As every other industrialized country in the world besides the United States has some form of universal health care in place as a national policy, the comparison between private health care and universal health care systems comes down to a comparison between the US and everybody else. And the differences between the two can pretty much be summed up as follows: in a private health care system, a person gets the health care he or she can afford, whereas (by and large, and the exceptions will be outlined later) in a universal health care system a person gets the health care he or she needs.

The difference is profound. Theoretically, in a private system, an individual buys insurance and receives health care when needed, and if not insured, is obligated to pay for it out of pocket. Although the power of large numbers leads to profitability for insurance companies in a private health system, the plain fact that the business is profit-driven instead of health care delivery driven means that the insured is at the mercy of quarterly profit and loss statements. And insurance becomes a fluid entity, changing in what it covers and what is charged for it on an almost constant basis. The inescapable equation that paying out claims directly impacts the bottom line means that the business model for American insurance depends on the denial of care rather than its delivery. Where health care is a commodity, the price of the commodity is paramount, and not the quality of the commodity. And the difference between the highest level of care and the lowest is gigantic–at the highest level a patient can receive the absolute best of care. At the lowest level a person might be lucky to have an emergency room nearby where urgent care can be obtained. At the worst, a person can simply not receive any care, often with fatal results.

Universal health care systems take the opposite tack: the assumption is that health care is a human right, and the function of a health care system is to provide health care, not health insurance. It's often derided as "socialized medicine," yet the various systems in place throughout the industrialized world often combine private insurance with government oversight, mixing the private and public sectors to the advantage of the citizenry. Because resources are not unlimited, universal health care systems always put some rationing system in place, and at the upper end of cost and/or the probability of the patient's survival, a particular treatment might be denied. The rationing, however, is not left to the policies of insurance companies. The immediate availability of health care in these countries means their populations are generally much healthier and happier.