Quality of health care varies widely amongst nations, and within nations.
Universal health care
Universal Health Care in many countries is free or low cost.
Quality
The quality in many countries is good - In France there are even house-calls. In other countries beset with inefficient executive branches, like India, public health care is often low quality - though even there, there are islands of high quality.
Delays, overuse
Free health care is often overused, leading to resource scarcity given that a limited amount of money is alloted for health care. This can lead to long delays in access to health care procedures or specialists (dentists, MRI scans) - in 2010, this was a problem for UK’s NHS and Canada’s health service.
Insurance based care
Systemic Inefficiency
Useless treatments
Insurance is a lousy way to pay, as it separates the consumer from the cost. Also, it results in care providers being paid per-procedure, rather than a salary. This encourages wasteful, useless treatments. 1/3 of the treatment provided in USA is wasteful.
The wrong belief among patients that more care implies lower sickness, cognitive defects in doctors who don’t rely on research and the fear of law-suits also lead to these useless treatments - but these are not specific to the insurance-system.
Administrative overhead
Claims processing tends to be a complicated procedure, with codes for diseases etc.., this results in a big portion of medical expenses being spent on paper-pushing.
Also, there is the overhead of negotiating with drug companies and health-care providers.
Partial interest in reducing cost
If health-care gets too cheap, less money flows through the insurance company as premiums, and there may be fewer customers. Also, insurance companies want to make a profit - so, people necessarily spend more than in the case of government health services.
Uninsured people
These are turned away - In USA, they are often dropped to homeless person shelters disoriented due to inability to pay or lack of insurance.
However, countries like USA offers Medicare insurance to the needy; but this is not automatic.
Low cost clinics like Rediclinic and minute-clinic are cropping up in USA to serve patients with common non-chronic illnesses.
USA
Comparison with other countries
This system is followed in USA, with unsatisfactory results. USA spends more money per capita on health-care than most countries in the world.
Yet, Infant mortality and life expectancy are worse than many other nations, including Cuba, Canada, France and UK. A documentary called Sicko has more criticism.
Employer choice
Employers are encouraged to provide health-insurance for employees, because they get a tax-break. So, patients are further removed from the payment service.
Forecast
This system is held in place by conservative politicians and by lobbying by drug and insurance companies; but even they are now (2011) realizing that unless they change slightly to keep everyone reasonably happy, a health-care revolution will replace them - health care costs are raising at alarming levels, and this is having a huge effect on slowing down the economy and reducing the quality of life of people.
Other options for health care, which are customer driven rather than employer driven, are cropping up.