... which generates another dependency on the employer (beyond the work visa thing).
I know the history of the employer-pays-for-health-care model in the US, but really: it's broken, fix it.
However, from a lifestyle perspective of a great programmer it's a non-issue. Once a person has an H1-B it is trivial to change companies. So even though technically you're tied to an employer (visa + healthcare), in a city like SF where a great programmer can get a job in a day (literally), it's a total non-factor.
But seriously after experiencing the american healthcare system a couple of times the only phrase I can use to describe it is "pure evil". I can pay my way out of that pure evilness, but it is evil that 99% of people can't. So I can totally understand if you don't want to be a party to that system for moral reasons, but that's a lot harder to be consistent about.
It's still broken (like so many other things in the US) and therefore one more deterrent to even considering going the work visa -> green card -> citizenship route.
It's not the upper-middle class programmers that get screwed by the US' ridiculously evil and horrible health care system. It's the 99% that make less than 100K/year.