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Out-of-pocket costs. Preferred providers. Non-preferred providers. Concierge medical services. Out-of-pocket expenses. Fixed payment. Co-insurance. Benefit advisers. Insurance brokers. Medical advisors. ACA. Health Maintenance Organization. Preferred Provider Organization. Exclusive Provider Organization. Point of Service. HDHP. Health Savings Account. FSA. Health Reimbursement Arrangement. Explanation of Benefits. COBRA. SHOP. Single coverage. Dependent coverage. Premium tax credits.

Baffled? It's understandable. Who understands this complex system? Certainly not the average business owner. Nor the typical worker. Selecting the right medical coverage for our business – or for households – seems like it requires advanced expertise in healthcare.

Our Healthcare System Isn't Just Complex, It Is Costly

According to a recent study, typical households spends $twenty-seven thousand each year for their health insurance (increasing by 6% from last year). Typical company healthcare expense is expected to exceed $seventeen thousand for each worker in 2026, a 9.5% jump from 2025.

Now federal operations is shut down due to partisan disputes over subsidies that experts say could cause a doubling of premiums for millions of Americans.

When Might We Seriously Consider National Health Insurance?

When will we genuinely evaluate universal healthcare coverage here in America? I'm convinced we're getting closer since this situation is unsustainable.

I'm not suggesting national healthcare. I'm proposing for our current Medicare program – an established insurance framework – merely extend to cover everyone. The existing system remains intact. How our healthcare providers get paid would change. Trust me, they will adjust.

The Way National Health Insurance Would Work

A national health insurance program would need contributions from both workers and companies. In similar programs, a worker earning moderate income pays approximately 5.3% toward medical coverage. Their employer pays about 13.75%.

Does this seem expensive? Not if you contrast it to what the typical US resident spends. I know multiple clients who are routinely paying anywhere from 8% to 15% of their employee wages to their healthcare costs. And keep in mind that with inclusive programs, those payments also cover retirement benefits, sick pay, maternity leave and unemployment benefits along with supporting healthcare facilities. When you add those costs compared with our current spending for our retirement plans, unemployment insurance and vacation benefits, the difference decreases.

Execution for America

For America, a national health premium would raise our Medicare tax deduction, a framework already established. It should be means-based – those at higher income levels would pay more than those earning less. There would be both an employee and company payments. Similar to many our government's military, IT, welfare services and transportation services, the system could be managed by private contractors instead of federal agencies.

Advantages for Entrepreneurs

Universal healthcare coverage represents a significant advantage for entrepreneurs such as my company. It would place small companies in equal competition against big corporations that can pay for better plans. It would render administration significantly simpler (a payroll deduction processed similarly to retirement and healthcare taxes, instead of individual transactions to benefit firms and insurance providers).

It would enable simpler to plan expenses annual expenditures, instead of enduring the complicated (and ineffective) theater of negotiating with major insurers required annually every year. Because it's simplified, there would exist a better understanding about benefits by our employees – as opposed to existing arrangements which require them to interpret the complexities of existing plans. And there would certainly be less liability for companies since we wouldn't have access to workers' health histories for purposes of risk assessment and different options.

Free-Market Viewpoint

I'm as pro-market as they get. But I've learned that government has a significant role in society, from providing defense to funding needed infrastructure. Providing healthcare to all through a national insurance system strengthens our economy's infrastructure. It's a better, simpler approach for small businesses that employ more than half of the country's workers and fund half of our GDP. It makes it possible employees to enjoy better health, come to work more often and increase productivity.

Considering Challenges

Are there a million considerations I haven't covered? Certainly. But with rising medical expenses we've seen in recent years, it's clear that the Affordable Care Act isn't functioning very well. I understand that we're not a compact European nation where big changes can be readily adopted. But expanding Medicare for all, despite the additional taxes that would be incurred, would still be a superior and more affordable approach both for managing medical expenses and ensuring coverage to everyone.

Need for Realistic Evaluation

We as Americans, we need to tone down national pride. Our healthcare system isn't exceptional. The US places well below many other countries with the best healthcare globally, according to comprehensive research. Perhaps a positive aspect in this present circumstances could be that we take serious examination in the mirror and acknowledge that big changes need to happen.