14 ms·

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.
      - toomuchtodo 14y ago
        You guys and Dr Chrono are doing some great work; keep it up!
  - EricDeb 14y ago
    How about more doctors as well? - more supply to lower prices. I'd be fine with doctors who are educated in more crowded Medical Schools... for the most part, I can diagnose myself.
  - eli_gottlieb 14y ago
    Make health insurance universal and put downward pressure on the insurers' costs. The insurers then bargain down the health-care costs. That's what we do over here, and the result is that doctors here complain about how hard they had to work to become merely upper-middle class rather than outright wealthy.
  - ajross 14y ago
    That doesn't work. Health care is inherently expensive. If you get a serious condition and need years of treatment, then it has to be paid for. But most people don't. This is why the insurance model exists -- the majority of people who aren't (yet) sick pay for the care of those who are. You can't wave a magic wand and make major surgery or chemotherapy affordable. All real world solutions here are collective, they differ only in whether access is fair and what entity (public or private) does the collection and distribution.
mjwalshe 14y ago
One advatage that the NHS has in the UK

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.
    - toomuchtodo 14y ago
      You guys and Dr Chrono are doing some great work; keep it up!
- EricDeb 14y ago
  How about more doctors as well? - more supply to lower prices. I'd be fine with doctors who are educated in more crowded Medical Schools... for the most part, I can diagnose myself.
- eli_gottlieb 14y ago
  Make health insurance universal and put downward pressure on the insurers' costs. The insurers then bargain down the health-care costs. That's what we do over here, and the result is that doctors here complain about how hard they had to work to become merely upper-middle class rather than outright wealthy.
- ajross 14y ago
  That doesn't work. Health care is inherently expensive. If you get a serious condition and need years of treatment, then it has to be paid for. But most people don't. This is why the insurance model exists -- the majority of people who aren't (yet) sick pay for the care of those who are. You can't wave a magic wand and make major surgery or chemotherapy affordable. All real world solutions here are collective, they differ only in whether access is fair and what entity (public or private) does the collection and distribution.

mjwalshe 14y ago

One advatage that the NHS has in the UK