It's called the free market, not communism. Healthcare is mostly organized through independent insurance companies in germany.

Now in the US, everything's expensive when it comes to health, because people don't need pre-emptive medical attention, as you said, even though it comes out cheaper overall. So you get this system in the US where somebody is stuck with an overpriced bill because there's not much of an organization behind ensuring costs are cut via insurance sponsored health checks.

Plus, insurance company oligarchy. If you want even more free market than the socialist style health insurance system in germany, look at poland or mexico prices for healthcare. These are even cheaper. The US is just the land of anti competitive practices.