Walter Hinteler wrote:
I din't use the term "national citizen".
Our health insurance isn't exclusive for persons of German nationality but for everyone earning/receiving money here. As are the other types of our soical insurances.
There are various forms of bias against hiring non-citizens everywhere, as far as I know. Sometimes official governmental laws/policies encourage hiring of citizens over non-citizens in various ways, and sometimes it is an informal feeling of solidarity that deters people from hiring foreigners when they feel that the domestic economy isn't providing enough jobs/prosperity for citizens, whose well-being they feel should take priority over non-citizens.
Your point seems to be that if preference for citizens is happening, it's not because they can't buy the insurance that's available and required. My question then just becomes what other factors limit the choice to live, work, and thus pay for the mandatory insurance. I can't believe that there are no social-economic effects caused by insurance or any other form of economic solidarity that don't play a roll in limiting and structuring all the various aspects of life-choices, from where people get to live to what they're allowed to do for work, to access to a healthy diet, lifestyle, healthcare, etc.
I also didn't introduce foreign competition.
There are some private health insurers, belonging to foreign companies, but they act here as German companies. (I'm sure, you have a lot foreign health insurers as competitive alternatives in the USA.)
Yes, and I think private/corporate healthcare drives up costs and thus stimulates exclusion of uninsured people in the US as it would/must anywhere. It's simply not possible for a corporation to control resources without effectuating exclusion unless the resources in question are somehow unlimited/abundant, which healthcare should be if it was used for what it is and not as a tool for business and economic growth, or as a privilege to control by powerful people, corporations, and governments.
However, the British Forces have created for the primary, community and secondary health care (restricted for members of the forces and their families) with the SSAFA GSTT Care LLP a "foreign" German mandatory health insurer. (It's a a partnership between SSAFA Forces Help [SSAFA] and Guy's and St Thomas' Trust [GSTT], because the Royal Forces use German civil doctors and civil hospitals.)
So your point is that it is an example of exclusionary health plan that utilizes 'German civil doctors and civil hospitals?' To me that implies that those civil doctors and hospitals should be liberated from exclusionary control, but then what factors would limit access to them? I am assuming that such health care resources aren't unlimited or abundant there.
I'm glad you introduced this example, because it provides an opportunity to examine potential solutions and their side-effects. E.g. would it be better if the military personnel brought doctors and hospitals into the local economy in proportion to their utilization? Would it also be better if all people had access to those doctors/hospitals, not just military insured? If they did, would de facto exclusion result, e.g. because waits for care would increase due to higher utilization?
Many subtly discriminatory scenarios are imaginable. E.g. if various healthcare businesses grew more lucrative as a result of health insurance mandates of the ACA (Obamacare), then the people making that money could gain the option to move to some other healthcare market where the quality of care was higher. If the same happened in Germany, for example, for whatever reason, you could have people making money on German healthcare but then traveling elsewhere for shorter waits or better quality care. It's very difficult to explore all these possibilities at the general level, but it's not very difficult to understand in general why they are possibilities.