The article examines the universal and optional component of health systems with the twin aims of clarifying both the meaning and the purpose of these two basic health care system components at the general theoretical concept level, and the outlining of the mechanisms of the construction and financing thereof, including the empirical data on the theme sourced from OECD countries. Each of the components has its own operational regulations (even in relation to the position of the patient) and cost control mechanisms. The universal part of the system may be characterised by a certain degree of variability, especially in systems that involve multiple health insurance companies. In principle there may be a supplementary/ complementary (with possible synergies that can be systemically supported) or substitutive relationship between the two components. Health policies should ideally utilise both parts of the system in accordance with their characteristics and the objectives that the policy aims to achieve. This may help to overcome problems with the standard and above-standard health care, an issue that has characterised Czech health policy for a long time.