RESEARCH ARTICLE n

Full list of author information is available at the end of the articleBackground Providing a good quality of care is a primary objective-in fact a priority and a duty- of healthcare institutions worldwide. The rapid development of medical tech-nologies and their application to a continuously wider spectrum of diseases, conditions, and patients; the un-stoppable growth of the health related requests of a population that is also growing in size; poverty and ageing; has all economically challenged health systems and insurance priorities around the world, to a point where their sustainability is nowadays very much ques-tioned in every country, and where most costs have been covered by the government. In these countries, a direct contribution is now increasingly being asked to anyone benefiting from a care and complementary cover, and whereby private insurance is being incentiv-ized. Even in countries like the USA, where private companies cover 2/3 of health spending, the discus- * Correspondence