the united states healthcare system€¦ · example: american board of internal medicine () 3....

الصحية للمهن الليبية اجلمعية

األمريكية املتحدة بالواليات

…A bridge to Excellence

The United States Healthcare System

Overview and a Proposed Model for Libya

www.lhsusa.orgApril 2013

Libyan Healthcare Society USA www.lhsusa.org

Introduction

The Regulatory Bodies for Healthcare Professions

1. Professional Licensing Boards

2. Boards for Training Accreditation and Certification

3. Professional Associations

4. Scientific Medical Organizations

5. Special National Agencies

Healthcare Facilities

Healthcare Finance

Medical and Healthcare Education and Training

Healthcare Research and Development

Department of Health and Human Services

The Advantages and Disadvantages of the U.S. Healthcare System

Proposal for Restructuring Healthcare System in Libya Based on the U.S. Model

Conclusion

Appendix-1

April 2013


Introduction

In Libya, healthcare is a vital sector that requires immediate attention. The state of neglect from

which it has suffered caused its services to deteriorate considerably. Thus, there is a pressing need for

fundamental changes to stay up to date so that Libyan citizens can be provided with the high-quality

services they deserve.

Considering the complex nature of healthcare and the overlapping of several factors in its operation,

the process of restructuring requires collaborative efforts as well as preparing detailed studies by which

experts can develop future plans.

As a professional, non-profit organization working in the United States, we believe that we must

study the U.S. healthcare system to identify its positive and negative aspects. Furthermore, we would

like to propose it as a model to be studied for restructuring healthcare in Libya. It should be pointed out

that this document addresses the topic primarily from the professional perspective, and only very briefly

from the financial aspect.

Pillars of the U.S. Healthcare System

The U.S. healthcare system is complex; however, its basic pillars can be summarized as follows:

I. The Regulatory Bodies for Healthcare Professions

II. Healthcare Facilities

III. Healthcare Finance

IV. Medical and Healthcare Education and Training

V. Healthcare Research and Development

VI. The Department of Health and Human Services

I. The Regulatory Bodies for Healthcare Professions

The healthcare system in the U.S. depends to a great extent on sharing responsibilities and duties

among several nonprofit organizations. They play a crucial role in setting the professional and ethical

guidelines that define the features of healthcare services. These bodies are formed by professionals

themselves without government interference in selecting their members. Quality and integrity are the

standards that form the basic framework governing these bodies. Moreover, competence and ethics are

observed as much as possible in their formation. A brief description of these bodies is to follow.


These boards are independent in nature; however, they generally enjoy governmental support

and legislative backing due to the importance of their role in protecting citizens and monitoring

professional ethics and conduct.

April 2013


Membership in the general assembly and its committees is not limited to physicians. In fact,

these boards include some ordinary citizens with distinguished social status to represent the

community.

Registration with these boards is mandatory for all professionals in order to practice.

These boards grant professional licenses to practice according to strict procedures, including

equivalency exams and evaluation of basic credentials. These exams are usually governed by a

supreme authority on a nationwide level, and are recognized by all states and counties.

The licensing boards are also responsible for investigating complaints concerning professionals

and taking potential disciplinary actions.

Each state board has the exclusive authority to issue, revoke, and reinstate all licenses to

practice medicine within a given state.

Example: Alabama Board of Medical Examiners (www.albme.org)


These boards are purely professional independent evaluation organizations, and most of their

members are academicians with extensive experiences.

The members of the general assembly are appointed by the recommendation and nomination of

their registered members.

Functions:

- To set scientific and academic standards

- To monitor and develop standards of medical training in universities and hospitals

- To conduct examinations and grant board certification based on a defined standard of

education, training, and knowledge

This is equivalent to the scientific committees in the Libyan Board for Medical specialties.

Example: American Board of Internal Medicine (www.abim.org)


Functions:

- To lobby for and defend physicians’ interest

- To assist physicians in obtaining professional and social benefits

Registration is recommended, but not mandatory.

This is equivalent to the Doctors’ Syndicate in Libya.

Example: Texas Medical Association (www.texmed.org)


These are purely scientific nonprofit organizations that work on advancing knowledge, maintaining standards of practice, and enhancing public education for a given specialty.

April 2013

http://www.albme.org/

http://www.abim.org/

http://www.texmed.org/


Membership is optional. However, it is recommended for most professionals in that field of

specialization.

They issue scientific recommendations pertinent to their field of specialization.

They are not involved with evaluating, holding examinations, granting certificates, or evaluating

the standards of education and medical training in universities and hospitals.

Example: American Diabetes Association (www.diabetes.org)


They are federal agencies responsible for protecting and promoting public health and safety and

enforcing the law and safety regulations in healthcare at a national level.

Examples:

- Food and Drug Administration (FDA) http://www.fda.gov/

- Center for Disease Control and Prevention (CDC) http://www.cdc.gov/

- Drug Enforcement Administration (DEA) http://www.justice.gov/dea/

We should point out that these examples apply to physicians. However, all other medical professions

are also governed in a nearly similar manner, where the same principles apply to their structure and

function.

II. Healthcare Facilities

Healthcare facilities are either owned by the government (state governments, the Dept. of Veterans

Affairs, etc.) or by the private sector (individuals, corporations, universities, etc.).

Types of Healthcare Facilities

Inpatient hospitals: Government and private.

Outpatient facilities: These treat acute and chronic cases, as well as performing minor

procedures such as Endoscopy, etc.

Long-term care facilities: These are for chronic stable patients who require special care, such as

the disabled, the elderly, rehabilitation, etc.

All healthcare facilities are subject to ongoing quality control procedures. The reports of these

measures must be transparent and accessible to public.

Management of Healthcare Facilities

Most healthcare facilities function according to a multi-tiered and multi-featured management

structure to ensure management integrity. Common features of this structure include:

April 2013

http://www.diabetes.org/

http://www.fda.gov/

http://www.cdc.gov/

http://www.justice.gov/dea/


1. Chief Executive Officer, CEO: The CEO is usually not a physician; rather, he/she is a person with

management experience and is considered the facility’s direct manager.

2. Chief Financial Officer, CFO: The CFO follows the CEO and is in charge of managing finances.

3. Medical Director: This position is usually held by a physician on the medical staff with a great

deal of experience, and serves as a liaison between the board of trustees, the hospital

administration, and the medical staff.

4. Board of Trustees: This consists of a number of people with distinguished social status. It is the

highest body to whom the CEO and the CFO submit periodic reports and plans for approval.

5. Professional Executive Committees: These committees consist of a group of professionals

working at a given facility to oversee the facility’s procedural operations. They usually meet

regularly.

The Joint Commission (TJC)

The Joint Commission (TJC) (www.jointcommission.org) is the most important non-profit

national body that evaluates healthcare facilities, ensuring that they comply with quality and

safety standards.

This commission was established in 1951. Today, it monitors more than 19,000 healthcare

facilities. This is done by conducting field visits to inspect these facilities, usually every three

years to ensure compliance with the agreed-upon safety and quality standards. It then submits

its detailed evaluation reports and recommendation to ensure compliance.

Most states require that healthcare facilities be approved by this commission as a prerequisite

to receive financial payments from the Centers of Medicare and Medicaid Services (CMS).

III. Healthcare Finance

The U.S. healthcare system is financed in general by taxpayers’ money, or by employers in the private

sector.

Financial Sources for Patient Care

1. Direct payments to healthcare providers and facilities by patients who do not have health

insurance.

2. Private and commercial healthcare insurance: Typically, people are enrolled in a health

insurance plan through their employment where services are covered in exchange for defined

premiums.

3. Government insurance: This includes particular groups of citizens, such as those over 65 years of

age, veterans, kidney failure patients, citizens living under the poverty line, etc. In these cases,

the government insurance pays for most services, sometimes for small fees or free of charge.

4. Charitable Organizations: They cover treatment for some patients who meet specific criteria.

April 2013

http://www.jointcommission.org/


Physician and Professional Compensation

There are three main methods for professional compensation:

1. Fixed salary: This is paid to the professionals by the healthcare facility regardless of the volume

of services they provide. This is the most common method of compensation for allied medical

professions.

2. Fees for service: This is the method most commonly used to compensate practicing physicians.

In this method, practitioners are paid in proportion to the services they provide. The cost of

services is based on contracts between the professionals and the payers (government or private

insurance companies). In recent years, this method has been scrutinized in effort to control the

costs of healthcare. Recently, there is a general shift towards the methodology of “payment for

outcomes” whereby practitioners receive incentives for positive outcomes and efficient

preventative care.

3. Fixed salaries along with incentives based on productivity: Which combines both systems

mentioned above.

Financing Healthcare Facilities

This is through either private or government sources or charitable organizations.

IV. Medical and Healthcare Education and Training

Physicians

Before entering medical school, a student has to obtain an undergraduate bachelor's degree at an

accredited university, which generally takes three to four years to complete. A student must then spend

four years in school to earn a medical degree. Upon graduation, almost all doctors enter a training

program called residency before beginning their practice. The length of residency training is entirely

dependent on the specialty. The residency is the time during which a physician gains an ample amount

of practical experience to be an independent practitioner.

After completing this training period, the physician can obtain a license to practice independently.

This is the most important step in the professional’s future, and it enables him/her to open an

independent practice. It also allows him/her to choose any other method of practice (group practices

with other physicians, working in hospital or a university, etc.)

After finishing their training successfully, physicians are eligible to receive board certification in their

specialty after passing the mandatory exams. In most states, however, the certification is not a

prerequisite to obtain license or practice independently, although it is recommended to do so.

April 2013


Mid-level Providers

Mid-level providers are medical professionals who are not physicians but are licensed and certified to

provide patient care. They can examine, diagnose, and treat patients under the supervision of a

physician.

Examples of mid-level professionals include nurse practitioners (NPs), physician assistants (PAs),

certified registered nurse anesthetics (CRNAs), and midwives. They have similar regulatory bodies as

physicians.

Allied Medical Professions

Most qualifications for allied medical professions require a university level or at least a high level

technical institute. There are several programs that grant certification for allied health professions in a

somewhat similar manner to that of physicians (theoretical study followed by a practical preparation

program, ending with obtaining a license to practice). However, they have a different system concerning

the number of years and nature of study.

V. Healthcare Research and Development

Healthcare research is strongly supported and funded by the government as it directly affects

healthcare delivery.

Annual budgets are earmarked for research either for academic institutions or for organizations

working under the umbrella of the U.S. Department of Health and Human Services, such as the National

Institute of Health (NIH). Research centers affiliated with universities, and academic institutions play a

fundamental role in developing healthcare services in the U.S. In some cases, these centers receive

financial support for scientific research and development from the government either directly or

indirectly. The government also provides educational scholarships to encourage students and physicians

to pursue research careers.

Pharmaceutical and medical industry also supports research, either through investments in their own

private research, or by financing research in universities and scientific centers. The work and research

done by these companies are subject to strict federal rules and laws in order to maintain quality and

patient safety.

VI. Department of Health and Human Services

This central body is equivalent to the Ministry of Health (MOH) in Libya. However, unlike the MOH, this

Cabinet department is not directly involved in the provision and details of health services. While it

leaves these tasks to the aforementioned professional bodies, it focuses on setting general policies for

health, and provides health insurance for a large number of citizens through the Centers for Medicare

April 2013


and Medicaid Services (CMS). Many of the services that are financed through this central department

are provided at a local level in collaboration with state and county governments, or through the private

sector. The department of health and Human Services oversees eleven departments. Eight of these

departments deal with public health, and three deal with human services:

1. Administration for Children and Families (ACF)

2. Administration for Community Living (ACL)

3. Agency for Healthcare Research and Quality (AHRQ)

4. The Agency for Toxic Substances and Disease Registry (ATSDR)

5. Centers for Disease Control and Prevention (CDC)

6. Centers for Medicare and Medicaid Services (CMS)

7. Food and Drug Administration (FDA)

8. The Health Resources and Services Administration (HRSA)

9. Indian Health Services (HIS)

10. National Institute of Health (NIH)

11. Substance Abuse and Mental Health Services (SAMHSA)

Office of the Inspector General

The office of the Inspector General investigates criminal activity related to the Department of Health,

including medical insurance fraud by individuals, health care professionals, or healthcare facilities.

Information Protection Act and Patient Privacy

Privacy of patient information and regulations governing the means of exchanging such information

are dealt with in a legal act known as HIPAA (The Health Insurance Portability and Accountability Act),

enacted in 1996. (www.hhs.gov/ocr/privacy/index.html)

Advantages of the U.S. Healthcare System

1. The expanded role of the professional organizations and the limited role of government in

regulating healthcare profession: Healthcare profession is regulated by several nonprofit

organizations. These bodies have balanced and complementary roles and work in parallel

independent of the government, which has only a limited role.

2. Reliance on competence and integrity in establishing professional organizations: Competence

and integrity are considered the most important criteria when creating these regulatory bodies.

That is particularly pertinent for leadership positions.

April 2013

http://www.hhs.gov/ocr/privacy/index.html


3. The prominent role of allied healthcare professionals: Allied health professions (nursing,

pharmacy, physical therapy, etc.) play an essential and active role in therapeutic and

preventative procedures.

4. Standardization of therapeutic and preventative methods: Healthcare services are

standardized and uniform across the nation, mainly due to the professional regulatory

frameworks in place.

5. Reliance on advanced technology: The U.S. has a leading and prominent role worldwide in the

field of research and medical sciences. This is clearly reflected in its healthcare system, as

technology is often used early on in the therapeutic process.

6. The expanded role of personal freedoms for the patient and family in the therapeutic process:

This stems from the concept of personal freedom in the U.S. Constitution. If the patient and the

family choose so, they have the right to know all details concerning the illness, therapeutic

alternatives, treatment success rates, potential complications of the disease or therapeutic

process, etc. Likewise, they may also reject all or some of the proposed alternatives and seek a

second or third opinion. Accordingly professionals routinely document all discussions with the

patient and family in the patient’s chart in order to avoid any problems that may arise in the

future.

7. Importance of observing quality and safety standards: Quality control and safety measures are

very closely monitored, and strictly enforced by regulatory bodies and institutions. Adherence to

these measures is subject to firm professional scrutiny and public transparency to minimize

violation.

8. Prominence of Continuing Medical Education (CME) for professionals: In order for healthcare

professionals to renew their licenses to practice, or to be affiliated with a healthcare facility,

they are required to submit a proof of CME credit. This can be achieved by attending

educational conferences or participating in local scientific activities at given facility, etc. Many of

these facilities grant vacation time and stipends to be used for CME. All continuing medical

education expenses are tax-exempt.

9. Advanced emergency medical ambulance system that is available to all citizens: Emergency

medical teams are spread throughout the U.S. Citizens may request their assistance by calling a

single number, 911, anywhere in the country and the emergency medical team will reach the

person in a very short period of time (10-15 minutes). In most cases, this team can provide first

aid as well as other advanced services, including cardiopulmonary resuscitation, dealing with

cardiac arrest, etc.

10. Emphasis on public health awareness: Several bodies and institutions work together to educate

citizens regarding various public health issues, particularly by utilizing the media, publishing

periodicals and brochures, sending e-mails, holding seminars, etc.

11. The culture of "consultation" and acceptance of "second opinion" between professionals: It is

a common practice for practitioners to seek the opinion of their colleagues in order to reach a

April 2013


diagnosis or to suggest the best methods of treatment, etc. In some cases, this may occur

between colleagues in the same specialty without causing any sense of embarrassment or being

viewed as a deficiency in knowledge even from the patient perspective who is the subject of

consultation.

12. Emphasis on direct and indirect communication between professionals: Professionals

concerned with a particular patient depend heavily on communication either directly (phone,

text messages, email, etc.), or indirectly (mailing report) which in general helps patient care.

13. The prominent role of primary care providers and family physicians: Primary care providers

play a very important role in patient's care. They provide and coordinate patients’ care between

different specialists and follow up on the patient after discharge from the hospital. In general,

people usually confide in their family physician and develop a genuine trust relationship that

helps and facilitates care.

14. Emphasis on medical documentation: Medical documentation is one of the pillars of the

treatment process. Healthcare facilities require that their practitioners must be compliant with

documentation, or they will be in direct violation of the institution’s rules and may be subject to

administrative punishment. In recent years, the electronic medical record (EMR) has become

prevalent and is spreading among medical institutions.

15. Legal protection of patient privacy. The law known as HIPAA, mentioned earlier in this

document, legally protects patient’s privacy. This law stipulates strict rules for exchange of

patient information and patient privacy.

Disadvantages of the U.S. Healthcare System

1. Lack of inclusiveness: Approximately, 15% of Americans or nearly 45 million people still lack

health insurance. In 2009, the Affordable Care Act (ACA) was introduced by the Congress to help

ameliorate this problem. However, this act is not yet effective and its impact on healthcare is

still unclear.

2. Defensive medicine: The American people enjoy a high level of legal protection. This has

resulted in a class of lawyers who specialize in cases of medical malpractice leading to

compensation verdicts that may be too exorbitant for practitioners and healthcare facilities. In

turn, this gave birth to a phenomenon known as “defensive medicine,” where professionals

order an excessive amount of examinations, diagnostic tests, and consultations, to avoid charges

of malpractice. This has brought an increase in the cost of malpractice insurance, and a resulting

increase in cost of treatment and health insurance.

3. Cases of occupational fraud: Examples include performing unnecessary procedures for financial

profit. For this reason, the federal government through the office of Inspector General

randomly audits medical services to ensure that they are actually medically necessary. If they

are found to be otherwise, severe penalties are imposed on the involved professionals or

institutions.

April 2013


4. The high costs of treatment: This is the consequence of several of the aforementioned factors.

It is also a product of the multiplicity of insurance companies and the complexity of

administrative procedures that has led to higher health insurance premiums. Many small

businesses and citizens are unable to afford health insurance. Since the law does not require

small businesses and individuals to purchase medical insurance, fair numbers of people are

unable to pay for medical services due to high costs. In general, the cost of these administrative

procedures constitutes about 31% of total healthcare spending.

The American Patient

The American people are a mixture of many cultures joined together within one land by a national

and legal bond. Despite disparities between patients in their social and educational levels, they often

share some of the same general characteristics:

1. Patient curiosity to know all details of his/her condition and treatment options.

2. Family involvement in treatment decisions.

3. Patients’ confidence that the health system will offer them the best available treatment.

4. Reliance largely on family and primary care physicians.

5. Patient expectations are usually realistic, including the risk of death and complications, etc.

These characteristics must be taken into consideration when studying the U.S. model to determine

its applicability in other settings.

April 2013


A Proposal for Restructuring Healthcare System in Libya

Based on the U.S. Model

In Libya, the existing system gives the Ministry of Health (MOH) full authority to deliver, regulate, and

finance healthcare. From our perspective, this clustering of responsibilities and authorities is a

fundamental defect that leads to conflict of roles and inefficiency as well as compromise quality of

health services. One way to address this is to reassign these tasks to professional regulatory

organizations and to restrict the role of MOH to oversee and finance healthcare system only. These

organizations should act independently. The MOH plays no role in their management or in appointing

their members whom should be elected by professionals based on competence and integrity. This

assures the consistency and continuity of the long-term healthcare policies regardless of the changes in

the MOH.

The following proposal stems from the aforementioned viewpoint.

This proposal, as shown in Appendix 1, consists of two parts:

1. A proposal to regulate healthcare profession based on the U.S. model

2. A proposal to regulate healthcare facilities and healthcare finance

I. A Proposal to Regulate Healthcare Profession Based on the U.S. Model

Four regulatory bodies should be elected directly by healthcare professionals without any

interference from the MOH. These bodies will receive financial support from the MOH in addition to

membership fees.


Structure:

Elected board members should be known for their experiences, integrity, financial solvency, and

professionalism.

Majority of members should be healthcare professionals as well as some legal specialists.

The Council should extend to cover all of Libya with branches in most parts of the country.

Public contact with the council should be facilitated through regular mail, email, and phone

calls.

The Council Chair should be granted an honorary position to attend the Parliament and the

MOH regular meetings.

April 2013


The Council’s disciplinary verdicts should require the approval of at least two-thirds of the

members.

Function:

To provide initial and renewed licensure to practice medicine in Libya.

Membership is mandatory for all professionals before practicing medicine.

Assessment and approval of graduation certificates for local and foreign professionals.

The boards are responsible for investigating complaints concerning professionals, and taking

potential disciplinary actions.

Its verdicts are disciplinary and punitive, as opposed to civil or criminal, with a maximum

punishment of withdrawal or suspension of license.

The council is not involved in quality assessment, training, or evaluating the professional or

occupational level.


Structure:

Elected members should be known for their experiences in academia and healthcare education.

They should cover all of Libya with branches in major cities.

The Council Chair should be granted an honorary position to attend the MOH and the Ministry

of Higher Education regular meetings.

Function:

To set scientific and academic standards.

To monitor and develop the standards of medical training in universities and hospitals.

Conducting examinations and granting board certification based on a defined standard of

education, training, and knowledge.

Evaluation of foreign graduate degrees and categorizing them professionally and occupationally.


Structure:

Leaders should be elected directly by professionals and to encourage the new graduates,

women, the disabled, etc. to be involved in leadership positions.

There should be a separate local syndicate in each of the large cities, and the general assembly

should be made up of their leaders from all over Libya.

April 2013


The Syndicate Chair should be granted an honorary position to attend the MOH and the Ministry

of Labor regular meetings.

Membership in the syndicate is not mandatory; however, it is recommended.

Function:

To defend professionals’ interest, and represent them at local authorities.

Formation of a general body for medical insurance to defend professionals in cases related to

medical responsibility, as well as creating awareness and educating professionals regarding the

field of malpractice and methods of avoiding it.

Conducting scientific and social activities for professionals.

The syndicate is not involved in issuing professional licenses or monitoring quality and

efficiency.


Structure:

These are formed by healthcare professionals for a given specialty. Each organization will

directly elect their board of directors from its members.

Examples: Pediatric Association, Radiology Association, etc.

Function:

To act as purely scientific organizations that work to advance knowledge, maintain standards of

practice, and issue scientific guidelines for a given specialty.

They should not be involved with evaluation, examinations, granting graduate degrees and

certification of specialization, or evaluating the scientific level of universities.


Examples:

Food and Drug Monitoring Agency

Medical Supply Monitoring Agency

Epidemiological, Communicable and Infectious Disease Surveillance Agency

Agency of Mother, Children and family welfare

Agency of Welfare of individuals of special needs

Quality Control Agency

National Body for Scientific Research and Medical Technology

April 2013


These agencies should be formed with coordination between the professionals and the MOH. They

should receive support from the MOH, and be monitored through collaboration between professionals

and the MOH.

II. A Proposal to Regulate Healthcare Facilities and Healthcare Finance

The Ministry of Health (MOH)

The MOH works in parallel with the abovementioned regulatory bodies to support them and

coordinate their efforts. As the administration of these authorities is formed directly by healthcare

professionals, the MOH does not have the jurisdiction to fire or appoint anyone to these independent

bodies.

The National Health Insurance Authority

The National Health Insurance Authority is considered the most important body for health insurance

in the country and should cover all citizens. The extent of services covered by this insurance should be

predetermined. The MOH should directly finance this authority, and part of the funding to be taken

from government tax revenue. Private insurance companies should be allowed to cover non-citizens and

employees of some private institutions and companies who desire extra services, which are not covered

by the national health insurance.


Hospitals and healthcare facilities should function independent of the MOH. Their budget is to be

allocated according to services delivered.

There should be a supreme national authority for healthcare facilities under the MOH responsible for

setting quality and safety standards for public and private healthcare facilities nationwide and for

monitoring the implementation of these standards. This body should be responsible for providing

licenses for public and private healthcare facilities. It should submit its reports directly to the MOH so

that any health institution in violation of safety or quality standards can be followed and monitored.

As a preliminary step, local hospitals could contracts for a specific period of time with reputable

international hospitals to pair them managerially and procedurally in order to raise the level of these

facilities at a faster pace.

Compensation for Professional Practitioners

The means of compensating professionals, particularly physicians, is to be decided through a national

physicians’ conference where all may participate in order to reach an agreement. Potential options

include: fee for service, salaries based on experience and the volume of services delivered, or fixed

salaries with incentives according to the volume of services delivered.

April 2013


Conclusion

Despite lack of universal healthcare coverage, the U.S. healthcare system delivers one of the best

health services around the world. It is very well regulated and focuses on quality and patient' safety.

Restructuring the healthcare system in Libya is a pressing and urgent matter that requires the

collaboration of all stakeholders to succeed.

We present this model as an alternative to be considered for this crucial process. Nonetheless, we do

respect different proposals based on other healthcare systems.


April 2013

A Proposal for Restructuring

Healthcare System in Libya Based on the U.S. Model

Appendix 1

Libyan Healthcare Society USA www.lhsusa.orgApril 2013

National Health Insurance Authority

Special National Agencies

Supreme National Authority for


Ministry of Health

Healthcare Facilities (Public and Private)

Healthcare Finance

MOH

Scientific Research & Medical Technology

Food & Drug Monitoring Agency

Quality Control

Communicable & Infectious Diseases

Mother, Children and Family welfare

Welfare of Individuals of special needs

Other Agencies

Medical Supply & Equipment Monitoring



Financing

Private Insurance

Healthcare Finance

MOH


Healthcare Professionals

Patient

Compensation

Compensation Compensation


Boards for Training Accreditation and Certification

Licensing and Monitoring

Training and Accreditation

Developing and Updating

Observing Professional Interests

Professionals

A Proposed Scheme for Professional Regulation

Professional Licensing Boards

Professional Association Scientific Medical Organizations


Patient

MOH

Professionals

Profes’l Licensing Board Boards for Training Accred’n & Certif’n

Professional Association Scientific Medical Organizations

Special National Agencies

Supreme National Authority for


Quality Control

Professional Regulation

Collaboration with MOH

General Overview

Libyan Professionals

Election

Financing

$ Compensation

$


Healthcare Facilities Care Care

Oversees Oversees

Finance


April 2013

the united states healthcare system€¦ · example: american board of internal medicine () 3....

Documents