Major models and types of health insurance systems worldwide.
Overview
Health Insurance Systems
Health insurance systems are social institutions designed to reduce citizens' medical expenses and ensure access to healthcare services. They are classified into four major types: the Beveridge Model (national health service), Bismarck Model (social health insurance), National Health Insurance Model, and Out-of-Pocket Model. Each country designs its system according to its national circumstances. Japan adopts the Bismarck Model, achieving universal health coverage through a three-tier structure of employee health insurance, national health insurance, and late-stage elderly medical care system.
health insurance
social security
healthcare system
universal health coverage
medical insurance
social insurance
healthcare costs
| code | slug | name | description | coverageRate | examples | fundingSource | originCountry |
|---|---|---|---|---|---|---|---|
| 01 | beveridge-model | Beveridge Model (National Health Service) | A healthcare model where the government provides and operates healthcare through tax revenue. | 99-100% | ["UK","Spain","Sweden","Norway","New Zealand","Cuba","Hong Kong"] | General taxation | United Kingdom |
| 02 | bismarck-model | Bismarck Model (Social Health Insurance) | A social insurance model where employers and employees share insurance premium contributions. | 85-99% | ["Germany","Japan","France","Netherlands","Belgium","Switzerland"] | Employer and employee contributions (payroll deductions) | Germany |
| 03 | national-health-insurance-model | National Health Insurance Model | A hybrid model where the government acts as the insurer while private providers deliver services. | 99-100% | ["Canada","Taiwan","South Korea","Australia"] | Government insurance program (taxes or premiums) | Canada |
| 04 | out-of-pocket-model | Out-of-Pocket Model (Market-Based) | A model without an organized system where individuals pay for healthcare directly. | Variable (often <50%) | ["Rural Africa","Rural India","Rural China","Cambodia","Burkina Faso"] | Individual direct payment | N/A (Developing countries) |
| 05 | japan-employee-insurance | Japan: Employee Health Insurance (Occupational) | Japanese health insurance for employees of companies and organizations and their families. | 約60%（日本国内） | ["協会けんぽ","健康保険組合","共済組合","船員保険"] | Equal employer-employee contributions | Japan |
| 06 | japan-national-health-insurance | Japan: National Health Insurance (Regional) | Japan's regional health insurance for self-employed, farmers, and non-regular workers. | 約27%（日本国内） | ["市町村国保","国民健康保険組合"] | Household premiums (with national, prefectural, and municipal subsidies) | Japan |
| 07 | japan-late-stage-elderly | Japan: Late-Stage Elderly Healthcare System | Japanese healthcare system for individuals aged 75 and older. | 約16%（75歳以上の全員） | ["後期高齢者医療広域連合"] | Premiums (with support contributions and public funding) | Japan |
| 08 | uk-nhs | UK: NHS (National Health Service) | The world's largest publicly funded healthcare service established in 1948. | 99-100% | ["NHS England","NHS Scotland","NHS Wales","HSC Northern Ireland"] | General taxation and National Insurance contributions | United Kingdom |
| 09 | germany-gkv-pkv | Germany: GKV and PKV Dual System | Germany's healthcare system with coexisting statutory and private health insurance. | 99-100% | ["AOK","TK","Barmer","DAK-Gesundheit (GKV)","Allianz","AXA (PKV)"] | GKV: payroll deductions (employer-employee split) / PKV: individual premiums | Germany |
| 10 | us-mixed-system | USA: Mixed Healthcare System | A complex system with private insurance as the mainstay and government programs for specific populations. | 約92%（未加入者約8%） | ["Medicare","Medicaid","CHIP","VA","Employer-sponsored insurance","ACA Marketplace"] | Private premiums, government tax revenue, individual payments | United States |
| 11 | singapore-medisave | Singapore: Medisave System | A unique healthcare financing system centered on personal savings accounts. | 100%（Medishield Lifeは強制） | ["Medisave","Medishield Life","Medifund","Integrated Shield Plans"] | Personal savings (CPF), insurance premiums, government funds | Singapore |
| 12 | france-universal | France: Universal Health Coverage | France's social insurance system renowned for world's highest healthcare access. | 99-100% | ["CPAM","CMU-C","mutuelle"] | Social insurance contributions (payroll), general taxation | France |
| 13 | canada-medicare | Canada: Medicare System | A single-payer public health insurance system operated by provincial governments. | 99-100% | ["OHIP (Ontario)","MSP (British Columbia)","RAMQ (Quebec)","AHCIP (Alberta)"] | Provincial taxes and federal transfers | Canada |
| 14 | taiwan-nhi | Taiwan: National Health Insurance (NHI) | An efficient single-insurer healthcare system introduced in 1995. | 99%以上 | ["National Health Insurance Administration (NHIA)"] | Premiums (employer-employee split for workers), government subsidies, tobacco taxes | Taiwan |
| 15 | south-korea-nhis | South Korea: National Health Insurance | A system introduced in 1977 that achieved universal coverage by 1989. | 99-100% | ["National Health Insurance Service (NHIS)","Health Insurance Review and Assessment Service (HIRA)"] | Premiums (employer-employee split for workers), government subsidies | South Korea |
| 16 | australia-medicare | Australia: Medicare | A public health insurance scheme introduced in 1984. | 99-100% | ["Medicare","Medicare Levy Surcharge","Private Health Insurance Rebate"] | General taxation (Medicare levy) | Australia |
| 17 | netherlands-mandatory | Netherlands: Mandatory Private Insurance | A mandatory private insurance system introduced in 2006. | 99-100% | ["Zorgverzekeringswet (Zvw)","Zorginstituut Nederland"] | Individual premiums, income-related premiums, government subsidies | Netherlands |
| 18 | switzerland-mandatory | Switzerland: Mandatory Health Insurance | A mandatory private insurance system introduced in 1996. | 99-100% | ["KVG/LAMal","Swiss Federal Office of Public Health (FOPH)"] | Individual premiums, cantonal subsidies | Switzerland |
| 19 | sweden-regional | Sweden: Regional Public System | A tax-funded public healthcare system operated by regional governments. | 99-100% | ["Region Stockholm","Region Skane","Vastra Gotalandsregionen"] | County and municipal taxes, national subsidies | Sweden |
| 20 | private-supplementary | Private Health Insurance (Supplementary) | Private health insurance that supplements public health insurance. | 各国・各制度により異なる | ["Cancer insurance","Advanced medical care riders","Private hospital rooms","International health insurance"] | Individual premiums | Various countries |
- Health Insurance System | Ministry of Health, Labour and Welfare official
- Health Care Systems - Four Basic Models | Physicians for a National Health Program official
- Health Care Systems - Four Basic Models reference
- Global Healthcare: 4 Major National Models And How They Work reference
- Health Insurance System Structure and Features | Japan Nursing Association reference