PHI provides a source of insurance in systems with targeted, non-universal access to health care coverage. It plays a particularly large role in countries with a history of private health coverage and an absence of universal coverage. For example, in the Netherlands, nearly all of the population without access to social insurance purchases PHI (about a third of the population), and the majority of the socially insured rely on PHI for coverage of services not included within social insurance. In the United States, the majority of the non-elderly population without public insurance are covered by PHI. However, unlike the case in the Netherlands, significant gaps in.