Hacker News Reader

Comment by SmellTheGlove | Hacker News Reader

You're a solid writer. I really liked the blog post.

Your definition of success happens to align with mine. I have "enough" right now, and I'd be really happy to work less and maintain my current income level - I just haven't yet been able to pull away from the corporate life. Eventually.

Anyway, had to ask, the one gap seems to be health insurance. I know you mentioned a cheap major medical policy, but what are folks doing to cover their families a little more comprehensively? At least in the US, this is the one big thing that makes it really hard to leave corporate life. I'm fortunate enough to have dual citizenship with a european country, so we could "just" relocate there, but ideally we'd do this while staying resident in the US. I still haven't solved the insurance issue.

View on HN

An individual policy isn't that crazy expensive. A single 20 year old guy can get a good plan for $200 a month. A family of 4 with parents in the 40s can get a good plan for $1500-$2000 per month.

Both are well within the realm of profits for a one man startup.

This must be the harsh side of the US. In Europe, the differences are almost neglectable.

Depends on where in Europe. Insurance isn't cheap in Switzerland, for instance, it's just that wages largely support the rates and individual subsidies will make up the rest. However, the Swiss system is probably the most portable to the United States, at least in the short/mid-term.

*negligible

Thanks

I'd encourage you to price out plans on your state's health insurance marketplace (every state has one thanks to the ACA).

You may find that the coverage you want is less expensive than you'd expect. For example, when I put in information for a family of 4 in California, "Gold" plans were between $850 and $1050 per month (and less if you qualify for a subsidy).

I did, it's about $1350/mo here for a family of 3. Deductible is still $2k on a gold plan. While that's not as bad as I thought, that sort of thing has to be a barrier to people with families considering taking a risk and doing a startup. Imagine if we had universal healthcare in this country...

We have universal healthcare in France and France isn't exactly buzzing with innovation. There is innovation, but there is more innovation happening at the Palo Alto Starbucks than in practically the entirety of France.

I'm not suggesting universal health care drives innovation. I'm suggesting that introducing it to an already innovative culture would serve as a multiplier of some kind.

Nonsense.

https://frenchinnovationweek-chicago.com/program-of-events/f...

I think you're romanticizing Silicon Valley. There's plenty of startups all across the world and there will likely be even more since we have such an anti-innovation administration now.

Here in GA I pay 1800 a month for a Bronze plan with 5k deductible. But we are older, so that might be part of it. Basically its catastrophic care, but since we are all healthy I serious wonder if it worth it.

I recently did this exercise, and the prices were much higher than they were 5 years ago when I was last self-employed. Searching for family-level marketplace plans.

Marketplace plans are very expensive and they are the only plans that carry the features of the ACA, e.g., coverage for pre-existing conditions. You can buy non-marketplace plans for much cheaper (about $600/mo for a family plan, in my case, which is more aligned with what I used to pay), but they will not have the features Obamacare mandates. This is a good option if you don't already have pre-existing conditions.

You can also check into freelance co-ops, which sort of function like a union, in that they negotiate group insurance plans, etc., on behalf of their members, providing more of the benefits of a traditional employment situation. I just started looking into these again too, so I don't know who is good for this right now.

To be honest it's worth pricing out whether expatriating to not-America is more cost effective than buying health insurance here.

> To be honest it's worth pricing out whether expatriating to not-America is more cost effective than buying health insurance here.

If I were to do a startup, it would be a no-brainer from a cost perspective to move, particularly because I already possess the requisite passports. It's just that I _want_ to be in the US, so any serious startup decision is going to presume that for me and my family.

In what world is $850-$1050 a month not expensive? That's a mortgage in most of the country, for which if you are healthy you get nothing at all in return (except perhaps peace of mind if you get in a car accident)

I've never shopped the ACA marketplaces since I have insurance through work. I'd hope they have an option like what I have from my employer: a high deductible plan with an HSA.

Insurance should be for unexpected large expenses. Not routine, predictable health care. Treat that like your your rent, groceries, etc. i.e. something you budget for.

What happens when you get diagnosed with a chronic health issue? The unexpected large expense of initial diagnosis and treatment might be covered but then your budgeted healthcare costs will barely make a dent in long term treatment. How do you cover a $15k monthly infusion? Or a $4k monthly pharmacy bill?

With the high deductible plan setting a ceiling on their health care costs, presumably. I'm not a fan personally but some people do a savings account to cover incidentals / the deductible portion.

Yeah, but that only works for a chronic issue that doesn't put you out of work. HDHPs are still on an annual deductible after all. I know I have a bit of a bias since it's my industry, but make sure to carry long term disability insurance if at all possible. Getting sick in this country is complicated when you really dig into it.

> Insurance should be for unexpected large expenses. Not routine, predictable health care. Treat that like your your rent, groceries, etc. i.e. something you budget for.

That's fine, budget for an annual physical and maybe a couple of sick visits. But that's not what's making people broke, and is not the risk people are concerned with. Unless you're young and healthy, there's very little that is predictable about health care. Also, HDHPs aren't available through the ACA market in every state - they're not in mine, for instance.

We need everyone in the risk pool, and we need to get costs under control. It is ridiculous that in the richest country in the world, someone could lose everything due to a medical condition. That's the wrong kind of lottery ticket out of the middle class.

individual and family plans aren't that expensive. have you actually priced it out? it's just a bill you get every month, like a car payment.

just be sure to buy the new health insurance before the old one expires. this is absolutely critical.

Reply on news.ycombinator.com