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Comment by MoreTuple | Hacker News Reader

Every person that I know that has considered starting their own business has decided against it for one reason only, health insurance. They have always been the obtainer in chief of health insurance for the family and it is too risky to go without. I strongly suspect that a public health option would blow the job market wide open between folks who want to retire but can't because health insurance is idiotically expensive and those of us who would love to start a business but cannot put a whole family at physical risk for a potential monetary reward.

I start a business means my present job opens up, as well as any additional hires my business would need. Jobs problem gone.

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"I strongly suspect that a public health option would blow the job market wide open ..."

Excellent argument for real reform to health insurance access.

Well, I learned the same logic in school. I found it compelling, too. And I guess I still do. Our teacher said: 'Because we have this safety net here in Germany, we can take more risks.'

Yet, I see more risk taking in the US than in Germany. I suppose, its rather that Europeans are less risk taking, so they also support a better safety net. I know its not my business, but I can't help being scared about the idea, that the most dynamic country in the western world might slow down because of copying Europe.

Israel has a German-like safety net (health, food, unemplouyment, training and otherwise), and more risk taking than the US - at least where technology is concerned (only silicon valley tops israel in startups per capita - even California does not). So neither explanation is good.

I think the difference is more cultural than anything. Making your own fortune is very much part of the American identity (from gold rushes to tech startups), whereas Europe has experienced over and over again that boundless ambition can lead to horrendous things (war, war, more war and genocide).

The US getting more universal health care coverage will not change that.

There are other ways to achieve the goal of breaking the link between employment and healthcare without a public insurer. Public insurers eventually become the predominant insurer by a large margin because they can use their size to obtain lower prices. Markets with few buyers or sellers are less efficient at providing the products people want at the prices they want than those with many. The result in this case would be less profit to be made in healthcare than people would be willing to pay for, so less effort would be spent to do so. Seems undesirable.

This is trending a bit off topic. Feel free to respond, but I won't.

Except that nations with socialized health care have single or few providers yet manage to get extremely low prices because they have the negotiation power of an entire nation behind them and lots of alternative providers.

Your theory may be interesting but is completely opposite from reality.

This is so true... if you don't have a spouse whose coverage you can utilize, the cost of health insurance is prohibitive, ESPECIALLY for anyone over 30 who has a spouse and kids. At that point going without insurance (as I did when doing a startup, and so many other entrepreneurs I've seen do) is not just risky, it's irresponsible and foolhardy. Taking financial risks to start a business is fine - but you shouldn't have to risk your health and your family's health.

If the government wants to see more people starting new businesses and taking risks, it needs to remove the HUGE disparity in healthcare costs between working for a large corporation and going solo. There's just no reason it should exist.

Out of curiosity, what is the large source of the disparity? I was aware you don't get as nice of a tax break (though that will become irrelevant when you are making no money). Individually, I'd be surprised if your family had to pay over $1,500 a month for everyone, which is pretty comparable to group rates.

It's not that uncommon for the employer to pay part of the group rate, as far as I can see.

Oh quite true, but then you can view it is salary. e.g. you aren't quitting a $80,000 a year job to do a startup; you are quitting a $100,000 a year job to do so.

(I find it hard to accept that a lack of free health insurance is keeping that many would-be entrepreneurs at their day jobs any more than a lack of free housing is. If you have some form of disease that keeps you from getting insurance, I completely sympathize (and I believe the health care law will solve that issue), but for most people it is just another cost to consider before leaving - like housing, transportation, etc.)

Housing and transportation can't bankrupt you (unless it is some crazy circumstance that is so rare that most people can't possibly fathom). You can walk away at anytime from your home or have your car repossessed. You simply cannot walk away from your chemotherapy unless you want to die.

If we can somehow find a way to rein in costs of health services (perhaps by disincentivizing supplier-induced demand through price ceilings in both malpractice awards AND gasp healthcare service price controls a la Singapore, Japan, or Switzerland), we can get further away from our dependence on large corporations to employ everyone.

IIRC employer-bvased healthcare in the US is more heavily regulated, and allows for coverage of pre-existing conditions and so on.

A friend of mine was considering dropping his current job and doing some contract work for a while. He has a wife and two kids, and was worried about insurance. He found that he could insure his entire family with a decent plan for about $450 a month (after spending a little time on http://ehealthinsurance.com/). Now, I'm not saying that's chump change when you're bootstrapping a business on no salary, but that's not insurmountable, either, given some up-front planning and saving.

Would a universal health care system make it even easier? Sure, no doubt. But I often hear that it's so difficult and costly to purchase individual health insurance, and that just seems to be untrue. Are there other factors I'm not considering?

These people either don't intend on being profitable in the next 18 months or else they didn't do their research.

If you quit your job, COBRA allows you to continue to pay 101% of the group rates for 18 months and keep your old insurance.

COBRA can be expensive. At my last job, my premium was around 60/month. When I quit, COBRA payments were 750/month. This was before kids.

Not everyone can afford the short term hit of paying 3-4X what they're paying now for their health insurance. If your monthly group policy is $1200/month for your family, but the employer's paying $800 of that, and you're only paying $400, you'll get quite a shock when the COBRA bill comes.

No one has to pay 3-4X what they're paying now for their health insurance. They have to pay 101%.

It's possible that they didn't understand the nature of their compensation, and mistakenly believed their compensation was lower than it was. But in that case, I'd suggest they simply failed at financial planning.

(Note: if you can't do proper financial planning, don't do a startup.)

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