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> 1. Fix the healthcare system. Right now, you're punished if you don't work for a large company in the sense that you're charged up the wazoo for health insura

by anamax 15y ago

> 1. Fix the healthcare system. Right now, you're punished if you don't work for a large company in the sense that you're charged up the wazoo for health insurance. Work for a large company and it's close to free. No, it's not "almost free". It's paid for by the company. And yes, paying yourself is tax-deductible in many circumstances. I've actually paid for health insurance out of pocket as an "older american". Rent was more expensive. That said, healthcare could be a lot less expensive, but since much of that expense comes from govt involvement, it's unclear why anyone would think that even more govt involvement would help. For example, there are a lot of procedures for which I don't want coverage, but thanks to govt requirements, I can't opt out and pay less. > 2. Fix student loans. One could argue don't go to college but I think we can agree there's some value to good schools. Student loans are one way to pay college costs. The method of payment doesn't actually affect the costs much. Increased student aid seems to increase college cost.

rabidsnail 15y ago
Being cheaper than rent is a pretty low bar.
eli 15y ago
> I've actually paid for health insurance out of pocket as an "older american". Rent was more expensive. I think you were very lucky. As a "young & healthy american," that was not my experience.
- philwelch 15y ago
  It's not luck, just state by state differences. Some states are much better than others.
  - philwelch 15y ago
    What the fuck, downvoters. Seriously, health insurance is regulated differently on a state to state level, and some states have more consumer-friendly laws than others on the matter.
  - anamax 15y ago
    It's hard to believe that CA is one of the better ones. And no, it wasn't a bare-bones policy, let alone an HSA. Either of those options would have reduced the cost significantly.
Retric 15y ago
The US and Canadian government spend the same amount per person on healthcare but Canada has universal health care. On average the US and Canadian healthcare systems provide vary similar outcomes on average. So, clearly more government involvement is an option. But, so is less the US could save a ridiculous amount of money if we could stop wasting it on end of life care that proves little to no benefit. Healthcare is an endless money sink and because the US government agrees to hand over money with little veto power we have are left with the worst healthcare system money can buy. Just think about this for a second would you rather have an extra 250,000$ to spend when your young, or have a 50/50% shot of spending an extra 2 months on your death bead in a semi lucid state?
- a3camero 15y ago
  Canadian here: Your post is kind of at odds with the final question you posed. You can have the money AND not sacrifice health outcomes. As you said, Cdn and US governments spend the same amount of money for the same outcomes.
  - dpritchett 15y ago
    Also Canada has dramatically less ethnic diversity, at least if I'm reading Wikipedia correctly.
    - burgerbrain 15y ago
      Are you really suggesting that a few ethnic diseases would render the Canadian healthcare system unworkable? I find it very hard to believe that a few more cases sickle cell or whatever would have that kind of effect.
      - anamax 15y ago
        > Are you really suggesting that a few ethnic diseases It isn't a "few ethnic diseases", but you are underestimating the cost of high-blood pressure and the like.
MikeMacMan 15y ago
No, it's not "almost free". It's paid for by the company. You are correct, but large companies get dramatically better rates and better coverage than small companies. My family's small business has seen healthcare premiums increase more than 20% each year for the past few years. We have had to cut benefits (increase deductibles and copays, etc). It's a sad state of affairs that employees of large companies are insulated from (for now).
- _delirium 15y ago
  More or less because reasonably-priced health insurance requires a risk pool in which membership isn't voluntary, and large companies provide such a pool by requiring that all their employees enroll in the company health insurance as a condition of employment (and pay their portion of the coverage fee with no opt-out allowed). The insurers assume that the number of people who'll turn down the job solely due to disagreeing with the mandatory-insurance aspect is small, so the coverage pool is in effect a large, mandatory-coverage pool selected for mostly-health-unrelated reasons, which is the kind that works as a risk pool. Entrepreneurs don't have anything similar unless there is a way to aggregate themselves into a pool where the opt-ins don't correlate with health condition too strongly, which currently there isn't. Insurers for good reason don't give good terms to non-mandatory-coverage risk pools, because of the strong bias towards high-risk people in such pools. And good luck if you have any congenital health issues; my friend who has a from-birth heart defect is essentially banned from ever doing a startup due to the employment-tied nature of the U.S. healthcare system and the preexisting-condition rules that make the health-insurance-via-corporate-job approach the only one open to him.
  - rphlx 15y ago
    The insurance company inherently pools everyone that it insures, whether they work in 10 large companies, or 1000 small ones. So I fail to see a legit statistical/risk-model reason why health insurers MUST gouge small companies/entrepreneurs. I think it's mostly due to small companies having less negotiating leverage.
    - 15y ago
specialist 15y ago
> healthcare could be a lot less expensive, but since much of that expense comes from govt involvement Citation please. (In other words, you're wrong. And you know it.)
- anamax 15y ago
  > Citation please. Govt mandates that "health insurance" cover things for which I have no interest. Those things increase the cost. Govt mandates that I can't buy health insurance across state lines, which reduces competition. There are so many ways in which govt increases the cost of healthcare that I could post large numbers of citations and not even scratch the surface. > (In other words, you're wrong. And you know it.) Are you claiming that govt involvement hasn't increased the cost of healthcare at all, or just quibbling about the size of the net increase?
  - specialist 15y ago
    Those are opinions, not citations. I'm surprised you didn't mention "tort reform" too, another one of the debunked talking points. If government is so bad, why does Medicare/Medicaid help more people at less cost than private insurance?

by anamax 15y ago

rabidsnail 15y ago

Being cheaper than rent is a pretty low bar.

eli 15y ago

> I've actually paid for health insurance out of pocket as an "older american". Rent was more expensive. I think you were very lucky. As a "young & healthy american," that was not my experience.

philwelch 15y ago
It's not luck, just state by state differences. Some states are much better than others.
- philwelch 15y ago
  What the fuck, downvoters. Seriously, health insurance is regulated differently on a state to state level, and some states have more consumer-friendly laws than others on the matter.
- anamax 15y ago
  It's hard to believe that CA is one of the better ones. And no, it wasn't a bare-bones policy, let alone an HSA. Either of those options would have reduced the cost significantly.

Retric 15y ago

The US and Canadian government spend the same amount per person on healthcare but Canada has universal health care. On average the US and Canadian healthcare systems provide vary similar outcomes on average. So, clearly more government involvement is an option. But, so is less the US could save a ridiculous amount of money if we could stop wasting it on end of life care that proves little to no benefit. Healthcare is an endless money sink and because the US government agrees to hand over money with little veto power we have are left with the worst healthcare system money can buy. Just think about this for a second would you rather have an extra 250,000$ to spend when your young, or have a 50/50% shot of spending an extra 2 months on your death bead in a semi lucid state?

a3camero 15y ago
Canadian here: Your post is kind of at odds with the final question you posed. You can have the money AND not sacrifice health outcomes. As you said, Cdn and US governments spend the same amount of money for the same outcomes.
- dpritchett 15y ago
  Also Canada has dramatically less ethnic diversity, at least if I'm reading Wikipedia correctly.
  - burgerbrain 15y ago
    Are you really suggesting that a few ethnic diseases would render the Canadian healthcare system unworkable? I find it very hard to believe that a few more cases sickle cell or whatever would have that kind of effect.
    - anamax 15y ago
      > Are you really suggesting that a few ethnic diseases It isn't a "few ethnic diseases", but you are underestimating the cost of high-blood pressure and the like.

MikeMacMan 15y ago

No, it's not "almost free". It's paid for by the company. You are correct, but large companies get dramatically better rates and better coverage than small companies. My family's small business has seen healthcare premiums increase more than 20% each year for the past few years. We have had to cut benefits (increase deductibles and copays, etc). It's a sad state of affairs that employees of large companies are insulated from (for now).

_delirium 15y ago
More or less because reasonably-priced health insurance requires a risk pool in which membership isn't voluntary, and large companies provide such a pool by requiring that all their employees enroll in the company health insurance as a condition of employment (and pay their portion of the coverage fee with no opt-out allowed). The insurers assume that the number of people who'll turn down the job solely due to disagreeing with the mandatory-insurance aspect is small, so the coverage pool is in effect a large, mandatory-coverage pool selected for mostly-health-unrelated reasons, which is the kind that works as a risk pool. Entrepreneurs don't have anything similar unless there is a way to aggregate themselves into a pool where the opt-ins don't correlate with health condition too strongly, which currently there isn't. Insurers for good reason don't give good terms to non-mandatory-coverage risk pools, because of the strong bias towards high-risk people in such pools. And good luck if you have any congenital health issues; my friend who has a from-birth heart defect is essentially banned from ever doing a startup due to the employment-tied nature of the U.S. healthcare system and the preexisting-condition rules that make the health-insurance-via-corporate-job approach the only one open to him.
- rphlx 15y ago
  The insurance company inherently pools everyone that it insures, whether they work in 10 large companies, or 1000 small ones. So I fail to see a legit statistical/risk-model reason why health insurers MUST gouge small companies/entrepreneurs. I think it's mostly due to small companies having less negotiating leverage.
  - 15y ago

specialist 15y ago

> healthcare could be a lot less expensive, but since much of that expense comes from govt involvement Citation please. (In other words, you're wrong. And you know it.)

anamax 15y ago
> Citation please. Govt mandates that "health insurance" cover things for which I have no interest. Those things increase the cost. Govt mandates that I can't buy health insurance across state lines, which reduces competition. There are so many ways in which govt increases the cost of healthcare that I could post large numbers of citations and not even scratch the surface. > (In other words, you're wrong. And you know it.) Are you claiming that govt involvement hasn't increased the cost of healthcare at all, or just quibbling about the size of the net increase?
- specialist 15y ago
  Those are opinions, not citations. I'm surprised you didn't mention "tort reform" too, another one of the debunked talking points. If government is so bad, why does Medicare/Medicaid help more people at less cost than private insurance?