in Germany, the actual doctors office that treats you may be a for-profit, but they get the cash from your (mandatory) insurance, and the law regulates what kind of treatment is essential and therefore included in the mandatory healthcare plan. You can have a private healthcare plan that gets you extra treatment, or pay yourself for it. But it's really Stuff you can live without.

another example, in Russia, you have _theoretically_ the same system, but the level of treatment covered by the mandatory insurance is totally insufficient by any reasonable modern standards, so you have to pay all the way. And it's not about debt, it's often about not getting live-saving treatment before you cash out.