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Out-of-pocket costs. Preferred providers. Non-preferred providers. Concierge medical services. Personal healthcare costs. Fixed payment. Shared insurance. Insurance consultants. Insurance brokers. Healthcare consultants. ACA. HMO. Preferred Provider Organization. Exclusive Provider Organization. Point of Service. HDHP. HSA. Flexible Spending Account. HRA. EOB. COBRA. SHOP. Individual coverage. Dependent coverage. Insurance subsidies.

Baffled? It's understandable. Who understands this complex system? Certainly not the average business owner. Neither the average employee. Choosing the appropriate medical coverage for companies – or for households – seems like demands a PhD in healthcare.

Our Medical System Is More Than Complicated, It's Costly

According to recent research, typical households pays $twenty-seven thousand annually on medical coverage (increasing by 6% compared to last year). Typical employer health insurance cost is projected to exceed $17,000 for each worker in 2026, a 9.5% jump from 2025.

Currently the government is shut down because partisan disputes over subsidies that experts say could cause a doubling of premiums for millions of Americans.

When Might We Seriously Consider Universal Healthcare?

How soon might we genuinely evaluate a national health insurance program here in America? I have to believe we're approaching that point because this situation is unsustainable.

I'm not suggesting government-run medicine. I'm advocating for our current Medicare program – an established insurance framework – merely extend to include all citizens. The existing system remains intact. The way medical professionals get paid would change. Believe me, they'll adapt.

How National Health Insurance Would Work

A national health insurance program would require payments from both employees and employers. In comparable systems, an employee making moderate income must contribute about five point three percent to their healthcare. The company must contribute approximately thirteen point seventy-five percent.

Does this appear like a lot? Unless you contrast that with what the typical US resident spends. I can name dozens of clients who are easily contributing between 8% to 15% of their employee wages for medical benefits. And keep in mind that with comprehensive systems, these contributions include retirement benefits, sick pay, maternity leave and job loss protection in addition to supporting healthcare facilities. When you add those costs versus what we pay for our retirement plans, unemployment insurance and vacation benefits, the difference decreases.

Execution for America

In the US, a national health premium would raise existing Medicare taxes, a framework that is already in place. It should be income-adjusted – those at higher income levels would pay more than those earning less. This includes both an employee and company payments. Similar to many federal defense, IT, welfare services and transportation services, the program should be outsourced to third-party administrators instead of federal agencies.

Advantages for Small Businesses

A national health insurance program would be a significant advantage for entrepreneurs like mine. It would put small companies in equal competition against big corporations who can afford superior coverage. It would render management significantly simpler (automatic payroll withholding remitted like social security and Medicare taxes, instead of separate payments to insurance companies and coverage administrators).

It would make simpler to plan expenses our yearly costs, rather than enduring the complicated (and ineffective) theater of negotiating with the big insurance providers that we must do each year. Due to simplification, there would exist a better understanding about benefits among workers – as opposed to the current system which require them to interpret the complexities of existing plans. Additionally there would definitely exist reduced responsibility for companies since we wouldn't have access to our employees' health histories for purposes of risk assessment and different options.

Capitalist Perspective

I'm as pro-market as they get. But I've learned that public institutions has a significant role in our lives, from providing defense to funding essential systems. Providing healthcare to all through a national insurance system strengthens our economy's infrastructure. It's a better, simpler approach for small businesses which hire more than half of the country's workers and generate half the economic output. It makes it possible for workers to be healthier, come to work more often and be more productive.

Considering Challenges

Are there numerous factors I haven't covered? Certainly. But with rising medical expenses we've seen in recent years, it's evident that the Affordable Care Act is not working very well. And I realize that America isn't a compact European nation where big changes are easier to implement. But expanding Medicare for all, even with increased taxation that would be incurred, would still be a superior and less expensive approach both for controlling healthcare costs but providing access for all citizens.

Need for Honest Assessment

As Americans, must tone down our own arrogance. Our healthcare system isn't so great. We rank well below many other countries in healthcare quality in the world, based on major studies. Perhaps a positive aspect in this current situation is that we take a hard look at ourselves and agree that major reforms are necessary.