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Deductibles. In-network. Non-preferred providers. Premium health services. Out-of-pocket expenses. Co-payment. Co-insurance. Benefit advisers. Coverage agents. Healthcare consultants. ACA. HMO. PPO. EPO. POS. High Deductible Health Plan. Health Savings Account. Flexible Spending Account. Health Reimbursement Arrangement. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Single coverage. Family coverage. Premium tax credits.

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

The Healthcare System Is More Than Complex, It's Costly

According to a recent study, typical households pays $27,000 each year on medical coverage (up 6% from last year). Typical company healthcare expense is expected to exceed $17,000 per employee in 2026, a 9.5% jump from 2025.

Now the government is shut down due to political disagreements regarding tax credits which analysts predict will lead to premium increases up to 100% for numerous US citizens.

When Might We Truly Examine National Health Insurance?

How soon might we genuinely evaluate universal healthcare coverage here in America? I have to believe we're getting closer because this can't continue.

I'm not suggesting government-run medicine. I'm advocating that our already existing Medicare system – an insurance system – simply expand to include all citizens. Our infrastructure remains intact. The way medical professionals get paid changes. Believe me, they will adjust.

How National Health Insurance Would Work

A national health insurance program would need payments from both workers and companies. In similar programs, an employee making average wages pays about five point three percent toward medical coverage. Their employer must contribute about thirteen point seventy-five percent.

Does this appear expensive? Unless you contrast that with what the typical US resident spends. I can name multiple clients that are routinely paying anywhere from 8% to 15% of their employee wages to their healthcare costs. Remember that with comprehensive systems, these contributions also cover pension plans, sick pay, maternity leave and unemployment benefits along with funding medical services. When including those costs compared with our current spending on retirement programs, job loss coverage and paid time off, the difference decreases.

Execution for America

For America, a national health premium would increase existing Medicare taxes, a framework that is already in place. It ought to be income-adjusted – those at higher income levels would contribute higher amounts than lower-income earners. This includes both an employee and company payments. Similar to much of federal defense, technology, welfare services and transportation services, the program should be outsourced to third-party administrators instead of a government office.

Benefits for Small Businesses

Universal healthcare coverage represents a significant advantage for entrepreneurs such as my company. It would put us on a level playing field against big corporations who can afford better plans. It would render administration much easier (automatic payroll withholding processed similarly to retirement and Medicare taxes, instead of individual transactions to benefit firms and coverage administrators).

It would make simpler for us to budget annual expenditures, rather than going through the complex (and ineffective) process of bargaining with major insurers that we must do every year. Due to simplification, there would be a better understanding of coverage among workers – as opposed to existing arrangements where they have to decipher the complexities of existing plans. And there would certainly be less liability for companies as we no longer would be privy to workers' health histories for purposes of risk assessment and alternative plans.

Free-Market Viewpoint

I'm as capitalist as they get. But I've learned that government has a significant role in society, from providing defense to funding essential systems. Providing healthcare for everyone via universal healthcare strengthens economic foundations. It represents superior, easier system for small businesses which hire more than half of the country's workers and fund half of our GDP. It makes it possible for workers to be healthier, have better attendance and increase productivity.

Considering Challenges

Are there numerous factors I'm not addressing? Of course there are. Given rising medical expenses experienced recently, 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 can be readily adopted. But expanding universal Medicare, despite increased taxation that would be incurred, would still be a better and less expensive approach both for managing medical expenses but providing access to everyone.

Need for Honest Assessment

We as Americans, we need to reduce our own arrogance. America's medical care isn't so great. We rank well below numerous nations in healthcare quality in the world, based on major studies. Perhaps a positive aspect in this current situation could be that we take a hard look in the mirror and acknowledge that big changes are necessary.