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In Germany you are given two options: pay into the state system or pay privately. Its either or, not a top up.
One is cheaper than the other when you're younger, but becomes more expensive as you get older. The split is about 77/23 the last time I checked, albeit a few years ago, on favour of public.
There is no stigma attached to using either, and all doctors and medical facilities are privately delivered, but funded by one of the above two methods.
It's an excellent system and provides more timely quality care (for all) than what we are used to in the UK.
Thats not knocking the NHS, I dont see why my BUPA cover can pay for a specialist tomorrow, but the NHS won't pay for the same specialist for 12 months or whatever