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Health Insurance Systems - JSON

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": "01",
    "slug": "beveridge-model",
    "name": "Beveridge Model (National Health Service)",
    "description": "A healthcare model where the government provides and operates healthcare through tax revenue.",
    "originCountry": "United Kingdom",
    "fundingSource": "General taxation",
    "coverageRate": "99-100%",
    "examples": [
      "UK",
      "Spain",
      "Sweden",
      "Norway",
      "New Zealand",
      "Cuba",
      "Hong Kong"
    ]
  },
  {
    "code": "02",
    "slug": "bismarck-model",
    "name": "Bismarck Model (Social Health Insurance)",
    "description": "A social insurance model where employers and employees share insurance premium contributions.",
    "originCountry": "Germany",
    "fundingSource": "Employer and employee contributions (payroll deductions)",
    "coverageRate": "85-99%",
    "examples": [
      "Germany",
      "Japan",
      "France",
      "Netherlands",
      "Belgium",
      "Switzerland"
    ]
  },
  {
    "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.",
    "originCountry": "Canada",
    "fundingSource": "Government insurance program (taxes or premiums)",
    "coverageRate": "99-100%",
    "examples": [
      "Canada",
      "Taiwan",
      "South Korea",
      "Australia"
    ]
  },
  {
    "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.",
    "originCountry": "N/A (Developing countries)",
    "fundingSource": "Individual direct payment",
    "coverageRate": "Variable (often <50%)",
    "examples": [
      "Rural Africa",
      "Rural India",
      "Rural China",
      "Cambodia",
      "Burkina Faso"
    ]
  },
  {
    "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.",
    "originCountry": "Japan",
    "fundingSource": "Equal employer-employee contributions",
    "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"
    ]
  },
  {
    "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.",
    "originCountry": "Japan",
    "fundingSource": "Household premiums (with national, prefectural, and municipal subsidies)",
    "coverageRate": "約27%（日本国内）",
    "examples": [
      "市町村国保",
      "国民健康保険組合"
    ]
  },
  {
    "code": "07",
    "slug": "japan-late-stage-elderly",
    "name": "Japan: Late-Stage Elderly Healthcare System",
    "description": "Japanese healthcare system for individuals aged 75 and older.",
    "originCountry": "Japan",
    "fundingSource": "Premiums (with support contributions and public funding)",
    "coverageRate": "約16%（75歳以上の全員）",
    "examples": [
      "後期高齢者医療広域連合"
    ]
  },
  {
    "code": "08",
    "slug": "uk-nhs",
    "name": "UK: NHS (National Health Service)",
    "description": "The world's largest publicly funded healthcare service established in 1948.",
    "originCountry": "United Kingdom",
    "fundingSource": "General taxation and National Insurance contributions",
    "coverageRate": "99-100%",
    "examples": [
      "NHS England",
      "NHS Scotland",
      "NHS Wales",
      "HSC Northern Ireland"
    ]
  },
  {
    "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.",
    "originCountry": "Germany",
    "fundingSource": "GKV: payroll deductions (employer-employee split) / PKV: individual premiums",
    "coverageRate": "99-100%",
    "examples": [
      "AOK",
      "TK",
      "Barmer",
      "DAK-Gesundheit (GKV)",
      "Allianz",
      "AXA (PKV)"
    ]
  },
  {
    "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.",
    "originCountry": "United States",
    "fundingSource": "Private premiums, government tax revenue, individual payments",
    "coverageRate": "約92%（未加入者約8%）",
    "examples": [
      "Medicare",
      "Medicaid",
      "CHIP",
      "VA",
      "Employer-sponsored insurance",
      "ACA Marketplace"
    ]
  },
  {
    "code": "11",
    "slug": "singapore-medisave",
    "name": "Singapore: Medisave System",
    "description": "A unique healthcare financing system centered on personal savings accounts.",
    "originCountry": "Singapore",
    "fundingSource": "Personal savings (CPF), insurance premiums, government funds",
    "coverageRate": "100%（Medishield Lifeは強制）",
    "examples": [
      "Medisave",
      "Medishield Life",
      "Medifund",
      "Integrated Shield Plans"
    ]
  },
  {
    "code": "12",
    "slug": "france-universal",
    "name": "France: Universal Health Coverage",
    "description": "France's social insurance system renowned for world's highest healthcare access.",
    "originCountry": "France",
    "fundingSource": "Social insurance contributions (payroll), general taxation",
    "coverageRate": "99-100%",
    "examples": [
      "CPAM",
      "CMU-C",
      "mutuelle"
    ]
  },
  {
    "code": "13",
    "slug": "canada-medicare",
    "name": "Canada: Medicare System",
    "description": "A single-payer public health insurance system operated by provincial governments.",
    "originCountry": "Canada",
    "fundingSource": "Provincial taxes and federal transfers",
    "coverageRate": "99-100%",
    "examples": [
      "OHIP (Ontario)",
      "MSP (British Columbia)",
      "RAMQ (Quebec)",
      "AHCIP (Alberta)"
    ]
  },
  {
    "code": "14",
    "slug": "taiwan-nhi",
    "name": "Taiwan: National Health Insurance (NHI)",
    "description": "An efficient single-insurer healthcare system introduced in 1995.",
    "originCountry": "Taiwan",
    "fundingSource": "Premiums (employer-employee split for workers), government subsidies, tobacco taxes",
    "coverageRate": "99%以上",
    "examples": [
      "National Health Insurance Administration (NHIA)"
    ]
  },
  {
    "code": "15",
    "slug": "south-korea-nhis",
    "name": "South Korea: National Health Insurance",
    "description": "A system introduced in 1977 that achieved universal coverage by 1989.",
    "originCountry": "South Korea",
    "fundingSource": "Premiums (employer-employee split for workers), government subsidies",
    "coverageRate": "99-100%",
    "examples": [
      "National Health Insurance Service (NHIS)",
      "Health Insurance Review and Assessment Service (HIRA)"
    ]
  },
  {
    "code": "16",
    "slug": "australia-medicare",
    "name": "Australia: Medicare",
    "description": "A public health insurance scheme introduced in 1984.",
    "originCountry": "Australia",
    "fundingSource": "General taxation (Medicare levy)",
    "coverageRate": "99-100%",
    "examples": [
      "Medicare",
      "Medicare Levy Surcharge",
      "Private Health Insurance Rebate"
    ]
  },
  {
    "code": "17",
    "slug": "netherlands-mandatory",
    "name": "Netherlands: Mandatory Private Insurance",
    "description": "A mandatory private insurance system introduced in 2006.",
    "originCountry": "Netherlands",
    "fundingSource": "Individual premiums, income-related premiums, government subsidies",
    "coverageRate": "99-100%",
    "examples": [
      "Zorgverzekeringswet (Zvw)",
      "Zorginstituut Nederland"
    ]
  },
  {
    "code": "18",
    "slug": "switzerland-mandatory",
    "name": "Switzerland: Mandatory Health Insurance",
    "description": "A mandatory private insurance system introduced in 1996.",
    "originCountry": "Switzerland",
    "fundingSource": "Individual premiums, cantonal subsidies",
    "coverageRate": "99-100%",
    "examples": [
      "KVG/LAMal",
      "Swiss Federal Office of Public Health (FOPH)"
    ]
  },
  {
    "code": "19",
    "slug": "sweden-regional",
    "name": "Sweden: Regional Public System",
    "description": "A tax-funded public healthcare system operated by regional governments.",
    "originCountry": "Sweden",
    "fundingSource": "County and municipal taxes, national subsidies",
    "coverageRate": "99-100%",
    "examples": [
      "Region Stockholm",
      "Region Skane",
      "Vastra Gotalandsregionen"
    ]
  },
  {
    "code": "20",
    "slug": "private-supplementary",
    "name": "Private Health Insurance (Supplementary)",
    "description": "Private health insurance that supplements public health insurance.",
    "originCountry": "Various countries",
    "fundingSource": "Individual premiums",
    "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"
    ]
  }
]