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I don't live in Costa Rica, but I have family there and they have combined. They complain that the private healthcare systems lobby to underfund the public heathcare system in order to turn people away from public healthcare, and off to their services where they make more money.
So combined systems cannot exist, if you want public healthcare then it should quickly phase our private.
EXACTLY!
I like to think of this way: If society has two boats (one private for profit one and the other public) wealthy people will always seek to pay extra to ride in and fund the upgrades of the private boat rather than the public one. By simply offering a paid alternative, they prevent the public boat from being improved upon for the good of everyone. Offering a paid choice effectively torpedoes the free standard for others.
If we’re all in the same boat, society as a whole will unite and work towards improvements to that communal boat.