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Deductibles. Preferred providers. Out-of-network. Concierge medical services. Out-of-pocket expenses. Co-payment. Co-insurance. Insurance consultants. Insurance brokers. Healthcare consultants. ACA. HMO. PPO. EPO. POS. HDHP. HSA. Flexible Spending Account. HRA. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Dependent coverage. Insurance subsidies.

Baffled? You should be. Who comprehends all this stuff? Certainly not the average entrepreneur. Neither the average worker. Selecting the right 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 Expensive

According to a recent study, the average family pays $27,000 annually on medical coverage (up 6% compared to last year). The average company healthcare expense is expected to surpass $17,000 per employee by 2026, an increase of 9.5% compared to 2025.

Now the government is shut down due to partisan disputes over subsidies that experts say could cause a doubling of premiums for numerous US citizens.

When Might We Seriously Consider Universal Healthcare?

When will we seriously consider universal healthcare coverage in the United States? I have to believe we're approaching that point because this can't continue.

I'm not suggesting national healthcare. I'm advocating for our current Medicare system – an insurance system – simply expand to include all citizens. The existing system remains intact. The way our healthcare providers receive payment would change. Believe me, they'll adapt.

The Way National Health Insurance Could Function

A national health insurance program would require payments from both workers and companies. In comparable systems, an employee earning moderate income must contribute approximately 5.3% toward medical coverage. The company pays approximately thirteen point seventy-five percent.

Does this appear like a lot? Not if you contrast it to what the typical US resident spends. I can name multiple businesses that are easily contributing between 8% to 15% of payroll costs for medical benefits. And keep in mind that in comprehensive systems, these contributions also cover retirement benefits, sick pay, maternity leave and job loss protection in addition to funding medical services. When you add those costs compared with our current spending for our retirement plans, unemployment insurance and vacation benefits, the gap narrows.

Execution in the US

In the US, a national health premium would raise existing Medicare taxes, a framework already established. It should be income-adjusted – those at higher income levels would contribute higher amounts than lower-income earners. There would be both worker and company payments. And, like much of federal military, IT, social programs and infrastructure, the program should be outsourced by private contractors instead of a government office.

Advantages for Small Businesses

A national health insurance program represents a huge benefit for entrepreneurs such as my company. It would place us on a level playing field with our larger competitors that can pay for superior coverage. It would make administration much easier (a payroll deduction remitted like retirement and healthcare taxes, instead of individual transactions to insurance companies and coverage administrators).

It would enable it easier for us to budget annual expenditures, rather than enduring the complicated (and fruitless) theater of bargaining with major insurers that we must do each year. Because it's simplified, there would be improved comprehension about benefits by our employees – as opposed to the current system which require them to interpret the complexities of current options. Additionally there would definitely exist less liability for employers since we wouldn't have access to workers' medical records for risk assessment and alternative plans.

Capitalist Perspective

I'm as capitalist as possible. However I recognize that government has a significant role in society, from providing defense to funding essential systems. Ensuring medical coverage to all through a national insurance system enhances economic foundations. It's a better, simpler approach for small businesses which hire more than half of American employees and generate half the economic output. It enables employees to be healthier, come to work more often and be more productive.

Considering Challenges

Exist a million considerations I haven't covered? Of course there are. Given all the healthcare cost increases experienced in recent years, it's evident that the Affordable Care Act is not working effectively. And I realize that we're not a small, Scandinavian country where big changes are easier to implement. But expanding universal Medicare, even with the additional taxes that would be incurred, would still be a superior and less expensive strategy both for managing medical expenses but providing access for all citizens.

Time for Realistic Evaluation

As Americans, we need to tone down our own arrogance. Our healthcare system isn't exceptional. The US places well below numerous nations with the best healthcare in the world, based on comprehensive research. Maybe one positive aspect in this current situation could be that we undertake a hard look at ourselves and agree that big changes are necessary.