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@Suzu @ChristiJunior @coldacid @mushroom_soup @teknomunk Aight, let me rant because this made me mad.
The german public medical system works by taxing anyone inside it (you can opt out if you earn enough shekels or are a public employee like a teacher) and then offering a bunch of "free" services. Doctors are required to inform you beforehand if any treatment is not covered, there is a lot of those. But basic shit is generally free including just seeing a doctor and figuring out what's next. There be lots of issues but for now...
The way the billing works is that every doctor, pharmacy and hospital has a local office they send the bills for public patients to. These then pay out the money, sort all the bills they got and send them to the insurance companies who pay those. The insurance companies are paid by the state.
Currently, goymoney has an issue. Too little goymoney in the system. (Totally unrelated but refugees buth of the nigger and the slav variant are inside that system and get their shit paid by the state before it's even decided if they get to stay, not that the decision matters in the slightest.)
So the solution is to budget certain sectors of medical treatment. Which means that every doctor ect. has a limit on how much they can be paid, depending on the amount of cases they treat and how much they get paid the last few years.
So, how much is that? Nobody knows. The doctors aren't told. They aren't told when they send their bills in. In fact, they get paid in full. Then about two years later they get a funny letter saying "well fuck you, we gave you 50k too much, pay us back and suck our cock or we take your license".
But since they never know when they start working for free, they have to guess. And since the amount they'll get the next year depends on how many patients they have, closing for the end of the year just means even less money. Besides, they're legally required to treat emergency cases (literally anyone who comes in personal and says "I'll wait", you can't send them away) or have a replacement

Relevant story I got from a relative who's a dentist:
Two years ago they overhauled the system for treating parodontitis. Went from essentially a one-and-done deal (guess we'll clean everything once) to a far better system where it starts with instruction on how to clean better and what other factors might help/hurt the situation, then the old cleaning, then a two year program with 2-6 checkups, each including another cleaning and more instruction.
As you might imagine, this new system costs a lot more money initially, with the idea being people don't loose their teeth and need a shitton of replacements which don't last forever either. It also means that dentists started a bunch of these two year treatments and got told to get fucked, so immediately the amount of new patients in the system went down. After all it's not an emergency treatment, the extractions a few years later are.

So, I wanna see how they get more welfare state when it's actively breaking down as I type this.

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