Out-of-pocket costs. Preferred providers. Out-of-network. Premium health services. Out-of-pocket expenses. Fixed payment. Co-insurance. Benefit advisers. Coverage agents. Healthcare consultants. Affordable Care Act. Health Maintenance Organization. PPO. Exclusive Provider Organization. POS. HDHP. HSA. FSA. HRA. EOB. COBRA. Small Business Health Options Program. Individual coverage. Dependent coverage. Premium tax credits.
Baffled? You should be. Who comprehends all this stuff? Not the typical business owner. Neither the average worker. Choosing the right medical coverage for our business – or for our families – seems like demands a PhD in medical insurance.
Based on a recent study, typical households spends $27,000 each year for their health insurance (increasing by 6% from last year). Typical company healthcare expense is expected to surpass $17,000 per employee in 2026, an increase of 9.5% compared to 2025.
Now the government has ceased functioning due to partisan disputes regarding subsidies that experts say could cause a doubling of premiums for millions of Americans.
How soon might we genuinely evaluate a national health insurance program here in America? I'm convinced we're approaching that point since this can't continue.
I'm not proposing government-run medicine. I'm advocating that our already existing Medicare program – an insurance system – simply expand to include all citizens. Our infrastructure remains intact. The way medical professionals get paid would change. Believe me, they will adjust.
A national health insurance program would require contributions from both employees and employers. In comparable systems, an employee making average wages must contribute about five point three percent to their healthcare. The company must contribute about 13.75%.
Does this seem like a lot? Not if you compare that with what the typical American pays. I can name multiple clients who are easily contributing anywhere from 8% to 15% of their employee wages to their healthcare costs. And keep in mind that with comprehensive systems, those payments also cover retirement benefits, illness coverage, maternity leave and unemployment benefits along with funding medical services. When including these expenses versus what we pay for our retirement plans, unemployment insurance and paid time off, the gap narrows.
In the US, a national health premium would increase our Medicare tax deduction, a system already established. It ought to be income-adjusted – those at higher income levels would contribute higher amounts than those earning less. This includes both worker and company payments. Similar to many our government's defense, IT, social programs and infrastructure, the program could be managed by private contractors instead of federal agencies.
A national health insurance program would be a significant advantage for small businesses like mine. It would put us on a level playing field with our larger competitors that can pay for superior coverage. It would render administration much easier (a payroll deduction remitted like social security and healthcare taxes, instead of individual transactions to benefit firms and insurance providers).
It would enable it easier for us to budget annual expenditures, instead of enduring the complex (and fruitless) theater of negotiating with major insurers that we must do every year. Due to simplification, there would exist a better understanding of coverage by our employees – as opposed to the current system where they have to decipher the complexities of existing plans. And there would certainly be less liability for employers as we no longer would be privy to our employees' health histories for risk assessment and alternative plans.
I'm as pro-market as possible. But I've learned that government has a significant role in society, including national security to funding needed infrastructure. Providing healthcare to all through a national insurance system strengthens economic foundations. It's a better, easier system for entrepreneurs that employ the majority of the country's workers and generate half the economic output. It makes it possible for workers to be healthier, have better attendance and be more productive.
Exist a million considerations I'm not addressing? Certainly. Given rising medical expenses experienced recently, it's evident that current healthcare legislation isn't functioning very well. I understand that America isn't a compact European nation where big changes can be readily adopted. However extending Medicare for all, even with the additional taxes required, would remain a better and less expensive strategy for not only controlling healthcare costs and ensuring coverage to everyone.
We as Americans, must tone down our own arrogance. America's medical care isn't so great. We rank well below many other countries in healthcare quality globally, based on comprehensive research. Perhaps a positive aspect in this present circumstances is that we undertake serious examination in the mirror and acknowledge that big changes are necessary.
A software engineer and tech writer passionate about open-source projects and AI advancements.
