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Out-of-pocket costs. Preferred providers. Non-preferred providers. Premium health services. Out-of-pocket expenses. Fixed payment. Co-insurance. Insurance consultants. Insurance brokers. Healthcare consultants. ACA. Health Maintenance Organization. Preferred Provider Organization. EPO. POS. High Deductible Health Plan. HSA. FSA. HRA. Explanation of Benefits. COBRA. Small Business Health Options Program. Individual coverage. Family coverage. Premium tax credits.

Baffled? It's understandable. Who understands all this stuff? Certainly not the average business owner. Nor the typical employee. Choosing the right healthcare insurance for companies – or for our families – seems like it requires a PhD in medical insurance.

The Healthcare System Is More Than Complicated, It's Expensive

Based on a recent study, typical households spends $27,000 each year on medical coverage (increasing by 6% compared to last year). Typical employer health insurance cost is projected to surpass $17,000 for each worker in 2026, a 9.5% jump compared to 2025.

Now the government is shut down due to political disagreements regarding subsidies that experts say will lead to a doubling of premiums for numerous US citizens.

When Might We Seriously Consider National Health Insurance?

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

I'm not proposing national healthcare. I'm advocating for our current Medicare system – an established insurance framework – simply expand to cover everyone. Our infrastructure doesn't change. The way medical professionals receive payment changes. Trust me, they will adjust.

How Universal Coverage Could Function

A national health insurance program would need contributions from both workers and companies. In similar programs, an employee making average wages must contribute about 5.3% toward medical coverage. Their employer pays about 13.75%.

Does this appear expensive? Not if you contrast it to what the typical American pays. I know dozens of businesses who are routinely paying between eight to fifteen percent of payroll costs for medical benefits. Remember that with inclusive programs, those payments also cover retirement benefits, illness coverage, maternity leave and unemployment benefits along with supporting medical services. When you add those costs compared with our current spending for our retirement plans, unemployment insurance and paid time off, the gap narrows.

Execution in the US

For America, a national health premium would increase our Medicare tax deduction, a system that is already in place. It ought to be income-adjusted – those at higher income levels would pay more than lower-income earners. This includes both an employee and employer contribution. Similar to many federal defense, IT, welfare services and transportation services, the system could be managed by private contractors rather than a government office.

Benefits for Entrepreneurs

A national health insurance program represents a significant advantage for small businesses like mine. It would place small companies in equal competition against big corporations that can pay for superior coverage. It would render administration significantly simpler (automatic payroll withholding processed similarly to social security and healthcare taxes, rather than individual transactions to benefit firms and coverage administrators).

It would enable it easier for us to budget annual expenditures, instead of enduring the complicated (and fruitless) process of negotiating with major insurers required annually each year. Because it's simplified, there would be improved comprehension of coverage among workers – as opposed to the current system which require them to interpret the complexities of existing plans. And there would certainly be less liability for companies since we wouldn't would be privy to our employees' medical records for purposes of weighing risks and alternative plans.

Capitalist Perspective

I'm as capitalist as they get. But I've learned that public institutions play important functions in society, including national security to funding needed infrastructure. Providing healthcare for everyone via universal healthcare strengthens economic foundations. It represents superior, easier system for small businesses which hire the majority of American employees and generate half of our GDP. It makes it possible for workers to enjoy better health, come to work more often and increase productivity.

Addressing Concerns

Are there a million considerations I'm not addressing? Of course there are. 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 can be readily adopted. But expanding Medicare for all, despite the additional taxes that would be incurred, would still be a better and more affordable approach for not only managing medical expenses but providing access to everyone.

Need for Honest Assessment

We as Americans, must reduce national pride. Our healthcare system isn't exceptional. The US places well below numerous nations in healthcare quality in the world, based on comprehensive research. Perhaps a bright spot amid present circumstances is that we take serious examination at ourselves and agree that major reforms need to happen.