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Out-of-pocket costs. In-network. Out-of-network. Premium health services. Out-of-pocket expenses. Fixed payment. Shared insurance. Benefit advisers. Coverage agents. Medical advisors. ACA. HMO. Preferred Provider Organization. EPO. POS. HDHP. HSA. Flexible Spending Account. HRA. EOB. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Family coverage. Premium tax credits.

Confused? It's understandable. Who understands this complex system? Not the typical business owner. Neither the average worker. Selecting the right healthcare insurance for companies – or for our families – appears to require it requires advanced expertise in medical insurance.

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

According to a recent study, the average family spends $27,000 annually for their health insurance (increasing by 6% from last year). Typical employer health insurance cost is projected to surpass $17,000 per employee in 2026, an increase of 9.5% compared to 2025.

Currently federal operations is shut down due to partisan disputes over tax credits which analysts predict will lead to premium increases up to 100% for millions of Americans.

When Might We Truly Examine 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 situation is unsustainable.

I'm not proposing national healthcare. I'm proposing for our current Medicare system – an insurance system – merely extend to include all citizens. The existing system remains intact. How medical professionals get paid changes. Trust me, they'll adapt.

How National Health Insurance Would Work

A national health insurance program would need payments from workers and companies. In comparable systems, an employee making moderate income pays about 5.3% toward medical coverage. Their employer pays about 13.75%.

Does this appear expensive? Unless you contrast that with what average American pays. I know dozens of clients who are routinely paying anywhere from eight to fifteen percent of payroll costs for medical benefits. And keep in mind that with comprehensive systems, those payments also cover pension plans, illness coverage, maternity leave and job loss protection in addition to funding medical services. When you add those costs versus our current spending on retirement programs, job loss coverage and vacation benefits, the difference decreases.

Execution for America

For America, a national health premium would raise our Medicare tax deduction, a framework that is already in place. It ought to be income-adjusted – those at higher income levels would pay more than those earning less. This includes both worker and employer contribution. Similar to much of federal defense, IT, welfare services and transportation services, the program should be outsourced to third-party administrators instead of a government office.

Advantages for Entrepreneurs

Universal healthcare coverage represents a significant advantage for small businesses such as my company. It would place us on a level playing field against big corporations who can afford superior coverage. It would render administration much easier (automatic payroll withholding processed similarly to social security and Medicare taxes, instead of separate payments to benefit firms and insurance providers).

It would enable it easier for us to budget annual expenditures, instead of enduring the complex (and ineffective) process of bargaining with the big insurance providers required annually every year. Because it's simplified, there would exist improved comprehension about benefits by our employees – contrasted with existing arrangements where they have to decipher the complexities of existing plans. And there would definitely exist reduced responsibility for companies as we no longer have access to workers' health histories for weighing risks and alternative plans.

Free-Market Viewpoint

I'm as pro-market as they get. However I recognize that public institutions play important functions in our lives, from providing defense to funding essential systems. Ensuring medical coverage for everyone via universal healthcare enhances our economy's infrastructure. It represents superior, simpler approach for entrepreneurs which hire more than half of American employees and generate half of our GDP. It enables employees to be healthier, come to work more often and increase productivity.

Considering Challenges

Are there a million considerations I'm not addressing? Of course there are. Given rising medical expenses we've seen recently, it's evident that current healthcare legislation isn't functioning very well. And I realize that we're not a compact European nation where major reforms can be readily adopted. But expanding universal Medicare, even with increased taxation required, would still be a better and more affordable strategy both for controlling healthcare costs but providing access for all citizens.

Need for Realistic Evaluation

We as Americans, we need to tone down our own arrogance. America's medical care isn't exceptional. We rank significantly behind many other countries in healthcare quality in the world, according to major studies. Perhaps a positive aspect amid current situation is that we undertake a hard look in the mirror and acknowledge that major reforms need to happen.