The public health insurance system in Czechia has been created 25 years ago and the conditions have changed since then. Consumption of health care is universal and should not be segmented according to social groups. Therefore, this paper objective is showing the possibilities to streamline the financial flows and transform Czech social health insurance into the earmarked health tax. The paper shows how and why it can be done in income taxation and how the contribution for the stated insured persons could be changed in the future. Since general income taxation is also viable approach in some European countries, the paper makes a comparative analysis of those possibilities. The paper concludes with findings of the new elements that earmarked taxation approach brings to public policy and argues for their careful evaluation in practice.