Tell HN: The disparity between employees and international contractors

Sorry that happened to you. My family is dealing with multiple health issues too.

It might help if we know the country. Even US based contractors need to buy their own insurance. That's part of why contractors usually get a higher rate. $110k USD is likely to be a very large amount in your country, as it about 150% the median household income in the US.

> Sorry that happened to you. My family is dealing with multiple health issues too.

I'm sorry to hear that. What's worrying you the most at the moment with relation to the health issues?

> $110k USD is likely to be a very large amount in your country, as it about 150% the median household income in the US.

It is a very good income for this part of the world, and also a good income for the US as you say. While higher pay can get you part of the way, there's some things that it can't get in my experience. For example, if I take out private health insurance at Allianz, it doesn't cover pre-existing conditions. Company-sponsored health insurance does usually cover pre-existing conditions.

"I'm sorry to hear that. What's worrying you the most at the moment with relation to the health issues?"

The usual- costs, coverage, quality of life.

Are you sure nobody will cover it pre-existing? I saw Cigna has an international plan that might. It's likely the premiums will be very large. Maybe medical tourism could help with costs, like in Thailand.

On a side note, maybe it's possible to manufacture the drug yourself? I mean, what will the company do - sue someone who's already broke from paying for the meds?

I guess the other option is to find a different job, with a local company, that will provide insurance.

> The usual- costs, coverage, quality of life.

I don't know what you're going through but I feel you, stay strong. Yesterday the stress and anxiety built up to a point where I had to let it out and cried a bit. It's a cycle that repeats every couple of weeks. I'm thinking about getting in touch with a psychologist, I don't want to develop depression or anxiety issues.

> I saw Cigna has an international plan that might.

I'll look into that, thanks for the suggestion. I'd researched a few and their reps told me they wouldn't cover pre-existing, but I hadn't looked at Cigna.

> On a side note, maybe it's possible to manufacture the drug yourself?

Kadcyla is the drug, by gut tells making it myself is not a viable option for a number of reasons.

> I guess the other option is to find a different job, with a local company, that will provide insurance.

Local health insurance companies don't cover oncology drugs. Also, they pay 4x less than what I'm getting now (I'm in a small South American country).

Oh yeah, that's an antibody drug, so probably not a good chance of manufacturing it.

Good luck!

I am sorry for your misfortune, but I believe this to be misdirected.

(1) Employers offering Healthcare options to employees is more of a failure of the healthcare system in the US than a positive employment perk.

(2) Your company chooses the Healthcare provider they partner with. You are likely ineligible to be covered by their provider.

(3) Contractors do not get benefits. This has nothing to do with you being international. If you were based in the US, you would not be provided with Healthcare either.

All contractors in every country all over the world do not get employee benefits and is more or less the definition of being a contractor.

Either you are mistranslating some words, or seem to be missing some valuable pieces of information that is making you conflate all these variables.

It does bother me quite a bit though that you signed a non-compete agreement, as you typically only see this with employees.

(1) This is not enforceable (assuming of course you aren't reusing their work for other clients)

(2) As a contractor you are running a business. You are responsible for taxes, paying your salary, insurance, and Healthcare.

(3) Another company cannot dictate how you run your business. You can grow your business, take on new clients, do whatever you want.

It sounds like you need to do either one of two things.

(1) Start running your contractor setup more like a proper contractor shop. Get advice from here about expanding your business.

or

(2) If you really want to be an employee of a US company you can ask if they will sponsor you for a visa.

Hopefully my response has not been too direct, but I do think you need to get out of this mindset of thinking you are an employee. You are a contractor, and should be able to leverage the benefits of that. Most notably the larger incomes contractors demand for the simple fact they have so much more overhead to run their business.

Businesses in turn are happy to pay inflated contractor costs because it means they do not have to provide them with benefits like insurance.

These are two different ways of working and should not be equating them as you seem to be.

If you really want to be an employee, pretty much the only options are asking them to sponsor you for a visa, or getting them to open a branch office in your country.

I hope this gives you some thoughts to push things in one direction or another, and I hope that things turn in your favor this year.

Thanks for this, it's given me food for thought and options to explore.

> Employers offering Healthcare options to employees is more of a failure of the healthcare system in the US than a positive employment perk.

I think this is a failure in many countries including the one I'm in. Employee-sponsored health insurance seems to be the best workaround.

> Your company chooses the Healthcare provider they partner with. You are likely ineligible to be covered by their provider.

Fair, my employer's health care partner probably can't insure people outside the US. There are new health care providers that cater for remote companies and their employees [1] but I don't have a good understanding of how good their offering is.

> Contractors do not get benefits. This has nothing to do with you being international. If you were based in the US, you would not be provided with Healthcare either.

Good point. I'm not sure if my employer is treating me like an international contractor though. I have a boss, don't get overtime, can't work for other clients, signed a non-compete, etc.

The latter part of your response is fair. I think I got the mindset that I'm a de facto employee. I work on a team where everyone else is an employee and I don't seem to be treated differently. Here's where I think I need to explore alternatives and see what my options are.

[1] https://safetywing.com/remote-health

> I have a boss, don't get overtime, can't work for other clients, signed a non-compete, etc.

When you are a contractor you don't really have a boss. You have clients, you need to start getting yourself in this mindset, even though the end result ends up being more or less the same.

So again, no boss, but you have a representative from the company that you have a contract with that is your liason and the person that is giving you the work. You need to keep them happy like a boss, but they are not your boss.

You don't get overtime from the company because you are not an employee of theirs, you are employee of your own contracting business. It is up to you whether you pay yourself overtime or not.

Whether there is money available for this or not in the contract depends on how you negotiated the contract.

Regarding not being able to work for other clients, this is just not true. You are your own business and you can take on all of the clients you please. The documents you signed are meaningless and do not hold any water. Of course if you do take on work for other clients, you do not need to let your current customer know unless it will materially impact them in some way.

> I work on a team where everyone else is an employee and I don't seem to be treated differently.

This is normal for contractors. You work alongside regular employees and everyone is focused on the same goal. The only issue is that you need to not think of yourself like an employee. You work for yourself and you create the rules around how you operate your business.

I think what you need to do more than anything else is to talk with other contractors about how they deal with clients.

Get better information about how long they take contracts for, how many contracts they take at once, how they negotiate prices with prospective employers and what formulas they use to factor in external costs, ask them how they budget the money for their operations, how far they plan ahead, ask them how they do their own healthcare.

You need to take your business to the next level, and currently you seem to be allowing a customer to drag you around by the shoestrings to do whatever you want.

It's time to start setting some better rules around how you operate, instead of just going with the flow.

I believe getting this advice from other people who are currently do this is probably the best way to start.

I think I've got a better picture of what you're saying: start thinking and acting like a contractor and treat my client as just that, a client.

Before I got this client I was earning 33K USD a year (high for my country). When I got this job offer I asked for a figure - despite my best efforts for them to give me one - and they came back with an offer of 20% more. Of course I was over the moon so didn't consider how competitive my salary was. I figured I'd easily get any health insurance I wanted for me and my family. Fast-forward one month and we have the cancer diagnosis and the bills start coming in.

I will look into this topic with other freelancers. I need to find out freelancers hang out online and learn from their experience.

You've been a great help, I appreciate the time you've put into these responses.

What country?

I'm in a developing country in South America. I'm avoiding mentioning it by name since my acquaintances are on here, it's a small country, and I want to stay anonymous.

You're making a lot of money... if it's Uruguay, it's unfortunate but yeah, most coverage excludes oncological drugs and public healthcare is also very backed up.

Not sure if you'd have a better outcome in the US, if anything you'd be WAY poorer.

A friend whose wife had cancer ended up going to a Sao Paulo clinic.

It is a lot of money here. The sad thing is that very few people here can pay for cancer treatment. They're literally playing lottery because if they have an expensive medical emergency, there is never adequate health insurance. Most people have to do a fundraising drive to get money for stents and things like that.

What I found was that there is proper healthcare here, but it is all out of pocket. Only accessible if you can pay for the oncology drugs from the pharmacy that imports it from the US.

Otherwise you form queues waiting and waiting for the government to get hold of the drugs (it almost never does) and waiting for them or repair their radiation machines which are always broken.

I've thought about the São Paulo option and got in contact with a hospital there Sírio-Libanês.

It appears from that we'd need my family member to relocate there though, since chemo treatments are usually ongoing for years at a time.