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Is employer-based health insurance a barrier to entrepreneurship?

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Re: Is employer-based health insurance a barrier to entrepreneurship?

#41
post #23

Earlier quoted context omitted.

What is the answer and is there anywhere in the world that it's currently functioning?

I'm kind of fond of Singapore's health care system... http://econlog.econlib.org/archives/2008/01/singapores_heal.... http://blog.jparsons.net/2009/08/why-singapores-health-care-...

Me too, but it's government run... Seems like your previous statement would preclude you from liking it.

Re: Is employer-based health insurance a barrier to entrepreneurship?

#42
post #24

Earlier quoted context omitted.

I don't want to sound like I'm attacking you, but the fact that you were able to start a company without providing health insurance or a salary sufficient to buy it individually is itself a problem. If your employees got sick, it would be spouses' companies or the public that would shoulder the cost. The drag on entrepreneurialism would significantly heavier if companies and individuals weren't allowed to freeload.

No one forced the employees of his company to apply. There should not be restrictions on companies like this. I don't even think there should be a minimum wage. If the employees are walking in the door, and asking for a job, then it's their choice whether to take it or not. When you raise the minimum wage, or require the employer to provide health insurance, you are closing the door on many potential employees and de…

He's not talking about unfairness to the employees in this case, but to third parties who are neither the employer nor the employee. If a company doesn't offer health insurance or a salary sufficient to buy private coverage, then what happens when one of their employees gets seriously ill? Generally they will still receive some care (at least in serious enough cases), so someone has to pay for it. It will be either: 1) a different company, indirectly via their health insurance package, which covers the person in question as a spouse or child; or 2) hospitals or the government, if a patient ends up going to the ER and receiving care they can't pay for.

Re: Is employer-based health insurance a barrier to entrepreneurship?

#43
post #22

Earlier quoted context omitted.

But they don't want to replace it with anything other than everyone buys their insurance on the open market if they want coverage, which is why unions are against it. If they wanted to move to a full coverage system (single payer?), unions would be happy because everyone has healthcare.

No, they wouldn't be happy with that... they would get waivers from the single payer system... just like 650 of the 773 ObamaCare waivers currently go to unions.

This list does indeed appear to be a veritable who's who of the president's campaign supporters. Seems hypocritical to me. If it's good enough for the rest of us, it should be good enough for them too.

http://www.hhs.gov/ociio/regulations/approved_applications_f...

Re: Is employer-based health insurance a barrier to entrepreneurship?

#44

Earlier quoted context omitted.

No one forced the employees of his company to apply. There should not be restrictions on companies like this. I don't even think there should be a minimum wage. If the employees are walking in the door, and asking for a job, then it's their choice whether to take it or not. When you raise the minimum wage, or require the employer to provide health insurance, you are closing the door on many potential employees and de…

He's not talking about unfairness to the employees in this case, but to third parties who are neither the employer nor the employee. If a company doesn't offer health insurance or a salary sufficient to buy private coverage, then what happens when one of their employees gets seriously ill? Generally they will still receive some care (at least in serious enough cases), so someone has to pay for it. It will be either:…

Exactly. Unless you're going to allow people to die in the waiting room at the ER because they don't have insurance, someone is bearing the cost of treating the uninsured. It's either a spouse, the government, or everyone else who has insurance via higher premiums.

Re: Is employer-based health insurance a barrier to entrepreneurship?

#45
post #22

Earlier quoted context omitted.

The Republicans have been trying to kill employer based health care forever... it's the unions responsible for it.

But they don't want to replace it with anything other than everyone buys their insurance on the open market if they want coverage, which is why unions are against it. If they wanted to move to a full coverage system (single payer?), unions would be happy because everyone has healthcare.

I don't think unions would be necessarily happy with single payer- I wouldn't be surprised to see most (non-public sector, at least) unions cease to exist before long if single payer becomes a reality. Negotiation of benefits is one of the few valuable roles unions play these days, outside of political lobbying for the assumed goals of their constituents. Which is arguably part of the problem.

Re: Is employer-based health insurance a barrier to entrepreneurship?

#46

Earlier quoted context omitted.

I haven't done so, but have done a fair bit of investigation. The most technically correct answer I can give is that it depends on where you're going and how you leave things in the US. First, where you're going. You obviously want to go somewhere with better healthcare than the U.S., which isn't all that difficult to find. The ? becomes what your obligations will be as a somewhat permanent resident and how you can m…

$92,900 in 2011 http://www.irs.gov/businesses/small/international/article/0,...

Considering that's a large salary in many first-world western-european countries, it's probably only a follow-on consideration (ie, GP-comment's hypothetical striking it rich in Singapore).

Furthermore, at that point, you will most likely be able to shelter your income anyway by putting it into a corporation, and you shouldn't be worried about striking it rich abroad.

Re: Is employer-based health insurance a barrier to entrepreneurship?

#47

Earlier quoted context omitted.

No one forced the employees of his company to apply. There should not be restrictions on companies like this. I don't even think there should be a minimum wage. If the employees are walking in the door, and asking for a job, then it's their choice whether to take it or not. When you raise the minimum wage, or require the employer to provide health insurance, you are closing the door on many potential employees and de…

He's not talking about unfairness to the employees in this case, but to third parties who are neither the employer nor the employee. If a company doesn't offer health insurance or a salary sufficient to buy private coverage, then what happens when one of their employees gets seriously ill? Generally they will still receive some care (at least in serious enough cases), so someone has to pay for it. It will be either:…

The costs incurred by people not paying for their medical services are relatively small, less than 5% of all health care costs.

A much bigger issue is higher insurance premiums due to unhealthy lifestyles.

Preventable poor health due to obesity, poor nutrition and lack of exercise are a major contributor to health care costs.

That results in higher costs for everybody.

As a healthy, fit, non-smoker and non-drug user, why should I have to pay their costs?

Re: Is employer-based health insurance a barrier to entrepreneurship?

#49
post #24
post #6

During our initial phases we lost a potential hire that we really wanted because we just couldn't afford to offer health insurance. They ended up taking a job with a similar startup in Toronto. We had our first hire leave primarily because we couldn't offer health insurance. I'm happy that we're in a place that we can offer those benefits now. Getting through those first couple of years was really tough. If my wife d…

I don't want to sound like I'm attacking you, but the fact that you were able to start a company without providing health insurance or a salary sufficient to buy it individually is itself a problem. If your employees got sick, it would be spouses' companies or the public that would shoulder the cost. The drag on entrepreneurialism would significantly heavier if companies and individuals weren't allowed to freeload.

> "I don't want to sound like I'm attacking you, but the fact that you were able to start a company without providing health insurance or a salary sufficient to buy it individually is itself a problem."

There is a big difference between financial compensation and offering health insurance for entrepreneurs. Startups frequently pay low salaries (ones that may not support the high cost of health insurance) in return for an equity stake that offers the possibility of a high future payout. You cannot similarly defer health care benefits: when cash is tight, you either offer costly benefits at the expense of other priorities or leave your employees without health insurance. This tradeoff is not present if the insurance system isn't employer-based.

Of course this is only part of the explanation for how our system impedes entrepreneurship. One way or another, we're all paying an absurd amount just to keep us (somewhat) healthy.

http://andrewsullivan.theatlantic.com/the_daily_dish/2011/02...

Re: Is employer-based health insurance a barrier to entrepreneurship?

#50
post #10

This grumbling keeps coming up here, so I just have to ask: how feasible is it for a young American like me to just pick up and leave for a place that does have a sane health care system, and work on whatever I want? As far as I can tell, these places tend to have fairly steep immigration/visa hurdles to overcome, usually involving some kind of employer sponsorship (presumably to deter freeloaders?). If anyone here h…

I don't know about going to europe, but going to Canada is not impossible. It isn't an open door - you need skills and/or a job offer, or you need to be in school. However, once you are there, you can apply for your health care card immediately. Some provinces have premiums - around $50 a month IIRC, which are waived if you are a student or make under a certain amount.

Note that the "free health care" only covers doctor and hospital visits/procedures. It does not cover dental, optical, or any medications. Like in the US, any Canadian employer will offer a benefits plan to cover these things, or you can purchase insurance for them on your own.

This is a trade-off though. There is not much of a startup scene in Canada. The few "major" tech centers are really weak compared to most US cities. There is not much innovation. How many tech startups can you think of that came out of Canada? They do exist, but the deck is clearly stacked against them. On the other hand, there is less competition for funding, so maybe you can use that as an advantage. I am sure you have read the PG article about why your city matters.

I've lived in both countries, and people in both get a "grass is greener" viewpoint (aside from the too-proud patriots on either side). It is easier to see the things you don't have and want, rather than the things that you do have and would miss.

My personal opinion is that the US is more extreme in all directions. Higher highs and lower lows. Crazier crazies. Except weather. Canada is cold :) But it depends what you want to do, and what will best cater to your needs.

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