National Healthcare Service (Istalia)

Servizio Sanitario Nazionale National Healthcare Service
Logo of the SSN since 4346
Founded	July, 4172
Disbanded	August, 5164 (Superseeded by the Federal Health System)
Employees	256.300 (highest figure) 21.700 (lowest figure)
Subordinate to	Government of Istalia Ministry of Health and Social Services National Department of Health
Legal Personality	Public National Healthcare Service, Administration, Insurer, Regulatory and Overseeing body
Legal Basis	D.d.l. 01/4171 - Universal Healthcare and Welfare Reform P.d.l 03/4490 Introduction of the Healthcare Allowance
Headquarters	Viale Majatra 12, Romula
Ministry Responsible	Ministry of Health and Social Services
Agency Executive	Director General
Website	www.ssn.ist

The National Healthcare Service (Istalian: Servizio Sanitario Nazionale, abbreviated SSN) was between 4172 and 5163 the national healthcare administration which managed the healthcare system in Istalia. During its long history the SSN was reformed several time in order to be adapted to the reforms and changements adopted in Istalia under its various governments and regimes in order to handle the matter of public health. Alongside a handfull of other national agencies and institutions, the SSN was one of the longest lasting services operated by the state (having been dissolved very few times and then always re-established). The SSN managed an universal, free and publicly funded healthcare system when it was superseeded by the Federal Health System (SSF) in 5163.

During its history the SSN acted both as publicly funded healthcare systems as well as just as regulatory and overseeing body tasked to oversee and regulate the several public-private or just private health insurance service-based systems in which several time the healthcare in Istalia was organized and in this case sometime the SSN acted also as public health insurer.

As publicly funded healthcare system, the SSN has been primarily financed through the general taxation system and overseen by the National Department of Health, part of the Ministry of Health and Social services, and it has been responsible for the accessibility of the healthcare system in the country to all legal Istalian residents. Some services, such as emergency treatment and treatment of infectious diseases were free for everyone, including visitors. Also when it was organized as regulatory and overseeing body the SSN reported to the National Department of Health and thus the Ministry of Health and Social Services.

History of healthcare in Istalia

With regard to the organization of health systems under the Istalian republics preceding the Fourth one and under the regimes that arose between them and preceding them, there are little and fragmentary informations and it is possible just to deal with the matter in a very general way. It is certain, however, that since the time of the First Republic and of the Quanzarian Republic, the state has usually always offered forms of universal public healthcare services to the citizens, influenced by the socialist-inspired social politicies adopted by the Union of Quanzari Soviets and also by the Hosian traditions of solidarity and compassion, especially for the most needy. It is however known that a previous National Healthcare Service was created already in 2419 under the First Republic.

Under the Fourth Republic

First logo of the SSN

When a public healthcare system was reintroduced in 4169 and the National Healthcare Service was created three years later in 4172, the SSN managed directly a public healthcare service providing the majority of healthcare in Istalia, including primary care, in-patient care, long-term healthcare, ophthalmology and dentistry. This organization lasted until 4488.

Earlier, in 4207, with the National Welfare Reform, the public healthcare service was reformed into a single-payer scheme system with the health services provided by private clinics, doctors and companies while the SSN was turned into an overseeing body and an agency of the Ministry of Health and Social services to handle the financial needs to cover the public subsides for the health insurances of the citizenship and for the basic health and emergency service, which any healthcare provider was obliged to ensure. The public welfare also provided a "National Social Insurance" for Healthcare and Pensions to those who could not afford a healthcare and a pension insurance.

Functioning under the 4488 reform

The reforms of healthcare system of 4488 was probably one of the most important and deepest of the SSN. The healthcare in Istalia was mostly privatized and based on a market based system of health insurances. The SSN mainly managed one of the two health insurances to which the istalian citizens had to be insured. If it was up to the citizens to take out their own basic General Healthcare Insurance, which was mandatory, the Government automatically assured all the citizens to the Long Term Healthcare insurance. For poor and low income families and individuals, the 4488 reform was completed with the provisions for a Healthcare Supplementary Allowance, a publicly founded insurance in the form of a monthly payout to be used for covering the costs of basic insurance.

A key feature of the system, which the SSN had to ensure that it was respected and applied by the private actors, was that premiums of the private insurances could not be related to health status or age. Risk variances between private health insurance companies due to the different risks presented by individual policy holders were compensated through risk equalization and a common risk pool. The funding for all short-term health care came for 50% from employers, 45% from the insured person and 5% by the government.

Health services and provisions granted by the State to all citizens

When the SSN was superseeded by the SSF the State provided several health services granted to all citizens as per law. The State was obliged to:

• Allows abortion during the first and second trimesters.
• Pays partially for all citizens' pharmaceutical drugs and pays entirely for those of low income citizens.
• Provides funding for abortions.
• Covers all the mandatory vaccination for all children.
  

Quality of the service

Thanks to a well funded administration (under most part of the Istalian governments and regimes the public healthcare, as well as the other social services, has often absorbed the largest part of the national budget) and thanks to the long lasting preserved convintion of the istalian politics and public opinion to grant an free and universal healthcare coverage for all the citizen, the Istalian healthcare has always been able to offer high quality services, probably among the best in Majatra and one of the best all over the world.

Health and Healthcare in Istalia

          See: Health in Istalia