Running a startup I've gone through this exact same thought process. My high level bullet points are: 1) It's insane that any business should spend so many cycl

Running a startup I've gone through this exact same thought process. My high level bullet points are: 1) It's insane that any business should spend so many cycles on managing this. I would have thought Republicans (pro business) might be more open to a state role in healthcare precisely so business's don't have to manage this burden. 2) Somebody who is 35 or 40 with children fully burdened is around $1200 a month or $14,000 per year. Someone who is 25 and single is $200. You think that differential never goes through our minds when assessing candidate and how much we'll pay them? That totally sucks but is a reality. 3) The wealthiest and most likely to vote Americans get their health insurance via their company. So they're entirely immune to the dysfunctional system. If ALL Americans were procuring health insurance in the private marketplace there'd be a much better system. Much less abuse. If the government (like EU/AUS) was the sole customer there would be a much better system. It's this mixture of employers, too small in aggregate to manage the demand side, + smaller individuals buying it on their own, that drives the spiraling costs here. 4) Having a startup provide your health insurance is really dumb. Startups have a much higher % chance of closing their doors. So one day you get laid off because your startup doesn't make it. Guess what, now you have to go and find a new job AND work out what you're COBRA options are. In the broader context, most people who get laid off in the US lose their job AND now have a $1000 or more (if they're family provider) costs layered on as they now have to start paying for healthcare. Like losing a war you didn't start then being forced to pay repatriation costs when your economy is at its weakest. Politically, I think we're more likely to get universal healthcare via the state through than to ever get all employers to stop offering it and put everyone into the marketplace. So I support these efforts because the current blend is the worst. (PS right now we're paying full costs because we lean toward hiring more mature people (read families) who understand what it would cost them in the marketplace to get it so they can balance it against their overall lowered financial compensation.)