Since their introduction following World War II, single-payer healthcare systems and universally mandated healthcare systems have stumbled, but in their pratfalls are many lessons that apply to the universal healthcare proposals currently on the table in the United States. The critical and often-overlooked point is that universal coverage does not guarantee that individuals will receive needed care—in many cases guaranteed access to care is a false promise or available only on a delayed timetable. A more feasible alternative lies in providing a safety net for citizens who truly need care and financial support with an appropriate system of checks and balances—without disrupting the economic and actuarial fundamental principles of supply and demand and risk classification.