I like the UK model — the state guarantees a certain standard of care that works for most people in most cases. Unlike in Canada where all doctors must work for the state health care system and where a doctor can not be in private practice, in the UK there are private doctors and private insurance. So you can buy supplementary insurance to get a higher standard of care than what the UK state insurance provides.

In fact we already have this system in the USA — if you're over 65, that is. Medicare provides a certain standard of care as determined by the legislature (in conjunction with doctors, etc.) and if you want “more” or “better” care (e.g. a private room at the hospital instead of a shared room) you can buy supplemental insurance or pay out of pocket to cover that extra level of care.

What Medicare and any state-run health plan for people of all ages in the USA could benefit from is a realignment of incentives. Right now doctors who serve Medicare patients are incentivized to do more — more tests, more procedures, etc. — since they get paid based upon volume and not on results. Any state run health care should change that incentive to encourage doctors to provide the best results for a patient, not the highest volume of care. A few private hospitals have begun doing this (Mayo Clinic for example) and some HMO's who own the whole system (hospitals, doctors on payroll, etc.) like Kaiser Permanente do this.

In the UK, general practice doctors get incentives to get their patients to stop smoking, lower their blood pressure and cholesterol, etc., resulting in a healthier population that is cheaper to care for. Here in the USA we often just eat our burgers, get obese, get diabetes, and then go on a lifetime of drugs and insulin, for example, rather than stopping the problem at the root cause.

As a small business owner, I'm all for an affordable health care system that my employees could use. Right now it is very hard and expensive to compete with large companies in terms of the benefits that I can offer.