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Out-of-pocket costs. In-network. Out-of-network. Premium health services. Out-of-pocket expenses. Fixed payment. Co-insurance. Benefit advisers. Coverage agents. Healthcare consultants. Affordable Care Act. Health Maintenance Organization. PPO. EPO. Point of Service. High Deductible Health Plan. HSA. Flexible Spending Account. Health Reimbursement Arrangement. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Dependent coverage. Premium tax credits.

Confused? It's understandable. Who comprehends all this stuff? Certainly not the average entrepreneur. Nor the typical worker. Selecting the right medical coverage for our business – or for our families – appears to require it requires a PhD in healthcare.

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

Based on a recent study, the average family spends $27,000 each year for their health insurance (up 6% from last year). Typical company healthcare expense is expected to exceed $17,000 per employee in 2026, an increase of 9.5% compared to 2025.

Currently federal operations is shut down due to political disagreements regarding tax credits which analysts predict could cause premium increases up to 100% for numerous US citizens.

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 since this can't continue.

I'm not suggesting government-run medicine. I'm advocating for our current Medicare program – an insurance system – simply expand to include all citizens. Our infrastructure doesn't change. How medical professionals get paid changes. Believe me, they will adjust.

How Universal Coverage Would Work

A national health insurance program would require payments from both employees and employers. In comparable systems, an employee earning average wages must contribute approximately five point three percent toward medical coverage. Their employer must contribute about thirteen point seventy-five percent.

Does this seem expensive? Unless you compare that with what the typical US resident spends. I know multiple businesses who are easily contributing between eight to fifteen percent of payroll costs for medical benefits. And keep in mind that with inclusive programs, those payments also cover pension plans, sick pay, parental benefits and unemployment benefits along with supporting medical services. When including those costs versus our current spending on retirement programs, job loss coverage and paid time off, the gap narrows.

Execution in the US

For America, a national health premium would raise our Medicare tax deduction, a framework that is already in place. It should be income-adjusted – wealthier individuals would contribute higher amounts than lower-income earners. There would be both worker and employer contribution. Similar to much of federal defense, technology, social programs and infrastructure, the system could be managed by private contractors instead of federal agencies.

Advantages for Entrepreneurs

A national health insurance program represents a significant advantage for entrepreneurs like mine. It would put us on a level playing field with our larger competitors that can pay for better plans. It would make management significantly simpler (a payroll deduction processed similarly to social security and Medicare taxes, instead of individual transactions to benefit firms and insurance providers).

It would make it easier for us to budget annual expenditures, rather than going through the complicated (and ineffective) theater of bargaining with major insurers that we must do each year. Because it's simplified, there would exist improved comprehension about benefits by our employees – as opposed to the current system where they have to interpret the complexities of existing plans. And there would certainly be reduced responsibility for companies since we wouldn't have access to our employees' medical records for weighing risks and alternative plans.

Free-Market Viewpoint

I'm as pro-market as possible. However I recognize that government has a significant role in our lives, including national security to funding needed infrastructure. Ensuring medical coverage for everyone through a national insurance system strengthens economic foundations. It represents superior, simpler approach for small businesses which hire more than half of American employees and generate half the economic output. It enables employees to enjoy better health, have better attendance and be more productive.

Addressing Concerns

Exist numerous factors I haven't covered? Certainly. Given rising medical expenses we've seen recently, it's clear that the Affordable Care Act isn't functioning effectively. And I realize that we're not a small, Scandinavian country where major reforms can be readily adopted. But expanding Medicare for all, even with increased taxation that would be incurred, would remain a better and more affordable strategy for not only controlling healthcare costs but providing access to everyone.

Need for Realistic Evaluation

We as Americans, we need to tone down national pride. Our healthcare system isn't so great. We rank well below many other countries with the best healthcare in the world, based on major studies. Maybe one bright spot in this current situation could be that we take a hard look at ourselves and agree that major reforms are necessary.