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Comment by cwyers | Hacker News Reader

> there isn't a whole lot of money to be made for corporations lowering the cost of healtcare.

I don't know if that's true. There are a lot of companies that would save money if healthcare was cheaper -- pretty much every company in America is a health-care consumer. It's just that benefits are diffuse and the downsides of lower-cost health care are concentrated.

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I think large companies love it the way it is. Healthcare being so tightly bound to employment makes it more difficult for employees to leave, which probably has a dampening affect on salaries. I haven't had to deal with it in a while, but getting healthcare for a small company ~10 years ago was a nightmare.

It wasn't too bad for us. We provide gold level healthcare for our employees (~20 FTEs). Companies like Zenefits (yes yes I know) and others have made it a lot simpler to get started.

Guessing you’re a tech company employing educated young single (low risk) workers?

Things look very different in other industries... not everyone gets the same price...

>>tech company

Nope.

>>not everyone gets the same price

I don't care about the price. I pay for insurance for my employees because it is the right thing to do.

The comment I am referring to is the nightmare of the setup, not the cost to me for providing the healthcare. And many middleware insurance navigators make it easy to provide it (at least for me).

As far as how much it costs me, whatever.

large firms would lose talent to smaller firms.

Then the smaller firms could be acquired. As it is, because of the slowing new-company generation, large firms have been getting fewer and fewer options. Small firms can take risks to create new products and processes which can then be acquired and taken up and expanded by large companies. Generally its much more difficult for a large company to do that creation part in-house. So insufficient small firms end up affecting the large-firm capability in the end.

Unfortunately this type of long term benefit for the large corporation doesn't affect the next quarterly report and is ignored in favor of more short term gains.

Productivity gains seem to be dropping and one theory is that companies are getting larger, but aren't able to pickup efficiency/new value generation boosts from acquisitions like they once were able to (at an economy wide scale, not talking about the acquisitions of any specific company or even sectors here). It is difficult to make any certain conclusions here though. But if true, they will have to care sooner or later.

Minor compared to the cost of funding health care

Exactly. Huge corporations would LOVE to push their health insurance costs to the taxpayers.

Maybe, but they LOVE the huge competitive advantage it gives them over smaller and more nimble firms nipping at their market share, because it's very onerous for small businesses to competitively offer health benefits.

I think they're afraid some of the cost would be dumped onto them.

I don't know about that. If your employer were to pay you more and you were to use your salary to buy health insurance, you'd be bumped into a higher tax bracket and you'd be using post tax money to buy the insurance.

It's not a long term benefit because the government should be able to lower taxes given the increased revenue, but you'd never look past the short term (and the government would never lower taxes).

Isn't YCs research arm looking into healthcare?

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