Structured Lists Directory

YAML

Health Insurance Systems - YAML

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"