>Isn't the assumption that universal health care will have no rules just as based in speculation as the idea that it will?
The problem is what's acceptable in terms of denying care is very dependent on culture. In the UK people accept that the NHS doesn't pay for a heart transplant when the patient is 80 years old. In the US people expect every intervention to be provided (if the patient wishes) up to the moment that person dies. Universal care isn't going to change that attitude, at least not for a generation or two.
The most likely outcome of universal care in the US is a two-tiered system, where the national system pays for some subset of the things that can be done, and people buy private insurance to cover what they're used to getting now.
That's what the UK has - there is the NHS for everyone, free at the point of delivery, and there is a smaller private health care sector where you can get anything you can pay for.
The problem is what's acceptable in terms of denying care is very dependent on culture. In the UK people accept that the NHS doesn't pay for a heart transplant when the patient is 80 years old. In the US people expect every intervention to be provided (if the patient wishes) up to the moment that person dies. Universal care isn't going to change that attitude, at least not for a generation or two.
The most likely outcome of universal care in the US is a two-tiered system, where the national system pays for some subset of the things that can be done, and people buy private insurance to cover what they're used to getting now.