It's a huge problem if you want to start a company. It's an even bigger problem if you want to hang up a sign and do business as a freelancer.

I agree with your point: the reason the country isn't completely behind health care reform is that they get it from their employer and don't understand how it works. Of course, they're also getting screwed financially in the process.

As others have said, it's a problem for anyone who wants to do work outside of the "middle class employment cocoon".

I'm self employed, and even if I go back to working for a larger company, I would prefer to continue to keep my private insurance. I have private homeowner's insurance. I have private car insurance. I have private life insurance. Why oh why do we demand/insist that employers provide health care, to the detriment of market forces favoring individual purchasing?

Conservatives in this country should be in an uproar that the 'free market' isn't allowed to run its course because of the combined interference of big business, big labor and big govt over the past several decades, but they're not.

> Conservatives in this country should be in an uproar that the 'free market' isn't allowed to run its course

Because unlike cars and homes you only have one life. If you let a profit seeking entity control and dictate what happens to your health, you might not have a chance to go back fix the problem by choosing a better one. You could be dead.

There was just recently a story on Reddit about someone who's relative a was killed by a driver and his dead relative' insurance company effectively provided council for the defendant. That's the kind of stuff you'd be dealing with. You health insurance company would be interested in killing you promptly as soon as you develop a chronic or expensive condition. And they'd all want to do it. All 1 of them after they merge into a giant conglomerate (since you know can't be messing with the free market and stuff, there will be nobody protecting against monopolies).

I agree, and I feel it used to work even better in that respect, when educated Americans typically had lifetime employment. I would guess that's one reason the debate is growing louder lately. The West basically solved the healthcare problem via collective coverage, but in different ways: the European countries did it nationwide, but the US did it with employer group plans. That was almost equivalent, for people with good jobs, as long as people stayed in jobs for life: having the IBM group plan was about as good as having state health coverage, as long as the IBM job was more or less for life.

It's more broken if you're middle-class-or-below (as you mention) or an entrepreneur who isn't either early-20s-and-healthy or raking in huge piles of cash. The part that seems most out of keeping with the American ethos is how anti-entrepreneur it is: you get good collectivized coverage if you work for IBM or Microsoft or Google (because it's socialized across their employee base), but if you start your own company or are trying to buy insurance for a 10-person company's employees, well then you're screwed.

It's not hard to get insurance for a 10 person company, but it is expensive.

Interesting. I mostly know people trying to buy individual health insurance, whose difficulty really varies, depending on age and health history. Is even a 10-person company big enough that buying it isn't a problem, if you're willing to pay the "10-person company" premium? In particular, do they inquire into the distribution of health among those 10 people? I would've guessed that if 1 of your 10 employees happened to have some disqualifying condition you'd be SOL.

Not entirely a theoretical question, b/c one of my friends has a congenital heart defect, and is himself not 100% sure how his condition would impact a small company. They aren't allowed to inquire into such things when hiring, but could it possibly tank their group health-insurance plan, if 1 of [small-N] members had a major preexisting condition?

You can get group coverage (by which I mean, "insurance plans in which individual members of the team will not need to fill out applications") for teams smaller than 10 people, but probably not much smaller.

In the US, group health coverage is distinguished in part by not "qualifying" patients, so that latter example doesn't really come up. There are horror stories about companies being forced out of their insurance plans by prohibitive cost spikes after major medical events, but I don't have any of them ready to deploy on this thread.

I disagree. It's really common for small software companies not to provide insurance, and of course anyone who wants to strike out on their own, either selling software or contracting, has to deal with the question. I would wager that the average programmer is more exposed to the problem of health insurance than the average.