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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?

#61

Post by EiZei »

dnautics wrote: post #56
Loic wrote: 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…

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? 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 going to get. Why should I be forced to pony up for other people's healthcare, too?

Don't you think that your argument might be somewhat flawed if the most plausible scenario you can come up with is this?

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

#62

Post by dangrossman »

dotBen wrote: post #52
jonknee wrote: post #16

Earlier quoted context omitted.

Not if you have an employer. The deduction is for self employed people.

which begs the question, if your company is so small that you can't offer health insurance, 401(k), etc then what is the point of having your employees salaried. You might as well have them as contractors so they can enjoy the maximum tax write offs (health insurance, %age of their home as office, all hardware and software, %age of electricity, internet, etc).

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.

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

#63

Post by abalashov »

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 improbable tragedy, it's as good as not having a policy at all. The charges are simply passed through to me unadjusted. And when you have a policy like that and run into a large claim (say, a $90,000 hospitalisation with an acute condition), you have a fairly high chance of being denied a claim on the basis of a "pre-existing condition" or some other reason they will find to try to deny your claim. Insurers have entire departments just to deal with disputing large claims. Much of the Obamacare "pre-existing condition" legislation doesn't apply to this scenario, or grandfathers in policies written in prior years.

An actually decent policy - some kind of low-deductible, high-choice PPO plan - is just absurdly expensive from an operational expense drag point of view, even for an ostensibly healthy 25 year old.

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

#64

Post by natrius »

Experimentalist wrote: post #59
lawnchair_larry wrote: post #54

Earlier quoted context omitted.

Some governments are good at running some things. The US government seems to screw up everything. I don't know why this is, but if public health care ever becomes reality, and it is anything like the DMV, or any government services in California for that matter, or VA hospitals...may [deity] help us all. I am in no way a fan of the perverse incentives created by a for-profit private health care system, but I am worri…

What wrong with a for-profit system? There should be MORE profit, not less. High profits attract entrepreneurs to compete for customers by offering lower prices and innovating - consumers benefit. The current system is the exact opposite - there is relatively little and uncertain profit (and high barriers to entry) in insurance and hospitals, and a ton of government interference and regulation. Few entrepreneurs want…

What evidence is there that few entrepreneurs want to get involved in hospitals? Here's some evidence to the contrary:

http://www.bizjournals.com/houston/news/2011/01/18/emerus-ho...

http://www.emerus.com/

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

#65

Post by Vivtek »

dnautics wrote: post #56
Loic wrote: 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…

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?

The capacity to observe reality?

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

#66

Post by wisty »

gamble wrote: post #44
_delirium wrote: post #42

Earlier quoted context omitted.

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.

Generally, that cost is much higher. US hospitals can only treat uninsured people who are on death's door, which is ridiculously expensive. Treating people before they need emergency treatment is much cheaper. Or you could be really hard-line, and just let them die if they can't pay for treatment.

Reality, you already have socialised care. It's just really inefficient. And you pay extra for private cover!

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

#67

Post by athst »

I certainly think so - I'm in the process of quitting my job to work on a company, and the health insurance will be my biggest expense other than rent and food. If it was more affordable, I could survive a lot longer without running out of money.

Also, if you're starting a company, you shouldn't even consider not having health insurance - while expensive, at least there is a limit to the downside. Without it, your potential downside is almost unlimited.

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

#69

Post by scraplab »

axod wrote: post #68
jonknee wrote: post #23

Earlier quoted context omitted.

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

The UK health system is absolutely fantastic FWIW.

+1 - it's fantastic. The thought of being freelance/starting a startup whilst having to pay health insurance is terrifying.

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

#70

Post by marknutter »

sammcd wrote: post #4

I remember an episode where this american life explained why health insurance came to be like it is. I was specifically interested in the fact that they said during WWII wages where not allowed to increase, so the only things that employers could increase were benefits. This was the biggest factor in making Health Insurance employer-based.

Ah, the law of unintended consequences.
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