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Health Insurance Systems - XML

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