What matters is universal coverage, not how it is provided, whether it be the Social Security system, a modified single payer model, regulated non-profit insurance, or a medical savings account plan. Every country I’ve visited has some sort of mechanism that provides worldwide coverage, in a uniform, easily explainable way. This allows them to focus on other, more important aspects of health.

But America cannot receive universal coverage, and that not only leaves too many people uninsured or underinsured; it also distracts us from doing anything else. We have all kinds of coverage plans, from Veterans Affairs to Medicare, and from Obamacare exchanges to employment-related insurance, and when you put them all together, it just doesn’t pan out. They are all too complicated and inefficient, and fall short of the goal of universal coverage. Our hassles, and the resulting administrative inefficiencies, weigh us down.

When I was younger, I was more of a single payer supporter, until I realized how many systems worked better than the ones in Canada. Recently, I turned to the highly regulated and fully private Swiss insurance system because it works so well with the private model that many Americans seem more acceptable. Today, on the other hand, I don’t care how we get to universal coverage.

If we can agree on a simpler plan—one of those—we can start focusing on what’s important: the provision of health services.

Public delivery systems are very important, as are personal choices

What sets the countries in which I travel apart from the United States is that they rely heavily on public services. Most people receive hospital care in centers run by the State. However, each country also has its own private system that acts as a decompression valve. If people do not like the public system, they may choose to pay more, either directly or indirectly through private and voluntary health insurance, to receive treatment in a different system.