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If America really wants to increase entrepreneurship, make health insurance portable and not tied to corporate America. That would encourage workers to start t

If America really wants to increase entrepreneurship, make health insurance portable and not tied to corporate America. That would encourage workers to start their own business. Trying to tweak the immigration process in the name of "increased entrepreneurship" is often just a ruse for "open the borders!!!". Fine in and of itself if that's your beef. Just please file it right folder. Letting Congress, political donors, H1-B employers and college administrators try and engineer the future by selecting "winners" seems like something they're going to mess up. Better to have limited, legal only immigration based on a points system rather than turn it into a subsidy for Sand Hill Road.

tomasien 14y ago
Agree with first point: healthcare access to all = job churn = more entrepreneurship
- rayiner 14y ago
  Healthcare access is keeping a huge important demographic out of the startup scene: older, experienced engineers with domain specific knowledge. A startup I worked for was founded by an electrical engineer with a PhD and 20 years of experience in radio engineering. He had three kids, but was lucky to have a wife whose job provided health insurance. Many potential founders aren't so lucky. And I think that fact is reflected in today's startup scene. A lot of innovation in areas amenable to being worked on by 22 year old fresh grads, but very little in "hard" areas of engineering. Projects like Tesla Motors are an unusual exception, and those seem mostly to be second-projects for successful founders.
  - enraged_camel 14y ago
    The fundamental problem is not that insurance is tied to employment, but that you need health insurance in the first place because healthcare is so ridiculously expensive. Make it more affordable and the lack of health insurance stops being such a big problem.
    - rayiner 14y ago
      Even with cheaper healthcare, some people are going to require inherently expensive care. Which is the whole point of insurance.
      - michaelt 14y ago
        Of course some things are expensive - but there are still efficiency savings to be made; Americans on average spend more for the same health outcomes. For example, American medicine has a culture of ordering lots of tests based on legal, rather than scientific guidance. Consider the Merenstein PSA case [1] for an example. Increasing efficiency and driving down average healthcare costs ought to reduce insurance costs. [1] http://www.kevinmd.com/blog/2004/05/doctor-sued-uspstf-guidelines-prostate-cancer-screening.html http://www.kevinmd.com/blog/2004/05/doctor-sued-uspstf-guide...
        rbanffy 14y ago
        Still, someone will end up having to pay for a month in the ICU. Health insurance is a way to share the risks so that nobody has to die just because they can't afford treatment. The odds I'll need expensive medical care increase every year.
    - toomuchtodo 14y ago
      Drop the expensive part. Make healthcare more efficient.
      - stephenhuey 14y ago
        I think this is the best approach at the moment. No one can wave a wand and get rid of the expense of many cutting-edge treatments, and neither do we want to do away with all the expensive cutting-edge treatments in an effort to return to "simpler times" when life expectancy was lower. This is why we are trying to build solutions which reduce the wasteful inefficiencies present in America's healthcare system.
- mjwalshe 14y ago
  One advatage that the NHS has in the UK
rogerbinns 14y ago
I'd add two other things to fix too. The first is housing. It is not a triumph every time the cost of housing goes up. That just diverts funds that could have been spent on other things into housing, makes it considerably more expensive to move, and reduces the runway given a certain amount of funding. We would all be better off if houses were $1 each not $1m each. The second is the pitiful broadband available all over the country. With better broadband it is far easier to take advantage of contributors all over the country. Telepresence would allow collaborators to feel as though they are in the same room, and is best served by high bandwidths. Data files keep getting larger so it helps there too. And if you are using a remote computer displaying locally then again it is best served by higher bandwidths (and lower latencies).
- potatolicious 14y ago
  > "We would all be better off if houses were $1 each not $1m each." We would? Last I checked $1 can't even build some branches and a tarp. But to address your main point: > "It is not a triumph every time the cost of housing goes up." Indeed. Neither is it a triumph every time the cost of food goes up. Or the cost of gas. Or the cost of clothing. Or the cost of basic needs like the plumber or the mechanic. We would all (on a micro scale) be much better off if prices simply stayed put. Except in an economy where all prices are fixed your entrepreneurship wouldn't go anywhere either... What you're proposing is a complete removal of the free market economy and putting vast portions of it under central planning. History has some indications as to how that works (tip: "disaster" doesn't begin to describe it).
  - rmason 14y ago
    Not in Detroit. True most of the $1 houses are gone but you'd be surprised by what $100 will purchase. http://www.businessinsider.com/detroit-houses-for-1-dollar-2012-2?op=1 http://www.businessinsider.com/detroit-houses-for-1-dollar-2...
    - potatolicious 14y ago
      And Detroit isn't the aftermath of a gigantic disaster? ;) Granted, Detroit is a disaster that didn't come from the nationalization of vast portions of private property.

tomasien 14y ago

Agree with first point: healthcare access to all = job churn = more entrepreneurship

rayiner 14y ago
Healthcare access is keeping a huge important demographic out of the startup scene: older, experienced engineers with domain specific knowledge. A startup I worked for was founded by an electrical engineer with a PhD and 20 years of experience in radio engineering. He had three kids, but was lucky to have a wife whose job provided health insurance. Many potential founders aren't so lucky. And I think that fact is reflected in today's startup scene. A lot of innovation in areas amenable to being worked on by 22 year old fresh grads, but very little in "hard" areas of engineering. Projects like Tesla Motors are an unusual exception, and those seem mostly to be second-projects for successful founders.
- enraged_camel 14y ago
  The fundamental problem is not that insurance is tied to employment, but that you need health insurance in the first place because healthcare is so ridiculously expensive. Make it more affordable and the lack of health insurance stops being such a big problem.
  - rayiner 14y ago
    Even with cheaper healthcare, some people are going to require inherently expensive care. Which is the whole point of insurance.
    - michaelt 14y ago
      Of course some things are expensive - but there are still efficiency savings to be made; Americans on average spend more for the same health outcomes. For example, American medicine has a culture of ordering lots of tests based on legal, rather than scientific guidance. Consider the Merenstein PSA case [1] for an example. Increasing efficiency and driving down average healthcare costs ought to reduce insurance costs. [1] http://www.kevinmd.com/blog/2004/05/doctor-sued-uspstf-guidelines-prostate-cancer-screening.html http://www.kevinmd.com/blog/2004/05/doctor-sued-uspstf-guide...
      - rbanffy 14y ago
        Still, someone will end up having to pay for a month in the ICU. Health insurance is a way to share the risks so that nobody has to die just because they can't afford treatment. The odds I'll need expensive medical care increase every year.
  - toomuchtodo 14y ago
    Drop the expensive part. Make healthcare more efficient.
    - stephenhuey 14y ago
      I think this is the best approach at the moment. No one can wave a wand and get rid of the expense of many cutting-edge treatments, and neither do we want to do away with all the expensive cutting-edge treatments in an effort to return to "simpler times" when life expectancy was lower. This is why we are trying to build solutions which reduce the wasteful inefficiencies present in America's healthcare system.
mjwalshe 14y ago
One advatage that the NHS has in the UK

rogerbinns 14y ago

I'd add two other things to fix too. The first is housing. It is not a triumph every time the cost of housing goes up. That just diverts funds that could have been spent on other things into housing, makes it considerably more expensive to move, and reduces the runway given a certain amount of funding. We would all be better off if houses were $1 each not $1m each. The second is the pitiful broadband available all over the country. With better broadband it is far easier to take advantage of contributors all over the country. Telepresence would allow collaborators to feel as though they are in the same room, and is best served by high bandwidths. Data files keep getting larger so it helps there too. And if you are using a remote computer displaying locally then again it is best served by higher bandwidths (and lower latencies).

potatolicious 14y ago
> "We would all be better off if houses were $1 each not $1m each." We would? Last I checked $1 can't even build some branches and a tarp. But to address your main point: > "It is not a triumph every time the cost of housing goes up." Indeed. Neither is it a triumph every time the cost of food goes up. Or the cost of gas. Or the cost of clothing. Or the cost of basic needs like the plumber or the mechanic. We would all (on a micro scale) be much better off if prices simply stayed put. Except in an economy where all prices are fixed your entrepreneurship wouldn't go anywhere either... What you're proposing is a complete removal of the free market economy and putting vast portions of it under central planning. History has some indications as to how that works (tip: "disaster" doesn't begin to describe it).
- rmason 14y ago
  Not in Detroit. True most of the $1 houses are gone but you'd be surprised by what $100 will purchase. http://www.businessinsider.com/detroit-houses-for-1-dollar-2012-2?op=1 http://www.businessinsider.com/detroit-houses-for-1-dollar-2...
  - potatolicious 14y ago
    And Detroit isn't the aftermath of a gigantic disaster? ;) Granted, Detroit is a disaster that didn't come from the nationalization of vast portions of private property.