Insurance is not the provision of service. Insurance pays for services by another business entity, the provider of service.
A National Heath Care Service are services that are provided for free by the government. There is no need for billing and no bill for services and no need for insurance.
A National Health Care Service has advantages over Market Based Systems where a market for the services is difficult or impossible. Emergency situations where the patient has no control over the services they receive is the obvious example of such a situation. Any walk in health care setting essentially removes the possibility for the service to be market based. This is true weather the service is described as Urgent Care or an Emergency Room whether or not the service is attached to a hospital.
National Heath Care Insurance pays for services for which there is a fee. Billing is necessary but presumably the co payments and deductibles will be reasonable. Billing for health care services is extremely complicated so a billing process introduces a great deal of complexity and overhead to the process of health care delivery.
A National Health Care Service would be useful when the services cannot be delivered effectively in the Market Economy. This typically would be where the patient has no ability to shop among reasonable choices. This primarily is the case in emergency situation wherein shopping for service is generally not possible.
With National Health Care Insurance the patient remains financially responsible for the service. It could be that this would be advantageous in some way. In any event, another layer of bureaucracy is added and there is an intermediary, the insurance company. It does not solve the problem of the market economy being ineffective.
Some health services are available from the local health care office for free. This in a sense is the National Health Care Service that we have. Much more extensive services are locally and freely obtainable in other countries. These countries service their citizens heath care needs much better that does the United States but the US still has some health care services funded by state and local governments.
A market economy may not exist where some health care services are needed. A person with a sudden illness or injury may not be in a position to shop for what they need. Urgency is the key. If the person has time to consider alternatives then a market may exist but no market exists where where they don’t have time or otherwise the ability to consider alternatives. This problem cannot be solved with insurance where the person remains responsible for the bill.
He who does not make the rules shouldn’t be paying and shouldn’t need any gold. Payment for services should follow decisions. If the provider of health services is selecting the service without consideration of the patient’s opinion then the provider should bear the cost of the service. This is the concept of a national health care service. The government (provider) decides the services that they will provide. Individual choice is by the nature of this process, limited. When the patient has no choice then the payment by the patient is inappropriate and can only serve to encourage wasteful services and perhaps worse outcomes.