Netherlands
While Dutch residents are automatically insured by the government for AWBZ, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don't take out insurance, you risk a fine. Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – it's illegal to refuse an application or impose special conditions. In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management.
Social inequality
In countries that have a universal health care system, health inequalities have been reduced. In Canada, for example, equity in the availability of health services has been improved dramatically through Medicare. People don't have to worry about how they will pay health care, or rely on emergency rooms for care, since health care is provided for the entire population. However, inequality issues still remain. For example, not everyone has the same level of access to services. Inequalities in health are not, however, only related to access to health care. Even if everyone had the same level of access, inequalities may still remain. This is because health status is a product of more than just how much medical care people have available to them. While Medicare has equalized access to health care by removing the need for direct payments at the time of services, which improved the health of low status people, inequities in health are still prevalent in Canada. This may be due to the state of the current social system, which bear other types of inequalities such as economic, racial and gender inequality.