A Universal Healthcare System That Finally Makes Sense
A Universal Healthcare System That Finally Makes Sense
For all the noise in Washington about healthcare reform, the political class keeps missing the obvious: the United States doesn’t need a bigger bureaucracy, a new entitlement, or another patchwork of subsidies. What we need is a system that acknowledges reality — that healthcare is essential, that markets work when they’re allowed to, and that tying insurance to employment is one of the most economically destructive ideas we’ve ever normalized.
The solution isn’t complicated. In fact, it’s embarrassingly straightforward: stop forcing employers to provide insurance, and instead require them to contribute a small, predictable percentage of their revenue into a national health pool. Not profit — revenue. Profit is whatever a clever accountant says it is. Revenue is real. Revenue is stable. Revenue can’t be gamed.
Once that pool exists, every American receives an income-based tax reduction, and every insurer — including the federal government, if it wants to play — competes in a true national marketplace. No more state-restricted monopolies. No more “your plan doesn’t operate in your new ZIP code.” No more job-locked coverage. Just a functioning market with universal access.
This is not a left-wing fantasy or a right-wing fever dream. It’s a structural fix that respects both competition and universality. And unlike the usual political proposals, this one actually adds up.
The Revenue Model That Makes Universal Coverage Possible
The United States economy generates more than $100 trillion in annual business revenue. That’s the number that matters — not GDP, not corporate profits, not taxable income. If employers contributed an average of 1.5 percent of their revenue into a national health pool, the country would generate roughly $1.5 trillion per year.
Here’s what that looks like in practice:
| Company Revenue | Contribution Rate | Annual Contribution |
|---|---|---|
| $500,000 | 1% | $5,000 |
| $5,000,000 | 1.5% | $75,000 |
| $50,000,000 | 2% | $1,000,000 |
| $500,000,000 | 3% | $15,000,000 |
This is not a burden. It’s a replacement. Employers already spend enormous sums on health benefits, administrative overhead, HR compliance, and insurance negotiations. Under this model, they pay into a single, predictable system and get out of the healthcare business entirely. No more choosing plans. No more managing networks. No more annual premium hikes. Just a clean contribution.
And because the contribution is based on revenue, not profit, every business participates — including the ones that currently avoid offering coverage altogether.
How the System Covers 300 Million Americans
Critics will immediately ask whether $1.5 trillion is enough to cover the entire population. The answer is yes — and the math is not complicated.
The average annual healthcare cost per person in the United States is roughly $6,000. Multiply that by 300 million people and you get $1.8 trillion. But that number assumes the government is paying for everything, which is not how this model works.
People still choose and pay for their own plans. The national pool simply subsidizes those plans based on income. High-income households receive modest reductions. Middle-income households receive moderate reductions. Lower-income households receive larger reductions. The marketplace — not the government — determines the price of coverage.
A realistic distribution looks like this:
| Income Level | Share of Population | Average Subsidy | Total Cost |
|---|---|---|---|
| Low income | 30% | $4,000 | $360B |
| Middle income | 50% | $3,000 | $450B |
| Upper income | 20% | $1,000 | $60B |
| Total | 100% | — | $870B |
Even after covering these subsidies, the system still has hundreds of billions left for catastrophic care, rural health support, mental health services, disability programs, public health infrastructure, and administrative costs. The pool is not just adequate — it’s robust.
And because insurers compete nationally, premiums fall. Competition does what competition always does: it forces efficiency, innovation, and price discipline. The government can offer its own plan, but it must compete like everyone else. No monopolies. No mandates. No coercion.
Why This Model Works When Everything Else Fails
The brilliance of this system is that it doesn’t rely on political fantasy. It doesn’t require confiscatory taxes, a government takeover of hospitals, or the elimination of private insurance. It doesn’t require employers to act as healthcare brokers. It doesn’t require the IRS to micromanage subsidies. It doesn’t require the federal government to guess what people need.
It simply requires three things: employers contribute a small percentage of revenue, Americans receive income-based tax reductions, and insurers compete in a national marketplace.
That’s it. No bureaucracy. No ideological crusade. No trillion-dollar surprises.
This model blends the best of the German employer-funded system, the Swiss universal private insurance model, and the American preference for choice. It is universal without being uniform, competitive without being chaotic, and market-driven without being cruel.
Most importantly, it treats healthcare as a shared national responsibility — not a perk of employment, not a political weapon, and not a privilege reserved for the lucky.
The Bottom Line
For the first time in decades, the United States could have a healthcare system that is fair, efficient, and economically sane. A system where every American has access to coverage, every employer contributes predictably, and every insurer competes on a level playing field. A system that doesn’t punish job changes, doesn’t trap people in employer plans, and doesn’t rely on magical thinking.
This is not radical. This is not utopian. This is simply the model that works when you stop trying to please lobbyists and start trying to build a system that serves the people who actually live in this country.
If Washington wants a healthcare reform that is universal, competitive, and financially grounded, this is the path. Everything else is noise.