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Out-of-pocket costs. Preferred providers. Out-of-network. Premium health services. Out-of-pocket expenses. Fixed payment. Co-insurance. Insurance consultants. Insurance brokers. Medical advisors. Affordable Care Act. HMO. PPO. Exclusive Provider Organization. Point of Service. HDHP. HSA. FSA. Health Reimbursement Arrangement. EOB. COBRA. Small Business Health Options Program. Single coverage. Dependent coverage. Insurance subsidies.

Confused? You should be. Who comprehends this complex system? Certainly not the average entrepreneur. Nor the typical employee. Choosing the appropriate healthcare insurance for companies – or for our families – appears to require it requires a PhD in medical insurance.

The Healthcare System Isn't Just Complex, It's Expensive

Based on recent research, typical households pays $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 from 2025.

Currently federal operations is shut down due to political disagreements over subsidies that experts say could cause a doubling of premiums for millions of Americans.

When Might We Seriously Consider Universal Healthcare?

When will we seriously consider universal healthcare coverage here in America? I'm convinced we're approaching that point because this situation is unsustainable.

I'm not proposing national healthcare. I'm advocating for our current Medicare program – an established insurance framework – simply expand to include all citizens. Our infrastructure doesn't change. The way medical professionals get paid would change. Believe me, they will adjust.

The Way National Health Insurance Could Function

Universal healthcare coverage would require payments from both employees and employers. In comparable systems, an employee making average wages must contribute approximately 5.3% to their healthcare. Their employer pays approximately thirteen point seventy-five percent.

Does this seem like a lot? Unless you contrast it to what average American pays. I know multiple businesses who are routinely paying between eight to fifteen percent of payroll costs to their healthcare costs. Remember that with comprehensive systems, those payments also cover pension plans, sick pay, parental benefits and unemployment benefits in addition to supporting healthcare facilities. When including those costs versus what we pay on retirement programs, job loss coverage and paid time off, the difference decreases.

Execution for America

For America, a national health premium would raise our Medicare tax deduction, a system that is already in place. It should be income-adjusted – wealthier individuals would contribute higher amounts than those earning less. There would be both an employee and company payments. And, like many federal defense, technology, welfare services and infrastructure, the system should be outsourced to third-party administrators rather than federal agencies.

Benefits for Entrepreneurs

Universal healthcare coverage would be a huge benefit for small businesses like mine. It would place us on a level playing field with our larger competitors who can afford better plans. It would make management significantly simpler (automatic payroll withholding remitted like retirement and Medicare taxes, rather than individual transactions to benefit firms and coverage administrators).

It would make it easier for us to budget annual expenditures, rather than enduring the complicated (and fruitless) theater of negotiating with the big insurance providers that we must do every year. Due to simplification, there would be a better understanding about benefits by our employees – as opposed to existing arrangements where they have to decipher the complications of existing plans. And there would definitely exist less liability for companies since we wouldn't would be privy to our employees' medical records for purposes of weighing risks and different options.

Free-Market Viewpoint

I'm as pro-market as possible. But I've learned that government play important functions in society, including national security to funding needed infrastructure. Ensuring medical coverage for everyone through a national insurance system strengthens economic foundations. It represents superior, easier system for small businesses which hire more than half of the country's workers and fund half the economic output. It enables employees to be healthier, have better attendance and be more productive.

Considering Challenges

Are there a million considerations I'm not addressing? Certainly. But with rising medical expenses experienced recently, it's clear that the Affordable Care Act is not working very well. And I realize that America isn't a small, Scandinavian country where major reforms are easier to implement. However extending Medicare for all, despite the additional taxes required, would remain a superior and less expensive approach both for managing medical expenses but providing access for all citizens.

Time for Realistic Evaluation

As Americans, we need to reduce national pride. Our healthcare system isn't exceptional. We rank significantly behind many other countries in healthcare quality in the world, according to major studies. Maybe one bright spot in this current situation is that we take serious examination in the mirror and agree that major reforms are necessary.