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Out-of-pocket costs. Preferred providers. Non-preferred providers. Premium health services. Out-of-pocket expenses. Co-payment. Shared insurance. Benefit advisers. Coverage agents. Healthcare consultants. Affordable Care Act. Health Maintenance Organization. PPO. EPO. POS. High Deductible Health Plan. Health Savings Account. FSA. HRA. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Individual coverage. Dependent coverage. Insurance subsidies.

Baffled? It's understandable. Who understands all this stuff? Certainly not the average business owner. Neither the average worker. Selecting the appropriate healthcare insurance for our business – or for our families – appears to require demands a PhD in medical insurance.

Our Healthcare System Is More Than Complex, It's Expensive

Based on a recent study, the average family spends $27,000 each year for their health insurance (increasing by 6% from last year). The average company healthcare expense is expected to surpass $17,000 for each worker in 2026, an increase of 9.5% from 2025.

Currently the government is shut down due to partisan disputes over subsidies that experts say will lead to a doubling of premiums for numerous US citizens.

When Might We Truly Examine National Health Insurance?

How soon might we genuinely evaluate a national health insurance program in the United States? I have to believe we're approaching that point since this situation is unsustainable.

I'm not suggesting government-run medicine. I'm advocating that our already existing Medicare program – an insurance system – simply expand to cover everyone. The existing system remains intact. The way medical professionals get paid changes. Trust me, they'll adapt.

How National Health Insurance Could Function

A national health insurance program would require payments from workers and companies. In similar programs, an employee making moderate income must contribute about five point three percent to their healthcare. The company must contribute approximately thirteen point seventy-five percent.

Does this appear like a lot? Unless you contrast that with what the typical US resident spends. I know dozens of clients who are routinely paying between 8% to 15% of their employee wages to their healthcare costs. And keep in mind that with inclusive programs, these contributions also cover retirement benefits, sick pay, maternity leave and unemployment benefits along with supporting healthcare facilities. When including those costs versus our current spending for our retirement plans, job loss coverage and paid time off, the gap narrows.

Implementation in the US

For America, a national health premium would raise our Medicare tax deduction, a system that is already in place. It should be means-based – wealthier individuals would pay more than those earning less. There would be both an employee and employer contribution. And, like many federal military, technology, welfare services and transportation services, the system should be outsourced by private contractors rather than federal agencies.

Advantages for Entrepreneurs

A national health insurance program would be a significant advantage for entrepreneurs like mine. It would place small companies in equal competition against big corporations that can pay for better plans. It would render management significantly simpler (automatic payroll withholding processed similarly to retirement and Medicare taxes, rather than individual transactions to insurance companies and coverage administrators).

It would enable it easier for us to budget annual expenditures, rather than going through the complicated (and ineffective) process of bargaining with major insurers required annually every year. Because it's simplified, there would be a better understanding about benefits by our employees – as opposed to existing arrangements which require them to interpret the complexities of existing plans. Additionally there would definitely exist reduced responsibility for employers since we wouldn't have access to workers' medical records for weighing risks and different options.

Capitalist Perspective

I'm as capitalist as they get. However I recognize that public institutions has a significant role in our lives, from providing defense to supporting essential systems. Ensuring medical coverage for everyone through a national insurance system strengthens our economy's infrastructure. It's a better, easier system for small businesses which hire more than half of the country's workers and generate half of our GDP. It enables for workers to enjoy better health, come to work more often and be more productive.

Considering Challenges

Exist numerous factors I'm not addressing? Certainly. Given rising medical expenses experienced recently, it's evident that current healthcare legislation isn't functioning effectively. And I realize that America isn't a compact European nation where major reforms can be readily adopted. However extending Medicare for all, even with the additional taxes required, would still be a superior and less expensive strategy for not only controlling healthcare costs but providing access for all citizens.

Need for Honest Assessment

As Americans, we need to tone down national pride. Our healthcare system isn't exceptional. We rank significantly behind numerous nations with the best healthcare in the world, based on major studies. Perhaps a positive aspect amid current situation could be that we undertake a hard look at ourselves and agree that big changes need to happen.