Out-of-pocket costs. Preferred providers. Out-of-network. Premium health services. Personal healthcare costs. Co-payment. Shared insurance. Benefit advisers. Coverage agents. Medical advisors. ACA. Health Maintenance Organization. Preferred Provider Organization. Exclusive Provider Organization. Point of Service. HDHP. HSA. FSA. HRA. Explanation of Benefits. Consolidated Omnibus Budget Reconciliation Act. Small Business Health Options Program. Individual coverage. Dependent coverage. Insurance subsidies.
Confused? You should be. Who understands this complex system? Certainly not the average entrepreneur. Nor the typical employee. Choosing the appropriate medical coverage for our business – or for our families – appears to require it requires advanced expertise in medical insurance.
Based on recent research, typical households spends $27,000 annually for their health insurance (increasing by 6% from last year). Typical company healthcare expense is projected to exceed $17,000 for each worker in 2026, a 9.5% jump compared to 2025.
Now the government has ceased functioning because political disagreements regarding subsidies which analysts predict could cause a doubling of premiums for numerous US citizens.
When will we genuinely evaluate universal healthcare coverage in the United States? I'm convinced we're approaching that point because this situation is unsustainable.
I'm not suggesting government-run medicine. I'm proposing that our already existing Medicare system – an insurance system – merely extend to cover everyone. Our infrastructure doesn't change. How our healthcare providers get paid would change. Trust me, they'll adapt.
Universal healthcare coverage would require payments from workers and companies. In comparable systems, a worker making average wages pays about 5.3% toward medical coverage. The company must contribute about thirteen point seventy-five percent.
Does this seem expensive? Unless you contrast it to what the typical American pays. I know multiple businesses that are easily contributing anywhere from eight to fifteen percent of their employee wages for medical benefits. Remember that in inclusive programs, those payments also cover pension plans, illness coverage, parental benefits and unemployment benefits along with supporting medical services. When you add these expenses compared with what we pay for our retirement plans, job loss coverage and paid time off, the gap narrows.
In the US, a national health premium would increase our Medicare tax deduction, a framework that is already in place. It should be means-based – wealthier individuals would pay more than those earning less. There would be both worker and company payments. Similar to many our government's defense, IT, social programs and transportation services, the program should be outsourced to third-party administrators instead of a government office.
A national health insurance program would be a significant advantage for entrepreneurs like mine. It would put us on a level playing field against big corporations that can pay for superior coverage. It would render administration significantly simpler (a payroll deduction remitted like social security and healthcare taxes, instead of separate payments to insurance companies and coverage administrators).
It would enable it easier for us to budget our yearly costs, rather than enduring the complex (and ineffective) theater of bargaining with the big insurance providers that we must do every year. Because it's simplified, there would be improved comprehension about benefits among workers – as opposed to existing arrangements where they have to interpret the complications of current options. And there would definitely exist reduced responsibility for companies since we wouldn't would be privy to our employees' medical records for risk assessment and alternative plans.
I'm as pro-market as they get. But I've learned that government has a significant role in our lives, including national security to funding needed infrastructure. Providing healthcare to all via universal healthcare enhances economic foundations. It's a better, simpler approach for entrepreneurs that employ more than half of the country's workers and fund half the economic output. It makes it possible employees to enjoy better health, come to work more often and increase productivity.
Exist numerous factors I'm not addressing? Of course there are. But with all the healthcare cost increases experienced recently, it's clear that current healthcare legislation is not working very well. And I realize that we're not a compact European nation where big changes can be readily adopted. However extending universal Medicare, even with the additional taxes that would be incurred, would still be a better and more affordable approach both for managing medical expenses but providing access to everyone.
As Americans, must tone down our own arrogance. Our healthcare system isn't so great. We rank significantly behind numerous nations in healthcare quality in the world, based on comprehensive research. Perhaps a bright spot amid current situation is that we undertake serious examination at ourselves and agree that big changes need to happen.
Maya Chen is an urban planner and writer with over a decade of experience in sustainable city development and community engagement.