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Out-of-pocket costs. In-network. Out-of-network. Premium health services. Personal healthcare costs. Fixed payment. Shared insurance. Insurance consultants. Insurance brokers. Healthcare consultants. Affordable Care Act. Health Maintenance Organization. PPO. Exclusive Provider Organization. POS. High Deductible Health Plan. HSA. Flexible Spending Account. HRA. EOB. COBRA. Small Business Health Options Program. Single coverage. Family coverage. Insurance subsidies.

Baffled? It's understandable. Who understands this complex system? Certainly not the average business owner. Neither the average worker. Choosing the right medical coverage for our business – or for our families – appears to require demands advanced expertise in medical insurance.

The Healthcare System Isn't Just Complicated, It's Costly

According to a recent study, the average family pays $27,000 annually for their health insurance (up 6% from last year). The average employer health insurance cost is expected to exceed $seventeen thousand per employee in 2026, an increase of 9.5% from 2025.

Now the government has ceased functioning due to political disagreements over tax credits that experts say could cause a doubling of premiums for numerous US citizens.

When Will We Seriously Consider National Health Insurance?

How soon might we seriously consider universal healthcare coverage here in America? I have to believe we're approaching that point since this can't continue.

I'm not suggesting national healthcare. I'm advocating for our current Medicare system – an established insurance framework – merely extend to cover everyone. The existing system doesn't change. The way our healthcare providers receive payment would change. Believe me, they'll adapt.

The Way Universal Coverage Would Work

A national health insurance program would need contributions from both employees and employers. In comparable systems, a worker making average wages must contribute approximately 5.3% to their healthcare. The company pays approximately 13.75%.

Does this seem like a lot? Unless you compare it to what average American pays. I know multiple clients that are routinely paying anywhere from eight to fifteen percent of their employee wages to their healthcare costs. Remember that in comprehensive systems, these contributions include retirement benefits, sick pay, parental benefits and unemployment benefits along with funding medical services. When including those costs versus what we pay on retirement programs, job loss coverage and paid time off, the gap narrows.

Execution in the US

In the US, a national health premium would increase our Medicare tax deduction, a system already established. It ought to be income-adjusted – those at higher income levels would pay more than those earning less. This includes both an employee and company payments. And, like much of our government's military, IT, welfare services and infrastructure, the system should be outsourced by private contractors instead of federal agencies.

Benefits for Entrepreneurs

Universal healthcare coverage would be a huge benefit for small businesses like mine. It would put small companies in equal competition with our larger competitors who can afford superior coverage. It would render administration significantly simpler (a payroll deduction remitted like social security and healthcare taxes, instead of separate payments to insurance companies and coverage administrators).

It would enable simpler for us to budget annual expenditures, instead of enduring the complicated (and ineffective) process of bargaining with the big insurance providers required annually each year. Due to simplification, there would be a better understanding about benefits by our employees – contrasted with existing arrangements which require them to interpret the complexities of current options. And there would definitely exist less liability for companies since we wouldn't have access to our employees' health histories for weighing risks and alternative plans.

Free-Market Viewpoint

I'm as pro-market as they get. But I've learned that public institutions play important functions in our lives, including national security to supporting essential systems. Providing healthcare for everyone via universal healthcare enhances our economy's infrastructure. It represents superior, easier system for entrepreneurs that employ more than half of the country's workers and generate half of our GDP. It enables employees to be healthier, have better attendance and increase productivity.

Considering Challenges

Are there numerous factors I haven't covered? Of course there are. But with all the healthcare cost increases we've seen recently, it's clear that the Affordable Care Act is not working very well. And I realize that we're not a small, Scandinavian country where major reforms 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 for not only controlling healthcare costs but providing access to everyone.

Time for Realistic Evaluation

We as Americans, we need to reduce national pride. Our healthcare system isn't so great. The US places significantly behind numerous nations in healthcare quality globally, according to major studies. Maybe one bright spot amid current situation could be that we take a hard look at ourselves and agree that major reforms need to happen.