You are correct that reform must happen. Before Obamacare, I had excellent insurance through my employer. Now I pay monthly for a $7500 high deductible plan that I cannot even use. The problem with your Germany example though is that you spend nearly half the year working for the government. The top tax rate of 42% applies to taxable income above €55,961. Finally, for taxable income above €265,327, a 45% tax is applicable. I'll take insurance the way it used to be (not that long ago) over the government running it into the ground any day!!