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Out-of-pocket costs. In-network. Non-preferred providers. Concierge medical services. Out-of-pocket expenses. Co-payment. Co-insurance. Benefit advisers. Insurance brokers. Healthcare consultants. Affordable Care Act. HMO. Preferred Provider Organization. EPO. POS. High Deductible Health Plan. HSA. Flexible Spending Account. HRA. EOB. COBRA. SHOP. Individual coverage. Dependent coverage. Premium tax credits.

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

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

Based on recent research, typical households spends $27,000 annually on medical coverage (up 6% from last year). The average company healthcare expense is expected to exceed $17,000 for each worker in 2026, a 9.5% jump compared to 2025.

Now the government is shut down because political disagreements over subsidies that experts say will lead to a doubling of premiums for numerous US citizens.

When Will We Seriously Consider Universal Healthcare?

How soon might we seriously consider universal healthcare coverage here in America? I'm convinced we're approaching that point because this can't continue.

I'm not suggesting government-run medicine. I'm advocating for our current Medicare program – an established insurance framework – merely extend to include all citizens. The existing system doesn't change. How our healthcare providers get paid would change. Believe me, they'll adapt.

The Way National Health Insurance Would Work

Universal healthcare coverage would need payments from employees and employers. In similar programs, an employee making average wages pays about five point three percent to their healthcare. Their employer pays about thirteen point seventy-five percent.

Does this appear like a lot? Unless you compare it to what average US resident spends. I know dozens of businesses that are routinely paying anywhere from 8% to 15% of payroll costs to their healthcare costs. Remember that in comprehensive systems, those payments include retirement benefits, sick pay, parental benefits and job loss protection along with funding healthcare facilities. When you add those costs versus what we pay on retirement programs, job loss coverage and paid time off, the gap narrows.

Execution in the US

In the US, 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. This includes both worker and employer contribution. And, like many our government's defense, IT, social programs and transportation services, the program could be managed by private contractors rather than a government office.

Advantages for Entrepreneurs

Universal healthcare coverage would be a huge benefit for small businesses like mine. It would put us on a level playing field against big corporations who can afford superior coverage. It would make management much easier (a payroll deduction remitted like social security and healthcare taxes, instead of individual transactions to benefit firms and insurance providers).

It would enable simpler for us to budget our yearly costs, instead of going through the complex (and fruitless) process of bargaining with the big insurance providers that we must do each year. Because it's simplified, there would exist a better understanding about benefits by our employees – as opposed to the current system which require them to interpret the complexities of existing plans. And there would certainly be reduced responsibility for companies as we no longer have access to workers' medical records for weighing risks and different options.

Capitalist Perspective

I'm as capitalist as possible. However I recognize that public institutions play important functions in our lives, including national security to funding essential systems. Providing healthcare for everyone through a national insurance system enhances our economy's infrastructure. It's a better, easier system for entrepreneurs which hire the majority of American employees and generate half of our GDP. It makes it possible for workers to be healthier, come to work more often and be more productive.

Addressing Concerns

Exist numerous factors I'm not addressing? Certainly. Given all the healthcare cost increases experienced in recent years, it's evident that the Affordable Care Act is not working effectively. And I realize that America isn't a small, Scandinavian country where major reforms are easier to implement. But expanding universal Medicare, even with increased taxation required, would remain a superior and more affordable strategy for not only controlling healthcare costs and ensuring coverage to everyone.

Need for Realistic Evaluation

As Americans, must tone down our own arrogance. Our healthcare system isn't exceptional. We rank significantly behind many other countries with the best healthcare in the world, according to major studies. Perhaps a positive aspect amid current situation could be that we undertake a hard look in the mirror and acknowledge that major reforms need to happen.