On average the Spanish pay $223/month on health care, not $50. Spain has a $GDP/capita of $30k and spends 9% of GDP on health care.
I hope you have a spanish pay slip (like I do) to see the figures for yourself. That, or you make a LOT of money.
The thing is, most people dont need to spend 50 euro per month so millions of people pay in order to not be left out the system if they need it. I need it when I was a kid, so now I pay gratefully.
In my opinion health welfare and security is a problem like the 'Three prisoners problem' where collaboration is better for everyone in the end.
What's the country?
Most of Europe
Monthly rates vary though. In the Netherlands you pay €90 or so a month for (mandatory) health insurance, with a €350 a year deductible. Low income households do get partly subsidized by the government of course.
The Netherlands spends ~$5200/pp on healthcare[1]. Where does the rest of the money come from?
Taxes withheld from salary, just like ainiriand mentioned. In The Netherlands (and most other European countries) you pay for insurance directly (which here includes a mandatory basic plan that can be expanded to include things like full dental) and via taxation of income.