Wherever you look in the world, the funding of healthcare is a crucial issue for individuals and governments. The way in which private insurance contributes alongside public funding varies considerably from one country to another, depending on the historical, economic, cultural and political context.
Some countries therefore ignore private insurance, whilst others see it as vital. Despite the difficulties involved in categorizing countries into standard models, the Organisation for Economic Co-operation and Development (OECD) has traditionally identified four major private healthcare systems around the world.

Healthcare systems worldwide:
4 private insurance models with 3 possible levels of cover

Private health insurance plays a role at different levels and for a variety of reasons.  In some countries, it is the only source of health cover for people with no access to the public healthcare system. In others, it offers an alternative to public health insurance, allowing individuals to choose between the two. It may also complement the public system.

Some examples of national healthcare funding systems

France
France has a unique system of complementary and supplementary cover for healthcare costs. According to a report published by the Inspection Générale des Affaires Sociales (IGAS) in June 2009, almost 93% of French people benefit from cover under personal policies, company or industry group agreements or the universal complementary healthcare scheme (CMU-C).

Canada
The Canadian health system aims to serve individuals on the fairest-possible basis. It is regulated by the Canada Health Act. Although the federal government provides the funding, healthcare provision is controlled by the provinces individually. All essential primary healthcare services (doctors, hospital treatment, etc.) are provided free of charge. Dental care (except that provided in hospital) and eye care are not provided free of charge, which is why many Canadians have supplementary private insurance policies to cover these expenses.

Japan
Japan operates a healthcare system based on universal social insurance covering everyone in the country, regardless of income. This universal health insurance system contains three distinct schemes:

• The kenkō hoken health insurance scheme for employees 
  
• The Kokumin Kenkō Hoken public health insurance scheme, which covers everyone under 75 without employee health cover
  
• The Koki Koreisha Iryo Seido health insurance scheme for senior citizens, which covers everyone aged over 75 (or 65 if the person concerned has a disability)

In addition to these national health insurance schemes, it is also possible to contribute to a private scheme providing access to supplementary services and cover.

 Switzerland
The basic compulsory insurance for residents (LaMal) offers the following principal covers: treatment by a doctor, medication and hospital treatment costs, including maternity. Approximately 80% of the Swiss population also has supplementary private health insurance in addition to the basic compulsory health cover.

Germany
Private health insurance is the primary cover adopted for those members of the population without access to public health cover. It also plays complementary and supplementary roles relative to the public scheme by covering the proportion of healthcare costs chargeable to patients. Germany is the only OECD country that allows those with high incomes to arrange exclusively private healthcare insurance as a total substitute to the state scheme. Those taking up this option may not return to the public scheme at a later time.

UK, Spain, Italy, Ireland and Portugal
In all these countries, healthcare funding is covered by a national scheme and private insurance. Private health insurance offers an alternative to the universal cover provided by the public scheme. Private insurers may therefore cover the health risk in its totality (including hospital expenses), thus duplicating the public system. Private health insurance may also play complementary and supplementary roles.

USA
In the USA, there is a liberal system of healthcare in which the majority of primary cover for treatment is privately funded. The public cover provided under the Medicare and Medicaid schemes is restricted to senior citizens, the disabled and certain underprivileged members of society. In 2007, approximately 65% of the US population had one form or another of private health insurance.