https://www.medicaid.gov/chip/index.html
"The Children’s Health Insurance Program (CHIP) is a joint federal and state program that provides health coverage to uninsured children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage."
Dozens (every US state and territory is handled separately) of separate systems in which you can fill out a bunch of paperwork to apply to have insurance for children is nowhere close to the zero friction "free at the point of use" goal of universal healthcare.
Some countries with universal healthcare don't do a great job of achieving zero friction, but they're all way ahead of a disjointed paperwork process that only results in getting insurance that ought to have been free for everyone from the outset.
And, one of the most obvious problems is: CHIP only covers children you can provide an SSN for. So maybe Steve, aged 4 is covered because you had him in San Antonio but his older sister Esther was born in Mexico and travelled over the border with you. She can't get CHIP because she doesn't have an SSN and powerful people want to make sure it stays that way.
I am not going to enumerate all the reasons why it’s a nonstarter, but at least one is that it massively increases the cost of any such social program to a point it becomes both practically and politically untenable.
I’ve visited and used healthcare services in many of those other Western countries as a foreigner, and every single time I was required to file paperwork and pay a deposit in cash (or rarely by card) before receiving services. I would not have expected any differently, as I’m not a tax-paying citizen in those countries. On a mostly unrelated note, I write this while currently residing in San Antonio (as used in your example scenario).
I would believe it’s more financially sensible in the larger scheme of things to cover the cost of healthcare for illegal residents, but I haven’t seen any evidence that demonstrates that, and even with such evidence its still politically untenable.
My point is that such a scheme is so politically untenable that even existing Western universal healthcare countries do not have such a scheme. It’s far more radical than what is typically advocated in the US.
Maybe they’ve changed the rules since then, but at least my personal experience was the flow was to establish whether I was a Spanish or EU citizen, as I was not I was obligated to pay a sizeable deposit before even being seen for triage. There was certainly no indication any other foreigner would have been treated differently.
That distinction can be in addition to, but will more often wholly replace a distinction between citizens and non-citizens.
You can make a purely economic rationale for this if you want: Residents pay tax, and non-residents don't (in the US some non-residents still pay tax but that's not usual for any other country). If your universal healthcare is largely paid for as an "insurance" scheme, such residents are probably obliged to join the scheme, so it makes sense they'd also get the benefits.
I assume if you're in Spain, with no proof of residence you'll be asked to pay?
Do you recall which hospital was that? Sounds like you were sent to a private hospital.
My experience may not have been representative then, as it could have gone differently in a public hospital, but I am unsure. It seemed based on what I was told at the time that I could only seek treatment at hospitals that accept foreigners except in the case of an emergency severe enough to require an ambulance (I called an Uber to take me). I think any hospital would have ensured I was stable but not admitted me for multiple days of care other than one with a foreigner's department. But, it may be that a public hospital would have treated me without any concerns about my citizenship or residency.
In some countries I visited the foreigner's department was more involved in handling currency exchange and payment details, but less concerned with care or providing services (Czech Republic was this way at FN Motol for instance: https://www.fnmotol.cz/en/samoplatci/).
If you are a resident citizen of an EU country, you can often seek treatment in other EU countries under the same social medicine scheme they have and your citizenship/residency paperwork covers you. I'm not sure if Country A bills Country B or how that works exactly, but it was pretty clear that the foreigner's department concept was for non-EU citizens who were private pay and ineligible for social medicine.
So you probably meant non-residents and illegal immigrants. I'm not aware of non-residents (tourists, mostly) being covered anywhere. As for illegal immigrants, it depends: France has at least some free coverage, so has Spain and I'm sure some other countries. In France it's called the AME (Aide Médicale d'État). Like any system it's being gamed and abused, hence why it's being reformed and should not be copied as-is. But at 1 billion EUR/year the benefits certainly outweigh the cost.
(The back of your card in Germany has the international information.)
As others have pointed out, I don't think any of these societies limit benefits to citizens. In the UK, emergency care is free for everyone, and there are few checks on other forms of care in practice. I seriously doubt that someone who was in the country illegally would have any problem registering their child with a GP. Doctors aren't trained to perform immigration checks, and are not usually interested in doing so.
But someone without an SSN? In Canada, you don't get healthcare coverage without proof of legal residency. And that's what most (not all) western countries do. Why would we hold the US up to a higher standard?
https://en.wikipedia.org/wiki/List_of_countries_with_univers...
Most likely, Esther can also "provide an SSN". Identity theft is normal.
I guess that it is widespread knowledge that you can be in such a situation, but to read it spelled out on medicaid.gov is really something...
At least they're nice enough to let you go without medical assistance, but save your children.