Incidentally, except for the doctrinaire follies of Canada and of course Cuba - of which I do not approve - the existence of a health system does not prevent a great deal of private healthcare from going on anyway. The idea is, or should be, to prevent citizens from dying like abandoned dogs, not to force every strand of health care to pass through the hands of the State. In many health care systems, such as (I believe) those of France or Japan, the State is simply the main client of a largely independent hospital and medical industry.