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Deductibles. Preferred providers. Out-of-network. Concierge medical services. Out-of-pocket expenses. Fixed payment. Shared insurance. Benefit advisers. Insurance brokers. Medical advisors. Affordable Care Act. Health Maintenance Organization. Preferred Provider Organization. Exclusive Provider Organization. Point of Service. High Deductible Health Plan. Health Savings Account. Flexible Spending Account. Health Reimbursement Arrangement. Explanation of Benefits. COBRA. Small Business Health Options Program. Individual coverage. Family coverage. Premium tax credits.

Confused? You should be. Who comprehends all this stuff? Not the typical business owner. Nor the typical employee. Choosing the right healthcare insurance for our business – or for our families – seems like demands a PhD in healthcare.

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

According to a recent study, typical households spends $27,000 each year on medical coverage (up 6% compared to last year). Typical employer health insurance cost is projected to exceed $17,000 for each worker by 2026, an increase of 9.5% compared to 2025.

Now the government is shut down due to political disagreements regarding tax credits which analysts predict will lead to premium increases up to 100% for millions of Americans.

When Will We Seriously Consider Universal Healthcare?

How soon might we seriously consider universal healthcare coverage here in America? I have to believe we're approaching that point since this situation is unsustainable.

I'm not suggesting government-run medicine. I'm proposing for our current Medicare system – an established insurance framework – simply expand to include all citizens. The existing system doesn't change. The way medical professionals get paid changes. Trust me, they will adjust.

The Way National Health Insurance Would Work

Universal healthcare coverage would require contributions from employees and employers. In similar programs, a worker earning moderate income pays approximately 5.3% toward medical coverage. Their employer must contribute approximately 13.75%.

Does this seem like a lot? Not if you contrast that with what the typical American pays. I can name dozens of clients that are easily contributing anywhere from eight to fifteen percent of payroll costs for medical benefits. Remember that in comprehensive systems, these contributions also cover retirement benefits, sick pay, maternity leave and job loss protection along with supporting medical services. When including those costs compared with 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 existing Medicare taxes, a framework already established. It should be means-based – wealthier individuals would pay more than those earning less. This includes both an employee and company payments. Similar to many federal defense, IT, welfare services and infrastructure, the program 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 such as my company. It would place us on a level playing field with our larger competitors who can afford better plans. It would make administration much easier (automatic payroll withholding remitted like social security and Medicare taxes, instead of separate payments to benefit firms and insurance providers).

It would enable simpler to plan expenses our yearly costs, instead of enduring the complicated (and fruitless) theater of negotiating 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 where they have to interpret the complexities of existing plans. Additionally there would definitely exist less liability for companies since we wouldn't have access to our employees' medical records for purposes of risk assessment and different options.

Capitalist Perspective

I'm as pro-market as they get. However I recognize that government has a significant role in society, from providing defense to funding needed infrastructure. Providing healthcare for everyone via universal healthcare enhances our economy's infrastructure. It's a better, simpler approach for small businesses which hire more than half of the country's workers and generate half of our GDP. It enables employees to be healthier, have better attendance and be more productive.

Addressing Concerns

Are there a million considerations I haven't covered? Certainly. But with rising medical expenses we've seen recently, it's evident that current healthcare legislation isn't functioning effectively. And I realize that we're not a compact European nation where major reforms are easier to implement. But expanding universal Medicare, despite the additional taxes required, would still be a better and more affordable approach for not only controlling healthcare costs but providing access to everyone.

Need for Honest Assessment

We as Americans, we need to reduce our own arrogance. Our healthcare system isn't exceptional. The US places well below numerous nations in healthcare quality globally, according to major studies. Perhaps a positive aspect amid present circumstances is that we take serious examination at ourselves and acknowledge that major reforms are necessary.