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Out-of-pocket costs. In-network. Out-of-network. Premium health services. Out-of-pocket expenses. Co-payment. Co-insurance. Insurance consultants. Coverage agents. Healthcare consultants. ACA. Health Maintenance Organization. PPO. EPO. Point of Service. High Deductible Health Plan. Health Savings Account. Flexible Spending Account. HRA. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Individual coverage. Family coverage. Premium tax credits.

Baffled? You should be. Who understands this complex system? Certainly not the average entrepreneur. Nor the typical worker. Selecting the appropriate medical coverage for our business – or for households – appears to require demands a PhD in medical insurance.

Our Medical System Is More Than Complicated, It Is Costly

According to recent research, the average family spends $27,000 each year on medical coverage (increasing by 6% compared to last year). The average employer health insurance cost is expected to exceed $17,000 for each worker by 2026, a 9.5% jump compared to 2025.

Now federal operations is shut down due to partisan disputes over tax credits that experts say will lead to a doubling of premiums for numerous US citizens.

When Might We Truly Examine National Health Insurance?

When will we seriously consider universal healthcare coverage here in America? I have to believe we're getting closer since this can't continue.

I'm not suggesting national healthcare. I'm advocating for our current Medicare system – an established insurance framework – simply expand to include all citizens. The existing system doesn't change. How our healthcare providers receive payment changes. Believe me, they'll adapt.

How Universal Coverage Would Work

A national health insurance program would need payments from employees and employers. In comparable systems, a worker earning average wages must contribute approximately 5.3% toward medical coverage. Their employer must contribute approximately 13.75%.

Does this appear like a lot? Unless you contrast that with what average American pays. I know dozens of clients who are easily contributing anywhere from eight to fifteen percent of payroll costs to their healthcare costs. Remember that with inclusive programs, those payments include pension plans, sick pay, parental benefits and job loss protection along with funding healthcare facilities. When you add those costs compared with our current spending for our retirement plans, unemployment insurance and vacation benefits, the difference decreases.

Execution for America

For America, a national health premium would raise our Medicare tax deduction, a system already established. It should be income-adjusted – wealthier individuals would pay more than lower-income earners. There would be both worker and employer contribution. Similar to much of our government's defense, technology, social programs and transportation services, the system should be outsourced to third-party administrators instead of federal agencies.

Advantages for Entrepreneurs

Universal healthcare coverage represents a significant advantage for entrepreneurs like mine. It would place small companies in equal competition with our larger competitors who can afford superior coverage. It would make administration much easier (a payroll deduction remitted like retirement and Medicare taxes, instead of separate payments to benefit firms and coverage administrators).

It would enable it easier to plan expenses annual expenditures, instead of going through the complicated (and fruitless) process of negotiating with the big insurance providers that we must do each year. Because it's simplified, there would exist improved comprehension about benefits among workers – contrasted with the current system which require them to interpret the complexities of current options. And there would definitely exist less liability for employers as we no longer would be privy to workers' health histories for purposes of weighing risks and different options.

Free-Market Viewpoint

I'm as capitalist as they get. But I've learned that public institutions play important functions in our lives, including national security to funding essential systems. Ensuring medical coverage for everyone via universal healthcare strengthens our economy's infrastructure. It's a better, simpler approach for entrepreneurs that employ the majority of the country's workers and generate half of our GDP. It makes it possible for workers to enjoy better health, come to work more often and increase productivity.

Addressing Concerns

Exist numerous factors I'm not addressing? Certainly. But with all the healthcare cost increases we've seen in recent years, it's evident that the Affordable Care Act isn't functioning very well. And I realize that America isn't a compact European nation where major reforms can be readily adopted. However extending Medicare for all, despite the additional taxes that would be incurred, would still be a superior and less expensive approach for not only managing medical expenses but providing access to everyone.

Need for Honest Assessment

We as Americans, must tone down our own arrogance. Our healthcare system isn't exceptional. The US places well below numerous nations with the best healthcare globally, based on comprehensive research. Maybe one positive aspect in this current situation could be that we take a hard look in the mirror and agree that major reforms are necessary.