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Comment by sajithdilshan | Hacker News Reader

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That is not "fucked up" it is called the solidarity principle. You contribute when you have the capacity to contribute, and society protects you when you happen to need more than you can afford. Netflix is a consumer product, and health insurance is risk pooling. You're treating health insurance as if you're buying healthcare services. You're not. You're buying protection against an uncertain financial risk.

Also you forgot the contribution assessment ceiling at €69,750/year.

However, Germany has a legitimate problem when contribution levels, service quality, and access aren't aligned with what people feel they're paying. That is a different discussion which needs much more nuance and intimate knowledge of the German healthcare system.

The fucked up part is the forced solidarity and high barrier to exit the so called solidarity principle. You need 77,400€ annual salary to switch to private insurance in 2026 and in 2027 it will be increased to 84,150€.

> The fucked up part is the forced solidarity

Of course it is forced, it has to be. What's the alternative? Make it voluntary, which immediately will lead to the total cost only being spread across sick people that definitely are going to cost the system money, resulting in an immediate increase in coverage cost, making it unavailable to a large part of the population? Just look at how well removal of the fee for non-coverage under the ACA worked in the US. That's just "let's take health insurance away from poor people" with more steps.

Not op, but it’s solidarity if money is freely given, let’s call it something else when money is taken without consent.

The Solidaritätsprinzip is named that to distinguish it from the Äquivalenzprinzip (equivalency principle) of private insurance: with private insurance, your cost rate is determined by the services you would like to have covered as well as the assessed risk that you will consume these services as calculated by the insurance carrier's actuaries. In Germany (and other European countries), the public option insurance instead only uses your income to determine your rate: the insured risks are common and paid by everyone together instead of by the individual.

"Solidarity" is a pretty good term for that abstract idea. What would you like to suggest instead?

And yeah, I understand that people that do not buy into the concept of a society pooling together such risk to create a model that works best in the aggregate instead of emphasizing individual choice are going to hate everything about this. If you want to be able to save money in exchange for taking on risk, such a society can't let you easily do that because it'll inevitably lead to a tragedy of the commons; such a society would also likely help you anyway if you made the wrong risk trade-offs and become a burden to the state.

Also, let's be clear: this principle is still very popular in Germany. I haven't lived there in a long time so I was curious and gave it 30 seconds. Admittedly the source here is an insurance carrier, but they found in a survey that while 66% of Germans last year were worried about insurance costs and the financial sustainability of the German healthcare system, 73% support the solidarity principle (https://www.aok.de/pp/gg/update/solidaritaet-gkv/)

Why not call it taxes?

And there certainly is consent, given voters can choose to elect people who will change the system, or not.

Are you in favor of abolishing car insurance as well? It’s the same principle, pool money, pay out when necessary.

It lets everyone, including those less well off, enjoy relatively low insurance premiums and you get personal mobility in return.

I’m well off, part of the reason I’m well off is because I was lucky enough to be born in a place that provided lots of stability and opportunity (schooling, health care, et al), it’s nice to give back. Sure, there’s flaws and waste in places, but I’ve had a family member go through extensive medical treatment because of cancer and I genuinely wish that level of care and options for everyone, so paying my taxes and health insurance premiums it is!

The word „solidarity“ means here that you empathize with other people and contribute to shared prosperity and success. You share the healthcare system with a lot of people who make the country what it is. Some of them earn less, some earn more, and that‘s ok. With your contributions you make sure that those who bake your wonderful bread, run the public transport or clean the streets in your neighborhood are covered. If you would rather prefer American system with its deficiencies, because you are high earner and don‘t like to share, you can always go there. Dubai is also nice for people with some cash and tolerance to human rights violations.

What is really fucked up about Germany, is that exit to private insurance exists in principle, and our Bundesmimose Friedrich Merz have never used statutory one. The existing system has deteriorated only because nobody in the government is using it and has no clue what people now experience daily.

> What is really fucked up about Germany, is that exit to private insurance exists in principle, and our Bundesmimose Friedrich Merz have never used statutory one. The existing system has deteriorated only because nobody in the government is using it and has no clue what people now experience daily <

its designed that way, no worries.

Well, people would not want to pay more, so free solidarity can not work. The net result will be higher taxes, of course. The question is whether these costs are worth it or not, but not the "let people do what they want" as that won't work - see how US billionaires don't really give up their wealth voluntarily. And now, building a foundation is just an excuse to not give the money to the people. It is for their protection of wealth, not for solidarity.

It would be solidarity, if there was not a heavy anti-solidarity side to it. You can import millions into this system that dont pay a dime, do not contribute to it (in fact need subsidys to make a living wage) but also consume the services in equal amounts.

That is not anti solidarity, I know Afternative für Deutschland voters like to frame it this way but it's not.

Please keep your narrow political views to yourself. Just because someone tells and true fact about hundreds of thousands of Ukrainian refugees that didn’t payed a single Euro into the health insurance system keeps on benefiting from it, doesn’t make them an AfD voter. That’s a sentiment shared by people from every political spectrum in Germany from Linke to AfD.

If you like it or not, it is anti-solidarity if you benefit from a system that you have never contributed. That is just free loading and one should be ashamed of it.

The act of giving involves someone who receives, that doesn't make it anti-giving.

> it is anti-solidarity if you benefit from a system that you have never contributed

What's your stance on disabled children who can never sustain themselves?

I don’t have any problem with disabled children or even adults being taken care of by the society. But that’s not the point. Fully able bodied people that can work and contribute are taking advantage of the system without giving back anything to the system. That’s what’s anti-solidarity

> Fully able bodied people that can work and contribute are taking advantage of the system

Evidence? Earlier you seem to be complaining that refugees are admitted or taken care of in the first place. The former is off topic IMO while the latter is taken for granted. Now you apparently shift to objecting that they refuse to work. Which is it?

Aren't Ukrainians actually large net contributors?

"Should be ashamed" linked to refugees.

This is a clear comment showing that your moral compass is quite broken.

That’s not true. There is a limitation where one is charitable without taken advantage of. You cannot expect one to be a life long refugee and keep on sucking resources from the system. They need to start contributing back as soon as possible. Otherwise how sustainable and just do you think the system would be.

Also this thread is the perfect example that one cannot even question the fairness of abusing the system because then they would be labled as immoral or an AfD voter

That isn't what happened here. You spewed unsubstantiated partisan taking points. Now (upon crying foul) you at least make a sensible argument but without any data supporting it. That isn't useful behavior for this website.

Welcome to HN :-))

That is not an argument though. He gave a specific example.

You brought up only AfD, without giving any counter-example or refuting his arguments. That's now how a discussion should work.

See it from the other side: the argument IS ENTIRELY IRRELEVANT with regards to AfD or any other party. So, an argument should be made from this point of view as well.

They haven't brought up any argument at all, they simply said that "millions imported into the system do not contribute", which is not an argument or a fact. Just a statement. What is there to discuss? Why are you holding my comment to a different standard, because you don't agree or what?

But just for you I have looked up the facts: 1.1 million Ukrainian refugees, and half of them are employed by now. 1.1 million including children, elderly, and so on, people who aren't able to work. A) its not "millions" B) german overall employment rate is about 45.5 million employed people out of 83.5 million residents. So they are totally in line with the average population.

noone was complaining about Ukrainian refugees, you missed the other area where refugees come but never contribute back to society except crime

> or a fact. <

Obviously, you are not a local! Statistics all around, from Gov to private orgs, tell quite the opposite.

Then go ahead and present those. That's what we're all here on HN for unless I've a gross misunderstanding. Otherwise your comment is no better than partisan noise.

You can’t remove party politics from a discussion of national healthcare. It is absolutely relevant.

As the main reason for my expatriation out fo a similar system I'd happily stay and pay if the service was good and the providence state was not collapsing.

As it stands its just an extraction machine to the boomer benefit and it wont survive by the time i will need it

I agree with you. People would not complain and happily pay a premium for a really good service. But that’s not the case in Germany.

Younger generation would absolutely end up paying even more in the future to sustain the health costs of aging boomers.

Also the pension scheme in Germany for a lack of better word, is a ponzi scheme. Again, younger generation is paying to sustain the boomers and by the time those young people goes into retirement, they would barely get anything out of what they have paid.

That's what universal healthcare fundamentally is; everyone pays for it regardless of whether they use it or not, and regardless of the quality of service they receive in return.

What, did you think universal healthcare meant everything would be free? That's not possible; doctors and nurses don't work for free.

No it’s not. The universal healthcare is everyone contributing to it equally. That’s not the case in Germany. Private health insurance holders doesn’t contribute to it at all and a certain professions like government workers, doctors, etc. have their own health insurance schemes and doesn’t pay into the statutory health insurance.

Even the people that has to pay for the statutory health insurance pays different amounts and also there’s a group of people that benefits from it even without paying a single euro for it. So it’s not universal at all. Only a certain group pays for the majority and takes on the burden

> certain professions like government workers, doctors, etc. have their own health insurance schemes <

Completely WRONG: you are mixing up "job-dedicated" pension schemes like for lawyers or doctors with the healthcare setup - in healthcare, there are only two parties: "public" healthcare ("GKV") and "private" healthcare ("PKV"), these two types are not anyhow related to the job dedicated pension schemes.

Correct is, mostly all politicians, high-earners, docs, lawyers etc. are chosing the "private" insurance version, for (at least until yet) several benefits compared to the ones using the "public" model.

You are allowed to enter the private model above a certain salary, but you are not forced. It may be cheaper for some time, but at least if kids arrive it gets fucking expensive, since in the public model your children are insured for free,while in private mode you have to pay for them.

Also handling private mode insurance is more work.

Sounds really complicated, but at the end of the day as long as everyone has health insurance that's still by definition universal health insurance, right? In particular, having "a group of people that benefits from it even without paying a single euro for it" seems mandatory for it to be truly universal.

It sounds to me like you're envisioning something different from universal healthcare, but it's not clear to me exactly what.

What I want to make it clear is that people outside of Germany/Europe, especially Americans have this idea that everyone in Europe has health care because money appears magically to take care of everyone.

But that’s not the case, it is true that everyone would get health care, but a group of people pays a significant portion to maintain that system (which is turning out to be unsustainable day-by-day) compared to majority of the people that truly benefit from it. For me universal healthcare would be something that everyone contributes equally and everyone benefits equally as well.

> For me universal healthcare would be something that everyone contributes equally and everyone benefits equally as well.

Your version of universal healthcare must not cover much, because equal contributions that everyone can afford is not very much.

Universal healthcare can only work if those with more ability to pay pay more or if you live in some utopia where everyone (including children, disabled people, and those too old to work) has the ability to pay for healthcare.

If you want equal contribution, equal benefit, maybe auto repair is a better model. You might get some limited warranty, then anyone can go to any mechanic to get their car fixed, rates are generally posted and you get a mostly binding estimate before the work starts. This is a nice system, but I don't think anyone would call it universal auto repair.

You can’t opt out from it

This is the part that makes it universal.

> Everyone pays for it as a mandatory percentage from their salaries every month as a health insurance fee. .... the higher your salary you end up paying more money to receive the same service

Correct me if I'm wrong, but this sounds exactly how almost all income taxes work.

> 5$ for Netflix and other paying 50$ to watch the same shows with no change in service offering.

Counterpoint -- you pay taxes to get the full benefits that a stable society provides, which includes your ability to make any income at all. The more income you earn, the more benefit you're literally getting.

> you’re young and single, you will be punished

Don't worry, it's impossible to stay young and single forever.

> I would say Germany is a good place if you’re married and have kids. Then you get a lot of subsidies from the government and it’s relatively cheap to raise children in Germany.

The number of newborns in germany last year was lowest since WW2. Seems like most germans don't agree with this assessment.

It’s not just financials. Young people just don’t want to have that responsibility and burden and restriction of freedom that comes with having children.

You have to be optimistic about the future, to have kids. And Germans lately are targeted with propaganda, algorithmic and amplified bad news. Every kind of german-speaking media and social media is full of dread, how the country is in a "freefall", etc. I saw the same in UK pre-brexit.

Because cheap healthcare only is not a parameter for having kids (-:

My siblings have covered most of your points, but I think one gets overlooked easily:

> Think of it as one paying 5$ for Netflix and other paying 50$ to watch the same shows with no change in service offering.

This used to be the norm before department stores made fixed price popular. People would haggle, and more wealthy people usually paid more because they couldn't be bothered to haggle as much.

> The fucked up part is that the higher your salary you end up paying more money to receive the same service as someone paying way less with a lowers salary.

That's basically how all progressive taxation works?

I hate to break it to you, but you have to wait for a specialist in US as well. Months is also a quite typical wait time.

And even if you're on a princely healthcare plan - you're still out several thousand dollars for an ER visit.

But the funny thing in Germany is that if you are on private health insurance, then you can get an appointment with a specialist like tomorrow or at most within a week.

The months waiting time only applies to statutory health insurance payees and ironically they are the ones most of the time that pays a higher premium

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