You seem to misunderstand what “there are many insurance companies“ means. There are multiple entities doing the paying. A person contracts health insurance wit

You seem to misunderstand what “there are many insurance companies“ means. There are multiple entities doing the paying. A person contracts health insurance with one among several insurers (at least one, different companies can be chosen for the compulsory insurance and the optional plans offering additional coverage). In the end healthcare is paid directly by the individuals (deductibles, contribution up to some threshold, non-covered charges), by their insurer(s) and by the state (public hospital budgets are not completely covered by the amounts they charge, a large share of the costs is paid from taxes).