Is Employer-Based Health Insurance A Barrier To Entrepreneurship? (2010) • Hacker News Board

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

#11

Post by mjn » Sat, Aug 10, 2013, 6:00 PM UTC

jjoonathan wrote: post #8

mjn wrote: post #5

Earlier quoted context omitted.

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.

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 (rat…

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.

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

#12

Post by incision » Sat, Aug 10, 2013, 6:14 PM UTC

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.

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

#13

Post by tptacek » Sat, Aug 10, 2013, 6:17 PM UTC

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.

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

#14

Post by Matti » Sat, Aug 10, 2013, 6:23 PM UTC

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.

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

#15

Post by Daniel_Newby » Sat, Aug 10, 2013, 6:23 PM UTC

jjoonathan wrote: post #8

mjn wrote: post #5

Earlier quoted context omitted.

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.

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 (rat…

> Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed ...

The British NHS discovered that by not feeding hospitalized patients they could realize tremendous savings in food, shortened length of hospital stay, followup costs, etc.

> half the price per person

Health care spending will dramatically increase under Obamacare. Americans spend a lot on health care as a lifestyle choice. Obamacare is nothing more than an attempt to recreate the housing bubble using health care.

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

#16

Post by tarikjn » Sat, Aug 10, 2013, 6:29 PM UTC

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.

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

#17

Post by sethev » Sat, Aug 10, 2013, 6:29 PM UTC

Matti wrote: post #14

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.

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.

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

#18

Post by tocomment » Sat, Aug 10, 2013, 6:33 PM UTC

Daniel_Newby wrote: post #15

jjoonathan wrote: post #8

Earlier quoted context omitted.

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 (rat…

> Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed ... The British NHS discovered that by not feeding hospitalized patients they could realize tremendous savings in food, shortened length of hospital stay, followup costs, etc. > half the price per person Health care spending will dramatically increase under Obamacare. Americans spend a lot on…

That sounds interesting. Can you explain more about the bubble angle?

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

#19

Post by riggins » Sat, Aug 10, 2013, 6:36 PM UTC

mgkimsal wrote: post #6

pixelmonkey wrote: post #2

+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-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 t…

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.

was this just for yourself

Might be NYC. I can tell you individual plans in NY run $1,500/month.

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

#20

Post by nawitus » Sat, Aug 10, 2013, 6:37 PM UTC

Matti wrote: post #14

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.

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-kan...