While it certainly makes sense to discuss the difference, for a US-based audience it doesn't make much sense to pedantically point out that these aren't taxes. Social insurance contributions are mandatory, based on income, and to a state entity (though independent from the government) enforced through exactly the same channels as regular taxation (as opposed to private debt).

The important difference is that they are legally committed to a certain issue (in this case: health insurance) and can't be appropriated to something else. That should be pointed out, yes, but the word "taxes" is internationally still appropriate for that.

That's simply not the case. It is exactly for an US audience important, because the German system is vastly different: universal health care, regulated by the government, 99.9% coverage, run by a system of 100+ insurers and various health care providers.

> Social insurance contributions are mandatory

Mandatory is to be insured.

> based on income

in a range, or if one is privately insured one pays based on risk/age

Family members (wife/husband + kids) without income are insured. Plus various other regulations.

> to a state entity

Krankenkassen and Krankenversicherungen are not generally state entities.

Would you call something like the Audi BKK a state entity?

https://www.audibkk.de/english/

> enforced through exactly the same channels as regular taxation

No, health care contributions are paid directly to the Krankenkasse/Krankenversicherung where one is a member, not the tax administration (Finanzamt).

> That should be pointed out, yes, but the word "taxes" is internationally still appropriate for that.

Obviously not. In the health care domain, the Social Insurance systems and tax-based health care systems are different models.

> Krankenkassen and Krankenversicherungen are not generally state entities

They are state entities established by law (Körperschaften öffentlichen Rechts mit Selbstverwaltung) and have to follow the strict regulations of the public sector. They regularly issue Verwaltungsakte.

> Would you call something like the Audi BKK a state entity?

Yes, absolutely. It's a state entity that provides care for Audi employees, since 2010 for everybody (and they can't legally refuse members). Audi has absolutely no input on their inner workings, it's really just the name and the fact that they have many members working there (and thus provide special services for them). It's basically a historical quirk of how the German insurance system came to be.

> No, health care contributions are paid directly to the Krankenkasse/Krankenversicherung where one is a member, not the tax administration (Finanzamt).

The Krankenkasse (to be exact their Einzugstelle) is really just a Finanzamt for social insurance contributions. If you don't pay they have the whole range to force you that's just available to state entities. See e.g. https://www.bundesversicherungsamt.de/fileadmin/redaktion/Kr... A private entity does not have these options and would need to go through general courts.

> Obviously not. In the health care domain, the Social Insurance systems and tax-based health care systems are different models.

They are different models (and should be contrasted) but both are financed through taxes (just different kinds). Yes, we don't call these "Steuern" in German but that doesn't translate 1-to-1 to other countries. "Abgaben" would be a much better translation for taxes.

I would not generally call a 'Körperschaften öffentlichen Rechts mit Selbstverwaltung' a clear state entity.

They are not owned by the state, they are independently run (by their members), they are independently funded (by their members), ...

Though they are heavily regulated, they have certain government mandated tasks and not typical companies.

'Private Krankenversicherungen' are not 'Körperschaften öffentlichen Rechts mit Selbstverwaltung', they are private companies.

> A private entity does not have these options and would need to go through general courts.

Like 'Private Krankenversicherungen' - they go through a court.

> Mandatory is to be insured.

While I will admit there are varying interpretation, for me, living in the USA, if I am mandated to pay for something, it's a tax.

I take it that as a German, working in Germany, I could not "opt out" of all of this and just take my chances?

Everybody is insured. If you can't work, you are insured. If you are ill and not employed, you are insured. If you are a baby just born, you are insured. If you are a student, you are insured - either through your family or on your own. If you receive social security payments, you are insured. Basically everybody, 99.9% of the population is insured.

If you are employed you pay to the health care insurance or sickness fund directly. Your employer also pays. The money is not collected by the tax authorities and is not administrated by them. Still it is public regulated system.

If you are privately insured, you pay directly to the private insurance company. This may provide additional services or a better quality.

OTOH if you are not member of a private insurance, then you still can get additional insurances from those. For example you can insure yourself privately for certain health care services if you travel to foreign countries.

In Germany we would only consider something to be a tax, if we pay somehow to the tax administration. For example if one is a member of the catholic church - which is voluntary - then one will pay 'Kirchensteuer' - 'church tax'. This tax is collected with ones usual tax payments, by the tax authorities - for the catholic church. If you are not a member of a church, like the catholic church (or some others), one does not pay this tax. If you are a member of a free church, then the tax authorities don't collect money for them. If you want to be a member, it is expected that you pay more or less 'voluntary' directly to them.

> I take it that as a German, working in Germany, I could not "opt out" of all of this and just take my chances?

You could opt out of the public system, and get a private insurance company. But once you have done so you can never re-enter the public system. And private insurances are cheaper for young people, but significantly more expensive later in life, so much that you’ll end up paying several times more over your lifetime.

Car insurance? Most US states do require a minimum level of insurance if you have a car.

You can't opt-out completely. Some people (including probably most HN readers) can purchase highly-regulated private insurance instead but even that isn't possible for the vast majority of the population.