Healthcare in the Republic of Nyrmod

2. All People directly employed by Hospitals are state employees thus qualifying for state pensions.
3. This Public Health Care is available to all citizens of Nyrmod.

### **Private Healthcare**

1. Standard Healthcare, such as injuries, emergency treatment, illnesses can be practiced by private healthcare providers
2. “Specialists” can be in private healhtcare
3. “Family Doctors” can be in private healhtcare
4. Chiropractors can be in private healthcare
5. Every Nyrmodian citizen is free to buy private health insurance that would mean that they would not be able to enroll in the public insurance program
6. Every person who enrolls in private health insurance would be able to receive a tax credit amounting to 10% of their monthly salary or pension.

### **Pharmaceuticals**

1. Nyrmods Pharmceutical Department (NPD) deals with pharmaceuticals and supervises pharmaceutical companies (under HH ministry)
2. To protect public health and ensure the availability of high quality, safe and effective medicines for Nyrmodian citizens, all medicines must be authorized by the NPD  before they can be placed on the market in Nyrmod.
3. Manufacturers, importers and distributors of medicines in Nyrmod  must be licensed before they can carry out those activities. The NPD gives out  such licenses.
4. The pharmaceutical companies are required to show the NPD their medical tests with the drugs The NPD monitors the safety of all medicines that are available on the Nyrmodian market throughout their lifespan.
5. Thre are no nationalized pharmaceutical companies The privatization will be handled by the Central Bank
6. The NPD sets the regulations on specific drugs which it finds necessary and the parliament can also add regulations if voted on, passed and signed by the president.
7. The NPDs head will be appointed by the minister of Home and Health affairs
8. The ministry of Home and Health affairs will negotiate with pharmaceutical companies to ensure the lowest possible prices
9. Do be a pharmacist you have to get a license from the regional Ministry of Home and Health Affairs, to get the license; you can't have a criminal record and you have to have a education on the subject

### **Nyrmod Mental Health Service**

1. All therapy and mental health institutions are organised and funded by the Central Government allowing it to regulate and better oversee said institutions.
2. All employees within the said facilities and institutions are government employees able to receive government pension.

### Public Insurnace Program

1. Evey Nyrmodian citizen is able to enroll in the public insurance program which will give them free of charge access to the healthcare services of the NHS and MHS.
2. People over 65, under 18 will be automatically enrolled in the third level coverage free of charge  unless they or their guardians prefer private insurance for them or if they are able to change the level of converge by playing for it with their pension
3. People receiving universal credit because they live under the poverty line or because they are unemployed will be automatically enrolled free of charge  in the 1st level coverage program unless they are able to pay the payroll taxes or prefer private insurance
4. The people enrolling in the NHS and MHS public insurance have different levels from which they can choose:

* The First level of Coverage will cover costs of:

Life threatening injuries, and Illnesses, childbirth, organ transplants, all medical procedures

* The Second Level of Coverage will cover costs of:

life threatening injuries and illnesses, childbirth, major injuries which could cause major mental and physical damage in the future, organ transplants, life saving pharmaceuticals, mental health services, all medical procedures

* The Third Level of Coverage will cover costs of:

All life threatening injuries and illnesses, all medicines for life threatening illnesses or injuries, childbirth, organ transplants, ,mental health services, standard injuries such as concussions and broken harms, medicines which do not work with life threatening illness or injury, all medical procedures

* The Fourth Level of Coverage will cover costs of:

All injuries, all medical procedures, all pharmaceuticals, all mental health services

Levels of Coverage
* Illnesses
* childbirth
* organ transplants
 Level 2
* childbirth,
* major injuries which could cause major mental and physical damage in the future,
* organ transplants,
* life saving pharmaceuticals,
* mental health services,
 Level 3
* all medicines for life threatening illnesses or injuries,
* childbirth,
* organ transplants,
* mental health services,
* standard injuries such as concussions and broken harms,
* medicines
 Level 4

### **Employee Salary, Pensions and Unions**

1. Employees of all the Public Health Services have every right to form a workers union in order to negotiate wages and benefits with the Central Government, and The Ministry of Health and Home Affairs.
2. Wages and Pensions are set yearly by the Ministry of Home and Health, and must be stated within the budget.
3. All forms of negotiation between healthcare workers and the Central Government must come to some terms of mediation rather than instantly forcing them back to work.

### **Added with the Healthcare reform act**

#### **112 and 1122**

1. The state creates a emergency telephone and a text line in all Nyrmod regions
2. This emergency line coordinates all emergency services ambulances, police etc.
3. You can either call or text to the number 112 to call a ambulance for yourself
4. You can call 1122 to ask for medical advice
5. Both of those lines will operate 24/7
6. Before becoming a operator in one of those centers you have to be trained by a professional at least for 4 months
7. People working in those centers go under the Home and Health affairs ministry management.

#### **Regulations**

1. All the service providers have to make sure that they provide adequate ambulance and emergency healthcare services

1. Every hospital needs to have a those departments

* Adult Intensive Care Department
* Anesthesiology and Child Intensive Care and Neonatology
* Anesthesiology hold Surgical Department
* General and Vascular Surgical Department
* Casualty and Orthopedic Surgical Department
* Dermatology  Department
* Child Department
* Day Rehabilitation Department
* Obstetric and Maternity Ward
* Internal Department
* Cardiology Department
* Laryngology Department
* Neurology Department
* Neonatology Department
* Ophthalmic Department
* First-Aid Department
* Urology  Department
* Internal Department
* Infection Observatory
* Dialysis Centre

1. Every clinic needs to have  those departments except for dental clinics and special clinics.

* Department of Emergency Medicine
* Department of Family Medicine
* Department of Medicine
* Department of Obstetrics and Gynecology
* Department of Pediatrics
* Department of Pat
* Department of Radiation Oncology
* Department of Radiology
* Department of Surgery
* Department of Urology
* Basic Science Departments

1. Those lists can be changed by adding departments to them or removing them by legislation approved by the parliament and signed by the president or by the department of Medical supervision which goes under the Home and Health affairs ministry.
2. The Home and Health affairs minister chooses the head of the department of Medical supervision.
3. Special clinics need to have

* Department of Dermatology

* Department of Anesthesiology
* Department of Neurology
* Department of Neurological Surgery
* Department of Psychiatry of Ophthalmology
* Department of Orthopedic Surgery
* Department of Otolaryngology

1.Insurance companies are not allowed to discriminate against people with         pre-existing conditions. They cannot charge them with higher premiums, higher deductibles nor with more out of pocket expenses. '

2.To supervise private companies' work, it shall be created an insurance regulator.

3.Health insurance providers are not allowed to

* directly or indirectly imposing unfair purchase or selling prices or other unfair trading conditions
* making the conclusion of a contract subject to acceptance by the other contract party of supplementary obligations which, by their nature or according to commercial usage, have no connection with the subject of such a contract.
* limiting production, markets or technical development to the prejudice of consumers
* directly or indirectly fix purchase or selling prices or any other trading conditions
* apply dissimilar conditions to equivalent transactions with other trading parties, thereby placing them at a competitive disadvantage

### Foreign Use of the Healthcare System

* Foreigners and Tourists will not be covered under the NHS
* Foreigners and Tourists will be covered under their home nations, or insurance companies plans.
* However, Foreigners and Tourists will receive coverage, if they are treated for a life threatening injury that takes place within Nyrmod, and its territorial Waters.

### Mandatory Coverage

1. Every adult citizen is required to buy statutory health insurance for themselves/their dependents  from private healthcare insurance companies or to enroll in the publicly funded NHS  program.
2. If an adult citizen fails to do that in 3 months after becoming a citizen the ministry of Health and Home affairs they will be automatically enrolled in the NHS public insurance program

### Hospitals and Clinics

1. Healthcare providers are allowed to operate in state hospitals and clinics as set in article 3 point a
2. The local governments will coordinate the work of private companies in public hospitals and clinics.
3. All private hospitals and clinics have to follow the regulations, standards and rules set up by the government.
4. If they do not they will lose their license to operate and their CEOs and other managers might face imprisonment and heavy fines both will be set by the court.