[flexblue]

> The difference is GKV being the default, and opting out of that kind of hard.

It's not hard at all, just go self-employed and you have the option.

> And the step is intentionally hard to reverse.

Yes, so that people towards the end of their lives don't profit from a system they never paid into. You're stuck with expensive private insurance for the rest of your life. In the US however, you would qualify for Medicaid.

> At that point people have to actively shoot them self in the foot, and I've little pity for those.

It's actually not that uncommon for people to fall into the trap of working self-employed for most of their lives, then retiring poor because they never paid into the pension system and their private insurance costs them over 500€/month.