enrollment in the public health care system is generally automatic and is linked to employment, however insurance is also guaranteed to co-insured persons (i.e. spouses and dependents ), pensioners, students, the disabled, and those receiving unemployment benefits. enrollment is compulsory, and it is not possible to cross-shop the various social security institutions. employers register their employees with the correct institution and deduct the health insurance tax from employees' salaries. some people, such as the self-employed, are not automatically enrolled but are eligible to enroll in the public health insurance scheme. the cost of public insurance is based on income and is not related to individual medical history or risk factors.