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Out-of-pocket costs. Preferred providers. Non-preferred providers. Concierge medical services. Personal healthcare costs. Co-payment. Shared insurance. Insurance consultants. Insurance brokers. Medical advisors. ACA. Health Maintenance Organization. PPO. Exclusive Provider Organization. POS. High Deductible Health Plan. Health Savings Account. Flexible Spending Account. HRA. EOB. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Family coverage. Premium tax credits.

Baffled? It's understandable. Who understands this complex system? Not the typical business owner. Nor the typical worker. Choosing the right healthcare insurance for our business – or for our families – seems like it requires a PhD in healthcare.

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

According to a recent study, the average family pays $27,000 annually for their health insurance (up 6% from last year). Typical employer health insurance cost is expected to surpass $17,000 per employee by 2026, a 9.5% jump compared to 2025.

Now federal operations is shut down because political disagreements over tax credits that experts say could cause premium increases up to 100% for millions of Americans.

When Will We Seriously Consider National Health Insurance?

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

I'm not suggesting government-run medicine. I'm proposing for our current Medicare program – an insurance system – merely extend to include all citizens. The existing system doesn't change. How our healthcare providers receive payment changes. Trust me, they'll adapt.

How Universal Coverage Could Function

A national health insurance program would require payments from both workers and companies. In comparable systems, an employee making moderate income pays about 5.3% to their healthcare. Their employer must contribute approximately thirteen point seventy-five percent.

Does this appear expensive? Unless you compare it to what the typical US resident spends. I can name multiple clients who are easily contributing anywhere from eight to fifteen percent of payroll costs for medical benefits. Remember that in inclusive programs, these contributions include pension plans, sick pay, parental benefits and job loss protection along with supporting healthcare facilities. When including those costs versus our current spending for our retirement plans, unemployment insurance and paid time off, the gap narrows.

Implementation for America

For America, 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 pay more than those earning less. There would be both worker and company payments. Similar to many federal defense, technology, social programs and transportation services, the program should be outsourced to third-party administrators rather than a government office.

Advantages for Entrepreneurs

A national health insurance program represents a significant advantage for entrepreneurs like mine. It would place small companies in equal competition with our larger competitors that can pay for better plans. It would render administration significantly simpler (a payroll deduction remitted like retirement and healthcare taxes, instead of individual transactions to benefit firms and coverage administrators).

It would enable it easier to plan expenses our yearly costs, instead of going through the complex (and ineffective) process of bargaining with the big insurance providers that we must do each year. Due to simplification, there would be improved comprehension about benefits by our employees – contrasted with the current system where they have to interpret the complexities of existing plans. And there would definitely exist less liability for employers as we no longer would be privy to workers' medical records for risk assessment and different options.

Free-Market Viewpoint

I'm as pro-market as possible. However I recognize that public institutions play important functions in society, from providing defense to funding essential systems. Ensuring medical coverage for everyone through a national insurance system strengthens our economy's infrastructure. It represents superior, easier system for small businesses which hire more than half of American employees and generate half of our GDP. It makes it possible for workers to enjoy better health, have better attendance and increase productivity.

Considering Challenges

Exist a million considerations I'm not addressing? Of course there are. Given rising medical expenses we've seen recently, it's clear that the Affordable Care Act isn't functioning very well. I understand that America isn't a small, Scandinavian country where big changes are easier to implement. However extending Medicare for all, despite the additional taxes that would be incurred, would still be a better and more affordable strategy both for managing medical expenses and ensuring coverage for all citizens.

Need for Honest Assessment

As Americans, we need to reduce our own arrogance. Our healthcare system isn't so great. The US places significantly behind many other countries in healthcare quality globally, based on comprehensive research. Perhaps a positive aspect amid current situation could be that we take a hard look at ourselves and agree that major reforms need to happen.