In my experience, as well as that of most of my friends, one of the most powerful reasons for working for a large organization is its health care plan. Big organizations, both public and private, usually have health insurance with coverage and prices that are unattainable by individuals. This is also one of the primary reasons why budding entrepreneurs decide not to take the entrepreneurial leap and go it alone. Quality health care is a powerful safety net. Yet, according to the Center for American Progress: “The share of private-sector workers with a pension dropped from 50.3% in 2000 to 43.2% in 2006, and the share of people with employer-provided health insurance dropped from 64.2% to 59.7%.” So that bastion of support seems to be eroding.
But what if quality health care were available to everyone, regardless of their employer? Then the fear of disaster if you became ill between job changes would vanish because you’d still be covered. The dread of physical and/or financial ruin would evaporate. How could this be possible in the good old US?
Both leading Democratic candidates for President are proposing some form of government-regulated health insurance that would cover most Americans. The Republicans shriek in horror at this idea and scorn it with the label “Socialized Medicine”, something apparently almost as bad as HIV in their minds. As Jacob S. Hacker says in the Washington Post of March 23rd: “Never mind that nobody is proposing to turn doctors into public employees and hospitals into government institutions — the literal meaning of socialized medicine.” What’s being proposed is portable health insurance; insurance you have regardless of your means of income, that goes where you go. The government’s role is to regulate the quality of care and to seriously reduce the inflation rate of such care (Hacker’s article goes into more detail).
The connection between portable health care, telework, and entrepreneurship is obvious, to me, at least. Let me illustrate this with some personal history. In my career as an officer in the USAF and then a “rocket scientist” I had excellent health insurance at relatively low cost. No problems. Then, when I moved to a newly-invented job at the University of Southern California, that availability of low-cost, quality health care continued. No worries. But, when I was considering jumping off the large-organization wagon and going it alone, the prospect of much more expensive insurance for the same health coverage that I enjoyed at USC was a major factor in the decision to make the leap. I made it anyway because I was more interested in practicing what I was preaching. I’m sure that these considerations are important in the decisions of many would-be entrepreneurs.
Now let’s look at the situation for telework. There are two kinds of teleworkers: those who are employed by medium-to-large organizations; and those who are self-employed or who are in small organizations. The former group tends to have suitable health coverage, the latter bunch is probably less secure in that respect. Yet again, even in the former group there may be problems with long distance teleworkers (as contrasted to telecommuters) if health plans/costs/coverage varies geographically. I’ve been told that the prospect of having to deal with multiple forms of health care for a geographically distributed workforce is one of the factors reducing enthusiasm of employers for adopting telework.
If, on the other hand, health coverage were to become portable and employer-independent both employers and employees might be greatly relieved. Employers would have some of the burden and stress of the health care issue relieved. Employees would be far less motivated to stay in dead-end or stressful jobs; entrepreneurship would accelerate.
Or not. What do you think?