Most recent example: Started freelancing in July again, got to pay nearly 1k per month. First money received is EUR 4400 end of September.
I tried the alternative route last time, and it's no fun: Write in certified mail that I make less and need a lower rate, they'll ignore it, say they didn't get anything, I'm not insured any more. Go to a lawyer with the proof of certified mail, win, get the lower rate and they have to pay back medical bills, EUR 500 lawyer costs though. Have to pay back 1k per month anyway if it turns out I make enough in the last few months of the year, so it was all for nothing.
I think it should work exactly like the fire department. Entirely tax funded, no hassle. A hospital is, in my eyes, more similar to a fire department or a police station than it is to a super market, and that's how it should work.
But it only works well all-in. A strange system of compromises forged between parties with entirely opposing views over 50 years is terrible.