Healthcare in the U.S. is a mess—and here's why expanding Medicare for all might be the only real solution.
Deductibles, in-network vs. out-of-network, concierge medicine, co-pays, co-insurance, benefit advisers, insurance brokers, consultants, ACA, HMO, PPO, EPO, POS, HDHP, HSA, FSA, HRA, EOB, COBRA, SHOP, single coverage, dependent coverage, premium tax credits—the list goes on. Feeling dizzy yet? You should be. Few people truly grasp all these terms, and that includes most business owners and regular employees. Choosing the right health insurance, whether for your family or your company, can feel like you need a PhD in healthcare policy.
And it’s not just confusing—it's incredibly costly. According to a recent study by KFF, the average American family spends about $27,000 annually on health insurance, up 6% from last year. For employers, the average health insurance cost per employee is projected to exceed $17,000 in 2026, a nearly 10% increase from 2025. These numbers are staggering.
But here’s where it gets controversial: the government is currently shut down over disputes about preserving premium tax credits. Experts warn that if these credits are removed, millions of Americans could see their premiums double next year. When will we, as a nation, start taking serious steps toward a national health insurance program? It’s clear something has to give.
I’m not advocating for an entirely new national healthcare system. I’m suggesting we expand the Medicare system we already have to cover everyone. The infrastructure is already in place—what would change is simply how providers are reimbursed. And trust me, they’ll adapt.
Such a program would involve contributions from both employees and employers. For perspective, in the UK, an employee earning £60,000 annually (around $78,000) contributes £3,211 ($4,174) to healthcare, about 5.3% of their income. Their employer adds £8,250 ($10,725), roughly 13.75%. That sounds high, but compare it to what many American companies already pay—often 8% to 15% of employee wages for healthcare alone. Plus, in the UK, those contributions also cover state pensions, sick pay, maternity leave, unemployment benefits, and public facilities. When you consider the full spectrum of costs Americans pay for retirement plans, unemployment insurance, and paid time off, the difference narrows significantly.
In the U.S., a national health insurance premium would simply raise the existing Medicare tax. It should be progressive, meaning higher earners contribute more. Contributions would come from both employees and employers, and much like military contracts, IT services, social programs, and transportation, administration could be outsourced to third-party companies instead of government offices.
Such a system could be transformative for small businesses. It would level the playing field, allowing smaller companies to compete with giants who can afford premium plans. Administration would become much simpler, with payroll deductions handled similarly to Social Security and Medicare taxes. Budgeting would be easier, and employers wouldn’t have to negotiate endlessly with insurance companies each year. Employees would better understand their coverage, reducing confusion, and employers would face less liability because they wouldn’t need access to individual health histories to determine coverage options.
I’ve always considered myself a staunch capitalist. Yet I’ve come to recognize the vital role government plays in areas like defense, infrastructure, and yes—healthcare. A national insurance system would strengthen the economic backbone, making small businesses more competitive and employees healthier, more consistent in attendance, and ultimately more productive.
Of course, there are countless details to work out. But after seeing healthcare costs surge since 2012, it’s clear that the Affordable Care Act hasn’t solved the problem. While we’re not a small Scandinavian country where sweeping changes are easier, expanding Medicare for all—even with slightly higher taxes—would be a smarter, more cost-effective solution that ensures healthcare access for everyone.
It’s time for Americans to acknowledge a hard truth: our healthcare system is far from world-class. On global rankings, the U.S. ranks 15th in one study and a shocking 69th in another. Yes, 69th! Perhaps the current government shutdown, fueled by disputes over healthcare subsidies, is a wake-up call. Maybe it’s time we finally face reality and admit that bold, systemic changes are not just necessary—they’re overdue.
What do you think? Are we ready to rethink healthcare in America, or will we keep sticking with a system that leaves millions behind?
