Dominion Healthcare (Health Bureau)
For a typical Dominion citizen, illness prompts someone to visit the doctor, be that the local medical clinic or a larger facility such as a hospital.
The issue will be diagnosed to the best ability of the physicians available.
Up to this point all good, and at no charge to the patient.
Once a diagnosis is made the diagnosing physician will determine treatment options, and refer the case to a Healthcare Treatment Coordinator (HTC) who will determine which treatments from the list of options are available for the patient based on the patient’s social class, occupation and other factors. This is called Schedule Treatment based on the Schedule published by the Health Bureau.
It is possible to apply for Special Consideration, which basically involves making a case as to why the Dominion should provide Non-Schedule Treatment to a person.
Once a treatment option is approved the patient will either be treated as an emergency case or go on a waiting list (stratified by social class and clinical urgency) and be treated in turn.
In cases where a diagnosis is unable to be made a patient may be referred for Advanced Diagnosis depending on social class, available facilities and expertise, known clinical indications, and other factors.
Private Healthcare
A number of private sector providers of varying legality and quality exist in the Dominion, and patients seeking a treatment option for which they are not approved may turn to such providers.
The majority of such providers (usually referred to as Private Clinics or Hospitals) operate at full-cost recovery. However, some providers are Registered Supplemental Healthcare Providers (RSHP) and charge only the gap between the approved treatment and the non-approved one, being able to claim the cost of the approved procedure from the Dominion. RSHP’s (sometimes called Gap Clinics) are tightly regulated and may have long waiting times.
Somewhat begrudgingly, the Dominion permits limited forms of insurance (essentially, Mutual Funds) watched over hawkishly by the Dominion Bank, although such funds are forever a slightly risky venture. As such, it is possible to obtain private health insurance if one wishes to do so.
Other Healthcare
The Legion
The Legion provides its own Healthcare services to Legion members.
Available treatments are subject to approval based on rank, in similar fashion to the civilian system, but are slightly more generous than civilian benefits.
The Vizierate
Members of the Vizierate generally use the Health Bureau’s Healthcare system, but the Schedule Treatment system does not apply. If the Vizierate authorises treatment for a person it will be provided, and usually as a priority case. Vizierate members may use Legion facilities in an emergency, but are entirely subject to Legion protocol regarding priority. In some circumstances the Vizierate may organise its own healthcare facilities, but this is not usual.
Senior Bureaucrats and Secretariat
Members are treated as part of the general Healthcare system, but receive priority and very few treatments are Non-Scheduled.
The Overlord’s Household
The Household maintains a separate set of medical facilities for use of the Overlord and household staff. Household Medical may call on Civilian or Legion assets as needed.