Healthcare in Delkora
Healthcare in Delkora is provided through a single-payer system characterized by public provision and funding of all services.
History
The first major piece of healthcare legislation in Delkora was passed in 1884 during the tenure of Chancellor Magnus Brom. The Federal Health Insurance Act of 1884 created a compulsory national health insurance scheme financed by a combination of worker, employer, and government contributions to state health funds. The Act also implemented accident and disability insurance. Although it greatly expanded access to care, it generally only covered industrial workers and did not include all services.
This system remained in place with various amendments until 1935, when the government of Chancellor Sofia Westergaard passed the Universal Care Act, which instituted a single-payer system. It was met with resistance by some state governments, most notably in Banderhus, where First Minister Søren Bjerre sought to obstruct implementation of the Act, provoking a constitutional crisis that ended with federal troops being sent into the state and Bjerre being ousted from office.
Under the new system created by the UCA, healthcare was primarily funded through state and local taxation, although private insurance continued to exist for a handful of services. Similarly, nominal user fees existed for various kinds of non-emergency care, and individuals had to pay a small deductible for pharmaceuticals. Most healthcare provision was through public hospitals and clinics, although a considerable number of private providers continued to exist.
During the 1940s and 50s, Conservative governments, as part of larger austerity efforts, sought to scale back public healthcare by slashing spending, increasing user fees, shuttering government clinics, and expanding private insurance. These reforms proved to be unpopular, and with the onset of a major economic depression in the early 50s, contributed to growing public resentment of right-wing governance that culminated in National Labor's landslide win in the 1959 federal election.
As part of the New Kingdom program, the governments of Mette Elvensar and Geirbjørn Feldengaard sought to institute a fully public system. Under the Public Health Act of 1963, the last remaining private health providers were brought under public ownership and user fees were gradually phased out. The Healthcare Profiteering Act of 1974 fully banned private health insurance.
Although the Conservative and Agrarian parties had initially campaigned against the New Kingdom health reforms, this opposition became politically costly as they were demonstrated to have widespread public support. By the late 1970s, observers in the media and academia began noting an emergent consensus on the issue of single-payer healthcare. This was to such an extent that a Conservative proposal in the 1980s to allow a small number of private clinics to open was met with such strong public backlash that it was never put up for a vote.
At present, the Delkoran healthcare system enjoys broad support across the political spectrum. Although right-wing parties often promote minor market-based reforms, there have been no serious calls for a complete overhaul of the current system or its central tenets of universal, free, and public care.
Organization
The healthcare system in Delkora is entirely public, with no private health providers. It is highly decentralized, administered primarily at the state and local level. Most hospitals and clinics are managed by the seven State Health Services, which are overseen by their respective state ministry of health. Local governments are responsible for nursing homes and long-term care, school health, primary prevention, and health education.
The federal Minstry of Health oversees healthcare at the national level, although its role is mostly limited to regulation, setting national health priorities, and providing resources to the State Health Services. It is responsible for maintaining the Federal Health Database, which stores electronic health records for patients.
Private health insurance does not exist.
Financing
Healthcare expenses in Delkora amount to around 9% of GDP, of which 82% is funded through state and local taxation. The remainder is funded by the federal health tax, revenues from which are distributed between states and subject to guidelines set by the federal Ministry of Health. Healthcare is entirely free at the point of service, with no user fees collected for any services.
Statistics
Delkora ranks high in Eracura on most measures of public health, having low rates of child mortality, communicable disease, and premature death. Relative to other wealthy countries, it has low rates of obesity, heart disease, and high blood pressure. Overall life expectancy in 2018 was 80.1 years for men and 80.4 years for women. There are approximately 3.1 doctors and 3.8 hospital beds for every 1,000 people.
Public satisfaction with Delkoran healthcare has been high since the 1930s. In 2018, 86% of respondents in a national survey said they were "somewhat" or "very" satisfied with the healthcare system.
Pharmaceuticals
The pharmaceutical industry in Delkora is entirely public. Kronapotek is the largest producer and distributor of pharmaceuticals, although several other publicly-owned companies exist. Individuals pay no out of pocket expenses for medications prescribed by a doctor.