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