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Deductibles. Preferred providers. Out-of-network. Premium health services. Personal healthcare costs. Co-payment. Shared insurance. Benefit advisers. Coverage agents. Healthcare consultants. Affordable Care Act. HMO. PPO. Exclusive Provider Organization. Point of Service. HDHP. HSA. FSA. Health Reimbursement Arrangement. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. SHOP. Individual coverage. Dependent coverage. Insurance subsidies.

Confused? It's understandable. Who understands this complex system? Not the typical entrepreneur. Neither the average employee. Selecting the appropriate medical coverage for companies – or for households – appears to require demands a PhD in healthcare.

Our Healthcare System Is More Than Complicated, It Is Expensive

According to a recent study, typical households pays $twenty-seven thousand annually on medical coverage (increasing by 6% from last year). Typical employer health insurance cost is expected to exceed $17,000 per employee by 2026, an increase of 9.5% from 2025.

Currently the government is shut down due to political disagreements over subsidies that experts say could cause premium increases up to 100% for millions of Americans.

When Might We Seriously Consider National Health Insurance?

How soon might we seriously consider a national health insurance program in the United States? I'm convinced we're approaching that point because this situation is unsustainable.

I'm not proposing national healthcare. I'm proposing for our current Medicare program – an established insurance framework – merely extend to include all citizens. Our infrastructure remains intact. How our healthcare providers get paid would change. Believe me, they'll adapt.

The Way National Health Insurance Would Work

A national health insurance program would require contributions from employees and employers. In similar programs, an employee earning average wages pays approximately five point three percent to their healthcare. The company pays about 13.75%.

Does this seem like a lot? Unless you contrast that with what average US resident spends. I know dozens of clients that are easily contributing anywhere from eight to fifteen percent of payroll costs for medical benefits. And keep in mind that with comprehensive systems, these contributions also cover pension plans, illness coverage, parental benefits and job loss protection along with supporting medical services. When you add these expenses versus what we pay on retirement programs, unemployment insurance and vacation benefits, the difference decreases.

Execution for America

In the US, a national health premium would raise our Medicare tax deduction, a framework that is already in place. It ought to be means-based – those at higher income levels would pay more than those earning less. There would be both worker and employer contribution. And, like many federal defense, technology, welfare services and infrastructure, the program could be managed to third-party administrators instead of federal agencies.

Advantages for Small Businesses

A national health insurance program represents a significant advantage for entrepreneurs like mine. It would put small companies in equal competition with our larger competitors that can pay for superior coverage. It would make management significantly simpler (automatic payroll withholding processed similarly to social security and Medicare taxes, instead of separate payments to benefit firms and coverage administrators).

It would enable it easier for us to budget our yearly costs, instead of enduring the complex (and fruitless) process of bargaining with major insurers required annually each year. Because it's simplified, there would exist improved comprehension of coverage among workers – contrasted with existing arrangements which require them to interpret the complexities of existing plans. And there would certainly be less liability for employers as we no longer have access to our employees' health histories for risk assessment and alternative plans.

Free-Market Viewpoint

I'm as pro-market as possible. But I've learned 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 enhances our economy's infrastructure. It's a better, simpler approach for small businesses that employ more than half of the country's workers and fund half of our GDP. It enables for workers to enjoy better health, come to work more often and be more productive.

Considering Challenges

Are there a million considerations I haven't covered? Of course there are. But with rising medical expenses experienced in recent years, it's clear that current healthcare legislation is not working effectively. And I realize that we're not a compact European nation where major reforms can be readily adopted. However extending Medicare for all, even with the additional taxes that would be incurred, would still be a better and more affordable strategy both for controlling healthcare costs and ensuring coverage to everyone.

Time for Honest Assessment

We as Americans, we need to tone down our own arrogance. America's medical care isn't so great. We rank significantly behind numerous nations with the best healthcare in the world, according to comprehensive research. Perhaps a positive aspect in this current situation is that we take serious examination at ourselves and agree that big changes need to happen.