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Out-of-pocket costs. In-network. Non-preferred providers. Premium health services. Out-of-pocket expenses. Co-payment. Shared insurance. Insurance consultants. Coverage agents. Medical advisors. ACA. HMO. PPO. Exclusive Provider Organization. POS. High Deductible Health Plan. Health Savings Account. Flexible Spending Account. Health Reimbursement Arrangement. EOB. Consolidated Omnibus Budget Reconciliation Act. SHOP. Single coverage. Family coverage. Premium tax credits.

Baffled? It's understandable. Who comprehends all this stuff? Certainly not the average entrepreneur. Nor the typical employee. Selecting the appropriate healthcare insurance for our business – or for our families – seems like demands advanced expertise in medical insurance.

The Healthcare System Isn't Just Complex, It Is Expensive

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

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

When Might We Seriously Consider Universal Healthcare?

How soon might we genuinely evaluate a national health insurance program in the United States? I'm convinced we're approaching that point because this situation is unsustainable.

I'm not proposing government-run medicine. I'm proposing that our already existing Medicare program – an insurance system – simply expand to include all citizens. The existing system remains intact. The way our healthcare providers receive payment changes. Believe me, they'll adapt.

The Way National Health Insurance Would Work

A national health insurance program would need payments from employees and employers. In similar programs, an employee earning average wages must contribute approximately 5.3% toward medical coverage. Their employer must contribute about 13.75%.

Does this appear expensive? Not if you contrast that with what the typical American pays. I can name multiple clients that are easily contributing between 8% to 15% of payroll costs to their healthcare costs. And keep in mind that with comprehensive systems, these contributions include pension plans, illness coverage, maternity leave and job loss protection in addition to supporting healthcare facilities. When including those costs versus what we pay for our retirement plans, job loss coverage and vacation benefits, the gap narrows.

Execution for America

For America, universal healthcare funding would increase existing Medicare taxes, a system already established. It should be means-based – wealthier individuals would contribute higher amounts than those earning less. There would be both an employee and company payments. Similar to many our government's military, technology, social programs and transportation services, the program could be managed by private contractors rather than federal agencies.

Benefits for Entrepreneurs

Universal healthcare coverage would be a huge benefit for entrepreneurs such as my company. It would put us on a level playing field with our larger competitors that can pay for better plans. It would make administration much easier (automatic payroll withholding processed similarly to social security and Medicare taxes, rather than individual transactions to insurance companies and coverage administrators).

It would enable it easier for us to budget our yearly costs, rather than enduring the complex (and fruitless) process of negotiating with the big insurance providers required annually every year. Due to simplification, there would exist a better understanding about benefits among workers – as opposed to existing arrangements which require them to interpret the complications of existing plans. Additionally there would definitely exist reduced responsibility for companies as we no longer have access to workers' medical records for risk assessment and different options.

Capitalist Perspective

I'm as pro-market as they get. But I've learned that public institutions play important functions in society, from providing defense to supporting needed infrastructure. Providing healthcare to all through a national insurance system strengthens economic foundations. It represents superior, easier system for small businesses that employ the majority of American employees and generate half of our GDP. It makes it possible employees to be healthier, have better attendance and be more productive.

Addressing Concerns

Exist numerous factors I haven't covered? Certainly. But with rising medical expenses we've seen in recent years, 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 Medicare for all, despite the additional taxes required, would remain a better and less expensive strategy for not only managing medical expenses but providing access for all citizens.

Need for Realistic Evaluation

We as Americans, must tone down national pride. America's medical care isn't so great. We rank significantly behind many other countries in healthcare quality in the world, according to major studies. Perhaps a bright spot in this current situation could be that we take serious examination at ourselves and agree that major reforms are necessary.