I personally do like the single-payer approach, where you get coverage on a no-fee basis purely by showing you're a citizen/resident; and that's how it's done here in Denmark. But it's not the only way of providing universal care, even in Europe. Germany, Switzerland, and the Netherlands are typically considered to also have universal healthcare, but it's administered via health insurance, not as a single-payer model with direct state provision of services. There are various options for coverage, but having some baseline coverage is mandatory and intended to be universal (with subsidies for people who can't afford it), somewhat closer to the ACA model than to the Scandinavian or Canadian model.