One thing to consider is that the NHS is a centralised and socialised system (barring the NHS internal market, which is in the process of abolition), whereas th

One thing to consider is that the NHS is a centralised and socialised system (barring the NHS internal market, which is in the process of abolition), whereas the German system has mandatory but private insurance which would involve more administrative costs, not to mention money spent on marketing and the like, so the costs are not directly comparable, and in general Germany probably spends more of the money on non-medical services.