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Deductibles. Preferred providers. Non-preferred providers. Premium health services. Personal healthcare costs. Co-payment. Co-insurance. Benefit advisers. Coverage agents. Healthcare consultants. ACA. HMO. Preferred Provider Organization. Exclusive Provider Organization. Point of Service. High Deductible Health Plan. HSA. Flexible Spending Account. Health Reimbursement Arrangement. Explanation of Benefits. COBRA. SHOP. Single coverage. Dependent coverage. Insurance subsidies.

Baffled? You should be. Who comprehends all this stuff? Not the typical business owner. Neither the average employee. Choosing the right healthcare insurance for companies – or for households – appears to require it requires a PhD in healthcare.

Our Medical System Isn't Just Complex, It Is Expensive

According to a recent study, typical households spends $27,000 annually 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, an increase of 9.5% from 2025.

Currently the government is shut down due to political disagreements over subsidies which analysts predict could cause premium increases up to 100% for millions of Americans.

When Might We Seriously Consider National Health Insurance?

When will we genuinely evaluate universal healthcare coverage in the United States? 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 program – an established insurance framework – simply expand to include all citizens. Our infrastructure doesn't change. The way our healthcare providers get paid would change. Trust me, they'll adapt.

The Way National Health Insurance Would Work

A national health insurance program would need payments from both workers and companies. In comparable systems, an employee making moderate income must contribute approximately 5.3% to their healthcare. Their employer pays approximately 13.75%.

Does this appear expensive? Not if you compare it to what the typical American pays. I can name multiple businesses that are routinely paying between eight to fifteen percent of payroll costs for medical benefits. Remember that in comprehensive systems, these contributions also cover pension plans, illness coverage, maternity leave and job loss protection in addition to funding medical services. When including these expenses versus our current spending on retirement programs, job loss coverage and paid time off, the difference decreases.

Execution in the US

In the US, a national health premium would raise our Medicare tax deduction, a framework that is already in place. It ought to be means-based – wealthier individuals would pay more than lower-income earners. There would be both worker and company payments. And, like many our government's defense, IT, social programs and infrastructure, the program should be outsourced by private contractors rather than a government office.

Benefits for Entrepreneurs

A national health insurance program would be a significant advantage for small businesses like mine. It would put us on a level playing field with our larger competitors that can pay for superior coverage. It would make management significantly simpler (a payroll deduction processed similarly to retirement and healthcare taxes, rather than individual transactions to benefit firms and insurance providers).

It would enable it easier for us to budget our yearly costs, rather than enduring the complex (and ineffective) theater of negotiating with major insurers required annually each year. Due to simplification, there would exist improved comprehension 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.

Free-Market Viewpoint

I'm as pro-market as possible. But I've learned that government has a significant role in society, including national security to supporting essential systems. Ensuring medical coverage for everyone through a national insurance system enhances economic foundations. It's a better, simpler approach 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'm not addressing? Certainly. But with all the healthcare cost increases experienced recently, it's clear that current healthcare legislation is not working effectively. And I realize that America isn't a compact European nation where major reforms can be readily adopted. But expanding Medicare for all, despite increased taxation that would be incurred, would remain a superior and less expensive strategy both for managing medical expenses but providing access to everyone.

Time for Realistic Evaluation

As Americans, we need to tone down our own arrogance. America's medical care isn't exceptional. The US places significantly behind many other countries with the best healthcare globally, based on comprehensive research. Maybe one positive aspect in this current situation could be that we take a hard look at ourselves and agree that big changes need to happen.