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Deductibles. In-network. Non-preferred providers. Concierge medical services. Out-of-pocket expenses. Fixed payment. Co-insurance. Insurance consultants. Insurance brokers. Medical advisors. Affordable Care Act. HMO. PPO. EPO. POS. HDHP. Health Savings Account. FSA. Health Reimbursement Arrangement. Explanation of Benefits. COBRA. SHOP. Individual coverage. Family coverage. Premium tax credits.

Baffled? You should be. Who understands all this stuff? Certainly not the average entrepreneur. Nor the typical employee. Choosing the appropriate healthcare insurance for our business – or for our families – seems like demands a PhD in healthcare.

Our Medical System Isn't Just Complicated, It's Costly

Based on recent research, typical households pays $twenty-seven thousand each year on medical coverage (up 6% from last year). The average employer health insurance cost is projected to exceed $seventeen thousand per employee in 2026, a 9.5% jump from 2025.

Currently federal operations is shut down due to political disagreements regarding tax credits that experts say could cause a doubling of premiums for millions of Americans.

When Will We Seriously Consider National Health Insurance?

When will we seriously consider universal healthcare coverage in the United States? I'm convinced we're approaching that point because this situation is unsustainable.

I'm not suggesting government-run medicine. I'm proposing that our already existing Medicare system – an established insurance framework – simply expand to include all citizens. Our infrastructure remains intact. The way our healthcare providers receive payment would change. Believe me, they'll adapt.

How National Health Insurance Could Function

A national health insurance program would need payments from both employees and employers. In similar programs, an employee earning average wages must contribute about 5.3% to their healthcare. Their employer must contribute about 13.75%.

Does this seem like a lot? Unless you compare it to what the typical US resident spends. I know dozens of clients who are routinely paying anywhere from eight to fifteen percent of payroll costs to their healthcare costs. And keep in mind that in inclusive programs, these contributions also cover pension plans, sick pay, maternity leave and job loss protection in addition to supporting medical services. When including those costs compared with our current spending for our retirement plans, unemployment insurance and paid time off, the gap narrows.

Implementation for America

For America, a national health premium would raise existing Medicare taxes, a framework already established. It ought to be income-adjusted – those at higher income levels would contribute higher amounts than lower-income earners. This includes both worker and company payments. Similar to many federal defense, IT, social programs and infrastructure, the system should be outsourced by private contractors rather than a government office.

Benefits for Small Businesses

A national health insurance program would be a significant advantage for entrepreneurs such as my company. It would place small companies in equal competition with our larger competitors that can pay for superior coverage. It would make management significantly simpler (automatic payroll withholding remitted like social security and Medicare taxes, rather than individual transactions to benefit firms and coverage administrators).

It would make it easier to plan expenses annual expenditures, instead of enduring the complicated (and fruitless) theater of bargaining with major insurers required annually every year. Because it's simplified, there would exist a better understanding about benefits among workers – as opposed to existing arrangements which require them to interpret the complexities of existing plans. And there would certainly be less liability for employers as we no longer would be privy to workers' health histories for purposes of risk assessment and alternative plans.

Capitalist Perspective

I'm as capitalist as they get. But I've learned that government play important functions in society, from providing defense to supporting essential systems. Ensuring medical coverage to all via universal healthcare strengthens our economy's infrastructure. It represents superior, easier system for entrepreneurs which hire the majority of the country's workers and fund half the economic output. It enables employees to enjoy better health, come to work more often and increase productivity.

Addressing Concerns

Exist numerous factors I haven't covered? Certainly. But with rising medical expenses we've seen in recent years, it's clear that the Affordable Care Act is not working effectively. I understand that we're not a small, Scandinavian country where major reforms can be readily adopted. However extending Medicare for all, despite increased taxation that would be incurred, would remain a superior and less expensive strategy for not only managing medical expenses and ensuring coverage for all citizens.

Need for Realistic Evaluation

As Americans, we need to tone down national pride. America's medical care isn't so great. The US places well below numerous nations in healthcare quality globally, according to major studies. Maybe one positive aspect in this current situation could be that we take serious examination in the mirror and acknowledge that big changes are necessary.