Political resolve. That's really where it ought to start. Thereafter, and most importantly, the delivery of socialised medicine must be agreeable and/or workable amongst the citizens.

The NHS in the UK was established two years after WWII. By a country devastated by war and, where its citizens still coped with rations of basic commodities until the late '50's. It was also financially indebted to the US under the Lend Lease Agreement for defence costs and re-building which the UK has ONLY paid in full this year...2007. The US did not have to rebuild from collateral damage and was the most prosperous of all nations immediately after WWII.

Socialised medicine in the UK is based on need and not ability to pay. And, this is provided ACROSS THE BOARD. That includes medical care for those who do not contribute to National Insurance in this country which would mean the unemployed, the refugee, the undocumented worker and, in some cases, even the tourist. Where medical care is needed, it will be given. Such is the spirit of socialised medicine. Generally, the attitude of those who contribute, do not begrudge those who cannot or do not. Nor would it be begrudged that Person A would avail of the NHS far more often than Person B if the case were such that both contribute equally.