Comment by docdeek

2 months ago

I was under the impression that German healthcare was essentially free (government funded) at the point of delivery, with additional top-insurance carried by most people similar to how it is in here in France.

Here I am self-employed and pay about 100 euros a month in top-up insurance (mutuelle) for myself and a couple of kids. Of course, the healthcare costs more, that’s why my taxes are high; but the insurance cost is about €1200 a year, not €2200 a month.

Free at point of delivery does not mean free at all. Netflix is also free when delivering you movies, but it costs a monthly fee.

I think it’s time that we all stop with the nonsense that government funded healthcare is free. Because who ends up funding the government are us, the citizens, and that costs lots of money.

Some governments, like the German one, still make the costs transparent to the citizen, something you can even see in your payslip. Other governments, after failed policies and extreme inefficiencies, hide that and just budget healthcare costs out of the rest of the taxes.

In your case you believe your cost is only 1200€ a year, because your government has not made at all clear to you how much you’re paying from your other taxes into the healthcare system. When governments hide that type of information is because they actually do have something they don’t want the normal citizen to see. And that’s worrying and not democratic at all.

  • >> In your case you believe your cost is only 1200€ a year, because your government has not made at all clear to you how much you’re paying from your other taxes into the healthcare system.

    I absolutely do not believe my healthcare costs only €1200 a year. As I wrote, my top-up insurance costs about €1200 a year, and the healthcare costs more and that is why my taxes are so high.

    • Ok, then I misinterpreted you.

      However it’s still unclear how much you’re paying, as the problem with socialized services like healthcare is that you never know exactly how much you’re paying and if you’re overpaying or underpaying as there’s no free competition whatsoever.

      There are of course also negative second order consequences. In socialized health care systems, where doctors and hospitals are payed the same no matter their performance, the economical incentives to provide modern treatments or provide better services do not exist, so best professionals need to leave the public systems if they believe they are being underpayed according to their value.

      I’ve seen that happening in Germany and Spain a lot. Best doctors I had left their public healthcare position to open their own private business as that was the only way to be compensated economically according to the level of service they were providing.

      3 replies →

My understanding (British citizen living in Berlin) is that the German system looks and acts like a tax, but is actually mandatory payments to one of a handful of almost-but-not-quite-identical private insurance companies, with care being free-at-point-of-use.

It's possible to opt out if you're rich enough, but if you change your mind later it's very hard to return to the normal system.

I'm currently not working*, my monthly insurance cost is €257,78.

* thanks to my very cheap lifestyle, my passive income of only about €1k/month means I don't strictly speaking need to work ever again.

Nevertheless, I am treating this time as a learning opportunity with a view to being able to change career path, given that I think LLMs make the "write the code" skill I've been leaning on for the last two decades redundant in favour of, at a minimum, all the other aspects of "engineering", "product management", and "QA", and possibly quite a bit more than that.

Plus, y'know, get that B1 certificate so I can get dual citizenship.

That will be hard to explain in English but you can find what you're paying to French healthcare system by looking at your paycheck (the document you receive every month that detail your paycheck rather). It basically either 7% or 13% of your paycheck (and .5% of non-work income via the CSG), and you have a hard cap on total contributions (4k/month, and healthcare if a bit more than half of that, so a bit more than 2k/month). It cover universal healthcare of course , but also maternity/paternity leave and invalidity benefits.

Paternity/maternity also cover the pension parents get (half a year of contribution to the pension system per child if you take care of them til they are 13, plus half a month for giving birth) (that's so awkward explaining this in English, sorry)

  • Thanks for this. I work independently (no CDI or CDD) so I don’t get the paycheck/payslip. I imagine it is broken down somewhere in the different taxes I pay, but unfortunately I don’t get the monthly reminder.