It's a problem with "Health Insurance in the US" as opposed to Obamacare.
I do advise that people not write-off criticisms of ACA as right-wing hysteria right now; the 2017 increases are really unbelievable in many states (Minnesota: 50%+). Everyone can browse these rates online.
The right-wing hysteria part is the (false) idea that premiums didn't go up like this pre-Obamacare, as well as the idea that "roll it back" is a tenable solution.
http://www.latimes.com/business/la-fi-obamacare-premiums-201...
> A new analysis from the Urban Institute found that the average unsubsidized premiums in the Affordable Care Act exchanges, commonly known as Obamacare, are actually 10% lower than the full premiums in the average employer plan nationally in 2016.
http://www.newsweek.com/fact-check-trump-clinton-claim-obama...
> According to the Kaiser Family Foundation the average cost of the second lowest priced silver metal plan, also known as the benchmark plan that is used to set subsidies, will see its price increase 9 percent next year. That's significantly higher than the 2 percent increase for these plans this year, but it's south of the figures provided by Trump.
Its absolutely silly we still tie retirement accounts and healthcare to employers.
Donald Trump's platform would actually allow individuals to take the same tax deductions on health insurance that companies get: https://www.donaldjtrump.com/positions/healthcare-reform
"Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn't Congress allow individuals the same exemptions?"
John Mackey had a very rational proposal as well: http://www.wsj.com/articles/SB100014240529702042514045743421...
"Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair."
"For the 2016 tax year, overall employer plus employee contribution limit is 100% of compensation with a maximum of $53,000"
Otherwise I believe it's a pretty good place to start a company. Our income taxes are equivalent to California and I believe our corporate taxes are lower but we have health care and relatively cheap housing downtown thanks to a housing development boom.
We also have a startup founder visa and an easier immigration policy. Access to seed capital and higher-end talent is the only constraint.
By contrast, Berlin seems to be doing fairly well, despite a language barrier (for English speakers). Israel (Tel Aviv) as well.
The specificity of high tech to the SF-SJ region is curious.
So why isn't Europe an entrepreneural juggernaut? Tech scene in Europe seems worse than the US IMO.
We should be hanging the people that caused this, but we're too nice and we won't until it all ends up like Venezuela.
That said, there's much more to "entrepreneurship" than tech startups! Opening your own restaurant - not a chain franchise - is entrepreneurship, too. Or a barbershop, or making custom clothing, or running a small theater, or any number of other things. Small business is mostly small, not a stepping stone on the way to being huge.
In those terms, is the US actually doing better than Europe? Do entrepreneurs - not the millionaires, just the people who don't have to answer to anyone but themselves - do better here, or in Europe?
At the time, I was 29 years old and spent about as much money on insurance as I spent on food. It was my single biggest expense after rent.
The ACA was flawed from the start. My takeaway from the whole fiasco is that even the smartest, most well-educated policy analysts and lawmakers can allow some combination of enthusiasm, politics, and momentum to blind themselves to the most basic predictive models of human behavior and incentives. When the law was published it was obvious to me how insurance companies would make money - you create the narrowest, cheapest network possible in order to cherry-pick the healthiest patients, leaving competitors dumb enough to have broader (more attractive) networks to soak up the most expensive cases (and lose money). This is exactly what happened and the so-called ''death spiral'' will start next year when (my prediction) 1+ million unsubsidized middle class families refuse to pay for the next round of rate hikes.
I'm 100% for free, universal health care for all Americans. I don't think we're that far away. The bemused Federal Reserve searches for helicopter drop scenarios - Federally-funded (or re-insured) universal health care is not a bad option. I'd much rather bleed out the treasury in order to build a great health care system than in the middle east or some other boondoggle.
edit: spelling.
It may not have been cheap, but it was cheaper than the "insurance" I as a 37-year-old perfectly healthy individual am now paying. >:(
I mean before Obamacare.
Everyone in the working class in the US is a single major medical event away from bankruptcy, insurance or not.
One angle of the employer-based system is the "healthy worker" effect. It's almost impossible to answer questions such as "is working in a plutonium factory bad for your health?" because almost any population of workers is healthier than the average population because less healthy people don't work.
Not exactly. Obamacare has other provisions that make this much worse. For example, Obamacare only allows insurance companies to charge older people at most three times as much as younger customers.
"But it’s worth noting that prior to 2014, there was no federal standard in terms of how rates could vary based on age. It was common for health insurance companies to charge older applicants five or six times a much as they charged younger applicants." [1]
This is a way of subsidizing the old (a better organized interest group), but it makes health insurance massively less cost effective for younger customers.
[1] https://www.healthinsurance.org/faqs/why-would-congress-let-...
It may seem like a tax on working people, but really, it is a payment for a very real benefit: a dramatic change in your personal healthcare risk. When you can purchase health insurance at any time even when you're unhealthy, you are essentially being granted an insurance policy for expensive, chronic conditions without even having to purchase anything.
You must mandate participation through payroll taxes, but also ensure services can be affordably provided to participants. Insurance companies are still raking 20% off total premiums paid; that's money that could go directly into providing care.
No, most of productivity growth in industrialized countries arose from economics of scale from multinationals.
Its the same for China, Germany, South Korea, Japan, Soviet Union ...
Countries do not industrialize due to small business and entrepreneurs - regardless of much the average american likes to think that is true.
You do this by making 'basic insurance' something everyone has, and a negotiating pool that more or less dutch-auctions per market with the practitioners. You might also include quality control measures like allowing patients to see any doctor they prefer from within the list (of doctors that met the group bid rate), and also allowing criminal mal-practice but not financial liability as a means of stripping titles from those who should not practice medicine. (The liability would be implicitly recognized as social; no big payout, but what life there is that is left you would be some degree of retired.)