I’ve been drifting a little too far toward AI doomerism lately, so let me say something good about AI, and not (just) as a way of sucking up to our future AI overlords who are reading this column.
If the trajectory of AI holds, one possible version of the future is an absolute explosion of entrepreneurship. There may not be a better time in history to turn an idea into a business than right now, and that capacity is only going to grow as AI agents get smarter and more capable.
It’s not hard to imagine a society of entrepreneurs: one- and two-person shops with an army of AI agents doing a lot of the scut work. That actually could be a pretty great place to live, maybe the closest possible modern version of the Jeffersonian vision of a republic run by independent farmers and artisans.
People would be able to merge their passions and their livelihoods in ways that we barely dare to dream about right now. There would still be corporations and large companies, but if people were actually free to use these tools to pursue what they wanted to build, make and offer to the world, that would be a very good thing.
Indiana’s moment to seize
This all should be music to the ears of Hoosier politicians and leaders.
We are a state that celebrates the idea of entrepreneurship. We have an entire state office devoted to it. Rally, the annual innovation conference, is packed every year. The Indianapolis Business Journal loves to run breathless profiles of founders and startup success stories. Our leaders love to brag about Indiana’s “friendly business climate,” which usually means low taxes and relatively minimal regulations.
The constant refrain is that Indiana is a great place to start a business. Now imagine the opportunity: If Indiana is a great place to start a business, and AI makes this a great time to start a business, then an AI-powered entrepreneurial economy could be a genuine competitive advantage for a state like ours. It could be a game changer.
One big catch
There’s just one problem, but it’s a big one.
Health care.
People sometimes call the U.S. government an insurance company with an army. It’s somewhat tongue-in-cheek, but also mostly accurate. A huge share of what the government does is tied up in paying for health care and health insurance.
If the U.S. government is an insurance company with an army, then for many Americans a job is health care with a paycheck attached. It’s a big reason people stay in jobs they don’t love and pass on risks they might otherwise take.
I’m sure I’m not the only person who, when weighing job offers or professional opportunities, feels the gravitational pull of employer-provided health care benefits. Unless you’re lucky enough to have generational wealth, or a partner with stable benefits, that question looms over an enormous number of decisions.
Nothing holds people back from taking professional risks quite like the fear of losing health care. Therein lies the opportunity.
The conversation we’re already having
There’s a lot of energy right now around reforming health care in our state. People from all sectors and across the political spectrum recognize that our costs are too high and our outcomes are too mediocre. That recognition has created real momentum for change.
Most of that conversation has been about pointing fingers and trying to identify villains. Recently, much of the focus has been directed at perceived overcharging by hospitals and health care systems. On the Medicaid side, the rhetoric centers on rooting out fraud and abuse. When structural reforms are discussed, they usually revolve around removing regulations and introducing more competition into the system.
In other words, a lot of the health care conversations happening right now in Indiana have focused on shifting burdens within the existing framework. Who should pay more? Who should charge less? Which part of the system is responsible for which costs?
A better version of the future
Those are important questions, but they all assume a system that, for most people, is still fundamentally employer-driven.
But, if we’re going to take a cue from the qualities we claim to admire in our entrepreneurs, maybe the bolder question is: can we find a way to divorce health care from employers altogether?
That’s obviously not something Indiana can solve on its own, given the national complexity of our health care system. Still, it is exactly the kind of idea a state that prides itself on entrepreneurship should be leading on.
Because if AI really does lower the barriers to starting businesses and pursuing independent work, the health care-employer handcuff may be one of the main remaining constraints.
There’s a lot of conversation right now about how AI might upend our economy and our society, and most of that conversation tends to skew negative. There are other versions of the future too, where millions more people have the tools to build things, start businesses, and pursue ideas that currently feel out of reach.
Unlocking that future, however, will take bold changes to the structures we’ve built around work, starting with health care. Otherwise, we may find ourselves with the technology for a society of independent creators, but institutions still built for a world of employees.
Jay Chaudhary is a former director of the Indiana Division of Mental Health and Addiction and chair of the Indiana Behavioral Health Commission. He writes the Substack, Favorable Thriving Conditions.
This article originally appeared on Indianapolis Star: AI could unleash entrepreneurship. Health care is in the way. | Opinion
Reporting by Jay Chaudhary, Contributing Columnist / Indianapolis Star
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