DACH - Deutschsprachige Community für Deutschland, Österreich, Schweiz

Another strong, but much less talked about reason for this is Bismarcks conflict with the pope. B did not want to leave the power (control through help, spiritually and materially) to the church.

I can't speak to that specific situation but I believe power should be held the shortest distance from the people it effects - balanced only by having more power for more people. I imagine health insurance owned and controlled by unions is less powerful than owned and controlled by the government but the distance is shorter. So ideally it would be held by a government to maximize the negotiating power essentially, but if the government is run by incompetent or immoral people (like I'd assert the CDU is) I could see union control being better.

The unions by and large dominate health insurance governance, they're generally getting majorities to supermajorities in elections. That's a different thing than the legal structure that health insurance operate under, including what they have to pay for and what not but when you're talking to your insurer you're pretty much always talking to union bureaucracy.

...which is also why I got a letter from my insurer telling me that a) they have to raise rates and b) they're sorry, but it's unavoidable and c) the federal government is to blame.