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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?

#141
post #91

It hasn't been for me, but only because I (and other, likeminded people) have chosen to bank on the fact that we're relatively healthy so far--knock on wood--and chosen to forego it. I don't mean that I'm literally uninsured. I mean that I have one of those "catastrophic" high-deductible policies that so many young people are stuck with, so for any kind of routine procedures or office visits or anything barring an im…

If you have catastrophic you may as well be uninsured. Can you take a $10k hit? I'm guessing you can't.

Absolutely not.

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

#142
post #90

Earlier quoted context omitted.

It's not like you can just pick what to call them. An employee is an employee and a contractor is a contractor. If you want someone to work in your office 9-5 and commit their code changes to your server each day, they're an employee, and you can't call them a contractor.

I think you can actually. EDIT: What's with the downvotes? Companies do call them a contractor. It happens every day. They're are special concerns but they can certainly work 9-5, etc.

If you tell someone to come in to your office 9-5 and tell them how to do the work, they're an employee. If you call them a contractor, and the IRS audits you and talks to that person, they're going to fine you for all the unpaid payroll taxes you'll owe. These are words with specific definitions in the tax code.

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

#143

Earlier quoted context omitted.

Why don't you believe in a free market for health insurance? Forcing people to pay into a health insurance is kind of scammy - let's say that I have a genetic condition that is certain to kill me rapidly at age 30. I want to live my life to the fullest, and I'd rather not be forced to buy health insurance that protects me from things like adult onset diabetes, alzheimer's, cancer, parkinson's, etc, that I'm just not…

> Why don't you believe in a free market for health insurance? There are two main reasons. First of all, as someone mentioned it in another thread here a few days ago, healthcare does not follow the rules of supply and demand, since people would pay anything for survival. You're never going to say that "ah this treatment is a bit overpriced; I think I'll get more value for my money if I'll just die instead". It's rid…

While I agree with some of what you say, I take issue with the following:

> You're never going to say that "ah this treatment is a bit overpriced; I think I'll get more value for my money if I'll just die instead".

No one is rationally arguing this. The free-market point-of-view is that multiple providers will offer you treatment, and you can select, based on quality, price, provider's reputation etc. etc. what best fits your needs.

Over and over in this debate I see this fallacy that a free-market system says "You pay this price or you die." If a procedure can be made cheaper or more effective, a variety of providers is going to scramble to provide it.

The difficulty we face in the U.S. is that there is no real competition in healthcare. As others have pointed out, the people making the purchasing decisions are not the people with a vested interest in the affordability and quality of healthcare, and price/quality signals are obscure at best, and typically hidden altogether.

You, as a consumer, can't make rational healthcare decisions when your insurance is selected by your employer, your doctor is chosen by your insurer, and your treatment is chosen with an eye toward liability rather than effectiveness.

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

#145
Next time try posting links that doesn't need subscription - not all of us here are backed by institutions to read hacker news :-)

http://www.rand.org/pubs/working_papers/2010/RAND_WR637-1.pd...

(viewer: http://docs.google.com/viewer?url=http%3A%2F%2Fwww.rand.org%...)

(scribd: http://www.scribd.com/full/49777774?access_key=key-1z4k6uefp...)

Not as well formated as ScienceDirect (which is sourced from the Journal of Health Economics) but doesn't require a subscription.

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

#146
post #130
post #8

Answer: Hell yes. Self-insurance is absurdly expensive while group insurance outside of an employer or credit union is harder to find than a Republican with a conscience. The lie that "Obama-Care kills small businesses and/or jobs" is a smokescreen for the truth: Healthcare reform would free employees from indentured health care servitude and allow small businesses to hire more competitively, creating more jobs.

This comment is, unfortunately, an illustration of how sites go downhill. It has 19 downvotes, including mine. So how does it have so many points? Because it has twice as many upvotes. When badness arrives in online communities, it arrives first in forms that make people invite it right in.

Is there currently a way on HN to see upvotes alongside downvotes? If not, it seems like a worthy enhancement to me.

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

#147
post #96
post #51

For information, here in Germany, from where I run my startup which itself is a UK Limited, I provide my employees with full health insurance (teeth, sick days, everything), pension, unemployment insurance, etc. for basically €700/month for an after tax salary of about €2500/month. As soon as you start to factor in all the costs of insurance, etc., doing business in the old Europe is pretty cheap. Even in Denmark, wh…

what I don't like on european (interpolating from czech, but it's probably quite similar everywhere in europe) health and welfare insurance is that you generally can't opt-out from that. Complete opt-out is probably bad idea, but I would like to pay insurance only when I actually have income, not be obliged by law to pay what equates to half of my other expenses every month. It seems fair to me to roll these "insuran…

In Germany, Denmark and France (the only places I was employed for more than 3 years), if you have no incomes, you are automatically covered. Of course as a consultant, if you have no incomes in a given month, you still need to pay. If you do not want, you need to switch to officially unemployed for the month, which is not worth it.

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

#148
post #46

Earlier quoted context omitted.

$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.

It's a standard deduction, not taxable income. Having a salary less than that is only favorable to you as a tax payer.

Once you shelter into a corporation, how do you un-shelter? Assumption being that you do want to spend a little of it. You can pay it yourself via salary, or dividends. However, from income tax perspective it's all income anyways.

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