There's also the option of the way the UK does it. You pay insurance. It's even called that - National Insurance. There is no alternative. Not having a National

There's also the option of the way the UK does it. You pay insurance. It's even called that - National Insurance. There is no alternative. Not having a National Insurance number is like not having a SSN. If you are in specific situations (student, low income, self-employed below a certain threshold etc) you become exempt from stamp, but it's still insurance. It's so well-entrenched and forgettable (comes out along with tax and student loan repayments - but I shouldn't stir that hornets' nest!) that hardly anyone realises what it is, or its origins as, quite descriptively, a nationalised form of healthcare and unemployment insurance.