpal 5y ago
        “The first 2 categories need better help than healthcare insurance. I think it's plainly obvious after SF spending $50k/homeless person that more money isn't going to help them.”
irjustin 5y ago
While a good premise, I don't believe it holds up. Healthcare is just one facet. Far and above is the lack of paycheck which encompasses healthcare. "If money was no object, what would you be doing?" The question isn't, "if you had your healthcare covered, what would you doing?" The answer to the first question effectively never, "working for my current employer". For the 2nd question, it's still plausible.
- danielrpa 5y ago
  This. Health insurance is indeed quite expensive in the US but, from a self-employment standpoint, it is just a cost like any other. You can get good health insurance for a family of 3 (middle aged parents of a teenager) where I live in the US for around 25k-30k/year, including the out of pocket costs for moderate usage. This is less than rent for said family in a lot of the big US cities. Nobody wants to "pay rent twice", and it can certainly be a lot harder to stop working when you have a big recurring expense like that, but it's possible to plan for it. Depending on the business you're getting into, it won't be your top expense.
newaccount2021 5y ago
many single entrepreneurs I know simply don't bother with health insurance and live with the risk
matthewhartmans 5y ago
I think another major reason holding people back is consistent cash flow. If you know you can lock in 6 months of work at a time and not worry about cash flow, that would give a lot of people a reason to jump quite easily.
chiefalchemist 5y ago
> it would boost the number of entrepreneurs and small businesses. Agreed. But this is exactly why it's been slow (read: impossible?) to happen. Big Inc has no interest in seeing the status quo change. High healthcare premiums keeps all but the bravest chained to the system. Even the ACA never lived up to its own name. Never. We all know this, yet no effort to fix it, adjust it, etc. That says a lot. Actions speaker louder than words. Let them eat ACA.
- kcplate 5y ago
  ACA was designed from the get go to fail and to be hated. Goal was to soften the public up on the idea of single payer as the solution to the problems that the ACA created. The problem with the plan came when the GOP and Trump went and gutted the penalties for non compliance of the individual mandate. At this point I doubt Biden re-instates it especially with all the hubbub over the vaccine mandate. The optics would be bad bad, especially with the vaccine mandate and the ACA individual mandate disproportionately hurting younger working families.
- PopAlongKid 5y ago
  ACA has accomplished a lot of what it was intended to, despite multiple efforts by some politicians to sabotage it at every turn. "Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs." https://www.hhs.gov/about/news/2021/06/05/new-hhs-data-show-more-americans-than-ever-have-health-coverage-through-affordable-care-act.html https://www.hhs.gov/about/news/2021/06/05/new-hhs-data-show-...
  - chiefalchemist 5y ago
    Just to clarify, yes it has done sone good. Unfortunately, it's not living up to its name. Affordable it is not. Furthermore, it's not making us any healthier. The healthcare system has been the single largest beneficiary of ACA. Note: I'm not against a national plan. But the current implementation is a mess.
refurb 5y ago
Yet countries like Canada who have universal care are less entrepreneurial.
- hungryforcodes 5y ago
  But the mind set strangely is super conservative in that regard. I've struck out and done my own business and most of my regularly working Canadian friends thought (and still think) I am crazy. Effectively most people in Canada work quietly for years to retirement and then...retire. It's pretty safe and easy -- though ultimately super boring.
  - ketzo 5y ago
    I mean, the vast majority of Americans do that, too. Entrepreneurship and self-employment are scary.
    - hungryforcodes 5y ago
      It is true. Definitely not for the faint of heart.
bdangubic 5y ago
I am not buying this - you can get very good insurance from the marketplace for $400-$500/month (I pay $445/month)
- nine_zeros 5y ago
  You are getting down voted because $445/mo is too high - especially for couples with a child.
  - shukantpal 5y ago
    My mother working at Walmart pays $60/month since the rest is paid by the government. If you’re starting something, you probably won’t have income so the cost goes down for you too.
    - kcplate 5y ago
      The challenge with almost all government subsidies is that you need a tax year of little to no income before you can qualify.
  - hanniabu 5y ago
    Also because it's not very good. Anybody that thinks it is hasn't seen the quality of the doctors that take that instance. It's noticeably lower.
  - kcplate 5y ago
    I disagree. $445/mo for a healthcare policy for a family would be cheap. Likely cheaper financially to a young family than the tax impact of socialized healthcare would be to them.
    - deleted 5y ago
      [deleted]
    - aix1 5y ago
      Your comment got me curious, so I looked up per-capita annual cost of the NHS (the socialised healthcare system in the country where I live). The latest official data says "In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development." This is about US$330 per person per month. (I don't have any point to make. Just thought I'd share the data I found.) https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
shrimpx 5y ago
I pay under $400/mo for a pretty good marketplace plan. That’s not prohibitive.
- deleted 5y ago
  [deleted]
- Rapzid 5y ago
  I just started at this startup and the Bronze "HSA" eligible plan for just me and my wife is over 500/mo. Maybe I should have left her off and went to the market lol.
VoodooJuJu 5y ago
The thing holding even more people back is lack of skill and education to strike out on their own.
asdff 5y ago
Another huge thing is rent. A lot of these freelance businesses can be feast or famine especially at the start when its mostly famine. You also need space to do this stuff. Imagine if Steve Jobs and Wozniak didn't have access to a single family home garage and had to try and make do in a studio apartment.
- sjtindell 5y ago
  Musk and his brother rented an office space and slept on the couch there.
  - asdff 5y ago
    Being able to afford rent for an office space is pretty tough for most people who can barely afford rent on their apartment while holding a fulltime job. Musk is the son of an emerald miner.
deleted 5y ago
[deleted]
cbetti 5y ago
Healthcare options were a major deciding factor when I pursued entrepreneurship in 2011. Ultimately we decided that the Massachusetts options at the time had sufficient coverage given we didn't yet have children, but the plans were significantly cheaper than today and employer packages offered higher degrees of security.
garrickvanburen 5y ago
Maybe fear of looking at health care premium bill every month. Healthcare can be found. Maybe it's not at a preferred price, but it can be found. Even post-ACA. Source: me working for myself and paying healthcare premiums for self and family 2003-2018
deleted 5y ago
[deleted]
ecommerceguy 5y ago
Options for individual and family healthcare plans in many of the less restrictive states don't stop at "Obamacare." While not for everyone, Short Term Medical is a viable option, many times much more attractive than IFP ACA plans as STM plans typically ride on a national network whereas "Obamacare" plans are typically EPO plans that are geographically limited. It's a commonly held myth that bigger companies offer lower premiums to employees, that is most certainly not always the case.

PragmaticPulp 5y ago

Having done this myself, I don't really see it. Yes, health insurance is expensive, but I can also bill substantially more than my non-US counterparts can in their respective countries. Even with paying for health insurance myself, I don't see how I'd come out ahead in any other country right now unless I relocated and kept my working hours / client base in the US.

macNchz 5y ago
Sure once you have solid revenue and a repeatable business model, but it certainly costs enough to have an impact on people just starting out. When I quit my job to work for myself in 2019 I was choosing between $600/mo COBRA or nominally cheaper marketplace plans with absolutely terrible coverage, just for myself. I had plenty of runway and software development is in demand so it wasn’t a huge burden, but with a family it could easily have cost $2k+/mo. I’m sure that’s enough to dissuade people from trying new things, especially in niches where it takes longer to get to profitability.

hsn915 5y ago

Health Freedom "Freedom Care" sounds like an oxymoron. If you need "care" you are not "free". It's not about "care", it's about risk mitigation. You are not sick now, but you have no idea when you or one of your dependents might become sick and need $$$.

deleted 5y ago
[deleted]
mcv 5y ago
The care frees you from the burden of illness.

belval 5y ago

That does not seem to pass the smell test for me. Do we see a greater percentage of entrepreneurs from Canada or Europe than from the US? I didn't look up hard numbers but I doubt it.

newshorts 5y ago
Anecdotally, healthcare benefits did factor in to my decision making when I thought about opening my own shop. I have two small kids and decided at this point in my life I’m going to stay put instead of starting something.
zz865 5y ago
Agreed it seems a paradox. Maybe it really is socialism kills entrepreneurial spirit. If you can be an artist or a 35hr/wk public servant and live well, why bother being an entrepreneur?
- mcv 5y ago
  > If you can be an artist or a 35hr/wk public servant and live well, why bother being an entrepreneur? Maybe because I don't want to be a public servant? I mean, it's important work that needs to be done, but the impression I get from my wife is that it involves a lot of bureaucracy. If we had a basic income or something like that, it would be much easier to take the risk to become an entrepreneur.
- belval 5y ago
  My take is that there is a whole culture side of things to consider. Some cultures will have a higher general opinion of entrepreneurs than others. In Quebec, Canada you still see a lot of that mindset where a successful entrepreneur is more associated with a slimy businessman than a smart person. It's slowly changing however.
  - 908B64B197 5y ago
    > In Quebec, Canada you still see a lot of that mindset where a successful entrepreneur is more associated with a slimy businessman than a smart person. Historically, didn't the employees speak French and the bosses English? From what I understood, there was very much a glass ceiling and discrimination, similar to what was going on here in the south. Capital wouldn't be loaned across ethnic lines for instance. That might contribute to the perception of entrepreneurs being shady: they historically were there to fleece the locals, not build and prosper.

deleted 5y ago

[deleted]

_9hey 5y ago

You have to correct the pharmaceutical industry for that to be effective. Capitalism works but we need to discover the rules at scale, similar to Physics. Seems like everyone agrees that the rules we know tend to break at scale.

_9hey 5y ago
[flagged]

b9a2cab5 5y ago

Socialized healthcare might be much more amenable if it were single-payer but without subsidies. You pay for insurance just like you do now, except there's only 1 provider and it's the government. The primary benefit most M4A people tout is that costs would be lower under a single payer system. This makes that happen without the welfare leeching. I and I'm sure many others are opposed to subsidizing people who decided to play video games and smoke weed all day with our tax dollars. If you're an entrepreneur, you're not harmed by this, you can afford to pay for it. If you're a small business owner, this should save you money. If you're disabled or old, you already get subsidized and would continue to get subsidized. Everyone else - pay for the services you receive.

katbyte 5y ago
so what about people who just cannot afford it? homeless, addicts, single mothers raising kids, collage kids, kids kicked out of home because of religious/abortions/pregnancy/LGBTQ/ect? do they just not get healthcare?
- b9a2cab5 5y ago
  Last 3 categories can afford it if they get a job. Single payer proponents claim on the order of 10x cost savings compared to the status quo. Presumably insurance costs wouldn't exceed $200/mo under single payer. Amazon pays $15/h minimum nationally. That's a day and a half of work for health insurance for the month. The first 2 categories need better help than healthcare insurance. I think it's plainly obvious after SF spending $50k/homeless person that more money isn't going to help them.
  - InvertedRhodium 5y ago
    So they just don't get healthcare? Or are you suggesting an additional welfare system to cater to those subsets specifically?
    - shukantpal 5y ago
      “The first 2 categories need better help than healthcare insurance. I think it's plainly obvious after SF spending $50k/homeless person that more money isn't going to help them.”

irjustin 5y ago

While a good premise, I don't believe it holds up. Healthcare is just one facet. Far and above is the lack of paycheck which encompasses healthcare. "If money was no object, what would you be doing?" The question isn't, "if you had your healthcare covered, what would you doing?" The answer to the first question effectively never, "working for my current employer". For the 2nd question, it's still plausible.

danielrpa 5y ago
This. Health insurance is indeed quite expensive in the US but, from a self-employment standpoint, it is just a cost like any other. You can get good health insurance for a family of 3 (middle aged parents of a teenager) where I live in the US for around 25k-30k/year, including the out of pocket costs for moderate usage. This is less than rent for said family in a lot of the big US cities. Nobody wants to "pay rent twice", and it can certainly be a lot harder to stop working when you have a big recurring expense like that, but it's possible to plan for it. Depending on the business you're getting into, it won't be your top expense.

newaccount2021 5y ago

many single entrepreneurs I know simply don't bother with health insurance and live with the risk

matthewhartmans 5y ago

I think another major reason holding people back is consistent cash flow. If you know you can lock in 6 months of work at a time and not worry about cash flow, that would give a lot of people a reason to jump quite easily.

chiefalchemist 5y ago

> it would boost the number of entrepreneurs and small businesses. Agreed. But this is exactly why it's been slow (read: impossible?) to happen. Big Inc has no interest in seeing the status quo change. High healthcare premiums keeps all but the bravest chained to the system. Even the ACA never lived up to its own name. Never. We all know this, yet no effort to fix it, adjust it, etc. That says a lot. Actions speaker louder than words. Let them eat ACA.

kcplate 5y ago
ACA was designed from the get go to fail and to be hated. Goal was to soften the public up on the idea of single payer as the solution to the problems that the ACA created. The problem with the plan came when the GOP and Trump went and gutted the penalties for non compliance of the individual mandate. At this point I doubt Biden re-instates it especially with all the hubbub over the vaccine mandate. The optics would be bad bad, especially with the vaccine mandate and the ACA individual mandate disproportionately hurting younger working families.
PopAlongKid 5y ago
ACA has accomplished a lot of what it was intended to, despite multiple efforts by some politicians to sabotage it at every turn. "Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs." https://www.hhs.gov/about/news/2021/06/05/new-hhs-data-show-more-americans-than-ever-have-health-coverage-through-affordable-care-act.html https://www.hhs.gov/about/news/2021/06/05/new-hhs-data-show-...
- chiefalchemist 5y ago
  Just to clarify, yes it has done sone good. Unfortunately, it's not living up to its name. Affordable it is not. Furthermore, it's not making us any healthier. The healthcare system has been the single largest beneficiary of ACA. Note: I'm not against a national plan. But the current implementation is a mess.

refurb 5y ago

Yet countries like Canada who have universal care are less entrepreneurial.

hungryforcodes 5y ago
But the mind set strangely is super conservative in that regard. I've struck out and done my own business and most of my regularly working Canadian friends thought (and still think) I am crazy. Effectively most people in Canada work quietly for years to retirement and then...retire. It's pretty safe and easy -- though ultimately super boring.
- ketzo 5y ago
  I mean, the vast majority of Americans do that, too. Entrepreneurship and self-employment are scary.
  - hungryforcodes 5y ago
    It is true. Definitely not for the faint of heart.

bdangubic 5y ago

I am not buying this - you can get very good insurance from the marketplace for $400-$500/month (I pay $445/month)

nine_zeros 5y ago
You are getting down voted because $445/mo is too high - especially for couples with a child.
- shukantpal 5y ago
  My mother working at Walmart pays $60/month since the rest is paid by the government. If you’re starting something, you probably won’t have income so the cost goes down for you too.
  - kcplate 5y ago
    The challenge with almost all government subsidies is that you need a tax year of little to no income before you can qualify.
- hanniabu 5y ago
  Also because it's not very good. Anybody that thinks it is hasn't seen the quality of the doctors that take that instance. It's noticeably lower.
- kcplate 5y ago
  I disagree. $445/mo for a healthcare policy for a family would be cheap. Likely cheaper financially to a young family than the tax impact of socialized healthcare would be to them.
  - deleted 5y ago
    [deleted]
  - aix1 5y ago
    Your comment got me curious, so I looked up per-capita annual cost of the NHS (the socialised healthcare system in the country where I live). The latest official data says "In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development." This is about US$330 per person per month. (I don't have any point to make. Just thought I'd share the data I found.) https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

shrimpx 5y ago

I pay under $400/mo for a pretty good marketplace plan. That’s not prohibitive.

deleted 5y ago
[deleted]
Rapzid 5y ago
I just started at this startup and the Bronze "HSA" eligible plan for just me and my wife is over 500/mo. Maybe I should have left her off and went to the market lol.

VoodooJuJu 5y ago

The thing holding even more people back is lack of skill and education to strike out on their own.

asdff 5y ago

Another huge thing is rent. A lot of these freelance businesses can be feast or famine especially at the start when its mostly famine. You also need space to do this stuff. Imagine if Steve Jobs and Wozniak didn't have access to a single family home garage and had to try and make do in a studio apartment.

sjtindell 5y ago
Musk and his brother rented an office space and slept on the couch there.
- asdff 5y ago
  Being able to afford rent for an office space is pretty tough for most people who can barely afford rent on their apartment while holding a fulltime job. Musk is the son of an emerald miner.

deleted 5y ago

[deleted]

cbetti 5y ago

Healthcare options were a major deciding factor when I pursued entrepreneurship in 2011. Ultimately we decided that the Massachusetts options at the time had sufficient coverage given we didn't yet have children, but the plans were significantly cheaper than today and employer packages offered higher degrees of security.

garrickvanburen 5y ago

Maybe fear of looking at health care premium bill every month. Healthcare can be found. Maybe it's not at a preferred price, but it can be found. Even post-ACA. Source: me working for myself and paying healthcare premiums for self and family 2003-2018

deleted 5y ago

[deleted]

ecommerceguy 5y ago

Options for individual and family healthcare plans in many of the less restrictive states don't stop at "Obamacare." While not for everyone, Short Term Medical is a viable option, many times much more attractive than IFP ACA plans as STM plans typically ride on a national network whereas "Obamacare" plans are typically EPO plans that are geographically limited. It's a commonly held myth that bigger companies offer lower premiums to employees, that is most certainly not always the case.