it's a mix, i, for example, have had no medical insurance for a decade (i look after my own health, run blood tests etc), if i want to see a specialist, i pay out of pocket

there's also private insurance, but they don't always pay out and, if i want to see a specialist, i need a referral first. I'm not interested in waiting. most private docs cost 20 euro for an appointment, you can get ultrasounds and xrays also for like 20 euros, so it's not worth paying premiums

as of recently i have been enrolled in the local health system, not by choice, but because it happens automatically after getting permanent residence and i suppose if i break a bone, I'll be fixed for free or something, or for cheap.

but there are nuances, my dad needs a cataract operation and he will get the op for free, but will have to pay for the actual lenses, which will be maybe 1000 euro.

but in the UK, i see people just paying out of pocket or going private more , which is what happens when the 'free' healthcare begins to basically fail or just not be as good as it was