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Out-of-pocket costs. In-network. Out-of-network. Premium health services. Personal healthcare costs. Co-payment. Co-insurance. Insurance consultants. Insurance brokers. Medical advisors. ACA. HMO. PPO. EPO. Point of Service. High Deductible Health Plan. HSA. FSA. Health Reimbursement Arrangement. EOB. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Single coverage. Dependent coverage. Premium tax credits.

Confused? It's understandable. Who comprehends all this stuff? Certainly not the average business owner. Nor the typical worker. Selecting the right healthcare insurance for our business – or for our families – appears to require it requires advanced expertise in healthcare.

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

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

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

When Might We Seriously Consider Universal Healthcare?

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 government-run medicine. I'm advocating that our already existing Medicare program – an insurance system – simply expand to include all citizens. Our infrastructure doesn't change. The way our healthcare providers get paid would change. Believe me, they will adjust.

How Universal Coverage Would Work

A national health insurance program would require contributions from both employees and employers. In comparable systems, an employee earning moderate income pays about five point three percent toward medical coverage. The company pays about thirteen point seventy-five percent.

Does this seem expensive? Not if you contrast that with what the typical US resident spends. I can name dozens of businesses who are easily contributing between eight to fifteen percent of payroll costs to their healthcare costs. Remember that in inclusive programs, those payments include retirement benefits, illness coverage, parental benefits and unemployment benefits along with funding medical services. When you add these expenses compared with what we pay on retirement programs, job loss coverage and vacation benefits, the difference decreases.

Implementation for America

In the US, a national health premium would raise our Medicare tax deduction, a framework that is already in place. It should be means-based – those at higher income levels would contribute higher amounts than those earning less. There would be both worker and company payments. Similar to much of federal military, IT, social programs and transportation services, the program should be outsourced by private contractors instead of a government office.

Advantages for Small Businesses

A national health insurance program represents a significant advantage for entrepreneurs like mine. It would put us on a level playing field against big corporations who can afford superior coverage. It would render administration much easier (a payroll deduction remitted like retirement and healthcare taxes, rather than individual transactions to benefit firms and insurance providers).

It would make it easier for us to budget annual expenditures, rather than enduring the complex (and ineffective) process of negotiating with major insurers required annually every year. Due to simplification, there would be improved comprehension of coverage among workers – as opposed to existing arrangements which require them to interpret the complications of current options. Additionally there would definitely exist less liability for companies as we no longer have access to workers' medical records for risk assessment and different options.

Free-Market Viewpoint

I'm as pro-market as they get. However I recognize that government play important functions in society, including national security to supporting essential systems. Ensuring medical coverage for everyone via universal healthcare strengthens our economy's infrastructure. It represents superior, easier system for entrepreneurs that employ the majority of the country's workers and fund half the economic output. It enables employees to be healthier, have better attendance and be more productive.

Addressing Concerns

Exist a million considerations I haven't covered? Of course there are. Given rising medical expenses 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 compact European nation where major reforms can be readily adopted. But expanding universal Medicare, despite the additional taxes that would be incurred, would remain a superior and more affordable 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. America's medical care isn't so great. The US places significantly behind numerous nations with the best healthcare globally, based on comprehensive research. Perhaps a positive aspect in this present circumstances is that we take a hard look in the mirror and acknowledge that major reforms are necessary.