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September 10, 2009

Healthcare and Entrepreneurship

President Obama's compelling healthcare speech last night made the case for acting now. In a follow-up email that he sent to millions, he urged action to finally address this pressing issue, positing that we are "closer now than we have been in 60 years." Here's my question - where can I find an analysis of the impact of the plan on entrepreneurship? Why has this major engine of job growth been silent or ignored in the debate - or have I just missed it? Anything that creates friction in entrepreneurship is a bad thing for our innovation economy. I have seen aspiring entrepreneurs hold back in pursuing their start-up dreams because of fear of losing health coverage. Lowering the barriers to allow the flow of great talent to seek great opportunity needs to be a fundamental tenant of the new plan and I'm concerned that our leadership isn't focused enough on this lens. Has anyone seen any good data or dialog on this topic? Led by former venture capitalist Karen Mills, shouldn't the SBA be a strong, relevant voice here?


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im totally 100% with you on this. health care for my wife and two children is a huge factor in my ability and willingness to start a new tech business or work at one

Great post Jeff, I wish these reforms provided some sort of incentive for aspiring entrepreneurs!

Indeed! We need to lower the barriers for entrepreneurship.

Your comment sums up a concern of many in HCIT circles. Some worry that the net result of "meaningful use" and "certification" in ARRA will do exactly that - stifle innovation. The large, established vendors may have a feeding frenzy at the expense of entrepreneurial, early stage companies, who may be left out.

With permission, from Oxford Bio's Jonathan Fleming:

In August White House CTO Chopra and FDA commsisoner Sharstein invited a small group of VCs and entrepreneurs to meet with them and comment on how proposed policies would impact innovation. A wide ranging discussion lasting several hours ensued. We were asked to follow up with a list of specific areas where innovation could be targeted to achieve breakthroughs as well as more data on what VCs are doing/changing as a result of current or future public policy. The responses will be coordinated by the NVCA. It is encouraging that the White House and FDA are aware of the possible impact of current and future policy on entrepreneurship and innovation. It is not clear that this awareness is shared by those in Congress or the White House in charge of formulating the Health Care Reform Plans.

Good work is also being done by The New England Healthcare Institute to raise awareness of the benefits of innovation in health care as well as policies which promote or retard the introduction of new health care innovations. NEHI has done several studies showing the economic and patient benefits of new products and services in specific areas. NEHI is especially active on the issue of comparative effectiveness to make sure it does not create a new and expensive regulatory hurdle that innovators must overcome.

So far as I know no one has focused on the "cost" of reform measured by jobs not created or patent benefits not achieved. Although health care as a percentage of gdp continues to go up - it should be noted that this created many thousands of new jobs and many products that resulted in longer lives of higher quality. These benefits of heath care innovation never get mentioned when there is a discussion of the cost.

Someone on my Businessweek.com blog posted this important link from the Council of Economic Advisors: http://www.whitehouse.gov/administration/eop/cea/Health-Care-Reform-and-Small-Businesses/

Health care should not be linked to employment in any way. It negatively impacts our global competitiveness, unfairly chains many employees to their job, and puts start ups and small businesses at a major disadvantage with large corporations. Unfortunately, decoupling health care and employment isn't realistically on the table right now, but it should be.

Amen, Vanessa!


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