Don't mistake governments with the state, or public institutions. For instance, here in Germany, we have what U.S. people would probably call 'socialized healt

Don't mistake governments with the state, or public institutions. For instance, here in Germany, we have what U.S. people would probably call 'socialized health care'. We invented it, basically. But this doesn't mean it's one gigantic insurance for all people. Actually, it's a system with hundreds of insurances, and you can pick the one you'd like (with some exceptions). The only thing you can not do is to not pick any of them. And no insurances is able to reject you. The insurances may be companies, but there are also non-profit entities. Either way, they are separate from government. Strictly speaking, they aren't even part of the state. As far as I know no one from the government is allowed to request their files without a court order. Additionally, there's a parallel 'free' system for people with sufficient income, and some special groups. Interestingly, civil servants seem to be one of these special groups. They may opt-in into the social system, but most of them seem to use the 'free' system -- not because of fear but because it's cheaper for them.