Systematic incentive of medical care; perspectives of employers

As a matter of fact, the employers own different perspectives regarding medical insurance and premium proposals. Although this right of employees in most of countries labour law but when the employer let private insurers cover the firm employees. The cost of insurance and medical service payments will twist his hand and over load deductable payments monthly. We are not with or against especially when employees own the right to get medical coverage premium depending on the mutual agreeable labour contracts. It is only matter of mention pros and cons of both parties on the road of work. As well known the most burden part of any business cycle is the payroll and consequences expenditures. Most of enterprises with regular abilities prefer to deal with publicly insurers in order to decrease involved expenses and with other firms which own strong cash revenues and big budget funds for employees. They found and considered the human labour the biggest asset of the firm then prefer to enhance the medical insurance standards for their own employees by doing coverage contracts with private insurers. Whether you are with this side or that one but my point of view slightly differ than what is commonly happened. Certain jobs and tasks need special kind of effort and high level of mind concentration and much self care parameters than others. By regular insurance threshold and minimum premium rate is hard to save the needed quality of job performance and may hinder the path of their work. The point here from their perspective not to load the budget by insurance expenditures were not needed for the segments existed than positioning precisely their needs to match and to be suited to the age and medical condition.

For sure, there are some mistakes and from dark human side some tricks to avoid high insurance budget of workers. In order to be honest with the readers; the point of medical coverage of employees is closer to internal human values than regular work issue. Because with dishonest employers there are a lot of tricks and accounting delusions could lead the workers and employees to get nothing back. The final judgement about this; determined by the corporation policies of employees choice and development. As said before employees could be biggest burdens and the most valuable asset depending on the way of leadership embraced to adapt their jobs.

Multinational firms take this point as a constitution of choice; whether will lead the business to be worldwide or in some worst stories take the corporation to the court and pay compensations as a result of unqualified employees or may be corrupted choice formerly. Back to our topic of healthcare insurance policies and involving to minimize the premium of the employees insurance. Deductible and copayments are considered one of the employer tricks to pay less for health insurance. Most of employees do not get the idea of this trick through transfer costs of medical care from the employer and even insurer to the patient/employee in order to make them more cost conscious and convert pre-tax shelter of employers to be out of pocket money of the employees. It seems good to help them to get their care and feel satisfied with their end values but also increased the pre-tax premium and push the patients to pay bigger part of the costs. Facts and stories of employers with healthcare and insurance has long roots along recent decades but still there are many care a lot and pay much attention toward their workers and employees. Full health J

Systematic incentive of medical care; perspectives of providers

As we talked formerly about healthcare prices and cost of medical care and inflated service costs and out of pocket fees. It could be directly affect the type and quality of services and full details already discussed in previous post but from provider perspective.  We are going to review different point of views but from other side of responsibility tunnel. Insurers are always caring about positive cash flow and traditionally they work on risk exaggeration among clients than modern managed competition. Because they are not a medical value manufacturer and more close to do their business efficiently than care about medical field problems. Undoubtedly; they prefer inflated costs of care and by their base of clients will form big funds to the corporations than low insurance premium in less inflated ones. As the same exactly going with providers; they prefer high cost of services and high expenditure rates of value receivers to make highest business profit and maximum earn utilization. Currency inflated societies sometimes went far to control and manage the medical care process while in less inflated societies providers found hard to exceed the budget cap of lowest and highest premium proposal accordingly. The incentives we are talking about divided into main categories:

Governmental (public) incentives: many of medical contribution programmes serve the low standards households through paying part or share percent to the provider synchronized by other part of insurers. Public incentives are common in inflated cost societies and main goal to cover and extend the percent of insured covered individuals by paying such percent on behalf of them. Although these kind of incentives give low income households some sort of demands inhibition for a while over a period of time but still not introduce final solutions for their society segments who suffer because of health gain problems.

Private incentives: some providers under certain condition and may be under collaboration with ministry of health affairs of the same country create separate incentives programmes dual purposes for both medical workers financially and by services to the patients in order to support and satisfy specific need and to deliver specific medical values in limited period of time. That used to happen occasionally in epidemic seasonal diseases and also in vaccination ages. 

Closed incentives: it is unique dual purpose incentives happen when there is a deal between insurers and providers to supply group of patients and individuals carry specific identity such as being belong to  private firm or get different kind of service depending on their special medical needs and values. Such kind of service contracts widely used among private firms and insurers whether to supply value receivers with certain quality, different sort of demands and high service standards or give them unpopular medical service commonly not found under normal work conditions. It means always not a matter of giving them something special than to give exactly what they actually in need to get.  The medical worker and nurses used to get some additional benefits in front of that way of standards by different higher reimbursement and more financial bonuses in return. Full health J

Budget cap

In order to get full understanding of the budget cap there is a clear example from the Clinton healthcare plans. In the budget cap there are two ways of pouring money and funds in healthcare delivery systems. First; through limited amount of money represented around twenty percent from individual payroll and around eight percent from the employer paid budget of health insurance for them. While the self employed and non- worker individual would have to pay the full premium of insurance which cover the whole services and received values. Second; insurance proposal would cover the insurance growth over the base of insurance premium and not attached to the prices growth which regularly should be keep just behind the cap of implementation. Retail prices of healthcare services and resources could firmly detached from premium cap of healthcare insurance and that simply to support new insurance participators and found new resources for market extension and growth horizontally than vertically by high service prices above the budget cap. Although there are some effort has paid and on the road to make healthcare insurance more available and coverage premium less difficult to reach but still there are many of insurer care somehow in hidden picture about longitudinally  from certain community segment. Here I would to refer to two point of budget cap implications could be by insurer taken into account.

The matter of market maturity and extension horizontally means increase the number of insured individuals and as possible minimize those who going to escape from the medical cap insurance. Budget cap strategy and keep the premium threshold in common availability for wide base of society reach these goals and build fame of health welfare among satisfied patients toward the insurers and work responsibilities of them.

I do not want here to waste the post in talking about how many millions in US living already out of medical insurance and how sadly the insurers there focusing only to get more benefits from the participators of certain segments of society neglecting others and how far the inflated prices of medical services exceed normal and even abnormal levels under any considerations. Some researchers explained that when the insurers managed longitudinally the market depending on the prices that eventually squeeze the market and increase numbers of those who escaped far from medical insurance umbrella. The other benefits of budget cap to push the insurers to control prices low than cap level that for sure will be direct reason for market growth and flourish. Finding a way to keep the premium proposal low with keeping the same quality level is a challenge but it is worth and carries multiple benefits over many axis of work. It takes years in business to get the idea and understand that some touch of humanity and discounts can easily lead to huge work opportunities and open market niches never seen before. Budget cap is example to cover and extent your insurance policy among society segments lack of setbacks under the light of public wins and improvements. Full healthJ

Elements of healthcare reforms: insurance reform

The matter of reform after former posts talked about Benchmarks of improvement nature and how would be measured. These posts actually opened wide door of study and notice the impact of each component over the process of service provision and indirectly on the whole reform proposals. In coming series could enumerate briefly some sides mentioned already in modern recent academic researches explained and analyze more tightly regarding the matter of such components individually. Here; insurance reform could dominate the aspect of our talk regarding issue of market nature and business demographical figures. Healthcare market which planned or intended to depend mainly on market competition fell in need to sponsors act the role of collective agents therefore; managing the matter of competition among different society segments and moreover; going to shift the market dependable values from risk competition frame into price completion frame. When particularly the service packages and delivery values are slightly differ with minor alternatives close to each other. 

Insurance firms are considered the biggest players in debit industry even a bit more above the bank because banks used to create negative cash flow from society members depending on services provision while insurance create more negative cash flow (it means from people pockets) depending on future hope or security represented in many circumstances while most of mentionable risks almost never happened sooner or may be never happen basically. Although most of people do not know that their work depending mainly on this issue especially with individuals and society inhabitants but when matter touch point of health the exaggeration of fear become huge. Managed competition from customer introduced risks to prices competition is experienced work strategy with healthcare providers and end value receivers. May be I said that in other posts implicitly but will be condensed more about provide premium rate of insurance coverage for certain market segment and neglect other ones to get nearer service provision create aside and hidden market of service supply to those who not authorized to do and this widely existed in high inflated countries that make the patient suffer and rotate in numerous supply programmes dilemma. Just to get the minimum threshold of provision and build cushion of healthcare insurance. Creating convergent segment of service provision depending on prices related pools than risks support the patients to share with their ability and by minimum fair provision build satisfaction to inner will to get more service segments by integrate into multiple insurance pools and achieve future selection to beneficiaries orientation and eventually achieve ripeness to the market. 

The market look like the nature exactly needs to be selected to build new orientation of customers involved whether with or not. This still the door of discussion of insurance markets and their direct role over people and their services which exceed traditional thoughts and lead new innovative solutions toward our society progress. Market soundness is much important than the business cycle and business process thus maturity of market review clear indicators about future, regarding the growth and amplitude of market depth and stability in front new products and services. Full health J

Self-sufficient of healthcare systems

The matter of self-sufficient is always controversial among investors and owners. Although it carries simple core of meaning but still the benefits and enclosed impact around the process and future consequences not clear for many. Proper calibration of the same concept in general way would be better and more explainable. Self-sufficient means create close self satisfaction cycle support life needs and other issues might be in need for future and that for personal level. The same on the level of companies and business cycles when the business covers the daily and monthly needs without considerable negatives that means the business process cover most expenditures demands and on the safe threshold of financial road. If the business process fit enough to be successful and revenues in progressive growth to create the liquidity cushion of the business that considered more preferable and much healthier form of profitable benefits. In cases of the liquidity got accumulated continuously the company or the business cycle looking to external fun to finance their extension projects instead of using their own money. As a hidden parameter for liquidity volume inside any business determined and measured by number of creditors involved and share part of credit money. Because simply impossible to find any creditor (who offer funds for projects) pouring money in a business not only self-sufficient but also own solid liquidity amounts to cover funds pay off. As a fact; it is simple now to see and understand why there are many insurers deadly insist to work and make a good deal contracts with health care providers whether over the public and private sectors.

There are some important parameters actually make the healthcare systems stunning ground for self-sufficient on any level of work. First, the continuously high demand from whole society segments that makes the hospitals and private providers could not find any opportunities to take a vacation especially in over population countries. Second; in some cases complete absence of willpower of value receivers who do not get the full idea from medical unnecessary expenses. Third; constant assets portfolio of the medical business that means medical assets are long term and difficult to be changed on short term. Forth; the governmental support regularly and academic provision for research and development by projects which build additional revenues in case of stuff training and certificates credentials for them. 

Fifth: corporation and private firms support providers to build indirect prescription and diagnostics products loyalty toward their own products. Sixth; this occasionally but still form some sort of revenues for medical providers who like to share and contribute with, some providers used to get some  funds in order to do medical and therapeutic campaign in remotely site of small towns and villages that cover and share medical values in short time with high benefits in return. For sure funds arrived from private companies who want to advertise and make their own products popular and from other side from government or external (abroad) to help low income inhabitants. There are many of other ideas to create and build additional and seasonal occasional revenues to cultivate the idea of healthcare self-sufficiency and hope next time you heard someone talking about that medical sector does not have enough money for improvement and development show him/her this post hope to get the real realistic medical work process. Although of all; to be hundred percent self-sufficient in your work is not fit with the country enemies and greedy neighbours because they somehow want to get some benefits from the country wealth but at least put the debits in normal level keep most of stakeholders in safe and secured point and make them get considerable level of benefits in return make them out of your business. Full health J

Benchmark of patient& provider autonomy

Some of who do not know the term think that autonomy means leave the patient alone or in funny way do not disturb and interrupt. Actually the opposite is the correct by autonomy. Share the care responsibility between the healthcare providers and the patients considered and form the real core and concept of autonomy. But in this post not for autonomy and interpretation of term itself, moreover the direct impact of autonomy over society segments and patients mindsets significantly appeared in their awareness and active responsiveness toward modern solutions and shared medical integrations. The point here how would be better from professional perspective to measure the patient autonomy for every community segment professionals are going to deal with and modify or adjust the self and mind control to improve such degree of patients care contributions, there is a question here that easy and possible?, the answer yes possible for sure but not easy at all.

The matter of adaptation of public interest begins with scoring and measuring where exactly the benchmark applied to build reforms. Dealing with human nature differ greatly according to personal, community and even national interest and coherent or deviated according to lifestyle and capabilities to embrace the change dogma. Service autonomy is much better in certain situations depending on hazards enclosed and around; in remote service and in case following the patients those are hard to keep them on monitoring most of time. Also in acute medical cases and chronic follow up, autonomy plays direct impact on patient life and can protect them away from harm complications. Below there is a simple Benchmark of patient and provider autonomy;

1. Degree of consumer choice

Of primary care providers

Of specialized care providers

Of alternative providers

Of procedures

2. Degree of practitioner autonomy

Provider autonomy is the degree of given authority to make patient related decisions and freedom to act according to one’s professional knowledge base. And the level of authority differs with care services of each provider; means general practitioner differs in autonomy strength than specialist and emergency care professionals. Moreover; at some point of provider autonomy needed written agreement in order to be able to exceed certain level of autonomy restrictions with patients especially in surgery. This benchmark can be stretched and divided to cover both categories of autonomy whether patient or provider use to achieve and analysis the proper measurement of reforms. Full health J

Benchmark of democratic accountability and empower

For creation good management atmosphere serve the main target of work supply toward end value receivers. That for sure needs favourable standards lead to build compact management concept, the standards should applied over medical workers and nurses. It means there is no way to train the employees and nurses to know and understand these standards. Own perspective considered a good management scheme base of any successful business and even with the most brilliant business process without can easily lead to unbearable problems. Here would like to give one example describe the significance of management quality; pharmaceutical firms worldwide are most profitable industry whether on the level of manufacture or distribution channels. How did I know that?; simply because of experience for years in pharmaceutical industry and business.

Anyway; there is no doubts about their huge profits annually they get from different market segments and in over population countries word millions repeatedly touch your ears in every sales meeting you attended. But the point here not talking about the industry but refer to quality management which be always the cause of success of business cycle. Many of those companies could not tolerate the matter of success and huge revenue daily and after few years they naively increase their expenses and business stopped at such point with no extension or creation. At the end; their business retreat till found themselves have to pay additional bonuses and in worst condition they have to offer bribe for physicians to prescribe the company items. This not ever because of anything else than inferior mindset of business and focusing only on revenues than working to increase them, many of these companies declined to disappear couple of years later because their inappropriate management concept. In coming Benchmark does explain fair and acceptable skeleton of productive management pathway of healthcare:

1. Explicit, public, detailed procedures for evaluating services with full public reports

Use reports

Performance reports

Compliance reports

Use of adequately qualified consultants

2. Explicit deliberative procedures for resource allocation with transparency and rationales for decisions based on reasons all ‘‘stakeholders’’ can agree are relevant.

3. Global budgeting

4. Fair grievance procedures

Legal procedures (malpractice)

Non-legal dispute resolution procedures

5. Adequate privacy protection

6. Measures for enforcement of compliance with rules and laws

7. Strengthening civil society

Enabling environment for advocacy groups

Stimulating public debate, including participation of vulnerable groups, full health J

Benchmark of administrative efficiency

Administrative work of healthcare is the raw material desktop and without many of work preparation and tabulation will be scattered and become useless. But the truth about administrative work is like a watery unites of management; there are no demarcations in order to define the borders and boundaries for checking and further development. In this benchmark we are going to draw some sort of demarcation lines to be in mind account when medical professionals work with healthcare systems and other management supportive unites. The importance of this benchmark lied in being the first line of patients dealing platform and also data management platform. You can remember when you visited last time a hospital with supposed professional integrated employees; what you felt at that time and what was your impression about the service and other neglecting signs!. Exactly; this is the main aim of administration efficiency to reach point of good impression and build subconscious loyalty lead the patient to feel comfortable when they get their medical care and get their demands. Exhaustion and drained effort of patient is repellent in medical care systems, indirectly even build loyalty not only with medical care but exceed that to reach loyalty to government and country sometimes.  One hint here I like much to mention that when country enemies like to destruct loyalty atmosphere of public toward the home country, they easily working to ruin education quality and healthcare loyalty through implanting less qualified or agenda oriented employees to build repellent living standards for most of citizens then forcing them implicitly to move and leave the country and there are many examples prove this plan. Please look below to find the main work skeleton of administrative efficiency and benchmark for further development and progress:

1. Minimize administrative overheads

Appropriate technology acquisition (Purchase- Maintenance- Training)

Reduce excessive marketing costs (hospitals or plans)

Efficient use of personnel (Reduction of excess- Appointments and promotions based on competence)

Appropriate economies of scale adequate risk pools for insurers

Reduction of duplicate structures, including integration of vertically organized programmes

Minimize transaction costs (Enrolment and non enrolment costs)

Oversupply of some services in some areas:

2. Cost-reducing purchasing

Reduce price variation

Drug cost reduction through large scale purchasing

Reliance on (quality) generics where possible

3. Minimize cost shifting

Cost shifting from PC to tertiary

Cost shifting to patients

Cost shifting to public sector or insurance from other types

Cost shifting between schemes

4. Minimize abuse and fraud and inappropriate incentives

Shadow providers, partial and total

Practitioner auto-referral

Drug sales at profit by rural doctor

Billing practices

Unqualified practitioners in rural areas

Inappropriate promotion of drugs and devices. Full health J

Comprehensiveness of healthcare benefits and tiering

There are many business model of healthcare system worldwide and certain achieve minimum level of value satisfaction while many still on the threshold of basics and only few could reach to be good and acceptable according to fairness standards of medical provision and value community coverage. The worst level of fairness lack among society individuals is called ‘Tiering’; which means inequality and considerable deviation of value coverage delivery and quality care to certain community segments. The real problem of Tiering is not about meaning and explanation but more touch the medical system mechanisms and way of value management between different insurance holders. Tiering can be found in rich societies and also in middle and poor societies. Moreover; there is Tiering inside the same category of insurance whether public and private sector, and so on. I would like here to highlight point of understanding to get the whole idea about Tiering; actually Tiering is not new and most of healthcare systems textbooks took about in details and the core meaning of such term lied in creating and building parallel layers of society segments could not get proper and achieve minimum threshold of healthcare whether if they public insured or in private one.

One of relapsed key leads to Tiering in healthcare increased successive interest toward certain customers segment and neglecting others according to their ability to pay more for their extra or additional values gained.  Private sector in UK is clear example about Tiering in rich countries and much interest in wealthy clients whereas there are many could not reach to only the minimum of the same care. Levels of the same service are important and quality improvements in compliance with budget disbursed for each value good to apply but the weird is when you found highest standards for certain group of customers depending on their living capabilities and neglecting the rest of society. And for that reason applying fairness standards among community segments considered urgent to remove Tiering layers and dependent gaps.

The other example regarding Tiering in rich country; failing to provide proper insurance to the poor population and worker in USA is common. Moreover; it is not a secret for anyone to reach how many millions medical insured uncovered in 2017 and number existed already online, that if we consider USA is as a rich country with $ 20. 453 Trillions National Debit.  In Colombia is the same Tiering problem of medical care regarding massive interest toward wealthy segment of population which almost represent 5 % of the whole society and neglecting others or/and keep them on minimum medical benefits while population masses of them not insured covered indeed. Before we are leaving the term would like to refer to types and degrees of Tiering among communities, hard to build zero Tiering medical system but to keep satisfied level of medical benefits and insurance package to majority of the society is not that impossible.

The direct sequences of Tiering in healthcare system is decrease fairness standards and increase service deficiency gaps among members of community and clearly noticed in chronic value receivers and elderly patients service. As I said before medical business cycle is most profitable cycle ever you can meet and work with and rarely to find any medical institution or service provider suffer from lack of customers and that everywhere from Alaska to New Zealand. Because of that highest demand surge forms irresistible dynamic business cycle with unlimited rewards. Full health J

Nonfinancial barriers to healthcare access 

We discussed the definition of benchmark formerly and what the best approach for analysis and reform policy identification. As we know now that the benchmark is the measurement of improvement and progress indicator than threshold of reforms. In our series about reform benchmarks and associated indicators is really useful to highlight a bit over the matter of access which was the first post of this blog. Matter of access is one word but indeed represented to the first mirror of the healthcare system everywhere; it means when someone able to enter the healthcare system smoothly and elegantly without inconveniences. That reflects how far this system well designed and much coherent to the core role of medical value delivery. Also matter of system accessibility subjected to many other parameters indirectly related to the end user values such as tradition and local community customs. In some country level of web use is limited to certain nature of work and public organization; in that case when I talk about mobile app for diagnosis and mobile data entry never make sense with society traditions and behavioural lifestyle. 

Some researchers defined the local community culture and work traditions as a source of medical care success and others top them on the peak of work move and improvements. To get my idea in simple way imagine some investors would like to sell winter  blankets in tropical countries than air condition, you can imagine the result depending on the same concept with healthcare systems. Put the matter of society traditions as a matter of priority to describe the key of medical care success with any system model wanted to be applied. In coming paragraph we will reveal third benchmark in our series regarding the matter of healthcare access suited and adaptable to numerous community segments and suited also to different strategic policy of medical values. There is hint here describe and summarize the coming Benchmark; the core of work depends mainly on addressing the poor distribution of drugs, supplies and facilities as follow:

1. Reduction of geographical mal-distribution

Family and services

Personnel (mix and training)

 Supplies

Drugs

Clinic hours (appropriate to village routines, work schedules)

Transportation for medical purposes

2. Gender

Status in family regarding decision-making

Mobility

Access to resources

Reproductive autonomy

Gender sensitive provision of services, involvement of community political groups to address gender barriers

3. Cultural

Language

Attitude and practices relevant to disease and health

Uninformed reliance on untrained traditional practitioners (some healers, midwives, dentists, pharmacists)

Perception of public sector quality

4. Discrimination by race, religion, class, sexual orientation, disease

Include stigmatization of groups receiving public care. Full health J

Financial strength indicators

In order to take break from heavy confused information about healthcare finance. There are questions about what is the link between some rich countries and present medical problems regarding medical care and regular medical services. As a matter of fact that most of healthcare gaps and financial convoluted problems emitted mainly from rich inflated communities. Whilst in growing and poor managed healthcare systems own better improvement and prosperity benchmarks. How does it work?!, the majority of populations put judgments of the finance of the society depending on the amount of salaries and quantities of banknotes the citizens and other resident can get from jobs. It is really sad to admit that has been never right to matching finance terminology and economy strength of that society. Money professionals and financial affairs experts know this truth by heart. The positive picture of having good salary only when prices is much affordable and inflation rate in control and such model few countries over the world could achieve and they always link their currency to the community such as gold. While other countries which use no reference for the money they suffered from excessive inflation and inferior purchase power and continuous devaluation of local currency without even central government intervention.

The point own two parts; one political (that will not mentioned here) and another monetary and that will be my concern. When you look to any country with low value of local currency then you find most of them have industrial and exportation power and when you check their out trading balance. Easily you can define there is industrial force in that society where high value of local currency defined importation power of that society and the central bank keen on working on to decrease the amount of money escapes from the local banks, in other mean decrease the negative cash flow of importation!. But in case of low currency value the central back likes to increase the amount or volume which going to enter the society from exportation and at the parallel line keep labour wages lower than surrounding countries to enhance the investment opportunities in future.

It is really not deniable that by high value currency the population enjoy welfare life more even with high importation scale than those who living in societies with devaluated local currency. The difference is actually big but the core still the same and there is not advantages or disadvantages on the level of citizens living standards because they do not pay much attention regarding the whole monetary and finances of the countries budget. They care more about daily life and monthly payment with likable will to cover needs and demands. The third and most risky model of currency that characteristic feature of heavy debtor nations that achieve false high value currency of local monetary dealing (it means inside the society) while its value actually dropped abroad and to avoid the obligatory subjugation to the real currency valuation in the international financial markets. Therefore; they always export the currency as a monopoly tool of money transactions.  

Financial obligations of healthcare located between government role of work and affordability expenditure of households. Actually; level of affordability carries impact on sort and quality of introduced services. Lack of balance between inflation and household income will produce gaps. Moreover; create new society segment suffered from inferior care profiles and in the worse conditions escaping from the healthcare coverage. Although; this work is not in medical professionals duties but it is really preferable to know about and understand the whole monetary cycle of community and how it works. Full health J

Financial Benchmarks for medical care reforms

We are coming back to the basic problem of healthcare for decades. But in this post review the appropriate strategic benchmark for reform that by which could be better and more fit in control. As a hint for those who a bit far from finance terminology and concepts; any healthcare systems suffer from funding difficulties must be there is something behind with who manage and handling the business cycle of care operations. Why I say that because many studies by statistics proved that process of healthcare is nearly self sufficient under normal conditions. There is big high demand on the medical care always whether insurance covered or self-financed. That makes the revenue current on peak for long time especially seasonally and in emergency situations. So, the liquidity of healthcare is high even with high unnecessary expenditures from medical staffs. In order to know that my inference about is right; easily deducted the money amount of your salary publicly and privately insured and fold them in the number of whole country population then subtract 70% of that money who already fit and in production age between 18-54 years where they occasionally use to check for seasonal ailment. You will happy when you found number never seen before produced as revenue every month for whole country healthcare duties for sure excluded the governmental budget share and research medical projects between different medical institutions plus universities!.

But anyway; this benchmark creates some sort of building reform strategy to overcome any fund misused and resource poor allocations;

A. Informal sector coverage: include most basic services and basic care regulations, Portability of coverage (geographical, employment status).

B. Insurance for formal sector: encourage populations to be in formal sector, decrease workers resistance and increase mandatory enrolment.

C. Family coverage for enrolled workers.

D. Drug coverage and medical transportation costs.

E. Uniform services provision among the same target segment of society population.

F. Integrating various schemes for best utilization of those workers.

Every point of this benchmark has many more complicated text and identification processes. But I preferred to keep them open points for talent imagination and fertile ground to get more effort and innovative ideas of future implementations. It is not hidden for experts that kind of Benchmark that it needs extraordinary transparency and necessarily honesty with analysis and also with the approach for reforms. Because human kind are not angels and sometime purposely misuse or gap of implantation time in order to hide corruption and illegal facts occurred. For this reason; preferred separate approach teams work on to declare and confirm if there are suspicious hidden fact of the medical system!. Full health J

Benchmarks care for strategic medical reforms

With community population increment and massive changes carried out on the nature and style of most of western and eastern societies. The matter of approved benchmarks for development and progress without improper consequences became the core of change and change policy management. Moreover; among jungles of debates and discussions from modest and less trained medical workers who claimed professionalism by elegant appearance and colourful ties!. Explanation precisely about parameters and keys of reforms became matter of urgency rather than stagnant talks about future. Standards based reform many of benchmarks should be followed. Indeed; there are setbacks and clear gaps in citizen affordability of life and care expenditures in inflated environment of spending. but still there some backbone selected in order to do future better implementations. Reforms decrease and increase according to capacity of population and their acceptance flexibility toward them. Therefore, any benchmark of medical reform takes the population pits of deprivation as a whole and dealing with in a one package procedure. It means it is not possible solve medical problem and apply benchmarks of reforms far away from social and societal correctness.

Benchmark one and work axis: Inter-sectoral public health:

A. Reform increases percent of population and demographically differentiated and properly distributed in compliance with gives on the ground;

-Basic Nutrition

-Housing: Crowding, Homelessness, Physical adequacy of population.

-Environmental Factors: Clean water and water treatment, Sanitation and Vector Control, Clean air, Reduced Exposure to workplace and Environmental Toxins.

-Literature and health education: Literacy, Basic education, Health literacy, Nutritional education, Sex education and promotion, Substance abuse education, Anti-smoking education, Anti-drug and alcohol abuse education

-Public safety and violence reduction: Vehicular accident reduction, Violence reduction (homicide, rape), Domestic abuse (women, children)

B. Foundation of Informative infrastructure for monitoring health status and inequality cases:

-Regular investigations about inequality and fairness deficiency standards

-Research and build favourable indicators to detect and identify inequality

C. Engagement of multiple sectors effort together on the levels of local, regional and national level of improvement national population health and welfare medical conditions. 

This Benchmark is considered the simplest and more approved among several communities who like to see and create brilliant productive future for their citizens and reallocate the topographical distribution of certain segment of people. It seems branched work and multiple tasks for execution but good news; it is work of teams not one person. Actually it is not the only strategic reform of medical care of society positively exaggeration; there are other and more could be better to implement for other domains and sectors of work such as financial and associated expenditure reforms. Full health J