This article deals with three different approaches to health care consumption and financing that have evolved in health policy of developed countries. After clas-sifying them, it focuses on public financing the necessary health care that should be universally available. Czech system of public health insurance has been established at the beginning of the 1990’s as a compromise between the institutional frame-work and aims, which were highly relevant during early phase of economic trans-formation. The article analyses the possibilities of transition from this system to earmarked health tax on personal income as a dominant source of health care financing, while preserving the current level of fiscal capacity for health budgets. Simultaneously the socio-economic consequences of such a system are discussed, while keeping social and health policy context relevant.