Out-of-pocket costs. In-network. Out-of-network. Premium health services. Out-of-pocket expenses. Co-payment. Co-insurance. Benefit advisers. Coverage agents. Medical advisors. ACA. HMO. PPO. Exclusive Provider Organization. POS. HDHP. Health Savings Account. FSA. Health Reimbursement Arrangement. EOB. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Individual coverage. Family coverage. Premium tax credits.
Confused? It's understandable. Who understands this complex system? Not the typical entrepreneur. Nor the typical employee. Choosing the appropriate medical coverage for our business – or for our families – seems like demands advanced expertise in medical insurance.
According to a recent study, typical households spends $twenty-seven thousand annually for their health insurance (up 6% from last year). Typical company healthcare expense is expected to exceed $seventeen thousand per employee by 2026, an increase of 9.5% compared to 2025.
Currently the government is shut down due to partisan disputes regarding tax credits that experts say could cause premium increases up to 100% for numerous US citizens.
When will we genuinely evaluate a national health insurance program in the United States? I have to believe we're approaching that point since this can't continue.
I'm not proposing national healthcare. I'm proposing that our already existing Medicare program – an established insurance framework – merely extend to include all citizens. The existing system doesn't change. How medical professionals get paid would change. Believe me, they'll adapt.
A national health insurance program would require payments from both workers and companies. In comparable systems, a worker earning moderate income must contribute approximately five point three percent to their healthcare. Their employer must contribute approximately 13.75%.
Does this appear like a lot? Not if you contrast that with what the typical US resident spends. I can name dozens of clients who are easily contributing anywhere from eight to fifteen percent of payroll costs for medical benefits. And keep in mind that with inclusive programs, these contributions also cover pension plans, sick pay, parental benefits and unemployment benefits along with funding medical services. When you add those costs compared with what we pay for our retirement plans, unemployment insurance and vacation benefits, the gap narrows.
In the US, universal healthcare funding would raise existing Medicare taxes, a system already established. It should be means-based – those at higher income levels would pay more than those earning less. This includes both an employee and employer contribution. And, like much of our government's defense, IT, welfare services and infrastructure, the program should be outsourced by private contractors instead of federal agencies.
Universal healthcare coverage represents a significant advantage for entrepreneurs like mine. It would place small companies in equal competition against big corporations who can afford better plans. It would render administration much easier (automatic payroll withholding remitted like social security and healthcare taxes, instead of individual transactions to benefit firms and insurance providers).
It would make it easier to plan expenses annual expenditures, rather than enduring the complicated (and ineffective) process of negotiating with the big insurance providers that we must do every year. Due to simplification, there would be improved comprehension of coverage by our employees – contrasted with the current system which require them to interpret the complexities of existing plans. Additionally there would definitely exist reduced responsibility for companies as we no longer would be privy to our employees' medical records for purposes of weighing risks and alternative plans.
I'm as pro-market as they get. However I recognize that government has a significant role in society, from providing defense to supporting essential systems. Ensuring medical coverage for everyone via universal healthcare enhances economic foundations. It represents superior, simpler approach for small businesses which hire the majority of the country's workers and generate half the economic output. It makes it possible employees to be healthier, have better attendance and increase productivity.
Exist a million considerations I'm not addressing? Certainly. But with all the healthcare cost increases experienced in recent years, it's evident that current healthcare legislation is not working very well. I understand that we're not a compact European nation where big changes are easier to implement. However extending universal Medicare, even with increased taxation that would be incurred, would remain a better and more affordable strategy both for controlling healthcare costs and ensuring coverage for all citizens.
We as Americans, must reduce national pride. America's medical care isn't so great. The US places well below many other countries in healthcare quality in the world, according to major studies. Perhaps a positive aspect in this current situation could be that we take serious examination at ourselves and acknowledge that big changes need to happen.
A tech strategist and writer passionate about digital transformation and emerging technologies.