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Deductibles. In-network. Out-of-network. Concierge medical services. Personal healthcare costs. Co-payment. Co-insurance. Benefit advisers. Insurance brokers. Medical advisors. ACA. HMO. Preferred Provider Organization. Exclusive Provider Organization. POS. High Deductible Health Plan. Health Savings Account. FSA. HRA. EOB. Consolidated Omnibus Budget Reconciliation Act. SHOP. Single coverage. Dependent coverage. Premium tax credits.

Baffled? It's understandable. Who understands all this stuff? Not the typical entrepreneur. Neither the average worker. Selecting the appropriate medical coverage for our business – or for households – appears to require it requires advanced expertise in medical insurance.

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

According to a recent study, the average family spends $27,000 each year on medical coverage (up 6% compared to last year). The average company healthcare expense is expected to exceed $17,000 per employee in 2026, a 9.5% jump compared to 2025.

Currently the government has ceased functioning because political disagreements over subsidies which analysts predict will lead to a doubling of premiums for millions of Americans.

When Will We Truly Examine National Health Insurance?

How soon might we genuinely evaluate a national health insurance program here in America? I'm convinced we're approaching that point because this can't continue.

I'm not proposing government-run medicine. I'm proposing for our current Medicare program – an insurance system – merely extend to include all citizens. Our infrastructure doesn't change. The way medical professionals get paid would change. Believe me, they'll adapt.

How National Health Insurance Would Work

Universal healthcare coverage would need contributions from employees and employers. In similar programs, an employee earning average wages pays approximately 5.3% to their healthcare. Their employer must contribute approximately 13.75%.

Does this seem expensive? Not if you compare it to what the typical American pays. I can name dozens of clients who are routinely paying between 8% to 15% of their employee wages to their healthcare costs. Remember that in inclusive programs, these contributions include pension plans, illness coverage, parental benefits and unemployment benefits along with funding medical services. When including those costs versus our current spending for our retirement plans, unemployment insurance and paid time off, the difference decreases.

Implementation in the US

In the US, a national health premium would raise our Medicare tax deduction, a framework already established. It should be income-adjusted – those at higher income levels would pay more than lower-income earners. There would be both an employee and company payments. And, like much of federal defense, IT, social programs and infrastructure, the system should be outsourced to third-party administrators rather than a government office.

Advantages for Entrepreneurs

Universal healthcare coverage would be a huge benefit for small businesses such as my company. It would put us on a level playing field with our larger competitors who can afford better plans. It would make management significantly simpler (a payroll deduction remitted like social security and healthcare taxes, instead of individual transactions to benefit firms and insurance providers).

It would make simpler to plan expenses our yearly costs, rather than enduring the complicated (and fruitless) process of negotiating with major insurers required annually every year. Because it's simplified, there would be a better understanding of coverage among workers – as opposed to existing arrangements where they have to interpret the complexities of current options. Additionally there would definitely exist less liability for employers as we no longer would be privy to our employees' health histories for purposes of risk assessment and alternative plans.

Free-Market Viewpoint

I'm as capitalist as possible. However I recognize 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 our economy's infrastructure. It represents superior, easier system for entrepreneurs which hire more than half of the country's workers and generate half the economic output. It makes it possible for workers to be healthier, have better attendance and increase productivity.

Considering Challenges

Are there a million considerations I haven't covered? Of course there are. But with rising medical expenses we've seen in recent years, it's evident that the Affordable Care Act isn't functioning effectively. And I realize that we're not a small, Scandinavian country where major reforms are easier to implement. However extending Medicare for all, despite the additional taxes that would be incurred, would remain a better and less expensive approach both for managing medical expenses and ensuring coverage to everyone.

Need for Realistic Evaluation

We as Americans, we need to reduce national pride. America's medical care isn't exceptional. The US places well below many other countries in healthcare quality globally, according to major studies. Maybe one positive aspect in this present circumstances could be that we take serious examination in the mirror and agree that big changes need to happen.