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So they force people who earn less than a certain cut-off to have state insurance.

 

This only applies to employees, however. Basically health insurance is always paid roughly 50-50 by employee and employer. You can pick up additional insurance from private insurancers for things not covered by the federal plans (there are actually several) though. Interestingly the health care costs in Germany are higher than in exclusively single payer systems, but still only around 50-60% of the US.

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