Your caveats and “details” also move the administrative and management burden into some weird place based on factors that are difficult to manage and track (need, quota, citizenship etc).
The answer is simple: everyone in the administrative region gets covered for everything. Anything else is discriminatory. Planning of care services can then respond to the medical and health need of the population at large rather than arbitrary permissions banding.
That leads to rampant abuses. For example in certain East Asian city states with "universal" healthcare people would use ambulances as taxis because they were free. You need copays to prevent this kind of abuse.
And you also forget that the US has a big illegal immigration problem. By and large illegal immigrants make minimum wage or lower, generally under the table (i.e. not paying taxes on it). By covering healthcare for them you are automatically subsidizing illegal immigrants at the cost of citizens and permanent residents. Is that fair?
If you think these aren't legitimate outcomes of allowing everyone to have free healthcare then you're naive.
The taxi issue seems trivial compared with the cost of actual healthcare. I’ve no objection to some light-touch system for reducing this risk, but it hardly seems worth worrying about. You (your government) could attempt to fix this by sorting out their transport networks and taxi legislation too. This isn’t a flaw in a healthcare system, it’s a symptom of a broken transport system.
Those immigrant workers “avoiding tax” are doing the worst jobs in your society, and living in the worst conditions. The very least you can do is pay their healthcare .
There may be an “immigration problem”, but it’s that national borders create an arbitrary and discriminatory barrier to free movement people and enforce QoL disparities across the world.
Nobody wants to sit next to piss/weed/cig smelling people and get their shit robbed on public transit (see: BART) if they can afford a car instead. Plus, US light rail runs at much slower speeds than places like China due to NIMBYism, so it also takes longer than driving to get places.
> The very least you can do is pay their healthcare .
The very least they could do is come into the country legally. And by the way, a lot of the really crappy jobs are done by legal residents, like garbagemen, sewer maintenance, lineman, etc. Guess what? My local taxes pay for those workers to have good salaries and I'm happy to pay. The US also has a visa for farm workers to come to the US as well.
> national borders create an arbitrary and discriminatory barrier to free movement people and enforce QoL disparities across the world.
Spoken like someone who is privileged and wealthy enough to be unaffected by open borders. Globalization has destroyed the American factory job, along with its high wages, and you still claim open borders are the way forward? Pro tip, don't claim to be morally superior when you work as a software engineer making $$$ that has a huge demand supply imbalance. If you really believe what you're saying then go work in India in a bodyshop making $10k and working 80h weeks, but pay your US cost of living. That's what millions of blue collar workers are facing when you open borders.
Please exit your bubble and talk to some real working class people for once. People like you are like the engineers I meet who openly talk about how self driving cars are going to disrupt the industry as they get into an Uber. Zero self-awareness.
I’m not in the US. I do live in a bubble, you’re right about that.
You didn’t read deep enough what I was saying and assumed I was only talking about borders. Borders permit (demand) national currencies. National currencies and their exchange reinforce arbitrary value disparities between countries. Value disparities between currencies are deep systemic racism, and work with border controls to limit QoL improvements and reinforce racial and cultural division. Globalisation as it has been thus-far implemented has been a scourge across the human world, and probably deeper into the material fabric we share. I’m unsurprised to hear your frustration with what it’s done: it’s the sickening profiteering tool of the already-powerful.
A human world that shared more information, allowed easier cultural and people flow, wasn’t gouged by currency exchange value extraction schemes, and focused more on local resource management and honestly dealing with externalities would have some chance of fixing the bigger issues.
I’m a dreamer. The bubble I live on is called Earth.
In broad strokes, that’s how I’d define it as well but, as with many things, there are devils in the details.
Should it be only “citizens” or should it cover all “lawful, permanent residents”, “anyone lawfully present”, or “anyone who can get themself into the covered territory”? If it’s only citizens and excludes mere residents, is that “universal”? [and in that case, this puts non-citizen residents at a huge disadvantage]
Should all care be covered, in unlimited amounts? Only well-accepted, standard care? Or experimental treatments as well? Should expected life outcomes (either absolute or relative among the possible care plans) be factored into the approval process?
Should public-paid care be metered in some way, with supplemental or elective care being paid out of pocket?
Should healthcare-adjacent services be covered? (independent living, assisted living, or nursing homes, or travel to medical care [routine commute, ambulance, or medevac])
Who defines what “undue financial burden” is?
It’s easy to imagine two people both strongly being “for universal healthcare” and disagreeing on many critical details.