If we are going to have a ' rich ' and  ' poor ' healthcare system then Germany has a good set up. If you want to go private then you must buy private insurance for your healthcare, you also must buy liability insurance just in case the operation gets botched and must be fixed. You cannot buy into both private and public. You must make your choice then stick with it.  This system of paying extra AND billing the public is nonsense and must be stopped. If you want to go private, go private but NOT on my dime.