9 ms·

Is Employer-Based Health Insurance A Barrier To Entrepreneurship? (2010)

62 points by ScottBurson 13y ago

pixelmonkey 13y ago
+1 this research being done. When I bootstrapped Parse.ly by doing consulting in 2009/2010, my biggest costs were rent and healthcare. I wrote about this in my blog post, "Startups: not for the faint of heart". http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-heart http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-h... To get a good "sole proprietorship" plan for me cost >$1,100 a month. My healthcare cost nearly as much as my rent in Astoria, NYC. I've spoken to many budding entrepreneurs in NYC, and they have told tell that the loss of an employer-provided healthcare plan is a major factor that stops people from quitting their jobs to start a company.
- mgkimsal 13y ago
  was this just for yourself, or a family? $1100 seems steep - a 'high deductible' HSA plan for a single person should be < $500/month - it's currently < $350 for two of us.
  - riggins 13y ago
    was this just for yourself Might be NYC. I can tell you individual plans in NY run $1,500/month.
    - rdl 13y ago
      Why is NY/NYC health insurance 5-10x what it is in WA/CA?
      - bbanyc 13y ago
        New York state law requires strict community rating, which means that an insurance company must charge the same prices to all customers. Elsewhere people with known health problems are charged higher premiums to cover their higher health costs. In New York that's illegal, so instead everyone is charged high premiums.
        rdl 13y ago
        Do people move/select based on this? I don't know if $1k/mo difference is enough to get people to move, since NYC is expensive (and thus obviously attractive to account for that). It would be an interesting study -- moving cities or states is way easier than countries.
  - mjn 13y ago
    When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible) for less than ~$400-500/mo. There were plans cheaper than that with no drug coverage (starting around $200), but that leaves you on the hook for unlimited liability if you end up needing an expensive prescription (and some can be very expensive). I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end.
    - mgkimsal 13y ago
      It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)
      - mjn 13y ago
        My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
  - deleted 13y ago
    [deleted]
sitkack 13y ago
Yes, and duh. Corp provided health insurance means the employer controls the labor liquidity, not the employees. The hypocrite Republicans should have loved to offload the cost of health insurance onto the taxpayer, not the corp. But the power of employee control even trumps direct bottom line profits. Wal-Mart gets it, that is why it encourages employees to seek public assistance and pays them so little that they still qualify.
brm 13y ago
Yes. It's a hindrance to most life paths that don't involve full-time employment. As someone with a chronic auto-immune condition I'm effectively tethered to an employer or a spouse if I want health coverage. Should I choose pursue an art as my vocation or start a company I'd have to be willing to endure a lag in my insurance until whatever I was pursuing became successful enough that I was eligible to be covered by a trade group or had enough revenue to buy health insurance. Guaranteed, affordable health coverage not tied to an employer or a spouse would remove a incredible burden from my life.
- mjn 13y ago
  Once the PPACA exchanges phase in next year, will that ameliorate the problems in your case? They seem like they target this case specifically, essentially trying to turn each state's population into a large risk pool that anyone can buy into, rather than having risk pools be employer-tied.
  - jjoonathan 13y ago
    You beat me to it! (For those who don't know, the PPACA is sometimes called "Obamacare" although it should be noted that the name is more a result of political maneuvering than the result of particularly close affiliation with Obama.) I still think we should go all the way to single-payer. Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed (rather than the other way around). If the US health industry had to compete directly with any of these systems, it would go out of business tomorrow, since they offer similar care (in terms of outcome rates) at half the price per person. That doesn't even include the effects on entrepreneurship and employment! While the ACA did little to fix the "US health care costs twice as much and doesn't deliver better outcomes" problem, it does have a good shot at fixing the preexisting condition and individual insurance debacles.
    - mjn 13y ago
      I agree it's not really a proper solution. My move from the U.S. to Denmark has been smooth when it comes to healthcare; I've been very impressed at the lack of paperwork and lack of stress over my coverage. But nonetheless I grudgingly supported PPACA, despite it seeming like a mess, because I can't see another way to solve the tied-to-employers issue that's politically feasible, at least for now.
bit_genesis 13y ago
This had a huge mindshare for me when deciding who to approach as a co-founder. While I'm younger and incredibly healthy, my ideal co-founder is 9 years older than me and spent much of his 20s as a semi-professional athlete. It's catching up to him now. After I approached him, I brought up healthcare and that I knew it would be important to him and that we'd figure that out together somehow. We were both disappointed at how little healthcare reform shelters entrepreneurs. In the end, languishing at someone else's company, but insured, is not the way he wanted to spend his life. If he had a family, that might have been a harder decision to make.
vijucat 13y ago
The larger the employer, the better the deal they can work out with the insurance provider for their employees. This is definitely one of the reasons why jobs with IBM or UBS, say, are more desirable to most folks than the assured struggle called entrepreneurship.
- digikata 13y ago
  Preferred pricing for large employers, vs small employers, vs individuals never made sense to me except for private insurers to divide up groups to maximize profits. If insurers were simply trying to provide best-value, then every customer should be in the same risk pool and excess administration costs to create and apply different rules for different groups could be eliminated. Instead, all the private insurers create many groups with complex rules, different coverage levels, then have to administer all these slightly different rule sets. That complexity then has to be dealt with by everybody, the customer, the health provider, as well as the insurer themselves. Profits are possibly maximized but value provided to customers and society is destroyed. I think this is pretty much reflected in the roughly 2x per capita costs for private healthcare in the US vs costs for universal care in many other first world nations.
deleted 13y ago
[deleted]
incision 13y ago
Yes, I'd say it's a huge one, particularly if you have or are planning to start/extend a family. I'd be overjoyed my coverage as a "self-employed" contractor were nearly as straightforward and affordable as it was in my FTE days.
tptacek 13y ago
Anecdotally, when we started hiring for Matasano, availability of health insurance was the #1 concern we heard from candidates. It even beat salary. Also: I almost didn't get to do Matasano, because private health insurance refused to cover my wife and my daughter.
- digikata 13y ago
  Yup, changing jobs recently, trying to calculate pricing/coverage comparisons between health benefits took up more time than all the other negotiation/salary/vacation/etc aspects of the offer.
Matti 13y ago
Looking at the Nordic countries you might possibly make the counterpoint that publicly funded health care implies a taxation model that makes it economically unrewarding to become an entrepreneur.
- sethev 13y ago
  I've never understood this argument. Unless the marginal rate is actually 100% how does higher taxation cause business owners to want less money? This strikes me as employee (i.e. dollars for hours) thinking. If you had to work more hours to earn more than I could kind of see how a higher marginal rate would discourage you from doing that but the owner of a $5million/year business doesn't work 10 times more hours than the owner of a $500,000/year business.
  - nwhitehead 13y ago
    You're right to look at the marginal tax rate but you're not considering all the options available. For goods like a hamburger it's easy to see why a tax on hamburgers makes people buy less hamburgers. Hamburgers cost more with the tax, so you can save money by buying chicken nuggets instead. This doesn't mean everyone will switch to chicken nuggets, just that many people who slightly preferred hamburgers to chicken nuggets before the tax will now switch over and slightly prefer the chicken nuggets after the tax. For business and entrepreneurship the argument is the same. Increased taxes and other types of costs decrease the rewards so you'll end up with less of it. It's not that business owners don't want more money. It's that they are continually deciding between many options. For example, years ago I had to decide between going to graduate school, getting a job in industry, and starting a business. The tax and subsidy breakdown is drastically different between all three. Of course tax implications wasn't the biggest factor in my decision, but it mattered.
- nawitus 13y ago
  At least in Finland entrepreneurs are taxed less than many full-time employees. Corporations are taxed at a flat percentage (about 28% of the profits), while income taxes are progressive and up to 50%. In fact, your argument doesn't make much sense. High taxation doesn't logically imply that it's necessarily unrewarding to become an entrepreneur but rewarding to be a full-time employe. You can have high taxes for entrepreneurs and low taxes for employees, or high taxes for both, of low taxes for both, or high taxes for employees and low taxes for entrepreuners. A lot of high-earning individuals are actually using the lower tax rate of corporations to lower their tax rate. If you look at a graph of tax rate versus income, it slowly increases, but after about 60k/year it becomes possible to lower the tax rate using tax palnning. 1. http://liljat.fi/2011/04/isojen-puolueiden-aanet-menevat-kankkulan-kaivoon/kuva1/ http://liljat.fi/2011/04/isojen-puolueiden-aanet-menevat-kan...
tarikjn 13y ago
I am from France and moved to the US over five years ago. I have been altering between working for an employer and taking time off to work on my projects. Within the first 2 years, I realized how cumbersome it was to switch healthcare and be covered between jobs, so I signed up for a private healthcare at once. I chose to have a low general coverage but a good one for accidents, I pay $20-40 for a doctor visit, nothing for annual dental check ups. No vision or drugs coverage (what's the point, for expensive drugs, the same drugs from the same labs are still cheaper in Mexico than a good insurance copay, and I have 20/20 vision). My insurance has been $90 per month for the first two years and recently went up to about $110 per month. When working for an employer, they would sometimes pay some extra cash when denying their coverage, if they don't, just add their insurance but keep the private one. My understanding is that the PPACA will make the cost of those single payer insurances go up a bit.
- j2d3 13y ago
  That's great for you, obviously you have no documented chronic health conditions that would exclude you entirely from private insurance. Unfortunately for me, I do, and am considered uninsurable as am individual, leaving only employer sponsored group coverage as a viable option until next year.
  - mathgladiator 13y ago
    The really crazy thing is how hard it is to not to eventually have a chronic health condition given the typical american diet.
    - tarikjn 13y ago
      I agree, and when making the conscious decision to get a entry-level private insurance, I made the calculation that what I save on a lower price insurance I could use to spend more on healthier food, in addition of me being physically active, and in my 20's, which makes me a lower risk profile and try to take advantage of it. I also realize that as I get older, I will probably need to set more aside for health-related coverage.
  - 13y ago
deleted 13y ago
[deleted]
deleted 13y ago
[deleted]
stuntmachine 13y ago
This is absolutely true, and it's nice to see attention being paid to a problem that the tinfoil hat in me thinks might just still exist by design.
microcolonel 13y ago
You know, we could just stop messing with healthcare providers and insurers, and let them provide a worthwhile service rather than just a legal one. Oh, and try to shut down the FDA too, with all their liability fobbing and bias toward dangerous, old, and addictive treatments.
smokey_the_bear 13y ago
I recently set up group health insurance for my five person company. Before then we'd all been on individual plans. I felt really awkward making medical decisions for our employees. The HSA high deductible plan was the best option for my husband (co-founder) and myself, but I didn't know if anyone had any medical issues, or when they intended to start families. Also, we founded our company five years ago, and it was just the two of us for years. One of the things that kept us in California was that we had selected Kaiser health insurance, and it was unclear if we could get pregnancy coverage on another plan in another state.
stretchwithme 13y ago
Yes, if insurance had nothing to do with your employer, the employer would be easier to leave. Imagine if your house and car and food were all paid for by your employer. And with a tax subsidy that makes it seem cheaper to do it that way than pay for these things on your own. Yes, leaving an employer would be a complicated choice. I'm also not convinced employer insurance is the deal people think it is. When I left my last full time job and continued the insurance using COBRA, it cost me $400 a month. I think you wind up subsidizing everyone having a baby or that do have major health problems. I'm in my late forties and have a high deductible policy that only cost me $150 a month before Obamacare made it go up to $260. I don't see it as much of an impediment, even now. People can spend more on coffee. Granted, if you have poor health or a family, this can cost quite a bit more. But these things by themselves can often be a greater barrier to entrepreneurship than the cost of insurance.
- sliverstorm 13y ago
  Employer insurance probably isn't a mega steal, but that's why it's called a benefit, not compensation. It's very nice to have.
  - stretchwithme 13y ago
    eh. its oversold

62 points by ScottBurson 13y ago

+1 this research being done. When I bootstrapped Parse.ly by doing consulting in 2009/2010, my biggest costs were rent and healthcare. I wrote about this in my blog post, "Startups: not for the faint of heart". http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-heart http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-h... To get a good "sole proprietorship" plan for me cost >$1,100 a month. My healthcare cost nearly as much as my rent in Astoria, NYC. I've spoken to many budding entrepreneurs in NYC, and they have told tell that the loss of an employer-provided healthcare plan is a major factor that stops people from quitting their jobs to start a company.

mgkimsal 13y ago
was this just for yourself, or a family? $1100 seems steep - a 'high deductible' HSA plan for a single person should be < $500/month - it's currently < $350 for two of us.
- riggins 13y ago
  was this just for yourself Might be NYC. I can tell you individual plans in NY run $1,500/month.
  - rdl 13y ago
    Why is NY/NYC health insurance 5-10x what it is in WA/CA?
    - bbanyc 13y ago
      New York state law requires strict community rating, which means that an insurance company must charge the same prices to all customers. Elsewhere people with known health problems are charged higher premiums to cover their higher health costs. In New York that's illegal, so instead everyone is charged high premiums.
      - rdl 13y ago
        Do people move/select based on this? I don't know if $1k/mo difference is enough to get people to move, since NYC is expensive (and thus obviously attractive to account for that). It would be an interesting study -- moving cities or states is way easier than countries.
- mjn 13y ago
  When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible) for less than ~$400-500/mo. There were plans cheaper than that with no drug coverage (starting around $200), but that leaves you on the hook for unlimited liability if you end up needing an expensive prescription (and some can be very expensive). I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end.
  - mgkimsal 13y ago
    It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)
    - mjn 13y ago
      My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
- deleted 13y ago
  [deleted]

sitkack 13y ago

Yes, and duh. Corp provided health insurance means the employer controls the labor liquidity, not the employees. The hypocrite Republicans should have loved to offload the cost of health insurance onto the taxpayer, not the corp. But the power of employee control even trumps direct bottom line profits. Wal-Mart gets it, that is why it encourages employees to seek public assistance and pays them so little that they still qualify.

brm 13y ago

Yes. It's a hindrance to most life paths that don't involve full-time employment. As someone with a chronic auto-immune condition I'm effectively tethered to an employer or a spouse if I want health coverage. Should I choose pursue an art as my vocation or start a company I'd have to be willing to endure a lag in my insurance until whatever I was pursuing became successful enough that I was eligible to be covered by a trade group or had enough revenue to buy health insurance. Guaranteed, affordable health coverage not tied to an employer or a spouse would remove a incredible burden from my life.

mjn 13y ago
Once the PPACA exchanges phase in next year, will that ameliorate the problems in your case? They seem like they target this case specifically, essentially trying to turn each state's population into a large risk pool that anyone can buy into, rather than having risk pools be employer-tied.
- jjoonathan 13y ago
  You beat me to it! (For those who don't know, the PPACA is sometimes called "Obamacare" although it should be noted that the name is more a result of political maneuvering than the result of particularly close affiliation with Obama.) I still think we should go all the way to single-payer. Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed (rather than the other way around). If the US health industry had to compete directly with any of these systems, it would go out of business tomorrow, since they offer similar care (in terms of outcome rates) at half the price per person. That doesn't even include the effects on entrepreneurship and employment! While the ACA did little to fix the "US health care costs twice as much and doesn't deliver better outcomes" problem, it does have a good shot at fixing the preexisting condition and individual insurance debacles.
  - mjn 13y ago
    I agree it's not really a proper solution. My move from the U.S. to Denmark has been smooth when it comes to healthcare; I've been very impressed at the lack of paperwork and lack of stress over my coverage. But nonetheless I grudgingly supported PPACA, despite it seeming like a mess, because I can't see another way to solve the tied-to-employers issue that's politically feasible, at least for now.

bit_genesis 13y ago

This had a huge mindshare for me when deciding who to approach as a co-founder. While I'm younger and incredibly healthy, my ideal co-founder is 9 years older than me and spent much of his 20s as a semi-professional athlete. It's catching up to him now. After I approached him, I brought up healthcare and that I knew it would be important to him and that we'd figure that out together somehow. We were both disappointed at how little healthcare reform shelters entrepreneurs. In the end, languishing at someone else's company, but insured, is not the way he wanted to spend his life. If he had a family, that might have been a harder decision to make.

vijucat 13y ago

The larger the employer, the better the deal they can work out with the insurance provider for their employees. This is definitely one of the reasons why jobs with IBM or UBS, say, are more desirable to most folks than the assured struggle called entrepreneurship.

digikata 13y ago
Preferred pricing for large employers, vs small employers, vs individuals never made sense to me except for private insurers to divide up groups to maximize profits. If insurers were simply trying to provide best-value, then every customer should be in the same risk pool and excess administration costs to create and apply different rules for different groups could be eliminated. Instead, all the private insurers create many groups with complex rules, different coverage levels, then have to administer all these slightly different rule sets. That complexity then has to be dealt with by everybody, the customer, the health provider, as well as the insurer themselves. Profits are possibly maximized but value provided to customers and society is destroyed. I think this is pretty much reflected in the roughly 2x per capita costs for private healthcare in the US vs costs for universal care in many other first world nations.

deleted 13y ago

[deleted]

incision 13y ago

Yes, I'd say it's a huge one, particularly if you have or are planning to start/extend a family. I'd be overjoyed my coverage as a "self-employed" contractor were nearly as straightforward and affordable as it was in my FTE days.

tptacek 13y ago

Anecdotally, when we started hiring for Matasano, availability of health insurance was the #1 concern we heard from candidates. It even beat salary. Also: I almost didn't get to do Matasano, because private health insurance refused to cover my wife and my daughter.

digikata 13y ago
Yup, changing jobs recently, trying to calculate pricing/coverage comparisons between health benefits took up more time than all the other negotiation/salary/vacation/etc aspects of the offer.

Matti 13y ago

Looking at the Nordic countries you might possibly make the counterpoint that publicly funded health care implies a taxation model that makes it economically unrewarding to become an entrepreneur.

sethev 13y ago
I've never understood this argument. Unless the marginal rate is actually 100% how does higher taxation cause business owners to want less money? This strikes me as employee (i.e. dollars for hours) thinking. If you had to work more hours to earn more than I could kind of see how a higher marginal rate would discourage you from doing that but the owner of a $5million/year business doesn't work 10 times more hours than the owner of a $500,000/year business.
- nwhitehead 13y ago
  You're right to look at the marginal tax rate but you're not considering all the options available. For goods like a hamburger it's easy to see why a tax on hamburgers makes people buy less hamburgers. Hamburgers cost more with the tax, so you can save money by buying chicken nuggets instead. This doesn't mean everyone will switch to chicken nuggets, just that many people who slightly preferred hamburgers to chicken nuggets before the tax will now switch over and slightly prefer the chicken nuggets after the tax. For business and entrepreneurship the argument is the same. Increased taxes and other types of costs decrease the rewards so you'll end up with less of it. It's not that business owners don't want more money. It's that they are continually deciding between many options. For example, years ago I had to decide between going to graduate school, getting a job in industry, and starting a business. The tax and subsidy breakdown is drastically different between all three. Of course tax implications wasn't the biggest factor in my decision, but it mattered.
nawitus 13y ago
At least in Finland entrepreneurs are taxed less than many full-time employees. Corporations are taxed at a flat percentage (about 28% of the profits), while income taxes are progressive and up to 50%. In fact, your argument doesn't make much sense. High taxation doesn't logically imply that it's necessarily unrewarding to become an entrepreneur but rewarding to be a full-time employe. You can have high taxes for entrepreneurs and low taxes for employees, or high taxes for both, of low taxes for both, or high taxes for employees and low taxes for entrepreuners. A lot of high-earning individuals are actually using the lower tax rate of corporations to lower their tax rate. If you look at a graph of tax rate versus income, it slowly increases, but after about 60k/year it becomes possible to lower the tax rate using tax palnning. 1. http://liljat.fi/2011/04/isojen-puolueiden-aanet-menevat-kankkulan-kaivoon/kuva1/ http://liljat.fi/2011/04/isojen-puolueiden-aanet-menevat-kan...

tarikjn 13y ago

I am from France and moved to the US over five years ago. I have been altering between working for an employer and taking time off to work on my projects. Within the first 2 years, I realized how cumbersome it was to switch healthcare and be covered between jobs, so I signed up for a private healthcare at once. I chose to have a low general coverage but a good one for accidents, I pay $20-40 for a doctor visit, nothing for annual dental check ups. No vision or drugs coverage (what's the point, for expensive drugs, the same drugs from the same labs are still cheaper in Mexico than a good insurance copay, and I have 20/20 vision). My insurance has been $90 per month for the first two years and recently went up to about $110 per month. When working for an employer, they would sometimes pay some extra cash when denying their coverage, if they don't, just add their insurance but keep the private one. My understanding is that the PPACA will make the cost of those single payer insurances go up a bit.

j2d3 13y ago
That's great for you, obviously you have no documented chronic health conditions that would exclude you entirely from private insurance. Unfortunately for me, I do, and am considered uninsurable as am individual, leaving only employer sponsored group coverage as a viable option until next year.
- mathgladiator 13y ago
  The really crazy thing is how hard it is to not to eventually have a chronic health condition given the typical american diet.
  - tarikjn 13y ago
    I agree, and when making the conscious decision to get a entry-level private insurance, I made the calculation that what I save on a lower price insurance I could use to spend more on healthier food, in addition of me being physically active, and in my 20's, which makes me a lower risk profile and try to take advantage of it. I also realize that as I get older, I will probably need to set more aside for health-related coverage.
- 13y ago

deleted 13y ago

[deleted]

deleted 13y ago

[deleted]

stuntmachine 13y ago

This is absolutely true, and it's nice to see attention being paid to a problem that the tinfoil hat in me thinks might just still exist by design.

microcolonel 13y ago

You know, we could just stop messing with healthcare providers and insurers, and let them provide a worthwhile service rather than just a legal one. Oh, and try to shut down the FDA too, with all their liability fobbing and bias toward dangerous, old, and addictive treatments.

smokey_the_bear 13y ago

I recently set up group health insurance for my five person company. Before then we'd all been on individual plans. I felt really awkward making medical decisions for our employees. The HSA high deductible plan was the best option for my husband (co-founder) and myself, but I didn't know if anyone had any medical issues, or when they intended to start families. Also, we founded our company five years ago, and it was just the two of us for years. One of the things that kept us in California was that we had selected Kaiser health insurance, and it was unclear if we could get pregnancy coverage on another plan in another state.

stretchwithme 13y ago

Yes, if insurance had nothing to do with your employer, the employer would be easier to leave. Imagine if your house and car and food were all paid for by your employer. And with a tax subsidy that makes it seem cheaper to do it that way than pay for these things on your own. Yes, leaving an employer would be a complicated choice. I'm also not convinced employer insurance is the deal people think it is. When I left my last full time job and continued the insurance using COBRA, it cost me $400 a month. I think you wind up subsidizing everyone having a baby or that do have major health problems. I'm in my late forties and have a high deductible policy that only cost me $150 a month before Obamacare made it go up to $260. I don't see it as much of an impediment, even now. People can spend more on coffee. Granted, if you have poor health or a family, this can cost quite a bit more. But these things by themselves can often be a greater barrier to entrepreneurship than the cost of insurance.

sliverstorm 13y ago
Employer insurance probably isn't a mega steal, but that's why it's called a benefit, not compensation. It's very nice to have.
- stretchwithme 13y ago
  eh. its oversold