[jusben1369]

I'm 100% with you. When I left my job to do my startup to maintain my health plan at current levels was $1400 per month. That's $18,000 or so a year pre tax dollars. Basically the first $25,000 a year you pay yourself is going to just having healthcare! Assuming you want a decent plan. When we were 4 people all making just enough bootstrapping before we raised 35% of our costs went to healthcare. It was never raised much if at all during the HC debates but affordable, company independent healthcare should make a meaningful difference to how many people take a chance.

[mcdougle]

I grew up with parents who worked in healthcare (my dad, specifically, has a ton of connections within the health and life insurance industry), I've sold health insurance, I now have a full-time job in a hospital system, and I'm working on launching a health insurance-related product (to augment Obamacare benefits for small businesses) and I can tell you, they didn't touch on many of the most important issues in the industry today.

I'm not going to criticize Obamacare, but there are a bunch of things they could've done that would've been easier to implement and easier to understand that would've fixed the system! For example, get rid of the PPOs and give the "discount" they provide to everyone. PPOs provide no real value and have basically stuck themselves in the middle of the transaction and inflated costs, which inflates insurance premiums. Getting rid of them would immediately reduce costs quite a bit and make healthcare (and, indirectly, health insurance) much more affordable.

I guess the politicians wouldn't outright get rid of a whole sector of an industry, though, which makes it harder...

When I sold health insurance, one of the things we would often suggest is, if possible, to get a cheap policy with a high deductible and simply put the difference into an emergency fund until you can cover the deductible. This gives you access to the PPO, so you can pay the reduced rates (which are actually quite affordable if you make a decent income!) if something happens, while making the whole thing much more affordable.

[ridgeguy]

The politicians can't get rid of the PPOs, even if they wanted to. Politicians have to get (re)elected, which takes increasing amounts of cash. No cash, no office. If you're out of office, you're out of power.

The PPOs have very large revenues and therefore wield great power in determining the outcome of any move to reduce their influence.

This is regulatory capture by economic interests that don't provide value in the health care service chain. It's making health care more expensive for everyone.

[atomi]

PPOs are the only way right now to get all health care providers to compete for patients.

disclosure: I'm for a single payer system that allows everyone to choose their preferred provider.

[steveplace]

Yup. If you're young and fit, you don't need coverage for diabetes. A high deductible with a cancer/accident supplemental will be 30% the cost of a more normal plan.

[logicalmind]

Same here. I've been a developer for years and as I've transitioned jobs I've met a number of really good developers. Any time an idea arises that would make a tempting startup I reach out to people I've worked with to solicit the opportunity to work on it together. Every time I've done so, the inevitable decline always has something to do with healthcare.

Once you're beyond your post-college years and have a wife, and possibly children, the risk of a startup suddenly includes the cost of healthcare and risk of not having any. All of us can make comfortable salaries and have money to take risks on our dreams and be protected from failure by incorporation. But that does not translate to the potential medical issues of yourself or your family which would lead to personal bankruptcy and future employment issues.