In this chapter, the comprehensive market failure of health care as a commodity is outlined. This provides the basis for why publicly funded health care is not only more equitable but also more efficient. This, more than any humanitarian basis, is why we, in the UK, have an NHS and other countries have their own systems, also dominated by government funding. Otherwise we, in the UK, would have a National Food Service as well as an NHS. The similarities between advanced economies’ publicly funded health care systems, in the form of some sort of collective insurance, are more striking than any differences, many of the latter being merely artefacts of history. Such artefacts lead to policy distractions which need to be discussed and dismissed, such as user charges; switching from one basic system to another (e.g. from NHS to social insurance); a hypothecated tax for the NHS and social care; and seeking new forms of financial support, such as social impact bonds.