Entrepreneurs feeling the pain

An idea: Subsidized health insurance for start-ups will spur the economy.

Posted: September 05, 2007

By Matt Joyce

As I slid slowly into Thomas Jefferson University Hospital's glistening, space-age MRI machine recently, preparing for a 40-minute, $1,500 procedure that would yield more than 100 images of my injured wrist, thoughts of American entrepreneurship, preventive care, and the glaring ironies of our health-care system circled through my head.

Three years ago, my former college roommate, Tim Ifill, and I started a nonprofit organization called Philly Fellows. Both of us chose to forgo traditional jobs with stable salaries and benefits to build a program that we were passionate about, and that we felt would make a tangible impact on the city of Philadelphia.

Today, Philly Fellows provides us with the full complement of salary and benefits, but like so many people who choose to start organizations and businesses, we went nearly three years without full health coverage to save on start-up costs.

In June, while we were shopping around to determine which carrier we would finally use to insure ourselves, I took a fairly minor fall during a soccer game, but landed awkwardly on my hand and bent back my wrist. A week later, when it continued to throb, my doctor suggested an X-ray. My insurance at the time, an $80-a-month, high-deductible PPO, which is really only useful if you end up in a plane crash or have a long-term bout with dengue, did not cover the $500 X-ray. So I decided to risk it; I bought Advil and a CVS splint for $20 and hoped it would heal on its own.

Three weeks into my new health plan and three months after the injury, my wrist only worsened and will now cost thousands to repair.

The incident brings two questions to mind. First, how much money do insurance companies and uninsured people lose because we let injuries and illnesses linger in hopes of saving a few bucks? Second, how many people have innovative ideas for starting an organization or business but don't pursue them because the risk of living without insurance is too high?

One of the strongest arguments against universal health insurance is that the United States is a capitalist, entrepreneurial country, and regulating the medical field would reduce competition and stifle innovation. Fair enough, but consider the flip side: In the current system, we ask that everyone considering starting a company spend thousands of dollars insuring themselves or risk spending far more by going uninsured.

I wonder which inhibits progress more.

While Philadelphia is a tough place to make the argument for socialized medicine - with an economy built on health care and insurance - I do believe that cities, states, and the entire country should take an interest in subsidizing insurance for emerging business owners, social entrepreneurs, artists, and self-employed men and women who have the potential to grow our economy and improve our communities.

In Pennsylvania, we give loans, grants, tax breaks, technical support and many more resources to people working to start and grow their businesses and organizations. All told, the state invests more than $2.8 billion in economic-stimulus programs, according to the Web site www.newpa.com. We commit funds liberally to the companies, but perhaps we should be investing just as heavily in the entrepreneurs themselves. Providing accessible health insurance to those starting and working for new businesses - especially in the first few years of their enterprise - would enable many more people to explore their ideas without taking on excessive personal risk.

As Pennsylvania continues to explore creative ways to spark economic growth, we should consider the impact of subsidizing health care for entrepreneurs. How many more Pennsylvanians would choose to start new businesses? How many industrious people would relocate here to implement their ideas? This kind of program, it seems, would not only receive bipartisan support, but would also benefit everyone it impacted - with the possible exception of the surgeon who operated on my wrist.

Matt Joyce (mjoyce@phillyfellows.org) is codirector of the Philly Fellows Program (www.phillyfellows.org).

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