Overview of different health & welfare systems

@MErmaid & I recently confused each other talking at cross purposes because the US medical system is so different to the UK system.

So we decided to create this thread to provide a simplified overview of our own health and welfare systems and the terms & acronyms frequently used when we talk about them.

If there are errors or omissions let us know, but bear in mind these are simply overviews to help those living within different systems to understand.

If you live in another country then please feel free to add an overview of your system. I would suggest putting the country name nice and clearly at the top of the post.

 

The UK System

Healthcare

UK healthcare is currently provided free of charge at point of service by the National Health Service (NHS). It is paid for through compulsory contributions deducted directly from wages.

The doctor who handles routine health care is called a General Practitioner (GP). The GP refers patients to specialists, also called consultants, as deemed necessary.

Clinical Commissioning Groups (CCGs) are regional NHS bodies who plan health and social care provision within the local area.

NICE (National Institute for Health and Social Care Excellence) is an organization that provides guidance about health and social care. They issue guidelines on treatments to the NHS.

A&E (Accident And Emergency) hospital department that provides urgent and critical care.

Some people in the UK purchase private health cover. Policies are either individually bought or provided by some employers as part of their employment package. There are chosen levels of cover and there are exclusions. Once a diagnosis is made, these policies do not usually provide cover for chronic health conditions. Most people who have private health cover will still also be entitled to NHS care.


Benefits /Social Welfare

The UK government department responsible for social welfare is called the Department of Work and Pensions (DWP).

The Benefits Agency administers social welfare in local regions in accordance with DWP policy.

The most common benefits paid to chronically ill people are:

Employment and Support Allowance (ESA) - this benefit is for people of working age who are unable to work due to health problems. People who successfully claim ESA are placed in one of two groups:

• Work Related Activity Group (WRAG) - it is assumed these people will recover sufficiently to return to some type of work within a year or so. During this year claimants are obliged to undertake tasks set by the Benefits Agency in preparation for a return to work.
• Support Group - these people are most likely to remain ill long term, but their cases will be reviewed from time to time.

Personal Independence Payments (PIP) - this benefit is to help chronically ill people aged between 16 and 64 with the costs of living with their long term health condition. It has a number of different components such as personal care and mobilty.

Universal Credit - this is a new way of paying benefits. It has not yet been implemented throughout the UK. It will replace the current benefits.

People applying for health related benefits in the UK are assessed. They fill in a form and once this is submitted they will usually be required to attend a face to face assessment. This is called the Work Capability Assessment (WCA). WCAs are usually carried out by private companies contracted by the DWP. Capita, Maximus and Atos are all companies that have carried out assessments on behalf of the DWP.

The Citizens' Advice Bureau (CAB) Is an organization funded by local government. It provides advice and support for benefit claimants, along with a range of other services.


Insurance

In the context of chronic health problems in the UK "insurance" usually refers to:

Permanent Health Insurance (PHI)- this type of policy is taken out by the individual or as group packages by employers. They generally pay out a percentage of salary on an ongoing basis up to a certain age. These policies often exclude mental health conditions and may require that the person covered by the policy undergo specific treatments or therapy if they are to pay out. Policy holders are usually required to undergo regular assessments while claiming.

Critical Illness Cover - these policies are taken out by individuals. They pay out a lump sum in the event of certain specified critical illnesses laid out in the policy.