Australia is a bit of the "step" system you are talking about Tiberius.
We have the medicare system (paid for via general taxation)that everyone can access and then we have the private health care insurance that those who want privilege (and can afford it and paid privately) can access.
I cannot fathom the American Health care system and so am unable to comment.
We have the medicare system (paid for via general taxation)that everyone can access and then we have the private health care insurance that those who want privilege (and can afford it and paid privately) can access.
I cannot fathom the American Health care system and so am unable to comment.

"The Universe is run by the complex interweaving of three elements: energy, matter, and enlightened self-interest." G'Kar-B5