UHCS
| Anning Helþ ond Cær Þæning (AHCÞ) | |
 UHCS (AHCÞ) logo, since 2006 | |
| Service overview | |
|---|---|
| Formed | 2 October 1906 |
| Jurisdiction | Esthursia |
| Employees | 4,331,000 FTE |
| Annual budget | $573 billion (2024) |
| Minister responsible |
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| Service executive |
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| Parent department | Redery of Health and Care |
| Website | ahcþ |
The Union Health and Care Service, or UHCS, (Atlish: Anning Helþ ond Cær Þæning; AHCÞ) is the publicly-funded universal healthcare system serving Esthursia, with Cordane operating a similar model under the Cordane Health Agency. Established in 1911 under the guise of National Health Insurance (NHI, AHS) - a public insurance programme - it was renamed to the Union Health and Care Service and expanded heavily in the following decades - particularly under George Asmont and Tanja Olsen - to provide virtually all healthcare provision through the state. It is increasingly an umbrella term, and is often conflated to include the CHA of Cordane, as well as both the Helmark and Osynstry and the West branches of the UHCS, which have somewhat diverged thanks to devolved administrations in recent decades. All UHCS services provide a wide range of healthcare services without charge to those ordinarily resident within Esthursia.
Notable for being entirely publicly funded and its wide breadth of service provision, it ensures that all citizens have equal access to healthcare services without any cost at the point of service; since the late-2010s, the UHCS has shifted to "self-supply" models and reverted from trust systems to local authority control. The UHCS is managed by its executive board, as well as local authorities and the Redery for Health and Care.
History
The history of the idea of universal healthcare in Esthursia can be traced back as early as the 1880s, when the Workers' Union narrowly missed out on winning the 1884 election running on a slate of "pro-health and anti-wealth" campaigns, which heavily influenced successive governments' actions on sanitation, health regulation and economic affairs.
In both elections of 1905, the Liberal party under its leader Islwyn Torcall promised to institute a "universal health dividend". Following an inconclusive result in January 1905, which left the Conservative Union under Winthrop Fowler still the largest party but with no ability to pass legislation, the Liberals campaigned on "life issues" - pensions, healthcare, poverty and housing. By December 1905, after a slew of by-election losses pushed the Conservative Union below any ability to meaningfully pass legislation, the House of Ministers called a vote of no confidence, and the ensuing landslide delivered in favour of the "Liberal future" gave Islwyn Torcall a significant mandate.
The National Health Insurance programme was first founded in October 1906, making it compulsory for all citizens to pay into a health dividend which covered all emergency costs, set up an independent body for medicine pricing and out-of-plan prices, and regulated the practice of private healthcare provision more strictly. The Liberal government also built a series of non-profit hospitals which were rented out to private providers, and gradually decreased the caps over time to make it more accessible for the poor, as well as installing means-testing for "the destitute to be freed from the vice of illness-skjeld (illness debt)."
The Conservative and Liberal governments which followed made slight changes to this following the departure of Islwyn Torcall in 1911 - mainly concerning the Salisbury and Grey governments' "ping-pong" over price caps and the means-tested health funding - carried on the tradition of this social market model for Esthursian healthcare, however the 1920s saw the Forethaneship of James Thorne heavily cut back healthcare provision in Esthursia. Although still remaining a programme, Thorne rerouted most health funding to the war effort in Scalvia as well as education, tax cuts and wider defence spending - this included the scrappage of means-testing guarantees, the end to building public hospitals (and subsequent sale of nearly all public-owned hospitals permanently), and the removal of the guarantee to cover all private health costs, causing a sudden explosion in healthcare costs due to both corporate profit-seeking and an increase in the price of pharmaceutical goods and labour.