This discussion over other countries' health care systems has been very informative.
I am not necessarily against having a public health system, but I have a problem with the mandate forcing citizens to participate in a privatized health insurance industry which is still very inequitable. Not all policies are available to everyone. And it's not really linked to income either. A poor person can have access to very good, affordable health insurance, or have access to only one plan with premiums and high deductibles. It depends on the size of the company you work for, whether it's a government job or a private sector one, how big it is, and where it's located. It's not on a sliding fee scale at all.
When we first got out of college, my husband worked for a retail store at minimum wage, and I was an intern at a job that didn't offer any insurance. Although his wages were small, we had three excellent health plans to choose from. That was the insurance plan we used for our first baby. Ironically, most of his co-workers didn't have insurance at all, because they qualified for Medicaid (free coverage for low-income households). We actually qualified for it too, but we were raised that it was wrong to rely on government handouts if you didn't need to, so we paid our small deductibles and co-payments. No one questioned us when we were paying into the plan for a year, but the minute insurance got billed for the baby's birth, we get a letter encouraging us to enroll in Medicaid so we can avoid deductibles and co-pays. The insurance company apparently hoped to get out of paying those bills!
Two years later, my husband gets a job in his field (and I go SAHM) and our income goes up, but we have a choice of exactly ONE insurance plan, it's 5x the cost of our former plan, and it has a $1,000 per person deductible (which rose to $1,500 after Obamacare passed - coincidence or not). Now our household income certainly didn't pentuple.
All "Obamacare" does is force everyone into some kind of plan, somewhere (or a fine that comes with no coverage). It doesn't guarantee everyone will be offered a plan that is affordable, or that you can find an in-network provider within 1000 miles, or even that your deductible will be less than your monthly income! It's not the same as what Cybele describes as Medicare Australia.
As far as I know, it doesn't really address the major government expenditures toward health care either. So-called illegal immigrants who utilize emergency rooms still won't have coverage (nor be fined). Seniors will still have to use Medicaid for nursing home care (since Medicare [the program for seniors] doesn't cover it) - and elderly nursing care accounts for 30% of Medicaid expenses. So where's the universal coverage? It's coverage in name only; you still go bankrupt if you require extensive care, and you are still at the mercy of whatever deal your employer is able to cut with the insurance companies.
To top that, only 80% of premiums must be spent on medical care (which, being run by the private sector, is a guarantee that 20% will be spent on profits). Now what is the best way to maximize your 20% profit allowance? Keep medical costs high (relative to GDP), so that the total amount is larger. Since it is insurance companies that negotiate prices with (in-network) providers, they do have a direct influence in how this plays out.
Remember, the public option didn't pass in Congress. Also, the anti-trust exemption wasn't repealed. So theoretically, health insurance companies could quickly monopolize and stifle any competition that might otherwise act as a cost control.
