I only ask because anyone who has knows that in a vast majority of examples, the simple act of guaranteeing basic care has nothing at all to do with the questions you raise, in the same way that not paying to use the interstate has nothing to do with you being able to drive to your friend's house for free.
> Who decides what health care I have access to
Society decides, in the same way it decides how to spend any tax dollars, such as when and where to build new public roads, when to open a new elementary school to better serve the changing population, etc. etc.
Keep in mind, any "heath care you have access to" is just the minimum provided to everyone. If you want to buy more/better care, you are absolutely free to do so with your own money. Go nuts. I've been living under this system in Canada and Australia for the majority of my life and have never felt the need to buy more converge, but that's just me personally. My aging parents buy extra.
> and what health care I'm required to take (vaccines, vitamins, exercise, etc)?
This is a great question. It's very topical right in Australia [1] as one state (NSW) now requires mandatory vaccinations before children can attend child care centers. This is analogous to you being required to buy car insurance before you can drive on public roads - if you don't, it's too risky for everyone else and society has deemed that unacceptable. You also can't nail together a few pieces of timber and call it a house, as it doesn't meet building codes, etc.
Of course, you are free not to participate in these rules - you just don't drive a car or build a house. NSW is now saying if you don't want to get vaccinations, then you don't get to participate in child care centers as it makes the cost to high for everyone else.
It remains to be seen if the people of NSW agree with this or not. If not, the rules will change.
Keep in mind that all of these rules are set by the society we live in. Plenty of people chose not to live within these rules. They break the rules and often face consequences as you mentioned (fines) or, if you chose, you can just move into the middle of nowhere in Alaska and do whatever the hell you want, and actually not be a part of any society. (I live right near Alaska, I know tons of people doing this)
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Based on your other comments further down, I have to say that it doesn't look like you're against universal health-care per se, but you in fact have absolutely no confidence that your society can determine what that would actually look like. You've lost all faith that your system of government is actually representing the interests of the people, so you would rather it doesn't represent any interests at all, and "butt out" of your life
This is a sad shame, and it's actually the root of the issue here. If you don't trust your system of representation to represent you, then of course you don't trust it with something like your health, or anything else for that matter.
[1] http://www.abc.net.au/worldtoday/content/2013/s3769940.htm
