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Out-of-pocket costs. Preferred providers. Non-preferred providers. Premium health services. Out-of-pocket expenses. Co-payment. Co-insurance. Benefit advisers. Coverage agents. Healthcare consultants. ACA. HMO. PPO. EPO. Point of Service. HDHP. HSA. FSA. Health Reimbursement Arrangement. EOB. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Dependent coverage. Premium tax credits.

Confused? It's understandable. Who understands all this stuff? Not the typical entrepreneur. Neither the average employee. Choosing the appropriate medical coverage for our business – or for our families – seems like it requires a PhD in medical insurance.

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

According to a recent study, typical households spends $twenty-seven thousand annually for their health insurance (increasing by 6% compared to last year). The average company healthcare expense is expected to surpass $seventeen thousand per employee in 2026, a 9.5% jump compared to 2025.

Now federal operations is shut down due to political disagreements over subsidies that experts say will lead to premium increases up to 100% for millions of Americans.

When Will We Truly Examine Universal Healthcare?

How soon might we seriously consider a national health insurance program here in America? I have to believe we're getting closer since this can't continue.

I'm not proposing national healthcare. I'm proposing for our current Medicare program – an established insurance framework – simply expand to include all citizens. Our infrastructure doesn't change. How medical professionals get paid would change. Trust me, they will adjust.

The Way Universal Coverage Could Function

A national health insurance program would require payments from both employees and employers. In similar programs, a worker earning moderate income pays approximately 5.3% toward medical coverage. The company pays approximately 13.75%.

Does this appear expensive? Unless you compare that with what average US resident spends. I know dozens of businesses who are easily contributing between 8% to 15% of their employee wages to their healthcare costs. Remember that in inclusive programs, those payments also cover pension plans, sick pay, parental benefits and job loss protection along with funding medical services. When you add these expenses versus what we pay on retirement programs, unemployment insurance and vacation benefits, the gap narrows.

Execution for America

In the US, a national health premium would increase existing Medicare taxes, a framework already established. It ought to be means-based – those at higher income levels would contribute higher amounts than those earning less. This includes both an employee and company payments. Similar to much of our government's military, IT, welfare services and infrastructure, the program should be outsourced to third-party administrators instead of a government office.

Advantages for Entrepreneurs

Universal healthcare coverage represents a huge benefit for small businesses like mine. It would put small companies in equal competition against big corporations that can pay for superior coverage. It would make management significantly simpler (automatic payroll withholding processed similarly to social security and healthcare taxes, rather than individual transactions to insurance companies and coverage administrators).

It would enable it easier for us to budget annual expenditures, instead of enduring the complex (and fruitless) process of negotiating with the big insurance providers that we must do every year. Because it's simplified, there would be a better understanding about benefits by our employees – as opposed to existing arrangements which require them to decipher the complexities of current options. Additionally there would definitely exist reduced responsibility for companies as we no longer have access to workers' health histories for purposes of weighing risks and alternative plans.

Capitalist Perspective

I'm as pro-market as possible. But I've learned that government has a significant role in society, including national security to supporting needed infrastructure. Providing healthcare for everyone through a national insurance system enhances economic foundations. It represents superior, easier system for small businesses which hire more than half of the country's workers and generate half of our GDP. It makes it possible for workers to be healthier, have better attendance and be more productive.

Addressing Concerns

Are there a million considerations I haven't covered? Certainly. But with all the healthcare cost increases we've seen in recent years, it's clear that the Affordable Care Act is not working effectively. And I realize that America isn't a small, Scandinavian country where big changes are easier to implement. But expanding Medicare for all, even with the additional taxes that would be incurred, would remain a better and more affordable approach both for managing medical expenses and ensuring coverage to everyone.

Time for Realistic Evaluation

We as Americans, we need to reduce national pride. America's medical care isn't exceptional. We rank well below many other countries in healthcare quality globally, based on major studies. Perhaps a positive aspect in this present circumstances could be that we take a hard look at ourselves and agree that major reforms are necessary.