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Comment by Justsignedup | Hacker News Reader

How about health insurance not being tied to profits. Startups pay the full brunt of health insurance since they don't have real profits they have nothing to write off. Meanwhile large orgs get to write off a ton of profits as Healthcare costs for employees.

So startups tend to have real garbage insurance. As someone older with kids startups are getting more and more prohibitive because I need that Healthcare. Maybe startups should be a young man's game. Maybe not.

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Radical suggestion (maybe I'm too British): health insurance not being tied to employment or work whatsoever?

Millions of us have been wishing for that our entire lives. We have about as much say in it as you do.

Here’s a radical suggestion: stop calling welfare-for-doctors insurance. If you want insurance, those are known as major-medical policies under which the sniffle visits are still the patient’s responsibility — just like how insured car owners pay for their own oil changes.

With “health” “insurance,” neither side has price sensitivity. Patients ask whether it’s covered and if so, back the truck up to get as much as possible. Physicians see enormous pots of money in tax-favored plans and seek to scoop out as much as they can. The inevitable result of such an awful system — that traces back to workarounds on executive pay limits imposed during the FDR administration — is unbounded price increases. Politicians scream about getting spending under control, and regulators impose rationing. This is a terrible system, but it’s a self-inflicted wound.

In the U.S., at least, we’re seeing cash-only practices become more common. Their fees are affordable because their customers pay out of pocket and because they don’t have to hire entire departments just to deal with “insurance” providers.

Take a look at Switzerland's medical system for how nationalized health insurance can work well. When the insurance system isn't privatized, it isn't for profit. This drives prices down to become affordable, even without insurance.

Just FYI, Switzerlands medical system is not nationalized. It is private and run for a profit (though there is centralized price setting for necessary procedures and basic insurance is mandatory and regulated well)

No one but the US considers Swiss healthcare to be affordable, and prices are certainly not being driven down. And as insurance is legally mandated, “even without insurance” is not something that can be properly evaluated here.

I am not sure where you got this info but it is very wrong.

Ding ding ding. You could fix our pricing woes practically overnight if everyone was put on a (very) high deductible plan.

What you are saying makes sense IN THEORY. however in practice in the US most people have the shittiest insurance, at the highest cost. A chunk of america doesn't have insurance and we all pay a lot extra for their problems, and a friend of mine is in the chunk who is taking medication he is alergic to, because the stuff he isn't he can't afford, and finally we have the wealthy who have the best healthcare in the world.

Insurance for an optional thing makes sense: You don't _have_ to drive (okay, I'm in NYC), but you can, and you need insurance if you do. And mainly its to cover damage _you_ do to others.

For health insurance. Everyone in the world will need healthcare. Period. The only exception is if you're super healthy and then get your head suddenly cut off and are dead instantly. Other than this one case, you will need health care. The problem is that in america, breaking your arm, or getting alcohol poisoning may bankrupt you. And as any doctor will tell you: An ounce of prevention is worth 2 in cure. Let people get treated before things get bad, and they can stay productive members of society. As John Oliver said "the national anthem should be people holding out their medical bills and complaining in unison, because it is the only experience that ever single american has in common"

There is no particular linkage between health insurance and profits. Small businesses such as early-stage startups tend to have worse and more expensive employee health plans because they lack the scale to go self-insured or to negotiate lower premiums with payers for fully-insured plans. Profitable small businesses face the same problem.

"Maybe startups should be a young man's game."

No. Anybody of any age should be able to take part in labor, otherwise you're arguing for ageism.

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