In the UK, National Insurance Contributions are paid in part by the (working) individual, and in part by the employer. Self-employed people have to bear the total amount prescribed to them. These monies do not actually go towards any particular service provided by the government, but just get tossed into the revenue pot, just like all other government receipts (of which, as we all know, there are many and various).
Personally, I would much prefer a more direct and transparent mechanism of funding the Health Service. That is, so people could see how the taxes they pay are being put to (hopefully) good use.
Regarding the healthcare system in the USA, is it unfair? I don't know much about it, so I can't really say. But what I
do know is that some of the finest hospitals in the world happen to be there, and some of the best medical equipment is manufactured there. There is
Medicare and
Medicaid (as you say), so some sort of provision if obviously being made for all and sundry.
