Health care in the Netherlands is financed by a dual system. Long-term treatments, especially those which involve (semi-)permanent hospitalization, and also disability costs such as wheelchairs, are covered by a a state-run mandatory insurance. This is laid down in the Algemene Wet Bijzondere Ziektekosten (AWBZ, see article in the Dutch Wikipedia), "general law on exceptional healthcare costs" which first came into effect in 1968.

For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments [1].

This system came into effect in January 2006. For those who would otherwise have insufficient income, an extra government allowance is paid to make sure everyone can pay for their health care insurance. People are free to purchase additional packages from the insurance companies to cover additional treatments such as dental procedures and physiotherapy. These additional packages are optional.

A key feature of the Dutch system is that premiums are set at a flat rate for all purchasers regardless of health status or age. Risk variances between funds due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool which makes it more attractive for insurers to attract risky clients. Funding for all short term health care is 50% from employers, and 45 percent from the insured person and 5% by the government. Children until age 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month with variation of about 5% between the various competing insurers.

Prior to 2006 (and since 1941) there were two separate systems of (short-term) health insurance: public and private. The public insurance system was executed by non-profit "health funds", and financed by premiums taken directly out of the wages (together with income taxes). Everyone earning less than a certain threshold income could make use of the public insurance system. However, anyone with income over that threshold was obliged to have private insurance instead.[2].

Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee: health insurance, accident insurance, and long-term care insurance.

Accident insurance (Unfallversicherung) is covered by the employer and basically covers all risks for commuting to work and at the workplace.

Long term care (Pflegeversicherung) is covered half and half by employer and employee and covers cases in which a person is not able to manage his or her daily routine (provision of food, cleaning of apartment, personal hygiene, etc.). It is about 2% of a yearly salaried income or pension, with employers matching the contribution of the employee.

There are two separate systems of health insurance: public health insurance (Gesetzliche Krankenversicherung) and private insurance (Private Krankenversicherung). Both systems struggle with the increasing cost of medical treatment and the changing demography. About 87.5% of the persons with health insurance are members of the public system, while 12.5% are covered by private insurance (as of 2006).

The entire population must pay compulsory health insurance. The insurers are non-profit independent agencies not linked to the State. A premium is deducted from all employees' pay automatically. An employee pays 0.75% of salary to this insurance, and the employer pays an amount to the value of 12.8% of the employee's salary. Those earning less than 6,600 euros per year do not make health insurance payments.

To allow full reimbursement of health costs, many employees also pay a voluntary premium (up to 2.5% of salary) to a mutual insurer. In the 1960s, 30% of the population paid for supplementary health insurance. This rose to 50% in the 1970s. By 2000, 85% of the population were paying privately for additional insurance coverage.[5]

In addition to payroll contributions, a general social contribution (or social security tax) of 7.5% (known as the Contribution Sociale Generalisée or CSG) is levied on employment and investment income. Most goes to health insurance.[5]

After paying the doctor's or dentist's fee, a proportion is claimed back. This is around 75 to 80%, but can be as much as 85%. Under recent rules (the coordinated consultation procedure [in French: parcours de soins coordonné]) General practitioners ("médecin généraliste" or "docteur") are more expected to act as "gate keepers" who refer patients to a specialist or a hospital.[5] The incentive is financial in that expenses are reimbursed at lower rates for patients who go direct to a specialist (except for dentists, gynecologists and psychiatrists).

As costs are borne by the patient and then reclaimed, patients have freedom of choice where to receive care.[5] Around 65% of hospital beds in France are provided by public hospitals, around 15% by private non-profit organizations, and 20% by for-profit companies.[5]