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Out-of-pocket costs. In-network. Non-preferred providers. Premium health services. Out-of-pocket expenses. Co-payment. Shared insurance. Benefit advisers. Coverage agents. Medical advisors. ACA. Health Maintenance Organization. Preferred Provider Organization. Exclusive Provider Organization. POS. HDHP. HSA. FSA. HRA. EOB. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Single coverage. Dependent coverage. Insurance subsidies.

Confused? You should be. Who understands all this stuff? Certainly not the average entrepreneur. Neither the average worker. Selecting the appropriate healthcare insurance for our business – or for our families – appears to require it requires a PhD in healthcare.

Our Healthcare System Is More Than Complex, It's Expensive

Based on a recent study, typical households pays $27,000 each year for their health insurance (increasing by 6% compared to last year). The average company healthcare expense is projected to surpass $17,000 per employee in 2026, an increase of 9.5% from 2025.

Currently federal operations is shut down due to political disagreements over tax credits which analysts predict will lead to premium increases up to 100% for millions of Americans.

When Might We Seriously Consider Universal Healthcare?

How soon might we genuinely evaluate universal healthcare coverage in the United States? I'm convinced we're getting closer since this can't continue.

I'm not suggesting national healthcare. I'm advocating for our current Medicare system – an insurance system – merely extend to include all citizens. Our infrastructure doesn't change. The way medical professionals receive payment would change. Believe me, they'll adapt.

The Way Universal Coverage Would Work

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

Does this appear like a lot? Unless you contrast that with what average US resident spends. I can name multiple businesses that are easily contributing anywhere from 8% to 15% of payroll costs to their healthcare costs. And keep in mind that with inclusive programs, those payments include retirement benefits, sick pay, parental benefits and unemployment benefits in addition to supporting healthcare facilities. When you add those costs versus our current spending on retirement programs, unemployment insurance and paid time off, the gap narrows.

Execution in the US

In the US, universal healthcare funding would raise existing Medicare taxes, a system 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 federal defense, IT, welfare services and infrastructure, the system could be managed to third-party administrators rather than a government office.

Advantages for Small Businesses

Universal healthcare coverage would be a significant advantage for small businesses like mine. It would put us on a level playing field against big corporations that can pay for better plans. It would make management significantly simpler (a payroll deduction remitted like retirement and healthcare taxes, instead of separate payments to benefit firms and insurance providers).

It would make it easier to plan expenses our yearly costs, rather than going through the complicated (and ineffective) theater of bargaining with the big insurance providers that we must do every year. Due to simplification, there would exist improved comprehension about benefits by our employees – as opposed to existing arrangements which require them to interpret the complications of current options. Additionally there would definitely exist less liability for companies as we no longer would be privy to our employees' medical records for purposes of risk assessment and alternative plans.

Free-Market Viewpoint

I'm as pro-market as they get. But I've learned that public institutions play important functions in society, from providing defense to supporting essential systems. Ensuring medical coverage to all via universal healthcare enhances our economy's infrastructure. It represents superior, simpler approach for small businesses that employ more than half of American employees and generate half of our GDP. It enables employees to be healthier, come to work more often and be more productive.

Considering Challenges

Are there a million considerations I'm not addressing? Of course there are. But with 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 Medicare for all, even with increased taxation required, would remain a superior and more affordable strategy both for controlling healthcare costs but providing access to everyone.

Time for Realistic Evaluation

As Americans, we need to reduce national pride. America's medical care isn't so great. We rank significantly behind many other countries with the best healthcare in the world, according to major studies. Perhaps a positive aspect in this present circumstances could be that we take a hard look in the mirror and acknowledge that major reforms are necessary.