21 Global and Open Exchange Bloc Licensing

A license grants legal rights to health personnel to diagnose ailments, to treat patients, and to administrate health care facilities. Licensing through knowledge exams and control tests are needed to assure safety and quality of care provided by those who are granted these legal rights.

In the age of global ICT, it is a waste of global resources for each country alone to try to improve safety and quality of health care by qualifying health care personnel through school diplomas or license at the national or state level.

Irrespective of socio-economic or ethnic differences, the competency needed for safe and effective health care remains the same, though additional certificates may be needed to cope with conditions peculiar to a given locality due to local health problems or its resources for health care.

Competent medical clinicians (such as dentists as mouth specialists) and health workers are most effectively licensed from knowledge exams and control tests,  rather than through a  requirement for university/college diplomas.  A diploma from a medical or dental school does not assure quality of care.

Benefits of Global Licensing:
Licensing at the global level has the following benefits in comparison with nation/state-level licensing;
1. It lessens waste of global resources.
Duplicated efforts made by nations for nation-level licensing is a substantial waste of resources, especially for poorer countries.  A single “Global Licensing Board” can integrate knowledge accumulated in nations/regions into one entity, which reduces cost of implementation of licensing exams and tests.
2. It improves quality of care.
Knowledge from a global database provides the best possible care with adaptation to local peculiarities.
3. It provides easier access to the care
4. It promotes cooperation among nations by reducing reasons for nation protection
5. Global licensing exams and control tests are easier to prepare for and to pass, which broadens the care options of licensed personnel.

Since it is not practical to jump directly from nation/state licensing to global licensing,  an intermediate step is needed, namely, licensing through Free Trade Blocs (e.g. EU and ASEAN or ASEAN+), or as we prefer to call them, Open Exchange Blocs (OEB) .

In this website, we propose OEB licensing of medical clinicians including mouth specialists, otherwise known as dentists, oral surgeons, stomatologists, etc.  This is the first step toward the goal of creating global licensing for all health personnel, including nurses, clinical technicians, paramedics, etc.

Applicants for OEB licensing should be grounded in the global knowledge and competency needed by health care personnel through; 1) licensing exams and certificates prepared by a group of health ministries in OEBs  and 2) clinical work in a range of community health services appropriate to the licenses or certificates granted.

The following pilot project is proposed as a feasibility study to assess and optimize steps to be taken for OEB licensing.

1) to persuage Ministries of Health to accept, in principle, OEB licensing examinations and their prerequisites which are oriented to global licensing,

2) to develop and validate rules on basic licensing examinations for care personnel and specialty certificates and/or local certificates issued to licensed care personnel,

3) to specify human body space and functions of health care facilities which are compatible with optimum use of human bodies, and

4) to achieve a consensus on licensing examinations and control tests to compile examples of their use and with compatible health care facilities.

Another possible benefit of this global level connection is that it makes it possilbe for knowledge, data, information and experience to be continuously shared among different countries, and makes it possible to compare what is and what is not effective in different settings and situations.  For example, data on different diseases and how they may be increasing or decreasing, information about what practices contribute to improving public health, and experience that health care workers on the ground are gaining on how to treat different health issues, etc.  Thus it can contribute to the advancement and evolution of the world's collective knowledge about health care.

Q & A

Q) What are the benefits of OEB licensing rules and exams in comparison with licensing exams and rules for one-nation or states within a nation?   
A) The collaborative effort in OEB will achieve a broader view of the use of global-local resources for health care. OEB licensing exams can more objectively appraise the qualifications of applicants for licensing exams. For it is difficult for one nation to accept globally oriented licensing exams and rules because of past habits and vested rights related to the nation’s special interests, laws and organization of schools. One example: US has difficulty in even moving from one-state licensing exams to national (50 state) Licensing Exams because of state-centered interest groups including associations, state accredited school faculties, etc.

Q) Why can OEBs such as EU and ASEAN be a world leader for approaching the goal of global licensing?
A) An OEB, as a legal entity, should play a role in the health care economy.  OEB licensing provides direct links between the local and global level as far as quality of health care, cost of health care and resources.

Q) Wouldn't OEB licensed professionals migrate from poor countries to richer countries in the block?
A) Immigration and emigration laws exist.  Distribution of professionals in OEB can be more easily managed than national distribution of professionals.

Q) What would be the impacts of GL (global licensing) on the field of health care?
A) GL has the potential to provide the beneficial impacts on;
- quality of licensing examinations
- quality of providers of community and patient care
- the health care economy, use of global and local resources
- access to health care
- appraisals of new findings
- spread of use of new findings
- the health care industry