Germany German patients have the option of choosing among all available health insurance plans,including plans run by other companies or faraway states. These plans are nominally private entities,they are extensively regulated (managed competition). Premiums to finance insurance are collected as payroll taxes,and vary only with income,not health. Patients and insurers are free to choose their health care providers,who can compete to attract them. Remember,providers must compete based on quality rather than price Bhattacharya,Hyde and Tu-HealthEconomicsBhattacharya, Hyde and Tu – Health Economics Germany  German patients have the option of choosing among all available health insurance plans, including plans run by other companies or faraway states.  These plans are nominally private entities, they are extensively regulated (managed competition). • Premiums to finance insurance are collected as payroll taxes, and vary only with income, not health. • Patients and insurers are free to choose their health care providers, who can compete to attract them. • Remember, providers must compete based on quality rather than price