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The Confederation of Alteran Republics

Thanks to the great original dispatch by Almorea on their healthcare system, I've created a .GOV style dispatch answering and addressing some of the more common questions around Alteran healthcare.





Health and Social Care
Organisation and Status of Health and Social Care in the Alteran Republics

The Alteran healthcare system is universal and of a very high standard, ranking highly
amongst the developed nations of the Western Isles. Everyone living or working in Altera must have basic health
and accident insurance to receive treatment. Unlike other countries with socialized medicine, the Alteran healthcare
system is not tax-based or financed by employers. However, employers can offer financial incentives to reduce
the cost of healthcare insurance to its employees and their families.



Healthcare System

How is healthcare organised in Altera?

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    The healthcare in Altera, like in most developed nations, is universal. This means that all citizens and civilians are entitled to receive medicine, medication and support at no extra cost.

    Healthcare within Altera regulated by the Government body, the Council for Health and Social Care.

    Whilst the regulatory body is run by state, there are no free state-provided health services. Instead, private health insurance is compulsory for all persons residing in the Altera Confederation. Health insurance is to be organized within three months of taking up residence or being born in the country.


How much and when do I pay?

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    Health insurance covers the costs of medical treatment, emotional and physical therapy, hospitalization and post-treatment support of the insured. Despite healthcare being provided by private insurers, the insured person pays part of the cost of treatment.

    Payments to private insurance providers are done by one of three methods:

  • Paid annually, quarterly or monthly by direct debit

  • Deducted from PAYE compatible payslip

  • Paid by employers, as part of a employment or Indentured Employment Contract

    The amount paid by citizens depends upon which group the insuree comes under:

  • Adults aged 60+ pay 205Ͼ ($246) a month

  • Adults aged 30 to 59 pay 275Ͼ ($330) a month

  • Adults aged 20 to 29 pay 240Ͼ ($288) a month

  • Adults aged 16 to 19 pay 180Ͼ ($216) a month

    Children under the age of 16, and retired adults over the age of 65 are not required to pay for their insurance. Young adults aged 16 to 19 are not responsible for paying it themselves if they are in full time education; rather their primary caregiver is responsible for that payment.

    However, not everyone will pay the above quoted prices. Private Health providers may charge more on top of the above baseline costs. Whilst some providers use the increased costs to cover the cost of paperwork and bureaucracy, some providers offer incentives to purchase their products, such as:

  • "Combination" Insurance packages to include home, car and travel insurance

  • Access to unique perks, including air miles, subscriptions to magazines and coffee vouchers

  • Free or reduced cost of gifts, including televisions, watches and holidays

  • Access to insurer-owned facilities, healthcare and services


Is all treatment covered by insurance?

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    Once a health insurance package is agreed upon and started, all healthcare needs are covered by the insurance. There are no extra costs, requirements for advance payment or post-treatment bills.

    However, there are exceptions to what isn't accounted for under health insurance:

  • Non-emergency cosmetic surgery

  • Exercise or dietary supplements

  • "Premium" or branded frames for glasses

  • Alternative medicine treatments or supplements

  • Health foods or non-meat alternatives

  • Vaccinations for travelling abroad

    If visitors to Altera require medical services but do not have the appropriate treatment, they would be subject to billing upon completion of the treatment. Likewise for Alteran nationals, whilst a lack of insurance is a criminal offence, citizens requiring treatment would also be billed. However, some cases waiver the cost of treatment, such as:

  • Child birth (including premature births)

  • Accidents and emergency treatments

  • Healthcare for Alteran-based diplomats, embassy staff and other international staff

  • Suicide prevention and severe mental-health related conditions

  • Citizens born with degenerative, life altering conditions


What social care is provided for?

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    Typically, most Alterans, when retired, will continue to live independently or within their family units - and as such would have access to care provided for by their family and relatives.

    In these cases, families and elderly citizens are entitled to, through their insurance schemes, gain access to a variety of care support networks - which include home visits, community clubs and projects, free public transport and transport to and from healthcare and social care facilities.

    However, living alone or with family units is not their only option. Many Alterans choose to retire in retirement villages, either living in flats, small dwellings or communally in larger homes. These homes and villages tend to be gated communities, with shops, entertainment and care facilities all within the local area.

    All citizens are able to gain access to these facilities if they have retired and are over the age of 65. However, as with the cost of different insurance providers, some of these gated retirement villages charge additional costs for more luxurious locations, facilities or a higher standard of care.


How is Health and Social care paid for?

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    The vast majority of the costs are covered through the health insurance scheme. However, it is estimated that this income alone does not account for the full cost of care. Where appropriate, the state provides additional funds to "top up" the cost of care giving.

    This is most evident in the cost of social care, where an increasing proportion of the state are non-productive citizens, but still require expensive, long-term care.



Merito non pareret. | By merit, not birth.



GOV.ALT service is designed and maintained by HORIZON Inc.
on behalf of the Alteran Council of Information, Altera.



Read dispatch

What I'm most pleased about, however, is that the entire thing was the first dispatch written by myself on a MacBook. I'm getting rather used to using it; I have a decent writing and art programs now - so I may just use this as my default NationStates device.

The Confederation of Alteran Republics

Corindia wrote:I for one think there should be a girth minimum to be president

You kinky beast~

The United Republics of Dormill and Stiura

Hospitaller West Indies wrote:To like what extent? I donít feel like deleting my Factbooks... if I donít have piracy then Iím just a religious nation, how do I preserve elements of it, without you invading me. I also donít want to change my beautiful flag...

You don't need to delete your dispatches, just rewrite them (and possibly use some formats to help organize your information). You don't need to completely get rid of piracy, but privateering shouldn't happen and your nation can't solely rely on piracy unless the entire thing has collapsed into anarchy. You can maintain some elements of your piracy while also keeping the Miklanian Navy off your back by having your pirates tailor their tactics to avoid confrontation (and that's of course excluding things like shifting into cybercrimes such as Ransomware, where the Miklanian government would have a harder time shutting it down). And you don't have to get rid of your flag, because the nation in this case just has it because it's always had it.

The Republic of Miklania

Having the Jolly Roger on your actual, official flag is a great way to be seen as a menace to international society.

The Bird Buddy of Shidei

Aromea wrote:Snipped to save space

Accomplished academics? Why would an astrophysicist know what makes a good leader? Who and what defines a great leader? Pol Pot could be considered great in the sheer scale of redoing Cambodian society that he managed to do. I really don't want my president to act like Pol Pot.

Show me these lie detecting brain wave monitors. And I find it really hard to believe that people are going to go "yeah, checks out" when you tell them that you're attaching a general health diagnostic machine to their head prior to asking them numerous questions about political ideology.

How do you eliminate bias in your reference points? If you use an unequal number of European rulers in your metric compared to African rulers, the results will skew towards eurocentric traits and accomplishments despite the difference in culture.

I don't know how someone can read "Dangling high wages (protected via the constitution) of the select few that will be running the system" as not catering to the rich. The way this whole argument was going is based on the actions of the prospective candidates, and you suddenly shift to talking about the people running the "system" with no context. You also never used the word Merit

Are you no longer talking about the candidates? You say "If the reward is high and the punishment severe enough, the breaking of the rules is avoidable." which again seems to imply the candidates are the ones to get punished. Unless you're talking about the l "System" runners now? In which case what stakes do the candidates have?

Being rich to the extent you seem to be talking about the System maintainers is a pathological addiction. The rich extort others for chump change as long as their bank account number goes up. Congress is richer than it's ever been but bribes are still flying left right and center under the guise of "donations" or "business endeavors" or whatever the feelgood definitely-not-bribes word of the day is

Proof that it affects crime rate?

If you make rape punishable by death, you aren't going to really have less rape, you're going to have more rape victims murdered because the rapist no longer has anything more to lose and leaving the victim alive means more chances they will inform others of what you did.
Numerous states in the US have the death penalty but we still have the highest incarceration rate per capita in the entire world and the recidivism rate is terrifyingly large.

I don't care if you say it's "not meant to punish the family", building from the ground up means everything was torn down and you're starting over. How is that not being punished? See my previous statement that punishing innocent people because of something the guilty party does is abhorrent.

Corruption will never go away while money is present. Full stop. It'll just be done in convoluted legal methods.

The Confederacy of Hospitaller West Indies

Miklania wrote:Having the Jolly Roger on your actual, official flag is a great way to be seen as a menace to international society.

Itís a symbol of our history and the founding of our nation. Iím sure to some symbols like the hammer and sickle for example can also be seen as a menace too

The Republic of Miklania

Hospitaller West Indies wrote:Itís a symbol of our history and the founding of our nation. Iím sure to some symbols like the hammer and sickle for example can also be seen as a menace too

There are symbols of political ideologies which some may not like, and then there are pirates, who are hated by all and may be hanged whenever caught.

The Kingdom of Nurbaria

Miklania wrote:There are symbols of political ideologies which some may not like, and then there are pirates, who are hated by all and may be hanged whenever caught.

down with the pirates

The Republic of Segentova

Hospitaller West Indies wrote:Itís a symbol of our history and the founding of our nation. Iím sure to some symbols like the hammer and sickle for example can also be seen as a menace too

Wasn't it founded by the knights hospitaller and just became a pirate state later? I really suggest not using the black flag for official purposes, arrgh (sorry, couldn't resist :P )

The Confederacy of Hospitaller West Indies

Pfff our flag using a skull and crossbones? merely a Totenkopf to symbolize how our country will never die, and the black, white and red are all colours that represent the Hospitallers, of course, along with the Maltese cross. The earring and the head bandana? Merely symbols of our lavish wealth and our countryís hard workers (their heads sweating requires a bandana) respectively

The Kingdom of Nurbaria

Hospitaller West Indies wrote:Pfff our flag using a skull and crossbones? merely a Totenkopf to symbolize how our country will never die, and the black, white and red are all colours that represent the Hospitallers, of course, along with the Maltese cross. The earring and the head bandana? Merely symbols of our lavish wealth and our countryís hard workers (their heads sweating requires a bandana) respectively

I mean nobody can force you to change your flag.

But it just comes with connotations of you know... being a menace like Miklania said.

The Kingdom of Havalland

I still kinda want to use some dingy pirates for target practice

Also a naval PMC isnít a bad idea atleast I donít think, as long as it is realistic with modified civilian boats.

The Kingdom of Havalland

Ohio has a naval militia thatís been around since 1896 and thatís basically what they do, modify civilian boats to patrol Lake Erie

Aromea

Shidei wrote:Accomplished academics? Why would an astrophysicist know what makes a good leader? Who and what defines a great leader? Pol Pot could be considered great in the sheer scale of redoing Cambodian society that he managed to do. I really don't want my president to act like Pol Pot.

Show me these lie detecting brain wave monitors. And I find it really hard to believe that people are going to go "yeah, checks out" when you tell them that you're attaching a general health diagnostic machine to their head prior to asking them numerous questions about political ideology.

How do you eliminate bias in your reference points? If you use an unequal number of European rulers in your metric compared to African rulers, the results will skew towards eurocentric traits and accomplishments despite the difference in culture.

I don't know how someone can read "Dangling high wages (protected via the constitution) of the select few that will be running the system" as not catering to the rich. The way this whole argument was going is based on the actions of the prospective candidates, and you suddenly shift to talking about the people running the "system" with no context. You also never used the word Merit

Are you no longer talking about the candidates? You say "If the reward is high and the punishment severe enough, the breaking of the rules is avoidable." which again seems to imply the candidates are the ones to get punished. Unless you're talking about the l "System" runners now? In which case what stakes do the candidates have?

Being rich to the extent you seem to be talking about the System maintainers is a pathological addiction. The rich extort others for chump change as long as their bank account number goes up. Congress is richer than it's ever been but bribes are still flying left right and center under the guise of "donations" or "business endeavors" or whatever the feelgood definitely-not-bribes word of the day is

Proof that it affects crime rate?

If you make rape punishable by death, you aren't going to really have less rape, you're going to have more rape victims murdered because the rapist no longer has anything more to lose and leaving the victim alive means more chances they will inform others of what you did.
Numerous states in the US have the death penalty but we still have the highest incarceration rate per capita in the entire world and the recidivism rate is terrifyingly large.

I don't care if you say it's "not meant to punish the family", building from the ground up means everything was torn down and you're starting over. How is that not being punished? See my previous statement that punishing innocent people because of something the guilty party does is abhorrent.

Corruption will never go away while money is present. Full stop. It'll just be done in convoluted legal methods.

Who mentioned Astrophysicists!? There are Political, Historical and Economic sciences You know -_-

You asked how the system would avoid corruption, I answered with rewards and punishments [that applies to all institutions]. The candidates would be affected if they pass and actually win the mandate.
China has a system of severe [too severe in most cases] punishments and there are no school shootings there [This is the only example I can think of right off the bat].

I don't know how someone can read "Dangling high wages (protected via the constitution) of the select few that will be running the system" as not catering to the rich. The way this whole argument was going is based on the actions of the prospective candidates, and you suddenly shift to talking about the people running the "system" with no context. You also never used the word Merit

The people that will be maintaining the system will have wages protected via the constitution so that any candidate that wins the election can't influence them and corrupt it. You asked how the system would be protected from corruption.

Think of it like giving a cookies to a child and telling it that it will receive cookies for doing chores, but if it takes cookies on it's own there will be punishment [the child will get grounded], just on a larger scale and with more extreme punishments.

That's why I said said great leaders, in the lines of Justinian, Julius Ceasar, Alexander III the Great, Ekaterina the Great, Peter the Great. Because if it's just any leader as a reference, someone could take Trump and we are back at square 1.

Show me these lie detecting brain wave monitors. And I find it really hard to believe that people are going to go "yeah, checks out" when you tell them that you're attaching a general health diagnostic machine to their head prior to asking them numerous questions about political ideology.

They are called Brainwave Monitors, they have been used for research of how the human brain functions for decades now, Google it. Where did You get political ideology!? And again, a Head of State needs to healthy, tell them that it's more time-effective and cost-effective to run the diagnostics on their health whilst they take the test. The questions don't have to be directly about ideology [economy, or whatever it is], they can be about basically anything as long as the underlying trait is hidden in them.

Take my example with the child and the cookies from above, the question would be: "If You told Your child that it would get cookies as rewards for doing chores, but to not take any on it's own. What would You do if it did?" and then there would be the offered answers: punish, scold, nothing, reward, lecture.

I don't care if you say it's "not meant to punish the family", building from the ground up means everything was torn down and you're starting over. How is that not being punished? See my previous statement that punishing innocent people because of something the guilty party does is abhorrent.

The idea is to increase the consequences on one's actions, feel free how to do so without using their family to do so [because some people don't care about their lives, but do care about their families].

Being rich to the extent you seem to be talking about the System maintainers is a pathological addiction. The rich extort others for chump change as long as their bank account number goes up. Congress is richer than it's ever been but bribes are still flying left right and center under the guise of "donations" or "business endeavors" or whatever the feelgood definitely-not-bribes word of the day is

That's where the punishments come in. They can't handle not being that filthy rich, it would mentally break them. Let's say out of 1000 rich people, 10 get punished in such a severe way (for taking bribes in this case) by a governmental body that they do not have any influence over. Would they not be terrified from the punishment?

Feel free to offer Your own suggestions here, show me another way to solve the issues that would give the theorized/desired effects.

As for the rapists, that's a whole other can of worms. [they should be publically castrated]

The Taa'zi of Remodio

So here's a difficult thing im seeing with the Keystone Pipeline cancelation.
On one hand, I know that our Earth is dying fast and Keystone is enhancing that.
On the other, I live in a small oil town and already 70 people have been laid off work, which affects a lot of people.

The Confederacy of Hospitaller West Indies

Remodio wrote:So here's a difficult thing im seeing with the Keystone Pipeline cancelation.
On one hand, I know that our Earth is dying fast and Keystone is enhancing that.
On the other, I live in a small oil town and already 70 people have been laid off work, which affects a lot of people.

70 people is a price to pay to save billions

The Commonwealth of Trigel

Trigel wrote:Choose one for my flag:

Flag 1: https://imgur.com/7CdIZZB
Flag 2: https://imgur.com/xZTIn3s
Flag 3: https://imgur.com/A2Oxq9h
Flag 4: https://imgur.com/VawW0li
Flag 5: https://imgur.com/JrEIH2M
Flag 6: https://imgur.com/MtyZwlm
Flag 7: https://imgur.com/EfMPOsw
Flag 8: https://imgur.com/LIX0CkQ
Flag 9: https://imgur.com/Jd5liWW

Voting: https://www.strawpoll.me/42483436

Guys keep voting we are tied for 1 5 and 7.

The Republic of Miklania

Hospitaller West Indies wrote:70 people is a price to pay to save billions

It's going to be a lot more than 70, and cancelling one pipeline in first world countries is not going to save "billions".

The Dominion of Nhoor

Trigel wrote:Guys keep voting we are tied for 1 5 and 7.

I still think you should have added a version of your current flag has e.g. the top left and the bottom left swapped. (so clockwise red yellow red yellow around the cross)

The Taa'zi of Remodio

Hospitaller West Indies wrote:70 people is a price to pay to save billions

Right, but that's just in my community. And that doesn't show the long term effects. Does our education start to fall because we have less oil money for our education, or do our roads start to crumble because we can't afford to keep them managed, or do families start to lose their homes because they lost the primary breadwinner or do our small businesses start to fall because all of their business from the pipeline is no longer there? I do understand that we have an obligation to save our planet from the horrors its already faced, especially since we are one of few nations who haven't, but I think before we forced companies to lay off their workers, we should have increased unemployment benefits and provided government sanctioned Healthcare.

The Bird Buddy of Shidei

Aromea please fix your formatting so it's easy to tell at a glance what's something I said vs your response to it... as for responding, I don't even know where to start so I'm going to start condensing ideas together as I think of points

School shootings have nothing to do with punishment and rewards, it has to do with serious gang culture, a disregard and hands off approach for mental health (especially of relatively well-to-do white males who make up the majority of the mass shooter types), and an overwhelmingly easy access to firearms.

Despite what you seem to think, adults aren't idiots. There's no way that people aren't going to figure out what you're trying to do when strapping them to medical equipment, especially if it's for screening political/power attempts. If I'm in some crazy medical contraption and they start asking me random questions, I'm going to assume that my response is being monitored in some way

Your cookie example is a false dichotomy. The third answer is "the child conspires with others for mutual reward, be it giving one's own cookies to another in return for more down the line, convincing someone to turn a blind eye to the theft, or taking the blame for someone else" and this is what corruption is.

Every last human being can and will be swayed by a bribe of some kind because while we're a social species, the animal instinct is to have control over resources for yourself. It's impossible to prevent this unless you take the human out of the equation. Offer me 20 bucks to go shoot my neighbor? Absolutely not. Offer me 20 million in dubiously tracked slush funds if I help draft a law granting tax exemptions for people like you? That's an entirely different story

Rich people love their money, that's why they move it offshores to places that better protect their money from being taken away

Twice now you've ignored me asking how punishing innocent people isn't punishing innocent people, and why it's acceptable in your imaginary society to do that. Please answer this one, otherwise I'm going to rightly assume you don't have a counterpoint.

The Kingdom of Wellsia

Hospitaller West Indies wrote:Pfff our flag using a skull and crossbones? merely a Totenkopf to symbolize how our country will never die, and the black, white and red are all colours that represent the Hospitallers, of course, along with the Maltese cross. The earring and the head bandana? Merely symbols of our lavish wealth and our countryís hard workers (their heads sweating requires a bandana) respectively

Switch them, put the black part with the skull and bones in the corner over a red flag with the Maltese cross. The Hospitallers were pirates as well as crusaders when at Rhodes and Malta. Look into the society at Tortuga and base your country off of that, along with the Knights of Malta at the end of the 1700ís

The Confederacy of Hospitaller West Indies

Also Miklania, look Iíve been having a bad day and I get you want a serious roleplay but I donít want to completely change my nation right now and ruin the fun for myself

The Blue Islands of Corindia

Wellsia wrote: The Hospitallers were pirates as well as crusaders when at Rhodes and Malta.

It's always wild reading about the behavior of captains and their crews prior to the 1800s and how much borderline piracy happened even on "official" vessels. Also crazy to think about how controlling potential mutiny basically informed every decision that was made.

The Confederacy of Hospitaller West Indies

Wellsia wrote:Switch them, put the black part with the skull and bones in the corner over a red flag with the Maltese cross.

I donít see how that would change anything, and why that change would matter

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