I am curious. What does the German hybrid system look like? I know nothing about it and had not heard that brought up before. I'm cool just Googling in but if you know something about it I'd be happy to hear a summary.
I think our healthcare system is a mess, and was made worse by Obamacare (though it was never good). The whole "you can keep your health insurance" was a lie - I could not. I was told I had to buy new health insurance, which covered less and cost more. And I was pissed about it. And my left-wing friends had no sympathy, and just kept repeating that more people had health insurance now and that was a small price to pay. As all of them enjoyed health insurance paid for by their employer (sometimes the Government or a University) and they paid no price
Let me see if I can dig this out of the long-term memory, it's been a long time since I was in Germany but:
Every adult is obligated to have health insurance, public or private.
The basic level (public) of this insurance is agreed periodically between the government, health care bodies and insurance bodies (Krakenkassen).
This agreement is that for X Euros, we cover Y benefits, illnesses and drugs, as well as ambulance etc.
If you're low income, or on benefits, the government covers/tops-up your payments at the minimum rate.
Otherwise you're paying a premium of ~7.5% of your income to cover healthcare (matched by employee).
Premiums don't increase with age, pre-existing conditions of anything like that.
The insurance groups are all not-for profit (at least with respect to the public insurance) and in many lander there is a government run option.If you earn a significantly high wage (>~65K Euro) you have the option of having private health insurance.
This is closer to American insurance in that the insurer is relatively free to set the rates and services provided/covered by the insurance (they cannot be worse than the basic public option).
The advantage of this is that a high-earning individual can avoid paying a massive premium compared to the public option (7.5% of the cut-off income is ~4,800 Euros, so a person earning $200,000 Euros is better off paying a 6,000 Euro premium instead of 7.5%). The dis-advantage of this is that premiums go up as you age, that pre-existing conditions can be considered and that if your income drops it can be bloody hard to get back into the basic system. When you turn up to the doctor or hospital they dock your insurance and treat you.
There may or may not be an out-of pocket before treatment and they're required to provide you a summary beforehand of those costs.
If you're admitted to hospital for a medically necessary procedure, there's generally no out-of pocket.
Hope that helps.