Betcha there'd be even more freelancers and entrepreneurs if there was a reliable universal healthcare system.
Freelancing? It varies greatly country by country. Easy and cheap in the UK, Ireland, New Zealand, Australia. Difficult and expensive in Germany. Moderate in Sweden and Canada.
Freelancing population is growing globally.
Despite the word "socialism", most socialist and social-democratic political parties in Europe are not trying to replace the market economy with socialized ownership of the means of production.
https://www.weforum.org/agenda/2017/10/why-does-sweden-produ...
This is like saying the Libertarian Party is the third largest political party in the United States. Yeah, it's true, but...
I too relate this mindset to our safety net.
But: The upside of being employed is very little risk of anything and a lot of paperwork/bureaucracy is done for you (Healthcare, unemployment insurance, retirement, accidents, your taxes etc). You'll pay a hefty premium for being employed but then again most others do too. So going self-employed is not just a bad deal in terms of risk it is also bad in terms of non-income related extra-work you have to take on.
https://de.statista.com/statistik/daten/studie/38297/umfrage...
Even though we have universal health care it is not free and not paid from taxes but from individual direct fees. the minimum monthly rate is currently a whopping ~400€ (450$). They will decrease the minimum rate to 200€ next year.
Not a German national, so I'm happy to be corrected.
Kind of reminiscent of a lot of tax-scandals that come along regularly: Usually nothing illegal but because of well meant intentions created a complicated system, gaming the system benefits only those that are able to do so.
"Of the 1,167,978 employer businesses active in Canada, micro-enterprises (firms with 1 to 4 employees) constitute 54.1 percent of all private employers, which is the largest SME group."
https://www.ic.gc.ca/eic/site/061.nsf/eng/h_03018.html#table...
Canadians seem to distrust big companies more than Americans do.
I would point out the fragmentation of workers is multivariate far beyond just the single payer + single provider healthcare system .
Of course, some of Canada's globally renowned companies have faded too. Blackberry used to employ 14,000 people in Canada as recently as 2011, but they're probably about 20% of that size today.
There's not actually /insurance/ except for in the largest sense; it's more about health cost payment, cost control, and how badly individuals can be excluded or directly charged if coverage isn't required for all at the same input rate.
I am all for requiring everyone to be part of the same single coverage pool so that the costs of medical coverage in society are more fairly distributed across all. In that respect I also support /broad/ and /generic/ taxes on things that are known to be unhealthy; such as specific addictive recreational drugs. (For example, don't tax only soda, but it's OK to tax all drinks that aren't water.)
I'm freelancer full-time, I pay monthly to my insurance company and use healthcare services I need. Maybe I'm doing something wrong.
0 - https://www.aetna.com/individuals-families/buy-health-insura...
Yes, this is the most unsettling part. Even if we can afford to pay our own healthcare now, it's very difficult to predict how long we'll be able to.
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thanks for replies to all... It's pretty impressive and prices are really, really high.
Do you have a family? Health insurance prices are far, far higher if you have a family.
The type of coverage you can by as an individual is also inferior to those you get access to at large companies, so it can be harder to get in-network coverage.
Put simply: there's little incentive for health insurance companies to provide good service to individuals; there's lot of incentive to provide good coverage to company employees.
But even so, they'll be a middle-man and they'll try to take as much profit from the group discounts they get instead of passing those savings on. An employer doesn't have an incentive to make profit there.
The real answer is that they do exist. I used Oscar for a year and their plans were actually by either United Healthcare or Aetna (I don't remember anymore) and the premiums were less and the quality was identical to what I had through a company provided insurance later. There's also Justworks that does something similar, though they're more of a full HR service provider.
2. Year-over-year changes to costs and benefits are less predictable.
2b. Continuity of coverage may itself be at risk with pre-existing conditions returning to the political debate.
If you have basic, predictable medical costs — and believe that you will stay in that bucket — these concerns may not be very relevant to you.
But a lot of people don’t fall in that bucket or aren’t confident that they’ll stay there. For these people, this adds a big risk to venturing out as an entrepreneur or freelancer.
A wholly privatized, largely deregulated health care market is toxic to entrepreneurialism because of these risks.
This reminds me, when I was in college I had a pretty bad accident, but I had some college provided health care plan my parents paid for that covered it.
Even after being employed and having employer health care, I kept renewing it incase I had a longer term issue related to the accident that my new insurance wouldn't cover due to it being pre-existing.
In particular, I had to get a rod inserted into my leg, and thought if I had a problem with it down the line, it might get denied by my new insurer.
Is there any proof of this? What makes a country "Entrepreneurial"?
Except that the American health insurance market is both regulated in the extreme and, in the case of the extremely poor and the elderly, heavily subsidized by taxpayers as Medicaid/Medicare. I really don't know what the effects of a private, deregulated health insurance market would be because we're so far from that.
I think there may be good arguments for either free market health care or nationalized health care. But whatever this thing that we've got is, it should be burned to the ground.
As a single income parent, I'd probably not be seeking out employment that I was passionate about, and would stick with what's safe.
The Freelancer Union, mentioned in the article, seems like a good start. Could they collectively pool funds to get high-deductible coverage for ~$200 per month?
At age 33, I pay 30 USD per month for 100% coverage of any illness, up to 30,000 USD per year, which is enough even for cancer. That's in Hong Kong.
The only problem is American prices. Socialized healthcare is not needed as long as prices are reasonable.
If I was an American I'd probably just fly to Thailand for any serious health issues because the cost of flight ticket plus treatment would be significantly less than in the US.
It's the nature of corporations to maximize profit. That can be a good thing, but not when health and lives are at stake, which is something that lower class conservatives don't understand the economics of, and upper class business owners profit off of. It's an ugly emergent property of the system we've built.
> "If I was an American I'd probably just fly to Thailand for any serious health issues because the cost of flight ticket plus treatment would be significantly less than in the US."
What you're describing is called "medical tourism" and it is slowly becoming more popular in the USA but still a fairly niche and underground idea.
Agreed that medical tourism for general procedures is a great value for many Americans that can afford this alternative.
What exactly do you pay on Upwork?
I wonder more about the lower tiers.
https://www.consultancy.uk/news/18474/uk-has-2-million-freel...
Universal systems in fact can be a hindrance to freelancers. They are expensive, making it hard to make the first step, and the result is people go illegal or underreport their income.
Freelancers in EU: https://ec.europa.eu/eurostat/documents/4187653/7825811/IMG+...
Shadow economy in EU: https://thumbor.forbes.com/thumbor/1280x868/https%3A%2F%2Fbl...
Money is an easy solution because you can get a job and make money. And you can live below your means and build a savings. And if you choose to freelance or start a business at some point you can use that savings to get yourself started.
As far as hard vs easy problems, health insurance is relatively easy because, for the most part, if you buy a reputable health insurance plan you're good. Obviously there's horror stories of people not getting the coverage they believe they paid for but generally it works as advertised. An example of a more difficult problem would be finding clients/customers. Even though you can pay money for leads/ads/content writers etc. you are not guaranteed a good client or customer. You can't directly pay for a good client or customer. You can directly pay for things that are likely to lead to good clients or customers but you are still going to have to work.
You can basically sign up for health insurance online and as long as you pay the bill there's no work involved. If you're setting out to WORK for yourself, and something that takes no work is stopping you, you don't really have the right attitude.
Also, if they have at least a minimal safety net and are not endangering their family, home, and bellies they will seek out work that is more fulfilling to them and therefore perform better.
Maybe it's because I work in the healthcare industry, but I don't see universal healthcare as having the same safety-net effect. Other than stabilizing prices, it would only be a situation where the healthy support the sick. That is not inherently a bad thing, but needs to be recognized that way.
Why not? People work shit jobs solely for health insurance. People need healthcare and will do demeaning, exploitative things to get it. We should aim to decrease exploitation of people and having something along the lines of Medicare for all or single payer insurance would accomplish that goal.
> Other than stabilizing prices, it would only be a situation where the healthy support the sick.
Sounds like insurance. Mutual aid ought be a founding principle of any society.
The fact that the US has the same principles already in place (MedicAid, MediCare, veterans...) shows that it is not a matter of your society's helpfulness but a matter of your society's institutions that block reform out of self-interest.
Americans really need to decide if people's medical costs should be shared, or if it's every man for himself.
Lack of supply of providers or fraudulent billing by providers is a separate cause of increased insurance premiums, but I don't see what ACA has to do that, and if anything, healthcare spending increases are slowing down since the passage of ACA, and premiums are even decreasing in many parts of the country.
My original response was to your claim that freelancers were better off in pre-ACA times, to which I wanted to point out that was only because people with pre-existing conditions were denied insurance. Nothing in ACA has caused the amount paid to providers to increase.
Fun fact: in 2011 nearly half of the US population had a preexisting condition that would have affected pre-ACA medical underwriting.
https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-...
This is not the profile of freelancers and entrepreneurs, and especially not the profile of the most qualified contributors to an entrepreneurial market.
As you get older, you get more experienced and better networked, which can yield the best opportunities for freelancing and entrepreneurialism. But you also accumulate dependents, medical conditions, and risks of the sams. All of thess were grossly penalized pre-ACA, to the point that many would-be entrepreneurs and freelancers wouldn’t be eligible for coverage at all.
Pre-ACA, I was denied coverage at 30 with a wife and kid, with no pre-existing conditions and from the same companies I had health insurance from when working fulltime. This was in 2011, it was scary and I felt the system was broken. I was healthy and had no idea why it happened, both BCBS, Aetna and other large private insurers hate individuals and small companies because they group by company not across everyone and individuals are riskier to them with that system. Aetna and BCBS are employer focused rather than individual/consumer focused.
Post-ACA pre-existing conditions are covered and everyone has to be approved for coverage, breaking healthcare from employers as the customer and making them focus on consumers is key and ACA started that movement and better private markets even if it was a rocky start.
Healthcare is the riskiest part of freelancing/contracting and now at least you can get it guaranteed with ACA.
If we removed it from employers entirely and made individuals/families the customers rather than get it through the job, it would help people change jobs, start businesses, travel, reduce ageism and allow us to compete better with countries that do have single payer/universal or healthcare not attached to employers over consumers, it may also fix pricing when it is closer to the consumer or there is a public Medicare for all option for competition that the individual can choose.
Employers don't want to pay for healthcare and people shouldn't want employers knowing their private health, nor choosing the service for them. Employers don't get your auto or home insurance, nor should they, why healthcare?
Private insurance or public options like Medicare for all will make business easier and healthcare more consumer focused, it is a pro-business way to set it up, right now we have anti-business healthcare legacy systems and it is making US companies less competitive because they are expected to offer it. They can pay more for employees to go get their own, they don't need to choose and manage it. That will also help reduce the 'real compensation' parasitic leech that healthcare costs are hiding under, sucking up raises and wage increases into 'real compensation' for healthcare benefits rather than actual wage increases.
At a macro level, everyone would be served better by healthcare where the consumer/individual is the customer focused on, not some deal with large employers where they are the customer. That current setup in healthcare purposefully tries to exclude people who are individuals, smaller businesses or other due to broken grouping that insurers use. We'd be better served by large groups across all ages, conditions and states, that would truly be insurance, more like auto insurance which is not bound to employers.
We don't get our auto or home insurance from employers. Why do we get the most private of insurance, healthcare, from employers? It is a legacy broken system that most of the world has moved on from. Benefits are one thing, pay is another, but healthcare should not be provided by employers as it leads to broken fixed pricing between large insurers, medical suppliers and the consumer is considered last if at all, leading to the worst pricing fixed market maybe in history. If you support entrepreneurs and small business growth, the engine of America, you'll come around.
https://wire.ama-assn.org/ama-news/growth-health-spending-sl...
Also, regarding out-of-pocket spending: https://www.bloomberg.com/opinion/articles/2018-01-04/out-of...