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Comment by uuilly | Hacker News Reader

I paid $60 a month for catastrophic healthcare from State Farm when I ran a ramen profitable startup. My deductible was $1500. When I nearly cut my toe off walking on a beach, I had surgery, $1000 worth of antibiotics and two follow up visits. I paid a grand total of $1500 for everything. I know I'm a healthy young man, but that seemed like a pretty fair deal to me.

Amazingly this plan will soon become illegal for being too minimalist under the new healthcare laws. I get that there are real problems with healthcare in the US. But entrepreneurs are mostly healthy young men, and it doesn't cost much to insure healthy young men.

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I know your point was specifically about young men, but this is one of the things that keeps women from doing startups. I'm young, healthy, female, and doing a startup, but one of my major concerns was finding a health care plan that would eventually cover maternity. Prior to the health reform law, if I'd developed any kind of condition I wouldn't have been able to switch plans, and even if I did, they often don't cover maternity for the first year.

I could afford to pay the costs of a normal birth, but my nephew's cost $300,000.

So you're comfortable pushing those costs onto healthy young men?

In Norway healthy young men make the most money, so they pay the most taxes. Essentially it's a lot harder to get super rich in Norway, but then again it's a hell of a lot harder to become super poor. We find that if everyone is moderately rich things work fairly well.

Edit: And there would be very few healthy young men if there were no healthy young women giving birth. Just check out Japan.

I don't know anyone who would mind pitching in a bit for a pregnant woman with complications.

I can't imagine that many ramen profitable founders would prioritize the finances of pregnant women over the finances of their company.

You don't know anyone who would admit to minding, true.

And you're comfortable with a system of laws that preempts women from doing start-ups? For one, that seems like it's not going to lead to good outcomes - it's in the country's and the world's best interest to have all capable young people able to be entrepreneurs.

Second, of course I'm comfortable subsidizing women, young people, poor people, and other groups, because I view the world in a Rawlsian fashion. That is, it is just chance that I am a healthy, young, and relatively wealthy young man. But if I were a woman, or an immigrant, or subject to any other set of circumstances, then I would want the same opportunities as anyone else.

As for the specific case of whether or not the healthcare laws should provide a way for all women to safely and affordably make babies - then I would say a hearty yes to this too. And as far as I can tell, this law benefits men and women equally. Unless there is a test tube involved, all babies need a man and a woman, so I really can't see how healthcare coverage for pregnancies has a sexist bias.

I hope you enjoy your youth and health, but when you get sick or old, I think you'll change your tune.

I don't think founders should concern themselves with fixing the inequities of the world. And I think it's in society's interest to place as little burden as possible on people who make goods or provide services that improve productivity.

I also don't think that you should presume to know anything about what my future tune may be.

'will not pay for' is not the same as 'law preempting' and countries don't have 'best interests' only people do, so speak plainly: you see greater financial equality as a good thing.

Insurers who share your philosophy would drive men away. So you advocate market-meddling as the solution. Which adds regulation, compliance, bureaucracy, etc, costs that are pushed onto everybody.

OR realize that women marry men (and thus buy share insurance). OR charities exist to support single mothers. OR they can use contraceptives --- unless you're arguing that women have a right to take risky business ventures while pregnant on other peoples dime.

Straw man. By buying health insurance as a healthy young man you are essentially voluntarily taking on those costs.

It is not a question of whether she wants others to fit the bill for her medical expenses, but whether society as a whole decides to accept an amount of responsibility for the health of its people.

You are only voluntarily taking on those costs because of threats of violence against anyone who would give you the opportunity to purchase insurance without those costs.

Insurers have been completely willing to sell maternity-free insurance, at least until men with guns threatened violence against them for doing so. It's not exactly voluntary when threats of violence eliminate all competing alternatives.

(As of 2014, it's not voluntary at all.)

Maternity is a ridiculous thing for insurance to cover, since it's an event entirely under the control of the insured. Similarly, you can't buy life insurance which covers suicide or fire insurance which covers arson committed by you.

Extremely expensive pregnancies are an insurable risk, but standard pregnancy is not.

Brilliant! You're saying we should set up healthcare laws so poor people don't have children.

While you're at it, let's completely fall down this slippery slope, and not insure people who smoke, people who play dangerous sports, or people who travel to countries with high rates of infectious disease.

Let's craft a healthcare system with all sorts of incentives not do things that might make perfect sense, and one that punishes all of people's foibles.

I'd love to fall down your slippery slope, and either not insure or charge very high rates to people who deliberately put their health at risk.

In general, a good regulatory scheme internalizes externalities (i.e., make polluters pay for the pollution they cause). If we force people who take care of their health to subsidize people who don't, we are externalizing an internality. That's the opposite of what good regulations should do.

If we're going to internalize externalities, men who get women pregnant should pay for half of all of her maternity-related healthcare expenses, and for half of the income she would have made if she hadn't had a kid. Do you agree?

I totally agree that smokers and daredevils and adventurers should have to pay higher insurance rates. But making women pay more simply because they get pregnant when they have sex without birth control (or their birth control fails) seems to be punishing them for being born with the wrong set of organs. Pregnancy is a much bigger deal for women than it is for men, yet men have at least as much agency in the process of causing a pregnancy.

I think the big issue is you're conflating healthy people with people who take care of themselves, and sick people with those who don't. There's certainly a correlation there, but there are a lot of sick people who are sick simply because of bad luck. I, for one, wouldn't like society to turn its back on me if I got too sick to work. And I would happily subsidize unlucky sick people in exchange for the promise that I'll get covered if I get sick.

If we accept the legality of abortion [1], then no - men should be able to terminate their rights/obligations within 3-9 months of discovering the pregnancy for a lump sum payment equal to half the price of an abortion. Equal rights and all that, right?

I'm not conflating anything. I'm distinguishing insurance from redistribution. Insurance protects you from bad luck - it just doesn't force other people to pay for your choices.

Raising the price of insurance based on people's choices protects them from bad luck while forcing them to pay the average cost of their choices.

[1] Which I do, but only until the baby grows a brain. Not going to debate that here.

[2] Again, insurance which covers the normal cost of maternity. Insurance which covers maternity costs in excess of 3x (or some such multiplier) the cost of a normal birth makes perfect sense.

Similarly, you can't buy life insurance which covers suicide

In the US your life insurance will pay out in the event of suicide after two years but not before.

> But entrepreneurs are mostly healthy young men

Could this be at least in part a self-fulfilling prophecy? Due to the way healthcare is set up in the U.S., the only people who really can consider quitting their jobs, and losing their group-health plan as a result, are: 1) people who are already rich (or have rich family); and 2) healthy young men.

edit: Actually, I suppose people over 65 also can, due to the U.S.'s strange age-based national health system. But people over 65 tend not to be likely startup candidates for other reasons.

"Could this be at least in part a self-fulfilling prophecy? Due to the way healthcare is set up in the U.S., the only people who really can consider quitting their jobs, and losing their group-health plan as a result, are: 1) people who are already rich (or have rich family); and 2) healthy young men"

Health care is a small part of it. The other part is that once you have a stable income and a family (wife+kids), most people don't want to take the risk of losing that income because the risk will have lasting effects on their entire family. When you are young and have no dependents, you can take this risk.

This is why you should get your company started first..and then settle down with a wife+kids.

Or go gay. You know. Either/or.

Serious point though: It's relatively easy to take risks on your income when you're half of a DINK family.

Being gay no longer automatically avoids the married with kids & big expensive house problem, at least not in Silicon Valley.

I'd have figured closet marriages would be less common now, especially in the bay area, excepting senators/televangelists I suppose. Or are you referring to adoption? Ugh kids.

The "need to support a family" argument may explain why founders are young men, but not why they are young men.

But entrepreneurs are mostly healthy young men, and it doesn't cost much to insure healthy young men

You're begging the question. Perhaps healthy young bachelors are the ones quitting their jobs to make the next social-coupon-micro-dating websites because they are the only ones who aren't constrained by the factors we're discussing.

That's debate in the US - everyone just says 'what is good for me'. The point of the article is that in Norway, the evaluation of 'what is good for us' works for them suprisingly well and doesn't stop people from starting businesses.

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