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Out-of-pocket costs. Preferred providers. Non-preferred providers. Premium health services. Personal healthcare costs. Fixed payment. Co-insurance. Insurance consultants. Coverage agents. Healthcare consultants. Affordable Care Act. Health Maintenance Organization. PPO. Exclusive Provider Organization. POS. High Deductible Health Plan. HSA. FSA. HRA. EOB. COBRA. Small Business Health Options Program. Individual coverage. Dependent coverage. Premium tax credits.

Confused? It's understandable. Who understands all this stuff? Certainly not the average business owner. Neither the average worker. Choosing the appropriate medical coverage for companies – or for households – seems like it requires a PhD in healthcare.

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

Based on a recent study, the average family spends $27,000 annually on medical coverage (up 6% from last year). The average company healthcare expense is projected to surpass $17,000 per employee in 2026, an increase of 9.5% from 2025.

Now federal operations is shut down due to political disagreements over tax credits that experts say could cause a doubling of premiums for millions of Americans.

When Might We Seriously Consider National Health Insurance?

How soon might we seriously consider a national health insurance program in the United States? I'm convinced we're getting closer because this can't continue.

I'm not proposing national healthcare. I'm advocating for our current Medicare program – an established insurance framework – simply expand to cover everyone. The existing system remains intact. The way medical professionals get paid would change. Believe me, they will adjust.

How National Health Insurance Would Work

A national health insurance program would need contributions from employees and employers. In similar programs, an employee earning moderate income must contribute approximately five point three percent toward medical coverage. The company must contribute approximately 13.75%.

Does this seem like a lot? Not if you compare that with what average American pays. I can name multiple clients that are routinely paying anywhere from 8% to 15% of payroll costs for medical benefits. Remember that with comprehensive systems, those payments include pension plans, illness coverage, maternity leave and job loss protection along with supporting healthcare facilities. When including those costs compared with what we pay on retirement programs, job loss coverage and paid time off, the gap narrows.

Implementation for America

In the US, a national health premium would raise existing Medicare taxes, a framework already established. It ought to be means-based – those at higher income levels would pay more than those earning less. This includes both worker and employer contribution. And, like many our government's defense, IT, social programs and infrastructure, the system could be managed by private contractors rather than federal agencies.

Advantages for Entrepreneurs

Universal healthcare coverage would be a significant advantage for small businesses such as my company. It would place small companies in equal competition with our larger competitors who can afford better plans. It would make administration significantly simpler (a payroll deduction processed similarly to retirement and Medicare taxes, instead of individual transactions to insurance companies and coverage administrators).

It would enable it easier for us to budget our yearly costs, rather than enduring the complicated (and ineffective) process of bargaining with the big insurance providers required annually every year. Due to simplification, there would be improved comprehension of coverage by our employees – as opposed to the current system where they have to interpret the complications of current options. And there would definitely exist reduced responsibility for companies since we wouldn't would be privy to workers' health histories for weighing risks and different options.

Free-Market Viewpoint

I'm as pro-market as possible. But I've learned that public institutions play important functions in society, including national security to funding essential systems. Providing healthcare to all via universal healthcare enhances economic foundations. It's a better, easier system for small businesses which hire more than half of the country's workers and fund half the economic output. It enables for workers to enjoy better health, come to work more often and increase productivity.

Addressing Concerns

Are there numerous factors I haven't covered? Certainly. Given all the healthcare cost increases experienced recently, it's clear that the Affordable Care Act isn't functioning very well. And I realize that America isn't a compact European nation where big changes are easier to implement. However extending universal Medicare, despite increased taxation that would be incurred, would remain a superior and less expensive strategy both for controlling healthcare costs but providing access to everyone.

Need for Honest Assessment

As Americans, we need to reduce national pride. America's medical care isn't exceptional. The US places significantly behind numerous nations in healthcare quality globally, based on comprehensive research. Maybe one positive aspect in this current situation is that we take a hard look in the mirror and agree that big changes need to happen.