I keep paying my health insurance premium at my home country just because the health insurance in the US is completely broken. I feel that if you get seriously sick in the US you're in an almost sure path to financial insolvency.

My employer pays probably a shit ton of money for my health insurance and what I get is the most subpar, confusing, broken and sometimes blatantly extortive service ever.

I live in Austin and sometimes I think if I really need a major procedure it would be just simpler to drive to Mexico and get it done there. In fact, that's what many people in South Texas do, so there's your benchmark for how broken is healthcare in the US.

This is an interesting idea. Is this an unintended consequence of binding health insurance to your employment?

According to the NYT: "During World War II, federal wage controls prevented employers from wooing workers with higher pay, so companies started offering health insurance as a way around the law. Of course, this form of nonmonetary compensation is still pay. When the war ended, the practice stuck."

I would much rather have a system where I was paid more and got to choose my health insurance provider. That way I could keep my insurance when I change jobs or if I wanted to freelance.

I run a company that helps software engineers find contract work, and the #1 question we get is "how much should I charge?". The #2 question is "what do I do for health insurance?"

It would seem like businesses brought this on themselves by offering benefits to get around compensation limits imposed by the government. Or you could say that this was caused by the government imposing limits on compensation. Super interesting to think that the root cause of our current problem could have been created 80 years ago.

It's not. That issue is tangential at best. If it was the crux of the issue here, you'd see many more companies going belly-up rather than pay for health insurance.

For this change, companies like Uber and Lyft will have to completely reorganize their internal systems, ranging from their relationships with drivers to their tooling for organizing their drivers.

They say things like "passengers would experience reduced service, especially in suburban and rural areas" when what they really mean is "lyft would have to pay drivers to be available in that area even when demand is low, and Lyft doesn't want to pay drivers to idle in low demand spaces". There are various solutions to this, but they would all cost Lyft and Uber money, and heaven forbid they not be able to pass those expenses onto others, such as drivers that would hang around those areas _without_ any compensation.

The real heart of the matter here is that 10 years ago Uber disrupted the taxi industry. Now that they're the incumbents, changes like these put Uber and Lyft in a position to be disrupted by newer companies that more easily adapt to regulatory changes, or possibly the taxi companies they disrupted a decade ago. What we're seeing now is Lyft taking drastic measures to try and enrage the public against these policies.

This is a kid throwing a tantrum because they aren't getting cake after refusing to their chores.

Health insurance is a major component. However, the broader theme is the offloading of risk from the company onto their workers, including not only health risk but also for example, accident risk.

Most rideshare drivers are not properly insured — while passengers are well-covered, the drivers and their vehicles are not. Because the drivers are contractors and must navigate the insurance system as individuals, many do not possess adequate knowledge and statistically speaking, a large number are guaranteed to make mistakes when purchasing coverage.

If drivers were employees, then accident coverage for drivers and their vehicles becomes the responsibility of the rideshare companies. There would be fewer bad outcomes for drivers, but because the rideshare companies would bear greater risk, their profits would be reduced.

A lot of these issues would go away if employers weren't responsible for providing healthcare group plans. But then again Europe also has similar drives to classify Uber/Lyft drivers as full time employees so they are entitled to other benefits and employment securities (but those don't exist in a very strong form in the USA anyways).

I think you can employ W-2-style employees without providing them healthcare. It’s a perk, but not legally required to have a W-2 employee.

I think the heart of the issue is the entirely artificial split between the concept of employee and contractor. (Much like the arbitrary split between taxi and car service in nyc.)

Making everyone a contractor for every job, with the terms of the job specified in the contract, seems much more straightforward. I don’t think that the concept of “employment” needs to be one size fits all, like standard W-2 is today in the US.

It’s an artifact of tax law, the scam that is withholding (make most people not “feel” their taxes), and a dominant manufacturing economy model that no longer exists in the US.

Also poor mass transit.

Not just healthcare- but other beenfits like sick leave, etc. and collecting taxes like unemployment insurance. When you do this -you better not leave any loopholes because companies have proven they will use it. IF Uber was successful, other companies would start fractional hiring of employees. I only need Finance people 2 days/week- they can come in anytime they like, work as long as they want and can work at other companies too. We'll save on taxes and benefits and they will enjoy their freedom. Too bad the Govt will lose taxes and the workers their benefits.

I don't think that changing driers to employee status will necessarily give them health benefits. I'm not an expert, but while ERISA generally requires uniform benefit options for all employees in a similar class, the companies could chose to not schedule the drivers as full time employees, use contract labor services, raise the employee contribution to unaffordable level, etc. Many companies with large numbers of employees have large fractions of their employees without health insurance (Walmart, for instance).

This is why I think it was a mistake for the ACA to limit catastrophic care to people under 30 (unless you get a hardship waiver [0]). That policy makes the cheapest non-job insurance that a lot of people can get cost >$500/month, whereas a catastrophic plan costs a lot less (about $120/month when I had such a plan in 2016).

For a lot of people who drive Lyft, catastrophic care could be a good fit, e.g. people in between jobs who expect to have a company plan at their next full-time position. This wouldn't entirely close the gap towards providing gig workers with benefits, but it would have helped.

There's also people for whom Lyft is a second job -- I'm thinking of a ride with a Chicago public school teacher who drove on weekends and breaks -- and I don't think it makes sense to force Lyft to provide them with insurance.

[0] https://www.healthcare.gov/health-coverage-exemptions/2019-e....

You are not nuts.

not just healthcare. sufficient income to support the basics of survival in our society are tied to full time jobs as well.

companies and their employees would both be better supported if we established a Universal Basic Income.

A fact that will not change for the next...idk ten years.

Yes this is a shitty patch job at best. It’s going to restrict individuals and not even solve the root issue.

I think the heart of the issue is VC-backed startups trying their hardest to circumvent laws until they are big enough that enforcing the laws makes people mad.

Both parties have supported Fed leadership that relied on worker insecurity to keep people in their jobs:

https://www.nytimes.com/1997/02/27/business/job-insecurity-o...

America does not have a stories history of being labor friendly. It’s pretty much old European pissing competitions imported anew after WW2. Identity which the country had begun to schlep off between the Gilded Age and WW1. Refugees brought it back over.

The best part of all this is Adam Smith only ever mentions markets in the context of a free labor market, buoyed by government support of equality of condition.

But Smith and Aristotle, who wrote Democracy is likely the most moral government, are cast aside for James Madison who wrote the Senate ought to protect the rich from Democracy or the people will take all the aristocrats stuff.

This is all 2,000+ years old rhetoric. Human biology hasn’t evolved so fast in that time that such concerns of the past are rendered obsolete.

That would not be an issue at all if anticompetitive licensure requirements hasn't driven up healthcare prices to insane levels.

The heart of the issue is big labor unions want more power, and independent contractor status is a threat to their power.