🔗 Share this article I'm a Hardcore Capitalist, But Medicare for All Represents the Top Hope for US Healthcare Out-of-pocket costs. In-network. Out-of-network. Concierge medical services. Personal healthcare costs. Co-payment. Co-insurance. Benefit advisers. Insurance brokers. Medical advisors. ACA. Health Maintenance Organization. PPO. Exclusive Provider Organization. Point of Service. HDHP. Health Savings Account. Flexible Spending Account. Health Reimbursement Arrangement. Explanation of Benefits. COBRA. SHOP. Single coverage. Dependent coverage. Premium tax credits. Baffled? You should be. Who comprehends this complex system? Not the typical business owner. Neither the average worker. Choosing the appropriate medical coverage for our business – or for our families – seems like demands a PhD in healthcare. Our Healthcare System Is More Than Complicated, It's Costly Based on a recent study, the average family pays $27,000 each year on medical coverage (increasing by 6% compared to last year). The average employer health insurance cost is projected to exceed $17,000 per employee in 2026, a 9.5% jump from 2025. Currently the government is shut down due to partisan disputes regarding tax credits that experts say will lead to a doubling of premiums for numerous US citizens. When Might We Seriously Consider National Health Insurance? When will we genuinely evaluate a national health insurance program here in America? I have to believe we're approaching that point since this can't continue. I'm not suggesting national healthcare. I'm advocating that our already existing Medicare program – an insurance system – merely extend to include all citizens. Our infrastructure doesn't change. The way our healthcare providers receive payment changes. Believe me, they will adjust. The Way Universal Coverage Would Work A national health insurance program would require contributions from both workers and companies. In similar programs, an employee making moderate income must contribute about 5.3% toward medical coverage. The company pays approximately 13.75%. Does this seem expensive? Not if you contrast that with what the typical American pays. I know dozens of clients that are routinely paying between eight to fifteen percent of payroll costs to their healthcare costs. And keep in mind that in inclusive programs, those payments also cover retirement benefits, illness coverage, parental benefits and unemployment benefits along with supporting medical services. When including these expenses compared with our current spending on retirement programs, unemployment insurance and paid time off, the gap narrows. Execution in the US For America, a national health premium would increase existing Medicare taxes, a framework already established. It should be means-based – those at higher income levels would pay more than lower-income earners. There would be both an employee and company payments. And, like much of federal military, technology, social programs and transportation services, the program should be outsourced to third-party administrators instead of federal agencies. Benefits for Small Businesses Universal healthcare coverage represents a significant advantage for small businesses like mine. It would place small companies in equal competition with our larger competitors that can pay for superior coverage. It would make management much easier (a payroll deduction remitted like retirement and healthcare taxes, rather than separate payments to insurance companies and coverage administrators). It would enable it easier to plan expenses annual expenditures, instead of going through the complex (and fruitless) theater of bargaining with major insurers that we must do every year. Because it's simplified, there would be a better understanding about benefits among workers – contrasted with existing arrangements which require them to interpret the complications of current options. And there would definitely exist less liability for employers since we wouldn't have access to our employees' health histories for risk assessment and different options. Free-Market Viewpoint I'm as pro-market as they get. However I recognize that government has a significant role in society, from providing defense to funding essential systems. Providing healthcare for everyone through a national insurance system strengthens economic foundations. It represents superior, easier system for entrepreneurs which hire more than half of the country's workers and generate half the economic output. It enables for workers to enjoy better health, come to work more often and increase productivity. Considering Challenges Exist numerous factors I'm not addressing? Certainly. Given rising medical expenses experienced in recent years, it's clear that current healthcare legislation isn't functioning effectively. I understand that we're not a compact European nation where big changes can be readily adopted. However extending universal Medicare, even with increased taxation required, would remain a better and less expensive strategy both for managing medical expenses and ensuring coverage to everyone. Time for Honest Assessment As Americans, we need to tone down national pride. America's medical care isn't exceptional. The US places significantly behind many other countries in healthcare quality in the world, based on major studies. Maybe one positive aspect amid current situation is that we take a hard look at ourselves and agree that big changes need to happen.