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Solidarity is an important element of every good health care system. Still many issues prevail and its position in health systems is debatable, thus no final solutions could be found, but it frequently calls for scientific discussion and evaluation. This paper deals with health expenditure in international perspective and analyses the dimensions of solidarity in Czechia. System here is perceived as highly solidaristic, however possible introduction of more equivalency should provide primarily better options and real choices for citizen, not forced cost-sharing for necessary care. For financing the universally available care, we should stick to proven public finance methods with respect to the specifics of health care sector. That way the valuable properties of Czech health system such as general accessibility and social responsiveness could be preserved. Higher optimization of the public part of the system could be achieved through the tax and social reform, the private schemes if desired should not be introduced as a partial replacement of public financing, but as an addition to the existing universal care.