If it’s like Germany they have highly regulated insurance companies. There are public and private insurers. Private insurance is only available for higher incomes. The main thing in Germany is that your premium is based on a percentage of your salary so the less you make the less you pay. There is also a cutoff from a certain salary on so the premiums don’t keep going up when you make above that cutoff amount. If you are unemployed the employment agency keeps paying. If you are on welfare then that department will pay. So you can never fall out of insurance.

Another big aspect is that the amount doctors and hospitals can charge and what insurance reimburses is regulated. So you don’t have the situation where hospitals charge whatever they feel like and the insurance reimburses whatever they feel like and the patient sits in the middle and has to figure it out somehow or potentially go bankrupt.

There is much more detail but I hope I got the basics right. You hear a lot of bad stories too but overall the system is way more predictable and just than the US system. I have experienced both and I can see the US system only making sense for millionaires or healthy people. Otherwise it’s an insanely bureaucratic, expensive and merciless system where every hospital visit is a big gamble. And definitely don’t get any chronic disease or they will bleed yoU dry.